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目的探讨高甘油三酯腰围表型(HTGW)与急性胰腺炎(AP)病情程度及预后的相关性。方法选取西南医科大学附属医院2018年9月-2019年8月收治的356例AP患者为研究对象,将患者分为甘油三酯和腰围正常组(NWNT)、单纯高甘油三酯组(NWET)、单纯腹型肥胖组(EWNT)、高甘油三酯腰围表型组(HTGW)4个组,对比4组患者的临床特点,包括年龄、性别、实验室指标、病情分级、并发症等。符合正态分布的计量资料组间比较采用one-way ANOVA检验,组内两两比较采用LSD-t检验;不符合正态分布的计量资料组间及组内两两比较均采用Kruskal-Wallis H检验。计数资料二分类变量组间及组内两两比较均采用χ2检验,有序多分类变量组间比较采用Kruskal-Wallis H检验,组内两两比较采用Mann-Whitney U检验。患者发生器官衰竭和胰腺感染坏死的影响因素采用单因素及多因素logistic回归分析。结果HTGW组中性粒细胞计数水平高于NWNT组,CRP水平高于NWNT、NWET组,肌酐水平高于NWNT组,总胆固醇、TG、低密度脂蛋白水平高于NWNT、EWNT组,高密度脂蛋白水平低于NWNT、EWNT组,血糖水平高于NWNT组,差异均有统计学意义(P值均<0.05)。HTGW组重型急性胰腺炎发生率高于其他3组,差异有统计学意义(χ2=189.519,P<0.001)。HTGW组感染性胰腺坏死和器官衰竭并发症比例均高于其他3组,差异均有统计学意义(χ2值分别为11.770、19.457,P值分别为0.008、<0.001)。单因素logistic回归分析显示性别、复发史是感染性胰腺坏死的危险因素,校正危险因素后,HTGW组发生感染性胰腺坏死的风险为NWNT的3.347倍[95%可信区间(95%CI):1.538~7.283,P=0.002];BMI、腰围甘油三酯指数、吸烟、糖尿病、HTGW是器官衰竭的危险因素(P<0.05),校正危险因素后,HTGW组发生器官衰竭的风险为NWNT的4.143倍(95%CI:1.299~13.219,P=0.016)。结论HTGW是重型急性胰腺炎发生的独立危险因素,影响患者的病情程度及并发症的发生,应早期识别和诊断此型患者,积极改善脂代谢紊乱,改善患者的病情及预后。 相似文献
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Pedro Valdivielso José Ramírez-Bollero Carmen Pérez-López 《World journal of diabetes》2014,5(5):577-585
Peripheral arterial disease, manifested as intermittent claudication or critical ischaemia, or identified by an ankle/brachial index 0.9, is present in at least one in every four patients with type 2 diabetes mellitus.Several reasons exist for peripheral arterial disease indiabetes. In addition to hyperglycaemia, smoking and hypertension, the dyslipidaemia that accompanies type2 diabetes and is characterised by increased triglyceride levels and reduced high-density lipoprotein cholesterol concentrations also seems to contribute to this association. Recent years have witnessed an increased interest in postprandial lipidaemia, as a result of various prospective studies showing that non-fasting triglycerides predict the onset of arteriosclerotic cardiovascular disease better than fasting measurements do. Additionally,the use of certain specific postprandial particle markers,such as apolipoprotein B-48, makes it easier and more simple to approach the postprandial phenomenon. Despite this, only a few studies have evaluated the role of postprandial triglycerides in the development of peripheral arterial disease and type 2 diabetes. The purpose of this review is to examine the epidemiology and risk factors of peripheral arterial disease in type 2 diabetes, focusing on the role of postprandial triglycerides and particles. 相似文献
26.
Symielle A. Gaston Nicolle S. Tulve 《International journal of hygiene and environmental health》2019,222(2):195-204
Objective
There is limited research on the association between phthalates and metabolic syndrome (MetS). Among adolescents, phthalate exposure, which can occur from multiple sources, has been linked to several risk factors for MetS. The objective was to investigate the association between urinary phthalate metabolite concentrations (i.e., mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP), mono-(3-carboxylpropyl) phthalate (MCPP), and di(2-ethylhexyl phthalate (DEHP)) and MetS in adolescents aged 12–19 years using the National Health and Nutrition Examination Survey (NHANES) data (2003–2014). A secondary aim was to assess if observed associations varied by a measure of socioeconomic status, economic adversity, which was defined using parental income and educational attainment as well as household food security.Methods
We used NHANES data which included physical examination, laboratory urinalysis and fasting blood profiles, and self-reported health characteristics and demographics. Physical examination and laboratory data were used to obtain values of MetS components and urinary phthalate metabolites. We created age-, sex-, and survey year-specific tertiles of creatinine-corrected urinary phthalate metabolites. Analysis was performed using appropriate weighting procedures that accounted for NHANES' complex sampling design. After univariate and bivariate analyses, we performed adjusted logistic regressions to test for associations between individual phthalate metabolites and MetS as well as MetS components and number of MetS components, separately, using the lowest tertile as the reference category. A cross-product term (phthalate metabolite*economic adversity) was subsequently added to adjusted models.Results
Among 918 participants (mean age 16 years, 45% female, 18% with economic adversity), the prevalence of MetS was 5.3%. Prior to adjustment, adolescents with MetS had marginally higher concentrations of phthalate metabolites than adolescents without MetS. There was a suggestive positive association between intermediate concentrations of MnBP and odds of MetS after adjustment (T2: Odds Ratio (OR)?=?2.66 (95% confidence interval: 0.98–7.24); T3: OR?=?2.11 (0.71–6.27)). Males with higher MnBP concentrations had higher odds of dyslipidemia; however, associations were mostly non-significant for females. Relationships between MiBP concentrations and odds of MetS varied by sex. Males with higher concentrations of MnBP and MiBP had greater odds of having a higher number of MetS components. Relationships between phthalate metabolites and MetS did not vary by economic adversity.Conclusion
There was a suggestive positive association between MnBP and MetS among adolescents. Associations between phthalate metabolites and MetS as well as MetS components may vary by sex, but may not vary by economic adversity. Further research of the relationships between phthalate exposures, MetS, and potential interactions with socioeconomic factors is warranted. 相似文献27.
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Aleksandra Cieluch Aleksandra Uruska Marcin Nowicki Ewa Wysocka Agata Grzelka-Woźniak Justyna Flotyńska Paweł Niedźwiecki Dorota Zozulińska-Ziółkiewicz 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2021,31(4):1219-1226
Background and aimsCholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) are crucial proteins in reverse cholesterol transport. There are insufficient data on regulating these proteins by insulin therapy in type 1 diabetes mellitus (T1DM). We aimed to assess prospectively the impact of insulin therapy initiation on transfer proteins serum levels in adults with newly diagnosed T1DM.Methods and results57 adults with newly diagnosed T1DM were enrolled in the InLipoDiab1 Study. All participants were treated with subcutaneous insulin in the model of intensive insulin therapy since the diagnosis of diabetes. Serum PLTP and CETP concentrations were measured at diagnosis, after three weeks, six months, and after one year of insulin treatment, using the immunoenzymatic method ELISA.A significant decrease in PLTP and CETP concentrations were demonstrated during twelve months of insulin therapy in newly diagnosed T1DM. The dynamics of changes in the level of these proteins varied depending on the occurrence of remission after a year of the disease. In the group without remission, a significant decrease in PLTP and CETP levels appeared after six months of follow-up. The remission group was characterized by a decrease in proteins concentration only after one year of treatment. In the non-remission group, significant negative correlations were found between the daily dose of insulin and levels of PLTP and CETP.ConclusionExogenous insulin is an inhibitor of lipid transfer proteins involved in high-density lipoprotein cholesterol metabolism in the first year of treatment. 相似文献
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Diana Ivanova Oskan Tasinov Yoana Kiselova-Kaneva 《International journal of food sciences and nutrition》2014,65(6):740-744
This study aimed to establish the effect of Sambucus ebulus L. (SE) ripe fruit infusion on body weight, blood pressure, glucose levels, lipid profile and antioxidant markers in healthy volunteers in respect of its possible protective activity against cardiovascular diseases and other oxidative stress-related diseases. The study involved 21 healthy volunteers, aged between 20 and 59, BMI 23.12?±?1.31, who consumed 200?ml SE infusion/day for a period of 30?d. Blood samples were collected before and at the end of the intervention. Significant decrease in triglycerides (14.92%), total cholesterol (15.04%) and LDL-C (24.67%) was established at the end of the study. In addition, HDL-C/LDL-C ratio increased by 42.77%. Improved serum antioxidant capacity and total thiol levels were also established. The results presented in this first human intervention study with SE fruit infusion indicate the potential of the plant to improve lipid profile and serum antioxidant capacity in humans. 相似文献
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Terence M. Davidson Susan F. Schafer Mark D. Bracker 《The Physician and sportsmedicine》2013,41(4):160-167
In brief: Rattlesnake bites are rarely fatal, but prevention is the best treatment. People who live in areas indigenous to rattlesnakes should take routine precautionary measures such as wearing boots and long pants. A person who encounters or is bitten by a snake should get away from it as soon as possible. First aid includes applying a constricting band and suction; incisions are not recommended. The victim should be transported to a medical facility as soon as possible. Medical management includes a history and physical examination and laboratory data, including blood coagulation studies and urinalysis. Intravenous antivenom is the mainstay of treatment. 相似文献