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Background/Aims@#Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. @*Methods@#A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. @*Results@#Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. @*Conclusions@#In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.
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Objective:To investigate the relationship between thyroid-stimulating hormone(TSH) levels and 10-year mortality in women aged 40 years and older.Methods:Residents aged 40 and over in urban areas of Guiyang City who participated in the " Epidemiological Study of Cancer Risk in Patients with Type 2 Diabetes in China(REACTION)" were followed up in 2011. Finally, 5 614 people were enrolled, and the baseline general information, physical examination and TSH detection were carried out. The average follow-up was(9.77±1.55) years, and the treatment and death of thyroid-related diseases were recorded. The Cox proportional hazards model was used to analyze the relationship between TSH level and 10-year mortality in middle-aged and elderly women, and plotting survival time curves(Kaplan-Meier curves) to study the association between elevated TSH levels and lifespan in subjects under 65 years old. Results:The multivariate Cox proportional hazards model showed that compared with the normal group, after multivariate adjustment, the risk of death in the TSH increased group was decreased( HR=0.644, 95% CI 0.478-0.868, P<0.05); after stratifying the elevated TSH group, the risk of death was decreased in the slightly elevated TSH group( HR=0.566, 95% CI 0.405-0.791, P<0.001); the elevated TSH group was further stratified by age. In the group under 65 years old, compared to the normal group, the mildly elevated group showed a reduced risk of mortality( HR=0.429, 95% CI 0.245-0.751, P=0.003). In the group aged 65 and above, there were no statistically significant differences in mortality risk between the mildly elevated group, severely elevated group, and the normal group( P>0.05). In the group under 65 years old, the K-M curve indicated that the survival rate of the mildly elevated TSH group was significantly higher than that of the normal group( χ2=11.931, P=0.003), the difference was statistically significant. Conclusion:Mildly elevated TSH levels in women aged 40-65 years are associated with a reduced risk of all-cause death and longer lifespan.
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Objective:To explore whether metabolically healthy obesity(MHO) is a healthy state by observing the incidence of metabolic syndrome(MS) including its components and cardiovascular disease(CVD) in this population.Methods:In 2011, a cohort of 10 140 residents aged 40-79 years old was selected with cluster sampling in the Guiyang urban area. Fasting plasma glucose(FPG), blood lipids, and blood pressure were examined to assess their metabolic status. Height and weight were also measured. Among them, 1 299 metabolically healthy subjects were divided into 3 groups according to body mass index, namely metabolically healthy normal weight(MHNW), metabolically healthy overweight(MHOW), and MHO. Three groups were reassembled in 2014, and finally a total of 966 subjects with baseline and complete follow-up data were included in the analysis. The relationship between MS and its components, and the incidence of CVD were compared among the three groups.Results:(1) After an average follow-up of 3 years, 47.77% of the MHO population transformed into a metabolically unhealthy state. There was no significant difference in the incidence of MS components among the three groups( P>0.05), but there was a significant difference in the incidence of MS( P<0.05); (2) There was no significant difference in the incidence of CVD among the three groups after 3 years of follow-up. Logistic regression was used to analyze the risk factors of CVD in the three groups. Taking the MHNW as the control group, after adjusting for age, gender, FPG, blood lipids, and blood pressure, the risk ratio of the MHOW group was 0.941(0.661-1.202), and MHO group was 0.974(0.702-1.291). Conclusions:After 3 years of follow-up, although the risk of CVD in the MHO population did not increase significantly, the incidences of MS, triglycerides, and FPG abnormality increased compared with the normal people, suggesting that the MHO is not a " stable" healthy state.
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Objective:To investigate the effect of the interaction between metabolic syndrome and smoking on the risk of subsequent cardiovascular events.Methods:Urban residents aged 40 and above in the Yunyan District of Guiyang City were selected from " Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal(REACTION) Study". The baseline survey started in 2011 and general information including gender, age, medical history, lifestyle habits, and smoking status were collected. Additionally, biochemical indicators related to metabolic syndrome(MS) were measured. The study participants were then followed up, and the first cardiovascular events occurring after the initial survey were recorded. The average follow-up period was 10.07±1.49 years. The interaction between metabolic syndrome and smoking on subsequent cardiovascular events was analyzed using Cox proportional hazards models.Results:The study included a total of 7 275 individuals, among whom 639 experienced cardiovascular events. After adjusting for multiple variables, compared to non-smokers without metabolic syndrome(MS), smokers with MS showed a higher risk of cardiovascular events, with a hazard ratio( HR) of 6.54(95% CI 4.88, 8.78). This risk was higher than that of individuals with MS who never smoked [ HR 1.39(95% CI 1.11, 1.75)] and non-MS smokers [ HR 2.48(95% CI 1.77, 3.49)]. There was an additive interaction between MS and smoking on the occurrence of cardiovascular events, with a relative excess risk due to interaction(RERI) of 3.30(95% CI 1.89, 4.70), an attributable proportion(AP) of 0.55(95% CI 0.43, 0.59), and a synergy index(S) of 3.07(95% CI 1.94, 4.84). Furthermore, when stratifying the duration of smoking cessation, long-term quitters(≥8 years) showed a lower risk of cardiovascular events compared to current smokers, regardless of whether they had MS. The hazard ratios were 0.45(95% CI 0.26, 0.78) for individuals with MS and 0.42(95% CI 0.19, 0.95) for individuals without MS. Conclusions:There is an additive interaction between smoking and MS on the risk of cardiovascular events. The coexistence of both factors significantly increases the risk of cardiovascular events.
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Objective:Explore the relationship between sleep duration, sleep time and brachial-ankle pulse wave velocity(baPWV) in community population.Methods:Questionnaire, physical examination, blood tests, and baPWV detection were applied to a community based population. Finally, 3 912 subjects with complete data were included in the study. The relationship between sleep duration, time to fall asleep and PWV was evaluated with binary logistic regression analysis. Results:Being adjusted for age, sex, prevalence of diabetes, sleep condition, body mass index, blood glucose, blood pressure, dyslipidemia, ankle-brachial index, sleep duration and time to fall asleep were correlated with PWV. The risk of PWV abnormalities was increased in the≥8 h group compared to the 6-8 h group( OR=1.155, 95% CI 0.995-1.367, P=0.037). The risk of abnormalities PWV was higher in the group with sleep time after 00: 00 than in the group -23: 00( OR=1.482, 95% CI 1.008-2.179, P=0.045). Conclusion:Long sleep duration(≥8 h) and late sleep time(after 00: 00) may be associated with higher risk of atherosclerosis.
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Objective:To investigate the relationship between cardiometabolic index and metabolic syndrome in people aged 40 and beyond in Guiyang city.Methods:A total of 4 506 residents over 40 years(including 3 067 females and 1 439 males) were enrolled in the analysis from those who participated in the epidemiological study of cancer risk in Chinese patients with type 2 diabetes in 2011 in Guiyang City. The cardiometabolic index (CMI) is calculated by triglycerides(TG)/high-density lipoprotein-cholesterol(HDL-C)×waist-to-height ratio (WHtR). Multivariable logistic regression was used to analyze the correlation between cardiometabolic index and metabolic syndrome, and ROC was used to analyze the predictive ability of CMI on the incidence of metabolic syndrome. Results:The average follow-up period was 3 years. According to the International Diabetes Federation (IDF) diagnostic criteria for metabolic syndrome in 2005, 985 patients (774 women and 211 males) had metabolic syndrome. The incidence rate of metabolic syndrome in the general population was 21.86%, the incidence rate of male metabolic syndrome was 14.66%, and that of women was 25.24%, and the incidence of CMI increased with the increase of the number of women. After multivariable logistic regression analysis, the odds ratio of CMI for metabolic syndrome in women is 1.303(95% CI 1.263-1.344) and 1.724(95% CI 1.162-2.558) in men, respectively. ROC results showed that CMI had a good ability to predict the incidence (AUC: 0.759 for men and 0.852 for women). Conclusion:CMI is positively associated with the incidence of metabolic syndrome. It supports CMI as a useful method to screen metabolic syndrome in China′s general population.
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Objective:To explore the association of cardiometabolic index(CMI) and other body fat evaluation indicators [body mass index(BMI), waist circumference(WC), waist to height ratio(WHtR), lipid accumulation index(LAP)] with the prevalence of metabolic syndrome(MS) as well as the predictive value of the above indicators for MS.Methods:A total of 10 140 residents over 40 years old in Guiyang city who participated in the " Epidemiological study on tumor risk of type 2 diabetes patients in China" in 2011 were recruited. The 2005 International Diabetes Federation diagnostic criteria were used to identify MS. Logistic regression was used to analyze the association of CMI and other body fat evaluation indicators with MS. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value and the optimal cut-off point of different indicators. Taking the best cut-off point value of each index as the boundary, the prevalence of MS was evaluated again by Chi square test.Results:The prevalence of MS in the study population was 39.81%(27.23% for men and 44.39% for women). Logistic regression analysis showed that the risk of MS increased with increasing CMI and quartile level of other body fat evaluation indicators in both men and women( P<0.05). The risks of MS in CMI Q4 group were 17.15(95% CI 11.64-25.27) for male and 45.14(95% CI 37.07-54.96) for female compared with Q1 group. In male, the area under curve(AUC) of MS by predicted CMI was 0.761(sensitivity 79.8%, specificity 63.2%, optimal cut-off point 0.71). WC displayed the highest value of AUC among the body fat evaluation indicators. In women, the AUC value of MS predicted by CMI was 0.831(sensitivity 76.8%, specificity 75.7%, optimal cut-off point 0.65), higher than those of BMI and WHtR while lower than those of WC and LAP. Further calculating the prevalence of MS with the best cut-off point value of each index as the boundary, WC was still the best predictor for male, while CMI was only secondary to LAP for women. Conclusion:CMI and other body fat evaluation indicators are significantly associated with MS. CMI could be used to predict MS.
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Dendritic cells (DC) represent a heterogeneous cell population including many subsets. DC subpopulations with different characteristics and functions have been identified. The liver, as an immunological organ, is important in induction of immune tolerance. The unique anatomical architecture and immune properties of the liver have given DC the ability to maintain liver homeostasis and respond quickly to liver tissue damage. This article reviewed the role of hepatic DC subsets in the maintenance of tissue homeostasis and repair of damaged tissue in the liver.
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Objective:To investigate the outcomes and influencing factors of newly diagnosed prediabetic subjects aged 40 years and above in Guiyang.Methods:A total of 10 015 residents aged 40 years and above were recruited from the Yunyan community, Guiyang, from May to August 2011. Physical examination, laboratory measurements, and questionnaires were conducted. The follow-up survey was conducted in July 2014. A total of 2 530 newly diagnosed prediabetic subjects at baseline were included in the analysis.Results:The 3-year cumulative morbidity of diabetes mellitus was 14.3%, and the risk of diabetes mellitus in combined impaired fasting glucose(IFG)and impaired glucose tolerance(IGT)groups was significantly higher than that in isolated IFG(i-IFG)or isolated IGT(i-IGT)group( P<0.01). High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes( OR=1.836, 95% CI 1.374-2.454; OR=1.398, 95% CI 1.261-1.550; OR=2.526, 95% CI 1.804-3.538, all P<0.01)and the inhibitory factors for reversion to normal glucose tolerance( OR=0.511, 95% CI 0.409-0.638; OR=0.715, 95% CI 0.661-0.774; OR=0.638, 95% CI 0.500-0.816, all P<0.01). High level of high density lipoprotein-cholesterol(HDL-C)was an promoting factor for reversion to normal glucose tolerance( OR=1.306, 95% CI 1.017-1.678, P=0.036). Subjects in the highest tertile of baseline HbA 1C level and body mass index(BMI)change before and after follow-up(ΔBMI=follow-up BMI minus baseline BMI)had a higher risk of diabetes mellitus than those in the lowest tertile( OR=2.398, 95% CI 1.733-3.322; OR=2.402, 95% CI 1.859-3.105, both P<0.01). The risk of diabetes mellitus in the significant weight loss group was reduced by 40.4% compared with the non-significant weight loss group when the subjects were divided into two groups according to the cutoff of the lower tertile of ΔBMI( RR=0.596, 95% CI 0.463-0.766, P<0.01). Conclusion:The risk of diabetes mellitus in combined IFG/IGT group was significantly higher than that in i-IFG or i-IGT group. High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes. High level of HDL-C was an promoting factor for reversion to normal glucose tolerance. Weight loss can significantly reduce the risk of progression to diabetes in individuals with prediabetes.
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Objective:To discuss hypertension situations of 40-79 years old residents with different glucose metabolic status in Guiyang urban area under the new hypertension diagnostic criteria proposed by American College of Cardiology/American Heart Association (ACC/AHA) in 2017 and provide a clue for diagnostic criteria and treatment strategy of hypertension.Methods:10 140 residents in 40-79 years old in Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgitudinal (REACTION) Study Research Guiyang Sub-center were conducted retrospective analysis. According to medical history of diabetes and oral glucose tolerance test results, these residents were divided into normal glucose group, impaired fasting glucose(IFG) group, impaired glucose tolerance (IGT) group, IFG+ IGF group, previous diagnostic diabetes group and newly diagnosed diabetes group. Hypertension situation of residents with different glucose metabolic status under the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), and Hypertension Guide of ACC/AHA in 2017 were calculated.Results:Under JNC 7 criteria, hypertension′s standardized prevalence rate of normal blood glucose people, prediabetes patients, and diabetes patients in 40-79 years old respectively reached 8.19%, 9.57%, and 8.19%. Under ACC/AHA 2017 criteria, hypertension′s standardized prevalence rate respectively reached 20.27%, 16.35%, and 11.59%. By contrast, the most obvious increase of hypertension′s prevalence rate was in the normal blood glucose group and IGT group. Newly increased hypertension patients reached 1 739. Among them, 25.8% required antihypertensive drugs for treatment. According to the 6th demographic census data of Guizhou Province in 2010, it was estimated that newly increased hypertensive patients aged 40-79 years in prediabetes patients reached 123 000, among them, 20 000 required treatment. Newly increased hypertensive patients aged 40-79 years in diabetes patients reached 68 000, among them, 21 000 required treatment.Conclusions:ACC/AHA Hypertension Guide in 2017 will obviously increase hypertension′s prevalence rate of people with different glucose metabolic status in 40-49 years old. The treatment ratio of hypertension groups with diabetes and prediabetes is considerably high. As a result, social medical burdens is going to aggravate.
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Objective:To search for the potential novel mutation site and to discuss related clinical characteristics by collecting detailed information and testing the gene of a family with highly suspected type 7 maturity-onset diabetes of the young (MODY7).Methods:The gene test was conducted in a 28-year-old female patient with a 20-year course of non-ketosis-prone diabetes, with non-effective long-term insulin treatment, and a 3-generation family history of diabetes, and the patient was found to carry KLF11 gene mutation. Thus, the clinical data of family members were collected and investigated, and the pathogenic gene was tested. Firstly, the proband was searched for pathogenic genes by chip-capture high-throughput sequencing method. Then the mutation sites were verified by Sanger sequencing technology, and other family members were searched for the same mutation sites by the Sanger sequencing technology.Results:A total of two members of the family was found to have heterozygous mutation of KLF11 gene: c. 920C>T (No. 920 nucleotide of the coding region mutated from cytosine to thymine), resulting in the change of corresponding amino acid p. P307L (No. 307 amino acid changed from proline to leucine), which was a missense mutation and was consistent with their clinical diagnosis of diabetes.Conclusions:The family in this study had a family history of diabetes caused by the missense mutation of KLF11 gene. This is the first report of the mutation site of c. 920C >T (p.P307l), which may be a new mutation site of MODY7.
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Objective:To investigate the effects of severe famine exposure during early life on their later adult obesity/central obesity.Methods:We recruited 4 495 subjects who were born before and during 3 years of unpredictable natural disasters in China and from Guiyang subcenter of the Risk Evaluation of cAncers in Chinese diabeTic Individual: a lONgitudinal (REACTION) Study for data analysis. The subjects were divided into childhood exposure group(born from October 1, 1954 to September 30, 1956, n=947), infant exposure group(born from October 1, 1956 to September 30, 1958, n=939), fetal exposure group(born from October 1, 1959 to September 30, 1961, n=525), and control group(born from October 1, 1952 to September 30, 1954 and from October 1, 1962 to September 30, 1964, n=1 525) according to their birth date. Obesity was defined as body mass index (BMI)≥28 kg/m 2, and central obesity was defined as waist circumference≥90 cm in men and ≥85 cm in women. We used logistic regression models to assess the effect of severe famine exposure on adult obesity/central obesity. Results:After adjusting for confounding factors, we found that men in the fetal exposure group had higher risk of adult obesity than the control group( OR=2.817, 95% CI 1.120-7.088, P=0.028), women in the fetal exposure group( OR=2.383, 95% CI 1.517-3.743, P=0.000), and infant exposure group( OR=1.554, 95% CI 1.039-2.324, P=0.032) had higher risk of adult obesity than the control group. In addition, compared with the control group, the male fetal exposure group had an increased risk of adult central obesity ( OR=2.440, 95% CI 1.253-4.752, P=0.009), which was unfound in females. Conclusion:Severe famine exposure during earlylife, especially in fetus and female infancy, increases the risk of obesity in their adulthood. In addition, males who experienced severe famine in their fetuses period may have higher risks of central obesity when reaching adulthood.
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Objective:To explore the relationship between famine exposure in early life and bone mineral density measured by ultrasound in postmenopausal women.Methods:From May 2011 to October 2011, 10 140 residents over 40 years old in Yunyan District of Guiyang City were randomly selected, and followed up for 3 years, 7 493 subjects were selected and finally included a total of 1 504 subjects. Grouped by date of birth, the differences in bone mineral density measured by ultrasound, and risk of osteoporosis between the exposed and non-exposed groups were compared.Results:SOS, T-score, and QUI in infant- and preschool-exposed group were lower than those of non-exposed group. The medium/high risk of osteoporosis in non-exposed, fetal-exposed, infant-exposed, and preschool-exposed groups were 50%, 46.8%, 58.4%, and 62.8%, respectively ( P<0.01). Multivariate linear regression analysis showed that famine exposure in infant- and preschool-exposed groups were significantly negative correlated with SOS, T-score, and QUI, while fetal-exposed group was not significantly correlated with SOS, T-score, and QUI. Compared with the non-exposed group, the OR of the medium/high risk of osteoporosis in the infant- and preschool-exposed groups were( OR=1.41, 95% CI 1.02-1.96)、( OR=1.68, 95% CI 1.21-2.34), with statistically significance ( P<0.05), and there was no statistical significance in the fetal-exposed group. After adjusting for confounding factors, the medium/high risk of osteoporosis in infant- and preschool-exposed group were 1.64 and 1.90 as compared with the non-exposed group ( OR=1.64, 95% CI 1.16-2.32, P<0.05 and OR=1.90, 95% CI 1.35-2.70, P<0.05). Conclusion:In postmenopausal women, famine exposure in early life was significantly negatively correlated with bone mineral density measured by ultrasound (SOS, T-score, and QUI), and was associated with an increased risk of osteoporosis.
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Objective:To explore the predictive value of brachial-ankle pulse wave velocity (baPWV)>1 400 cm/s in fragility fracture in middle-aged and elderly population.Methods:From May to October 2011, questionnaire survey was conducted on a total of 3 265 males over 50 years old and postmenopausal females in Yunyan District, Guiyang City, and physical examination was carried out to measure their metabolic related indicators such as blood lipids, QUS calcaneus bone densities, and brachial-ankle pulse wave velocities. According to their baPWV, the enrolled subjects were divided into a normal baPWV group and an elevated baPWV group. Follow-up was performed for 38 months, and the incidence of fractures was tracked. Finally, 2 637 subjects with complete baseline and follow-up data were enrolled in this research for analysis.Results:The 3-year total incidence of fragility fracture was 5.08%. In particular, the rate of fragility fractures among males in the normal baPWV group was 1.6%, and that in the elevated baPWV group was 2.0%. There was no statistically significant difference between the two groups ( P>0.05). The rate of fragility fracture events among postmenopausal females in the normal baPWV group was 4.4%, and that in the elevated baPWV group was 7.1%. There was statistically significant difference between the two groups ( P<0.05). Further multivariate COX regression (or proportional hazards regression) analysis showed that the bone density T value ( HR 0.839, 95% CI 0.741-0.952, P=0.006) and baPWV ( HR 1.700, 95% CI 1.046-2.763, P=0.042) were related with risk of fragility fractures in postmenopausal women. Conclusion:A baPWV greater than 1 400 cm/s could be independently associated with the risk of fragility fractures in postmenopausal females and might be an independent risk factor for predicting fragility fractures. However, such differences were not as evident in middle-aged and elderly male patients.
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Objective:To investigate the correlation between sleep duration, sleep timing and the risk of osteoporosis in postmenopausal women, to identify contributing mechanisms and guide the prevention and treatment of osteoporosis.Methods:A total of 5 449 postmenopausal women were included in this study. All participants completed questionnaires, medical examinations, blood test and the measurement of bone mineral density using calcaneal quantitative ultrasonography. After adjusting for potential confounders, logistic regression model was used to assess the association of sleep duration, sleep timing with the risk of osteoporosis. Results:In postmenopausal women, there were significant differences in sleep duration and timing among groups with different risk of osteoporosis( P<0.05). After controlling ages, BMI, diabetes, hypertension, dyslipidemia, smoking, alcohol consumption and physical activity, sleep duration was correlated with the risk of osteoporosis, long sleep duration(≥9 h)increased the risk of osteoporosis( OR=1.39, 95% CI 1.17-1.65, P<0.05)compared with the group with sleep duration of 7~8 hours. In analysis of the combined effect of sleep duration and sleep time on the risk of osteoporosis, compared with normal sleep duration(7-8 h)and normal sleep timing(22: 00-23: 00), long sleep duration(≥9 h)and normal sleep timing(22: 00-23: 00)increased the risk of osteoporosis( OR=1.38, 95% CI 1.01-1.87, P<0.05), which was higher in the group of long sleep duration(≥9 h)and late sleep timing(≥23: 00; OR=1.43, 95% CI 1.01-2.01, P<0.05). Conclusion:Long sleep duration(≥9 h)and late sleep timing(≥22: 00)are risk factors for the increased risk of osteoporosis in postmenopausal women, the late sleep timing leads to the higher risk.
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Objective@#To explore the influence of metabolic syndrome on the risks of cardiovascular disease (CVD) events and all-cause mortality.@*Methods@#In this prospective cohort study, urban residents aged 40-79 years in Guiyang were followed-up for three years. The end-points were CVD events and all-cause mortality. COX proportional hazards model were used for the corresponding hazard ratios (HRs) of CVD events and all-cause mortality. Metabolic syndrome was defined according to the 2005 International Diabetes Federation (IDF) criteria.@*Results@#A total of 7 313 subjects were included. 146 cases of CVD events and 80 cases of all-cause mortality were recorded. After adjusting for gender, age, smoking, alcohol consumption, and blood lipid levels, the metabolic syndrome increased the risks of CVD events and all-cause mortality. The HRs were 1.43 (P=0.037) and 1.25 (P=0.418), respectively. As compared metabolic syndrome with non-metabolic syndrome, an increased risk of CVD events was found. The HR was 1.43 (P=0.013). No significantly increased risk of all-cause mortality was found in subjects with metabolic syndrome.@*Conclusion@#The metabolic syndrome was associated with increased risk of CVD events and there was no significant increase in all-cause mortality. Metabolic syndrome is an important risk factor for CVD events.
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Objective To explore the influence of metabolic syndrome on the risks of cardiovascular disease ( CVD) events and all-cause mortality. Methods In this prospective cohort study, urban residents aged 40-79 years in Guiyang were followed-up for three years. The end-points were CVD events and all-cause mortality. COX proportional hazards model were used for the corresponding hazard ratios ( HRs ) of CVD events and all-cause mortality. Metabolic syndrome was defined according to the 2005 International Diabetes Federation ( IDF ) criteria. Results A total of 7313 subjects were included. 146 cases of CVD events and 80 cases of all-cause mortality were recorded. After adjusting for gender, age, smoking, alcohol consumption, and blood lipid levels, the metabolic syndrome increased the risks of CVD events and all-cause mortality. The HRs were 1.43 (P=0.037) and 1.25 (P=0.418) , respectively. As compared metabolic syndrome with non-metabolic syndrome, an increased risk of CVD events was found. The HR was 1.43 (P=0.013). No significantly increased risk of all-cause mortality was found in subjects with metabolic syndrome. Conclusion The metabolic syndrome was associated with increased risk of CVD events and there was no significant increase in all-cause mortality. Metabolic syndrome is an important risk factor for CVD events.
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Objective@#To study the role of miR-155 in the development of allergic contact dermatitis in mice.@*Methods@#A mouse model of allergic contact dermatitis was induced by dinitrofluorobenzene (DNFB). Ear swelling was measured by caliper. Inflammatory changes in ears were observed with hematoxylin-eosin (HE) staining. Percentages of epidermal Langerhans cells (LC) and γδT cells in wild type (WT) and miR-155 knockout (miR-155KO) mice were detected by flow cytometry (FCM). Expression of major histocompatibility complex class Ⅱ (MHCⅡ) and costimulatory molecules on epidermal LC was tested by FCM to evaluate the maturation of LC in WT and miR-155KO mice. Fluorescein isothiocyanate-labeled Dextran (FITC-Dextran) was used to evaluate the phagocytotic abilities of LC by analyzing the percentages of FITC+ cells and mean fluorescence intensities (MFI) with FCM. Purified LC were co-cultured with antigen-specific CD4+ T cells sorted from OT Ⅱ mice for 72 h to analyze T cell proliferation by analyzing split peaks of CFSE. The co-culture system was stimulated with PMA and ionomycine, and blocked by Golgi stop at the same time to evaluate CD4+ T differentiation by analyzing the levels of IFN-γ and IL-17.@*Results@#Compared with WT mice, ear swelling was alleviated in miR-155KO mice. miR-155 deficiency had no significant influence on epidermal LC and γδT cells, but inhibited the maturation of in vitro-cultured LC through down-regulating the expression of MHC Ⅱ and costimulatory molecules. miR-155 deficiency did not affect the phagocytotic ability of LC, but inhibited the antigen-presenting ability of LC that could stimulate CD4+ T cell proliferation and differentiation.@*Conclusion@#miR-155 might play an important role in allergic contact dermatitis by enhancing the maturation and function of epidermal LC in mice.
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To improve clinicians'understanding of the diagnosis and treatment of pseudohypoparathyroidism with hypokalemia and hypomagnesemia. The clinical manifestations, laboratory examinations, imaging data, gene results, diagnosis and treatment of a pseudohypoparathyroidism type Ⅰb with hypokalemia and hypomagnesemia patient were retrospectively analyzed. The literatures related to pseudohypoparathyroidism in recent years were also summarized. A young man, mainly manifested as repeated tetany. The physical examination showed short stature, round face, short neck, with positive Trousseau sign. The laboratory examination revealed parathyroid hormone resistance, hypocalcemia, hyperphosphatemia, hypokalemia and hypomagnesemia. The urinary calcium and phosphorus levels were low. Cerebral magnetic resonance imaging ( MRI ) showed bilateral basal ganglia calcification. Genetic screening revealed a hybrid deletion mutation of GNAS-AS1 gene Exon 5E. After the supplement of element calcium 720 mg/d, plain vitamin D 375 U/d, active vitamin D 0.5 μg/d and potassium chloride 3 g/d, the levels of blood potassium and phosphorus rise to normal, the levels of blood calcium and magnesium were close to normal. Pseudohypoparathyroidism typeⅠb may accompany with hypokalemia and hypomagnesemia.
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Objective To study the relationship between liver enzymes [ alanine transaminase ( ALT), gamma-glutamyltransferase ( GGT), aspartate amino transferase ( AST)] and the incidence of impaired glucose tolerance(IGT) in middle-aged and elderly people. Methods A group of middle-aged and elderly residents who participated in the REACTION study in 2011 from Guiyang community were enrolled in our study. Of which, a total of 4228 participants with normal blood glucose detected by oral glucose tolerance test (OGTT) and serum ALT levels were investigated as baseline population. The baseline survey included questionnaire survey and physical examination (height, weight, waist circumference, blood pressure, etc. ), and the serum ALT, AST, GGT, total cholesterol ( TC ), triglyceride ( TG ), high density lipoprotein-cholesterol ( HDL-C ), low density lipoprotein-cholesterol (LDL-C), fasting blood glucose, postprandial 2h plasma glucose(2hPG) in OGTT, and fasting insulin(FINS) were tested. After 3 years of follow-up, all subjects received quartile grouping according to the basal liver enzyme levels, and the incidence of IGT was respectively calculated. One-way analysis of variance was used to compare the differences of basal liver enzyme levels between IGT and normal blood glucose groups. The risk of IGT based on quartile grouping was assessed by multivariate regression analysis, and the odds ratios (ORs) were estimated by the logistic regression model. Results After eliminating the 35 died patients, 3188 participants were followed over 3 years. Among them, 2400 subjects revealed normal blood glucose level, 61 developed into type 2 diabetes mellitus(T2DM), 91 developed into IFG, and 636 developed into IGT. The incidence of IGT increased along with the elevation of serum ALT level (P<0. 01). After adjusting the risk factors including body mass index, regular smoking, regular drinking, regular exercise, family history of diabetes,homeostasis model assessment for insulin resistant index(HOMA-IR), post-load 2h blood glucose, and GGT, the results manifested that patients in high basal ALT level group had 1. 462-fold chance of susceptibility in developing IGT compared with that in the low level group, with 95％ CI of 1. 129 to 1. 891. The analysis based on gender showed that the incidence of IGT was associated with basal ALT level in the female group. The OR value was estimated to be 1. 481(95％ CI 1. 107-1. 981) in high basal ALT level group as compared with the low level group. Basal serum GGT and AST levels were not associated with the incidence of IGT. Conclusion Even an elevated level of ALT within normal reference range also tends to be a risk factor for IGT in middle-aged and elderly women.