ObjectiveTo investigate the existence of persistent systemic inflammation (PSI) among patients with chronic obstructive pulmonary disease (COPD) in local areas, and identify the risk factors of PSI.MethodsA total of 150 patients with stable COPD and 70 non-smoking healthy individuals were enrolled in our study. The levels of interleukin-6 (IL-6), IL-18 and activin A in serum were detected. Pulmonary function was tested, and basic information of the candidates was acquired at the same time. All of the patients were followed-up at 6 months, 12 months and 24 months for two years. The value at the 95th percentile of the concentration of inflammation markers of non-smoking healthy samples was defined as the threshold value, also known as normal ceiling limit value. Existence of PSI was defined as the condition that two or more kinds of inflammation markers exceed the threshold at each follow-up visit. The COPD patients were categorized into three classes, in which there were respectively none, one and two or more kinds of inflammation markers with over-threshold values. Based on a 2-year followup, patients with two or more kinds of inflammation markers exceeding threshold values were classified as PSI subgroup, and patients without inflammation markers exceeding threshold values as never inflamed subgroup.ResultsThere were 22 patients (14.7%) had persistent systemic inflammation, whereas 60 patients (40.0%) did not show evidence of systemic inflammation. Single factor analysis of two subgroups showed that the patients in PSI subgroup had higher body mass index (BMI), higher smoking index, higher prior frequency of time to exacerbation, higher proportion of patients at high risk for recurrent acute exacerbation during 2-year followup, higher SGRQ total score, lower FEV1%pred and lower FEV1/FVC ratio significantly (all P<0.05). Higher BMI and higher risk of recurrent acute exacerbation were independent risk factors leading to PSI, of which the higher risk of recurrent acute exacerbation had a more important effect on PSI.ConclusionsSome COPD patients have PSI in this region, which may constitute a novel COPD phenotype (called systemic inflammatory phenotype). Higher BMI and higher risk of recurrent acute exacerbation are independent risk factors leading to PSI. Individualized treatment to prevent acute exacerbation and appropriate weight control may be a better intervention for these patients.
Objective To investigate the relationship between adipocyte fatty acid binding protein ( A-FABP) and obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods A total of 120 patients were recruited and underwent polysomnography. The groups were allocated according severity of OSAHS and obesity. Plasma A-FABP ( ng/mL) levels were measured by ELISA. The associations between A-FABP and AHI, BMI, LSaO2 , MSaO2 , neck collar, waist /hip ratio, insulin resistance index were analyzed. Results Plasma A-FAPB levels were significantly higher in the OSAHS group than in the non-OSAHS group of same weight, independent of age and gender. In the non-OSAHS group and the severe OSAHS group, plasma A-FABP levels of obesity persons were significantly higher than those without obesity, independent of age and gender. Plasma A-FAPB level was positively correlated with AHI, BMI, insulin resistance index, neck collar, SLT90% , and waist/hip ratio, but negatevely correlated with LSaO2 and MSaO2 in the OSAHS group. In the non-OSAHS group, plasma A-FAPB level was positively correlated with BMI and insulin resistance index. Conclusions Plasma A-FABP level is higher in patients with severe OSAHS. Plasma A-FABP level is positively correlated with BMI and insulin resistance index both in OSAHS and non-OSAHS patients.
Objective We aimed to describe the prevalence of metabolic syndrome, its epidemiological characteristics, and to analyse the relationship of waist-to-hip ratio (WHR) and body mass index (BMI) with metabolic syndrome (MS) among staff at Southeast University. Methods The data from the overall physical examination of 1979 staff were analyzed.Results The crude prevalence of MS were 21.7%,26.4% and 14.2% in the whole population, men and women respectively. The standardized rates were 14.7%,19.0% and 9.4%. The prevalence of MS in men was significantly higher than that in women(Plt;0.05). Both abdominal obesity and visceral obesity were positively correlated with the prevalence of MS(r=0.295, 0.248, P=0.000). Conclusion The prevalence of MS among staff of Southeast University has shown a significant increase in 2006. WHR and BMI are both correlated with the prevalence of MS.
Objective To evaluate the relationship between body mass index (BMI) and malignant lymphoma by means of Meta-analysis. Methods Such databases as Web of Science, PubMed, EBbase, CNKI, Wanfang, VIP and CBM were searched from the date of their establishment to April 2011 to collect the case control studies on the relationship between BMI and malignant lymphoma. Two researchers independently selected studies, extracted data and assessed the quality according to the inclusive and exclusive criteria, and then conducted Meta-analyses by using RevMan5.0 software for heterogeneity test and pooled OR calculation. Results Seven case control studies involving 8416 malignant lymphoma patients and 14760 other patients were included. The quality of all studies scored 4, indicating reliable quality. Meta-analyses of the low BMI, overweight and obesity population were OR=0.8, 95%CI 0.79 to 0.95, P=0.003; OR=1.04, 95%CI 0.98 to 1.11, P=0.16; and OR=1.22 95%CI 1.04 to 1.43, P=0.01, respectively. The stratified Meta-analysis on histological subtypes showed that obesity was associated with a significantly increased risk of diffuse large B cell lymphoma (OR=1.33 95%CI 1.18 to 1.50, Plt;0.000 01), but was not associated with the follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. Conclusion These findings demonstrate that low BMI is associated with the decrease of malignant lymphoma, and obesity is an increasing risk of malignant lymphoma, especially, the diffuse large B cell lymphoma.
Objective To explore the relationship between obesity and the three targets including blood pressure, glucose, and lipid. Methods A total of 181 adult Tibetans who underwent physical examination between March and September 2015 at Xigaze People's Hospital were enrolled in this study. Their obesity degrees were assessed with body mass index (BMI) and waist circumference (WC) respectively. The levels of blood pressure, glucose, and lipid were compared at the different levels of BMI or WC. Results The incidence of systematic obesity and central obesity in these adults were 57.5% and 79.0%, respectively. Compared the overweight group with the normal BMI group, the systolic pressure and diastolic pressure of the former were 9.26 mm Hg (1 mm Hg=0.133 kPa) [95% confidence interval (CI) (3.46, 15.07) mm Hg, P=0.002] and 7.76 mm Hg [95%CI (3.96, 11.57) mm Hg, P<0.001] higher, respectively. Similarly, the systolic pressure and diastolic pressure of the central obesity group were 8.24 mm Hg [95%CI (1.03, 15.46) mm Hg,P=0.026] and 6.79 mm Hg [95%CI (2.03, 11.55) mm Hg, P=0.006] higher than those in the normal WC group, respectively. For the normal WC or normal BMI subjects, the detection rate of dyslipidemia reached up to 50.0% and 52.6%. Conclusions With the increase of BMI/WC values, the level of blood pressure rises. Even though WC or BMI is normal, the detection rate of dyslipidemia is high.
Objective To analyze the influence of the body mass index (BMI) and age on deep vein thrombosis (DVT) after the total hip arthroplasty(THA) or total knee arthroplasty(TKA) in Chinese patients who received prophylactic treatment for DVT. Methods We used a randomized clinical case-control study. From April 2004 to August 2004, weperformed THA and TKA for 95 patients (128 hips and knees). There were 27 men and 68 women with an average age of 60 years (range, 23-78) at surgery, and withan average BMI of 25.88 kg/m2 (range, 14.34-40.39) before surgery. All the patients were given low-molecular-weight heparin for 7-10 days pre-and postoperatively to prevent DVT. Color Doppler ultrasonography was used to detect DVT of bilateral lower extremities in all the patients before operation and 7-10 days after operation.The patients were divided into 4 groups according to their BMI:the non-obese group (BMI≤25.00 kg/m2), the overweight group (BMI, 25.01-27.00 kg/m2), the obese group (BMI, 27.01-30.00 kg/m2), and the morbidly obese group (BMIgt;30.00 kg/m2); and they were also divided into 4 groups according to their ages (≤40, 4160, 61.70, gt;70 yr) so as to analyze the influence of the BMI and age on DVT. Results The total incidence ofDVT in all the patients was 47.4% (45/95) and the incidence of proximal DVT was 3.2%. Forty-five patients had DVT and 50 patients had no DVT. The average BMI of the patients with DVT was significantly higher than that of the patients with no DVT (Plt;005). The overweight, obese, and morbidly obese patients had an odds ratio of 7.04, 4.8,and 9.6 for DVT compared with the nonobese patients (P＜0.05); but the obese group had a less risk than the other 2 groups.The 41-60, 61-70, and gt;70-year-old patients had an odds ratio of 24.0, 38.2, and 24.4 for DVT compared with the ≤40year-old patients (P＜0.05). Conclusion Obesity (BMIgt;25 kg/m2) and an increasing age (gt;40 yr) are identified as statistically significant risk factors for DVT after THA or TKA, and patients aged 61-70 years are more likely tohave DVT than the other patients. We should pay more attention to those obesity and aged patients when they are undergoing the total joint replacement, and we should give them enough prophylaxis and closely observe the symptoms in their bilateral lower extremities after operation, taking ultrasonography or venography to check DVT if necessary, so that we can give them prompt treatment and prevent fatal pulmonary thromboembolism.
ObjectiveTo explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.MethodsA retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.ResultsThe detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).ConclusionUsing SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.
ObjectiveTo analyze the latest epidemiological status of breast cancer in China, trends in morbidity and mortality from 1990 to 2019, and related prognostic risk factors.MethodsData on incidence and mortality of Chinese female breast cancer, their related age-standardized rates (ASRs) from 1990 to 2019, and attributable risk factors were obtained from the Global Burden of Disease (GBD) database, and data on disability-adjusted life years (DALYs) of 34 provinces in China were obtained from literature. Joinpoint regression analysis was used to analyze the trends of ASRs. The exposure levels of each attributable risk factor and the increased cancer burden were analyzed.ResultsThe incidence of breast cancer in Chinese females increased annually, from 17.07/100 000 in 1990 to 35.61/100 000 in 2019, while the mortality rate initially increased and decreased, and then exhibited an upward trend after 2016 and there was no obvious variation from 1990 (9.16/100 000) to 2019 (9.02/100 000). Among the 34 provinces of China, Shandong Province had the most serious breast cancer burden, while Macao Special Administrative Region had the lowest. Among the seven prognostic risk factors, high body mass index (BMI) contributed the most to the breast cancer burden and the exposure risk of a diet high in red meat had shown a significant increasing trend in the past 30 years. Therefore, the disease burden caused by a high red meat diet would be increasing.ConclusionsThe incidence rate of breast cancer in Chinese females is increasing. With the development of social economy and the change of people’s dietary habits, the breast cancer burden in China trends to become heavier and heavier. Therefore, it is necessary to conduct the "three early" prevention and treatment and advocate healthy and reasonable diet and living habits to reduce the burden of breast cancer to improve prognosis and quality of life.
ObjectiveTo collect the nutrition data in patients with chronic kidney disease (CKD) from stage 1 to 4 and provide the basis for further intervention by analyzing the specific problems of the patients. MethodsA total of 132 CKD patients from stage 1 to 4 were enrolled between December 2012 and December 2013. Nutritionists used inbodyS10ww as a body composition analyzer to test the patients. The data from inbodyS10ww and laboratory indexes were analyzed on marasmus, overweight and obesity, risk of malnutrition, malnutrition, anemia and hypoalbuminemia. ResultsThe percentage of marasmus in those CKD patients was 3.0%, overweight and obesity was 39.4%, the risk of malnutrition was 22.7%, malnutrition was 19.7%, anemia was 34.1%, and hypoalbuminemia was 9.8%. ConclusionOur search shows that combining the application of anthropometry and laboratory indexes can evaluate the nutritional status of patients with CKD. The most common nutritional problems in CKD patients include malnutrition, overweight and obesity, risk of malnutrition, and anemia. As for hypoalbuminemia, it is low in early CKD patients.
ObjectiveTo explore the levels of serum leptin,TNF-α,IL-8 and hypersensitivity C-reactive protein (hs-CRP) in stable COPD patients with different body mass index (BMI). Methods30 healthy controls with BMI 18.5 to 23.9 kg/m2 and 105 patients with stable COPD were recruited in the study. The serum levels of leptin,TNF-α,and IL-8 were determined by radioimmunoassay and hs-CRP level was determined by versatile biochemical automatic analyzer. The COPD patients were divided into a low BMI group (BMI<18.5 kg/m2,n=32),a normal BMI group (BMI 18.5-23.9 kg/m2,n=48),and a high BMI group (BMI≥23.9 kg/m2,n=25). ResultsSerum leptin level in the COPD patients was significantly reduced compared with the control subjects (P<0.05). Serum leptin levels were reduced in the low BMI and the high BMI groups compare with the normal BMI group [(7.89±3.16)ng/L and (10.52±5.98)ng/L vs. (13.04±5.73) ng/L,P<0.01 or P<0.05]. Leptin level in the low BMI group was lower than that in the high BMI group (P<0.05). Serum TNF-α levels were significantly increased in the low BMI group compared with the normal BMI and high BMI groups [(229.39±89.57)μg/L vs. (180.06±74.24) μg/L and (189.46±82.41) μg/L,P<0.01]. Serum TNF-α level in the COPD patients was significantly increased compared with the control subjects [(192.37±83.65) μg/L vs. (178.59±60.38) μg/L,P<0.05]. The IL-8 levels were not significant different among three BMI groups with COPD. The hs-CRP level in the high BMI group was higher than that in the low BMI and normal BMI groups (P<0.05). ConclusionLeptin and TNF-α may be involved in weight-loss of COPD malnutritional patients.