Glucometabolic state of in-hospital primary hypertension patients with normal fasting blood glucose in a sub-population of China.

BACKGROUND: There is a high prevalence of abnormal glucometabolism (AGM) in patients with coronary heart disease (CHD) and primary hypertension (PH). However, little is known about the glucometabolic state of PH patients with normal fasting blood glucose (FBG). METHODS: Oral glucose tolerance test (OGTT) was performed for 445 in-hospital PH patients with normal FBG and re-performed for those patients with impaired glucose tolerance (IGT) during the follow-up period. RESULTS: Diabetes mellitus (DM), IGT, and AGM (including IGT and DM) accounted for 4.4, 24.5, and 28.9% of patients, respectively. Prevalence of AGM in patients with higher haemoglobin A(1c) (HbA(1c)) (> or =6.0%), risk factors (CHD, overweight, hyperlipidaemia, proteinuria) was significantly higher than that in patients without these factors. Regression analysis showed that age, overweight, proteinuria, HbA(1c), and CRP were the independent risk factors of AGM. Follow-up data in 98 IGT patients showed that no improvement of glucometabolism was found, but contrarily, a significant increase of new onset of impaired fasting glucose (IFG) and DM was found after 9 months (P < 0.05), even if diet control and moderate exercise were adopted. CONCLUSIONS: AGM is prevalent and underestimated in PH patients with normal FBG, and it will develop even if therapeutic life-style changes are adopted. Except for FBG, more attention should be paid to postprandial blood glucose. OGTT should be a routine procedure for PH patients, especially in-hospital PH patients, regardless of normal FBG, and active drug intervention for IGT patients with PH may be recommended.

Value of BNP and tumour marker CA125 in patients with heart failure.

OBJECTIVE: The objective was to study the association between B-type natriuretic peptide (BNP) and tumour markers and heart failure (HF) to evaluate the value of BNP and carbohydrate antigen 125 (CA125) in HF patients. DESIGN AND SETTING: A university hospital-based cross-over study of 285 subjects (157 men and 128 women) in HF, chronic obstructive pulmonary disease (COPD), mild-mid pulmonary hypertension patients and control subjects. RESULTS: CA125 and BNP were significantly higher in the HF group than in the non-HF group and in severe HF than in mild HF (P < 0.01). No changes were observed in other tumour markers. CA125 and BNP decreased obviously after clinical improvement by aggressive treatment (P < 0.01). Left ventricular ejection fraction correlated positively with CA125 (r = 0.789, P < 0.01) and BNP (r = 0.730, P < 0.01) in left heart failure patients, but not in other patients. BNP and CA125 had better accuracy and positive predictive value in diagnosing HF from the characteristic receiver-operator curve. CONCLUSIONS: CA125 and BNP are markedly elevated in heart failure and closely reflect heart function. They are better markers in evaluating the efficiency of short-term therapy. Detecting BNP combined with CA125 may be more valuable than only detecting BNP or CA125 for diagnosing HF and evaluating the efficiency of treatment.

Matrix metalloproteinase-1, -3, and -9 gene polymorphisms and the risk of idiopathic dilated cardiomyopathy in a Chinese Han population.

OBJECTIVES: To investigate the association between matrix metalloproteinase (MMP)-1(-1607 1G/2G), MMP-3(-1171 5A/6A), and MMP-9(-1562 C/T) polymorphism and susceptibility to idiopathic dilated cardiomyopathy (IDCM). DESIGN AND METHODS: MMP-1, -3, -9 genotypes were determined by PCR-RFLP analysis. RESULTS: Genotype frequency of MMP-3, but not MMP-1 and MMP-9 in IDCM patients, was significantly different from that in healthy controls. CONCLUSIONS: Our data suggested that MMP-3 5A/6A polymorphism could be a risk factor for the susceptibility to IDCM.