普伐他汀对慢性心力衰竭患者血浆C-反应蛋白、N-末端脑钠素前体水平及心功能的影响

目的:探讨普伐他汀对慢性心力衰竭(CHF)患者血浆C-反应蛋白(CRP)、N-末端脑钠素前体(NT-proBNP)水平和心功能的影响.方法:将90例CHF患者随机分为对照组(38例)和普伐他汀组(52例),对照组给予强心、利尿、扩血管治疗,普伐他汀组在此基础上加用普伐他汀10mg.d-1,疗程12周.采用改良Simpson法测定心衰患者治疗前后左心室舒张末内径(LVEDD)、左心室射血分数(LVEF).免疫比浊法测定血清C-反应蛋白(CRP)水平.采用酶联免疫法血浆NT-proBNP水平的变化.结果:两组患者治疗后LVEF和LVEDD水平较治疗前均明显改善(p＜0.05);普伐他汀组LVEF由(36.2±3.5)%升至)45.6±4.8)%;血浆CRP浓度由(12.05+1.62)mg/L降至(6.43±1.35)mg/L;NT-proBNP浓度由(1198.7±312.2)fmol/ml降至(742.1±231.2)fmol/ml;TC由(5.60±0.63)mmol/L降至(4.03±0.41)mmol/L.与对照组比较差异均有统学意义(P＜0.05).且患者血浆NT-proBNP水平与LVEDD呈正相关(r=0.52,P＜0.05),而与LVEF存在负相关(r=-63,P＜0.05).结论:CHF患者加用普伐他汀短期治疗可进一步改善心功能,降低CRP和NT-proBNP水平.     

青海湖流域矮嵩草草甸土壤有机碳密度分布特征

通过对青海湖流域不同退化程度矮嵩草草甸土壤容重和有机碳含量的测定,确定了其土壤有机碳密度。结果表明:不同退化程度下矮嵩草草甸土壤有机碳含量和变化特征各有不同。从未退化-重度退化,0—100 cm土壤剖面平均有机碳含量分别为(25.17±4.73)g/kg,(17.51±3.06)g/kg,(20.79±1.30)g/kg和(14.53±1.20)g/kg,即未退化中度退化轻度退化重度退化;0—20 cm土壤平均有机碳含量从(64.47±11.70)g/kg减少为(14.52±1.52)g/kg,减少了77.48%。土壤剖面有机碳密度变化趋势与其有机碳含量变化趋势一致。0—100 cm土壤剖面有机碳密度分别为(18.16±4.12)kg/m3,(14.24±3.52)kg/m3,(18.64±2.82)kg/m3和(13.27±2.28)kg/m3,即中度退化未退化轻度退化重度退化;土壤有机碳集中分布在0—40 cm深度,从未退化到严重退化,该深度有机碳密度分别为(32.06±6.41)kg/m3,(25.10±4.20)kg/m3,(22.68±3.17)kg/m3和(17.10±2.77)kg/m3,比整个剖面有机碳密度高出76.53%,76.25%,21.68%和28.88%。不考虑其他因素,以空间尺度代替时间尺度,这一结果说明矮嵩草草甸的退化导致土壤逐渐释放有机碳,其作为储存碳的功能在减弱,必须加强对矮嵩草草甸生态系统的保护,以防止其碳库变为碳源。     

优化联合降压治疗对高血压左室肥厚患者左室重量指数及血清瘦素水平的影响

目的:比较优化联合降压治疗及标准联合降压治疗对高血压左室肥厚患者左室重量指数及血清瘦素水平的影响,并探讨左室肥厚与血清瘦素水平的关系.方法:72例高血压左室肥厚患者随机分配到优化联合降压组(n=36)或标准联合降压组(n=36).优化降压组为:氨氯地平5 mg/d+替米沙坦80 mg/d.标准降压组为:氨氯地平5 mg/d+复方盐酸阿米洛利1片/d.治疗6个月后,检测并比较两组患者治疗前后左室重量指数及血清瘦素水平的变化.结果:标准联合降压组及优化联合降压组患者经过6个月药物干预后,(1)平均左室重量指数分别由183.3±44.6 g/m2,174.9±37.2 g/m2降至154.4±34.4 g/m2,138.0±33.9 g/m2(均P<0.01),优化降压组降低程度更为显著(P<0.05).(2)血清瘦素水平分别由(7.3±1.6)μg/L,(7.2±1.9)μg/L降至(4.8±1.3)μg/L,(3.4±1.3)μg/L,差异有统计学意义(P<0.01),且优化降压组降低程度更为明显(P<0.05).结论:优化联合降压组比标准联合降压组对高血压患者左室肥厚的逆转效果及降低血清瘦素水平的作用更佳.瘦素参与了左心室肥厚的发生、发展.     

中亚热带森林更新方式对土壤磷素的影响

为了深入了解磷(P)在中亚热带森林生态系统内的有效性,在三明市梅列区陈大采育场黄坑工区,选择天然林采伐后采取不同更新方式的多种森林,以米槠天然林为对照,研究森林不同更新方式对中亚热带森林土壤全磷、有效磷及可溶性有机磷的影响。结果显示:在0—100 cm土层,(1)土壤全磷平均含量大小顺序依次为米槠天然林(NF)(0.49±0.09)g/kg,米槠轻度干扰人促更新林(LAR)(0.35±0.04)g/kg,米槠强度干扰人促更新林(HAR)(0.34±0.03)g/kg,马尾松人工林(PIM)(0.32±0.02)g/kg,杉木人工林(CUL)(0.3±0.03)g/kg,人促更新林比人工林高,NF显著高于其它的林分(P0.05);(2)土壤有效磷(Na HCO3提取)平均含量大小顺序依次为NF(0.41±0.39)mg/kg,LAR(0.26±0.2)mg/kg,HAR(0.23±0.16)mg/kg,PIM(0.17±0.05)mg/kg,CUL(0.13±0.06)mg/kg,NF显著高于其它林分,LAR显著比人工林高(P0.05)。(3)在0—10 cm土层,各林分可溶性有机磷含量在夏季最高,冬季最低,温度和降水量的季节变化是影响其重要因子之一;同一季节,人促更新林比人工林高,NF显著高于人工林(P0.05)。结果表明,全磷、有效磷和可溶性有机磷含量随人为干扰强度的增强呈降低趋势,其与年凋落物量和土壤有机碳储量呈显著正相关,与土壤容重呈显著负相关,全磷和有效磷在土壤剖面呈表聚性特征。相比于人工林经营,采取人促天然更新的方式,更有利于中亚热带森林养分的贮存和转化,有利于森林的长期经营和管理。     

不同注射途径的脂肪间充质干细胞对大鼠肠炎疗效的实验研究

目的探讨脂肪间充质干细胞(ADMSCs)腹腔及静脉注射对三硝基苯磺酸(TNBS)诱导肠炎疗效的影响。方法将32只大鼠完全随机分成正常组、腹腔注射组、静脉注射组及模型组,每组8只。用TNBS诱导炎症性肠病(IBD)动物模型,腹腔及静脉注入ADMSCs,记录大鼠的疾病活动指数(DAI)、观察结肠宏观损伤及微观变化、测定结肠的髓过氧化物酶(MPO)活性、检测结肠Ki-67^+细胞的表达、比较血液中IL-1β、TNF-α浓度及结肠TGF-β、IL-6、IL-17A、IL-10的基因表达水平。采用单因素方差分析及独立t检验进行统计学分析。结果 ADMSCs腹腔注射组(98.05±0.63)g高于静脉注射组[(94.32±0.48)g,t=12.281,P=0.000],同时腹腔注射组DAI评分1.71±0.75低于静脉注射组3.57±0.97,(t=-3.980,P=0.002)。另外发现腹腔注射组结肠组织内髓过氧化物酶MPO浓度(95.75±5.52)U/g低于静脉注射组(74.37±5.12)U/g,(t=-7.513,P=0.000),腹腔注射组结肠病理评分2.14±0.69低于静脉注射组3.57±0.76,(t=-3.612,P=0.004)。结肠免疫荧光检查发现腹腔注射组比静脉注射组有更多的Ki-67^+细胞。酶联免疫吸附测定(ELISA)发现腹腔注射组血浆中IL-1β的浓度(130.71±7.08)pg/ml比静脉注射组(163±9.09)pg/ml低,(t=-8.518,P=0.000),同样腹腔注射组血浆中TNF-α的浓度(201.71±6.75)pg/ml也比静脉注射组(242.28±8.30)pg/ml低,(t=-10.033,P=0.000)。此外,结肠组织实时定量聚合酶联反应(RT-qPCR)的结果显示腹腔注射组IL-6 mRNA的表达4.34±0.48比静脉注射低6.15±1.05,(t=-4.147,P=0.001),腹腔注射组IL-17A mRNA的表达2.61±0.53也比静脉注射低3.57±0.46,(t=-4.301,P=0.001)。然而,腹腔注射组IL-10 mRNA的表达水平37.75±4.46比静脉注射组高27.68±2.25,(t=5.327,P=0.001),腹腔注射组TGF-β mRNA的表达水平15.82±0.99也比静脉注射组高11.97±2.25,(t=3.740,P=0.003)。结论 ADMSCs腹腔注射优于静脉注射并可能成为ADMSCs治疗IBD的较好选择。     

连续高强度运动刺激对大学生压力影响研究

为了测试连续高强度运动刺激对大学生压力影响,本研究选择10位在校男性大学生(年龄(20.2±2.7)岁,身高(173.41±3.15) cm,体重(68.12±4.12) kg)作为研究对象。经最大努力运动测试后,实施3 d高强度跑步运动(80%HRR, 20 min)。运动前后包含30 min的安静值和恢复期测量。利用双因素方差分析,比较心率和血压在连续3 d运动后的平均安静值与恢复期差异、3 d运动的可的松浓度增加百分比之间的差异。研究显示,心率和血压的安静值、恢复期和运动后可的松浓度增加百分比之间皆无显著差异(p0.05),而运动后可的松浓度显著大于运动前(p0.05)。本研究表明,连续实施3 d跑步运动,身体的压力反应程度皆维持相同。     

鼎湖山季风常绿阔叶林土壤微生物量碳和有机碳对模拟酸雨的响应

在鼎湖山季风常绿阔叶林设置人工模拟酸雨实验,研究土壤总有机碳含量、微生物量碳含量、土壤p H值和土壤呼吸速率几个指标对不同酸处理梯度(CK:p H值4.5的天然湖水;T1:p H值4.0;T2:p H值3.5;T3:p H值3.0)的响应。结果表明,在模拟酸雨的持续作用下,样地土壤酸化有加剧趋势。2011年的6月(CK:(603.76±46.18)mg/kg,T1:(565.41±44.48)mg/kg,T2:(521.58±30.92)mg/kg,T3:(509.49±19.40)mg/kg)、12月(CK:(488.92±22.71)mg/kg,T1:(379.65±49.46)mg/kg,T2:(346.08±33.81)mg/kg,T3:(318.00±52.35)mg/kg)和2012年6月(CK:(540.48±39.11)mg/kg,T1:(492.30±43.15)mg/kg,T2:(489.65±51.39)mg/kg,T3:(428.53±49.66)mg/kg)3次测定的土壤微生物量碳含量有随模拟酸雨强度增加而显著降低的趋势,高强度的酸处理T3显著低于CK值(P0.05);土壤呼吸速率在各处理中的响应与土壤微生物量碳含量变化一致。由于旱季和湿季的土壤温湿度相差较大,以上各指标在旱湿两季的差异明显,表现为湿季大于旱季。由于土壤总有机碳含量变化缓慢,其在各酸梯度处理下无显著差异(P0.05)。以上结果显示,长期酸雨作用使土壤酸化不断加剧,并降低了土壤微生物量碳的含量,抑制了土壤的呼吸速率,有利于土壤碳的累积,但对土壤总有机碳的影响仍需长期实验研究。     

松嫩草地80种草本植物叶片氮磷化学计量特征

以松嫩草地常见草本植物为研究对象, 分析了各生活型和功能群叶片氮磷化学计量特征。结果显示: 松嫩草地80种草本植物的叶片氮、磷质量浓度分别为(24.2 ± 0.96) mg·g ^-1和(2.0 ± 0.10) mg·g ^-1, 面积浓度分别为(13.0 ± 0.54) mg·cm ^-2和(1.0 ± 0.05) mg·cm ^-2, 氮磷比为13.0 ± 0.39, 氮磷比与叶片磷质量浓度、叶片氮、磷面积浓度有显著相关关系; 松嫩草地植物生长受到氮限制。一年生植物叶片氮、磷质量浓度和变异系数高于其他生活型, 各生活型之间氮面积浓度和氮磷比差异不显著。豆科植物叶片氮的质量浓度、面积浓度和氮磷比高于其他功能群。在不同生活型或功能群之间, 植物叶片磷的面积浓度差异不显著, 都在1.0 mg·cm ^-2左右; 适当地增加群落中豆科植物的比例, 可能有助于提高松嫩草地产量和质量。     

胸腺五肽联合辛伐他汀治疗COPD合并肺动脉高压的疗效及对患者血清PAF-AH、esRAGE、CA125水平的影响

目的:探讨胸腺五肽联合辛伐他汀治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压的疗效及对患者血清血小板活化因子乙酰水解酶(PAF-AH)、内源性分泌型晚期糖基化终末产物受体(esRAGE)、糖类抗原125(CA125)水平的影响。方法:选择2016年1月至2017年12月我院接诊的65例COPD合并肺动脉高压患者,通过随机数表法分为观察组35例和对照组30例。对照组在常规治疗基础上给予辛伐他汀治疗,观察组在对照组基础上给予胸腺五肽治疗,两组均连续治疗4周。治疗后,比较两组血清PAF-AH、esRAGE、CA125水平、免疫功能、肺功能、血气分析指标的变化及不良反应的发生情况。结果:治疗后,观察组血清PAF-AH、esRAGE水平明显高于对照组,而血清CA125水平明显低于对照组[(187.20±15.10)ng/mL vs.(135.13±11.42)ng/mL,(0.32±0.08)ng/L vs.(0.26±0.05)ng/L,(21.06±3.27)U/mL vs.(30.49±4.23)U/mL](P0.05);观察组CD3~+、CD4~+、CD4~+/CD8~+明显高于对照组[(69.56±7.89)%vs.(57.56±6.05)%,(43.30±5.11)%vs.(37.86±4.53)%,(2.14±0.30) vs.(1.82±0.26)](P0.05);观察组血清第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)明显高于对照组,肺动脉收缩压(PASP)明显比对照组低[(2.17±0.34)L vs(1.84±0.29)L,(67.34±8.28)%vs.(60.37±6.05)%,(36.23±3.15)mmHg vs.(42.85±3.88)mmHg](P0.05);观察组动脉血压分压(PaO_2)明显高于对照组,二氧化碳分压(PaCO_2)明显低于对照组[(89.45±7.40)mmHg vs.(80.23±6.82)mmHg,(33.83±3.11)mmHg vs.(40.02±3.86)mmHg](P0.05)。两组不良反应的总发生率比较差异无统计学意义(P0.05)。结论:胸腺五肽联合辛伐他汀治疗COPD合并肺动脉高压患者效果显著优于单用辛伐他汀治疗,可更有效改善患者肺功能和肺动脉高压状态,其内在机制可能和调节血清PAF-AH、esRAGE、CA125水平及缓解气道炎症反应相关。     

主胰管在胰体尾切除术中的应用解剖学研究

目的:为行胰腺体尾部切除时寻找主胰管减少胰瘘提供解剖学资料。方法:解剖观测胰腺标本、胰腺动脉与胰管联合铸型标本各10例。结果:主胰管起于胰尾的中部,在胰颈、体、尾部与上缘之间的距离分别为(7.51±1.06)mm,(10.98±1.81)mm,(8.44±1.72)mm。胰腺各横断面上主胰管的后距,胰颈处为(2.15±0.61)mm,距胰颈1cm处的胰体部为(5.84±1.11)mm,2cm处为(6.12±0.93)mm,胰尾处为(7.44±0.86)mm。铸型标本中脾动脉有9例走行于胰腺上缘,与主胰管的距离在胰颈左侧2 cm处为(9.37±1.05)mm,胰体部中点处为(11.72±1.63)mm,胰尾处为(8.98±1.01)mm,脾动脉的位置变异1例。结论:在胰颈左侧2cm处按自下而上、由前往后的顺序分离并结扎主胰管可减少胰体尾切除术后胰瘘的发生。     

Randomized controlled trial of chewing gum for weight loss

The possible effects on body weight of chewing gum on a regular schedule have not been tested in a randomized controlled trial (RCT). We conducted an 8-week RCT in 201 overweight and obese adults to test the hypothesis that receiving printed material on good nutrition and chewing gum for a minimum of 90 min/day (n = 102) would lead to greater weight loss than receiving printed nutrition information only (n = 99). Changes in BMI, waist circumference, and blood pressure were secondary outcomes. Adherence to the gum-chewing protocol in the intervention group was >95%. In the intention-to-treat analysis, there were virtually no changes in weight or BMI in either group between baseline and the end of the intervention at 8 weeks. Waist circumference decreased significantly in the intervention group between baseline and 8 weeks (mean ± SD change = -1.4 ± 5.3 cm; P = 0.0128); however, there was no significant difference in change in waist circumference comparing the groups. Similarly, systolic and diastolic blood pressure decreased significantly in the intervention group between baseline and 8 weeks (-3.0 ± 9.9 mm Hg; P = 0.0032 and -3.2 ± 7.3 mm Hg; P = 0.0001, respectively); however, there were no significant differences in the changes in systolic or diastolic blood pressure between the groups. Analyses including completers only produced essentially the same results. We conclude that chewing gum on a regular schedule for 8 weeks did not facilitate weight loss in these overweight and obese adults.     

Effects of aerobic exercise on serum leptin levels in obese women

It has been demonstrated that leptin concentrations in obese patients may be altered by weight loss. We examined the effects of a 9-week aerobic exercise program on serum leptin concentrations in overweight women (20-50% above ideal body mass) under conditions of weight stability. Sixteen overweight women, mean (SE) age 42.75 (1.64) years, comprised the exercise group which adhered to a supervised aerobic exercise program. A graded exercise treadmill test was conducted before and after the exercise program to determine maximal oxygen uptake (VO2max) using open-circuit spirometry. The women demonstrated improved aerobic fitness (VO2max increased 12.29%), however, body fat and the body mass index did not change significantly [42.27 (1.35)-41.87 (1.33)%]. Fourteen women, age 40.57 (2.80) years, did not exercise over the same time period and served as a control group. Serum leptin levels were not significantly altered for either the exercise [28.00 (2.13)-31.04 (2.71) ng x ml(-1)] or the control group [33.24 (3.78)-34.69 (3.14) ng x mg(-1)]. The data indicate that 9 weeks of aerobic exercise improves aerobic fitness, but does not affect leptin concentrations in overweight women.     

Influence of abdominal obesity on vascular endothelial function in overweight/obese adult men

It has been suggested that body fat distribution may be an important determinant of the impact of adiposity on endothelial function. We tested the hypothesis that overweight/obese adults with abdominal adiposity exhibit worse endothelial vasodilator and fibrinolytic function than overweight/obese adults without abdominal adiposity. Sixty adult men were studied: 20 normal weight (BMI: 22.3 ± 0.7 kg/m2; waist circumference (WC): 84.9 ± 2.0 cm); 20 overweight/obese with WC <102 cm (29.2 ± 0.3 kg/m2; 98.1 ± 0.7 cm); and 20 overweight/obese with WC ≥102 cm (30.0 ± 0.4 kg/m2; 106.7 ± 1.0 cm). Forearm blood flow (FBF) responses to intra-arterial acetylcholine and sodium nitroprusside (SNP) were measured. Additionally, net endothelial release of tissue-type plasminogen activator (t-PA) was determined in response to bradykinin (BK) and SNP. Overweight/obese men demonstrated lower (~30%; P < 0.01) FBF responses to acetylcholine compared with normal weight controls. However, there were no differences in FBF responses to acetylcholine between overweight/obese men with (4.1 ± 0.3-10.8 ± 1.3 ml/100 ml tissue/min) and without (4.5 ± 0.3-11.6 ± 0.8 ml/100 ml tissue/min) abdominal adiposity. Similarly, endothelial t-PA release to BK was lower (~40%; P < 0.05) in the overweight/obese men compared with normal weight controls; however, t-PA release was not different between the overweight/obese men with (-0.7 ± 0.4-40.4 ± 6.2 ng/100 ml tissue/min) and without (-0.3 ± 0.6-48 ± 7.5 ng/100 ml tissue/min) abdominal adiposity. These results indicate that abdominal obesity is not associated with greater impairment in endothelial vasodilation and fibrinolytic capacity in overweight/obese men. Excess adiposity, regardless of anatomical distribution pattern, is associated with impaired endothelial function.     

前列腺切除术围术期出血与临床护理预处理的关系

研究护理中术前服用度他雄胺2周减少前列腺内二氢睾酮和前列腺组织血管分布对前列腺术后出血的影响。本研究纳入了83例符合TURP适应症的良性前列腺增生患者。度他雄胺组由40名患者组成,术前两周内接受度他雄胺(0.5 mg/d)治疗;对照组由43名患者组成,术前两周内不接受度他雄胺治疗。根据术前、术后、术后24 h的血清血红蛋白(Hb)和血细胞比容(Hct)水平来评估失血情况。本次研究还探究了药物对留置尿道导管的使用时间、连续盐水膀胱冲洗时间和住院时间的影响。术后和术后1 d平均失血量方面,度他雄胺组低于对照组(ΔHb=(0.65±1.27) g/d L∶(1.16±0.73) g/d L,(1.30±1.00) g/dL∶(1.86±1.05) g/dL,p=0.019,p=0.011;ΔHct=(1.89±3.83)%∶(3.47±2.09)%,(3.69±2.95)%∶(5.39±3.23)%,p=0.016,p=0.011)。此外,在度他雄胺组中,尿道留置导尿管天数((2.95±1.02) d∶(3.92±1.14) d,p=0.000)、连续盐水膀胱冲洗时间((1.81±1.08) d∶(2.36±1.06) d,p=0.016)和TURP后的住院时间((3.95±1.09) d∶(4.76±1.19) d,p=0.001)较小。本研究表明,在TURP术前护理中用度他雄胺进行两周的治疗,可减少术后出血和TURP术后住院时间。这种临床护理预处理可用于减少与TURP相关的手术出血,建议临床使用。     

Prevalence of Metabolically Discordant Phenotypes in a Mediterranean Population—the Imap Study

ObjectiveTo study the prevalence and correlates of body size phenotypes in an adult Spanish population.MethodsWe undertook a cross-sectional analysis in a random sample of 2,270 individuals. We defined six body size phenotypes based on body mass index category (normal-weight, 18.5 to 24.9 kg/m²; overweight, 25 to 29.9 kg/m²; obese, ≥30.0 kg/m²) and the presence of ≤1 (meta- bolically healthy) or ≥2 (metabolically abnormal) cardio- metabolic abnormalities: metabolically healthy normal- weight (MHNW), metabolically abnormal normal-weight (MANW), metabolically healthy overweight (MHOW), metabolically abnormal overweight (MAOW), metaboli- cally healthy obese (MHO), and metabolically abnormal obese (MAO). We considered four cardiometabolic abnormalities: systolic and/or diastolic blood pressure ≥130/85 mm Hg, triglycerides ≥150 mg/dL, high-density-lipopro- tein cholesterol levels <40/<50 mg/dL in men/women, and elevated glucose (fasting plasma glucose ≥100 mg/dL or previous diabetes).ResultsSubmitted for publication October 30, 2012 Accepted for publication April 1, 2013From the ¹The prevalence of the MHO, MHOW, and MANW phenotypes was 2.2, 13.9, and 7.9%, respectively. Whereas 9.6% of obese and 32.6% of overweight individuals were metabolically healthy, 21.3% of the normal- weight subjects were metabolically abnormal. A multivariate regression model (adjusted for age, sex, and waist circumference) showed that age >40 years, male sex, and higher waist circumference were independently associated with the metabolically abnormal phenotype MANW, whereas younger age, female sex, and lower waist circumference were independently associated with the metabolically healthy phenotypes.ConclusionThe prevalence of MHO in our population is low and is more common in women and younger people. In contrast, a high proportion of normal-weight individuals (mainly over 40 years of age) in our population show cardiometabolic abnormalities. (Endocr Pract. 2013;19:758-768)     

Clinical Use of Liraglutide in Type 2 Diabetes and its Effects on Cardiovascular Risk Factors

ObjectiveTo assess whether liraglutide, a glucagonlike peptide-1 receptor agonist, has cardioprotective properties in addition to its glycemic effects.MethodsWe performed a retrospective analysis of medical records of 110 obese patients with type 2 diabetes mellitus treated with liraglutide for at least 6 months between March 2010 and April 2011 at our tertiary care referral center. The variables analyzed were body mass index, hemoglobin A_1c (A1C), systolic blood pressure (SBP), plasma C-reactive protein (CRP) concentrations, and serum lipids.ResultsIn our overall study cohort, we noted a reduction in mean weight from 120 ± 5 kg to 115 ± 3 kg and a decrease in mean A1C from 7.8% ± 0.6% to 7.2% ± 0.2%. The mean triglyceride concentration decreased from 173 ± 19 mg/dL to 151 ± 15 mg/dL, the mean SBP was reduced from 132 ± 6 mm Hg to 125 ± 4 mm Hg, and the mean CRP concentration declined from 4.7 ± 0.8 mg/L to 3.2 ± 0.4 mg/L after treatment with liraglutide for a minimal duration of 6 months and a mean duration of 7.5 months (for all the foregoing changes, P < .05).These variables decreased whether these patients were previously treated with orally administered hypoglycemic agents alone or in combination with insulin or exenatide.ConclusionOur findings in a clinical practice show that liraglutide is a potent antidiabetes drug, whether given in combination with orally administered agents or insulin or as a substitution for exenatide. It lowers body weight, A1C levels, SBP, and CRP and triglyceride concentrations. (Endocr Pract. 2012;18:140-145)     

Effects of Calcium and Dairy on Body Composition and Weight Loss in African‐American Adults

Objective: Our objective was to determine the effects of dairy consumption on adiposity and body composition in obese African Americans. Research Methods and Procedures: We performed two randomized trials in obese African‐American adults. In the first (weight maintenance), 34 subjects were maintained on a low calcium (500 mg/d)/low dairy (<1 serving/d) or high dairy (1200 mg Ca/d diet including 3 servings of dairy) diet with no change in energy or macronutrient intake for 24 weeks. In the second trial (weight loss), 29 subjects were similarly randomized to the low or high dairy diets and placed on a caloric restriction regimen (?500 kcal/d). Results: In the first trial, body weight remained stable for both groups throughout the maintenance study. The high dairy diet resulted in decreases in total body fat (2.16 kg, p < 0.01), trunk fat (1.03 kg, p < 0.01), insulin (18.7 pM, p < 0.04), and blood pressure (6.8 mm Hg systolic, p < 0.01; 4.25 mm Hg diastolic, p < 0.01) and an increase in lean mass (1.08 kg, p < 0.04), whereas there were no significant changes in the low dairy group. In the second trial, although both diets produced significant weight and fat loss, weight and fat loss on the high dairy diet were ～2‐fold higher (p < 0.01), and loss of lean body mass was markedly reduced (p < 0.001) compared with the low dairy diet. Discussion: Substitution of calcium‐rich foods in isocaloric diets reduced adiposity and improved metabolic profiles in obese African Americans without energy restriction or weight loss and augmented weight and fat loss secondary to energy restriction.     

Short-term weight loss in overweight/obese low-income women improves plasma zinc and metabolic syndrome risk factors

Metabolic syndrome is a group of disorders involving obesity, insulin resistance, dyslipidemia and hypertension. Obesity is the most crucial risk factor of metabolic syndrome, because it is known to precede other risk factors. Obesity is also associated with disturbances in the metabolism of the trace mineral, zinc. The overall purpose of this study was to investigate the effects of short-term weight loss on plasma zinc and metabolic syndrome risk factors. An 8-week weight loss intervention study was conducted with 90 low-income overweight/obese mothers, whose youngest child was 1–3 years old. Plasma levels of zinc, glucose, insulin, leptin, triglycerides, total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol were measured and compared at weeks 0 and 8 of the weight loss program. At pre-study, plasma zinc was low in 39% and, within normal values in 46%, of obese/overweight mothers. By the end of intervention, plasma zinc rose by 22% and only 5% of the mothers continued to exhibit low plasma zinc. At post-study, the metabolic syndrome risk factors of waist circumference, HDL cholesterol, and diastolic blood pressure (p < 0.05) showed significant improvements. Plasma zinc increased by a greater margin (67%) in women with low zinc, as compared to those with normal zinc (18%); weight reduction was similar in both the groups. Finally, changes in % body fat were related negatively with changes in plasma zinc (r = ? 0.28, p < 0.05). The circulating levels of zinc, as well as the metabolic syndrome components, showed significant improvements in overweight/obese low-income women after weight loss.     

Effects of Obesity Phenotype on Coronary Heart Disease Risk Factors in Response to Weight Loss

Objective: To determine whether there is a difference in risk‐factor improvement for coronary heart disease (CHD) between the intra‐abdominal fat (IF) and subcutaneous fat (SF) obesity phenotypes after weight loss. Research Methods and Procedures: Subjects included 55 mildly obese women (body mass index, 25 to 36 kg/m²; age range, 34 to 63 years) who had at least two of three CHD risk factors [systolic blood pressure (SBP), >140 mm Hg; total cholesterol (TC), >220 mg/dL; fasting plasma glucose, >110 mg/dL). Using computed tomography, IF obesity was classified as ≥110 cm² of the IF area measured; subjects with <110 cm² were classified as having SF obesity. The IF and SF obesity groups were divided into diet‐only and diet‐plus‐exercise groups. Assays and measurements were performed before and after a 14‐week (98‐day) intervention. Results: Weight was reduced by 7 to 10 kg in each group. The IF and SF areas, SBP, diastolic blood pressure, TC, and low‐density lipoprotein‐cholesterol were significantly reduced in all groups (p < 0.01). Reduction in IF area was greater in IF obesity than in SF obesity, whereas no differences were observed in the improvement of CHD risk factors. Sample sizes needed for observing a significant difference for SBP, TC, triglycerides, and fasting plasma glucose were greater than the number of subjects in this study. Discussion: Our results suggest that the influence of the obesity phenotype on improving CHD risk factors is not apparent. A larger study is needed to prove the validity of this finding.     

Effect of Protein Intake on Bone Mineralization during Weight Loss: A 6‐Month Trial

Objective: The long‐term effect of dietary protein on bone mineralization is not well understood. Research Methods and Procedures: Sixty‐five overweight (body mass index, 25 to 29.9 kg/m²) or obese (≥30 kg/m²) subjects were enrolled in a randomized, placebo‐controlled, 6‐month dietary‐intervention study comparing two controlled ad libitum diets with matched fat contents: high protein (HP) or low protein (LP). Body composition was assessed by DXA. Results: In the HP group, dietary‐protein intake increased from 91.4 g/d to a 6‐month intervention mean of 107.8 g/d (p < 0.05) and decreased in the LP group from 91.1 g/d to 70.4 g/d (p < 0.05). Total weight loss after 6 months was 8.9 kg in the HP group, 5.1 kg in the LP group, and none in the control group. After 6 months, bone mineral content (BMC) had declined by 111 ± 13 g (4%) in the HP group and by 85 ± 13 g (3%) in the LP group (not significant). Loss of BMC was more positively correlated with loss of body fat mass (r = 0.83; p < 0.0001) than with loss of body weight. Six‐month BMC loss, adjusted for differences in fat loss, was greater in the LP group than in the HP group [difference in LP vs. HP, 44.8 g (95% confidence interval, 16 to 73.8 g); p < 0.05]. Independent of change in body weight and composition during the intervention, highprotein intake was associated with a diminished loss of BMC (p < 0.01). Discussion: Body‐fat loss was the major determinant of loss of BMC, and we found no adverse effects of 6 months of high‐protein intake on BMC.