Lower vitamin D levels are associated with depression in patients with gout.

BACKGROUND: Depression is commonly observed among patients with gout. Low levels of vitamin D have been associated with depression in non-gout subjects. We examined the association of vitamin D levels with depression in patients with gout. METHODS: We conducted a cross-sectional study of 186 gout patients at the Endocrinology Department of First Affiliated Hospital of Jiaxing University. Levels of serum 25-hydroxyvi-tamin D (25(OH)D) were determined using a competitive protein-binding assay. The 17-item Hamilton Depression Scale was used for screening for depressive symptoms. Diagnosis of depression in gout patients was made in accordance with Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for depression. Multivariate analysis was performed using logistic regression models. RESULTS: Thirty-two gout patients (17.2%) were diagnosed as having depression. Patients with depression showed significantly lower 25(OH)D levels as compared to patients without depression (46.4±19.0 vs 57.0±17.3 nmol/L, P<0.001). Significant differences in 25(OH)D quartiles of gout patients were observed between the patients with depression and the patients without depression (P=0.003). In multivariate analyses, serum 25(OH)D levels (≤40.0 nmol/L) were independently associated with depression in patients with gout (OR 3.833, 95% CI 1.406-10.453, P=0.009). CONCLUSION: Our study demonstrates an important association between serum vitamin D levels and depression in patients with gout.

Euthyroid sick syndrome in trauma patients with severe inflammatory response syndrome.

OBJECTIVE: To investigate the alternations of thyroid hormone in traumatic patients with severe inflammatory response syndrome (SIRS). METHODS: Fifty traumatic patients with severe SIRS were enrolled and divided into two groups according to whether they presented multiorgan dysfunction syndrome (MODS). Thyroid hormone measurements were taken, including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH). The acute physiology and chronic health evaluation II (APACHE II) score was calculated according to clinical data. The outcomes of recovery or deterioration were recorded, as well as the length of time from the onset of SIRS to the time thyroid hormones were measured. RESULTS: Euthyroid sick syndrome (ESS) was presented in 45 cases. TT3 level was negatively correlated with APACHE II score (r = -0.330, P<0.05), and TT3/TT4 value was negatively correlated with the duration of SIRS( r = -0.316, P<0.05). TT3, TT4 and FT3 levels in MODS patients were significantly lower than those without MODS (P<0.05). MODS patients got low TT4 or FT4 level more frequently than those without MODS (P<0.05). Compared with the patients in normal TSH group, the patients with decreased TSH had lower T3, T4, recovery rate and higher APACHE II scores, MODS incidence, but there was no difference between two groups (P>0.05). CONCLUSIONS: Trauma patients with severe SIRS have high possibility to get ESS, which occurs more frequently and severely in MODS patients. It shows the influences of SIRS on the thyroid axes. With the persistence and aggravation of SIRS, there is a progressive reduction of thyroid hormone.

Changes of macrovascular endothelial ultrastructure and gene expression of endothelial nitric oxide synthase in diabetic rats.

BACKGROUND: The most intimidatory pathological changes in patients with DM are cardiovascular illnesses, which are the major causes of death in diabetic patients and are far more prevalent than in nondiabetics because of accelerated atherosclerosis. In this study, we tried to clarify the changes in macrovascular endothelial ultrastructure and in the gene expression of endothelial nitric oxide synthase (eNOS)mRNA in diabetic rats. METHODS: The study was conducted on 52 of 10-week old Sprague Dawley (SD) rats with body weight of (320 +/- 42) g. SD rats were divided into: experimental group treated with a single intraperitoneal injection of streptozotocin (STZ, 60 mg/kg), (male, n = 20, diabetes mellitus (DMM)); female, n = 12, diabetes mellitus female (DMF)) and control group (male, n = 10, diabetes mellitus male control (DMMC); female, n = 10, diabetes mellitus female control (DMFC)). Four weeks after treatment, half of the rats were sacrificed; the remainders were sacrificed ten weeks after treatment. One part of the abdominal aortic sample was stored under glutaraldehyde (volume fraction psiB = 2.5%). After the process of chemical fixation, chemical dehydration, drying and conductivity enhancement, all samples were observed and photographed using scanning electron microscopy (Leica-Stereoscan 260, England). The other part of the abdominal aortic sample was treated with liquid nitrogen and the expression of eNOSmRNA was assessed by semi-quantitative RT-PCR. RESULTS: The aortic lumen of both experimental groups adsorbed much more debris than that of either control group. The endothelial surfaces of diabetic rats were coarse, wrinkled and protuberant like fingers or villi. The vascular endothelial lesions of diabetic male rats were very distinct after 4 weeks, and as obvious as those at 10 weeks. The vascular endothelial lesions of diabetic female rats were not severe at 4 weeks and only became marked after 10 weeks. In both males and females, the abdominal aortic eNOSmRNA content of 4 weeks and 10 weeks diabetic rats was very significantly lower (P < 0.01) than that of controls. CONCLUSIONS: Aortic endothelial ultrastructure in DM rats is injured compared with controls. Abnormal changes of aortic endothelia in male DM rats are more obvious than those in females. Expression of abdominal aortic eNOSmRNA content of DM rats is significantly lower than that of controls.