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BackgroundPatients with schizophrenia are at high risk of suffering from metabolic syndrome. Most previous studies on the influencing factors of metabolic syndrome focused on the inpatients and limited ones on patients dwelling in community. ObjectiveTo explore the influencing factors at different risk levels of metabolic syndrome in community-dwelling patients with schizophrenia in Guangzhou， so as to provide references for future interventions on metabolic syndrome in this patient population. MethodsIn November 2021， 3 339 patients with schizophrenia who were registered in and administered by Guangzhou Mental Health Information System were included. All these patients had finished the physical examination in 2020， and whether they had metabolic syndrome was assessed basing on Guideline for the prevention and treatment of type 2 diabetes mellitus in China （2020 edition）. Patients were divided into high-risk group （n=423）， critical group （n=1 524） and metabolic syndrome group （n=1 392） according to the Chinese expert consensus on the management of metabolic syndrome in patients with schizophrenia. Multiple logistic regression analysis were performed on the risk factors of metabolic syndrome in community-dwelling patients with schizophrenia. ResultsThe prevalence rate of metabolic syndrome in community-dwelling patients with schizophrenia was 41.69%. Univariate analysis showed that the results in gender （χ2=44.610）， age （χ2=55.992）， marriage status （χ2=30.755）， illness course （χ2=25.913） and body mass index （χ2=829.265） were significantly different among the three groups （P<0.01）. Kruskal-Wallis H test showed that the levels of waist circumference （H=920.331）， systolic blood pressure （H=436.673）， diastolic blood pressure （H=393.337）， fasting blood glucose （H=807.304）， triglyceride （H=1 134.125） and high-density lipoprotein cholesterol （H=593.615） among the three groups were significantly different （P<0.01）. Logistic regression analysis showed that age ≥50 （OR=1.761， 95% CI： 1.087~2.853）， overweight （OR=2.418， 95% CI： 1.862~3.140） and obesity （OR=57.903， 95% CI： 14.340~233.802） were risk factors contributing to high-risk patients becoming critical population （P<0.05 or 0.01）. Female gender （OR=1.295， 95% CI： 1.034~1.622）， aged 40~49 （OR=2.597， 95% CI： 1.582~4.263）， age ≥50 （OR=4.392， 95% CI： 2.609~7.395）， overweight （OR=7.844， 95% CI： 6.018~10.223） and obesity （OR=426.785， 95% CI： 105.724~1 722.839） were risk factors for high-risk patients developing into metabolic syndrome population （P<0.05 or 0.01）. ConclusionThe prevalence rate of metabolic syndrome is higher in community-dwelling patients with schizophrenia. Female gender， older age， overweight and obesity would increase the risk of metabolic syndrome in schizophrenic patients. ［Funded by Health Science and Technology Project in Guangzhou （number， 20221A010028）］
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Objective To evaluate the role of reactive oxygen species (ROS) in emulsified isoflurane postconditioning-induced activation of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway in rat cardiomyocytes.Methods Primarily cultured cardiomyocytes of rats were divided into 4 groups (n =20 each) using a random number table:control group (group C),hypoxia/reoxygenation (H/R) group,emulsified isoflurane postconditioning group (group EIP),and emulsified isoflurane postconditioning plus ROS scavenger N-2-mercaptopropionyl glycine (MPG) group (group EIP+MPG).Cardiomyocytes were exposed to the mixed air to establish the cardiomyocyte H/R damage model.Emulsified isoflurane (final concentration 1.68 mmol/L) was added at 45 min of hypoxia,and the cells were incubated for 5 min followed by restoration of oxygen supply for 60 min in group EIP.In group EIP+MPG,MPG (final concentration 2 mmol/L) was added at 5 min of incubation with emulsified isoflurane,the cells were incubated for 10 min,and the other treatments were similar to those previously described in group EIP.At the end of reoxygenation,the ultrastructure of cardiomyocytes was observed,and the damage to mitochondria was evaluated and scored,the intracellular free Ca2+ level and Nrf2 activity were measured,and the expression of Nrf2,heme oxygenase-1 (HO-1),superoxide dismutase 1 (SOD1) and quinine oxidoreductase 1 (NQO1) protein and mRNA was detected using real-time polymerase chain reaction and Western blot.Results Compared with group C,the mitochondrial damage score and intracellular free Ca2+ level were significantly increased,the Nrf2 activity was enhanced,and the expression of Nrf2,HO-1,SOD1 and NQO1 protein and mRNA was down-regulated in the other three groups (P＜0.05).Compared with group H/R,the mitochondrial damage score and intracellular free Ca2+ level were significantly decreased,the Nrf2 activity was enhanced,and the expression of Nrf2,HO-1,SOD1 and NQO1 protein and mRNA was up-regulated in group EIP and group EIP+MPG (P＜0.05).Compared with group EIP,the mitochondrial damage score and intracellular free Ca2+ level were significantly increased,the Nrf2 activity was weakened,and the expression of Nrf2,HO-1,SOD1 and NQO1 protein and mRNA was down-regulated in group EIP+MPG (P＜0.05).Conclusion The mechanism by which emulsified isoflurane postconditioning activates Nrf2/ARE signaling pathway may be related to ROS in rat cardiomyocytes.