Association of serum resistin with cystatin C and urinary albumin-to-creatinine ratio in elderly Chinese men with essential hypertension.

PURPOSE OF THE STUDY: Resistin, a recently discovered proinflammatory cytokine, has been strongly linked to kidney dysfunction. The aim of this study was to determine the relationship of serum resistin with serum cystatin C (sCysC) and albuminuria, two sensitive endogenous markers of renal function, in elderly male patients with essential hypertension (EH). STUDY DESIGN: This was a cross-sectional study enrolling 296 Chinese men (age ≥60 years, mean age 81.42 years) diagnosed with EH between January 2008 and May 2011. Renal function was assessed by measurement of sCysC levels and albuminuria (calculated as the urine albumin-to-creatinine ratio (uACR)). Serum resistin and selected metabolic and cardiovascular markers were determined by serological testing. Relationships between serum resistin levels and sCysC levels and uACR were analysed using multiple regression analysis. RESULTS: Multiple linear regression analyses revealed that the serum resistin level was positively associated with the sCysC level and uACR (ß(uACR)=0.132, p(uACR)=0.002; ß(sCysC)=0.015, p(sCysC)=0.008). CONCLUSIONS: Our findings demonstrated that a raised serum resistin level is a potential indicator of renal dysfunction in elderly patients with EH. Resistin may be explored as a potential biomarker in addition to sCysC and uACR to provide a more accurate diagnosis of renal damage in elderly men with EH.

Serum cystatin C and indices of lung function in elderly Chinese men with chronic obstructive pulmonary disease.

OBJECTIVE: The aim of this cross-sectional case-control study was to determine the relationship between serum cystatin C (sCysC) levels and lung function in elderly male patients with chronic obstructive pulmonary disease (COPD). METHODS: This study included 251 Chinese men (age ≥ 65 years) who were divided into COPD (n = 129) and non-COPD (n = 122) groups. Participants underwent lung function and laboratory testing, including measurement of sCysC levels. Relationships between sCysC concentration and indices of lung function were assessed by multiple regression analysis. RESULTS: Participants in the COPD group displayed higher sCysC concentrations (P = 0.041) and lower lung function (P < 0.001) compared to participants in the non-COPD group. Multiple linear regression analyses revealed that the reciprocal of the sCysC concentration (1/sCysC) was positively associated with the predicted forced expiratory volume in 1 s in all subjects (ß = 0.156, P = 0.009). The findings indicate that high sCysC levels were directly associated with decreased lung function in elderly Chinese men with COPD. CONCLUSIONS: High sCysC concentration may be a potential indicator of impaired lung function, and its application may improve the diagnosis and assessment of COPD severity in elderly male patients.

Correlation between sex hormone levels and obesity in the elderly male.

OBJECTIVE: To investigate the levels of sex hormones and androgen receptor (AR) in elderly male patients and to explore a possible correlation with obesity. METHODS: The cross-sectional study included 314 Elderly males (age ≥ 65 year). Of these subjects, 104 were healthy (age range 65-92 year; mean 71.38 ± 5.154 year), 74 were obese (65-87 year; 71.32 ± 4.74 year), and 111 were overweight (65-85 year; 71.43 ± 5.03 year). The following parameters were measured: total testosterone (TT), free testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), estradiol (E2), luteinizing hormone, follicle-stimulating hormone and AR. RESULTS: (i) The levels of TT and SHBG in the obesity group were significantly lower than those in non-obese subjects. (ii) Body mass index (BMI) negatively correlated with TT and SHBG. (iii) Multiple regression analysis revealed that TT (ß: -0.230; p = 0.045) and SHBG (ß: -0.163; p = 0.02) were statistically correlated with BMI. CONCLUSION: Testosterone levels in the obese population were significantly lower than in the non-obese population and there is a significant association between testosterone levels and the extent of obesity.

Sex hormones and androgen receptor: risk factors of coronary heart disease in elderly men.

OBJECTIVE: To investigate the variation of sex hormone and its receptor level in elderly male patients with coronary heart disease (CHD) and to evaluate the correlations between CHD and sex hormone as well as sex hormone receptor. METHODS: Altogether 139 male CHD patients (CHD group) aged 60-92 years and 400 healthy men (control group) aged 60-90 years were included in this cross sectional study. The plasma concentrations of dehydroepiandrosterone sulfate (DHEAS), total testosterone (TT), free testosterone (FT), estradiol (E2), sex hormone binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured. The androgen receptor (AR) was tested by flow cytometry. Correlations between CHD and levels of sex hormones and AR were analyzed. RESULTS: Compared with the control group, the levels of DHEAS, TT, FT, SHBG, and the fluorescence intensity of AR in the CHD group significantly reduced (P < 0.05), while the levels of FSH and E2 significantly increased (P < 0.01). Age was negatively correlated with TT (r = -0.28, P = 0.00) and FT (r = -0.17, P = 0.01), while it was positively correlated with SHBG (r = 0.14, P = 0.04) and E2 (r = 0.33, P = 0.00). AR fluorescence intensity was negatively correlated with systolic blood pressure (r = -0.12, P = 0.01). Binary logistic regression analysis showed that TT, SHBG, and AR were all negatively correlated with CHD (P < 0.05). CONCLUSIONS: Elderly male patients with CHD are found to have low levels of DHEAS, TT, FT, SHBG, and AR, while high concentrations of E2 and FSH. Low levels of TT and SHBG may be the potential risk factors of CHD in elderly men.

High serum resistin level may be an indicator of the severity of coronary disease in acute coronary syndrome.

OBJECTIVE: To investigate the correlation between serum resistin level, cardiovascular risk factors and severity of coronary disease in acute coronary syndrome (ACS). METHODS: After evaluated by clinical history, electrocardiography, exercise tolerance tests, laboratory tests, and coronary angiography, 220 consecutive patients with suspected chest pain were divided into normal control group, stable angina pectoris (SAP) group, and ACS group, respectively. Baseline clinical characteristics, including height, weight, waist circumference, hip circumference, white blood cell count, high-sensitive C-reactive protein (hsCRP), total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, were compared among three groups. ELISA was used to detect serum resistin levels. Pearson's correlation coefficient analysis was used to assess association between resistin and other traditional cardiovascular risk factors. Multinomial logistic regression analyses were used to define the relationship between serum resistin level and SAP or ACS. RESULTS: Serum resistin level in ACS group (1.18+/-0.48 microg/L) was significantly higher than that in normal control and SAP groups (0.49+/-0.40 and 0.66+/-0.40 microg/L; P<0.01). Only in ACS group, increased serum resistin level was significantly correlated with hsCRP (r=0.262, P=0.004) and white blood cell count (r=0.347, P=0.001). Furthermore, serum resistin levels showed a stepwise increase with the number increase of > 50% stenosed coronary vessels. Multinomial logistic regression test demonstrated that serum resistin was a strong risk factor for ACS (OR=29.132, 95 % CI: 10.939-77.581, P<0.001). CONCLUSION: These findings suggested the potential role of resistin in atherosclerosis and especially its involvement in ACS.

Drug therapy of paroxysmal atrial fibrillation in the elderly over 75 years old.

OBJECTIVE: To investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old. METHODS: Totally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22.3%) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used. RESULTS: The cardioversion ratio of atrial fibrillation were 9.5%, 46.9%, 71.7%, 55.9%, 32.7%, and 73.6% in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84.9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group. CONCLUSION: Amiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.