AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men ...AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program.NAFLD was diagnosed by abdominal ultrasonography.The metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ criteria.Five years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered questionnaire.RESULTS:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular events.But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.CONCLUSION:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model.NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.展开更多
OBJECTIVE: To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS: Recurrence quantification analysis (...OBJECTIVE: To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS: Recurrence quantification analysis (RQA) was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease (CHD) and 37 normal subjects (controls). An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine (SVM) classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS: RQA measures can be divided into two groups. One group of measures [ecurrence rate(RR), determinism (DEL), average diagonal line length (L), maximum length of diagonal structures (Lmax), Shannon entropy of the frequency distribu- tion of diagonal line lengths (ENTR), laminarity (LAM), average length of vertical structures (TT), maximum length of vertical structures (Vmax)] showed significantly higher values for patients with CHD than for normal subjects (P〈0.0S). The other measures (RR_std, L_std, Lmaxstd, TT_std, Vmax_std) showed significantly lower values for the CHD group than for normal subjects (P〈0.05). SVM classification accuracy was higher with RQA measures: With RQA (16 parameters) accuracy was at 88.21%, and with RQA(12 parameters) accuracy was at 84.11%. In contrast, with classic time-do- main (15 parameters) accuracy was 75.73%, and with time-domain (7 parameters) accuracy was 74.7O%. CONCLUSION: Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.展开更多
基金Supported by a grant from the Gifu Medical Association
文摘AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program.NAFLD was diagnosed by abdominal ultrasonography.The metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ criteria.Five years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered questionnaire.RESULTS:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular events.But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.CONCLUSION:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model.NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.
基金Supported by Innovation Program of Shanghai Municipal Education Commission(No.11YZ71)the 3rd Shanghai Leading Academic Discipline Project(No.S30302)the National Natural Science Foundation of China(No. 81173199)
文摘OBJECTIVE: To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS: Recurrence quantification analysis (RQA) was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease (CHD) and 37 normal subjects (controls). An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine (SVM) classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS: RQA measures can be divided into two groups. One group of measures [ecurrence rate(RR), determinism (DEL), average diagonal line length (L), maximum length of diagonal structures (Lmax), Shannon entropy of the frequency distribu- tion of diagonal line lengths (ENTR), laminarity (LAM), average length of vertical structures (TT), maximum length of vertical structures (Vmax)] showed significantly higher values for patients with CHD than for normal subjects (P〈0.0S). The other measures (RR_std, L_std, Lmaxstd, TT_std, Vmax_std) showed significantly lower values for the CHD group than for normal subjects (P〈0.05). SVM classification accuracy was higher with RQA measures: With RQA (16 parameters) accuracy was at 88.21%, and with RQA(12 parameters) accuracy was at 84.11%. In contrast, with classic time-do- main (15 parameters) accuracy was 75.73%, and with time-domain (7 parameters) accuracy was 74.7O%. CONCLUSION: Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.