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February 2013, Volume 16, No.5 Abstracts

 Associations between Subclinical Hypothyroidism and Carotid Intima Media Thickness:A Meta Analysis

WANG Hai-long,ZHANG Na,ZHANG Wen-liang,et al.Department of Clinical Epidemiology,the First Affiliated Hospital,China Medical University,Shenyang 110001,China

Abstract Objective To explore the associations between subclinical hypothyroidism(SCH) and carotid intima-media thickness(C-IMT).

Methods The literatures on associations of SCH and C-IMT published between January 2001 and August 2011were retrieved in large databases.The data were extracted and the weighted mean difference (WMD) and 95%CI were calculated.Publication bias was assessed by Beggs test.Stata 11.0 was used to perform meta analysis on the associations between SCH and C-IMT.

Results A total of nine articles were included in the study.Analysis results showed that C-IMT of SCH patients and normal controls was significantly differentWMD=0.05, 95%CI0.02, 0.07).Subgroup analysis showed that C-IMT were significantly different between SCH patients and normal controls in mean age 60 years old group,and between hospital based SCH patients and normal controls(P0.05).The differences were significant in both TSH level 10 mU/L and TSH level 10 mU/L groups,and the combined value of WMD in TSH level 10 mU/L group was greater than that in TSH level 10 mU/L group.Conclusion SCH was associated with C-IMT.

Key words Subclinical hypothyroidism;Carotid artery diseases;Carotid intima media thickness;Meta analysis

Role of Urien Prostate Cancer Gene 3 Assay for the Diagnosis of Prostate CancerA Meta Analysis

GAO Jian-jun, HAN Rui-fa.Department of Urinary Surgery, the Second Hospital of Tianjin Medical University, Tianjin 300211, China

Abstract Objective To evaluate the role of urine prostate cancer gene 3(PCA3) assay in the diagnosis of prostate cancer.

Methods By searching literature published in PubMed (from January 1966 to October 2010), Cochrane Library (Section 3, 2010), CNKI(March 1994 to October 2010), we collect the relevant cohort or case control studies on urine PCA3 assay for the diagnosis of prostate cancer.The aggregated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the received operative curve(AUC) were calculated using Meta-disc 1.4 and STATA 11.0 statistic software.

Results A total of 11 studies including 2 694 subjects were included in this Meta-analysis.The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and AUC were 61%〔95%CI58%, 64%), 72%〔95%CI70%, 74%), 2.2395%CI1.88, 2.66), 0.5495% CI0.46, 0.62), and 0.7395%CI0.69, 0.77), respectively.

Conclusion Urine PCA3 assay has acceptable sensitivity and specificity and can be a used as a non-invasive tool for the diagnosis of prostate cancer.

Key words Prostate cancer gene 3; Prostate-specific antigen; Prostatic neoplasms; Diagnosis; Meta Analysis

Relevance Study on Iodine Intake and Immunologic Mechanism in Nodular Goiter Patients

ZHANG Bo, SU Jun-ping, CHEN Yun-xia, et al.The Second Department of Tumor Section, the Central Hospital of Cangzhou, Cangzhou 061000, China

Abstract Objective To investigate the effect of different levels of iodine intake on autoimmune in nodular goiter(NG) cases.

Methods 70 NG patients(permanent residents of Cangzhou) admitted to our hospital from September 2009 to September 2010 were divided into NG group (urine iodine487.8 μg/L) and NG group (urine iodine<487.8 μg/L) according to urine iodine median 487.8 μg/L.Another 49 healthy people underwent physical examination in the same period were involved as control group.Thyroid function(FT3, FT4, TSH, TG and thyroid auto-antibodies of TPOAb and TGAb) of the three groups was detected.

Results The FT3(5.3±1.1), (2.6±0.8) and(3.8±1.1)pmol/L, FT4(16.4±3.2), (8.4±0.5) and(13.1±0.4) pmol/L, TSH(1.7±0.8), (2.6±1.2) and(1.5±0.8) mU/L, TG(31.8±45.2), (59.3±50.5) and(49.1±47.3) μg/L, positive rate of TPOAb(18.4%, 43.7% and 21.1%) and positive rate of TGAb(12.2%, 46.9% and 23.7%) between control group, group and group all showed statistically significant differences(P0.05).The FT3 and FT4 in group were significantly lower than control group and group , the TSH and positive rates of TPOAb and TGAb in group were significantly higher than control group and group , and the TG of group was significantly higher than control group(P0.05).The FT3 and FT4 in group were significantly lower than control group, while the TG level in group was significantly higher than control group(P0.01).Correlation analysis showed that TGAb was positively correlated with TPOAb(r=0.526, P0.01), TG was positively correlated with TPOAb and TGAb(r=0.420 and 0.262, P0.05).

Conclusion Excessive iodine intake can aggravate the immune dysfunction in patients with nodular goiter, so the intake of iodine should be limited in patients with nodular goiter.

Key words Goiter, nodular; Autoantibodies; Iodine; Thyroglobulin

Relationship between Alterations of Cardiac Output and Clinical Manifestations in Children with Hand-foot-mouth Disease

SHI Jun.Department of Pediatrics, Shangdong Medical College, Linyi 276002, China

Abstract Objective To observe the alterations of cardiac output(CO) in patients with hand-foot-mouth disease(HFMD) and to explore their relationship with clinical manifestations.

Methods 78 HFMD infants admitted to Linyi Peoples Hospital from March to September in 2009 were divided into HFMD group(25 cases),brainstem encephalitis group(20 cases),pulmonary hemorrhage group(19 cases) and recovery group(14 cases).20 healthy infants were selected as control group. Two-dimensional and Doppler echocardiography was used to detect LVD,RVD,LA,LVPWT,IVST,AO and PA. Meanwhile, electrocardiogram was recorded and HR, SV, CO and CI were calculated.

Results The LVD,RVD,LA,LVPWT,IVST,AO and PA among control group, HFMD group, brainstem encephalitis group, pulmonary hemorrhage group and recovery group showed no statistically significant differences(P0.05),but HR,SV,CO and CI among the five groups showed statistically significant differences(P0.05).Compared with control group,HFMD group,brainstem encephalitis group and recovery group,the HR,SV,CO and CI in pulmonary hemorrhage group showed statistically significant differences(P0.05).In the pulmonary hemorrhage group,the CI of the 7 died cases was 2.03±0.28L·min-1·m-2,while in the 12 survived cases was 2.45± 0.27L·min-1·m-2,and the difference was statistically significant(t=3.1910,P0.05).The CI reduction rate of the four groups showed statistically significant differences after taking CI lower than 2.5 L·min-1·m-2as criteria(P0.0001).

Conclusion Severe HFMD infants have transient low cardiac output,and the CI of pulmonary hemorrhage group is significantly decreased than survived cases.The detection of CI is of good significance for the evaluation of cardiac function and prognosis.

Key words Hand,foot and mouth disease; Cardiac output; Stroke volume

Study on the Relationship between Serum Nesfatin-1, Apelin and Insulin-resistance in Newly Diagnosed Type 2 Diabetic Patients

TAN Li-yan, XU Hai-bo, TAN Li-ping, et al.Department of Endocrinology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154002, China

Abstract Objective To investigate the relationship between nesfatin-1, apelin and insulin resistance in newly diagnosed type 2 diabetes mellitus(T2DM) patients.

Methods A total of 60 T2DM patients(T2DM group) and 30 non-diabetic controls(NC group) admitted to our hospital from June 2011 to February 2012 were recruited.Fasting plasma nesfatin-1 and apelin levels were assayed by enzyme-linked immunosorbent assay(ELISA).At the same time, the fasting plasma glucose(FPG), fasting insulin(FINS) and blood lipid indexes were detected.Homeostasis model assessment insulin resistance index(HOMA-IR) and insulin sensitivity index(ISI) were used to evaluate insulin sensitivity, while homeostasis model assessment of pancreatic islet β cell function index(HOMA-β) were used to evaluate islet β cell function.The Spearman rank correlation and multiple linear stepwise regression analysis were used to test the correlation between nesfatin-1, apelin and glucose metabolism and insulin resistance.

Results The levels of serum nesfatin-1 and apelin in T2DM group were significantly higher than the NC group(P0.01), and the levels of both nesfatin-1 and apelin were positively correlated with body mass index(BMI), FPG, triglyceride(TG), cholesterol(TC), low-density liporotein cholesterol(LDL-C), FINS and HOMA-IR(P0.05), but were negatively correlated with high-density liporotein cholesterol(HDL-C), ISI and HOMA-β(P0.01).The nesfatin-1 and apelin were positively correlated with each other(P0.01).Multiple linear stepwise regression analysis showed that apelin was the independent correlative factor for nesfatin-1(constant term=0.018, β=0.574, P0.01).

Conclusion Significant increases of serum nesfatin-1 and apelin are found in patients with T2DM patients compared with the normal controls.The increase is to some extent associated with insulin resistance, indicating that nesfatin-1and apelin may be involved in the occurrence and development of T2DM and IR.

Key words Nesfatin-1; Apelin; Diabetes mellitus, type 2; Insulin resistance

Correlation of Subclinical Hypothyroidism with Coronary Artery Disease

QIN Zhong-xin, LIU Qi-zhi, JIANG Shou-tao, et al.Department of Cardiology,Suizhou Affiliated Hospital of Hubei University of Medicine,Suizhou 441300, China

Abstract Objective To explore the correlation of subclinical hypothyroidism with coronary artery disease (CAD).Methods Totally 149 patients who were admitted in our hospital from January 2011 to February 2012 were enrolled in this study.They were divided normal coronary artery group (control group) (n=89) and CAD group (n=60) based on angiographic findings.The CAD group was further divided into two sub-groups:single-vessel CAD subgroup (n=25) and multi-vessel CAD subgroup (n=35).Serum free triiodothyronine (FT3),free thyroxine (FT4),and thyroid stimulating hormone (TSH) were measured.The conventional risk factors of CAD,clinical characteristics,serum lipid profiles,fibrinogen(Fbg),and angiographic results of coronary artery were also recorded and compared.Results The incidence of subclinical hypothyroidism was significantly higher in CAD group than in the control group (P0.05).The concentration of sTSH was significantly higher in the CAD group than in the control groupP0.05,and was significantly higher in the multi-vessel CAD subgroup than in the single-vessel CAD subgroupP0.05.In the CAD group,the incidences of abnormal lipid metabolism and TC/ApoB were significantly higher in patients with subclinical hypothyroidism than those with normal thyroid function.Also,the risks of CAD and multi-vessel coronary atherosclerosis were significantly higher in subjects with subclinical hypothyroidism than those with normal thyroid function OR=2.41, 95%CI(0.91,6.38); OR=2.93,95%CI (0.72,12.04); Respectively.

Conclusion Subclinical hypothyroidism is a risk factor of CAD.

Key words Subclinical hypothyroidism;Coronary disease; Multivessel coronary artery stenosis; Risk factors

Risk Factors of Non-alcoholic Fatty Liver Disease in Patients with Non-obese Type 2 Diabetes Mellitus

YE Ting, SUN Kan, CHANG Xiang-yun, et al.Medicine College of Shihezi University, Department of Endocrinology, the First Affiliated Hospital of Medicine College, Shihezi University, Shihezi 832002, China

Abstract Objective To investigate the risk factors of non-alcoholic fatty liver diseaseNAFLDin patients with non-obese type 2 diabetes mellitusT2DM.

Methods Totally 188 patients with non-obese T2DM who were treated in our hospital from Junuary 2011 to June 2012 were enrolled in this study.These patients were divided into the NAFLD groupn=96and non-NAFLD groupn=92.The demographic data, physical examination results, and laboratory findings were recorded and compared between these two groups.Including gender, age, disease course, blood pressure, and fasting plasma glucose(FPG), glycosylated hemoglobin AHbA1c, C-peptide, fasting insulinFins, blood fat and 2 h postprandial blood glucose were measured.Body mass indexBMI, waist-to hip ratioWHRand insulin resistance indexHOMA-IRwere calculated, and the results were statistics analysised.

Results The incidence of NAFLD was 51.1%96/188in our cohort, among whom there were 50 males and 46 females(χ2=0.019, P0.05.Comparison of the WHR, FPG, total cholesterol TG, and high-density lipoprotein showed significant differences between these two groupsP0.05.Logistic regression analysis showed that WHROR=1.42, 95% CI 1.13, 1.65)〕, TGOR=1.37, 95% CI1.08, 1.74)〕, and HOMA-IROR=1.01, 95% CI0.98, 1.04)〕 were independently positively associated with the incidence of NAFLD in non-obese T2DM patients(P0.05).

Conclusion Non-obese T2DM patients are more susceptible to NAFLD, with increased WHR, TG, and HOMA-IR being the independent risk factors.

Key words Obesity; Diabetes mellitus, type 2; Non-alcoholic fatty liver; Risk factors

Blood Pressure Responses during Exercise Testing and Subclinical Target Organ Damage in Hypertension Patients

QIAN Zong-jie, LI Quan-zhong, LIAO Fa-rong.Department of Cardiology, Affiliated Hospital of Guilin Medical College, Guilin 541001, China

Abstract Objective To investigate the correlation of subclinical target organ damage with blood pressure (BP) response in exercise testing in patients with mild or moderate hypertension.

Methods A total of 112 patients with stage or hypertension were divided,according to levels of blood pressure in exercise testing,into groups A (n=21,BP increased mildly),B (n=48,BP increased moderately),C (n=43,BP increased severely).Clinical data were recorded,and blood fat,homocysteic acid (Hcy),glomerular filtration rate (GFR),microalbuminuria (MA),carotid intima-media thickness (IMT),left ventricular mass index (LVMI) determined.

Results Group C were different from group B,A in age,body mass index,resting heart rate,percentage of women,smoking rate (P0.05),and group B different from group A (P0.05).But no significant difference was noted in blood fat and incidence of familial hypertension between 3 groups (P0.05).There was significant difference in MA,GFR,carotid IMT,LVMI between group C and group B(P0.05),and between B and A groups(P0.05).

Conclusion Blood pressure responses in exercise testing can be used to assess the severity of subclinical target organ damage in patients with hypertension.

Key words Hypertension; Exercise test; Target organ

Comparison of Influencing Factors of CHD and Features of Coronary Artery Lesions between Hui and Han People

QU Ling-guang,SHANG Jia,WEI Shu-jun,et al.Ningxia Medical University,Yinchuan 750004,China

Abstract Objective To analyze comparatively the difference of influencing factors of coronary heart disease (CHD) and coronary artery lesions between Hui and Han patients.

Methods A total of 701 CHD patients confirmed by coronary angiography(CAG) were divided,according to nationality,into Hui (n=92) and Han (n=609) groups.Age,gender,body mass index (BMI),smoking,hypertension,diabetes,family history,features of lesions,and the levels of total cholesterol (TC),triacylglycerol (TAG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) were compared between 2 groups.

Results Age was less in Hui group than in Han group,and TC and LDL-C levels lower,the difference was significant(P<0.05).No significant difference was noted in diseased region or number of coronary arteries between 2 groups(P>0.05).Gensini scores were higher in Hui group aged 40~70 than Han group(

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