The correlation between serum Klotho levels and frailty in elderly people / 中华老年医学杂志

Objective:To examine the correlation between serum Klotho levels and frailty in elderly people.Methods:In this cross-sectional study, 150 community-dwelling elderly people aged 65 years and over were enrolled.Subjects were divided into a frail(n=50, 33.3%), a pre-frail(n=47, 31.3%)and a non-frail(n=53, 35.3%)group based on the Fried phenotype.General participant data, routine laboratory test results, short physical performance battery(SPPB)results and human body composition data were collected.Serum Klotho protein levels were measured by an enzyme-linked immunosorbent assay.The relationship between serum Klotho protein levels and frailty was analyzed by using Spearmen's correlation analysis and Logistic regression analysis.Results:Klotho protein levels were lower in the frail group than in the non-frail group( P=0.001), whereas differences between the frail group and the pre-frail group and between the pre-frail group and the non-frail group were not statistically significant(all P>0.05).When Klotho protein levels were classified into four quartiles, i.e., Q 1, Q 2, Q 3, and Q 4, using three cut-off vales(2.28, 3.52, and 5.09 mg/L), the prevalences of frailty were 51.4%(19/37), 39.5%(15/38), 24.3%(9/37)and 18.4%(7/38), respectively.The prevalence of frailty decreased with increasing Klotho protein levels( χ2=11.204, P=0.011).Spearman correlation analysis showed that the Klotho protein level was negatively correlated with frailty( r=-0.310, P<0.001).Multivariate Logistic regression analysis results showed that age( OR=1.109, 95% CI: 1.011-1.217, P=0.028)and sarcopenia( OR=6.511, 95% CI: 1.279-33.147, P=0.024)were risk factors for frailty, while walking( OR=0.104, 95% CI: 0.033-0.326, P<0.001), a high SPPB score( OR=0.780, 95% CI: 0.627-0.970, P=0.026), and a high Klotho protein level( OR=0.752, 95% CI: 0.581-0.974, P=0.031)were protective factors against frailty. Conclusions:The serum Klotho protein level may be used as a parameter for the assessment of frailty.It is negatively correlated with frailty, suggesting that elderly people with low serum Klotho protein levels are at high risk of developing frailty.

Strong evolutionary convergence of receptor-binding protein spike between COVID-19 and SARS-related coronaviruses

Coronavirus Disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS)-related coronaviruses (e.g., 2019-nCoV and SARS-CoV) are phylogenetically distantly related, but both are capable of infecting human hosts via the same receptor, angiotensin-converting enzyme 2, and cause similar clinical and pathological features, suggesting their phenotypic convergence. Yet, the molecular basis that underlies their phenotypic convergence remains unknown. Here, we used a recently developed molecular phyloecological approach to examine the molecular basis leading to their phenotypic convergence. Our genome-level analyses show that the spike protein, which is responsible for receptor binding, has undergone significant Darwinian selection along the branches related to 2019-nCoV and SARS-CoV. Further examination shows an unusually high proportion of evolutionary convergent amino acid sites in the receptor binding domain (RBD) of the spike protein between COVID-19 and SARS-related CoV clades, leading to the phylogenetic uniting of their RBD protein sequences. In addition to the spike protein, we also find the evolutionary convergence of its partner protein, ORF3a, suggesting their possible co-evolutionary convergence. Our results demonstrate a strong adaptive evolutionary convergence between COVID-19 and SARS-related CoV, possibly facilitating their adaptation to similar or identical receptors. Finally, it should be noted that many observed bat SARS-like CoVs that have an evolutionary convergent RBD sequence with 2019-nCoV and SARS-CoV may be pre-adapted to human host receptor ACE2, and hence would be potential new coronavirus sources to infect humans in the future.

Effects of individualized management on indicators of patients with type 2 diabetes mellitus / 中华全科医师杂志

Thirty eight patients with type 2 diabetes mellitus (T2DM) signed with the Lingering Garden Subdistrict Community Health Service Center of Suzhou Gusu District from October to December 2015 were enrolled in the study. The patients were classified as low risk group (n=3), moderate risk group (n=11), high risk group (n=21) and extremely high risk group (n=3) according to risk stratification of the JADE program based on estimated glomerular filtration rate (eGFR) and risk factors [obesity, dyslipidemia, hypertension, diabetic retinopathy, urinary protein creatinine ratio, foot disease, glycosylated hemoglobin A1c(HbA1c), fasting plasma glucose(FPG) or non fasting plasma glucose]. The patients were managed by a team consisting of general practitioners, general nurses and specialists; the individualized management was implemented with reduction of controllable risk factors and complications as the goal. After one year of management (March 2016 to February 2017) the indicators of T2DM were evaluated. The results showed that the TC, LDL-C, FPG and HbA1c levels were significantly improved in both moderate and high risk groups (P<0.05); the TC, LDL-C and FPG levels in the extremely high risk group were also significantly improved (P<0.05).

Assay of ischemia-modified albumin and C-reactive protein for early diagnosis of acute coronary syndromes.

Diagnosis of cardiac ischemia in patients coming to emergency departments (ED) with symptoms of acute chest pain is often difficult. Many markers are sensitive and specific for the detection of myocardial necrosis but may not rise during reversible myocardial ischemia. Ischemia-modified albumin (IMA) has recently been shown to be a sensitive and early biochemical marker of ischemia. The variation laws were observed by measuring IMA and C-reactive protein (CRP) of 113 patients in ED within 12 hr after onset of chest pain. In the observation, blood was taken for IMA and CRP. Patients underwent standardized triage, diagnostic procedures, and treatment. Results of IMA and CRP were correlated with final diagnoses of nonischemic chest pain (NICP) and acute coronary syndrome (ACS). There were obvious distinction of IMA and CRP levels between the NICP and ACS groups. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS patients from NICP. The area under the curves of IMA is 0.948. The sensitivity and specificity of albumin cobalt binding (ACB) at a cutoff value of 70.0 units/mL were 94.4% and 82.6%, respectively. The area under the curves of CRP is 0.746. Sensitivity and specificity of CRP at a cutoff value of 3.16 mg/L were 70.0% and 73.9%, respectively. Negative predictive value (NPV) of IMA and CRP for ischemia origin was 79.2% and 38.6%, respectively. IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity and specificity of ACS.

The inhibitory effect of ghrelin on insulin release of mouse islet ?-cell line and its mechanism / 中国糖尿病杂志

Objective To explore the effect of ghrelin on insulin release of mouse pancreatic islet ?-cell line(NIT-1 cells) and its probable mechanism.Methods NIT-1 cells were incubated in high-glucose DMEM with ghrelin.Then,the media was sampled for the assay of insulin by RIA.The(mRNA) expressions of glucose transporter 2(GluT2),pancreatic-duodenal homeobox-1(PDX-1),inwardly rectifying potassium channel with two transmembrane regions(Kir6.2) and sulphonylurea receptor 1(SUR-1) in the cells were detected by using RT-PCR.The cell proliferation was determined by MTT assay.Results(1) 10~(-9)mol/L to 10~(-7)mol/L of ghrelin inhibited dose-dependently the high-glucose challenged insulin release of the NIT-1 cells.(2) The mRNA expression of Kir6.2,but not GluT2,PDX-1and SUR-1,was down-regulated by 10~(-7)mol/L of ghrelin.(3) Ghrelin had no effect on proliferation of the cells.Conclusions Ghrelin inhibits high-glucose induced insulin secretion of the islet ?-cells.This effect may be secondary to the down-regulation for the expression of Kir6.2,(a component) of ATP-sensitive potassium channel.