肥胖儿童脂联素水平与肥胖相关生化指标的研究

目的 探讨肥胖儿体内脂联素水平的变化情况及脂联素与肥胖相关生化指标的关系.方法 采用配对设计,测定78对肥胖和对照儿童的血清脂联素,胰岛素,糖、脂代谢指标等.结果 儿童脂联素测定值为非正态分布.肥胖儿童脂联素水平低于正常对照儿童(7.60 μg/ml±4.58 μg/ml vs 10.08 μg/ml±5.36 μg/ml,P＜0.05;中位数P50 6.12 μg/ml vs 8.71μg/ml).肥胖组谷丙转氨酶、甘油三酯的异常率都明显高于对照组.正常体重儿童的脂联素水平与载脂蛋白A1呈正相关(r=0.32,P=0.012);与血糖呈负相关(r=-0.33,P=0.004).肥胖儿童脂联素水平与血糖呈正相关(r=0.23,P=0.041);与谷酰转肽酶(r=-0.25,P=0.049)、胰岛素(r=-0.31,P=0.006)、胰岛素敏感指数(r=-0.36,P=0.001)呈负相关.结论 肥胖儿童脂联素水平比正常儿童低,脂联素水平与机体肝细胞损伤,糖、脂代谢紊乱有一定的关系.     

肥胖儿童血清脂联素水平及代谢相关研究

目的探讨肥胖儿童血清脂联素分布特点及与糖、脂代谢相关生化指标的关系。方法采用病例对照研究,选择180名肥胖儿童和160名健康儿童为肥胖组和对照组,进行体格测量和血生化检测（包括血清脂联素、糖、脂代谢指标）,分析脂联素与体重指数、血脂、血糖和胰岛素的相关性。结果肥胖组血浆脂联素水平（8.32±4.78 mg/L）低于对照组（12.38±6.45 mg/L）（P〈0.01）;儿童血清脂联素与BMI和腰臀比呈负相关关系（r=-0.382、-0.342,P〈0.05）,与脂代谢指标（TC和TG）呈负相关关系（r=-0.311、-0.295,P〈0.05）,与糖代谢指标（FINS、HOMA-IR）相关关系不显著（r=-0.120、-0.147,P〉0.05）。结论肥胖症儿童血清脂联素水平降低,与血脂异常及胰岛素抵抗相关。     

血清趋化素、瘦素、脂联素浓度与学龄前单纯性肥胖儿童糖脂代谢的关系

目的 研究血清趋化素、瘦素、脂联素水平与3~6岁学龄前期儿童单纯性肥胖及代谢的关系,为学龄前单纯性肥胖儿童临床监测及治疗效果提供依据。方法 选取2019年1月—2020年5月于大连市妇幼保健院儿童保健门诊体检的3~6岁儿童为研究对象,获取单纯性肥胖儿童41例作为研究组,另获取同年龄、同时期儿童43例作为对照组。测量其身高和体重,并计算身高别体重;测定血清趋化素、瘦素、脂联素、空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c),同时计算胰岛素抵抗指数。结果 单纯性肥胖组的FINS、胰岛素抵抗指数(HOMA-IR),LDL-c,血清趋化素,瘦素明显高于对照组,差异有统计学意义(t=3.288、2.927、4.939、3.078、5.456,P＜0.05),HDL-c,脂联素明显低于对照组,差异有统计学意义(t=-5.179、-3.145,P＜0.05)。而两组FPG、TG、TC差异无统计学意义(t=0.391、0.768、-0.266,P＞0.05); 趋化素与身高别体重、FINS、HOMA-IR、 LDL-c、瘦素呈正相关(r=0.339、0.416、0.227、0.376、0.266,P＜0.05),与HDL-c、脂联素呈负相关(r=-0.410、-0.309,P＜0.05)。瘦素与身高别体重、FINS、HOMA-IR、 LDL-c、趋化素呈正相关(r=0.492、0.375、0.279、0.269、0.266,P＜0.05),与HDL-c、脂联素呈负相关(r=-0.467、-0.326,P＜0.05)。脂联素与身高别体重、FINS、HOMA-IR,LDL-c、趋化素、瘦素呈负相关(r=-0.296、-0.351、-0.278、-0.229、-0.309、-0.326,P＜0.05),与HDL-c呈正相关(r=0.234,P=0.032)。结论 血清趋化素、瘦素、脂联素水平与学龄前单纯性肥胖儿童糖脂代谢密切相关,这些指标对于识别、监测、干预学龄前单纯性肥胖儿童有着重要意义。     

儿童单纯性肥胖症血清脂联素的研究

目的:研究血清脂联素浓度与儿童单纯性肥胖症的关系。方法:采用ELISA法测定131例单纯性肥胖症儿童和131例正常健康儿童的血清脂联素浓度。结果:肥胖组血清脂联素浓度与正常对照组比较有非常显著差异(P<0.01)。结论:血清脂联素浓度变化可能与儿童单纯性肥胖症密切相关。     

儿童单纯性肥胖程度和脂肪细胞因子的关系

目的 探讨儿童单纯性肥胖程度与脂肪细胞因子瘦素、脂联素和抵抗素水平的关系.方法 选取2～6岁单纯性肥胖儿童110例(肥胖组),其中轻度肥胖组40例,中度肥胖组40例,重度肥胖组30例,另选取正常体重健康儿童40例为对照组,检测空腹血清瘦素、脂联素和抵抗素水平,比较脂肪因子的差异.结果 肥胖组血清瘦素、抵抗素水平明显高于对照组(P<0.01),血清脂联素水平明显低于对照组(P<0.01).中度肥胖组血清瘦素、抵抗素水平明显高于轻度肥胖组[分别为(14.3±1.9)μg/L比(7.8±1.5)μg/L与(14.6±2.2)μg/L比(13.1±3.0)μg/L](P<0.01),脂联素水平明显低于轻度肥胖组[(6.7±3.0)mg/L比(9.1±3.5)mg/L](P<0.01);重度肥胖组血清瘦素、抵抗素水平[分别为(20.4±4.7)、(18.3±3.2)μg/L]明显高于中度肥胖组(P<0.01),脂联素水平[(5.1±1.2)mg/L]明显低于中度肥胖组(P<0.01).结论 儿童脂肪细胞因子水平与肥胖程度密切相关,内脏脂肪堆积可能是造成脂肪因子改变的主要原因之一.     

陆良县单纯性肥胖症儿童血液流变学和血脂指标的研究

目的研究单纯性肥胖症儿童的血液流变学及血脂变化,以便为成年期疾病的早期预防提供科学依据.方法对陆良县3～12岁儿童进行单纯性肥胖症的群体调查,应用全自动血黏度分析仪和生化仪,检测中、重度单纯性肥胖儿童(肥胖组)80例和正常体重健康儿童(对照组)70名的血液流变学和血脂指标.结果肥胖组儿童的三酰甘油、总胆固醇、LDL-C分别为(0.92±0.1)mmol/L,(5.1±1.0)mmoL/L,(1.93±0.3)mmol/L,对照组相应为(0.72±0.1)mmol/L,(4.1±1.0)mmol/L,(1.73±0.3)mmol/L;肥胖组的血浆黏度、红细胞刚性指数分别为(1.77±0.25)mpa·s,3.89±0.55,对照组相应为(1.52±0.20)mpa·s,3.54±0.48,2组的血液流变学指标及血脂指标的差异有显著意义(P值均＜0.05),表现为肥胖组的血浆黏度增高、红细胞变形能力减低及血脂增高.结论单纯性肥胖症儿童出现血液流变学改变和脂代谢紊乱,提示单纯性肥胖症对心血管功能有潜在的危害,是成人肥胖症、心血管疾病的危险因素.     

肥胖症儿童血清脂联素与高敏C反应蛋白水平研究

目的探讨血清中脂联素、高敏C反应蛋白与儿童肥胖症及其相关疾病的关系及临床意义。方法收集74名肥胖症儿童及30名正常对照儿童血清标本。分别检测血清脂联素、高敏C反应蛋白(hs-CRP)、总胆固醇(TCH)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)浓度;并分析脂联素、hs-CRP与体重指数(BMI)、血脂浓度之间的相关性。结果(1)肥胖症儿童血清脂联素及HDL-C水平显著低于正常对照组(P<0.05);(2)肥胖症儿童血清hs-CRP及LDL-C含量显著高于正常对照组(P<0.01);(3)肥胖症儿童血清TCH、TG与正常对照组相比差异无显著性(P>0.05)。结论脂联素、hs-CRP水平的变化与儿童肥胖症及其相关疾病的发病密切相关,对儿童肥胖症的发展趋势及预后判断有一定意义。     

综合健康干预措施对肥胖儿童血脂水平的影响

目的 评估综合健康干预措施对单纯性肥胖儿童血脂水平的影响.方法 采用综合健康干预措施对在深圳市宝安区人民医院治疗的67名单纯肥胖儿童(肥胖组)进行为期1年的干预试验,测定干预前后身高、体重、体重指数(BMI)、血压及血脂水平变化,同时选取65名体重正常儿童作为对照组.结果 肥胖组儿童干预前体重、BMI值、收缩压、舒张压、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均显著高于对照组(P<0.05或P<0.01);干预后BMI、收缩压和TG显著低于干预前(P<0.05或P<0.01),HDL-C明显高于干预前(P<0.05)但显著低于对照组(P<0.05).结论 综合健康干预措施能有效降低单纯性肥胖儿童的体重和BMI,改善其血脂水平,起到调节异常内分泌代谢的作用.     

血清网膜素-1水平与儿童非酒精性脂肪肝的关系

目的 探索网膜素-1与儿童非酒精性脂肪肝(NAFLD)的相关性,为儿童脂肪肝的防治提供参考。方法 将116名肥胖儿童分为肥胖伴脂肪肝组(61名)、肥胖不伴脂肪肝组(55名),同时选择正常体重儿童55名作为对照组,对每位儿童进行身高、体重、腰围、血压等测量,并行血脂、血糖、肝功等化验,留取静脉血清标本测血清胰岛素、网膜素-1、瘦素、脂联素水平等,判断三组间指标差异及网膜素-1与其他指标相关性。采用Logistics回归判断有无脂肪肝与其他指标的关系,采用ROC曲线评估腰围、体重指数(BMI)、网膜素-1水平对儿童脂肪肝诊断标准有无价值。结果 血清网膜素-1在肥胖伴脂肪肝患儿中水平较另两组水平低(P<0.05)。矫正年龄及腰围后网膜素-1与有无合并脂肪肝、瘦素/脂联素(LAR)、低密度脂蛋白胆固醇(LDL-C)为负相关,与脂联素呈正相关(P<0.05)。Logistics回归分析发现BMI、胰岛素抵抗指数(HOMA-IR)为脂肪肝的危险因素,网膜素-1为脂肪肝的保护因素。腰围、BMI、血清网膜素-1水平对儿童脂肪肝诊断有一定价值。结论 血清网膜素-1水平与儿童中心性肥胖、脂代谢紊乱及脂肪肝密切相关,在儿童脂肪肝的发病中有保护作用。     

青春期儿童血清瘦素脂联素与血脂水平的配对研究

目的探讨青春期儿童血清瘦素(LEP)、脂联素(ADIPO)与血脂的关系,为心血管疾病的早期预防提供线索。方法选取13～14岁肥胖和体重正常儿童共73对,用放射免疫法测血清LEP,用酶联免疫法测血清ADIPO,用酶比色法测三酰甘油(TG)及总胆固醇(TC),用沉淀法测高密度脂蛋白(HDL)和低密度脂蛋白(LDL),进行配对分析。结果肥胖组儿童血清LEP(24.011±6.831)μg/L,TG(1.574±0.889)mmol/L水平高于对照组(12.542±6.565)μg/L,(0.913±0.362)mmol/L(P值均=0.000);ADIPO(4.074±2.493)μg/mL,HDL(1.115±0.256)mmol/L水平低于对照组(5.526±3.194)μg/mL,(1.404±0.331)mmol/L(P值均0.01)。女童血清LEP与LDL呈正相关(r=0.246,P=0.043),与HDL呈负相关(r=-0.438,P=0.000);男童血清LEP与TG(r=0.518,P=0.000),TC(r=0.284,P=0.012)均呈正相关,与HDL呈负相关(r=-0.353,P=0.002),ADIPO与HDL呈正相关(r=0.253,P=0.025)。结论青春期肥胖儿童存在瘦素、脂联素和血脂代谢紊乱,瘦素较脂联素与血脂有明显的相关性。     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.