Association between obstructive sleep apnea and low bone mass in adults: a systematic review and meta-analysis.

Introduction: This study aimed to synthesize existing evidence on the potential association between obstructive sleep apnea (OSA) and low bone mass in adults. Methods: Electronic searches of four main databases were performed. The inclusion criteria consisted of observational studies investigating the relationship between OSA and bone mass, osteoporosis, fractures, or bone metabolism markers in adult population. Bone mineral density (BMD) and T score of lumbar and femur neck, incidence of osteoporosis and fractures, bone metabolism marker levels were extracted as primary outcomes. Results: Among the 693 relevant publications, 10 studies consisting of 158,427 participants met with the inclusion and exclusion criteria. Meta-analysis showed a significant lower BMD of lumbar (mean difference (MD) = - 0.03; 95% CI - 0.05, - 0.01; I2 = 46%), femur neck (MD = - 0.06; 95% CI - 0.12, 0.00; I2 = 71%), and a significant lower T score of lumbar (MD = - 0.42; 95% CI - 0.79, - 0.05; I2 = 63%) in the OSA group. The results suggested that both male (odds ratio (OR) = 2.03; 95% CI 1.23, 3.35; I2 = 38%) and female (OR = 2.56; 95% CI 1.96, 3.34; I2 = 0%) had higher risk of osteoporosis in the OSA group. Besides, meta-analysis also showed that bone-specific alkaline phosphatase was significantly lower in OSA patients (MD = - 1.90; 95% CI - 3.48, - 0.32; I2 = 48%). Conclusions: A potential association between OSA and lower bone mass in adults is preliminarily proved. It also seems plausible that both male and female with OSA have a higher risk of osteoporosis. Supplementary Information: The online version contains supplementary material available at 10.1007/s41105-023-00481-1.

Clinical profile analysis and nomogram for predicting in-hospital mortality among elderly severe community-acquired pneumonia patients: a retrospective cohort study.

BACKGROUND: Severe community-acquired pneumonia is one of the most lethal forms of CAP with high mortality. For rapid and accurate decisions, we developed a mortality prediction model specifically tailored for elderly SCAP patients. METHODS: The retrospective study included 2365 elderly patients. To construct and validate the nomogram, we randomly divided the patients into training and testing cohorts in a 70% versus 30% ratio. The primary outcome was in-hospital mortality. Univariate and multivariate logistic regression analyses were used in the training cohort to identify independent risk factors. The robustness of this model was assessed using the C index, ROC and AUC. DCA was employed to evaluate the predictive accuracy of the model. RESULTS: Six factors were used as independent risk factors for in-hospital mortality to construct the prediction model, including age, the use of vasopressor, chronic renal disease, neutrophil, platelet, and BUN. The C index was 0.743 (95% CI 0.719-0.768) in the training cohort and 0.731 (95% CI 0.694-0.768) in the testing cohort. The ROC curves and AUC for the training cohort and testing cohort (AUC = 0.742 vs. 0.728) indicated a robust discrimination. And the calibration plots showed a consistency between the prediction model probabilities and observed probabilities. Then, the DCA demonstrated great clinical practicality. CONCLUSIONS: The nomogram incorporated six risk factors, including age, the use of vasopressor, chronic renal disease, neutrophil, platelet and BUN, which had great predictive accuracy and robustness, while also demonstrating clinical practicality at ICU admission.

Clinical characteristics and postoperative outcomes of systemic artery-to-pulmonary vessel fistula in hemoptysis patients.

OBJECTIVES: To investigate the clinical characteristics and outcomes on the success of bronchial arterial embolization (BAE) in patients with and without systemic artery-to-pulmonary vessel fistula (SA-PF) and to evaluate the feasibility of CTA in the assessment of SA-PF. METHODS: We retrospectively enrolled 420 consecutive patients that underwent BAE for hemoptysis control in our hospital from September 2011 to May 2019. The clinical characteristics, preprocedural CTA findings, BAE procedural findings, and follow-up outcomes were collected. Patients were divided into two groups according to DSA findings: patients with SA-PF and those without. RESULTS: A total of 184 (43.7%) patients presented with SA-PF. Pneumonia was less likely to be the concomitant condition in patients with SA-PF (p < 0.001). The mean number of culprit arteries per patient was significantly higher in patients with SA-PF compared to that in patients without SA-PF (p = 0.017). The SA-PF patients saw a greater probability of recurrence (HR: 2.782, 95% CI: 1.617-4.784, p < 0.001). SA-pulmonary venous fistula (SA-PVF) favored lower hemoptysis recurrence rate (HR: 0.199, 95%CI: 0.052-0.765, p = 0.019). SA-pulmonary artery fistula (SA-PAF) can be detected by optimized CTA protocol with a detection rate of 65.3% (49/75). CONCLUSIONS: The presence of SA-PF is an independent risk factor predicting early recurrence of hemoptysis after BAE. SA-PVF seems to be a protective factor for longer hemoptysis control compared to SA-PAF. Optimized preprocedural CTA is a reliable examination to identify SA-PAF. KEY POINTS: • The appearance of SA-PF is associated with a greater probability of early recurrent hemoptysis after bronchial artery embolization. • The presence of SA-PVF seems to be a protective factor for longer hemoptysis control after BAE compared to SA-PAF. • Optimized CTA protocol seems to be a promising auxiliary examination to detect SA-PAF.

CT-guided transthoracic pulmonary artery catheterization: an experimental study in a porcine model.

OBJECTIVES: We investigated the safety and feasibility of CT-guided transthoracic pulmonary artery catheterization (TPAC) in a porcine model. METHODS: Procedures were conducted on ten mature Bama miniature pigs. After anesthesia, chest CT was performed in the left lateral decubitus position to determine the puncture route. Under the guidance of multiple CT scans, the introducer sheath was inserted from the right chest wall of the pig into the right pulmonary artery using the Seldinger technique. Then, a catheter connected with a transducer was inserted into the sheath to measure the pulmonary artery pressure. Finally, an active approximator was used to close the puncture site on the pulmonary artery. The pigs were followed up for 8 weeks to evaluate the operation-related complications and survival. RESULTS: Ten of 11 CT-guided TPAC procedures were successfully performed on ten pigs, rendering a technical success rate of 90.9%. One pig had hemoptysis while the needle was being inserted during the first operation, and a second procedure was successfully conducted 17 days later. Other complications, including pulmonary bleeding along the needle track (3 of 11; 27.3%), unclosed pulmonary artery puncture sites (3 of 10; 30%), pneumothorax (1 of 11; 9.1%), and hemopericardium (1 of 11; 9.1%), spontaneously resolved without complication-specific treatment. The mean pulmonary arterial pressure was 32 ± 17.6 mmHg. All animals survived the procedure and reached the end of the follow-up period. CONCLUSIONS: CT-guided TPAC is feasible and safe in a porcine model, serving as a potential alternative pathway for pulmonary artery intervention. KEY POINTS: • TPAC is feasible and safe in a porcine model, serving as a potential alternative pathway for pulmonary artery intervention. • This novel approach allows for faster access to the pulmonary artery, and it might be easier to operate the tip of the catheter to super-select the intent branch of the pulmonary artery. • TPAC can be an alternative pulmonary artery intervention pathway in patients with mechanical right-heart valves, great-vessel transposition, and other obstacles.

A novel mouse model simulating transurethral laser vaporization prostatectomy / 亚洲男科学杂志(英文版)

Benign prostatic hyperplasia (BPH) is a common disease in elderly men, and transurethral laser prostatectomy (TULP) has been widely used in the clinic to remove bladder outlet obstruction caused by BPH. Previous animal models for wound repair after prostatectomy have many limitations, and there have been no previous reports of a mouse model of TULP. Therefore, this study aimed to establish a novel mouse model of TULP. Twelve healthy adult Kunming (KM) mice received transurethral laser vaporization prostatectomy with a 200-μm thulium laser. The mice were sacrificed, and wound specimens from the prostatic urethra and bladder neck were harvested at 1 day, 3 days, 5 days, and 7 days after surgery. Hematoxylin-eosin (HE) and immunohistochemistry were applied to confirm the establishment of the mouse TULP model. One day after the surgery, urothelium expressing uroplakin (UPK) was absent in the urethral wound site, and a large number of necrotic tissues were found in the wound site. There was no UPK-positive urothelium in the wound 3 days after surgery. At 5 days after surgery, monolayer urothelium expressing UPK was found in the wound site, indicating that the re-epithelization of the wound had been completed. On the 7th day after surgery, there were multiple layers of urothelium with UPK expression, indicating that the repair was completed. It is feasible to establish a mouse TULP model by using a microcystoscope system and a 200-μm thulium laser.

A novel LMNA indel mutation identified in a family with atrioventricular block and atrial fibrillation.

ABSTRACT: It is well known that many genetic factors are involved in the occurrence and progression of atrioventricular block (AV block) and atrial fibrillation (AF). However, the genetic variants discovered so far have only explained parts of these processes. More genes and variants remain to be identified. In the present study, a three-generation family with an autosomal dominant form of AV block and AF was enrolled. Whole exome sequencing was conducted in three affected and one unaffected family member. A total of 64 nonsynonymous variants was shared by three affected individuals and not present in the unaffected individual. By selection of variants absent in the known databases and were predicted to be deleterious, 4 novel variants were identified. Only one novel frameshift insertion in the LMNA gene (c.825_826insCAGG) was identified in another affected family member and not detected in other non-affected family members and the 100 controls. Our finding expanded the spectrum of variants associated with AV block and AF, and was valuable in the genetic diagnosis of AV block and AF.

Cleansing efficacy and safety of bowel preparation protocol using sodium picosulfate/magnesium citrate considering subjective experiences: An observational study.

BACKGROUND: Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation. AIM: To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients' experiences due to the procedure. METHODS: Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital, Beijing, China, from April 29 to October 29, 2020, for whom the colonoscopy was planned, were enrolled. Bowel preparation was performed using sodium picosulfate/magnesium citrate. The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale, defecation conditions and adverse reactions were recorded, and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score (VAS). RESULTS: The bowel preparation procedure was planned for all patients enrolled, which included 42 males and 22 females. The results showed an average liquid rehydration volume of 3000 mL, an average onset of action for the first dose at 89.04 min, an average number of bowel movements of 4.3 following the first dose, an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose. The total average Ottawa Bowel Preparation Scale score was 3.6, with 93.55% of bowel preparations in the "qualified" and 67.74% in the "excellent" grade. The average VAS score of effect on sleep was 0, and the average VAS score of perianal pain was also 0. The average VAS score for ease of taking and taste perception of the bowel cleanser was 10. Side effects included mild to moderate nausea (15.63%), mild vomiting (4.69%), mild to moderate abdominal pain (7.81%), mild to moderate abdominal distension (20.31%), mild palpitation (7.81%) and mild dizziness (4.69%). CONCLUSION: Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance, thus improving overall patient compliance.

LncRNA-PCAT1 controls the growth, metastasis and drug resistance of human colon cancer cells.

PURPOSE: The long non-coding (lnc) RNAs have been shown to exhibit profound regulatory roles in maintaining the growth and proliferation of human cancer cells. Taking this fact into consideration, the current research work was scheduled to explore the regulatory control of lncRNA-PCAT1 in maintaining the growth and progression of human colon cancer cell. METHODS: The expression of lncRNA-PCAT1 was assessed through qRT-PCR method. DAPI and acridine orange (AO)/ethidium bromide (EB) staining protocols along with the colony formation protocols were performed to evaluate the viability of cancer cells. The migratory and invasion properties of cancer cells were examined by the wound-healing and transwell assays, respectively. Western blotting was used to assess the expression of proteins of interest. MTT assay was used for the assessment of cell proliferation. RESULTS: lncRNA-PCAT1 was highly up-regulated in the colon cancer tissues and cancer cell lines. The repression of lncRNA-PCAT1 in colon cancer cells reduced their viability through induction of Bax/Bcl-2 mediated apoptosis. The inhibition of lncRNA-PCAT1 expression further declined the migration and invasion of colon cancer cells along with the decline of cell proliferation and enhanced the chemosensitivity of colon cancer cells. CONCLUSION: lncRNA-PCAT1 expression may be utilized as a vital prognostic tool in colon cancer and highlighted its regulatory effects in maintaining the colon cancer growth and proliferation.

Global projections of future urban land expansion under shared socioeconomic pathways.

Despite its small land coverage, urban land and its expansion have exhibited profound impacts on global environments. Here, we present the scenario projections of global urban land expansion under the framework of the shared socioeconomic pathways (SSPs). Our projections feature a fine spatial resolution of 1 km to preserve spatial details. The projections reveal that although global urban land continues to expand rapidly before the 2040s, China and many other Asian countries are expected to encounter substantial pressure from urban population decline after the 2050s. Approximately 50-63% of the newly expanded urban land is expected to occur on current croplands. Global crop production will decline by approximately 1-4%, corresponding to the annual food needs for a certain crop of 122-1389 million people. These findings stress the importance of governing urban land development as a key measure to mitigate its negative impacts on food production.

Fugitive Road Dust PM2.5 Emissions and Their Potential Health Impacts.

Fugitive road dust (FRD) particles emitted by traffic-generated turbulence are an important contributor to urban ambient fine particulate matter (PM2.5). Especially in urban areas of developing countries, FRD PM2.5 emissions are a serious environmental threat to air quality and public health. FRD PM2.5 emissions have been neglected or substantially underestimated in previous study, resulting in the underestimation of modeling PM concentrations and estimating their health impacts. This study constructed the FRD PM2.5 emissions inventory in a major inland city in China (Lanzhou) in 2017 at high-resolution (500 × 500 m2), investigated the spatiotemporal characteristics of the FRD emissions in different urban function zones, and quantified their health impacts. The FRD PM2.5 emission was approximately 1141 ± 71 kg d-1, accounting for 24.6% of total PM2.5 emission in urban Lanzhou. Spatially, high emissions exceeding 3 × 104 µg m-2 d-1 occurred over areas with smaller particle sizes, larger traffic intensities, and more frequent construction activities. The estimated premature mortality burden induced by FRD PM2.5 exposure was 234.5 deaths in Lanzhou in 2017. Reducing FRD emissions are an important step forward to protect public health in many developing urban regions.

Neuroprotective effect of tanshinone IIA weakens spastic cerebral palsy through inflammation, p38MAPK and VEGF in neonatal rats.

As one of main active ingredients of salvia miltiorrhizae, which is a traditional Chinese medicine, tanshinone IIA is the basis of its pharmacological activities. In the present study, the effect of tanshinone IIA on weakening spastic cerebral palsy (SCP) in neonatal rats was investigated. Radial arm water maze and holding tests were used to measure the alterations of spastic cerebral palsy, inflammation was measured using an ELISA kit, and western blot analysis was used to analyze the protein expression of p­p38 mitogen­activated protein kinase (MAPK) and vascular endothelial growth factor (VEGF). The central mechanisms involved in the mediation or modulation of inflammation, p­p38 MAPK and VEGF were also investigated. Treatment with tanshinone IIA effectively inhibited spastic cerebral palsy, and the activities of interleukin (IL)­1ß, IL­6, tumor necrosis factor­α, monocyte chemoattractant protein 1, cyclooxygenase­2 and prostaglandin E2 in a neonatal rat model of SCP. Tanshinone IIA effectively suppressed the protein expression of inducible nitric oxide synthase (NOS), phosphorylated (p­) nuclear factor (NF)­κB, p­p38MAPK and VEGF, and activated the phosphorylation of inhibitor of NF­κB and the protein expression of neuronal NOS in the SCP rat model. These results suggested that the neuroprotective effect of tanshinone IIA weakened SCP through inflammation, p38MAPK and VEGF in the neonatal rats.

Association between the expression of somatostatin receptors and pathological features, prognosis in hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the expression of somatostatin receptors (SSTRs) in hepatocellular carcinoma (HCC) tissue and its association with clinicopathological features and prognosis of HCC.Methods HCC samples were collected from 80 patients who visited Third Hospital of PLA and Department of Hepatobiliary Surgery in The Second Affiliated Hospital of Dalian Medical University and who underwent hepatectomy from July 2012 to December 2014 and were diagnosed with HCC based on postoperative pathology (trial group).Another 80 patients who were suspected of liver disease and were not diagnosed with HCC by liver biopsy were enrolled as control group.RT-PCR and immunohistochemistry were used to measure the mRNA and protein expression of SSTR-2 and SSTR-3.The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,the Kaplan-Meier method was used to analyze patients' survival,and the Cox regression analysis was used to investigate the influencing factors for the prognosis of HCC patients.Results The control group had significantly higher mRNA and protein expression of SSTR-2 and SSTR-3 than the trial group (t =6.456 and 8.128,x2 =7.992 and 9.157,all P ＜ 0.05).The univariate analysis showed that the mRNA expression of SSTR-2 and SSTR-3 was significantly correlated with tumor nodule (t =6.533 and 5.041,both P ＜ 0.05),degree of tumor differentiation (t =4.672 and 4.013,both P ＜ 0.05),depth of infiltration (t =6.735 and 7.019,both P ＜ 0.05),viral hepatitis (t =4.929 and 4.535,both P ＜ 0.05),alcoholic hepatitis (t =4.032 and 4.362,both P ＜ 0.05),and diabetes (t =4.372 and 6.293,both P ＜ 0.05),and the protein expression of SSTR-2 and SSTR-3 was significantly correlated with tumor nodule (x2 =25.223 and 15.399,both P ＜ 0.05),degree of tumor differentiation (x2 =7.535 and 10.944,both P ＜ 0.05),and depth of infiltration (x2 =22.520 and 9.968,both P ＜ 0.05).Compared with the group with positive expression of SSTR-2 and SSTR-3,the group with negative expression had significantly lower cumulative postoperative disease-free survival rate (P =0.015 and 0.004) and postoperative overall survival rate (P =0.009 and ＜ 0.001).The Cox model analysis showed that protein expression of SSTR-2 and SSTR-3,the number of tumor nodules,liver cirrhosis,and vein infiltration in HCC tissue were independent risk factors for overall survival after HCC surgery (P ＜ 0.05).Conclusion HCC patients have lower expression of SSTR-2 and SSTR-3 than non-HCC patients,and such low expression is closely associated with invasion/metastasis and poor prognosis of HCC.SSTRs may be the markers for the prognosis of HCC.

Arenobufagin is a novel isoform-specific probe for sensing human sulfotransferase 2A1

Human cytosolic sulfotransferase 2A1 (SULT2A1) is an important phase II metabolic enzyme. The detection of SULT2A1 is helpful for the functional characterization of SULT2A1 and diagnosis of its related diseases. However, due to the overlapping substrate specificity among members of the sulfotransferase family, it is difficult to develop a probe substrate for selective detection of SULT2A1. In the present study, through characterization of the sulfation of series of bufadienolides, arenobufagin (AB) was proved as a potential probe substrate for SULT2A1 with high sensitivity and specificity. Subsequently, the sulfation of AB was characterized by experimental and molecular docking studies. The sulfate-conjugated metabolite was identified as AB-3-sulfate. The sulfation of AB displayed a high selectivity for SULT2A1 which was confirmed by reaction phenotyping assays. The sulfation of AB by human liver cytosols and recombinant SULT2A1 both obeyed Michaelis-Menten kinetics, with similar kinetic parameters. Molecular docking was performed to understand the interaction between AB and SULT2A1, in which the lack of interaction with Met-137 and Tyr-238 of SULT2A1 made it possible to eliminate substrate inhibition of AB sulfation. Finally, the probe was successfully used to determine the activity of SULT2A1 and its isoenzymes in tissue preparations of human and laboratory animals.

Progressive Reduction in Myocyte Autophagy After Myocardial Infarction in Rabbits: Association with Oxidative Stress and Left Ventricular Remodeling.

BACKGROUND/AIMS: The alterations in myocyte autophagy after myocardial infarction (MI) and the underlying mechanisms have not been fully understood. In this study, we investigated the temporal changes of myocyte autophagy in the remote non-infarcted myocardium in rabbits after MI and the relationships between alterations of myocyte autophagy and left ventricular (LV) remodeling and myocardial oxidative stress. METHODS: Rabbits were assigned to MI or sham operation. Rabbits with MI or sham were randomly assigned to receive chloroquine, an autophagy inhibitor, antioxidant vitamins C and E or placebo for 4 weeks. H9C2 cardiomyocytes were subjected to hypoxia or hydrogen peroxide (H2O2) treatment. RESULTS: MI rabbits exhibited progressive increases of LV end-diastolic dimension (EDD), and decreases of LV fractional shortening (FS) and dP/dt over 8 weeks. Myocyte autophagy assessed by the scores of LC3 and Beclin1 expression was progressively decreased at 1, 4 and 8 weeks after MI. The ratio of LC3 II/I and Beclin1 and Atg5 proteins were also decreased at 4 weeks after MI. There was a negative correlation between autophagy and LV EDD and a positive correlation between autophagy and LV FS and dP/dt. The autophagy inhibitor chloroquine worsened LV remodeling after MI. Decreased myocyte autophagy was associated with increased myocardial 4-hydroxynonenal. Antioxidant vitamins C and E prevented the decrease in myocyte autophagy after MI. In cultured H9C2 cardiomyocytes, the LC3 II/I ratio was decreased at 4 and 8 h after exposure to hypoxia, and the change was associated with increased 8-hydroxy-2-deoxyguanosine. A low concentration of H2O2 decreased the LC3 II/I ratio. CONCLUSION: Progressive reduction in myocyte autophagy in the remote non-infarcted myocardium was associated with myocardial oxidative stress and LV remodeling after MI. Antioxidants prevented the reduction in myocyte autophagy after MI, suggesting that oxidative stress mediates reduction in myocyte autophagy that contributes to post-MI remodeling.

Features of continuous glycemic profile and glycemic variability in patients with obstructive sleep apnea syndrome.

AIMS: To investigate glycemic variability (GV) in Obstructive Sleep Apnea Syndrome (OSAS) patients by monitoring continuous blood glucose profile. METHODS: OSAS group (n=86) and normal control group (n=40) were included. Continuous blood glucose was monitored. The relationship of GV, insulin resistance index (IRI) and the respiratory disturbance index (AHI) were analyzed. RESULTS: The daily average blood glucose level was significantly higher in the OSAS patients than in the control group (6.31±0.61vs. 4.94±0.78; P<0.01). The postprandial glycemic peaks in the OSAS patients were significantly higher and prolonged. The indicators of GV were all significantly higher in the OSAS patients, including blood glucose fluctuation coefficient (BGFC, 1.93±0.71vs. 1.21±0.38, P<0.05), mean amplitude of glycemic excursions (MAGE, 4.18±0.65vs. 2.18±0.48; P<0.05) and night mean amplitude of glycemic excursions (NMAGE, 2.00±0.53vs. 1.11±0.43; P<0.05). Pearson correlation analysis showed that among the OSAS patients, the severity of OSAS (AHI) was positively correlated with the IRI (r=0.310); and the GV indicators (MAGE and NMAGE) were positively correlated with IRI and AHI (r=0.318 and 0.349, respectively) (P<0.01 or 0.001). CONCLUSIONS: Continuous glycemic spectrum and GV provide comprehensive glycemic profiles and may reveal important aspects of glucose metabolism abnormality beyond regular examinations, and are therefore of particular significance for glycemic management in OSAS patients.

Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction.

BACKGROUND: While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI. METHODS: We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables. RESULTS: Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = -2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (ß= 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (ß = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (ß = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (ß = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels. CONCLUSIONS: Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.

Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI.</p><p><b>METHODS</b>We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables.</p><p><b>RESULTS</b>Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = -2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (β= 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (β = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (β = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (β = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels.</p><p><b>CONCLUSIONS</b>Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.</p>