目的:探讨血清铁蛋白（SF）、红细胞参数（红细胞计数RBC、血红蛋白HGB、红细胞体积MCV）及炎症标志物（白细胞计数WBC、纤维蛋白原FIG、血沉ESR）与老年代谢综合征（MS）的关系。方法:148例老年人,依据MS组分数量多少分为MS0（无MS组分）、MS1～2（有1～2个MS组分）和MS3～5（有3～5个MS组分）三组。测定三组的血SF、空腹血糖FPG、甘油三酯TG、高密度脂蛋白胆固醇HDL-C、RBC、HGB、MCV、WBC、FIG及ESR水平,并进行分析。结果:老年女性及非吸烟老年男性MS组SF、RBC、HGB、WBC及ESR均较MS0组高。老年女性的SF、WBC与腰围,SF、RBC、HGB、WBC与MS组分数量,SF与RBC,均呈正相关。老年非吸烟男性的WBC与TG,HGB与MS组分数量,MCV与BMI及腰围,FIG与BMI,呈正相关。老年人HGB与DBG、TG呈正相关；与HDL-C呈负相关。结论:SF水平与MS发展相关,MS组分数量增加与聚集、超重与肥胖,可能促进体内感染状态。有MS的老年男女,常呈现低度感染状态,但同时又有一定的铁储备及相对稳定的造血机能；无MS的老年男女造血功能倾向减退。老年男性吸烟者较非吸烟者易呈现感染状态,并具有较低的铁储备。
Objective To explore the effects of Metabolic Syndrome (MS) and its components on the condition and prognosis of patients with Severe Pneumonia. Methods 306 patients with severe pneumonia admitted to the intensive care unit of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2020 to July 2023 were included as study subjects.The patients were divided into MS and non-MS groups according to whether they were combined with MS,and into survival and death groups according to 28-day prognosis,and the general data, laboratory indexes, condition and prognostic indexes of the two groups were compared; multifactorial logistic regression was used to analyze the independent risk factors for the prognosis of patients with severe pneumonia. ResultsThe levels of test indicators such as body mass index (BMI), fasting blood glucose (FBG), triglyceride (TG), blood lactate,white blood cell count(WBC),urea phosphate (Urea), creatinine (SCr),as well as the incidence of acute respiratory distress syndrome (ARDS), shock,multiple organ dysfunction syndrome (MODS), rate of endotracheal intubation and mortality, ICU treatment cost,and total treatment cost of the MS group were significantly higher than those of the non-MS group; the levels of high-density lipoprotein cholesterol (HDL-C) and oxygenation index (OI) of the MS group were significantly lower than those of the non-MS group (P<0.05).Multifactorial logistic regression analysis showed that the risk of death from severe pneumonia was 1.276 times higher in combined MS than in no combined MS (95%CI: 1.013, 5.114, P=0.047). Subgroup analyses also showed that the risk of death from non-viral severe pneumonia was 2.147 times higher in those with MS than those without (95%CI: 1.175, 8.428, P=0.023). ConclusionSevere pneumonia with MS may be more severe and may have a worse prognosis.
Objective To evaluate the correlation between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS). Methods Total 666 elderly male patients admitted to West China Hospital for routine physical examination in May, 2010 were included in this study. The related laboratory tests of BPH and MS were taken. The correlation among BPH, lower urinary tract Symptoms (LUTS), prostate volume (PV), MS and its component diseases were analyzed. Results Hypertension was an important risk factor for BPH (OR=1.309, 95%CI 1.033 to 1.661), low HDL-C hyperlipidemia was a risk factor for IPSS scored over 7 points (OR=1.573, 95%CI 0.330 to 0.997), and the score of PV was positively correlated to obesity, hypertension, low HDL-C hyperlipidemia and MS (all Plt;0.05). Conclusion For the patient with BPH, MS and its component diseases mainly exert their effects on PV changes rather than LUTS.
Objective To evaluate the efficacy and safety of thiazolidinediones for metabolic syndrome.Methods Up through 2007, we searched The Cochrane Library, MEDLINE, EMbase, the China Biological Medicine Database, VIP and CMAC. We also handsearched relevant literature. Randomized controlled trials about usingthiazolidinedioes to treat metabolic syndrome were included. Two reviewers independently extracted the data from the eligible studies and evaluated the quality of the included studies. Meta-analysis was performed for the results ofhomogeneous studies using RevMan 4.2.9 software. Results Ten randomized control trials involving 1,183 patients with metabolic syndrome met the inclusion criteria. Meta-analysis was not carried out because of apparent heterogeneity. Five trials compared rosiglitazone and placebo, which of single study reported CVD events at the end of 9 month follow-up. The results suggested that no significant differences were found between the two groups in occurrence of CVD events (RR=0.50, 95%CI 0.25 to 1.00), such as myocardial infarction and urgent vessel revascularization after coronary stent implantation, in the patients with metabolic syndrome, while rosiglitazone significantly decreased the proportion of metabolic syndrome (RR=4.0, 95%CI 1.63 to 9.82) and HOMA-index (WMD=-0.80, 95%CI -0.90 to -0.70) as compared with placebo. Pioglitazone did not affect TG, significantly decreased HOMA-index (WMD=0.02, 95%CI 0.01 to 0.03), and increased HDL-c (WMD=0.02, 95%CI 0.01 to 0.03), compared with placebo. Pioglitazone plus glimepirde was better than rosiglitazone plus glimepiride in TG and HDL-c improvement, with no significant differences in improving BP, FPG, PPG, HbA1c, and HOMA-index for both treatments. The combination of rosiglitazone with metformin was similar to pioglitazone-metformin combination in improving FPG, PPG, HbA1c and HOMA-index, whereas pioglitazone plus metformin was superior to rosiglitazone plus metformin in improving TG and HDL-c. No differences between rosiglitazone-metformin combination and glimepirde-metformin combination were observed in improving FPG, PPG, and HbA1c, but rosiglitazone plus metformin significantly lowered HOMA-index and SBP/DBP more than glimepirde plus metformin. The results of included trails revealed that rosiglitazone and pioglitazone had no favorable effects on BMI and WC or resulted in weight gain. The adverse drug reactions for thiazolidinediones were mild to moderate, and well tolerated. Conclusion The results suggest that thiazolidinediones produce positive effects on blood glucose level and insulin sensitivity in the absence of favorable obesity effects or resulting in weight gain. Pioglitazone favorably affects HDL-c. Thiazolidinediones show a certain effect on decreasing the proportion of metabolic syndrome, but the therapeutic effect on BP is uncertain. Overall there is insufficient evidence to recommend the use of thiazolidinediones for metabolic syndrome due to low methodological quality, small sample size, and limited number of trials. More high-quality, largescale randomized controlled trials are required.
ObjectiveTo understand the relationship between obesity, hyperglycemia, hypertension, and lipid metabolism disorder in metabolic syndrome and hepatocellular carcinoma (HCC), and to provide reference for screening, diagnosis, treatment, and prevention of HCC in clinic.MethodThe related literatures about the relationship between metabolic syndrome related factors (obesity, hyperglycemia, hypertension, and lipid metabolism disorder) and HCC were searched and summarized.ResultsObesity, hyperglycemia, hypertension, and abnormal lipid metabolism in metabolic syndrome were closely related to HCC, which were the high risk factors for leading to HCC, indicating that metabolic syndrome was closely related to the risk of HCC.ConclusionsMetabolic syndrome is closely related to the risk of HCC. It is of great significance for screening, diagnosis, treatment, and prevention of HCC to deeply understand the mechanism and determinants of HCC caused by metabolic syndrome.
ObjectiveTo analyze the prevalence and risk factors of metabolic syndrome (MS) after adult liver transplantation (LT) recipients. MethodsThe clinicopathologic data of patients with survival time ≥1 year underwent LT in the People’s Hospital of Zhongshan City from January 1, 2015 to August 31, 2020 were analyzed retrospectively. The logistic regression model was used to analyze the risk factors affecting MS occurrence after LT, and the receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff value of the index of predicting MS occurrence and its corresponding evaluation effect. ResultsA total of 107 patients who met the inclusion criteria were collected in this study. Based on the diagnostic criteria of MS of Chinese Medical Association Diabetes Association, the occurrence rate of MS after LT was 32.7% (35/107). Multivariate logistic regression analysis showed that the increased age of the recipient [OR (95%CI)=1.106 (1.020, 1.199), P=0.014], preoperative increased body mass index [OR (95%CI)=1.439 (1.106, 1.872), P=0.007] and blood glucose level [OR (95%CI)=1.708 (1.317, 2.213), P<0.001], and with preoperative smoking history [OR (95%CI)=5.814 (1.640, 20.610), P=0.006] and drinking history [OR (95%CI)=5.390 (1.454, 19.984), P=0.012] increased the probability of MS after LT. The areas under the ROC curve (AUC) corresponding to these five indexes were 0.666, 0.669, 0.769, 0.682, and 0.612, respectively. The corresponding optimal cutoff values of three continuous variables (recipient’s age, preoperative body mass index, and blood glucose level) were 53 years old, 23.1 kg/m2, and 6.8 mmol/L, respectively. The AUC of combination of the above five indexes in predicting occurrence of MS was 0.903 [95%CI (0.831, 0.952)], and the sensitivity and specificity were 80.0% and 90.3%, respectively. ConclusionsIncidence of MS after adult LT recipient is not low. For recipients with preoperative hyperglycemia, obese, elderly, histories of drinking and smoking before LT need to pay attention to the early detection and early intervention of MS.
In recent years, more and more studies have shown that obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic syndrome are closely related and interact with each other, while hypertension, abnormal glucose metabolism, lipid metabolism disorders and obesity, as the main components of metabolic syndrome, have been further studied. Continuous positive airway pressure is currently the main treatment for OSAHS. This review focuses on the association between OSAHS and hypertension, glucose metabolism abnormalities, lipid metabolism disorders, obesity and the effects of treatment with positive airway pressure, aiming to provide a theoretical basis for the pathogenesis and treatment of OSAHS complicated with metabolic syndrome.
Objective To introduce the research progress on the relationship between gut microbiota dysbiosis and osteoarthritis (OA), focus on the possible mechanism of gut microbiota dysbiosis promoting OA, and propose a new therapeutic direction. Methods The domestic and foreign research literature on the relationship between gut microbiota dysbiosis and OA was reviewed. The role of the former in the occurrence and development of OA and the new ideas for the treatment of OA were summarized. Results The gut microbiota dysbiosis promotes the development of OA mainly in three aspects. First, the gut microbiota dysbiosis destroys intestinal permeability and causes low-grade inflammation, which aggravate OA. Secondly, the gut microbiota dysbiosis promotes the development of OA through metabolic syndrome. Thirdly, the gut microbiota dysbiosis is involved in the development of OA by regulating the metabolism and transport of trace elements. Studies have shown that improving gut microbiota dysbiosis by taking probiotics and transplanting fecal microbiota can reduce systemic inflammation and regulate metabolic balance, thus treating OA. Conclusion Gut microbiota dysbiosis is closely related to the development of OA, and improving gut microbiota dysbiosis can be an important idea for OA treatment.
【摘要】 目的 探讨成都市成华区中老年人群血脂水平、分布特点及其与胰岛素抵抗指数（HOMA-IR）的关系。 方法 2007年5月在此区中老年（50~79岁）人群中随机抽取672人进行心血管危险因素研究调查，对其血脂水平及HOMA-IR进行统计分析。 结果 人群当中①女性各血脂项目的水平均比男性高，其中总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）的差异有统计学意义（Plt;0.05）；②三酰甘油（TG）升高的比例较高，其中男性为30.0%，女性为27.6%；大部分人群HDL-C、低密度脂蛋白胆固醇（LDL-C）水平处于合适范围，HDL-C降低的比例为6.0%，LDL-C升高的比例为7.3%；③随着TG水平的升高、HDL-C 水平的降低，HOMA-IR呈升高趋势；LDL-C水平的升高，HOMA-IR呈升高趋势，仅在女性人群中差异有统计学意义（Plt;0.05），在男性人群中差异无统计学意义；④TG与HOMA-IR呈正相关，相关系数为0.185（P=0.000）；HDL-C与HOMA-IR呈负相关，相关系数为-0.145（P=0.000）。LDL-C与HOMA-IR呈正相关，相关系数为0.099（P=0.010）。 结论 TG增高是成都市成华区中老年人群的显著特点，女性HDL-C比男性高；血脂紊乱与胰岛素抵抗相关。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.