Objectives Frailty is one of the major health problems facing aging societies worldwide. We investigated the association between serum SIRT6 and frailty in older adults. Design Cross-sectional analysis of associations of serum SIRT6 and frailty in older people. Setting Enrolled community-dwelling and hospital outpatient clinic adults older than 65 years old in Wuhan City, Hubei Province, China. Participants A total of 540 community-dwelling older adults (age ≥ 65 years) in Wuhan were included in the study. Measures We used Frailty Phenotype criteria for classifying participants based on their frailty status. Serum SIRT6 was measured using an ELISA kit. Results A total of 540 older adults were included in this cross-sectional study. Serum SIRT6 was lower in the slowness group (7.23±1.81 vs 5.89±1.74, p<0.001), weakness group (6.87±1.88 vs 5.68±1.64, p<0.001), and exhaustion group (6.73±1.90 vs 5.88±1.74, p<0.001) compare with the normal group. ROC curves were used to assess the efficiency of SIRT6 in predicting frailty in older adults. The AUC for SIRT6 was 0.792 (95% CI: 0.7514 to 0.8325), with the highest sensitivity of 68.0% and the specificity of 91.9%, and the optimal critical value of 4.65ng/ml according to Youden’s index. Multivariate logistic regression analysis showed that serum SIRT6 level was independently associated with frailty in older people. Conclusion In conclusion, serum SIRT6 was decreased in frailty compared with robust older adults. A decreased serum SIRT6 was independently associated with an increased risk of frailty. SIRT6 may be a potential target for the treatment of patients with frailty.

Objective:To investigate the correlation between Helicobacter pylori ( H.pylori) infection and albuminuria inphysical examination population. Methods:It was a cross-sectional study. All the adults who received physical examination and underwent 13C-urea breath test at the Physical Examination Center in Tongji Hospital in 2021 were selected as the study subjects. General data (such as demographic information and past medical history) were documented. The physical measurement and blood biochemical indicators were checked too. Multivariate analysis was used to analyze the relationship between H. pylori infection and albuminuria. Results:A total of 30 311 subjects were included in this analysis. There were 17 123 males and 13 188 females with an age of (44.51±12.17) years. The positive rate of H. pylori infection was 27.3%. The incidence of albuminuria in subjects with H. pylori infection was 6.7%, and it was 6.1% in the subjects without H. pylori infection ( P=0.031). After adjusting for the confounding factors such as gender, age, diabetes and hypertension, H. pylori infection was independently associated with the risk of albuminuria (odds ratio ( OR)=1.133, 95% CI: 1.018-1.261, P=0.022). Conclusion:H. pylori infection is positively correlated with the occurrence of albuminuria in the physical examination population.

Objective:To analyse the relationship between serum electrolyte concentrations and risk of cardiovascular events in physical examination population.Methods:A cross-sectional study design was applied to survey 8 445 adults whose serum high-sensitivity cardiac tropon Ⅰ (hs-cTnⅠ) and serum electrolytes (chloride, phosphorus, calcium, sodium, potassium and magnesium) concentrations were measured at the health examination center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to February 28, 2022. The risk of cardiovascular events was classified into three levels according to the serum hypersensitive cardiac troponin Ⅰ(hs-cTnⅠ) concentration: low, middle or high risk group. One-way analysis of variance was applied to compare the differences in serum electrolyte concentrations of participants with different risk levels of cardiovascular events. Ordered multi-category logistic regression was performed to analyze the correlation between serum electrolyte levels and the risk of cardiovascular events.Results:The concentration of potassium and magnesium ion in the subjects with low risk of cardiovascular events were both higher than those in the middle and high risk group [potassium ion (4.28±0.29) vs (4.24±0.34), (4.23±0.36) mmol/L, magnesium ion (0.88±0.06) vs (0.87±0.07), (0.87±0.07) mmol/L](both P<0.05), while the concentration of sodium ion was lower [(140.54±1.75) vs (140.88±1.73), (140.81±2.20) mmol/L]( P<0.001); the concentration of phosphorus ion in the high-risk group was lower than those in the middle and low risk groups [(1.04±0.17) vs (1.08±0.16), (1.05±0.15) mmol/L]( P=0.001); no significant difference was found in the concentrations of chloride and calcium ion among the three groups (both P>0.05). Compared to subjects with normal concentrations of electrolyte, the risk level of cardiovascular events in subjects with hypokalemia ( OR=6.96, 95% CI: 3.67-13.10) and hypomagnesemia ( OR=5.00, 95% CI: 1.01-24.50) was higher(both P<0.05). Within the normal range, sodium concentration was positively correlated with the risk of cardiovascular events ( OR=1.08, 95% CI: 1.03-1.14; P<0.001). Conclusions:The serum sodium, potassium and magnesium concentrations in health examination subjects are correlated with the risk of cardiovascular events. Maintaining the balanced concentration of serum potassium and magnesium, as well as low sodium levels within normal limits may help prevent cardiovascular events.

Objective Dyslipidemia is associated with an increased risk of cardiovascular disease, the major cause of death in an aging population. This study aimed to estimate the prevalence of dyslipidemia for the past decade among adults in Wuhan, China. Methods We performed a serial cross-sectional study that recruited 705 219 adults from the Health Management Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2010 to 2019. The diagnosis of dyslipidemia was based on the 2016 Chinese Guidelines for the Management of Dyslipidemia in Adults. Fixed effects and random effects models were applied to adjust the confounding variables (gender and age). Results The overall prevalence of dyslipidemia was 33.1% (46.2% in men and 14.7% in women) in 2019. The prevalence of dyslipidemia was significantly increased over 10 years [from 28.6% (95% CI: 28.2%–29.1%) in 2010 to 32.8 % (95% CI:32.6%–33.1%) in 2019;. P –0.001], especially for hypo-high-density lipoprotein cholesterolemia [from 18.4% (95% CI: 18.0%–18.8%) in 2010 to 24.5% (95% CI: 24.3%–24.7%) in 2019; P –0.001]. In 2019, the prevalence of dyslipidemia was higher in participants with comorbidities, including overweight/obesity, hypertension, diabetes, hyperuricemia, or chronic kidney disease, and dyslipidemia was the most significant among participants aged 30–39 years. Conclusion This study demonstrated that dyslipidemia is on the rise in men, and more emphasis should be provided for the screening of dyslipidemia in young males for the primary prevention of cardiovascular and renal diseases.

BACKGROUND:Sepsis is an important disease that endangers human health and is the main cause of death in ICU patients, which has been a focus of clinical treatment. This study aims to evaluate the significance of the readily available quick sequential organ failure assessment (qSOFA) score in clinical cases of sepsis.METHODS:A retrospective cross-sectional study of patients with sepsis treated in the Department of Infectious Diseases, the Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from January 2015 to December 2016 was conducted, and the patients were divided into a high-score group (≥2 points) and the low-score group (<2 points) according to the diagnostic criteria for sepsis (Sepsis 3.0). The differences in disease outcome and inflammatory indicators were compared between groups.RESULTS:A total of 74 patients with sepsis were included in this study. When the cutoff qSOFA score was 2 points, the patients in the high-score group showed a higher mortality rate (71.43%), and the patients in the low-score group showed a higher improvement rate (87.76%). The inflammatory indicators did not show statistically significant differences between the two groups.CONCLUSIONS:The qSOFA score can better predict the prognoses of non-ICU patients with sepsis compared with traditional inflammatory indicators. Clinicians should raise their awareness about qSOFA and improving its accuracy.

Gilbert’s syndrome (GS) is a mild condition characterized by periods of hyperbilirubinemia, which results in variations in the UDP-glucuronosyltransferase 1 (UGT1A1) gene. Variant genotypes of UGT1A1 vary in different populations in the world. The present study aimed to determine the genotype of the UGT1A1 promoter and exon that are related to the serum total bilirubin (STB) level in the Chinese Han population. A total of 120 individuals diagnosed with GS (GS group) and 120 healthy individuals (non-GS group) were enrolled. Routine blood, liver function tests, and antibodies associated with autoimmune liver diseases were assessed. Blood samples were collected for DNA purification. Sequencing of the UGT1A1 promoter and exons was conducted for post segment amplification by PCR. Compound heterozygous UGT1A1*28 and UGT1A1*6 (25/120, 20.83%), single homozygous UGT1A1*28 (24/120, 20.00%) and single heterozygous UGT1A1*6 (18/120, 15.00%) were the most frequent genotypes in the GS group. However, single heterozygous UGT1A1*6 (30/120, 25.00%) and single heterozygous UGT1A1*28 (19/120, 15.83%) were the most frequent genotypes in the non-GS group. Further, the frequencies of single homozygous UGT1A1*28, compound heterozygous UGT1A1*28 and UGT1A1*6, and compound heterozygous UGT1A1*28, UGT1A1*6 and UGT1A1*27 were significantly higher in the GS group than those in the non-GS group. The STB levels of GS patients with the homozygous UGT1A1*28 genotype were remarkably higher than those of patients with other genotypes. Homozygous UGT1A1*28 and heterozygous UGT1A1*6 variants were associated with the highest and lowest risks of hyperbilirubinemia, respectively. Our study revealed that compound heterozygous UGT1A1*28 and UGT1A1*6, or single homozygous UGT1A1*28 are major genotypes associated with GS in Chinese Han people. These findings might facilitate the precise genomic diagnosis of Gilbert’s syndrome.

Background & aims: The association between serum 25-hydroxyvitamin D [25(OH)D] and type 2 diabetes mellitus (T2DM) remains inconclusive. Moreover, whether inflammatory biomarkers are involved in this association has not been explored. This study aims to investigate serum 25(OH)D in relation to T2DM in a Chinese population and provide clues for the inflammatory mechanism whereby serum 25(OH)D deficiency increases T2DM risk. Methods: A cross-sectional study of 47,803 participants aged 18-96 years was performed in a health management center in 2017. Multivariate linear or logistic regression models and mediation analysis were used to examine the relationships between serum 25(OH)D, inflammatory biomarkers (white blood cell counts and mean platelet volume), and T2DM. Results: Of the 47,803 participants included, 5.2% were diabetic and 51.4% were serum 25(OH)D deficient. The study revealed a significant inverse association between serum 25(OH)D and T2DM risk after adjustment for potential confounders (P for trend 1/4 0.002); the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) across serum 25(OH)D levels (sufficiency, insufficiency, and deficiency) were 1.00 (reference), 1.17 (1.03-1.33), and 1.25 (1.09-1.43), respectively. This study also showed a significant indirect effect of serum 25(OH)D on T2DM risk through total white blood cell count, neutrophil count, lymphocyte count, and monocyte count (P values < 0.05); the proportions mediated were 9.89%, 7.51%, 2.94%, and 2.82%, respectively. Conclusions: Serum 25(OH)D deficiency was independently associated with an elevated risk of T2DM in a Chinese adult population and low-grade systemic inflammation might be one of its biological mechanisms. (C)& nbsp;2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Objectives Hyperuricaemia is a risk factor for gout attacks, kidney damage and cardiovascular events. Evidence on the trends in hyperuricaemia burden in Wuhan city, China, was limited. The present study aimed to estimate the prevalence of and a decade trend in hyperuricaemia in Wuhan city.Design Cross-sectional study.Setting Health Management Center of Tongji Hospital.Participants A total of 732 527 adult participants from the general population who took a physical examination in the Health Management Center between 2010 and 2019.Main outcome measures Prevalence of and trends in hyperuricaemia.Results The overall prevalence of hyperuricaemia was 25.8% (36.6% in men and 10.8% in women) in 2019. The hyperuricaemia prevalence and serum uric acid (SUA) levels were significantly higher in young men, old women and participants with obesity, hypertension, diabetes or dyslipidaemia (p<0.05). SUA levels among men and women gradually increased from 358.0 (313.0–407.0) umol/L and 250.0 (217.0–288.0) umol/L in 2010 to 388.0 (338.0–445.2) umol/L and 270.0 (233.0–314.0) umol/L in 2019, respectively, p<0.05. From 2010 through 2019, hyperuricaemia prevalence significantly increased in each age category and it increased most sharply among participants aged 20–39 years. The multivariate-adjusted prevalence among men was 26.1% (25.4% to 26.7%) in 2010, 30.9% (30.4% to 31.4%) in 2015 and 34.4% (34.1% to 34.8%) in 2019, while among women it was 5.8% (5.4% to 6.2%) in 2010, 7.2% (6.9% to 7.5%) in 2015 and 10.1% (9.9% to 10.3%) in 2019.Conclusions Hyperuricaemia was highly prevalent among adults in Wuhan city. More attention should be paid to the increasing burden of hyperuricaemia, especially for those at higher risks.

The emerging coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic, and brings formidable challenges to public health, society and the economy worldwide. Currently, the antibody responses against SARS-CoV-2 remains largely unknown. We herein estimated the longevity of specific antibodies against SARS-CoV-2, and reported that antibodies waned over substantially in COVID-19 patients after recovery. This article is protected by copyright. All rights reserved.

目的:从人口、年龄分布及危险因素聚集等方面探讨高血压、糖尿病、高脂血症、超重/肥胖及高尿酸血症发生的特点,并分析它们与心血管疾病的相互关系.方法:健康体检人群24654人纳入本研究,按照五种疾病的诊断标准分别采用仪器、实验室等多种检查,并结合临床诊断资料筛选高血压、糖尿病、高脂血症、超重/肥胖及高尿酸血症病例,分别观察其在人口、年龄分布上的特征及在性别上的差异.结果:在24654总体人群中,高血压、糖尿病、高脂血症、超重/肥胖、高尿酸血症的检出率依次为16.5％、3.7％、58.3％、42.2％、22.5％;且男性检出率明显高于女性.除高尿酸血症以外,高血压、糖尿病、高脂血症、超重/肥胖的阳性检出率随着年龄的增长而增加,危险因素的等级也与年龄呈正相关,且男性高于女性.结论:影响心血管疾病的高危因素中高脂血症人群所占比例最大,其检出阳性率依次为高脂血症(58.3％)、超重/肥胖(42.2％)、高尿酸血症(22.5％)、高血压(16.5％)、糖尿病(3.7％);五种危险因素的检出率和等级上升均与增龄有密切关系,并且男性高于女性.

AbstractAims/IntroductionSeveral epidemiological studies investigated the effect of Helicobacter pylori infection on diabetes, but the conclusions remained inconsistent. We aimed to explore the relationship between H. pylori infection and diabetes, as well as glycemic metabolism profiles.Materials and MethodsA cross‐sectional study including 58,482 Chinese adults was carried out between January 2016 and December 2017. H. pylori infection was diagnosed by the 13C‐urea breath test. Multivariate regression analyses were carried out to evaluate the association of H. pylori infection with diabetes.ResultsOf the 58,482 participants, 3,449 (5.9%) had diabetes. The H. pylori‐positive participants had a higher rate of diabetes (7.3% vs 5.2%, P < 0.001), and higher levels of fasting plasma glucose (5.36 ± 1.12 mmol/L vs 5.28 ± 0.95 mmol/L, P < 0.001) and glycated hemoglobin A1c (5.63 ± 0.68% vs 5.57 ± 0.60%, P < 0.001) than the H. pylori negative group. Multivariate regression analyses showed that H. pylori infection was positively related to diabetes (odds ratio 1.25, 95% confidence interval 1.15–1.35). Among the H. pylori‐positive participants, the elevated levels of fasting plasma glucose and glycated hemoglobin A1c were 0.033 mmol/L (95% confidence interval 0.016–0.049 mmol/L) and 0.024% (95% confidence interval 0.008–0.041%), respectively. Additionally, H. pylori infection was significantly related to diabetes in participants aged ≥44 years, but not in participants aged <44 years.ConclusionsThe present study showed that H. pylori infection is associated with diabetes among Chinese adults. More attention should be paid to adults with H. pylori infection for effective prevention of diabetes.

Objective To explore the association between Helicobacter pylori (H. pylori) infection and overweight/obesity in a Chinese population. Methods This was a cross-sectional study that included all adult participants who underwent a 13C-urea breath test at the physical examination center in Tongji Hospital (Wuhan, China) in 2016. Data on demographic characteristics, anthropometric index, biochemical variables, and medical history were collected. Multivariate analyses were performed to assess the relationship between H. pylori infection and overweight/obesity, as well as body mass index (BMI). Results Of the 27 883 participants included, 17 585 were males and 10 298 were females. They were aged (43.94±11.31) years. The prevalence rate of H. pylori infection was 33.1%. The BMIs of subjects with and without H. pylori infection were (24.30±3.28) kg/m2 and (23.99±3.35) kg/m2, respectively (t=-7.28, P<0.001). After adjusting for age, sex, blood lipid levels, diabetes, and hypertension, the BMI of subjects with H. pylori infection was 0.120 kg/m2 (95% CI: 0.050-0.191, P=0.001), which was higher than that of subjects without H. pylori infection. Moreover, H. pylori infection was independently associated with a higher risk of prevalent overweight/obesity, with an odds ratio (OR) of 1.09 (95%CI: 1.03-1.16, P=0.004). The positive association between H. pylori infection and overweight/obesity was more evident among women, with an OR of 1.19 (95%CI: 1.07-1.31, P=0.001). Conclusion H. pylori infection was closely correlated with overweight/obesity. Control of H. pylori infection may be useful in reducing the heavy disease burden caused by overweight/obesity. Key words: Helicobacter pylori; Overweight; Obesity

Epidemiological studies demonstrated that Helicobacter pylori (H. pylori) infection was associated with cardiovascular disease and its risk factors. However, the association between H. pylori infection and hypertension remained unclear. The aim of this study was to investigate the association between H. pylori infection and prevalence of hypertension among Chinese adults. We performed a cross-sectional study of 5246 adult participants who were recruited from a health manage center. All participants underwent a 13C-urea breath test and a routine health check-up. Logistic and liner regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension in relation to H. pylori infection. Of the 5168 study participants aged 18–70 years, 2034 (39.4%) were females and 955 (18.5%) had hypertension. After adjustment for potential confounders, H. pylori infection was associated with an increased prevalence of hypertension (OR, 1.23; 95% CI, 1.04, 1.46). In addition, compared with participants not infected with H. pylori, those with H. pylori infection had an increase of 0.735 mmHg (95% CI, 0.101, 1.369) for diastolic blood pressure and 0.723 mmHg (95% CI, 0.034, 1.413) for mean arterial pressure. There was no significant interaction between H. pylori infection and age, sex, and body mass index on the prevalence of hypertension (all P values for interaction >0.05). Findings from this study demonstrate that H. pylori infection was positively associated with prevalence of hypertension among Chinese adults. More well-designed studies are warranted to confirm our findings.

Gut microbiota interacts with host immune system in ways that influence the development of disease. Advances in respiratory immune system also broaden our knowledge of the interaction between host and microbiome in the lung. Increasing evidence indicated the intimate relationship between the gastrointestinal tract and respiratory tract. Exacerbations of chronic gut and lung disease have been shown to share key conceptual features with the disorder and dysregulation of the microbial ecosystem. In this review, we discuss the impact of gut and lung microbiota on disease exacerbation and progression, and the recent understanding of the immunological link between the gut and the lung, the gut-lung axis.

Cirrhotic patients with dysfunctional and/or low numbers of leukocytes are often infected with bacteria, especially Gram-negative bacteria, which is characterized by producing lipopolysaccharide (LPS). Granulocyte–macrophage colony-stimulating factor (GM-CSF) is a pleiotropic cytokine that influences the production, maturation, function, and survival of various immune cells. In this paper, we reviewed not only Toll-like receptors 4 (TLR4) signaling pathway and its immunological effect, but also the specific stimulating function and autocrine performance of GM-CSF on hematopoietic cells, as well as the recent discovery of innate response activator-B cells in protection against microbial sepsis and the direct LPS–TLR4 signaling on hematopoiesis. Thus we concluded that GM-CSF might play important roles in preventing Gram-negative bacterial infections in cirrhotic patients through maintaining immune system functions and homeostasis.

Lamivudine, adefovir, telbivudine, and entecavir are nucleoside analogues that can inhibit hepatitis B virus replication and are licensed in China by the Food and Drug Administration. This study presents the cases of 2 patients who were chronically infected with HBV and suffered hepatic failure resulting from withdrawal of telbivudine and adefovir, respectively.

This study aimed to evaluate the efficacy and safety of entecavir, lamivudine and telbivudine for treating patients with HBV-ACLF and to validate the Tongji prognostic predictor model (TPPM) in these patients.

Hepatitis B-related acute-on-chronic liver failure (ACLF) has a poor prognosis with very high mortality. Unfortunately, most prognostic predictive models of liver failure are complicated and offer suboptimal sensitivity. Experience in entecavir (ETV)-treated patients with hepatitis B virus (HBV)-ACLF is limited.

An inwardly rectifying potassium channel (Kir) is a kind of protein complex that is widely expressed on excitable and nonexcitable cell membranes. Kir channels serve important roles in cellular physiology such as cell excitability and K+ homeostasis. The Kirs (KIR1-7) are regulated by many factors: phosphatidylinosital-4, 5-bisphosphate (PIP2), ATP, or G-proteins. Other factors like polyamines, kinases, pH, and Na+ ions act cooperatively to modulate Kir channels. Different types and specific distributions of KIR channels determine the diversity of regulatory mechanisms. This review provides insight into Kir channel regulation.