Investigation of Daily Glucose Profile of Inpatients in Non-endocrinology Departments in Chinese Population.

Background: Inpatient hyperglycemia is associated with poor prognosis and increased hospitalization expenses. China has a large population of inpatients with hyperglycemia, but their glucose monitoring states (including preprandial, postprandial and bedtime glucose) are unknown, especially in non-endocrinology departments. Methods: In this cross-sectional study, 5,790 patients with hyperglycemia from 31 non-endocrinology departments were enrolled, and a total of 1,22,032 point-of-care blood glucose (POC-BG) records were collected. The "patient-day" unit of measure was used as a metric for the inpatient glucose. A total of 2,763 patients from endocrinology wards were included for the comparison of the improvement of glycemic management during hospitalization in non-endocrinology wards. Results: A total of 61.16% of patient-days had <4 POC-BG tests. Postprandial POC-BG was tested significantly less frequently than preprandial POC-BG (10.60% vs. 58.85% of all records, P < 0.001). The patient-day-weighted mean BG was higher in non-ICU wards than in the ICU (9.72 ± 3.37 vs. 9.00 ± 3.19 mmol/L, P < 0.001). The rate of hyperglycemia (BG >10 mmol/L) was 37.60% in all non-endocrinology wards (ICU vs. non-ICU: 33.19% vs. 39.17%, P < 0.001). In non-ICU wards, the rate of hyperglycemia (BG >10 mmol/L) was significantly higher in surgical wards than in medical wards (40.30% vs. 36.90%, P < 0.001). ICU had a significantly higher rate of achieving the blood glucose target than the non-ICU wards (32.50% vs. 26.38%, P < 0.001). In the non-ICU departments, medical wards had higher rate of achieving the blood glucose target than surgical wards (39.70% vs. 19.08%, P < 0.001). With increasing days of hospitalization, there was no improvement in glycemic control in non-endocrinology wards. The ICU had a significantly higher rate of hypoglycemia than non-ICU wards (4.62% vs. 3.73%, P < 0.05). In non-ICU wards, medical wards had a significantly higher rate of hypoglycemia than surgical wards (5.71% vs. 2.75%, P < 0.05). Conclusions: Both the frequency of BG monitoring and the daily glucose profile of inpatients in Chinese non-endocrinology departments were less than ideal and need to be urgently improved.

Postprandial Blood Glucose Outweighs Fasting Blood Glucose and HbA1c in screening Coronary Heart Disease.

The objective of the present study is to assess the performance of fasting blood glucose (FBG), postprandial blood glucose (PBG), and glycated hemoglobin (HbA1c) as screening for coronary heart disease (CHD) in an inpatient population undergoing coronary angiography. 1852 consecutive patients scheduled for coronary angiography were classified into Normal Glucose Tolerance (NGT), Impaired Glucose Regulation (IGR), and diabetes, based on FBG, PBG, and HbA1c. Correlations of Gensini score with glucose metabolism and insulin resistance were analyzed. The associations between glycemic variables and Gensini score or the presence of CHD were analyzed by multiple linear regression and logistic regression, respectively. CHD was diagnosed in 488, 622, and 414 patients with NGT, IGR, and diabetes, respectively. Gensini score was positively correlated with FBG (r = 0.09, p < 0.01), PBG (r = 0.20, p < 0.01), and HbA1c (r = 0.19, p < 0.01). Gensini score was not correlated with fasting insulin (r = -0.081, p = 0.36), post-prandial insulin (r = -0.02, p = 0.61), or HOMAIR (r = -0.0059, p = 0.13). When FBG, PBG and HbA1c were pooled altogether, only PBG persisted in its association with Gensini score and the prevalence of CHD. The severity of CHD was associated with glucose rather than insulin resistance in this Chinese population. PBG was optimally correlated with the presence and severity of CHD.

Serum-Free Thyroxine Levels Were Associated with Pulmonary Hypertension and Pulmonary Artery Systolic Pressure in Euthyroid Patients with Coronary Artery Disease.

The aim of this study was to evaluate the association between thyroid hormone levels, pulmonary hypertension (PH), and pulmonary artery systolic pressure (PASP) in euthyroid patients with coronary artery disease (CAD). A cross-sectional study was conducted in individuals who underwent coronary angiography and were diagnosed as CAD from March 2013 to November 2013. 811 subjects (185 women and 626 men) were included in this study. PASP was measured by transthoracic Doppler echocardiography. 86 patients were diagnosed as PH and had significantly higher free thyroxine (FT4) levels than those without PH. Multiple logistic regression analysis demonstrated an independent association of FT4 levels with PH after adjustment of gender, age, body mass index, systolic blood pressure, left ventricular ejection fraction, hypertension, and medication use of calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, and nitrates. Serum-free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) were not associated with PH. Furthermore, multivariate linear regression analysis showed that FT4 levels emerged as an independent predictor for PASP, while FT3 and TSH levels were not associated with PASP. Our study demonstrated that, in euthyroid patients with CAD, FT4 was an independent risk factor for PH, and FT4 levels were independently associated with PASP.

Effect of Metabolic Syndrome Score, Metabolic Syndrome, and Its Individual Components on the Prevalence and Severity of Angiographic Coronary Artery Disease.

BACKGROUND: The clinical significance of metabolic syndrome (MS) score, MS, and its individual components with respect to risk prediction of coronary artery disease (CAD) remains unclear. The objective of this study was to investigate whether and to what extent MS score, MS, and its individual components were related to the risk of CAD. METHODS: Among 1191 participants who underwent coronary angiography for the confirmation of suspected myocardial ischemia, 858 were included in this study according to the inclusion criteria from September 2010 to June 2013. MS was diagnosed with the 2005 National Cholesterol Education Program Adult Treatment Panel III criteria. The severity of coronary atherosclerosis was assessed by Gensini score. RESULTS: The results showed that the age- and sex-adjusted odds ratios (OR s) for CAD were as follows: MS score, 1.327; MS, 2.013; elevated waist circumference, 1.447; reduced high-density lipoprotein cholesterol, 1.654; and elevated fasting glucose, 1.782; all P < 0.05; whereas for elevated triglycerides, 1.324, and elevated blood pressure, 1.342, both P > 0.05. After multivariate adjustment, results showed that only MS and elevated fasting glucose were significantly associated with CAD (OR, 1.628, 95% confidence interval [CI], 1.151-2.305, P = 0.006 for elevated fasting glucose, and OR, 1.631, 95% CI, 1.208-2.203, P = 0.001 for MS). The study showed that only MS score and elevated fasting glucose were significantly associated with Gensini score (standardized coefficient, 0.101, P = 0.031 for elevated fasting glucose and standardized coefficient, 0.103, P = 0.009 for MS score). CONCLUSIONS: The present study demonstrated that MS score, MS, and its individual components might have different contributions to CAD prevalence and severity. MS and elevated fasting glucose were independent risk factors for the prevalence of angiographic CAD whereas MS score and elevated fasting glucose were significantly associated with the severity of CAD.

Development of PVDF Membrane Nanocomposites via Various Functionalization Approaches for Environmental Applications.

Membranes are finding wide applications in various fields spanning biological, water, and energy areas. Synthesis of membranes to provide tunable flux, metal sorption, and catalysis has been done through pore functionalization of microfiltration (MF) type membranes with responsive behavior. This methodology provides an opportunity to improve synthetic membrane performance via polymer fabrication and surface modification. By optimizing the polymer coagulation conditions in phase inversion fabrication, spongy polyvinylidene fluoride (PVDF) membranes with high porosity and large internal pore volume were created in lab and full scale. This robust membrane shows a promising mechanical strength as well as high capacity for loading of adsorptive and catalytic materials. By applying surface modification techniques, synthetic membranes with different functionality (carboxyl, amine, and nanoparticle-based) were obtained. These functionalities provide an opportunity to fine-tune the membrane surface properties such as charge and reactivity. The incorporation of stimuli-responsive acrylic polymers (polyacrylic acid or sodium polyacrylate) in membrane pores also results in tunable pore size and ion-exchange capacity. This provides the added benefits of adjustable membrane permeability and metal capture efficiency. The equilibrium and dynamic binding capacity of these functionalized spongy membranes were studied via calcium ion-exchange. Iron/palladium catalytic nanoparticles were immobilized in the polymer matrix in order to perform the challenging degradation of the environmental pollutant trichloroethylene (TCE).

Engineered Iron/Iron Oxide Functionalized Membranes for Selenium and Other Toxic Metal Removal from Power Plant Scrubber Water.

The remediation of toxic metals from water with high concentrations of salt has been an emerging area for membrane separation. Cost-effective nanomaterials such as iron and iron oxide nanoparticles have been widely used in reductive and oxidative degradation of toxic organics. Similar procedures can be used for redox transformations of metal species (e.g. metal oxyanions to elemental metal), and/or adsorption of species on iron oxide surface. In this study, iron-functionalized membranes were developed for reduction and adsorption of selenium from coal-fired power plant scrubber water. Iron-functionalized membranes have advantages over iron suspension as the membrane prevents particle aggregation and dissolution. Both lab-scale and full-scale membranes were prepared first by coating polyvinylidene fluoride (PVDF) membranes with polyacrylic acid (PAA), followed by ion exchange of ferrous ions and subsequent reduction to zero-valent iron nanoparticles. Water permeability of membrane decreased as the percent PAA functionalization increased, and the highest ion exchange capacity (IEC) was obtained at 20% PAA with highly pH responsive pores. Although high concentrations of sulfate and chloride in scrubber water decreased the reaction rate of selenium reduction, this was shown to be overcome by integration of nanofiltration (NF) and iron-functionalized membranes, and selenium concentration below 10 µg/L was achieved.

Thyroid Function, Prevalent Coronary Heart Disease, and Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography.

This study investigated if free T4 and TSH concentrations or thyroid function categories were associated with prevalent CHD and the severity of coronary atherosclerosis in a population undergoing coronary angiography. This was a cross-sectional study including 1799 patients who were consecutively admitted and underwent coronary angiography. We evaluated the severity of coronary atherosclerosis using Gensini score. In the entire study population, free T4 level was inversely associated with prevalent CHD (OR = 0.95, 95% CI 0.91-0.99, P = 0.01) and the natural log-transformed Gensini score (ln(Gensini score)) (ß = -0.03, 95% CI -0.05--0.01, P = 0.005). The odds of CHD increased gradually across hyperthyroidism, subclinical hypothyroidism, and overt hypothyroidism groups using the euthyroid group as the reference, and the trend is borderline significant (P for trend = 0.051). When comparing to the euthyroid group, ln(Gensini score) of the overt hypothyroidism group was significantly higher (P = 0.009), but the trend was not significant (P for trend = 0.08). A significant association of thyroid function with CHD or ln(Gensini score) in euthyroid patients was not observed. The present study demonstrated an association of thyroid function with prevalent CHD and the severity of coronary atherosclerosis in a population undergoing coronary angiography. However, this association was not observed in euthyroid individuals.

Fasting plasma glucose correlates with angiographic coronary artery disease prevalence and severity in Chinese patients without known diabetes.

Type 2 diabetes mellitus is a risk factor for coronary artery disease (CAD). While there is a clear association of fasting plasma glucose (FPG) with microvascular complications, the risk for CAD conferred by FPG is relatively less clear. Therefore, we investigate the association between different FPG and the prevalence and severity of angiographic CAD in high-risk Chinese patients without known diabetes. Among 1,419 subjects who were to undergo coronary angiography for the confirmation of suspected myocardial ischemia, 906 subjects without known diabetes were included in this study and categorized into four groups according to the level of FPG: group 1, ≤5.5 mmol/l; group 2, 5.6-6.0 mmol/l; group 3, 6.1-6.9 mmol/l; and group 4, ≥7.0 mmol/l. Significant angiographic CAD was defined as ≥50 % lumen diameter reduction in at least one major coronary artery in a given subject. The severity and extent of coronary atherosclerosis were defined as the number of diseased vessels, the proportion of totally occluded vessel and the Gensini score. Associations between FPG and the prevalence and severity of CAD were assessed by logistic and linear stepwise regression analyses. The angiographic CAD prevalence, the number of diseased vessels, the totally occluded vessel, and the Gensini score increased corresponding to increasing FPG levels from ≤5.5 mmol/l to 5.6-6.0 mmol/l to 6.1-6.9 mmol/l to ≥7.0 mmol/l (P < 0.05). The FPG had significant association with angiographic CAD (adjusted OR, 1.53; 95 % CI, 1.19-1.98; P = 0.001) and the Gensini score (standardized regression coefficient = 0.172, P = 0.011). Compared with group 1, group 2, 3 and 4 demonstrated significantly higher CAD prevalence after adjustment (adjusted OR, 1.61 [1.16-2.19]; P = 0.015 for group 2; 1.49 [1.11-2.59]; P = 0.027 for group 3; and 4.19 [2.85-6.16]; P = 0.024 for group 4, respectively). FPG group was also significantly associated with the Gensini score (Standardized coefficients, 0.185; P = 0.007, respectively). FPG was an independent risk factor for the prevalence and severity of significant angiographic CAD in our study population. The severity of angiographic CAD increased along with the increasing FPG levels even in prediabetic state.

Reactive Functionalized Membranes for Polychlorinated Biphenyl Degradation.

Membranes have been widely used in water remediation (e.g. desalination and heavy metal removal) because of the ability to control membrane pore size and surface charge. The incorporation of nanomaterials into the membranes provides added benefits through increased reactivity with different functionality. In this study, we report the dechlorination of 2-chlorobiphenyl in the aqueous phase by a reactive membrane system. Fe/Pd bimetallic nanoparticles (NPs) were synthesized (in-situ) within polyacrylic acid (PAA) functionalized polyvinylidene fluoride (PVDF) membranes for degradation of polychlorinated biphenyls (PCBs). Biphenyl formed in the reduction was further oxidized into hydroxylated biphenyls and benzoic acid by an iron-catalyzed hydroxyl radical (OH•) reaction. The formation of magnetite on Fe surface was observed. This combined pathway (reductive/oxidative) could reduce the toxicity of PCBs effectively while eliminating the formation of chlorinated degradation byproducts. The successful manufacturing of full-scale functionalized membranes demonstrates the possibility of applying reactive membranes in practical water treatment.

Association of the adiponectin gene rs1501299 G>T variant, serum adiponectin levels, and the risk of coronary artery disease in a Chinese population.

BACKGROUND: The present study aimed to investigate whether the single nucleotide polymorphism (SNP) 276G>T (rs1501299) of the adiponectin (ADIPOQ) gene was associated with the risk of coronary artery disease (CAD) and serum adiponectin levels in a Chinese population. METHODS: The rs1501299 polymorphism of the ADIPOQ gene was genotyped in 438 subjects with angiographically diagnosed CAD and 443 controls. Levels of serum adiponectin were determined in 152 CAD subjects and 155 controls. RESULTS: The CAD subjects had GT and TT genotypes more frequently, and had GG genotype less frequently than the controls. The OR increased and was significant after adjustment for known CAD risk factors. Significant difference was also observed with T allele being more frequent among the CAD subjects. The T allele at the rs1501299 polymorphism was associated with a higher risk of CAD. The mean adiponectin levels of CAD patients were lower than control subjects. No significant correlation was seen of different genotypes with serum adiponectin levels. CONCLUSIONS: The adiponectin rs1501299 G>T variant was positively related with an increased risk of CAD, and the CAD patients had lower adiponectin levels which were not affected by the different genotypes of rs1501299 in the present study.

Iron oxide nanoparticle synthesis in aqueous and membrane systems for oxidative degradation of trichloroethylene from water.

The potential for using hydroxyl radical (OH•) reactions catalyzed by iron oxide nanoparticles (NPs) to remediate toxic organic compounds was investigated. Iron oxide NPs were synthesized by controlled oxidation of iron NPs prior to their use for contaminant oxidation (by H2O2 addition) at near-neutral pH values. Cross-linked polyacrylic acid (PAA) functionalized polyvinylidene fluoride (PVDF) microfiltration membranes were prepared by in situ polymerization of acrylic acid inside the membrane pores. Iron and iron oxide NPs (80-100 nm) were directly synthesized in the polymer matrix of PAA/PVDF membranes, which prevented the agglomeration of particles and controlled the particle size. The conversion of iron to iron oxide in aqueous solution with air oxidation was studied based on X-ray diffraction, Mössbauer spectroscopy and BET surface area test methods. Trichloroethylene (TCE) was selected as the model contaminant because of its environmental importance. Degradations of TCE and H2O2 by NP surface generated OH• were investigated. Depending on the ratio of iron and H2O2, TCE conversions as high as 100 % (with about 91 % dechlorination) were obtained. TCE dechlorination was also achieved in real groundwater samples with the reactive membranes.

Reactive nanostructured membranes for water purification.

Many current treatments for the reclamation of contaminated water sources are chemical-intensive, energy-intensive, and/or require posttreatment due to unwanted by-product formation. We demonstrate that through the integration of nanostructured materials, enzymatic catalysis, and iron-catalyzed free radical reactions within pore-functionalized synthetic membrane platforms, we are able to conduct environmentally important oxidative reactions for toxic organic degradation and detoxification from water without the addition of expensive or harmful chemicals. In contrast to conventional, passive membrane technologies, our approach utilizes two independently controlled, nanostructured membranes in a stacked configuration for the generation of the necessary oxidants. These include biocatalytic and organic/inorganic (polymer/iron) nanocomposite membranes. The bioactive (top) membrane contains an electrostatically immobilized enzyme for the catalytic production of one of the main reactants, hydrogen peroxide (H(2)O(2)), from glucose. The bottom membrane contains either immobilized iron ions or ferrihydrite/iron oxide nanoparticles for the decomposition of hydrogen peroxide to form powerful free radical oxidants. By permeating (at low pressure) a solution containing a model organic contaminant, such as trichlorophenol, with glucose in oxygen-saturated water through the membrane stack, significant contaminant degradation was realized. To illustrate the effectiveness of this membrane platform in real-world applications, membrane-immobilized ferrihydrite/iron oxide nanoparticles were reacted with hydrogen peroxide to form free radicals for the degradation of a chlorinated organic contaminant in actual groundwater. Although we establish the development of these nanostructured materials for environmental applications, the practical and methodological advances demonstrated here permit the extension of their use to applications including disinfection and/or virus inactivation.

Impact of the metabolic syndrome and its individual components on risk and severity of coronary heart disease.

The clinical use of criteria for metabolic syndrome (MetS) and its individual components with respect to risk prediction of coronary heart disease (CHD) remains uncertain. In this study, we investigated whether and to what extent MetS and its individual components were related to risk for CHD. A total of 1,028 subjects, who had undergone coronary angiography or were diagnosed as acute myocardial infarction, were selected according to inclusion criteria. MetS was diagnosed with National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. CHD was diagnosed with clinical data and confirmed by coronary angiography. The severity of coronary atherosclerosis was estimated by CHD Gensini cumulative index. All the patients were aged 33-87 years. The results showed that the age- and sex-adjusted odds ratios (ORs) for CHD in different individual components of MetS were as follows: low-high density lipoprotein (low-HDL), 3.15 (1.94-5.12); high-fasting plasma glucose (high-FPG), 2.26 (1.63-3.69); high-blood pressure (high-BP), 2.13 (1.38-3.29); high-triglycerides (high-TG), 1.55 (1.13-2.11); all P < 0.05, whereas high-body mass index (high-BMI), 0.75 (0.55-1.03) and high-waist circumference, 0.75 (0.51-1.10), both P > 0.05. Among all the components, the triad of low-HDL, high-FPG, and high-BP had the highest OR for CHD: 4.28 (3.12-5.87) (P < 0.001). MetS subjects had significant increases in number of disease vessel and CHD Gensini index (P < 0.001). When individual components of MetS were considered separately, groups with low-HDL, or high-FPG, or high-BP had significant increases in number of disease vessel and Gensini index (all P < 0.001). In conclusion, our present results demonstrated that individual components of MetS and their various combinations may have different contributions to CHD and the severity of coronary artery stenosis. Clinical focus should remain on establishing optimum-risk algorithms for CHD.

The comparison of coronary angiographic profiles between diabetic and nondiabetic patients with coronary artery disease in a Chinese population.

BACKGROUND: It is well known that diabetes mellitus (DM) is a crucial risk factor for coronary artery disease (CAD). The present study aimed to investigate angiographic profiles of the coronary arteries in diabetic CAD patients in comparison with nondiabetics. METHODS: A total of 546 Chinese patients were angiographically documented for CAD, 375 of whom were diabetics and 171 were nondiabetics according to the WHO diabetes criteria (1999). The patients in these two groups were matched for age, sex, and body mass index (BMI). The 75 g oral glucose tolerance test (OGTT) was performed in all patients, for whom blood glucose, insulin, glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)] were measured. Insulin resistance (Homa-IR) and insulin secretion index (Homa-IS) were determined by the HOMA model. The clinical features and the data from selective coronary angiographies were compared between the diabetic and nondiabetic CAD patients. RESULTS: Diabetic CAD patients had significantly higher waist to hip ratio (WHR) (p=0.016), fasting plasma glucose (FPG), 2h plasma glucose (2hPG), glycosylated hemoglobin (HbA1c) (p<0.001), insulin resistance index (Homa-IR) (p=0.001), and apolipoprotein A (ApoA) (p=0.008), with a significantly lower insulin secretion index (Homa-IS) level (p<0.001). Diabetic patients had one-vessel disease less frequently (28.8% vs 46.2%, p<0.001), and three-vessel disease more frequently (35.2% vs 24.0%, p=0.009), and they also had significantly higher cumulative coronary atherosclerosis score (CAS) (p=0.003). The right coronary artery was significantly more frequently involved in diabetics (66.4% vs 52.6%, p=0.002), with a clearly higher CAS at the same time (p=0.002). CONCLUSIONS: Diabetics were presented with more severe and diffuse angiographically documented coronary artery disease compared to nondiabetics. The right coronary artery was significantly more frequently involved in the diabetics. Duration of CAD, Homa-IR, and diabetes mellitus were the independent risk factors for CAD found in the present study, while ApoA was the protective one.

High sensitive C-reactive protein, adiponectin, and urine albumin excretion rate in Chinese coronary artery disease patients with different glucose tolerance status.

BACKGROUND: Serum high sensitive C-reactive protein (hs-CRP), adiponectin levels and urine albumin excretion rate (UAER) are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease (CAD) subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well. METHODS: A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups: the normal glucose tolerance (NGT) + CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance (IGT) + CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus (T2DM) + CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects. RESULTS: Serum hs-CRP levels were increased in the T2DM + CAD group compared with the NGT + CAD group (4.71 +/- 2.59) vs (3.60 +/- 2.46) mg/L, P = 0.037. Serum adiponectin levels were gradually decreased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (5.99 +/- 1.84), (5.82 +/- 1.72) and (4.65 +/- 1.71) mg/L, P = 0.002 and 0.040 for NGT + CAD and IGT + CAD groups vs T2DM + CAD group, respectively. While the UAER was gradually increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (6.42 +/- 2.51), (6.89 +/- 2.94) and (15.03 +/- 4.22) microg/min (P < 0.001) for NGT + CAD and IGT + CAD groups vs T2DM + CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio (WHR) and low density lipoprotein cholesterol (LDL-C) were the significant determinants of serum hs-CRP levels; triglyceride (TG), high density lipoprotein cholesterol (HDL-C), age, WHR, T2DM, 2-hour serum insulin (2hINS), sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure (SBP), T2DM, and hemoglobin A1c (HbA1c) were the significant determinants of UAER in all subjects (R(2) = 0.070, 0.352, and 0.214, respectively). However, no significant correlation was seen for hs-CRP, adiponectin and UAER with the severity of CAD. Hs-CRP levels were significantly correlated with UAER. CONCLUSIONS: There was a trend of increased serum hs-CRP levels from the NGT + CAD to IGT + CAD to T2DM + CAD groups, though it only showed significance in the T2DM + CAD group compared with the NGT + CAD group. Serum adiponectin levels were decreased and UAER was increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups. Increased UAER and serum hs-CRP, and decreased adiponectin levels were associated with traditional CAD risk factors but failed to be correlated with the severity of CAD. Hs-CRP levels were significantly correlated with UAER.

Characteristics of the populations defined by different criteria of the metabolism syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare the characteristics of over weight and obesity subjects defined by three criteria: World Health Organization (WHO) in 1999, the National Cholesterol Education Program Adult Treatment Panel Nll (NCEP-ATP II ) in 2001, and the International Diabetes Federation (IDF) in 2005.</p><p><b>METHODS</b>Medical history collection, physical examination, oral glucose tolerance test ( OGTT) , and frequently sampled intravenous glucose tolerance test (FSIGTT) were performed in 371 subjects with body mass index (BMI)> or =23 kg/m(2). Fasting blood samples were taken to test lipid profiles, urea acid level and so on. Data was analyzed including comparison and relationship statistics.</p><p><b>RESULTS</b>Data from FSIGTT showed that insulin resistance existed in all over weight and obesity subjects. The relationship between waist and sensitivity index (SI) was superior than that between BMI and SI ( r = - 0. 198 and r = - 0. 194, P < 0. 001). Totally 107 subjects (28. 8%) did not meet any definitions, 187 (50. 4%) met ATP definition, 98 (26. 4%) met WHO definition, and 234 (63. 1% ) met IDF definition. ATP and IDF definitions had the highest coincidence rate (70. 3% ) , and subjects in these two groups almost had basically the same manifestations. The age of onset in WHO group was higher than those in other two groups. Meanwhile, subjects in the WHO group was characterized by lower BMI, higher hyperlipidemia, and significantly increased fasting and postprandial blood glucose level. The MS component scores were positively correlated with age, BMI, waist, and waist-to-hip ratio (WHR) , and were negatively correlated with SI. However, no correlation was found between MS component scores and gender, fat% , or acute insulin response to glucose index.</p><p><b>CONCLUSIONS</b>Some of over weight and obesity subjects only have insulin resistance and have no metabolism syndrome. The group defined by IDF criteria of the metabolic syndrome (MS) has the highest incidence rate. Limited by the requirements of insulin resistance evaluation, the definition proposed by WHO is somewhat unfeasible for practices. ATP definition may be replaced by IDF definition, because the populations defined by ATP definition is covered by the latter. Meanwhile, the abnormalities of fat mass distribution in the body ( i. e. , central obesity) , rather than its contents, may exacerbate the occurrence of MS, as well as the development of insulin resistance.</p>