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1.
Nutr Metab (Lond) ; 18(1): 99, 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774072

RESUMO

PURPOSE: To evaluate the effect of fluctuations in waist circumference (WC), weight, and body mass index (BMI) on the incidence of diabetes in older adults. PATIENTS AND METHODS: A prospective cohort of 61,587 older adults (age, 60-96 years) who did not have diabetes at study initiation was examined. Data on weight, BMI, and WC were collected, and participants were followed up until 31 December 2018. The main end point was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios [HRs] and confidence intervals [CI]) in these participants. RESULTS: During a mean follow-up of 3.6 years, being overweight (HR [95% CI] 1.87 [1.62-2.17]), obesity (1.41 [1.26-1.59]), abdominal obesity (1.42 [1.28-1.58]), and obesity plus abdominal obesity at baseline (1.93 [1.66-2.25]) increased the risk of diabetes onset. Compared with older adults who "maintained normal WC", those who "remained abdominally obese" (HR = 1.66), "became abdominally obese" (HR = 1.58), or "achieved normal WC" (HR = 1.36) were at a higher risk of diabetes onset, as well as those with an increase in WC > 3 cm or > 5% compared with the baseline level. Weight gain or loss > 6 kg or weight gain > 5%, increase or decrease in BMI > 2 kg/m2, or an increase in BMI > 10% were associated with a higher diabetes risk. The diabetes risk was reduced by 19% in overweight older adults who exercised daily. CONCLUSION: For older adults, WC, BMI, and healthy weight maintenance reduce the diabetes risk. The findings may provide evidence for developing guidelines of proper weight and WC control for older adults.

2.
Front Neurol ; 12: 739298, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744979

RESUMO

Objective: To observe the efficacy of bilateral subthalamic nucleus deep brain stimulation on Pisa syndrome in patients with Parkinson's disease. Methods: A total of 52 patients with Parkinson's disease who underwent deep brain stimulation in Beijing Hospital from July 1, 2016 to July 1, 2020 were reviewed. The clinical data were collected for the patients who met the diagnostic criteria of Pisa syndrome on "Medication-Off" state pre-operatively. Results: Two patients met the diagnostic criteria of Pisa syndrome before operation, with a Pisa angle of 10 and 14°, respectively. The lateral trunk flexion of the two patients improved after operation. In stimulation-on/medication-off state, the Pisa angle decreased from 10 to 2° and from 14 to 6°, respectively. Conclusion: Bilateral subthalamic nucleus deep brain stimulation might have beneficial effects on lateral trunk flexion in PD patients, but the predictors of curative effect are not clear.

3.
BMC Public Health ; 21(1): 1900, 2021 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-34670542

RESUMO

BACKGROUND: In recent years, HIV testing has become one of the effective strategies to reduce the risk of the infection. Frequent quarterly HIV testing can be cost effective. Therefore, an in-depth study of factors related to the testing behavior of men who have sex with men (MSM) were analyzed to optimize intervention strategies. METHODS: From March 2011 to October 2018, the project was implemented in a Tianjin (China) bathhouse, and 5165 MSM were surveyed using snowball sampling. Factors related to HIV testing behavior were analyzed by ordinal logistic regression analysis after grouping according to testing frequency, and comprehensive analysis was performed. RESULTS: The multivariate logistic analysis showed that 6 variables including young MSM (OR = 0.67, 95% CI: 0.49-0.92, p = 0.01), low-educated MSM (OR = 0.60, 95% CI: 0.48-0.77, p < 0.0001), low HIV/AIDS knowledge (95% CI: 0.57-0.83, p < 0.0001), marital status (OR = 1.30, 95% CI: 1.07-1.57, p = 0.007), acceptance of condom promotion and distribution (OR = 14.52, 95% CI: 12.04-17.51, p < 0.0001), and frequency of condom use (p < 0.05) could link to HIV testing behaviors. CONCLUSIONS: In order to achieve the 95-95-95 goal, target publicity, HIV/AIDS education and promotion of HIV self-testing kits should be carried out to encourage frequent HIV testing among MSM who are young (especially students), married to women, poorly educated and who are reluctant to always use condoms.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , China/epidemiologia , Preservativos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Teste de HIV , Homossexualidade Masculina , Humanos , Masculino , Fatores de Risco , Comportamento de Redução do Risco , Comportamento Sexual , Inquéritos e Questionários
4.
Front Cell Infect Microbiol ; 11: 687827, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34557424

RESUMO

Background: Gut microbiota dysbiosis can contribute to the progression of atherosclerosis. We investigated the association of the gut microbiota and the severity of coronary artery lesions and prognosis of patients with ACS. Methods: In this case-control study, 402 ACS patients and 100 controls were enrolled from June 2017 to December 2018. The number of bacterial species was determined by real-time PCR. A SYNTAX score was calculated for all ACS patients based on their coronary angiography results. Results: Compared with the healthy controls, the gut microbial levels in Escherichia coli, Streptococcus, and Enterobacteriaceae were significantly increased in ACS patients, while the Lactobacillus level was significantly decreased. Lactobacillus level was as an independent predictor of disease severity on the coronary angiography [high vs. low SYNTAX score: adjusted odds ratio (aOR) = 0.024, 95% confidence interval (CI): 0.004-0.155] and myocardial necrosis [high vs. low cardiac troponin T (cTNT): aOR = 0.317, 95% CI: 0.099-0.914]. Subsequently, a higher Lactobacillus level was associated with a lower risk of an all-cause death [adjusted hazard ratio (aHR) = 0.239; 95% CI: 0.093-0.617] and major adverse cardiac events (MACE) in ACS patients (aHR = 0.208; 95% CI: 0.081-0.531). After stratifying by the type of ACS, a higher Lactobacillus level was significantly associated with the decreased risks of high SYNTAX score, all-cause death, and MACE in the STEMI subgroup but not in the NSTEMI and UAP subgroups. Conclusions: Lower Lactobacillus levels may indicate a higher risk of a more severe coronary atherosclerotic lesions and myocardial necrosis and worse prognosis for patients with ACS, particularly in the STEMI subgroup.


Assuntos
Síndrome Coronariana Aguda , Aterosclerose , Síndrome Coronariana Aguda/diagnóstico por imagem , Estudos de Casos e Controles , Angiografia Coronária , Humanos , Lactobacillus
5.
Biomed Res Int ; 2021: 8852574, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34136574

RESUMO

The pathogenesis of the osteoarthritis (OA) is complex. Abnormal subchondral bone metabolism is an important cause of this disease. Further understanding on the pathology of the subchondral bone in OA may provide a new therapy. This research is about to investigate the role of SDF-1 in the subchondral bone during the pathological process of OA. In vitro, Transwell was used to test the migratory ability of bone marrow mesenchymal stem cells (BMSCs) and human umbilical vein endothelial cells (HUVECs). Western blot presented the protein level after SDF-1 treatment in BMSCs and HUVESs. Alizarin red was used to assess the ability of osteogenic differentiation. To inhibit SDF-1 signaling pathway in vivo, AMD3100 (SDF-1 receptor blocker) was continuously delivered via miniosmotic pump for 4 weeks in mice after performing anterior cruciate ligament transaction surgery. Micro-CT, histology staining, immunofluorescence, immunohistochemistry, and TRAP staining were used to assess the role of SDF-1 on osteogenesis and angiogenesis in the subchondral bone. Our results showed that SDF-1 could recruit BMSCs, activate the p-ERK pathway, and enhance osteogenic differentiation. SDF-1 promoted the ability of proliferation, migration and tube formation of HUVECs by activating the ERK and AKT signaling pathways. In an animal study, inhibition of SDF-1/CXCR4 axis could significantly reduce subchondral osteogenesis differentiation and H-type vessel formation. Furthermore, the AMD3100-treated group showed less cartilage destruction and bone resorption. Our research shows that SDF-1 alters the microenvironment of the subchondral bone by promoting osteoid islet formation and abnormal H-type angiogenesis in the subchondral bone, resulting in articular cartilage degeneration.


Assuntos
Osso e Ossos/metabolismo , Quimiocina CXCL12/metabolismo , Neovascularização Patológica , Osteoartrite/metabolismo , Receptores CXCR4/metabolismo , Animais , Reabsorção Óssea , Cartilagem/patologia , Cartilagem Articular/metabolismo , Movimento Celular , Proliferação de Células , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fêmur/patologia , Células Endoteliais da Veia Umbilical Humana , Humanos , Masculino , Células-Tronco Mesenquimais , Camundongos , Camundongos Endogâmicos C57BL , Osteogênese , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais , Tíbia/patologia , Microtomografia por Raio-X
6.
Eur J Nutr ; 60(8): 4505-4517, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34129072

RESUMO

PURPOSE: We aimed to investigate whether the gut microbiota and fecal short-chain fatty acids (SCFAs) are associated with bone mass in healthy children aged 6-9 years. METHODS: In this study, 236 healthy children including 145 boys and 91 girls were enrolled. 16S rRNA gene sequencing was used to characterize the composition of their gut microbiota. Total and 10 subtypes of SCFAs in the fecal samples were determined by high-performance liquid chromatography. Dual X-ray absorptiometry was used to measure the bone mineral density (BMD) and bone mineral content (BMC) for total body (TB) and total body less head (TBLH). Z score of TBLH BMD was calculated based on the recommended reference. RESULTS: Four gut microbiota principal components (PCs) were identified by the compositional principal component analysis at the genus level. After adjustment of covariates and controlling for the false discovery rate, multiple linear regression analysis showed that PC3 score (positive loadings on genera Lachnoclostridium and Blautia) was significantly negatively associated with TBLH BMD/BMC/Z score, TB BMC and pelvic BMD (ß: - 0.207 to - 0.108, p: 0.002-0.048), whereas fecal total and several subtypes of SCFAs were correlated positively with TBLH BMD/Z score and pelvic BMD (ß: 0.118-0.174, p: 0.038-0.048). However, these associations disappeared after additional adjustment for body weight. Mediation analysis suggested that body weight significantly mediated 60.4% and 78.0% of the estimated association of PC3 score and SCFAs with TBLH BMD Z score, respectively. CONCLUSIONS: The associations of gut microbiota composition and fecal SCFA concentrations with bone mass in children were largely mediated by body weight.


Assuntos
Densidade Óssea , Microbioma Gastrointestinal , Absorciometria de Fóton , Criança , Estudos Transversais , Ácidos Graxos Voláteis , Feminino , Humanos , Masculino , RNA Ribossômico 16S/genética
7.
Hellenic J Cardiol ; 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34058371

RESUMO

BACKGROUND: The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in predicting major adverse cardiovascular events (MACEs) in Non-ST elevation myocardial infarction (NSTEMI) patients is still an open question, and the PCSK9 concentration of clinical usefulness remains unknown in guiding treatment. METHODS AND RESULTS: A total of 272 patients with NSTEMI were included in our prospective observational cohort study. Patients were followed up for 1 year. Their baseline plasma PCSK9 levels were determined by enzyme-linked immunosorbent assay. Patients were divided into high, medium, and low PCSK9 groups. All patients followed up for the occurrence of MACEs and received PCI therapy after admission. The associations of PCSK9 with MACEs were evaluated. The results showed that the incidence of composite MACEs was greater at higher concentrations of PCSK9. PCSK9 level was related to the level of lipoproteins, high-sensitivity C-reactive protein (hs-CRP), platelet volume distribution width, and D-Dimer. There was also a statistically significant correlation between PCSK9 concentrations and the GRACE score. The Kaplan-Meier curves showed that patients with high PCSK9 level had lower event-free survival rate. The survival analysis indicated high level of PCSK9-predicted MACEs independently. Subgroup analysis demonstrated that the prognostic value of high PCSK9 level was greater for patients classified by the GRACE score as high risk. CONCLUSION: In an NSTEMI setting, the concentration of PCSK9 is associated with hypercoagulability and hyperinflammation. High levels of PCSK9 independently predict future MACEs in patients with NSTEMI, particularly those classified by the GRACE score as high risk.

8.
Lipids Health Dis ; 20(1): 56, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044829

RESUMO

BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (Pcsk9) correlated with incidence and prognosis of coronary heart disease. However, it is unclear whether Pcsk9 contributed to coronary artery lesion severity in patients with premature myocardial infarction (PMI). The present study investigated associations between Pcsk9 and coronary artery lesion severity in PMI patients who underwent coronary angiography (CAG). METHODS: This prospective cohort study included young men (age ≤ 45 years, n = 332) with acute MI who underwent CAG between January 2017 and July 2019. Serum Pcsk9 levels and clinical characteristics were evaluated. SYNTAX scores (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) were calculated to quantify coronary artery lesions. RESULTS: Serum Pcsk9 levels were positively associated with SYNTAX scores (r = 0.173, P < 0.05). The diagnostic cutoff value of PSCK9 level was 122.9 ng/mL, yielding an area under the curve (AUC) of 0.63, sensitivity 81%, and specificity 40%. Serum Pcsk9, LDL-C, Apob, NT-proBnp, CK level, and diabetes history were independent predictors of high SYNTAX scores (P < 0.05). After stratifying by serum LDL-C level (cutoff = 2.6 mmol/L), medium-high Pcsk9 levels had increased risk of high SYNTAX scores in patients with high LDL-C (P < 0.05), and higher serum Pcsk9 levels had increased risk of major adverse cardiac events (MACE) after adjusting for confounding factors (P < 0.05). CONCLUSION: Serum Pcsk9 levels correlates with severity of coronary artery lesion in PMI patients and may serve as a biomarker for severity of coronary artery stenosis in this patient population, which may contribute to risk stratification.

9.
Ann Palliat Med ; 10(5): 5231-5243, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34044561

RESUMO

BACKGROUND: In recent years, the hospital admission rate of non-ST-elevation myocardial infarction (NSTEMI) patients has exhibited an increasing trend, and a forthcoming transition from ST-elevation myocardial infarction (STEMI) to NSTEMI has been observed in China. The association between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and major adverse cardiac events (MACEs) within 12 months after discharge among patients with NSTEMI remains unclear. METHODS: A total of 1,357 consecutively admitted NSTEMI patients were from the TAMI cohort. The patients' baseline demographic and clinical information were collected, and follow-up was carried out for 12 months. The primary outcome was composite MACEs consisting of all-cause death, hospital admission for unstable angina, hospital admission for heart failure, non fatal recurrent myocardial infarction, and target lesion revascularization (TLR). We adopted a Cox proportional hazard model to analyze the effect of NT-proBNP on MACEs and quantified the added prognostic value of NT-proBNP on the Global Registry of Acute CoronaryEvents (GRACE) risk score using the Harrell C-index, NRI, and IDI. RESULTS: The overall average follow-up period was 313 days. In total, 211 (15.55%) patients suffered from at least one MACE, and 97 patients were lost to follow-up, with a median follow-up time of 147 days. As the NT-proBNP level increased, a significant uptrend in the incidence of composite MACEs, all-cause death, and heart failure was observed. The multivariable Cox model revealed that NT-proBNP was an independent risk factor for composite MACEs [medium- vs. low-, HR: 2.19 (1.45-3.32), P=0.0002]; [high- vs. low-, HR: 3.07 (1.78-5.29), P<0.0001], as well as for all-cause death and heart failure. Subgroup analysis indicated that NT-proBNP was a robust prognostic biomarker, and the prognostic value was more evident for patients older than 60 years and whose LVEF was less than 40%. NT-proBNP (log-scale) was moderately correlated with the GRACE score (r=0.58, P<0.0001). The Harrell C-index of NT-proBNP combined with the GRACE score was 0.7715, which was higher than that of the GRACE score alone (0.7149) for predicting composite MACEs, and this improvement was verified by significant IDI (0.064, 95% CI: 0.027-0.106). CONCLUSIONS: NT-proBNP is a robust long-term prognostic biomarker for patients diagnosed with NSTEMI, especially for older patients and those with impaired cardiac ejection function. Combined usage of NT-proBNP levels with the GRACE score might help identify a subset of NSTEMI patients at a particularly high risk of MACEs 12 months after discharge.


Assuntos
Peptídeo Natriurético Encefálico , Infarto do Miocárdio sem Supradesnível do Segmento ST , Biomarcadores , China , Humanos , Fragmentos de Peptídeos , Prognóstico , Medição de Risco
10.
Ann Palliat Med ; 10(2): 1296-1303, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33040556

RESUMO

BACKGROUND: Glycosylated hemoglobin (HbA1c) is directly proportional to the level of glucose in the blood, and it has been the gold standard to evaluate the status of long-term blood glucose levels. Exploring the factors that lead to HbA1c improvement is beneficial for effectively controlling of HbA1c levels. METHODS: Data collected from 52 hospitals in five cities in northern China were divided into training and test sets at a ratio of 7:3. The training set was used to build models, and the test set was used to evaluate the generalizability of the models. The performance of multivariate adaptive regression splines (MARS) models and logistic regression was evaluated, namely, the accuracy, Youden's index, recall rate, G-mean and area under the ROC curve (AUC) with 95% confidence intervals (CIs). RESULTS: The prevalence of improvements in HbA1c levels was 38.35%. Doses of insulin less than 13 U, more than 3 kinds of oral medicine, exercise frequency greater than once per week and 2 h postprandial blood glucose (2hPBG) less than 10.56 mmol/L were found to improve HbA1c. The following interactions were negatively associated with improvement in HbA1c levels: patients with relative complications and 2hPBG less than 10.56 mmol/L, type 2 diabetes mellitus (T2DM) duration more than 7 years and insulin dose less than 13U. Compared to logistic regression, the MARS model performed better in the above aspects, except for accuracy. CONCLUSIONS: Given the interaction between factors affecting HbA1c improvement, medical staff should conduct comprehensive interventions to further reduce HbA1c levels in patients. In this study, the MARS model was superior to the traditional logistic regression in improving HbA1c levels. MARS had greater generalizability because it not only considered nonlinear relations in the process of model fitting but also adopted cross-validation. Nevertheless, more studies are needed to provide evidence for this result.


Assuntos
Diabetes Mellitus Tipo 2 , Glicemia , China , Hemoglobina A Glicada/análise , Humanos , Prevalência
11.
Am J Cardiol ; 140: 13-19, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33159905

RESUMO

We aimed to explore the utility of multiple biomarkers with GRACE risk stratification for non-ST-elevation myocardial infarction (NSTEMI). A total of 1,357 patients diagnosed with NSTEMI were enrolled in this study at multiple medical centers in Tianjin, China. The outcomes were 1-year all-cause death and major adverse cardiac events (MACE: all-cause death, hospital admission for unstable angina, hospital admission for heart failure, nonfatal recurrent myocardial infarction, and stroke). C-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to verify that the biomarkers improve the predictive accuracy of the GRACE score. A total of 57 participants died, while 211 participants experienced 231 MACEs during follow-up (mean: 339 days). For all-cause death, the combination of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and D-dimer improved the predictive accuracy of GRACE the most, with C-index, IDI, and NRI values of 0.88, 0.085, and 1.223, respectively. For MACE, trigeminal combination of NT-proBNP, fibrinogen, and D-dimer resulted in C-index, IDI, and NRI values of 0.80, 0.079, and 0.647, respectively. As a result, NT-proBNP, D-dimer, fibrinogen, and GRACE comprise a new scoring system for assessing 1-year clinical events. Kaplan-Meier analysis revealed a significant increase in 1-year mortality (score ≥3.85 vs <3.85, p < 0.0001) and 1-year MACE (score ≥1.72 vs <1.72, p < 0.0001) between different score groups. In conclusion, the combination of NT-proBNP and D-dimer added prognostic value to GRACE for all-cause death. Combining NT-proBNP, fibrinogen, and D-dimer increased the prognostic value of GRACE for MACE. This newly developed scoring system is strongly correlated with all-cause mortality and MACE, and can be easily utilized in clinical practice.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Peptídeo Natriurético Encefálico/sangue , Infarto do Miocárdio sem Supradesnível do Segmento ST/sangue , Fragmentos de Peptídeos/sangue , Sistema de Registros , Medição de Risco/métodos , Idoso , Biomarcadores/sangue , Causas de Morte/tendências , China/epidemiologia , Eletrocardiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Infarto do Miocárdio sem Supradesnível do Segmento ST/epidemiologia , Prognóstico , Estudos Prospectivos , Precursores de Proteínas , Curva ROC , Fatores de Risco , Taxa de Sobrevida/tendências
12.
HIV Med ; 22(3): 185-193, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33197141

RESUMO

OBJECTIVES: Despite being a key population in whom to initiate pre-exposure prophylaxis (PrEP), the awareness of and willingness to use PrEP are still unclear in Chinese young men who have sex with men (YMSM). We report factors associated with PrEP awareness and willingness in the population. METHODS: From 1 August to 31 December 2018, 495 participants aged 15-24 years were included in a cross-sectional study about awareness of and willingness to use PrEP among YMSM. Logistic regression models were used to identify factors associated with two outcomes: awareness of PrEP; and willingness to use PrEP. RESULTS: Among 495 eligible participants, 129 participants (26.1%) knew about PrEP. PrEP awareness among YMSM was associated with higher education level [adjusted odds ratio (aOR) = 1.812, 95% CI: 1.113-2.951] and previous HIV testing (aOR = 3.507, 95% CI: 1.261-9.752). YMSM with shorter local residence time (aOR = 0.317, 95% CI: 0.101-0.992) and internet-based partner-seeking (aOR = 0.171, 95% CI: 0.096-0.305) were less likely to be aware of PrEP. In those with previous knowledge of PrEP, 36 (27.9%) conveyed their willingness to use it. PrEP willingness was associated with internet-based partner-seeking (aOR = 9.593, 95% CI: 1.965-46.844). The main barriers influencing those who knew about PrEP but refused to use it were the high price of PrEP (69.9%), the need to use condoms consistently (52.7%), and concerns about side effects (39.8%) and effectiveness of prevention (22.6%). CONCLUSIONS: Chinese YMSM have low awareness of and willingness to use PrEP. Adequate PrEP promotions should be implemented, especially on the Internet and dating software.

13.
J Diabetes Res ; 2020: 3673980, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33134393

RESUMO

Background: Research investigating the effect of air pollution on diabetes incidence is mostly conducted in Europe and the United States and often produces conflicting results. The link between meteorological factors and diabetes incidence remains to be explored. We aimed to explore associations between air pollution and diabetes incidence and to estimate the nonlinear and lag effects of meteorological factors on diabetes incidence. Methods: Our study included 19,000 people aged ≥60 years from the Binhai New District without diabetes at baseline. The generalized additive model (GAM) and the distributed lag nonlinear model (DLNM) were used to explore the effect of air pollutants and meteorological factors on the incidence of diabetes. In the model combining the GAM and DLNM, the impact of each factor (delayed by 30 days) was first observed separately to select statistically significant factors, which were then incorporated into the final multivariate model. The association between air pollution and the incidence of diabetes was assessed in subgroups based on age, sex, and body mass index (BMI). Results: We found that cumulative RRs for diabetes incidence were 1.026 (1.011-1.040), 1.019 (1.012-1.026), and 1.051 (1.019-1.083) per 10 µg/m3 increase in PM2.5, PM10, and NO2, respectively, as well as 1.156 (1.058-1.264) per 1 mg/m3 increase in CO in a single-pollutant model. Increased temperature, excessive humidity or dryness, and shortened sunshine duration were positively correlated with the incidence of diabetes in single-factor models. After adjusting for temperature, humidity, and sunshine, the risk of diabetes increased by 9.2% (95% confidence interval (CI):2.1%-16.8%) per 10 µg/m3 increase in PM2.5. We also found that women, the elderly (≥75 years), and obese subjects were more susceptible to the effect of PM2.5. Conclusion: Our data suggest that PM2.5 is positively correlated with the incidence of diabetes in the elderly, and the relationship between various meteorological factors and diabetes in the elderly is nonlinear.


Assuntos
Poluentes Atmosféricos , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etiologia , Medição de Risco , Idoso , Poluição do Ar , Pressão Atmosférica , Índice de Massa Corporal , China/epidemiologia , Exposição Ambiental , Feminino , Humanos , Umidade , Incidência , Masculino , Conceitos Meteorológicos , Pessoa de Meia-Idade , Análise Multivariada , Dinâmica não Linear , Ozônio , Material Particulado , Estações do Ano , Temperatura
14.
J Glob Health ; 10(2): 020407, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110572

RESUMO

Background: Life expectancy (LE) and healthy life expectancy (HALE) are indicators measuring the national health level. GAP is the difference between them. This study systematically analyzed and projected LE, HALE, and GAP across global regions from 1995 to 2025. Methods: We obtained the data of 195 countries/regions on their LE, HALE, and influencing factors from 1995 to 2017. We compared the overall changes of LE, HALE, and GAP. Multiple linear regression analysis examined relationships among LE, HALE, GAP, and the associated factors. Using the Autoregressive Integrated Moving Average (ARIMA) model, we projected trends in LE, HALE, and GAP for 2017-2025. Results: During 1995-2017, LE, HALE, and their GAP in 195 countries/regions in the world showed overall increasing trends. Global average LE increased from 66.20 to 72.98 years, HALE from 57.59 to 63.25 years, and GAP from 8.62 to 9.72 years. LE and HALE in North America, Europe, and Australia were generally higher, while Africa had the lowest rates. Females' LE, HALE, and GAP were all higher than males', but females' growth rates of LE and HALE were lower. Different factors were included to project LE, HALE, and GAP, respectively, and prediction results showed that approximately 18% of the 195 countries/regions might achieve improved LE and HALE and lower GAP. Conclusions: LE, HALE will likely continue to increase in most of countries and regions worldwide in the future and GAP will further expand. While striving to improve LE and HALE, more attention needs be made to reduce GAP and improve quality of life.


Assuntos
Expectativa de Vida , Qualidade de Vida , África , Europa (Continente) , Feminino , Nível de Saúde , Humanos , Masculino , América do Norte
15.
J Orthop Translat ; 24: 12-22, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32518750

RESUMO

Background: Abnormal bone formation in subchondral bone resulting from uncoupled bone remodeling is considered a central feature in osteoarthritis (OA) pathogenesis. H-type vessels can couple angiogenesis and osteogenesis. We previously revealed that elevated H-type vessels in subchondral bone were correlated with OA and focal adhesion kinase (FAK) in MSCs is critical for H-type vessel formation in osteoporosis. The aim of this study was to explore the correlation between H-type vessels and MSCs in OA pathogenesis through regulation of H-type vessel formation using defactinib (an FAK inhibitor). Methods: In vivo: 3-month-old male C57BL/6J (WT) mice were randomly divided into three groups: sham controls, vehicle-treated ACLT mice, and defactinib-treated ACLT mice (25 mg/kg, intraperitoneally weekly). In vitro: we explored the role of conditioned medium (CM) of MSCs from subchondral bone of different groups on the angiogenesis of endothelial cells (ECs). Flow cytometry, Western blotting, ELISA, real time (RT)-PCR, immunostaining, CT-based microangiography, and bone micro-CT (µCT) were used to detect changes in relative cells and tissues. Results: This study demonstrated that inhibition of H-type vessels with defactinib alleviated OA by inhibiting H-type vessel-linked MSCs in subchondral bone. During OA pathogenesis, H-type vessels and MSCs formed a positive feedback loop contributing to abnormal bone formation in subchondral bone. Elevated H-type vessels provided indispensable MSCs for abnormal bone formation in subchondral bone. Flow cytometry and immunostaining results confirmed that the amount of MSCs in subchondral bone was obviously higher in vehicle-treated ACLT mice than that in sham controls and defactinib-treated ACLT mice. In vitro, p-FAK in MSCs from subchondral bone of vehicle-treated ALCT mice increased significantly relative to other groups. Further, the CM from MSCs of vehicle-treated ACLT mice enhanced angiogenesis of ECs through FAK-Grb2-MAPK-linked VEGF expression. Conclusions: Our results demonstrate that defactinib inhibits OA by suppressing the positive feedback loop between H-type vessels and MSCs in subchondral bone. The translational potential of this article: Our results provide a mechanistic rationale for the use of defactinib as an effective candidate for OA treatment.

16.
Obesity (Silver Spring) ; 28(6): 1141-1148, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32374520

RESUMO

OBJECTIVE: This study aimed to assess whether metabolically healthy obesity (MHO) increases the risk of diabetes and to explore how the occurrence of metabolic disorders affects the risk of diabetes and which factors determine metabolic health. METHODS: This study examined 49,702 older people without diabetes via the Binhai Health Screening Program in Tianjin. RESULTS: Compared with individuals with metabolic health and normal weight, the risk of diabetes was increased in older adults with MHO (hazard ratio [HR]: 1.786, 95% CI: 1.407-2.279) but was not significantly increased when metabolic health was characterized by the absence of metabolic abnormalities. The older adults who were initially affected by MHO and then converted to having an unhealthy phenotype had a higher diabetes risk than older individuals with stable and healthy normal weight (HR: 3.727, 95% CI: 2.721-5.105). Waist circumference was an independent predictor of the transition from a metabolically healthy status to an unhealthy status in all BMI categories (odds ratio: 1.059, 95% CI: 1.026-1.032). CONCLUSIONS: The MHO phenotype was associated with an increased incidence of diabetes in older adults. The presence of metabolic disorders in the group with MHO was associated with an increased diabetes risk and was predicted by the waist circumference at baseline.


Assuntos
Diabetes Mellitus/epidemiologia , Obesidade Metabolicamente Benigna/complicações , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Metabolicamente Benigna/epidemiologia , Fenótipo , Fatores de Risco , Fatores de Tempo
17.
J Cell Physiol ; 235(11): 8653-8666, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32324278

RESUMO

Osteoarthritis (OA), a disease of the entire joint, is characterized by abnormal bone remodeling and coalescent degradation of articular cartilage. We have previously found that elevated levels of H-type vessels in subchondral bone correlate with OA and that focal adhesion kinase (FAK) is critical for H-type vessel formation in osteoporosis. However, the potential role of FAK in OA remains unexplored. Here, we demonstrate that the p-FAK level was dramatically elevated in subchondral bone following anterior cruciate ligament transection (ACLT) in rats. Specific inhibition of FAK signaling with Y15 in subchondral bone resulted in the suppression of subchondral bone deterioration and this effect was mediated by H-type vessel-induced ectopic bone formation. Further, articular cartilage degeneration was also alleviated after Y15 treatment. In vitro, the p-FAK level was significantly elevated in mesenchymal stem cells (MSCs) from vehicle-treated ACLT rats as compared to that in MSCs from sham controls and Y15-treated ACLT rats. Elevated p-FAK level in MSCs promoted vascular endothelial growth factor (VEGF) expression, as demonstrated from the high VEGF level in the blood, subchondral bone, and conditioned medium (CM) of MSCs from vehicle-treated ACLT rats. The CM of MSCs from vehicle-treated ACLT rats might promote the angiogenesis of endothelial cells and the catabolic response of chondrocytes through the FAK-growth factor receptor-bound protein 2-mitogen-activated protein kinase-mediated expression of VEGF. The effect of the CM from MSCs of Y15-treated ACLT rats or that treated with a VEGF-neutralizing antibody on vessel formation and the catabolic response was lowered. Thus, the specific inhibition of FAK signaling may be a promising avenue for the prevention or early treatment of OA.


Assuntos
Cartilagem Articular/metabolismo , Quinase 1 de Adesão Focal/antagonistas & inibidores , Proteína-Tirosina Quinases de Adesão Focal/efeitos dos fármacos , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Osteoartrite/tratamento farmacológico , Alendronato/farmacologia , Animais , Ligamento Cruzado Anterior/patologia , Remodelação Óssea/efeitos dos fármacos , Remodelação Óssea/fisiologia , Osso e Ossos/patologia , Condrócitos/metabolismo , Modelos Animais de Doenças , Células Endoteliais/efeitos dos fármacos , Masculino , Osteoartrite/patologia , Ratos Sprague-Dawley
18.
J Immunotoxicol ; 17(1): 21-30, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31922435

RESUMO

Macrophage polarization has been demonstrated to exert a vital role on asthma pathogenesis. Mesenchymal stem cells (MSC) have the capacity to modulate macrophage differentiation from a pro-inflammatory M1 phenotype toward an anti-inflammatory M2 phenotype. However, the impact of MSC-macrophage interactions on asthma development and underlying mechanisms responsible for this interaction remain largely unknown. The aim of this study was to investigate the role of AhR expressed on MSC in macrophage polarization in a cockroach extract (CRE)-induced asthma mouse model. The studies here revealed that MSC polarized macrophages from a pro-inflammatory M1 phenotype toward an anti-inflammatory M2 phenotype in this model. The mRNA levels of interleukin (IL)-6, IL-1ß, and NOS2 as M1 markers were significantly decreased while those of select M2 markers such as Arg-1, FIZZ1, and YM-1 were significantly enhanced. It was also observed that aryl hydrocarbon receptor (AhR) signaling was significantly increased during asthma pathogenesis as demonstrated by enhanced mRNA expression of AhR, CYP1a1, and CYP1b1. It was also seen that the elevated AhR signaling was able to attenuate the onset of asthma. Use of an AhR antagonist (CH223191) resulted in significant inhibition of the AhR signaling and increases in M2 marker expression, but led to elevation of expression of M1 markers in the CRE-induced asthma model. Taken together, the current study showed that MSC can modulate macrophage polarization, in part, via activation of AhR signaling during CRE-induced asthma.


Assuntos
Asma/imunologia , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Macrófagos/imunologia , Células-Tronco Mesenquimais/metabolismo , Receptores de Hidrocarboneto Arílico/metabolismo , Alérgenos/administração & dosagem , Alérgenos/imunologia , Animais , Asma/tratamento farmacológico , Asma/patologia , Compostos Azo/farmacologia , Compostos Azo/uso terapêutico , Fatores de Transcrição Hélice-Alça-Hélice Básicos/antagonistas & inibidores , Comunicação Celular/efeitos dos fármacos , Comunicação Celular/imunologia , Células Cultivadas , Baratas/imunologia , Técnicas de Cocultura , Modelos Animais de Doenças , Humanos , Pulmão/imunologia , Pulmão/patologia , Ativação de Macrófagos/efeitos dos fármacos , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Camundongos , Cultura Primária de Células , Pirazóis/farmacologia , Pirazóis/uso terapêutico , Receptores de Hidrocarboneto Arílico/antagonistas & inibidores , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/imunologia
19.
Chin Med J (Engl) ; 133(1): 17-24, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31923100

RESUMO

BACKGROUND: Blood glucose control is closely related to type 2 diabetes mellitus (T2DM) prognosis. This multicenter study aimed to investigate blood glucose control among patients with insulin-treated T2DM in North China and explore the application value of combining an elastic network (EN) with a machine-learning algorithm to predict glycemic control. METHODS: Basic information, biochemical indices, and diabetes-related data were collected via questionnaire from 2787 consecutive participants recruited from 27 centers in six cities between January 2016 and December 2017. An EN regression was used to address variable collinearity. Then, three common machine learning algorithms (random forest [RF], support vector machine [SVM], and back propagation artificial neural network [BP-ANN]) were used to simulate and predict blood glucose status. Additionally, a stepwise logistic regression was performed to compare the machine learning models. RESULTS: The well-controlled blood glucose rate was 45.82% in North China. The multivariable analysis found that hypertension history, atherosclerotic cardiovascular disease history, exercise, and total cholesterol were protective factors in glycosylated hemoglobin (HbA1c) control, while central adiposity, family history, T2DM duration, complications, insulin dose, blood pressure, and hypertension were risk factors for elevated HbA1c. Before the dimensional reduction in the EN, the areas under the curve of RF, SVM, and BP were 0.73, 0.61, and 0.70, respectively, while these figures increased to 0.75, 0.72, and 0.72, respectively, after dimensional reduction. Moreover, the EN and machine learning models had higher sensitivity and accuracy than the logistic regression models (the sensitivity and accuracy of logistic were 0.52 and 0.56; RF: 0.79, 0.70; SVM: 0.84, 0.73; BP-ANN: 0.78, 0.73, respectively). CONCLUSIONS: More than half of T2DM patients in North China had poor glycemic control and were at a higher risk of developing diabetic complications. The EN and machine learning algorithms are alternative choices, in addition to the traditional logistic model, for building predictive models of blood glucose control in patients with T2DM.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobina A Glicada/metabolismo , Insulina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , China , Feminino , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Lasers Med Sci ; 35(1): 31-40, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30341668

RESUMO

This study was designed to investigate the effect of 650-nm low-level laser irradiation (LLLI) as an adjunctive treatment of experimental periodontitis. To investigate possible LLLI-mediated anti-inflammatory effects, we utilized an experimental periodontitis (EP) rat model and analyzed c-Jun, c-Fos, ICAM-1, and CCL2 gene expressions on PB leukocytes and in the gingival tissue. Total RNA was isolated from the gingivae and peripheral blood (PB) leukocytes of normal, EP, scaling, and root planing (SRP)-treated EP and LLLI + SRP-treated EP rats, and gene expressions were analyzed by real-time PCR. The productions of c-Jun, c-Fos, ICAM-1, and CCL2 in gingivae were analyzed immunohistochemically. Tartrate-resistant acid phosphatase (TRAP) staining was used to determine osteoclast activity in alveolar bone. The c-Jun and ICAM-1 messenger RNA (mRNA) levels were significantly decreased in the EP rat gingival tissue treated by SRP + LLLI than by SRP, the c-Jun, ICAM-1, and c-Fos mRNA levels on PB leukocytes reduced after LLLI treatment but did not show any significant differences in both groups. There was no significant difference in CCL2 mRNA levels on PB leukocytes and in gingivae between the SRP + LLLI and the SRP groups. The c-Fos mRNA levels in gingivae did not show significant difference in both groups. Immunohistochemistry showed that the CCL2, ICAM-1, c-Jun, and c-Fos productions were significantly reduced in rats of the SRP + LLLI group compared with the only SRP group. LLLI significantly decreased the number of osteoclasts as demonstrated by TRAP staining. The 650-nm LLLI might be a useful treatment modality for periodontitis.


Assuntos
Quimiocina CCL2/metabolismo , Molécula 1 de Adesão Intercelular/metabolismo , Terapia com Luz de Baixa Intensidade , Periodontite/metabolismo , Periodontite/radioterapia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Proteínas Proto-Oncogênicas c-jun/metabolismo , Animais , Quimiocina CCL2/genética , Regulação da Expressão Gênica , Gengiva/metabolismo , Gengiva/patologia , Molécula 1 de Adesão Intercelular/genética , Masculino , Osteoclastos/patologia , Osteoclastos/efeitos da radiação , Periodontite/genética , Periodontite/patologia , Proteínas Proto-Oncogênicas c-fos/genética , Proteínas Proto-Oncogênicas c-jun/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos Sprague-Dawley
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