不同糖代谢状态人群的肥胖指标与动脉硬化的相关性

目的研究北京市社区不同糖代谢状态人群的肥胖指标与动脉硬化的相关性。方法用臂-踝脉搏波传导速度(baPWV)反映动脉硬化程度。对北京市石景山区两个社区大于或等于40岁居民进行体格检查,测量体重(weight)、腰围(WC)、体重指数(BMI)、腰臀比(WHR)、腰围升高比(WHtR)及标准化问卷调查、生化和糖化血红蛋白检测、75 g葡萄糖耐量实验及baPWV测量。对数据资料完整及BMI大于或等于18.5 kg/m2的9 080名人员根据75OGTT试验及糖尿病史分为NGT、IGR和DM组,分析BMI、WC、WHR、WHtR与baPWV之间的关系。结果在NGT、IGR、DM组,根据WC、WHR、WHtR分成亚组,中心型肥胖组的baPWV明显高于正常组(P0.01),在DM组内,以BMI作为肥胖标准,baPWV仅在NGT和IGR组内有统计学意义,在DM组无显著差异(P0.05)。在NGT、IGR和DM组内,中心型肥胖指标(WC、WHR、WHtR)与baPWV呈显著正相关(P0.05),BMI仅在NGT组内与baPWV呈正相关,在IGR和DM组内无明显相关(P0.05)。校正年龄、性别、心血管危险因素,通过多元回归分析发现,WHR和WHtR每增加0.1,baPWV则随之升高40.6 cm/s和55.3 cm/s。结论在糖代谢异常人群中,中心性肥胖指标(WC、WHR、WHtR)与动脉硬化呈正相关,较BMI更能反映动脉硬化程度。     

哈萨克族成人6种肥胖评价指标准确性比较

目的 比较身体质量指数（BMI）、腰围（WC）、腰臀比（WHR）、腰围身高比（WHtR）、肥胖指数（BAI）、体脂率（PBF）对哈萨克族肥胖筛查的准确性,并确定6种指标在判断哈萨克族肥胖的最佳切点。方法 采用卡方检验、直线相关分析及受试者工作特征曲线（ROC）分析,比较BMI、WC、WHR、WHtR、BAI、PBF对肥胖预测的准确性,并确定各项指标的最佳切点。结果 经卡方检验分析结果显示,WC与WHtR、BMI与BAI对哈萨克族肥胖判断的结果相近。在直线相关分析中,BMI、WC与身体脂肪含量具有很强的相关性。ROC曲线分析显示,WC的曲线下面积(AUC)最大,其次是BMI。 结论 哈萨克族是超重、肥胖的高发人群,腰围对哈萨克族肥胖筛查的准确性最高,建议使用BMI、WC及WHtR 3项指标共同判定哈萨克族肥胖情况。     

人体测量学肥胖判定指标与微量白蛋白尿的相关性

目的:探讨各项人体测量学肥胖判定指标与微量白蛋白尿(MAU)的相关性。方法:采取分层的整群随机抽样方法,从糖尿病流行病学调查数据库中抽取1 170例,清晨留取随机测定尿微量白蛋白和尿肌酐,根据尿微量白蛋白/尿肌酐比值(UACR)水平分为:正常白蛋白尿(NAU)组(男398例,女409例)和MAU组(男175例,女188例)。收集一般临床资料和测定生化指标,统计学处理采用SPSS 16.0软件。结果:与NAU组相比,MAU组年龄、空腹血糖(FBG)、舒张压(DBP)、收缩压(SBP)、血清尿酸(SUA)、腰围(WC)、腰身比(WHtR)、腰臀比(WHR)、高血糖(HG)、原发性高血压、血脂异常及肥胖,尤其腹型肥胖患病率均高于前者,差异有统计学意义;多元线性回归分析,年龄、DBP、FBG、WHtR、WC、WHR与UACR相关。调整年龄、性别、FBG及DBP等因素后,对MAU影响大小依次WHtRWCWHR;采用受试者工作特征曲线(ROC)分析男性人群WHtR、WC、WHR等预测MAU的曲线下面积依次为0.68(95%CI:0.67-0.70)、0.64(95%CI:0.62-0.65)、0.57(95%CI:0.55-0.59),预测切点0.52、91.8、0.90cm。在女性人群中,WHtR、WC、WHR等预测MAU的曲线下面积依次为0.71(95%CI:0.70-0.72)、0.69(95%CI:0.68-0.70)和0.64(95%CI:0.62~0.65),预测切点0.52、82.5、0.84 cm。结论:人体测量学腹型肥胖指标与微量白蛋白尿密切相关,可作为预测、评估人群患病风险的简易指标;在人体测量学腹型肥胖指标中,WHtR是预测本地区人群微量白蛋白尿等风险的最好指标,最佳切割点为0.52。     

广州市某农村居民高血压患病率及其与体重指数的关系

目的了解农村居民高血压患病情况及其与体重指数（BMI）的关系。方法对广州市某农村602名≥15岁村民进行问卷调查及身高、体重和血压的测量,资料采用SPSS11.5软件进行统计分析。结果调查人群高血压的总患病率为18.91%,其中男性为20.10%,女性为18.39%,男性与女性高血压患病率均随着年龄的增加而增加。BMI与收缩压（SBP）和舒张压（DBP）存在显著正相关。肥胖患病率男性高于女性,但是女性血压与BMI的相关性高于男性,特别是在肥胖组（BMI≥25）。在低体重组（BMI〈18.5）,血压与BMI无显著相关性。结论广州农村≥15岁人群高血压患病率较高,且肥胖与高血压患病正相关,BMI控制在正常范围对控制高血压有重要意义。     

四川省成年健康人1989名脉压差及相关因素调查

背景:调查研究发现,无论高血压人群还是正常血压人群,脉压差增大都是动脉硬化和心血管疾病危险度增大的标志之一。目的:通过对四川省1989名成年健康人群脉压差及其相关因素分析,探讨预防脉压差过大、降低心血管疾病发病率以及提高人群生活质量等问题。方法:采取分层、整群抽样,对1989名健康成年人进行问卷调查,并进行体质检查和血液生物化学血糖、肾功能以及血脂4项等检测,分析脉压差与各观察指标间的关系。结果与结论:男性、女性脉压差随年龄增加而增加,其中50岁以上人群,脉压差随年龄呈线性增加,空腹血糖、尿酸、血尿素氮、总胆固醇、三酰甘油、收缩压、舒张压随脉压差增大而增大,且年龄、BMI、腰臀比、三酰甘油与脉压差呈线性依存关系,脉压差与体育锻炼呈显著负相关。脉压差随着年龄、BMI、腰臀比、三酰甘油增加而增加,随着脉压差的增大,肾功能和血糖调节能力相对下降。提示,中老年人群需要通过合理饮食、运动控制向心性肥胖,从而控制脉压差,减小脉压差增大对肾脏功能损害,降低心血管疾病发病率。     

内蒙古绝经后女性正常高值血压危险因素分析

目的探讨绝经后女性正常高值血压的危险因素。方法以2015年4月在内蒙古呼和浩特市赛罕区健康档案的非高血压女性人群共计2 592人,平均年龄(43±12)岁,其中未绝经女性1 895名,(37±8)岁,绝经女性697名,(58±6)岁为研究对象,通过t检验、χ~2检验和Logistic回归等方法分析绝经女性正常高值血压相关危险因素。结果绝经组收缩压、舒张压、体质指数(BMI)、空腹血糖、三酰甘油和低密度脂蛋白水平较未绝经组明显升高(P0.05);绝经组正常高值血压患病率、超重、肥胖患病率、空腹血糖受损患病率、糖尿病患病率、血脂异常患病率、三酰甘油异常患病率和低密度脂蛋白异常患病率均较未绝经组明显升高(P0.05);年龄段在55~59岁、60~64岁和65岁以上,超重、肥胖、空腹血糖受损和糖尿病为正常高值血压的独立危险因素。结论年龄≥55岁、超重、肥胖、空腹血糖受损和糖尿病为绝经女性正常高值血压的独立危险因素。     

采用Logistic回归以及ROC曲线分析小儿血脂紊乱筛检指标

目的探讨与小儿血脂紊乱发病有关的危险因素,找寻小儿血脂紊乱的筛检试验指标。方法调查分析北京市某中、小学在校学生(5-19岁)的血脂水平,应用日立7060型全自动生化分析仪检测其空腹血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)含量。测量其身高、体重、坐高、腰围、上臂围及血压,计算体重指数(BMI)及腰围身高比值(WHR)反映身体的肥胖程度,通过Logistic回归分析以及ROC曲线进一步分析这些指标与血脂水平的关系。结果在962例学生中,共检出血脂紊乱患者107例,患病率为11.12%;血脂紊乱组的坐高、上臂围、BMI、WHR及舒张压(DBP)、收缩压(SBP)等6项指标均明显高于血脂正常组;BMI、WHR、DBP和家族史4项是血脂紊乱发病的危险因素。结论可根据BMI、WHR、血压及阳性家族史筛查出小儿血脂紊乱的高危人群,进而进行空腹血浆血脂成分的检测。     

非酒精性脂肪肝肥胖人群的血尿酸水平分析

目的:分析非酒精性脂肪肝非肥胖及肥胖人群的血尿酸(SUA)水平变化.方法:体检人群筛选出来的非酒精性脂肪肝非肥胖和肥胖者与正常对照组同时检测血尿酸(SUA)、体重指数(BMI)、腰臀比(WHR)及相关生化指标.结果:非酒精性脂肪肝非肥胖组和肥胖组SUA、BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC...     

瘦素和脂联素在儿童肥胖相关性高血压发病中的作用

目的探讨瘦素和脂联素在儿童肥胖相关性高血压发病中的作用。方法基于北京市儿童青少年代谢综合征研究项目的现况调查结果,非随机选择3502名6-18岁学龄儿童（其中男1784名,女1718名）为研究对象,按照超重（包括肥胖）和高血压状态将研究对象分为4组,正常体重正常血压组（对照组,1497名）、正常体重高血压组（HBP组,125名）、超重但血压正常组（OB组,1349名）和超重合并高血压组（OB＋HBP组,531名）。通过比较4组人群血清瘦素和脂联素水平,以及瘦素和脂联素与血压之间的相关回归分析,探讨其与肥胖和血压之间的关系。结果超重肥胖人群BMI、血压、胰岛素和瘦素水平显著升高,脂联素水平降低。HBP组与对照组BMI、瘦素、脂联素水平差异无统计学意义。OB组和OB＋HBP组与对照组比较,BMI、SBP、DBP、胰岛素和瘦素水平升高,脂联素水平降低,与HBP组比较仍可见BMI、胰岛素和瘦素水平升高,脂联素水平降低。与OB组比较,OB＋HBP组BMI和胰岛素水平及男性的瘦素水平明显升高。血压与年龄、BMI、胰岛素、瘦素均呈显著正相关（r=0.260-0.643,P〈0.01）,与脂联素呈显著负相关（r=-0.171--0.332,P〈0.01）。但在调整胰岛素或BMI后,瘦素、脂联素与血压的相关性减弱或消失。结论超重人群血压、胰岛素及瘦素水平均高于对照人群,脂联素水平低于对照人群。瘦素、脂联素可能通过肥胖或胰岛素抵抗与血压相关。     

北京市3—18岁人群腰围和腰围身高比分布特征及其适宜界值的研究

目的 研究北京市3～18岁人群腰围（WC）、腰围身高比（WHtR）的分布特征；在心血管疾病（CVD）危险因素评估的基础上提出6—18岁人群WC和WHtR的适宜界值。方法 对2004年北京市儿童青少年代谢综合征研究项目总人群中3—18岁人群的WC、WHtR进行描述性分析；基于CVD危险因素评估，采用工作者特征曲线分析方法，研究6—18岁人群WC和WHtR的适宜界值；并利用《北京市学校卫生防病工作规划》（2006）血脂健康调查中6—17岁人群生理、生化检测数据，对上述界值进行交叉验证。结果 基于CVD危险因素评估基础上的WC适宜界值为性别年龄组的第80百分位值，WHtR的适宜界值为0．46。交叉验证显示：按WC和WHtR适宜界值划分的肥胖组血压、血脂等CVD危险因素无论均值还是检出率均显著高于正常体重组。结论 上述WC、WHtR适宜界值可敏感地区分高血压、高三酰甘油和低高密度脂蛋白胆固醇等CVD危险因素，WC作为相对简单的测量方法应列入学生体检的常规测量项目。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.