肥胖者内脏脂肪蓄积与脂代谢的关系

目的:研究内脏脂肪蓄积与脂代谢的相关性。方法:选择首次就诊的163名单纯性肥胖病人。采用CT测定腹腔内脂肪面积,依据腹腔内脂肪面积分为内脏型肥胖组(腹腔内脂肪面积≥100cm2,115例)及皮下型肥胖组(腹腔内脂肪面积<100cm2,48例),并进行人体指标、脂代谢指标测定。结果:与皮下型肥胖组比较,内脏型肥胖组甘油三酯[TG,(1.69±1.51)mmol/L比(2.67±2.61)mmol/L]、总胆固醇[TC,(5.07±1.03)mmol/L比(5.65±1.19)mmol/L]水平显著升高(P<0.01),高密度脂蛋白胆固醇[HDL-C,(1.17±0.48)mmol/L比(1.02±0.22)mmol/L]水平显著降低(P<0.05)。直线相关分析显示,腹腔内脂肪面积与TG呈正相关(r=0.235,P=0.003),与HDL-C负相关(r=-0.162,P=0.039)。结论:内脏脂肪蓄积与脂代谢紊乱密切相关。     

银杏叶提取物对健康老年人冠状动脉血流的影响

衰老使血管内皮分泌活性一氧化氮能力下降,诱发血管内皮功能障碍和冠状动脉血流调节异常[1,2].研究发现,银杏叶提取物具有明显的抗衰老作用[3],可明显改善血管内皮功能,提示银杏叶提取物有可能减轻衰老诱发的冠状动脉血流调节的异常,对于心血管疾病的预防产生有益的作用.然而,尚未见银杏叶提取物对健康老年人冠状动脉血流的研究报道.本实验观察银杏叶提取物注射液对健康老年人冠状动脉左前降支血流的影响.     

心外膜脂肪因子促进血管新生的分子机制

心外膜脂肪组织是沉积在心脏尤其是冠状动脉周围的脂肪组织,可以表达多种脂肪因子参与动脉粥样硬化的发生与发展,最近这些脂肪因子已经被证实还可以引起冠状动脉粥样硬化斑块内的血管新生。这些新生血管在斑块内可能具有双重效应：一方面,新生血管具有很强的通透性,可以改善斑块局部缺氧状况;另一方面,新生血管可能促进斑块进展并导致其不稳定性增加。因此,通过研究脂肪因子致血管新生作用的机制,抑制斑块内的血管新生增强其稳定性可能成为未来治疗冠心病新的靶点。     

彩超评价原发性高血压对老年肾脏血流动力学参数的影响

目的应用多普勒超声技术观察、分析老年原发性高血压患者肾脏血流动力学的改变,为临床进行早期干预、治疗提供参考指标。方法将我院住院的45例老年原发性高血压患者分成2组,即血压控制不佳组（A组）和血压控制尚好组（B组）,并选取20例正常老年人作为对照组（C组）,均进行肾动脉彩色多普勒超声检查,分别获得三级肾动脉（肾主动脉、肾段动脉、叶间动脉）的收缩期最大流速（PSV）、舒张末期最低流速（EDV）、收缩期加速时间（AT）和阻力指数（RI）,在此基础上将2组高血压患者分别与C组进行对比研究。结果老年人在非空腹状态下检查,肾动脉的显示满意率为94.6%。A组中发现3例肾动脉狭窄疑似病例。A组三级肾动脉的EDV较C组减低,RI较C组增高,差异显著（P均〈0.05）,而PSV、AT比较无显著差异（P〉0.05）。B组肾动脉的各项血流参数与C组间均无显著差异（P〉0.05）。结论对于条件合适的老年人,可以适度放宽超声检查前的准备要求。对于长期血压波动的老年人,应定期做肾动脉检查,及时排除动脉粥样硬化性肾动脉狭窄。老年人控制高血压对于预防高血压肾病有重要意义;肾动脉的RI可作为高血压引起肾功能损害的监测指标之一。     

血管外膜周围脂肪组织对动脉张力的影响

前言 血管活性和再塑受神经因子[1]、内分泌因子[2]和内皮细胞衍生的血管活性因子[3,4]等所调节.近年来,越来越多的研究着重于脂肪组织对血管功能的影响.长期以来,脂肪组织一直被认为是一种无活性的能量库.     

体重指数对心周脂肪与代谢综合征关系的影响

目的探讨体重指数(BMI)对心周脂肪与代谢综合征(MS)关系的影响。方法入选776例患者均行心脏双源CT检查,在心脏平扫图像上测量心周脂肪含量。根据BMI标准将患者分为3组:正常体重组(18.5 kg/m~2≤BMI<24 kg/m~2)、超重组(24 kg/m~2≤BMI<28 kg/m~2)和肥胖组(BMI≥28 kg/m~2)。结果 3组患者平均心周脂肪含量分别为(179.21±90.03)cm~3、(227.40±77.22)cm~3和(278.10±112.63)cm~3,与正常体重组比较,超重组和肥胖组的心周脂肪含量明显增加,差异有统计学意义(P=0.001)。随代谢危险因素的增多,心周脂肪含量呈上升趋势,但仅在正常体重组,心周脂肪含量随代谢危险因素的增加而显著增多(P=0.000),超重组与肥胖组均差异无统计学意义。多元回归分析心周脂肪含量与腰围呈正相关,但与MS无相关性。结论合并MS患者心周脂肪含量增加,可能在正常体重组患者中心周脂肪含量更能预测MS。     

2型糖尿病血糖波动指标与体脂分布的关系

目的 探讨2型糖尿病(T2DM)患者血糖波动指标与体脂分布的关系.方法 收集T2DM患者102例,根据2017年《中国糖尿病患者血糖波动管理专家共识》计算出各项血糖波动指标,测量腹部皮下脂肪组织(SAT)和内脏脂肪组织(VAT)面积.根据VAT面积分为VAT<100 cm2组和VAT≥100 cm2组,比较两组间血糖波动指标与体脂肪分布和各项生化指标的差异,Pearson相关分析法分析血糖波动指标与体脂肪分布指标的相关性.结果 与VAT<100 cm2组相比,VAT≥100 cm2组身高、体质量、体质量指数(BMI)、体脂指数(FMI)、VAT、SAT、VAT/SAT、腰围、臀围、胰岛素抵抗指数(HOMA-IR)升高(P均<0.05).Pearson相关分析显示,血糖水平标准差与VAT/SAT、HbA1c、HOMA-IR呈正相关(r分别为0.228、0.283、0.260,P均<0.05);餐后血糖波动幅度与胰岛β细胞功能(HOMA-β)呈负相关(r=-0.248,P<0.05);最大血糖波动幅度与VAT/SAT、HbA1c、HOMA-IR呈正相关(r分别为0.210、0.293、0.260,P均<0.05);血糖平均值与HbA1c、HOMA-IR呈正相关(r分别为0.516、0.412,P均<0.05),与胰岛素敏感指数(HOMA-ISI)呈负相关(r=-0.369,P<0.05).结论 血糖波动与VAT/SAT、HbA1c、HOMA-IR呈正相关;与HOMA-β、HOMA-ISI呈负相关;内脏脂肪面积越大血糖波动越大,SAT面积越大血糖波动越小,减少VAT和/或增加SAT可降低T2DM患者血糖波动.     

体外诱导人脂肪干细胞向内皮细胞分化的研究

目的摘要目的诱导人脂肪间充质干细胞（hADAS cells）成内皮细胞,探索最佳诱导条件,为血管组织工程种子细胞的来源及其临床应用提供基础。方法分为内皮细胞生长因子（VEGF）50ng／ml和20ng／ml、碱性成纤维细胞生长因子（b-FGF）10ng／ml两组诱导脂肪干细胞成内皮细胞,流式细胞仪检测其表面抗原CD34、CD31表达,荧光显微镜下观察其吞噬乙酰化低密度脂蛋白（DiI—ac—LDL）和结合植物凝集素（FITC—Lectin）的能力,细胞免疫荧光法检测Ⅷ因子的表达。结果流式证实间充质干细胞在诱导第4和8天CD31、CD34表达逐渐增加;可吞噬DiI—ac—LDL,与Letin结合;细胞免疫荧光法可检测到Ⅷ因子表达。结论VEGF、b-FGF可诱导脂肪干细胞成内皮样细胞,对VEGF有很大的依赖性,成为血管组织工程种子细胞的选择之一。     

髓源性生长因子对肥胖小鼠白色脂肪棕色化的影响

目的:探讨髓源性生长因子（MYDGF）对肥胖小鼠白色脂肪棕色化的影响。方法:高脂饲料喂养雄性C57BL/6J野生型（WT）小鼠和MYDGF基因敲除（KO）小鼠12周,根据使用腺相关病毒（AAV）-MYDGF或AAV-绿色荧光蛋白（GFP）干预,将WT和KO小鼠分为WT-GFP组、WT-MYDGF组、KO-GFP组和KO...     

马兜铃酸Ⅰ对大鼠肾血流动力学的影响

目的 :研究马兜铃酸Ⅰ (AristolochicacidⅠ ,AAI)静脉给药后短期内对大鼠肾血流动力学指标的影响。　 方法 :大鼠麻醉后 ,静脉给予不同浓度 (1 0mg/kg ,5 0mg/kg ,2 5 0mg/kg)的AAI,采用生理压力记录仪记录血压变化 ,采用对氨基马脲酸清除率法观察有效肾血浆流量 (RPF)变化 ,采用菊糖清除率法观察肾小球滤过率(GFR)变化 ,根据上述指标计算肾血管阻力值 (RVR)变化。　 结果 :①大鼠平均动脉压未见明显变化 ,而大鼠尿量显著增加 (P <0 0 1) ,且三组尿量上升幅度相近 ,均为给药前的 3倍左右。②大鼠RPF与给药前相比显著上升 (P<0 0 1) ,其中以 2 5 0mg/kg组最为明显。③大鼠GFR有上升趋势 ,其中 5 0mg/kg组和 2 5 0mg/kg组给药前后GFR差异显著 (P <0 0 5 )。④大鼠RVR显著下降 (P <0 0 1) ,以 2 5 0mg/kg组下降最为明显。　 结论 :AAI在给药后的短期内具有减少RVR、增加RPF、GFR率和尿量的作用。AAI不具有引起肾组织一过性缺血从而加重肾组织损伤的能力     

Body fat distribution in healthy young and older men

Central and/or intraabdominal (IA) fat is an independent predictor of obesity-related metabolic abnormalities in young and middle-aged subjects. The elderly are "fatter" at any given relative weight and often have similar metabolic abnormalities. In this study we compare body composition, circumferences, and specific fat depots areas in a population of healthy young and older men. Although the two groups were similar in body mass index and percent body fat, their distribution of adiposity was different. The young subjects had 16% and 10% larger thigh (p = .0001) and arm (p less than .01) circumferences respectively, while the ratio of waist-to-hip circumference was greater in the older subjects (0.93 +/- 0.04 vs 0.97 +/- 0.04, p = less than .01). The most striking differences between the groups were noted on computed tomography, with a twofold greater IA fat area (72.6 +/- 38.2 vs 143.6 +/- 56.2 cm2, p less than .0001), and a twofold lesser thigh subcutaneous fat area (156.3 +/- 69.3 vs 82.4 +/- 29.7 cm2, p less than .001) in the older subjects. We conclude there is an age-related central and intraabdominal redistribution of adipose mass, even in healthy older subjects. Since these changes occur in the absence of clinical disease, the associations between metabolic abnormalities and a central and or IA distribution of adiposity in the elderly must be investigated further.     

正常人脂肪餐前后血脂变化与酰化刺激蛋白的关系

目的了解正常人脂肪餐前后血液中酰化刺激蛋白（ASP）变化，探讨ASP与糖脂代谢的关系。方法取18例正常人标准脂肪餐前及餐后2h外周静脉血，测定PG、Ins、TG、TC，酶联免疫法测定ASP及FFA水平。结果餐后ASP水平稍低于餐前水平，但差异无统计学意义。相关分析结果显示，空腹ASP（FASP）与BMI、FIns、FTG、2hTG相关，2hASP与2hFFA、FIns、FTG相关，餐后TG与FIns、FFFA、FASP相关。结论血浆ASP与BMI、Ins、TG、FFA正相关。     

Influence of age and sex on 19 blood variables in healthy subjects.

Normal values exist for all clinical chemical tests, but it is not very clear what is normal for healthy elderly subjects. Therefore, routine blood variables were determined in 80 ambulatory, disease-free persons who had undergone rigorous health screening. The subjects were divided into the following age groups: 20 (+/- 3), 40 (+/- 3), 60 (+/- 3), and 80 (+/- 5) years, with 10 males and 10 females per age group. Blood variables were determined after an overnight fast. It was found that even with conservative statistical measures more than half of the variables were significantly affected by age or sex. Significant age differences were found for total cholesterol, triglycerides, sodium, and ASAT. Urea, creatinine, gamma-GT, phosphate, alkaline phosphatase, and albumin were characterized by both age and sex differences. No age or sex differences were found for glucose, potassium, chloride, calcium, calcium ion, iron, magnesium, total protein, and ALAT. The findings suggest that the age or sex-related changes of a number of blood variables such as cholesterol, triglycerides, and liver enzymes are not only of statistical significance, but are also of clinical relevance.     

Evaluation of small bowel blood flow in healthy subjects receiving low-dose aspirin

AIM:To investigate the relationship between low-dose aspirin-induced small bowel mucosal damage and blood flow,and the effect of rebamipide. METHODS:Ten healthy volunteers were enrolled in this study.The subjects were divided into two groups:a placebo group given low-dose aspirin plus placebo and a rebamipide group given low-dose aspirin plus rebamipide for a period of 14 d.Capsule endoscopy and contrast-enhanced ultrasonography were performed before and after administration of drugs.Areas under the curves ...     

Influence of family history of hypertension on blood pressure in young healthy men

Hypertension belongs to the most frequent illnesses of circulatory system and in regard for its spread in population and great effects determines one of the most important medical, social and economical problems. In spite of turbulent progress which took place in diagnostic methods pathogenesis of primary hypertension still remains not fully detected. There are many proofs, that the important role plays here genetical factor. The purpose of these studies were to find answer the question, if young men age between 18-30 years with family medical hypertension history have a difference in middle systolic, diastolic and mean blood pressure in comparison to coevals without familiar hypertension. Lipoid parameters such as: total cholesterol, and its fractions HDL and LDL and triglyceride were also studied to. In order to exclude some well-known factors but which have influence blood pressure of studies height, weight and body mass index were measured. All around a clock registration blood pressure was made by means of ERKA machine with frequency three times a hour in the daily activity (6 a.m.-10 p.m.) and one time a hour during the night (10 p.m.-6 a.m.), arranging in this way 57 time points (measuring points). Obtaining mean systolic, diastolic and mean BP were in reality higher in studying group (p < 0.05). As well as mean systolic, diastolic and mean BP as following time points in majority studies in all sort of BP were in reality higher in group with family hypertension history. Any major changes were obtained in instance of pulse amplitude, systolic, diastolic minimal and maximal blood pressure. Any major differences were observed in above described lipoid parameters. Height, weight, the body mass index establishing were almost the same (entrance examination). The following studies proved that in the age of 18-30 were strongly marked the differences in blood pressure. They are higher in young men with family hypertension history. It proves about undoubted genetical predisposition and contribution of this factor in pathogenesis of primary hypertension.     

Age-related changes in regional cerebral blood flow and brain volume in healthy subjects

Using the xenon-133 inhalation method, we studied the age-related decline in regional cerebral blood flow, calculated as the initial slope index (ISI), in neurologically normal subjects without any risk factors for cerebral arteriosclerosis (154 men and 123 women), ranging in age from 19 to 88 years. The decline in the ISI was rapid in younger age groups and gradual in older age groups. The ISI was higher in women than in men older than 40 years. Using computed tomography, we studied the age-related decline in brain volume index (BVI; 100% X brain volume/cranial cavity volume) in neurologically normal subjects without any risk factors for cerebral arteriosclerosis (92 men and 49 women), ranging in age from 37 to 86 years. The decline in the BVI was gradual in younger age groups and rapid in older age groups. The BVI was higher in women than in men older than 60 years.     

Clinical characteristics influence aortic root dimension and blood flow velocity in healthy subjects

The aim of this study was to determine if aortic root dimension and blood flow velocity correlate with clinical and echocardiographic characteristics of healthy individuals. To assess the aortic root dimension and blood flow velocity in a healthy population, 503 subjects (253 women and 250 men) aged 18 to 66 years (mean, 36.9+/-11.9 years) who were normotensive, free of clinically apparent heart disease and any drug at the baseline examination were included in the study. M-mode echocardiographic measurements were performed according to the criteria recommended by the American Society of Echocardiography. Aortic blood velocity was obtained by pulsed wave Doppler echocardiography. Correlations between aortic root dimension and blood flow velocity and age, gender, body surface area, waist/hip ratio, and echocardiographic parameters such as left ventricular mass, ejection fraction, and left ventricular systolic and diastolic dimensions were evaluated by using regression analysis and Student's t test. Men had greater aortic root dimension (p<0.001). There were correlations between aortic root dimensions and age, body surface area, waist/hip ratio, and left ventricular mass in both genders (p<0.05). No correlation was found with left ventricular dimensions and ejection fraction. Aortic blood flow velocity correlated only with age (r=0.32, p<0.001). There was no gender difference in aortic blood flow velocity. This study shows that age, gender, body surface area, and waist/hip ratio should be considered in the evaluation of aortic root dimension. However, only age has an important impact on aortic blood flow velocity in both genders.     

Complex ventricular arrhythmia in apparently healthy young subjects

The aim of this study of 20 young subjects (28 +/- 10.6 years) with no apparent cardiac disease on clinical examination and chest X-ray was to determine the origin of complex ventricular arrhythmias: monomorphic or polymorphic ventricular extrasystoles, isolated or in valves (average 18 158 +/- 12 388 per 24 hours) and/or ventricular tachycardia (5 cases, sustained in 3). These arrhythmias were aggravated (N = 6), disappeared (N = 8) or remained unchanged (N = 5) during exercise. The inter-critical ECG showed ST changes in 5 cases. The extrasystoles had a left bundle branch block configuration in 14 cases and a right bundle branch block configuration in 9 cases. Nine patients were Grade 2 (45%) and 11 patients Grade 4B of Lown's classification. Complementary investigations (echocardiography), radionuclide investigations, right and left heart catheterisation, selective right and left ventriculography and coronary angiography) showed a high incidence of arrhythmogenic right ventricular dysplasia (N - 14) associated with left ventricular abnormalities in 13 cases: hypofixation of Thallium (N = 14) associated with left ventricular abnormalities in 13 cases: hypofixation of Thallium (N = 11), abnormal global left ventricular function (N = 13) with decreased ejection fractions in half the cases, left ventricular dilatation in a third of cases (average and diastolic volume: 109.8 ml/m2), mean velocity of circumferential fibre shortening decreased in 86% of cases (average 0.88 cir/sec), angiographic abnormalities of segmental left ventricular wall motion in 36% of cases; 2 clinically silent cases of mitral valve prolapse were associated with these left ventricular changes; these cases represent forms of arrhythmogenic cardiac disease localised to the right ventricle or involving both ventricles which should be searched for routinely in young patients with apparently normal hearts but with idiopathic and severe ventricular arrhythmias. The diagnosis can only be established by angiography. In other cases, isolated left ventricular abnormalities are detected: two cases of hypertrophic non obstructive cardiomyopathy including one apical form, a condition which may be suspected from analysis of the surface ECG and careful 2D echocardiographic study; phonomechanography may be normal; one idiopathic left ventricular aneurysm which was only diagnosed at ventriculography; one dilated cardiomyopathy affecting the left ventricle. In our series, none of the patients had coronary artery disease and two patients even had no abnormality of any of these investigations.(ABSTRACT TRUNCATED AT 400 WORDS)     

Influence of chemoreflexes on respiratory variability in healthy subjects

The background of this study was the hypothesis that respiratory variability is influenced by chemoreflex regulation. In search for periodicities in the variability due to instability of the respiratory control system, spectral analysis was applied to breath-to-breath variables in 19 healthy subjects at rest. During room-air breathing, coherent oscillations in end-tidal CO2 (PET(CO2)) and mean inspiratory flow (VI/TI) were found in 15 subjects with frequencies mostly below 0.15 cycles per breath. Coherent oscillations in PET(CO2) and VI/TI were expressed by gain (0.13 to 0.34 L/second small middle dot kPa) and phase (-170 degrees to +8 degrees ). The oscillations in VI/TI were in phase with inspiratory volume (VI). A model that describes the effects of chemoreflex feedback to noise in the system could explain these gains and phases, whereas a model without chemoreflex could not. During 100% O2 breathing, only eight subjects had coherent oscillations in PET(CO2) and VI/TI. The coherent oscillations in PET(CO2) and VI/TI were interpreted as a manifestation of chemoreflex activity. We conclude that respiratory variability is not a random process but contains information on chemoreflex properties, such as the chemoreflex gain. The analysis of respiratory variability therefore provides a new tool to study the action of the chemoreflexes without application of external stimuli.