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Objective:To investigate the effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment(MCI).Methods:Totally 449 community residents were selected for a 2-year follow-up survey.Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were selected for overall cognitive function assessment.Fuld Object Memory(FOM)and Digital Span Test(DST)were used to evaluate delayed recall and instantaneous memory.Demographic data such as gender, age, education level, marital history, annual income, blood pressure, medical history etc.were collected.The glycosylated hemoglobin, fasting insulin, and carotid artery intima-media thickness were checked regularly.All subjects were grouped into non-diabetes mellitus normal cognitive group(NDM-NC group), non-diabetes mellitus mild cognitive impairment group(NDM-MCI group), diabetes mellitus normal cognitive group(DM-NC group)and diabetes mellitus mild cognitive impairment group(DM-MCI group).Results:In cross-sectional observation, the first, second, and last recall scores in the FOM showed a decreasing trend in the DM-MCI group, showed a word "U" -shaped fluctuation trend in the DM-NC group and the NDM-MCI group, and showed no significant change in the NDM-NC group.There were no significant differences in DST anterior-backward test scores between the DM-MCI group and NDM-MCI group(all P>0.05).Through longitudinal follow-up and two-by-two comparison with the other three groups, the average value of glycosylated hemoglobin in the DM-MCI group(6.78±0.60)% was the highest, and the differences were statistically significant( P<0.05).During follow-up, the average carotid intima-media thickness(CIMT)was higher in the DM-MCI group(1.03±0.20)mm than in NDM-NC group(0.89±0.20)mm( P<0.05), and the difference was statistically significant.Comparing with the other three longitudinal follow-up groups, the CIMT thickening speed in DM-MCI group was fastest. Conclusions:Elderly DM patient population have a higher prevalence of MCI, and their memory function fluctuates or declines significantly.Therefore, regular detection of memory function is conducive to delaying the progression of DM and MCI.
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Objective To evaluate effects of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia Methods Totally 80 the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia were treated with Atorvastatin (10mg/d) for 12 weeks.Fasting plasma levels of glucose(FPG),glycosylated hemoglobin(HbA1 c),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol(LDL-C),adiponectin(APN) and leptin(LEP) were measured at baseline and 12 weeks after treatment.And the adiponectin/leptin(A/L)ratio was calculated.Results Before versus 12 weeks after medication,TG[(4.92±1.23)mmol/L vs.(4.26±1.07)mmol/L,t=11.124,P＜ 0.001],TC[(2.69 ± 1.17) mmol/L vs.(1.66 ± 1.01) mmol/L,t=24.816,P＜0.001] and LDL-C[(2.79 ± 1.02) mmol/L vs.(1.91 ± 0.92) mmol/L,t=21.508,P＜0.001]were decreased obviously;HDL-C increased obviously [(1.03 ± 0.30) mmol/L vs.(1.33 ± 0.26) mmol/L,t =-12.011,P ＜ 0.001];APN increased slightly without statistical significance (P =0.064);LEP level decreased slightly without statistical significance(P=0.068),and A/L increased obviously(P＜ 0.05).Conclusions Atorvastatin treatment can significantly decrease TG,TC and LDL-C level in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia,and significantly increase HDL-C as well as A/L level,while it has no obvious influence on APN and LEP.
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Objective To explore the correlation of the gene polymorphism of the two single nucleotide polymorphisms(SNPs)rs1443434andrs925489onforkheadboxEl(FOXE1)withthehighnormalthyroidstimulating hormone ( TSH) level in Chinese Han population. Methods 1 400 subjects with normal serum TSH and thyroid peroxidase antibody(TPOAb) levels were included. According to TSH or TPOAb levels, the subjects were divided into high normal TSH group(H-TSH group,n=195) and normal TSH control group(TSH control group,n=1 205) or high normal TPOAb group ( H-TPOAb group, n=711 ) and low normal TPOAb group ( L-TPOAb group, n=689 ) , respectively. The genotypes on the two SNPs of all the subjects were performed by whole-genome genotyping chips. Results There were significant differences in rs925489 genotypic distributions and allele frequencies between H-TSH group and TSH control group(both P<0. 05). The genotype TT and allele T in H-TSH group were significantly higher than those in TSH control group(89. 75% vs 83. 15%, 94. 62% vs 91. 29%). The normal TSH levels were positively associated with rs925489 genotypic distributions after adjustment for sex, age, and high density lipoprotein cholesterol(P<0. 01). There were no significant differences in rs1443434 genotypic distributions and allele frequencies between two TSH groups or two TPOAb groups. Conclusion FOXE1 rs925489 gene polymorphism may be correlated with the high normal TSH level in Chinese Han population.
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[Summary] A total of 1 510 subjects undergoing physical examination in the Central Hospital of Xuzhou were included in this study. According to the level of TSH, the subjects were divided into low TSH group(0. 30-0. 99 mIU/L,n=351), moderate TSH group(1. 00-1. 89 mIU/L, n=703), and high TSH group(1. 90-4. 80 mIU/L, n=456). Analysis of variance and linear regression were used for data analysis. The results showed that systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , and high-density lipoprotein cholesterol( HDL-C) revealed significant differences among 3 group(P<0. 05 or P<0. 01). In the univariate linear regression model, serumTSHwithinthereferencerangewasnegativelyassociatedwithSBPandDBP(P<0.05orP<0.01),and positively associated with TG and HDL-C (P<0. 05 or P<0. 01). However, the correlations disappeared after adjustment for gender, age, body mass index, fasting plasma glucose ( FPG ) , and TG. In the multiple linear regression model, a significant negative correlation of TSH with SBP and FPG was found in males(P<0. 05).
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<p><b>OBJECTIVE</b>To compare the effects of video or leaflet in conjunction with traditional patient education (TPE) with traditional patient education alone for the compliance and satisfaction of the patients with temporomandibular disorders (TMD).</p><p><b>METHODS</b>One hundred and thirty-three patients with TMD who needed intra-articular injection of hyaluronate were included and randomly divided into three groups: Group I accepted video education plus TPE, Group II accepted leaflet education plus TPE, Group III accepted TPE alone. All the participants were recorded by demographic characteristics (sex, age) before treatment, and their compliance, satisfaction and self-exercise were also recorded after one month followed-up.</p><p><b>RESULTS</b>The baseline parameters (sex, age and diagnosis) of the groups were similar (P > 0.05). Seventeen participants lost in follow-up, including 4.5% in Group I, 11.1% in Group II and 22.7% in Group III. There were significant differences in lost rates among the three groups (P = 0.035). The rates of participants who exactly followed the appointed follow-up were higher in Group I and II than in group III (P = 0.04). And the satisfaction rates were 90.5% in Group I, 92.5% in Group II, 76.5% in Group III. The satisfaction rates of Group I and Group II were significantly higher than that of Group III (P = 0.05). The patients in Group I and Group II were more compliant with the self-exercise than that in Group III (P = 0.007).</p><p><b>CONCLUSION</b>Adding video or leaflet education to the TPE could increase the patients' compliance, satisfaction and execution of the self-exercise.</p>
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Humans , Hyaluronic Acid , Personal Satisfaction , Temporomandibular Joint DisordersABSTRACT
The level of serum insulin-like growth factor-Ⅰ (IGF-Ⅰ) in 308 healthy men aged 20 to 79 years was measured by ELISA.and fasting blood glucose (FBG),two hours postprandial blood glucose (2hPG),fasting insulin (FINS),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) and C reactive protein (CRP) were determined at the same time.The results showed that the average level of serum IGF-Ⅰ was 140.61 ±39.04 ng/ml.Compared with the group aged 20 ～ 29 years,the levels of IGF-Ⅰ in other age groups were all loweded (P＜0.05).After adjusting for age,partial correlate analysis showed that the level of serum IGF-Ⅰ was negatively correlated with triglyceride (TG),LDL-C,systolic blood pressure,2hPG,CRP (P＜0.05 or P＜0.01),and positively correlated with HDL-C (P＜0.01) . Based on the quartile levels of IGF-Ⅰ,systolic blood pressure and TG were decreased and HDL-C was increased with increased IGF-Ⅰ levels(P＜0.01).
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Objective To investigate the effects of testosterone (T) replacement therapy (TRT) on carotid artery intima-media thickness (IMT) in middle aged and elderly male patients.Methods A total of 80 middle-aged and elderly male patients with testosterone deficiency and increased carotid artery IMT were selected and randomly divided into two groups:the treatment group (n=38,treated with testosterone for 1 year) and the control group (n=42,without any treatment).The serum T level,IMT and prostate-specific antigen (PSA) before and after treatment were determined.The correlation between the testosterone level and carotid artery IMT was analyzed.Results There were no significant differences in the serum T level and IMT between the control group and the treatment group before treatment [(10.39 ± 1.44) nmol/L vs.(10.88 ± 1.87) nmol/L,(1.25 ±0.11) mm vs.(1.24±0.13) mm,t=1.32,-0.26,P=0.191,0.794].Compared with pretreatment,the serum T level was significantly increased and the IMT was significantly decreased in the treatment group afterTRT [(10.88±1.87) nmol/L vs.(22.83±1.56) nmol/L,(1.24±0.13) mmvs.(1.18±0.16) mm,t=-29.14,2.55,P=0.000,0.015],while no significant differences in the serum T level and IMT were found in the control group before and after treatment [(10.39± 1.44)nmol/L vs.(9.99±1.72) nmol/L,(1.25±0.11) mm vs.(1.27±0.11) mm,t=1.24,-1.00,P =0.219,0.323].Linear correlation analysis showed that the serum T level was negatively correlated with IMT (r-0.605,P=0.000) and multiple regression analysis showed that the T level was an independent factor for IMT.Conclusions Testosterone replacement therapy is an effective treatment to alleviate IMT in middle-aged and elderly male patients,which may play an important role in preventing cardiovascular diseases in middle-aged and elderly male patients.
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Objective To investigate whether fasting obestatin level is different in patients with impaired glucose tolerance or type 2 diabetes, and to explore the association between obestatin and lipid metabolism. Methods Eighty-four subjects without known diabetes were divided into three groups: normal glucose tolerance(NGT), impaired glucose tolerance (IGT) and type 2 diabetes (DM) Plasma obestatin levels were measured with a radioimmunoassay. The relationship between fasting obestatin levels and metabolic parameters was also analyzed. Results Fasting obestatin levels were lower in DM group [(2.82±0.78)ng/ml] and IGT group [(3.25±0.29)ng/ml] than in NGT group[(3.55±0.57) ng/ml, P＜0.01]. Triglycerides and low density lipoprotein cholesterol levels gradually increased among the three groups (P＜0.05). Multiple linear regression analysis revealed fasting obestatin level was independently associated with waist-to-hip ratio, triglyeride and low density lipoprotein cholesterol. The regression equation was obestatin=6.953-3.412×W/H-0.175×TG-0.123×LDL-C. Conclusions The decreased obestatin may be associated with IGR and T2DM, and obestatin level may be associated with lipid metabolism.
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Objective To study the changes of circulating triglyceride (TG) in the obese elderly, and to investigate the effect of hypertriglyceridemia on the development of insulin resistance. Methods A total of 82 subjects were divided into simple obesity group, obesity with IGT group, obesity with T2DM group and normal control group. The body height, body weight, blood pressure, fasting plasma glucose (FPG) and insulin(FPI), circulating TG and total cholesterol (TC) were measured. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated. Results The levels of serum TG were significantly higher in the simple obesity group ( 1.3 ± 0. 6) mmol/L, obesity with IGT group (1.9 ± 0.9)mmol/L and obesity with T2DM group (2.1±0.7) mmol/L than in the normal controls [(1.0±0.2)mmol/L, all P<0. 05], Furthermore, the levels of TG, FPG, FPI, HOMA-IR and systolic pressure were significantly higher(all P<0. 05) in obesity with IGT group and obesity with T2DM group than in simple obesity group. There were significantly positive correlations between TG and body mass index (BMI), FPG, HOMA-IR, TC, systolic pressure respectively (all P < 0.05). Multiple linear regression analysis indicated that FPG and HOMA-IR were the independent factors affecting TG (both P < 0. 05 ). Conclusions Hypertriglyceridemia may play an important role in the development of insulin resistance.
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Objective To observe the correlation between 1-hour postload plasma glucose and carotid intima-media thickness (IMT) in elderly male patients with hypertension.Methods One hundred and twenty six elderly male patients with hypertension were enrolled and divided into four groups: normal glucose tolerance with normal 1 h plasma glucose (1 hPG) group (low-NGT, n=42); normal glucose tolerance with high lh plasma glucose group (high-NGT, n=23);impaired glucose tolerance group (IGT, n=27) and diabetic group (n=84). The differences of blood pressure, blood glucose, blood lipid and intimia-media thickness among groups were analyzed.Results OGTT 1 hPG in high-NGT group was similar with IGT group[(12.0±1.1)mmol/L vs. (11.1±1.8)mrnol/L, P>0. 053 ,but significantly higher than that in Iow-NGT group ((12.0±1.1)mmol/L vs. (9. 1±1.4) mmol/L, P<0.01]. The value of IMT was gradually increased in four groups (P<0.05) and it was (1.02±0. 12) mm in high-NGT group. OGTT 1 hPG was the independent risk factor for IMT(P< 0.01).Conclusions OC-TT 1h plasma glucose is associated with atherosclerosis in elderly male hypertensive people.
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Objective To observe the distribution proportion of insulin resistance(IR) and non -insulin resistant(NIR) in aged subjects with impaired glucose tolerance (IGT)and to evaluate their states of metabolic syndrome and atherosclerosis. Methods Some indexes were detected in elderly subjects with IGT such as body mass index(BMI),waist-to-hip ratio(WHR), cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C), systolic blood pressure (SBP), diastolic pressure (DBP), insulin,insulin area under curve(InsAUC) , inflammation markers(hsCRP,Fg), proinsulin and proinsulin area under curve(PIAUC),IMT and carotid artery atheromatous plaque were also examined in some people. Subjects were divided into insulin resistance group(IR group) and non-IR group(NIR group) according to HOMA-IR. Results (1)156 subjects with IGT, the rates of IR and NIR were 75.6% and 24.4% respectively.(2)BMI, TG,TC,LDL-C,hsCRP, Fg, SBP, DBP,HOMA-IR, InsAUC, PIAUC in IR group\[(26.8?2.1) kg/m2,0.96?0.23,(2.9?1.3)mmol/L,(5.4?1.8)mmol/L,(3.9?1.5)mmol/L,(154?12)mm Hg,(96?7) mm Hg,(239?71)mU/L,(170?42)pmol/L,(7.5?1.2)mg/L,(4.5?1.4) g/L \] were higher than those in NIR group\[(22.8?2.5) kg/m2, 0.80?0.2,(1.7?1.2) mmol/L,(4.5?1.5)mmol/L, 3.0?0.8 mmol/L,(133?10)mm Hg,(83?1)mm Hg,(180?66)mU/L,(109?25) pmol/L,(4.3?0.8)mg/L,(3.8?1.5 )g/L\], but HDL-C in IR group was lower than that in NIR group(1.0?0.4)mmol/L (P
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Proinsulin(PI)_(AUC) increased,and insulin action index,HOMA-? and △I_(30)/△G_(30) decreased progressively from NGT(n=131) to IGT(n=120) to T2DM(n=107).Obese group had higher HOMA?,Ins_(AUC),C-P_(AUC) and PI_(AUC) than did the non-obese group.