Circulating p-Cresyl Sulfate,Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease

Patients with chronic kidney disease (CKD), especially those undergoing hemodialysis, are at a considerably high risk of bone fracture events. Experimental data indicate that uremic toxins intricately involved in bone-related proteins exert multi-faced toxicity on bone cells and tissues, leading to chronic kidney disease–mineral and bone disorder (CKD-MBD). Nonetheless, information regarding the association between p-cresyl sulfate (PCS), non-hepatic alkaline phosphatase (NHALP) and skeletal events remains elusive. We aim to explore the association between PCS, NHALP and risk of bone fracture (BF) in patients with hemodialysis. Plasma concentrations of PCS and NHALP were ascertained at study entry. Cox proportional hazard regression analyses were used to determine unadjusted and adjusted hazard ratios (aHRs) of PCS for BF risk. In multivariable analysis, NHALP was associated with incremental risks of BFs [aHR: 1.06 (95% CI: 1.01–1.11)]. The association between the highest PCS tertile and BF risk remained robust [aHR: 2.87 (95% CI: 1.02–8.09)]. With respect to BF events, the interaction between NHALP and PCS was statistically significant (p value for the interaction term < 0.05). In addition to mineral dysregulation and hyperparathyroidism in hemodialysis patients, higher circulating levels of PCS and NHALP are intricately associated with incremental risk of BF events, indicating that a joint evaluation is more comprehensive than single marker. In light of the extremely high prevalence of CKD-MBD in the hemodialysis population, PCS may act as a pro-osteoporotic toxin and serve as a potential surrogate marker for skeletal events.     

Protein-Bound Uremic Toxins Lowering Effect of Sevelamer in Pre-Dialysis Chronic Kidney Disease Patients with Hyperphosphatemia: A Randomized Controlled Trial

P-cresyl sulfate and indoxyl sulfate are strongly associated with cardiovascular events and all-cause mortality in chronic kidney disease (CKD). This randomized controlled trial was conducted to compare the effects between sevelamer and calcium carbonate on protein-bound uremic toxins in pre-dialysis CKD patients with hyperphosphatemia. Forty pre-dialysis CKD patients with persistent hyperphosphatemia were randomly assigned to receive either 2400 mg of sevelamer daily or 1500 mg of calcium carbonate daily for 24 weeks. A significant decrease of total serum p-cresyl sulfate was observed in sevelamer therapy compared to calcium carbonate therapy (mean difference between two groups −5.61 mg/L; 95% CI −11.01 to −0.27 mg/L; p = 0.04). There was no significant difference in serum indoxyl sulfate levels (p = 0.36). Sevelamer had effects in terms of lowering fibroblast growth factor 23 (p = 0.01) and low-density lipoprotein cholesterol levels (p = 0.04). Sevelamer showed benefits in terms of retarding CKD progression. Changes in vascular stiffness were not found in this study.     

慢性肾脏病患者血清Periostin水平与左心室肥厚的相关性研究

目的探讨慢性肾脏病(CKD)患者血清Periostin水平与左心室肥厚(LVH)的相关性。方法选取CKD患者136例,根据估算肾小球滤过率(eGFR)将患者分为A组(Ⅰ～Ⅱ期,56例)、B组(Ⅲ期,38例)、C组(Ⅳ～Ⅴ期,42例);另选取同期体检健康者30例作为对照组。比较CKD不同分期患者临床资料及血清Periostin水平差异,Pearson法分析CKD患者血清Periostin与其他指标的相关性。根据CKD患者是否合并LVH将其分为LVH组(32例)和非LVH组(104例),比较2组一般资料及血清Periostin水平差异,Logistic回归分析CKD患者并发LVH的危险因素。结果 (1)对照组、A组、B组、C组的收缩压、舒张压、同型半胱氨酸(HCY)、肌酐(SCr)、尿素氮(BUN)、左心室质量指数(LVMI)、Periostin均逐渐升高,组间比较差异均有统计学意义(P<0.05)。(2)CKD患者血清Periostin与收缩压、HCY、SCr、BUN、LVMI均呈正相关(P<0.05)。(3)LVH组患者收缩压、舒张压、HCY、SCr、BUN、LVMI、Pe...     

Serum Galectin-3 Level Is Positively Associated with Endothelial Dysfunction in Patients with Chronic Kidney Disease Stage 3 to 5

Galectin-3, which is a novel biomarker of cardiovascular stress and related to inflammation, could predict adverse cardiovascular events. However, its relationship with endothelial function in patients with chronic kidney disease (CKD) remains inconclusive. This study aimed to investigate the association between serum galectin-3 levels and endothelial function in patients with stages 3–5 CKD. Fasting blood samples were obtained from 130 patients. Serum galectin-3 levels were determined using the enzyme-linked immunosorbent assay. The endothelial function, demonstrated as a vascular reactivity index (VRI), was measured noninvasively through digital thermal monitoring test. Then, we sorted the patients into poor, intermediate, and good vascular reactivity (VRI < 1.0, 1.0 ≤ VRI < 2.0, and VRI ≥ 2.0), accounting for 24 (18.5%), 44 (33.8%), and 62 (47.7%) patients, respectively. As the VRI decreased, the serum galectin-3 and C-reactive protein (CRP) levels significantly increased. The galectin-3 value positively correlated with the CRP value but negatively correlated with estimated glomerular filtration rate. In multivariable stepwise linear regression analysis, serum log-transformed galectin-3 level and log-transformed CRP were significantly negatively associated with VRI values. Therefore, galectin-3 together with CRP is associated with VRI values and is a potential endothelial function modulator and a valuable biomarker of endothelial dysfunction in patients with CKD.     

Metabolic syndrome and its components in relation to brachial-ankle pulse wave velocity in middle-aged Taiwanese males

To evaluate the association of The study is to evaluate the association of metabolic syndrome (MS) and its components on brachial-ankle pulse wave velocity (baPWV), an indirect marker of subclinical atherosclerosis, in middle-aged Taiwanese males. A total of 442 men aged 40 to 65 years were included in this cross-sectional survey. Arterial stiffness was measured using a non-invasive method by baPWV. MS is defined by the presence of ≥ 3 components using the modified National Cholesterol Education Program criteria. The mean baPWV was 1478.6 and 1520.3 cm/sec in normal-weight and overweight adults, respectively. Age, systolic blood pressure (BP), diastolic BP, and fasting blood glucose (FBG) correlated with baPWV levels in normal-weight and overweight males. In multiple logistic regression analysis, after adjusting for potential confounders, MS and its components (such as high BP and high FBG) were significantly associated with abnormal baPWV (≥1400 cm/sec) (p < 0.001). MS and its components are significantly associated with abnormal baPWV in Taiwanese middle-aged males and in addition, high BP was the component of MS most significantly associated with abnormal baPWV.     

Efficacy and Safety of a Fixed Combination of Irbesartan/Hydrochlorothiazide in Chinese Patients with Moderate to Severe Hypertension

Background and Objectives

In a multi-center, single-arm, prospective study, we investigated the efficacy and safety of the fixed irbesartan/hydrochlorothiazide combination in Chinese patients with moderate to severe hypertension.

Methods

Eligible patients were aged 18–75 years, with a blood pressure of 160–199 mmHg systolic or 100–119 mmHg diastolic during a 1-week wash-out phase off antihypertensive medication. The enrolled patients started antihypertensive treatment with irbesartan/hydrochlorothiazide 150 mg/12.5 mg once daily, with the possible addition of irbesartan 150 mg once daily and up-titration to irbesartan/hydrochlorothiazide 300 mg/25 mg once daily at 4 and 8 weeks of follow-up, respectively. The primary efficacy variable was the goal blood pressure-attaining rate at 12 weeks of follow-up (<140/90 mmHg, or <130/80 mmHg in patients with diabetes mellitus).

Results

In the intention-to-treat analysis (n = 501) at 12 weeks of follow-up, the goal blood pressure-attaining rate was 57.3 %, and the mean change in blood pressure from baseline was 27.8 mmHg [95 % confidence interval (CI) 26.4–29.1 mmHg; p < 0.001] systolic and 13.5 mmHg (95 % CI 12.6–14.4 mmHg; p < 0.001) diastolic. Similar findings were observed in the per-protocol analysis (n = 449). The prevalence of microalbuminuria and left ventricular hypertrophy significantly (p ≤ 0.01) decreased from 33.4 % (150/449) and 50.4 % (215/427) at baseline to 23.4 % (105/447) and 41.3 % (176/427) at the end of follow-up, respectively. Four patients (2.0 %) reported a serious adverse event.

Conclusion

The fixed irbesartan/hydrochlorothiazide combination may control blood pressure to the target level in about 60 % of Chinese patients with moderate to severe hypertension, with an acceptable safety profile.     

Protein-Bound Uremic Toxins: New Culprits of Cardiovascular Events in Chronic Kidney Disease Patients

Chronic kidney disease (CKD) has been considered a major risk factor for cardiovascular diseases. Although great advances have recently been made in the pathophysiology and treatment of cardiovascular diseases, CKD remains a major global health problem. Moreover, the occurrence rates of cardiovascular events among CKD patients increase even in cases in which patients undergo hemodialysis, and the mechanisms underlying the so-called “cardiorenal syndrome” are not clearly understood. Recently, small-molecule uremic toxins have been associated with cardiovascular mortality in CKD and/or dialysis patients. These toxins range from small uncharged solutes to large protein-bound structures. In this review, we focused on protein-bound uremic toxins, such as indoxyl sulfate and p-cresyl sulfate, which are poorly removed by current dialysis techniques. Several studies have demonstrated that protein-bound uremic toxins, especially indoxyl sulfate, induce vascular inflammation, endothelial dysfunction, and vascular calcification, which may explain the relatively poor prognosis of CKD and dialysis patients. The aim of this review is to provide novel insights into the effects of indoxyl sulfate and p-cresyl sulfate on the pathogenesis of atherosclerosis.     

Assessing Pharmacy Students’ Ability to Accurately Measure Blood Pressure Using a Blood Pressure Simulator Arm

Objective. To compare student accuracy in measuring normal and high blood pressures using a simulator arm.Methods. In this prospective, single-blind, study involving third-year pharmacy students, simulator arms were programmed with prespecified normal and high blood pressures. Students measured preset normal and high diastolic and systolic blood pressure using a crossover design.Results. One hundred sixteen students completed both blood pressure measurements. There was a significant difference between the accuracy of high systolic blood pressure (HSBP) measurement and normal systolic blood pressure (NSBP) measurement (mean HSBP difference 8.4 ± 10.9 mmHg vs NSBP 3.6 ± 6.4 mmHg; p<0.001). However, there was no difference between the accuracy of high diastolic blood pressure (HDBP) measurement and normal diastolic blood pressure (NDBP) measurement (mean HDBP difference 6.8 ± 9.6 mmHg vs. mean NDBP difference 4.6 ± 4.5 mmHg; p=0.089).Conclusions. Pharmacy students may need additional instruction and experience with taking high blood pressure measurements to ensure they are able to accurately assess this important vital sign.     

老年代谢综合征患者动脉弹性的相关研究

目的探讨老年代谢综合征(MS)与动脉弹性的关系。方法根据2005年国际糖尿病联盟MS诊断标准将256例受试者分为健康对照组(无任何指标异常)、非MS组(不满足MS标准但含有1个以上代谢指标异常)、MS组亚组1(腰围+其他2项指标异常)、亚组2(腰围+其他3项或以上指标异常)。应用全自动脉搏波速度测量系统测定臂—踝动脉脉搏波速度(baPWV)作为反映动脉弹性的指标,并与各临床观察指标进行多元回归分析。结果MS各亚组baPWV均显著高于健康对照组(P<0.01)及非MS组(P<0.01),非MS组与对照组间差异也有统计学意义(P<0.01)。ba PWV与年龄(r=0.543,P<0.001)、收缩压(r=0.562,P<0.001)、舒张压(r=0.387,P<0.001)、平均动脉压(r=0.468,P<0.001)、脉压(r=0.487,P<0.001)、空腹血糖(r=0.519,P<0.001)、甘油三酯(r=0.236,P<0.001)、腰围(r=0.136,P=0.029)和尿酸(r=0.162,P=0.010)呈显著正相关。多元逐步回归分析显示,年龄、收缩压和甘油三酯是影响baPWV的独立因素。结论在老年人群中MS组成成分的聚集可能促进动脉硬化的发生和发展。对老年MS患者进行代谢成分聚集的评估及进行脉搏波速度检测有助于心血管事件的一级预防。     

Contribution of Gut Microbiota-Derived Uremic Toxins to the Cardiovascular System Mineralization

Chronic kidney disease (CKD) affects more than 10% of the world population and leads to excess morbidity and mortality (with cardiovascular disease as a leading cause of death). Vascular calcification (VC) is a phenomenon of disseminated deposition of mineral content within the media layer of arteries preceded by phenotypic changes in vascular smooth muscle cells (VSMC) and/or accumulation of mineral content within the atherosclerotic lesions. Medial VC results in vascular stiffness and significantly contributes to increased cardio-vascular (CV) morbidity, whereas VC of plaques may rather increase their stability. Mineral and bone disorders of CKD (CKD-MBD) contribute to VC, which is further aggravated by accumulation of uremic toxins. Both CKD-MBD and uremic toxin accumulation affect not only patients with advanced CKD (glomerular filtration rate (GFR) less than 15 mL/min/1.72 m², end-stage kidney disease) but also those on earlier stages of a disease. The key uremic toxins that contribute to VC, i.e., p-cresyl sulphate (PCS), indoxyl sulphate (IS) and trimethylamine-N-oxide (TMAO) originate from bacterial metabolism of gut microbiota. All mentioned toxins promote VC by several mechanisms, including: Transdifferentiation and apoptosis of VSMC, dysfunction of endothelial cells, oxidative stress, interaction with local renin–angiotensin–aldosterone system or miRNA profile modification. Several attractive methods of gut microbiota manipulations have been proposed in order to modify their metabolism and to limit vascular damage (and VC) triggered by uremic toxins. Unfortunately, to date no such method was demonstrated to be effective at the level of “hard” patient-oriented or even clinically relevant surrogate endpoints.     

厄贝沙坦联合叶酸对H型高血压患者血压及血浆同型半胱氨酸水平的影响

目的:观察厄贝沙坦联合叶酸对H型高血压患者血压及血浆同型半胱氨酸水平的影响。方法:将100例H型高血压患者按随机数字表法均分为对照组和治疗组。对照组患者给予厄贝沙坦150 mg/次,qd,口服;治疗组患者在对照组治疗基础上给予叶酸0.4 mg,qd,口服。两组患者疗程均为3个月。观察两组患者治疗前后肱踝脉搏波传导速度(baPWV)、血浆同型半胱氨酸(Hcy)水平、血压的变化及不良反应发生情况。结果:治疗前,两组患者血浆Hcy、baPWV、舒张压、收缩压比较差异均无统计学意义(P>0.05);治疗后,两组患者血浆Hcy、baPWV、舒张压、收缩压均显著低于同组治疗前,且治疗组低于对照组,两组比较差异均有统计学意义(P<0.05)。两组患者治疗期间均未见明显不良反应发生。结论:厄贝沙坦联合叶酸可降低H型高血压患者血压,改善患者Hcy及baPWV水平。     

Ⅲ~Ⅴ期非透析治疗的慢性肾脏病患者血清VK2、Runx2的表达及其与心血管钙化的关系

目的　探讨Ⅲ~Ⅴ期非透析治疗的慢性肾脏病（CKD）患者血清维生素K2（VK2）、Runt相关转录因子2（Runx2）的表达及其与心血管钙化的关系。方法　选取Ⅲ~Ⅴ期非透析治疗CKD患者149例,根据临床分期将其分为Ⅲ期组（58例）、Ⅳ期组（52例）和Ⅴ期组（39例）。另根据患者的心血管钙化情况将其分为钙化组（42例）和无钙化组（107例）。收集所有患者的一般资料,采用全自动生化分析仪检测血磷、钙、肌酐（Cr）、胱抑素C（Cys C）的水平,采用酶联免疫吸附试验检测血清VK2、Runx2的表达。结果　Ⅲ期组、Ⅳ期组和Ⅴ期组的磷、Cr、Cys C、Runx2水平以及心血管钙化率均逐渐升高,钙、VK2水平均逐渐降低（P＜0.05）。钙化组的磷、Cys C、Runx2水平高于无钙化组,VK2水平低于无钙化组（P＜0.05）。多因素分析显示,磷、Runx2高表达是CKD患者合并心血管钙化的危险因素,而VK2高表达是CKD患者合并心血管钙化的保护因素（P＜0.05）。ROC分析显示,血清VK2、Runx2和磷对CKD患者合并心血管钙化有较高的评估价值,曲线下面积分别为0.843（95%CI：0.773～0.913）、0.819（95%CI：0.749～0.889）、0.797（95%CI：0.726～0.868）。结论　Ⅲ~Ⅴ期非透析治疗的CKD患者血清VK2水平随着分期的增加而降低,Runx2水平随着分期的增加而增加,两者均与患者的心血管钙化情况密切相关。     

Shortening baroreflex delay in hypertrophic cardiomyopathy patients – an unknown effect of β-blockers

Aims

Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy and impaired diastolic and systolic function. Abnormal sympathetic–parasympathetic balance is a potential stimulus for left ventricular hypertrophy in HCM patients. β-Blockers are routinely used in HCM for their strong negative inotropic effect; however, these drugs also influence the sympathetic–parasympathetic balance. This study aimed to determine the autonomic control of the cardiovascular system and the autonomic effects of β-blockers in HCM patients treated or untreated with β-blockers.

Methods

Among 51 HCM outpatients (18–70 years old; 29 men) there were 19 individuals with no medication and 32 subjects treated with a β-blocker. Fourteen age- and gender-matched (23–70 years old; nine men) healthy volunteers were enrolled in the control group. Continuous, non-invasive finger blood pressure was recorded during supine rest for 30 min. Autonomic regulation of the cardiovascular system was measured by heart rate variability and spontaneous baroreflex function (cross-correlation sequence method).

Results

The mean pulse interval, time domain and spectral measures of heart rate variability and baroreflex sensitivity were comparable between HCM patients, treated or not with β-blockers, and the control group. However, the delay of the baroreflex was significantly longer in HCM patients who were not treated with β-blockers [2.0 (1.6–2.3) s] in comparison with HCM patients receiving β-blockers [1.4 (1.1–1.8) s; P = 0.0072] or control subjects [1.2 (0.8–1.8) s; P = 0.0025]. This delay did not differ between HCM patients treated with β-blockers and the control group.

Conclusions

Hypertrophic cardiomyopathy not treated with β-blockers is accompanied by prolonged baroreflex delay. The use of β-blockers normalizes this delay.     

Pyroptosis: A Common Feature of Immune Cells of Haemodialysis Patients

NLRP-3 inflammasome activation can result in interleukin-1β (IL-1β) release and inflammatory cell death (pyroptosis). Caspase-1 is able to trigger both processes. However, other caspases, caspase-4, -5 and -8, are believed to initiate pyroptosis without affecting IL-1 secretion. In this study, we evaluated two cardiovascular risk groups, haemodialysis patients (HD) and patients with intact kidney function but high blood pressure (BP), to analyse the mechanisms driving pyroptosis. Twenty HD were age-, gender- and diabetes-matched to BP. We found a common pyroptotic pattern in both patient groups, at which pyroptosis rates but not IL-1 β levels were significantly higher in monocytes (HD vs. BP: p < 0.05), granulocytes (p < 0.01) and lymphocytes (p < 0.01) of HD patients. As uremic toxins are drivers of inflammation and regulated cell death, we applied a monocyte- and macrophage-like THP-1 model system to demonstrate that the protein-bound uremic toxin indoxyl sulfate (IS) is an inducer of pyroptotic cell death, particularly engaging caspase-4/caspase-5 and to a lesser extent caspase-8 and caspase-1. These data suggest that the uremic toxin IS can mediate pyroptosis in HD patients and the inflammatory caspase-4 and/or caspase-5 contribute to pyroptosis rates to a higher extent in comparison to caspase-1.     

Coenzyme Q10 in the Treatment of Heart Failure with Preserved Ejection Fraction: A Prospective,Randomized, Double-Blind,Placebo-Controlled Trial

BackgroundHeart failure with preserved ejection fraction (HFpEF) is common in elderly people and is increasing in prevalence. No specific treatment for this condition exists. Coenzyme Q10 (CoQ10) is an essential cofactor for energy production, with reduced levels being noted in HF. Previous studies have suggested a possible role for CoQ10 in the treatment of HF. This study examined the effect of CoQ10 supplementation on diastolic function in HFpEF patients.MethodsWe conducted a prospective, randomized, double-blind, placebo-controlled trial including patients aged > 55 years presenting with New York Heart Association class II–IV heart failure symptoms and left ventricular ejection fraction > 50%, with impaired diastolic function. Echocardiography and levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) were performed at baseline and following 4 months of CoQ10 or placebo supplementation.ResultsA total of 39 patients were enrolled—19 in the CoQ10 group and 20 in the placebo group. Baseline clinical characteristics were similar between groups, while compliance was high and also similar between the CoQ10 and placebo groups. There was no significant effect of treatment on indices of diastolic function (difference in the lateral E/e'' ratio: −0.86 ± 6.57 in the CoQ10 group, +0.18 ± 3.76 in the placebo group; p = 0.561) or on serum NT-proBNP levels (− 72 pg/mL vs. − 42 pg/mL; p = 0.195).ConclusionsIn this pilot trial in elderly patients with HFpEF, treatment with CoQ10 did not significantly affect echocardiographic indices of diastolic function and serum NT-proBNP levels.Trial RegistrationThis trial was registered in the US National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT02779634","term_id":"NCT02779634"}}NCT02779634).     

高血压患者PWV与早期肾功能损害及左室肥厚的相关性分析

【摘要】目的 探讨原发性高血压患者脉搏波传导速度与早期肾功能损害及左室肥厚之间的关系。方法 选取年龄60~90岁的原发性高血压患者427例,测定其臂踝脉搏波传导速度（baPWV）,根据baPWV四分位数将人群分成4组。测定其各项生化指标,计算肾小球滤过率（eGFR）;心脏多普勒超声检查计算左室心肌质量指数（LVMI）以评价左室肥厚的程度。结果 4组间年龄、踝臂指数(ABI)、收缩压、平均动脉压、脉压、空腹血糖、LVMI及eGFR差异有统计学意义（P＜0.05）;偏相关分析发现,控制年龄及血糖后,baPWV与收缩压、平均动脉压、脉压、LVMI呈正相关（r 分别为0.295、0.187、0.292和0.159,P＜0.01）,baPWV与eGFR呈负相关（r=-0.314,P＜0.01）。多元线性回归显示,调整其他心血管危险因素后,年龄、baPWV和舒张压仍是eGFR的影响因素（t分别为8.251、6.834、2.142,P＜0.05）,收缩压和ABI是LVMI的影响因素（t分别为4.557和3.016,P＜0.05）,尚不能认定baPWV是LVMI的影响因素(t=1.722,P=0.086)。结论 baPWV对预测心血管危险因素及高血压导致肾功能损害的早期筛查和预防有重要作用。     

Effect of captopril on renin and blood pressure in cirrhosis

Summary In hepatic cirrhosis neurohumoral vasoconstrictor systems are activated to compensate for circulatory disturbances. To study the renin-angiotensin-aldosterone system in more detail, angiotensin converting enzyme in 15 patients with advanced liver disease was inhibited with captopril after moderate sodium restriction.Captopril caused an increase in plasma renin activity (p<0.005) and a decrease in plasma aldosterone (p<0.025) from an elevated baseline, and a moderate drop in systolic (p<0.025) and diastolic (p<0.05) blood pressure. Hyperreninaemia after captopril was inversely related to the prevailing plasma sodium level (r=–0.66,p<0.01), and the changes in both systolic and diastolic blood pressure were correlated with baseline plasma renin activity (r=0.49,p<0.05 for systolic andr=0.71,p<0.01 for diastolic blood pressure). No change occurred in heart rate or in stimulated plasma noradrenaline and vasopressin levels.The data suggest that in these cirrhotic patients the reactivity of the renin-angiotensin-aldosterone system was still intact, although it occurred at a higher level. They confirm the importance of the renin-angiotensin-aldosterone system in arterial blood pressure regulation in cirrhosis.     

体检人群臂踝脉搏波传导速度特征分析

目的:研究体检者的臂踝脉搏波传导速度( baPWV)特点及其与临床指标的相关性.方法:选择1052例体检者,应用多功能血管病变诊断仪测量其baPWV,并分为baPWV升高组和正常组.同时测量其身高、体质量、腹围、心率、血压、空腹血糖(FBG)、三酰甘油(TG)、胆固醇(TC),并收集其吸烟及饮酒情况等资料.结果:baPWV升高组的年龄、BMI、心率、收缩压、舒张压、平均动脉压、脉压、FBG、TG和TC均高于正常组,身高低于正常组,差异均有统计学意义(P＜ 0.05或P＜0.01),2组腹围差异无统计学意义.对于不同情况的baPWV值,男性高于女性,吸烟者高于不吸烟者,饮酒者高于不饮酒者,TG和TC升高者高于正常者,差异均有统计学意义(均P＜0.01);不同年龄、血压及空腹血糖者的baPWV差异有统计学意义(均P＜0.01).年龄、血压、血糖是baPWV的影响因素.结论:baPWV可提示血管壁的硬度及弹性的早期改变.     

非肥胖多囊卵巢综合征患者血清hsCRP的变化与相关因素分析

目的：研究多囊卵巢综合征（PCOS）患者超敏C-反应蛋白（hsCRP）的变化与胰岛素抵抗、高雄激素血症、收缩压、舒张压、腰围等指标的关系,确定与PCOS患者血清hsCRP相关的因素。方法：选取PCOS患者19例,正常月经周期健康女性17例,受试者进行体重指数（BMI）、腰围、收缩压、舒张压的测量;抽取血样测定hsCRP、性激素、总胆固醇、三酰甘油、HDL、性激素结合球蛋白等;葡萄糖耐量试验、血糖钳技术检测胰岛素敏感性,比较PCOS患者hsCRP变化与胰岛素抵抗、高雄激素血症、收缩压、舒张压、腰围等指标的关系,确定与PCOS患者血清hsCRP水平相关的因素。结果：PCOS患者血清hsCRP水平高于健康组,调整BMI后差异显著性仍然存在。PCOS患者血清hsCRP水平与腰围、收缩压、舒张压呈正相关,和胰岛素介导的葡萄糖摄取（IMGU）呈负相关。BMI、收缩压和IMGU可以预测PCOS患者血清hsCRP水平。结论：PCOS本身并不增加患者血清hsCRP水平,但已知的与心血管疾病相关的危险因素如BMI、收缩压、舒张压和IMGU影响PCOS患者血清hsCRP水平。