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The prevalence of heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of the total heart failure population, and with the aging of the population and the increasing prevalence of hypertension, obesity, and type 2 diabetes (T2DM), the incidence of HFpEF continues to rise and has become the most common subtype of heart failure. Compared with heart failure with reduced ejection fraction, HFpEF has a more complex pathophysiology and is more often associated with hypertension, T2DM, obesity, atrial fibrillation, renal insufficiency, pulmonary hypertension, obstructive sleep apnea, and other comorbidities. HFpEF has generally been considered a syndrome with high phenotypic heterogeneity, and no effective treatments have been shown to reduce mortality to date. Diuretics and comorbidity management are traditional treatments for HFpEF; however, they are mostly empirical due to a lack of clinical evidence in the setting of HFpEF. With the EMPEROR-Preserved and DELIVER results, sodium-glucose cotransporter 2 inhibitors become the first evidence-based therapies to reduce rehospitalization for heart failure. Subgroup analyses of the PARAGON-HF, TOPCAT, and CHARM-Preserved trials suggest that angiotensin receptor-neprilysin inhibitors, spironolactone, and angiotensin II receptor blockers may be beneficial in patients at the lower end of the ejection fraction spectrum. Other potential pharmacotherapies represented by non-steroidal mineralocorticoid receptor antagonists finerenone and antifibrotic agent pirfenidone also hold promise for the treatment of HFpEF. This article intends to review the clinical evidence on current pharmacotherapies of HFpEF, as well as the comorbidities management of atrial fibrillation, hypertension, T2DM, obesity, pulmonary hypertension, renal insufficiency, obstructive sleep apnea, and iron deficiency, to optimize the clinical management of HFpEF.
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Fibrilação Atrial , Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Hipertensão Pulmonar , Hipertensão , Insuficiência Renal , Apneia Obstrutiva do Sono , Humanos , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Fibrilação Atrial/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hipertensão Pulmonar/epidemiologia , Volume Sistólico/fisiologia , Comorbidade , Hipertensão/epidemiologia , Obesidade/epidemiologiaRESUMO
OBJECTIVE: To investigate the effects of glucagon-like peptide 1 receptor (GLP-1R) agonist liraglutide on endothelial dysfunction in LDL receptor-deficient (LDLR-KO) mice and ox-LDL-challenged human umbilical vein endothelial cells (HUVECs) and its possible mechanism. METHODS: LDLR-KO mice were randomly treated with normal saline, liraglutide, or liraglutide plus a GLP-1R antagonist exendin-9 for four weeks. In parallel, HUVECs were cultured with ox-LDL alone or combined with liraglutide, in the presence or absence of lectin-like ox-LDL receptor-1(LOX-1) overexpression or GLP-1R knockdown. Endothelial-dependent relaxation and LOX-1 protein expression of thoracic aorta, circulating levels of oxidative and inflammatory markers in mice, and cell survival, reactive oxygen species production, and expression of adhesion molecules and signal regulators in ox-LDL cultured endothelial cells were measured. RESULTS: liraglutide effectively enhanced acetylcholine-induced vasodilation, reduced LOX-1 expression in aortas, and decreased circulatory oxidative and inflammatory levels in LDLR-KO mice, which were abolished by cotreatment with exendin-9. HUVECs exposed to ox-LDL exhibited reduced cell viability, increased reactive oxygen species production and apoptosis, and elevated protein expression of ICAM-1, VCAM-1, LOX-1, NOX4, and NF-κB, which were markedly ameliorated by liraglutide treatment. The protective effects of liraglutide against ox-LDL-induced cell injury were abrogated in HUVECs overexpressing LOX-1 or silencing GLP-1R. CONCLUSIONS: Liraglutide improved oxidized LDL-induced endothelial dysfunction via GLP-1R-dependent downregulation of LOX-1-mediated oxidative stress and inflammation.
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Liraglutida , Doenças Vasculares , Humanos , Animais , Camundongos , Liraglutida/farmacologia , Liraglutida/uso terapêutico , Liraglutida/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Regulação para Baixo , Receptor do Peptídeo Semelhante ao Glucagon 1/genética , Receptor do Peptídeo Semelhante ao Glucagon 1/metabolismo , Lipoproteínas LDL/metabolismo , Estresse Oxidativo , Células Endoteliais da Veia Umbilical Humana/metabolismo , Doenças Vasculares/metabolismo , Receptores Depuradores Classe E/genética , Receptores Depuradores Classe E/metabolismo , Inflamação/tratamento farmacológico , Inflamação/metabolismoRESUMO
Membrane-disruptive peptides/peptidomimetics (MDPs) are antimicrobials or anticarcinogens that present a general killing mechanism through the physical disruption of cell membranes, in contrast to conventional chemotherapeutic drugs, which act on precise targets such as DNA or specific enzymes. Owing to their rapid action, broad-spectrum activity, and mechanisms of action that potentially hinder the development of resistance, MDPs have been increasingly considered as future therapeutics in the drug-resistant era. Recently, growing experimental evidence has demonstrated that MDPs can also be utilized as adjuvants to enhance the therapeutic effects of other agents. In this review, we evaluate the literature around the broad-spectrum antimicrobial properties and anticancer activity of MDPs, and summarize the current development and mechanisms of MDPs alone or in combination with other agents. Notably, this review highlights recent advances in the design of various MDP-based drug delivery systems that can improve the therapeutic effect of MDPs, minimize side effects, and promote the co-delivery of multiple chemotherapeutics, for more efficient antimicrobial and anticancer therapy.
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Objective@#To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA).@*Methods@#This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants′ characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values.@*Results@#The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24).@*Conclusion@#The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.
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Objective: To explore the relationship between longitudinal trajectory of systolic blood pressure (SPB) and atrial fibrillation (AF) in Kailuan group population. Methods: Our study cohort consisted of 40727 participants with the specific criteria in Kailuan group, Tangshan. SAS Proc Traj procedure was used to identify longitudinal trajectories of SPB throughout 2006-2007, 2008-2009 and 2010-2011. There were 5 longitudinal trajectories generated: Low-stable group,n=10950, Moderate-stable group, n=19158, Moderate-high stable group,n=3713, High-moderate stable group,n=4702 and High stable group,n=2181. Log-rank test was performed to compare AF incidence throughout 2012-2013 and 2014-2015 by physical examination among different groups; Multi Cox regression analysis was conducted to study the relationship among different SBP longitudinal trajectories and AF occurrence. Results:①The mean age of participants was (51.81±11.54) years including 30693 (75.4%) male.②AF occurrence rates in Low-stable, Moderate-stable, Moderate-high stable, High-moderate stable and High stable groups were 0.1%, 0.2%, 0.5%, 0.5% and 0.6% respectively, allP<0.05.③Multi Cox regression analysis presented that with adjusted confounding factors, compared with the patients in Low-stable group, Moderate-high stable, High-moderate stable and High stable SBP longitudinal trajectories were the risk factors for new AF occurrence (HR=7.58, 95% CI 2.08-27.73), (HR=5.30, 95% CI 1.88-14.95) and (HR=8.52, 95% CI 1.96-37.09) respectively, allP<0.05. With excluded history of myocardial infarction/stroke, the sensitivity study showed the similar result with the major research trend. Conclusion: Elevated long trajectory of SPB was the risk factor for new AF occurrence in Kailuan group population.
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Objective To evaluate the clinical value of iohexol contrast agent in patients with malignant tumor by spiral CT scan combined with endoscopy.Methods 100 patients with pathologically confirmed malignancies were selected and randomly divided into two groups, with 50 cases in each group, the experimental group received iodohexanol contrast agent combined with spiral CT scan and endoscopy , the osmotic pressure of iohexol at 37℃600 mOsm/kg, 5 minutes before the injection of intravenous injection of 10 mg prophylaxis of dexamethasone, and then spiral CT scan was performed.The control group were treated with diatrizoate contrast agent combined with spiral CT scan and endoscopy.The osmotic pressure of diatrizoate was 1500 mOsm/kg at 37℃, and 10 mg of prophylactic drug dexamethasone was injected intravenously 5 minutes before the injection.And then a spiral CT scan was performed.Results The adverse reaction in experimental group was 4%, which was mild compared with 12% in control group ( P<0.05 ) .The tolerance and spiral CT image quality of experimental group were better than those of control group ( P<0.05 ) .Conclusion Iohexol contrast agent, whether adverse reaction or image quality than the effect of diatrizoate contrast agent , in the spiral CT scan combined with endoscopy in patients with malignant tumors of higher clinical value, can be more accurate diagnosis of malignant tumors.
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Objective: To explore the predictive value of inlfammatory factors on all cause mortality in normal population. Methods: In our prospective cohort study, a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled, nobody had acute inlfammation. The death information was collected once per year and the last follow-up was conducted in 2013-12-31. According to baseline levels, white blood cells (WBC), ratio of neutrophil/lymphocyte ratio (N/L) and C-reactive protein (CRP) were respectively divided into 4 Quartile groups; all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis. Results: The average follow-up time was 6.9 years. All cause mortality in Quartile 1, Quartile 2, Quartile 3 and Quartile 4 groups for WBC were 4.2%, 4.5%, 4.5% and 5.0% respectively; for N/L were 3.3%, 3.6%, 4.5% and 6.7% respectively; for CRP were 3.0%, 3.6%, 4.8% and 6.8% respectively. Multi-Cox regression analysis indicated that with adjusted age, gender, waist and other confounders, by elevation of WBC, N/R and CRP, the risks of all cause mortality were increased accordingly, and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC, it was 1.17-time (95% CI 1.06-1.29);for N/L, it was 1.44-time (95% CI 1.31-1.59); for CRP, it was 1.33-time (95% CI 1.20-1.47) respectively. Conclusion: Elevated WBC, N/R and CRP are independent risk factors for all cause mortality in normal population.
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Objective: To investigate the changes of cardiovascular health indicator and arteriosclerosis in middle and elder population. Methods: A total of 4190 subjects with the average age of (49.78 ± 9.74) years by 3 physical examinations in Kailuan group from 2006 to 2011 were randomly stratiifed for arm ankle arterial pulse wave velocity (baPWV) examination. According to 7 AHA cardiovascular health indicators of non-smoking, normal BMI, active excise, healthy diet, normal cholesterol, blood pressure and fasting blood glucose, each indicator had 3 conditions as ideal, general and poor by scores of 2, 1 and 0 respectively. Based on the 1st and 3rd physical examinations, the changes of cardiovascular health scores (△CHS), the subjects were divided into 8 groups as△CHS≤-4,-3,-2,-1, 0, 1, 2 and△CHS≥3, n=241, 368, 611, 855, 911, 647, 354 and 203 respectively. The impacts of△CHS on baPWV values were studied by liner and Logistic regression analyses. Results: As△CHS increased by △CHS ≤ -4, -3,-2,-1,0,1, 2 and△CHS ≥ 3, the baPWV values were decreased accordingly by cm/s as (1590.78 ± 17.93), (1566.4 ± 14.5), (1552.83 ± 11.25), (1536.59 ± 9.51), (1508.85 ± 9.21), (1499.81 ± 10.93), (1485.92 ± 14.82) and (1475.85 ± 19.57) respectively. Multiple linear regression analysis showed that with adjusted confounding factors, as△CHS increasing 1 score, baPWV increasing 15.58 cm/s (B=15.58, P Conclusion: △CHS was negatively related to baPWV in middle and elder subjects, improving cardiovascular health indicator may decrease arteriosclerosis occurrence.
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Objective To analyze the application of multi‐slice spiral CT and 3D airway reconstruction technique on obstruc‐tive sleep apnea syndrome (OSAS) of pharyngeal soft tissue and upper airway stenosis .Methods Selected 92 patients with OSAS in our hospital as the observation group and another 92 healthy persons were selected as control group ,all patients achieved multi‐slice CT and 3D airway reconstruction technical inspections ,counted and compared their pharyngeal soft tissue and upper airway stenosis .Results Airway stenosis of tongue back ,and hypopharynx retro‐palatal of control group were more narrow compared with the control group(P<0 .05);the observation group′s pharyngeal soft tissue was more thick than the control group ,so as the length and width(P< 0 .05) .Conclusion Multi‐slice spiral CT and 3D airway reconstruction technique can effectively share pharyngeal soft tissue and upper airway stenosis of patients with OSAS .
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<p><b>OBJECTIVE</b>To investigate the relationship between ideal cardiovascular behaviors/factors and nonalcoholic fatty liver disease.</p><p><b>METHODS</b>In our study, 54 303 workers who had participated in the 2006-2007 Kailuan health examination with complete data and without history of drinking, myocardial infarction, stroke or cancer, were recruited. All workers were under observation and their prevalence of nonalcoholic fatty liver disease recorded. According to the American Heart Association definition of ideal cardiovascular health behaviors and factors, multiple logistic regression method was used to calculate the OR and 95% CI for baseline behaviors and factors.</p><p><b>RESULTS</b>The prevalence of nonalcoholic fatty liver disease according to 0-1, 2, 3, 4, 5-7 ideal cardiovascular health behaviors/factors were 62.6% , 48.9% , 33.3% , 16.1% and 7.5% , respectively. Results from the logistic model showed that after adjustment for age, gender, income, education level and other confounders, the ideal cardiovascular health behaviors/factors were associated with nonalcoholic fatty liver disease and the ORs (95% CI) were reduced gradually with the increase of ideal cardiovascular health behaviors/factors, which were 1,0.61(0.56-0.66), 0.37(0.34-0.40), 0.17(0.15-0.18) and 0.08 (0.07-0.09), respectively, in the 2, 3, 4, 5-7 ideal behaviors/factors groups.</p><p><b>CONCLUSION</b>Ideal cardiovascular health behaviors and factors were associated with nonalcoholic fatty liver disease.</p>
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Humanos , Consumo de Bebidas Alcoólicas , Doenças Cardiovasculares , Epidemiologia , China , Epidemiologia , Comportamentos Relacionados com a Saúde , Modelos Logísticos , Hepatopatia Gordurosa não Alcoólica , Epidemiologia , Prevalência , Fatores de Risco , Estados UnidosRESUMO
Objective To explore the relationship between‘ideal’cardiovascular behaviors and factors and the incidence of hypertension. Methods A prospective cohort study including 52 133 workers who had participated in the 2006-2007 Kailuan health examination without history of cerebral infraction,myocardial infarction or hypertension but with complete data,was carried out. All workers were followed on their occurrence of hypertension. According to the AHA definition of‘ideal’ cardiovascular health behaviors and factors,the cumulative incidence rates of hypertension in different groups were calculated under the life table method,and compared by Log-rank test,Cox proportional hazards regression was used to calculate the hazard rations and 95% confidence intervals for baseline behaviors and factors. Results The cumulative incidence rates of hypertension according 0-1,2,3,4, 5-7 ideal cardiovascular health behaviors and factors were 65.72%,59.14%,54.59%,50.24% and 34.22%,respectively in the 0-1,2,3,4,5-7 groups. Data from the Cox proportional hazards model showed that after adjusting for age,education level and family history of hypertension,the ones who had 2,3,4,5-7 ideal cardiovascular behaviors/factors were 0.75,0.69,0.63,0.36 times more than those who had 0-1 ideal behaviors. Conclusion The incidence of hypertension and risk reduced along with the increase of ideal cardiovascular health behaviors and factors.
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Objective To explore the association between serum uric acid (SUA) and all-cause mortality in men. Methods In this prospective cohort study,data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction,stroke,cancer, eGFR<30 ml/(min·1.73 m2)accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid,were excluded. All the information was gathered from a unified questionnaire,measured by blood biochemistry and with the mean period of follow up as(47.5±4.3) months. Based on the 2006-2007 SUA value,observed objects were divided into five groups,with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men. Results 1)At the end of the follow-up period in 2010-2011, the number of deaths were 315,278,243,292 and 341 among the different SUA quinte,with incidence rates of all-cause mortality as 2.43%,2.36%,1.96%,2.42%and 2.92%,respectively. 2)Data from the Single factor Cox proportional hazard regression analysis showed that,when comparing with the third quinte,HR values of the all-cause mortality were 1.32(1.11-1.56),1.19(1.00-1.41),1.20(1.01-1.43)and 1.41(1.19-1.66)in other four groups,respectively. 3)When factors were adjusted for age, systolic blood pressure,diastolic blood pressure,body mass index,triglyceride,total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein,smoking history and history of drinking,education,profession, economy,etc.,results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26(1.06-1.51),1.20(1.01-1.44),1.25(1.05-1.49),1.42 (1.19-1.68) in other four groups,respectively,comparing to the third quinte. Conclusion Using SUA as the independent risk factor of all-cause mortality,the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an“U”shaped curve.
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Objective To explore the relationship between‘ideal’cardiovascular behaviors and factors and the incidence of hypertension. Methods A prospective cohort study including 52 133 workers who had participated in the 2006-2007 Kailuan health examination without history of cerebral infraction,myocardial infarction or hypertension but with complete data,was carried out. All workers were followed on their occurrence of hypertension. According to the AHA definition of‘ideal’ cardiovascular health behaviors and factors,the cumulative incidence rates of hypertension in different groups were calculated under the life table method,and compared by Log-rank test,Cox proportional hazards regression was used to calculate the hazard rations and 95% confidence intervals for baseline behaviors and factors. Results The cumulative incidence rates of hypertension according 0-1,2,3,4, 5-7 ideal cardiovascular health behaviors and factors were 65.72%,59.14%,54.59%,50.24% and 34.22%,respectively in the 0-1,2,3,4,5-7 groups. Data from the Cox proportional hazards model showed that after adjusting for age,education level and family history of hypertension,the ones who had 2,3,4,5-7 ideal cardiovascular behaviors/factors were 0.75,0.69,0.63,0.36 times more than those who had 0-1 ideal behaviors. Conclusion The incidence of hypertension and risk reduced along with the increase of ideal cardiovascular health behaviors and factors.
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Objective To explore the association between serum uric acid (SUA) and all-cause mortality in men. Methods In this prospective cohort study,data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction,stroke,cancer, eGFR<30 ml/(min·1.73 m2)accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid,were excluded. All the information was gathered from a unified questionnaire,measured by blood biochemistry and with the mean period of follow up as(47.5±4.3) months. Based on the 2006-2007 SUA value,observed objects were divided into five groups,with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men. Results 1)At the end of the follow-up period in 2010-2011, the number of deaths were 315,278,243,292 and 341 among the different SUA quinte,with incidence rates of all-cause mortality as 2.43%,2.36%,1.96%,2.42%and 2.92%,respectively. 2)Data from the Single factor Cox proportional hazard regression analysis showed that,when comparing with the third quinte,HR values of the all-cause mortality were 1.32(1.11-1.56),1.19(1.00-1.41),1.20(1.01-1.43)and 1.41(1.19-1.66)in other four groups,respectively. 3)When factors were adjusted for age, systolic blood pressure,diastolic blood pressure,body mass index,triglyceride,total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein,smoking history and history of drinking,education,profession, economy,etc.,results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26(1.06-1.51),1.20(1.01-1.44),1.25(1.05-1.49),1.42 (1.19-1.68) in other four groups,respectively,comparing to the third quinte. Conclusion Using SUA as the independent risk factor of all-cause mortality,the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an“U”shaped curve.
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Objective To elucidate the interaction between osteoblast of bone marrow microenvironment and leukemia cells,and to investigate the role of osteoblast in the leukemia cells survival and apoptosis and the influence of leukemia cells on the osteoblast.Methods Leukemia cells from AML1-ETO9a-Rac1 mouse leukemia model and osteoblast cells were used.The ratio of GFP+ leukemia cells that co-cultured with or without osteoblast was detected by FACS.In addition,the apoptosis level of leukemia cells was detected by flow cytometry by PI and Annexin Ⅴ labeling.Activation level of PARP was determined by Western-blot.Real-time PCR (RT-PCR) was utilized to detect the mRNA level of TPO,N-cadherin,OPN and Ang1 in osteoblast which was separated from leukemic mice.Results The ratio of GFP+ cells in AE9a-Rac1 leukemia cells co-cultured with osteoblast cell was significantly higher than that of AE9a-Rac1 leukemia cells cultured alone.The apoptotic level of AE9a-Rac 1 leukemia cells cultured alone was significant higher than that of AE9a-Rac 1 leukemia cells in co-culture system.Western blot showed that activated level of PARP in AE9a-Rac1 leukemia cells co-cultured with osteoblast was lower than that cultured alone.RT-PCR result showed that TPO and N-cadherin mRNA levels in primary osteoblast separated from leukemic mice were higher than that from normal mice.Ang1 and OPN mRNA levels of osteoblast from leukemia mice were lower.Conclusion Osteoblast cell can support the survival and inhibit the apoptosis of leukemia cells.Leukemia cells can influence the functions of osteoblast by microenvironment associated cytokines production.
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<p><b>OBJECTIVE</b>To explore the association between serum uric acid (SUA) and all-cause mortality in men.</p><p><b>METHODS</b>In this prospective cohort study, data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction, stroke, cancer, eGFR < 30 ml/(min × 1.73 m(2)) accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid, were excluded. All the information was gathered from a unified questionnaire, measured by blood biochemistry and with the mean period of follow up as (47.5 ± 4.3) months. Based on the 2006-2007 SUA value, observed objects were divided into five groups, with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men.</p><p><b>RESULTS</b>1) At the end of the follow-up period in 2010-2011, the number of deaths were 315, 278, 243, 292 and 341 among the different SUA quinte, with incidence rates of all-cause mortality as 2.43%, 2.36%, 1.96%, 2.42% and 2.92%, respectively. 2) Data from the Single factor Cox proportional hazard regression analysis showed that, when comparing with the third quinte, HR values of the all-cause mortality were 1.32 (1.11-1.56), 1.19 (1.00-1.41), 1.20 (1.01-1.43) and 1.41 (1.19-1.66) in other four groups, respectively. 3) When factors were adjusted for age, systolic blood pressure, diastolic blood pressure, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein, smoking history and history of drinking, education, profession, economy, etc., results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26 (1.06-1.51), 1.20 (1.01-1.44), 1.25(1.05-1.49), 1.42 (1.19-1.68) in other four groups, respectively, comparing to the third quinte.</p><p><b>CONCLUSION</b>Using SUA as the independent risk factor of all-cause mortality, the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an "U" shaped curve.</p>
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Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Causas de Morte , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Ácido Úrico , SangueRESUMO
<p><b>OBJECTIVE</b>To explore the relationship between 'ideal' cardiovascular behaviors and factors and the incidence of hypertension.</p><p><b>METHODS</b>A prospective cohort study including 52 133 workers who had participated in the 2006-2007 Kailuan health examination without history of cerebral infraction, myocardial infarction or hypertension but with complete data, was carried out. All workers were followed on their occurrence of hypertension. According to the AHA definition of 'ideal' cardiovascular health behaviors and factors, the cumulative incidence rates of hypertension in different groups were calculated under the life table method, and compared by Log-rank test, Cox proportional hazards regression was used to calculate the hazard rations and 95% confidence intervals for baseline behaviors and factors.</p><p><b>RESULTS</b>The cumulative incidence rates of hypertension according 0-1, 2, 3, 4, 5-7 ideal cardiovascular health behaviors and factors were 65.72%, 59.14%, 54.59%, 50.24% and 34.22%, respectively in the 0-1, 2, 3, 4, 5-7 groups. Data from the Cox proportional hazards model showed that after adjusting for age, education level and family history of hypertension, the ones who had 2, 3, 4, 5-7 ideal cardiovascular behaviors/factors were 0.75, 0.69, 0.63, 0.36 times more than those who had 0-1 ideal behaviors.</p><p><b>CONCLUSION</b>The incidence of hypertension and risk reduced along with the increase of ideal cardiovascular health behaviors and factors.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamentos Relacionados com a Saúde , Hipertensão , Epidemiologia , Incidência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de RiscoRESUMO
Objective To observe the prevalence of metabolic syndrome(MS) among people with diabetes.Methods 9 275 diabetic patients (FPG was ≥7.0 mmol/L or FPG<7.0 mmol/L but diagnosed as diabetes or having history of diabetes,or were under hypoglycemic agents treatment) of 101 510 employees of Kailuan group who took physical check-up between 2006 and 2007,were recruited to take part in this study.Using the latest defined diagnostic criteria on MS from the 2010 hypertension guidelines,prevalence of MS among the population was analyzed,according to age and gender.Multiple logistic regression analysis was used to test the relevant factors of MS.Results There were 6 105 cases with MS among the population with the prevalence as 65.8% (female:70.0%,male:64.9%).Stratified by age and gender,the prevalence rates of MS among young-age group,middle-age group and elderly group were 59.7%,66.0% and 68.8%,respectively.The prevalence in males among the three groups was 61.4%,64.9% and 67.0%,respectively.The prevalence rates in females among the three groups were 50.3%,70.7% and 78.8%,respectively Stratified by age and gender,the prevalence of waist abnormal in female was the highest (100.0%) in the youth group that with MS.However,the prevalence of dyslipidemia appeared the highest (86.3%) in males.In the elderly group with MS,the prevalence of abnormal blood pressure was the highest in both males and females,up to 96.0%.Results from multi-factor logistic regression analysis showed that cigarette smoking would increase the risk of developing MS in the youth group (OR=1.89,95%CI:1.09-3.28) and the risk of developing MS of man was lower than women in the middle-aged group (OR=0.77,95% CI:0.67-0.89; OR=0.48,95% CI:0.35-0.66).Conclusion In the diabetic population,MS prevalence in female appeared to be higher than in males.The prevalence of MS tended to increase with age.Cigarette smoking could increase the risk of MS in the youth group.
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<p><b>OBJECTIVE</b>To investigate the impact of ideal cardiovascular health behaviors and factors on resting heart rate (RHR).</p><p><b>METHODS</b>A cross-sectional study method was used in our study.83 824 workers who had participated in the 2006-2007 Kailuan health examination were included, individuals with arrhythmia, hemoglobin ≤ 90g/L, taking drugs which might affect RHR, history of cerebral infarction or myocardial infarction or cancer were excluded.Related information was obtained from the unified questionnaire, blood biochemistry was performed. Multivariate logistic regression was used to analyze the impact of ideal cardiovascular health behaviors and factors on the RHR.</p><p><b>RESULTS</b>(1) The RHR was (76.4 ± 10.3), (75.2 ± 10.3), (74.3 ± 9.9), (73.6 ± 10.0), (72.6 ± 9.9), (72.1 ± 9.7) and (71.8 ± 9.2) beats/min in workers whose number of ideal cardiovascular health behaviors and factors was 1, 2, 3, 4, 5 and ≥ 6 respectively (P < 0.01). (2) Multivariate logistic regression showed that, after adjusted by gender, age, triglyceride, high density lipoprotein cholesterol, high-sensitive C-reactive protein, tea drinking, alcohol drinking, the risk of RHR ≥ 80 beats/min gradually reduces along with the increasing of number of ideal cardiovascular health behaviors and factors (1, 2, 3, 4, 5 and ≥ 6) compared with those who did not have ideal cardiovascular health behaviors and factors, the value of OR (95%CI) was 0.79 (0.71-0.87), 0.68 (0.62-0.75), 0.61 (0.55-0.67), 0.52 (0.47-0.58), 0.50 (0.44-0.56), 0.49 (0.40-0.60) respectively.</p><p><b>CONCLUSION</b>Ideal cardiovascular health behavior and factors is related to lower RHR in individuals without cardiovascular diseases.</p>
Assuntos
Humanos , Proteína C-Reativa , Doenças Cardiovasculares , HDL-Colesterol , Estudos Transversais , Comportamentos Relacionados com a Saúde , Frequência Cardíaca , Modelos Logísticos , Infarto do Miocárdio , Fatores de Risco , Inquéritos e Questionários , TriglicerídeosRESUMO
Objective To study the therapeutic effects of Bioenterics Intragastric Balloon (BIB) on obesity under gastroscopy.Methods Data of 47 patients treated with Bioenterics Intragastric Balloon under gastrscopy were reviewed from July,2010 to May,2011.Results Weight loss ( mean 15.4 kg ) was successfully achieved in all the patients during 6 months.BMI decreased by 3.2-6.4 kg/m2 ( mean 4.7 kg/m2 ).There was no serious side effect with a better result for obesity according to the follow-up.Conclusion BIB is effective for obesity for noninvasiveness,stable speed of weight loss and less pain.