Advanced oxidation protein products (AOPPs) in juvenile overweight and obesity prior to and following weight reduction

Objectives

To evaluate the formation of advanced oxidation protein products (AOPPs) in juvenile overweight/obesity and obesity-related disorders and to investigate the effect of weight reduction on AOPPs.

Design and methods

AOPPs were determined in 114 overweight/obese children and adolescents without/with insulin resistance and metabolic syndrome and compared with 53 lean controls. Measurements were repeated following weight reduction program (diet/exercise, bran-enriched diet/exercise, and diet/exercise plus metformin).

Results

Overweight/obese subjects had higher AOPPs than lean controls, more elevated in patients with co-occurring metabolic syndrome. AOPPs positively correlated with central obesity, triglycerides, lipid peroxidation and insulin, and negatively with glucose to insulin ratio. AOPPs decreased following obesity intervention and ΔAOPPs correlated with ΔBMI%. AOPPs reduction was more pronounced in subjects on bran-enriched diet. Baseline AOPPs were a better predictor of clinically significant weight reduction than BMI%.

Conclusions

Juvenile overweight/obesity was associated with AOPPs accumulation, more pronounced in metabolic syndrome. Body mass reduction decreased oxidative stress, with bran-enriched diet being more effective than diet/exercise alone.     

Statin therapy may protect against acute kidney injury in patients hospitalized for interstitial SARS-CoV2 pneumonia

Background and aimsCOVID-19-associated acute kidney injury (AKI) represents an independent risk factor for all-cause in-hospital death in patients with COVID-19. Chronic statin therapy use is highly prevalent in individuals at risk for severe COVID-19. Our aim is to assess whether patients under treatment with statins have a lower risk of AKI and in-hospital mortality during hospitalization for interstitial SARS-CoV2 pneumonia.Methods and resultsOur study is a prospective observational study on 269 consecutive patients admitted for COVID-19 pneumonia at the Internal Medicine Unit of IRCCS Sant'Orsola Hospital in Bologna, Italy. We compared the clinical characteristics between patients receiving statin therapy (n = 65) and patients not treated with statins and we assessed if chronic statin use was associated with a reduced risk for AKI, all-cause mortality, admission to ICU, and disease severity. Statin use was associated with a significant reduction in the risk of developing AKI (OR 0.47, IC 0.23 to 0.95, p 0.036) after adjustment for age, sex, BMI, hypertension, diabetes, and chronic kidney disease (CKD). Additionally, statin use was associated with reduced C-reactive protein (CRP) levels (p 0.048) at hospital admission. No significant impact in risk of all-cause mortality (HR 1.98, IC 0.71 to 5.50, p 0.191) and ICU admission (HR 0.93, IC 0.52 to 1.65, p 0.801) was observed with statin use, after adjustment for age, sex, BMI, hypertension, diabetes, and CKD.ConclusionThe present study shows a potential beneficial effect of statins in COVID-19-associated AKI. Furthermore, patients treated with statins before hospital admission for COVID-19 may have lower systemic inflammation levels.     

Terminalia arjuna Wight & Arn.--a useful drug for cardiovascular disorders

Ancient Indian physicians used the powdered tree bark of Terminalia arjuna Wight & Arn. for alleviating "hritshool" (angina) and other cardiovascular conditions. Its stem bark possesses glycosides, large quantities of flavonoids, tannins and minerals. Flavonoids have been detected to exert antioxidant, anti-inflammatory and lipid lowering effects while glycosides are cardiotonic, thus making Terminalia arjuna unique amongst currently used medicinal plants. In this review an attempt has been made to discuss various aspects of its ethnomedical, pharmacognostical, phytochemical, pharmacological and clinical relevance to cardiovascular conditions. Experimental studies have revealed its bark exerting significant inotropic and hypotensive effect, increasing coronary artery flow and protecting myocardium against ischemic damage. It has also been detected to have mild diuretic, antithrombotic, prostaglandin E(2) enhancing and hypolipidaemic activity. There is ample clinical evidence of its beneficial effect in coronary artery disease alone and along with statin. However, toxicological studies in experimental animals are lacking. Considering its anti-ischemic activity and its potential to correct dyslipidemia, reduce left ventricular mass and increase left ventricular ejection fraction, it is essential to examine the molecular mechanism of its action and its core constituents. Proposition to administer Terminalia arjuna along with statins deserves to be explored in depth for defining its place in the over all management and prevention of coronary artery disease.     

城市社区居民高尿酸血症与脂代谢异常的关系

目的通过社区人群筛查了解国内现阶段城市居民中高尿酸血症患病率变化，同时探讨其与脂代谢异常及胰岛素抵抗的相关性。方法选择桂林市城区原住居民集中的象山社区，针对年龄在18-75岁之间居民（n=4075）采取随机横断面进行筛查。结果高尿酸血症总患病率为19．1％，男性高尿酸血症患病率为22．9％，显著高于女性高尿酸血症患病率的15．9％（P〈0．001）。尿酸增高还与年龄、运动时间、食用动物油、饮酒（P〈0．001）及吸烟（P〈0．05）有关。血尿酸水平越高，脂代谢异常越显著．并且胰岛素水平和超敏C反应蛋白水平也越高。尿酸水平与甘油三酯、胰岛素和超敏C反应蛋白水平呈正相关（P〈0．01）。尿酸增高的居民，血压、体重指数及腰围均较尿酸正常者高（P〈0．01）。结论本研究发现我国社区居民高尿酸血症患病率已显著增高，与性别、年龄及生活习惯有关，高尿酸血症与脂代谢异常有相关性，高尿酸血症的增加与胰岛素抵抗有关，不良生活习惯可能是高尿酸血症、血脂异常以及胰岛素抵抗的共同风险因素。     

新诊断2型糖尿病患者血脂谱和低密度脂蛋白亚组分特征及与慢性并发症关系

目的　探讨新诊断 2型糖尿病患者血脂谱和低密度脂蛋白 (LDL)亚组分的特征及与慢性并发症的关系。方法　采用横断面研究 ,调查 175例新诊断的 2型糖尿病患者 (糖尿病组 )和 39名无高血压、糖尿病和血脂异常的正常人 (正常对照组 )。分别测定两组的身高、体重、血压、腰围、腰臀比、血糖、血脂 ,并采用 2 %～ 16 %聚丙烯酰胺梯度凝胶电泳 (PAGE)法检测LDL颗粒直径。对糖尿病组患者进行眼底、尿微量白蛋白、尿肌酐和颈动脉、股动脉、髂总动脉内 中膜厚度 (IMT)检查。结果　糖尿病组总胆固醇 (TC)和三酰甘油 (TG)水平均明显高于正常对照组 [TC :(4 .5 9± 0 .80 )mmol/L∶(4 .32± 0 .5 4 )mmol/L ;TG :(1.91± 1.15 )mmol/L∶(0 .89± 0 .2 9)mmol/L ,P值均 <0 .0 5 ];LDL颗粒直径明显小于正常对照组 [(2 6 .5 9± 1.18)nm∶(2 7.4 3± 1.2 4 )nm ,P <0 .0 5 ]。相关和多元逐步回归分析显示 ,TG与LDL颗粒直径成负相关 ,且是LDL颗粒直径的主要影响因素。糖尿病组中 ,伴有大血管病变者的LDL颗粒直径明显小于不伴有大血管病变者。Logistic回归模型分析显示 ,LDL颗粒直径变小是糖尿病患者发生大血管病变的主要危险因素之一。结论　新诊断的 2型糖尿病患者普遍存在血脂紊乱 ,TG升高是LDL颗粒直径变小的主要影     

Lessons From Diseases Mimicking Sjögren’s Syndrome

Sjögren’s syndrome (SS) is a systemic autoimmune disease that mainly affects the exocrine glands and usually presents as persistent dryness of the mouth and eyes because of functional impairment of the salivary and lacrimal glands. The histological hallmark is a focal lymphocytic infiltration of the exocrine glands, and the spectrum of the disease extends from an organ-specific autoimmune disease (autoimmune exocrinopathy) to a systemic process with diverse extraglandular manifestations. In the absence of an associated systemic autoimmune disease, patients with this condition are classified as having primary SS. The differential diagnosis includes processes that specifically involve the exocrine glands. On the one hand, some chronic viral infections may induce lymphocytic infiltration of the exocrine glands, in some cases indistinguishable from that observed in primary SS. On the other hand, some processes may mimic the clinical picture of SS through nonlymphocytic infiltration of the exocrine glands. This review focuses on these two groups of diseases that mimic SS (infections and infiltrating processes).     

Dietary program and physical activity impact on biochemical markers in patients with type 2 diabetes: A systematic review

Objectives

Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over.

Dyslipidemia and coronary artery calcium: From association to development of a risk-prediction nomogram

Background and aimsThe associations between dyslipidemia and coronary artery calcium (CAC) are controversial. We investigated their cross-sectional relationships and developed a predictive scoring system for prognostically significant coronary calcification (PSCC).Methods and resultsThis study evaluated the lipid profiles and the CAC score (CACS) measured through multidetector computed tomography (MDCT) among Taiwanese adult patients in a tertiary hospital between 2011 and 2016. Patients with CACS higher than 100 were classified as having PSCC. Dyslipidemia for each lipid component was defined based on the clinical cutoffs or the use of the lipid-lowering agents. Multivariable logistic regression was used to assess the association between dyslipidemia and PSCC and the model performance was assessed using calibration plot, discrimination, and a decision curve analysis.Of the 3586 eligible patients, 364 (10.2%) had PSCC. Increased age, male sex, higher body mass index (BMI), and higher level of triglyceride (TG) were associated with PSCC. The adjusted odds ratios (95% confidence intervals) of PSCC was 1.15 (0.90–1.47) for dyslipidemia defined by total cholesterol (TC) ≥200 mg/dL, 1.06 (0.83–1.35) for low-density-lipoprotein-cholesterol (LDL-C) ≥130 mg/dL, and 1.36 (1.06–1.75) for TG ≥ 200 mg/dL. The positive association between TG ≥ 200 mg/dL and PSCC was not modified by sex. Incorporating hypertriglyceridemia did not significantly improve the predictive performance of the base model comprising of age, sex, BMI, smoking, hypertension, diabetes, estimated glomerular filtration rate, and fasting glucose.ConclusionsHypertriglyceridemia was significantly associated with the prevalent odds of PSCC. Our proposed predictive model may be a useful screening tool for PSCC.