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1.
Introduction
Despite the considerable overlap of asthma and chronic obstructive pulmonary disease (COPD), the extent to which the two diagnoses are the manifestations of the same disease remains unresolved. We conducted these analyses to evaluate the role of active asthma in the prevalence of physician-diagnosed COPD.Methods
From 2006 through 2010, 74,209 adults aged 18–99 years and with a history of asthma participated in the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey and responded to interview-administered questionnaires via telephone. We used publicly available data from 71,639 (97%) participants to identify respondents with and without active manifestations of asthma and self-reported, physician-diagnosed COPD. We generated population-weighted estimates of physician-diagnosed COPD prevalence and conducted linear regression to estimate associations between active asthma status and the prevalence of COPD among current smokers, former smokers, and lifetime nonsmokers separately.Results
Physician-diagnosed COPD was reported in an estimated 29% of the population with any history of asthma, including both active and inactive asthma. Age-specific prevalences of physician-diagnosed COPD were consistently higher among adults with active asthma than adults without active asthma. Compared to inactive asthma, active asthma was associated with an 8.3% [95 % confidence interval (CI) 6.1, 10.5] higher prevalence of physician-diagnosed COPD among lifetime nonsmokers, a 20.6% (95 % CI 18.0, 23.3) higher prevalence among former smokers, and a 26.7% (95 % CI 22.5, 30.9) higher prevalence among current smokers.Conclusions
Among adults with a history of asthma, active manifestations of asthma may play an important role in the epidemiology of COPD. 相似文献2.
Purpose
The aim of our study was to evaluate volumetric capnography (VCap) in the differentiation between chronic obstructive pulmonary disease (COPD) patients and normal subjects.Patients and Methods
Thirty-nine healthy male volunteers and 60 male COPD patients were enrolled. Regression equations between VCap indices and age, weight, height, and tidal volume in healthy volunteers were established by stepwise regression analysis. Predicted normal values of VCap indices in COPD patients were calculated. A paired t test was used to compare the difference between observed and predicted values for VCap indices in COPD patients. Receiver operating characteristic (ROC) curve analysis was used to evaluate the power of each VCap index alone in differentiating COPD patients and normal subjects. The power of the combination of VCap indices was assessed by discriminant analysis.Results
All regression equations were significant (P < 0.01) as were the differences between the observed and predicted normal VCap indices in COPD patients (P < 0.001). ROC curve analysis showed that the volume between 25 and 50 % of F CO2et (Vm25-50), slope of Phase II (dC2/dV), and slope of Phase III (dC3/dV) were valuable predictors. Nearly all (90.9 %) subjects were correctly classified by discriminant analysis.Conclusion
Vm25-50, dC2/dV, or dC3/dV alone are valuable for differentiating COPD patients and normal subjects, but more powerful are the combinations of Vm25-50, dC2/dV, and dC3/dV, the ratio of dC2/dV to dC3/dV (SR23), dead space according to the Bohr method (VDB), and dead space according to the Wolff and Brunner methods (PIE). 相似文献3.
Paola Rogliani Luigino Calzetta Andrea Segreti Annapina Barrile Mario Cazzola 《Acta diabetologica》2014,51(6):933-940
Type 2 diabetes mellitus is a common comorbidity of COPD, but there are still many doubts about the relation among diabetes and COPD. We retrospectively collected data from patients afferent to our Respiratory Diseases outpatient clinic at the Tor Vergata University Hospital between 2010 and 2012. The study population was analyzed by clusters of age, gender, body mass index (BMI), smoking status, lung function, concomitant pharmacologic therapies and comorbidities. The values of the association between variables were expressed as odds ratio. Data were adjusted for gender, age and possible confounding variables by Mantel–Haenszel method. We identified 493 patients with COPD. Ninety-two (18.7 %) patients were affected by type 2 diabetes mellitus, with no significant gender differences. The prevalence distribution was similar among the different age clusters, but the association was stronger in patients younger than 65 years. The association was present only in obese subjects in whom it was significant only in patients with moderate-to-severe COPD, but not mild COPD. The presence of cardiovascular diseases was significantly associated with diabetes mellitus in patients with COPD. There was a slight association of inhaled corticosteroid (ICS) use with the presence of diabetes mellitus in COPD, but the combination of an ICS with a β2-agonist apparently reduced this association. The association with type 2 diabetes mellitus was greater in patients with COPD respect to general population, and correlated with the increase in BMI and the presence of other comorbidities, suggesting that both diseases may be targets of systemic inflammation. 相似文献
4.
Background
Gamma-glutamyltransferase (GGT) levels within the normal reference range, possibly a biomarker of oxidative stress and/or exposure to various environmental chemicals, are associated with pulmonary function. However, it is unclear whether it is totally independent of cigarette smoking. Also, the potential interaction between serum GGT and cigarette smoking has not ever been evaluated. Therefore, this study investigated (1) whether serum GGT levels are associated with pulmonary function and chronic obstructive pulmonary disease (COPD), independent of cigarette smoking, and (2) whether there is any interaction between serum GGT and cigarette smoking status on pulmonary function.Methods
The study subjects were 4,583 participants aged ≥40 in the 2010–2011 Korean National Health and Nutrition Examination Survey. The outcomes were pulmonary function (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]) and spirometrically defined COPD.Results
After adjusting for potential confounders, including cigarette smoking, serum GGT levels were inversely associated with FEV1 and FVC in both genders and positively associated with the risk of COPD in men (all P values <0.01). In men, adjusted odds ratios of COPD were 1.0, 1.69, 1.97, and 2.02 across the quartiles of GGT level (P trend = 0.002). However, the associations between serum GGT and pulmonary function seemed to differ depending on the smoking status; inverse associations of GGT with FEV1 % and FVC % were clearly observed only among non-current smokers.Conclusions
In conclusion, in non-smokers serum GGT levels can be used to detect individuals at high risk of decreased pulmonary function and/or COPD. 相似文献5.
The relationship between indices of the single-breath nitrogen test (SBNT) measured in 1974 and hospitalization in the 9 year period 1977–1986 was examined in a random population sample of 876 men aged 46–69 years. Men who could not perform acceptable SBNT tracings had an increased risk of hospitalization due to respiratory disease in general. When age and smoking habits were controlled for, slope of phase III was significantly related to hospitalization due to respiratory disease in general and chronic obstructive pulmonary disease (COPD), whereas closing volume and closing capacity were marginally related to hospitalization due to respiratory disease in general but not to hospitalization due to COPD. The relationship between slope of phase III and hospitalization due to COPD remained significant after the forced expiratory volume in 1 sec (FEV1) was controlled for: odds ratio 1.4 per % N2/L (95% confidence interval 1.1–1.7). The effect of the slope of phase III was considered to be clinically insignificant, and we conclude that in a random population sample indices from only 1 SBNT do not provide prognostic information concerning hospitalization in addition to that provided by FEV1. 相似文献
6.
Dr. A.Ç. Aykan T. Gökdeniz F. Boyacı İ Gül E. Hatem E. Kalaycıoğlu T. Turan H. Bektaş M.B. Çilingir D.A. Aykan F. Ayyıldız S. Altun 《Herz》2014,39(7):822-827
Background
Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular morbidity and mortality. Increased arterial stiffness is associated with the presence and severity of cardiovascular disease. The cardio-ankle vascular index (CAVI) is a new method for assessment of arterial stiffness that is not influenced by blood pressure at the time of measurement and is significantly correlated with the presence and severity of cardiovascular disease. The aim of the present study was to evaluate whether there is an association between the spirometric severity of COPD, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, with arterial stiffness as assessed by CAVI.Methods
We enrolled 123 patients with COPD (102 men) followed up by the chest medicine outpatient clinics and 35 healthy subjects (26 men). All patients were assessed with spirometry, CAVI, and clinical history.Results
Patients with COPD had significantly increased CAVI values compared with control subjects (10.37?±?2.26 vs. 6.74?±?1.42, p?0.001). CAVI was correlated with FEV1?% predicted, FEV1/FVC, and COPD stage (r: ??0.54, p?0.001; r: ??0.58, p?0.001 and r: 0.78, p?0.001, respectively). Multivariate regression analysis showed that CAVI was independently associated with GOLD stages (p?0.001).Conclusion
In this study, we have shown that increased arterial stiffness assessed by CAVI is associated with the spirometric severity of COPD. 相似文献7.
Olga Amengual Tetsuya Horita Walter Binder Gary L. Norman Zakera Shums Masaru Kato Kotaro Otomo Yuichiro Fujieda Kenji Oku Toshiyuki Bohgaki Shinsuke Yasuda Tatsuya Atsumi 《Rheumatology international》2014,34(9):1225-1230
Phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) were strongly correlated with the presence of lupus anticoagulant showing a high specificity for the diagnosis of antiphospholipid syndrome. However, the main criticism for the clinical applicability of aPS/PT testing is the lack of reproducibility of the results among laboratories. In this study, we measured IgG and IgM aPS/PT using our original in-house enzyme-linked immunosorbent assays (ELISA) and commercial ELISA kits to assess the assay performance and to evaluate the accuracy of aPS/PT results. The study included 111 plasma samples collected from patients and stored at our laboratory for aPS/PT assessment. Sixty-one samples were tested for IgG aPS/PT using two assays: (1) aPS/PT in-house ELISA and (2) QUANTA Lite? aPS/PT IgG ELISA kit (INOVA Diagnostics, Inc., USA). Fifty samples were evaluated for IgM aPS/PT using two assays: (1) aPS/PT in-house ELISA and (2) QUANTA Lite? aPS/PT IgM ELISA kit (INOVA Diagnostics). Ninety-eight percent of samples yielded concordant results for IgG aPS/PT and 82 % for IgM aPS/PT. There was an excellent agreement between the IgG aPS/PT assays (Cohen κ = 0.962) and moderate agreement between the IgM aPS/PT assays (κ = 0.597). Statistically significant correlations in the aPS/PT results were obtained from both IgG and IgM aPS/PT assays (r = 0.749, r = 0.622, p < 0.001, respectively). In conclusion, IgG and IgM detection by ELISA is accurate. The performance of aPS/PT is reliable, and concordant results can be obtained using different ELISA methods. 相似文献
8.
We review the impact of mitochondrial DNA (mtDNA) maintenance and mitochondrial function on the aging process. Mitochondrial function and mtDNA integrity are closely related. In order to create a protective barrier against reactive oxygen and nitrogen species (RONS) attacks and ensure mtDNA integrity, multiple cellular mtDNA copies are packaged together with various proteins in nucleoids. Regulation of antioxidant and RONS balance, DNA base excision repair, and selective degradation of damaged mtDNA copies preserves normal mtDNA quantities. Oxidative damage to mtDNA molecules does not substantially contribute to increased mtDNA mutation frequency; rather, mtDNA replication errors of DNA PolG are the main source of mtDNA mutations. Mitochondrial turnover is the major contributor to maintenance of mtDNA and functionally active mitochondria. Mitochondrial turnover involves mitochondrial biogenesis, mitochondrial dynamics, and selective autophagic removal of dysfunctional mitochondria (i.e., mitophagy). All of these processes exhibit decreased activity during aging and fall under greater nuclear genome control, possibly coincident with the emergence of nuclear genome instability. We suggest that the age-dependent accumulation of mutated mtDNA copies and dysfunctional mitochondria is associated primarily with decreased cellular autophagic and mitophagic activity. 相似文献
9.
Yochai Birnbaum Manjyot K. Nanhwan Shukuan Ling Jose R. Perez-Polo Yumei Ye Mandeep Bajaj 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2014,28(5):447-457
Purpose
Statins increase the incidence of new onset diabetes. Prolonged statin therapy upregulates PTEN expression. PTEN levels are also elevated in diabetic animals. Activation of protein kinase A by cAMP decreases PTEN expression. We assessed whether prolonged treatment with rosuvastatin (ROS) induces glucose intolerance by upregulating Phosphatase and Tensin Homologue on Chromosome 10 (PTEN) in mice receiving normal (ND) or Western Diet (WD) and whether concomitant treatment with cilostazol (CIL, a phosphodiesterase-3 inhibitor) attenuates the effects.Methods
PTENloxp/cre or PTEN+/? mice received ND or WD without or with ROS (10 mg/kg/day). Wild-type mice received ND or WD without or with ROS, CIL (10 mg/kg/day), or ROS+CIL for 30 days. Fasting insulin and glucose tolerance test were measured as well as PTEN and P-AKT levels in skeletal muscle.Results
Serum glucose after intraperitoneal injection of glucose was higher in PTENloxp/cre mice receiving WD or ROS and especially WD+ROS. Levels were lower in PTEN+/? mice compared to PTENloxp/cre in each treatment group. CIL decreased glucose levels in mice receiving WD, ROS and their combination. Insulin levels were higher in the WD+ROS group. CIL decreased insulin in mice receiving WD+ROS. WD, ROS and especially their combination increased PTEN and decreased P-AKT levels. CIL attenuated the effect of WD, ROS and their combination.Conclusions
Long-term ROS can induce diabetes by upregulating PTEN. CIL attenuates these changes. Partial knockdown of PTEN also ameliorates ROS-induced insulin resistance. Further studies are needed to assess the effects of increasing cAMP levels to prevent the induction of diabetes by statins. 相似文献10.
Arnab Ghosh Anuradha Moirangthem Rabindranath Dalui TapanKumar Ghosh Arghya Bandyopadhyay Anindya Dasgupta Uma Banerjee Narayan Jana Anupam Basu 《Journal of cancer research and clinical oncology》2014,140(9):1585-1593
Purpose
The objective was to study the gelatinolytic activity of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in preinvasive and invasive carcinoma of the uterine cervix. The expressions were analysed against different age groups, as to demonstrate whether the expression of MMP-2 and MMP-9 is an early or a late event during the progression of cervical cancer. Additionally, the diagnostic accuracy of MMP-2 and MMP-9 was evaluated with ROC curve.Methods
A total number of 180 samples of cervical tissue were studied for MMP-2 and MMP-9 gelatinolytic activity. The cases were selected as to include 63 normal cases, 94 CIN cases and 23 cervical carcinoma cases. Among 94 CIN cases, 40 were CIN1, 26 were CIN2 and 28 were CIN3, as reported by histopathology. The gelatinolytic activities of MMP-2 and MMP-9 were evaluated by gelatin zymography in premenopausal and postmenopausal groups.Results
MMP-2 expressions (latent and active) were very low in control samples, followed by increase in CIN1, decrease in CIN2 and further increase in advance stages. MMP-9 had also shown the same expression pattern that of MMP-2. While comparing the expression of MMP-2 and MMP-9 in different age groups, we found initial CIN stages were prevalent in early age that expressed considerable amount of MMP-2 and MMP-9, and advance stages of carcinoma cervix were prevalent at an elderly age.Conclusion
Both MMP-2 and MMP-9 have role in cancer progression and remodelling of the ectocervix. Although expression level varies intricately, a distinctive ROC curve demonstrated MMP-2 active form and MMP-9 form could be used in diagnostic purpose in detection of cervical lesion and cancer. 相似文献11.
Background
Interest in using the nitrogen single-breath washout (N2SBW) test to measure ventilation inhomogeneity and small airway function in COPD patients has grown in recent years. Our aim was to assess the correlation of the measures obtained by the N2SBW test and other pulmonary function parameters with the six-minute walk distance (6MWD), the degree of dyspnea score, and health status in COPD patients.Methods
In this cross-sectional study, 31 patients with COPD were subjected to the N2SBW test, spirometry, whole-body plethysmography, carbon monoxide diffusing capacity measurement, the six-minute walk test, the modified Medical Research Council (mMRC) scale, and the COPD Assessment Test (CAT).Results
We found a strong correlation between the 6MWD and the phase III slope of the nitrogen single-breath washout (Phase III slopeN2SBW) (r = ?0.796; p = 0.0001). We found moderate correlations between the 6MWD and the residual volume (RV) (r = ?0.651; p = 0.0001) and RV/total lung capacity (RV/TLC) (r = ?0.600; p = 0.0004). We also found moderate correlations between the CAT score and Phase III slopeN2SBW (r = 0.728; p = 0.0001), RV (r = 0.646; p = 0.0001) and RV/TLC (r = 0.603; p = 0.0003). There was a significant difference between the mMRC grades for the following variables: Phase III slopeN2SBW (p = 0.0001), RV (p = 0.0001), and smoking history (p = 0.008). Multivariate analysis showed that Phase III slopeN2SBW was the only independent predictor of the 6MWD (R 2 = 0.703; p = 0.0001), CAT score (R 2 = 0.586; p = 0.0001), and mMRC scale (relative risk = 1.14; p = 0.0001).Conclusions
In patients with COPD, our findings suggest that the ventilation inhomogeneity impacts the functional exercise capacity, the degree of dyspnea, and health status. 相似文献12.
Chuang Wang Jianrui Zhang Yang Lu Peipei Lin Tonghe Pan Xin Zhao Aiming Liu Qinwen Wang Wenhua Zhou Han-Ting Zhang 《Metabolic brain disease》2014,29(3):673-682
Inhibition of phosphodiesterase-4 or 5 (PDE4 or PDE5) increases cyclic adenosine monophosphate (cAMP)- or cyclic guanosine monophosphate (cGMP), respectively, which activates cAMP response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF)/neuropeptide VGF (non-acryonimic) signaling and produces antidepressant-like effects on behavior. However, causal links among these actions have not been established. In the present study, mice were evaluated for the effects of etazolate and sildenafil, the inhibitor of PDE4 or PDE5, respectively, on depressive-like behavior induced by chronic unpredictable mild stress (CUMS) in the forced-swimming test (FST) and tail suspension test (TST), in the presence or absence of the inhibitor of protein kinase A (PKA) or protein kinase G (PKG) via intracerebroventricular (i.c.v.) infusions. The levels of cAMP, cGMP and expression of pCREB, CREB, BDNF and VGF in both the hippocampus and prefrontal cortex were determined. The results showed that etazolate at 5.0 mg/kg or sildenafil at 30 mg/kg significantly reversed CUMS-induced depressive-like behavior; the effects were paralleled with the increased levels of cAMP/pCREB/BDNF/VGF or cGMP/pCREB/BDNF/VGF signaling, respectively. These effects were completely abolished following inhibition of PKA or PKG, respectively. The results suggest that inhibition of PDE4 by etazolate or PDE5 by sildenafil produced antidepressant-like effects in CUMS-treated animals via cAMP or cGMP signaling, which shares the common downstream signal pathway of CREB/BDNF/VGF. 相似文献
13.
14.
15.
Liwei Zhang Dangsheng Huang Qiushuang Wang Dong Shen Yumei Wang Bingyang Chen Jinqian Zhang Luyue Gai 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2014,28(4):303-311
Purpose
Inflammation participates centrally in all stages of atherosclerosis (AS), which begins with pro-inflammatory processes and inflammatory changes in the endothelium, related to lipid metabolism. MicroRNA (miRNA) inhibition of inflammation related to SIRT1 has been shown to be a promising therapeutic approach for AS. However, the mechanism of action is unknown.Methods
We investigated whether miRNAs regulate the SIRT1 and its downstream SREBP-lipogenesis-cholesterogenesis metabolic pathway in human umbilical vein endothelial cells (HUVECs). HUVECs were transfected with miR-132 mimics and inhibitors, and then treated with or without tumor necrosis factor α (TNFα). The effects of miR-132 on pro-inflammatory processes, proliferation and apoptosis were assessed.Results
We identified that the relative 3’ UTR luciferase activities of SIRT1 were significantly decreased in miR-132 transfected HUVECs (0.338?±?0.036) compared to control (P?=?0.000). miR-132 inhibited SIRT1 expression of mRNA level in HUVECs (0.53?±?0.06) (P?0.01) as well as proteins of SIRT1. mRNA expression and protein levels of SREBP (0.45?±?0.07), fatty acid synthase (FASN) (0.55?±?0.09) and 3-hydroxy-3-methylglutaryl CoA reductase (HMGCR) (0.62?±?0.08) (P?0.01), which are downstream regulated genes, were reduced in HUVECs by miR-132. MiR-132 promoted pro-inflammatory processes and apoptosis of HUVECs induced by TNF-α, and inhibited its proliferation, viability and migration.Conclusions
SIRT1 mRNAs are direct targets of miR-132. miR-132 controls lipogenesis and cholesterogenesis in HUVECs by inhibiting SIRT1 and SREBP-1c expression and their downstream regulated genes, including FASN and HMGCR. Inhibition of SIRT1 by miR-132 was associated with lipid metabolism-dependent pro-inflammatory processes in HUVECs. The newly identified miRNA, miR-132 represents a novel targeting mechanism for AS therapy. 相似文献16.
Maria Francesca Cassarino Antonella Sesta Luca Pagliardini Marco Losa Giovanni Lasio Francesco Cavagnini Francesca Pecori Giraldi 《Pituitary》2014,17(5):464-469
Purpose
It is well known that methylation plays an important role in regulating tissue expression of proopiomelanocortin (POMC) and recent studies have shown that demethylation can occur also in vitro in neuroendocrine tumors. Aim of the present study was to evaluate whether inhibition of methylation modulates POMC expression and ACTH secretion by human corticotrope tumors.Methods
Twenty two ACTH-secreting pituitary tumors were incubated with 5-AZA-2′-deoxycytidine (AZA), an inhibitor of DNA-methyltransferases, with or without 10 nM corticotropin-releasing hormone (CRH). Both dose response (100 nM–10 μM AZA) and time course (4–96 h) experiments were carried out for measurement of ACTH secretion and POMC gene expression.Results
Incubation with AZA increased constitutive POMC expression and ACTH secretion by human corticotrope adenomas. The effect appeared most notable at 24 and 48 h with 1 μM AZA. Incubation with AZA did not exert an additional stimulatory effect on CRH-stimulated POMC and ACTH.Conclusions
The present study shows that AZA increases POMC gene expression and ACTH secretion in human pituitary ACTH-secreting tumors. This can be taken to indicate that mechanisms set into motion by AZA play a role in the regulation of ACTH secretion/POMC expression in tumoral corticotropes and paves the way to further studies in Cushing’s disease. 相似文献17.
18.
H. Gungor MD M. Fatih Ayik C. Engin T. Yagdi Y. Atay M. Ozbaran S. Nalbantgil 《Herz》2014,39(5):633-637
Objective
The six-minute walk test (6MWT) evaluates the functional exercise capacity in patients with cardiopulmonary disease. We aimed to investigate the association between 6MWT distance and transthoracic echocardiographic (TTE) findings as well as cardiopulmonary exercise testing (CPET) parameters in Eisenmenger’s syndrome (ES) patients waiting for heart–lung transplantation on their initial admission to our center.Patients and methods
A total of 23 patients with ES (12 women, 11 men; mean age, 28.2?±?8.1 years) were included in the study. The correlation between 6MWT distance and CPET and TTE findings was retrospectively analyzed.Results
The most frequent underlying heart diseases were ventricular septal defect (VSD) with complex congenital heart disease (n?=?10, 43?%) and isolated VSD (n?=?7, 30?%). The 6MWT distance was 349.7?±?77.4 m in the study group. An inverse correlation was found between 6MWT distance and systolic pulmonary arterial pressure (SPAP) measured with TTE (r?=???0.445; p?=?0.03). All patients underwent CPET at the first visit. Mean VO2 max was 14.9?±?3.3 ml/kg/min and the VE/VCO2 rate was 50.4?±?9.2?%. No significant correlation was observed between 6MWT and CPET findings. SPAP, which did not display any correlation with CPET findings, was the only independent predictor of 6MWT distance.Conclusion
We suggest that 6MWT distance may be more suitable than CPET in the follow-up of ES patients. Further prospective, randomized, controlled trials are necessary to make more robust interpretations of this issue. 相似文献19.
20.
Ling Liu Qinghua Tan Bin Hu Hao Wu Chunhui Wang Chengwei Tang 《Digestive diseases and sciences》2014,59(10):2423-2432