Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area / 临床肝胆病杂志

ObjectiveTo investigate the risk factors and insulin resistance (IR) of nonalcoholic fatty liver disease (NAFLD) with a normal visceral adipose tissue (VAT) area. MethodsA total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group, and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area, waist circumference, fasting blood glucose (FBG), and fasting insulin (FINS) were measured for both groups, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated, and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. ResultsThe NAFLD group had a significantly higher level of IR than the control group, and there was a significant difference in HOMA-IR between the two groups (2.66(1.59-4.06) vs 1.84(125-2.47), Z=364.000, P=0005). IR was positively correlated with FBG (r=0.412, P=0.005), FINS (r=0.789, P＜0001), and TG (r=0.306, P=0041). IR was negatively correlated with HDL(r=-9398,P=0007). The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area (regression coefficient = 0.181, odds ratio = 1.198, 95% confidence interval: 1.099-1.306, P＜0.001). ConclusionThere is a certain degree of IR in NAFLD patients with a normal VAT, and waist circumference is an independent risk for NAFLD with a normal VAT.

Association of hemoglobin level with thyroid-stimulating hormone in different trimester pregnant women with subclinical hypothyroidism / 中华内分泌代谢杂志

To investigate the association between hemoglobin ( Hb ) and thyroid-stimulating hormone ( TSH) levels in different trimester pregnant women with subclinical hypothyroidism (SCH). 62 pregnant women, who were diagnosed as SCH when they had their first antenatal care and eventually delivered in the Affiliated Quanzhou First Hospital of Fujian Medical University from March 2013 to December 2014, were enrolled in this study. These subjects were divided into three groups according to weeks of gestation when they had their first prenatal care:including first trimester (n＝24), second trimester (n＝17), and third trimester (n＝21) groups. All SCH pregnant women were treated with levothyroxine ( L-T4). The clinical and laboratory data in the first antenatal care and antepartum period were collected. Association of Hb level with other clinical and laboratory data were analyzed. Compared to baseline, the levels of TSH, γ-glutamyl transpeptidase, alanine aminotransferase, and total cholesterol were lower (all P<0.05), and the levels of Hb were higher (P<0.05), after treated with L-T4in three groups. Pearson correlation analysis showed that the level of Hb was negativly correlated with TSH in all pregnancies or in third trimester groups (r＝－0.394,－0.308,－0.537 and－0.453 respectivly, all P<0.05). Multivariate regression analysis indicated that the level of Hb was independently associated with TSH and body mass index in pregnant women with SCH. In pregnant women with SCH, the higher TSH and body mass index levels are correlated with increased risk of anemia. L-T4treatment may ameliorate anemia during pregnancy.

Effect of humanistic care on quality of life and self efficacy of patients with diabetes mellitus / 中国实用护理杂志

Objective To explore the effect of humanistic care on quality of life and self-efficacy of diabetic patients. Methods According to the principle of convenience sampling, 135 patients with diabetes mellitus from January 2016 to June 2016 were randomly divided into two groups according to the random number table method. The patients in the observation group were treated with fishbone analysis to analyze the quality of life and the self-efficacy, and the patients were given humanistic nursing care. The patients in the control group were treated with routine diabetes care. After 6 months of care, the quality of life and self-efficacy were analyzed between the two groups. Results After treatment, the quality of life scores in the observation group (50.33 ± 3.02, 30.55 ± 2.03, 17.20 ± 2.01, 12.35 ± 0.87) were significantly higher than those in the control group (41.57 ± 3.46, 23.60±2.17,13.55±2.34, 9.02±0.64) , the difference between the two groups was statistically significant (t=8.112-21.137, all P <0.01); The score of self-efficacy in the observation group (30.52 ± 2.33) was significantly higher than that in the control group (24.69 ± 1.98), the difference between the two groups was statistically significant (t=13.072, P<0.01). Conclusions Humanistic care can significantly improve the quality of life and self-efficacy of patients with diabetes mellitus. The application of the nursing model in patients with diabetes has significant effect, which is worthy of clinical application.

Optimal cut-off point of waist-to-height ratio for predicting metabolic syndrome / 中华临床营养杂志

Objective To investigate the relationship between waist-to-height ratio and metabolic syndrome,in order to identify the optimal cut-off point of waist-to-height ratio for predicting metabolic syndrome.Methods In this cross-sectional study,we recruited 343 people who received physical examination in First Hospital of Quanzhou between January 2012 and June 2014,and collected the information of their waist circumference,height,weight,blood pressure,laboratory test results (including fasting blood glucose,2-hour glucose after oral glucose tolerance test,triglyceride,high-density lipoprotein cholesterol) and visceral fat area assessed by computed tomography.Then a receiver operating characteristic (ROC) curve analysis was used to estimate the optimal cut-off points of waist-to-height ratio for the prediction of metabolic syndrome.Results Among the 343 people,there were 195 metabolic syndrome patients,the prevalence rate was 56.8％,which was 70.2％ in men (127/181) and 42.0％ in women (68/162).In ROC curve analysis,the area under the curve of waist-to-height ratio for the prediction of metabolic syndrome was 0.664 for men,and 0.673 for women.The optimal cut-off point of waist-to-height ratio for predicting metabolic syndrome was 0.543 0 (sensitivity 88.2％,specificity 44.4％) for men,and 0.568 3 (sensitivity 86.8％,specificity 46.8％).Conclusion The optimal cut-off point of waist-to-height ratio for predicting metabolic syndrome in Quanzhou population is 0.543 0 for men and 0.568 3 for women.

The analysis of the relationship between the severity of non-alcoholic fatty liver disease and metabolic syndrome / 中国综合临床

Objective To investigate the relationships between the severity of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS).Methods One hundred and twenty-seven cases of NAFLD patients were selected from March 2011 to August 2012 in the First Hospital Affiliated to Fujian Medical University,of them,61 patients with mild NAFLD,45 patients with moderate and 21 patients with severe.And 21 cases without NAFLD were selected as control group during the same hospitalized period.All objects received the measures of height,body weight,waist circumference (WC),blood pressure; Liver ultrasonic examination,the examination of fasting plasma glucose,blood fat and hepatic function detections were also handed by special people.Results The proportion of overweight in the control group and the three NAFLD subgroups were 57.1％ (12/21),88.5％ (54/61),95.6％ (43/45) and 100％ (21/21) respectively (x2 =18.376,P ＜0.001) ;The proportion of the obesity in control group and the three NAFLD subgroups were 19.0％ (4/21),44.3％ (27/61),64.4％ (29/45) and 71.4％ (15/21) respectively(x2 =16.440,P =0.001).The proportion of the metabolic syndrome of the control group and the three NAFLD subgroups were 14.3％ (3/21),45.9％(28/61),71.1％ (32/45) and 71.4％ (15/21) respectively (x2 =22.637,P ＜ 0.05).All three subgroups of NAFLD were higher than the control group (x2 =6.641,P ＜ 0.05 ; x2 =18.562,P ＜ 0.05 ; x2 =14.000,P ＜0.05,respectively).The severity of NAFLD was positively correlated with BMI,WC,TG,FBG,SBP,and DBP (r =0.467,0.503,0.386,0.369,0.279,0.295,P ＜ 0.01),and negatively correlated with HDL-C (r =-0.209,P ＜0.05).Conclusion The severity of NAFLD had significant correlations with metabolic syndrome's components.

Risk factors of hyperamylasemia in diabetic ketoacidosis / 中华全科医师杂志

Risk factors of hyperamylasemia in 152 diabetic ketoacidosis(DKA)patients who had no acute pancreatitis were examined.Serum levels of hemodiastase,natrium,kalium,chlorine,calcium,phosphonium,creatinine,carbon dioxide combining power,osmotic pressure,blood glucose,blood lipids and uric acid were measured.With hemodiastase and other 14 factors as independent variables,the multiple linear regression analysis was performed and the partial regression coefficient was estimated.Blood glucose,serum natrium,osmotic pressure and triglyceride entered the regression equation,and their partial coefficients were 10.26,10.35,2.21 and 8.00,respectively.The constant quantitv was -2162.06.Compared with amylase-normal group,hyperamylasemia group showed statistically significant difference in blood glucose,serum natrium,osmotic pressure and triglyceride levels.Higher blood glucose and triglyceride might be the primary causes of hyperamylasemia.