February 2014, Volume 17, No.5 Abstracts
Transforming from White Fat to Brown： A New Strategy for Obesity Treatment
WANG Jiao，WANG Shou-jun.Department of Endocrinology and Metabolism，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
【Abstract】 Obesity has become a world-wide public health problem，but no safe and effective treatments have been found yet.In contrast to white adipose tissue（WAT），brown adipose tissue（BAT）has 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】 Obesity；Adipose tissue,brown；Tretinoin；Retinoid X receptors；Peroxisome proliferator-activated receptor-γ coactivator-1α
Dong′s Qixue Acupuncture Therapy in Simple Central Obesity
CHEN Shao-hui，SONG Xiang，MA Xing-fan，et al.Acupuncture Teaching and Research Section，Traditional Chinese Medicine School of Southern Medical University，Guangzhou 510515，China
【Abstract】 Objective To explore the clinical effects of Dong′s 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 study，control，45 in each.Based on basic treatments（those were therapies of diet and exercises），control group were given additional conventional acupuncture，study group given Dong′s Qixue acupuncture.Both groups were treated once every other day，15 times as a course，3 courses totally，7-day rest between 2 courses.Weight，BMI，fat percentage，aist circumference（WC），hip circumference（HC），waist-hip ratio（WHR）and treatment-related complications were observed.Results Three patients in control group，4 in study group did not complete the first course of treatment.A total of 15 patients discontinued treatment after the first course，who were included in the statistics of curative effects.In intra-group comparison，there were significant differences in weight，BMI，fat percentage，WC，HC before，after courses 1，2，3 between 2 groups（P＜0.05），but there was no difference in WHR（P＞0.05）.In group comparison，there was difference in WC after courses 1，3（P＜0.05），there was no difference in other indicators（P＞0.05）.Conclusion Based on treatments of diet and exercises，Dong′s Qixue acupuncture has satisfactory effect on simple central obesity，and improves WC more obviously，which is worthy of generalization and application.
【Key words】 Obesity；Prescription， acupunture；Points,extraordinary；Treatment 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 Center，Beijing 100191，China
【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 BMI≥24 kg/m2 as diagnostic criteria of overweight,BMI≥28 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-PWV≥1 400 cm/s as criteria of hAS,the subjects divided into groups hAS(n=594),non-hAS(n=626).The relationship between BMI and the hAS，and the risk factors of hAS were analyzed.Results BMI was positively correlated with ba-PWV in both males and females(r=0.089,0.083，P＜0.05).Ba-PWV and the incidence of hAS were higher in O/O group than in non-O/O group(P＜0.05),and higher in community residents aged ＜40 and 40~59 years of O/O group than in those of non-O/O group(P＜0.05);there was no significant difference between residents aged ≥60 years of 2 groups(P＞0.05);there was difference between varying age groups of 2 groups(P＜0.05).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(P＜0.05).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(P＜0.05);there were no significant difference in gender composition,renal dysfunction rate,smoking rate between 2 groups(P＞0.05).In Logistic regression model,OR(95%CI) of continuous variable BMI predicting hAS was 1.589（1.163，2.015） after correction of age,PP,hypertension,diabetes,hyperlipemia,CHD(P＜0.05);when BMI was categorical variable,OR(95%CI) of O/O predicting hAS was 1.611（1.194，2.028）(P＜0.05).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 Division，Affiliated Hospital of Qingdao University Medical College，Qingdao 266003，China
【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/m2≤BMI＜24.0 kg/m2,n=90),B(24.0 kg/m2≤BMI＜28.0 kg/m2,n=76),C(BMI≥28.0 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(P＜0.05).LAD,LVEDV were higher in groups B,C than in group A(P＜0.05),higher in group C than in group B(P＜0.05).No difference was noted in LVEF,incidence of E/A＜1 among the 3 groups(P＞0.05),there were differences in CO,SBP,DBP,SVR,STR(P＜0.05).CO was lower,SBP,DBP,SVR,STR higher in groups B,C than in group A(P＜0.05),and CO lower,SBP,DBP,SVR,STR higher in group C than in group B(P＜0.05).There were no differences in HR,LCW among the 3 groups(P＞0.05).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】 Overweight；Obesity；Left ventricular function；Hemodynamic
Secondary Preventive Medication Adherence in Patients with Ischemic Stroke after Discharge
ZHOU Zi-yi,WEI Lin,ZHANG Xiao-Pei,et al.Cerebrovascular Disease Research Center，Guangdong Provincial Hospital of Chinese Medicine，the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine，Guangzhou 510120，China
【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 infarction（AMI）or 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(P＜0.05).The compliance was lower in months 6,12 than in month 1 after discharge(P＜0.05).There was no difference in clopidogrel,doublet and warfarin compliance at different follow-up time points(P＞0.05).There was difference in medication persistence of 4 antithrombotic drugs in months 12 after discharge(χ2=20.025，P=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 treatment〔54.0％（47/187）〕,reasons for antihypertensive,hypoglycemic drug compliance was drug discontinuance due to normal examination indicators〔26.6％(21/79),48.0(12/25)〕,reasons for lipid-lowering drug compliance was not knowing course of treatment〔53.5%（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】 Stroke；Protective agents；Self administration
Characteristics of β Cell Function of Pancreas in People with Metabolic Syndrome Risk Factors
YU Dan，WANG Hong-xing，HUA Wen-jin，et al.Department of Endocrinology,the Third People′s 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(P＜0.05).HOMA-IR,ISIc were correlated with scores of diabetes risk prediction models(P＜0.05).HOMA-IR was positively correlated with BS,insulin,BMI,WC,TG on different time points(P＜0.05),ISIc negatively with BS,insulin,BMI,WC,TG,TC,LDL(P＜0.05).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(P＜0.05).HOMA-IR and ISIc were correlated with scores of varying models(P＜0.05).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 X；Islets；Insulin resistance；Hemoglobin A，glycosylated
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 People′s 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,P＜0.05),high low-hensity lipoprotein(LDL，OR=3.880,P＜0.05),glycosylated hemoglobin(HbA1c，OR=9.249,P＜0.05),hs-CRP(OR=2.988,P＜0.05) and reduced FDM(OR=0.635,P＜0.05) 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 hospitalization，and 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(P＜0.05);HDL higher in groups b,c than in group a in month 1 of treatment(P＜0.05),and higher in group c than in groups a,b in months 3(P＜0.05);FDM higher in group c than in groups a,b(P＜0.05),and higher in group b than in group a in months 1,3(P＜0.05).Seattle Angina scores were higher in group c than in groups a,b in month 1 of treatment(P＜0.05),higher in groups b,c than in group a in months 1,3(P＜0.05).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 circulation；Inflammation；Slow coronary flow；Intensive statin therapy
Value of Carotid Artery Plaque Score in Diabetic Retinopathy
YU Lei，SONG Yi-ning，LI Jian-guo.Department of Ultrasound，People′s Hospital of Peking University，Beijing 100044，China
【Abstract】 Objective To investigate the value of carotid artery plaque score in diagnosis of diabetic retinopathy（DR）.Methods A total of 120 DR patients（200 eyes）admitted to People′s Hospital of Peking University from June 2010 to December 2012 were enrolled as study group，50 T2DM patients without fundus lesions（100 eyes）as control group.The study group were subdivided into groups proliferating DR（PDR group，n=60），non-PDR（NPDR group，n=60）.Color Doppler ultrasound was used to check patients′bilateral 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 were（1.14±1.26）in control group，（2.64±1.38）in PDR group，（1.80±1.64）in NPDR group，higher in PDR group than in groups NPDR，control，respectively（q=4.502，7.665，P＜0.01），higher in NPDR group than in control group （q=3.373，P＜0.05）.The area under curve of carotid plaque scores diagnosing DR was 0.720.When carotid plaque score was 2.5，the sensitivity was 52%，specificity was 86%，the Youden index was the biggest（0.38）.Conclusion Carotid plaque score is of high value in DR diagnosis.Carotid plaque score≥2.5 can be used as a good indicator predicting DR.
【Key words】 Diabetes mellitus，type 2；Diabetic retinopathy；Carotid artery plaque；Diagnosis
Relationship of Urinary Microalbumin/Creatinine Ratio to Coronary Artery Disease in Patients with Pre-diabetes
ZHENG Jian-lei，CAI Xue-ying