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1.
Mazzoccoli G Fontana A Grilli M Dagostino MP Copetti M Pellegrini F Vendemiale G 《Age (Dordrecht, Netherlands)》2012,34(3):751-760
Arterial and venous thrombosis have always been regarded as different pathologies and epidemiological studies have examined
the association between venous thrombosis and indicators of atherosclerosis and/or arterial thromboembolic events. We measured
the flow-mediated dilation (FMD), a well-known marker of arterial endothelial dysfunction, in young–middle-aged and old-aged
patients with and without unprovoked deep venous thrombosis (DVT). The aim of this study was to investigate whether DVT was
a significant predictor for impaired FMD, considering all the patients and young–middle-aged (age < 65 years) and old-aged
(age ≥ 65 years) patients separately. FMD was measured in the brachial artery on a population of 120 subjects with the same
atherosclerosis risk factors, 68 male and 52 female, 70 young–middle-aged subjects (mean age ± SD 49.5 ± 10.5 years) and 50
old-aged subjects (76.2 ± 7.7 years). Patients with DVT showed a significant decrease of FMD compared to patients without
DVT (6.8 ± 5.5% vs. 10.9 ± 3.5%, p < 0.001). Moreover, old-aged patients showed a significant decrease of FMD compared to the young–middle-aged subjects (7.4 ± 4.1%
vs. 9.8 ± 5.3%, p = 0.005). In the whole study population, DVT was strongly associated with FMD (risk factors adjusted β = −4.14, p < 0.001). A significant interaction between age and the presence of DVT on predicting FMD was found (p = 0.003) suggesting a differential behavior of DVT as predictor of FMD. In young–middle-aged group, multivariate model confirmed
that DVT was the most significant predictor of continuous FMD (β = −6.06, p < 0.001). On the contrary, DVT was no more a predictor of FMD in the old age group (β = −0.73, p=0.556). Furthermore, old-aged patients without DVT showed a statistically significant decrease of FMD compared to the young–middle-aged
subjects without DVT (8.2±2.1% vs. 12.6±2.7%, p<0.001) and old-aged patients with DVT showed a not statistically significant decrease of the FMD compared to the young–middle-aged
patients with DVT (6.7±5.3% vs. 6.8±5.7%, p = 0.932). In conclusion, young–middle-aged patients with spontaneous DVT show an impaired FMD, whereas this impairment in
old-aged subjects is evident independently from the presence or absence of DVT. Aging per se may be associated with physiologic
abnormalities in the systemic arteries and with endothelial dysfunction. 相似文献
2.
Micha T. Maeder Peter Ammann Hans Rickli Otto D. Schoch Wolfgang Korte Christoph Hürny Jonathan Myers Thomas Münzer 《Sleep & breathing》2008,12(1):7-16
The obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular abnormalities including left ventricular hypertrophy,
left ventricular diastolic dysfunction, and endothelial dysfunction. The present study evaluated whether N-terminal pro-B-type
natriuretic peptide (NT-proBNP) and peak oxygen consumption (peak VO2), both integral markers of cardiovascular function, are related to OSAS severity. In addition, we tested whether NT-proBNP
levels depend on body composition in OSAS patients, similar to what has been reported in patients without OSAS. Eighty-nine
patients with untreated OSAS underwent NT-proBNP measurement, dual X-ray absorptiometry, and cardiopulmonary exercise testing.
In a representative subgroup (n = 32), transthoracic echocardiography was performed. The severity of OSAS was classified based on apnea–hypopnea index (AHI)
values as mild (AHI 5–15 h−1), moderate (AHI 15–30 h−1), and severe (AHI >30 h−1). OSAS was mild in 19 (21%), moderate in 21 (24%), and severe in 49 (55%) patients. NT-proBNP levels did not differ among
patients with mild [30 (10–57)], moderate [37 (14–55)], and severe [24 (13–49) pg/ml; p = 0.8] OSAS and were not related to body mass index (r = 0.07; p = 0.5), percent lean body mass (r = −0.17; p = 0.1), and percent fat mass (r = 0.18; p = 0.1). Percent predicted peak VO2 was on average normal and did not differ among patients with mild (115 ± 26), moderate (112 ± 23), and severe OSAS (106 ± 29%;
p = 0.4). Body weight-indexed peak VO2 did not differ among patients with mild (31.9 ± 10.3), moderate (32.1 ± 7.9), and severe OSAS (30.0 ± 9.9 ml kg−1 min−1; p = 0.6) either. Lower NT-proBNP (β = −0.2; p = 0.02) was independently but weakly associated with higher body weight-indexed peak VO2. In the echocardiography subgroup, NT-proBNP was not significantly related to left ventricular mass index (r = 0.26; p = 0.2). In conclusion, NT-proBNP and peak VO2 are not related to OSAS severity, and NT-proBNP poorly reflects left ventricular hypertrophy in OSAS. The lack of a relationship
between NT-proBNP and OSAS severity is not due to a significant influence of body composition on NT-proBNP. There is an association
between higher NT-proBNP and lower peak VO2, indicating that NT-proBNP is a marker of cardiorespiratory fitness in patients with OSAS. However, the association is too
weak to be clinically useful. 相似文献
3.
Elina Sakellaridou Heike Wersching Julia Reinholz Hubertus Lohmann Stefan Knecht 《Age (Dordrecht, Netherlands)》2011,33(1):101-106
Verbal comprehension is critical to the success of medical counseling. Here, we tested how age and vascular risk factors affect
the ability to understand complex instructions. Verbal comprehension, cognitive functions, and vascular risk factors were
assessed in 39 mid- and 38 late-life community-dwelling individuals (48 to 59 years and >59 years of age, respectively). To
test for verbal comprehension, we used a modified version of the Token Test (TT). In midlife individuals, education (β = 0.572, p < 0.05) was the only predictor for extended-TT performance. In late-life individuals, age (β = −1.015, p < 0.001) and body mass index (β = −0.651, p = 0.003) were significantly correlated with extended-TT performance and explained 50% of the variance in extended-TT performance
(adjusted R
2 = 0.503). This relation is only partly explained by conventional neuropsychological measures as the ones used in our test
battery. These results indicate that aging and overweight impair comprehension of complex instructions. Therefore, medical
counseling appropriate for midlife individuals may be less successful in elderly people and particularly in those with metabolic
disturbances. 相似文献
4.
Chen-Liang Chou Min-Jung Wu Chia-Li Yu Ming-Chi Lu Song-Chou Hsieh Tsai-Hung Wu Chung-Tei Chou Chang-Youh Tsai 《Clinical rheumatology》2010,29(8):875-881
Anti-agalactosyl IgG antibody (anti-Gal(0) IgG) has been regarded as a useful serological marker for rheumatoid arthritis
(RA). It is unknown whether it is also elevated in serum and implicated in the pathogenesis of joint inflammation in seronegative
spondyloarthropathy (SpA) such as ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Sera were collected from 43 patients
with AS or PsA with axial joint involvement, 22 patients with RA, and 25 healthy normal individuals for the detection of anti-Gal(0)
IgG with a cup-type lectin enzyme immunoassay (Eitest CA.RF). The disease activity of the AS/PsA was evaluated by Bath Ankylosing Spondylitis Disease Activity Score (BASDAI), the
serum C-reactive protein (CRP) and IgA were measured by nephelometry, and erythrocyte sedimentation rate (ESR) was measured
by Westergren’s method. The median titers of anti-Gal(0) IgG were significantly elevated in patients with RA (167.85, 15.73∼797.58 AU/mL)
and AS/PsA (186.15, 34.71∼651.19 AU/mL), compared to those of the normal controls (13.04, 12.00∼202.43 AU/mL). The titers
of the anti-Gal(0) IgG in patients with AS/PsA were correlated to the BASDAI scores (r
2 = 0.422, SEE = 1.443, p < 0.001) and serum CRP (r
2 = 0.345, SEE = 2.434, p < 0.001) but not to IgA (r
2 = 0.0259, SEE = 126.30, p < 0.001) or ESR (r
2 = 0.171, SEE = 31.053, p = 0.0059). Collectively, the anti-Gal(0) IgG is elevated and vaguely correlated with the disease activity of AS/PsA although
its titers in these patients were erratic. The result of the present investigation has suggested that anti-Gal(0) IgG may
be more ubiquitously present in inflammatory arthritides including RA or SpA. 相似文献
5.
Pál Soltész Henriett Dér György Kerekes Péter Szodoray Gabriella Szücs Katalin Dankó Yehuda Shoenfeld Gyula Szegedi Zoltán Szekanecz 《Clinical rheumatology》2009,28(6):655-662
Patients with autoimmune diseases may have increased vascular risk leading to higher mortality rates. Novel imaging techniques
are necessary for the early assessment and management of these patients. In this study, we compared augmentation index (AIx)
and pulse wave velocity (PWV), indicators of arterial stiffness, to brachial arterial flow-mediated vasodilation (FMD) and
common carotid artery intima–media thickness (ccIMT), standard indicators of endothelial dysfunction and atherosclerosis,
respectively. We wished to assess the vascular status of autoimmune patients by using a novel, cheap, and reproducible technique,
the arteriograph. Altogether, 101 patients with systemic autoimmune diseases including primary antiphospholipid syndrome,
systemic sclerosis, rheumatoid arthritis, and polymyositis, all having various types of vasculopathies, as well as 36 healthy
individuals were investigated. Arterial stiffness was assessed by a TensioClinic arteriograph, a recently validated technique.
Brachial arterial FMD and ccIMT were determined using high-resolution ultrasonography. Autoimmune patients exerted impaired
FMD (3.7 ± 3.8%), increased ccIMT (0.7 ± 0.2 mm), AIx (1.2 ± 32.2%), and PWV (9.7 ± 2.4 m/s) in comparison to control subjects
(FMD = 8.4 ± 4.0%; ccIMT = 0.6 ± 0.1 mm; Aix = −41.1 ± 22.5%; PWV = 8.0 ± 1.5 m/s; p < 0.05). We found a significant negative correlation of FMD with AIx (R = −0.64; p < 0.0001) and PWV (R = −0.37; p = 0.00014). There were significant positive correlations between ccIMT and AIx (R = 0.34; p = 0.0009), ccIMT and PWV (R = 0.44; p < 0.0001), as well as AIx and PWV (R = 0.47; p < 0.0001). AIx, PWV, and ccIMT positively correlated and FMD negatively correlated with the age of the autoimmune patients.
Arterial stiffness indicated by increased AIx and PWV may be strongly associated with endothelial dysfunction and overt atherosclerosis
in patients with autoimmune diseases. Assessment of arterial stiffness, FMD, and ccIMT are reproducible and reliable noninvasive
techniques for the complex assessment of vascular abnormalities in patients at high risk. 相似文献
6.
Oelzner P Franke S Lehmann G Eidner T Müller A Wolf G Hein G 《Clinical rheumatology》2007,26(12):2127-2135
The aim of our study was to investigate determinants of bone mineral density (BMD) measured by dual X-ray absorptiometry at
the lumbar spine (BMD-LS) and at the femoral neck (BMD-FN) in patients with rheumatoid arthritis (RA) with special respect
to bone resorbing proinflammatory cytokines and their physiological antagonists. In 142 RA patients the following parameters
were measured in parallel with BMD: serum levels of soluble receptor activator of nuclear factor kappa-B-ligand (sRANKL),
osteoprotegerin (OPG), interleukin (IL)-6, soluble glycoprotein 130 (sgp130), 25-hydroxyvitamin D3 (25OHD3), 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), intact parathyroid hormone, osteocalcin, ionized calcium, renal excretion of pyridinolin and deoxypyridinolin, C-reactive
protein, and erythrocyte sedimentation rate (ESR). No significant differences of sRANKL, OPG, IL-6, and spg130 were found
between patients with osteoporosis (47.9% of patients), osteopenia (36.6%), and normal BMD (15.5%). However, total sRANKL
was significantly higher in postmenopausal women with osteoporosis at FN than in those without (p < 0.05) and showed a negative correlation with BMD-LS in patients older than 60 years (p = 0.01). BMD-LS and BMD-FN (p < 0.001) and total sRANKL (p < 0.01) were negatively related with the age of the patients. Only IL-6 (positive correlation, p < 0.001) and 1,25(OH)2D3 (negative correlation, p < 0.001) but not sRANKL, OPG, and sgp130 were related to disease activity. Using multiple linear regression analysis, menopause
was identified as the crucial negative determinant of BMD-LS (R
2 = 0.94, p = 0.001), whereas cumulative glucocorticoid dose (β = −0.80, p = 0.001) and ESR (β = −0.44, p = 0.016) were the negative determinants of BMD-FN (R
2 = 0.86, p = 0.001). The results indicate that influences of age and gender must be considered in investigations on the relationship
between BMD and sRANKL in RA and that high serum levels of sRANKL seems to be associated with osteoporosis only in subgroups
of RA patients. 相似文献
7.
Prognostic value of morphological classifications and clinical variables in elderly and young patients with multiple myeloma 总被引:2,自引:0,他引:2
Kurabayashi H Kubota K Tsuchiya J Murakami H Tamura J Naruse T 《Annals of hematology》1999,78(1):19-23
The prognostic value of morphological classifications and clinical variables was compared between 31 elderly (≥65 years)
and 43 young (<65 years) patients with myeloma. Prognostic factors were divided into three groups: factors useful in elderly
patients, e.g., calcium, albumin; factors useful in young patients, e.g., platelet, creatinine, light-chain type; and factors
useful in both patients, e.g., clinical stage, hemoglobin, LDH, CRP, bone marrow plasma cell and plasmablast percentages,
light- and electron-microscopic classifications. The 5-year survival rates of elderly patients with calcium <12 and ≥12 mg/dl
were 66.2 and <11.1%, respectively (p<0.01). Those of the young patients were 64.1 and 33.3%, respectively. The 5-year survival rates of elderly patients with
platelets ≥200×109/l and <100×109/l were 59.7 and 50.0%, respectively. Those of the young patients were 68.9 and 33.3%, respectively (p<0.05). The 5-year survival rates of elderly patients with few and numerous electron-microscopic abnormalities were 90 and
0%, respectively (p<0.01), those of young patients were 92.9 and <14.3%, respectively (p<0.01). These findings suggest that individual clinical variables may differ in prognostic importance in elderly and young
patients.
Received: March 11, 1998 · Accepted: September 14, 1998 相似文献
8.
Haemoglobin levels are associated with bone mineral density in the elderly: a population-based study
Hypoxemia has been associated with low bone mineral density (BMD) in animal and human models. We assessed the association
of haemoglobin levels with ultrasound-derived (UD) T score, Z score and the stiffness index in all 358 subjects aged 75+ living
in Tuscania (Italy). Also, we searched for the haemoglobin cutoff levels that might best identify participants with osteoporosis.
In the multivariable linear regression analysis, haemoglobin levels were associated among participants with the UD T score
[β = 0.13; 95% confidence interval (CI) = 0.01–0.25; p = 0.030], Z score (β = 0.11; 95% CI = 0.01–0.22; p = 0.045) and stiffness index (β = 1.87; 95% CI = 0.51–3.21; p = 0.007) after adjusting for potential confounders. Haemoglobin levels <140 g/L in men and <130 g/L in women best predicted
osteoporosis in linear discriminant analysis. Haemoglobin is independently associated with all UD-BMD parameters. Haemoglobin
levels <140 g/L in men and 130 g/L in women might be adopted in clinical practice to identify older subjects in whom screening
for osteoporosis might yield higher effectiveness. 相似文献
9.
Bakhtadze E Cervin C Lindholm E Borg H Nilsson P Arnqvist HJ Bolinder J Eriksson JW Gudbjörnsdottir S Nyström L Agardh CD Landin-Olsson M Sundkvist G Groop LC 《Diabetologia》2008,51(12):2224-2232
Aims/hypothesis Type 1 diabetes in children is characterised by autoimmune destruction of pancreatic beta cells and the presence of certain
risk genotypes. In adults the same situation is often referred to as latent autoimmune diabetes in adults (LADA). We tested
whether genetic markers associated with type 1 or type 2 diabetes could help to discriminate between autoimmune and non-autoimmune
diabetes in young (15–34 years) and middle-aged (40–59 years) diabetic patients.
Methods In 1,642 young and 1,619 middle-aged patients we determined: (1) HLA-DQB1 genotypes; (2) PTPN22 and INS variable-number tandem repeat (VNTR) polymorphisms; (3) two single nucleotide polymorphisms (rs7903146 and rs10885406) in
the TCF7L2 gene; (4) glutamic acid decarboxylase (GAD) and IA-2-protein tyrosine phosphatase-like protein (IA-2) antibodies; and (5)
fasting plasma C-peptide.
Results Frequency of risk genotypes HLA-DQB1 (60% vs 25%, p
= 9.4×10−34; 45% vs 18%, p
= 1.4 × 10−16), PTPN22 CT/TT (34% vs 26%, p
= 0.0023; 31% vs 23%, p
= 0.034), INS VNTR class I/I (69% vs 53%, p
= 1.3 × 10−8; 69% vs 51%, p
= 8.5 × 10−5) and INS VNTR class IIIA/IIIA (75% vs 63%, p
= 4.3 × 10−6; 73% vs 60%, p
= 0.008) was increased in young and middle-aged GAD antibodies (GADA)-positive compared with GADA-negative patients. The type
2 diabetes-associated genotypes of TCF7L2 CT/TT of rs7903146 were significantly more common in young GADA-negative than in GADA-positive patients (53% vs 43%; p
= 0.0004). No such difference was seen in middle-aged patients, in whom the frequency of the CT/TT genotypes of TCF7L2 was similarly increased in GADA-negative and GADA-positive groups (55% vs 56%).
Conclusions/interpretation Common variants in the TCF7L2 gene help to differentiate young but not middle-aged GADA-positive and GADA-negative diabetic patients, suggesting that young
GADA-negative patients have type 2 diabetes and that middle-aged GADA-positive patients are different from their young GADA-positive
counterparts and share genetic features with type 2 diabetes.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorised users.
G. Sundkvist died in September 2006. 相似文献
10.
L. Sibal A. Aldibbiat S. C. Agarwal G. Mitchell C. Oates S. Razvi J. U. Weaver J. A. Shaw P. D. Home 《Diabetologia》2009,52(8):1464-1473
Aims/hypothesis Type 1 diabetes is associated with premature arterial disease. Bone-marrow derived, circulating endothelial progenitor cells
(EPCs) are believed to contribute to endothelial repair. The hypothesis tested was that circulating EPCs are reduced in young
people with type 1 diabetes without vascular injury and that this is associated with impaired endothelial function and increased
carotid intima–media thickness (CIMT).
Methods We compared 74 people with type 1 diabetes with 80 healthy controls. CD34, CD133, vascular endothelial (VE) growth factor
receptor-2 (VEGFR-2) and VE-cadherin antibodies were used to quantify EPCs and progenitor cell subtypes using flow-cytometry.
Ultrasound assessment of endothelial function by brachial artery flow-mediated dilatation (FMD) and CIMT was made. Circulating
endothelial markers, inflammatory markers and plasma plasminogen activator inhibitor-1 (PAI-1) levels were measured.
Results CD34+VE-cadherin+, CD133+VE-cadherin+ and CD133+VEGFR-2+ EPC counts were significantly lower in people with diabetes (46–69%;
p = 0.004–0.043). In people with type 1 diabetes, FMD was reduced by 45% (p < 0.001) and CIMT increased by 25% (p < 0.001), these being correlated (r = −0.25, p = 0.033). There was a significant relationship between FMD and CD34+VE-cadherin+ (r = 0.39, p = 0.001), CD133+VEGFR-2+ (r = 0.25, p = 0.037) and CD34+ (r = 0.34, p = 0.003) counts. Circulating high-sensitivity C-reactive protein, PAI-1, interleukin-6 and E-selectin were significantly
higher in the diabetes group (p < 0.001 to p = 0.049), the last two of these correlating with FMD (r = −0.27, p = 0.028 and r = −0.24, p = 0.048, respectively).
Conclusions/interpretation These findings suggest that abnormalities of endothelial function in addition to pro-inflammatory and pro-thrombotic states
are already common in people with type 1 diabetes before development of clinically evident arterial damage. Low EPC counts
confirm risk of macrovascular complications and may account for impaired endothelial function and predict future cardiovascular
events.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorised users. 相似文献
11.
Ambulatory pulse pressure, decreased nocturnal blood pressure reduction and progression of nephropathy in type 2 diabetic patients 总被引:1,自引:1,他引:0
S. T. Knudsen E. Laugesen K. W. Hansen T. Bek C. E. Mogensen P. L. Poulsen 《Diabetologia》2009,52(4):698-704
Aims/hypothesis We followed type 2 diabetic patients over a long period to evaluate the predictive value of ambulatory pulse pressure (PP)
and decreased nocturnal BP reduction (non-dipping) for nephropathy progression.
Methods Type 2 diabetic patients (n = 112) were followed for an average of 9.5 (range 0.5–14.5) years. At baseline, all patients underwent 24 h ambulatory BP
measurement. Urinary albumin excretion rate was evaluated by three urinary albumin:creatinine ratio measurements at baseline
and follow-up.
Results At baseline, patients who subsequently progressed to a more advanced nephropathy stage (n = 35) had reduced diastolic night/day BP variation and higher 24 h systolic BP and PP values; they also had more advanced
nephropathy and were more likely to smoke than those with no progression of nephropathy (n = 77). In a Cox regression analysis, independent predictors of nephropathy progression were 24 h PP (p < 0.01), diastolic night:day BP ratio (p = 0.02) and smoking (p = 0.02). The adjusted hazards ratio (95% CI) for each mmHg increment in 24 h PP was 1.04 (1.01–1.07), whereas the adjusted
hazards ratio (95% CI) for each 1% increase in diastolic night:day BP ratio was 1.06 (1.01–1.11). Only one of 33 patients
(3.0%) with both a diastolic night:day BP ratio and a 24 h PP below the median progressed, whereas 17 of 32 patients (53.1%)
with both a diastolic night:day BP ratio and a 24 h PP equal to or above the median progressed to a more advanced nephropathy
stage (p < 0.001).
Conclusions/interpretation Ambulatory PP, impaired nocturnal BP decline and smoking are strong, independent predictors of nephropathy progression in
type 2 diabetic patients. 相似文献
12.
Arterial dysfunction has been documented in patients with beta-thalassaemia major. This study aimed to determine the quantity
and proliferative capacity of circulating CD133+VEGFR2+ and CD34+VEGFR2+ cells in patients with beta-thalassaemia major and those after haematopoietic stem cell transplantation (HSCT), and their
relationships with arterial function. Brachial arterial flow-mediated dilation (FMD), carotid arterial stiffness, the quantity
of these circulating cells and their number of colony-forming units (CFUs) were determined in 17 transfusion-dependent thalassaemia
patients, 14 patients after HSCT and 11 controls. Compared with controls, both patient groups had significantly lower FMD
and greater arterial stiffness. Despite having increased CD133+VEGFR2+ and CD34+VEGFR2+ cells, transfusion-dependent patients had significantly reduced CFUs compared with controls (p = 0.002). There was a trend of increasing CFUs across the three groups with decreasing iron load (p = 0.011). The CFUs correlated with brachial FMD (p = 0.029) and arterial stiffness (p = 0.02), but not with serum ferritin level. Multiple linear regression showed that CFU was a significant determinant of FMD
(p = 0.043) and arterial stiffness (p = 0.02) after adjustment of age, sex, body mass index, blood pressure and serum ferritin level. In conclusion, arterial dysfunction
found in patients with beta-thalassaemia major before and after HSCT may be related to impaired proliferation of CD133+VEGFR2+ and CD34+VEGFR2+ cells. 相似文献
13.
C-reactive protein (CRP) and interleukin-6 (IL-6) are pro-inflammatory proteins and important risk factors for atherosclerosis.
Plasma CRP levels in snoring children may or may not be elevated. Since obesity is prevalent among snoring children and is
associated with elevated CRP levels, we aimed to investigate the relative contributions of sleep-disordered breathing (SDB)
and obesity to the inflammatory processes in snoring children in this prospective study. Two hundred forty-four children (mean
age 8.9 ± 3.4 years) underwent polysomnographic evaluation. CRP was measured the following morning, and plasma IL-6 levels
from 111 randomly selected children were also examined. Plasma CRP and IL-6 levels were elevated in children with SDB. Log
plasma CRP levels were higher in the moderate-severe SDB group (apnea/hypopnea index, AHI ≥ 5) compared to the mild SDB group
(AHI ≥ 1 and <5; p < 0.0001) or the control group (AHI < 1; p = 0.0001). Log plasma CRP levels correlated with AHI, arousal index, relative BMI, and SpO2 nadir (r = 0.30, p < 0.0001; r = 0.21, p = 0.002; r = 0.39, p < 0.0001, r = −0.36, p < 0.0001, respectively). Log plasma CRP levels were lower in children with SpO2 nadir ≥90 (p < 0.0001). Sub-analysis of the 116 non-obese children in the cohort revealed similar findings. Log plasma IL-6 levels were
increased in children with moderate–severe SDB compared to controls (p = 0.03) and correlated with AHI (r = 0.28, p = 0.003) and SpO2 nadir (r = −0.24, p = 0.02). Children with SDB display significant severity-dependent increases in plasma CRP and IL-6 levels independent of
obesity. 相似文献
14.
This cross-sectional study was designed to investigate the status of social support, health service use and mental health
among caregivers for the elderly in a Chinese rural community. With randomized stratified sampling method, 199 caregivers
providing long-term care for the elderly recruited from a Chinese rural community responded to the survey and were administered
the questionnaire, measuring the caregiving outcome for the elderly. The social support was assessed with the social support
scale (SSS) and social network scale (SNS). Health service utilization was assessed with the questionnaire on health service
use (HSU). Depression was evaluated with the Center for Epidemiological Studies—Depression Scale (CES-D). Most caregivers
are elder’s spouse (39.7%), son (26.1%) and daughter-in-law (18.1%). Three common health service used by the caregivers are
visiting physician (68.0%), help from relatives or friends (43.9%) and seeking help of herbal doctors or traditional healers
(34.0%). Between caregivers for healthy and non-healthy elders, there was significant difference of depression scale score
(t = 3.195, p < 0.01), not of SSS and SNS scale scores (p > 0.05). The score of depression scale are associated with caregivers’ age (β = 0.260) and income (β = −0.231), care-recipients’
gender (β = 0.187) and age (β = 0.800), caring time (β = 0.138) and the total SNS score (β = −0.194) (all p < 0.05). The findings suggest, in Chinese rural area, family provides main source for caregiving to the elderly, with spouse
and sons playing central roles. Most often elderly caregivers utilize medical resources. Depression during the process of
caregiving is associated with caregivers and care-recipients’ background characteristics, with potential mediator effect of
social support. It is implied that social support may be important when providing mental health service to the elderly caregivers
in Chinese rural areas. 相似文献
15.
We and others have previously shown that IL-17 is elevated in the synovial fluid of patients with reactive arthritis (ReA)/undifferentiated
spondyloarthropathy (uSpA) having acute synovitis. Major source for IL-17 is Th17 cells, which differentiate from Th0 cells
under the influence of TGF-β and IL-6, IL1-β and are maintained by IL-21 and 23. There is a paucity of data on these cytokines
in ReA/uSpA. Thus, we measured the levels of Th-17 differentiating and maintaining cytokines in synovial fluid of patients
with ReA and uSpA. Fifty patients with ReA/uSpA (ReA 24, uSpA 26), 19 patients with rheumatoid arthritis (RA) and 11 patients
with osteoarthritis (OA) were included in the study. Synovial fluid (SF) were collected from knee joint and stored at −80°C
until analysis. Cytokines were assayed using ELISA in SF specimens. The median IL-17A levels were significantly elevated in
ReA (48.3 pg/ml) and uSpA (32.5 pg/ml) as compared to non-inflammatory OA controls (<7.8 pg/ml; p < 0.0001), while comparable to RA (57.9 pg/ml). Further, IL-6 median values were higher in ReA (25.2 ng/ml) and uSpA (13.6 ng/ml)
as compared to OA (0.76 ng/ml; p < 0.0001), and comparable to RA (15.8 ng/ml). The median levels of IL-1β, IL-21 levels were elevated in ReA, uSpA and RA
as compared to OA but were not statistically significant. TGF-β levels in ReA and uSpA were similar to OA but lower than in
RA (4340 pg/ml; p < 0.05). IL-23 was not detectable in any synovial fluid sample. However, levels of these cytokines did not correlate with
disease activity parameters. Significant positive correlation was observed between IL-17 and IL-1β (r = 0.38, p < 0.005), IL-17 and IL-6 (r = 0.659, p < 0.0001), and IL-1β and IL-6 (r = 0.391, p < 0.0001) in ReA and uSpA group. Inflammatory synovitis in ReA/uSpA is mediated by pro-inflammatory cytokines like IL-17,
IL-6, IL-1β, and IL-21. However, IL-23 was not detectable in SF. Good correlation between IL-17, IL-6, and IL 1β suggest that
either they are co-regulated or they regulate each other. 相似文献
16.
Song MK Chung JS Shin HJ Lee SM Lee SE Lee HS Lee GW Kim SJ Lee SM Chung DS 《Annals of hematology》2012,91(5):697-703
The objective of this study was to investigate whether metabolic tumor volume (MTV) by positron emission tomography (PET)
can be a potential prognostic tool when compared with Ann Arbor stage, in stages II and III nodal diffuse large B cell lymphoma
(DLBCL). We evaluated 169 patients with nodal stages II and III DLBCL who underwent measurements with PET prior to rituximab
combined with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP). Cutoff point of MTV was measured using the
receiver operating characteristic (ROC) curve. During a median period of 36 months, stage II was 59.2% and III was 40.8%.
Using the ROC curve, the MTV of 220 cm3 was the cutoff value. The low MTV group (<220 cm3) had longer progression-free survival (PFS) and overall survival (OS), compared with the high MTV group (≥220 cm3) (p < 0.001, p < 0.001). Stage II patients had longer survival than those in stage III (PFS, p = 0.011; OS, p = 0.001). The high MTV group had lower PFS and OS patterns, regardless of stage, compared with the low MTV group (p < 0.001, p < 0.001). Multivariate analysis revealed an association of the high MTV group with lower PFS and OS (PFS, hazard ratio (HR) = 5.300,
p < 0.001; OS, HR = 7.009, p < 0.001), but not stage III (PFS, p = 0.187; OS, p = 0.054). Assessment of MTV by PET had more potential predictive power than Ann Arbor stage in the patients that received
R-CHOP. 相似文献
17.
Jong Suk Park Min Ho Cho Ji Sun Nam Chul Woo Ahn Bong Soo Cha Eun Jig Lee Sung Kil Lim Kyung Rae Kim Hyun Chul Lee 《Acta diabetologica》2010,47(2):113-118
The inflammatory marker, C-reactive protein (CRP) is associated with long-term cardiovascular events. The aim of the study
was to investigate the factors contributing to serum CRP, assess the relationship between CRP level and the parameters of
visceral obesity, and examine the association between leptin and CRP level in type 2 diabetic patients. 150 patients with
type 2 diabetes were enrolled. These patients were recently diagnosed (≤3 years) with type 2 diabetes and were drug naive
or taking sulfonylureas only. BMI, WC, and serum concentration of CRP, glycosylated hemoglobin (HbA1c), glucose, lipids, plasminogen
activator-1 (PAI-1) and leptin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis
model assessment (HOMA-IR). We measured the carotid intima-media thickness (IMT). Fat mass assessed by dual-energy X-ray absorptionmetry
and abdominal fat distribution was determined by CT scan. Serum concentration of CRP was significantly correlated with BMI
(γ = 0.257, P < 0.01), WC (γ = 0.293, P < 0.01), fat mass (γ = 0.213, P < 0.01), total adipose tissue (γ = 0.263, P < 0.01), visceral adipose tissue (γ = 0.296, P < 0.01), insulin (γ = 0.189, P = 0.047), PAI-1 (γ = 0.206, P < 0.01), leptin (γ = 0.322, P < 0.01), mean IMT (γ = 0.132, P = 0.042), and HOMA-IR (γ = 0.172, P = 0.045). After adjustment for age and gender, multiple regression analysis showed that serum CRP was significantly associated
with leptin (β = 0.326, P = 0.01) and visceral adipose tissue (β = 0.265, P = 0.035). In conclusion, serum CRP level is significantly associated with obesity, especially the visceral adipose tissue,
and serum leptin is another important independent factor associated with CRP in Korean type 2 diabetic patients. 相似文献
18.
M. Wijkman T. Länne J. Engvall T. Lindström C. J. Östgren F. H. Nystrom 《Diabetologia》2009,52(7):1258-1264
Aims/hypothesis This study was designed to evaluate the prevalence of masked nocturnal hypertension (MNHT) and its impact on arterial stiffness
and central blood pressure in patients with type 2 diabetes.
Methods Middle-aged patients (n = 414) with type 2 diabetes underwent clinic and ambulatory BP measurements and applanation tonometry.
Results MNHT (clinic BP < 130/80 mmHg and night-time BP ≥ 120/70 mmHg) was found in 7.2% of patients (n = 30). Compared with patients with both clinical and nocturnal normotension (n = 70), patients with MNHT had higher aortic pulse wave velocity (PWV) (10.2 ± 1.8 m/s vs 9.4 ± 1.7 m/s; p = 0.03) and higher central BP (117.6 ± 13.9/74.0 ± 9.1 mmHg vs 110.4 ± 16.4/69.7 ± 9.6 mmHg, p = 0.04). In patients with clinical normotension, night-time systolic BP correlated significantly with PWV.
Conclusions/interpretation Thirty per cent of patients with clinical normotension had nocturnal hypertension. This was accompanied by increased arterial
stiffness and higher central BP. We conclude that in clinically normotensive patients with type 2 diabetes, ambulatory BP
measurement may help clinicians to identify patients with increased cardiovascular risk. 相似文献
19.
Jian-Jun Li Hong-Bing Yan Xiao-Ping Xiang Xue-Wen Qin Chao-Yang Zhang 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2009,23(2):137-143
Background Systemic inflammation after coronary intervention identifies patients at increased risk of subsequent cardiac events. Cardiac
events, especially in-stent restenosis, are less frequent after use of sirolimus-eluting stent (SES) compared with paclitaxel-eluting
stent (PES). However, the underlying mechanism for this disparity is not well investigated. We hypothesize that an attenuated
inflammatory response after SES implantation may be a contributor.
Purpose In the present study, we sought to determine the early inflammatory response after SES implantation in patients with single-vessel
disease compared with PES implantation, and evaluate the relationship between inflammatory response and late clinical outcomes
in a randomized design.
Methods Thirty-two patients with stable angina were randomly enrolled into the two groups, SES or PSE group (n = 16 respectively). Peripheral blood samples were taken before PCI, 24 and 72 h after stenting. The plasma concentrations
of C-reactive protein (CRP) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). The clinical
and angiographic follow-up was performed at 8 months after stenting.
Results The data showed that there was no significant difference in clinical and angiographic baseline characteristics between the
two groups. The plasma CRP and IL-6 levels at 24 h after stenting were significant higher in both groups compared with baseline
(p < 0.01 respectively). Likewise, the CRP levels at 72 h after stenting were also significant higher compared with baseline
in both groups (p < 0.01 respectively). However, the plasma levels of IL-6 at 24 h and CRP at 72 h after stenting were higher in PES group
compared with SES group (p < 0.05). At 8 months follow-up, the rates of major adverse cardiac events, target lesion revascularization, in-stent and
in-segment restenosis were similar in both groups. However, the late loss in both in-stent and in-segment was significantly
higher in the PES group than in SES group (p < 0.001 respectively).
Conclusions Our findings suggest that a drug-eluting stent implantation could trigger a systemic inflammatory response as previously demonstrated.
However, SES implantation results in a lower inflammatory response compared with PES implantation, which seems to be associated
with greater late of in-stent and in-segment loss at 8-month follow-up with PES. 相似文献
20.
Sun LY Zhou KX Feng XB Zhang HY Ding XQ Jin O Lu LW Lau CS Hou YY Fan LM 《Clinical rheumatology》2007,26(12):2073-2079
Defects of hematopoietic stem cells (HSCs) have been suggested to contribute to the development of systemic lupus erythematosus
(SLE). The aim of this study was to investigate the phenotypic characteristics of bone marrow (BM) CD34+ cells in patients with SLE and its relationship with SLE disease activity. Ten SLE patients and 10 healthy subjects were
recruited and their BM CD34+ cells were analyzed by flow cytometric analysis with CD45/SSC gating for the expression of CD90, CD95, CD117, CD123, CD164,
CD166, FAS-L, and HLA-DR. The percentage of BM CD34+ cells was significantly decreased in active SLE patients (1.48 ± 0.41%, n = 7) compared to the healthy controls (2.31 ± 0.75%, n = 10, p < 0.01), but no significant difference was found between the inactive patients (2.04 ± 0.44%, n = 3) and the controls. The expression of CD95, CD123, and CD166 on BM CD34+ cells were significantly increased in SLE patients (48.31 ± 10.59%, 44.9 ± 21.5%, 30.9 ± 19.54%, respectively, n = 10) when compared with the control subjects (24.33 ± 11.1%, 19.5 ± 4.4%, 10.7 ± 5.5%, respectively, n = 10, p < 0.05). The increased CD123 expression was negatively correlated with the number of peripheral white blood cells (r = −0.700, p < 0.05, n = 10). The percentage of CD166 expression was found significantly correlated with the index of SLE disease activity (r = 0.472, p < 0.05, n = 10) and 24 h proteinuria (r = 0.558, p < 0.05, n = 10), but negatively correlated with serum C3 level (r = −0.712, p < 0.01, n = 10). Our study found that the surface marker expression of CD95, CD123, and CD166 on BM CD34+ cells were significantly increased in patients. This supports the hypothesis that there are abnormalities of the HSC in SLE.
Since CD166 and CD123 correlated with the overall lupus activity, their role as a biomarker of inflammatory disease activity
also requires further study. 相似文献