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.Howeve...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.展开更多
目的 探究住院老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并肌少症的影响因素。方法 采用病例对照研究,回顾性分析2020年1月至2023年5月在北京医院内分泌科住院的老年T2DM患者,根据亚洲肌少症工作组(Asian Working Group for ...目的 探究住院老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并肌少症的影响因素。方法 采用病例对照研究,回顾性分析2020年1月至2023年5月在北京医院内分泌科住院的老年T2DM患者,根据亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)2019年诊断标准诊断肌少症,应用多因素Logistic回归分析探究糖尿病合并肌少症的影响因素。结果 住院老年T2DM患者共469例,男性发生率高于女性(65.3%比34.7%,P<0.05)。糖尿病合并肌少症组(T2DM+Sar组)年龄高于T2DM无肌少症组(T2DM组)(P<0.01)。T2DM+Sar组49例,T2DM组420例。倾向性评分匹配(propensity score matching,PSM)后纳入糖尿病无肌少症组153例(T2DM组),T2DM+Sar组45例,矫正性别、年龄混杂因素后,T2DM+Sar组体质指数(body mass index,BMI)显著低于T2DM组(P <0.01),T2DM+Sar组中,BMI<24kg/m2患者比例更高(53.6%比11.1%,P<0.01),合并脑血管病及糖尿病周围神经病变比例更高(P<0.05)。T2DM+Sar组较T2DM组,Morse跌倒评分更高,日常生活能力(activities of daily living,ADL)评分更低,5次坐站所需时间更长、优势手握力低(均P<0.05),T2DM+Sar组的优势侧上肢臂围更细,总瘦组织含量、骨矿物质含量、内脏脂肪面积均低于T2DM组(P<0.05)。多因素Logistic回归分析显示:合并糖尿病周围神经病变(OR=3.348,95%CI:1.252~8.955)、内脏脂肪面积(OR=1.042,95%CI:1.005~1.079)、血尿酸(OR=1.007,95%CI:1.002~1.012)是老年T2DM合并肌少症的危险因素,BMI (OR=0.512,95%CI:0.363~0.721)、骨矿物质含量(OR=0.037,95%CI:0.008~0.186)是老年T2DM合并肌少症的保护因素。在BMI<24kg/m2的老年T2DM患者群体中,血尿酸(OR=1.010,95%CI:1.003~1.017)为老年T2DM合并肌少症的危险因素,下肢平均腿围(OR=0.624,95%CI:0.447~0.870)、高密度脂蛋白胆固醇(OR=0.195,95%CI:0.040~0.945)、总瘦组织含量(OR=0.889,95%CI:0.797~0.990)为老年T2DM合并肌少症的保护因素。结论 在老年T2DM的管理中,不建议将BMI控制在过低水平,身体成分对于老年T2DM患者合并肌少症的预测作用可能比BMI更有意义。展开更多
文摘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.
文摘目的 探究住院老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并肌少症的影响因素。方法 采用病例对照研究,回顾性分析2020年1月至2023年5月在北京医院内分泌科住院的老年T2DM患者,根据亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)2019年诊断标准诊断肌少症,应用多因素Logistic回归分析探究糖尿病合并肌少症的影响因素。结果 住院老年T2DM患者共469例,男性发生率高于女性(65.3%比34.7%,P<0.05)。糖尿病合并肌少症组(T2DM+Sar组)年龄高于T2DM无肌少症组(T2DM组)(P<0.01)。T2DM+Sar组49例,T2DM组420例。倾向性评分匹配(propensity score matching,PSM)后纳入糖尿病无肌少症组153例(T2DM组),T2DM+Sar组45例,矫正性别、年龄混杂因素后,T2DM+Sar组体质指数(body mass index,BMI)显著低于T2DM组(P <0.01),T2DM+Sar组中,BMI<24kg/m2患者比例更高(53.6%比11.1%,P<0.01),合并脑血管病及糖尿病周围神经病变比例更高(P<0.05)。T2DM+Sar组较T2DM组,Morse跌倒评分更高,日常生活能力(activities of daily living,ADL)评分更低,5次坐站所需时间更长、优势手握力低(均P<0.05),T2DM+Sar组的优势侧上肢臂围更细,总瘦组织含量、骨矿物质含量、内脏脂肪面积均低于T2DM组(P<0.05)。多因素Logistic回归分析显示:合并糖尿病周围神经病变(OR=3.348,95%CI:1.252~8.955)、内脏脂肪面积(OR=1.042,95%CI:1.005~1.079)、血尿酸(OR=1.007,95%CI:1.002~1.012)是老年T2DM合并肌少症的危险因素,BMI (OR=0.512,95%CI:0.363~0.721)、骨矿物质含量(OR=0.037,95%CI:0.008~0.186)是老年T2DM合并肌少症的保护因素。在BMI<24kg/m2的老年T2DM患者群体中,血尿酸(OR=1.010,95%CI:1.003~1.017)为老年T2DM合并肌少症的危险因素,下肢平均腿围(OR=0.624,95%CI:0.447~0.870)、高密度脂蛋白胆固醇(OR=0.195,95%CI:0.040~0.945)、总瘦组织含量(OR=0.889,95%CI:0.797~0.990)为老年T2DM合并肌少症的保护因素。结论 在老年T2DM的管理中,不建议将BMI控制在过低水平,身体成分对于老年T2DM患者合并肌少症的预测作用可能比BMI更有意义。
