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Carmen Mateo-Pascual Rosa Julián-Viñals Teresa Alarcón-Alarcón Maria Victoria Castell-Alcalá Jose Manuel Iturzaeta-Sánchez Angel Otero-Piume 《Revista espa?ola de geriatría y gerontología》2014
Introduction
Vitamin D deficiency is common in the elderly, especially among institutionalized and/or hip fracture patients. However, there are few population studies on the prevalence of this deficiency in the general population over 64 years in our environment. The aim of this study was to determine the prevalence of vitamin D deficiency in an urban population cohort of over 64 years, and analyze its relationship with sociodemographic, climatic, and health factors.Material and methods
Cross-sectional study from «Peñagrande cohort», a population-based cohort consisting of people over 64 years. We determined 25-hydroxyvitamin D levels, and recorded sociodemographic data (age, sex, marital status, education, socioeconomic status), season of measurement and health variables (comorbidity, obesity, malnutrition, renal failure, cognitive impairment, vitamin D supplements, and disability).Results
A total of 468 individuals with a mean age of 76.0 years (SD: 7.7) were included, of which 53.4% were women. The mean value of vitamin D was 20.3 ± 11.7 ng/mL. The large majority (86.3%, 95% CI: 83.0-89.5) had a vitamin insufficiency (≤ 30 ng/ml), and 35.2% (95% CI: 30.8-39.7) showed severe vitamin deficiency (≤ 15 ng/ml). Vitamin insufficiency increases linearly with age (OR 1.06; 95% CI: 1.01-1.11), and was associated with low socioeconomic status (OR 3.29; 95% CI: 1.55-6.95). Severe vitamin D deficiency increases with age (OR 1.06; 95% CI: 1.02-1.09), female gender (OR 1.80; 95% CI: 1.18-2.75) and with cognitive impairment (OR 1.71; 95% CI: 1.04-2.83).Conclusion
The prevalence of vitamin D deficiency in people over 65 years of age in our community is high. It would be advisable to determine the vitamin D values in the high risk elderly in order to introduce measures of pharmacological supplementation in those with inadequate levels. 相似文献3.
Martínez-Gallardo Prieto L Hermida Galindo LF D'hyver de Las Deses C 《Revista espa?ola de geriatría y gerontología》2012,47(1):19-22
Introduction
Foot disease is common among the elderly. Little is known about its prevalence and impact over mobility, gait and tendency to fall.Material and methods
A geriatric history was taken from 171 women living in a long-term care facility. Photographs were taken of the feet and evaluated by an orthopaedic surgeon and a dermatologist. A multivariate analysis was made to assess de effect of the independent variables over mobility, gait and tendency to fall.Results
The foot diseases most commonly found were hammer toes (122), callus (79) and peripheral vascular disease (74). Hallux rigidus (OR 24.897, 95% CI, 1.231-503.542) and peripheral vascular disease (OR 2.481, 95% CI, 1.095-5.623) seemed to be associated with changes in gait; both where associated with dependency on instrumental activities of daily living (OR 44.166, 95% CI, 2.402-812.233, and OR 2.659, 95% CI, 1.069-6.615). Hallux rigidus was related to falls (OR 19.27, 95% CI, 1.102-337.26). Tinea pedis was associated with dependency in activities of daily living (OR 11.52, 95% CI, 1.325-100.125).Conclusions
Foot disorders are common in the elderly. Only hallux rigidus and peripheral vascular disease had an impact on function and gait. 相似文献4.
Pilar Jürschik Maria Viladrosa Teresa Botigué Ana Lavedán Ana Belen Vena Teresa Noguera 《Revista espa?ola de geriatría y gerontología》2013
Objective
To know the prevalence of mistreatment and to identify the associated factors among elderly people without cognitive impairment, seen in the geriatric unit, located in the hospital emergency area.Methods
Cross-sectional study of a population of 65 years or older assessed by the geriatric Interdisciplinary Social Welfare Functional Unit (ISSFU) of the emergency area in the Arnau de Vilanova hospital of Lleida. We excluded participants with cognitive impairment. The total number of participants was 127. The suspicion of mistreatment was measured using the Questionnaire of the American Medical Association (AMA) and the Canadian Task Force (CTF). The variables studied were social demographic characteristics and functional dependency.Results
Prevalence of suspicion of mistreatment was 29.1% (95% CI: 0.21-0.37). The most frequent subtypes were neglect and psychological, and less frequent was negligence. Associated factors were being female, being in unpaid work, being a widow and living alone.Conclusions
Three out of ten elderly people were identified as possible victims of abuse. Due to the relative isolation of many of the elderly who were abused, an unexpected visit to the emergency area may be the only opportunity for detection. Geriatric units located in this area should include the suspicion of mistreatment of this population in their comprehensive assessment. For this, it is necessary to have tool with a high degree of sensitivity and specificity for detection of abuse in the elderly. 相似文献5.
Sandra Gómez-Talavera Iván Núñez-Gil David Vivas Borja Ruiz-Mateos Ana Viana-Tejedor Agustín Martín-García Javier Higueras-Nafría Carlos Macaya Antonio Fernández-Ortiz 《Revista espa?ola de geriatría y gerontología》2014
Introduction
Several risk scores regarding the probability of death/complications in the acute setting and during the follow-up of patients admitted with acute coronary syndromes (ACS) have been published, such as the GRACE, TIMI and ZWOLLE risk score. Our objective was to assess the prognosis of nonagenarians admitted to a coronary care unit with an ACS, as well as the usefulness of each of these scores.Material and methods
A retrospective analysis was performed on nonagenarians with an ACS admitted between 2003 and 2011. Vital status was determined at 14, 30 days, and 6 months after the ACS, and later during the follow-up. The risk scores were evaluated by area under the curve ROC (AUC).Results
A total of 45 patients with an ACS, 26 (57.8%) with ST-segment elevation and 19 (42.2%) with non-ST elevation. The GRACE- AUC for in-hospital mortality was excellent, 0.91, (95% CI: 0.82-1; P<.001), and for the combined event (in-hospital mortality and re-infarction) was 0.83 (95% CI: 0.66-1.0; P<.01). However, the GRACE-AUC at 6 months for mortality was 0.34 (95% CI: 0.09-0.58; P=.45), and for the combined event it was 0.51 (95% CI: 0.26-0.77; P=.95). The TIMI-AUC and ZWOLLE-AUC did not reach statistical significance.Conclusions
It is useful calculate the GRACE risk score in order to estimate risk and survival in the acute phase of ACS in nonagenarians. This can help appropriate in making invasive or conservative treatment decisions. 相似文献6.
Marco A. Zelada Rodríguez Javier Gómez-Pavón Pilar Sorando Fernández Andrés Franco Salinas Laurenny Mercedes Guzmán Juan José Baztán 《Revista espa?ola de geriatría y gerontología》2012
Objective
To report on the interrater reliability of four common comorbidity indexes used in the hospitalised elderly: Charlson Index (CI), Geriatric Cumulative Illness Rating Scale (CIRS-G), Index of Co-existent Disease (CoD) and Kaplan-Feinstein Index (KFI).Method
Four trained observers, independently reviewed the same 40 medical charts of hospitalised geriatric patients. Scores for the four indexes were calculated, along with the intraclass correlations coefficient (ICC) (quantitative index: CI and CIRS-G) and Kappa coefficient (qualitative index: CoD and KFI). The agreement <0.4 was considered deficient, 0-4-0.75 acceptable and >0.75 excellent.Results
A total of 40 patients (29 women) of 85.93 (±5.35) years were analysed. Intraclass correlations coefficient: CI: 0.78 (95% CI: 0.67-0.86); CIRS-G (score): 0.66 (95% CI: 0.53-0.78). Kappa coefficient: KFI: 0.51 to 0.76; CoD: 0.44-0.66. The application time was lower for the Charlson index (median of 39 seconds [30-45]) and the KFI (42 seconds [35-52]) and higher for CIRS-G (score) (128 seconds [110-160]) and CoD (102 seconds [80-124]).Conclusions
Of the four comorbidity indexes used in a hospitalised elderly population, the CI, and CIRS-G (score), are those that have better interrater reliability. The Charlson index and KFI show a lower application time than the CIRS-G (score). 相似文献7.
Sergio A. Alfonso Silguero Marta Martínez-ReigLlanos Gómez Arnedo Gema Juncos MartínezLuis Romero Rizos Pedro Abizanda Soler 《Revista espa?ola de geriatría y gerontología》2014
Introduction
The objective of this study was to analyse the relationships between the major chronic diseases and multiple morbidity, with mortality, incident disability in basic activities of daily living, and loss of mobility in the elderly.Material and methods
A total of 943 participants were selected from the FRADEA Study, using available baseline data of chronic diseases, and at the follow-up visit of mortality, incident disability, and loss of mobility. The analysis was made of the unadjusted and adjusted association between the number of chronic diseases, the number of 14 pre-selected diseases, and the presence of two or more chronic diseases (multiple morbidity) with adverse health events recorded.Results
Participants with a higher number of diseases (OR 1.11; 95% CI: 1.02-1.22), and 14 pre-selected diseases (OR 1.19; 95% CI: 1.03-1.38) had a higher adjusted mortality risk, but not a higher incident disease or mobility loss risk. Subjects with multiple morbidity had a higher non-significant mortality risk (HR 1.45; 95% CI: 0.87-2.43), than those without multiple morbidity. Disability-free mean time in participants with and without multiple morbidity was 846 ± 34 and 731 ± 17 days, respectively (Log-rank χ2 7.45. P =.006), and with our without mobility loss was 818±32 and 696±13 days, respectively (Log rank χ2 10.99. P =.001).Conclusions
Multiple morbidity was not associated with mortality, incident disability in ADL, or mobility loss in adults older than 70 years, although if mortality is taken into account, the number of chronic diseases is linear. 相似文献8.
Alicia Conde Martel Marion Hemmersbach-Miller Basilio J. Anía Lafuente Natacha Sujanani Afonso Miriam Serrano-Fuentes 《Revista espa?ola de geriatría y gerontología》2013
Introduction
Depressive symptoms in hospitalized patients are very common, and they have been related to higher mortality. The aim of the study was to estimate the prevalence of depressive symptoms in hospitalized elderly patients and its relationship to various diseases, as well as their functional and mental status and mortality.Material and methods
A total of 115 patients over 64 years of age were prospectively studied. The validated Spanish version of the Geriatric Depression Scale of Yesavage (15-item version) was used. Patients were considered to have depressive symptoms if ≥6 points were obtained. The demographic characteristics, the Charlson comorbidity index, the diagnosis at admission, the functional status assessed by the Barthel and Lawton-Brodie index, the mental capacity assessed by the Pfeiffer questionnaire, the length of the hospital stay, and hospital mortality were recorded.Results
Out of the 115 patients studied, with a mean age of 70.5 years, 71 (61.7%) were female. Depressive symptoms were observed in 46 patients (40%, 95% CI: 34.8-43.9). Patients who died showed a significantly higher score on the Yesavage scale (P=.04). The multivariate analysis showed a significantly independent association between depressive symptoms and functional capacity (P=.026), mental status (P=.021), renal failure (P=.001), liver disease (P=.018), and osteoarthritis (P=.017), but losing the previously seen significant association with diabetes (P=.43).Conclusions
The prevalence of depressive symptoms in hospitalized elderly patients is high, and is associated with the diagnoses of renal failure, liver disease and osteoarthritis, with a higher comorbidity and especially with a poorer functional capacity. 相似文献9.
Background
The epidermal growth factor receptor (EGFR) plays important roles in the development of gastric cancer. This study aims to analyze the prognostic value of EGFR in patients with gastric cancer.Methods
A meta-analysis is performed by searching Cochrane Library, PubMed, EMBASE and Science Direct databases from Jan 1970 to May 2013. Data are extracted from studies evaluating the survival of gastric cancer patients with either positive or negative EGFR expression. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) are calculated.Results
Totally 1600 cases of gastric cancer patients from five studies are subjected to final analysis. The HR of post-operational survival of patients with positive EGFR expression is 1.16 (95% CI: 0.94–1.43) as compared with those with negative expression, indicating that positive EGFR expression does not significantly predict the poor survival of gastric cancer.Conclusions
EGFR expression is not an independent predictor for the survival of gastric cancer patients. 相似文献10.
Yang Wang Xujie Gao Feng Wei Xinwei Zhang Jinpu Yu Hua Zhao Qian Sun Fan Yan Cihui Yan Hui Li Xiubao Ren 《Gene》2014
Background
MicroRNAs (miRNAs) have been reported to be aberrantly expressed in patients with cancer. Many studies have shown that circulating miRNAs could play potential roles as diagnostic and prognostic biomarkers of cancers. The aim of this meta-analysis is to summarize the role of circulating miR-21 as a biomarker in patients with a variety of carcinomas.Material and methods
Eligible studies were identified and assessed for quality through multiple search strategies. For diagnostic meta-analysis, the sensitivity, specificity, and other measures of miR-21 in the diagnosis of cancer were pooled using bivariate random-effects approach models. For prognostic meta-analysis, pooled hazard ratios (HRs) of circulating miR-21 for survival were calculated.Results
A total of 36 studies dealing with various carcinomas were included for the systemic review. Among them, 23 studies were finally enrolled in the global meta-analysis (17 studies for diagnosis and 6 studies for prognosis). For diagnostic meta-analysis, the overall pooled results for sensitivity, specificity, positive likelihood ratio (LRP), negative likelihood ratios (LRN) and diagnostic odds ratio (DOR) were 75.7% (95% CI: 67.1%–82.6%), 79.3% (95% CI: 74.2%–83.5%), 3.65 (95% CI: 2.83–4.70), 0.31 (95% CI: 0.22–0.43), and 11.88 (95% CI: 6.99–20.19), respectively. For prognostic meta-analysis, the pooled HR of higher miR-21 expression in circulation was 2.37 (95% CI: 1.83–3.06, P < 0.001), which could significantly predict poorer survival in general carcinomas. Importantly, subgroup analysis suggested that higher expression of miR-21 correlated with worse overall survival (OS) significantly in carcinomas of digestion system (HR, 5.77 [95% CI: 2.65–12.52]).Conclusions
Our findings suggest that circulating miR-21 may not suitable to be a diagnostic biomarker, but it has a prognostic value in patients with cancer. 相似文献11.
Background
Many studies have reported the associations of polymorphic CAG repeats in androgen receptor (AR) gene with PCOS risk, but with inconsistent results. So, the aim of present meta-analysis was to clarify such inconsistence, so as to provide more conclusive results.Methods
PubMed was searched for the eligible reports published until February 2012 without language limitation. The studies reporting the relationship between CAG repeat length and PCOS were selected for the meta-analysis according to the inclusion criteria. Two reviewers independently extracted the data and evaluated the study quality.Principal findings
As for the relationship between CAG repeat length and PCOS risk, the pooled results showed that the biallelic mean was not significantly different between PCOS and controls (SMD − 0.03, 95% CI − 0.16–0.10, P = 0.603), and that the ORs of PCOS were not demonstrated for the individuals with the biallelic mean less than median (OR 0.96, 95% CI 0.68–1.35, P = 0.794), with the short CAG allele (OR 0.94, 95% CI 0.80–1.10, P = 0.424), or with the X-weighted biallelic mean (OR 0.81, 95% CI 0.46–1.41, P = 0.447). Further, as for the relationship between CAG repeat length and T levels in PCOS patients, the biallelic mean was not significantly different between PCOS patients with high T and those with low T (SMD 0.79, 95% CI − 0.12–1.70, P = 0.088), while the summary correlation r indicated that the CAG biallelic mean appeared to be positively associated with T levels in PCOS (r 0.20, 95% CI 0.11–0.30, p = 0.000).Conclusions
This meta-analysis demonstrates no evident association between the CAG length variations in AR gene and PCOS risk, while the CAG length appears to be positively associated with T levels in PCOS patients. 相似文献12.
José Luis Lobato Miguelez Julio Moreno DomingoTania Arriba Olivenza Saioa Ajuriagogeascoa AndradaMiguel López Valverde 《Revista espa?ola de geriatría y gerontología》2012
Background
The number of elderly patients with breast cancer is increasing, and a large proportion of these older patients do not receive conventional treatment. Clinical and biological characteristics of tumours at this age and survival according to local or systemic therapy were analysed.Material and method
A total of 96 consecutive early breast cancer patients over 80 years of age diagnosed in our Unit between January 2002 and September 2008 were retrospectively investigated. Of them, 54 underwent surgery with or without adjuvant hormonal treatment, and 42 received primary hormonal therapy.Results
Tumours of patients 80 years old or older had more favourable biological characteristics, including expression of steroid receptors, and absence of c-erb B2 expression. Overall survival was 50 months for the group subjected to surgery, and 44 months for the group who did not undergo surgery. The survival free of local recurrence in the surgery group was 44 months, whereas it was 18 months in the non-surgery group.Conclusion
In a cohort of patients aged 80 years and older, survival was similar in those who received hormonal or surgical therapy, although the former had a shorter period of progression-free survival or local recurrence. 相似文献13.
Background
Many microRNAs (miRNAs) exhibit altered expression levels in cancers, and they may be considered as valuable prognostic biomarkers for cancers. Here we aimed to summarize the recent advances in miR-210 involvement in human breast cancer and analyze the predicting role of miR-210 for survival.Methods
A meta-analysis was performed by searching PubMed, Cochrane Library, and Science Direct databases. Data were extracted from studies comparing survival in patients with breast cancer having higher expression of miR-210 with those having lower expression. Pooled hazard ratios (HRs) and 95% confidence intervals (CI) were calculated.Results
A total of 511 cases of breast cancer were involved for this global meta-analysis. For post-operational survival, the HR of higher miR-210 expression in breast cancer tissue was 3.39 (95% CI: 2.04–5.63, P < 0.05), which could significantly predict poorer survival.Conclusions
High expression of miR-210 might predict poor survival in patients with breast cancer. 相似文献14.
Yufeng Qin Xiumei Han Yuzhu Peng Rong Shen Xirong Guo Li Cao Ling Song Jiahao Sha Yankai Xia Xinru Wang 《Gene》2012
Objectives
Epoxide hydrolases are involved in detoxifying and excreting the environmental chemicals, which are associated with decreased semen quality and male infertility. We hypothesized that polymorphisms in epoxide hydrolases may be associated with risk of oligozoospermia and asthenospermia.Design and methods
In this study, 468 fertile controls and 672 idiopathic male infertile patients were recruited. SNPstream and TaqMan assay were used to genotype four single nucleotide polymorphisms in EPHX1 and EPHX2. The semen analysis was performed by computer-assisted semen analysis system.Results
Our results demonstrated that rs1042064 of EPHX2 was significantly associated with decreased risk of oligozoospermia (OR = 0.65, 95% CI: 0.44–0.98) and asthenospermia (OR = 0.66, 95% CI: 0.46–0.94).Conclusions
Our results provided evidence that genetic variants in epoxide hydrolases may modify the risk of oligozoospermia and asthenospermia in Han-Chinese population. 相似文献15.
Pilar Pérez-Ros Francisco Martínez-Arnau Immaculada Tormos Miñana Aranzazu López Aracil M. Carmen Oltra Sanchis Leidy E. Pechene Mera Francisco José Tarazona-Santabalbina 《Revista espa?ola de geriatría y gerontología》2014
Objective
To evaluate the results of a fall prevention programme designed to be applied to the elderly living in the community.Material and methods
The sample consisted of 249 participants ≥70 years of age, who were randomly assigned to one of three groups. The monthly intervention group (GIM): instructions on fall prevention and healthy exercises to improve physical function and balance at beginning of the study, and a monthly theoretical and practical refresher session. The quarterly intervention group (GIT), with the same beginning intervention and a refresher session every three months. The control group (GC), the same beginning intervention but no refresher sessions.Results
The mean age of the sample was 74.47 years (SD 5.33), with 64% women. The incidence of falls was reduced from 0.64 per patient year in the previous year to 0.39 in the post-intervention year in GIM, from 0.49 to 0.47 in GIT, and in the GC it remained at 0.47 before and twelve months after, but with no significant differences in the reduction between groups (P=.062). At the end of the study there was a decrease in Rizzo scale of 0.72 points (95% CI: 0.57-0.88, P<.001).Conclusion
An interdisciplinary community intervention programme can contribute to reducing the incidence of falls. Further studies are required to continue research into the incidence of falls in the elderly living in the community. 相似文献16.
Kim WH Min KT Jeon YJ Kwon CI Ko KH Park PW Hong SP Rim KS Kwon SW Hwang SG Kim NK 《Gene》2012,504(1):92-97
Background
Recent studies have suggested that common genetic polymorphisms alter the processing of microRNA (miRNA) and may be associated with the development and progression of cancer.Patients and methods
The association of miRNA polymorphisms with HCC survival was analyzed in 159 HCC patients and 201 controls by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Results
The risk of HCC was significantly lower for the miR-499A>G, AG + GG in HCC patients (AOR = 0.603, 95% CI = 0.370–0.984) and hepatitis B virus (HBV)-related HCC patients (AOR = 0.561, 95% CI 0.331–0.950). In addition, the risk of HCC was significantly lower for the miR-149C>T, CT and CT + CC in HCC patients (CT; AOR = 0.542, 95% CI = 0.332–0.886, CT + CC; AOR = 0.536, 95% CI = 0.335–0.858) and HBV-related HCC patients (CT: AOR = 0.510, 95% CI 0.305–0.854, CT + CC: AOR = 0.496, 95% CI 0.302–0.813). The miR-149C>T polymorphism was also associated with survival rate of HCC patients in OKUDA II stage.Conclusions
miR-149C>T and miR-499A>G were associated with HBV-related HCC. Further studies on larger populations will need to be conducted to confirm these results. 相似文献17.
Background
The clinical implication of O6-methylguanine-DNA methyltransferase (MGMT) promoter status is ill-defined in elderly glioblastoma patients. Here we report a meta-analysis to seek valid evidence for its clinical relevance in this subpopulation.Methods
Literature were searched and reviewed in a systematic manner using the PubMed, EMBASE and Cochrane databases. Studies investigating the association between MGMT promoter status and survival data of elderly patients (≥65 years) were eligible for inclusion.Results
Totally 16 studies were identified, with 13 studies included in the final analyses. The aggregate proportion of MGMT promoter methylation in elderly patients was 47% (95% confidence interval [CI]: 42–52%), which was similar to the value for younger patients. The analyses showed differential effects of MGMT status on overall survival (OS) of elderly patients according to assigned treatments: methylated vs. unmethylated: (1) temozolomide (TMZ)-containing therapies: hazard ratio [HR] 0.49, 95% CI 0.41–0.58; (2) TMZ-free therapies: HR 0.97, 95% CI 0.77–1.21. More importantly, a useful predictive value was observed by an interaction analysis: TMZ-containing therapies vs. RT alone: (1) methylated tumors: HR 0.48, 95% CI 0.36–0.65; (2) unmethylated tumors: HR 1.14; 95% CI 0.90–1.44.Conclusion
The meta-analysis reports an age-independent presence of MGMT promoter methylation. More importantly, the study encouraged routine testing of MGMT promoter status especially in elderly glioblastoma patients by indicating a direct linkage between biomarker test and individual treatment decision. Future studies are needed to justify the mandatory testing in younger patients. 相似文献18.
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Background
Some studies suggested that Glutathione S-transferases M1/T1(GSTM1/T1) null polymorphisms may be associated with the risk of vitiligo.Aims
The purpose of this study is to further evaluate the association between GSTM1/T1 null polymorphisms and the susceptibility to vitiligo.Methods
We carried out a retrieval of studies in the databases. Odds ratios (OR) and 95% confidence intervals (95% CIs) were used to assess the strength of this association. We analyzed the data using Stata 11.0.Results
Six case–control studies including 1358 cases and 1673 controls were included in this meta-analysis. Our overall results showed the GSTM1 or GSTT1 null polymorphism was associated with vitiligo (GSTM1:OR = 1.59, 95% CI: 1.21–2.08, P = 0.001; GSTT1: OR = 1.30, 95% CI: 1.12–1.51, P = 0.001). In the subgroup analysis, the GSTM1 null polymorphism might be a genetic risk factor to vitiligo in East Asian (OR = 1.71, 95% CI: 1.12–2.63, P = 0.014) but not in the Mediterranean, however individuals with the GSTT1 null polymorphism in the Mediterranean (OR = 1.76, 95% CI: 1.15–2.71, P = 0.010) but not in East Asian have a greater predisposition to vitiligo. In addition there was also a significant trend toward an association with the combination of the GSTM1 null and GSTT1 null in either East Asians or Mediterraneans.Conclusion
The GSTM1/T1 null polymorphisms may be associated with vitiligo. More studies are needed to confirm this conclusion. 相似文献20.