Impact of serum uric acid on renal function after bariatric surgery: a retrospective study

BackgroundDespite a known negative association between serum uric acid level (SUA) and renal function, this correlation in patients after bariatric surgery remains unknown.ObjectiveTo assess correlation between postoperative SUA and estimated glomerular filtration rate (eGFR) at 12 months after bariatric surgery.SettingA single tertiary referral center.MethodsA total of 252 patients (age = 40.5 ± 11.2; body mass index = 39.0 ± 5.5 kg/m²) undergoing bariatric surgery divided into 2 groups (i.e., normal renal function [90 ≤ eGFR < 125 mL/min/1.73 m², n = 176] versus renal function impairment [eGFR < 90 mL/min/1.73 m², n = 76]) were assessed for relationships between SUA and eGFR in both groups (primary endpoint) and associations of percentage weight loss with changes in SUA (△SUA) and eGFR (△eGFR) for all patients (secondary endpoint) at 12 months.ResultsOverall, prevalence of hyperuricemia was 40.4% and 22.2% (baseline and postoperative 12 mo, respectively). Reverse relationship was observed between SUA and eGFR (r = −.152, P = .007) for all patients with no association noted between baseline SUA and eGFR in each group as well as between SUA and eGFR at 12 months in the normal group (r = −.076, P = .437). The reverse relationship was found (r = −.417, P = .005) in renal function impairment group for whom SUA was identified as a predictor of eGFR at 12 months. There was no association of percentage weight loss with △SUA (r = .089, P = .601) and △eGFR (r = −.046, P = .785).ConclusionThe results demonstrated a negative relationship between postoperative SUA and renal function in patients with preexisting renal dysfunction undergoing bariatric surgery. Clinical significance of our findings warrants further investigation.     

Abnormal lipid metabolism induced apoptosis of spermatogenic cells by increasing testicular HSP60 protein expression

Long-term consumption of high-fat and high-calorie foods not only causes obesity, but also may cause a decline in sperm quality in men. Rats with abnormal lipid metabolism (high-fat rats) were established by high-fat diet for 24 weeks. HE staining was used to observe the morphological changes of testis in rats, TUNEL and flow cytometer was used to detect the cell apoptosis in rat testis and in vitro. Immunohistochemistry and Western blotting were used to detect the expression of protein. After 24 weeks of high-fat food feeding, the body weight, serum lipids and number of apoptotic spermatogenic cells in the high-fat group rat were significantly higher than those in the control group. In vivo, the expression of HSP60 protein in testis of high-fat rats was positive related to apoptosis of spermatogenic cells, cleaved caspase 3/caspase 3 protein expression and Bax/Bcl2 protein expression in testis of high-fat rats. Proportion of apoptotic spermatogenic cells was increased by up-regulation of HSP60 protein expression in vitro. Long-term consumption of high-fat diets can cause high expression of HSP60 and spermatogenic cells apoptosis in rats, while HSP60 over-expression promotes spermatogenic cell apoptosis and MAPK signal pathway in vitro.     

Nano-purification of raw semen minimises oxidative stress with improvement in post-thaw quality of buffalo spermatozoa

The study consisted of application of anti-ubiquitin antibodies (Abs)-coated iron oxide-nanoparticles (IONPs) for minimisation of oxidative stress to contemporary live spermatozoa from the raw semen. Round-shaped IONPs (12.09 ± 0.91 nm) after two-stage functionalisation (silanisation and pegylation) were conjugated with Abs. Four aliquots from each of the 24 ejaculates (4 buffalo bulls) formed Control (Group I) and treatment (II, III and IV) groups; each containing 150 ± 25 million dead/damaged spermatozoa. IONPs-Abs complex were added at ratio of 1:1 (0.5 µg/ml), 1:2 (1.0 µg/ml) and 1:4 (2.0 µg/ml), respectively, in Groups II, III and IV. The semen quality parameters showed improvement at lag-stage (post-nano-purification before processing for cryopreservation). The mean post-thaw motility (%) in Group IV was found to be greater (p < .05) than Group I. Moreover, the overall DNA integrity (%) at post-thaw stage was improved in the nano-purified semen samples. The value of malondialdehyde was greater (p < .001) in Group I than Groups II, III and IV. The mean total antioxidant capacity and superoxide dismutase (U/mg protein) activity values in Group IV was greater (p < .05) than Group I. The study results show that IONPs conjugated with anti-ubiquitin Abs at 2.0 µg/ml can be an effective dose for depletion of dead/damaged spermatozoa from buffalo ejaculates to minimise oxidative stress.     

GDM患者血清25-羟维生素D3变化及其与炎症因子、血脂指标的相关性研究

目的检测妊娠期糖尿病(GDM)患者血清25-羟维生素D3[25-(OH)2-VitD3]水平,评估其水平与机体炎症因子、血脂的相关关系。方法选取2018年2~9月在中国医科大学航空总医院产检并确诊为GDM的孕妇178例作为GDM组,同期在本院进行产检且糖耐量检查正常的孕妇100例作为正常对照组。对比两组孕妇血清中25-(OH)2-VitD3、炎症因子及血脂指标水平的差异,采用Pearson检验评估GDM患者血清25-(OH)2-VitD3水平与机体炎症因子、血脂指标的相关关系。结果GDM组血清中25-(OH)2-VitD3的含量显著低于正常对照组(P<0.05)。GDM组血清中炎症因子白介素-1β(IL-1β)、IL-6、IL-18和肿瘤坏死因子α(TNF-α)水平显著高于正常对照组(P均<0.05);血脂指标总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo-B)和载脂蛋白CⅢ(Apo-CⅢ)的水平显著高于正常对照组,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)的水平显著低于正常对照组(P均<0.05)。相关性分析发现,GDM孕妇血清中25-(OH)2-VitD3水平与炎症因子、血脂指标均相关(P均<0.05)。结论GDM患者血清25-(OH)2-VitD3水平明显降低,且其水平与机体炎症因子、血脂指标相关,这在GDM发生及病情评估中具有重要意义。     

糖尿病视网膜病变患者泪膜脂质层厚度与黄斑微血管改变的相关性

目的:分析糖尿病视网膜病变患者泪膜脂质层厚度(LLT)与黄斑区微血管结构参数的相关性。方法:选取2018-01/12于我院确诊的2型糖尿病合并非增生期(NPDR组)和增生期(PDR组)糖尿病视网膜病变患者各60例60眼,另选取年龄、性别相匹配的健康志愿者60例60眼作为正常对照组。三组受检者均经Lipiview眼表面干涉仪检查LLT,OCT血流成像仪(OCTA)检查黄斑无血管区面积(FAZ)、视网膜浅层毛细血管层(SCL)和视网膜深层毛细血管层(DCL)血管密度,比较各参数之间的差异和相关性。结果:正常对照组受检者LLT(69.87±11.401nm)高于NPDR(54.87±7.453nm)和PDR组(42.67±5.246nm),FAZ(0.312±0.021mm^2)小于NDPR组(0.389±0.037mm^2)和PDR组(0.437±0.032mm^2),SCL血管密度(51.977%±4.164%)显著高于NPDR(47.067%±4.757%)和PDR组(41.865%±5.512%),DCL血管密度(49.578%±2.619%)高于NPDR组(46.032%±2.622%)和PDR组(40.598%±2.671%)(均P<0.01)。正常受检者LLT与FAZ、SCL和DCL血管密度无相关性;NPDR组和PDR组患者LLT与FAZ均呈负相关关系(r=-0.922、-0.923,均P<0.01),与SCL血管密度均呈正相关关系(r=0.798、0.902,均P<0.01),与DCL血管密度均无相关性(r=0.140、0.073,P=0.285、0.581)。结论:糖尿病视网膜病变患者泪膜脂质层厚度降低,泪膜稳定性下降,并与黄斑微血管结构改变存在相关关系。     

单项血脂及其比值与翼状胬肉的相关性研究

目的:分析单项血脂和血脂比值与翼状胬肉的关系。方法:采用回顾性病例研究。纳入2016-01/2019-02在我院眼科和体检中心确诊的翼状胬肉患者500例(翼状胬肉组)和同期进行健康体检、年龄和性别匹配的健康体检者500例(正常对照组),检测两组研究对象外周静脉血中血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,计算TG/HDL、TC/HDL、LDL/HDL的比值。结果:翼状胬肉患者500例中,血脂异常者68.2%(341/500),翼状胬肉组血清TG、TC、LDL-C水平和TG/HDL、TC/HDL、LDL/HDL的比值均明显高于正常对照组(P<0.001),血清HDL水平低于正常对照组,但无差异(P>0.05)。Logistic回归分析提示,TG(OR=4.132)、TC(OR=2.194)、TG/HDL (OR=2.184)、TC/HDL (OR=2.007)均是翼状胬肉发病的影响因素(P<0.05)。结论:血脂代谢异常是翼状胬肉发病的影响因素,加强血脂管理对翼状胬肉患者的发病和治疗均具有重要的临床意义。     

上海地区老年男性血脂参考值及其分布

目的分析60岁以上老年男性血清脂类水平的参考值及其分布。方法752名健康老年男性按年龄分组,先按年龄5岁为组距分组并分析各血清脂类水平,根据统计结果重新分组。结果按不同年龄段之间的差异分为3组,其中随年龄增长,致动脉粥样硬化的脂类下降,抗动脉粥样硬化脂类成分上升。在不同年龄组间三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-I(apo A-I)、载脂蛋白B(apo B)、非高密度脂蛋白胆固醇(non-HDL-C)差异有统计学意义,调查人群各指标的95%范围分别为:胆固醇(Chol)3.18～6.60 mmol/L,TG 0.66～3.66 mmol/L,HDL-C>0.92 mmol/L,低密度脂蛋白胆固醇(LDL-C)1.22～4.16 mmol/L,apo A-I0.91～1.65 g/L,apo B 0.56～1.34 g/L,non-HDL-C 1.87～5.13 mmol/L,LDL/LDL-apo B>1.07。结论老年人群的血脂合适范围较一般人群升高,特别是TG水平,在临床应用时应按不同年龄段选用恰当的合适范围。     

Evaluation of use of essential fatty acids in topical ophthalmic preparations for dry eye

PurposeEssential fatty acids (EFAs) as dietary supplements are used in treating dry-eye for reducing inflammation at the ocular surface. Their topical application in eye drops to deliver fatty acid (FA) directly to the ocular surface requires thorough investigation. Being lipids in nature EFAs can interact with tear lipids and affect tear stability. This study aimed at investigating the biophysical interactions of EFAs with Meibomian lipids.MethodsRheology of mixtures of Human Meibomian lipids with EFAs (LA-linoleic acid, ALA-alpha-linolenic acid), OA (oleic acid), and GLA (gamma-linolenic acid) was studied using Langmuir trough technology on an artificial tear solution at the ocular surface temperature. Pressure-area profiles were used to determine compressibility and elasticity of the mixed films.ResultsLA enhanced spreading of Meibomian lipids and increased their compressibility and elasticity which can be beneficial for tear stability. ALA condensed Meibomian lipids film with less elasticity deemed unfavourable for tear stability. OA expanded Meibomian lipids but decreased elasticity at high compressions making films less stable. GLA had little or no favourable effect on tear stability. Higher concentrations of FAs made films less stable.ConclusionsEFAs or OA in topical ophthalmic preparations can affect spread and stability of the tear film lipid layer. Rheology of mixed films should be tested using Langmuir trough technology to determine suitable type and amount of a lipid additive for therapeutic eye drops. In topical applications, the omega-6 LA (not omega-3 FA) at low concentrations (20 mol%) can be beneficial for enhancing tear stability in dry eye patients.