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
【目的】探讨海南省特发性性早熟(idiopathic central precocious puberty,ICPP)女童的中医证型分布特点。【方法】回顾性选取海南省妇女儿童医学中心于2019年1月至2021年12月收治的216例ICPP女童为研究对象,对其中医证候进行频数统计...【目的】探讨海南省特发性性早熟(idiopathic central precocious puberty,ICPP)女童的中医证型分布特点。【方法】回顾性选取海南省妇女儿童医学中心于2019年1月至2021年12月收治的216例ICPP女童为研究对象,对其中医证候进行频数统计和分级评分,并按阴虚火旺证、气血亏虚证和心肾不交证三大中医证型,探讨其中医证型分布特点。【结果】(1)发病年龄方面,216例ICPP女童的发病年龄在4~10岁之间,平均发病年龄为(7.15±1.06)岁,其中满7岁且不满8岁阶段的ICPP女童发病率最高,为49.54%。(2)中医证型方面,三大证型中,阴虚火旺证的占比最高(147例,占68.06%),其次是气血亏虚证(41例,占18.98%)及心肾不交证(28例,占12.96%)。(3)中医证候方面,临床常见证候(频率>25.0%)按出现频率由高到低依次为:怕热盗汗、手足心热、乳房胀痛、性情急躁、脉细数、大便干结、咽干口燥、潮热、多食肥甘、舌红少苔、抑郁、精神乏力、颧红、失眠多梦、舌红苔黄和口苦口干等16种。(4)各证型的年龄分布方面:阴虚火旺证和气血亏虚证均多见于满7岁且不满8岁年龄段的ICPP女童(占58.50%和51.22%),心肾不交证多见于满8岁且不满9岁年龄段的ICPP女童(占89.29%)。【结论】阴虚火旺证是海南省ICPP女童占比最高的中医证型。研究性早熟女童的中医证型分布,有助于性早熟女童的早期临床症状观察以及疾病的早期诊断,从而为ICPP女童的临床辨证用药提供线索和依据。展开更多
Several guidelines have indicated that liver stiffness(LS)assessed by means of shear wave elastography(SWE)can safely replace liver biopsy in several clinical scenarios,particularly in patients with chronic viral hepa...Several guidelines have indicated that liver stiffness(LS)assessed by means of shear wave elastography(SWE)can safely replace liver biopsy in several clinical scenarios,particularly in patients with chronic viral hepatitis.However,an increase of LS may be due to some other clinical conditions not related to fibrosis,such as liver inflammation,acute hepatitis,obstructive cholestasis,liver congestion,infiltrative liver diseases.This review analyzes the role that SWE can play in cases of liver congestion due to right-sided heart failure,congenital heart diseases or valvular diseases.In patients with heart failure LS seems directly influenced by central venous pressure and can be used as a prognostic marker to predict cardiac events.The potential role of LS in evaluating liver disease beyond the stage of liver fibrosis has been investigated also in the hepatic sinusoidal obstruction syndrome(SOS)and in the Budd-Chiari syndrome.In the hepatic SOS,an increase of LS is observed some days before the clinical manifestations;therefore,it could allow an early diagnosis to timely start an effective treatment.Moreover,it has been reported that patients that were successfully treated showed a LS decrease,that reached pre-transplantation value within two to four weeks.It has been reported that,in patients with Budd-Chiari syndrome,LS values can be used to monitor short and long-term outcome after angioplasty.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.
文摘【目的】探讨海南省特发性性早熟(idiopathic central precocious puberty,ICPP)女童的中医证型分布特点。【方法】回顾性选取海南省妇女儿童医学中心于2019年1月至2021年12月收治的216例ICPP女童为研究对象,对其中医证候进行频数统计和分级评分,并按阴虚火旺证、气血亏虚证和心肾不交证三大中医证型,探讨其中医证型分布特点。【结果】(1)发病年龄方面,216例ICPP女童的发病年龄在4~10岁之间,平均发病年龄为(7.15±1.06)岁,其中满7岁且不满8岁阶段的ICPP女童发病率最高,为49.54%。(2)中医证型方面,三大证型中,阴虚火旺证的占比最高(147例,占68.06%),其次是气血亏虚证(41例,占18.98%)及心肾不交证(28例,占12.96%)。(3)中医证候方面,临床常见证候(频率>25.0%)按出现频率由高到低依次为:怕热盗汗、手足心热、乳房胀痛、性情急躁、脉细数、大便干结、咽干口燥、潮热、多食肥甘、舌红少苔、抑郁、精神乏力、颧红、失眠多梦、舌红苔黄和口苦口干等16种。(4)各证型的年龄分布方面:阴虚火旺证和气血亏虚证均多见于满7岁且不满8岁年龄段的ICPP女童(占58.50%和51.22%),心肾不交证多见于满8岁且不满9岁年龄段的ICPP女童(占89.29%)。【结论】阴虚火旺证是海南省ICPP女童占比最高的中医证型。研究性早熟女童的中医证型分布,有助于性早熟女童的早期临床症状观察以及疾病的早期诊断,从而为ICPP女童的临床辨证用药提供线索和依据。
文摘Several guidelines have indicated that liver stiffness(LS)assessed by means of shear wave elastography(SWE)can safely replace liver biopsy in several clinical scenarios,particularly in patients with chronic viral hepatitis.However,an increase of LS may be due to some other clinical conditions not related to fibrosis,such as liver inflammation,acute hepatitis,obstructive cholestasis,liver congestion,infiltrative liver diseases.This review analyzes the role that SWE can play in cases of liver congestion due to right-sided heart failure,congenital heart diseases or valvular diseases.In patients with heart failure LS seems directly influenced by central venous pressure and can be used as a prognostic marker to predict cardiac events.The potential role of LS in evaluating liver disease beyond the stage of liver fibrosis has been investigated also in the hepatic sinusoidal obstruction syndrome(SOS)and in the Budd-Chiari syndrome.In the hepatic SOS,an increase of LS is observed some days before the clinical manifestations;therefore,it could allow an early diagnosis to timely start an effective treatment.Moreover,it has been reported that patients that were successfully treated showed a LS decrease,that reached pre-transplantation value within two to four weeks.It has been reported that,in patients with Budd-Chiari syndrome,LS values can be used to monitor short and long-term outcome after angioplasty.
