A novel strain of Levilactobacillus brevis PDD-5 isolated from salty vegetables has beneficial effects on hyperuricemia through anti-inflammation and improvement of kidney damage

Hyperuricemia is a metabolic disorder caused by abnormal purine metabolism,resulting in abnormally high serum uric acid.In this study,a novel Levilactobacillus brevis PDD-5 isolated from salty vegetables was verified with the function of alleviating hyperuricemia.The relevant effects of L.brevis PDD-5 in lowering uric acid were analyzed by in vitro and in vivo experiments.The results showed that the L.brevis PDD-5 has(68.86±15.46)%of inosine uptake capacity and(95.75±3.30)%of guanosine uptake capacity in vitro.Oral administration of L.brevis PDD-5 to hyperuricemia rats reduced uric acid,creatinine,and urea nitrogen in serum,as well as decreased inosine and guanosine levels in the intestinal contents of rats.Analysis of relevant markers in the kidney by ELISA kits revealed that L.brevis PDD-5 alleviated oxidative stress and inflammation.Moreover,the gene expression of uric acid transporter 1(URAT1)and glucose transporter 9(GLUT9)was down-regulated,and the gene expression of organic anion transporter 1(OAT1)was up-regulated after treatment with L.brevis PDD-5.Western blot analysis showed that L.brevis PDD-5 alleviated hyperuricemia-induced kidney injury through the NLRP3 pathway.The se findings suggest that L.brevis PDD-5 can lower uric acid,repair kidney damage,and also has the potential to prevent uric acid nephropathy.

Andrias davidianus bone peptides alleviates hyperuricemia-induced kidney damage in vitro and in vivo

Hyperuricemia(HUA)is a vital risk factor for chronic kidney diseases(CKD)and development of functional foods capable of protecting CKD is of importance.This paper aimed to explore the amelioration effects and mechanism of Andrias davidianus bone peptides(ADBP)on HUA-induced kidney damage.In the present study,we generated the standard ADBP which contained high hydrophobic amino acid and low molecular peptide contents.In vitro results found that ADBP protected uric acid(UA)-induced HK-2 cells from damage by modulating urate transporters and antioxidant defense.In vivo results indicated that ADBP effectively ameliorated renal injury in HUA-induced CKD mice,evidenced by a remarkable decrease in serum UA,creatinine and blood urea nitrogen,improving kidney UA excretion,antioxidant defense and histological kidney deterioration.Metabolomic analysis highlighted 14 metabolites that could be selected as potential biomarkers and attributed to the amelioration effects of ADBP on CKD mice kidney dysfunction.Intriguingly,ADBP restored the gut microbiome homeostasis in CKD mice,especially with respect to the elevated helpful microbial abundance,and the decreased harmful bacterial abundance.This study demonstrated that ADBP displayed great nephroprotective effects,and has great promise as a food or functional food ingredient for the prevention and treatment of HUA-induced CKD.

Effect of Uric-acid-lowering Therapy on Progression of Chronic Kidney Disease: A Meta-analysis

The efficacy and safety of uric-acid-lowering therapy （UALT） on slowing the progression of chronic kidney disease （CKD） accompanied by hyperuricemia were assessed. We searched Cochrane Library, PubMed, EMbase, CNKI, Wanfang and Vip databases up to November 15, 2012 for randomized controlled trials （RCTs） which compared the effect of UALT to control therapy in hyperuricemic patients secondary to CKD, and then performed quality evaluation and meta-analysis on the included studies. Seven RCTs involving 451 cases were included. UALT delayed the increase of serum creatinine （MD=-62.55 μol/L, 95% CI： -98.10 to -26.99） and blood urea nitrogen （MD= -6.15 mmol/L, 95% CI -8.17 to -4.13） as well as the decrease of glomerular filtration rate [MD=5.65 mL/（min.l.73 m2）, 95% CI： 1.88 to 9.41], decreased systolic blood pressure （SBP） （MD= -6.08 mmHg, 95% CI： -11.67 to -0.49）, and reduced the risk of the renal disease progression （RR=0.30, 95% CI： 0.19 to 0.46）. However, there was no statistically significant difference in 24-h urinary protein quantity and diastolic blood pressure （P〉0.05）. We identified that UALT could delay the progression of CKD with secondary hyperuricemia. And this also indirectly proved that hyperuricemia was a risk factor for the CKD progression.

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.

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.

Etiological Analysis of 256 Hypouricemia Cases

Objective: To analyze the serum uric acid results of patients with hypouricemia hospitalized in the Affiliated Hospital of Hebei University, thereby providing new insights for the prevention and treatment of hypouricemia. Method: This study employed a retrospective case analysis, dividing patients into two groups: 16 cases with uric acid levels less than 50 μmol/L (group Level 1), and 240 cases with uric acid levels between 50 μmol/L and 119 μmol/L (group Level 2). Basic data such as age, gender, department, and clinical diagnosis were collected for each patient. Renal indices, including creatinine, urea, β2-microglobulin, and cystatin C, were analyzed and compared. Results: The highest percentage of patients with uremia was found in Level 1, with a rate of 31.25%. In Level 2, the highest percentage of patients had malignant tumors, with a rate of 15.41%. Tumor sites included the liver, lungs, endometrium, ovaries, breasts, stomach, pancreas, colon, hypopharynx, and others. The second highest percentage was 13.75% for patients with lung diseases, followed by 10% for patients with cranio-cerebral diseases. Other prevalent conditions included renal diseases, hematological diseases, multiple injuries, orthopedic diseases, rheumatological-immunological diseases, and cardiac diseases. There were significant differences between the two uric acid level groups in terms of prevalent diseases (P < 0.05). Additionally, gender differences were significant between the two groups (P < 0.05). However, for renal disease indicators, no significant differences were found between the two levels (P > 0.05). Conclusion: The types of diseases presented by patients were related to different low uric acid levels. Most patients‘ renal function indices were within normal reference ranges at different low uric acid levels. The prevalence of different low uric acid levels was related to gender.

Ameliorative effect of Lacticaseibacillus rhamnosus Fmb14 from Chinese yogurt on hyperuricemia

Hyperuricemia is a critical threat to human health,and a high inosine diet can increase the prevalence of it.Lacticaseibacillus rhamnosus Fmb14 was isolated from traditional fermented Chinese yogurt,and its inosine degradation rate reached 36.3%at 109 CFU/mL for 24 h.LC-MS analysis revealed that high concentrations of inosine could activate compensatory metabolic pathways of L.rhamnosus Fmb14 to catalyse inosine as an energy source and produce intracellular folic acid and riboflavin.The contents of folic acid and riboflavin were 6.0 and 4.3 fold increased after inosine treatment in the cell-free extracts(CFE).L.rhamnosus Fmb14 CFE treatment ameliorates hyperuricemia through xanthine oxidase(XOD)inhibition and ATP-binding cassette subfamily G member 2(ABCG2)promotion,both of which are responsible for uric acid(UA)synthesis and secretion in HepG2 and Caco2 cells,respectively.The in vivo results showed that the serum UA level decreased from 236.28 to 149.28μmol/L after 8 weeks of oral administration of L.rhamnosus Fmb14 in inosine-induced hyperuricemia model mice.Our results revealed that L.rhamnosus Fmb14 has a potential as a biological therapeutic agent in hyperuricemia prevention.

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.

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.

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.

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.

2型糖尿病合并冠心病患者血清Hcy、HbAlc和血尿酸水平变化的临床意义

目的探讨2型糖尿病合并冠心病患者血清同型半胱氨酸(Hcy)、糖化血红蛋白(HbAlc)和血尿酸水平变化的临床意义。方法选取2型糖尿病合并冠心病患者60例为合并冠心病组,单纯2型糖尿病患者45例为单纯糖尿病组,健康志愿者30名为健康对照组。采集空腹外周静脉血,检测血清Hcy、HbAlc及血尿酸水平;行冠状动脉造影检查,记录冠脉狭窄程度50%及以上的病变累及左前降支、回旋支或右冠脉的支数(单支病变、双支病变、多支病变)。收集2型糖尿病合并冠心病患者的年龄、性别、身高、体质量、吸烟情况及低密度脂蛋白、总胆固醇、甘油三酯、空腹血糖、维生素B12、叶酸水平。进行3 a随访,记录患者病情加重再入院、死亡情况。结果合并冠心病组血清Hcy、HbAlc及血尿酸水平明显高于单纯糖尿病组和健康对照组(P<0.05);多支病变患者血清Hcy、HbAlc及血尿酸水平明显高于双支病变和单支病变患者(P<0.05);预后不良组患者血清Hcy、HbAlc及血尿酸水平明显高于预后良好组患者(P<0.05);预后不良组患者中吸烟比例、空腹血糖水平明显高于预后良好组(P<0.05)。Hcy、HbAlc、血尿酸是2型糖尿病合并冠心病患者预后的独立影响因素。ROC曲线分析显示,血清Hcy、HbAlc及血尿酸水平对2型糖尿病合并冠心病患者预后具有较高的预测价值(P<0.05),联合检测的预测价值最高(AUC=0.947)。结论2型糖尿病合并冠心病患者血清Hcy、HbAlc及血尿酸水平升高,且与冠脉病变程度密切相关,联合检测可用于患者预后评估。

桂枝芍药知母汤治疗痛风性关节炎急性期疗效及对患者可调节相关因子与嘌呤受体水平变化的影响

目的:观察桂枝芍药知母汤联合非布司他、塞来昔布治疗痛风性关节炎(GA)急性期的效果,为临床治疗提供参考。方法:选取GA患者110例,根据随机原则分为对照组(西药)和观察组(桂枝芍药知母汤+西药),每组55例。记录两组治疗前及治疗3、7 d后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、Diekkopf-1(DKK-1)、白细胞介素-18(IL-18)、嘌呤能受体(P2X7R)水平及中医证候积分的变化,统计两组疗效和不良反应。结果:治疗7 d后,观察组总有效率为90.91%(50/55),明显高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗3、7 d后,两组皮色皮温、全身症状及关节相关积分较治疗前下降,观察组低于对照组,且两组治疗7 d后低于治疗3 d后(P<0.05)。治疗3、7 d后,两组UA、IL-1β、DKK-1、IL-18、P2X7R、ESR较治疗前下降,观察组低于对照组,且两组治疗7 d后上述因子低于治疗3 d后(P<0.05)。观察组不良反应发生率为9.09%(胸闷1例、胃肠道症状4例),与对照组的20.00%(胸闷2例、胃肠道症状8例和皮疹1例)比较,差异无统计学意义(P>0.05)。结论:桂枝芍药知母汤联合西药治疗GA急性期可减轻症状,提高疗效,可能与调节相关因子的表达水平有关。

Preparation, characterization and evaluation of kaempferol phospholipid complex: Improvement of its solubility and biological effect

Kaempferol(KA),as one of the flavonoids,has extensive pharmacological properties.However,the poor solubility of KA severely limits its clinical application.In our study,the kaempferol phospholipid complex(KA-PC)has been prepared by solvent evaporation for the enhancement of the bioavailability of KA.KA-PC was verified by scanning electron microscope characterization methods.Drug loading,solubility and long-term stability were measured.The characterization results showed that KA-PC was formed through the intermolecular interaction between KA and phospholipids.The solubility of KA-PC in water was 189 times higher than that of KA,and the solubility in n-octanol was also significantly improved.Besides,pharmacodynamic studies showed that KA-PC can significantly reduce the level of serum uric acid in mice without causing renal injury.This study expanded the clinical application of KA by preparing KA-PC.

老年与中青年抑郁障碍患者非酶抗氧化物水平差异

目的探索不同年龄阶段抑郁障碍患者非酶抗氧化物水平的差异。方法纳入抑郁障碍患者135例(包括年龄≥60岁的老年抑郁组63例和<60岁的中青年抑郁组72例),健康对照98名(包括年龄≥60岁的老年对照组46名和<60岁的中青年对照组52名)。测定被试血清非酶抗氧化物尿酸、总胆红素和白蛋白水平。结果双因素方差分析表明,对于尿酸、总胆红素水平,抑郁因素主效应均有统计学意义(P<0.05),抑郁障碍患者的尿酸[(314.30±85.18)μmol/L vs.(339.68±85.27)μmol/L]、总胆红素[(12.81±6.16)μmol/L vs(.15.09±5.97)μmol/L]水平低于对照(P<0.05)。年龄分组与抑郁因素对白蛋白水平的影响存在交互作用(F=11.059,P<0.001),老年抑郁组患者的白蛋白[(41.05±3.97)g/L vs.(46.01±4.49)g/L]水平低于中青年抑郁组患者(P<0.01)。结论抑郁障碍患者存在非酶类抗氧化物的异常,老年患者的损害更为突出。

脊柱退变住院患者血清尿酸/高密度脂蛋白比值与骨密度的相关性

目的探索脊柱退变住院患者血清尿酸/高密度脂蛋白比值与骨密度的相关性。方法共纳入803例脊柱退变的受试者,评估临床因素及实验室检查结果,测量骨密度,按照骨密度结果分为骨质疏松症组及非骨质疏松症组。采用多元Logistic回归分析血清尿酸/高密度脂蛋白比值(uric acid to high-density lipoprotein cholesterol ratio,UHR)与骨质疏松症的相关性。结果与非骨质疏松症组相比,骨质疏松症组的UHR更低(244.93±.102.51 vs 199.97±.91.96,P<0.001),多元Logistics回归分析提示,在校正了骨质疏松症的传统危险因素后,UHR最高的四分位患者发生骨质疏松症的可能性是UHR最低的四分位患者的0.402倍(P=0.018)。骨质疏松症的患病率在UHR四分位呈下降的趋势,骨密度在UHR四分位呈升高的趋势。UHR在骨量正常、骨量减少及骨质疏松症3组呈下降的趋势。结论低UHR是昆山地区脊柱退变住院患者发生骨质疏松症的危险因素。对于UHR较低的脊柱退变患者,应注意筛查骨质疏松症。

牛蒡根多糖的结构表征及体外抗氧化、降血糖、降尿酸作用研究

以牛蒡根多糖(Arctium lappa polysaccharide, ALP)为原料,通过高效凝胶渗透色谱法、紫外分光光度法、气相色谱-质谱联用法与核磁共振的方法,解析ALP结构。通过研究ALP对1,1-二苯基-2-三硝基苯肼(1,1-diphenyl-2-picrylhydrazyl, DPPH·)自由基和羟基(hydroxyl radical,·OH)自由基的清除能力,对α-葡萄糖苷酶和α-淀粉酶的抑制活性,以及对黄嘌呤氧化酶的抑制率,研究ALP的体外抗氧化活性、体外降血糖活性和体外降尿酸活性。结果表明:ALP相对分子量为1941 Da,具有果糖和葡萄糖的结构特点,ALP有较强的抗氧化能力、体外降血糖和降尿酸作用。研究结果可为牛蒡根作为功能性食品与医药保健品的开发提供科学依据。

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。

急性缺血性卒中入院后血尿酸水平对老年血管性痴呆的预测价值

目的检测急性缺血性卒中(AIS)患者血尿酸(SUA)水平变化,并分析不同时间点SUA水平对血管性痴呆(VD)的预测价值。方法纳入2019-01—2022-08在唐山市人民医院接受治疗的AIS患者208例,完成随访195例,根据AIS 3个月后是否合并VD,将患者分为non-VD组(n=160)和VD组(n=35)。采用t检验或χ^(2)检验分析影响AIS合并VD的因素,检测患者入院时、入院24 h、入院7 d和入院14 d时患者外周血中SUA水平,Pearson相关性分析不同时段SUA水平的相关性,Logistic多因素回归分析影响AIS合并VD的独立危险因素,受试者工作特征(ROC)曲线评估不同时段血尿酸水平预测AIS合并VD的临床价值。结果脑卒中史、心房颤动、病死灶大小和入院时NIHSS评分在2组间差异有统计学意义(P<0.05)。VD组入院24 h(415.0±21.3)μmol/L、入院7 d(436.2±24.0)μmol/L和入院14 d(407.3±18.2)μmol/L时SUA水平高于non-VD组[(398.4±26.8)μmol/L、(372.1±20.7)μmol/L、(358.1±14.7)μmol/L],组间比较差异有统计学意义(P<0.05)。脑卒中史、心房颤动、大梗死病灶和入院SUA水平增加为影响AIS并发VD的危险因素。入院7 d SUA水平预测AIS并发VD的曲线下面积0.935,高于入院时和入院24 h SUA(0.763、0.786,Z=4.526、4.084,P=0.009、0.016)。结论SUA水平增加是AIS合并VD独立危险因素,入院第7天SUA水平对AIS合并VD具有较高的预测价值。