Clinical characteristics of cerebral vascular dementia and early diagnostic value of cranial nuclear magnetic resonance.

Objective: This study aimed to observe the diagnostic value of cranial magnetic resonance imaging (MRI) in patients with vascular dementia induced by ischemic stroke. Methods: The experiment was designed according to the randomized control principle. Two hundred and eighty patients with ischemic stroke who were admitted to Gucheng County Hospital between June 2019 and June 2021 were selected as research subjects. Patients without vascular dementia after stroke were included in the control group, and patients with vascular dementia after stroke were included in the observation group. The cranial MRI was performed in both groups. Result: Proportions of patients with large and moderate infarct lesions in brain tissues were significantly higher in the observation group than the control group. The data variation of relevant MRI detection indicators of the observation group was more obvious than that of the control group (P<0.05). The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores of the observation group were lower than those of the control group (P<0.05), but the HIS score was higher (P>0.05). Patients with changes in brain morphology were more in the observation group than the control group (P<0.05). Conclusion: Patients with vascular dementia induced by ischemic stroke are characterized by cortical atrophy, widening of the cerebral sulcus, large infarct lesion area and sparse cerebral white matter. Cranial MRI can effectively identify these features. The application of cranial MRI has some clinical values for early treatment and prognostic assessment.

The associations of adipokines with hypertension in youth with cardiometabolic risk and the mediation role of insulin resistance: The BCAMS study.

The mechanisms link obesity and hypertension are not well understood. One possibility is the alterations in adipose-derived adipokines that modulate insulin resistance (IR) and cardiovascular homeostasis. We aimed to assess the associations between hypertension and four adipokine levels in Chinese youth, and to examine to what extent the associations are mediated by IR. We utilized cross-sectional data from the Beijing Children and Adolescents Metabolic Syndrome (BCAMS) Study Cohort (n = 559, mean age = 20.2 years). Plasma leptin, adiponectin, retinol binding protein 4 (RBP4) and fibroblast growth factor 21 (FGF21) levels were assayed. The relationships between adipokines and hypertension and the possible mediation effect of IR were evaluated. Youth with hypertension have lower adiponectin and higher leptin, FGF21 (all P < 0.001) and RBP4 levels (p = 0.06) compared to their counterparts. Moreover, the co-existence of these two or more adipokine abnormalities in youth leads to a 9-fold increased risk for hypertension (OR: 9.19; 95% CI, 4.01-21.08) compared with these without abnormalities. However, in the fully adjusted and BMI-adjusted analyses, only FGF21 was a significant predictor of hypertension (OR: 2.12; 95% CI, 1.34-3.36). Mediation analysis revealed that the associations between leptin, adiponectin, RBP4 and hypertension are totally mediated by IR (proportion: 63.9%, 65.4%, and 31.6%, respectively), while BMI and IR partly mediated the association between FGF21 and hypertension (proportion: 30.6%, 21.2%). Our findings suggest that dysregulation of adipokines might result in hypertension in youth. Leptin, adiponectin and RBP4 may exert their functions in hypertension through adiposity-related IR, whereas FGF21 might be used as an independent marker of hypertension in youth.

Relationship Between Subclinical Cardiovascular Diseases and Cardiac Morpho-Functional Parameters in Preclinical Stage A/B Heart Failure Adults with Type 2 Diabetes.

Purpose: Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular disease which increases the risk of heart failure. This study aimed to determine whether clinical characteristics and subclinical cardiovascular disease (CVD) features are correlated with echocardiographic morpho-functional parameters of T2DM patients. Patients and Methods: Two hundred and fifty-five T2DM patients without a history of coronary heart disease were enrolled in this cross-sectional study. The demographic characteristics, glucose and lipid levels were assessed for each patient. Carotid ultrasonography and peripheral artery examination were performed to measure carotid intima-media thickness (cIMT), carotid plaque, ankle-brachial index (ABI), brachial artery pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cfPWV). Furthermore, echocardiography was conducted to evaluate cardiac morphology and systolic and diastolic function. The relationship between clinical characteristics, subclinical cardiovascular diseases, and cardiac morpho-functional parameters was explored with the Pearson and stepwise multivariable linear regression analyses. Results: A total of 255 subjects aged 18-80 years were enrolled in the study. Multiple regression analysis revealed that left ventricular mass index (LVMI) was correlated with age (ß=0.463, p = 0.000) and systolic blood pressure (SBP) (ß=0.179, p = 0.003). Relative wall thickness (RWT) was related to cfPWV (ß=0.006, p = 0.007) and homeostasis model assessment of insulin resistance (HOMA-IR) (ß=0.000, p = 0.036). In contrast, left ventricular ejection fraction (LVEF) was inversely related to cIMT (ß=-0.925, p = 0.019). The ratio of the peak flow velocity of early diastole to atrial contraction (peak E/A) was correlated with age (ß=-0.014, p = 0.000), diastolic blood pressure (DBP) (ß=-0.006, p = 0.001) and cfPWV (ß=-0.025, p = 0.044). Conclusion: In preclinical stage A/B heart failure adults with T2DM, age, BP, HOMA-IR, cfPWV and cIMT are correlated with cardiac morpho-functional parameters.

[Correlations of serum alanine aminotransferase and insulin resistance, pancreatic B-cell function].

OBJECTIVE: To explore the correlations of serum alanine aminotransferase (ALT), insulin resistance and pancreatic B-cell function. METHODS: A total of 351 first-degree relatives of type 2 diabetes mellitus received a standard oral glucose tolerance test (OGTT) at our outpatient clinic. All subjects were analyzed for the parameters of body mass index (BMI), waist-hip ratio, blood pressure (BP), serum lipids, ALT, aspartate aminotransferase (AST), plasma glucose (PG), true-insulin and proinsulin. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance and pancreatic B-cell function. They were divided into 4 groups according to the quartiles of ALT: ALT1 group (< 12.9 U/L), ALT2 group (12.9 - 17.3 U/L), ALT3 group (17.4 - 24.2 U/L) and ALT4 group (≥ 24.2 U/L). The diagnosis of metabolic syndrome was made according to the definition of Chinese Diabetic Society. RESULTS: With the rising serum ALT levels (ALT4 vs ALT1), the levels of BMI [(26.3 ± 2.9) kg/m(2) vs (23.2 ± 3.7) kg/m(2), P < 0.01], HOMA-IR [1.93 (1.21 - 3.26) vs 1.06 (0.65 - 1.54), P < 0.01] and LnHOMA-beta (2.00 ± 0.32 vs 1.87 ± 0.28, P < 0.05) were elevated; BP, serum lipids, PG, true-insulin and proinsulin also increased (P < 0.05 or P < 0.01). The levels of serum ALT [23.3 (16.3 - 37.6) vs 14.3 (10.3 - 18.5) U/L, P < 0.01] and AST [21.5 (18.3 - 32.8) U/L vs 17.9 (15.5 - 22.1) U/L, P < 0.01] increased with the rising number of metabolic disorders (0 vs 3 - 4 metabolic disorders). After adjustments for gender, age, BMI and waist-hip ratio, serum ALT were still positively correlated with BP, serum lipids, PG, fasting true-insulin, 2 h proinsulin, 2 h proinsulin/true-insulin, HOMA-IR and the numbers of metabolic disorder (r = 0.117 - 0.236, P < 0.05 or P < 0.01). After adjustments for gender, age, BMI, waist-hip ratio and HOMA-IR, the serum ALT level remained positively correlated with the numbers of metabolic disorders (r = 0.120, P < 0.05). Multiple stepwise regression analysis showed that triglyceride, HOMA-IR, total cholesterol and 2 h-proinsulin were the independent risk factors for the level of serum ALT (P < 0.05 or P < 0.01). CONCLUSION: The elevated levels of serum ALT are significantly correlated with metabolic syndrome, insulin resistance and compensatory increases of pancreatic B-cell function. Independently of insulin resistance, the serum ALT level is correlated with metabolic syndrome.

Role of adipokines FGF21, leptin and adiponectin in self-concept of youths with obesity.

The mechanisms by which obesity increases the risk of psychosocial disorders remain unclear. We aimed at exploring the association between obesity and self-concept in Chinese youths and the role of adipokines. Data for 559 participants (aged 14-28 years) were analyzed. Self-concept was assessed by utilizing the Self-Description Questionnaire II (SDQ-II). Subjects with obesity had higher leptin, FGF21 and lower adiponectin levels (all p < 0.001). They also had lower SDQ-II scores especially in the domains of general school, physical abilities, physical appearance and opposite-sex relations (all p < 0.001). Both elevated FGF21 and leptin were correlated with lower scores in math (p < 0.01), physical abilities (p < 0.01), and opposite-sex relations (p < 0.05), meanwhile FGF21 negatively correlated with the scores in general school and honesty/trustworthiness, and leptin negatively correlated with physical appearance (p < 0.01) but positively with verbal (p < 0.01). In contrast, decreased adiponectin was correlated with poorer physical abilities (p < 0.05), physical appearance (p < 0.05), and parent relations (p < 0.01). Moreover, these associations of leptin, FGF21 and adiponectin with certain domains remained significant after adjustment for BMI and other metabolic confounders. In conclusion, youths with obesity experienced poorly on self-concept, and these associations may be explained in part by adipokines leptin, FGF21 and adiponectin.

Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing: data from Beijing Child and Adolescent Metabolic Syndrome Study.

BACKGROUND: Obstructive sleep apnea (OSA) syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome (MS). METHODS: A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test (OGTT), echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire (BQ). RESULTS: Among the subjects in obesity, 33.7% of whom were likely to have OSA by BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA (P < 0.001). Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA (P < 0.05). The rates of nonalcoholic fatty liver disease (71.0% vs. 24.2%), MS (38.9% vs. 7.0%), and its components in high-risk group were significantly higher than in low-risk group. CONCLUSIONS: The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.