ABSTRACT
Objective@#To investigate the relationship between menopausal status at different FPG levels and the risk of new onset of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM).@*Methods@#Female subjects were selected from the females who joined in the epidemiological survey between May and September in 2009 in six counties of Guanlin Village and Xushe Village in Yixing City in Jiangsu Province by cluster sampling method. Subjects with diabetes at baseline or pre-menopause with age above 65 years old or surgical menopause were excluded. Finally there were 2 084 eligible subjects included in this study. According to FPG at baseline, subjects were categorized into two groups as normal FPG group (FPG<5.6 mmol/L) and IFG group (5.6≤FPG≤6.9 mmol/L). Follow-up study was conducted from May in 2014 to January in 2016. Cox regression model was used to investigate the association between menopausal factors and IFG and T2DM among groups based on FPG.@*Results@#The average age of subjects at baseline was 58.08 (51.74-65.82) years old, and the number of post-menopausal women was 1 631 (78.3%). The number of subjects in normal FPG group was 1 569 (75.3%), and in IFG group was 515 (24.7%). There were 104 subjects with new onset T2DM among which 34 subjects from normal FPG group and 70 subjects from IFG group. And there were 199 subjects with new onset IFG in normal FPG group. Among subjects with normal FPG, the incidence density of IFG in post-menopausal women (2 752/100 000 person-years) was statistically higher than that in premenopausal women (1 670/100 000 person-years) (P<0.001). After age and BMI adjusted, post-menopausal women had a higher risk of having IFG in normal FPG subjects with hazard ratio (HR) at 2.60 (P<0.001). Among subjects with normal FPG, the risk of new onset IFG decreased in post-menopausal women with menopause age increasing after age and BMI adjusted, with HR at 0.96 (P=0.046). No statistical association was found between menopausal factors and risk of T2DM either in the overall subjects or in the subgroups(P>0.05).@*Conclusion@#Menopause can increase the risk of IFG incidence in subjects with normal FPG. The incidence of IFG decreases with the menopause age increasing.
ABSTRACT
Objective To explore the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) and perioperative myocardial injury (PMI),and to discuss the predictive value of Lp-PLA2 in patients with stable angina after percutaneous coronary intervention (PCI).Methods A total of 222 consecutive patients with stable angina,who were admitted to Yixing Municipal People's Hospital,Jiangsu Province,China to receive PCI during the period from June 2015 to March 2017,were enrolled in this study.The patients' baseline data as well as the distribution pattern of coronary lesions,were recorded.According to the paclitaxel-PCI and the surgical cooperative study (SYNTAX) score,the severity of target vascular lesions was assessed,which was classified into low score group (0 to 22 points),middle score group (23 to 32 points) and high score group (≥33 points).The preoperative blood lipid level and renal function,both preoperative and postoperative Troponin T (cTnT),high sensitive C reactive protein(hs-CRP),as well as the postoperative Lp-PLA2 were tested.Results After the procedure,the Lp-PLA2 levels in patients with normal cTnT value (n=155) and in patients with elevated cTnT value (n=67) were(122.21±43.80) ng/ml and (224.53±65.00) ng/ml respectively (P＜0.05).SYNTAX score analysis showed that low score group had 120 patients,middle score group had 78 patients and high score group had 24 patients,the Lp-PLA2 levels of the above three groups were (119.51±51.96) ng/ml,(178.67±61.49) ng/ml and (233.16±61.32) ng/ml respectively,the differences were statistically significant between each other among the three groups (P＜0.05).Pearson correlation analysis indicated that a parallel correlation existed between Lp-PLA2 levels and postoperative cTnT values (R=0.492,P＜0.05).Logistic regression analysis revealed that Lp-PLA2 was the independent risk factor for elevated cTnT value during the perioperative period of PCI (OR=7.377,95％CI=3.368-16.156,P＜0.05).The area under ROC curve of Lp-PLA2 was 0.896 (95％CI=0.874-0.945,P＜0.001),the best cut-off point was 179 ng/ml,and the sensitivity and specificity for the diagnosis of PMI were 92.2％ and 66.7％,respectively.Conclusion Lp-PLA2 levels are closely correlated with the increased cTnT values after PCI,and the preoperative high level of Lp-PLA2 is the independent risk factor for PMI after PCI.