Latest progress: study on intestinal microecology and sarcopenia / 中华老年医学杂志

Sarcopenia causes significant changes inskeletal muscle mass and function in the elderly, and leads to an increased incidence of related diseases, which has affected the quality of life in the elderly.The causes and mechanisms of sarcopenia are closely related to genetic and innate factors, endocrine disorders, reduced number of muscle fibers, nutritional deficiency, inflammation, immune dysfunction and other factors.This paper systematically describes the progress of studying the effects of intestinal microecology on sarcopenia, so as to provide potential targets for the prevention and treatment of sarcopenia.

Study on the changes in intestinal phylum firmicutes in elderly patients with type 2 diabetes / 中华老年医学杂志

Objectives To compare the differences in intestinal phylum firmicutes between elderly patients with type 2 diabetes (T2DM)and the healthy elder people.Methods 37 elderly patients with T2DM and 69 healthy controls in Shaoxin city were recruited.DNA of phylum firmicutes from fecal samples was extracted.The real-time quantitative PCR was used with special primers for bacterial genus including Faecalibacterium prausnitzii,Eubacterium rectale,Clostridium leptum,and Peptostrepyococc.The differences in content of different bacteria between two groups were analyzed and compared.Results In healthy elderly group versus the elder patient with T2DM,the contents of intestinal phylum firmicutes were[(6.22±1.41) × 107 versus(5.41± 1.40) × 107,t=2.83,P=0.006] in Eubacterium rectale,[(7.46 ± 0.98) × 107 versus (6.96 ± 1.40) × 107),t =2.13,P =0.036] in Faecali bacterium prausnitzii,[(7.89±0.89) × 107 versus(7.46±1.11) × 107,t=2.15,P=0.034]in Clostridium leptum,and[(4.86 ± 1.33) × 107 versus (4.21 ± 1.24) × 107,t=2.45,P =0.016] in Peptostrepyococc,which showed that the contents of intestinal phylum firmicutes were less in T2DM group than in healthy elderly group.Conclusions There are some differences in intestinal flora between the elderly patients with T2DM and healthy people.These intestinal flora may play an important role in the development of T2DM.This study may provide new evidences for probiotic treatment of T2DM.

Relationship between the prothrombotic state and leukoaraiosis in elderly patients with metabolic syndrome / 中华老年医学杂志

Objective To investigate the relationship between the prothrombotic state and leukoaraiosis(LA)in elderly patients with metabolic syndrome.Methods A total of 350 metabolic syndrome patients in the affiliated hospital of Zhejiang University who received treatment from January 2013 to January 2015.According to the results of head MRI,patients were divided into LA group(n=203)and non-LA group(n=147).The severity of LA was graded by its MRI appearance and the Blennow scale.The plasma levels of fibrinogen (Fib),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time(APTT),D-dimer (D-D) and yon willebrand factor (vWF) were measured and compared between the two groups.Results The levels of Fib,vWF and D-D were higher in LA group than in non-LA group(all P＜0.05).Spearman correlation analysis showed that the severity of leukoaraiosis was positively correlated with Fib,vWF and D-D(r=0.014,0.089,0.215,respectively,all P ＜ 0.05).Multivariate linear regression analysis showed that Fib,course of hypertension,vWF and HbA1c were the main influencing factors with the standardized regression coefficient of 2.516,0.312,0.206 and 0.167 respectively for leukoaraiosis in elderly patients with metabolic syndrome.Conclusions The course of hypertension and HbAlc level are positively related with LA.The prothrombotic state markers including Fib and vWF can be considered as the predictors for LA severity in elderly patients with metabolic syndrome.

Gliquidone versus metformin: differential effects on aorta in streptozotocin induced diabetic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetic cardiovascular complication is a major cause of mortality in type 2 diabetic patients. Hyperglycemia markedly increases the risk of cardiovascular disease. Endothelial dysfunction is common in type 2 diabetes mellitus (DM) and is an early indicator of diabetic vascular disease. Therefore, it is necessary to identify the effect of different hypoglycemic agents on vascular endothelium. The aim of the study was to examine and compare the effects of metformin and gliquidone on atherosclerotic lesions in streptozotocin-induced diabetic rats.</p><p><b>METHODS</b>Forty male Sprague-Dawley rats (age, 8 weeks; weight, 180-200 g) were included in this study and fed with a normal chow diet for 1 week. Rats (n = 10) served as the normal control group (NC group) were fed with a normal chow for another 2 weeks and received an injection of saline. The rest 30 rats fed with a high-fat diet for 2 weeks and injected streptozotocin were randomly assigned to three groups (n = 10 rats per group) as follow: type 2 DM group (DM group), DM + gliquidone group (GLI group) and DM + metformin group (MET group). Five weeks later, all rats were fasted overnight and taken tail blood samples for biochemical determinations. Then rats in the NC and DM groups were administrated with normal saline, while rats in the MET and GLI groups were administrated with metformin (100 mg/kg) or gliquidone (10 mg/kg), respectively. All medicines were given via intragastric administration for 8 weeks. After 16 weeks, plasma triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were measured. The aortic arch was isolated from diabetic rats and was assessed by pathological sectioning using H&E staining.</p><p><b>RESULTS</b>Metformin treatment prevented weight gain ((315.80 ± 52.16) g vs. (318.70 ± 68.48) g, P = 0.773), improved plasma TG, HDL-C and LDL-C levels (P = 0.006, 0.003, 0.001, respectively, all P < 0.05). However, gliquidone showed no significant effects on plasma TG and TC levels (P = 0.819, 0.053, respectively). LDL-C and HDL-C in the GLI group changed ((0.46 ± 0.10) mmol/L vs. (0.36 ± 0.14) mmol/L, P = 0.007; (0.99 ± 0.27) mmol/L vs. (1.11 ± 0.18) mmol/L, P = 0.049). Both metformin and gliquidone treatment lowered blood glucose levels (P = 0.001, 0.004, respectively, P < 0.05). Under light microscopy, no changes were observed in the aortic wall structure of each layer; the intima was smooth and the membrane elastic fibers were normal in the NC group. In the DM group, the aortic wall structure was unclear, the intima was thickened with irregular intima, and membrane elastic fibers collapsed. The aortic intima in the MET and GLI groups was smoother compared with the DM group, but the endothelial structure of the MET group was closer to that of the NC group.</p><p><b>CONCLUSIONS</b>Both metformin and gliquidone have anti-atherosclerotic effects. But the endothelial structure of the MET group was closer to that of the NC group. Metformin and gliquidone therapy can reduce serum level of LDL-C and increase level of HDL-C, whereas gliquidone therapy did not lose weight and decrease serum level of TG. These data may have important implications for the treatment of patients with type 2 DM.</p>

Initial investigation of magnetic resonance perfusion-weighted imaging in leukoaraiosis / 中华老年医学杂志

Objective To investigate whether perfusion-weighted imaging (PWI) can be used to evaluate blood perfusion of patients with leukoaraiosis (LA), its relationship to clinical features, and the therapy effect of LA. Methods The 44 patients with LA were recruited in the study. All the subjects were examined with both conventional and dynamic susceptibility contrast-enhanced perfusion MR imaging, 13 of them repeated the examinations after the treatment. The shapes and sizes of the biggest lesions in each patient were confirmed by conventional MR imaging, then the values of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and relative mean transit time (rMTT) in each lesion were calculated respectively. Furtherly, a Pearson's correlation analysis was performed to show whether these values were correlated with mini-mental state examination (MMSE)scores or activities of daily living (ADL) scores. Results The 44 lesions of all the subjects showed significant decreases in rCBV (0. 797 ± 0. 160) and rCBF (0. 779± 0. 164) but increase in rMTT (1. 029±0. 073). There were positive correlations between rCBV and MMSE (r = 0. 524, P =0. 000), between rCBV and ADL (r=0. 621, P=0. 000), between rCBF and MMSE (r=0. 555, P=0. 000), and between rCBF and ADL (r= 0. 690, P= 0. 000), and negative correlations between rMTTand MMSE (r=-0.307, P=0.043), and between rMTT and ADL (r=-0.434, P=0. 003). The blood perfusion was enhanced in 10 out of 13 patients who received the repeated examinations after the treatment, most of whom showed the improvement of clinical symptoms.Conclusions Perfusion MR imaging can assess hemodynamic alterations in LA, which could reflect the clinical symptoms. Moreover, the changes of blood perfusions can be used to evaluate and monitor the therapy effect of LA.