[Effectiveness of tofacitinib combined with iguratimod in the treatment of difficult-to-treat moderate-to-severe rheumatoid arthritis].

OBJECTIVE: To investigate the efficacy and safety of iguratimod combined with tofacitinib in patients with difficult-to-treat moderate-to-severe rheumatoid arthritis (RA). METHODS: In this prospective clinical study, 30 patients with difficult-to-treat moderate-to-severe RA who attended the Department of Rheumatology and Immunology of Shanxi Province Fenyang Hospital from September 2021 to June 2022 were selected. Twenty-three patients enrollment had been treated with 2 or more conventional synthetic disease modifying anti-rheumatic drugs (DMARDs) for more than 6 months. At least, methotrexate or leflunomide was included. Seven patients were treated with conventional synthetic DMARDs combined with tumor necrosis factor antagonists. Because all the patients had not reached the target of treatment, the combination treatment regimen of DMARDs was changed to iguratimod and tofacitinib. The observation period was 12 weeks. Clinical data were collected before and after treatment. At the end of 4 weeks, 8 weeks and 12 weeks, the clinical data were collected such as swollen joints count (SJC), tender joints count (TJC), time of morning stiffness, clinical disease activity index (CDAI), health status assessment questionnaire (HAQ), and 28-joint disease activity score (DAS28) were included. We collected laboratory indicators, recorded the patient's medication, and observed some changes to see if any adverse drug reactions occurred during the treatment. RESULTS: There were significant differences in erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), platelet (PLT), SJC, TJC, DAS28 based on ESR(DAS28-ESR), time of morning stiffness, HAQ, CDAI, and anti-cyclic citrullinated peptide antibody before and after treatment. The differences had statistical significance (P < 0.05). There was no statistical differences in globulin before and after treatment (P>0.05). During the treatment of iguratimod combined with tofacitinib, there was no serious adverse reactions such as leukopenia, significant elevation of liver enzymes, allergy or thromboemblolic events that occurred in all the patients. CONCLUSION: Iguratimod combined with tofacitinib in the treatment of difficult-to-treat moderate-to-severe RA may have efficacy. The machanism was improving the patients' recent clinical symptoms by reducing inflammatory indexes. This combination treatment regimen with iguratimod and tofacitinib has a good safety profile.

The relationship between transforming growth factor ß superfamily members (GDF11 and BMP4) and lumbar spine bone mineral density in postmenopausal Chinese women.

PURPOSE: The relationship between transforming growth factor ß superfamily members (GDF11 and BMP4) and bone metabolism remains controversial. The aim of this study was to investigate the association between serum GDF11 and BMP4 levels and lumbar spine bone mineral density (LBMD) in a cohort of postmenopausal Chinese women. METHODS: This was a non-prospective cross-sectional study of 350 postmenopausal women with a mean age of 63.13 ± 8.66 years who came from Shenyang, China. LBMD was measured using dual-energy X-ray absorptiometry. Serum GDF11 and BMP4 concentrations were detected using a sandwich enzyme immunoassay kit. Pearson's correlation analysis and regression analyses were carried out to investigate the relationships between LBMD and serum GDF11 and BMP4 levels. RESULTS: A linear association between LBMD and serum LgGDF11 concentration was observed after adjusting for numerous confounders (P = 0.018). In addition, the osteoporosis (OP) was inversely related to LgGDF11 and the odds ratios for postmenopausal women with lumbar OP in LgGDF11 quartile group 2, group 3, and group 4 were 0.46 (95% CI 0.23-0.90, P < 0.05), 0.41 (95% CI 0.20-0.84, P < 0.05), and 0.30 (95% CI 0.14-0.63, P < 0.01), respectively (P = 0.001 for the trend), when compared to the highest quartile of LgGDF11 after adjustments for many confounding variables in this study. CONCLUSIONS: This study showed that serum GDF11 levels were linearly related to LBMD, and it was also revealed that serum GDF11 levels were significantly associated with lumbar OP in postmenopausal women. However, serum BMP4 levels were not associated with LBMD and lumbar OP.

Poor cardiovascular health status among Chinese women.

BACKGROUND: Systematic investigation and analysis of cardiovascular health status (CVHS) of Chinese women is rare. This study aimed to assess CVHS and atherosclerotic cardiovascular disease (ASCVD) burden in the Chinese women physicians (CWP) and community-based non-physician cohort (NPC). METHODS: In this prospective, multicenter, observational study, CVHS using the American Heart Association (AHA) defined 7 metrics (such as smoking and fasting glucose) and ASCVD risk factors including hypertension, hyperlipidemia and type-2 diabetes were evaluated in CWP compared with NPC. RESULTS: Of 5832 CWP with a mean age of 44 ± 7 years, only 1.2% achieved the ideal CVHS and 90.1% showed at least 1 of the 7 AHA CVHS metrics at a poor level. Total CVHS score was significantly decreased and ASCVD risk burden was increased in postmenopausal subjects in CWP although ideal CVHS was not significantly influenced by menopause. Compared to 2596 NPC, fewer CWP had ≥ 2 risk factors (8% vs. 27%, P < 0.001); CWP scored significantly higher on healthy factors, a composite of total cholesterol, blood pressure, fasting glucose (P < 0.001), but, poorly on healthy behaviors (P < 0.001), specifically in the physical activity component; CWP also showed significantly higher levels of awareness and rates of treatment for hypertension and hyperlipidemia, but, not for type-2 diabetes. CONCLUSION: Chinese women's cardiovascular health is far from ideal and risk intervention is sub-optimal. Women physicians had lower ASCVD burden, scored higher in healthy factors, but, took part in less physical activity than the non-physician cohort. These results call for population-specific early and improved risk intervention.

Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population.

BACKGROUND: Diastolic electromechanical couple, a well-described phenomenon in symptomatic heart failure, has not been well studied in healthy people. We hypothesized that ventricular repolarization variables, such as the QT interval, Tpeak-to-Tend (Tpe) interval and Tpe/QT ratio, are associated with cardiac diastolic function in the healthy Chinese population. AIM: To assess the relationship between ventricular repolarization variables and cardiac diastolic function in apparently healthy Chinese individuals. METHODS: This was a community-based cross-sectional study conducted in Shenyang, China. A total of 414 healthy subjects aged 35-91 years were enrolled. All subjects underwent standard 12-lead electrocardiography (ECG) and comprehensive echocardiography. ECG enabled the measurement of QT and Tpe intervals and Tpe/QT ratio. echocardiographic parameters, such as the ratio of mitral early diastolic inflow velocity (E) and late diastolic inflow velocity (A), E-wave deceleration time, left atrial volume (LAV) and LAV index, were measured to assess diastolic function. E/A < 0.75 was considered to indicate reduced diastolic function. ECG and echocardiography results were analyzed separately and in a blinded fashion. Correlation and regression analyses were applied to determine associations. RESULTS: Ventricular repolarization variables, such as the QTc interval (393.59 ± 26.74 vs 403.86 ± 33.56; P < 0.001), Tpe interval (72.68 ± 12.41 vs 77.26 ± 17.86; P < 0.01), Tpec interval (76.36 ± 13.53 vs 83.32 ± 21.25; P < 0.001) and Tpe/QT ratio (0.19 ± 0.03 vs 0.20 ± 0.04; P < 0.01), were significantly different between the normal diastolic function group and the reduced diastolic function group. Significant associations were found between repolarization variables and diastolic function. After adjusting for all other possible confounders, the QTc and Tpec intervals were significantly associated with the E/A ratio (P = 0.008; P = 0.010). In men, the QTc interval was associated with abnormal diastolic function, and compared to the third QTc tertile, in the second QTc tertile, the odds ratio was 0.257 (95%CI: 0.102-0.649; P = 0.004). CONCLUSION: Repolarization variables are associated with cardiac diastolic function even in healthy people. Moderate levels of the QTc interval exert a protective effect on diastolic dysfunction in men.

The relationship between serum fibroblast growth factor 23, Klotho, and lumbar spine bone mineral density in northern Chinese postmenopausal women.

OBJECTIVES: Changes in serum protein levels of fibroblast growth factor 23 (FGF23) and Klotho resulting from bone metabolism are still controversial. The purpose of this study was to observe the relationship between FGF23 and Klotho serum proteins and lumbar spine bone mineral density (LBMD) in northern Chinese postmenopausal women. METHODS: This was a community-based cross-sectional study carried out in Shenyang, a northern Chinese city. The study included 355 postmenopausal women with an average age of 62.92 ±â€Š8.78 years. FGF23 and Klotho serum proteins were measured using a sandwich enzyme immunoassay. LBMD was examined using dual-energy X-ray absorptiometry. Pearson's correlation and regression analyses were performed to investigate the associations among them. RESULTS: The LgKlotho was positively correlated with LBMD (r = 0.105). There was a linear relationship between LgKlotho serum levels and LBMD (P = 0.007) after adjusting for BMI, and the relationship still existed after adjustments for many confounding variables (P = 0.045), including age, BMI, systolic blood pressure, diastolic blood pressure, total protein, total bilirubin, high-density lipoprotein cholesterol, fasting blood glucose, serum calcium, estimated glomerular filtration rate, serum uric acid, estradiol, cigarette smoking, alcohol consumption, milk intake, calcium and vitamin D supplements, physical exercise, and fracture history in postmenopausal women. FGF23 serum levels were, however, not significantly associated with LBMD. CONCLUSIONS: Klotho was positively correlated with LBMD, and there was a linear relationship between Klotho serum protein levels and LBMD; however, the levels of serum Klotho were not independently associated with reduced LBMD in northern Chinese postmenopausal women. Moreover, serum FGF23 levels were not significantly related to LBMD in this sample population.

Central Blood Pressure Parameters Correlate with Cardiac Structure and Function in Healthy Chinese Individuals without Cardiovascular Disease.

PURPOSE: To explore the relationship between central blood pressure (BP) parameters and cardiac structure and function parameters in healthy individuals. METHODS: Four hundred Chinese participants with no overt cardiovascular disease participated in this study. One hundred and seventy-one participants (42.8%) were male and the mean age was 60 years. Central BP was measured with the SphygmoCor system. Cardiac structure and function were assessed by echocardiography. RESULTS: We showed a significant association of left atrial volume and left ventricular mass index (LVMI) with brachial and central systolic BP (SBP) and pulse pressure (PP; r = 0.189-0.0.39, p < 0.001). Left ventricular diastolic function and the E/A ratio were significantly associated with brachial and central BP (r = 0.228-0.469, p < 0.001). Multivariate regression analysis revealed that central SBP and PP were independently correlated with LVMI after normalization for age and other confounding variables (sex, body mass index, smoking, and alcohol intake, and the levels of triglycerides, high-density lipoprotein, low-density lipoprotein, creatinine, uric acid, fasting blood glucose, log C-reactive protein, and fibrinogen. However, only central SBP was found to be independently correlated with the E/A ratio. CONCLUSIONS: Cardiac structure and diastolic function were associated with brachial and central BP. However, after normalization, cardiac structure parameters were independently correlated with central SBP and PP. Diastolic function was the only cardiac function parameter that correlated with central SBP.

Association between the age-related decline in renal function and lumbar spine bone mineral density in healthy Chinese postmenopausal women.

OBJECTIVES: The relationship between the decline of renal function and bone mineral density (BMD) in healthy populations is not well-researched. The aim of this study was to investigate the association between the age-related decline in renal function and lumbar spine BMD (LBMD) in a community-based cross-sectional study of 390 healthy postmenopausal women (mean age 62.97 ±â€Š8.79 years) from Shenyang, China. METHODS: Dual-energy x-ray absorptiometry was used to measure LBMD. Estimated glomerular filtration rate (eGFR) was calculated using a modified Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for Asians and the CKD-EPI serum creatinine-cystatin c equation. Pearson's correlation analysis and binary logistic regression were used to evaluate associations. RESULTS: The eGFR-ASIA and eGFR-Scys were positively correlated with LBMD (r = 0.120 and r = 0.108, respectively). After adjustments for numerous potential confounders, the odds ratio for participants with LBMD decline in eGFR-ASIA quartile 3 group and 4 group were 2.45 (95% confidence interval [CI] 1.12-5.38, P < 0.05) and 3.89 (95% CI 1.55-9.76, P < 0.01), respectively, with P = 0.003 for the trend in eGFR-ASIA compared with the lowest quartile 1 group of eGFR-ASIA, where the odds ratio of eGFR-Scys for the quartile of 3 and 4 groups were 2.47 (95% CI 1.09-5.62, P < 0.05) and 2.63 (95% CI 1.10-6.29, P < 0.05), respectively, with P = 0.016 for the trend in eGFR-Scys compared with the lowest quartile 1 group of eGFR-Scys. CONCLUSIONS: The renal function decline was independently associated with decreased LBMD, and it was possible that the age-related decline in kidney function was an independent risk factor for decreased LBMD in healthy Chinese postmenopausal women.

Changes with aging in gastric biomarkers levels and in biochemical factors associated with Helicobacter pylori infection in asymptomatic Chinese population.

AIM: To observe changes in gastric biomarker levels with age and effects of Helicobacter pylori (H. pylori) infection in a healthy population, and explore factors associated with gastric biomarkers. METHODS: Three hundred and ninety-five subjects were selected and underwent physical examinations, biochemical tests, and measurement of serum pepsinogen (PG) I and II, gastrin-17 (G-17) and H. pylori antibody levels. Analyses were made by Student's t-test, ANOVA, Pearson's correlation and multiple linear regressions. RESULTS: PGII levels were higher in the ≥ 65-years-old age group (P < 0.05) and PGI/PGII were lower in the ≥ 75-years-old age group (P = 0.035) compared to the 35-44-years-old age group. Levels of low-density lipoprotein cholesterol (LDL-C) were higher (P = 0.009) in H. pylori-infected subjects that were male. LDL-C levels were higher in 55-74-years-old age group (P < 0.05) for H. pylori-infected subjects and 45-64-years-old age group (P < 0.05) for non-infected subjects compared to 35-44-years-old age group. Hp-IgG level positively correlated with PGI, PGII and G-17 (P < 0.001, P < 0.001, P = 0.006), and negatively correlated with PGI/PGII (P < 0.001). Creatinine positively correlated with PGI, PGII and G-17 (P < 0.001, P < 0.001, P < 0.001). Fasting blood glucose (FBG) positively correlated with PGI/PGII and G-17 (P < 0.001, P = 0.037). Age positively correlated with PGII and G-17 (P = 0.005, P = 0.026). CONCLUSION: PGII levels increased while PGI/PGII declined with age in a healthy population. H. pylori infection had an effect on raising LDL-C levels to increase the risk of atherosclerosis in males, especially those of elderly age. Age, H. pylori infection, levels of renal function and FBG were associated with levels of pepsinogens and gastrin.

A correlation study of telomere length in peripheral blood leukocytes and kidney function with age.

The current study aimed to investigate the association between telomere length in peripheral blood leukocytes and kidney function in various age groups of a healthy population. A total of 139 healthy individuals were divided into five groups according to their age: 35­44, 45­54, 55­64, 65­74 and >75 years old. Peripheral blood leukocytes were obtained and the telomere restriction fragment (TRF) length was assayed using a digoxigenin­labeled hybridization probe in Southern blot assays. Laboratory assays of kidney function were also performed. A correlation was observed between TRF length and age (r=­0.314, P<0.001), with the telomere length of the individuals >75 years group being significantly shorter than the telomere length of the 35­44, 45­54 and 55­64 years age groups (P<0.05). By contrast, the TRF length for males versus females did not differ for any of the age groups, while a correlation was observed between TRF length and serum levels of cystatin C (r=­0.195, P<0.05). There was also a correlation between TRF length and glomerular filtration rate (r=­0.184, P<0.05). The current study demonstrated that in this cohort, leukocyte telomere length reduced with age and was correlated with serum levels of cystatin C and glomerular filtration rate. Therefore, TRF length is associated with kidney function and may serve as a marker of aging.

The correlation between peripheral leukocyte telomere length and indicators of cardiovascular aging.

OBJECTIVES: To investigate the relationship between telomere length in peripheral blood white cells and cardiovascular function in a healthy, aging Han Chinese population. METHODS: In 2012, peripheral blood leukocytes were obtained from 139 healthy individuals in Beijing, China, and telomere restriction fragment (TRF) length was assayed using a digoxigenin-labeled hybridization probe in Southern blot assays. Indicators of cardiovascular function were also evaluated, including electrocardiograms (ECG), (RR, P, PR, QRS, ST and T intervals); blood pressure (BP), (SBP, DBP, PP, PPI); cardiovascular ultrasound (left ventricular ejection fraction, LVEF); mitral early and late diastolic peak flow velocity (MVE and MVA); and lipid indices (TC, TG, HDL, LDL, LCI). The relationships of these cardiovascular indictors to telomere length were evaluated. RESULTS: No correlations were found between telomere length and ECG, BP or lipid indices even after adjustment for age. Correlations were found between TFR length and some cardiovascular ultrasound indictors (D, MVEA, MVEDT, MVES, MVEL, MVEI, IMT), but these were not seen after adjusting for age. CONCLUSIONS: We did not find that leukocyte TFR length was associated with cardiovascular ultrasound indictors, ECG, BP, or lipid indices in this population of healthy Han Chinese individuals. Telomere length may serve as a genetic factor in biological aging.

Select aging biomarkers based on telomere length and chronological age to build a biological age equation.

The purpose of this study is to build a biological age (BA) equation combining telomere length with chronological age (CA) and associated aging biomarkers. In total, 139 healthy volunteers were recruited from a Chinese Han cohort in Beijing. A genetic index, renal function indices, cardiovascular function indices, brain function indices, and oxidative stress and inflammation indices (C-reactive protein [CRP]) were measured and analyzed. A BA equation was proposed based on selected parameters, with terminal telomere restriction fragment (TRF) and CA as the two principal components. The selected aging markers included mitral annulus peak E anterior wall (MVEA), intima-media thickness (IMT), cystatin C (CYSC), D-dimer (DD), and digital symbol test (DST). The BA equation was: BA = −2.281TRF + 26.321CYSC + 0.025DD − 104.419MVEA + 34.863IMT − 0.265DST + 0.305CA + 26.346. To conclude, telomere length and CA as double benchmarks may be a new method to build a BA.

Associations between bone mineral density and subclinical atherosclerosis: a cross-sectional study of a Chinese population.

CONTEXT: The significance of associations between bone mineral density (BMD) and atherosclerosis in the Asian population is less clear. OBJECTIVE: The aim of this study was to explore the population-level associations between BMD and subclinical atherosclerosis. DESIGN AND SETTING: This was a community-based cross-sectional study conducted in Shenyang, China. PARTICIPANTS: A total of 385 Chinese women and men aged 37-87 years were studied. MAIN OUTCOME MEASURES: The BMD was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry. The ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) were measured to assess atherosclerosis. Multiple regression analysis was applied to study the associations. Multicolinearity was examined using the variance inflation factor, condition index, and variance proportions. Factor analysis and principal component regression were used to remove the problem of multicolinearity. RESULTS: The differences of ABI, PWV, and CIMT among the normal BMD, osteopenia, and osteoporosis groups were not found. Total hip BMD was correlated with ABI in women after adjustment for age (r = 0.156). Sex-specific regression models included adjustment for age, body mass index, cigarette smoking, alcohol consumption, menopausal status (women), systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, serum uric acid, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and fibrinogen. Total hip BMD was associated with ABI in women after adjustment for age (per SD decrease in ABI: -0.130 g/cm(2), P = .022), but the association was borderline significant after full adjustment (P = .045). Total hip BMD and lumbar spine BMD were not associated with ABI, PWV, and CIMT after full adjustment in participants without a fracture history. The risk of osteoporosis was not associated with ABI, PWV, and CIMT. CONCLUSIONS: Low BMD is not associated with subclinical atherosclerosis as assessed by ABI, PWV, and CIMT.

[Correlation of cardiovascular risk factors and cognitive function].

OBJECTIVE: To evaluate the relationship between cardiovascular risk factors and cognitive function in a healthy population. METHODS: A community-based cross-sectional study was conducted in Shenyang. The Framingham gender-specific risk equation was employed to evaluate the cardiovascular risk factors, calculate Framingham risk score and estimate the risk of 10-year coronary heart disease (CHD). A total of 505 study subjects were divided into 3 groups according to 10-year CHD risk: low risk(<10%), moderate risk (10%-20%) and high risk groups(>20%). They were also divided into 5 groups according to age; ≤ 44 year old; 45-54 year old; 55-64 year old; 65-74 year old and ≥ 75 years old. Clock drawing test and mini-mental state examination (MMSE) were used to evaluate the cognitive function and compare it among different risk groups. And correlation coefficients between Framingham risk score and cognitive function were calculated. RESULTS: Framingham risk score, clock drawing test sore and MMSE score in the low risk group was (2.6 ± 0.8), (4 ± 1) and (27 ± 3). In comparison to low risk group, Framingham risk score increased significantly (P < 0.01), MMSE score(25 ± 4) decreased significantly (P < 0.01) in moderate risk group, Framingham risk score (9.7 ± 1.0) increased significantly (P < 0.05) and clock drawing test scores (3 ± 1) and MMSE scores (23 ± 4) decreased significantly (P < 0.05) in high risk group; in comparison to moderate risk group, clock drawing test and MMSE scores decreased significantly (P < 0.05) in high risk group. There was a significantly inverse correlation between Framingham risk score and cognitive function. And the Pearson correlation coefficients were -0.196(clock drawing test, P < 0.01) and -0.333 (MMSE, P < 0.01) . CONCLUSIONS: An inverse correlation exists between cardiovascular risk factors and cognitive function in healthy population. With more risk factors and greater severity, Framingham risk score increases while cognitive function decreases.

[Comparison on efficacy and safety between domestic levosimendan versus dobutamine for patients with acute decompensated heart failure].

OBJECTIVE: To compare the efficacy and safety of domestic levosimendan versus dobutamine for patients with acute decompensated heart failure (ADHF). METHODS: ADHF patients from 8 medical centers were recruited in this multicenter, blind, positive-controlled, randomized study and received 24 h intravenous levosimendan (n = 114) or dobutamine (n = 114) therapy. SWAN-GANZ catheter was performed in patients with pulmonary capillary wedge pressure (PCWP) ≥ 15 mm Hg (1 mm Hg = 0.133 kPa) and cardiac index (CI) ≤ 2.5 L·min(-1)×m(-2) (n = 39 each). RESULTS: Compared with baseline level, LVEF increased [(31.56 ± 9.69)% vs. (28.44 ± 7.08)%, P < 0.01] at 24 h in both groups. LVEF increase at 24 h was similar between two groups [(3.11 ± 6.90)% vs. (3.00 ± 6.63)%, P > 0.05]. The PCWP decrease at 24 h was significantly greater in levosimendan group than in dobutamine group [(-8.90 ± 7.14) mm Hg vs. (-5.64 ± 6.83) mm Hg, P = 0.04]. Decrease in NT-proBNP at 3 days was also more significant in levosimendan group than in dobutamine group [the percentage change compared to baseline: (-22.36 ± 38.98)% vs. (-8.56 ± 42.42)%, P < 0.01]. Dyspnea improvement at 24 h was more significant in levosimendan group than in dobutamine group. The incidences of adverse reactions and events were similar between two groups. CONCLUSION: LVEF improvement is similar between dobutamine and domestic levosimendan while greater decreases in PCWP and NT-proBNP are achieved with domestic levosimendan in patients with ADHF.

[Estimation of individual biological aging and individualized evaluation of biomarkers of aging in healthy people].

OBJECTIVE: To estimate the degree of biological aging for healthy people by the biological age score equation and observe the differences of various aging biomarkers so as to provide targets for clinical anti-aging intervention. METHODS: A total of 2876 subjects aged 30 - 98 years old were recruited from 3 Chinese cities in 2003. After screening, 852 healthy subjects were finally selected and assigned into 4 groups according to ages: young group (< 45 yr), middle-aged group (45 - 59 yr), young-elder group (60 - 74 yr) and elder group (≥ 75 yr). They received a total of 108 physical, morphological, physiologic and biochemical examinations. The biological age score equation was employed to compute the individual biological age scores for all subjects. Then the biological age score was taken as a dependent variable and the chronological age as an independent variable for linear regression. Based on the confidence interval with ± 1 standard deviation of regression line, they were divided into 3 groups (delayed aging, normal aging and early aging). According to the chronological ages and degrees of aging, two-way analysis of variance was conducted for the following 7 biomarkers: end diastolic velocity (EDV), intima-media thickness (IMT), ratio of peak velocity of early filling to atrial filling (E/A), mitral valve annulus lateral wall of peak velocity of early filling (MVEL), arterial pulse pressure (PP), fibrinogen (FIB) and cystatin C (CYSC). At the same time, the differences of 7 biomarkers were observed in different aging groups in 4 age groups. RESULTS: (1) A comparison of biological age score: there were no significant differences in chronological age among 3 biological aging groups in same chronological age groups. However, there were some significant differences in biological age score (young group: F = 91.8, P < 0.01; middle-aged group: F = 134.5, P < 0.01; young-elder group: F = 199.5, P < 0.01; elder group: F = 82.1, P < 0.01). (2) Two-way analysis of variance (aging groups and chronological age groups for biomarkers): there were significant differences of 7 biomarkers in different chronological age groups and different aging groups. (3) A comparison of biomarkers among aging groups: there were significant differences in PP among 3 aging groups in 4 age groups. PP increased significantly in early aging group to normal aging group and delayed aging group (young group: 49.0 ± 6.9, 37.6 ± 6.4, 30.8 ± 7.6 mm Hg, F = 93.2, P < 0.01; middle-aged group: 52.9 ± 7.3, 44.3 ± 5.9, 32.7 ± 8.4 mm Hg, F = 125.7, P < 0.01; young-elder group: 61.9 ± 7.6, 51.6 ± 6.6, 37.1 ± 8.7 mm Hg, F = 196.5, P < 0.01; elder group: 72.2 ± 13.7, 61.1 ± 6.8, 43.8 ± 10.8 mm Hg, F = 60.2, P < 0.01). There were significant differences in EDV among 3 aging groups in 4 age groups. EDV increased significantly in early aging group to normal aging group and delayed aging group. There were significant changes in IMT, MVEL, E/A, CYSC and FIB among aging groups in different age groups. CONCLUSION: (1) Biological age score plays an essential role in the evaluation of aging. Based on individual evaluation of biological age score, the degrees of aging can be categorized by grouping so that a clinician may provide clinical anti-aging interventions within the target groups. (2) The above 7 biomarkers are competent for the evaluation of aging. They can not only be used to construct biological age score equation, but also provide clinical targeted interventions for aging.

Association between kidney and cardiac diastolic function in Chinese subjects without overt disease: correlation with ageing and inflammatory markers.

BACKGROUND: Age-related changes in kidney structure and function have been well documented. This study aimed to assess the relationship between declines of normal ageing-related kidney function and cardiac diastolic function in a healthy Chinese population. MATERIALS AND METHODS: A total of 852 healthy adults aged 30-98 years were enrolled and divided into four groups according to quartiles of estimated glomerular filtration rate (eGFR) and cystatin C (CYSC). Cardiac diastolic function was measured by ratio of peak velocity of early filling to peak velocity of atrial filling (E/A), which was derived by B-mode echocardiography. Lower E/A was defined as measures under the 25th percentile of sample distribution (0·784). RESULTS: Age was significantly associated with eGFR (r = -0·102, P < 0·01), CYSC (r = 0·544, P < 0·01) and E/A (r = -0·381, P < 0·01). Binary logistic regression analysis revealed that second, third and fourth quartile groups of CYSC and fourth quartile of eGFR were significantly associated with lower E/A in an unadjusted model. However, these associations were lost after full adjustment. CONCLUSIONS: Our results confirm that ageing is a major factor contributing to declines in both kidney and cardiac diastolic function in a healthy population. Adjustment for covariates, however, showed that normal ageing-related declines in kidney function and cardiac diastolic function are not independently linked.

SIRT1 variants are associated with aging in a healthy Han Chinese population.

BACKGROUND: Aging is influenced by diverse environmental and genetic risk factors. The SIRT1 (silent information regulator 1) gene has been shown to regulate lifespan and aging in previous studies. We determined whether variation in the SIRT1 gene is associated with aging in healthy Chinese population. METHODS: The study population comprised 482 healthy, unrelated Chinese subjects, of which 246 were aging individuals from 60 to 91years old, and 236 younger individuals from 35 and 59years old. All subjects were from Shenyang, China. Two single-nucleotide polymorphisms (SNP) were analyzed: rs3758391 near the 5' end of the SIRT1 gene; and rs4746720, in the 3' untranslated region. RESULTS: Differences in allele and genotype frequency were seen between the groups, with rs3758391/C more common than rs3758391/T in the aging subjects (odds ratio=1.453, p=0.026), and with rs3758391/CC more common than rs3758391/CT and rs3758391/TT in the aging subjects (odds ratio=3.042, p=0.027). For the 3' SNP, rs4746720/C was more common than rs4746720/T in the aging subjects (odds ratio=1.347, p=0.022), and rs4746720/CC was more common than rs4746720/CT and rs4746720/CT in the aging subjects (odds ratio=1.461, p=0.049). The haplotype frequency distribution was also different, with haplotype CC more common in the older group (odds ratio=1.63, p=0.01). CONCLUSION: These results suggest that SIRT1 gene polymorphisms may add a new factor on the multifactorial genetic contributions to aging.

[Correlation of cardiovascular risk factors versus glomerular filtration rate in healthy population].

OBJECTIVE: To evaluate the relationship between cardiovascular risk factors and glomerular filtration rate in healthy population. METHODS: A community-based cross-sectional study was conducted in Shenyang. The Framingham sex-specific risk equation was employed to evaluate the cardiovascular risk factors of 501 healthy study objects, calculate Framingham risk score and estimate the risk of 10-year coronary heart disease (CHD). A total of 501 study subjects were then divided into 3 groups according to 10-year CHD risk: low risk group (< 10%), moderate risk group (10% -20%) and high risk group ( > 20%). Study subjects were also divided into 5 groups according to age: < or = 44 years old; 45 - 54 years old; 55 - 64 years old; 65 - 74 years old and > or = 75 years old. The Cockcroft-Gault equation (GFR(CG)), abbreviated MDRD equation (GFR(MDRD1)) and modified MDRD equation (GFR(MDRD2)) were used to estimate glomerular filtration rate (GFR). Glomerular filtration rate (GFR) were compared among different risk groups and correlation coefficients between Framingham risk score and glomerular filtration rate calculated. RESULTS: GFR(CC), GFR(MDRD1) and GFR(MDRD2) in the low risk group was [(103 +/- 27) ml x min(-1) GFR(MDRD2) in moderate risk group all decreased [(84 +/- 24) ml x min(-1) x (1.73 m2) (-1), (101 +/- 27) ml x min(-1) x (1.73 m2) (-1), (124 +/- 33)ml x min(-1) (1.73 m2) (-1), all P < 0.01]. GFR(CG), GFR(MDRD1) and GFR(MR(MDRD2) in the high risk group all decreased [(71 +/- 15) ml x min(-1) (1.73 m2) (-1), (88 +/- 15) ml x min(-1) x (1.73 m2)(-1), (109 +/-18)ml x min(-1) x (1.73 m2) (-1), all P < 0.01]. The GFR(CG), GFR(MDRD1) and GFR(MDRD2) in the high risk group all decreased compared with the moderate risk group (P < 0.05). There was a significantly inverse correlation between Framingham risk score and GFR with the Pearson correlation coefficient -0.586 (GFR(CG), P < 0.01) and -0.449 (GFR(MDRD1) and GFR(MDRD2), P < 0.01). CONCLUSION: There is an inverse correlation between cardiovascular risk factors and GFR in healthy population. With the increasing of risk factors and their severity, Framingham risk score increases and GFR decreases.