Immunoglobulin G-mediated food intolerance and metabolic syndrome influence the occurrence of reflux esophagitis in Helicobacter pylori-infected patients

BACKGROUND Reflux esophagitis has an increasing prevalence and complex and diverse symptoms.Identifying its risk factors is crucial to understanding the etiology,prevention,and management of the disease.The occurrence of reflux esophagitis may be associated with food reactions,Helicobacter pylori(H.pylori)infection,and metabolic syndromes.AIM To investigate the risk factors for reflux esophagitis and analyze the effects of immunoglobulin(Ig)G-mediated food intolerance,H.pylori infection,and metabolic syndrome on reflux esophagitis.METHODS Outpatients attending the Second Medical Center of the PLA General Hospital between 2017 and 2021 were retrospectively enrolled.The patients’basic information,test results,gastroscopy results,H.pylori test results,and IgG-mediated food intolerance results were collected.Multivariate logistic regression analysis was used to analyze risk factors for reflux esophagitis.Statistical mediation analysis was used to evaluate the effects of IgG-mediated food intolerance and metabolic syndrome on H.pylori infection affecting reflux esophagitis.RESULTS A total of 7954 outpatients were included;the prevalence of reflux esophagitis,IgG-mediated food intolerance,H.pylori infection,and metabolic syndrome were 20.84%,61.77%,35.91%,and 60.15%,respectively.Multivariate analysis showed that the independent risk factors for reflux esophagitis included IgG-mediated food intolerance(OR=1.688,95%CI:1.497-1.903,P<0.00001)and metabolic syndrome(OR=1.165,95%CI:1.030-1.317,P=0.01484),and the independent protective factor for reflux esophagitis was H.pylori infection(OR=0.400,95%CI:0.351-0.456,P<0.00001).IgG-mediated food intolerance had a partially positive mediating effect on H.pylori infection as it was associated with reduced occurrence of reflux esophagitis(P=0.0200).Metabolic syndrome had a partially negative mediating effect on H.pylori infection and reduced the occurrence of reflux esophagitis(P=0.0220).CONCLUSION Patients with IgG-mediated food intolerance and metabolic syndrome were at higher risk of developing reflux esophagitis,while patients with H.pylori infection were at lower risk.IgG-mediated food intolerance reduced the risk of reflux esophagitis pathogenesis in patients with H.pylori infection;however,metabolic syndrome increased the risk of patients with H.pylori infection developing reflux esophagitis.

Advancements in Lynch Syndrome Management: Applying Immunotherapy for Therapeutic Success

Lynch syndrome is the fourth most common cancer in the United States, with an early age of onset and poor prognosis. Here, we present a unique case of a patient with progressive colon cancer due to a late diagnosis of Lynch syndrome showing excellent response to immunotherapy. A 59-year-old male with a history of rectal cancer 30 years ago came to the hospital due to a fever and further found a large necrotic colon mass. Biopsy was positive for colorectal cancer;however, due to the size of the tumor, the patient was deemed not a surgical candidate and offered hospice with palliative chemotherapy. Based on further workup, the patient was diagnosed with Lynch syndrome, with colon cancer determined to be responsive to Immunotherapy. He was started on JEMPERLI (Dosterlimab-gxly), and after three cycles of therapy, imaging and PET scan were repeated, showing decreased activity and extent of the tumor—a tremendous success.

Global research landscape of Peutz-Jeghers syndrome and successful endoscopic management of intestinal intussusception in patients with recurrent laparotomies

BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.

Diagnostic Accuracy of Computerized Bowel Sound Analysis with Non-Invasive Devices for Irritable Bowel Syndrome:A Systematic Review and Meta-Analysis

Objective To assess the diagnostic accuracy of bowel sound analysis for irritable bowel syndrome(IBS)with a systematic review and meta-analysis.Methods We searched MEDLINE,Embase,the Cochrane Library,Web of Science,and IEEE Xplore databases until September 2023.Cross-sectional and case-control studies on diagnostic accuracy of bowel sound analysis for IBS were identified.We estimated the pooled sensitivity,specificity,positive likelihood ratio,negative likeli-hood ratio,and diagnostic odds ratio with a 95% confidence interval(CI),and plotted a summary receiver operat-ing characteristic curve and evaluated the area under the curve.Results Four studies were included.The pooled diagnostic sensitivity,specificity,positive likelihood ratio,nega-tive likelihood ratio,and diagnostic odds ratio were 0.94(95%CI,0.87‒0.97),0.89(95%CI,0.81‒0.94),8.43(95%CI,4.81‒14.78),0.07(95%CI,0.03‒0.15),and 118.86(95%CI,44.18‒319.75),respectively,with an area under the curve of 0.97(95%CI,0.95‒0.98).Conclusions Computerized bowel sound analysis is a promising tool for IBS.However,limited high-quality data make the results'validity and applicability questionable.There is a need for more diagnostic test accuracy studies and better wearable devices for monitoring and analysis of IBS.

Cyclops syndrome following anterior cruciate ligament reconstruction: Can relapse occur after surgery?

Symptomatic cyclops lesions are complications that can be seen at rates of up to approximately 10%after anterior cruciate ligament reconstruction.However,recurrent cyclops lesions have rarely been documented.There are case rare series in the literature regarding the treatment of recurrent cyclops lesion.Future large studies are needed to investigate factors contributing to the development of cyclops lesions and syndrome and treatment options.

Jaffe-Campanacci syndrome resulted in amputation: A case report

BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept holds that the natural course of non-ossifying fibromas(NOFs)grows with the development of bones,and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion.But in this case,the bone lesions were potentially biologically aggressive,which led to severe limb deformities and pain.CASE SUMMARY We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,axilla,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,armpit,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.CONCLUSION In our opinion,education on preventing pathological fractures and explaining the consequent serious consequences to the parents is a matter of prime significance.At the same time,prophylactic treatment(restricted exercise,support,or surgery)is also considerable for JSC.

Successful splenic artery embolization in a patient with Behçet’s syndrome-associated splenic rupture:A case report

BACKGROUND Splenic rupture associated with Behçet’s syndrome(BS)is extremely rare,and there is no consensus on its management.In this case report,a patient with BSassociated splenic rupture was successfully treated with splenic artery embolization(SAE)and had a good prognosis after the intervention.CASE SUMMARY The patient was admitted for pain in the left upper abdominal quadrant.He was diagnosed with splenic rupture.Multiple oral and genital aphthous ulcers were observed,and acne scars were found on his back.He had a 2-year history of BS diagnosis,with symptoms of oral and genital ulcers.At that time,he was treated with oral corticosteroids for 1 month,but the symptoms did not alleviate.He underwent SAE to treat the rupture.On the first day after SAE,the patient reported a complete resolution of abdominal pain and was discharged 5 d later.Three months after the intervention,a computed tomography examination showed that the splenic hematoma had formed a stable cystic effusion,suggesting a good prognosis.CONCLUSION SAE might be a good choice for BS-associated splenic rupture based on good surgical practice and material selection.

Successful management of infection and macrophage activation syndrome patient using low-dose etoposide:A case report

BACKGROUND Macrophage activation syndrome(MAS),a sub-type of hemophagocytic lymphohistiocytosis(HLH)secondary to autoimmune rheumatic diseases,is a critical and potentially fatal condition characterized by an excessive inflammatory response.Despite the established efficacy of the HLH-2004 guideline in diagnosing and treating HLH over the years,ongoing discussion persists regarding its application,especially for HLH secondary to complicated conditions,such as autoimmune rheumatic diseases combined with severe infection.Etoposide(VP-16),a topoisomerase II inhibitor that effectively induces DNA damage and subsequent apoptosis in hyperactivated immune cells,has been widely used for the treatment of HLH.However,its suppressive effect on immune system may also cause potential exacerbation of infection in autoimmune rheumatic disease-induced HLH patients complicated with severe infection.Therefore,the use of VP-16 in such cases was inconclusive.CASE SUMMARY In this case study,we propose a potentially effective strategy for managing a patient diagnosed with secondary HLH complicated with systemic lupus erythematosus(SLE)and chronic coronavirus disease 2019 infection.Our approach involves early administration of low-dose VP-16(100 mg twice a week,300 mg in total),combined with methylprednisolone,cyclophosphamide,and cyclosporine A.The administration of etoposide effectively led to improvements in various indices of HLH.CONCLUSION Low dose etoposide proves to be an effective approach in alleviating HLH while mitigating the risk of infection.

Refractory Ventricular Fibrillation with Underlying Coronary Artery Disease after COVID-19 Vaccine-Kounis Syndrome or Coincidence

A 63-year-old man with diabetes and asymptomatic coronary artery disease developed refractory ventricular arrhythmia at 20 hours at rest after his second COVID-19 vaccine. Despite significant stenosis in the coronary arteries, there was no evidence of acute or old myocardial infarction, heart failure, myocarditis or structural abnormalities on post-mortem to account for the substrate for the fatal arrhythmia. The refractory and incessant nature of the ventricular fibrillation and post-mortem finding of a grossly elevated unexplained IgE level (in the absence of acute myocardial infarction) suggested the possibility of Kounis Syndrome or allergic acute coronary syndrome.

海上CCS/CCUS作业模式探讨与分析

CO_(2)地质封存与利用是应对温室气体排放、实现碳达峰碳中和目标的关键技术。从CCS/CCUS作业类型、CO_(2)来源等角度对全球海上CCS/CCUS项目进行分析,总结形成4类海上CCS/CCUS作业模式。通过对CO_(2)相态变化、杂质含量等因素对CO_(2)性能的影响研究,分析了海上CO_(2)源汇匹配、运输、注入的难点。结合国内海上CCS/CCUS业务现状与发展需求,从海上CO_(2)集群枢纽式源汇匹配模式探索、注入模式优化及配套设备研发、流动保障技术能力建设3个方向明确今后海上CCS/CCUS作业技术发展方向。

西南油气田CCUS/CCS发展现状、优势与挑战

中国石油西南油气田公司(以下简称西南油气田)是中国西南地区首个天然气年产量超400×10^(8) m^(3)的油气生产企业,其天然气新建产能、产量的增量分别占到全国增量的1/4和1/3,预计2030年天然气开发的碳排放量将突破500×10^(4) t。为解决天然气高质量上产过程中碳排放量刚性增长的问题,西南油气田主动围绕“天然气+CCUS”的战略规划,积极部署CCUS/CCS工作,以期打造“绿色能源西南模式”,助力实现“双碳”目标。为此,系统阐述了西南油气田在CCUS/CCS业务规划、标准体系、技术系列等方面的发展现状,梳理了其CCUS/CCS业务在资源、技术方面的优势,并分析了面临的技术成熟度不高、经济效益缺乏、社会接受度不高等挑战,最后作出了展望并有针对性地提出了下一步建议:①攻关形成具有气田特色的CCUS/CCS技术体系,打造气田CCUS/CCS原创技术策源地;②建立气田CCUS/CCS标准体系,推广应用气田CO_(2)驱气提高采收率(CCUS-EGR)和CO_(2)埋存技术;③依托西南油气田自有碳捕集、输送、驱气、封存等技术,进一步延伸拓展传统油气主营业务产业链,建立西南片区CCUS/CCS产业集群和碳库,助力中国石油成为CCUS/CCS产业链链长;④探索页岩气注CO_(2)及混合气体提高采收率技术,支撑在页岩气领域开辟新的CCUS方向。

鄂尔多斯盆地CCS-EOR项目CO_(2)泄漏环境风险评估

以鄂尔多斯盆地乔家洼CCS-EOR项目为例,通过工程活动指标分解及选项设计,形成涵盖油区特征、储盖层特征、工程设计、工程监管4大类20个指标的环境风险可能性判定指标体系,利用问卷调查和专家打分法,界定驱油工程环境风险可能性。结合国内外文献分析,开展项目对空气、土壤和微生物、作物、动物及人群等环境风险受体的影响程度界定,基于界定结果,按照风险评估矩阵,对该工程CO_(2)泄漏环境风险水平的评估结论为低风险,在后期运行过程中应强化风险防范与监测。

海上CCS工程项目全流程技术进展与展望

分析了海上典型场景CCS全流程的技术进展,提出面临的挑战和对未来发展趋势的展望。海上CCS项目主要有两个典型场景,包括海上平台CO_(2)捕集直接回注和陆地排放源CO_(2)捕集后运输到海上进行离岸封存。海上平台CO_(2)捕集工艺以膜分离为主,同时配合多种工艺组合;陆地排放源主要有天然气处理终端和炼化企业,根据气源浓度选择捕集工艺,以化学吸收法为主,重点研究低成本的工艺。海上CO_(2)运输主要有船舶运输和管道运输,目前管道运输处在中试阶段,大型CO_(2)运输船正在设计建造中。海上封存场地主要包括咸水层和枯竭油气藏,咸水层封存重点研究盖层封闭性、长期稳定性以及海上监测技术。综合考虑技术和成本因素,海上CCS项目未来向集群项目发展,联合排放企业和封存企业共同开展CO_(2)利用及封存,技术上需要重点攻关海上平台CO_(2)高效低成本捕集工艺、海上CO_(2)运输大型装备以及海上封存监测过程中的难题。

中国CCS/CCUS发展瓶颈与应对策略

碳捕集与封存(Carbon Capture and Storage, CCS)或碳捕集、利用与封存(Carbon Capture, Utilization and Storage, CCUS)能够与传统能源耦合进行深度减碳,是碳中和重要的技术选择和推手。由于中国能源结构的煤基特点,发展CCS/ CCUS是中国能源转型的必经路径。目前中国CCS/ CCUS发展处于起步阶段,存在诸多短板有待补齐:技术成熟度、集成度低,顶层设计缺失、宏观规划不足,市场机制、政策激励与基础设施等商业化基础薄弱,大型项目商业模式仍不明确,法律框架与标准化空白,这些因素共同制约着CCS/ CCUS的规模化发展。为此建议:国家层面上要把握能源转型的窗口期,做好政策规划与顶层设计,出台系统的政策体系激励产业发展,健全法律框架和技术标准,在管道布局上要未雨绸缪,技术创新要明确重点,丰富、完善碳交易市场与碳税机制,合力构筑有助于CCS/ CCUS快速发展的商业环境。

滇水金凤耐铜相关基因CAX3和CCS的克隆及表达分析

植物CAX(Ca2+/H+反向转运蛋白)和CCS(铜锌超氧化物歧化酶铜伴侣蛋白)分别是重要的液泡膜转运蛋白和铜伴侣蛋白,通过不同机制在缓解重金属胁迫中发挥着重要作用。本课题组前期研究发现滇水金凤(Impatiens uliginosa)对铜胁迫具有很好的耐受性,并通过转录组测序筛选出耐铜相关基因。在此基础上,本研究以野生滇水金凤为材料,通过RT-PCR技术克隆获得耐铜相关基因CAX3和CCS,分别命名为IuCAX3和IuCCS,其cDNA序列长度分别为1320 bp和975 bp,分别编码439个和324个氨基酸。生物信息学分析结果表明,IuCAX3为不稳定蛋白,具有caca2超家族的保守结构域,定位在质膜、液泡上;IuCCS为稳定蛋白,具有PLN02957超家族的保守结构域,定位在叶绿体上。系统进化分析结果显示,IuCAX3和IuCCS均与喜马拉雅凤仙花的相应基因聚为一支,相似性分别为98.18%和89.81%。通过设置不同的铜处理浓度(0、5、10、15、20、25 mg·L^(-1))研究了IuCAX3和IuCCS基因在滇水金凤叶片中的表达情况,qRT-PCR分析结果表明,铜处理能诱导两个基因大幅上调表达,且铜浓度为15 mg·L^(-1)时的上调幅度最大,并均在处理12 d达到最高水平;随处理时间延长,IuCAX3的表达量先升高后降低,IuCCS的表达量在铜浓度不高于15 mg·L^(-1)时呈先升后降再升的趋势,但当铜浓度高于15 mg·L^(-1)后则呈先升后降的趋势,而且铜处理下IuCCS的表达水平明显高于IuCAX3,因此推测IuCAX3基因主要在铜胁迫前期起作用,而IuCCS基因在铜胁迫后期仍发挥重要作用。本研究结果可为深入研究滇水金凤耐铜分子机制提供一定的参考依据。

Hepatocardiorenal syndrome in liver cirrhosis:Recognition of a new entity?

Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context.In the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease.It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities.Despite the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS.Yet from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients.In this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting.The temporality of heart and kidney dysfunction in HRS will be discussed.For a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is reviewed.Continued research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.

Tricuspid mass-curious case of Li-Fraumeni syndrome: A case report

BACKGROUND Li-Fraumeni syndrome(LFS)is a rare autosomal dominant cancer-predisposing syndrome,which can manifest as a polymorphic spectrum of malignancies.LFS is associated with an early onset in life,with the majority of cases occurring prior to the age of 46.Notwithstanding the infrequency of primary cardiac tumors,it behooves clinicians to remain vigilant in considering the differential diagnosis of such tumors in LFS patients who present with a cardiac mass.This is due to the markedly elevated risk for malignancy in this particular population,far surpassing that of the general populace.CASE SUMMARY Herein,we present a case of a 30-year-old female with LFS who was found to have a tricuspid valve leaflet mass.CONCLUSION This case exemplifies valuable learning points in the diagnostic approach for this exceptionally rare patient population.

Protective mechanism of quercetin in alleviating sepsis-related acute respiratory distress syndrome based on network pharmacology and in vitro experiments

BACKGROUND:Sepsis-related acute respiratory distress syndrome(ARDS)has a high mortality rate,and no effective treatment is available currently.Quercetin is a natural plant product with many pharmacological activities,such as antioxidative,anti-apoptotic,and anti-inflammatory effects.This study aimed to elucidate the protective mechanism of quercetin against sepsis-related ARDS.METHODS:In this study,network pharmacology and in vitro experiments were used to investigate the underlying mechanisms of quercetin against sepsis-related ARDS.Core targets and signaling pathways of quercetin against sepsis-related ARDS were screened and were verified by in vitro experiments.RESULTS:A total of 4,230 targets of quercetin,360 disease targets of sepsis-related ARDS,and 211 intersection targets were obtained via database screening.Among the 211 intersection targets,interleukin-6(IL-6),tumor necrosis factor(TNF),albumin(ALB),AKT serine/threonine kinase 1(AKT1),and interleukin-1β(IL-1β)were identified as the core targets.A Gene Ontology(GO)enrichment analysis revealed 894 genes involved in the inflammatory response,apoptosis regulation,and response to hypoxia.Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis identified 106 pathways.After eliminating and generalizing,the hypoxia-inducible factor-1(HIF-1),TNF,nuclear factor-κB(NF-κB),and nucleotide-binding and oligomerization domain(NOD)-like receptor signaling pathways were identified.Molecular docking revealed that quercetin had good binding activity with the core targets.Moreover,quercetin blocked the HIF-1,TNF,NF-κB,and NODlike receptor signaling pathways in lipopolysaccharide(LPS)-induced murine alveolar macrophage(MH-S)cells.It also suppressed the inflammatory response,oxidative reactions,and cell apoptosis.CONCLUSION:Quercetin ameliorates sepsis-related ARDS by binding to its core targets and blocking the HIF-1,TNF,NF-κB,and NOD-like receptor signaling pathways to reduce inflammation,cell apoptosis,and oxidative stress.

Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Incidence and risk factors of depression in patients with metabolic syndrome

BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.