内源分泌型晚期糖化终末产物受体与2型糖尿病颈动脉内膜中层厚度相关

The carotid initima-media thickness(CIMT)in 78 cases of type 2 diabetic patients was measured.The level of plasma endogenous secretion receptor for advanced glycation end-products(esRAGE)in patients with normal CIMT was higher than those with chickened CIMT[(0.257 3±0.165 6 vs 0.155 4±0.0701)μg/L,P<0.01].esRAGE was negatively associated with CIMT(r=-0.247,P<0.05).Logistic regression analysis showed that CIMT was negatively associated with esRAGE and hish density lipoprotein cholesterol,but was positively associated with age.     

内源分泌型晚期糖化终末产物受体与2型糖尿病颈动脉内膜中层厚度相关

The carotid initima-media thickness(CIMT)in 78 cases of type 2 diabetic patients was measured.The level of plasma endogenous secretion receptor for advanced glycation end-products(esRAGE)in patients with normal CIMT was higher than those with chickened CIMT[(0.257 3±0.165 6 vs 0.155 4±0.0701)μg/L,P<0.01].esRAGE was negatively associated with CIMT(r=-0.247,P<0.05).Logistic regression analysis showed that CIMT was negatively associated with esRAGE and hish density lipoprotein cholesterol,but was positively associated with age.     

Roles of adipocyte derived hormone adiponectin and resistin in insulin resistance of type 2 diabetes

AIM: To detect plasma levels of new adipocyte derived hormone adiponectin and resistin in type 2 diabetes patients and to explore their potential roles in insulin resistance in type 2 diabetes. METHODS: According to the body mass index (BMI), 60 type 2 diabetes patients were divided into two groups, one group was non-obese diabetes patients with BMI < 25Kg/M2 (30 cases) and the other group was obese diabetes patients with BMI>25Kg/M2(30 cases). There were 28 healthy persons in the control group. ELISA technique was employed to determine the plasma adiponectin and resistin concentrations. The fasting blood glucose, insulin and blood lipid were detected respectively by eiectrocheminescence immunoassay and immunoturbidimetric assay. Insulin resistance index and insulin sensitive index were calculated by the homeosta-sis model assessment (HOMO). RESULTS: The levels of plasma adiponectin were decreased significantly in diabetes group compared to that in control group (non-obese: 8.58±0.86, obese: 6.22±1.34 vs 10.53±1.47 P<0.05); moreover, adiponectin concentration in obese diabetes group was significantly decreased compared to that in non-obese diabetes group (6.22±1.34 vs 8.58±0.86, P<0.05). The levels of plasma resistin were increased significantly in diabetes group compared to that in control group (obese: 18.64±4.65, non-obese: 24.05±9.07 vs 14.16±5.25,P<0.05, P<0.05); furthermore, the levels of resistin in obese diabetes group were increased significantly compared to that in non-obese diabetes group (P<0.05). Plasma adiponectin was correlated negatively with BMI, blood glucose, insulin resistance index and triglyceride (respectively, r=-0.55, P<0.01; r=-0.51, P<0.05; r=-0.52, P<0.05; r=-0.39, P<0.05), while it was positively correlated with insulin sensitive index (r=0.45, P<0.05). Conversely, plasma resistin correlated positively with BMI, blood glucose, triglyceride and insulin resistance index (respectively, r=0.40, P<0.05; r=0.52, P<0.05; r=0.46, P<0.01; r=0.27, P<0.05), and negatively correlated with insulin sensitive index (r=-0.32, P<0.05). CONCLUSION: Plasma adiponectin and resistin are associated with the disorder of metabolism of glucose and lipid in diabetes. The relationship between these hormone and insulin sensitivity suggests that they may take part in the development of insulin resistance of type 2 diabetes.     

Circulating DNA level is negatively associated with the long-term survival of hepatocellular carcinoma patients

AIM: To quantify the circulating DNA in plasma from patients with hepatocellular carcinoma (HCC) and to evaluate its prognostic value. METHODS: Blood samples were collected from 79 patients with HCC before operation, 20 patients with liver cirrhosis, and 20 healthy volunteers. Circulating DNA was extracted from plasma and quantified. The association between circulating DNA level and prognosis of HCC patients was evaluated. RESULTS: Compared with the healthy volunteers (17.6±9.5 ng/mL), a significant higher circulating DNA level was found in the patients with HCC (47.1±43.7 ng/ mL, P = 0.000) or with liver cirrhosis (30.0±13.3 ng/ mL, P - 0.002). The circulating DNA level was closely associated with tumor size (P = 0.008) and TNM stage (P = 0.040), negatively associated with the 3-year disease-free survival (DFS) (P - 0.017) and overall survival (OS) (P = 0.001). CONCLUSION: Large or invasive tumor may release more circulating DNA, and higher level of circulating DNA may be associated with poor prognosis of HCC patients.     

Changes of microRNA-1 and microRNA-21 in human atrial fibrillation

Objectives To investigate changes of microRNA- 1(miR-1) and microRNA-21(miR-21) expressions in human atrial fibrillation(AF).Methods Right atrial appendages were obtained from 12 rheumatic valvular heart disease patients with sinus rhythm(SR)and 14 patients with chronic AF.Quantitative real time polymerase chain reaction(qRT-PCR) was applied to assess expressions of miR-1 and miR- 21.Immunohistochemistry was used to evaluate Kir2.1 expression and masson staining was used to estimate collagen deposition.Results Expressions of miR-1 was decreased (relative expression:0.68±0.09 vs.1.76±0.15,PmiR-21 was increased(relative expression:2.23±0.31 vs.0.94±0.24 vs. 0.043±0.005 vs.8.3±0.01;PmiR-l was negatively correlated to that of left atrium diameters(r=-0.47,P=0.02).Expression of miR-21 was positively correlated to collagen content (r=0.45,P<0.01).Conclusions Expression of miR-1 was down-regulated in AF patients,which may be associated with the increase in Kir2.1.miR-21 level was significantly up-regulated, which may contribute to the increase in collagen content in the atrium.     

系统性红斑狼疮患者循环annexin Ⅱ水平的变化及临床意义

目的 探讨系统性红斑狼疮(SLE)患者血自细胞annexinⅡ的表达水平及其在SLE中的临床意义.方法 采用流式细胞术检测SLE患者35例,慢性肾炎患者10例,糖尿病肾病(DN)患者10例,健康对照组20名血白细胞annexinⅡ的表达水平,并分析其与临床指标间的相关性.采用t检验、方差分析及直线相关性分析进行统计学分析.结果 SLE、DN组患者血白细胞annexin Ⅱ水平[(7.1±2.9)%,(8.0+3.7)%]均显著低于健康对照组[(10.6±1.6)%](P<0.01,P<0.05);有活动性[(SLE疾病活动指数(SLEDAI)评分≥9分]的SLE患者annexinⅡ水平[(5.6±2.4)%]显著低于非活动性(SLEDAI评分<9分)的SLE患者[(7.8±2.8)%](P<0.05);SLE患者annexinⅡ水平与尿蛋白/肌酐呈负相关(r=-0.382,P<0.05),与血白蛋白呈正相关(r=0.439,P<0.01),与SLEDAI呈负相关(r=-0.417,P<0.05),与D-二聚体呈负相关(r=-0.336,P<0.05).结论 SLE患者血白细胞annexin Ⅱ表达水平降低,参与了SLE患者高凝和继发性纤溶亢进状态的发生发展的病理生理过程,可作为一种早期反映SLE血栓前状态的良好指标,对判断SLE的活动性及疗效有一定的帮助.

Abstract：

Objective To compare the level of Annexin Ⅱ in patients with systemic lupus erythematosus(SLE),diabetic nephropathy(DN),chronic glomerulonephritis and normal controls,and explorle the significance of the annexin Ⅱ in SLE.Methods Thirty-five cases of patients with SLE,ten cases of patients with DN,ten cases of patients with chronic glomerulonephritis were enrolled in this study,twenty cases of healthy controls were also enrolled.Circulating annexin Ⅱ in white blood cells was detected bv flow cytometry.Student's t test,variance analysis and Lineat correlation analysis were used for statistial analysis.Resuits Compared with healthy controls,the level of annexin Ⅱ in white blood cells in SLE patients (7.1±2.9)%and DN patients(8.0±3.7)%were significantly lower than that of the healthy controls(P<0.01,p<0.05).In the SLE group,the level of annexin Ⅱ of patients who had more active disease(SLEDAI≥9)decreased more thall those with less active disease(SLEDAI<9),(P<0.05).A positive correlation was found between annexin Ⅱ and serum albumin level(r:0.439,P<0.01),but negative correlation was found between annexin and urine protein/urine creatinine(r=-0.382,P<0.05),SLEDAI(r=-0.417,P<0.05),D-dimer(r=-0.336.p＜0.05) levels.Conclusion The level of annexin Ⅱ is decreased in patients with SLE,so it can renectthe abnormality of coagulation and fibrinolytic systems,and it may be used as a good indicator for prothrombotic status in SLE patients.It can be helpful to evaluatethe activity of the disease and the therapeutic efficacy.     

胰岛素治疗对血清中胰岛素样生长因子I水平的影响

探讨胰岛素治疗对2型糖尿病患者血清中胰岛素样生长因子I(IGF-I)水平的影响以及两者之间的关系.结果 发现2型糖尿病患者外源性胰岛素治疗可增加血清中的IGF-I水平[(126.70±51.91对90.04±43.68)μg/L,P<0.01],并且IGF-I水平与胰岛素水平呈正相关(r=0.298,P<0.05).

Abstract：

To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).     

Free triiodothyronine in relation to coronary severity at different ages: Gensini score assessment in 4206 euthyroid patients

Objective To study whether free triiodothyronine (FT3) within normal range has effects on the presence and severity of coronary artery disease (CAD) in different gender and age groups. Methods A total of 4206 euthyroid patients were consecutively enrolled and divided into CAD group (n = 3306) and non-CAD group (n = 900). All patients underwent coronary angiography (CAG). Gensini score (GS) was used to determine the severity of coronary artery stenosis. Severe CAD was defined as GS > 32 and mild CAD was defined as GS ≤ 32. Logistic regression analysis and linear regression analysis were conducted to determine the association of FT3 with CAD in patients with different gender and ages. Results Concentration of FT3 was lower in patients with CAD than that in angiography-normal control group (P ? 0.05). In addition, concentration of FT3 was lower in severe CAD than that in mild CAD. After adjusting for traditional cardiovascular risk factors and potential confounders, FT3 was negatively correlated with the presence of CAD, but not in the old patients (? 65 years old). Multivariable linear regression analysis showed that FT3 was negatively associated with GS in male and young patients with stable CAD, but not in the old patients. Conclusions Low FT3 within normal range was negatively associated with the presence and severity of CAD in young patients, but not in the old ones. Further studies are needed to confirm our findings.     

Upregulated voltage-gated potassium channel Kv1.3 on CD4+CD28null T lymphocytes from patients with acute coronary syndrome

Objective The purpose of our study is to observe the voltage-gated potassium channel Kv1.3 expressed on CD4+ CD28null T cells from the peripheral blood of acute coronary syndrome (ACS) patients by the patch clamp technique. Methods Kvl.3 potassium channels expression from 17 patients with ACS and 11 healthy age-match controls was detected in single cell(CD4+CD28null T cells and CD4+CD28+T cells) by fluorescence microscopy and patch clamp. Results The percentage of CD4+CD28null T cells was higher in the ACS patients [(6.97±2.05)%] than that in the controls [(1.38±0.84)%, P<0.05]. The concentration of hsCRP was directly correlated with the number of the CD4+CD28null T cells in the ACS patients (r=0.52, P<0.05). The conductance (6.89±1.17ns vs 3.36±0.66ns), dens (1.95±0.80 μm2 vs 1.13±0.57 μm2) and numbers (574.5±97.6 n/cell vs. 280.3±55.3 n/cell) of the Kvl.3 channels on the CD4+CD28null T cells were significantly higher than those on the CD4+CD28+T cells (all P<0.0l) in ACS patients, but were similar on CD4+CD28+T between ACS patients and controls. Conclusion The CD4+CD28null T cells and the numbers of Kv1.3 channels on the CD4+CD28null T cells from patients with ACS are significantly upregulated and might contribute to the pathogenesis of ACS.     

Relationship of plasma level of Lp-PLA2 and pulse wave velocity and carotid intima-media thickness

Background Increased plasma level of Lp-PLA2 is a potential risk factor for atherosclerosis. Nevertheless,whether Lp-PLA2 has effects on both vascular function and structure changes is still unclear. Method One hundred and eighty-six outpatient subjects without overt cardiovascular disease were enrolled and anthropometric data, plasma level of Lp-PLA2 and other related laboratory parameters were collected. Measurements of pulse wave velocity(PWV) and carotid intima-media thickness(CIMT) were performed by an experienced investigator. According to plasma level of Lp-PLA2, all the subjects were divided into two groups as follows : 200 ng / m L(n = 96) and ≥200 ng / m L(n = 90). Result Body mass index, smoking, diabetic mellitus,systolic blood pressure, and LDL-C level were positive correlation with plasma level of Lp-PLA2, while use of statins was negatively correlative. Both PWV and CIMT positively correlated with smoking, systolic blood pressure, LDL-C level and plasma level of Lp-PLA2, while negatively correlated with HDL-C level and usage of statins. CIMT in the group with plasma level of Lp-PLA2 200 ng / m L(0.9 ± 0.2 mm, n = 96) was significantly less than that with plasma level of Lp-PLA2≥200 ng / m L(1.2 ± 0.4 mm, n = 90, P = 0.32), and similar finding was also observed in PWV(9.1 ± 0.5 m / s vs 12.7 ± 0.4 m / s, P = 0.38). Conclusion Our present study shows that in subjects without overt CVD, increased plasma level of Lp-PLA2 is associated with vascular function(PWV) and structure(CIMT) deterioration.     

内源分泌型晚期糖基化终末产物受体与糖尿病周围神经病变的相关性

目的 探讨2型糖尿病患者周围神经病变(DPN)与内源分泌型晚期糖基化终末产物受体(esRAGE)的关系.方法 收集2008年6月至2009年3月于福建医科大学第二医院内分泌科住院的2型糖尿病患者61例及门诊体检的健康志愿者24名,根据有无合并糖尿病周围神经病变将糖尿病患者分2组,DPN组62例,无DPN组19例.采用酶联免疫吸附法(ELISA)测定血浆esRAGE水平.应用肌电诱发电位仪进行神经功能检查.测定受试者血压、体重指数、空腹血糖、糖化血红蛋白(HbA1c)、血脂.采用student t检验和非参数Mann-Whitney U检验分析两组问数据,利用Logistic回归分析糖尿病周围神经病变的相关因素.结果 正常对照组和2型糖尿病组患者血浆esRAGE水平无明显差别[(0.28±0.13)μg/L和(0.25±0.15)μg/L,P＞0.05],但在2型糖尿病患者中合并DPN组和无合并DPN组之间血浆esRAGE水平差别有显著性意义[(0.21±0.14)μg/L和(0.33±0.13)μg/L,P＜0.01],两组之间的年龄和糖化血红蛋白(HbA1c)也存在差别,Logistic回归分析提示年龄、HbA1c、血浆esRAGE水平与糖尿病周围神经病变相关,esRAGE是糖尿病周围神经病变保护因素(OR=0.001,P＜0.05).结论 2型糖尿病患者血浆esRAGE水平和正常人无明显差别.esRAGE是2型糖尿病周围神经病变的保护因素,而年龄和HbAlc是其危险因素.     

福建地区2型糖尿病患者脂联素基因启动子区多态性与颈动脉内膜中层厚度有关

目的 探讨脂联素基因启动子区-11377位点单核苷酸多态性与2型糖尿病患者颈动脉内膜中层厚度(CIMT)之间的关系.方法 采用PCR-限制性片段长度多态性(RFLP)技术在504例2型糖尿病患者(CIMT正常组254例,CIMT增厚组250例)中检测脂联素基因-11377位点多态性,同时检测血脂、空腹血糖、空腹胰岛素及血清脂联素水平.结果 脂联素基因-11377C→G基因型和等位基因频率在CIMT正常组与CIMT增厚组的分布有显著性差别(P相似文献   

Elevated serum retinol-binding protein 4 concentrations are associated with chronic kidney disease but not with the higher carotid intima-media thickness in type 2 diabetic subjects

To examine the association of serum retinol-binding protein 4 (RBP4) concentrations with carotid intima-media thickness (CIMT) in type 2 diabetic subjects with chronic kidney disease (CKD). A total of 239 type 2 diabetic patients (64 ± 13 years, 154 males) were divided into two groups: one with CKD, defined as estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m(2) (n = 86), and one without (n = 153). We recorded clinical and biochemical data as well as CIMT. The patients with CKD were older, had had diabetes mellitus longer, and had higher incidence of hypertension, dyslipidemia and microalbuminuria than those without. They also had higher serum concentrations of RBP4 (44.8 ± 6.4 vs 39.5 ± 4.9 μg/mL, p < 0.001), higher mean CIMT (0.75 ± 0.16 vs 0.69 ± 0.14 mm, p = 0.0070), and higher incidence of carotid plaques (27.9 vs 11.8 %, p = 0.002). The RBP4 were negatively correlated with eGFR (r = -0.514, p < 0.001). However, the RBP4 were not correlated with mean CIMT (r = 0.065, p = 0.318). Moreover, when dividing the patients into two groups by the mean CIMT, those with mean CIMT above 0.71 mm did not have different RBP4 concentrations compared with those below (41.5 ± 5.7 vs 41.3 ± 6.3 μg/mL, p = 0.856). In conclusion, we observed an elevation of serum RBP4 concentrations and CIMT levels in type 2 diabetic subjects with CKD. However, the elevated RBP4 were not associated with the higher CIMT among these patients.     

2型糖尿病高血压患者血浆内源性分泌型晚期糖基化终末产物受体和氧化应激的关系

探讨2型糖尿病高血压患者血浆内源性分泌型晚期糖基化终末产物受体(esRAGE)与氧化应激的关系.结果 显示2型糖尿病患者esRAGE与体重指数(BMI,r=-0.33)、舒张压(r=-0.38)、氧化应激均显著相关(均P相似文献   

Carotid intima media thickness in patients with sporadic idiopathic hypoparathyroidism: a pilot study

Alteration in calcium and phosphate levels predisposes to increase in carotid intima media thickness (CIMT) as in chronic kidney disease. However, information on CIMT changes is lacking in patients with sporadic idiopathic hypoparathyroidism (SIH) which is also a disorder of altered calcium and phosphate levels and hence, we planned this case-control study. In this study, we compared CIMT in 18 consecutive patients of SIH, with age and sex matched healthy subjects. CIMT was measured by B-mode ultrasonography by a single trained operator blinded to subject's details. CIMT values in patients with SIH were significantly higher than healthy subjects (0.63 ± 0.06 mm vs 0.47 ± 0.07 mm, p<0.001). Despite, healthy subjects had higher body mass index, higher low density lipoprotein cholesterol and fasting plasma glucose, CIMT was higher in subjects with SIH. Neither clinical nor biochemical parameters correlated with CIMT in patients with SIH except age. In conclusion, sporadic idiopathic hypoparathyroidism is associated with increased CIMT but biochemical parameters do not correlate with CIMT.     

冠心病患者颈动脉内膜中层厚度及颈动脉斑块与SYNTAX评分的相关性研究

目的探讨冠心病患者颈动脉内膜中层厚度(CIMT)及颈动脉斑块与冠状动脉SYNTAX评分的关系。方法选择行冠状动脉造影的患者256例,根据冠状动脉造影结果分组:51例冠状动脉狭窄50%为对照组,余205例为冠心病组。冠心病组又根据SYNTAX评分结果分为低分组(1~22分)70例、中分组(23~32)94例、高分组(32分)41例。所有患者均采用超声检测双侧CIMT及颈动脉斑块情况。结果与对照组比较,冠心病组患者CIMT及斑块发生率明显高于对照组(P0.05)。与低分组比较,中分组和高分组CIMT及斑块发生率明显升高(P0.05)。Spearman线性回归分析结果显示冠心病患者CIMT与SYNTAX评分呈直线正相关(r=0.64,P0.01)。多因素Logistic回归分析结果显示,CIMT及颈动脉斑块是SYNTAX积分32分的独立预测因素(P0.05)。结论 CIMT及颈动脉斑块与冠心病患者SYNTAX评分密切相关,可间接预测冠状动脉病变严重程度。     

内源分泌型高级糖基化终末产物受体与冠心病危险因素对动脉弹性的影响

目的探讨冠心病患者内源分泌型高级糖基化终末产物受体(esRAGE)与冠心病危险因素对动脉弹性的影响。方法选择180例冠心病患者,检测颈-股动脉脉搏波传导速度(cf-PWV)、肱-踝动脉脉搏波传导速度(ba-PWV)和血esRAGE,分析与冠心病相关的危险因素。结果与未合并高血压、糖尿病、腰围正常和≤3个异常代谢组分患者比较,合并高血压、糖尿病、腰围异常和3个异常代谢组分患者的cf-PWV、ba-PWV明显增高,血esRAGE降低(P0.05)。log cf-PWV与年龄、收缩压、舒张压、稳态模式评估法胰岛素抵抗指数呈正相关,与esRAGE呈负相关(P0.05)。ba-PWV与年龄、收缩压、舒张压呈正相关,与esRAGE呈负相关(P0.05)。log cf-PWV与年龄、收缩压、esRAGE独立相关;ba-PWV与年龄、收缩压独立相关。结论合并危险因素的冠心病患者的动脉弹性功能明显减低,冠心病患者esRAGE水平下降在动脉弹性减低方面起着重要作用。     

Glycemic and blood pressure control in older patients with hypertension and diabetes: association with carotid atherosclerosis

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp) control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic vs. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure: tight control, < 130 mmHg; usual control, 130–139 mmHg; or uncontrolled, ≥ 140 mmHg, and by their hemoglobin A1c (HbA1c) level: tight control, < 6.5%; usual control, 6.5%–7.5%; or uncontrolled, ≥ 7.5%, respectively. Results The mean CIMT was 8.20 ± 0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥ 1.1 mm). The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ± 0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03) but not between glycemic control categories (8.20 ± 0.10 mm, 8.1 ± 0.08 mm, and 8.40 ± 0.14 mm, respectively, P = 0.13) using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR = 1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1.17, 95% confidence interval (CI) 1.04–2.24, and OR = 1.54, 95% CI 1.36–2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.     

Impact of Serum Apolipoprotein A-IV as a Marker of Cardiovascular Disease in Maintenance Hemodialysis Patients

The aim of this study was to investigate the relationship between serum apolipoprotein (apo) A-IV levels and markers for atherosclerosis, including carotid intima-media thickness (CIMT) and the ankle–brachial index (ABI), in hemodialysis patients. We performed a cross-sectional study involving 116 maintenance hemodialysis patients (70 males; median age, 64 years), measuring CIMT, ABI, the usual laboratory examinations, and serum apo A-IV before the dialysis session. The apo A-IV concentration was measured by a noncompetitive ELISA. Serum apo A-IV concentrations were significantly lower in hemodialysis patients with cardiovascular disease and plaque in the carotid artery. The apo A-IV level was positively associated with urea nitrogen and creatinine, and negatively associated with age, interleukin-6, the neutrophil/lymphocyte ratio, and maximum CIMT. Moreover, serum apo A-IV concentrations were significantly lower in the low ABI group. On logistic analysis, patients with high apo A-IV levels had a lower odds ratio for atherosclerosis (maximum CIMT > 1.0) and cardiovascular disease compared to patients with low apo A-IV levels. On stepwise multivariate regression analysis, the serum apo A-IV level was independently associated with creatinine, the neutrophil/lymphocyte ratio, and the maximum CIMT. Serum apo A-IV is associated with atherosclerotic lesions in hemodialysis patients. Apo A-IV levels may be useful for estimating the risk of cardiovascular disease in dialysis patients.     

血清丙种球蛋白Fc段唾液酸化水平及其临床意义

目的 建立丙种球蛋白(IgG)Fc段唾液酸化水平的检测方法,并探讨血清IgG-Fc段唾液酸化在系统性红斑狼疮(SEE)尤其是神经精神狼疮(NPSLE)中的临床意义.方法 采用基于亲和素的夹心法酶联免疫吸附试验(ELISA)检测75例SLE患者(进一步分为NPSLE和非NPSLE 2个亚组),30例类风湿关节炎(RA)患者,32例幼年特发性关节炎(JIA)患者和41名健康对照者血清唾液酸化IgG,同时记录SLE患者临床资料,计算SLE疾病活动指数(SLEDAI),分析唾液酸化IgG的临床意义.结果 唾液酸化的IgG在RA组为(0.82±1.81)mg/mg/ml,JIA组为(0.69±1.30)mg/ml,健康对照组为(0.64±1.09)mg/ml,组间差异无统计学意义(P=0.82),SLE组为(0.12±0.17)mg/ml,唾液酸化水平明显降低(P<0.01),其中NPSLE组为(0.03±0.03)mg/ml,较其他组显著下降(P<0.01);健康对照组IgG唾液酸化的程度为(4.64±5.90)%,显著高于非NPSLE组的(1.88±2.16)%和NPSLE组的(0.29±0.47)%(P<0.01).唾液酸化的IgG占总IgG的百分数与SLEDAI负相关(r=-0.43,P<0.01).结论 SLE患者的IgG-Fc段唾液酸化水平较健康人群显著降低,且与狼疮活动度负相关,尤其在神经精神累及患者的IgG-Fc段唾液酸化水平下降尤为突出,提示唾液酸化的IgG有可能成为一种新的生物治疗手段.