A coronary artery calcium (CAC) score of zero is generally considered a strong negative predictor for coronary heart disease (CHD). However, it does not exclude obstructive disease in symptomatic adults, particularly younger patients with non-calcified plaque. We evaluated whether Atherogenic Index of Plasma (AIP) and Neutrophil-to-HDL Ratio (NHR) improve identification of obstructive CHD in this population. We analyzed 362 symptomatic adults with suspected premature CHD (men < 55, women < 65 years) and CAC = 0 from an invasive angiography registry. AIP and NHR were calculated from fasting laboratory tests. The endpoint was angiographic obstructive CHD (≥ 50

The association between serum level of folate and length of hospital stay (LOS) remains unclear. Adult participants were retrospectively recruited from two teaching hospitals in Shanghai, China. Serum level of folate and vitamin C were measured within three days after hospital admission. LOS was defined as the interval between admission and discharge. Patients were classified into tertile groups based on serum level of folate to assess the association with LOS. We further re-analyzed the association between serum level of folate and LOS under different serum level of vitamin C (also divided into tertile groups). A total number of 9,645 patients were included. Each standard deviation (SD) increase in serum level of folate was associated with 0.41 d (95% CI: -0.73 d, -0.09 d) decrease in LOS in the crude model; however, it lost significance after full adjustment. Taken the interaction effect of vitamin C into consideration, serum level of folate was inversely associated with LOS in those whose serum level of vitamin C was higher than 41.6 μmol/L. Serum level of folate was inversely associated with LOS, but the association was limited to patient with high vitamin C level.

We aim to evaluate the effects of partial meal replacement (MR) with different timing of MR on body weight in Chinese adults. A multicenter open-labeled, randomized, parallel study was performed. Participants were randomly assigned to receive partial MR at breakfast and lunch or breakfast and dinner for 16 weeks. The primary outcome was the absolute change in body weight between baseline and the end of the intervention. The BMI of participants is between 24.0 kg/m2 and 35.0 kg/m2, without a history of diabetes, hypertension, or gout, and whose baseline blood pressure, fasting blood glucose, serum level of glycated hemoglobin A1c, uric acid, and liver enzymes within the pre-determined range, were recruited. A total number of 153 individuals were included in the analysis (106 females and 47 males; mean age 32.6 ± 6.7 years, mean BMI 28.5 ± 2.8 kg/m2 at baseline). Partial MR for 16 weeks resulted in significant body weight loss (−5.1 kg, 95 https://www.chictr.org.cn/showproj.html?proj=47475 (ChiCTR2100042637).

Background Glasgow Prognostic Score (GPS) is a prognostic tool that combines an inflammatory marker [C-Reactive Protein (CRP)] with a nutritional marker (serum albumin). Yet, there is few published work on the reliability of GPS in patients with haematological cancer. Methods This is a retrospective single-centre study. All the participants (n = 1,621) were adult inpatients at Ren Ji Hospital between 2018 and 2022. The GPS (CRP < 10 mg/L and albumin ≥ 35 g/L = 0; CRP ≥ 10 mg/L and albumin < 35 g/L = 2; either CRP ≥ 10 mg/L or albumin < 35 g/L = 1) and a variety of biochemical variables were examined at admission and was obtained by reviewing the medical records. GPS = 0 were classified as low-risk while GPS = 2 as high-risk. Length of hospital stay (LOS) was defined as the interval between the admission and discharge date. Results 8.8% of patients were high-risk. GPS was associated with LOS (β = 2.7 d; 95% CI: 0.8 d, 4.6 d; p trend < 0.001) after adjustment of sex, age, type of diseases, BMI, alanine aminotransferase, aspartate aminotransferase, total bilirubin, estimated glomerular filtration rate, haemoglobin, red blood cell count, white blood cell count and fasting blood glucose. Each point of GPS was associated with 1.9 days (95% CI: 1.4 d, 2.4 d) longer in LOS with full adjustment. The association was more prominent in younger patients (< 65 y), patients with leukaemia and myelodysplastic syndrome, and those with normal body weight status (18.5–24 kg/m2), compared with their counterparts. Conclusion GPS was associated with LOS in Chinese patients with haematological cancer, indicating GPS could be a useful assessment tool to predict outcome.

Background: A commercial three-dimensional optical (3DO) scanning system was reported to be used in body composition assessment. However, the applicability in Chinese adults has yet to be well-studied.Methods: This secondary analysis was based on a 16-week weight-loss clinical trial with an optional extension to 24 weeks. Waist and hip circumference and body composition were measured by 3DO scanning at each follow-up visit during the study. Bioelectrical impedance analysis (BIA) was also performed to confirm the reliability of 3DO scanning at each visit. We used Lin's concordance correlation coefficients (CCC) to evaluate the correlation between the two methods above-mentioned. Bland-Altman analysis was also performed to evaluate the agreement and potential bias between different methods.Results: A total number of 70 Chinese adults overweight and obese (23 men and 47 women, aged 31.8 +/- 5.8 years) were included in the analysis, which resulted in 350 3DO scans and corresponding 350 BIA measurements. The percent body fat, fat mass, and fat-free mass were 33.9 +/- 5.4%, 26.7 +/- 4.6 kg, and 50.3 +/- 8.7 kg before the trial by 3DO scanning. And they were 30.5 +/- 5.8%, 22.5 +/- 4.7 kg, and 49.4 +/- 8.3 kg after 16 weeks of the trial. Compared with BIA, 3DO scanning performed best in the assessment of fat-free mass (CCC = 0.89, 95%CI: 0.86, 0.90), then followed by fat mass (CCC = 0.76, 95%CI: 0.71, 0.80) and percent body fat (CCC = 0.70, 95%CI: 0.64, 0.75). Subgroup analysis showed that 3DO scanning and BIA correlated better in women than that in men, and correlated better in measuring fat-free mass in participants with larger body weight (BMI >= 28.0 kg/m(2)) than those with smaller body weight (<28.0 kg/m(2)).Conclusions: 3DO scanning is an effective technology to monitor changes in body composition in Chinese adults overweight and obese. However its accuracy and reliability in different ethnicities needs further exploration.

Objective·To evaluate the relationship between body mass index(BMI)and chronic metabolic diseases.Methods·The elderly(≥60 years old)who were underwent physical examination in the Physical Examination Center of Renji Hospital,Shanghai Jiao Tong University School of Medicine from 2014 to 2021 were studied.Their results of biochemical indicators were collected.Their height,body weight,and blood pressure were measured by trained nurses.The history of chronic metabolic diseases was collected by self-reported questionnaire.Systolic blood pressure≥140 mmHg(1 mmHg=0.133 kPa),diastolic blood pressure≥90 mmHg,or self-reported hypertension history was defined as hypertension.Fasting blood glucose≥7.0 mmol/L or self-reported history of diabetes was defined as diabetes.Total cholesterol≥6.2 mmol/L,triglyceride≥2.3 mmol/L,or self-reported history of dyslipidemia was defined as dyslipidemia.The relationship between BMI and hypertension,diabetes,and dyslipidemia was evaluated by using receiver operator characteristic(ROC)curve analysis and binary logistic regression.Results·Data of 59 083 subjects were collected[30 807 men and 28 276 women,average age:(67.9±6.3)years old].The prevalence of hypertension,diabetes and dyslipidemia was 76.5%(45 219/59 083),24.1%(14 225/59 083)and 50.0%(29 544/59 083),respectively.Compared to the elderly people aged 60‒74 years,those aged 75 years and above had a higher proportion of hypertension and diabetes,and a lower proportion of dyslipidemia and no metabolic abnormalities.With ROC analysis,the BMI cut-off values for hypertension,diabetes,and dyslipidemia were 24.3,23.9,and 23.9 kg/m2.The BMI cut-off values for hypertension and diabetes in elderly men were similar to those in elderly women(for hypertension:24.3 kg/m2 in elderly men vs 24.2 kg/m2 in elderly women;for diabetes:24.0 kg/m2 in elderly men vs 23.7 kg/m2 in elderly women);however,BMI cut-off value for dyslipidemia was obviously higher in elderly men than that in elderly women(24.0 kg/m2 in elderly men vs 22.5 kg/m2 in elderly women).The BMI cut-off value for chronic metabolic diseases was higher in the elderly people aged 60‒74 years than that in the elderly people aged 75 years and above(24.2‒24.7 kg/m2 vs 22.9‒23.8 kg/m2).Conclusion·Elderly people aged 60‒74 years should maintain the BMI below 24.0 kg/m2,while those aged 75 years and above should aim for the BMI below 23.0 kg/m2,so as to reduce the risk of chronic metabolic diseases.

Abstract Background Data is limited on the prevalence of hypophosphatemia in general hospitalized patients, and its association with length of hospital stay (LOS) and mortality remained unclear. We aimed to investigate the prevalence of admission phosphate abnormality and the association between serum phosphate level and length of hospital stay and all-cause mortality in adult patients. Methods This was a multi-center retrospective study based on real-world data. Participants were classified into five groups according to serum phosphate level (inorganic phosphorus, iP) within 48 h after admission: G1, iP < 0.64 mmol/L; G2, iP 0.64–0.8 mmol/L; G3, iP 0.8–1.16 mmol/L; G4, iP 1.16–1.45 mmol/L; and G5, iP ≥ 1.45 mmol/L, respectively. Both LOS and in-hospital mortality were considered as outcomes. Clinical information, including age, sex, primary diagnosis, co-morbidity, and phosphate-metabolism related parameters, were also abstracted from medical records. Results A total number of 23,479 adult patients (14,073 males and 9,406 females, aged 57.7 ± 16.8 y) were included in the study. The prevalence of hypophosphatemia was 4.74%. An “L-shaped” non-linear association was determined between serum phosphate level and LOS and the inflection point was 1.16 mmol/L in serum phosphate level. Compared with patients in G4, patients in G1, G2 or G3 were significantly associated with longer LOS after full adjustment of covariates. Each 0.1 mmol/L decrease in serum phosphate level to the left side of the inflection point led to 0.64 days increase in LOS [95% confidence interval (CI): 0.46, 0.81; p for trend < 0.001]. But there was no association between serum phosphate and LOS where serum levels of phosphate ≥ 1.16 mmol/L. Multivariable logistic regression analysis showed that adjusted all-cause in-hospital mortality was 3.08-fold greater in patients in G1 than those in G4 (95% CI: 1.52, 6.25; p for trend = 0.001). Similarly, no significant association with either LOS or mortality were found in patients in G5, comparing with G4. Conclusions Hypophosphatemia, but not hyperphosphatemia, was associated with LOS and all-cause mortality in adult inpatients. It is meaningful to monitor serum levels of phosphate to facilitate early diagnosis and intervention.

Objective. The association between vitamin D status and inflammation remains unclear in hospitalized patients. Materials and Methods. We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12–20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. Results. A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m2, respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 109/mL (95% CI: 0.2 × 109/mL, 0.06 × 109/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m2, those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. Conclusions. The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection.

Background and Objectives: Patients with inflammatory bowel disease ( IBD) are more likely to be confirmed with vitamin D deficiency. However, the association between inflammation and vitamin D remains unclear. The purpose of this study was to evaluate the association between inflammation and vitamin D in hospitalized patients with IBD. Methods and Study Design: All the participants were recruited from one teaching hospital from June 2018 to October 2022. Inflammation was evaluated by serum concentration of C-reactive protein (CRP), using an immunoturbidimetric method at admission. We further divided the participants into five groups based on serum CRP levels: <5, 5-9.9, 10-19.9, 20-39.9, and >40mg/L. Serum 25-hydroxy-vitamin D (25-(OH)-D) was assessed by liquid chromatography tandem mass spectrometry. Additional information, including age, sex, body mass index (BMI), IBD (ulcerative colitis vs. Crohn's disease) subtype, was abstracted from medical records. Results: This study included 1,989 patients with IBD (average age was 39.4 years, 33.8% of them were women, 1,365 CD and 624 UC patients). The median CRP was 5.49 mg/L (range of quartiles: 1.64 similar to 19.5 mg/L) and the prevalence of 25-(OH)-D deficiency was 69.8%. CRP was significantly associated with serum level of 25-(OH)- D. The difference in 25-(OH)-D was -4.28 ng/ml (-5.27 ng/ml, -3.31 ng/ml) between two extremist CRP groups after adjustment of potential covariates (age, sex, BMI, type of IBD, dietary type, season, and lymphocyte count). Subgroup analysis in sex, type of IBD, and age, were similar to the main analysis results. Conclusions: There was a negative association between CRP levels and vitamin D in hospitalized patients with IBD.

Abdominal aortic aneurysm (AAA) is characterized by localized structural deterioration of the aortic wall, leading to progressive dilatation and rupture. Protease activated receptor 2 (PAR2) dependent signaling has been implicated in the pathophysiology of atherosclerosis through the regulation of smooth muscle cell function. However, its role in AAA remains unclear. This study investigates the function and potential mechanism of PAR2 in AAA progression. Angiotensin II (Ang II) and β-aminopropionitrile (BAPN) were administered to wild type (WT) mice to induce AAA. Increased PAR2 expression was observed in the aneurysmal tissues of these mice and in Ang II-treated vascular smooth muscle cells (VSMCs). We demonstrated that PAR2 deficiency markedly inhibited aorta dilatation and vascular remodeling in the AAA model relative to WT mice. Immunohistochemical staining showed significant upregulation of contractile markers and a reduction in synthetic markers in PAR2 knockout mice. Consistent with in vivo results, PAR2 knockdown diminished the effects of Ang II on VSMCs phenotypic switching, resulting in reduced proliferation and migration. Conversely, a PAR2 agonist (SLIGRL) induced the opposite effect, which was partially mitigated by pretreatment with an extracellular signal-regulated kinase (ERK) inhibitor (PD98059). This study suggests that PAR2 deficiency restrains aortic expansion and mitigates adverse vascular remodeling in AAA models, mediated in part by the ERK signaling pathway, indicating that PAR2 could be a potential therapeutic target for mitigating AAA development or progression.

Background:The impact of quarantine-induced changes in dietary behavior on weight gain remained unclear. This study aimed to evaluate the association between changes in dietary behavior and body weight during quarantine and to identify the risk factors of weight gain. Methods:This was a pilot observational cross-sectional study. All the potential participants were those who underwent body weight management program in one teaching hospital in China from 26th April 2021 to 31st March 2022. An online self-reported questionnaire was sent to collect information on sex, age, self-reported body weight before and after quarantine, dietary quality, meal time, food consumption, physical activities, and sleep quality. Weight gain was defined as an increase of 1 kilogram or more. The study has been performed in accordance with the Declaration of Helsinki and approved by the Ethics Committee (KY2020-204). The participants were informed about the objectives of the study and electronic informed consent was obtained from each participant. Results:Finally, 79 participants (22.8% male and 77.2% female, aged 33.3 ± 7.1 years) was included in the analysis. During quarantine, the mean body weight gain was 0.8 (interquartile range: -1.0~3.0) kg. The proportion of weight gain among the participants was 45.6%. Increased cooked white rice (OR=16.93; 95% CI: 2.66-108.00), convenient food (OR=11.69; 95% CI: 2.00-68.26), and snack consumption (OR=5.56; 95% CI: 1.08-28.56), delayed dinner time (OR=6.64; 95% CI: 1.20-36.74) and house working time less than 30 minutes (OR=12.80; 95% CI: 2.01-81.44) were risk factors for body weight gain. Conclusion:During the quarantine, weight gain was observed even in participants who were previously on body weight management. Increased consumption of cooked white rice, convenient food, and snack, as well as delayed dinner time and reduced house working time (less than 30 minutes), were found to be associated with body weight gain.

目的 比较多学科合作(multi-disciplinary team,MDT)联合以问题为基础的(problem based learning,PBL)的整合教学法与传统教学法(lecture based learning,LBL)在心血管内科临床实习教学中的差别.方法 入选2018年1月～2020年1月在上海交通大学医学院附属第九人民医院心血管内科实习的80名临床五年级本科生,随机分为研究组(MDT联合PBL教学)及对照组(LBL教学).教学结束后对两组学生分别进行理论知识、临床病例分析以及教学满意度评价.结果 研究组学生理论知识、病例分析的成绩均高于对照组(P＜0.05).满意度问卷调查结果显示,研究组在增加学习兴趣、培养临床思维、教学新颖程度、提高人文素养以及整体满意度5个方面评分高于对照组.结论 MDT联合PBL教学模式在提升理论知识以及临床思维等方面优于LBL教学法,学生整体满意度更高.

目的:探讨沙库巴曲缬沙坦钠联合呋塞米治疗高血压伴慢性心力衰竭(CHF)的疗效及对心功能、炎症因子水平的影响.方法:选择2021 年3 月至2022 年 3 月我院收治的 100 例高血压伴CHF患者展开研究,用简单随机数字表法将其分为观察组和对照组,每组各50 例.对照组患者给予呋塞米治疗,观察组患者给予沙库巴曲缬沙坦钠+呋塞米联合治疗.治疗 3 个月后,比较两组患者临床疗效.记录患者治疗前后心功能[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)]、血压(舒张压、收缩压、心率)、血清炎症因子[N末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)、血清肿瘤坏死因子-α(TNF-α)、心肌肌钙蛋白I(cTnI)]水平变化,记录两组患者不良反应.结果:观察组患者治疗总有效率为96.00%,高于对照组的 80.00%(P＜0.05).治疗后,两组患者的LVEDD、LVESD水平均降低,观察组患者降低幅度大于对照组;两组患者LVEF水平均升高,观察组患者升高幅度大于对照组(P＜0.05).治疗后,两组患者的舒张压、收缩压、心率均降低,且观察组患者的降低幅度大于对照组(P＜0.05).治疗后,两组患者血清NT-proBNP、CRP、cTnI、TNF-α指标水平均降低,且观察组患者的降低幅度大于对照组(P＜0.05).两组患者不良反应发生率差异无统计学意义(P＞0.05).结论:沙库巴曲缬沙坦钠联合呋塞米治疗高血压伴CHF效果理想,可有效改善患者心功能,有效降低血清炎症因子水平,且不会增加不良反应.

Hypophosphatemia might cause respiratory and heart failure and even death. We aimed to evaluate risk factors for hypophosphatemia and refeeding-related hypophosphatemia in patients requiring parental nutrition (PN). This was a single-center, retrospective study. Clinical parameters were obtained from medical records. Serum phosphate (inorganic phosphorus) was measured by photometric analysis. Hypophosphatemia was confirmed when serum phosphate level was less than 0.8 mmol/L (≈2.5 mg/dl). Refeeding related hypophosphatemia was confirmed if serum phosphate level had a decrease of 0.16 mmol/L or more from baseline and if the final assessment was below 0.65 mmol/L. A total number of 655 (426 men and 229 women, aged 62.8 ± 14.8 years) hospitalized patients requiring PN were included in the study, and 60.6% of them were patients with cancer. The average body mass index (BMI) was 21.1 ± 4.1 kg/m2 and the median of serum phosphate was 0.9 mmol/L (quartile range: 0.68 mmol/L, 1.11 mmol/L). The prevalence of hypophosphatemia was 37.6% (246/655). Older age (≥ 65 years vs. < 65 years), lower serum level of pre-albumin (< 160 mg/L vs. ≥ 160 mg/L), calcium (< 2.11 mmol/L vs. ≥ 2.11 mmol/L), and magnesium (< 0.75 mmol/L vs. ≥ 0.75 mmol/L) were associated with high risk of hypophosphatemia by multivariate logistic regression (OR ranged from 1.43 to 3.06, all p < 0.05). Refeeding related hypophosphatemia was 9.5% (16/168). Serum level of calcium at baseline was significantly lower in participants with refeeding related hypophosphatemia than those without it. Total calorie and nitrogen delivered during first week of PN period showed no obvious difference between patients with and without refeeding related hypophosphatemia. Hypophosphatemia is common (37.6%) in hospitalized patients requiring PN. Monitoring of serum level of phosphorus is necessary to facilitate early treatment of hypophosphatemia.

Existing evidence has indicated a role of inflammation in the development of carotid artery plaque (CAP). We thus evaluated the association between inflammation and CAP in a population with normal body weight and metabolically healthy status. A total of 8050 normal-body-weight and metabolically healthy participants (2613 men and 5437 women, aged 40.5 ± 11.3 y) were included in this study. Inflammatory status was evaluated by three parameters: serum hs-CRP (high-sensitivity C-reactive protein), WBC (white blood cell) count, and NLR (neutrophil-to-lymphocyte ratio). CAP was detected by ultrasound B-mode imaging. Clinical data were abstracted from medical records. Metabolically healthy status was defined as no history of metabolic diseases and normal blood pressure, fasting blood glucose level, hemoglobin A1c level, lipid profile, and liver ultrasonographic findings. The serum level of hs-CRP, but not WBC or NLR, was associated with the risk of CAP after adjustment for age, sex, BMI, blood pressure, fasting blood glucose, glycated hemoglobin A1c, lipid profile, and estimated glomerular filtration rate. The adjusted odds ratio for the risk of CAP was 2.71 (1.64, 4.46) for participants with a high level of hs-CRP (≥3 mg/L), compared with those with a low level (<1 mg/L). Each unit increase in hs-CRP was associated with a 24% higher risk of CAP (OR = 1.24; 95% CI: 1.12, 1.37). Inflammation was associated with the risk of CAP even in individuals with a normal body weight and metabolically healthy status.

Background and objective Patients on parenteral nutrition (PN) are at high risk of both liver and pancreatic injury. More efforts were focused on liver, however, limited data is available to evaluate the effects of PN on pancreas. Thus, we performed a retrospective observational study to evaluate the association between PN and pancreatic injury in Chinese adult patients. Methods Adult patients (18–80 years), who received PN for a week or longer, and with repeated measurements of pancreatic enzymes, were included in the analysis. Pancreatic injury was confirmed by serum level of pancreatic amylase (P-AMYwas 53 U/L or higher) or lipase (LP was 63 U/L or higher), which were evaluated at baseline and following every week during PN duration. Age, sex, body weight, height, diagnosis of diseases, history of diseases, surgery, white blood cell, c-reactive protein, liver and renal function, fasting blood glucose, lipid profile, and daily energy supplied by PN and enteral nutrition were abstracted from medical records. Results A total number of 190 adult patients (125 men, 65 women) were included in the study. The average age and BMI were 61.8 ± 13.0 years and 21.7±3.3 kg/m 2 , while medium serum level of P-AMY and LP were 29.0 U/L (quartile range: 18.0, 47.0) and 33.0 U/L (quartile range: 19.0, 58.0), respectively at baseline. The median duration of PN was 15 days (quartile range: 11.0, 21.0). The prevalence of pancreatic injury was 42.1% (80/190) while it was 28.4% (54/190), 43.3% (77/178), 47.8% (44/92) after one-, two-, and three-week or longer PN adminstration. The proportion of daily energy supplement by PN (OR = 3.77, 95%CI: 1.87, 7.61) and history of infection were positively (OR = 3.00, 95%CI: 1.23, 7.36), while disease history for diabetes mellitus (OR = 0.38, 95%CI: 0.15, 0.98) and cancer (OR = 0.46, 95%CI: 0.23, 0.95), were negetively associated with pancreatic injury. Total bile acids were associated with the increment of P-AMY (beta = 0.98, 95%CI: 0.39, 1.56) and LP (beta = 2.55, 95%CI: 0.98, 4.12) by multi-variate linear regression. Conclusion PN was associated with pancreatic injury, as demonstrated by the increase of both serum P-AMY and LP.

目的:检索国内外文献,综合分析家庭食物环境与儿童肥胖的关系,为儿童肥胖的预防和治疗提供依据.方法:维普数据库、万方数据库、中国期刊网、Pubmed、Medline、Cochrane Library检索1998-2020年国内外公开发表的(国内限核心期刊)的相关研究文献,语种限定为中文和英文.结果:共检索出文献144篇,共纳入8篇文献作为本研究的主要证据,综合评价家庭食物环境与儿童肥胖的关系.家庭食物环境包括家庭食物可及性、家庭共餐情况、家庭成员营养素养等.塑造健康的家庭食物环境有益于儿童青少年形成健康的饮食习惯、维系合理体重.结论:良好的家庭食物环境有利于塑造儿童健康的饮食行为,但对儿童体重和肥胖发生率的影响尚缺乏足够的证据.

BackgroundBody mass index (BMI) is the most widely used parameter to assess the body weight status. Both the increase of BMI (overweight and obesity) and decrease of BMI (underweight) has been associated with high risk of adverse outcome, such as stroke, disability, and even death. However, recent data on secular differences in BMI in the Chinese aged population are limited. The present study provides robust new evidence about the evolving epidemic of obesity among aged adults in China.ObjectiveEvaluating secular difference in BMI in a group of Chinese older adults.Materials and MethodsWe analyzed 7 continuous survey years (2014–2020), including 50,192 Chinese aged participants (25,505 men and 24,687 women, aged 71.9 ± 6.1 years, age range: 65–99 years). Information on sex, age, height, and body weight, was collected based on medical history. Participants were classified into four groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 kg/m2 ≤ BMI < 25 kg/m2), overweight (25 kg/m2 ≤ BMI < 30 kg/m2), and obesity (BMI ≥ 30 kg/m2). Linear regressions were used to assess the secular difference in BMI. Sex and age differences were also evaluated by stratified analyses.ResultsFrom 2014 to 2020, age-adjusted mean BMI increased by 0.3 kg/m2 (95% CI: 0.1, 0.5 kg/m2) in men, and 0.5 kg/m2 (95% CI: 0.2, 0.7 kg/m2) in women. Age-standardized prevalence of underweight decreased from 3.0 to 2.3% in men, and from 3.0 to 2.1% in women. Age-standardized prevalence of overweight increased in both men (from 40.1 to 41.7%) and women (from 37.8 to 39.8%), and so as obesity (men: from 4.1 to 6.1%; women: from 5.8 to 8.7%).ConclusionOur results confirmed that BMI gradually increased from 2014 to 2020. The age-adjusted mean BMI increased by 0.3 kg/m2 in older men, and 0.5 kg/m2 in older women. The age- and sex-standardized prevalence of overweight and obesity significantly increased, especially in 70–79-year age group, while the prevalence of underweight decreased. The combination of a balanced-diet and physical exercise is needed to maintain optimal BMI range for the aged population.

Background:Cholesterol crystals (CCs) in lesions are the hallmark of advanced atherosclerotic plaque. Previous studies have demonstrated that CCs could activate NLRP3 inflammasome, which played an important role in atherosclerotic lesion progression. However, the relationship between CCs, NLRP3 inflammasome pathway, and plaque vulnerability in patients with ACS is still not elucidated.Methods:Two hundred sixty-nine consecutive acute coronary syndrome (ACS) patients with 269 culprit lesions were included in this study. CCs and other plaque characteristics within the culprit lesion segment were evaluated by optical coherence tomography (OCT) before percutaneous coronary intervention (PCI). The NLRP3 mRNA expression in peripheral blood mononuclear cells (PBMCs) and the serum levels of interleukin (IL)-1β, IL-18, and other biological indices were measured.Results:Cholesterol crystals were observed in 105 (39%) patients with 105 culprit lesions. There were no significant differences in baseline clinical characteristics between the patients with CCs (CCs group, n = 105) and the patients without CCs (non-CCs group, n = 164) within the culprit lesion segment except for lipoprotein(a) [Lp(a)]. The CCs group had a higher level of NLRP3 mRNA expression in PBMCs and higher levels of serum cytokine IL-1β and IL-18. OCT showed that the CCs group had longer lesion length, more severe diameter stenosis, and less minimum luminal area (MLA) than the non-CCs group (all p < 0.05). The frequency of thin-cap fibroatheroma (TCFA), thrombus, accumulation of macrophages, plaque rupture, micro-channel, calcification, spotty calcification, and layered plaque was higher in the CCs group than in the non-CCs groups (all p < 0.05). Multivariate logistic analysis revealed that the level of NLRP3 expression (OR = 10.204), IL-1β levels (OR = 3.523), IL-18 levels (OR = 1.006), TCFA (OR = 3.593), layered plaque (OR = 5.287), MLA (OR = 1.475), macrophage accumulation (OR = 2.881), and micro-channel (OR = 3.185) were independently associated with CCs.Conclusion:Acute coronary syndrome patients with CCs in culprit lesions had a higher expression of NLRP3, IL-1β, and IL-18, and had more vulnerable plaque characteristics than patients without CCs. CCs might have interacted with NLRP3 inflammasome activation in patients with ACS, which could contribute to plaque vulnerability in culprit lesions.

目的 拟探讨老年人体质量指数(body mass index,BMI)与高血压发生风险的关系,为老年人适宜BMI范围制定提供参考.方法 收集上海交通大学医学院附属仁济医院体检中心老年研究对象(≥60岁)共9474例资料,其中男性5337例,女性4137例.所有研究对象均随访5年.基线资料为2014年的身高、体质量,计算体质量指数(body mass index,BMI).根据基线BMI将所有老年研究对象分为5组:BMI<18.5 kg/m2组,BMI 18.5～22.9 kg/m2组,23.0～24.9 kg/m2组,25.0～29.9 kg/m2组和BMI≥30.0 kg/m2组.调查问卷法收集既往慢性疾病史(高血压、糖尿病、脂代谢异常).收集基线收缩压、舒张压、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白和肾小球滤过率数据.随访期间每年测量收缩压和舒张压.收缩压≥140 mmHg(1 mmHg=0.133 kPa)和(或)舒张压≥90 mmHg认定为高血压.采用Cox比例风险回归模型评估基线BMI与高血压发生风险的关系.结果 随访5年期间新发高血压2138例.调整年龄、性别、糖代谢、脂代谢和肾小球滤过率后发现,以BMI为18.5～22.9 kg/m2的老年人群为对照,BMI<18.5 kg/m2组,23.0～24.9 kg/m2组,25.0～29.9 kg/m2组,≥30.0 kg/m2组高血压发生风险的HR值分别为0.65(95％CI:0.48～0.88),1.23(95％CI:1.10～1.38),1.47(95％CI:1.32～1.63)和1.85(95％CI:1.44～2.38).BMI每增加1.0 kg/m2,高血压发生风险增加7％(HR:1.07;95％CI:1.06～1.09,P<0.001).男女分组的结果与总人群趋势一致.排除60～65岁、糖代谢异常、脂代谢异常的老年人进行敏感性分析得到的结果与主效应分析一致.结论 老年人BMI升高可明显增加高血压发生风险.为降低老年人群发生高血压的风险,建议将体质量控制在正常范围.