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February 2014, Volume 17, No.5 Abstracts

Transforming from White Fat to Brown A New Strategy for Obesity Treatment

WANG JiaoWANG Shou-jun.Department of Endocrinology and Metabolismthe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

    Abstract  Obesity has become a world-wide public health problembut no safe and effective treatments have been found yet.In contrast to white adipose tissueWAT),brown adipose tissueBAThas entirely different functions on energy metabolism.Researchers have tried to transform white adipose tissues into brown to explore a new way for obesity treatment.This paper summarizes its mechanism and reviews related issues to understand its research progress.

    Key words  ObesityAdipose tissue,brownTretinoinRetinoid X receptorsPeroxisome proliferator-activated receptor-γ coactivator-1α

 

Dongs Qixue Acupuncture Therapy in Simple Central Obesity

CHEN Shao-huiSONG XiangMA Xing-fanet al.Acupuncture Teaching and Research SectionTraditional Chinese Medicine School of Southern Medical UniversityGuangzhou 510515China

    Abstract  Objective  To explore the clinical effects of Dongs Qixue acupuncture in the treatment of simple central obesity.Methods  Ninety patients with simple central obesity admitted to this hospital from January to July 2013 were divided randomly into groups studycontrol45 in each.Based on basic treatmentsthose were therapies of diet and exercises),control group were given additional conventional acupuncturestudy group given Dongs Qixue acupuncture.Both groups were treated once every other day15 times as a course3 courses totally7-day rest between 2 courses.WeightBMIfat percentageaist circumferenceWC),hip circumferenceHC),waist-hip ratioWHRand treatment-related complications were observed.Results  Three patients in control group4 in study group did not complete the first course of treatment.A total of 15 patients discontinued treatment after the first coursewho were included in the statistics of curative effects.In intra-group comparisonthere were significant differences in weightBMIfat percentageWCHC beforeafter courses 123 between 2 groupsP0.05),but there was no difference in WHRP0.05.In group comparisonthere was difference in WC after courses 13P0.05),there was no difference in other indicatorsP0.05.Conclusion  Based on treatments of diet and exercisesDongs Qixue acupuncture has satisfactory effect on simple central obesityand improves WC more obviouslywhich is worthy of generalization and application.

    Key words  ObesityPrescription acupunturePoints,extraordinaryTreatment outcome

 

Relationship between Overweight/Obesity and Arterial Stiffness in Community Residents

XIE Xiao-liang,LI Jue,HU Da-yi.Peking University Health Science Center Hospital/Community Health Service CenterBeijing 100191China

    Abstract  Objective  To analyze the relationship between overweight/obesity and high arterial stiffness(hAS) in community residents.Methods  Cluster random sampling method was used to choose 1 254 community residents aged over 18 years from Inner Mongolia and a total of 1 220 subjects were enrolled in this study excluding 34 residents due to incomplete data.Taking BMI24 kg/m2 as diagnostic criteria of overweight,BMI28 kg/m2 as that of obesity,the subjects were divided into groups overweight/obesity(O/O group,n=764),non-O/O(n=456);taking ba-PWV1 400 cm/s as criteria of hAS,the subjects divided into groups hAS(n=594),non-hAS(n=626).The relationship between BMI and the hASand the risk factors of hAS were analyzed.Results  BMI was positively correlated with ba-PWV in both males and females(r=0.089,0.083P0.05).Ba-PWV and the incidence of hAS were higher in O/O group than in non-O/O group(P0.05),and higher in community residents aged 40 and 40~59 years of O/O group than in those of non-O/O group(P0.05);there was no significant difference between residents aged 60 years of 2 groups(P0.05);there was difference between varying age groups of 2 groups(P0.05).Ba-PWV and the incidence of hAS were higher in 60 age group than in 40~59 age group,higher in 40~59 age group than in 40 age group(P0.05).The age,BMI,pulse pressure(PP),the incidence of O/O,hypertension,diabetes,hyperlipemia,coronary heart disease(CHD) were higher in hAS group than in non-hAS group(P0.05);there were no significant difference in gender composition,renal dysfunction rate,smoking rate between 2 groups(P0.05).In Logistic regression model,OR(95%CI) of continuous variable BMI predicting hAS was 1.5891.1632.015 after correction of age,PP,hypertension,diabetes,hyperlipemia,CHD(P0.05);when BMI was categorical variable,OR(95%CI) of O/O predicting hAS was 1.6111.1942.028(P0.05).Conclusion  The hAS incidence of O/O group is higher than that of non-O/O group.Overweight/obesity,an independent risk factor of hAS,should be attached importance to and community prevention and control of overweight/obesity and cardiovascular diseases be strengthened.

    Key words   Epidemiology;Overweight;Obesity;Arterial stiffness

 

Non-invasive Hemodynamic Monitoring for Prophase Left Heart Function in Overweight and Obese Adults

HU Yi,ZHANG Yi,ZHAO Peng-fei,et al.Special Care DivisionAffiliated Hospital of Qingdao University Medical CollegeQingdao 266003China

    Abstract  Objective  To evaluate the left heart function of overweight and obese adults using non-invisive hemodynamics detector combined with echocardiogram and explore the changes of their early heart systolic and diastolic functions.Methods  From October 2012 to July 2013 a total of 223 adults,128 males,95 females,aged(50.4±12.4) years,were divided,according to BMI,into groups A(18.5 kg/m2BMI24.0 kg/m2,n=90),B(24.0 kg/m2BMI28.0 kg/m2,n=76),C(BMI28.0 kg/m2,n=57).The echocardiogram indicators such as left ventricular ejection fraction(LVEF),left atrioventricular valve peak early diastolic flow velocity(E)/left atrioventricular valve peak late diastolic flow velocity(A),left atrial diameter(LAD),left ventricular end-diastolic volume(LVEDV) and non-invasive hemodynamic indicators such as heart rate(HR),cardiac output(CO),systolic blood pressure(SBP),diastolic blood pressure(DBP),systemic vascular resistance(SVR),LCW,systole time ratio(STR) were compared among the 3 groups.Results  There were significant differences in LAD,LVEDV among the 3 groups(P0.05).LAD,LVEDV were higher in groups B,C than in group A(P0.05),higher in group C than in group B(P0.05).No difference was noted in LVEF,incidence of E/A1 among the 3 groups(P0.05),there were differences in CO,SBP,DBP,SVR,STR(P0.05).CO was lower,SBP,DBP,SVR,STR higher in groups B,C than in group A(P0.05),and CO lower,SBP,DBP,SVR,STR higher in group C than in group B(P0.05).There were no differences in HR,LCW among the 3 groups(P0.05).Conclusion  Overweight,obesity can lead to CO reduction,increases of LAD,LVEDV,SBP,DBP,SVR,STR.As compared with echocardiogram,non-invasive hemodynamic monitoring can explore better the effects of weight increase on changes of left heart systolic and diastolic functions.

    Key words   OverweightObesityLeft ventricular functionHemodynamic

 

Secondary Preventive Medication Adherence in Patients with Ischemic Stroke after Discharge

ZHOU Zi-yi,WEI Lin,ZHANG Xiao-Pei,et al.Cerebrovascular Disease Research CenterGuangdong Provincial Hospital of Chinese Medicinethe Second Affiliated Hospital of Guangzhou University of Traditional Chinese MedicineGuangzhou 510120China

    Abstract  Background  The recent studies have shown that the application of secondary prevention medication and patients drug therapy compliance are poor.Objective  To evaluate the antithrombotic agent compliance of IS patients and the application of drugs controlling risk factors and analyze the reasons for patients poor medication compliance and discontinuation of medication.Methods  The patients with acute myocardial infarctionAMIor transient ischemic attack(TIA) hospitalized in this hospital from August 2011 to June 2012 were enrolled in this study.The status of medication and reasons for discontinuation of medication were recorded within 12 months after discharge.Medication days according doctors advice equal to or more than 80% of follow-up days were considered as good compliance.Medication during follow-up consistent to that at discharge considered as good persistence.Results  A total of 393 patients were enrolled,31 were excluded;362 entered into follow-up study,including 40 losing follow-up due to varying reasons within 12 months,18 excluded due to dying during follow-up,304(77.4%) completed the follow-up study at last.In the 304 patients,217 had good compliance to antithrombotic agents,87 had poor.The relevant factors influencing medication compliance were educational level(χ2=5.523,P=0.019),reimbursement methods(χ2=12.233,P=0.002) and stroke subtype(χ2=16.562,P=0.000).There was significant difference in medication compliance of aspirin at different time points after discharge(P0.05).The compliance was lower in months 6,12 than in month 1 after discharge(P0.05).There was no difference in clopidogrel,doublet and warfarin compliance at different follow-up time points(P0.05).There was difference in medication persistence of 4 antithrombotic drugs in months 12 after discharge(χ2=20.025P=0.000),the persistence of aspirin was higher than that of clopidogrel and doublet(=18.484,P=0.000,χ2=6.660,P=0.010).The good compliance rate of patients combined with hypertension,diabetes and hyperlipemia in months 12 were 66.5%(157/236,77.1%(84/109,39.3%(92/234,respectively.The main reason for poor antithrombotic drug compliance was poorly understanding the course of treatment54.0%(47/187)〕,reasons for antihypertensive,hypoglycemic drug compliance was drug discontinuance due to normal examination indicators26.6(21/79),48.0(12/25),reasons for lipid-lowering drug compliance was not knowing course of treatment53.5%76/143)〕.Conclusion  Secondary preventive medication adherence is generally low within 12 months after discharge,aspirin medication compliance is higher than that of clopidogrel and doublet.The main reasons for poor compliance are poorly understanding course of treatment,discontinuity due to improved symptoms and to normal examination indicators.Educational level,reimbursement methods,stroke subtype are factors influencing antithrombotic drug compliance.

    Key words  StrokeProtective agentsSelf administration

 

Characteristics of β Cell Function of Pancreas in People with Metabolic Syndrome Risk Factors

YU DanWANG Hong-xingHUA Wen-jinet al.Department of Endocrinology,the Third Peoples Hospital of Wuxi,Wuxi 214041,China

    Abstract  Objective  To evaluate the β cell function of pancreas and insulin resistance(IR) in people with Metabolic Syndrome(MS) risk factors to provide reference for its early prevention.Methods  From March 2012 to March 2013,a total of 575 cases in Wuxi Huishan Community hospital with high risk of MS according to diagnostic criteria of MS in International Diabetes Federation(IDF) had standard oral glucose tolerance test(OGTT) and insulin stimulation test.The blood sugar(BS),insulin and C-peptide in fasting and minutes 30,120 after glucose load were detected,βcell function of pancreas and IR evaluated,the correlation of pancreas related indicators with the scores of diabetes risk prediction models analyzed.Results  By OGTT results,411 cases had normal BS(control group,accounting for 71.5%),139 had impaired fasting glucose(IFG) /impaired glucose tolerance(IGT)(IFG/IGT group,24.2%),25 had diabetes mellitus(DM group,4.3%).HBCI,insulin sensitivity index(ISI),compound ISI(ISIc) were lower in DM group than the other 2 groups,HOMA-IR higher(P0.05).HOMA-IR,ISIc were correlated with scores of diabetes risk prediction models(P0.05).HOMA-IR was positively correlated with BS,insulin,BMI,WC,TG on different time points(P0.05),ISIc negatively with BS,insulin,BMI,WC,TG,TC,LDL(P0.05).HBCI negatively with the scores of American ARIC scoring model;insulinogenesis index(IGI) negatively with Danish Diabetes Risk Score,Cambridge Diabetes Risk Scoring Model,American ARIC Scoring Model,Oman Diabetes Prediction Model(P0.05).HOMA-IR and ISIc were correlated with scores of varying models(P0.05).Conclusion  The proportion of postprandial glucose is high in non-diabetes group with high risks,in whom BS should be screened actively.IR exists in impaired glucose regulation patients,basic and post-glucose-load early insulin secretion functions reduce,new DM patients had severe IR and pancreaticβ cell secretory dysfunction.Risk factors influence pancreatic islet function are different in MS high risk group.Specific measures should be taken to prevent and treat it.

    Key words  Metabolic syndrome XIsletsInsulin resistanceHemoglobin Aglycosylated

 

Slow Coronary Flow:Analysis of Influencing Factors and Effect of Intensive Statin Combined with Liposomal Prostaglandin E1

CAO Ming-ying,YAO Zhu-hua,ZHOU Xin,et al.Department of Cardiology,Tianjin Peoples Hospital,Tianjin 300121,China

    Abstract  Objective  To analysis the influencing factors of slow coronary flow(SCF) and the clinical effects of intensive statin combined with liposomal prostaglandin E1(Lipo-PGE1) on SCF.Methods  Sixty-three SCF patients hospitalized from October 2010 to October 2012(group A) and 107 patients with normal coronary angiography and blood flow(group B) were enrolled in this study.The influencing factors related to SCF were detected by multivariate Logistic regression analysis.Group A were subdivided,based on treatment protocols,into groups a,b(given intensive statin treatment),c(given intensive statin combined with Lipo-PGE1).Liver function,blood lipids,creatine kinase(CK),high-sensitivity C-reactive protein(hs-CRP) were determined,brancial artery flow-mediated dilatation(FMD) measured and Seattle Angina Questionnaire filled out in SCF patients on admission and months 1,3 after admission.Results  Multivariate Logistic regression analysis showed that smoking(OR=6.260,P0.05),high low-hensity lipoprotein(LDLOR=3.880,P0.05),glycosylated hemoglobin(HbA1cOR=9.249,P0.05),hs-CRP(OR=2.988,P0.05) and reduced FDM(OR=0.635,P0.05) were independent risk factors of SCF.TC,LDL(except LDL in group a),hs-CRP decreased,HDL,FDM and Seattle Agina scores increased in groups a,b,c in 1 month of treatment as compared with those during hospitalizationand also in 3 month to 1 month(except LDL in group a and c,HDL in group b).TC,LDL,hs-CRP were lower in groups b,c than in group a in months 1,3 of treatment(P0.05);HDL higher in groups b,c than in group a in month 1 of treatment(P0.05),and higher in group c than in groups a,b in months 3(P0.05);FDM higher in group c than in groups a,b(P0.05),and higher in group b than in group a in months 1,3(P0.05).Seattle Angina scores were higher in group c than in groups a,b in month 1 of treatment(P0.05),higher in groups b,c than in group a in months 1,3(P0.05).Conclusion  The independent risk factors of SCF are smoking,increased LDL,HbA1c,inflammatory reaction and reduced vascular endothelial function.Intensive statin combined with Lipo-PGE1 can improve vascular endothelial function better and SCF patients symptoms at last.

    Key words  Coronary circulationInflammationSlow coronary flowIntensive statin therapy

 

Value of Carotid Artery Plaque Score in Diabetic Retinopathy

YU LeiSONG Yi-ningLI Jian-guo.Department of UltrasoundPeoples Hospital of Peking UniversityBeijing 100044China

    Abstract  Objective   To investigate the value of carotid artery plaque score in diagnosis of diabetic retinopathyDR.Methods  A total of 120 DR patients200 eyesadmitted to Peoples Hospital of Peking University from June 2010 to December 2012 were enrolled as study group50 T2DM patients without fundus lesions100 eyesas control group.The study group were subdivided into groups proliferating DRPDR groupn=60),non-PDRNPDR groupn=60.Color Doppler ultrasound was used to check patientsbilateral carotid arteries and calculate carotid plaque scores.ROC curve was drawn to evaluate the value of carotid plaque scores in diagnosis of DR.Results  The carotid plaque scores were1.14±1.26in control group,(2.64±1.38in PDR group,(1.80±1.64in NPDR grouphigher in PDR group than in groups NPDRcontrolrespectivelyq=4.5027.665P0.01),higher in NPDR group than in control group q=3.373P0.05.The area under curve of carotid plaque scores diagnosing DR was 0.720.When carotid plaque score was 2.5the sensitivity was 52%specificity was 86%the Youden index was the biggest0.38.Conclusion  Carotid plaque score is of high value in DR diagnosis.Carotid plaque score2.5 can be used as a good indicator predicting DR.

    Key words   Diabetes mellitustype 2Diabetic retinopathyCarotid artery plaqueDiagnosis

 

Relationship of Urinary Microalbumin/Creatinine Ratio to Coronary Artery Disease in Patients with Pre-diabetes

ZHENG Jian-leiCAI Xue-ying

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