背景心血管疾病(CVD)是腹膜透析(PD)患者死亡的主要原因,而营养不良是PD患者发生CVD及死亡的重要危险因素之一。预后营养指数(PNI)作为一种综合评估患者免疫、炎症和营养状态的指标,因其具有便利性与可靠性等优点,在肿瘤等多种疾病的预...背景心血管疾病(CVD)是腹膜透析(PD)患者死亡的主要原因,而营养不良是PD患者发生CVD及死亡的重要危险因素之一。预后营养指数(PNI)作为一种综合评估患者免疫、炎症和营养状态的指标,因其具有便利性与可靠性等优点,在肿瘤等多种疾病的预后评估中得到了广泛应用。然而,不同时间点的营养状态与PD患者预后之间的关系仍有待进一步探究。目的探讨PD患者首年PNI与CVD死亡之间的关系。方法本研究为多中心、回顾性观察性队列研究,纳入2000-01-01—2019-07-01在南方医科大学南方医院、南方医科大学顺德医院、佛山市第一人民医院以及赣州市人民医院4所中心置管并开始接受PD治疗的1640例PD患者作为研究对象。对患者进行随访,随访截止时间为2021-07-01,终点事件为CVD死亡并记录患者生存时间及具体死亡原因。应用限制性立方条图(RCS)分析PNI与PD患者CVD死亡风险之间的非线性关联;采用Kaplan-Meier法绘制PD患者的生存曲线,绘制PNI预测PD患者CVD死亡的受试者工作特征(ROC)曲线,并根据最佳截断值(cut-off=40.46)将患者分为低PNI组703例与高PNI组937例;采用Log-rank检验和Cox风险回归模型分析探讨PNI对PD患者CVD死亡的影响。结果本研究中位随访时间为30个月,随访期间共148例患者死亡,其中CVD死亡73例(49.32%)。RCS结果表明,PNI与CVD死亡事件呈线性关联(P for Nonlinear=0.655)。ROC曲线显示,PNI预测PD患者CVD死亡的曲线下面积(AUC)为0.717(95%CI=0.659~0.775,P<0.001),灵敏度为74.0%,特异度为58.6%。Kaplan-Meier生存分析结果显示,低PNI组CVD生存率低于高PNI组(χ^(2)=26.685,P<0.001)。多因素Cox风险回归模型分析,校正性别、年龄及CVD病史等混杂因素后,低PNI组仍是CVD死亡的独立预测因素(HR=7.76,95%CI=1.72~35.06,P=0.008),亚组分析结果仍稳健,无明显交互作用。结论PNI降低是PD患者CVD死亡的独立影响因素,PD首年PNI评分在评估PD患者预后有一定的指导意义。展开更多
Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and compl...Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.展开更多
Purpose: Aortic augmentation index (AIx) and cardiovagal tone (CVT) are indicators of cardiovascular health. Associations between these variables provide information about their roles in cardiovascular disease. Howeve...Purpose: Aortic augmentation index (AIx) and cardiovagal tone (CVT) are indicators of cardiovascular health. Associations between these variables provide information about their roles in cardiovascular disease. However, evaluating these associations from a gender perspective and gaining an understanding of the relationship between cardiorespiratory fitness and AIx based on gender can provide additional information. Therefore, we examined the relationships between CVT, measured as the log transformed high-frequency power of R-R intervals from electrocardiogram measurements (lnHFR-R);cardiorespiratory fitness, measured as maximum oxygen consumption (VO2max);and AIx at a heart rate of 75 beats·min-1(AIx@75). We hypothesized that the relationships between CVT, cardiorespiratory fitness, and AIx@75 would differ based on gender. Methods: We examined the associations between lnHFR-R, VO2max, and AIx@75 in 41 women and 39 men. Power spectral density analysis of heart rate variability determined lnHFR-R, radial tonometry determined AIx@75 and the Bruce Treadmill Protocol determined VO2max. Results: In men, lnHFR-R positively correlated with and significantly predicted AIx@75 (P = 0.005) but not in women (P = 0.49). For every unit increase in lnHFR-R, there was a 4.6 unit increase in AIx@75 in men versus a 1.0 unit increase in women. There was a significant inverse relationship between VO2max and AIx@75, with VO2max being a significant predictor of AIx@75 in men (P = 0.01). For every unit increase in VO2max, there was a 0.60 unit decrease in AIx@75 in men versus a 0.2 unit decrease in women. Conclusions: The associations between CVT and AIx@75 and between cardiorespiratory fitness and AIx@75 differ by gender. CVT and cardiorespiratory fitness are significant predictors of AIx@75 in men but not in women.展开更多
Background: Japanese women’s body mass index (BMI) was known to be the lowest among people in OECD countries. We wanted to compare foods intakes and relationships between intakes of particular food species and BMI. M...Background: Japanese women’s body mass index (BMI) was known to be the lowest among people in OECD countries. We wanted to compare foods intakes and relationships between intakes of particular food species and BMI. Methods: We asked young and middle-aged women to participate and used a brief-type self-administered diet history questionnaire (BDHQ) to know the amounts of various food species they took. Results: Weights and BMI of young and middle-aged women were not different. Middle-aged women took almost all species of foods and energy more than young women. Except for cholesterol of soluble dietary fibers, there was no correlation between foods intakes and BMI. Conclusion: Both young and middle-aged Japanese women are lean (BMI;around 22). Middle-aged women took more energy, and proteins, carbohydrates, and lipids compared with young women. Middle-aged women spend more energy on house workings than young women in Japan.展开更多
AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health...AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.展开更多
目的探讨格列美脲联合利格列汀对2型糖尿病(diabetes mellitus type 2,T2MD)患者糖脂代谢、体重指数(body mass index,BMI)及心血管事件发生率的影响。方法选取2020年10月至2021年10月长春市中心医院收治的84例T2MD患者作为研究对象,采...目的探讨格列美脲联合利格列汀对2型糖尿病(diabetes mellitus type 2,T2MD)患者糖脂代谢、体重指数(body mass index,BMI)及心血管事件发生率的影响。方法选取2020年10月至2021年10月长春市中心医院收治的84例T2MD患者作为研究对象,采用随机信封法分为参照组与联合组,每组42例。参照组采用口服格列美脲治疗,联合组采用格列美脲联合利格列汀治疗。比较两组治疗前后糖脂代谢情况、BMI变化情况及心血管事件发生率。结果治疗后,两组空腹血糖(fasting blood glucose,FPG)及餐后2 h血糖(2 h postprandial blood glucose,2 h PG)、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbAlc)、血糖标准差(standard deviation of blood glucose,SDBG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平均低于治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。治疗3、6个月后,两组BMI均低于治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。随访期间,联合组心血管事件发生率低于参照组,差异有统计学意义(P<0.05)。结论格列美脲联合利格列汀治疗能有效调节T2MD患者糖脂代谢,降低BMI和心血管事件发生率,值得临床推广应用。展开更多
目的研究心肌挽救指数(MSI)对ST段抬高型心肌梗死(STEMI)患者再灌注预后的预测价值。方法回顾性分析2021年7月-2022年6月期间在盐城市第一人民医院接受再灌注治疗的102例首次STEMI患者的临床资料,通过心血管磁共振技术测量STEMI患者的M...目的研究心肌挽救指数(MSI)对ST段抬高型心肌梗死(STEMI)患者再灌注预后的预测价值。方法回顾性分析2021年7月-2022年6月期间在盐城市第一人民医院接受再灌注治疗的102例首次STEMI患者的临床资料,通过心血管磁共振技术测量STEMI患者的MSI,根据MSI中位值将STEMI患者分为低MSI组和高MSI组,各51例。比较两组间主要不良心血管事件(MACE)临床资料、实验室指标、MACE发生率以及心功能和心室重构指标[左室射血分数(LVEF)、左心室舒张末内径(LVEDd)、左心室收缩末内径(LVESD)]。采用受试者工作特征(ROC)曲线分析术后3~7 d时MSI预测STEMI患者再灌注治疗后MACE发生的效能。结果低MSI组患者血清肌钙蛋白I(cTnI)、氨基末端-脑钠肽前体(NT-proBNP)、总胆固醇(TC)、低密度脂蛋白(LDL)显著高于高值组患者,差异有统计学意义(P<0.05)。低MSI组患者LVEF显著低于高MSI组,LVFS、LVEDd和LVESD显著高于高MSI组患者(P<0.05)。102例STEMI患者PCI术后随访1年内有27例出现MACE,MSI低值组和高值组患者各发生25例(49.02%)和2例(3.92%)MACE,低值组患者MACE发生率显著高于高值组(P<0.05)。ROC曲线分析显示术后3~7 d时MSI预测STEMI患者发生不良预后的AUC分别为0.874(95%CI:0.805~0.943),最佳诊断cut-off值为61.65,此时的灵敏度、特异度、约登指数、阳性预测和阴性预测值分别为85.18%、85.33%、70.52%、67.65%和94.12%。结论术后3~7 d MSI能够有效评估行PCI治疗的STEMI患者的预后。展开更多
文摘背景心血管疾病(CVD)是腹膜透析(PD)患者死亡的主要原因,而营养不良是PD患者发生CVD及死亡的重要危险因素之一。预后营养指数(PNI)作为一种综合评估患者免疫、炎症和营养状态的指标,因其具有便利性与可靠性等优点,在肿瘤等多种疾病的预后评估中得到了广泛应用。然而,不同时间点的营养状态与PD患者预后之间的关系仍有待进一步探究。目的探讨PD患者首年PNI与CVD死亡之间的关系。方法本研究为多中心、回顾性观察性队列研究,纳入2000-01-01—2019-07-01在南方医科大学南方医院、南方医科大学顺德医院、佛山市第一人民医院以及赣州市人民医院4所中心置管并开始接受PD治疗的1640例PD患者作为研究对象。对患者进行随访,随访截止时间为2021-07-01,终点事件为CVD死亡并记录患者生存时间及具体死亡原因。应用限制性立方条图(RCS)分析PNI与PD患者CVD死亡风险之间的非线性关联;采用Kaplan-Meier法绘制PD患者的生存曲线,绘制PNI预测PD患者CVD死亡的受试者工作特征(ROC)曲线,并根据最佳截断值(cut-off=40.46)将患者分为低PNI组703例与高PNI组937例;采用Log-rank检验和Cox风险回归模型分析探讨PNI对PD患者CVD死亡的影响。结果本研究中位随访时间为30个月,随访期间共148例患者死亡,其中CVD死亡73例(49.32%)。RCS结果表明,PNI与CVD死亡事件呈线性关联(P for Nonlinear=0.655)。ROC曲线显示,PNI预测PD患者CVD死亡的曲线下面积(AUC)为0.717(95%CI=0.659~0.775,P<0.001),灵敏度为74.0%,特异度为58.6%。Kaplan-Meier生存分析结果显示,低PNI组CVD生存率低于高PNI组(χ^(2)=26.685,P<0.001)。多因素Cox风险回归模型分析,校正性别、年龄及CVD病史等混杂因素后,低PNI组仍是CVD死亡的独立预测因素(HR=7.76,95%CI=1.72~35.06,P=0.008),亚组分析结果仍稳健,无明显交互作用。结论PNI降低是PD患者CVD死亡的独立影响因素,PD首年PNI评分在评估PD患者预后有一定的指导意义。
文摘Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.
文摘Purpose: Aortic augmentation index (AIx) and cardiovagal tone (CVT) are indicators of cardiovascular health. Associations between these variables provide information about their roles in cardiovascular disease. However, evaluating these associations from a gender perspective and gaining an understanding of the relationship between cardiorespiratory fitness and AIx based on gender can provide additional information. Therefore, we examined the relationships between CVT, measured as the log transformed high-frequency power of R-R intervals from electrocardiogram measurements (lnHFR-R);cardiorespiratory fitness, measured as maximum oxygen consumption (VO2max);and AIx at a heart rate of 75 beats·min-1(AIx@75). We hypothesized that the relationships between CVT, cardiorespiratory fitness, and AIx@75 would differ based on gender. Methods: We examined the associations between lnHFR-R, VO2max, and AIx@75 in 41 women and 39 men. Power spectral density analysis of heart rate variability determined lnHFR-R, radial tonometry determined AIx@75 and the Bruce Treadmill Protocol determined VO2max. Results: In men, lnHFR-R positively correlated with and significantly predicted AIx@75 (P = 0.005) but not in women (P = 0.49). For every unit increase in lnHFR-R, there was a 4.6 unit increase in AIx@75 in men versus a 1.0 unit increase in women. There was a significant inverse relationship between VO2max and AIx@75, with VO2max being a significant predictor of AIx@75 in men (P = 0.01). For every unit increase in VO2max, there was a 0.60 unit decrease in AIx@75 in men versus a 0.2 unit decrease in women. Conclusions: The associations between CVT and AIx@75 and between cardiorespiratory fitness and AIx@75 differ by gender. CVT and cardiorespiratory fitness are significant predictors of AIx@75 in men but not in women.
文摘Background: Japanese women’s body mass index (BMI) was known to be the lowest among people in OECD countries. We wanted to compare foods intakes and relationships between intakes of particular food species and BMI. Methods: We asked young and middle-aged women to participate and used a brief-type self-administered diet history questionnaire (BDHQ) to know the amounts of various food species they took. Results: Weights and BMI of young and middle-aged women were not different. Middle-aged women took almost all species of foods and energy more than young women. Except for cholesterol of soluble dietary fibers, there was no correlation between foods intakes and BMI. Conclusion: Both young and middle-aged Japanese women are lean (BMI;around 22). Middle-aged women took more energy, and proteins, carbohydrates, and lipids compared with young women. Middle-aged women spend more energy on house workings than young women in Japan.
文摘AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.
文摘目的探讨格列美脲联合利格列汀对2型糖尿病(diabetes mellitus type 2,T2MD)患者糖脂代谢、体重指数(body mass index,BMI)及心血管事件发生率的影响。方法选取2020年10月至2021年10月长春市中心医院收治的84例T2MD患者作为研究对象,采用随机信封法分为参照组与联合组,每组42例。参照组采用口服格列美脲治疗,联合组采用格列美脲联合利格列汀治疗。比较两组治疗前后糖脂代谢情况、BMI变化情况及心血管事件发生率。结果治疗后,两组空腹血糖(fasting blood glucose,FPG)及餐后2 h血糖(2 h postprandial blood glucose,2 h PG)、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbAlc)、血糖标准差(standard deviation of blood glucose,SDBG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平均低于治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。治疗3、6个月后,两组BMI均低于治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。随访期间,联合组心血管事件发生率低于参照组,差异有统计学意义(P<0.05)。结论格列美脲联合利格列汀治疗能有效调节T2MD患者糖脂代谢,降低BMI和心血管事件发生率,值得临床推广应用。
文摘目的研究心肌挽救指数(MSI)对ST段抬高型心肌梗死(STEMI)患者再灌注预后的预测价值。方法回顾性分析2021年7月-2022年6月期间在盐城市第一人民医院接受再灌注治疗的102例首次STEMI患者的临床资料,通过心血管磁共振技术测量STEMI患者的MSI,根据MSI中位值将STEMI患者分为低MSI组和高MSI组,各51例。比较两组间主要不良心血管事件(MACE)临床资料、实验室指标、MACE发生率以及心功能和心室重构指标[左室射血分数(LVEF)、左心室舒张末内径(LVEDd)、左心室收缩末内径(LVESD)]。采用受试者工作特征(ROC)曲线分析术后3~7 d时MSI预测STEMI患者再灌注治疗后MACE发生的效能。结果低MSI组患者血清肌钙蛋白I(cTnI)、氨基末端-脑钠肽前体(NT-proBNP)、总胆固醇(TC)、低密度脂蛋白(LDL)显著高于高值组患者,差异有统计学意义(P<0.05)。低MSI组患者LVEF显著低于高MSI组,LVFS、LVEDd和LVESD显著高于高MSI组患者(P<0.05)。102例STEMI患者PCI术后随访1年内有27例出现MACE,MSI低值组和高值组患者各发生25例(49.02%)和2例(3.92%)MACE,低值组患者MACE发生率显著高于高值组(P<0.05)。ROC曲线分析显示术后3~7 d时MSI预测STEMI患者发生不良预后的AUC分别为0.874(95%CI:0.805~0.943),最佳诊断cut-off值为61.65,此时的灵敏度、特异度、约登指数、阳性预测和阴性预测值分别为85.18%、85.33%、70.52%、67.65%和94.12%。结论术后3~7 d MSI能够有效评估行PCI治疗的STEMI患者的预后。
