ABSTRACT
Eleven old male patients with hyperuricemia were collected ( hyperuricemia group,65-90 years old ).10 healthy middle-aged males ( middle-aged group,30-40 years old) and 10 healthy old males ( older group 60-70 years old ) with normal blood uric acid level were used as controls.All of the subjects were given low purine content diet ( 250 mg/d ) for 3 days followed by high purine content diet ( 800 mg/d ) consecutively for another three days.The samples of fasting blood and 24 h urine were collected for assay.The results showed that there were no significant changes of serum uric acid ( UA ) concentration in three groups after low purine content diet.But the levels of serum UA in three groups all increased significantly after high purine content diet,and the change was higher in hyperuricemia group than middle-aged group [ ( 507.7 ± 108.1 vs 378.9 ± 80.1 ) μmol/L,P＜0.05 ].24 h urine uric acid excretion in three groups was all significantly decreased after low purine content diet and increased after high purine content diet.After high purine content diet,24 h urine uric acid was lower in hyperuricemia group than middle-aged group [ ( 2.99 ± 1.21 vs 3.62 ± 1.02 ) mmol/24 h,P＜0.05 ].Blood urea nitrogen levels in all subjects decreased after low purine content diet and increased after high purine content diet ( P＜0.05 or P＜0.01 ).Creatinine clearance rate in hyperuricemia group was decreased after high purine content diet compared with baseline [ (75.3 ± 20.3 vs 80.7 ±20.0) ml/min ],and there were no significant changes in other groups after low and high purine content diet.24 h urine protein in hyperuricemia group was higher than middle-aged group ( P＜0.05 ),and increased after high purine content diet with significant difference ( P＜0.05 ).These results suggest that high purine content diet and decreased by renal uric acid clearance mainly contribute to hyperuricemia in old people.
ABSTRACT
Objective To study the outcomes and influencing factors of the conversion from normal glucose tolerance -hyperinsulinemia (NCT-HINS) to diabetes in the population of a community in Beijing.Methods All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in May, 2006 and May, 2008. Data were calculated to analyze the outcomes and influencing factors of the conversion. HINS was diagnosed if fasting serum insulin & 15 mIU/L and/or 2-hour serum insulin after glucose loading ≥ 80 mIU/L Results The prevalence of NGT-HINS in the community in 2006 and 2008 was 5.28% and 8.67% (P<0.01) respectively and that of diabetes mellitus (DM) and impaired glucose regulation (IGR) was 3.52% , 6.56% in 2006 and 4.42% ,6.47% in 2008.The probability of the conversion from NGT-HINS to IGR and DM was 18.6% and 2.3% , being much higher than that from normal glucose tolerance- normoinsulinemia (NGT-NINS) (5.4% and 0.7% , P <0.01). However, the probability of the conversion from NGT-HINS to DM was 2.3% , which was much lower than that from IGR (26.3% , P <0.01). The reason might be that individuals with NGT-HINS had a higher waist circumference, BMI, fasting plasma glucose, 2 h plasma glucose and TG but a lower HDL-C than individuals with NGT-NINS in 2006. The HOMA β-cell function index/HOMA insulin resistance index (HBCI/IR) of individuals with NGT-HINS was much lower than that of individuals with NGT-NINS, but much higher than that of individuals with IGR. Logistic regression analysis showed that age, TG and HBCI/IR were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of conversion from NGT to DM was increased remarkably when HINS was diagnosed. The reason might be that individuals with NGT-HINS suffered more metabolic risk factors and had a decreased β-cell function. Therefore, individuals with NGT-HINS should be paid attention to in diabetes prevention study.
ABSTRACT
Objective To evaluate the safety of mefformin in the treatment of elderly type 2 diabetes mellitus(T2DM). Methods Two hundred and forty-three cases of elderly T2DM hospitalized from Jan.1996 to Dec. 2006 were reviewed; the changes of fasting blood glucose(FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), liver and renal function and blood lactic acid were evaluate before and after treatment. Results The mean time of treatment with mefformin was (6.6±3.9) years (3 months-21 years)in these 243 cases. The levels of FBG, PBG and HbAlc significantly reduced after treatment with mefformin only in 43 cases (17.7%), mefformin combined with other oral hypoglycemic drugs in 124 cases (51.0%) and mefformin combined with insulin in 76 cases (31.3%). There was only 18.1% of the cases with normal range ( > 80 ml/min) of creatinine clearance rate (Ccr), and 25.8% of the cases with Ccr≤50 ml/min. The liver and renal function as well as the blood lactic acid had no significant change after treatment no matter in total cases or in different groups separated by Ccr.Conclusions Mefformin is safety in the treatment of elderly T2DM patients. Ageing is not the contraindication of mefformin. To the patients with high risk, we should monitoring the level of blood lactic acid.
ABSTRACT
Objective To study the relationships between serum uric acid levels in adult male patients with the risk factors of metabolic syndrome and insulin resistance.Methods In the persons undergone health check up in General Hospital of PLA in 2006,blood pressure(BP),body mass index(BMI),waistline,total and HDL cholesterol,serum triglycerides,fasting blood glucose(FBG),serum creatine(Cr)and uric acid(SUA)concentrations were measured.To the subjects without diabetes mellitus,75g oral glucose tolerance test(75g-OGTT)was given.Comparison was made on the components of MS between high SUA group(HUA)and normal SUA group(NUA).Logistic regression analysis was made to examine the relationship between UA and the symptom components of MS.The subjects without diabetes mellitus were then divided into 4 groups according to SUA levels,and then the relationships were analyzed between the levels of symptom components and the prevalence of MS among the different SUA groups.Results The mean age of the 1399 adult males was 56.3 ? 21.0 years.Among them the patients with hyperuricemia accounted for 14.37%.The levels of BMI,waistline,triglyceride,low density lipoprotein cholesterol,FBG,post prandial blood glucose(PBG),SBP and DBP were higher in HUA than that in NUA,while the HDL-C was lower.The incidence of MS in HUA group was higher with an increased SUA level compared with that in NUA group(P
ABSTRACT
Objective To analyze the significance of the waistline (WC), body mass index (BMI) and hyperinsulinaemia (HIns) on evaluating the metabolic syndrome. Methods The data of routine clinical examination were collected from the mid-aged and senile individuals (middle-senile group) who received oral glucose tolerance test (OGTT) for diabetes screening, and from a group of subjects who received annual OGTT for diabetes screening (mature group). Data were collected by a specialized person, input into a special computer database, and then analyzed with SAS 5.0 software by specialized staffs. Abnormal WC and BMI were determined according to IDF and CDS criteria. HIns was determined if fasting insulin (FIns) ≥15mU/L and 2-hour insulin after glucose burdening (2hPIns) ≥80mU/L. Results In the middle-senile group, the abnormality frequencies of WC and HIns as well as overall insulin level were obviously higher than that in the mature young group. The abnormality frequency of BMI was higher in mature young group. A higher detection rate of HIns existed in intolerance glucose test (IGT) and normal glucose test (NGT). The coincidence of WC and BMI diagnostic criteria were 77.5% and 74.3%, respectively, on evaluating with or without obesity in the middle-senile group and mature young group. When only WC criterion was used for evaluating the existence of insulin resistance, there would be 28.2% of missed diagnosis rate for MS patients. Conclusion WC, BMI and HIns are all risk factors for abnormal glucose metabolism, hypertension and dyslipidemia. There is different prevalence among different populations. The combination of WC, BMI and HIns might be more helpful for identifying MS at early stage.
ABSTRACT
Objective To investigate the correlation of blood lipid metabolism abnormity and other components of metabolic syndrome on angiocardiopathy and cerebrovascular diseases in the elderly people. Methods The clinical data of elderly people, who underwent medical examination during 1996 to 2005 in the General Hospital of PLA, were retrospectively analyzed. Based on the analysis, the co-existence of blood lipid disorders with glucose metabolic abnormity, hypertension and obesity, as well as their influence on cardio-cerebrovascular diseases were further analyzed. Results The prevalence of blood lipid metabolic disturbance was 69.6%, in which the prevalence of hyper-cholesteremia and hyper-triglyceride were 23.6% and 21.7%, respectively. The prevalence of hyper-cholesteremia accompanied by hyper-triglyceride (mixed group) was 19.3%, that of hyper-triglyceride with lower high density lipoprotein cholesterol was 5.03%, while it was 30.4% in the normal group. There was a higher risk of having the above abnormal condition in patients with type 2 diabetes mellitus (T2DM) and obesity, and they were more frequently complicated by hypertension in the hyper-triglyceride group (70.8%). When the patients with lipid metabolic disturbance were complicated by T2DM, hypertension and obesity, the prevalence of cardiovascular or cerebrovascular diseases increased. The prevalence of CHD was higher in the patients with hyper-cholesteremia and hypertension or diabetes, and incidence of both CHD and CVD was higher in the patients with hyper-triglyceride and either one of hypertension, diabetes or obesity. Conclusion There is high prevalence of lipid metabolic disturbance (more than two thirds) and other components of metabolic syndrome, and high risk of suffering from cardiovascular or cerebrovascular diseases in elderly people. The aging patients with hyper-triglyceride are vulnerable to cardiovascular or cerebrovascular diseases, and more attention should be paid in clinical practice in future.
ABSTRACT
Objective:To study the changes of testicular steroidogenic acute regulatory protein (StAR), 17?-hydroxys-teroid dehydrogenase (17?-HSD) and aromatase (P450arom) in elder SD rats, exploring the effects of aging on testicular steroidogenic function. Methods:The young male rats and old male rats were treated with human chorionic gonadotropin (hCG) for 3 times and then rat serum testosterone(T) and estradiol(E2) levels were determined by chemiluminescentenzyme immunoassay(CLIA) and the mRNA levels of StAR, 17?-HSD Ⅲ and P450arom were determined by RT-PCR. Results: (1) The levels of serum T and 17?-HSD Ⅲ mRNA of old SD rats were significantly lower than those of young rats before and after hCG stimulation (P
ABSTRACT
Objective To investigate the prevalence of metabolic syndrome (MS) and its risk factors in the population of age between 21 to 78 years in Beijing, and to study the clinical significance of evaluation of MS and hyperinsulinaemia by the use of waist circumference and body mass index (BMI). Methods A standard questionnaire and 75g oral glucose tolerance test (OGTT) were used in the investigation. All the data, including plasma glucose (fasting blood glucose level and postprandial glucose level), blood levels of insulin, blood lipid, blood uric acid, and creatinine, as well as height, weight, waist circumference (WC), blood pressure, body mass, were determined or measured. Obesity was defined by WC and BMI value. The incidence of obesity complicated with two abnormal metabolic disorders (IDF), as well as hyperinsulinaemia in these subjects, were analyzed. Results The prevalence of obesity as determined by WC and BMI were 20.6% and 41.5%, respectively, in the said popalation of Beijing (P0.05) in subjects of obesity complicated with two other metabolic abnormality as defined by WC and BMI criteria, accounting for 1.37% and 3.13% of the whole investigated population (P
ABSTRACT
Objective To analyze the characteristics of hypertension by cross-sectional study of the aged patients with metabolic syndrome (MS). Methods The data, collected from senile population who underwent medical examination in the General Hospital of PLA in 2005, were analyzed retrospectively in order to identify the clinical features of hypertension in aged patients with MS, and the significance of hypertension, as single or one of the components of MS, the prevalence of MS, including the prevalence of MS and its component ailments, prevalence of hypertension in MS population, the constituent ratio of MS and coronary heart disease, and cerebrovascular disease in patients with hypertension. Results The prevalence of MS was 32.19%, in which 8.16% patients were having all the four metabolic abnormalities. Hypertension was the most common metabolic abnormality with a prevalence of 61.78%, which tended to increase with increasing age. The most common combination in MS was abnormalities of blood pressure, glucose and BMI, with a prevalence of 24.67%. Among the population with hypertension, 46.67% of them could be diagnosed as MS, accounting for 89.57% of all MS patients. Patients with MS but without hypertension accounted for only 10.43%. Hypertension complicated with MS or another metabolic disorder showed a high risk of cardiovascular diseases, and the prevalence was 73.52% and 72.69%, respectively. No significant difference was found in the incidence of cerebrovascular disease. The prevalence of abnormal renal function was significantly increased in the group of MS with hypertension, by 1.69 and 1.65 folds of that in the group without MS and the group only with MS and without hypertension. Conclusions There was higher prevalence of MS in the elderly people, and in about 2/3 hypertensive patients it co-existed with one of the components of MS. Hypertension was the most common disorder in MS. Patients with MS and hypertension are having a higher risk of suffering from cardiovascular diseases and abnormal renal function.