Diseases Concomitant With Asthma in Middle-Aged and Elderly Subjects in Korea: A Population-Based Study

Purpose

Asthma is prevalent in many countries. Few studies have investigated the association between asthma and concomitant diseases. We retrospectively analyzed the fourth Korean National Health and Nutrition Survey database, performed in 2008 using nationwide stratified random sampling to obtain a representative cohort of the Korean population.

Methods

We evaluated the association between both self-reported ever-asthmatics and wheezers and concomitant diseases such as arthritis, hypertension, gastrointestinal (GI) ulcers, dyslipidemia, diabetes mellitus, rhinitis, depression, stroke, and obesity in subjects aged ≥40 years. A multivariate analysis was performed to identify concomitant diseases independently associated with asthma, after adjustment for age, gender, income, cigarette smoking, and other chronic diseases.

Results

Of the total of 4,445 subjects, 2,596 (58.4%) were female and the mean age was 58.3 years. Of the 4,445 subjects, 195 (4.4%) had been diagnosed with asthma at some point, and 444 (10%) were wheezers. Multivariate analysis showed that arthritis (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.26-2.42), rhinitis (OR 1.78, 95% CI 1.14-2.78), depression (OR 1.45, 95% CI 1.05-2.07), and obesity (OR 1.61, 95% CI 1.08-2.40) were significantly associated with self-reported ever-asthma, and arthritis (OR 1.50, 95% CI 1.19-1.909), hypertension (OR 1.34, 95% CI 1.07-1.67), GI ulcers (OR 1.48, 95% CI 1.05-2.08), rhinitis (OR 1.60, 95% CI 1.16-2.19), depression (OR 1.94, 95% CI 1.51-2.48), and obesity (OR 1.56, 95% CI 1.17-2.09) were significantly associated with wheezers.

Conclusions

These findings indicate that arthritis, rhinitis, depression, and obesity may be associated with both self-reported ever asthma and wheezers in the Korean population.     

446例中老年体检者血清同型半胱氨酸水平分析

目的 探讨中老年人群血同型半胱氨酸（Homocysteine,Hcy）水平的变化及其影响因素.方法 化学发光法检测446例中老年体检者血清Hcy水平,分析不同性别和年龄血清Hcy水平的差别,比较高血压、冠心病及脑卒中等心脑血管基础疾病对血清Hcy水平的影响.结果 446例体检者血清Hcy平均水平为（16.60±7.58） μmol/L,男性高于女性,80岁以上年龄组血Hcy水平最高.心脑血管基础疾病者血清Hcy水平均较正常对照组升高;冠心病及脑卒中组血清Hcy水平高于高血压组;冠心病组与脑卒中组之间血清Hcy水平未见明显差异.结论 中老年人群中因性别和年龄的不同导致血清Hcy水平有差异,高Hcy血症是心脑血管疾病的危险因素.     

Distinguishable Patterns of Connectivity in Serum Immunoglobulins from SLE Patients and Healthy Individuals

Given that normal individuals maintain significant levels of serum autoantibodies that share many characteristics with those found in association with autoimmune diseases (AID), it has been proposed that disease could result from defects in supraclonal regulation, namely deviations of normal patterns of immunoglobulin (Ig) connectivity. Using conventional methods, together with a recently developed technique to quantitatively score a variety of V-region-dependent serum IgG interactions, the authors have now compared serum Ig connectivity in a group of patients with systemic lupus erythematosus (SLE) to healthy controls. The results demonstrate the existence of V-region interactions of serum IgG and IgM in SLE patients and healthy donors, with comparable connectivity titres, diversity and average affinities (μ m range), but a wider individual variation and a tendency for higher F(ab')2 directed reactivities in the group of SLE patients. Multivariate statistics analysis of the data derived from reactivity patterns on F(ab')2 subsets, however, distinguished the two groups of donors, and demonstrated a larger dispersion and wider time-dependent variations in the patient population, as compared to healthy controls. The authors conclude that SLE is associated with circulating antibody repertoires that deviate from the patterns and levels of V-region connectivity characteristic of healthy individuals. These findings may shed light on the mechanisms of disease maintenance, and on the basis for the therapeutic effects of normal polyclonal Igs at high doses.     

Reference Ranges and Determinant Factors for Exhaled Nitric Oxide in a Healthy Korean Elderly Population

Purpose

Exhaled nitric oxide (NO) is a useful non-invasive biomarker for asthma diagnosis; however, the literature suggests that exhaled NO levels may be affected by demographic factors. The present analysis investigated determinant factors that present exhaled NO reference levels for Korean elderly adults.

Methods

For reference levels, we analyzed the baseline data of healthy adult participants in the Ansung cohort. The fraction of exhaled NO (FeNO) was measured by NIOX MINO®. The characterization of the subjects was performed through structured questionnaires, spirometry, and methacholine challenge tests. To validate the diagnostic utility of the determined reference levels, asthma patients were recruited from medical institutions for FeNO measurement.

Results

A total of 570 healthy subjects were analyzed (mean age, 59.9±12.3; male, 37.0%) for reference levels. FeNO levels significantly correlated with weight, height, body mass index, atopy, or forced expiratory volume in 1 second % predicted by simple linear regression analysis. Multiple linear regression analysis identified gender as an independent determinant for FeNO levels; subsequently, the reference values for FeNO were 18.2±10.6 ppb (5th to 95th percentile, 6.0 to 37.4 ppb) for males and 12.1±6.9 ppb (5th to 95th percentile, 2.5 to 27.0 ppb) for females. The diagnostic utility of FeNO reference levels was validated by receiver operating curve analysis (area under curve, 0.900 for males and 0.885 for females) for diagnosing asthma. The optimal cutoff values for the prediction of asthma were 30.5 ppb for males and 20.5 ppb for females.

Conclusions

The current analysis presented reference ranges and the diagnostic utility of FeNO levels for asthma in Korean elderly adults.     

绝经期后女性血尿酸参考区间的建立及与雌激素相关性研究

目的 建立绝经期后女性血清尿酸参考区间及探讨血清尿酸与雌二醇相关性.方法 收集2013年6月至8月期间于北京大学深圳医院进行健康体检的人群,其中绝经期妇女166名（年龄均＞55岁）,检测血清尿酸、雌二醇,非绝经期女性139名,检测血清尿酸,采用SPSS软件统计分析.结论 绝经期妇女血尿酸95％可信区间为（143.3～492.2 μmol/L）,高于于非绝经期女性（98.6～336.3μmol/L）,差异有显著意义（P＜0.05）,雌二醇与血尿酸呈负相关（r=-0.593,P＜0.01）.结论 各实验室应建立绝经期后女性的血清尿酸参考区间;雌二醇与尿酸呈负相关,可作为高尿酸血症的一项诊疗指标.     

广西地区健康中老年人群Lp-PLA2参考区间的建立及探讨

目的 初步建立广西地区50岁以上健康中老年人脂蛋白相关磷脂酶A2(Lipoprotein-associated phospholipase A2,Lp-PLA2)的参考区间.方法 对符合筛查标准的504例(男230例,女274例)50岁以上健康中老年人的血清进行Lp-PLA2检测,运用统计学分析性别及各年龄段(50?5...     

Serum Ferritin Is Inversely Correlated with Serum Adiponectin Level: Population-Based Cross-Sectional Study

Background: The serum concentrations of ferritin and adiponectin are associated with several metabolic disorders and have been used as predictors of insulin resistance and metabolic syndrome. But there have been no reports demonstrating a direct correlation between serum ferritin and adiponectin levels. We performed this study to evaluate the association between serum ferritin and adiponectin concentrations. Subjects and methods: We evaluated a total of 995 subjects from the Korea Rural Genomic Cohort Study in a population-based cross-sectional study. Extensive clinical and laboratory measurements, including adiponectin and ferritin concentrations, were recorded. Results: Univariate analysis revealed that the serum adiponectin level was correlated with age, sex, BMI, diastolic blood pressure, triglyceride, HDL-cholesterol, fasting blood glucose, fasting insulin, HOMA-IR, hs-CRP, and ferritin. Multivariate analysis demonstrated that the adiponectin concentration was correlated with age, BMI, fasting glucose, hs-CRP, and ferritin. The ferritin concentration was the most powerfully associated with serum adiponectin. In non-diabetic subgroups, the adiponectin level was correlated with BMI, triglyceride, HDL-cholesterol, fasting glucose, and ferritin level in multivariate analysis. In diabetic subgroups, the adiponectin level was correlated with BMI, triglyceride, hs-CRP, and ferritin level in multivariate analysis. Conclusions: The serum adiponectin concentration was correlated with conventional clinical variables, but the most powerfully associated factor was the serum ferritin level.     

Urinary Immunoglobulins in Healthy Individuals and Children with Acute Pyelonephritis

Urine samples obtained from children with acute pyelonephritis and from healthy children and adults were analysed with regard to the molecular form and specific antibody activity of urinary immunoglobulins. The urinary IgA and IgG levels were quantified in unconcentrated urine by radioimmunoassay. The children with urinary tract infection had significantly higher levels of IgG and IgA than age-matched controls but not higher than healthy adults. After tenfold concentration, the urine was fractionated on an Ultrogel AcA 22 column, and the IgA, secretory IgA, and IgG in the fractions were determined by radioimmunoassay. IgA in urine from healthy adults was predominantly represented by polymeric IgA linked to secretory component; small quantities of monomeric IgA were also present. IgG eluted in the position of the serum standard. Increased proportions of IgG and monomeric IgA were found in the infected patients. Specific antibody activity of the IgG and IgA classes to antigens of the infecting Escherichia coli strain was detected in whole and in fractionated urine from children with acute pyelonephritis. The specific antibody activity in healthy adults and children was low.     

Sex Differences in Subjective and Actigraphic Sleep Measures: A Population-Based Study of Elderly Persons

Study Objectives:

To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons.

Design:

Cross-sectional study.

Setting:

The study was embedded in the Rotterdam Study, a population-based study.

Participants:

Nine hundred fifty-six participants aged 59 to 97 years.

Interventions:

N/A.

Measurements and Results:

Participants wore an actigraph and kept a sleep diary for an average of 6 consecutive nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Unadjusted sex differences in sleep parameters were assessed with t tests. Women reported shorter total sleep time, a less favorable sleep-onset latency, lower sleep efficiency, and worse global sleep quality, as compared with men. When assessed with actigraphy, however, women were found to have longer and less-fragmented sleep than men. Sex differences in diary-reported sleep duration and other subjective sleep parameters were attenuated by adjustment for marital status, the use of sleep medication, and other covariates, but all sex differences remained significant in a multivariate-adjusted model. Sex differences in actigraphic sleep parameters were barely attenuated by multivariate adjustment, although the shorter actigraphically measured sleep duration in men was partly explained by their higher alcohol consumption. Some covariates (eg, sleep medication) had a different relationship with diary-reported or actigraphic total sleep time in men and women.

Conclusions:

If assessed by diary or interview, elderly women consistently reported shorter and poorer sleep than elderly men. In contrast, actigraphic sleep measures showed poorer sleep in men. These discrepancies are partly explained by determinants of sleep duration, such as sleep medication use and alcohol consumption.

Citation:

van den Berg JF; Miedema HME; Tulen JHM; Hofman A; Knuistingh Neven A; Tiemeier H. Sex differences in subjective and actigraphic sleep measures: a population-based study of elderly persons. SLEEP 2009;32(10):1367-1375.     

Population-Based Hematologic and Immunologic Reference Values for a Healthy Ugandan Population

To assess the validity of the reference values for hematologic and immunologic indices currently used in Africa, we evaluated blood samples from 3,311 human immunodeficiency virus (HIV)-negative Ugandans aged 1 week to 92 years. Erythrocyte, hemoglobin, and hematocrit levels and mean corpuscular volume all significantly increased with age (P < 0.001) and were independent of gender until the age of 13 years, after which the levels were higher in males than in females (P < 0.001). White blood cell, neutrophil, lymphocyte, basophil, and monocyte counts significantly declined with age until the age of 13 years (P < 0.001), with no differences by gender, while platelet counts declined with age (P < 0.001) and showed differences by gender only among adults older than age 24 years. CD4⁺- and CD8⁺-cell counts declined with age until the age of 18 years; thereafter, females had higher counts than males. The absolute values for many of these parameters differed from those reported for populations outside Africa, suggesting that it may be necessary to develop tables of reference values for hematologic and immunologic indices specific for the African population. This may be particularly important with regard to CD4⁺-cell counts among children because significant differences in absolute and percent CD4⁺-cell counts exist between the values for Western populations and the values for the population evaluated in our study. These differences could influence the decision to initiate antiretroviral therapy among children infected with HIV.     

Occurrence of Specific Phytohaemagglutinin- Reactive Immunoglobulins in the Sera of Certain Individuals

While investigating sera for possible antibodies to TL-like determinants, multiparous sera were selected that had specific cytotoxic reactivity against phytohaemagglutinin (PHA)-activated lymphocytes of certain individuals and were negative against unstimulated T or B cells from the same donor. The reactivity patterns were not correlated to any HLA specificities. However, in an indirect immunofluorescence assay with flow cytometry, these same sera had strong specific monomorphic reactivity to PHA-activated lymphocytes from all the individuals in the panel. Unstimulated cells remained negative. In contrast, other human sera lacked reactivity with PHA-stimulated lymphocytes. The addition of PHA to fresh lymphocytes followed by incubation at 4 degrees C for 30 min resulted in the same pattern of reactive and non-reactive sera. When incubated with PHA, different cell types, including 0- erythrocytes and a murine lymphoid cell line, reacted similarly with the sera. Using plates coated directly with PHA-E, L, and P in a cell-free ELISA system. PHA-specific sera reacted specifically with PHA-coated wells. The anti-PHA activity was removed by absorption with 0- erythrocytes coated with PHA without affecting the titre of the anti-HLA antibody in the same serum. These findings suggested that IgG molecules in certain sera react directly with residual PHA bound to the cell surface and not necessarily with molecules of cellular origin induced by exposure to PHA, complicating the search for antibodies specific for T-cell activation antigens.     

Neck Circumference and Incidence of Type 2 Diabetes in Chinese Elderly Individuals: A Community-Based Cohort Study

IntroductionThis study aimed to investigate whether neck circumference (NC) was associated with the incidence of type 2 diabetes in Chinese elderly individuals.MethodsA community-based cohort study was conducted on elderly inhabitants in Shanghai with a mean age of 71.0 ± 5.8 years (n = 2,646). Binary logistic regression analysis was performed to evaluate the association between NC and the prevalence of type 2 diabetes, while a Cox regression model was used to determine the association between NC and the incidence of type 2 diabetes after a follow-up of 2 years.ResultsLogistic regression analysis showed that a larger NC was significantly associated with an increased risk for type 2 diabetes in men (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.07–1.31; p = 0.001) and women (OR 1.25, 95% CI 1.13–1.38; p < 0.001). Cox regression analysis revealed that NC was independently associated with the incidence of type 2 diabetes in both men (hazard ratio [HR] 1.14, 95% CI 1.05–1.23; p = 0.002) and women (HR 1.18, 95% CI 1.10–1.27; p < 0.001).ConclusionsA larger NC was associated with a higher risk of developing type 2 diabetes in Chinese elderly individuals. However, studies with larger sample sizes and longer follow-up durations are needed to definitively determine the relationship between NC and the risk of developing type 2 diabetes.     

Immunoglobulins and Other Serum Proteins in Feces from Infants and Children

IgA in variable amounts was found in extracts of feces from all of 14 infants and children with no apparent diseases involving the gastrointestinal tract or the immune system, whereas IgG and IgM were only found in some. No age variation was evident's even one-month-old infants seemed fully able to secrete intestinal immunoglobulins. Freeze-drying of the feces facilitated the extraction, and the amounts of immunoglobulins were related to the dry weight of fecas. Most of the immunoglobulins were easily dissolved in saline. Of other serum proteins α₁ antitrypsin was constantly present; α₁ antichymotrypsin and α₂ macroglobulin were found in many. Only traces of albumin were sometimes demonstrated.     

Major Determinants of Serum Homocysteine Concentrations in a Korean Population

The objective of this study was to identify the factors that determine serum homocysteine concentrations in Korean population. In a community-based study, 871 participants completed detailed questionnaires and physical examination. We found that increased age, male sex, family history of stroke, deficiencies of serum folate and vitamin B12, and elevated serum creatinine significantly increased the risk of hyperhomocysteinemia. However, hormonal and behavioral factors (smoking, alcohol drinking, coffee consumption, and sedentary time) were not associated with the risk of hyperhomocysteinemia. The risk of hyperhomocysteinemia was steeply increased in subjects with two or more risk factors among four selected risk factors (deficiencies of serum folate and vitamin B12, elevated creatinine, and family history of stroke) compared to subjects who did not have any risk factors, especially subjects over the age of 65 yr (odds ratio [OR], 33.5; 95% confidence interval [CI], 3.71-302.0 in men; OR, 39.2; 95% CI, 7.95-193.2 in women). In conclusion, increased age, male sex, family history of stroke, deficiencies of serum folate and vitamin B12, and elevated serum creatinine are important determinants of serum homocysteine concentrations with interaction effects between these factors.     

中青年男性血清睾酮水平变化的初步探讨

了解健康中、青年男性血清性激素水平的变化.选取126例健康男性分为20～29岁、30～39岁、40～49岁共3个年龄组.分别测定血清睾酮(T)、游离睾酮(FT)、性激素结合球蛋白(SHBG)、雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH),对各组测定值进行统计学分析.结果显示:血清T、FT水平在30～39岁组...     

Polyethylene Glycol Precipitates of Serum Contain a Large Proportion of Uncomplexed Immunoglobulins and C3

High pressure liquid chromatography (HPLC) was used to fractionate redissolved polyethylene glycol (PEG) precipitates isolated from the sera of normal volunteers and from patients with IgA nephropathy (IgAN) and systemic lupus erythematosus (SLE), 2 diseases characterized by elevated levels of circulating immune complexes. The individual fractions were analyzed by solid phase ELISA for IgA, IgM, C3, IgG, and complexes of IgG-IgA and IgG-C3. Although PEG precipitates were enriched for high molecular weight IgA and IgG (presumably bound within CIC), significant amounts of IgM, unbound IgG and C3 were also present. The quantities of the PEG-precipitable proteins did not correlate with their serum concentrations. IgG-IgA and IgG-C3 complexes were found in all precipitates examined, but the levels of complexes were higher in both patient groups. These results indicate that PEG precipitates a considerable quantity of proteins not bound in immune complexes. There appeared to be greater protein precipitation from sera of the patient groups compared to the amount precipitated from the normal sera. These results suggest that an understanding of the mechanism of PEG precipitation may be important in defining abnormalities in IgAN, SLE and perhaps other diseases characterized by elevated levels of CIC. In addition, the possibility of undetected CIC in PEG precipitable material must be considered.     

Polyethylene Glycol Precipitates of Serum Contain a Large Proportion of Uncomplexed Immunoglobulins and C3

High pressure liquid chromatography (HPLC) was used to fractionate redissolved polyethylene glycol (PEG) precipitates isolated from the sera of normal volunteers and from patients with IgA nephropathy (IgAN) and systemic lupus erythematosus (SLE), 2 diseases characterized by elevated levels of circulating immune complexes. The individual fractions were analyzed by solid phase ELISA for IgA, IgM, C3, IgG, and complexes of IgG-IgA and IgG-C3. Although PEG precipitates were enriched for high molecular weight IgA and IgG (presumably bound within CIC), significant amounts of IgM, unbound IgG and C3 were also present. The quantities of the PEG-precipitable proteins did not correlate with their serum concentrations. IgG-IgA and IgG-C3 complexes were found in all precipitates examined, but the levels of complexes were higher in both patient groups. These results indicate that PEG precipitates a considerable quantity of proteins not bound in immune complexes. There appeared to be greater protein precipitation from sera of the patient groups compared to the amount precipitated from the normal sera. These results suggest that an understanding of the mechanism of PEG precipitation may be important in defining abnormalities in IgAN, SLE and perhaps other diseases characterized by elevated levels of CIC. In addition, the possibility of undetected CIC in PEG precipitable material must be considered.     

Serum Immunoglobulins,Complement Levels and Lymphocyte Subpopulations in Phenytoin-Treated Epileptic Patients

Abstract

The peripheral blood lymphocytes, serum immunoglobulins, C3 and C4 complement protein concentrations of 20 patients with idiopathic epilepsy who were receiving phenytoin were examined and compared with 30 healthy controls in order to obtain a detailed profile of the effects of the drug on the humoral and cellular immune systems. The T-lymphocyte subsets were identified using monoclonal antibodies. A significant decrease in suppressor T-cells (p<0.05) and an increase in the ratio of T-helper to T-suppressor lymphocytes (p<0.01) have been found. Furthermore, an increase in B-lymphocytes (p<0.01) and a significant rise in serum Ig M concentrations (p<0.05) have been observed. No significant changes in serum concentrations of Ig G, Ig A and complement proteins were detected.