Glycemic index, glycemic load and insulinemic index of Chinese starchy foods

AIM:To determine the glycemic index(GI),glycemic load(GL)and insulinemic index(Ⅱ)of five starchy foods that are commonly used in Chinese diets.METHODS:Ten healthy subjects aged between 20-30 years were recruited.Each subject was asked to consume 50 g of available carbohydrate portions of test foods and reference food.Finger capillary blood samples were collected at the start of eating and 15,30,45,60,90 and 120 min after consumption.The GI and Ⅱ of foods were calculated from the ratio of incremental area under the glucose/insulin response curves of test and reference foods.The GL for each test food was determined from its GI value and carbohydrate content.RESULTS:The results showed that brown rice elicited the highest postprandial glucose and insulin responses,followed by taro,adlay,yam and mung bean noodles,which produced the lowest.Among the five starchy foods,brown rice evoked the highest GI and GL at 82±0.2 and 18±0.2,followed by taro(69±0.4,12±0.2),adlay(55±0.4,10±0.2),yam(52±0.3,9±0.0)and mung bean noodles(28±0.5,7±0.2),respectively.The Ⅱ values of the test foods corresponded with GI values.Similarly,brown rice gave the highest Ⅱ at 81±0.1,followed by taro(73±0.3),adlay(67±0.3),yam(64±0.5) and mung bean noodles(38±0.3).All five starchy foods had lower GI,GL and Ⅱ than reference bread(P<0.05).CONCLUSION:The GI,GL and Ⅱ values of starchy foods provide important information for the public to manage their diet and could be useful for the prevention of lifestyle-related diseases such as diabetes mellitus.     

心电图Morris,Macruz指数与经皮球囊二尖瓣成形术疗效的相关性分析

分析32例经皮球囊二尖瓣成形术(PBMV)前、后的心电图Morris指数(PTFv_1)和Macruz指数(Ⅱ导联P/P-R段比值),探讨心电图对判定PBMV疗效的价值。结果Morris指数术前—0.061±0.005mm·s,术后—0.038±0.003mm·s,Macruz指数术前2.54±0.12,术后2.02±0.15,均有极显著性差异(P<0.001)。将两指数分别与多项血流动力学和超声心动图测值比较,术前,后均有较好的相关。认为Morris指数和Macruz指数可作为PBMV后疗效判定及心功能随访的一种可靠而简便的方法。     

踝臂指数及心踝血管指数对冠状动脉病变的诊断价值

目的评价踝臂指数(ankle brachial index,ABI)与心踝血管指数(cardio-ankle vascular index,CAVI)对冠状动脉病变的诊断价值。方法选择2012年6月至2012年11月在重庆医科大学附属第一医院心血管内科住院,因拟诊为冠状动脉粥样硬化性心脏病(冠心病)而行冠状动脉造影的127例患者,根据冠状动脉造影结果,88例冠状动脉狭窄患者列入冠状动脉病变组(D组):根据狭窄程度,将患者分为轻度病变亚组(A组,31例),中重度病变亚组(B组,57例);依累及血管支数,分为单支病变亚组(22例),双支病变亚组(26例),三支病变亚组(40例)。对照组为39例冠状动脉造影阴性患者。入选患者接受ABI及CAVI检测,比较分析各组间ABI及CAVI。结果对照组、A组、B组3组比较,ABI依次降低,且对照组、A组、B组两两比较差异有统计学意义(P<0.05)。CAVI在对照组、A组、B组3组数值依次增高,但两两比较差异无统计学意义(P>0.05);但D组与对照组比较CAVI明显升高,且差异有统计学意义(P<0.05)。对照组、单支病变组、双支病变组、三支病变组4组ABI值依次降低,对照组与各病变组ABI值差异有统计学意义(P<0.05),但各病变组之间两两比较差异无统计学意义(P>0.05)。在各组中随病变范围增大,CAVI数值并未依次增高,且各病变组两两比较差异无统计学意义(P>0.05)。结论 ABI值能很好地反映病变狭窄程度,ABI数值越低,冠状动脉狭窄程度越重,但无法反映病变范围;CAVI既不能反映冠心病的病变程度,也无法反映病变范围。     

冠心病患者CAVI与ABI改变的临床研究

目的探讨冠状动脉粥样硬化性心脏病（CHD,冠心病）患者在动脉硬化及僵硬度指标心踝血管指数（cardio-ankle vascular index,CAVI）与踝臂指数（ankle-brachial index,ABI）改变的临床价值。方法随机选取在安徽医科大学第一附属医院心血管内科行选择性冠状动脉造影检查及治疗的患者269例,其中经冠脉造影证实的冠心病患者（狭窄≥50%）217例作为实验组（冠心病组）,并根据冠状动脉血管病变支数分为相应的亚组,其余52例（狭窄〈50%）作为对照组（非冠心病组）,比较两组间在CAVI、ABI的差异。结果①随着冠状动脉狭窄程度的加重,CAVI进行性增高,组间的差异有统计学意义（P〈0.01）。②非冠心病组与冠心病组的ABI均在正常范围,但冠心病组的ABI低于非冠心病组（P〈0.01）。多支病变组ABI低于对照组、单支病变组（P〈0.05）。③CAVI（＋）预测冠心病的敏感性较高（66.4%）,特异性欠佳（32.7%）;ABI降低预测冠心病的敏感性低（18.0%）,但特异性高（96.2%）。结论 CAVI（-）可能是非冠心病有意义的独立预测因子,CAVI（＋）有利于早期发现动脉硬化,ABI降低是冠心病独立的危险因子,可作为冠心病诊断参考指标。     

Shared and additional risk factors for decrease of toe-brachial index compared to ankle-brachial index in Japanese patients with diabetes mellitus

Objective

Some diabetic patients have a low toe-brachial index (TBI) despite their normal ankle-brachial index (ABI). We statistically investigated whether the impact of risk factors on TBI would be different compared to ABI.

Research design and methods

We used a database of 1738 limbs of consecutive 869 Japanese diabetic patients whose ABI and TBI were simultaneously evaluated. We developed a common regression model to ABI and TBI by extending the linear mixed model, and statistically detected the difference in the impact of risk factors between the two indices.

Results

Sex, smoking, proteinuria, hypertension, and history of stroke and coronary artery disease were common independent risk factors for the decrease of ABI and TBI; their impacts on ABI and TBI were not significantly different. On the other hand, the impact of age, diabetic duration, and body mass index was significantly different between the two indices (all p < 0.05). Age and body mass index were significantly associated with TBI but not with ABI. Diabetic duration had a significant impact both on TBI and ABI, but the impact on TBI was significantly greater than that on ABI (β = −0.144 vs. −0.087; p < 0.05). In the population with normal ABI, patients with these risk factors had a higher prevalence of decreased TBI.

Conclusions

The risk factors for the decrease of ABI and TBI were not identical in Japanese diabetic patients. Age, diabetic duration and body mass index were associated with reduced TBI in patients with normal ABI.     

Sokolow指数与Cornell指数诊断左心室肥大敏感性的比较

目的 比较Sokolow指数(Rv1 Rv5)与Cornell指数(RaVL Rv3)诊断左心室肥大的敏感性。方法 对1999-2003年体检者153例以超声心动描记术测定的左心室重量指数作为左心室肥大标准，分别测量Sv1 Rv5及RaVL Sv3值，比较二者诊断左心室肥大的敏感性。结果 Sokolow指数的敏感性男性为47．9％，女性为66．7％；Cornell指数的敏感性男性为13．95％，女性为24．4％。结论 Sokolow指数诊断左心室肥大的敏感性高于Cornell指数，两种指数的敏感性女性均高于男性。     

Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis.

OBJECTIVES: We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease. METHODS AND RESULTS: We examined 4159 randomly sampled individuals from the Danish general population, of which 250 had severe atherosclerosis. After adjustment for gender and age, individuals with ankle brachial index of 0.71-0.90 and <0.70 vs. 0.91-1.10 had odds ratios for severe atherosclerosis of 1.6 (95%CI:1.1-2.3) and 2.9 (1.9-4.6), respectively. C-reactive protein of >3.0 or 1.0-3.0 mg/L vs. <1.0 mg/L as well as central augmentation index in quintiles did not identify individuals with severe atherosclerosis, and did not improve further the ability of ankle brachial index to identify such individuals. On a continuous scale using receiver operating characteristics curves, presence of severe atherosclerosis was predicted by ankle brachial index (P=0.00000003), C-reactive protein (P=0.000003), as well as central augmentation index (P=0.001); these three curves did not differ. CONCLUSION: Ankle brachial index <0.9 identify individuals with severe atherosclerosis in the general population, while C-reactive protein in three groups and central augmentation index in quintiles did not. On a continuous scale, all three variables predicted severe atherosclerosis.     

Sonographic evaluation of hypertension: Role of atrophic index and renal resistive index

Hypertension can cause structural and functional renal damage. Intrarenal ultrasound parameters have been extensively investigated in hypertensive patients and among the parameters introduced, the renal resistive index (RI) is associated with the progression of chronic kidney disease and hypertension. Atrophic index (AI) is an indirect anatomical ultrasound index that reports the atrophic changes of the renal parenchyma and it is mainly studied in chronic glomerular diseases. The present study aimed to evaluate renal RI and AI in hypertensive patients with normal renal function. AI showed correlations with all parameters associated with renal function reduction (age, creatinine, and intrarenal arterial stiffness). AI, in combination with RI, can represent in hypertensive patients an additional marker for renal damage progression.     

Association of waist circumference,body mass index and conicity index with cardiovascular risk factors in postmenopausal women

Abstract

In menopause, changes in body fat distribution lead to increasing risk of cardiovascular disease and metabolic disorders. The aim of this study was to assess the association of adiposity using the conicity index (CI), body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors (hypertension, diabetes and dyslipidaemia). The sample of this cross-sectional study was collected from June to October 2010 and 165 consecutive menopausal women who had attended the Health and Treatment Centre and Endocrine Research Centre of Firoozgar Hospital in Tehran, Iran were assessed. Age, weight, height, WC, waist–hip ratio (WHR), CI and fat mass were measured. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose, insulin, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels were also determined. All statistical analyses were performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA).Results showed that BMI was positively and significantly associated with SBP (r = 0.21; p = 0.009). WC was positively and significantly correlated with SBP (r = 0.26; p = 0.02) and DBP (r = 0.16; p = 0.05). WHR was also significantly and positively associated with SBP (r = 0.29; p = 0.001). Age and WC were associated with CI quartiles at the 0.05 significance level. The correlation of CI quartiles with SBP and weight were at the 0.01 significance level.We showed a significant association of WC with SBP and DBP, and that BMI could be an important determining factor of SBP. For assessing the association between CI and cardiovascular risk factors, future studies with larger sample sizes are recommended.     

踝臂指数、趾臂指数、LDL-C/HDL-C在冠状动脉疾病中的应用价值

目的探讨踝臂指数(ABI)、趾臂指数(TBI)、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(LDL-C/HDL-C)在冠状动脉疾病患者中的应用价值。方法纳入2011年10月-2013年2月于中国医科大学附属第一医院心内科住院治疗的160例患者,依据冠状动脉多层螺旋CT造影(CTA)检查结果将患者分为两组,其中对照组患者57例(冠状动脉狭窄程度≤25%),冠状动脉病变组患者103例(冠状动脉狭窄程度25%)。冠状动脉病变组患者中冠状动脉单支病变患者30例(单支病变组)、双支病变患者31例(双支病变组)、三支病变患者42例(三支病变组);轻度病变组患者55例(冠状动脉狭窄程度≤50%)及中重度病变组患者48例(冠状动脉狭窄程度50%)。对入组患者行ABI、TBI、LDL-C/HDL-C检查,分析冠状动脉病变不同亚组间ABI、TBI、LDL-C/HDL-C水平变化及其对判断冠状动脉病变程度的价值。结果对照组与冠状动脉单支病变组、双支病变组、三支病变组间ABI、TBI呈降低趋势,LDL-C/HDL-C水平呈升高趋势,组间ABI、TBI、LDL-C/HDL-C水平比较,差异均有统计学意义(P0.05);三支病变组与对照组、单支病变组ABI、TBI及LDL-C/HDL-C水平间比较,差异均有统计学意义(P0.05);双支病变组与对照组ABI水平间比较,差异有统计学意义(P0.05)。对照组与冠状动脉狭窄轻度病变组、中重度病变组间ABI、TBI呈降低趋势,LDL-C/HDL-C水平呈升高趋势,组间ABI、TBI、LDL-C/HDL-C水平比较,差异均有统计学意义(P0.05);中重度病变组与对照组ABI、TBI及LDL-C/HDL-C水平间比较,差异有统计学意义(P0.05);中重度病变组与轻度病变组及轻度病变组与对照组ABI水平间比较,差异有统计学意义(P0.05)。结论 ABI能较好反应冠脉病变程度,ABI值越低冠脉狭窄越重,但并不能全面反映冠脉病变范围;LDL-C/HDL-C、TBI对冠脉病变的判断有一定意义,但不适用于准确评价冠脉病变程度及范围。     

胸腔血容量指数与外肺水指数对烧伤患者肺水肿的早期预测价值

目的研究胸腔血容量指数与外肺水指数对烧伤患者肺水肿的早期预测价值。方法选取2013年1月到2014年12月在我院烧伤科接受治疗及Pi CCO检测且伤后10天内发生肺水肿的严重烧伤患者42例,根据患者肺水肿类型分为肺损伤型组与静水压型组,对比两组Pi CCO监测指标及肺损伤评分,探索EVLWI与ITBVI、氧合指数的相关性。结果两组患者EVLWI水平相差不大,但静水压型组ITBVI及氧合指数均明显大于非损伤组,Murray评分明显低于肺损伤组;EVLWI与ITBVI呈显著正相关性,r=0.921,P0.05;EVLWI与氧合指数呈明显的负相关性,r=-0.718,P0.05。结论烧伤早期实行监测胸腔血容量指数与外肺水指数对患者发生肺水肿预测和鉴别具有重要参考意义。     

Usefulness of bispectral index and patient state index during sevoflurane anesthesia in children: A prospective observational study

Cortical electroencephalography-based devices are used to monitor the depth of anesthesia. In this study, we evaluated the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the maintenance and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of 2 monitors.Fifty children (3–12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil followed by propofol administration. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Maintenance state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. Pk, agreement or correlation of BIS and PSI in different anesthesia state were calculated.Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% confidential interval [CI]: 0.78–0.91) and PSI (95% CI: 0.82–0.91) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for maintenance state. Pk values were comparable for BIS and PSI.Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population.     

BODE指数预测慢性阻塞性肺疾病急性发作的意义

目的探讨BODE指数对慢性阻塞性肺疾病（COPD）急性加重的预测价值。方法选取2006年～2007年确诊为COPD的患者168例，分别测定BODE指数。依据指数分为4组：0～2分为A组，3～4分为B组，5～6分为C组，7～10分为D组。进行为期3年的随访，记录急性加重发病的次数及时间。结果Kaplan—Meier法分析表明BODE指数能较好的预测4组COPD患者急性发作的不同趋势（P〈0．05）；ROC曲线表明BODE指数是优于FEV1的预测指标（P〈0．05）。结论BODE指数是预测COPD患者急性发作的较好指标之一。     

甘油三酯葡萄糖指数和血浆致动脉粥样硬化指数对冠心病患者PCI后再次血运重建的预测价值

【摘要】目的：探究甘油三酯葡萄糖指数（TyG）和血浆致动脉粥样硬化指数（AIP）对植入药物洗脱支架（DES）的冠心病患者再次血运重建的预测价值。方法：选取2018年1月至2020年1月DES植入后冠脉造影复查的787例冠心病患者。将患者分为再次血运重建组和对照组。使用SPSS 25.0版本和R软件4.1.3版本进行统计分析。结果:再次血运重建组TyG指数和AIP均高于对照组,差异有统计学意义（P＜0.05）。在完全校正Cox回归模型中,TyG指数和AIP的血运重建事件的风险比(95% CI)分别为1.05(0.76-1.46)和1.47(1.11-1.93)。时间依赖的ROC分析显示,TyG指数的曲线下面积(AUC)为0.571-0.618,AIP为0.573-0.605,TyG指数与AIP联合的AUC为0.577-0.614。结论:对冠心病PCI后的患者,TyG指数和AIP对再次血运重建事件有较好的预测价值。     

临床疾病活动指数和简化疾病活动指数在类风湿关节炎疾病活动性评估中的比较研究

目的 评价临床疾病活动指数( CDAI)、简化疾病活动指数(SDAI)同疾病活动指数28( DAS28),对类风湿关节炎(RA)疾病活动性的评估价值.方法 连续纳入200例RA患者,评估每例RA患者的关节肿胀数(SJC)、关节压痛数(TJC)、患者对病情的总体评估(PGA)、医生对病情的总体评估( PhGA)、健康评估问卷(HAQ),检测红细胞沉降率(ESR)、C反应蛋白(CRP),计算DAS28、CDAI、SDAI.用Pearson相关分别分析DAS28、CDAI、SDAI与上述任意指标的相关性.按DAS28、CDAI、SDAI各活动分期截止点将200例RA患者分类,记录各活动期患者例数,用Kappa值描述CDAI与SDAI的内部一致性,并用Kappa值分别描述CDAI、SDAI与DAS28的内部一致性.以DAS28为参照标准,用ROC曲线描述CDAI和SDAI划分RA的缓解/低度和中/重度的区分效能.结果 200例RA患者的CDAI (17.2±11.1)、SDAI (19.1±11.6)与DAS28(4.3±1.5)均呈正相关(r=0.876,0.861,P＜0.05).二者及DAS28与HAQ(0.6±0.7)亦均呈正相关(r=0.522,0.523,0.482,P＜0.05).比较CDAI与SDAI,二者Kappa值为0.777,进一步比较CDAI、SDAI与DAS28的Kappa值分别为0.482,0.394.以DAS28作为参照标准,CDAI、SDAI的ROC曲线下面积分别为0.906、0.888.结论 CDAI、SDAI同目前国际公认的DAS28一样,亦可以很好地评估RA疾病活动性,且二者与HAQ的相关性高于DAS28.相比于SDAI,CDAI缺少炎性指标,但二者一致性极好,且CDAI与DAS28的内部一致性优于SDAI与DAS28.此外,CDAI划分RA的缓解/低度和中/重度的效能稍高于SDAI.CDAI更简便、快捷、准确,适用于RA的日常评估.     

溶质清除指数量化血液透析充分性的研究

目的寻找一个充分的透析剂量,以提高透析患者生存质量。方法对２０例稳定血液透析患者进行了溶质清除指数的临床研究。检测患者透析前、结束和透析后１小时血尿素氮（ＢＵＮ）水平,用尿素动力学二室模型方法计算出尿素生成量（Ｇ）、蛋白分解代谢率（ＰＣＲ）、溶质排除量（Ｒ）和溶质清除指数（ＳＲＩ）。结果透析后１小时尿素反跳率（１８５０±３３５）％,Ｒ（１３８２±５４８）ｇ,Ｇ（４８５±１３９）ｇ,ＰＣＲ（０９４±０２９）ｇ·ｋｇ－１·ｄ－１,ＳＲＩ（７１３３±６８０）％。结论提示ＳＲＩ是量化透析剂量的一个较好的指标。     

Beyond body mass index

Body mass index (BMI) is the cornerstone of the current classification system for obesity and its advantages are widely exploited across disciplines ranging from international surveillance to individual patient assessment. However, like all anthropometric measurements, it is only a surrogate measure of body fatness. Obesity is defined as an excess accumulation of body fat, and it is the amount of this excess fat that correlates with ill‐health. We propose therefore that much greater attention should be paid to the development of databases and standards based on the direct measurement of body fat in populations, rather than on surrogate measures. In support of this argument we illustrate a wide range of conditions in which surrogate anthropometric measures (especially BMI) provide misleading information about body fat content. These include: infancy and childhood; ageing; racial differences; athletes; military and civil forces personnel; weight loss with and without exercise; physical training; and special clinical circumstances. We argue that BMI continues to serve well for many purposes, but that the time is now right to initiate a gradual evolution beyond BMI towards standards based on actual measurements of body fat mass.     

Myocardial performance index (Tei index) does not reflect long-term changes in left ventricular function after acute myocardial infarction

AIMS: To evaluate whether changes in myocardial performance index (MPI or Tei index) were related to changes in other Doppler echocardiographic parameters after acute myocardial infarction, or had any independent prognostic impact in a 2-year observational study. METHODS AND RESULTS: Seventy-one patients with acute myocardial infarction without heart failure were examined at baseline, 3 months, and 2 years. MPI was significantly related to end-diastolic and end-systolic volume indexes, ejection fraction, maximal velocity, and time velocity integral of early mitral filling wave at 3 months and 2 years. MPI did not contribute significantly to the prediction of any changes in the measures of diastolic or systolic function at 3 months or 2 years. Baseline MPI was significantly higher in patients who later developed heart failure(0.55 +/- 0.16)than in other patients(0.43 +/- 0.13, P = 0.006), but had no independent predictive power for the development of heart failure or death relative to end-systolic volume index and deceleration time of early mitral filling wave. CONCLUSION: MPI did not accurately reflect changes in Doppler and two-dimensional echocardiographic measures of diastolic or systolic function during a 2-year follow-up after acute myocardial infarction, and did not have any independent prognostic impact.