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Objective:To analyze the characteristics of laboratory test results and multimorbidities in elderly patients with rheumatoid arthritis(RA)and thus to provide a basis for the treatment of RA in the elderly.Methods:Retrospective analysis was performed on RA patients admitted to the Second Affiliated Hospital of Nanjing Medical University from March 2018 to December 2020.Patients were divided into an elderly RA(ERA)group(≥60 years)and a non-elderly RA(NERA)group(<60 years).The prevalences of multimorbidities and laboratory results were compared between the two groups, and influencing factors of multimorbidities in ERA patients were analyzed by using binary Logistic regression.Results:There were 215 patients in this cohort, of whom 156 patients were in the ERA group and 59 patients were in the NERA group.The prevalences of comorbid hypertension, diabetes mellitus, coronary heart disease(CHD)and interstitial lung disease in the ERA group were higher than those in the NERA group( χ2=19.890, 6.977, 5.964, 7.484, all P<0.05).The disease duration in the ERA group was longer than that in the NERA group[117.5(36.0, 240.0)months vs.72.0(10.5, 123.5)months, Z=3.142, P=0.002], and the levels of serum C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), urea, creatinine and cystatin C were higher than those in NERA group[9.7(3.2, 24.8)mg/L vs.3.1(3.0, 8.3)mg/L, 31.0(13.0, 53.3)mm/h vs.17.0(11.0, 31.5)mm/h, (5.38±1.54)mmol/L vs.(4.75±1.46)mmol/L, (63.82±15.33)μmol/L vs.(57.31±11.38)μmol/L, (1.23±0.42)mg/L vs.(0.90±0.23)mg/L]( Z=4.275, 2.770, t=2.714, 2.966, 5.714, all P<0.05).The levels of serum magnesium, albumin and hemoglobin were lower than those in the NERA group[(0.84±0.08)mmol/L vs.(0.86±0.06)mmol/L, (37.46±5.32)g/L vs.(40.77±4.95)g/L, (114.52±18.06)g/L vs.(124.32±16.40)g/L]( t=2.653, 4.147, 3.648, all P<0.05).Correlation analysis showed that the level of serum CRP in the ERA group was negatively correlated with serum albumin and magnesium( r=-0.449, -0.329, all P<0.05).Uric acid was positively correlated with rheumatoid factor(RF), cystatin C, urea, age and disease duration( r=0.259, 0.416, 0.210, 0.232, 0.179, all P<0.05), but negatively correlated with hemoglobin and magnesium( r=-0.262, -0.207, all P<0.05).RF was positively correlated with uric acid, urea, total cholesterol, low density lipoprotein, the 28-joint Disease Activity Score(DAS28 score), age and disease duration( r=0.259, 0.177, 0.205, 0.234, 0.248, 0.225, 0.211, all P<0.05), but negatively correlated with albumin and hemoglobin( r=-0.301, -0.182, all P<0.05).Serum magnesium was negatively correlated with CRP, ESR, urea, uric acid and cystatin C( r=-0.273, -0.192, -0.175, -0.207, -0.315, all P<0.05).These correlations were not found in the NERA group.Multivariate Logistic regression analysis showed that factors affecting hypertension in ERA patients were age, RF and albumin.Influencing factors of CHD were age, disease duration, serum magnesium and triglycerides.Factors that affect interstitial lung disease were RF, DAS28 score and albumin. Conclusions:Compared with NERA patients, ERA patients show an elevated level of systemic inflammation and poorer nutrition assessed by relevant parameters.CRP, RF and uric acid have complex correlations with serum magnesium, hemoglobin, and albumin.ERA patients have higher prevalences of multimorbidities.Age, disease duration, RF, triglycerides, DAS28 score, serum magnesium and albumin affect the occurrence of multimorbidities in ERA patients.
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<p><b>OBJECTIVE</b>To study the association of methylenetetrahydrofolate reductase (MTHFR) gene C677T mutation and plasma homocysteine (Hcy) levels with hyperlipidemia.</p><p><b>METHODS</b>Blood samples were collected from 1591 adults for detecting MTHFR gene C677T polymorphism with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), plasma Hcy levels with enzymatic cycling method, and blood lipid levels as well. The patients were divided according to the lipid levels into hyperlipidemia group (n=694) and healthy control group (n=897) and the differences in MTHFR gene C677T polymorphisms and plasma Hcy levels were compared.</p><p><b>RESULTS</b>The hyperlipidemia group and healthy control group showed no significant differences in CC, CT, or TT genotype frequencies or C and T allele frequencies of MTHFR C677T gene, and had comparable plasma Hcy levels (P>0.05). Patients with 3 different MTHFR C677T genotypes had significant differences in plasma Hcy levels (P<0.01) but not in blood lipid levels (P>0.05). Pairwise comparison indicated a significantly higher plasma Hcy level in TT genotype than in CC and CT genotypes (P<0.01), and the latter two genotypes showed no significant difference (P>0.05).</p><p><b>CONCLUSION</b>MTHFR C677T polymorphisms and plasma Hcy levels are closely related but neither of them is associated with hyperlipidemia. The TT genotype is associated with a significantly higher plasma Hcy level than CC and CT genotypes.</p>
Subject(s)
Adult , Humans , Gene Frequency , Genotype , Homocysteine , Blood , Hyperlipidemias , Blood , Genetics , Methylenetetrahydrofolate Reductase (NADPH2) , Genetics , Mutation , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment LengthABSTRACT
Objective To compare the efficacy of urinary type Ⅳ collagen( Ⅳ C), N-acetyl-β-D-glucosaminidase( NAG ), serum cystatin C ( CysC ), β2 microglobulin ( β2-MG ) in early diagnosis of diabetic nephropathy(DN) ,and to develop a multiple regression equation using above mentioned indices. Methods One hundred and eight cases of DM patients were enrolled in the study. All those DM patients were divided into two groups according to 24 hr urinary albumin excretion(UAE): non-DN group( UAE ＜30 mg/24 h)and DN group (UAE ≥30 mg/24 h). Receiver operating characteristics (ROC)curve was developed using urinary IVC, NAG,serum CysC and β2-MG,and the efficiency of the four indices for early diagnosis of diabetic nephropathy were assessed by area under the curve ROC (AUCROC). Furthermore, the regression equation of four indicators was developed. All statistical analyses were performed using SPSS 13.0. Results The levels of urine Ⅳ C, NAG,CysC,β2-MG,were(3.91±1.93)ng/ml, ( 12.20 ±3.46)U/L, ( 1.18 ±0.41 )mg/L , (2. 50 ±0. 74)mg/ml in the non-DN group, respectively; and ( 14.14 ± 11.17 ) ng/ml, ( 23.12 ± 13.57 ) U/L, ( 2.69 ± 1.69 ) mg/L and(5.21 ± 2.78)mg/ml in the DN group, respectively. There were significant differences in the comparison of the four indicators between the two groups ( Ps ＜ 0.01 ). AUCROC of Ⅳ C, NAG, CysC and β2-MG were 0. 747,0.732,0.764 and 0.823 respectively;which meant the diagnostic efficacy for DN decended from β2-MG, CysC,Ⅳ C, to NAG in order. All these indices showed significant efficiency in assisting diagnosis of early DN ( Ps ＜0.01 ). The regression equation of UAE and the four indices was: UAE = - 242.624 + 6.362IVC + 8.662NAG + 64. 622CysC + 29.488β2-MG, and the equation had statisticl significance( P ＜ 0.O1 ). Conclusion Urine Ⅳ C, NAG,serum CysC, and β2-MG showed significant value in assisting diagosis of early DN, and could be sensitive indices for DN.
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Objective To study the clinical significance of urinary type Ⅳ collagen(IVC)and UmAlb/UCr ratio in the diagnosis of early diabetic nephropathy. Methods We collected 52 cases of diabetes(group A)without DN(UAE ＜30 mg/24 h),35 cases of diabetes(group B)with early DN(UAE as 30-300 mg/24 h),and 50 cases of healthy controls. The differences of urine IVC,UmAlb/UCr were compared among group A,B and the control group. ROC curve was used for evaluating the use of urine IVC and UmAlb/UCr in the diagnosis of early DN. The correlation of urine IVC and UmAlb/UCr with UAE were investigated,and linear model curve were established. IVC in urine was detected by chemiluminescence,UmAlb was detected by immunoturbidimetric assay,UCr was detected by enzymatic. Statistical analysis were performed with SPSS13.0 statistical software. Results The urine IVC testing of group A,B and the control group were(2. 64 ± 0. 91),(3.91 ± 1.93)and(10. 08 ± 6. 50)μg/L,respectively. The UmAlb/UCr(mg/mmol)testing of group A,B and the control group were(1.50 ± 0. 40),(2. 58 ±2. 10)and(17.95 ± 13. 38)mg/mmol,respectively. Urine IVC and UmAlb/UCr were significant difference between group A,B and the control group(Ps ＜ 0. 01);the ROC area under the curve(AUCROC)of urine IVC and UmAlb/UCr were 0. 724,0. 945,the two indicators for early diagnosis of DN were significant(Ps ＜ 0. 01);The pearson correlation coefficients of the urine IVC and UmAlb/UCr were 0. 529,0. 919 ,respectively. They were positive and significant correlation(Ps ＜ 0. 01),On the basis of the correlation coefficient and linear model fitting curve with the UAE,the relationship of UmAlb/UCr with the UAE was better than that of IVC. Conclusions Urine IVC and UmAlb/UCr ratio,which significantly assists diagnosis in diabetic nephropathy ,can be used as a sensitive diagnostic indicator of diabetic nephropathy. Moreover,the relationship of UmAlb/UCr with the UAE is better than that with IVC.
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Objective To evaluate the value of brain natriuretic peptide(BNP) in estimating risk stratification in patients with acute myocardial infarction(AMI) and to determine the relationship between BNP and adverse cardiac events after AMI.Methods The 135 subjects were selected into the study including 25 healthy subjects and 110 patients with a first AMI.The plasma concentrations of BNP were measured at two to four days after infarction in patients and healthy controls.Left ventricular function was evaluated by echocardiography with the parameters of left ventricular ejection function(LVEF) after 3 months.Patients were followed up at 12 months.The main outcome measures were heart failure,left remodeling mortality and other adverse cardiac events at one year.Results Plasma BNP concentrations in patients with AMI were much higher than those in the health control people[(416.7?208.0)ng/L versus (61.8?34.1)ng/L,P400ng/L,P=0.019).Plasma BNP concentrations remained associated with the development of clinical end points in multivariable model that adjusted for potential confounding variables.Conclusion The results of the present study confirm that the elevated BNP count related to the risk stratification and prognosis in patients with AMI elevations in BNP count is associated with a higher incidence of new CHF and adverse clinical outcomes after AMI it could serve as s strong predictor for the subsequent development of poor outcomes in AMI patients.
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In this study, the effect of prophylactic anti-inflammation on the development of smoke-induced emphysema was investigated. Young male guinea-pigs aged 1.5-2 months (weighing 198.3+/-26.9 g) were randomly divided into 4 groups: group A (cigarette smoke exposure only), group B (cigarette smoke exposure plus pentoxifylline-rich (PTX, 10 mg/d) forage feeding), group C (cigarette smoke exposure plus intermittent cortical steroid injection (Triamcinolone acetonide, 3 mg, i.m., every three weeks) and control group (group D: animals with sham smoke exposure, raised under the same conditions). Animals in group A, B and C were exposed to smoke of cigarettes for 1 to 1.5 h twice a day, 5 days a week. All animals were killed at the 16th week and followed by morphometrical analysis of the midsagittal sectioned lung slices. Smoke exposure of 16 weeks resulted in visible emphysematous development in Group A but not in Group B and C. It was evidenced by the indicator of air-space size, mean linear intercept (Lm): 120.6+/-16.0 microm in Group A; 89.8+/-9.2 microm in Group B and 102.4+/-17.7 microm in Group C. The average Lm in either group B or group C was shorter than that in Group A (ANOVA and Newman-Keuls test, F=8.80, P=0.0002) but comparable to that (94.8+/-13.2 microm) in group D (P>0.05). It is concluded that long-term prophylactic anti-inflammation inhibits pulmonary emphysema induced by cigarette smoking in the guinea pigs.
Subject(s)
Animals , Male , Anti-Inflammatory Agents , Pharmacology , Guinea Pigs , Pentoxifylline , Pharmacology , Pulmonary Emphysema , Pathology , Random Allocation , Smoking , Triamcinolone Acetonide , PharmacologyABSTRACT
In this study, the effect of prophylactic anti-inflammation on the development of smoke-induced emphysema was investigated. Young male guinea-pigs aged 1.5-2 months (weighing 198.3+/-26.9 g) were randomly divided into 4 groups: group A (cigarette smoke exposure only), group B (cigarette smoke exposure plus pentoxifylline-rich (PTX, 10 mg/d) forage feeding), group C (cigarette smoke exposure plus intermittent cortical steroid injection (Triamcinolone acetonide, 3 mg, i.m., every three weeks) and control group (group D: animals with sham smoke exposure, raised under the same conditions). Animals in group A, B and C were exposed to smoke of cigarettes for 1 to 1.5 h twice a day, 5 days a week. All animals were killed at the 16th week and followed by morphometrical analysis of the midsagittal sectioned lung slices. Smoke exposure of 16 weeks resulted in visible emphysematous development in Group A but not in Group B and C. It was evidenced by the indicator of air-space size, mean linear intercept (Lm): 120.6+/-16.0 microm in Group A; 89.8+/-9.2 microm in Group B and 102.4+/-17.7 microm in Group C. The average Lm in either group B or group C was shorter than that in Group A (ANOVA and Newman-Keuls test, F=8.80, P=0.0002) but comparable to that (94.8+/-13.2 microm) in group D (P>0.05). It is concluded that long-term prophylactic anti-inflammation inhibits pulmonary emphysema induced by cigarette smoking in the guinea pigs.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Pentoxifylline/pharmacology , Pulmonary Emphysema/etiology , Pulmonary Emphysema/pathology , Pulmonary Emphysema/prevention & control , Random Allocation , Smoking/adverse effects , Triamcinolone Acetonide/pharmacologyABSTRACT
Objective To determine the relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B. Methods Serum HBeAg and HBV DNA were assayed by MEIA and PCR in 74 patients with HBeAg-negative and 73 patients with HBeAg-positive chronic hepatitis B who had undergone liver biopsy and pathological grading. Results The serum HBV DNA levels in 27 patients(36%) HBeAg-negative chronic hepatitis B were higher 10~5 copies/ml.The number of patient at the HBV DNA level increase along with G1～G4 grading ascendant.The correlation between two factors has statistically remarkable significance.Those serum HBeAg quantitative levels are 0～29 PEIU/ml. The number of HBeAg quantitative-positive patients increase also along with G1～G4 grading ascendant and the correlation between two items has statistically significance.However,there are no relationship between serum HBeAg and HBV DNA and G1～G4 grading in 73 patients with HBeAg-positive chronic hepatitis B whose HBV DNA levels are higher than 10~5 copies/ml. Conclusions Serum HBV DNA level is the indicator by which grading of liver inflammation can be judged in the patients with HBeAg-negative chronic hepatitis B and former is positively interrelated with latter significantly.That Serum HBeAg level is low but HBV DNA duplicate actively may indicate that there is C-zone mutation in 36% patients with HBeAgnegative chronic hepatitis B.Serum HBV DNA level cannot reflect grading of liver inflammation in the patients with HBeAg-positive chronic hepatitis B.