Bone Density Reduction in Patients with Crohn Disease and Associations with Demographic and Disease Variables: Cross-sectional Data from a Population-based Study

Background: The extent of bone density reduction in patients with Crohn disease is still being debated. The aim of this study was to examine bone mineral density (BMD) and factors associated with reduced BMD in a representative population of patients with Crohn disease aged between 20 and 70 years. Methods: BMD (using dual energy X-ray absorptiometry) was measured in spine and hip in 55 patients with Crohn disease recruited from the entire Crohn population (n = 96) in a defined area of southern Norway. Demographic and clinical data were also collected. The patients were compared with 52 ageand gender-matched healthy controls. Potential demographic and disease-related factors associated with BMD reduction were statistically tested with bi- and multivariate analyses. Results: The BMD reduction in patients with Crohn disease was 7.1% (P = 0.02) in spine L1-4, 6.1% (P = 0.08) in femoral neck and 8.4% (P = 0.02) in total hip as compared with the controls. In total hip and femoral neck, age, body weight and gender were independently associated with reduced BMD, but in the spine only body weight. Among the disease-related variables, only ever use of prednisolone was independently associated with reduction in BMD but this only in the femoral neck. Conclusions: The spine and hip BMD reduction of 6%-8% is similar to that found in a comparable population-based study performed in another area in Norway. Among the disease-related variables tested for, only the use of prednisolone was independently associated with BMD reduction. However, the BMD reduction measured in this study indicates that disease-related mechanisms are involved.     

Deranged Vitamin D Metabolism but Normal Bone Mineral Density in Finnish Noncirrhotic Male Alcoholics

To study the effect of prolonged ethanol consumption on calcium metabolism and on the prevalence of osteoporosis we examined 38 Finnish noncirrhotic male alcoholics (30-55 years of age) with dietary interviews and biochemical measurements and by measuring the bone mineral content of the forearm using single photon absorptiometry (SPA) and the bone mineral density of the spine, humerus and proximal femur using nonquantified computer tomography (CT) and dual-energy x-ray absorptiometry (DEXA). In comparison two groups of healthy controls were studied. The mean daily dietary intake of calcium was 1.3 g in the patients and 1.2 g in the controls. The dietary intake of vitamin D was equal in the study groups, too. The serum levels of calcium, phosphate and parathyroid hormone did not show any difference between the patients and controls but in the alcoholics the urinary excretion of calcium was reduced by 42% (p less than 0.0001) as compared to the controls. The serum levels of 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and 24,25-dihydroxyvitamin D3 were reduced in the alcoholics by 40% (p less than 0.0001), 23% (p less than 0.01), and 48% (p less than 0.0001), respectively, as compared to the controls. The alcoholic men had normal levels of serum testosterone and they did not have hypercortisolism. The bone mineral content of the dominant forearm measured by SPA was similar in the study groups as were the bone mineral densities (BMD) of the lumbar and humeral areas measured by CT. The BMD at the lumbar, femoral neck, Ward's triangle and trochanter sites measured by DEXA did not differ, either.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of Citalopram on Alcohol Intake in Heavy Drinkers

The effect of the selective serotonin reuptake inhibitor citalopram (40 mg daily dose) on alcohol intake was investigated in a doubleblind, placebo-controlled cross-over study. Thirty men with heavy alcohol consumption (mean daily alcohol intake 111 ± 51 g pure alcohol) completed the study. After a 2-week baseline period, subjects were randomly allocated to treatment with either citalopram or placebo for 5 weeks. In the total sample of heavy drinkers, no difference was found between citalopram and placebo treatment in alcohol consumption or days of abstinence. However, the response to citalopram was negatively correlated ( r _a=–0.67, p < 0.01) with baseline levels of mean daily alcohol intake. Therefore, we divided the total sample into two subgroups with baseline mean daily alcohol intake above and below median (107 g pure alcohol), respectively. In the group with the higher baseline values (138 ± 25 g pure alcohol), citalopram was not different from placebo in reducing the daily alcohol intake, but in subjects with the lower baseline values (85 ± 15 g pure alcohol), citalopram was significantly ( p < 0.01) superior to placebo. Consequently, citalopram at the present dose appears capable of reducing alcohol intake only in a subgroup of heavy drinkers with a mean daily consumption of between 60 and 100 g pure alcohol.     

老年男性2型糖尿病患者下肢血管病变与骨质疏松的关系

目的探讨老年男性2型糖尿病患者下肢血管病变与骨质疏松的关系。方法老年男性2型糖尿病患者148例,采用双能X线吸收法测定腰椎骨和股骨区的骨密度,同时用超声探测双下肢动脉内膜中膜厚度及粥样斑块等情况。结果无血管病变组33例,轻中度血管病变组65例,重度血管病变组50例,三组间骨密度值依次降低(P<0.05或0.01);多元Logistic回归分析显示,仅年龄、体质指数、下肢血管病变积分为决定骨质疏松的独立危险因素(OR值分别为1.50、0.52及1.87)。结论老年男性2型糖尿病下肢血管病变患者骨密度减低,骨质疏松风险增加。     

上海地区812名老年人尺桡骨骨密度的测定结果

本文报道应用γ线吸收法对上海地区812史60岁以上老人尺橈骨骨密度进行测定,结果与中、壮年比较。男性老年组骨密度平均为0.8002g/cm~2,较中年组(0.8657g/cm~2)、壮年组(0.8386g/cm~2)分别降低7.50％(P<0.01)和4.59％(P<0.01)。女性老年组骨密度平均为0.6216g/cm~2,较中年组(0.7581g/om~2)、壮年组(0.7221g/cm~2)分别降低18％(P<0.01)和10.9％(P<0.01)。女性老年骨密度降低速度比男性老年快2～3倍。812名老人中骨折发生率为14.4％,有骨折者的骨密度明显低于无骨折者。重视对骨密度的监测和骨质疏松症的预防是老年保健的一项重要措施。     

Health Care Providers’ Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016

Objective

Health care providers are encouraged to prescribe lifestyle modifications for preventing and managing obesity and associated chronic conditions. However, the pattern of lifestyle advice provision is unknown. We investigate the prevalence of advised lifestyle modification according to weight status and chronic conditions in a US nationally representative sample.

新疆部分维吾尔族、汉族和哈萨克族居民骨密度影响因素分析

为了确定各种生活因子和膳食营养素对新疆不同民族骨密度的影响,以指导骨质疏松症的防治工作,对新疆乌鲁木齐、伊犁、乌苏、吐鲁番地区20～70岁的维吾尔族、汉族和哈萨克族887名健康人进行问卷调查,并用QCT法测定腰椎松质骨密度(Bone mineral density,BMD)值,结果表明;(1)各民族相比较,哈萨克族和维吾尔族女性BMD高于汉族女性(P相似文献   

Effectiveness of a Comprehensive Lifestyle Modification Program for Asthma Patients: A Randomized Controlled Pilot Trial

Objective. The aim of the study was to investigate the effectiveness and feasibility of conducting a complementary 8-week comprehensive lifestyle modification program (CLMP) compared to standard care in patients with bronchial asthma over a 6-month period. Methods. This was a randomized controlled pilot trial with two groups: intervention (N = 15) group and attention-placebo control (N = 14) group. The intervention group received an 8-week CLMP in addition to standard care. Quality of life, asthma control, lung function, reduction of rescue medication, perceived stress, and psychosocial and spiritual status were measured at the end of the intervention and at the 4-month follow-up. Results. In the intervention group, there was a statistically significant difference in the improvements of quality of life, asthma control, lung function, and the reduction of rescue medication intake at both the end of the intervention and at the 4-month follow-up, with no change being observed in the control group. Significant stress reduction and greater psychosocial and spiritual well-being were observed during the 8-week CLMP in the intervention group. At the end of the intervention, the measures of stress and psychological and spiritual well-being reached statistical significance. Conclusions. Preliminary findings suggest that adding a CLMP to standard care in patients with bronchial asthma offers greater clinical benefit than standard care alone and also suggest that conducting a large randomized clinical trial is feasible.     

Effect of acute ethanol administration on the intestinal absorption of endotoxin in rats

BACKGROUND: Endotoxin has been implicated in the pathogenesis and progression of alcoholic liver disease. Not only inactivation of reticuloendothelial function, which reduces clearance of endotoxin, but also an increase in absorption of endotoxin from the intestine may be involved in mechanisms of ethanol-induced endotoxemia. However, it is unclear how ethanol affects absorption of endotoxin from the intestine in vivo. METHODS: We gave 10 mg/kg of lipopolysaccharides to rats with water (group 1), 5% ethanol (group 2), or 20% ethanol (group 3) using an intubation tube to the stomach. Blood samples were collected and plasma endotoxin levels were measured. We used fluorescence spectrophotometer to examine permeability of the gut to macromolecules (fluorescein isothiocyanate-dextran; 4,000 Da [FD4] or 20,000 Da [FD20]). RESULTS: Plasma endotoxin levels were not different between group 1 (9 +/- 2 pg/ml) and group 2 (14 +/-3 pg/ml), whereas they significantly increased in group 3 with a peak at 60 min (87 +/- 35 pg/ml). Acute ethanol administration did not affect clearance of endotoxin in rats. Hemorrhagic erosions of the proximal small intestine with epithelial cell loss were observed in group 3 at 4 hr, but no significant histological change was observed at 30 min by light microscopy. Acute ethanol administration (20%) increased the permeability of the small intestine to FD4 and FD20 in 30 min when no hemorrhagic erosions of the proximal small intestine with epithelial cell loss were observed. CONCLUSIONS: Acute ethanol administration increases intestinal permeability before pathological changes are revealed by light microscopy. Acute ethanol ingestion, especially at high concentrations, facilitates the absorption of endotoxin from rats' small intestine via an increase in intestinal permeability, which may play an important role in endotoxemia observed in alcoholic liver injury.     

Effect of ALDH2 and CYP2E1 Gene Polymorphisms on Drinking Behavior and Alcoholic Liver Disease in Japanese Male Workers

Aims: We examined the relationships of ALDH2 and CYP2E1 genotypes on drinking behavior and the incidence of alcoholic liver disease in Japanese male workers.
Methods: Two hundred and eighty-seven Japanese men were selected from one metal company to adjust for similar economic and social backgrounds. Drinking behavior was assessed from a self-assessment questionnaire. Genotypes of ALDH2 and CYP2E1 were analyzed with the polymerase chain reaction-single strand conformation polymorphism and with the polymerase chain reaction-restriction fragment length polymorphism, respectively.
Results: The frequency of the ALDH2 genotype was 55% for typical homozygotes, 42% for heterozygotes, and 4% for atypical homozygotes. The frequency of the CYP2E1 genotype was 62% for c1 homozygotes, 35% for heterozygotes, and 3% for c2 homozygotes. The ALDH2 genotype closely influenced drinking habits, but not the CYP2E1 genotype. Among habitual drinkers, ALDH2 typical homozygotes consumed significantly larger amounts of ethanol than ALDH2 heterozygotes, whereas CYP2E1 genotypes did not influence daily alcohol consumption. Sixteen men (5.6%) were diagnosed with alcoholic liver disease. In terms of ALDH2 genotypes, 12 cases (7.6%) were typical homozygotes and 4 (3.4%) were heterozygotes, whereas the incidence of alcoholic liver disease was not different between c1/c1 homozygotes and c1/c2 heterozygotes. When the interactive contribution of the ALDH2 and CYP2E1 genotypes on drinking behavior and the incidence of alcoholic liver disease were examined, there were no significant differences in the CYP2E1 genotype among the subjects with the same ALDH2 genotype.
Conclusion: The ALDH2 genotype is strongly associated with individual alcohol drinking behavior and the development of alcoholic liver disease in Japanese male workers, but the CYP2E1 genotype is not.     

生活方式干预对妊娠糖尿病病人的血糖控制和妊娠结局的影响探讨

目的研究分析生活方式干预对妊娠糖尿病患者的血糖控制和妊娠结局的影响。方法选取该院2013年5月—2014年5月所收治的妊娠糖尿病患者130例作为研究对象,按随机表法将其分成两组,即观察组与对照组,对照组患者采取常规护理措施,在此基础之上,对观察组患者实施生活方式干预措施,并对两组患者的血糖控制及其妊娠结局进行对比与观察。结果干预前,观察组与对照组在FPG、2hPG以及HbAlc等的比较上无明显差异;干预后,观察组患者FPG、2hPG以及HbAlc等指标明显低于对照组,差异显著,具有统计学意义（P〈0.05）。结论在常规护理的基础之上,对妊娠期糖尿病患者实施生活方式干预,能够有效降低患者的血糖水平,降低并发症的发生率,值得在临床上大力推广与使用。     

理想心血管健康行为和因素对非酒精性脂肪性肝病发病的影响

目的探究理想心血管健康行为和因素与非酒精性脂肪性肝病（NAFLD）发病的关系,为制订NAFLD的防控策略提供依据。方法采用回顾性队列的研究方法,收集2006年7月—2007年6月50 511例参加健康查体的开滦集团职工的体检资料,并在随后每2年1次的随访中,观察NAFLD的发病情况。正态分布的计量资料多组间比较采用单因素方差分析;偏态分布的计量资料多组间比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ²检验。根据心血管简易评分（CHS）四分位水平将观察对象分为四组,采用人年发病率计算各组人群NAFLD的发病情况,使用限制性立方样条曲线（RCS）计算连续型变量与结局事件间的剂量-反应关系,采用Cox比例风险模型分析各组NAFLD的发病风险比及95%CI,并对心血管健康行为和因素各组分对NAFLD发病的影响进行了Cox比例风险模型分析。结果在平均5.58年的随访过程中,共发生NAFLD 15 265例,Q1、Q2、Q3、Q4组观察对象人年发病率分别为77.88/千人年、61.33/千人年、46.37/千人年、33.69/千人年。RCS结果表明,CH...     

Cyclophilin A通过调控炎症/免疫反应介导动脉粥样硬化

亲环素A(Cyclophilin A,CyPA)是一种胞质蛋白,属于亲免素家族。亲环素A是既可由氧化应激诱导释放,又可触发细胞免疫反应的前炎症因子。由于动脉粥样硬化是一种全身性、慢性进展性的血管炎症病变,亲环素A刺激的炎症/免疫反应参与了动脉粥样硬化性疾病的病理生理过程。1亲环素A与血管细胞粘附血管细胞粘附分子存在于血管内皮细胞膜上,由致炎因子刺激增加,在体内参与许多生理和病理过程。作者从氧化应激处理的血管平滑肌条件培养液....     

Bone Marrow Stem Cells for the Treatment of Ischemic Heart Disease: A Clinical Trial Review

Cardiovascular disease continues to represent a significant and growing source of morbidity and mortality despite advances in traditional treatments. As a result, increasing interest and research in regenerative therapies has emerged in recent years. Among them, cell therapy represents an area of significant potential. An expanding clinical literature now exists involving the use of bone marrow-derived stem cells in the treatment of ischemic heart disease. These early studies appear to provide promising results in patient populations that include those with refractory angina, ischemic cardiomyopathy with left ventricular dysfunction, and end-stage heart failure. This review serves to provide a comprehensive examination of these clinical trials focused on several components including cell preparation, cell delivery, safety, and efficacy of these trials.     

Effects of Uremic Toxins from the Gut Microbiota on Bone: A Brief Look at Chronic Kidney Disease

Patients with chronic kidney disease (CKD) frequently have mineral and bone disorders (CKD‐MBD) that are caused by several mechanisms. Recent research has suggested that uremic toxins from the gut such as p‐cresyl sulfate (PCS) and indoxyl sulfate (IS) could also be involved in the development of bone disease in patients with CKD. IS and PCS are produced by microbiota in the gut, carried into the plasma bound to serum albumin, and are normally excreted into the urine. However, in patients with CKD, there is an accumulation of high levels of these uremic toxins. The exact mechanisms of action of uremic toxins in bone disease remain unclear. The purpose of this brief review is to discuss the link between uremic toxins (IS and PCS) and bone mineral disease in chronic kidney disease.     

The effect of a modified etidronate cyclical regimen on postmenopausal osteoporosis: A four-year study

Summary To develop an improved treatment schedule for osteoporosis, a study was undertaken in 100 postmenopausal women using a modified ADFR 90-day cyclical regimen with etidronate. After one year of treatment, the etidronate-treated group showed a significant increase in bone density of the spine, which continued over the following 2 years of treatment and remained stable during the fourth year. In contrast, in the non-etidronate group, bone density decreased significantly after four years. In addition, the fracture rate was significantly lower in the etidronate group than in the non-etidronate group. Side effects were minimal in both groups and no serious adverse reactions were reported. In conclusion, it appears that a cyclical regimen using 1,25-dihydroxyvitamin D₃, etidronate and calcium increases bone mass and reduces fractures with no significant side effects, thus making a useful contribution in the treatment of postmenopausal osteoporosis.     

Effect of Abstinence from Alcohol on the Depression of Glutathione Peroxidase Activity and Selenium and Vitamin E Levels in Chronic Alcoholic Patients

Glutathione peroxidase activity and selenium and vitamin E levels were measured in the plasma and erythrocytes of 25 chronic alcoholic patients without liver cirrhosis before and after 14 days of abstinence from alcohol, and compared with the levels in 25 sex-and age-matched healthy controls. Before abstinence, all three levels were shown significantly depressed in the alcoholic patients compared with the controls, in both plasma (80, 71, and 89% of control values) and erythrocytes (68, 70, and 83% of control values). After a 14-day abstinence period with no dietary supplementation, a trend towards normalization was noted in erythrocyte (vitamin E and glutathione peroxidase 74 and 91% of control values respectively), in whole blood selenium (82%) and plasma in vitamin E (74%). However, plasma selenium and glutathione peroxidase values were lower than pre-abstinence values (76% and 86% of control values respectively).
Our results point to a deficiency in the antioxidant defense system of chronic alcoholics before the occurrence of severe liver disease. This lack of protection against lipoperoxides is all the more important in circumstances like chronic alcohol consumption, in which lipid peroxidation is known to increase. However, the present study also demonstrated that during 14 days of a normal diet free of ethanol, a rapid trend occurred towards the normalization of the factors.