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71.
Introduction and objectivesSeveral types of lipoproteins beyond low-density lipoproteins (LDL) are causally related to cardiovascular disease. We aimed to analyze an advanced lipoprotein profile in individuals with normal and impaired glucose metabolism from different cohorts of a Mediterranean region.MethodsCross-sectional study in 929 participants (463 normoglycemia, 250 prediabetes, and 216 type 2 diabetes mellitus) with normal renal function, free from cardiovascular disease, and without lipid-lowering treatment. Conventional and advanced (nuclear magnetic resonance [NMR] spectroscopy) lipoprotein profiles were analyzed.ResultsCompared with men, normoglycemic women showed lower serum triglyceride and LDL cholesterol concentrations, lower total LDL particles (P) as well as their subclasses and their cholesterol and triglyceride content, higher high-density lipoproteins (HDL)-P and all HDL-related variables (P    .05 for all comparisons). Compared with normoglycemic participants, diabetic participants showed higher large and small very LDL-P concentrations (P < .05) and lower total HDL-P and medium HDL-P concentrations (P < .05). Waist circumference and Fatty Liver Index were positively associated with a proatherogenic profile.ConclusionsWomen had a better advanced lipoprotein profile than did men. Adiposity indexes related to insulin-resistance were positively associated with a proatherogenic lipid profile. NMR revealed altered lipoprotein particles other than LDL in participants with diabetes, frequently associated with an increased cardiovascular risk. Our findings support the usefulness of extended lipoprotein analysis by NMR spectroscopy to uncover new therapeutic targets to prevent cardiovascular events in at-risk participants.  相似文献   
72.
73.

Background

Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population.

Methods

From 2004 to 2006, blood sampling and pulmonary function tests were performed on 3045 people over the age of 40 years in annual health check-ups held in Takahata, Yamagata Prefecture, Japan. Pulmonary function was re-evaluated in 2009 and 2011.

Results

The prevalence of diabetes did not differ between subjects with and without airflow obstruction. Furthermore, although body mass index decreased, no increase in the prevalence of diabetes was observed with the progression of airflow obstruction. The annual changes in forced expiration volume in 1 s (FEV1) did not differ depending on the presence or absence of diabetes in the study population.

Conclusion

There was no difference in the prevalence of diabetes between subjects with airflow obstruction and those without. As patients with COPD in Japan are thinner than in the West, diabetes may not be a common comorbidity in Japanese patients with COPD.  相似文献   
74.
75.
目的探讨广州市番禺区人群2型糖尿病(T2DM)与Preproghrelin基因rs696217位点单核苷酸多态性的相关性。方法提取来自番禺人群的非糖尿病人(对照组)和T2DM患者(T2DM组)的DNA,采用PCR-RFLP,检测其Preproghrelin基因rs696217位点的基因型,比较组间基因型、等位基因频率分布的差异。结果对照组116例样本中,CC 96例、AC 20例,AA 0例;基因型频率分别为:0.828、0.172、0。T2DM组118例样本中,CC 89例、AC 24例、AA 5例,基因型频率分别为:0.754、0.203、0.043。对照组和T2DM组的基因型频率分布符合Hardy-Weinberg平衡。组间基因型和等位基因频率差异无统计学意义。结论未发现Preproghrelin基因rs696217位点单核苷酸多态性与广州市番禺区人群2型糖尿病直接相关。但在T2DM组中检测到AA基因型,预测等位基因A在T2DM发生中可能有某种作用,有待进一步研究。  相似文献   
76.

Objective

To compare renal function decline, incident end-stage renal disease (ESRD), and mortality among patients with 5 common glomerular diseases in a large diverse population.

Patients and Methods

A retrospective cohort study (between January 1, 2000, and December 31, 2011) of patients with glomerulonephropathy using the electronic health record of an integrated health system was performed. Estimated glomerular filtration rate (eGFR) change, incident ESRD, and mortality were compared among patients with biopsy-proven focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MN), minimal change disease (MCD), immunoglobulin A nephropathy (IgAN), and lupus nephritis (LN). Competing risk models were used to estimate hazard ratios for different glomerulonephropathies for incident ESRD, with mortality as a competing outcome after adjusting for potential confounders.

Results

Of the 2350 patients with glomerulonephropathy (208 patients [9%] younger than 18 years) with a mean follow-up of 4.5±3.6 years, 497 (21%) progressed to ESRD and 195 (8%) died before ESRD. The median eGFR decline was 1.0 mL/min per 1.73 m2 per year but varied across different glomerulonephropathies (P<.001). The highest ESRD incidence (per 100 person-years) was observed in FSGS 8.72 (95% CI, 3.93-16.72) followed by IgAN (4.54; 95% CI, 1.37-11.02), LN (2.38; 95% CI, 0.37-7.82), MN (2.15; 95% CI, 0.29-7.46), and MCD (1.67; 95% CI, 0.15-6.69). Compared with MCD, hazard ratios (95% CIs) for incident ESRD were 3.43 (2.32-5.08) and 2.35 (1.46-3.81), 1.28 (0.79-2.07), and 1.02 (0.62-1.68) for FSGS, IgAN, LN, and MN, respectively. No significant association between glomerulonephropathy types and mortality was detected (P=.24).

Conclusion

Our findings from a real-world clinical environment revealed significant differences in eGFR decline and ESRD risk among patients with 5 glomerulonephropathies. These variations in presentation and outcomes warrant different management strategies and expectations.  相似文献   
77.

Objective

To examine whether a Rasch analysis is sufficient to establish the construct validity of the Motor Function Measure (MFM) and discuss whether weighting the MFM item scores would improve the MFM construct validity.

Design

Observational cross-sectional multicenter study.

Setting

Twenty-three physical medicine departments, neurology departments, or reference centers for neuromuscular diseases.

Participants

Patients (N=911) aged 6 to 60 years with Charcot-Marie-Tooth disease (CMT), facioscapulohumeral dystrophy (FSHD), or myotonic dystrophy type 1 (DM1).

Interventions

None.

Main Outcome Measure(s)

Comparison of the goodness-of-fit of the confirmatory factor analysis (CFA) model vs that of a modified multidimensional Rasch model on MFM item scores in each considered disease.

Results

The CFA model showed good fit to the data and significantly better goodness of fit than the modified multidimensional Rasch model regardless of the disease (P<.001). Statistically significant differences in item standardized factor loadings were found between DM1, CMT, and FSHD in only 6 of 32 items (items 6, 27, 2, 7, 9 and 17).

Conclusions

For multidimensional scales designed to measure patient abilities in various diseases, a Rasch analysis might not be the most convenient, whereas a CFA is able to establish the scale construct validity and provide weights to adapt the item scores to a specific disease.  相似文献   
78.
我国中医药资源丰富,历史悠久,中医药大数据目前仍在“沉睡”。运用大数据的理论及其研究方法整理和挖掘中医药宝库,将给中医药领域带来前所未有的机遇和挑战。本文从概念、特点、分析技术介绍了“大数据”,并着重说明了中医药信息、中医药古籍、中医药学术创新等方面在大数据时代面临的机遇和挑战。  相似文献   
79.

Objective

To evaluate the utility of the quick Sepsis-related Organ Failure Assessment (qSOFA) score to predict risks for emergency department (ED) and hospital mortality among patients in a sub-Saharan Africa (SSA) setting.

Methods

This retrospective cohort study was carried out at a tertiary-care hospital, in Kigali, Rwanda and included patients ≥15 years, presenting for ED care during 2013 with an infectious disease (ID). ED and overall hospital mortality were evaluated using multivariable regression, with qSOFA scores as the primary predictor (reference: qSOFA = 0), to yield adjusted relative risks (aRR) with 95% confidence intervals (CI). Analyses were performed for the overall population and stratified by HIV status.

Results

Among 15,748 cases, 760 met inclusion (HIV infected 197). The most common diagnoses were malaria and intra-abdominal infections. Prevalence of ED and hospital mortality were 12.5% and 25.4% respectively. In the overall population, ED mortality aRR was 4.8 (95% CI 1.9–12.0) for qSOFA scores equal to 1 and 7.8 (95% CI 3.1–19.7) for qSOFA scores ≥2. The aRR for hospital mortality in the overall cohort was 2.6 (95% 1.6–4.1) for qSOFA scores equal to 1 and 3.8 (95% 2.4–6.0) for qSOFA scores ≥2. For HIV infected cases, although proportional mortality increased with greater qSOFA score, statistically significant risk differences were not identified.

Conclusion

The qSOFA score provided risk stratification for both ED and hospital mortality outcomes in the setting studied, indicating utility in sepsis care in SSA, however, further prospective study in high-burden HIV populations is needed.  相似文献   
80.

Background

Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.

Methods

Information of all newly diagnosed and registered patients in the District Chest Clinic, Kalutara in year 2013 were ascertained. Out of 687 newly reported TB patients, 669 records were included in final analysis.

Results

Majority of patients were males (n = 451, 67.4%), in the age group of 36–60 years (n = 306, 45.7%) and underweight (n = 359, 61.7%). Substantial proportion of normal weight or overweight adult patients (92.1%) had sputum conversion at 2–3 months as compared to underweight adult patients (82.5%) (p = 0.034). Those who smoke tobacco is less likely to have sputum conversion at 2–3 months as compared to non-smokers (90.2% vs. 82.1%, p = 0.045).

Conclusion

Provision of good nutrition, maintaining of appropriate body mass index (i.e., BMI), and abstinence from smoking and alcohol consumption are important for sputum conversion among smear-positive pulmonary TB patients.  相似文献   
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