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Objective To identify the risk factors of new-onset hypertriglyceridemia (HTG) in kidney transplant recipients. Methods Clinical data of 149 kidney transplant recipients were retrospectively analyzed. According to serum triglyceride (TG) level after operation, they were divided into the non-HTG group (TG≤1.7 mmol/L, n=60) and new-onset HTG group (TG>1.7 mmol/L, n=89). Baseline data of all recipients were compared between two groups. The risk factors of HTG in kidney transplant recipients were analyzed by generalized estimating equation (GEE), and validated by multiple regression equations. Results No significant differences were observed in baseline data between two groups (all P>0.05). Multivariate analysis showed that the incidence of HTG in the middle and high tacrolimus (Tac) concentration groups was higher than that in the low Tac concentration group [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.22-7.93, P=0.018 in the middle Tac concentration group; OR 5.11, 95%CI 1.31-19.98, P=0.019 in the high Tac concentration group]. Compared with type-A blood recipients, the risk of new-onset HTG was significantly increased in type-O blood counterparts (OR 2.77, 95%CI 1.14-6.71, P=0.024). The risk of new-onset HTG was decreased along with the increase of preoperative globulin level (OR 0.93, 95%CI 0.87-0.99, P=0.043). At postoperative 3 months, Tac blood concentration in the new-onset HTG group was significantly higher compared with that in the non-HTG group, and significant difference was observed (P<0.05). Multiple regression equations confirmed that the risk of new-onset HTG in type-O blood kidney transplant recipients was higher than that in type-A blood counterparts, and the risk of new-onset HTG in the middle and high Tac concentration groups was higher than that in the low Tac concentration group (all P<0.05). Conclusions Type-O blood kidney transplant recipients are more prone to HTG. It is necessary to strengthen postoperative monitoring and control of blood lipids. The blood concentration of Tac probably affects the new-onset HTG in kidney transplant recipients. Maintaining an appropriate blood concentration of Tac may be beneficial to lowering the risk of HTG.
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Objective:To explore the application value of real-time three-dimensional echocardiography (RT-3DE) in evaluating the characteristics and regularities of left atrial volume and function changes in patients with hyperthyroidism and hyperthyroid heart disease.Methods:Fifty-six patients who were diagnosed with hyperthyroidism and hyperthyroid heart disease without treatments in Henan Provincial People′s Hospital from March 2020 to September 2020 were selected. They were divided into hyperthyroidism group(30 patients) and hyperthyroid heart disease group (26 patients). Another 30 healthy volunteers were selected as the control group. The following parameters were obtained by RT-3DE left atrial automatic quantification technology, left atrial minimum, maximum, presystolic volume index(LAVImin, LAVImax, LAVIpreA), left atrial passive, active emptying volume index and stroke volume index (LAVIp, LAVIa, LAVIEV), left atrial passive, active, total ejection fraction(LApEF, LAaEF, LAEF), during left ventricular systole, early diastole, late diastole left atrial longitudinal strain (LASr, LAScd, LASct) and circumferential strain (LASr-c, LAScd-c, LASct-c). The differences of the above parameters between the two groups were compared.Results:Compared with the control group, LAVImax, LAVIpreA, LAaEF, LAVIEV, LAVIa, LASr, LASct-c increased and LApEF decreased in the hyperthyroidism group (all P<0.05). While, LAVImin, LAVImax, LAVIpreA and LAVIEV increased, and LAaEF, LApEF, LAEF, LASct, LAScd-c and LASr-c decreased in hyperthyroid heart disease group(all P<0.05). Compared with the hyperthyroidism group, LAVImin, LAVImax and LAVIpreA in hyperthyroid heart disease group were further increased, while LAEF, LAaEF, LASr, LASr-c, LASct, LASct-c and LAScd-c were decreased (all P<0.05). LAEF were positively correlated with LASr and LASr-c ( r=0.617, 0.837; all P<0.01), LApEF were positively correlated with LAScd and LAScd-c ( r=0.620, 0.800, all P<0.01), LAaEF were positively correlated with LASct and LASct-c ( r=0.680, 0.727; all P<0.01). Conclusions:In the patients with hyperthyroidism, the left atrial reserve and systolic function are increased, which are still in the compensation stage, and the pipeline function is decreased. The left atrial reserve, pipeline and systolic function in the hyperthyroid heart disease patients are all decreased, and the pipeline function may be impaired earlier than the systolic and reserve function.
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Objective:To evaluate the carotid artery elasticity in severely abdominal obese children by RF-data based quantitative analysis on vessel stiffness (R-VQS), and explore the correlation between visceral fat distribution and carotid artery elasticity.Methods:Seventy severely abdominal obese children aged 7-14 years old and 55 healthy children with normal body mass index were selected as obese group and control group in Children′s Hospital Affiliated to Zhengzhou University from July 2018 to July 2019. Epicardial fat thickness (EFT), visceral fat thickness (VFT), subcutaneous fat thickness (SFT), maximum preperitoneal fat thickness (PFTmax), minimum subcutaneous fat thickness (SFTmin), perirenal fat thickness (PRFT) were measured by ultrasound. Real-time intima-media thickness (RIMT) and R-VQS were employed to evaluate common carotid intima-media thickness (IMT), systolic diameter (Diam), distance (Dist), pulse wave velocity (PWV) and hardness coefficient (HC). The correlation between fat thickness and carotid artery elasticity was analyzed.Results:There were statistically differences of common carotid IMT, elasticity parameters (IMT, Diam, Dist, PWV, HC) and fat thickness (EFT, VFT, SFT, PFTmax, SFTmin, PRFT) between two groups ( P<0.05). In obese children, PFTmax, VFT, EFT, PRFT were positively correlated with IMT, PWV, and HC (with IMT: r=0.334, 0.425, 0.415, 0.370, P<0.05; with PWV: r=0.853, 0.744, 0.590, 0.358, P<0.05; with HC: r=0.822, 0.691, 0.526, 0.320, P<0.05), and there was no correlation between SFT, SFTmin and IMT, PWV, HC( P>0.05). The degree of correlations between visceral fat thickness and carotid artery elasticity was PFTmax>VFT>EFT>PRFT, however, the correlations between EFT, PRFT and carotid elastic elasticity were weak ( r<0.7). Conclusions:R-VQS can sensitively reflect the carotid artery elasticity in severely abdominal obese children, and it can be used as an important reference indicator for early evaluation of atherosclerosis in obese children. Their visceral fat thickness (EFT, PRFT, VFT and PFTmax) have a good correlation with carotid artery elasticity, among which PFTmax has the best correlation and shows a certain clinical significance for the treatment and follow-up of obese children.
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Objective To assess the clinical significance of QT interval dispersion (QTd) in the diagnosis and prognosis of early heart damage in patients with severe acute pancreatitis.Methods All patients received complete ECG,There were 58 patients with SAP (the SAP group) and 189 patients with mild acute pancreatitis (the control group).These patients were analyzed retrospectively and 60 normal people were used as the healthy control group.The QT interval were measured respectively in serial 12-lead electrocardiogram and QTd,QTcd were calculated.Result QTd and QTcd were significantly longer in the SAP group than in the MAP group and in the healthy control group (P＜0.01).QTd,QTcd were not remarkably extended in the MAP group than in the healthy control group (P＞0.05).Conclusions QTd and QTcd have clinical values to diagnose and to predict early heart damage in patients with SAP.They might be useful in evaluating the condition of cardiac function in patients with SAP.