The significance and risk factor analysis of homocysteine in diabetic patients with macroangiopathy / 中华检验医学杂志

Objective To investigate the significance of serum homocysteine (HCY) level in the patients with diabetic macroangiopathy, and analyze the related risk factors.Methods Case control study.279 diabetics (male 198, female 111) aged 59.6(55.0-67.0) were selected in Shanghai Zhongshan Hospital from May 2015 to February 2016.According to the medical history and Carotid intima-media thickness, they were divided into carotid artery disease group (137 cases), cardiovascular disease group (197 cases) and cerebrovascular disease group (29 cases).We detected veinal blood HCY , fasting blood glucose, glycated albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, L-, gamma glutamyl transferase, urea nitrogen, creatinine, uric acid, cholesterol, three triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin and albumin , creatinine in urine.The groups were compared with Mann-Whitney U test and χ2 test;Pearson correlation analysis was used to determine the correlations between HCY and other indicators;logistic regression model was used to analyze the risk factors of diabetic macroangiopathy and its subclasses;ROC curve was used to analyze the diagnostic value of HCY and uric acid in diabetic macroangiopathy.Results HCY in diabetic with macroangiopathy group was significant hiher than that in diabetic without macroangiopathy group 10.40(8.50-12.48) μmol/L 9.10(7.50-10.70) μmol/L, P<0.01).The incidence of diabetic macroangiopathy (χ2=7.030, P=0.030) and carotid artery lesions (χ2=7.258, P=0.027) was different in patients with different HCY levels.The correlation coefficients of HCY with urea nitrogen, creatinine, uric acid, urinary albumin/creatinine and estimated glomerular filtration rate (eGFR) were 0.340, 0.248, 0.278, 0.133,-0.369 (P<0.05), respectively.HCY was a risk factor for diabetic macroangiopathy, carotid plaque and cardiovascular disease;HCY, age and uric acid were independent risk factors for some of the diabetic macroangiopathy (P<0.05);HCY and UA had a certain diagnostic value for diabetic macroangiopathy(P<0.05).Conclusions Serum HCY is a risk factor for diabetic macroangiopathy, and detection of HCY levels will contribute to the diagnosis and prevention of the disease.

Prognostic analysis of C5L2 in patients with hepatocellular carcinoma / 复旦学报（医学版）

Objective To investigate the prognostic value of C5L2 in patients with hepatocellular carcinoma (HCC).Methods The data of 175 patients with HCC who underwent curative resection at Zhongshan Hospital,Fudan University from Oct.,2012 to Sep.,2013 were analyzed retrospectively.The correlation between C5L2 and clinicopathologic characteristics were explored.COX regression model was used to determine the influence of clinical parameters on predicting recurrence,and the prognostic value of combined application of C5L2 and AFP were evaluated by Kaplan-Meier method.In vitro,the expression of C5L2 were tested in 5 HCC cell lines,and Hep3B and Huh7 were chosen for down-regulation and up-regulation of C5L2,respectively,the abilities of invasion and migration were examined by transwell and the potential mechanism was explored.Results The C5L2 expression was correlated to gender,tumor size and recurrence,and the recurrence rate of low C5L2 expression group was higher.Also,the multivariate analysis showed that C5L2 low expression was an independent risk factor for recurrence.Moreover,the combined application of C5L2 and AFP could estimate prognosis more effectively.Knockdown of C5L2 in Hep3B promoted the invasiveness and motility,and increased the level of β-catenin and MMP2;conversely,overexpression of C5L2 in Huh7 inhibited the invasiveness and motility,and decreased the level of β catenin and MMP2.Conclusions C5L2 could be regarded as an auxiliary indicator for prognosis of HCC,thereby the evaluation of C5L2 could help with making effective and comprehensive management for HCC patients.

Research on the association between sex hormone binding globulin and the risk of developing cardiovascular diseases in community elderly population / 复旦学报（医学版）

Objective To explore the correlation between sex hormone binding globulin (SHBG) and cardiovascular disease (CVD) in community elderly population.Methods In 2014,1916 elderly people (796 males,and 1 120 females) were selected from Baoshan District Friendship Community,Shanghai.We collected basic epidemiological data and fasting venous blood samples to carry out the detection of biomarkers,and then calculated their ten-year Framingham risk score.In this study,obesity,systolic blood pressure,fasting blood glucose,lipid concentration,and high-sensitive C-reactive protein were considered as CVD risk factors;Framingham risk score was considered as a CVD event prediction risk score.We analyzed the correlations of these factors with SHBG.Results SHBG mean values in the population with a history of CVD were lower than those without a history of CVD (P＜0.001).The correlation coefficient between male SHBG and waist circumference,hip circumference,BMI,systolic pressure,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high sensitive C-reactive protein were-0.312,-0.307,-0.266,-0.113,0.155,-0.277,0.510,0.394 and-0.130,respectively (P＜0.01).The correlation coefficient between female SHBG and waist circumference,hip circumference,BMI,fasting glucose,cholesterol,triglycerides,high density lipoprotein cholesterol,apolipoprotein A,high-sensitive C-reactive protein were-0.236,-0.248,-0.168,-0.183,0.135,-0.264,0.445,0.358 and-0.295,respectively (P＜0.001).The decrease of SHBG level was consistent with the increase of Framingham score (κ =0.062,P＜0.001).Elevated level of SHBG would reduce the risk of CVD in ten years (P＜0.01).Conclusions There was a negative correlation between baseline SHBG level and CVD risk factors,positive correlation between baseline SHBG level and CVD protection factors in community elderly population;lower SHBG level indicated higher risk of developing CVD events.

Serum small dense low-density lipoprotein cholesterol and performance evaluation of commercial detection kits and its relationship with the severity of coronary heart disease / 中华检验医学杂志

Objective To evaluate the performance of serum small dense low-density lipoprotein cholesterol(sdLDL-C)kit using enzymic method and evaluate the relationship with the severity of coronary heart disease.Methods Performance verification methodology. The analytical performance consisted of accuracy, precision and linearity of serum sdLDL-C kit using enzymic method was assessed. One hundred and twenty healthy persons were recruited to establish serum sdLDL-C reference interval. Two hundred and twelve patients underwent coronary angiography were enrolled in the study.Among them 110 cases were positive for coronary angiography, where as 102 cases were negative. We examined serum levels of sdLDL-C in 110 patients with positive angiography, 102 patients with negative angiography and 120 healthy volunteers. Positive group was classfied into severe group(Gensini score>30) and mild group (Gensini score≤30).Results The accuracy and precision of sdLDL-C examination were in compliance with manufacturer′s statement and there was a good linear correlation(Y=0.9937X-0.1063,R2=0.99) in range of 0.06-2.45 mmol/L. The reference interval of sdLDL-C was 0.15-0.97 mmol/L and without gender and age specificity. The level of sdLDL-C was higher in positive angiography group than in negative angiography group and healthy control group(P<0.01). The level of sdLDL-C was higher in severe group than in mild group(P<0.05). Binary stepwise regression analysis demonstrated that sdLDL-C was independently associated with the severity of coronary heart disease(OR=3.101,P<0.05).ConclusionsExperiment data demonstrated that serum sdLDL-C kit using enzymic method has good performance in the accuracy, precision and linearity. SdLDL-C that plays an important role in the occurrence and progression of coronary heart disease, is an independent important risk of the severity of coronary heart disease.

Relationship between Plasma Total Homocysteine and Carotid Atherosclerosis in Hypertentive Patients / 中国康复理论与实践

@#Objective To investigate the level of plasma total homocysteine(Hcy),the carotid intima-media thickness(IMT)and relationship of the plasma Hcy and carotid atherosclerosis in hypertensive patients.Methods Sixty patients with hypertension and sixty health controls were measured for carotid IMT and the level of plasma total Hcy.Results The level of plasma total Hcy and the carotid IMT in hypertensive patients increased significantly compared with that of the controls.The level of plasma total Hcy increased with the severity of the carotid plaque.The carotid IMT was correlated with age,cholesterol,low-density cholesterol,systolic blood pressure(P<0.05 or P<0.01).Conclusion The average carotid IMT is correlated with the level of plasma Hcy in hypertensive patients;the level of plasma total Hcy,age,cholesterol,low-density cholesterol,systolic blood pressure are the important risk factors of carotid atherosclerosis.

Heart Rate Variability in Senile Coronary Artery Disease Complicated with Depression and Anxiety / 中国康复理论与实践

@#Objective To investigate heart rate variability(HRV)of senile unstable angina patients complicated with depression and anxiety.Methods 39 senile unstable angina patients with depression and anxiety were selected as the A group,51 patients without depression and anxiety as B group.Their Holter reports(supervision)of two groups were analyzed.Results The SNDD,RMSSD,PNN50 in A group decreased compared with those in B group(P<0.05).The incidence of ventricular arrhythmias,ischemic ST segment depression and HRV in A group was higher than those in B group(P<0.05).Conclusion The senile unstable angina patients with depression and anxiety tend to have more ventricular arrhythmias,ischemic ST segment depression and less HRV.