Assessment of Autonomic Function in Patients with a Parkinsonian Syndrome

The integrity of the autonomic nervous system was assessed in 11 Parkinsonian patients with symptoms suggestive of autonomic dysfunction. Three had the additional clinical features of the Shy-Drager variant of idiopathic orthostatic hypotension and were found to have a gross disturbance of vasomotor, sudomotor, pilomotor, and bladder function; assessment indicated that a lesion was present at sympathetic ganglionic level or beyond in two cases, though a more centrally placed lesion may well have been present also, as in the third case. In the remaining eight patients with paralysis agitans no unequivocal functional disturbance was found except in the bladder; nevertheless, the low resting blood pressure and the supersensitivity to intravenously infused L-noradrenaline in the three patients in whom it was tested is taken to imply defective regulation from higher centres, with a consequent reduction in impulse traffic at sympathetic nerve terminals. Such a concept is supported by experimental studies in animals and would account for the low renin and aldosterone secretion rates and reduced noradrenaline formation reported by others in patients with paralysis agitans.     

93例糖尿病住院患者的营养状况评价

对糖尿病住院患者入院时进行营养评价,分别对93例30～60岁糖尿病患者入院时做人体测量和生化检查,与正常人群作对照.结果显示,观察组患者的体质量、体质指数、总蛋白、白蛋白、低密度酯蛋白以及三酰甘油的平均值均高于正常组、而高密度脂蛋白低于正常组,差异有显著性意义(p＜0.05).结果表明,采用多项综合指标评价糖尿病患者的...     

Selenium and Glutathione Peroxidase Status in Adult Egyptian Patients with Acute Myeloid Leukemia

This study was undertaken to evaluate selenium (Se) and glutathione peroxidase (GPX) status in patients with newly diagnosed acute myeloid leukemia (AML) before and after induction therapy. Twenty-five patients with newly diagnosed AML and 15 healthy age- and sex-matched control subjects were included in this study. Serum Se level by the graphite furnace atomic absorption spectrometric technique and GPX activity by an adaptation of Beutler method was performed for the patients before and after receiving the induction therapy. Serum Se level was significantly lower in patients with AML versus control subjects (63.1?±?8.8 versus 77?±?8.8 µg/L before therapy with a P value <0.01 and 69?±?6.8 versus 77?±?8.8 µg/L after therapy with a P value <0.01).GPX activity was significantly lower in patients with AML versus control subjects (1.6?±?0.4 versus 3.4?±?0.7 µ/g protein pretreatment with a P value <0.01and 1.9?±?0.6 versus 3.4?±?0.7 µ/g protein post induction treatment with P value <0.01).Se level and GPX activity significantly increased in AML patients after treatment. Patients who accomplished complete remission after induction harbored significantly higher Se levels than resistant patients before and after treatment. There was no significant correlation between serum Se level and GPX activity. Decreased Se level and reduced GPX activity in AML patients support the association of carcinogenesis and subnormal Se states.     

Diseases in Patients Coming to a Sleep Center with Symptoms Related to Restless Legs Syndrome

Study Objective

To explore the profile of patients who visit a sleep center with symptoms that fulfill the four essential criteria for restless legs syndrome (RLS).

Design

A prospective study.

Setting

Outpatients from one sleep disorders clinic in Taiwan.

Participants

1,200 consecutive patients visit sleep disorders clinic with any sleep complaints.

Interventions

After completing a history and physical examination, all participants answered the RLS questionnaire. Subjects who fulfilled the four essential criteria for RLS were referred to a special clinic. A work-up including blood tests, polysomnography, and specialized neurological tests etc. was performed to make the final diagnosis.

Measurements and Results

A total of 1,185 participants were enrolled, and, of these, 131(11.1%) fulfilled the four essential criteria for RLS, and 121 completed the supplemental work-up. Their mean age was 47.6±13.3 and 52.9% were male. Insomnia and snoring were the most common chief complaints. Obstructive sleep apnea syndrome and other diseases were found in 103 patients. Only 18 (14.9%) patients had no comorbid condition and were diagnosed with primary RLS.

Conclusions

Symptoms of RLS are common in patients with sleep complaints. Even in a sleep clinic, using a questionnaire approach for identification of RLS has a low positive predictive value. Clinicians should pay attention to the limitations of the 4-item questionnaire in diagnosis of RLS and also the importance of a careful differential diagnosis to identify possible secondary causes of RLS.     

Physical Activity,Body Composition and Metabolic Syndrome in Young Adults

ObjectiveLow physical activity (PA) is a major risk factor for cardiovascular and metabolic disorders in all age groups. We measured intensity and volume of PA and examined the associations between PA and the metabolic syndrome (MS), its components and body composition among young Finnish adults.ResultsThe prevalence of MS ranged between 8-10%. Higher total mean volume (MET-hours) or intensity (MET) were negatively associated with the risk of MS and separate components of MS, while the time spent at sedentary level of PA was positively associated with MS.ConclusionsMS was prevalent in approximately every tenth of the young adults at the age of 24 years. Higher total mean intensity and volume rates as well as longer duration spent at moderate and vigorous PA level had a beneficial impact on the risk of MS. Longer time spent at the sedentary level of PA increased the risk of MS.     

Beyond Body Mass Index - Body Composition Assessment by Bioimpedance in Routine Endocrine Practice

ObjectiveTo explore the body composition of pediatric patients referred for endocrine evaluation.MethodsThis real-life observational study conducted between January 2018 and January 2020 included 10 001 clinic visits of 3500 children and adolescents; first visits of 5 to 18-year-old patients were included. Anthropometric data, blood pressure levels, pubertal status, and bioelectrical impedance analysis (BIA, Tanita MC-780 MA) were extracted from medical files. Excluded from the analysis were patients participating in other studies.ResultsA total of 1001 patients (48% boys, mean age 11.3 ± 3.4 years, 33.5% prepubertal) were included. Mean anthropometric z-scores were normal and similar for boys and girls. Sex differences in body composition were as follows: boys had lower fat percentage, lower truncal fat percentage, higher appendicular skeletal muscle mass, and a higher muscle-to-fat ratio (MFR) than girls (P < .001 for all). MFR correlated with body mass index-standard deviation scores (BMI-SDS) in overweight/obese patients (r = −0.558, P < .001), although not in underweight patients. Systolic blood pressure (SBP) correlated with BMI-SDS in overweight/obese patients (r = 0.262, P < .001), although not in underweight patients. Diastolic blood pressure (DBP) did not correlate with BMI-SDS in either group of extreme weight status. MFR correlated with SBP and DBP in overweight/obese patients (r = −0.230, P < .001 and r = −0.141, P = .018, respectively) as well as in underweight patients (r = 0.331, P < .001 and r = 0.264, P = .005, respectively).ConclusionsOur findings support BIA for a more refined characterization of patients referred for endocrine evaluation than BMI-SDS. MFR may be a better surrogate marker of blood pressure levels than BMI-SDS in both underweight and overweight/obese pediatric patients.     

Serum and Urinary Selenium Status in Patients with the Pre-diabetes and Diabetes in Northeast China

Biological Trace Element Research - Homeostasis imbalance of selenium (Se) in diabetes has received great attention. This study investigated serum and urinary Se levels in patients with impaired...     

Metabolic and Body Composition Risk Factors Associated with Metabolic Syndrome in a Cohort of Women with a High Prevalence of Cardiometabolic Disease

BackgroundThe aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome.ResultsMetabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors.ConclusionsAdiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.     

Sex chromosome analysis in Turner Syndrome by a pentaplex PCR assay

In this study, we describe a pentaplex PCR to determine the parental origin of the X chromosome and the presence of mosaicism, via amplification of four polymorphic markers located along the X chromosome (DXS10011, DXS6807, HUMARA, DXS101) and the X-Y amelogenin marker, in 41 families having a daughter with Turner Syndrome. Our results confirmed the cytogenetic findings and we found that the parental origin of the single X chromosome to be maternal in 84% of cases.     

Startling Mosaicism of the Y-Chromosome and Tandem Duplication of the SRY and DAZ Genes in Patients with Turner Syndrome

Presence of the human Y-chromosome in females with Turner Syndrome (TS) enhances the risk of development of gonadoblastoma besides causing several other phenotypic abnormalities. In the present study, we have analyzed the Y chromosome in 15 clinically diagnosed Turner Syndrome (TS) patients and detected high level of mosaicisms ranging from 45,XO:46,XY = 100:0% in 4; 45,XO:46,XY:46XX = 4:94:2 in 8; and 45,XO:46,XY:46XX = 50:30:20 cells in 3 TS patients, unlike previous reports showing 5–8% cells with Y- material. Also, no ring, marker or di-centric Y was observed in any of the cases. Of the two TS patients having intact Y chromosome in >85% cells, one was exceptionally tall. Both the patients were positive for SRY, DAZ, CDY1, DBY, UTY and AZFa, b and c specific STSs. Real Time PCR and FISH demonstrated tandem duplication/multiplication of the SRY and DAZ genes. At sequence level, the SRY was normal in 8 TS patients while the remaining 7 showed either absence of this gene or known and novel mutations within and outside of the HMG box. SNV/SFV analysis showed normal four copies of the DAZ genes in these 8 patients. All the TS patients showed aplastic uterus with no ovaries and no symptom of gonadoblastoma. Present study demonstrates new types of polymorphisms indicating that no two TS patients have identical genotype-phenotype. Thus, a comprehensive analysis of more number of samples is warranted to uncover consensus on the loci affected, to be able to use them as potential diagnostic markers.     

冠心病患者人体成分的测定与回顾性分析

目的:探讨肥胖与冠心病的相关性.方法:随机整样选取体检人员中175例男性冠心病患者(冠心痛组)及175例健康男性(对照组),应用生理电阻抗分析(bioelectrical impedance analysis,BIA)进行人体成分测定,并对测定结果进行统计分析.结果:(1)冠心病组与对照组的人体成份组成比较,体脂肪(BF)、体脂百分数(BF%)、腰臀脂肪比(WHR)在冠心病组明显升高(P＜0.05),下肢非脂肪物质(LBM)明显下降(P＜0.05);(2)以BF%作为标准,冠心病组的肥胖率明显高于对照组(P＜0.01);(3)多因素逐步回归分析显示,冠心病与BF%、WHR、下肢LBM具有显著的回归效果,且WHR的偏回归系数最大.结论:肥胖是冠心病的危险因素之一,在冠心病的发病中起着重要作用.冠心痛与肥胖,特别是中央型肥胖关系密切.     

Platelet Selenium Indices as Useful Diagnostic Surrogate for Assessment of Selenium Status in Lambs: an Experimental Comparative Study on the Efficacy of Sodium Selenite vs. Selenium Nanoparticles

Biological Trace Element Research - Unlike in human medicine, information on the platelet selenium (Se) concentration and glutathione peroxidase (GPx) activity, as potential biomarkers of Se...     

Status of Systemic Oxidative Stresses in Patients with Primary Open-Angle Glaucoma and Pseudoexfoliation Syndrome

Background

The involvement of local and systemic oxidative stress in intraocular pressure (IOP) elevation and optic nerve damage has been hypothesized in the pathogenesis of glaucoma. To test this, we measured the systemic levels of prooxidants and antioxidants by analyzing the blood biochemistry in patients with glaucoma.

Methods

Peripheral blood samples were collected from Japanese patients with primary open-angle glaucoma (PG) (n = 206), exfoliation syndrome (EX) (n = 199), and controls (n = 126). Plasma levels of lipid peroxides, ferric-reducing activity, and thiol antioxidant activity were measured by diacron reactive oxygen metabolites (dROM), biological antioxidant potential (BAP), and sulfhydryl (SH) tests, respectively, using a free radical analyzer.

Results

In the PG, EX, and control groups, the mean ± standard deviation values were 355±63, 357±69, and 348±56 (U. Carr), respectively, for dROM; 1,951±282, 1,969±252, and 2,033±252 (µmol/L), respectively, for BAP (µmol/L); and 614±98, 584±91, and 617±99 (µmol/L), respectively, for SH. The differences in the BAP values were significant between the PG and control groups (p = 0.0062), for SH between the EX and control groups (p = 0.0017), and for SH between the PG and EX groups (p = 0.0026). After adjustment for differences in age and sex among groups using multiple regression analysis, lower BAP values were correlated significantly with PG (p = 0.0155) and EX (p = 0.0049). Higher dROM values with and without glaucoma were correlated with female gender, and lower SH values with older age. There were no significant differences between the higher (≥21 mmHg) and lower (<21 mmHg) baseline IOPs in the PG group or between the presence or absence of glaucoma in the EX group.

Conclusions

Lower systemic antioxidant capacity that measured by ferric-reducing activity is involved in the pathogenesis of PG and EX.     

Assessment of Health Status in Patients with Newly Diagnosed Chronic Obstructive Pulmonary Disease

Subject

Chronic obstructive pulmonary disease (COPD) is a common disease worldwide. This study aimed to investigate the health status of patients with newly diagnosed COPD.

Methods

A total of 45 healthy controls and 218 patients with newly diagnosed COPD were recruited. Pulmonary function test (PFT) values, COPD assessment test (CAT) scores, exacerbation history, and demographics were recorded.

Results

Forced expiratory volume in 1 s percent (FEV1%) predicted was significantly decreased and the CAT score was significantly increased in patients with COPD compared with healthy controls (P <0.001). Among the COPD patients, the most commonly reported respiratory symptoms were cough (86.7%), sputum (80.3%), and dyspnea (45%). A total of 86.2% patients were in the moderate or severe stage (spirometric classification) of COPD, and 71.5% were in Group C or Group D (combined assessment). A total of 33.9% of the patients had 2 or more exacerbations in the previous year. Nearly half of the patients (45.4%) had a high CAT score of ≥10. Patients with a history of more exacerbations had a higher CAT score.

Conclusions

Most COPD patients were symptomatic and appeared to have moderate to severe airflow limitation or a high risk of exacerbation before definitely being diagnosed with COPD using the PFT.     

生化指标与2型糖尿病患者实验诊断及预后相关性研究

目的：研究BMI、HbA1c、病程、相关代谢指标与2型糖尿病（T2DM）诊断及预后的关系。方法：收集379例T2DM患者与383例健康体检者,采用生化分析仪分析二组人群的生化指标,采用高效液相色谱法检测T2DM组HbA1c水平,胰岛素及C肽采用电化学发光法检测。计量资料采用t检验、单因素方差及相关性分析,计数资料采用卡方检验分析。结果：对各组结果进行比较显示（1）T2DM患者的BMI、FBG、TG、LDL-C、BUN、uA、HbA1c水平明显高于正常对照组（P均〈0．01）,HDL-C、CREA水平明显低于对照组（P均〈0．01）;（2）TC、LDL—C、BUN、CREA及2hINS与年龄相关。（3）肥胖组的TG、CREA、UA、FCP、2hCP高于非肥胖组（P均〈0．05）;（4）初诊T2DM患者的FBG、TG、HbA1c、LDL-C水平明显高于5年以上患者（P均〈0．05）,而HDL-c低于5年以上患者（P〈0．05）;（5）HbA1c≥11％组的FBG水平明显高于HbA1c≤8％及HbA1c=8-11％组（P〈0．01）,而UA、FINS、FCP、2hINS、2hCP水平明显低于HbA1c〈8％组（P均〈0．01）;FBG、TG与HbA1c水平呈正相关（P〈0．05）;FINS、FCP、2hINS、2hCP、UA与HbA1c水平呈负相关（P〈0．01）;结论：BMI、FBG、TG、LDL-C、BUN、UA、HDL-C、CREA均可作为T2DM诊断的参考指标。其中LDL—C、BUN、CREA、2hINs指受年龄影响。TG、CREA、uA、FCP（空腹C-肽）、2hCP与肥胖相关。FBG、TG、HbA1c、LDL-C、HDL-C与病程相关;FBG、TG、HbA1c、FINS、FCP、2hINS、2hCP、UA与HbA1c相关。     

生化指标与2 型糖尿病患者实验诊断及预后相关性研究

目的：研究BMI、HbA1c、病程、相关代谢指标与2 型糖尿病（T2DM）诊断及预后的关系。方法：收集379 例T2DM 患者与 383 例健康体检者,采用生化分析仪分析二组人群的生化指标,采用高效液相色谱法检测T2DM 组HbA1c 水平,胰岛素及C 肽 采用电化学发光法检测。计量资料采用t 检验、单因素方差及相关性分析,计数资料采用卡方检验分析。结果：对各组结果进行比 较显示（1）T2DM 患者的BMI、FBG、TG、LDL-C、BUN、UA、HbA1c 水平明显高于正常对照组（P均<0.01),HDL-C、CREA 水平明 显低于对照组（P均<0.01);（2 ）TC、LDL-C、BUN、CREA及2hINS 与年龄相关。（3）肥胖组的TG、CREA、UA、FCP、2hCP 高于非肥 胖组（P 均<0.05);（4 ）初诊T2DM 患者的FBG、TG、HbAlc、LDL-C 水平明显高于5 年以上患者（P均<0.05),而HDL-C 低于5 年 以上患者（P<0.05);（5 ）HbA1c≥ 11%组的FBG水平明显高于HbA1c≤ 8%及HbA1c＝8～11%组（P<0.01）,而UA、FINS、FCP、 2hINS、2hCP 水平明显低于HbA1c<8%组（P 均<0.01);FBG、TG 与HbA1c 水平呈正相关（P<0.05）;FINS、FCP、2hINS、2hCP、UA 与HbA1c 水平呈负相关（P<0.01);结论：BMI、FBG、TG、LDL-C、BUN、UA、HDL-C、CREA均可作为T2DM诊断的参考指标。其中 LDL-C、BUN、CREA、2hINS 指受年龄影响。TG、CREA、UA、FCP(空腹C-肽）、2hCP与肥胖相关。FBG、TG、HbAlc、LDL-C、HDL-C 与病程相关;FBG、TG、HbA1c、FINS、FCP、2hINS、2hCP、UA与HbA1c 相关。     

Relationship Between Bone Mineral Density and Body Composition According to Obesity Status in Children

ObjectiveTo analyze the relationship between body composition, metabolic parameters, and bone mineral density (BMD) according to sex and the degree of obesity in children and adolescents.MethodsA total of 236 subjects with obesity, aged 10 to 15 years (36.9% girls), were enrolled. Obesity was classified into simple (SmOb) and extreme (ExOb) forms. The BMD of the total body, less head, was measured by dual energy x-ray absorptiometry, and the BMD z-score was used to evaluate the relationship of body composition with metabolic parameters.ResultsBMD z-scores were higher in subjects with ExOb than in those with SmOb. Lean mass index (LMI), body mass index z-score, and vitamin D intake showed positive relationships, whereas percentage of body fat and serum leptin level showed negative relationships with BMD z-scores in boys. In girls, LMI and body mass index z-score showed positive relationships with BMD z-scores. In multivariable linear regressions, serum leptin level showed negative relationships with BMD z-score, only in boys. In addition, positive relationships of LMI and negative relationships of percentage of body fat with BMD z-scores were observed in subjects with SmOb. However, positive relationships of LMI with BMD z-scores were attenuated in subjects with ExOb.ConclusionHigh BMD appears to be positively associated with lean mass in children and adolescents with obesity, which might be a natural protective mechanism to withstand the excess weight. However, excessive body fat appears to be negatively associated with BMD, which might attenuate the positive relationship between lean mass and BMD in subjects with ExOb.