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2.
Curr Med Res Opin ; 37(6): 917-927, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33729889

RESUMO

BACKGROUND: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. METHODS: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. RESULTS: Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts. CONCLUSIONS: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.


Assuntos
COVID-19 , Medição de Risco/métodos , COVID-19/epidemiologia , COVID-19/mortalidade , China , Hospitalização/estatística & dados numéricos , Humanos , Itália , Fatores de Risco
3.
Cell Metab ; 33(2): 258-269.e3, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33421384

RESUMO

Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19. But one key question is how to objectively identify severely ill patients who may benefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitals in Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyte ratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly, however, corticosteroid treatment in such individuals was associated with a lower risk of 60-day all-cause mortality. Conversely, in individuals with an NLR ≤ 6.11 or with type 2 diabetes, corticosteroid treatment was not associated with reduced mortality, but rather increased risks of hyperglycemia and infections. These results show that in the studied cohort corticosteroid treatment is associated with beneficial outcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptoms as defined by NLR.


Assuntos
Corticosteroides/uso terapêutico , COVID-19/tratamento farmacológico , Linfócitos/citologia , Neutrófilos/citologia , Corticosteroides/efeitos adversos , Área Sob a Curva , COVID-19/mortalidade , COVID-19/patologia , COVID-19/virologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/patologia , Humanos , Hiperglicemia/complicações , Hiperglicemia/patologia , Tempo de Internação , Modelos de Riscos Proporcionais , Curva ROC , Fatores de Risco , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Taxa de Sobrevida , Resultado do Tratamento
4.
World J Clin Cases ; 8(22): 5576-5588, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33344548

RESUMO

BACKGROUND: Dipeptidyl peptidase-4 (DPP4) is commonly targeted to achieve glycemic control and has potent anti-inflammatory and immunoregulatory effects. Recent structural analyses indicated a potential tight interaction between DPP4 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), raising a promising hypothesis that DPP4 inhibitor (DPP4i) drugs might be an optimal strategy for treating coronavirus disease 2019 (COVID-19) among patients with diabetes. However, there has been no direct clinical evidence illuminating the associations between DPP4i use and COVID-19 outcomes. AIM: To illuminate the associations between DPP4i usage and the adverse outcomes of COVID-19. METHODS: We conducted a multicenter, retrospective analysis including 2563 patients with type 2 diabetes who were hospitalized due to COVID-19 at 16 hospitals in Hubei Province, China. After excluding ineligible individuals, 142 patients who received DPP4i drugs and 1115 patients who received non-DPP4i oral anti-diabetic drugs were included in the subsequent analysis. We performed a strict propensity score matching (PSM) analysis where age, sex, comorbidities, number of oral hypoglycemic agents, heart rate, blood pressure, pulse oxygen saturation (SpO2) < 95%, CT diagnosed bilateral lung lesions, laboratory indicators, and proportion of insulin usage were matched. Finally, 111 participants treated with DPP4i drugs were successfully matched to 333 non-DPP4i users. Then, a linear logistic model and mixed-effect Cox model were applied to analyze the associations between in-hospital DPP4i use and adverse outcomes of COVID-19. RESULTS: After rigorous matching and further adjustments for imbalanced variables in the linear logistic model and Cox adjusted model, we found that there was no significant association between in-hospital DPP4i use (DPP4i group) and 28-d all-cause mortality (adjusted hazard ratio = 0.44, 95%CI: 0.09-2.11, P = 0.31). Likewise, the incidences and risks of secondary outcomes, including septic shock, acute respiratory distress syndrome, or acute organ (kidney, liver, and cardiac) injuries, were also comparable between the DPP4i and non-DPP4i groups. The performance of DPP4i agents in achieving glucose control (e.g., the median level of fasting blood glucose and random blood glucose) and inflammatory regulation was approximately equivalent in the DPP4i and non-DPP4i groups. Furthermore, we did not observe substantial side effects such as uncontrolled glycemia or acidosis due to DPP4i application relative to the use of non-DPP4i agents in the study cohort. CONCLUSION: Our findings demonstrated that DPP4i use is not significantly associated with poor outcomes of COVID-19 or other adverse effects of anti-diabetic treatment. The data support the continuation of DPP4i agents for diabetes management in the setting of COVID-19.

5.
Cell Metab ; 32(2): 176-187.e4, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32592657

RESUMO

Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after propensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use-associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and randomized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Reposicionamento de Medicamentos/métodos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Idoso , Enzima de Conversão de Angiotensina 2 , Betacoronavirus/efeitos dos fármacos , COVID-19 , Comorbidade , Infecções por Coronavirus/mortalidade , Síndrome da Liberação de Citocina/tratamento farmacológico , Quimioterapia Combinada , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pandemias , Peptidil Dipeptidase A/efeitos dos fármacos , Pneumonia Viral/mortalidade , Estudos Retrospectivos , SARS-CoV-2
6.
Hepatology ; 72(2): 389-398, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32359177

RESUMO

BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) is a new infectious disease. To reveal the hepatic injury related to this disease and its clinical significance, we conducted a multicenter retrospective cohort study that included 5,771 adult patients with COVID-19 pneumonia in Hubei Province. APPROACH AND RESULTS: We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). AST elevated first, followed by ALT, in severe patients. ALP modestly increased during hospitalization and largely remained in the normal range. The fluctuation in TBIL levels was mild in the non-severe and the severe groups. AST abnormality was associated with the highest mortality risk compared with the other indicators of liver injury during hospitalization. Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. CONCLUSION: The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID-19-associated liver injury. Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Fígado/fisiopatologia , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Adulto , Idoso , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Biomarcadores , COVID-19 , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , SARS-CoV-2
7.
Hepatology ; 71(5): 1851-1864, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32012320

RESUMO

With dramatic changes in lifestyles over the last 20 years, nonalcoholic fatty liver disease (NAFLD) has become the most prevalent liver disorder in China but has not received sufficient attention. NAFLD-related advanced liver disease and its mortality along with its overall disease burden are expected to increase substantially. There is thus an imperative need to clarify the epidemiological features of NAFLD to guide a holistic approach to management. We summarize eight epidemiological features of NAFLD in China over the past two decades using systematic review and meta-analysis methodology. Our data reveal a rapid growth in the NAFLD population, especially among younger individuals. Importantly, there is a strong ethnic difference in body mass index (BMI) and genetic risk of NAFLD compared with the US population. The etiology of advanced liver disease and its complications (e.g., hepatocellular carcinoma) has been altered because of a Westernized lifestyle and the implementation of effective vaccination strategies against viral hepatitis. Regional epidemiological patterns of NAFLD indicate that economics, environment, and lifestyle are critical factors in disease progression. The analysis also indicates that a large number of patients remain undiagnosed and untreated because of the inadequacy of diagnostic tools and the absence of effective pharmacologic therapies. Given the burden of NAFLD, future policy and research efforts need to address knowledge gaps to mitigate the risk burden.


Assuntos
Efeitos Psicossociais da Doença , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Índice de Massa Corporal , China/epidemiologia , Saúde Holística , Humanos , Estilo de Vida , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/terapia , Prevalência , Fatores de Risco
8.
Clin Nutr ; 39(1): 33-39, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30665817

RESUMO

OBJECTIVES: To assess and quantify sarcopenia as a risk for falls among community-dwelling older people and nursing home older persons. METHODS: Prospective cohort studies that evaluated the association between sarcopenia and falls in older adults were identified via a systematic literature search of Medline (via Ovid), PubMed, EMBASE, and the Cochrane CENTRAL Library from database inception until October 15, 2018, in English and Chinese. RESULTS: 10 studies (10,073 participants) were included in the meta-analysis. Among older adults, having sarcopenia was significantly associated with a higher risk of falls, compared to older adults without sarcopenia (pooled OR-odds ratio = 1.52, 95% CI-confidence interval: 1.32-1.77, I2 = 39.1%). In addition, the results of subgroup analysis indicated that male participants with sarcopenia had a higher risk of falls than mixed gender participants with sarcopenia (pooled OR = 1.72, 95% CI: 1.36-2.18 versus pooled OR = 1.41, 95% CI: 1.16-1.70). Other subgroup analyses were conducted using different study follow-up periods (>1 year versus ≤ 1 year) (pooled OR 1.63, 95% CI: 1.38-1.92 versus 1.20, 95% CI: 0.87-1.65). In addition, community-dwelling older people with sarcopenia was significantly increase risk of fall, compared with non-sarcopenia (pooled OR = 1.69, 95% CI: 1.43-2.00), whereas it was not found among nursing home residents (pooled OR = 1.12, 95% CI: 0.84-1.51). Furthermore, sarcopenia definition subgroup analysis found that older adults with sarcopenia increase the risk of falls when using EWGSOP (pooled OR = 1.43, 95% CI: 1.19-1.72), FNIH (pooled OR = 1.82, 95% CI: 1.39-2.37), AWGS (pooled OR = 7.68, 95% CI: 1.41-41.80), respectively. CONCLUSION: The present study found that sarcopenia is a risk factor for falls among community-dwelling older people, but not among nursing home older persons. Future research is needed to provide evidence for specific interventions aimed at treating sarcopenia and preventing falls among older adults dwelling in the community.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Avaliação Geriátrica/métodos , Instituição de Longa Permanência para Idosos , Vida Independente , Casas de Saúde , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Avaliação Geriátrica/estatística & dados numéricos , Humanos
10.
PeerJ ; 7: e7052, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223528

RESUMO

Dehydration-responsive element-binding factor 2 (DREB2) belongs to the C-repeat-binding factor (CBF)/DREB subfamily of proteins. In this study, a 2,245 bp PsDREB2 promoter fragment was isolated from the genome of Paeonia suffruticosa. The fragment was rich in A/T bases and contained TATA box sequences, abscisic acid (ABA)-response elements, and other cis-elements, such as MYB and CAAT box. The promoter was fused with the ß-glucuronidase (GUS) reporter gene to generate an expression vector. Arabidopsis thaliana was transformed with a flower dipping method. Gus activity in different tissues and organs of transgenic plants was determined via histochemical staining and quantified via GUS fluorescence. The activity of promoter regulatory elements in transgenic plants under drought, low-temperature, high-salt, and ABA stresses was analyzed. The results showed that the PsDREB2 gene promoter was expressed in the roots, stems, leaves, flowers, and silique pods but not in the seeds of transgenic Arabidopsis. Furthermore, the promoter was induced by drought, low temperature, high salt, and ABA. Hence, the PsDREB2 promoter is tissue- and stress-specific and can be used in the genetic engineering of novel peony cultivars in the future.

11.
Hepatology ; 70(4): 1119-1133, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31070259

RESUMO

With rapid lifestyle transitions, the increasing burden of nonalcoholic fatty liver disease (NAFLD) in China has emerged as a major public health issue. To obtain a comprehensive overview of the status of NAFLD over the past decade, we evaluated the epidemiology, risk factors, complications, and management of NAFLD in China through a systematic review and meta-analysis. Five English literature databases and three Chinese databases were searched for relevant topics from 2008 to 2018. A total of 392 studies with a population of 2,054,554 were included. National prevalence of NAFLD was 29.2%, with a heavier disease burden among the middle-aged, males, those in northwest China and Taiwan, regions with a gross domestic product per capita greater than 100,000 yuan, and Uygur and Hui ethnic groups. Currently, original studies on natural history and complications of NAFLD in China are scarce. Several studies revealed that NAFLD is positively correlated with the incidence of extrahepatic tumors, diabetes, cardiovascular disease and metabolic syndrome. The Chinese population may have a higher hereditary risk of NAFLD due to more frequent nonsynonymous mutations in genes regulating lipid metabolism. Ultrasonography is the primary imaging tool in the detection of NAFLD in China. Serum tests and risk stratification algorithms for staging NAFLD remain under investigation. Specific pharmaceutical treatments for NAFLD are still undergoing clinical trials. It is noteworthy that the Chinese are underrepresented compared with their proportion of the NAFLD population in such trials. Conclusion: China experienced an unexpected rapid increase in the burden of NAFLD over a short period. Rising awareness and urgent actions need to be taken in order to control the NAFLD pandemic in China.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Cirrose Hepática/epidemiologia , Neoplasias Hepáticas/epidemiologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Distribuição por Idade , Idoso , China/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Humanos , Incidência , Cirrose Hepática/fisiopatologia , Neoplasias Hepáticas/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo
12.
J Rehabil Med ; 51(7): 473-478, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31093683

RESUMO

OBJECTIVE: To investigate the effect of different levels of exercise on telomere length. METHODS: CINAHL, SPORTDiscus (EBSCO), OVID (Medline) and EMBASE databases were searched for eligible studies. Methodological quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity among the studies was assessed using the I-squared test. When heterogeneity among studies was high (I2 > 50%), a random-effects model was used (Review Manager version 5, Cochrane Collaboration, Copenhagen, Denmark); otherwise, a fixed-effects model was used. RESULTS: Eleven eligible studies involving 19,292 participants were included in this meta-analysis. Longer telomere length was associated with physically active individuals, with a mean difference (MD) of 0.15 (95% confidence interval; 95% CI 0.05, 0.24); I2 = 99%. Longer telomere length was significantly associated with robust exercise (MD 0.08 (95% CI 0.04, 0.12)); I2 = 99%, as was moderate exercise (MD 0.07 (95% CI 0.03, 0.11)); I2 = 100%. Subgroup analysis revealed that longer telomere length was positively associated with exercise, regardless of sex, but was not statistically significant in elderly populations. CONCLUSION: Compared with inactive individuals, telomere lengths were longer in active subjects, regardless of the intensity of exercise.


Assuntos
Terapia por Exercício/métodos , Exercício Físico/fisiologia , Atividade Motora/fisiologia , Telômero/fisiologia , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(2): 224-228, 2019 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-31106544

RESUMO

OBJECTIVE: To determine the prevalence of sarcopenia in community-dwelling elderly populations in Chengdu and its associated risk factors. METHODS: A total of 947 community dwelling residents aged ≥60 yr. in Chengdu participated in this study. Their appendicular skeletal muscle mass was measured through bioelectrical impedance analyses. Sarcopenia was defined using the diagnostic algorithm recommended by the Asia Working Group (AWGS) for Sarcopenia. Data in relation to the demographic characteristics, chronic diseases and life style of the participants were obtained through a questionnaire survey, which included the 15-item geriatric depression scale (GDS-15) and the mini nutritional assessment (MNA). RESULTS: Overall, 10.5% of the elderly participants were identified with sarcopenia: 8.4% in men and 12.5% in women. The prevalence of sarcopenia increased with age: 2.3% in the 60-64 yr., 5.6% in the 65-74 yr., 19.7% in the ≥75 yr.. Age [odds ratio (OR)=1.109, 95% confldence interval (CI):1.054-1.168], smoking (OR=3.482, 95%CI:1.356-8.938) and Malnorishment (OR=5.598, 95%CI:2.677-11.709) are significant predictors of sarcopenia after adjustment for potential confounders. CONCLUSION: Approximately 10% community-dwelling elderly in Chengdu have sarcopenis. Age, smoking, malnutrition are risk factors of sarcopenia.


Assuntos
Sarcopenia/epidemiologia , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
14.
World J Gastroenterol ; 25(11): 1307-1326, 2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30918425

RESUMO

With the increasing number of individuals with diabetes and obesity, nonalcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent, affecting one-quarter of adults worldwide. The spectrum of NAFLD ranges from simple steatosis or nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH). NAFLD, especially NASH, may progress to fibrosis, leading to cirrhosis and hepatocellular carcinoma. NAFLD can impose a severe economic burden, and patients with NAFLD-related terminal or deteriorative liver diseases have become one of the main groups receiving liver transplantation. The increasing prevalence of NAFLD and the severe outcomes of NASH make it necessary to use effective methods to identify NAFLD. Although recognized as the gold standard, biopsy is limited by its sampling bias, poor acceptability, and severe complications, such as mortality, bleeding, and pain. Therefore, noninvasive methods are urgently needed to avoid biopsy for diagnosing NAFLD. This review discusses the current noninvasive methods for assessing NAFLD, including steatosis, NASH, and NAFLD-related fibrosis, and explores the advantages and disadvantages of measurement tools. In addition, we analyze potential noninvasive biomarkers for tracking disease processes and monitoring treatment effects, and explore effective algorithms consisting of imaging and nonimaging biomarkers for diagnosing advanced fibrosis and reducing unnecessary biopsies in clinical practice.


Assuntos
Carcinoma Hepatocelular/prevenção & controle , Medicina Baseada em Evidências/métodos , Cirrose Hepática/prevenção & controle , Neoplasias Hepáticas/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Algoritmos , Biomarcadores/análise , Biópsia/efeitos adversos , Carcinoma Hepatocelular/patologia , Progressão da Doença , Técnicas de Imagem por Elasticidade/métodos , Estudos de Viabilidade , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Cirrose Hepática/patologia , Testes de Função Hepática/métodos , Neoplasias Hepáticas/patologia , Imageamento por Ressonância Magnética , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/terapia , Prevalência , Resultado do Tratamento
15.
Clin Interv Aging ; 13: 1605-1611, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30233157

RESUMO

Purpose: The aim of this study was to assess the prevalence of sarcopenia and depressive symptoms and estimate the association between them in elderly Chinese community-dwelling individuals. Patients and methods: A total of 948 elderly Chinese community-dwelling individuals were recruited through leaflets and posters from three communities in Chengdu, and 865 participants were analyzed in this cross-sectional study. Muscle mass was measured using the bioimpedance analysis, handgrip strength was measured with a handheld dynamometer, and physical performance was assessed via usual gait speed on a 6 m course. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS). Depressive symptoms were assessed using the Chinese version of 15-item Geriatric Depression Scale (GDS-15) with a score of ≥5 indicative of the presence of depressive symptoms. Results: A total of 865 participants were included in the analysis. The participants had a mean age of 68.68±6.46 years. Sixty-one (7.1%) participants and 71 (8.2%) participants were identified as having sarcopenia and depressive symptoms, respectively. After adjusting for age, sex, and other potential confounders, sarcopenia was found to be significantly associated with depressive symptoms (odds ratio [OR]: 2.23, 95% CI 1.06-4.92). Conclusion: The prevalence rates of sarcopenia and depressive symptoms were 7.1 and 8.2%, respectively, in elderly Chinese community-dwelling individuals, and sarcopenia was significantly associated with depressive symptoms.


Assuntos
Depressão/epidemiologia , Sarcopenia/epidemiologia , Idoso , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Força da Mão , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Sarcopenia/fisiopatologia , Teste de Caminhada
16.
Sleep Med ; 48: 107-112, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29883927

RESUMO

OBJECTIVE: We aimed to provide a more precise estimate of the relationship between telomere length and obstructive sleep apnea (OSA) by systematically reviewing evidence. METHOD: We conducted a systematic electronic search in the databases of the PUBMED, PsycINFO, OVID (Medline), EMBASE and other resources (such as Google Scholar). The methodological quality of the articles was assessed according to the Newcastle Ottawa Scale. Heterogeneity was assessed using the chi-square test for Cochrane's Q statistic and I-squared. When heterogeneity was found to be reasonably high between studies, the random-effects model with the mean difference (95% confidence interval [CI]) was conducted using RevMan 5 software by using the inverse variance method (P < 0.05; chi-square test). By contrast, the fixed-effects model was carried out. RESULTS: Eight eligible studies involving 2639 participants were included in our meta-analysis. Shortened telomere length was significantly associated with OSA with mean difference of -0.03 (95% CI: -0.06, -0.00; P = 0.003 with I-square of 85%). The results of subgroup analysis preformed by age and sample number suggested that shorter telomere length was significantly associated with OSA, with mean difference of -0.07 (95% CI: -0.07, -0.01; P = 0.005) for adult group and -0.04 (95% CI: -0.02, -0.06; P = 0.005) for large-sample studies. CONCLUSION: Compared to healthy people, individuals with OSA have shorter telomere lengths which implicates early intervention and timely treatment for preventing future adverse outcomes.


Assuntos
Apneia Obstrutiva do Sono/genética , Encurtamento do Telômero/fisiologia , Humanos
17.
Aging Clin Exp Res ; 30(12): 1459-1464, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29777476

RESUMO

AIM: Procalcitonin (PCT) has predictive value for patients with infectious diseases, but has not been studied in frailty. The purpose of this study was to compare PCT to two other inflammatory biomarkers [interleukin-6 (IL-6)] and C-reactive protein (CRP) in their association with frailty among older hospitalized patients. METHODS: Retrospective study of inpatients (June-December, 2016), who had all three biomarkers measured within 24 h of admission. Frailty was defined according to the Chinese version of a validated frailty scale. Due to the association of biomarkers with infection, we divided patients into "non-infected" (no pneumonia or other infections) and "pneumonia" (using standard criteria) groups. RESULTS: Of 435 patients (mean age 81.6 ± 8.6 years), 181 (41.6%) were designated the non-infected group and 254 (58.4%) the pneumonia group. Prevalence of frailty in the non-infected group was 32.0% (58/181) and frailty (univariate analysis) was associated with higher PCT and IL-6 levels but not CRP. Prevalence of frailty in the pneumonia group was 40.2% (102/254) and frailty was associated with all three biomarkers. In multivariable analysis adjusting for age, gender, smoking, alcohol use, hemoglobin, albumin, neutrophils and creatinine, PCT (not IL-6 and CRP) was associated with frailty in the non-infected group (OR = 5.244; 95% CI, 1.622-16.947; P = 0.006) and none of the biomarkers were associated with frailty in the pneumonia group. CONCLUSIONS: Although the study is limited due to the retrospective methods, PCT but not IL-6 or CRP, was associated with frailty among older inpatients without infection. None of these biomarkers were associated with frailty among patients with pneumonia.


Assuntos
Proteína C-Reativa/análise , Fragilidade/sangue , Interleucina-6/sangue , Pró-Calcitonina/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Fragilidade/diagnóstico , Humanos , Masculino , Pneumonia/sangue , Valor Preditivo dos Testes , Estudos Retrospectivos
18.
Exp Gerontol ; 106: 16-20, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29518479

RESUMO

BACKGROUND: Several studies have examined the association between telomere length and frailty, but results from these studies are contradictory. Therefore, we conducted a systematic review and meta-analysis to examine the association between telomere length and frailty. METHODS: We searched the literature in Ovid (MEDLINE), Embase, PubMed, Web of Knowledge and Cochrane databases in July 2017 for studies evaluating the association of telomere length and the risk of frailty. RESULTS: A total of 5 studies (3268 participants) were eligible in our study. The prevalence of frailty ranged from 5.4% to 51.1%. The pooled mean difference of telomere length for the non-frail versus frail was 0.06 (95% CI: -0.01, 0.13), suggesting that no significant association was found between telomere length and frailty. In addition, the subgroup analysis indicated that telomere length was not significantly associated with the risk of frailty in all gender groups. Similar results were also found when frailty was defined by the Fried criteria (mean difference = 0.07, 95% CI: -0.03, 0.16) and frailty index (mean difference = -0.02, 95% CI: -0.05, 0.01), but not by the frailty scale (mean difference = 0.18, 95% CI: 0.04, 0.32). CONCLUSION: Telomere length is not associated with the risk of frailty. Well-designed prospective studies are needed to evaluate further whether telomere length is a meaningful biological marker for frailty.


Assuntos
Envelhecimento/fisiologia , Fragilidade/genética , Encurtamento do Telômero , Humanos , Fatores de Risco , Homeostase do Telômero
19.
BMC Plant Biol ; 17(1): 262, 2017 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-29273002

RESUMO

BACKGROUND: The artificial enlargement of the planting area and ecological amplitude of ornamentals for horticultural and landscape applications are significant. Herbaceous peony (Paeonia lactiflora Pall.) is a world-famous ornamental with attractive and fragrant flowers and is mainly planted in temperate and cool areas. Comparatively higher winter temperatures in the subtropical and tropical Northern Hemisphere result in a deficit of chilling accumulation for bud dormancy release, which severely hinders "The southward plantation of herbaceous peony". Studies on the dormancy, chilling requirement (CR) and relevant molecular mechanisms of peony are needed to enhance our ability to extend the range of this valuable horticultural species. RESULTS: Based on natural and artificial chilling experiments, and chilling hour (CH) and chilling unit (CU) evaluation systems, the lowest CR of 'Hang Baishao' was between 504.00 and 672.00 CHs and the optimal CR was 672.00 CHs and 856.08 CUs for achieving strong sprouting, growth and flowering performance. Transcriptome sequencing and gene identification by RNA-Seq were performed on 'Hang Baishao' buds during the dormancy and sprouting periods. Six gene libraries were constructed, and 66 temperature- and photoperiod-associated unigenes were identified as the potential candidate genes that may regulate or possibly determine CR characteristics. The difference in the expression patterns of SUPPRESSPOR OF OVEREXPRESSION OF CONSTANS1 (SOC1) between the winters of 2012-2013 and 2015-2016, and the difference of CR fulfillment periods also between these two winters represented the interesting congruent relationships. This correlation was also observed for WRKY DNA-BINDING PROTEIN 33 (WRKY 33). CONCLUSIONS: Combined with the results acquired from all of experiments, 'Hang Baishao' was confirmed to be a superb peony resource that have significantly low CR characteristics. The two genes of SOC1 and WRKY33 are likely involved in determining the CR amount and fulfillment period of 'Hang Baishao'. HEAT SHOCK PROTEIN, OSMOTIN and TIMING OF CAB EXPRESSION 1 also deserve attention for the CR research. This study could contribute to the knowledge of the deep factors and mechanisms that regulate CR characteristics, and may be beneficial for breeding new germplasms that have low CRs for landscape or horticulture applications in subtropical regions.


Assuntos
Temperatura Baixa , Flores/crescimento & desenvolvimento , Flores/genética , Paeonia/fisiologia , Transcriptoma , Paeonia/genética
20.
BMC Geriatr ; 17(1): 188, 2017 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-28826406

RESUMO

BACKGROUND: Gastric cancer is a major health problem, and frailty and sarcopenia will affect the postoperative outcomes in older people. However, there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery. METHODS: We searched Embase, Medline through the Ovid interface and PubMed websites to identify potential studies. All the search strategies were run on August 24, 2016. We searched the Google website for unpublished studies on June 1, 2017. The data related to the endpoints of gastrectomy surgery were extracted. Odds ratios (ORs) and their 95% confidence intervals (CIs) were pooled to estimate the association between sarcopenia and adverse postoperative outcomes by using Stata version 11.0. PRISMA guidelines for systematic reviews were followed. RESULTS: After screening 500 records, we identified eight studies, including three prospective cohort studies and five retrospective cohort studies. Only one study described frailty, and the remaining seven studies described sarcopenia. Frailty was statistically significant for predicting hospital mortality (OR 3.96; 95% CI: 1.12-14.09, P = 0.03). Sarcopenia was also associated with postoperative outcomes (pooled OR 3.12; 95% CI: 2.23-4.37). No significant heterogeneity was observed across these pooled studies (Chi2 = 3.10, I2 = 0%, P = 0.685). CONCLUSION: Sarcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes. Well-designed prospective cohort studies focusing on frailty and quality of life with a sufficient sample are needed.


Assuntos
Fragilidade/complicações , Gastrectomia , Sarcopenia/complicações , Neoplasias Gástricas/cirurgia , Idoso , Mortalidade Hospitalar , Humanos , Neoplasias Gástricas/complicações , Resultado do Tratamento
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