Statin use and development and progression of non-alcohol fatty liver disease based on ultrasonography: a cohort study.

INTRODUCTION: Non-alcohol fatty liver disease (NAFLD) has emerged as a public health issue, while no drugs have been specifically approved for treatment. This study aimed to examine the association between statin use and NAFLD occurrence, progression, and regression. METHODS: A cohort study was designed based on the Kailuan Study and electronic medical records (EMRs) from the Kailuan General Hospital. Participants aged 18 years with statin indication, including statin and non-statin users, were enrolled in 2010-2017. Propensity score-matched cohorts were also used. RESULTS: In the entire cohort, 21 229 non-NAFLD and 22 419 NAFLD patients (including 12 818 mild NAFLD) were included in the final analysis. After a median follow-up of about four years, the incidence of NAFLD occurrence and progression for statin users were lower than those for non-statin users (occurrence: 84.7 vs. 106.5/1000 person-years; progression: 60.7 vs. 75.5/1000 person-years). Compared with non-statin users, the risk of NAFLD occurrence (hazard ratio [HR]: 0.78, 95% confidence interval [CI]: 0.70-0.87) and regression (HR [95%CI], 0.71[0.60-0.84]) was decreased in statin users. The significantly negative association was only observed in those with cumulative statin duration ≥ 2 years (HR [95%CI] for occurrence 0.56 [0.46-0.69] vs. 0.52 [0.30-0.90] for progression) and those with low or moderate ASCVD-risk (HR [95%CI] for occurrence 0.74 [0.66-0.82] vs. 0.68 [0.57-0.80] for progression). No significant correlation was observed between statin use, statin use duration, and NAFLD regression. The PS-matched cohort had similar results. CONCLUSION: Taking statin may decrease the risk of NAFLD occurrence and progression in the population with statin indication, suggesting the potential role of statin in both primary and secondary prevention strategies for NAFLD, especially among those with low or moderate ASCVD risk.

[Egg consumption and non-alcoholic fatty liver disease: a prospective cohort study].

OBJECTIVE: To explore the association between egg consumption and the risk of non-alcoholic fatty liver disease(NAFLD), which will provide epidemiological evidence for NAFLD prevention. METHODS: A total of 6734 non-NAFLD participants(5500 men and 1234 women, aged(45±14) years old)in the Kailuan cohort followed up in 2014-2015 were enrolled. Semi-quantitative food frequency questionnaires were used to collect the diet frequency, including the consumption of eggs, over the past years. Then the score of dietary approaches to stop hypertension(DASH) was calculated. Abdominal ultrasound was applied for fatty liver diagnosis. The Kaplan-Meier method was used to estimate the cumulative incidences of NAFLD for the three groups(0-4, 5-7 and >7 eggs/week). Furthermore, Cox regression models under various adjusted factors were used to compare the risks of NAFLD. RESULTS: During the median follow-up of 45 months, 1484 NAFLDs were identified among 6734 non-NAFLD participants. The 4-year cumulative incidence rates of NAFLD for the individuals consuming 0-4, 5-7, and >7 eggs/week were 27.1%, 19.9% and 29.6%(P<0.05). The DASH score was significantly higher in those who consumed 5-7 eggs/week than in the other two groups(P<0.001). After adjusting confounders, including DASH score and dietary cholesterol, we found that compared with those consuming 5-7 eggs/week, the individuals with 0-4 and >7 eggs/week had a higher NAFLD hazard, with hazard ratios(95% confidence interval) of 1.20(1.03, 1.41) and 1.25(1.06, 1.47), respectively. The association was more significant in the population with a higher DASH score(P_(interaction)=0.02). CONCLUSION: Eating 5-7 eggs/week may have the lowest risk of NAFLD, suggesting taking a moderate amount of eggs to prevent NAFLD, even if the overall diet quality is relatively healthy.

Development of an online UPLC-PDA-ESI-Q-TOF-MS-LOX-FLD system for rapid screening of anti-inflammatory compounds in Polygala tenuifolia Willd.

In this study, the first ultra-high performance liquid chromatography-photo-diode array-electrospray ionization-quadrupole-time-of-flight-mass spectrometry-lipoxygenase-fluorescence detector (UPLC-PDA-ESI-Q-TOF-MS-LOX-FLD) online system was developed for the identification and evaluation of anti-inflammatory active ingredients in Polygala tenuifolia Willd. Using this system, the UPLC fingerprints, mass fragments and LOX-binding peak profiles in the samples were rapidly and simultaneously obtained. A total of 101 compounds were isolated and identified and 38 compounds (11 oligosaccharide esters, nine xanthones, 17 saponins, and one glycosyloxyflavone) showed strong LOX-binding activity. Six compounds were selected to study their LOX-binding ability, and the results indicated that the content of the six compounds had a good linear relationship with the LOX-binding ability, and it was found that the substitution position, the type of substituent and the number of glycosyl groups all had a certain influence on the LOX-binding ability of the compounds. The LOX-binding activities of 10 compounds were verified by the surface plasmon resonance (SPR) technique and the activity results were consistent with the online system. After validation, we identified 7 active compounds that combined with LOX to exert anti-inflammatory effects for the first time. All the results fully demonstrate the efficiency, stability and reliability of the online system and this work provides an exemplary and useful method for the rapid screening of potential anti-inflammatory active compounds in P. tenuifolia and other traditional Chinese medicines. At the same time, it provides a new direction for screening small molecule inhibitors of enzymes like LOX.

The Relation of Social-ecological Factors and Health Literacy to Medical Students' Alcohol Use Behavior in Hubei Province, China.

BACKGROUND: Health literacy (HL) plays a crucial role in the adolescent's behavior. Inadequate HL can contribute to engaging in risky alcohol consumption, but little is known about this relationship among medical students. We aimed to investigate the relationship between HL and alcohol use among Chinese medical students. Study Design: A cross-sectional design. METHODS: This research was conducted on 1146 medical students in Hubei province, China. The data were collected using a web-based online questionnaire. Multiple logistic regression was applied to investigate factors related to alcohol use. RESULTS: Approximately 45.3% of medical students were drinkers, about 11.5% were hazardous drinkers, and 33.8% were low-risk drinkers; furthermore, about 49.3% of them reported lower levels of HL. In both the low-risk and hazardous drinking groups, the subjects who had low levels of all six dimensions of HL were more likely to use alcohol after adjusting for other covariates, including cognitive skill (adjORfor low-risk=3.50; 95% CI: 2.41, 5.07, adjORhazardous=2.07; 95% CI: 1.22, 3.51), access skill (adjORfor low-risk=2.11; 95% CI: 1.46, 3.05, adjORhazardous=2.40; 95% CI: 1.37, 4.19), communication skill (adjORfor low-risk=1.72; 95% CI: 1.20, 2.47, adjORhazardous=2.21; 95% CI: 1.22, 4.00), self-management skill (adjORfor low-risk=1.73; 95% CI: 1.15, 2.59, adjORhazardous=4.01; 95% CI: 1.91, 8.44), media skill (adjORfor low-risk=1.50; 95% CI: 1.01, 2.23, adjORhazardous=4.68; 95% CI: 2.15, 10.17), and decision skill (adjORfor low-risk=2.12; 95% CI: 1.49, 3.00, adjORhazardous=2.25; 95% CI: 1.35, 3.74). CONCLUSION: Inadequate HL plays an important role in increasing alcohol use. Thus, prevention and intervention strategies should be based on improving medical students' HL.

Patient-reported outcome measures used in patients undergoing total knee arthroplasty.

Patient-reported outcome measures (PROMs) are being used increasingly in total knee arthroplasty (TKA). We conducted a systematic review aimed at identifying psychometrically sound PROMs by appraising their measurement properties. Studies concerning the development and/or evaluation of the measurement properties of PROMs used in a TKA population were systematically retrieved via PubMed, Web of Science, Embase, and Scopus. Ratings for methodological quality and measurement properties were conducted according to updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Of the 155 articles on 34 instruments included, nine PROMs met the minimum requirements for psychometric validation and can be recommended to use as measures of TKA outcome: Oxford Knee Score (OKS); OKS-Activity and Participation Questionnaire (OKS-APQ); 12-item short form Knee Injury and Osteoarthritis Outcome (KOOS-12); KOOS Physical function Short form (KOOS-PS); Western Ontario and McMaster Universities Arthritis Index-Total Knee Replacement function short form (WOMAC-TKR); Lower Extremity Functional Scale (LEFS); Forgotten Joint Score (FJS); Patient's Knee Implant Performance (PKIP); and University of California Los Angeles (UCLA) activity score. The pain and function subscales in WOMAC, as well as the pain, function, and quality of life subscales in KOOS, were validated psychometrically as standalone subscales instead of as whole instruments. However, none of the included PROMs have been validated for all measurement properties. Thus, further studies are still warranted to evaluate those PROMs. Use of the other 25 scales and subscales should be tempered until further studies validate their measurement properties. Cite this article: Bone Joint Res 2021;10(3):203-217.

Obesity-Related Genetic Variants and Hyperuricemia Risk in Chinese Men.

Objective: Obesity/metabolic syndrome and hyperuricemia are clinically associated; however, the association of obesity/metabolic syndrome-related genetic variants with hyperuricemia is not clear. Therefore, we assessed this association in Chinese men diagnosed with hyperuricemia in comparison to a non-hyperuricemia group. Methods: We genotyped 47 single nucleotide polymorphisms (SNPs) previously identified to be associated with obesity or metabolic syndrome in 474 adult males (aged ≥ 18 years) using multiplex polymerase chain reaction. Multivariate logistic regression was used to investigate the association between the genetic variations and hyperuricemia. Stratified analyses were applied to further assess the associations. Results: The obesity-related SNP in MSRA rs545854 significantly affected serum uric acid levels. In addition, the G-allele of rs545854 was positively associated with the risk of hyperuricemia [odds ratio (OR) = 2.80, 95% confidence interval (CI) = 1.19-6.64, P = 0.0188]. After adjusting the model for body mass index and central obesity, rs545854 was shown to be an independent factor increasing the risk of hyperuricemia (OR = 2.81, 95%CI = 1.18-6.70, P = 0.0196). Stratified analyses also showed a significant association between rs545854 and hyperuricemia among meat eaters (OR = 2.62, 95%CI = 1.09-6.26, P = 0.0308). Conclusion: The obesity-related SNP rs545854 was correlated with the serum uric acid level and risk of hyperuricemia in a male Chinese population. Therefore, men carrying this SNP could benefit from limiting their meat consumption to prevent hyperuricemia. These findings suggest an underlying genetic link between obesity and hyperuricemia worthy of further exploration.

Comparative study of trigeminocardiac reflex after trigeminal ganglion compression during total intravenous anesthesia.

BACKGROUND: Percutaneous compression of the trigeminal ganglion (PCTG) is an alternative surgical treatment for trigeminal neuralgia (TN). Manipulation of PCTG can lead to significant hemodynamic changes, which may increase the risk of cardiovascular complications. However, to our knowledge, few studies have focused on anesthesia experience during PCTG as treatment for TN so far. It was our primary focus on how to ensure the stability of hemodynamics during our clinical anesthesia experience. This study aimed to compare the study group (using sodium nitroprusside [SNP] as soon as the puncture began) with the control group (without using SNP as soon as the puncture began) to investigate cardiovascular parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate [HR]) at 5 periods during total intravenous anesthesia. METHODS: A total of 256 patients who underwent PTCG were enrolled and randomly assigned into the study group (n=137) (using SNP as soon as the puncture began) and the control group (n=119) (without using SNP as soon as puncture began); the relationship between the hemodynamic changes and using SNP or without using SNP was compared. Blood pressure and HR were measured at 5 periods: preoperative (T1), before puncture (T2), during compression (T3), 1 minute after compression ended (T4), and 1 minute after the procedure ended (T5). Multivariate analysis of variance and the Pearson χ test were used, and a value of P<0.05 was considered statistically significant. RESULTS: The mean values of SBP were higher in the control group at the evaluation during T3 (P<0.001 vs. control), T4 (P<0.05 and P=0.040 vs. control), and T5 (P<0.05 and P=0.037 vs. control) and DBP was the only observed significant difference during T3 (P<0.001 vs. control), when compared with the study group. Meanwhile, means of SBP, DBP, and HR comparison in the same group were observed between T2 and T3. In the control group, means of SBP (P<0.001 vs. T2), DBP (P<0.001 vs. T2), and HR (P<0.001 vs. T2) showed significant differences in comparison with control group; means of HR (P<0.001 vs. T2) was the only observed significant difference between T2 and T3 in the study group. However, PTCG elicited significant abrupt bradycardia during T3 in almost all patients. CONCLUSIONS: The control group and the study group were not able to prevent bradycardia elicited during PTCG. Compared with control group, dramatic elevations of the systemic blood pressure can be prevented using intravenous drip SNP as soon as the puncture began during total intravenous anesthesia in the study group. Our findings verify that intravenous drip SNP is an effective method to control abrupt rise of blood pressure.