Coagulation Factors for Diagnosis of Periprosthetic Joint Infection / 中山大学学报(医学科学版)

ObjectivePeriprosthetic joint infections （PJI） are currently the most calamitous complication after arthroplasty. Although achievements have been made in many markers for the diagnosis of PJI， the lack of a gold standard remains a great obstacle for early diagnosis. This study aimed to investigate the association between coagulation markers and the development of PJI in patients undergoing revision total joint arthroplasty （TJA）. MethodsWe conducted a retrospective cohort study with a total of 2 517 patients who underwent hip or knee arthroplasties from January 2011 to January 2022 （2 394 with primary TJA， 87 with aseptic revision and 36 with PJI）. We applied univariate analysis and multivariate logistic regression to analyze differences of coagulation factors between primary TJA and aseptic revision or PJI group. Receiver operating characteristic （ROC） curve and area under the curve （AUC） were used to measure the diagnostic value of coagulation factors in predicting PJI. ResultsCoagulation factors and their ratios including plasma fibrinogen （FBG）， prothrombin time （PT）， thrombin time （TT）， activated partial thromboplastin time （APTT）， platelet （PLT）， mean platelet volume （MPV）， platelet distribution width （PDW）， plateletcrit （PCT）， PLT / MPV， PLT / PDW and PLT / PCT were included in this study. High FGB level was strongly correlated with the risk of PJI compared to other coagulation factors. The optimal threshold value of FBG was 4.53 g/L with a sensitivity of 47.22%， a specificity of 93.07% （Primary TJA group vs. PJI group）. Similarly， the optimal threshold value of FBG was 4.44 g/L with a sensitivity of 47.22%， a specificity of 95.40% between the other two groups （Aseptic revision group vs. PJI group）. ROC curve analysis demonstrated moderate diagnostic performance of FBG （AUC value）， indicating a potential to be a diagnostic marker for PJI. ConclusionsFBG is significantly correlated with PJI and it can be used as a potential non-invasive marker for early detection. It may serve as a safe and cost-effective tool for assessing PJI in clinical work.

Repalr of large-segmental femoral defects using lentivirus-mediated bone morphogenetic protein 2/bone marrow mesenchymal stem cells/demineralized bone matrix / 中国组织工程研究

BACKGROUND: Our research team has confirmed that compared to the adenoviral vector, transfection by lentiviral vector to rabbit bone marrow mesenchymal stem cells (BMSCs) is more effective that the expression of enhanced green fluorescent protein (EGFP)/bone morphogenetic protein 2 (BMP-2) can be persistent for a longer term. But further investigations are needed to explore whether BMSCs transfected with hBMP-2 through lentivirus combined with demineralized bone matrix (DBM) can promote bone defect repair. OBJECTIVE: To evaluate the effect of lentivirus-mediated hBMP-2/BMSCs/DBM (LV-hBMP-2/BMSCs/DBM) on the repair of large-segmental femoral defects and to explore the new treatments for large-segmental femoral defects. METHODS: Large-segmental bone defect models were made in the right femur of 48 New Zealand white rabbits by cutting the middle femoral bone and steel plate fixation. Then, animal models were randomly divided into four groups (n=12 per group) and implanted with nothing (control), DBM, hBMP-2/DBM, and LV-hBMP-2/BMSCs/DBM. Three rabbits from each group were sacrificed at 2, 4, 8 and 12 weeks after surgery to evaluate the repairing effect of femoral defects through hematoxylin-eosin staining, biomechanical analysis and radiological examination. RESULTS AND CONCLUSION: X-ray results revealed that osteotylus formed in all the four groups to different extents, and Lane - Sandhu X-ray scores were ranked as follows: control group < DBM group < hBMP-2/DBM group < LV-hBMP-2/BMSCs/DBM group (P < 0.05). Findings from the three-point bending test showed that the maximum load of the LV-hBMP-2/BMSCs/DBM group was significantly higher than that of the hBMP-2/DBM group, but is still lower than that of the normal femur at 8 and 12 weeks after modeling (P < 0.05). Hematoxylin-eosin staining results revealed that a few trabecular bones arranged disorderedly and a large amount of fibrous tissues in the control group; the DBM scaffold was basically degraded in the DBM group presenting with partially disordered trabecular bones and a large amount of fibrous tissues; the trabecular bones in the bone defect area were basically connected into line to start the shaping of the cortical bone, and recanalization of the medullary cavity was insignificant in the hBMP-2/DBM group; new cortical bone formed in the bone defect area and the medullary cavity was recanalized in the LV-hBMP-2/BMSCs/DBM group. These findings indicate that LV-hBMP-2/BMSCs/DBM can produce a large amount of calluses, promote formation of new cortical bone, and promote bone conduction, bone induction and osteogenesis after implantation into the bone defect; and this material has good repairing effect on large-segmental femoral defects of rabbits.

Comparison of lentiviral vector and adenoviral vector mediated gene transfer into rabbit bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND: Both lentiviral vector and adenoviral vector are considered as good vectors for gene mediation, and their differences in transferring bone morphogenetic protein 2 (BMP-2) into rabbit bone marrow mesenchymal stem cells (BMSCs) are unclear. OBJECTIVE: To compare the duration, efficiency and the deviation of exogenous gene expression after rabbit BMSCs transfection using lentiviral vector and adenoviral vector which are used to mediate enhanced green fluorescent proteins (EGFP) and BMP-2. METHODS: Rabbit BMSCs at passage 5 were exposed to Ad-EGFP-BMP-2 (group A) or Lenti-EGFP-BMP-2 (group B) with multiplicity of infection of 100, as transfection groups. And in control group (group C), the same quality of culture medium was required equivalent to the groups A and B. The expression of EGFP was observed by inverted fluorescence microscope at various time intervals. And the expression of exogenous gene BMP 2 in cells was detected and analyzed by immunohistochemical staining at 72 hours after transfection as well as by western blot at 72 hours, 1, 3 weeks after transfection. RESULTS AND CONCLUSION: The intense green fluorescence emerged under the microscope at 24-48 hours after transfection in group A, which was stronger than group B, reached the peak at 72 hours, and then decreased at 1 week until disappearance at 3 weeks. No EGFP expression was detected in group C. High expression of BMP-2 was found in group A but was dramatically downregulated after 1 week. Group B showed the high expression of EGFP/BMP-2 persisted for a longer period after transfected that even lasted for 3 weeks. Overall, the lentiviral vector and adenoviral vector can efficiently transfect rabbit BMSCs and stably express the target gene of EGFP/BMP-2. Under the same MOI, compared to the adenoviral vector, transfection of lentiviral vector to rabbit BMSCs is more effectively and expression of EGFP/BMP-2 can be persistent in a longer term.

Status of household disaster preparedness and affecting factors among the general public of four counties in Shaanxi / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the status of household disaster preparedness in 4 counties of Shaanxi province and explore the affecting factors.</p><p><b>METHODS</b>During the period from September to October in 2008, multi-stage sampling was used to select subjects from urban and rural residents in Xincheng district, Hantai district, Fuping county and Xunyang county of Shaanxi province. Questionnaire survey was conducted among 1945 subjects aged 18-88 years to investigate their experience and expectation of disaster events, preparedness knowledge, activities and emergency supplies. Logistic regression was used to analyze the factors influencing household disaster preparedness.</p><p><b>RESULTS</b>The average age of the 1945 subjects was (43.55 ± 12.76) years old. A total of 7.12% (138/1939) of respondents never experienced disaster. Earthquake and fire (57.35% (1175/2049), 19.81% (406/2049), respectively) were rated as the two disasters most likely to occur. The awareness rate of knowledge about household disaster preparedness was 51.43% (989/1923), and 23.41% (454/1939) discussed how to prepare for disaster with their family, only 9.27% (179/1932) attended evacuation drill. The rates of preparing household emergency supplies were 23.64% (230/973), 30.56% (55/180), 31.19% (141/452) and 54.49% (97/178) for urban residents, subjects with junior college or above education, subjects having frequent family discussions of disaster preparedness and subjects participating in emergency rescue drills, respectively. For subjects with junior high school, senior high school and junior college or higher education, the likelihood of preparing household emergency supplies was 5.02 (95%CI: 1.12 - 22.42), 5.74 (95%CI: 1.27 - 26.04) and 6.84 (95%CI: 1.44 - 32.39) times as that of illiterate, respectively. Urban residents, subjects who often discussed disaster preparedness with their family, and who participated in emergency rescue drills were more likely to prepare emergency supplies than rural residents (OR = 4.38, 95%CI: 2.74 - 7.00), those who never discussed (OR = 4.99, 95%CI: 2.52 - 9.91), and who didn't participate (OR = 5.72, 95%CI: 3.84 - 8.51).</p><p><b>CONCLUSION</b>The residents in 4 counties of Shaanxi lack comprehensive knowledge and appropriate activities of disaster preparedness, the rate of preparing household emergency supplies is low. Higher education, living in urban area, frequent family discussions of disaster preparedness and participating in emergency rescue drills are facilitating factors of preparing household emergency supplies.</p>

Status quo of lifestyle among women of five occupations in six provinces of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To learn the status quo of lifestyle among women of five occupations in six provinces of China.</p><p><b>METHODS</b>A questionnaire was administered among 7416 women from five occupations (civil servants, teachers of elementary and high schools, technical staff, enterprise managers and physical laborers) in Beijing, Hebei, Jilin, Hubei, Ningxia and Gansu of China. The sample was selected by multi-stage stratified cluster random sampling method from December 2009 to June 2010. The questionnaire information included demographic characteristics, diet, sleep habit, smoking, physical exercise. The χ(2) test was used to analyze the different in life style of different occupations.</p><p><b>RESULTS</b>There were 7416 valid questionnaires received, and the valid rate of the questionnaires was 97.58% (7416/7682). About 38.00% (2818/7416) respondents preferred to bland diet and 28.44% (2109/7416) preferred to salty and oily food and 33.56% (2489/7416) had no preference. The proportion of sleep time between seven and eight hours per day was highest (accounting for 56.23%, 4154/7416), 25.27% (1867/7416) with sleep time less than seven hours. Among the population who had the sleep time less seven hours, teacher that had the highest rate accounted for 33.19% (531/1607) and technical staff had the lowest rate accounted for 21.05% (301/1401) (P < 0.01). Most of respondents were non-smokers, accounting for 93.10% (6869/7416). 22.73% (1671/7416) respondents passively smoked. The proportion of always passive smoking was highest among civil servants and lowest among teachers, accounting for 26.60% (404/1531) and 18.71% (298/1607), respectively. The proportion of having no physical exercises was highest, accounting for 62.87% (4637/7416). The proportion of having three times physical exercises per week was 12.68% (935/7416). The proportion of having no physical exercises among physical laborers (66.42%, 912/1386), enterprise managers (66.64%, 987/1491) and teachers (62.40%, 999/1607) were higher than others and the proportion of having physical exercises per week among technical staff was 40.83% (569/1401), higher than others (P < 0.01). The proportion of person who worked in sitting quietly beyond six hours per day was 42.62% (3146/7416). The technical staff had the higher rate than other occupational populations (P < 0.01), accounting for 57.83% (809/1401).</p><p><b>CONCLUSION</b>The female occupational population had some unhealthy lifestyles, such as taking in high salt food, lacking of sleep, smoking and passive smoking, lacking of physical exercises and working in sitting quietly. Different occupational populations had different unhealthy lifestyles.</p>

The expression of arginase Ⅰ in heptocellular carcinoma and its clinicopathological significance / 中华消化杂志

Objective To investigate the expression of arginase Ⅰ(ARG1)in hepatocellular carcinoma(HCC)and to analyze its correlation with clinicopathological features.Methods The expression of ARG1 at protein level in 167 samples of HCC and corresponding adjacent liver tissue was detected with high-throughput tissue microarray technique and immunohistochemistry.The correlation between ARG1 expression and clinicopathological features was analyzed with x2 test and Spearman rank correlation analysis.The expression of ARG1 at mRNA level in 68 samples of HCC and corresponding adjacent liver tissue was determined by real-time polymerase chain reaction(real-time PCR).Results The expression of ARG1 at protein level in HCC(3.540±3.702)was significantly lower than that of the corresponding adjacent liver tissues(10.290 ± 2.303)(t=-22.421,P=0.000).The ARG1 expression was correlated with differentiation degree of HCC,histological grade,vascular invasion,preoperative level of α-fetoprotein(AFP)and recurrence after operation(all P＜0.05).The ARG1 expression at mRNA level in 68 HCC tissue[0.0997(0.213)]was lower than that of the corresponding adjacent liver tissues[0.563(0.459)],and the difference was statistical significant(u=-6.544,P=0.000).Conclusion Low expression of ARG1 in HCC may take part inHCC genesis and development.Detecting the expression of ARG1 may be helpful in HCC diagnosis,differentiation degree and prognosis assessment.

Study on lifestyle and self-rated health among 5 kinds of occupational populations in 6 provinces in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To know about the status of self-rated health and life style among 5 kinds of occupational populations in 6 provinces in China and to explore the influencing factors related with health of the occupational population.</p><p><b>METHODS</b>From May to August 2009, a total of 13 492 persons aged 18 - 60 years including civil servants, scientific and technical personnel, administrative staff, teachers and physical workers were selected by multi-stage stratified sampling from Beijing city, Ningxia Hui autonomous region, Liaoning, Zhejiang, Hubei and Qinghai provinces to undergo surveys on the Lifestyle of Occupational Population in Urban in China and Self-rated Health Measurement Scale Version 1.0 (SRHMS V1.0). The effects of lifestyles on health scores were analyzed by logistic linear regression.</p><p><b>RESULTS</b>Overall, 13 073 valid questionnaires of the Lifestyle of Occupational Population in Urban in China and 13 177 valid questionnaires of SRHMS V1.0 were collected. The valid rate was 96.9% and 97.7% respectively. Among the respondents, 46.9% (6136/13073) ate timely in a day, 50.9% (6658/13 073) ate breakfast every day, 27.8% (3635/13 073) worked over 8 hours per day, 31.0% (4057/13 073) didn't do any exercises, 14.6% (1906/13073) sat for over 4 hours in spare time, 39.3% (5137/13 073) were drinking and 24.8% (3230/13 073) were current smokers. The average score of SRHMS of all respondents was 73.34 +/- 11.86, of which the civil servant had the highest score (74.83 +/- 11.89) while the teacher had the lowest score (71.65 +/- 11.44, P < 0.05). The results of multiple linear regression showed that females (b = -0.945, b' = -0.041), the elderly (b = -0.098, b' = -0.087), teachers (b = - 2.151, b' = -0.074), the divorced (b = -1.607, b' = -0.021), the widowed (b = -2.926, b' = -0.019), and smokers (b = -1.198, b' = -0.045) were with worse condition. Respondents with higher education (b = 0.588, b' = 0.037), eating timely (b = 2.301, b' = 0.141), eating breakfast every day (b = 1.503, b' = 0.096), paying more attention on diet (b = 0.499, b' = 0.021) and doing more exercises (b = 1.820, b' = 0.058) had better condition.</p><p><b>CONCLUSION</b>Eating irregularly, working long hours, lack of exercise, sitting for long hours, smoking and drinking were common among occupational population. The self-rated physical health status was associated with gender, age, education level, occupation, diet and exercise.</p>

Development and interpretation of China medical nutrition therapy guideline for diabetes (2010) / 中国医学科学院学报

Nutritional therapy is the basis for all types of diabetes treatment, but has not been properly applied due to the lack of scientific criteria. In 2010, the China Medical Nutrition Therapy Guideline for Diabetes was successfully developed based on the up-to-dated scientific research evidences (especially those from China) using Oxford Centre for Evidence-Based Medicine grading system. These guidelines cover the nutrition-based prevention and treatment of diabetes and its complication as well as the parenteral and enteral nutritional supports, with an attempt to improve the quality of life and lower the burdens of diabetes and its complications.

Study on indicator system for evaluating the adult health literacy in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish a comprehensive evaluation indicator system for healthy literacy based on national survey data.</p><p><b>METHOD</b>A multi-stage stratified sampling method was carried out to select the sample population in six provinces of China, which were adults aged 18 - 69 years old. The national health literacy questionnaire was used to investigate the sample populations. The answers were scored according to the error answer of 0, uncertain answer of 1 and the correct answer of 2. The degrees of difficulty and difference were calculated and be used to screen the indicators from the questionnaire as to establishing the comprehensive evaluation indicator system of the health literacy. The Cronbach alpha coefficient, correlation analysis, regression analysis and cluster analysis methods were used to assess the reliability and validity of the indicator system.</p><p><b>RESULTS</b>The samples were 11 759 people, the valid questionnaires were 11 693 and the effective recovery rate was 99.4%, the Myer' index of sample was 4.92. There were 40 indexes selected to establish the comprehensive evaluation indicator system of health literacy. The correlation coefficient between indicator system and the questionnaire scores was 0.948 (P < 0.01), there were the significant differences between groups of being clustered by Q cluster analysis method (P < 0.01). The VIF of these four dimensions was less than 5.</p><p><b>CONCLUSION</b>In this study, the comprehensive evaluation indicator system had a good reliability and validity, and there existed no collinearity among four dimensions of indicator system, it should be the foundation for developing comprehensive evaluation index of health literacy.</p>

Assessment of serum micronutrients in children with short bowel syndrome / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess micronutrients level in children with short bowel syndrome.</p><p><b>METHODS</b>Clinical data of 17 children with short bowel syndrome from April 2004 to July 2006 were collected. They received the measurement of serum vitamin A, E and - carotene by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>There were 9 boys and 8 girls with age range of 3 months to 18 years. Eleven children did not need parenteral nutrition (PN), and 6 still depended on PN. Six cases were free of ileocolic valve and 11 cases had ileocolic valve. The length of remaining intestine was more than 75 cm in 5 patients and less than 75 cm in 12 patients. Among 11 cases without PN, 9 were tested for serum iron, zinc and copper levels. Their incidences of below the reference value of vitamin A, E and beta - carotene were 23.5%, 35.3% and 58.8%, respectively. The incidences of below the reference value of vitamin A and beta - carotene were higher in patients with weaned PN, less than 75 cm remaining intestine and without ileocolic valve. The patients with more than 75 cm remaining intestine and still with PN had a higher incidence of below the reference of vitamin E, but the incidence was similar in the patients with or without ileocolic valve. Serum zinc was lower than normal level in 3 cases and serum iron was low in 1 case.</p><p><b>CONCLUSION</b>Supplement of extra micronutrients is essential for short bowl syndrome patient whatever they receive the PN or have normal diets, and follow- up is recommended.</p>

Benzo (a) pyrene induces quiescent diploid human embryonic lung fibroblast cells undergoing a reversible G1 arrest / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the influence of Benzo (a) pyrene on cell cycle distribution of quiescent diploid human embryonic lung fibroblast (HELF) cells.</p><p><b>METHODS</b>HELF cells were synchronized at G0 phase of cell cycle by 0.5% serum starvation for 48 hours and identified by flow cytometry (FCM). Cells were treated with 20 micromol/L benzo (a) pyrene for 4 h and detected for the changes of cell cycle distribution 0 h, 24 h, 48 h after treatment respectively. HELF cells were treated with 0, 5, 10, 20 micromol/L Benzo (a) pyrene for 24 h and detected for cell cycle regulators p53, p21 and p16 expression changes using Western Blotting method. On the other hand, the dynamic changes of these regulators were also been detected within 24 h after 20 micromol/L Benzo (a) pyrene treated for 4h.</p><p><b>RESULTS</b>0.5% Serum starvation for 48 hours could effectively synchronize HELF at G0 stage and G0 reached 78%. Well-modulated control cells entered into cell cycle to synthesize DNA and cells at S phase reached 43.9% 24 h after serum re-stimulate, while 20 micromol/L B (a) P treated cells were arrested in G1 stage. Control cells entered into the G1 stage of next cell cycle another 24 h later, B (a) P treated cells recovered from G1 arrest, 26.5% of which reached S phase, having a delay of almost 24 h compared with controls. After a series of B (a) P concentrations acting for 24 h, we found that P53 and P21 expression increased dramatically. On the other hand, P53 and P21 increased 4 h after treatment, P53 recovered to normal level after 12 h while P21 kept increasing in 24 h. P16 initially decreased and became normal at 24 h.</p><p><b>CONCLUSION</b>B (a) P induced quiescent HELF cells undergoing a reversible G1 arrest related with p53-p21 pathway.</p>

Factors derived from parenteral nutrition associated with cholestasis in 612 neonates / 中华儿科杂志

<p><b>OBJECTIVE</b>Some neonates especially premature infants, low birth weight infants and extremely low birth weight infants have limited endogenous energy stores. It is necessary to establish continuous administration of postnatal nutrition. The use of parenteral nutrition (PN) in neonates with immaturity of digestive system and intentionally delayed feedings has gained widespread acceptance. PN has been shown to provide sufficient nutrients to maintain growth in newborn infants. The major complication of PN in neonates is PN-associated cholestasis (PNAC). It remains a significant and frequent clinical problem for neonatal practitioners. In some cases, progressive liver damage, liver failure and death may become inevitable. In order to analyze the risk factors of the PNAC in neonates and to provide the evidence of safety and efficiency in clinical nutrition support, the clinical data of 612 neonates who had received PN for more than 5 days during the past 20 years were reviewed.</p><p><b>METHODS</b>Retrospective analysis on data collected from April 1985 to March 2005 was performed. The records of 612 neonates were divided into two groups according to the established Nutrition Support Team (NST) in our hospital. Each group included two sub-groups. Seventy neonates of the first group were divided into PNAC group (n = 6) and non-PNAC group (n = 64); these patients were seen between 1st April 1985 and 31st March 1995. The remaining 542 neonates of the second group who were also divided into 2 groups, i.e. PNAC group (n = 12) and non-PNAC group (n = 530) who were seen from 1st April 1995 through 31st March 2005. The incidence of PNAC between the first group and the second group was compared and the associated factors were analyzed. The PNAC was defined when serum level of direct-bilirubin exceeded 1.5 mg/dl or direct-bilirubin greater than 50% of the bilirubin and excluding cholestasis resulted from other diseases.</p><p><b>RESULTS</b>The total incidence of PNAC in neonates who had received TPN for more than 5 days was 2.94%. The incidence of PNAC of the first and the second decade was 8.57% and 2.21%, respectively (OR = 0.242, 95% CI = 0.088 approximately 0.666). The average gestational age (GA) and birth weight (BW) of PNAC group were less than those of the non-PNAC group (GA: (33 +/- 5) w vs. (36 +/- 4) w, P = 0.009; OR = 0.827, 95% CI = 0.698 approximately 0.980. BW: (2003 +/- 743) g vs. (2393 +/- 764) g, P = 0.045; OR = 1.001, 95% CI = 0.999 approximately 1.002). The PN duration and calorie intake of PNAC group was longer than that of the non-PNAC group (PN duration: 32 +/- 30 d vs. (13 +/- 10) d, P = 0.000; OR = 1.072, 95% CI = 1.032 approximately 1.112. Calorie intake: [(272 +/- 46) kJ/(kg.d)] [(65.0 +/- 10.9) kcal/(kg.d)] (1 kcal = 4.184 kJ) vs. [(232 +/- 55) kJ/(kg.d) (55.5 +/- 13.1) kcal/(kg.d)], (P = 0.002; OR = 1.066, 95% CI = 1.012 approximately 1.122), but the weight gain in the non-PNAC group had a tendency to increase as compared to that of the PNAC group [(20 +/- 27) g/d vs. (9 +/- 19) g/d, P = 0.175].</p><p><b>CONCLUSIONS</b>The incidence of PNAC was associated with the longer duration of PN, the smaller age at initiation of PN, the higher calorie intake, prematurity and lower birth weight. Establishment of the nutrition support team can normalize the practice of the PN administration and decrease the incidence of the complication with nutrition support. It is a favorable mode and it can provide a safer, more effective and reasonable means in clinical nutrition support. To avoid PNAC, it is suggested that the administration of enteric feeding should start as soon as possible, which may enhance effective contraction of gallbladder and secretion of gastrointestinal hormones, and it is best to avoid high calorie of PN and control the calorie intake under 251.04 approximately 334.72 kJ/(kg.d) [60 approximately 80 kcal/(kg.d)].</p>

Optimal variables and corresponding cut-off points for identification of cardiovascular risk factors clustering among elderly males / 上海第二医科大学学报

Objective To explore the optimal cut-off points of body mass index(BMI),percentage of body fat(PBF) and body fat mass index(BFMI) for identification of cardiovascular risk factors clustering among elderly males. MethodsThe data of physical examinations from 1 052 Shanghai elderly males in 2007 were collected.The relationship between cardiovascular risk factors clustering and different strata of BMI,PBF and BFMI was analyzed.Receiver Operator Characteristic(ROC) curve analysis was employed to determine the optimal cut-points for identification of cardiovascular risk factors clustering,and area under curve(AUC) was worked out.The population attributable risk proportion(PARP) of risk factors clustering was calculated. Results Odds ratios of risk factors clustering tended to increase with BMI,PBF and BFMI.BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 were the cut-off points that had approximate sensitivity and specificity,and/or had the shortest distance in ROC curve.AUC of all the three indexes was larger than 0.5.Analysis of PARP indicated that BMI under 24 kg/m2,PBF under 21% and BFMI under 5 kg/m2 could prevent 27.1%,37.44% and 36.63% risk factors clustering,respectively. Conclusion BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 can well reflect the cardiovascular risk factors clustering among elderly males.