Prevalence and Risk Factors of Non-Alcoholic Fatty Liver Disease (NAFLD) in Non-Obese Patients with Schizophrenia: A Retrospective Study.

Background: To assess the prevalence and risk factors of NAFLD in non-obese patients with schizophrenia in a public psychiatric hospital in China. Methods: A total of 1,305 adult inpatients with schizophrenia in 2019 were included in this retrospective study. Body mass index (BMI) ≥ 25 kg/m2 was considered obese, and BMI < 25 kg/m2 was considered non-obese. We obtained the data from electronic records of the Affiliated Brain Hospital of Guangzhou Medical University. Results: A total of 1,045 non-obese patients and 260 obese patients were included in this study. The prevalence of NAFLD in non-obese patients was 25.0%, and it was much lower that in the obese patients (25.0% vs 64.6%, p < 0.001). Among the non-obese patients, there were significant differences in age, BMI, alanine aminotransferase (ALT), metabolic indices, and the prevalence of diabetes and hypertension between patients with NAFLD and patients without NAFLD. According to the results of binary logistic regression analysis, age, BMI, ALT, triglyceride (TG) and diabetes were significantly related to NAFLD among non-obese patients with schizophrenia. In contrast, HDL-C was was negatively associated with NAFLD among non-obese patients. Conclusion: This study suggested that NAFLD was common in patients with schizophrenia, even in non-obese patients with schizophrenia. In non-obese patients with schizophrenia, age, BMI, ALT, TG and diabetes are significantly associated with NAFLD. Moreover, HDL-C level was an independent protective factor against NAFLD. Given the adverse outcomes of NAFLD, it is necessary to increase awareness of NAFLD in patients with schizophrenia, especially in non-obese patients with schizophrenia.

First identification and molecular subtyping of Blastocystis in free-living wild birds from urban Xinxiang, China.

Blastocystis is a common enteric protist infecting humans, domestic animals, and wildlife worldwide. However, data on the prevalence and subtype diversity of Blastocystis in free-living wild birds in urban districts are rare. In this study, a total of 138 fresh fecal samples from free-living wild birds were collected from three universities and three communities in Xinxiang, China, to explore the infection rate, Blastocystis subtypes present and zoonotic potential of this protist. Blastocystis presence was determined with nested-PCR amplification based on the partial small ribosomal subunit (SSU rRNA) gene. Presence was detected from one community (Wupu) at an overall rate of 1.5% (2/136). Further DNA sequencing and phylogenetic analyses identified two ruminant-associated subtypes, ST10 (n = 1) and ST24 (n = 1), implying a cross-species transmission of Blastocystis from ruminants. This is the first report on the infection of ST10 and ST24 in free-living wild birds in an urban area in China. As potentially zoonotic subtypes, the occurrence of ST10 and ST24 suggests that these free-living birds could play a role in spreading Blastocystis to humans in Xinxiang.

The Correlation of Regional Microstructure and Mechanics of the Cervical Articular Process in Adults.

PURPOSE: Using micro-CT and finite element analysis to establish regional variation microarchitectures and correlation with mechanical properties of cervical articular facet trabecular bone to predict cervical spine security and material properties. METHODS: A total of 144 cervical articular processes (each articular was separate to four region of interest (ROI), superior-anterior (SA), superior-posterior (SP), inferior-anterior (IA), and inferior-posterior (IP) regions) specimens with a volume of 5 × 5 × 5 mm3 were scanned by micro-CT, and allowable stress and other mechanical properties parameters in each region were calculated after mechanical testing, then the effectiveness was verified of finite element models by ABAQUS software. RESULTS: Maximum and minimum values of C2-C7 articular processes and regions are C5 and C7 level, SA and SP regions for bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), whose variation tendency is similar to the Young's modulus, allowable stress, BMD, maximum force and strain. Between Young's modulus and all microstructure parameters, especially between BV/TV, bone mineral density (BMD) and Tb.Th, had higher linear regression coefficients R2 = 0.5676, 0.6382, 0.3535, respectively. BMD and yield strength, BV/TV, and allowable stress also had better regression coefficients, R2 = 0.5227, 0.5259, 0.5426, respectively. CONCLUSIONS: The contribution of the microstructure and mechanical properties of the C2-C7 cervical spine to the movement of the cervical spine is different and has a good correlation and the effectiveness of the finite element model is also verified that we can correctly calculate the microstructure and mechanical properties of the cervical articular process to evaluate the stability and injury risk of cervical vertebrae by the established model.

Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial.

BACKGROUND: The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. METHODS: The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China. Chinese patients with coronary heart disease and impaired glucose tolerance were randomly assigned (1:1), in blocks by site, by a centralised computer system to receive oral acarbose (50 mg three times a day) or matched placebo, which was added to standardised cardiovascular secondary prevention therapy. All study staff and patients were masked to treatment group allocation. The primary outcome was a five-point composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospital admission for unstable angina, and hospital admission for heart failure, analysed in the intention-to-treat population (all participants randomly assigned to treatment who provided written informed consent). The secondary outcomes were a three-point composite outcome (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, development of diabetes, and development of impaired renal function. The safety population comprised all patients who received at least one dose of study medication. This trial is registered with ClinicalTrials.gov, number NCT00829660, and the International Standard Randomised Controlled Trial Number registry, number ISRCTN91899513. FINDINGS: Between March 20, 2009, and Oct 23, 2015, 6522 patients were randomly assigned and included in the intention-to-treat population, 3272 assigned to acarbose and 3250 to placebo. Patients were followed up for a median of 5·0 years (IQR 3·4-6·0) in both groups. The primary five-point composite outcome occurred in 470 (14%; 3·33 per 100 person-years) of 3272 acarbose group participants and in 479 (15%; 3·41 per 100 person-years) of 3250 placebo group participants (hazard ratio 0·98; 95% CI 0·86-1·11, p=0·73). No significant differences were seen between treatment groups for the secondary three-point composite outcome, death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, or impaired renal function. Diabetes developed less frequently in the acarbose group (436 [13%] of 3272; 3·17 per 100 person-years) compared with the placebo group (513 [16%] of 3250; 3·84 per 100 person-years; rate ratio 0·82, 95% CI 0·71-0·94, p=0·005). Gastrointestinal disorders were the most common adverse event associated with drug discontinuation or dose changes (215 [7%] of 3263 patients in the acarbose group vs 150 [5%] of 3241 in the placebo group [p=0·0007]; safety population). Numbers of non-cardiovascular deaths (71 [2%] of 3272 vs 56 [2%] of 3250, p=0·19) and cancer deaths (ten [<1%] of 3272 vs 12 [<1%] of 3250, p=0·08) did not differ between groups. INTERPRETATION: In Chinese patients with coronary heart disease and impaired glucose tolerance, acarbose did not reduce the risk of major adverse cardiovascular events, but did reduce the incidence of diabetes. FUNDING: Bayer AG.