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Objective@#To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population.@*Methods@#An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ 2-test was used for the measurement of categorical data.@*Results@#A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01).@*Conclusion@#An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.
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AIM:To discuss the effect of Shenmai injection on insulin resistance ( IR) in 3T3-L1 cells and its mechanisms.METHODS:3T3-L1 preadipocytes were induced by chemical reagents to differentiate into fully differentiated adipocytes.Oil red O staining was used to detect the differentiation level of the adipocytes .The insulin-resistant 3T3-L1 cell model was demonstrated using insulin , which was confirmed by glucose concentration in cell supernatant .The IR cell model was given 10 μmol/L rosiglitazone , 25 and 50 g/L Shenmai injection and normal saline for comparison .MTT assay was used to assess the cell activity of 3T3-L1 cells which was treated with drugs for 8, 16, 24 and 36 h.Glucose oxidase method was used to detect the glucose concentration in the cell supernatant at 8, 16 and 24 h.The protein levels of glucose transporter-4 (GLUT4), phosphatidylinositol 3-kinase (PI3K), AKT and p-AKT were determined by Western blot .RE-SULTS:3T3-L1 adipocytes were successfully induced as shown by the positive oil red O staining .The IR cell model was demonstrated , and glucose concentration in the cell supernatant after treatment with Shenmai injection showed that Shenmai injection reduced the IR in 3T3-L1 cell model.The protein levels of GLUT4, PI3K and p-AKT increased compared to con-trol group.CONCLUSION:Shenmai injection reduces the IR in 3T3-L1 cell model, which functions by increasing the protein levels of GLUT4, PI3K and p-AKT.
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Objective To study the correlation between non-alcoholic fatty liver disease (NAFLD)and glycosylated hemoglobin (HbA1 c) in middle-aged and aged population.Methods A total of 4 127 inservice workers and retirees aged 45 years old or above from one petrochemical enterprise in Ningbo were enrolled in our study.The waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,glutamyltranspeptidase,HbA1c and epigastrium B ultrasound were investigated.According to the quartile of HbA1c level,participants were divided into four groups,namely,Q1 group ≤5.2％,Q2 group ＞ 5.2％-5.4％,Q3 ＞ 5.4％-5.6％ and Q4 group ＞ 5.6％.The prevalence of NAFLD and clinical characteristics of each group were analyzed.Logistic regression was used to predict independent risk factors of NAFLD.Results The morbidity of NAFLD was 27.2％ with 31.9％ in male and 21％ in female,which was significantly higher in men.In Q1,Q2,Q3 and Q4 group,the prevalence of NAFLD were 18.5％ (178/961),22.8％ (185/812),25.6％ (280/1 095),38.1％ (480/1 259) respectively.With the increase of HbA1 c level,the morbidity of NAFLD increased synchronously.The age,systolic pressure,total cholesterol,low densitylipoprotein cholesterin and fasting blood-glucose were all elevated according to the increase of HbA1 c in 1 123 NAFLD patients.Multi-factor logistic regression analysis indicated that high HbAlc level was the risk factor of NAFLD (OR =1.67,95％ CI 1.15-2.43,P =0.007).Conclusion HbA1c is an independent risk factor of NAFLD and both of these are closely related to blood lipid metabolism disorder.
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Objective To explore the relationship between thyroid hormone and colorectal adenomatous polyps (CAP) in middle-aged and elderly people.Methods We surveyed 3 042 middle-aged employees and retirees aged 45 years and over at a petrochemical enterprise of Ningbo.Their colonoscopic findings,body mass index,waist circumference and thyroid function were analyzed.Results Age and serum free triiodothyronine (FT3) of females with CAP were higher than those of the corresponding non-CAP group,so were age and waist circumference of males with CAP (P ＜ 0.05).Furthermore,these differences were statistically significant.The detection rate of CAP was significantly higher in males than in females (x2 =49.418,P ＜ 0.01).The detection rate of CAP was higher in females with higher levels of FT3.Multivariate unconditional logistic regression analyses showed the effects of thyroid hormone on the CAP differed by gender.Age and FT3 (OR =1.60,95％ CI:1.12-2.28,P =0.01) were correlated with CAP in females.However,only age and waist circumference were correlated with CAP in males.Conclusion Elevated FT3 may be a risk factor of CAP in elderly females.The detection rate of CAP may not be affected by FT3 levels in males.
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Objective To study the relationship between the prevalence of thyroid dysfunction and components of metabolic syndrome.Methods A total of 10 461 working and retired employees aged 20 to 90 years in a Petrochemical Corporation in Ningbo were included.Body mass index ( BMI),waist circumference,blood pressure,fasting blood glucose,blood lipid profile,serum thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and free triiodothyronine (FT3 ) were measured in all subjects. Metabolic syndrome was diagnosed according to the International Diabetes Federation(IDF) criteria.Results ( 1 ) The prevalences of metabolic syndrome and overall thyroid dysfunction were 10.2％ and 4.6％,respectively. ( 2 ) 18.1％ petrochemical employees had abdominal obesity with at least one component of metabolic syndrome.( 3 ) There was no significant difference in the prevalence of metabolic syndrome among the groups with lowered,normal,and elevated TSH. (4) Logistic regression analysis revealed that lowered high density lipoprotein cholesterol ( HDL-C ) was associated with lowered TSH ( OR =0.313,95％ CI 0.184-0.530 ),and raised triglyceride was associated with elevated TSH ( OR =0.767,95％ CI 0.595-0.991 ). ( 5 ) There were significant associations between serum TSH levels and lipid parameters such as total cholesterol in males,triglyceride and low density lipoprotein cholesterol in females,and HDL-C in both genders.Conclusion The prevalence of thyroid dysfunction was not associated with central obesity,hypertension,and hyperglycemia.Lipid disorder was correlated with serum TSH levels.
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Objective To estimate the prevalence of thyroid dysfunction among the retired staffs of a petrochemical corporation in Ningbo. Methods The 1709 retired staffs at 60 years of age and over were enrolled in the census. Their medical history were investigated by questionnaires,and blood samples were collected for thyroid function detection. Results In this elderly cohort, the morbidity of diagnosed thyroid diseases was 3.8% (65/1709), with 6.7% (39/584) in females and 2. 3% (26/ 1125) in males. The morbidity of unrecognized thyroid dysfunctions was 6.7% (110/1644), with 9.7% (53/545) in females and 5.2% (57/1099) in males. The prevalence of total thyroid dysfunctions was 10. 2%(175/1709), with 15.8% (92/584) in females and 7.4% (83/1125) in males. Subclinical hypothyroidism accounted for 87. 3% of unrecognized thyroid dysfunctions. Conclusions The prevalence of thyroid dysfunctions is over 10. 2% in the elderly retired staffs of the petrochemical corporation in Ningbo. Subclinical hypothyroidism is the most popular form in all kinds of unrecognized thyroid functional disorders, and its prevalence is higher in females than in males.
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AIM: To gain an insight into preference for elderly diabetic patients with angina pectoris between Shexiang Baoxin Pill (SXBXP) (Moschus, Radix Ginseng, Calculus Bovis, etc.) and Extended Release Isosorbide 5-Mononitrate (ERIM). METHODS: Followed a two-week run-in, 56 elderly patients were randomized to take SXBXP 2 pills tid or ERIM 60 mg qd for 4 weeks; then followed a two-week wash-out, patients crossed over to the complementary therapy for another 4 weeks. Daily diary cards were used to record the side effects, the frequency of angina pectoris attacks and use of rescue medication. At the end of the study, participants were asked to complete a 3-item scale questionary to assess their angina pectoris treatment in terms of convenience, side effects and overall preference. RESULTS: No treatment difference in the frequency of angina pectoris attacks and use of rescue medication was found; 71.4% of patients thought use of SXBXP was the same convenient as that of ERIM; patients felt SXBXP had side effects fewer than ERIM and overall 75% of patients preferred SXBXP. CONCLUSION: Elderly diabetic patients with angina pectoris prefer SXBXP to ERIM.