无左室肥厚的非杓型高血压患者血清GDF-15、YKL-40水平表达及其临床意义

摘要 目的：探讨无左室肥厚（NLVH）的非杓型高血压患者血清生长分化因子15（GDF-15）、人软骨糖蛋白39（YKL-40）水平的表达及其临床意义。方法：选取2019年6月至2020年6月张家口学院附属人民医院收治的NLVH原发性高血压患者104例为研究对象,根据夜间收缩压下降率（SBPF）将其分为非杓型组（SBPF＜10%,n=60）和杓型组（10%≤SBPF≤20%,n=44）。另选取同期于张家口学院附属人民医院进行体检的健康志愿者49例记为对照组。比较三组受试者的血清GDF-15、YKL-40水平,比较非杓型和杓型NLVH患者的舒张压、收缩压、颈动脉内膜中层厚度（IMT）值、僵硬度、紧张度和扩张性、超声心动图参数、血压昼夜节律指标,分析NLVH的非杓型高血压患者血清GDF-15、YKL-40水平与超声心动图参数、血压昼夜节律、颈动脉粥样硬化指标的相关性。采用多元线性逐步回归分析非杓型高血压发病的影响因素。结果：非杓型NLVH组和杓型NLVH组患者的血清GDF-15、YKL-40水平均高于对照组患者,且非杓型NLVH组高于杓型NLVH组（P<0.05）;与杓型NLVH组患者比较,非杓型NLVH组患者的IMT、僵硬度、夜间平均收缩压（nSBP）、平均舒张压（nDBP）、左室舒张末期内径（LVEDD）、左房内径（LAD）、室间隔厚度（LVSD）、左室后壁厚度（PWD）均升高,LVEF、紧张度、扩张性则降低（P<0.05）,但两组患者的白天平均收缩压（dSBP）、白天平均舒张压（dDBP）比较差异无统计学意义（P>0.05）。经Pearson相关性分析显示,NLVH的非杓型高血压患者的血清GDF-15、YKL-40水平与IMT、僵硬度、LAD、LVEDD、LVSD、PWD、nSBP、nDBP呈正相关,与LVEF、紧张度、扩张性呈负相关（P<0.05）,而与dSBP、dDBP无明显相关性（P>0.05）;GDF-15与YKL-40水平呈正相关（P<0.05）。多元线性逐步回归分析显示：颈动脉IMT、僵硬度、LAD、LVEDD、nSBP、nDBP、LVEF、颈动脉紧张度、GDF-15是非杓型高血压发病的独立影响因素（P<0.05）。结论：NLVH的非杓型高血压患者血清GDF-15、YKL-40水平异常升高,且与超声心动图参数、血压昼夜节律、颈动脉粥样硬化具有一定关联,患者发病受多种因素影响,临床工作中应结合相关因素对患者进行适当干预。     

中老年男性2型糖尿病患者不同年龄段的骨代谢情况

摘要 目的：探讨中老年男性2型糖尿病患者不同年龄段的骨代谢的情况。方法：选取中老年男性2型糖尿病患者203人,按年龄分为50-59岁组(A组)、60-69岁组（B组）、70-80岁组（C组）,测定各组的身体质量指数（BMI）、腰围（WC）、收缩压（SDP）、舒张压（DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HD L-c)、骨钙素(OC)、I型前胶原氨基末端前肽(P1NP)、I型胶原交联C-末端肽(CTX)和骨密度（BMD）。结果：C组的OC、P1NP低于A组、B组,CTX高于A组、B组,C组的病程长于A组、B组,B组的病程长于A组,B、C组股骨颈的BMD值低于A组,C组L4的BMD值高于A、B组,P均<0.05。3组的HbA1c、BMI、股骨干、全髋、L1、L2、L3的BMD值无统计学差异（P>0.05）。相关分析显示：年龄与糖尿病病程（r=0.284,P<0.001）、BMI成正相关（r=0.193,P=0.007）;OC与P1NP正相关（r=0.465,P<0.001）,与CTX（r=-0.312,P=0.002）、糖尿病病程（r=-0.264,P<0.001）、BMI（r=-0.425,P<0.001）负相关;P1NP与CTX（r=-0.341,P<0.001）、糖尿病病程（r=-0.206,P=0.004）、BMI（r=-0.468,P<0.001）负相关;CTX与糖尿病病程（r=0.171,P=0.017）、BMI（r=0.443,P<0.001）正相关。结论：中老年男性2型糖尿病患者中,骨代谢指标与BMI、糖尿病病程相关,与年龄关系不明显。     

老年高血压患者颈动脉内膜中膜厚度与动态血压参数的相关性

目的:探究老年高血压患者颈动脉内膜中膜厚度(IMT)与动态血压参数间的相关关系,为老年高血压患者的临床治疗提供理论基础。方法:选取2015年1月至2016年1月在我院接受治疗的老年高血压患者204例,根据超声检查结果分为A、B、C三组,每组68例。24 h无创检测患者动态血压参数,包括24h平均收缩压(24h SBP),24 h平均舒张压(24h DBP)、白天平均收缩压(d SBP)、白天平均舒张压(d DBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP),24h脉压(24h PP)及白天脉压(d PP)、夜间脉压(n PP),记录冠心病的发生率、杓型与非杓型高血压比例,利用Person相关性分析IMT与冠心病发生率及动态血压参数的相关性。结果:收缩压和脉压比较差异均有统计学意义(P0.05),其中B组、C组高于A组,C组高于B组,差异具有统计学意义(P0.05)。非杓型高血压在A组占54.41%,B组占60.29%,C组占79.41%,各组间差异有统计学意义(P0.05);A组、B组、C组冠心病发病率分别为41.18%、54.41%和91.18%,组间比较差异有统计学意义(P0.05)。IMT同冠心病发生率和24h SBP、d SBP、n SBP、24h PP、d PP、n PP呈正相关(r=0.876,0.448,0.378,0.476,0.443,0.491,0.438,P0.05)。结论:老年高血压患者收缩压,脉压升高以及非杓型高血压是造成颈动脉内膜中膜厚度增加的主要原因,同时,IMT与冠心病发病率和动态血压参数间呈正相关关系。     

2型糖尿病住院患者心脏自主神经病变的影响因素及对夜间AH和夜间VA的影响

摘要 目的：分析2型糖尿病（T2DM）住院患者心脏自主神经病变（CAN）的影响因素,探讨其对夜间无症状低血糖（AH）和夜间室性心律失常（VA）的影响。方法：选取2020年1月～2022年7月肇庆医学高等专科学校附属医院收治的174例T2DM患者,根据是否发生CAN分为CAN组和非CAN组,采用多因素Logistic回归分析T2DM住院患者CAN的影响因素。采用动态血糖监测系统监测夜间AH发生情况,动态心电图监测夜间VA发生情况。结果：174例T2DM患者CAN发生率为37.93%（66/174）。单因素分析显示,CAN组年龄大于非CAN组,病程长于非CAN组,收缩压、舒张压、糖化血红蛋白（HbA1c）、稳态模型评估-胰岛素抵抗（HOMA-IR）、血尿酸和微血管并发症比例高于非CAN组（P＜0.05）。多因素Logistic回归分析显示,年龄增加、病程延长、HOMA-IR升高、血尿酸升高、微血管并发症为T2DM住院患者CAN的独立危险因素（P＜0.05）。与非CAN组比较,CAN组夜间AH、VA发生率增加（P＜0.05）。结论：年龄、病程、HOMA-IR、血尿酸和微血管并发症为T2DM住院患者CAN的影响因素,CAN增加了T2DM住院患者夜间AH和夜间VA的发生率,早期筛查CAN可能有助于降低T2DM住院患者夜间AH和夜间VA的发生风险。     

血浆Apelin-36水平与高血压病的相关性研究

目的：探讨原发性高血压（EH）患者24小时平均血压水平与血浆Apelin-36水平的相关性。方法：选择2009年6月一2010年6月在我院心内二科住院的EH患者146例为观察组,选择144例血压正常者作为对照组。抽取空腹静脉血,采用放射免疫法（RIA）检测所有研究对象的血浆Apelin-36水平。结果：①血压正常组血浆Apelin-36水平24.65±4.10pmol/l;EH组20.81±4.98 pmol/l;两组间比较有显著统计学差异（P〈0.01）。②EH患者者血浆Apelin-36水平与24小时平均收缩压、白天平均收缩压、夜间平均收缩压均呈负相关（P〈0.05）。结论：EH组血浆Apelin-36水平显著低于正常对照组,24小时平均血压越高,血浆Apelin-36水平越低,且血浆Apelin-36水平与24小时平均血压水平呈负相关。     

急性缺血性脑卒中不同水平血压管理应用效果及其对近期预后及认知功能的影响

摘要 目的：急性缺血性脑卒中不同水平血压管理应用效果及其对近期预后及认知功能的影响。方法：选择我院2021年7月-2022年9月收治的急性缺血性脑卒中患者180例作为本次研究对象,分为对照组及观察1组、观察2组,对照组不进行降压治疗,将观察1组患者急性期血压控制120/80 mmHg,观察2组血压控制在140/90 mmHg,观察各组患者临床治疗效果、近期预后改善情况及对认知功能的影响。采用美国国立卫生研究院脑卒中量表对患者治疗效果和NIHSS测量评定。结果：治疗后各组NIHSS评分较入院时明显降低,且治疗期间NIHSS评分变化12 d＞8 d＞4 d,观察1组、观察2组患者治疗4 d、8 d、12 d后NIHSS评分较对照组明显降低（P＜0.05）;治疗后观察1组和观察2组总有效率较对照组患者显著提高（P＜0.05）,观察1组与观察2组相比无统计学意义（P＞0.05）;观察1组、观察2组患者治疗后MMSE和MoCA评分较对照组明显升高（P＜0.05）,观察1组和观察2组MMSE和MoCA评分差异无统计学意义（P＞0.05）。Logistic回归分析提示血压控制和入院NIHSS评分则与脑卒中患者近期预后显著相关（P＜0.05）。结论：急性脑缺血性脑卒中急性期对患者进行血压控制能够有效提高患者预后效果,促进患者神经功能恢复,但血压控制120/80 mmHg与140/90 mmHg血压管理方案效果相似。     

维持性血液透析患者透析期血压波动的危险因素及其对生存状况的影响

摘要 目的：观察维持性血液透析（MHD）患者透析期血压波动的状况,分析其危险因素及其对生存状况的影响。方法：从江苏省人民医院选取于2018年4月~2021年7月期间接受治疗的210例MHD患者。将患者根据△收缩压（SBP）的绝对值大小,分为血压低波动组（84例,△SBP的绝对值大小<10 mmHg）和血压高波动组（126例,△SBP的绝对值大小≥10 mmHg）。收集两组患者的一般资料和实验室资料,MHD患者血压波动的危险因素采用Logistic回归模型进行分析。以门诊复查或电话的形式随访1年,统计两组预后情况。结果：单因素结果显示,MHD患者透析期血压波动与透析龄、体质量指数（BMI）、收缩压（SBP）、舒张压（DBP）、磷（P）、白蛋白（ALB）、血红蛋白（Hb）、全段甲状旁腺激素（iPTH）、尿素清除指数（Kt/V）、超滤量有关（P<0.05）。而与年龄、性别、血肌酐（Scr）、尿素氮（BUN）、钙（Ca）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）无关（P>0.05）。多因素Logistic 回归模型结果显示：透析龄越长、iPTH升高、Kt/V下降、P升高、BMI升高是导致MHD患者透析期血压波动的危险因素,ALB上升为保护因素（P<0.05）。两组患者1年生存率、死亡率组间对比无统计学差异（P>0.05）。结论：MHD患者透析期血压波动受到透析龄、iPTH、Kt/V、P、ALB、BMI变化的影响,MHD患者透析期血压波动均会导致患者发生死亡风险。     

达格列净联合利拉鲁肽对肥胖型T2DM患者的血糖控制、胰岛素功能的影响及安全性分析

摘要 目的：探究达格列净联合利拉鲁肽对肥胖型2型糖尿病（T2DM）患者的血糖控制、胰岛素功能的影响及安全性分析。方法：将106例肥胖型T2DM患者按照治疗方法分为两组：联合组患者采用达格列净联合利拉鲁肽治疗（55例）、对照组采用利拉鲁肽治疗（51例）。记录对比两组治疗疗效、不良反应发生情况。检测两组治疗前后血脂代谢指标[脂联素(APN)、总胆固醇（TC）、甘油三酯（TG)]、胰岛素功能指标[稳态胰岛 β 细胞分泌功能指数（HOMA-β）、胰岛素评价指数（HOMA-IR）]、血压[收缩压（SBP）、舒张压（DBP）]以及身体质量指数（BMI）变化。结果：联合组治疗总有效率高于对照组（P＜0.05）,不良反应总发生率高于对照组（P＜0.05）。治疗后,观察组外周血TC、TG水平、HOMA-IR以及SBP、DBP低于对照组（P＜0.05）,APN浓度、HOMA-IR以及BMI高于对照组（P＜0.05）。结论：达格列净联合利拉鲁肽可有效控制肥胖型T2DM患者的血糖、血脂以及血压水平,保护胰岛功能,但也可能导致更多的不良反应。     

利拉鲁肽联合达格列净对超重或肥胖2型糖尿病患者肾功能、氧化应激以及内脏脂肪含量的影响

摘要 目的：探讨利拉鲁肽联合达格列净对超重或肥胖2型糖尿病（T2DM）患者肾功能、氧化应激以及内脏脂肪含量的影响。方法：选取我院于2018年1月~2020年5月期间接收的108例超重或肥胖T2DM患者,按照随机数字表法分为对照组（n=54）和观察组（n=54）。对照组给予利拉鲁肽治疗,观察组给予利拉鲁肽联合达格列净治疗,均治疗12周。对比两组肾功能[血胱抑素 C（CysC）、血肌酐（Scr）、血尿酸（SUA）]、氧化应激[丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-PX）、超氧化物歧化酶（SOD）]、体质量指数（BMI）、腰围、血糖指标[空腹血糖（FBG）、餐后2 h血糖（2hPBG）、糖化血红蛋白（HbA1c）]以及体成分指标（全身脂肪百分比、内脏脂肪含量）,记录两组治疗期间不良反应情况。结果：两组治疗后BMI、腰围、2hPBG、FBG、HbA1c均下降,且观察组较对照组低（P<0.05）。两组治疗后MDA均下降,且观察组较对照组低（P<0.05）,两组治疗后SOD、GSH-PX均升高,且观察组较对照组高（P<0.05）。两组治疗后全身脂肪百分比、内脏脂肪含量均下降,且观察组较对照组低（P<0.05）。两组治疗前后CysC、Scr、SUA组内及组间对比均无统计学差异（P>0.05）。两组不良反应发生率对比无统计学差异（P>0.05）。结论：超重或肥胖T2DM患者利拉鲁肽治疗基础上联合达格列净,降糖效果确切,减轻机体氧化应激,降低内脏脂肪含量,对肾功能无显著影响,且不增加不良反应发生率。     

多囊卵巢综合征肥胖患者血清维生素D、铁蛋白水平、sICAM-1与胰岛素抵抗、糖脂代谢指标的相关性

摘要 目的：探讨多囊卵巢综合征（PCOS）肥胖患者血清维生素D、铁蛋白、可溶性细胞间粘附分子-1（sICAM-1）水平与胰岛素抵抗、糖脂代谢指标的相关性。方法：2018年8月到2021年11月,选择在本院妇科诊治的PCOS患者65例作为研究对象,分为PCOS肥胖组（n=30,体重指数＜28 kg/m²）和PCOS非肥胖组（n=35,体重指数<28 kg/m²）。检测与计算两组清维生素D、铁蛋白、sICAM-1、胰岛素抵抗、糖脂代谢指标并进行相关性分析。结果：两组的血清甲状腺素（T4）、促甲状腺激素（TSH）与泌乳素（PRL）对比差异无统计学意义（P>0.05）,肥胖组的血清促黄体生成素（LH）、促卵泡生成素（FSH）、睾酮（T）水平高于非肥胖组（P<0.05）。肥胖组的血清铁蛋白、sICAM-1水平高于非肥胖组,血清维生素D水平低于非肥胖组（P<0.05）。肥胖组的胰岛素抵抗指数（HOMA-IR）、胰岛素水平（FINS）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）较非肥胖组,高密度脂蛋白胆固醇（HDL-C）低于非肥胖组（P<0.05）。在PCOS肥胖患者中,Pearson分析显示血清维生素D、铁蛋白、sICAM-1与胰岛素抵抗、糖脂代谢指标都存在相关性（P<0.05）。结论：PCOS肥胖患者与非肥胖患者的血清维生素D、铁蛋白、sICAM-1、胰岛素抵抗、糖脂代谢指标水平存在差异,血清维生素D、铁蛋白、sICAM-1水平与胰岛素抵抗、糖脂代谢指标存在相关性。     

Systolic Blood Pressure is Related to Catecholamine Sensitivity in Subcutaneous Abdominal Fat Cells

A relationship between abdominal obesity and hypertension is well established. In search for an early-onset defect in adipocyte function linking these two conditions, we compared catecholamine sensitivity in subcutaneous abdominal fat cells with 24-hour systolic, mean arterial and diastolic blood pressure in 16 healthy, normotensive subjects. Clear inter-individual variations in the adipocyte lipolytic adrenoceptor sensitivity (pD₂) for noradrenaline were observed in dose-response experiments (i.e., about 4 log units). An inverse and independent correlation was found between the 24-hour systolic blood pressure and pD₂ for noradrenaline (r = ?0.67, p < 0.01). The mean arterial blood pressure was also negatively correlated to peripheral noradrenaline sensitivity (r = ?0.58, p < 0.05). However, no significant relationship between the 24-hour diastolic blood pressure and pD₂ for noradrenaline was demonstrated. In conclusion we suggest that catecholamine resistance in subcutaneous fat cells may be associated with autonomic dysfunction and impaired blood pressure regulation. This finding is supported by the fact that both noradrenaline sensitivity and 24-hour systolic blood pressure also are correlated to the individual orthostatic heart rate responses, reflecting the sympathetic nervous system tone (r=0.61, p=0.01 and r= ?0.53, p=0.03, respectively). The relationship between noradrenaline sensitivity and systolic blood pressure may be of importance in the early development of hypertension in man.     

Association between Serum Leptin Levels and 24‐Hour Blood Pressure in Obese Women

Objective: To assess the relationship between serum leptin and 24‐hour blood pressure (BP) in obese women, according to body fat distribution. Research Methods and Procedures: A cross‐sectional study was carried out in a population of 70 nondiabetic, normotensive, obese women (40 with android and 30 with gynoid type of obesity) and 20 nonobese healthy women as a control group. All subjects underwent 24‐hour ambulatory BP monitoring. Blood samples were collected for serum leptin and plasma insulin measurements. Total cholesterol and high‐density lipoprotein cholesterol were also measured. Results: Serum leptin levels were significantly higher in obese subjects than in controls, and they were more elevated in android obese women than in gynoid ones. Leptin levels were positively related to body mass index (BMI), insulin, and waist and hip circumferences in the android group. Among gynoid subjects, leptin levels showed positive associations with BMI and insulin. In women with android obesity, strong positive correlations (p < 0.001) were found between leptin levels and 24‐hour systolic BP (SBP), daytime SBP, nighttime SBP, 24‐hour diastolic BP (DBP), and daytime DBP. Multiple regression analyses, including age, insulin and leptin concentrations, BMI, and waist and hip circumferences on 24‐hour and daytime SBP and DBP, showed that only leptin levels contributed to the variability of BP. Conclusions: Our study shows that serum leptin levels are directly related to 24‐hour BP levels in normotensive women with android fat distribution, independently of BMI.     

原发性高血压患者心率变异性及血压变异性与血管损害的相关性研究

目的:探讨原发性高血压患者心率变异性(HRV)及血压变异性(BPV)与血管损害的相关性。方法:选取2014年12月到2017年12月期间在我院接受治疗的原发性高血压患者94例,根据脉搏波传导速度(PWV)的不同分为对照组(60例)和血管受损组(34例)。比较两组患者的HRV、BPV指标,并分析PWV与HRV、BPV指标的相关性。结果:血管受损组的5 min心搏R-R间期平均值的标准差(SDANN)低于对照组,低频(LF)、高频(HF)、低高频之比(LF/HF)高于对照组,差异均有统计学意义(P0.05);血管受损组的24h平均收缩压(24h SBP)、24h平均脉压(24h PP)、白天平均收缩压(dSBP)、白天平均脉压(dPP)、夜间平均收缩压(nSBP)、夜间平均脉压(nPP)高于对照组,差异均有统计学意义(P0.05);PWV与LF、HF、LF/HF、24h SBP、24h PP、dSBP、dPP、nSBP、nPP均呈正相关(P0.05)。结论:原发性高血压患者部分HRV、BPV指标与PWV呈明显的相关性,说明HRV和BPV与患者的血管损害密切相关。     

贝那普利联合氨氯地平对高血压患者降压效果、血压变异性及心功能的影响

目的:探讨贝那普利联合氨氯地平对高血压患者降压效果、血压变异性(BPV)及心功能的影响。方法:选取2015年2月～2018年12月期间西安交通大学医学院附属三二〇一医院收治的131例高血压患者,根据随机数字表法分为对照组(n=65)和研究组(n=66),对照组患者给予氨氯地平治疗,研究组在对照组基础上联合贝那普利治疗。比较两组患者治疗后的降压效果、BPV以及心功能指标,记录两组患者治疗期间不良反应情况。结果:两组患者治疗4个月后收缩压(SBP)、舒张压(DBP)均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后24 h收缩压变异性(24hSBPV)、白天收缩压变异性(dSBPV)、24h舒张压变异性(24hDBPV)、白天舒张压变异性(dDBPV)均下降,且研究组低于对照组(P0.05),而夜间收缩压变异性(nSBPV)、夜间舒张压变异性(nDBPV)比较差异无统计学意义(P0.05)。两组患者治疗4个月后A峰速度、A/E峰值均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后E峰速度、EF值均升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:贝那普利联合氨氯地平治疗高血压患者的降压效果确切,可有效改善患者BPV及心功能,且安全性较好。     

Non-dipping blood pressure in the metabolic syndrome among Arabs of the Oman family study

Objective: The objective was to examine the circadian changes in blood pressure and their relation to the metabolic syndrome and its components in Omani Arabs. Research Methods and Procedures: Ambulatory blood pressure (ABPM) was recorded in 1124 subjects from 5 large, extended, consanguineous, and young Arab pedigrees. According to the International Diabetes Federation's definition, 264 subjects had the metabolic syndrome, a prevalence of 23%. Subjects were defined as non‐dippers when their nocturnal systolic blood pressure (SBP) fell by <10% from daytime SBP. Results: Non‐dippers with the metabolic syndrome were 131 of 264 (50%), compared with 265 of 860 (31%) without the metabolic syndrome. Of the non‐dippers, 99 of 131 (76%) were females and 32 of 131 (24%) were males. Daytime and nighttime SBP and DBP and nighttime pulse pressure were significantly higher in non‐dipper subjects with the metabolic syndrome. The important determinants of a non‐dipping BP in this cohort were high BMI and high serum triglycerides. Discussion: We hypothesize that obesity and nocturnal volume‐dependent hypertension may be involved in the pathophysiology of non‐dipping in the metabolic syndrome. This study showed that non‐dipping BP was common in subjects with the metabolic syndrome. Higher 24‐hour blood pressure load may add to the indices of the overall cardiovascular burden already associated with the metabolic syndrome.     

Effects of muscular and aqua aerobic combined exercise on metabolic indices in elderly women with metabolic syndrome

The purpose of this study was to investigate the effects of muscle strengthening exercise using elastic thera-band and aquatic aerobic combined exercise on metabolic syndrome index in elderly with metabolic syndrome. Fifty-four were assigned to muscle strengthening exercise group (n = 19), aquatic aerobic exercise group (n = 19), and combined exercise group (n = 16). The muscle strength exercise, aquatic aerobic exercise and combined exercise were provided three times a week for 12 weeks. Metabolic syndrome indices[Fasting blood glucose, triglyceride, high density lipoprotein cholesterol (HDL-C), systolic blood pressure, diastolic blood pressure and waist circumference] were measured before and after the program. One-way ANOVA, paired t-test and two-way repeated ANOVA were used with the SPSS program for data analysis. There was a significant difference in triglyceride (p < .001), HDL-C (p = .010) and waist circumference (p = .016). Triglyceride and waist circumference was significantly decreased in combined group than muscle strength exercise group and aquatic exercise group. HDL-C was significantly increased in combined group than muscle strength exercise group. The results indicate that combined exercise was more effective in the improvement of dyslipidemia and abdominal obesity.     

Circadian Blood Pressure Rhythm in Primary and Secondary Hypertension

Circadian blood pressure variability was recorded in patients with primary hypertension and with different forms of secondary hypertension using ambulatory 24-h blood pressure measurement. A group of 20 patients with different forms of secondary hypertension was compared with a matched group of patients with primary hypertension. Although the mean 24-h blood pressure was not different between the two groups, the patients with secondary hypertension had significantly higher systolic blood pressure during sleep and higher systolic and diastolic blood pressure in the early morning, compared with the primary hypertension group. This nocturnal blood pressure fall was then investigated in various groups of patients with different forms of secondary hypertension and compared with normotensives and patients with primary hypertension. Patients with mild primary hypertension (n = 152) and with severe primary hypertension (n = 30) had the same blood pressure fall (14–16 mm Hg systolic and diastolic) during the night (23:OO–05:OO h) as normotensives (n = 20). However, in patients with renoparenchymal hypertension (n = 29), renovascular hypertension (n = 20), hyperaldosteronism (n = 6), and hyperthyroidism (n = 14), the nocturnal blood pressure fall was significantly (p < 0.01) reduced. One patient with coarctation ofthe aorta and nine patients with primary hyperparathyroidism and elevated blood pressure had a normal circadian blood pressure profile with a normal nocturnal blood pressure fall. The heart rate decrease during the night was equal in all patient groups. Ambulatory blood pressure measurement allows blood pressure recording under everyday conditions, including nighttime. In primary hypertension the blood pressure variability exhibits the same circadian variation as in normotension, showing a marked nocturnal fall. However, in different forms of secondary hypertension, blood pressure shows a blunted circadian curve. This could have important diagnostic and therapeutic implications.     

A green tea extract high in catechins reduces body fat and cardiovascular risks in humans

Objective: The body fat reducing effect and reduction of risks for cardiovascular disease by a green tea extract (GTE) high in catechins was investigated in humans with typical lifestyles. Research Methods and Procedures: Japanese women and men with visceral fat‐type obesity were recruited for the trial. After a 2‐week diet run‐in period, a 12‐week double‐blind parallel multicenter trial was performed, in which the subjects ingested green tea containing 583 mg of catechins (catechin group) or 96 mg of catechins (control group) per day. Randomization was stratified by gender and body mass index at each medical institution. The subjects were instructed to maintain their usual dietary intake and normal physical activity. Results: Data were analyzed using per‐protocol samples of 240 subjects (catechin group; n = 123, control group; n = 117). Decreases in body weight, body mass index, body fat ratio, body fat mass, waist circumference, hip circumference, visceral fat area, and subcutaneous fat area were found to be greater in the catechin group than in the control group. A greater decrease in systolic blood pressure (SBP) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher. Low‐density lipoprotein (LDL) cholesterol was also decreased to a greater extent in the catechin group. No adverse effect was found. Discussion: The continuous ingestion of a GTE high in catechins led to a reduction in body fat, SBP, and LDL cholesterol, suggesting that the ingestion of such an extract contributes to a decrease in obesity and cardiovascular disease risks.     

Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesity

[Purpose]Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity.[Methods]We enrolled 70 male children (age 9–17 years [sumo group, n = 14] and 9–14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels).[Results]The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups.[Conclusion]Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.