Zhonghua yi xue za zhi最新文献

{"title":"[Effects of high-fat diet on the morphology and function of the thyroid gland and glycolipid metabolism in thyroid clock gene Bmal1 knockout mice].","authors":"Q T Ye, S L Zhang, W W Feng, H X Guan","doi":"10.3760/cma.j.cn112137-20240808-01819","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240808-01819","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the changes in thyroid morphology and function in mice with thyroid-specific knockout of the clock gene Bmal1 under high-fat diet (HFD), and to examine its effects on glycolipid metabolism in mice. <b>Methods:</b> Construct a mouse model with specific knockout of the Bmal1 gene in the thyroid (T-Bmal1<sup>-/-</sup>) (knockout group, <i>n</i>=10), and use Bmal1<sup>flox/flox</sup> mice without thyroid peroxidase-cyclization recombination enzyme (T-Bmal1<sup>+/+</sup>) as the control group (non-knockout group, <i>n</i>=10). The mice were fed until 6 weeks (body weight 20-23 g), and then use the random number table method to evenly divide each group of mice into two subgroups. They were then fed either with normal diet (ND) or (HFD), resulting in four final groups: ND non-knockout group, HFD non-knockout group, ND knockout group, and HFD knockout group, with 5 mice in each group. From the 6th week onwards, the body weights of the mice were measured for 10 consecutive weeks. On the first day of the 14th week, the intraperitoneal glucose tolerance test (IPGTT) was conducted, and on the first day of the 15th week, the intraperitoneal insulin tolerance test (IPITT) was performed. On the first day of the 16th week after the mice were born, blood samples (0.2 ml) were taken from the eyes under anesthesia at 7∶00, 13:00, 19:00, and 1∶00 the next day, and the thyroid, liver, kidneys, spleen, inguinal white adipose tissue, and scapular brown adipose tissue were rapidly removed. Thyroid tissue morphology, thyroid function indexes, thyroid clock genes and thyroid hormone synthesis and secretion related genes expression, body weight, IPGTT and IPITT area under the curve (AUC) and lipid levels were detected and compared among all groups. <b>Results:</b> There was no significant difference in the number of thyroid follicles, the area of thyroid follicles and the height of thyroid follicle cavity between ND knockout group and ND non-knockout group (all <i>P</i>>0.05), but the height of thyroid follicle cavity in HFD knockout group was lower than that in HFD knockout group [(25.8±1.6) vs (54.4±9.5) μm, <i>P</i>=0.002]. The level of serum T4 in knockout group after ND or HFD feeding was higher than that in non-knockout group (all <i>P</i><0.05). There was no significant difference in the mRNA expression level of sodium iodine transporter between ND knockout group and ND non-knockout group (<i>P</i>=0.550), but the mRNA expression level of sodium iodine transporter in HFD knockout group was higher than that in HFD non-knockout group [0.67±0.27 vs 0.20±0.09, <i>P</i>=0.006].There was no significant difference in weight gain and groin white fat weight between ND knockout group and ND non-knockout group (both <i>P</i><0.05), but weight gain and groin white fat tissue weight in HFD knockout group were lower than those in HFD knockout group (both <i>P</i><0.05). The IPGTT results showed no statistically significant difference in AUC ","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of LDL-C/HDL-C ratio on severity of coronary artery disease and 2-year long-term prognosis in elderly patients with coronary heart disease].","authors":"J J Xu, Y X Liu, Q X Li, Y Song, L Jiang, Y C Hao, Z Gao, J X Li, Y Zhang, L J Gao, X Y Zhao, L Song, Z Y Liu, X F Lu, J Q Yuan","doi":"10.3760/cma.j.cn112137-20240626-01425","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240626-01425","url":null,"abstract":"<p><p><b>Objective:</b> To explore the effect of low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio on the severity of coronary artery disease and 2-year adverse events in elderly patients with coronary heart disease. <b>Methods:</b> This prospective, multicenter, observational cohort study was from the prospective observational multicenter cohort for ischemic and hemorrhage risk in coronary artery disease patients (PROMISE) study, in which 18 701 patients with coronary heart disease (CHD) were included from January 2015 to May 2019. Among them, 6 770 elderly patients with CHD were enrolled in the current study. According to the median of LDL-C/HDL-C ratio (2.1), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.1, <i>n</i>=3 346) and high LDL-C/HDL-C group (LDL-C/HDL-C2.1, <i>n</i>=3 424). Baseline data and 2-year outcomes (including death, myocardial infarction, revascularization, stroke) were collected and analyzed in order to found the differences of elderly CHD patients with different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and prognosis using Cox multivariate regression analysis. <b>Results:</b> Patients in the low LDL-C/HDL-C group were older [(71.9±5.5) vs (71.5±5.4) years old, <i>P</i>=0.003], and there was no statistically significant difference in the proportion of males between the two groups (61.9% vs 63.4%,<i>P</i>=0.208). The indicators reflecting the severity of coronary artery lesions, including the number of target lesions, the number of coronary artery disease, preoperative SNYTAX score, and the proportion of triple-vessel disease (1.01±0.81 vs 0.88±0.78, 2.28±0.81 vs 2.14±0.83, 16.05±10.67 vs 13.59±9.49, 49.0% vs 41.0%, respectively, all <i>P</i>0.05) were higher in the high LDL-C/HDL-C group. The 2-year follow-up showed that there was no statistically significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause mortality, cardiac death, myocardial infarction, and revascularization between the high LDL-C/HDL-C ratio group and the low LDL-C/HDL-C ratio group. Compared by gender, the incidence of all-cause death and cardiac death in the high LDL-C/HDL-C group of female patients were higher than the low LDL-C/HDL-C group (6.9% vs 4.8%, 5.3% vs 3.7%, both <i>P</i>0.05, respectively); There was no statistically difference in the incidence of adverse events between the two groups of male patients. Cox multivariate regression analysis showed that, regardless of gender, the LDL-C/HDL-C ratio was not a risk factor for 2-year MACCE in elderly patients with CHD (male: <i>HR</i>=1.21, 95%<i>CI</i>: 0.87-1.69; female: <i>HR</i>=0.96, 95%<i>CI</i>: 0.65-1.43;total: <i>HR</i>=1.09, 95%<i>CI</i>: 0.85-1.39,all <i>P</i>0.05). <b>Conclusions:</b> The severity of coronary artery disease is higher in elderly patients with high LDL-C/HDL-C r","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4221-4228"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Associations of plasma acylcarnitine and bile acid levels with incidence of coronary heart disease in Chinese adults].","authors":"Z Y Wu, S Y Song, C Q Yu, D J Y Sun, P Pei, H D Du, J S Chen, Z M Chen, J Lyu, L M Li, Y J Pang","doi":"10.3760/cma.j.cn112137-20240626-01428","DOIUrl":"10.3760/cma.j.cn112137-20240626-01428","url":null,"abstract":"<p><p><b>Objective:</b> To explore the associations of plasma acylcarnitine and bile acid levels with the risk of incident coronary heart disease (CHD) in Chinese adults. <b>Methods:</b> The baseline survey of China Kadoorie Biobank (CKB) took place in 10 areas across China during 2004-2008, and the first resurvey took place from July to October 2008, with collection of data via questionnaire, physical examination and blood samples. The current study was based on 2 159 individuals with targeted mass spectrometry metabolomic measurements from the first resurvey of CKB. The associations of acylcarnitines and bile acids with incident CHD were assessed using Cox proportional hazards regression models. Unweighted metabolites scores were constructed to assess the overall effect of acylcarnitines and bile acids on incident CHD. The impact of metabolites on the performance of CHD prediction model was evaluated with the receiver operating characteristic (ROC) area under the curve (AUC). Follow-up for CHD incidence was censored on December 31, 2018. <b>Results:</b> The mean age of the participants was (53.1±9.8) years and 754 were males (34.9%). During (10.5±0.1) years of follow-up, 140 cases of CHD were recorded. Four metabolites including acylcarnitines C3-OH, C5:1, C5:1-DC, and deoxycholic acid (DCA) showed associations with CHD incidence and the <i>HR</i> (95%<i>CI</i>) were 1.474 (1.230-1.767), 0.761 (0.637-0.909), 0.773 (0.650-0.918), and 1.309 (1.113-1.539), respectively [false discovery rate (FDR)0.05]. All metabolite scores, including short-chain, medium-chain, long-chain acylcarnitines, primary and secondary bile acids scores were associated with the risk of CHD (FDR0.05). Compared to the traditional models, the addition of DCA or 4 key metabolites increased the AUC of the predictive model from 0.803 (0.761-0.845) to 0.812 (0.772-0.852) and 0.817 (0.778-0.857), respectively (all <i>P</i>0.05). <b>Conclusions:</b> Acylcarnitine and bile acid levels are associated with the risk of CHD, and DCA or 4 key metabolites can improve the predictive ability for CHD incidence.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4204-4211"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Focus on cardiovascular metabolism research and guide the prevention and control of chronic diseases in the older adults].","authors":"Y B Lyu, X M Shi","doi":"10.3760/cma.j.cn112137-20241011-02290","DOIUrl":"10.3760/cma.j.cn112137-20241011-02290","url":null,"abstract":"<p><p>With the acceleration of global population aging, the incidence and mortality of cardiovascular disease (CVD) among the older adults are continuously rising, posing an essential public health challenge that severely threatens their health and quality of life. In recent years, significant progress has been made in the research on epidemiological characteristics, risk factors, and prevention strategies of CVD in older adults. This review aims to summarize the current research status of CVD in the old adults, explore key factors affecting cardiovascular health, including genetic factors, lifestyle, and metabolic abnormalities, and evaluate the effectiveness of novel interventions. The goal is to provide a scientific basis for developing CVD prevention and management strategies tailored to the old adults.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4189-4192"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between cumulative body mass index exposure and cognitive function among elderly people aged 60 years and older in China].","authors":"W Y Wang, S F Chen, J X Li, J Cao, K Y Huang, Y X Zhao, C Shen, D S Hu, J F Huang, D F Gu, X F Lu, F C Liu","doi":"10.3760/cma.j.cn112137-20240626-01423","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240626-01423","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the relationship between cumulative body mass index (BMI) and cognitive score or cognitive impairment at different age groups among elderly adults aged≥60 years old. &lt;b&gt;Methods:&lt;/b&gt; Participants were recruited from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). A total of 27 227 participants aged≥60 years old, who completed at least 2 physical examinations between 1992-1994 and 2018-2021, and completed cognitive function tests from 2018 to 2021, were included in the final analysis. Cognitive score was assessed using the Minimum Mental State Examination (MMSE). Cognitive impairment was defined based on education level: illiterate individuals with MMSE≤17, primary school graduates with MMSE≤20, and secondary school graduates with MMSE≤24. Multivariate linear regression or multivariate logistic regression models were used to analyze the association between 10-year weighted cumulative BMI and cognitive score or cognitive impairment in the general population, as well as in specific age groups (including 60-64 years, 65-69 years, 70-74 years, and≥75 years). Restricted cubic spline was adopted to explore the dose-response relationship. &lt;b&gt;Results:&lt;/b&gt; The age of enrolled participants was (72.3±5.8) years, and 10 639 (39.1%) were males. The mean MMSE score was (24.9±6.8), and 4 171 (15.4%) participants had cognitive impairment. In the general population, the MMSE score increased and the risk of cognitive impairment decreased with the increase in cumulative BMI when cumulative BMI was280 kg/m&lt;sup&gt;2&lt;/sup&gt; (β=0.095, 95%&lt;i&gt;CI&lt;/i&gt;: 0.060-0.130; &lt;i&gt;OR&lt;/i&gt;=0.962, 95%&lt;i&gt;CI&lt;/i&gt;: 0.946-0.978). When cumulative BMI≥280 kg/m&lt;sup&gt;2&lt;/sup&gt;, the associations between cumulative BMI level and MMSE score and cognitive impairment risk were not statistically significant (β=-0.105, 95%&lt;i&gt;CI&lt;/i&gt;:-0.212-0.001; &lt;i&gt;OR&lt;/i&gt;=1.047, 95%&lt;i&gt;CI&lt;/i&gt;: 0.992-1.102). Subgroup analysis according to age groups revealed a potential\"U-shaped\"correlation between cumulative BMI and MMSE score or cognitive impairment risk in participants aged75 years old. For cumulative BMI levels280 kg/m&lt;sup&gt;2&lt;/sup&gt;, the &lt;i&gt;OR&lt;/i&gt; and 95%&lt;i&gt;CI&lt;/i&gt; for cognitive impairment were 0.983 (0.904-1.069), 0.953 (0.919-0.987), and 0.951 (0.922-0.982) for each 10 kg/m&lt;sup&gt;2&lt;/sup&gt; increment in cumulative BMI in the 60-64, 65-69, and 70-74 years old groups, respectively. For cumulative BMI≥280 kg/m&lt;sup&gt;2&lt;/sup&gt;, the &lt;i&gt;OR&lt;/i&gt; and 95%&lt;i&gt;CI&lt;/i&gt; were 1.548 (1.134-2.186), 1.037 (0.938-1.139), and 1.109 (1.014-1.208) in the 60-64, 65-69, and 70-74 age groups. Among those aged≥75 years old, the cumulative BMI level was statistically associated with the increased MMSE score and decreased cognitive impairment (β=0.132, 95%&lt;i&gt;CI&lt;/i&gt;: 0.074-0.190; &lt;i&gt;OR&lt;/i&gt;=0.961, 95%&lt;i&gt;CI&lt;/i&gt;: 0.944-0.979). &lt;b&gt;Conclusions:&lt;/b&gt; Overall, when cumulative BMI is280 kg/m&lt;sup&gt;2&lt;/sup&gt;, an increase in cumulative BMI is associated with a reduced risk of cognitive impairment in the general ","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4229-4239"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New insights into the nature and classification of myelodysplastic neopmasm].","authors":"H Q Wang, Z H Shao","doi":"10.3760/cma.j.cn112137-20240718-01647","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240718-01647","url":null,"abstract":"<p><p>The World Health Organization's (WHO) International Agency for Research on Cancer (IARC) released the fifth edition of the Classification of Tumors of the Hematopoietic and Lymphoid Tissues, renaming myelodysplastic syndrome (MDS) to myelodysplastic neoplasm (still abbreviated as MDS). This new classification integrates next-generation sequencing data to standardize the disease's nature. The name change reflects a deeper understanding of the disease, transitioning from the vague \"syndrome\" to a clearly defined neoplastic disease. The new classification divides MDS into two major categories: cytogenetic abnormalities and morphological abnormalities. Cytogenetic abnormalities include MDS with low blasts and isolated 5q deletion, MDS with low blasts and SF3B1 mutation, and MDS with biallelic TP53 alterations. Morphological abnormalities include MDS with low blasts, MDS with increased blasts and hypoplastic MDS. This revision provides a foundation for precise diagnosis and treatment of MDS, further restricting the application of immunosuppressive therapy and advancing genetic research in diagnostics and therapeutics.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4193-4196"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the emergency standard ischemic stroke care system time points for in-hospital-onset ischemic stroke and community-onset stroke in general hospital].","authors":"H H Fu, Y H Hong, D C Shen, Y Z Cao, N Su, F F Zhai, J Y Shi, Z Zhang, Y C Zhu, J Ni","doi":"10.3760/cma.j.cn112137-20240613-01330","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240613-01330","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the treatment situation at each time node in the standard in-hospital-stroke(IHS) in the general hospital compared with that in the emergency(community)-onset stroke (COS) group. <b>Methods:</b> A single-center retrospective case-control study was performed.The clinical cases of acute COS group and IHS group who were treated by the same stroke green channel team at Peking Union Medical College Hospital from Jan.2021 to Apr.2024 were included. The treatment process of acute stage of stroke was divided into four time nodes (onset, recognition, admission, and treatment), and the time of each time node was compared and analyzed. <b>Results:</b> A total of 219 ischemic stroke cases were included, comprising 83 and 136 cases in IHS and COS groups, respectively. There were 134 male patients (61.2%) with a mean onset age of (66.3±15.1) years. IHS occurred across various departments, mainly in surgical departments(55/83, 66.2%). Of the perioperative IHS events, 93.7% (45/48) occurred after the surgery. Compared with the COS group, the IHS group showed a higher rate of post-waking stroke[11/32(34.4%) vs 18/136(13.2%), <i>P</i>=0.004], a lower rate of intravenous thrombolysis[9/32 (29.0%) vs 128/136 (94.8%), <i>P</i>0.001], and a higher rate of mechanical thrombectomy [11/32(34.4%) vs 4/136 (2.9%), <i>P</i>0.001].The overall median onset-CT time in the IHS group was shorter than that in the COS group[<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] [100 (59, 189)min vs 135(75, 210)min, <i>P</i>=0.030]. In different stages, median time from stroke onset to recognition[25(1, 140) vs 1(1, 30)min,<i>P</i>=0.005] and the on-site/reception CT [30 (19, 40) min vs 16 (11, 26) min, <i>P</i>=0.001] in the IHS group were longer than those in the COS group, while the median time from recognition to admission[30 (10, 48) min vs 76 (53, 137)min, P0.001]was shorter than that in the COS group. <b>Conclusions:</b> By using the standard ischemic stroke care system, the overall treatment time for IHS group is shorter than that of COS groups. However, compared with COS patients, the onset-recognition and admission to examination/treatment time was significantly prolonged for IHS patients, reflecting the need for further optimization of the standardized in-hospital stroke treatment process.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4240-4245"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association of dietary patterns with blood lipid level among the older adults over 65 years old in 9 longevity areas of China].","authors":"Z N Xu, Y Li, J Wang, L J Xu, C Chen, Z H Zhang, Y Q Li, Y Xia, Z H Lu, S X Liu, X J Guo, Z H Li, X M Shi, C Mao, Y B Lyu","doi":"10.3760/cma.j.cn112137-20240629-01459","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240629-01459","url":null,"abstract":"<p><p><b>Objective:</b> To explore the impact of adherence to plant-based and animal-based dietary patterns on blood lipid level in Chinese older adults aged≥65. <b>Methods:</b> The study subjects were from the Chinese Longitudinal Health Biomarker Survey on Aging conducted between 2008 and 2018. The project carried out a baseline survey on elderly people in nine longevity areas of China from 2008 to 2009, and conducted 3 follow-up visits respectively in 2011-2012, 2014, and 2017-2018. The information about their demographic characteristics, lifestyles, physical examinations and fasting venous blood samples were collected. Food Frequency Questionnaire was used to collect data on food intake frequency. Priori plant-based and priori animal-based dietary patterns were constructed, and plant-based diet index (PDI) and animal-based diet index (ADI) were calculated in 2 011 older adults. Linear mixed-effects models were used to analyze the associations of different dietary pattern indices with blood lipid level in older adults. <b>Results:</b> The average age of 2 011 subjects was (83.1±11.5) years, 52.8% (1 061) of them were women. The PDI and ADI [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] were 41.0 (38.0, 45.0) and 43.0 (39.0, 46.0), respectively. After adjusting for covariates, the results of the linear mixed effects model analysis showed that for each increment of 10-unit in PDI, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased by 0.097 (95%<i>CI</i>:-0.151--0.042) mmol/L and 0.078 (95%<i>CI</i>:-0.118--0.038) mmol/L, respectively. For each increment of 10-unit in ADI, TC and LDL-C levels increased by 0.096 (95%<i>CI</i>: 0.042-0.151) mmol/L and 0.078 (95%<i>CI</i>: 0.038-0.118) mmol/L, respectively. <b>Conclusions:</b> In Chinese older adults≥65 years, higher adherence to the plant-based dietary pattern may lead to reductions in TC and LDL-C levels, while higher adherence to the animal-based dietary pattern may lead to increases in TC and LDL-C levels.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4212-4220"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The level of thyroid stimulating hormones in different gender and age and the association with the risk of coronary heart disease in cohort population].","authors":"J H Liu, H K Xie, Y Liu, M Liu, D Wu, C N Hu, T Xu, Y Fan, W Tang, C Shen","doi":"10.3760/cma.j.cn112137-20240624-01399","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240624-01399","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the thyroid stimulating hormone (TSH) levels in different genders and ages, and the association between TSH level and the risk of coronary heart disease. <b>Methods:</b> The baseline survey was conducted using a multi-stage cluster random sampling method from September to December 2015, in Jurong City, Jiangsu Province. A total of 10 703 participants were included in the analysis. The proportion of participants with abnormally elevated TSH defined by three cut-off values (4.5, 7.0, and 10.0 mU/L) were calculated. The cohort was followed up until August 2023 to collect and verify new cases of coronary heart disease. The population was divided into age-and gender-specific quintile subgroups based on TSH. Multivariate Cox regression analysis was used to examine the relationship between TSH and the risk of coronary heart disease. <b>Results:</b> The median age was [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] 61.1(51.8, 67.9) years-old, and there were 4 168 males (38.94%) in the study. The proportions of participants with abnormally increased TSH rose with aging in different genders, and was higher in females than in males (all <i>P</i>_trend0.05). A total of 206 participants with coronary heart disease at baseline were excluded, and the other 10 497 were followed up for an average of (7.33±1.49) years, during which 350 new cases of coronary heart disease occurred, and the cumulative incidence rate was 3.34%. The cumulative incidence rates among TSH quintile Q1-Q5 groups were 3.62%, 3.32%, 3.56%, 3.28% and 2.57% respectively. Multivariate Cox regression analysis indicated that compared with TSH Q1 group, participants in Q5 group had a lowest risk of coronary heart disease (<i>HR</i>=0.704, 95%<i>CI</i>: 0.498-0.994). The TSH Q5 group was associated with a reduced risk of coronary heart disease in individuals60 years old (<i>HR</i>=0.484, 95%<i>CI</i>: 0.243-0.965), and the risk of coronary heart disease decreased as TSH levels increased (<i>P</i>_trend=0.008). <b>Conclusions:</b> TSH level increases with aging, and is higher in females than in males. In individuals 60 years old, higher levels of TSH may assaciate with a lower incidence rate of coronary heart disease.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4197-4203"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of short-to medium-term ischemia and bleeding risks between unfractionated heparin and bivalirudin in patients with acute coronary syndrome after PCI].","authors":"Y Y Hou, S S Su, F C Zhang, X Wu, G Xue, Z F Wang","doi":"10.3760/cma.j.cn112137-20240730-01755","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240730-01755","url":null,"abstract":"<p><p><b>Objective:</b> To compare the short-and medium-term ischemia and bleeding risk between unfractionated heparin and bivalirudin in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). <b>Methods:</b> A total of 742 patients with ACS who underwent emergency PCI in Xinxiang Central Hospital of Henan Province from January 2016 to June 2022 were selected and divided into unfractionated heparin group (385 cases) and bivalirudin group (357 cases) according to the anticoagulant regimen. All patients were followed up for 6 months. The incidence of ischemic and bleeding events at 30 days and 6 months after operation were compared between the two groups. Multivariate Cox proportional regression model was used to analyze the risk factors of ischemic and bleeding events in the two groups. Kaplan Meier method was used to calculate the cumulative survival rate, and log rank method was used to analyze the difference in survival rates. <b>Results:</b> The age of 742 patients was (62.5±14.8) years old, and male accounted for 58.5% (434 cases). The age of unfractionated heparin group was (61.8±14.8) years old, and male accounted for 59.2% (228 cases); The age of bivalirudin group was (63.3±14.8) years old, and male accounted for 57.7% (206 cases). The incidence of bleeding events at 30 days and 6 months in the unfractionated heparin group were 6.8% (26 cases) and 9.9% (38 cases), respectively, which were higher than 3.4% (12 cases) and 4.5% (16 cases) in the bivalirudin group (all <i>P</i>0.05); The incidence of ischemic events at 30 days and 6 months in the unfractionated heparin group were 7.5% (29 cases) and 11.2% (43 cases), respectively, which were not observed to be significantly different with those in the bivalirudin group [6.2% (22 cases) and 9.5% (34 cases)] (all <i>P</i>0.05). Compared with patients using bivalirudin, the <i>HR</i> value (95%<i>CI</i>) of bleeding events after emergency PCI in patients using unfractionated heparin was 1.964 (1.317-3.125) (<i>P</i>0.05), and the <i>HR</i> value (95%<i>CI</i>) of ischemic events was 0.948(0.595-1.510) (<i>P</i>0.05). The cumulative incidence of bleeding events was 9.9% in unfractionated heparin group and 4.5% in bivalirudin group (<i>P</i>=0.005); The cumulative incidence of ischemic events was 11.2% in unfractionated heparin group and 9.5% in bivalirudin group (<i>P</i>=0.459). <b>Conclusions:</b> The incidence of short-term hemorrhage events in ACS patients treated with bivalirudin anticoagulation after emergency PCI is lower than that of unfractonated heparin, which can reduce the risk of short-term hemorrhage.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 46","pages":"4246-4252"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}