血管性痴呆患者认知功能与血浆同型半胱氨酸水平的关系

目的探讨血管性痴呆(VaD)患者认知功能与血浆同型半胱氨酸(Hcy)水平的关系。方法选取2013-06~2015-02在该院住院的VaD患者46例、同期收治的非痴呆性脑梗死患者50例以及同龄健康者40名。根据简易精神状态检查量表(MMSE)评分对VaD患者划分严重程度。观察各组血浆中Hcy、叶酸、维生素B_(12)水平及其与VaD严重程度的关系。结果 VaD组及非痴呆性脑梗死组血浆Hcy水平高于健康组(P0.05),VaD组血浆Hcy水平高于非痴呆性脑梗死组(P0.05),VaD组叶酸及维生素B_(12)水平低于非痴呆性脑梗死组和健康组(P0.05),痴呆程度轻、中、重组Hcy浓度逐次升高,叶酸及维生素B_(12)浓度逐次降低(P0.05)。结论血浆Hcy浓度和VaD的发生和发展密切相关,高Hcy血症可能是导致VaD的危险因素之一,检测Hcy水平有助于VaD的防治。     

血浆高半胱氨酸水平与缺血性卒中患者颅内外动脉狭窄的相关性

目的 探讨血浆高半胱氨酸(homocysteine,Hcy)水平与缺血性卒中患者颅内外动脉狭窄的相关性.方法 收集缺血性卒中患者的病史、基线临床资料、影像学检查和Hcy等实验室检查结果,根据磁共振血管造影检查结果分为动脉狭窄组和非狭窄组,动脉狭窄组进一步分为单纯颅内动脉狭窄组、单纯颅外动脉狭窄组和颅内外动脉同时狭窄组,分析血浆Hcy水平与颅内外动脉狭窄的相关性.结果 共纳入147例缺血性卒中患者,其中动脉狭窄组115例,非狭窄组32例.狭窄组年龄(-4.577,p＜0.001)、Hcy(t=3.65,p＜0.001)、C-反应蛋白(t=2.06,P=0.041)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)(t=1.896,P=0.046)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)(t--4.261,P＜0.001)水平以及糖尿病(x2=5.772,P=o.016)、高血压(x2=10.507,P=0.001)和吸烟(x2=12.282,P＜0.001)的患者构成比与非狭窄组差异存在统计学意义.多变量logistic回归分析显示,年龄≥60岁[优势比(odds ratio,OR)3.374,95％可信区间(confidence interval,CI)1.351 ～ 8.426;P=0.009]、Hcy＞ 15 μmol/L(OR 2.274,95％ CI1.147 ～8.173;P =0.025)、高血压(OR 5.782,95％ CI2.045 ～16.345;P=0.001)、吸烟(OR 3.514,95％ CI1.200～ 10.293;P=0.022)是颅内外动脉狭窄的独立危险因素,而HDL-C＞ 1.0 mmol/L是颅内外动脉狭窄的独立保护因素(OR0.166,95％ CI0.054～0.511;P=0.002).狭窄组根据狭窄部位再分为单纯颅外动脉狭窄组(24例)、单纯颅内动脉狭窄组(61例)、颅内外动脉同时狭窄组(30例).3组间临床资料和危险因素比较显示,高血压的患者构成比(x2=7.024,P=0.003)以及LDL-C(F=3.276,P=0.042)和C-反应蛋白(F=3.645,P=0.029)水平差异有统计学意义.多变量logistic回归分析显示,高血压是单纯颅内狭窄(OR 3.795,95％ CI1.261～11.424;P=0.018)、单纯颅外狭窄(OR18.490,95％ CI3.117～ 10.966;P=0.001)和颅内外动脉同时狭窄(OR 9.178,95 ％CI2.211～38.094;P =0.002)的共同独立危险因素,而HDL-C水平增高是单纯颅内狭窄(OR 0.150,95％ CI0.043 ～0.523;P =0.003)、单纯颅外动脉狭窄(OR 0.078,95％ CI0.012～0.488;P=0.006)和颅内外动脉同时狭窄(OR 0.089,95％ CI0.021～0.385;P=0.001)共同的独立保护因素;年龄为单纯颅内动脉狭窄的独立危险因素(OR 6.351,95％ CI2.277～ 17.717;P＜0.001),LDL-C水平增高为单纯颅外动脉狭窄的独立危险因素(OR 6.021,95％ CI1.212～29.917;P=0.028),Hcy水平增高为单纯颅外动脉狭窄(OR 4.376,95％ CI1.026 ～ 18.671;P=0.046)以及颅内外动脉同时狭窄(OR4.951,95％ CI1.378～17.783;P=0.014)的独立危险因素.结论 血浆Hcy水平升高与颅外动脉狭窄相关.     

微量白蛋白尿与血管性痴呆的相关性

目的 探讨微量白蛋白尿(microalbuminuria, MA)与血管性痴呆(vascular dementia, VaD)之间的相关性.方法 纳入VaD患者和同期住院的非痴呆对照者.检测尿白蛋白/肌酐比率(urinary albumin/creatinine ratio, UACR),MA定义为UACR 30~300 mg/g.对2组人口统计学和临床资料进行比较,并采用多变量logistic回归分析探讨MA与VaD的相关性.结果 共纳入45例VaD患者和58例对照者.VaD组年龄[(82.36±7.68)岁对(78.57±9.46)岁;t=-2.183,P=0.031]、受教育年限[(10.84±3.59)年对(13.41±2.03)年;t=4.590,P<0.001]、收缩压[(137.11±14.31)mmHg对(128.57±16.90)mmHg,1 mmHg=0.133 kPa;t=-2.717,P=0.008]、空腹血糖[(5.75±1.01)mmol/L对(5.22±1.25)mmol/L;t=-2.344,P=0.021]、糖化血红蛋白[(6.35±1.10)%对(6.00±0.66)%;t=1.950,P=0.05]以及高脂血症(64.4%对39.7%;χ2=6.229,P=0.013)和MA阳性(82.2%对25.9%;χ2=32.199,P<0.001)的患者构成比与对照组差异有统计学意义.多变量logistic回归分析显示,高脂血症[优势比(odds ratio, OR) 5.169,95%可信区间(confidence interval, CI) 1.243~21.494;P=0.024]、空腹血糖(OR 3.090,95% CI 1.317~7.247;P=0.009)、糖化血红蛋白(OR 3.951,95% CI 1.017~8.608;P=0.047)、MA(OR 7.220,95% CI 1.912~27.266;P=0.004)均与VaD独立相关.结论 MA与VaD的发生密切相关,MA、空腹血糖、糖化血红蛋白和高脂血症均是VaD的独立危险因素.     

血浆高半胱氨酸水平与动脉粥样硬化性类烟雾病的相关性

目的 探讨血浆高半胱氨酸(homocysteine,Hcy)水平与动脉粥样硬化性类烟雾病的关系.方法 选取动脉粥样硬化性类烟雾病缺血性卒中患者(类烟雾病组)95例、大动脉粥样硬化性卒中患者(卒中组)95例、健康志愿者(对照组)94例.检测血浆Hcy水平,收集人口统计学资料、血管危险因素和实验室检查结果 .分析血浆Hcy水平与动脉粥样硬化性类烟雾病的相关性.结果 类烟雾病组高血压、高脂血症、既往卒中或短暂性脑缺血发作(transient ischemic attack,TIA)史、高同种半胱氨酸血症(hyperhomocysteinemia,HHcy)的患者构成比以及收缩压、总胆固醇、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、Hcy、维生素B12、叶酸水平与对照组比较差异有统计学意义(P均<0.017);类烟雾病组既往卒中或TIA史的患者构成比以及收缩压和叶酸水平与卒中组比较差异有统计学意义(P均<0.017).与对照组比较,多变量logistic回归分析显示,HHcy[优势比(odds ratio,OR)1.806,95%可信区间(confidence interval,CI)1.348~2.420;P<0.001]、 既往卒中或TIA史(OR 3.519,95%CI 1.709~7.028;P=0.013)、收缩压(OR 1.099,95%CI 1.035~1.168;P=0.002)、LDL-C(OR 38.473,95%CI 6.384~231.842;P<0.001)是动脉粥样硬化性类烟雾病的独立危险因素,HDL-C(OR 0.025,95%CI 0.001~0.768;P=0.035)和叶酸(OR 0.779,95%CI 0.608~0.996;P=0.047)是其独立保护因素;与卒中组比较,多变量logistic回归分析显示,既往卒中或TIA史(OR 3.280,95%CI 1.664~6.466;P=0.001)、收缩压(OR 1.019,95%CI 1.002~1.035;P=0.029)是类烟雾病的独立危险因素,叶酸(OR 0.845,95%CI 0.750~0.952;P=0.006)是其独立保护因素.结论 血浆Hcy水平升高是动脉粥样硬化性类烟雾病的独立危险因素,在其发病机制中起重要作用.     

痴呆及其心理、行为症状与血浆同型半胱氨酸水平关系

目的 探讨痴呆及痴呆心理和行为症状(Psychological and behavioral symptoms of dementia，BPSD)的可能发病机制，研究血浆同型半胱氨酸(homocysteine，Hcy)水平与痴呆及BPSD的关系。方法 阿尔茨海默病(Alzheimer Disease，AD)、混合性痴呆(Mixed dementia，MD)、血管性痴呆(Vascular dementia，VD)和正常对照组各30例参加本研究。采用Alzheimer病行为症状评定量表(The Behavioral Pathlology in Alzheimer Disease Rating Scale，BEHAVE-AD)评定痴呆患者BPSD。采用高压毛细血管电泳紫外检测法测定经2，4-二硝基氟苯(2，4-dimntrifluorobenzen，DNFB)衍生后的血浆Hcy水平。结果 AD、MD和VD患者血浆Hcy浓度均显著高于正常对照组，血浆高Hcy水平的痴呆患者BEHAVE-AD总分较高。结论 血浆高Hcy水平不仅与痴呆的发生发展有关，且在痴呆患者BPSD的发病机制中扮演了一个重要角色。     

老年血管性痴呆患者血浆二甲基精氨酸及同型半胱氨酸的表达及相关性

目的探讨老年血管性痴呆(VD)患者血浆二甲基精氨酸(ADMA)及同型半胱氨酸(Hcy)水平及其相关性。方法老年VD患者65例为观察组,老年认知功能正常脑梗死患者60例为对照组,采用多变量一般线性模型对教育水平、高血压、高血脂、糖尿病史因素进行矫正,比较两组血浆ADMA、Hcy水平及简易精神状态检查(MMSE)评分,采用Pearson分析法分析三者的相关性,采用Logistic回归方程分析VD发生的独立危险因素。结果矫正前、后对照组患者血浆ADMA、Hcy水平均显著低于观察组,MMSE评分均显著高于观察组(P0.05)。Pearson相关分析显示,血浆ADMA与Hcy呈正相关关系(r=0.631,P=0.004),而血浆ADMA、Hcy均与MMSE呈现负相关关系(r=-0.353,-0.441;P=0.023,0.017)。矫正后Logistic回归分析显示,高水平血浆ADMA(OR=2.314,P=0.013)与Hcy(OR=1.834,P=0.006)是VD发生的独立危险因素。结论老年脑血管疾病患者机体血浆ADMA与Hcy存在正相关关系,且高水平血浆ADMA及Hcy是VD发生的独立危险因素。     

脂蛋白相关磷脂酶 A2基因 R92 H多态性与中国山东地区汉族人群缺血性卒中及其亚型的相关性

目的：探讨脂蛋白相关磷脂酶A2（lipoprotein-associatedphospholipaseA2,Lp-PLA2）基因多态性位点R92H与中国山东地区汉族人群缺血性卒中及其亚型的相关性。方法纳入中国山东地区386例首次发病的缺血性卒中患者和386名健康对照组,根据TOAST 标准将患者进一步分为大动脉粥样硬化性卒中（ large artery atherosclerotic, LAA）和小动脉闭塞性卒中（ smal artery occlusion, SAO）。采用酶联免疫吸附法测定血清Lp-PLA2水平,聚合酶链反应及基因直接测序法测定R92H基因多态性。结果缺血性卒中组、LAA组和SAO组血清Lp-PLA2水平均高于对照组,差异有统计学意义（P均<0.01）。缺血性卒中组GA（P=0.006）、AA（P=0.020）、AA+GA基因型（P=0.009）以及A等位基因（P=0.001）分布频率均显著高于对照组,LAA组GA+AA基因型（P=0.007）及A等位基因（P<0.001）分布频率与对照组相比亦存在统计学差异,而SAO 组则不然。多变量logistic回归分析显示,GA+AA基因型[优势比（odds ratio, OR）1.43,95％可信区间（confidence interval, CI）1.02~2.00;P=0.029]、GA基因型（OR 1.42,95％CI 1.01~2.00;P=0.037）及A等位基因（OR 1.44,95％CI 1.11~2.18;P=0.028）是缺血性卒中发病的独立危险因素。 GA+AA 基因型（ OR 1.73,95％CI 1.18~2.55;P<0.001）和GA基因型（OR 1.67,95％CI 1.13~2.48;P<0.001）是LAA的独立危险因素,而与S AO 无显著独立相关性。结论缺血性卒中患者血清Lp-PLA2水平升高, LAA组升高最明显;R92H基因多态性可能与中国山东地区汉族人群缺血性卒中的易感性有关。     

痴呆病人同型半胱氨酸水平与痴呆程度及类型的相关性研究

目的探讨痴呆病人血浆同型半胱氨酸(Hcy)水平与痴呆程度及痴呆类型间的关系。方法对江苏省人民医院425例入院病人进行Hcy水平测定,分为痴呆组(106例)与非痴呆组(319例);痴呆程度分为轻度、中度、重度,依据痴呆类型分为阿尔茨海默病(AD)组36例、血管性痴呆(VD)组33例、帕金森病痴呆(PDD)组30例,其他痴呆类型7例排除。结果痴呆组血浆Hcy水平明显高于非痴呆组,差异有统计学意义(P0.05);Hcy水平与简易智能精神状态量表(MMSE)评分呈负相关(r=-0.46,P0.05);痴呆类型中VD组血浆Hcy水平高于AD组、PDD组(P0.05),AD组与PDD组比较血浆Hcy水平差异无统计学意义(P0.05)。结论高Hcy血症(HHcy)是痴呆的一个高危因素且与痴呆程度有关,Hcy水平对VD病人的影响明显高于AD病人、PDD病人。     

血清睾酮及雌二醇与老年男性痴呆类型和严重程度的关系

目的探讨血清总睾酮(TT)、雌二醇(E2)与老年男性痴呆类型和严重程度的关系。方法选择111例男性老年人,将认知功能正常的老年人28例作为正常组,轻度认知损害(MCI)患者15例作为MCI组,阿尔茨海默病(AD)患者50例作为AD组(其中轻、中、重度分别为17、18和15例),血管性痴呆(VaD)患者18例作为VaD组,检测TT和E2浓度。痴呆严重程度根据通用的临床痴呆评价量表评分。应用协方差分析、相关分析和χ~2检验方法分析TT、E2与AD和VaD及其严重程度的关系。结果 MCI组、正常组和轻度AD患者的TT和F2水平差异均无统计学意义。AD组患者TT和E2水平明显低于正常组(P<0.05)。随着认知损伤程度的加重,AD组患者TT呈下降趋势(Spearman's ρ_s=-0.4709,P<0.001),且TT低下患者的比例增多。VaD组、AD组、正常组3组间比较,TT和E2水平以及TT和E2低下患者的比例差异均无统计学意义。结论 TT下降与AD及其严重程度相关,血清E2下降与AD相关,但与其严重程度无关,二者与VaD均无明显相关性。     

高同型半胱氨酸血症与痴呆相关性研究

目的 探讨血浆同型半胱氨酸（Hcy）水平对血管性和（或）变性性痴呆的影响。方法 应用酶联免疫吸附试验（ELISA）测量90例急性脑卒中患者血浆Hcy水平。将研究对象分为痴呆组与非痴呆组，脑白质损伤组与非脑白质损伤组。对不同类型脑卒中患者血浆Hcy水平进行比较。结果 痴呆组与脑白质损伤组血浆Hcy水平与各自对照组均有差别（P〈0．01）。校正年龄后血浆Hcy每增加1μmol／L脑卒中患者痴呆发病风险增加1．084倍，95％可信区间（CI）为1．032．1．139（P〈0．05）。结论 高同型半胱氨酸血症（HH）与血管性痴呆和（或）变性性痴呆有关。     

脑白质疏松与脑大血管疾病危险因素的异同

目的：探讨脑白质疏松（LA ）与脑大血管疾病（LVD ）在流行病学危险因素上的异同。方法回顾性纳入307名脑梗死或TIA的患者,通过头颅MRI评估LA ,血管DSA评估LVD ,同时登记患者血管危险因素。根据头颅MRI和DSA评估结果将患者分成三组：LA组,LVD组及对照组。应用单因素和多因素分析探讨各个危险因素在三组之间的差异。结果性别、年龄、高血压、糖尿病、同型半胱氨酸（Hcy ）、总胆固醇（TC ）、低密度脂蛋白（LDL ）、吸烟史、他汀类用药史在三组患者中分布不全相同（ P＜0.05）。年龄、高血压、Hcy与LA呈正相关（OR＝1.12-5.66,P＜0.01）;年龄、男性、高血压、糖尿病与LVD呈正相关（OR＝1.08-4.19,P＜0.01）。结论 LA与LVD在病因学上既有相同的危险因素,同时也存在着显著的差异。     

小血管闭塞性卒中的危险因素分析

目的 探讨小血管闭塞性卒中(small artery occlusion,SAO)及其2种亚型的相关危险因素.方法 从南京卒中注册系统中收集2009年12月至2010年11月注册、符合TOAST标准中大血管动脉粥样硬化性卒中(large artery atherosclcrosis,LAA)或SAO的首发急性缺血性卒中患者的临床和影像学资料.病例分为LAA组和SAO组,后者再分为腔隙性脑梗死伴缺血性白质疏松(ischaemic leukoaraiosis,ILA)亚组和单纯腔隙性梗死(isolated lacunar infarction,ILI)亚组,比较LAA组与SAO组及其亚组的危险因素,并进行多变量logistic回归分析,筛选独立危险因素.结果 共纳入291例病例,其中LAA组120例,SAO组171例(ILI亚组87例,ILA亚组84例).SAO组平均年龄大于LAA患者,高血压患者比例和血清同型半胱氨酸(homocysteine,Hcy)水平显著高于LAA患者(P均＜0.05).多变量logistic分析表明,高龄[优势比(odds ratio,OR)1.041,95%可信区间(confidence interval,CI)1.02～1.06,P=0.045]、高血压(OR=2.912,95%CI 1.11～6.46,P=0.031)和血浆Hcy水平增高(OR=1.109,95%CI 1.11～1.32,P=0.001)是SAO的独立危险因素.在SAO的两亚组中,高龄(OR=1.047,95%CI 1.00～1.09,P=0.043)、高血压(OR=2.632,95%CI 1.08～6.41,P=0.033)和血浆Hcy水平增高(OR=1.211,95%CI 1.11～1.32,P＜0.001)是ILA的独立危险因素,而高胆固醇血症(OR=0.136,95%CI 0.05～0.37,P＜0.001)则是ILI的独立危险因素.结论 高龄、高血压和血浆Hcy水平增高可能在SAO的发病机制中起着重要作用.高胆固醇血症是ILI的独立危险因素,而高龄、高血压病和血浆Hcy水平增高是ILA的独立危险因素.

Abstract：

Objective To investigate the related risk factors for small artery occlusion (SAO) and its 2 subtypes. Methods The clinical and imaging data in 291 patients with first-ever stroke who met the TOAST criteria of large artery atherosclerotic stroke (LAA) or SAO were collected from the Nanjing Stroke Registry Prog-am from December 2009 to November 2010. All the patients were divided into a LAA group (n = 120) and a SAO group (n = 171). The latter was redivided into either a lacunar infarction with ischemic leukoaraiosis (ILA) subgroup (n = 84)or an isolated lacunar infarction (ILI) subgroup (n = 87). The risk factors of the LAA group and SAO group and its subgroups were compared. Multivariate logistic regression analysis was conducted and the independent risk factors were screened. Results The mean age in the SAO group was larger than that in the LAA group. The proportion of the patients with hypertension and the serum homocysteine (Hcy) level were significantly higher than those in the LAA group (all P ＜0. 05). Multivariate logistic analysis showed that the advanced age (odds ratio, [OR] = 1.041,95% confidence interval [CI] 1.02-1.06, P = 0.045), hypertension (OR = 2. 912,95% CI 1. 11-6. 46, P =0. 031) and increased plasma Hcy (OR = 1. 109, 95% CI 1. 11-1. 32, P =0. 001) were the independent risk factors for SAO. The advanced age (OR = 1. 047,95% CI 1.00-1.09, P = 0.043), hypertension (OR = 2. 632, 95% CI 1.08-6.41, P= 0.033) and increased plasma Hcy (OR = 1. 211, 95% CI 1. 11-1. 32, P ＜0. 001) were the independent risk factors for ILA, while the hypercholesterolemia (OR =0. 136, 95% CI 0. 05-0. 37, P ＜0. 001) was the independent risk factor for ILI. Conclusions The advanced age, hypertension and increased plasma Hcy level may play important roles in the pathogenesis of SAO. The hypercholesterolemia is an independent risk factor for ILI, while advanced age, hypertension and increased plasma Hcy level are the independent risk factors for ILA.     

Homocysteine levels and risk of essential hypertension: A meta-analysis of published epidemiological studies

Background: Plasma homocysteine (Hcy) levels may be associated with essential hypertension (EH). However, the results of previous studies on this association are inconsistent.Methods: In this meta-analysis, we performed a systematic literature search of the Embase, PubMed, Cochrane Library, and Web of Science for the relevant articles dated up to March 2016. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate the estimates.Results: We included 11 studies with a total of 16,571 participants (4,830 EH cases). We found that elevated Hcy levels were associated with the risk of EH (pooled OR: 1.36, 95% CI: 1.02–1.80 in the random-effects model). However, subsequent subgroup analyses showed that elevated Hcy levels increased the EH risk in retrospective studies (OR: 1.82, 95% CI: 1.53–2.16; p < 0.001) and unadjusted studies (OR: 1.72, 95% CI: 1.43–2.07; p < 0.001), but not in perspective studies (OR: 0.99, 95% CI: 0.73–1.28; p = 0.939) and adjusted studies (OR: 1.21, 95% CI: 0.85–1.72; p = 0.297). No significant publication bias was found (p = 0.876 for Begg’s test, p = 0.144 for Egger’s test).Conclusion: Plasma Hcy levels are associated with EH risk. However, our findings do not support a causal association between Hcy levels and EH.     

Association between Lp-PLA2 and coronary artery disease: focus on its relationship with lipoproteins and markers of inflammation and hemostasis

Lipoprotein-associated phospholipase A2 (Lp-PLA2) generates pro-inflammatory molecules from oxidized LDL. We examined the association between Lp-PLA2 plasma concentrations and risk of stable coronary artery disease (CAD) in a large case-control study and further assessed the relationship between Lp-PLA2 and various lipid, inflammatory and hemostatic parameters. Lp-PLA2 concentrations were measured in 312 patients with CAD and in 479 age- and gender-matched blood donors. Various sensitive inflammatory and hemostatic markers and a complete lipoprotein profile were obtained. Lp-PLA2 concentrations were significantly higher in cases than in controls (296.1 ng/mL versus 266.0 ng/mL, p<0.0001). In multivariable logistic regression, the age- and gender-adjusted OR for the presence of CAD was 1.61 (95% CI, 1.07-2.44) if the top quartile of the Lp-PLA2 distribution was compared to the bottom quartile. Adjustment for traditional cardiovascular risk factors and statin use resulted in an OR of 2.04 (95% CI, 1.19-3.48). After additional controlling for vWF, the OR was slightly attenuated but still remained statistically significant (OR 1.91; 95% CI, 1.12-3.28). Thus, elevated Lp-PLA2 concentrations were associated with the presence of stable CAD, independent of various biochemical markers. Our results support the hypothesis that Lp-PLA2 may be a novel, independent risk marker for CAD.     

Anemia in human immunodeficiency virus-infected and uninfected women in Rwanda

To determine the prevalence and risk factors of anemia among human immunodeficiency virus (HIV)-infected women in Rwanda and the influence of highly active antiretroviral therapy (HAART) on anemia, we analyzed 200 HIV-positive women and 50 HIV-negative women in a cross-sectional study. Clinical examinations and iron and vitamin B(12) assays were performed, and complete blood counts, serum folic acid levels, and CD4 cell count determined. The prevalence of anemia was significantly higher among HIV-positive women (29%) than among HIV-negative women (8%) (P < 0.001). Risk factors for anemia were lower body mass index (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 2.4-4.1), zidovudine use (OR = 1.14, 95% CI = 1.01-1.29), lack of HAART (OR = 1.44, 95% CI = 1.21-1.67), oral candidiasis (OR = 1.4, 95% CI = 1.2-1.6), pulmonary tuberculosis (OR = 1.8, 95% CI = 1.7-2.2), cryptococcal meningitis (OR = 1.6, 95% CI = 1.21-1.8), Pneumocystis jiroveci pneumonia (OR = 1.41, 95% CI = 1.20-1.65) and CD4 lymphocyte count < 200 cells/μL (OR = 2.41, 95% CI = 2.01-3.07). The mean ± SD hemoglobin level of 10.9 ± 1.6 g/dL at HAART initiation significantly increased to 12.3 ± 1.5 g/dL in 8 months (P < 0.001). Anemia increases with HIV stage, and HAART is associated with a significant improvement in hemoglobin levels.     

Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China

Background

Elevated plasma homocysteine (Hcy) is considered to be a risk factor of coronary artery disease (CAD), although this is still controversially discussed. This study investigated the role of Hcy in young patients with CAD in southern China.

Methods

A total of 146 consecutive patients (aged ≤?55 years) with angiographically proven CAD were enrolled in the study and 138 age-matched non-CAD individuals were included as the control group. Hcy levels were measured by enzymatic assay. Hyperhomocysteinemia (HHcy) was defined as Hcy ≥?15 µmol/l. A 10-year CAD risk was calculated using the Framingham risk score (FRS) modified according to the National Cholesterol Education Program Adult Treatment Panel III.

Results

There were significant differences between the CAD and control groups with regard to male sex (P?<?0.01), smoking history (P?<?0.05), and triglyceride levels (TG, P?<?0.05), but no remarkable difference in other conventional risk factors (all P?>?0.05). Hcy and high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the CAD group than those in the control group (both P?<?0.05). The FRS and estimated 10-year absolute CAD event risk were low in both groups and did not show a statistical difference. Multivariate logistic regression showed that male sex (odds ratio, OR, 3.68; 95?% confidence interval, 95?% CI, 1.54–10.01), smoking (OR, 2.54; 95?% CI, 1.15–5.36), TG (OR, 1.30; 95??% CI, 1.08–3.06), hs-CRP (OR, 3.74; 95?% CI, 1.72–12.21), and HHcy (OR, 2.03; 95?% CI, 1.26–5.83) were independently correlated with CAD in young patients.

Conclusion

HHcy is an important independent risk factor for CAD in young patients in southern China after adjusting for other risk factors.     

NNMT基因多态性与非酒精性脂肪性肝炎的相关性

目的 探讨NNMT基因多态性（rs694539）与非酒精性脂肪性肝炎（NASH）的相关性.方法 收集2010年1月至2013年6月本院76例NASH患者和160例与入组患者种族、年龄、性别相匹配的健康志愿者为研究对象,利用聚合酶链限制性长度多态性分析（PCR-RFLP）技术检测NNMT基因多态性.基因型及等位基因频率的比较行χ2检验,两组间均数的比较采用t检验.以非条件性Logistic回归模型计算的比值比及其95%可信区间表示基因型与NASH发生的相对风险度.结果 NNMT基因多态性与NASH发病具有相关性,其中NNMT基因型的GG型（OR为0.57,95%CI为0.33~0.98; χ2=4.13;P=0.04）为保护因素,AA型（OR为2.55,95%CI为1.10~5.88; χ2=5.02;P=0.03）为危险因素.NASH患者血清同型半胱氨酸（Hcy）水平显著低于正常对照组[（12.97±1.65）vs （13.52±1.72） μmol/L,P=0.02].在Logistic回归分析中,将AST、ALT、身体质量指数（BMI）、甘油三酯（TG）、总胆固醇（TC）、Hcy等变量进行校正后,A等位基因（OR为3.79,95%CI为1.21~11.89; P=0.02）及ALT水平（OR为1 08,95%CI为1.05~1.11; P=0.00）为危险因素.结论 NNMT基因多态性（rs694539）与NASH的发生具有相关性.     

Plasma adiponectin levels and incident glucose intolerance in Japanese-Brazilians: a seven-year follow-up study

The objective of this study was to investigate whether decreased baseline adiponectin levels are an independent risk factor for development of glucose intolerance in a population-based study of Japanese-Brazilians, a group with one of the highest prevalence rates of diabetes worldwide. We examined 210 Japanese-Brazilians (97 male and 113 female, aged 56.7+/-10.1 years) with normal glucose tolerance (NGT). Plasma adiponectin, insulin, fasting and 2-h plasma glucose and lipid profile were evaluated at baseline and also at 7-year follow-up. Plasma adiponectin levels were significantly lower in glucose intolerance progressors compared with subjects who remained NGT. By increasing tertiles of adiponectin, the frequencies of subjects who progressed to glucose intolerance were 40%, 33% and 27% and the frequencies of subjects who remained NGT were 13%, 35% and 52% (chi2=15.8, p=0.001). Logistic regression analyses showed that adiponectin levels (OR for the highest versus lowest tertile: 0.31; 95% CI: 0.12-0.84, p=0.021), male sex (OR: 2.61, 95% CI: 1.21-5.65, p=0.015), fasting plasma glucose (0R: 3.05, 95% CI: 1.35-6.91, p=0.008) and waist circumference (OR: 1.04, 95% CI: 1.00-1.08, p=0.046) were independent risk factors for the progression to glucose intolerance. In conclusion, low plasma levels of adiponectin is one of several independent predictors of glucose intolerance in a Japanese-Brazilian population.