Analysis on the reproductive health situation of unmarried floating young women in cities

Objective: To understand the prevalence of RTIs/STIs, the incidence of sex violence and the KAP of the sex and reproductive health among unmarried floating young women.Methods: During Ocb.2002 to Feb.2003, in the maternal and child health hospital of Beijing, Shenzhen, Nanning and Zhengzhou, 1,219 unmarried floating young women who wanted termination of pregnancy and was under 24 years old before induced abortion received gynecological and laboratory examination. At the same time, they also answered a self-questionnaire. Results: The mean age of all respondents was (22.0±1.6) years old. The respondents' average age of having first sexual activity was (20.3±1.8) years old. The rate of induced abortion history was 38.7%. 17.5% of young women had never used contraception. The incidence of sex violence was 15.6%. The prevalence of RTIs and STIs was 56.1% and 9.7%, respectively. Young women were lack of the knowledge about reproductive health care. Conclusions: The reproductive health situation of unmarried floating young women was serious, especially on sex violence and RTIs/STIs and higher rate of induced abortion.     

结直肠癌组织中p27基因甲基化与其临床病理的关系

目的 检测结直肠癌组织中p27基因启动子区CpG岛甲基化水平及其表达,并结合其临床病理参数进行分析,探讨其在结直肠癌发生发展中的作用.方法 应用甲基化特异性聚合酶链反应分析技术检测106例结直肠癌组织及其正常结直肠黏膜组织、22例结肠腺瘤组织中p27基因启动子甲基化,用免疫组织化学SP方法检测其蛋白表达.结果 本组结直肠癌组织中p27甲基化阳性率为59.4%(63/106),结肠腺瘤组织中为18.2%(4/22),而正常结直肠黏膜组织中为3.8%(4/106),前组与后两组之间相比差异有统计学意义(P＜0.05).低分化组结直肠癌组织中p27甲基化阳性率明显高于高中分化组(48.0%比24.7%,P＜0.05);Dukes-A+B期组与C+D期组之间相比差异有统计学意义(20.0%比41.2%,P＜0.05);有无淋巴结转移两组之间的阳性率相比差异有统计学意义(41.5%比23.1%,P＜0.05);浸润深达浆膜层的结直肠癌组织中的甲基化阳性率与未达浆膜层组相比差异无统计学意义(32.5%比24.1%,P＞0.05).结论 结直肠癌组织中存在p27基因启动子甲基化.p27基因的高甲基化与结直肠癌分化程度、浸润深度、Dukes分期及有无淋巴结转移有关.

Abstract：

Objective To investigate the relationship between p27 gene methylation and pathology of colorectal carcinoma. Methods p27 gene methylation promotor region and p27 protein expression were detected respectively by methylation specificity polymerase chain reaction and immunohistochemical staining SP in 106 cases of colorectal carcinoma and each adjacent normal mucous membrane tissue and 22 cases of colorectal adenoma tissue. Results The positive expression rate of p27 gene methylation was statistically different in colorectal carcinoma tissue compared with normal mucous membrane and colorectal adenoma tissue (P＜0.05). Their positive expression rate were 59.4% (63/106), 18.2% (4/22) and 3.8%(4/106) respectively in colorectal carcinoma tissue,colorectal adenoma and normal mucous membrane tissue (P ＜ 0. 05). p27 gene methylation in poorly differentiated group was significantly higher than that in welldifferentiated group (48.0% vs. 24. 7%, P ＜0. 05), in Dukes-A + B stage group was significantly lower than that in Dukes C + D stage group(20. 0% vs. 41.2%, P ＜ 0. 05 ), and it was higher in lymph nodes metastases group than that in lymph nodes negative group(41.5% vs. 23. 1%, P ＜0. 05), that in positive serosa infiltration group was higher than negative serosa infiltration group(32. 5% vs. 24. 1%, P ＞ 0. 05 ).Conclusions Methylated p27 gene protein expression in colorectal carcinoma was significantly higher than normal mucous membrane and colorectal adenoma tissue. The methylation rate of p27 gene in colorectal carcinoma was significantly associated with tumor differentiation, invasive depth, Dukes stage, lymph node metastasis.     

结直肠腺癌中候选干细胞标记基因Musashi-1和β1-integrin的表达

目的 观察候选干细胞标记基因Musashi-1、β1-integrin在结直肠腺瘤及结直肠腺癌组织中的表达.方法 应用免疫组织化学链霉生物素-过氧化物酶法(SP法),检测结直肠癌组织芯片(8例正常结直肠黏膜,8例腺瘤,69例腺癌,其中8例为黏液腺癌组织)中Musashi-1和β1-integrin蛋白表达,分析其与临床病理特征的关系.结果 结直肠腺癌组织中Musashi-1阳性表达率为66.7%(46/69),腺瘤为50.0%(4/8).结直肠腺瘤和腺癌中β1-integrin阳性表达率分别为37.5%(3/8)和59.2%(41/69)(P＜0.05).腺癌组β1-integrin阳性表达率显著高于腺瘤组(P＜0.05).TNMⅢ期腺癌组Musashi-1和β1-integrin蛋白表达显著高于TNM Ⅰ～Ⅱ期组(P＜0.05).相关分析显示,Musashi-1与β1-integrin呈正相关(rs=0.631,P＜0.01).结论 候选干细胞标记基因Musashi-1、β1-integrin可能在结直肠癌发生、进展中起重要作用.

Abstract：

Objective To investigate the expression of two putative stem cell genes Musashi-1 and β1-integrin in human colorectal carcinomas. Methods Musashi-1 and β1-integrin immunoreactivity was studied immunohistochemically in tissue microarray-based samples containing 69 cases of colorectal adenocarcinomas, 8 cases of normal mucosa, and 8 cases of adenomas. Results Musashi-1 protein expression rate was 66. 7% (46/69) in colorectal adenocarcinomas. The positive rate of βl-integrin protein was59. 2% (41/69) in adenocarcinomas, higher than in the colorectal adenomas tissues (37.5%, 3/8, P ＜0. 05). The expression levels of Musashi-1 and β1-integrin protein were significantly higher in samples of TNM stage Ⅲ than in those of TNM stage Ⅰ -Ⅱ (P ＜0. 05 ). Musashi-1 expression was closely correlated with β1-integrin (r, =0.631 ,P＜0.01). Conclusion Putative intestinal stem cell genes Musashi-1 and β1-integrin may be involved in human colorectal tumor carcinogenesis and progression.     

Impact of organophosphorous pesticide exposure on semen quality of Chinese peasants

Aim: To investigate the impact of organophosphorous pesticide exposure and other risk factors on the semen quality of Chinese peasants. Method: Questionnaire investigation, external genital examination and laboratory examination were conducted on 322 male peasants, including the exposed and the control groups of 161 subjects each. Results: Multivariate analysis showed that the educational level and the years of alcohol drinking influenced the semen volume. Compared with subjects of primary school education or lower, those with junior high school education had a higher semen volume (OR=1.961). Proportion of subjects with higher semen volume decreased with increased years of alcohol drinking (OR=0.962). Organophosphorous pesticide exposure decreased the number of forward progression sperm (OR=0.528), the sperm density (OR=0.266), the sperm viability (OR=0.398) and the percentage of normal morphology sperm (OR=0.281). A possible relationship was present between the season of semen collection and the number     

Cross-sectional study on AIDS knowledge and condom use in rural areas

<正> Objective:To understand AIDS knowledge and condom use in rural areas,and to analyze theinfluencing factors of condom use.Methods:This is a cross-sectional study using the cluster-sampling method.4,800 subjects,randomly selected from six counties in China,were questioned using an anonymous survey.Results:36% of the subjects knew that tooth extraction could transmit AIDS.38.4% of thesubjects knew that the use of public razors could transmit AIDS.27.1% of the subjects had useda condom in the last year.The influencing factors of condom use were:sex(OR=1.325),age(OR=1.419),AIDS counseling(OR=2.181),educational level(OR=0.622),location of regis-tered permanent residence(OR=0.732),AIDS knowledge score(OR=0.736),and resident ofhigh AIDS prevalent province(OR=0.354).Conclusion:AIDS knowledge in rural areas is still lacking.The rate of condom use was verylow.The main influencing factors of low condom use were being female,elderly,and no AIDScounseling.Higher educational level,registered permanent resident in town,high AIDS knowl-edge score,and resident of high AIDS prevalent provinces were the propitious factors for condomuse.     

血脂和体重异常增加与胆囊结石病危险度的评价△

Objective of this study is to prognose the possibility of developing gallstone in subjects with the dyslipidemia and obesity. The multivariable logistic regression model was used to evaluate the odds ratio (OR) of the dyslipidemia and obesity to induce the formation of gallstone. OR＞1 indicates dangerous factor, OR＜1 protective factor, and OR=1 no significance. The results showed that if triglyceride (TG) and very low density lipoprotein cholesterol (VLDL-C) increased an average level of normal respectively, and there would be OR of TG 2.43 (P＜0.05) and OR of VLDL-C 6.09 (P＜0.05), the high levels of TG and VLDL-C were the factors of lithogenesis. High density lipoprotein cholesterols (HDL₁-C, HDL₂-C, HDL₃-C), with OR less than one, were the factors of protecting against the formation of gallstone. OR of low density lipoprotein cholesterol (LDL-C) and OR of total cholesterol (TC) were also less than one, but present research indicated that they may be a way of lipid metabolism not to be a protective factor. OR of BMI in male subjects was 1.16 (P＞0.05), and in female 1.38 (P＜0.05). These suggest that both correction of the metabolism of dyslipidemia and reduction of body weight are important to decrease the morbidity of cholecystolithiasis.     

结直肠癌组织中p27基因甲基化与其临床病理的关系

Objective To investigate the relationship between p27 gene methylation and pathology of colorectal carcinoma. Methods p27 gene methylation promotor region and p27 protein expression were detected respectively by methylation specificity polymerase chain reaction and immunohistochemical staining SP in 106 cases of colorectal carcinoma and each adjacent normal mucous membrane tissue and 22 cases of colorectal adenoma tissue. Results The positive expression rate of p27 gene methylation was statistically different in colorectal carcinoma tissue compared with normal mucous membrane and colorectal adenoma tissue (P＜0.05). Their positive expression rate were 59.4% (63/106), 18.2% (4/22) and 3.8%(4/106) respectively in colorectal carcinoma tissue,colorectal adenoma and normal mucous membrane tissue (P ＜ 0. 05). p27 gene methylation in poorly differentiated group was significantly higher than that in welldifferentiated group (48.0% vs. 24. 7%, P ＜0. 05), in Dukes-A + B stage group was significantly lower than that in Dukes C + D stage group(20. 0% vs. 41.2%, P ＜ 0. 05 ), and it was higher in lymph nodes metastases group than that in lymph nodes negative group(41.5% vs. 23. 1%, P ＜0. 05), that in positive serosa infiltration group was higher than negative serosa infiltration group(32. 5% vs. 24. 1%, P ＞ 0. 05 ).Conclusions Methylated p27 gene protein expression in colorectal carcinoma was significantly higher than normal mucous membrane and colorectal adenoma tissue. The methylation rate of p27 gene in colorectal carcinoma was significantly associated with tumor differentiation, invasive depth, Dukes stage, lymph node metastasis.     

结直肠癌组织中p27基因甲基化与其临床病理的关系

Objective To investigate the relationship between p27 gene methylation and pathology of colorectal carcinoma. Methods p27 gene methylation promotor region and p27 protein expression were detected respectively by methylation specificity polymerase chain reaction and immunohistochemical staining SP in 106 cases of colorectal carcinoma and each adjacent normal mucous membrane tissue and 22 cases of colorectal adenoma tissue. Results The positive expression rate of p27 gene methylation was statistically different in colorectal carcinoma tissue compared with normal mucous membrane and colorectal adenoma tissue (P＜0.05). Their positive expression rate were 59.4% (63/106), 18.2% (4/22) and 3.8%(4/106) respectively in colorectal carcinoma tissue,colorectal adenoma and normal mucous membrane tissue (P ＜ 0. 05). p27 gene methylation in poorly differentiated group was significantly higher than that in welldifferentiated group (48.0% vs. 24. 7%, P ＜0. 05), in Dukes-A + B stage group was significantly lower than that in Dukes C + D stage group(20. 0% vs. 41.2%, P ＜ 0. 05 ), and it was higher in lymph nodes metastases group than that in lymph nodes negative group(41.5% vs. 23. 1%, P ＜0. 05), that in positive serosa infiltration group was higher than negative serosa infiltration group(32. 5% vs. 24. 1%, P ＞ 0. 05 ).Conclusions Methylated p27 gene protein expression in colorectal carcinoma was significantly higher than normal mucous membrane and colorectal adenoma tissue. The methylation rate of p27 gene in colorectal carcinoma was significantly associated with tumor differentiation, invasive depth, Dukes stage, lymph node metastasis.     

Obesity and cardiometabolic disease risk factors among US adolescents with disabilities

AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with(n = 256) and without disabilities(n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome(Met S, ≥ 3 risk factors present) were examined by the following standardized body mass index(BMI) categories for those with and without disabilities; overweight(BMI ≥ 85th- 95 th percentile for age and sex), obesity(BMI ≥ 95 th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. RESULTS: Adolescents with disabilities were significantlymore likely to be overweight(49.3%), obese(27.6%) and severely obese(12%) vs their peers without disabilities(33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as Met S(18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities(9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have Met S(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities.CONCLUSION: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.     

Prevalence of obesity and diabetes in patients with schizophrenia

AIM To compare the prevalence of diabetes in patients with schizophrenia treated at a community mental health center with controls in the same metropolitan area and to examine the effect of antipsychotic exposure on diabetes prevalence in schizophrenia patients. METHODS The study was a comprehensive chart review of psychiatric notes of patients with schizophrenia and schizoaffective disorder treated at a psychosis program in a community mental health center. Data collected included psychiatric diagnoses, diabetes mellitus diagnosis, medications, allergies, primary care status, height, weight, body mass index(BMI), substance use and mental status exam. Local population data was downloaded from the Centers for Disease Control Behavioral Risk Factor Surveillance System. Statistical methods used were χ~2 test, Student's t test, general linear model procedure and binary logistic regression analysis.RESULTS The study sample included 326 patients with schizophrenia and 1899 subjects in the population control group. Demographic data showed control group was on average 7.6 years older(P = 0.000), more Caucasians(78.7% vs 38.3%, P = 0.000), and lower percentage of males(40.7% vs 58.3%, P = 0.000). Patients with schizophrenia had a higher average BMI than the subjects in the population control(32.11, SD = 7.72 vs 27.62, SD = 5.93, P = 0.000).Patients with schizophrenia had a significantly higher percentage of obesity(58.5% vs 27%, P = 0.000) than the population group. The patients with schizophrenia also had a much higher rate of diabetes compared to population control(23.9% vs 12.2%, P = 0.000). After controlling for age sex, and race, having schizophrenia was still associated with increased risk for both obesity(OR = 3.25, P = 0.000) and diabetes(OR = 2.42, P = 0.000). The increased risk for diabetes remained even after controlling for obesity(OR = 1.82, P = 0.001). There was no difference in the distribution of antipsychotic dosage, second generation antipsychotic use or multiple antipsychotic use within different BMI categories or with diabetes status in the schizophrenia group. CONCLUSION This study demonstrates the high prevalence of obesity and diabetes in schizophrenia patients and indicates that antipsychotics may not be the only contributor to this risk.     

Impact of family history of gastric cancer on colorectal neoplasias in young Japanese

Aim The aim of this study was to elucidate risk factors for the development of colorectal neoplasia in the young population. In particular, we focused on the family history of gastric cancer. Method Young Japanese subjects aged 30–49 years old who underwent colonoscopy for the first time from August 2007 to August 2008 were included in this study. A total of 300 unselected consecutive patients (mean age 40.5 years) were eligible for analysis, and family history of colorectal cancer and gastric cancer, sex, age, body mass index, positivity of faecal occult blood test and the presence of symptoms were evaluated. Risk factors for developing colorectal adenoma and/or carcinoma were assessed. Results Colorectal neoplasias were detected in 83 (27.7%) cases. Two were found to have invasive carcinoma. Univariate and multivariate analyses revealed that family history of gastric cancer (OR 2.09, 95% CI 1.12–3.92, P = 0.02) was an independent risk factor for the development of colorectal neoplasia, as well as male sex (OR 1.89, 95% CI 1.10–3.27, P = 0.02), older age (OR 2.05, 95% CI 1.18–3.55, P = 0.01) and positive faecal occult blood test (OR 1.99, 95% CI 1.14–3.48, P = 0.02). Conclusion In the young population under 50 years of age, a family history of gastric cancer is an independent risk factor for the development of colorectal neoplasia.     

肥胖青年人蛋白尿的危险因素评估

目的调查分析青年人肥胖的患病率及蛋白尿的危险因素。方法回顾性分析2008年11月-2009年8月期间本院体检中心的年龄20-39周岁的人群体检资料。资料包括姓名、性别、年龄、身高、体质量、体质量指数、收缩压、舒张压、血肌酐、尿素氮、空腹血糖、尿酸、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、尿蛋白。分析该人群男女各自肥胖、蛋白尿患病率，各种因素与蛋白尿的关系。结果在资料完整的2293例青年体检者中，男性肥胖患病率33．3％，蛋白尿患病率2．5％；女性肥胖患病率7．5％，蛋白尿患病率1．7％。经单因素、多因素回归分析显示，肥胖、血压、血脂紊乱、高血糖、高尿酸与蛋白尿独立相关。结论小于40岁的青年人，男性肥胖率是33．3％，女性肥胖率是7．5％，总的肥胖率是22．0％，男、女蛋白尿患病率分别是2．5％和1．7％，高血压、血脂紊乱、高血糖、高尿酸、肥胖是蛋白尿危险因素。     

不同类型肥胖与骨质疏松症的研究

目的旨在分析肥胖与骨质疏松症的关系,为肥胖与骨质疏松症的防治提供切实可信的数据。方法选取2014年1月至2015年1月在哈尔滨医科大学附属第二医院体检中心进行体检人员1192例,测定甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(FBG)的值。采用双能X线骨密度扫描双侧股骨及腰椎进行骨密度检测,根据骨密度T值分为骨量正常组、骨量减少组和骨质疏松组并结合身高、体重、血压、腰围等分为全身性肥胖、复合型肥胖、中心性肥胖,使用t检验和χ~2检验各组间有无统计学差异,对检测结果进行分析。结果在男性群体中50~59岁年龄组骨质疏松检出率明显升高(12.06%),80~89岁组达到最高(16.67%);女性群体中随年龄增长骨质疏松检出率有所增加,而70~79岁组骨质疏松的检出率最高为54.55%。在骨量正常组、骨量减少组及骨质疏松组3组中空腹血糖、甘油三酯和低密度脂蛋白胆固醇组间比较有差异,且具有统计学意义(P0.05)。合并一种代谢异常与骨质疏松的研究中,高血糖、血脂异常合并骨质疏松组间比较差异显著,有统计学意义;两种代谢异常合并骨质疏松组间比较差异显著,有统计学意义(P0.05)。复合型肥胖、中心性肥胖合并骨质疏松组间比较差异显著,有统计学意义(P0.05)。结论不同类型的肥胖与骨质疏松的关系并不一致。     

胆囊结石和肥胖及血脂代谢异常的相关性

目的 了解上海张江地区成年人胆囊结石的患病情况及其与肥胖、血脂代谢异常的相关性。方法 回顾性分析2019年1月至2019年12月在上海中医药大学附属曙光医院东院体检的24 914名20～79岁的张江地区成年常驻居民的腹部B超、体质量指数和血脂资料。以10岁为一个年龄段进行统计,比较各年龄段胆囊结石和肥胖发生率,采用Logistic回顾分析胆囊结石相关危险因素。结果 总胆囊结石患病率为2.78%（693/24 914）,随年龄段的上升而增高,20～59岁4个年龄段的胆囊结石患病率均存在统计学差异（P＜0.05）;按男女性别分别统计也均呈现相同的上升趋势和统计学差异情况;30～49岁2个年龄段男性的胆囊结石患病率高于同年龄段女性。总肥胖发生率为13.12%,男性肥胖人群分布呈纺锤形,以40～49岁年龄段为高峰;女性肥胖人群分布呈线性,随年龄增长不断升高。20～59岁4个年龄段男性肥胖率明显高于女性（P＜0.05）。50岁以下育龄期女性中,患有胆囊结石的女性LDL水平高于无胆囊结石的女性（P＜0.05）。Logistic分析显示女性（OR 1.263,95%CI 1.061～1.502）、50岁以上（OR 3.290,95%CI 2.820～3.838）、肥胖（OR 2.045,95%CI 1.709～2.449）、LDL≥3.4 mmol/L（OR 1.384,95%CI 1.111～1.724）、HDL（男性＜1.16 mmol/L,女性＜1.29 mmol/L）（OR 2.135,95%CI 1.786～2.551）的人群胆囊结石患病风险相对增加。结论 肥胖和HDL、LDL异常是胆囊结石发病的重要危险因素。其中高肥胖率在中青年男性中极为突出,而育龄期女性尤其需要关注LDL水平。     

血管内皮生长因子936C／T基因多态性与结直肠腺瘤易感性的关系

目的探讨血管内皮生长因子（VEGF）1498C／T、936C／T基因多态性与结直肠腺瘤易感性的关系。方法对224份结直肠腺瘤及200份正常对照标本进行研究．应用TaqMa。探针法检测VEGF1498C／T、936C／T基因型,搜集相对应的临床病理资料。结果与VEGF936CC基因型相比．CT基因型和CT＋TT基因型患者结直肠腺瘤的发生危险显著增加（DR=2．00,95％CI：1．23—3．25,P=0．006;OR=2．04,95％C1：1．28—3．26,P=0．003）;与VEGF936-C等位基因相比,T等位基因携带者结直肠腺瘤的发生危险亦显著增加（DR=1．91,95％CI：1．25—2．91．P=0．003）。结直肠腺瘤患者为VEGF936CT＋TT基因型或携带T等位基因,其病理类型倾向于绒毛状腺瘤（OR=2．54,95％CI：1．12—5．75,P：0．040;OR=3．08,95％CI：1．64-5．80,P=0．001）。VEGF1498C／T基因多态性在腺瘤组与对照组间的差异无统计学意义（19〉0．05）。结论VEGF936C／T基凶多态性与结直肠腺瘤易感性密切相关。     

Serum gastrin level in patients with colorectal adenoma or carcinoma]

During the last years interest has focused on the trophic effect of gastrin in colorectal carcinomas. Some reports indicated an increased serum level of gastrin in patients with colorectal adenomas or carcinomas. In a prospective study in 261 patients submitted to colonoscopy fasting serum gastrin concentrations were determined. 91 patients served as control, 89 patients had one or more adenomas, 55 patients suffered from a colorectal carcinoma, 17 had a benign, postoperative stenosis of the colon, and 9 had a chronic inflammatory bowel disease. All patients fulfilled the following criteria: No regular drug intake, no previous gastric or small bowel operation, no known ulcer disease, no abnormalities in serum calcium, creatinine, triglycerides, cholesterol and blood urea. Mean gastrin level was 86.63 +/- 23.8 pg/ml in the control, 84.57 +/- 25.1 pg/ml in the adenoma group and 84.6 +/- 24.4 pg/ml in the carcinoma group. No difference of serum gastrin levels were observed regarding sex, age, tumor stage and localisation.     

Risk Factor, Age and Sex Differences in Chronic Kidney Disease Prevalence in a Diabetic Cohort: The Pathways Study

Background/Aims: Women with diabetes experience a disproportionately greater burden of diabetic kidney disease (DKD) risk factors compared to men; however, sex-specific differences in DKD are not well defined. The effect of age on sex differences in DKD is unknown. Methods: We performed a cross-sectional analysis of the prevalence of DKD (eGFR <60 ml/min/1.73 m(2) or microalbuminuria), advanced DKD (eGFR <30 ml/min/1.73 m(2)), and common DKD risk factors in the Pathways Study (n = 4,839), a prospective cohort study of diabetic patients from a managed care setting. Subjects were stratified by age <60 and ≥60 years to examine for differences by age. Logistic regression models examined the association between sex and prevalence of DKD and risk factors. Results: Women of all ages had 28% decreased odds of DKD (OR 0.72, 95% CI 0.62-0.83); however, they had a greater prevalence of advanced DKD (OR 1.67, 95% CI 1.05-2.64), dyslipidemia (OR 1.42, 95% CI 1.16-1.74), and obesity (OR 1.87, 95% CI 1.60-2.20) compared to men. Women had similar odds of hypertension and poor glycemic control as men. Women ≥60 years had increased odds of advanced DKD, hypertension, dyslipidemia, and obesity compared to similarly aged men. Women <60 years had increased odds of obesity compared to their male counterparts. Conclusion: Women with diabetes had an increased prevalence of advanced DKD and common DKD risk factors compared to men and these disparities were most prominent amongst the elderly.     

Mild Elevation of Fasting Plasma Glucose is a Strong Risk Factor for Postoperative Complications in Gastric Bypass Patients

Background: Bariatric surgery may be associated with surgical complications. The aim of the study was to identify significant risk factors for postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGBP). Methods: The study consisted of 75 consecutive patients undergoing RYGBP. Full medical examination was performed, and the following parameters were assessed in the fasting state: plasma glucose, insulin, leptin, serum lipids, liver function tests, and lipoprotein Lp(a). All subjects had oral 75 g glucose tolerance test before the surgery. All complications occurring within 6 months after the RYGBP were recorded. The patients were divided into Group 1 - patients in whom complications occurred, and Group 2 - patients with no complications in the 6-month period. Results: Postoperative complications occurred in 16 patients (wound infection, hernia, splenic injury, gastro-jejunal obstruction, duodenal ulcer, lower limb deep vein thrombosis). 3 significant risk factors for postoperative complications within 6 months after gastric bypass were found: 1) fasting plasma glucose ≥ 6.0 mmol/l (OR 11.0; 95% confidence interval (CI) 2.1-77.3), 2) age ≥40 years (OR 5.89, 95% CI 1.35-29.4), and 3) BMI ≥45 kg/m² (OR 4.1, 95% CI 1.04-17.2). Conclusion: RYGBP is associated with increased risk of developing early postoperative complications in subjects with even slightly elevated fasting plasma glucose, age ≥40 and BMI ≥45 kg/m².     

南昌市部分社区40岁以上人群骨质疏松症流行现状调查及影响因素分析

目的 明确南昌市部分社区40岁以上人群骨质疏松症(Osteoporosis,OP)的患病状况及其影响因素,为OP的社区干预提供基础信息和依据.方法 应用HOLOGIC公司生产的Sahara定量超声骨密度检测仪测量南昌部分社区10071名40岁以上人群跟骨骨密度.对所有受试者进行问卷调查,检测其肝肾功能、血糖、糖化血红蛋白(HbA1C)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、总胆固醇(TC);测量血压、身高、体重、腰围、臀围,计算其腰臀比(WHR)、体质指数(BMI).首先行单因素Logistic分析,有统计学意义者(P＜0.1)进一步行二分类Logistic回归分析,计算OR值及其95％置信区间.结果 (1)OP的总患病率为9.3％,男性7.1％,女性10.8％;年龄、性别标化后的总患病率为11.3％,男性7.9％,女性11.7％;(2)在男性,单因素分析显示年龄、文化程度、饮酒、饮牛奶、舒张压、HDL-c、BMI、体力劳动、OP家族史等与OP患病可能相关(P＜0.1).二分类Logistic回归分析显示增龄、OP家族史为OP可能危险因素;高文化程度、饮酒、饮牛奶、大BMI为OP的可能保护性因素;(3)在女性,单因素分析显示年龄、婚姻状况、文化程度、吸烟、饮牛奶、收缩压、HDL-c、LDL-c、TG、TC、HbA1c、BMI、WHR、体力劳动、孕次、产次、初潮年龄、绝经状态、绝经年龄、绝经年限、哺乳是OP的可能影响因子(P＜0.1);二分类Logistic回归分析显示增龄、无配偶、多产次、已绝经、长绝经年限和大WHR是OP的可能危险因素;经常饮用牛奶、晚绝经年龄、高BMI为其可能保护性因素.结论 南昌市部分社区OP骨质疏松症的主要危险因素在男性是OP家族史和增龄;在女性是增龄、绝经、无配偶、多产次以及中心性肥胖.饮牛奶和合适的体质指数是男女共同的OP保护因素,在男性良好的教育和适量饮酒,女性晚的绝经年龄可能有助于减少OP的患病风险.应要采取相应的干预措施,控制OP的可控因素,预防和延缓骨质疏松症的发生.     

Serum total 8-iso-prostaglandin F2alpha: a new and independent predictor of peripheral arterial disease

OBJECTIVE: Circulating 8-iso-prostaglandin F 2alpha (8-iso-PGF 2alpha ) has been proposed as new indicator of oxidative stress, which is involved in the pathophysiologic changes of atherosclerosis. We proposed to test the hypothesis that 8-iso-PGF 2alpha is an independent predictor of symptomatic peripheral arterial disease (PAD). METHODS: A case-control study in 100 patients with symptomatic PAD and 100 control subjects matched for age, sex, and diabetes mellitus was conducted. Smokers and subjects using lipid-lowering drugs were excluded. Serum total 8-iso-PGF 2alpha was quantified with an enzyme immunoassay. RESULTS: Median 8-iso-PGF 2alpha was higher in patients with PAD than in control subjects (63 vs 42 pg/mL; P = .001). Logistic regression with hypertension, body mass index, and creatinine, low-density lipoprotein (LDL) cholesterol, triglyceride, high-sensitivity C-reactive protein (hs-CRP), 8-iso-PGF 2alpha , and total homocysteine concentrations as independent variables and case-control status as dependent variable revealed significant odds ratios (OR) for hypertension (OR, 3.74; 95% confidence interval [CI], 1.85-7.53), low-density lipoprotein cholesterol (OR, 1.16, for an increment of 10 mg/dL; 95% CI, 1.07-1.27), high-sensitivity C-reactive protein (OR, 1.02, for an increment of 1 mg/L; 95% CI, 1.00-1.03), and 8-iso-PGF 2alpha (OR, 1.11, for an increment of 10 pg/mL; 95% CI, 1.03-1.20). CONCLUSIONS: Serum total 8-iso-PGF 2alpha was an independent predictor of PAD in the population studied. This finding supports the hypothesis that 8-iso-PGF 2alpha is a risk marker for PAD. Our results indicate increased systemic oxidative stress in patients with PAD.