Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Effect of dapagliflozin on uric acid in patients with chronic heart failure and hyperuricemia

BACKGROUND Patients with chronic heart failure(CHF)frequently develop hyperuricemia,an elevated serum uric acid level,associated with adverse outcomes.Dapagliflozin,a sodium-glucose cotransporter-2 inhibitor,demonstrates reduction in cardiovascular mortality and hospitalization in patients with CHF and ejection fraction(HFrEF),irrespective of diabetes.However,dapagliflozin’s effect on the uric acid levels in patients with CHF and hyperuricemia remain unclear.AIM To investigate the effects of dapagliflozin on uric acid levels in CHF patients with hyperuricemia.METHODS We conducted a randomized,double-blind,placebo-controlled trial in 200 patients with CHF and hyperuricemia,with HFrEF and serum uric acid levels≥7 mg/dL(≥416μmol/L).The participants were randomly assigned to receive a daily dose of 10 mg dapagliflozin or placebo for 24 months.The primary endpoint was the change in serum uric acid level from baseline to 24 months.Secondary endpoints included changes in left ventricular ejection fraction(LVEF),Nterminal pro-B-type natriuretic peptide(NT-proBNP),and quality of life(QoL)scores,as well as the incidence of cardiovascular death and hospitalization for heart failure.RESULTS At 24 months,dapagliflozin significantly reduced serum uric acid levels by 1.2 mg/dL(71μmol/L)compared with placebo(95%CI:-1.5 to-0.9;P<0.001).Dapagliflozin also significantly improved LVEF by 3.5%(95%CI:2.1-4.9;P<0.001),NT-proBNP by 25%(95%CI:18-32;P<0.001),and QoL scores by 10 points(95%CI:7-13;P<0.001)and reduced the risk of cardiovascular death and hospitalization for heart failure by 35%(95%CI:15–50;P=0.002)compared with the placebo.Adverse events were similar between the two groups,except for a higher rate of genital infections in the dapagliflozin group(10%vs 2%,P=0.01).CONCLUSION Dapagliflozin significantly lowered serum uric acid levels and improved the clinical outcomes in patients with CHF and hyperuricemia.Therefore,dapagliflozin may be a useful therapeutic option for this high-risk population.

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

血清Hb、NLR、SUA/CR与糖尿病骨质疏松患者临床风险因素及利拉鲁肽治疗效果的相关性

目的分析血清血红蛋白(Hb)、中性粒细胞与淋巴细胞比值(NLR)、血尿酸/肌酐比值(SUA/CR)与糖尿病骨质疏松(DOP)患者临床风险因素的关系,并探讨三者与利拉鲁肽治疗后骨密度的相关性。方法回顾性分析2020年1月至2023年1月平顶山市第一人民医院内分泌科收治的185例糖尿病患者的临床资料,根据是否合并骨质疏松将其分为骨质疏松组58例和无骨质疏松组127例。比较两组患者的血清Hb、NLR、SUA/CR水平;经二元Logistic回归模型分析DOP的临床风险因素;采用Pearson相关性分析法分析骨质疏松患者血清Hb、NLR、SUA/CR与临床风险因素的相关性;骨质疏松组患者均采用利拉鲁肽治疗,比较其治疗前后的骨密度;采用Pearson相关性分析法分析血清Hb、NLR、SUA/CR与治疗后骨密度的相关性。结果与无骨质疏松组比较,骨质疏松组患者的年龄更大,体质量指数(BMI)、握力降低,糖尿病病程延长,差异均有统计学意义(P<0.05)。骨质疏松组患者的血清Hb水平为(112.67±15.33)g/dL,明显低于无骨质疏松组的(129.78±19.27)g/dL,而NLR、SUA/CR分别为2.68±0.57、(84.53±9.71)mg/g,明显高于无骨质疏松组的2.17±0.48、(57.63±7.17)mg/g,差异均有统计学意义(P<0.05)。二元Logistic回归模型分析结果显示,年龄(OR=8.919,95%CI:1.904~41.788)、糖尿病病程(OR=6.830,95%CI:1.147~40.689)是DOP的危险性因素,而BMI(OR=0.331,95%CI:0.148~0.738)、握力(OR=0.292,95%CI:0.121~0.705)是其保护性因素(P<0.05)。Pearson相关性分析结果显示,年龄、糖尿病病程与血清Hb呈负相关(P<0.05),BMI、握力与血清NLR、SUA/CR呈负相关(P<0.05);年龄、糖尿病病程与血清NLR、SUA/CR呈正相关(P<0.05);BMI、握力与血清Hb呈正相关(P<0.05)。骨质疏松患者经利拉鲁肽治疗后的骨密度为(0.79±0.16)g/cm^(2),明显高于治疗前的(0.65±0.12)g/cm^(2),差异有统计学意义(t=9.521,P<0.05)。Pearson相关性分析结果显示,血清Hb与治疗后骨密度呈正相关(P<0.05),血清NLR、SUA/CR与治疗后骨密度呈负相关(P<0.05)。结论血清Hb、NLR、SUA/CR与DOP的临床风险因素及利拉鲁肽治疗后骨密度密切相关,可为临床DOP风险及治疗效果评估提供参考。

血清Hcy、TBIL联合SUA检测对首发缺血性脑卒中及不良预后的预测价值

目的探讨血清同型半胱氨酸(Hcy)、总胆红素(TBIL)联合血尿酸(SUA)水平检测对首发缺血性脑卒中(FIS)及不良预后的预测价值。方法该研究为回顾性分析,选择2020年1月至2021年7月在该院神经内科住院治疗的210例FIS患者作为观察组,另匹配同期体检健康者210例作为对照组。比较两组血清Hcy、TBIL和SUA水平。统计FIS患者出院后1个月时的脑卒中致残、复发情况并使用改良Rankin量表(mRS)评估出院3个月时的预后情况,采用多因素Logistic回归分析FIS及其不良预后事件的危险因素。采用受试者工作特征(ROC)曲线评价血清Hcy、TBIL和SUA联合检测对FIS及复发、致残、mRS评分≥3分等不良预后事件的预测价值。结果与对照组相比,FIS患者的血清Hcy和SUA水平均显著升高,血清TBIL水平显著降低,差异有统计学意义(P<0.01)。出现复发、致残和mRS评分≥3分等不良预后事件的患者群体血清Hcy和SUA水平显著升高,血清TBIL水平显著降低,差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,血清Hcy、TBIL和SUA不仅是FIS的影响因素(P<0.01),也是FIS患者疾病复发、致残和mRS评分≥3分等不良预后事件的影响因素(P<0.01)。ROC曲线分析结果显示,血清Hcy、TBIL和SUA 3项指标联合诊断FIS的曲线下面积(AUC)为0.835(95%CI:0.789~0.875),3项指标联合诊断FIS的效能显著优于单指标检测(P<0.01)。3项指标联合检测对致残(AUC=0.859,95%CI:0.804~0.903)、复发(AUC=0.807,95%CI:0.747~0.858)、mRS≥3分(AUC=0.847,95%CI:0.791~0.893)等不良预后事件也具备一定的预测效能,且预测效能显著优于单指标检测(P<0.05)。结论血清Hcy、TBIL和SUA水平与FIS发生及预后密切相关,血清Hcy、TBIL和SUA联合检测在FIS的诊断和预后评估中具有较高的临床价值。

Cys C、C1q、β_(2)-MG、Urea、UA检测对初诊多发性骨髓瘤患者合并肾损伤的诊断价值

目的探讨肾功能指标胱抑素C(cystatin C,Cys C)、补体C1q(complement C1q)、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)、尿素(Urea)、尿酸(uric acid,UA)对初诊多发性骨髓瘤(multiplemyeloma,MM)患者合并肾损伤(renal impairment,RI)的诊断价值。方法回顾性分析2021年8月~2022年12月首都医科大学附属北京积水潭医院血液科收治的93例初诊MM患者的病例资料,按照血肌酐水平将MM患者分为RI组[血肌酐>176.80mmol/L(2mg/dl),n=19]及非RI组[血肌酐≤176.80mmol/L(2mg/dl),n=74],对RI组和非RI组的临床资料及实验室指标进行分析。采用单因素和多因素Logistic回归分析评价MM患者发生RI的危险因素,应用受试者工作特征(receiver operating characteristic,ROC)曲线评估危险因素对MM患者发生RI的预测价值。结果93例初诊MM患者发生RI者占25.68%,RI组轻链型占比最高(36.84%,7/19),IgG-λ型和IgA-κ型比例最低(10.53%,2/19);非RI组IgA-κ型比例最高(29.73%,22/74),IgG-λ型比例最低(12.16%,9/74)。DS分期中,RI组19例全部为Ⅲ期,非RI组72例全部为Ⅲ期。ISS分期中,RI组Ⅲ期最多(68.42%,13/19),非RI组中Ⅰ期最多(41.89%,31/74)。RISS分期中,RI组Ⅱ期和Ⅲ期最多(36.84%,7/19),非RI组Ⅱ期最多(58.11%,43/74)。DS分期和ISS分期组间差异有统计学意义(P<0.05)。RI组中Cys C、β_(2)-MG、Urea、UA水平均高于非RI组,差异均有统计学意义(P<0.05)。单因素分析结果显示,Cys C、Urea、β_(2)-MG水平异常升高是MM患者发生RI的危险因素(P<0.05),C1q对MM患者发生RI没有影响(P>0.05);多因素Logistic回归分析结果显示,Cys C、Urea、β_(2)-MG水平异常升高均是MM患者发生RI的独立影响因素(P<0.05)。Cys C、Urea、β_(2)-MG预测MM患者发生RI的敏感度分别为88.9%、50.0%、94.4%,特异性分别为90.4%、100.0%、84.9%;Cys C、Urea、β_(2)-MG联合检测预测MM患者发生RI的敏感度为100.0%,特异性为87.7%。结论Cys C、Urea、β_(2)-MG均能较好地预测初诊MM患者发生RI的可能性,3项指标联合检测对MM患者发生RI具有更高的预测价值。

SUA、hs-CRP水平联合Tan评分对急性脑梗死静脉溶栓患者再发卒中的预测价值

目的:探讨血尿酸(SUA)、超敏C反应蛋白(hs-CRP)水平联合CT血管造影(CTA)脑侧支循环(Tan)评分对急性脑梗死静脉溶栓患者再发卒中的预测价值。方法:回顾性分析2021年1月至2022年6月于该院接受静脉溶栓治疗的126例急性脑梗死患者的临床资料,出院后随访12个月,根据患者是否再发卒中将其分为再发组和未发组。比较两组SUA、hs-CRP水平和Tan评分,并采用受试者工作特征(ROC)曲线分析三者单独及联合检测对急性脑梗死静脉溶栓患者再发卒中的预测价值。结果:126例急性脑梗死患者经静脉溶栓治疗后,31例再发卒中,再发率为24.60%(31/126);再发组SUA、hs-CRP水平均高于未发组,Tan评分低于未发组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,SUA、hs-CRP水平及Tan评分单项及联合检测预测急性脑梗死静脉溶栓患者再发卒中的曲线下面积分别为0.833、0.824、0.756、0.935,联合检测的预测价值最高,高于三者单项检测预测。结论:SUA、hs-CRP水平联合Tan评分对急性脑梗死静脉溶栓患者再发卒中的预测价值高于三者单项检测预测。

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults

Objective The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio(UHR) and the risk of nonalcoholic fatty liver disease(NAFLD) in Chinese adults.Methods A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination and a blood test. NAFLD was diagnosed using ultrasonography after other etiologies were excluded. Logistic regression and restricted cubic spline model were conducted to evaluate the relationship of UHR with NAFLD risk.Results The multivariable adjusted odds ratio(95% confidence interval, CI) for NAFLD in the highest versus lowest quartile of UHR was 3.888(2.324–6.504). In analyses stratified by sex and age, we observed significant and positive associations between UHR and the risk of NAFLD in each subgroup. In analyses stratified by body mass index(BMI), a significant and positive association was found only in individuals with a BMI of ≥ 24 kg/m2. Our dose-response analysis indicated a linear positive correlation between UHR and the risk of NAFLD.Conclusion UHR is positively associated with the risk of NAFLD and may serve as an innovative and noninvasive marker for identifying individuals at risk of NAFLD.

绝经后骨质疏松患者血清DPP-4、UA、P、25(OH)D_(3)水平变化及其与骨代谢指标的相关性

目的检测绝经后骨质疏松患者血清二肽基肽酶-4(DPP-4)、尿酸(UA)、孕酮(P)、25羟维生素D_(3)[25(OH)D_(3)]水平,并分析其与骨代谢指标的相关性。方法选择2022年2月至2023年2月西安医学院第一附属医院收治的320例绝经后骨质疏松患者作为观察组,并选择同期在我院接受体检的300名健康绝经女性作为对照组,比较两组受检者的血清DPP-4、UA、P、25(OH)D_(3)水平及骨代谢指标[骨钙素(OC)、I型前胶原氨基末端前肽(PINP)、β-胶联降解产物(β-CTX)及骨碱性磷酸酶(BALP)],并采用Pearson法分析血清DPP-4、UA、P、25(OH)D_(3)水平与骨代谢指标的相关性。结果观察组患者的血清DPP-4水平为(183.41±21.49)IU/L,明显高于对照组的(125.82±13.04)IU/L,UA、P、25(OH)D_(3)水平分别为(252.83±21.69)μmol/L、(1.23±0.18)nmol/L、(21.21±3.72)ng/mL,明显低于对照组的(304.34±25.77)μmol/L、(1.70±0.22)nmol/L、(32.74±3.51)ng/mL,差异均有统计学意义(P<0.05);观察组患者OC、PINP、β-CTX、BALP分别为(8.02±1.18)μg/L、(225.34±34.02)ng/mL、(0.75±0.09)ng/mL、(21.76±3.05)μg/L,明显高于对照组的(5.57±0.84)μg/L、(175.06±26.71)ng/mL、(0.45±0.06)ng/mL、(15.80±2.43)μg/L,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清DPP-4与OC、PINP、β-CTX、BALP均呈正相关(P<0.05),UA、P、25(OH)D_(3)与OC、PINP、β-CTX、BALP均呈负相关(P<0.05)。结论绝经后骨质疏松患者血清DPP-4水平升高,UA、P、25(OH)D_(3)水平降低,且均与骨代谢指标具有明显相关性,临床上应予以密切关注。

2型糖尿病视网膜病变患者血清APN、SUA及MLR水平的变化及诊断价值研究

目的通过比较血清脂联素(APN)、血尿酸(SUA)及单核细胞与淋巴细胞比值(MLR)在2型糖尿病视网膜病变(DR)患者中的水平变化,探讨其辅助DR早期诊断的价值。方法选取2022年1月至2022年8月在首都医科大学附属北京同仁医院(以下简称为“我院”)收治的2型糖尿病(T2DM)患者150例,依据临床诊断分为3组:糖尿病无视网膜病变组(T2DM组)55例,非增生性糖尿病视网膜病变组(NPDR组)39例、增生性糖尿病视网膜病变组(PDR组)56例;另选取我院同期健康体检者51例作对照组。测定所有研究对象的血清APN水平,并收集所有对象的血糖、血脂、肝功、肾功等生化指标及血常规中单核细胞计数和淋巴细胞计数,计算三酰甘油-葡萄糖(TyG)指数、MLR。比较各项指标在4组之间水平变化,寻找差异性指标,运用ROC曲线分析各指标单独及联合辅助诊断DR的价值。结果(1)4组间比较,血清APN、SUA、MLR比较差异具有统计学意义(P<0.001、P=0.004、P=0.001),T2DM组、NPDR组、PDR组APN水平均低于对照组;T2DM组、NPDR组及PDR组SUA、MLR均高于对照组,且随病情加重而上升。(2)2组间比较中,PDR组APN、SUA、MLR水平均显著高于T2DM组,差异均有统计学意义(P<0.05),而NPDR组APN、SUA、MLR水平与T2DM组和PDR组的组间比较差异无统计学意义(P>0.05)。(3)Logistic回归分析中,结果显示APN、MLR、SUA为2型糖尿病患者发生视网膜病变的危险因素(OR>1,P<0.05)。(4)ROC曲线分析显示APN、SUA、MLR、APN+SUA+MLR的灵敏度分别为56.8%、61.1%、68.4%、77.9%,特异性分别为74.5%、63.6%、58.2%、74.5%,曲线下面积(AUC)分别为0.691、0.615、0.639、0.816,阴性预测值分别为50.0%、48.6%、51.6%、66.1%,阳性预测值分别为79.4%、74.4%、73.9%、84.1%,对判断糖尿病是否合并视网膜病变具有一定诊断价值。结论DR的发生发展与APN、SUA、MLR水平相关,3项指标单独检测对DR的辅助诊断价值有限,3者联合检测更有助于DR的辅助诊断。

Science Letters:Evaluation of a kinetic uricase method for serum uric acid assay by predicting background absorbance of uricase reaction solution with an integrated method

A patented kinetic uricase method was evaluated for serum uric acid assay. Initial absorbance of the reaction mixture before uricase action （A0） was obtained by correcting the absorbance at 293 nm measured before the addition of uricase solution, and background absorbance （Ab） was predicted by an integrated method. Uric acid concentration in reaction solution was calculated from AA, the difference between A0 and Ab, using the absorptivity preset for uric acid. This kinetic uricase method exhibited CV〈4.3% and recovery of 100%. Lipids, bilirubin, hemoglobin, ascorbic acid, reduced glutathione and xanthine 〈0.32 mmol/L in serum had no significant effects. △A linearly responded to 1.2 to 37.5 μmol/L uric acid in reaction solution containing 15 μl serum. The slope of linear response was consistent with the absorptivity preset for uric acid while the intercept was consistent with that for serum alone. Uric acid concentrations in clinic sera by different uricase methods positively correlated to each other. By Bland-Altman analysis, this kinetic uricase method accorded with that by quantifying the total change of UV absorbance on the completion of uricase reaction. These results demonstrated that this kinetic uricase method is reliable for serum uric acid assay with enhanced resistance to both xanthine and other common errors, wider range of linear response and much lower cost.

Association between Serum Uric Acid and the Early Marker of Kidney Function Decline among Chinese Middle-Aged and Older Population:Evidence from the China Health and Retirement Longitudinal Study

Objective To evaluate the association between serum uric acid(SUA)and kidney function decline.Methods Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis.The kidney function decline was defined as an annual estimated glomerular filtration rate(e GFR)decrease by>3 mL/min per 1.73 m^(2).Multivariable logistic regression was applied to determine the association between SUA and kidney function decline.The shape of the association was investigated by restricted cubic splines.Results A total of 7,346 participants were included,of which 1,004 individuals(13.67%)developed kidney function decline during the follow-up of 4 years.A significant dose-response relation was recorded between SUA and the kidney function decline(OR 1.14,95%CI 1.03-1.27),as the risk of kidney function decline increased by 14%per 1 mg/d L increase in SUA.In the subgroup analyses,such a relation was only recorded among women(OR 1.22,95%CI 1.03-1.45),those aged<60 years(OR 1.22,95%CI 1.05-1.42),and those without hypertension and without diabetes(OR 1.22,95%CI 1.06-1.41).Although the dose-response relation was not observed in men,the high level of SUA was related to kidney function decline(OR 1.83,95%CI 1.05-3.17).The restricted cubic spline analysis indicated that SUA>5 mg/dL was associated with a significantly higher risk of kidney function decline.Conclusion The SUA level was associated with kidney function decline.An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.

Clinical Significance of Serum Uric Acid Combined with Cystatin C Detection in Patients with Different Levels of Hypertension with High Risk Degree and Above

Objective: To explore the clinical significance of serum uric acid combined with cystatin C detection in high risk degree of hypertension of different grades. Methods: The patients who were treated in the Department of Cardiovascular Medicine of our hospital from January to December 2022 were selected as the study subjects, and the high risk and extremely high risk groups of grade I, II and III hypertension were selected for comparative analysis to explore their clinical significance. Results: There was a statistically significant difference in the number of patients with extremely high risk of grade II hypertension between men and women (P 0.05), which showed that there was no specificity in the concentration detection of serum uric acid and cystatin C in different grades of hypertension;there was no significant difference in serum uric acid concentration between grade II and grade III of hypertension with high risk grade and cystatin C concentration between grade I and grade III of hypertension with high risk grade (P > 0.05), but there was significant difference in the concentration detection of serum uric acid and cystatin C between the other groups (P < 0.05), which indicates that the detection of serum uric acid and cystatin C has important clinical significance in the high risk degree of hypertension. Conclusion: In the comparison of the detection of blood uric acid and cystatin C in different levels of hypertension with extremely high risk, the difference of cystatin C in grade I and grade III was not statistically significant, and the rest were statistically significant;therefore, the detection of serum uric acid and cystatin C can provide reliable laboratory data for clinical diagnosis and treatment of the extremely high risk degree of different levels of hypertension.

冠心病合并2型糖尿病患者SUA、25(OH)D、血脂水平的变化及其与冠脉病变严重程度的相关性

目的探讨冠心病合并2型糖尿病患者血尿酸(SUA)、25-羟基维生素D[25(OH)D]、血脂水平变化及其与冠脉病变的相关性。方法回顾性分析2019年12月至2021年12月上海市宝山区罗店医院收治的99例冠心病合并2型糖尿病患者(观察组)的临床资料,根据冠脉病变程度SYNTAX评分将观察组患者分为为轻度组(SYNTAX<22分)32例、中度组(SYNTAX为23~32分)31例和重度组(SCORAD>33分)36例,另选取30例同期健康体检者作为对照组。比较四组受试者的SUA、血脂[总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]和25(OH)D水平,并采用Spearman相关性分析法分析其与冠状血管病变严重程度的相关性;采用广义线性回归(Logistic)模型对冠心病合并2型糖尿病患者的冠脉病变严重程度的影响因素进行多因素分析。结果随着冠脉病变程度的加重,TC、TG、LDL-C、SUA水平逐渐升高,HDL-C、25(OH)D水平逐渐降低,且重度组、中度组、轻度组患者的TC、TG、LDL-C、SUA明显高于对照组,HDL-C、25(OH)D水平明显低于对照组,差异均具有统计学意义(P<0.05);经Spearman相关性分析结果显示,TC、TG、LDL-C、SUA水平与冠脉病变程度呈显著正相关性(r=0.261、0.345、0.203、0.456,P<0.05),血清25(OH)D、HDL-C水平与冠脉病变程度呈显著负相关性(r=-0.237、-0.342,P<0.05);经Logistic多因素回归分析结果显示,TC、TG、LDL-C和SUA升高,HDL-C及25(OH)D降低是冠脉病变严重程度的危险因素(P<0.05)。结论冠心病合并2型糖尿病患者存在25-羟基维生素D缺乏和不足、胆固醇代谢不良情况;TC、TG、LDL-C和SUA升高,HDL-C及25(OH)D降低是冠脉病变严重程度的危险因素。

Study on the effect of lowering uric acid and effect on the kidney of Poriae cutis in hyperuricemia mice

Objective:To explore the pharmacodynamic and renal protective effects of Poriae cutis extract on hyperuricemia(HUA)mice.Methods:The active components from the Poriae cutis were extracted with Alcohol solvent and aqueous solvent,HUA mice were established by hypoxanthine with potassium oxonate.Totally70 male Kunming mice were randomly divided into normal,model(500 mg/kg hypoxanthine+250 mg/kg potassium oxonate),Poriae cutis ethanol(PCE)and water extract(PCW)with high and low dose(388 mg/kg and 97mg/kg),benzbromarone(BEN)groups(7.5 mg/kg),all mice were administered with corresponding medication for 16 d.After the last administration,collected the 24 h urine volume,the urine uric acid(UUA)and urine creatinine(UCr)were determined.The morphological changes of the left kidney were viewed and the pathological changes in right kidneys were observed by hematoxylin-eosin(HE)staining.The serum contents of uric acid(SUA),creatinine(SCr)and urea nitrogen(BUN)were measured.Uric acid excretion index include fractional uric acid excretion(FEUA)and uric acid clearance rate(CUr)were calculated.The contents of OAT1,URAT1,GLUT9,TNF-αand IL-6 in the kidney were detected by ELISA.Results:PCE and PCW could increase UUA,UCr,FEUA,CUr and OAT1(P<0.05,P<0.01),reduce SUA,SCr,BUN,URAT1,GLUT9,TNF-αand IL-6(P<0.05,P<0.01).The pathological and morphological changes of kidneys in HUA mice were improved and the effect is better than BEN.Conclusion:Poriae cutis extractscould lower uric acid and possessed a protective effect on the kidney of mice with HUA,which was achieved by promoting uric acid excretion,regulating the expression of uric acid transporters and reducing the level of inflammatory factors.

Clinical significance of serum oxidative stress and serum uric acid levels before surgery for hepatitis B-related liver cancer

BACKGROUND The incidence and mortality of liver cancer are among the highest of all malignant tumors in China.The high recurrence rate after conventional hepatectomy is worrying.There is a lack of effective prognostic indicators for liver cancer.AIM To explore the clinical significance of preoperative serum oxidative stress and serum uric acid(UA)levels in hepatitis B-related liver cancer.METHODS The medical records of 110 hepatitis B-related liver cancer patients who under-went hepatectomy in Gansu Provincial Hospital were retrospectively analyzed.Recurrence in patients within 3 years after surgery was determined.The logistic regression model and Pearson or Spearman correlation were used to analyze the correlation between oxidative stress level and UA,and the recurrence of hepatitis B-related liver cancer.RESULTS Compared with the non-recurrence group,the levels of superoxide dismutase(SOD)and glutathione(GSH)in the recurrence group were lower and the levels of malondialdehyde(MDA)and UA were higher(all P<0.05).UA,SOD,MDA,and GSH were risk factors for postoperative recurrence in hepatitis B-related liver cancer patients(P<0.05).UA was positively correlated with MDA(r=0.395,P<0.001)and negatively correlated with GSH(r=-0.204,P=0.032).The area under the receiver operating characteristic curve(AUC)of SOD,MDA,GSH,and UA in predicting the prognosis was 0.276,0.910,0.199,and 0.784,respectively(all P<0.001).CONCLUSION The preoperative serum SOD,GSH,MDA,and UA levels had significant predictive effects on postoperative recurrence of hepatitis B-related liver cancer.

Square wave voltammetric quantification of folic acid,uric acid and ascorbic acid in biological matrix

Nowadays, modified electrodes with metal nanoparticles have appeared as an alternative for the electroanalysis of various compounds. In this study, gold nanoparticles（GNPs） were chosen as interesting metal nanoparticles for modifying carbon paste electrode（CPE）. GNPs and the gold nanoparticles-modified carbon paste electrode（GNPs/CPE） were characterized by UV–Vis spectroscopy, transmission electron microscopy（TEM） and scanning electron microscopy（SEM）. GNPs/CPE as a simple and sensitive electrode was used to study three important biological molecules： folic acid（FA）, uric acid（UA） and ascorbic acid（AA）. Square wave voltammetry（SWV） was used as an accurate technique for quantitative measurements. A good linear relation was observed between anodic peak current（ipa） and FA（5.2 × 10（-6）– 2.5 × 10（-5）M）, UA（1.2 × 10（-6）– 2.1 × 10（-5）M） and AA（1.2 × 10（-6）– 2.5 × 10（-5）M） concentrations in simultaneous determination of these molecules.

AECOPD患者UA/Cr比值、NLR与低氧血症的关系

目的探讨血尿酸(UA)/肌酐(Cr)比值和中性粒细胞/淋巴细胞比值(NLR)在急性加重期慢性阻塞性肺疾病(AECOPD)患者合并低氧血症中的临床意义。方法回顾性分析2019年1月—2021年12月中国中医科学院西苑医院126例AECOPD患者的临床资料。根据动脉血氧分压(PaO_(2))水平将126例患者分为低氧血症组(86例,PaO_(2)<83 mmHg)和非低氧血症组(40例,PaO_(2)≥83 mmHg)。比较2组患者中医证型、相关临床资料和相关实验室指标的差异。采用Spearman/Pearson相关分析评估UA/Cr比值、NLR与AECOPD合并低氧血症患者第1秒用力呼气容积(FEV1)/用力肺活量(FVC)、第1秒用力呼气容积占预计值的百分比(FEV1pred%)、慢性阻塞性肺疾病自我评估测试(CAT)评分、改良版英国医学研究委员会(mMRC)呼吸困难分级的相关性。采用受试者工作特征(ROC)曲线分析UA/Cr比值、NLR单项和联合预测AECOPD患者合并低氧血症的效能。结果低氧血症组UA/Cr比值和NLR均高于非低氧血症组(P<0.001)。2组各中医证型患者所占比例差异无统计学意义(P>0.05)。UA/Cr比值、NLR与CAT评分、mMRC呼吸困难分级呈正相关(P<0.05),与FEV1/FVC、FEV1pred%呈负相关(P<0.05)。UA/Cr比值、NLR单项和联合预测AECOPD患者合并低氧血症的曲线下面积分别为0.792、0.768、0.876。结论UA/Cr比值和NLR可用于预测AECOPD患者合并低氧血症,2项指标联合使用预测效能更高。

ACI患者溶栓后SUA、Hcy水平变化及其与患者发生END的关系

目的分析急性脑梗死(ACI)患者溶栓后血尿酸(SUA)、同型半胱氨酸(Hcy)水平变化及其与患者发生早期神经功能恶化(END)的关系。方法回顾性分析2020年5月至2023年5月浦口区中医院收治的110例接受溶栓治疗的ACI患者的临床资料。患者均接受阿替普酶联合丁苯酞治疗,均治疗14 d,记录患者不同时间点(治疗前及治疗3、7、14 d时)美国国立卫生院卒中量表(NIHSS)评分,将发生END患者纳入END组,将未发生END患者纳入非END组;比较治疗前、治疗后(治疗14 d后)神经功能指标及血清SUA、Hcy水平;采用Pearson相关分析血清SUA、Hcy水平与S100β、NSE、MBP水平的关系;采用二元Logistic回归分析血清SUA、Hcy水平与ACI患者溶栓后发生END的关系;绘制受试者工作特征(ROC)曲线分析Hcy、SUA单独及2项指标联合检测预测ACI患者溶栓后发生END的价值;采用剂量反应分析血清SUA、Hcy水平变化与ACI患者溶栓后发生END的关系。结果治疗3、7、14 d时NIHSS评分低于治疗前,差异有统计学意义(P<0.05),呈逐渐下降趋势;治疗后,ACI患者S100β、NSE、MBP水平低于治疗前,差异有统计学意义(P<0.05);治疗后,ACI患者Hcy低于治疗前,SUA水平高于治疗前,差异有统计学意义(P<0.05);Pearson相关分析结果显示,Hcy水平与S100β、NSE、MBP水平呈正相关(r=0.219、0.275、0.200,P<0.05),SUA水平与S100β、NSE、MBP水平呈负相关(r=-0.275、—0.261、—0.212,P<0.05)。110例ACI患者经溶栓治疗后,发生END 29例,纳入END组,发生率为26.36%,未发生END 81例,纳入非END组,未发生率为73.64%;END组糖尿病患者占比高于非END组,S100β、NSE、MBP、Hcy水平高于非END组,SUA水平低于非END组,差异有统计学意义(P<0.05);二元Logistic回归分析结果显示,有糖尿病及血清S100β、NSE、MBP、Hcy水平升高是ACI患者溶栓后发生END的危险因素(OR>1,P<0.05);ROC曲线分析结果显示,Hcy,SUA单独及联合检测预测ACI患者溶栓后发生END的曲线下面积(AUC)均大于0.70,其中2项联合检测的AUC最大。血清SUA水平升高是ACI患者溶栓后发生END的保护因素(OR<1,P<0.05);血清SUA水平与ACI患者溶栓后发生END呈负相关,特别当血清SUA<329.05μmol/L时,ACI患者溶栓后发生END的风险随SUA水平下降而升高;血清Hcy水平与ACI患者溶栓后发生END呈正相关,特别当血清Hcy>22.93μmol/L时,ACI患者溶栓后发生END的风险随Hcy水平升高而升高。结论ACI患者血清SUA、Hcy水平与患者溶栓治疗后END的发生关系密切,同时二者能够有效评估ACI患者发生END风险。

血UA、Smad1蛋白、尿mALB含量与2型糖尿病肾病患者达格列净治疗效果的相关性分析

目的观察2型糖尿病肾病患者血尿酸(uric acid,UA)、Smad同源物1(recombinant mothers against decapentaplegic homolog 1,Smad1)蛋白、尿微量白蛋白(urine microalbumin,mALB)含量,并分析三者与达格列净治疗2型糖尿病肾病效果的相关性。方法选取2021年6月至2022年9月皖南医学院第二附属医院2型糖尿病肾病患者纳入糖尿病肾病组(n=170),另取同期单纯2型糖尿病患者纳入单纯糖尿病组(n=120),所有患者入院时均接受血UA、Smad1蛋白、尿mALB检测,对比糖尿病肾病组与单纯糖尿病组上述3项指标水平。所有2型糖尿病肾病患者均采用达格列净治疗,随访3个月,观察患者治疗效果。依据治疗效果分为有效组(n=142)与无效组(n=28),对比有效组与无效组血UA、Smad1蛋白、尿mALB含量,分析3项指标与达格列净治疗2型糖尿病肾病效果的相关性,绘制受试者工作特征曲线(ROC)分析上述3项指标对达格列净治疗2型糖尿病肾病效果的预测价值。结果糖尿病肾病组血UA、Smad1蛋白、尿mALB水平高于单纯糖尿病组(t=8.843、12.097、8.858,P<0.05);治疗3个月后,170例2型糖尿病肾病患者中有效142例(83.53%),无效28例(16.47%);无效组血UA、Smad1蛋白、尿mALB水平高于有效组(t=3.508、4.622、3.563,P<0.05);经点二列相关性分析结果显示,血UA、Smad1蛋白、尿mALB水平与达格列净治疗2型糖尿病肾病效果呈负相关(r=-0.261、-0.336、-0.265,P<0.05);经Logistic回归分析,结果显示,血UA(95%CI:1.001~1.021)、Smad1蛋白(95%CI:1.167~1.610)、尿mALB(95%CI:1.011~1.048)水平升高是达格列净治疗2型糖尿病肾病无效的危险因素(OR=1.011、1.371、1.029,P<0.05);绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),结果显示,血UA(95%CI:0.622~0.793)、Smad1蛋白(95%CI:0.685~0.841)、尿mALB(95%CI:0.630~0.803)水平对达格列净治疗2型糖尿病肾病效果具有一定预测价值(AUC=0.707、0.763、0.716),联合检测(95%CI:0.734~0.881)预测价值更高(AUC=0.808)。结论血UA、Smad1蛋白、尿mALB水平与达格列净治疗2型糖尿病肾病效果密切相关,可用于预测其治疗效果。