Objective To investigate the correlation between sarcopenia and H-type hypertension in the elderly.Methods A total of 409 elderly patients（age≥60 years） in Geriatric medicine Center, geriatric outpatient clinic and physical examination center of Inner Mongolia Autonomous Region People’s Hospital from December 2021 to October 2022 were selected. According to the diagnostic criteria of hypertension, they were divided into geriatric hypertension group and geriatric non-hypertension group. According to homocysteine measurement, elderly hypertension was divided into H-type hypertension group and non-H-type hypertension group. The number of patients with sarcopenia, general data and biochemical indexes of the two groups were statistically analyzed. To explore whether sarcopenia is an independent risk factor for H-type hypertension in the elderly by regression analysis.Results（1）The number of elderly patients with hypertension combined with sarcopenia was higher than that of non-hypertension group, and the difference was statistically significant（P＜0.05）.（2）The number of elderly patients with H-type hypertension combined with sarcopenia was higher than that of non-H-type hypertension group, and the difference was statistically significant（P＜0.05）.（3）There were more males than females in the H-type hypertensive sarcopenia group（P＜0.05）.（4）Hcy and CysC in the elderly H-type hypertension group were higher than those in the non-H-type hypertension group, and the differences were statistically significant（P＜0.05）.（5）The muscle mass, ASM, ASMI and grip strength of the left and right arms, left and right legs in the H-type hypertensive sarcopenia group were lower than those in the non-sarcopenia group（P＜0.05）.（6）Spearman correlation analysis showed that sarcopenia and CysC were positively correlated with H-type hypertension（P＜0.05）. logistic regression analysis showed that sarcopenia and CysC were risk factors for H-type hypertension in the elderly（P＜0.05）.Spearman correlation analysis showed that Hcy and male were positively correlated with H-type hypertension combined with sarcopenia（P＜0.05）.logistic regression analysis showed that Hcy and male were risk factors for H-type hypertension combined with sarcopenia（P＜0.05）.Conclusion Sarcopenia is a risk factor for H-type hypertension in the elderly. Hcy is a risk factor for sarcopenia in elderly patients with H-type hypertension.

慢性心力衰竭是各种心血管疾病的终末期,其中射血分数保留性心衰占比大于50％,且随着年龄的增加发病率增加.肌少症是增龄相关性疾病,以肌肉质量的减少和肌力下降为主.越来越多的研究表明,射血分数保留性心衰与肌少症的发生相关,如年龄、缺乏运动、炎症、激素等.当射血分数保留性心衰与肌少症同时存在时可加重患者的病情,降低生活质量,致残、致死率增加.目前治疗手段通过药物控制心衰,同时通过运动、营养支持等治疗来阻止疾病的进展.本文就心力衰竭与肌少症的相关研究进展进行综述.

H型高血压是一种伴有血浆同型半胱氨酸(Hcy)升高的原发性高血压,在老年人群中较为多见.高血压和Hcy均是心脑血管疾病的独立危险因素,两者叠加可增加心脑血管疾病的发生风险.肌少症是随着年龄增长出现的一种进行性和全身性骨骼肌疾病,主要表现为肌肉量减少、肌力下降及躯体功能减退,也是人体衰老的重要标志.有研究发现,肌少症可增加心血管疾病的再住院率和死亡率,已成为老年人不容忽视的问题.越来越多的研究发现,肌少症与高血压之间存在相关性,但国内外关于老年H型高血压与肌少症方面的研究甚少,本文就老年H型高血压与肌少症的研究进展做一综述.

目的 探讨老年人肌少症性肥胖与高血压的相关性,为临床防治老年高血压提供参考.方法 选择2018年1月—2021年1月在内蒙古自治区人民医院老年医学中心住院的老年患者210例,其中高血压134例(63.81％),非高血压76例(36.19％),分别测定2组患者身高、体重、四肢骨骼肌肉量(ASM)、握力、血糖、血脂、肝肾功能,计算体重指数(BMI)及四肢骨骼肌质量指数(RSMI),并进行比较分析.结果 高血压组ASM、RSMI低于非高血压组[(14.90±3.38)kg vs.(19.41±1.56)kg,P＜0.001;(5.59±1.37)kg/m2 vs.(7.ll±0.84)kg/m2,P＜0.001].高血压组年龄和 BMI 高于非高血压组[(72.79±7.20)岁 vs.(70.79±6.51)岁,P=0.046;25.66±3.48 vs.24.46±2.81,P=0.011].高血压组肌少症及肌少症性肥胖患病率均高于非高血压组(67.91％vs.38.16％,P＜0.001;25.37％vs.2.63％,P＜0.001).多因素logistic回归分析显示,高龄、肌少症、肌少症性肥胖为老年高血压的危险因素.结论 ASM与老年高血压密切相关,高ASM是老年高血压的保护性因素,肌少症性肥胖、肌少症是老年高血压的重要危险因素.

目的:探讨肌肉减少症(简称肌少症)与蒙古族、汉族老年冠心病的相关性.方法:选取2018-08～2020-11在内蒙古自治区人民医院老年医学中心、心内科住院及体检中心的老年患者(年龄≥60岁)509例,根据民族及冠脉病变情况分为蒙古族老年冠心病组、汉族老年冠心病组和蒙古族老年非冠心病组、汉族老年非冠心病组,比较蒙古族老年冠心病与汉族老年冠心病肌少症的发病人数及一般资料、生化指标进行统计学分析.结果:(1)蒙、汉族老年冠心病组肌少症的发病人数高于非冠心病组,差异有统计学意义(P<0.001);(2)蒙古族老年冠心病组肌少症的发病人数高于汉族组,差异有统计学意义(P=0.029);(3)蒙古族老年冠心病组不同年龄亚组中,男性较女性合并肌少症人数多,差异有统计学意义(P<0.05);(4)蒙古族老年冠心病组合并肌少症的年龄早于汉族组(P=0.019),且蒙古族老年冠心病肌少症组的GLU、TC、LDL-C水平均高于汉族组,差异均有统计学意义(P<0.05);(5)蒙古族老年冠心病组的左、右手臂和左、右腿肌肉量均低于汉族组,差异均有统计学意义(P<0.001);(6)logistic回归分析发现肌少症(P<0.001)是蒙、汉族老年冠心病的危险因素.结论:(1)肌少症为蒙、汉族老年冠心病的危险因素,蒙、汉族老年冠心病患者较非冠心病患者合并肌少症人数多;(2)蒙古族人特殊的生活饮食习惯导致其冠心病患病率较汉族高,且冠心病患者合并肌少症人数较汉族多.

Background Recent studies have shown that the gut microbiota is closely related to the pathogenesis of Inflammatory Bowel Disease (IBD), but the causal nature is largely unknown. The purpose of this study was to assess the causal relationship between intestinal bacteria and IBD and to identify specific pathogenic bacterial taxa via the Mendelian randomization (MR) analysis. Materials and Methods MR analysis was performed on genome-wide association study (GWAS) summary statistics of gut microbiota and IBD. Specifically, the TwinsUK microbiota GWAS (N = 1,126 twin pairs) was used as exposure. The UK inflammatory bowel disease (UKIBD) and the Understanding Social Program (USP) study GWAS (N = 48,328) was used as discovery outcome, and the British IBD study (N = 35,289) was used as replication outcome. SNPs associated with bacteria abundance at the suggestive significance level (α = 1.0 × 10–5) were used as instrumental variables. Bacteria were grouped into families and genera. Results In the discovery sample, a total of 30 features were available for analysis, including 15 families and 15 genera. Three features were nominally significant, including one family (Verrucomicrobiaceae, 2 IVs, beta = −0.04, p = 0.05) and two genera (Akkermansia, 2 IVs, beta = 0.04, p = 0.05; Dorea, 2 IVs, beta = −0.07, p = 0.04). All of them were successfully replicated in the replication sample (Verrucomicrobiaceae and Akkermansia Preplication = 0.02, Dorea Preplication = 0.01) with consistent effect direction. Conclusion We identified specific pathogenic bacteria features that were causally associated with the risk of IBD, thus offering new insights into the prevention and diagnosis of IBD.

肌肉减少症(简称肌少症)是老年人脆弱、残疾和死亡的强有力预测因子,可影响老年病人免疫、运动和生活能力.国际老年肌少症工作组普遍认为,应通过测量肌肉质量和肌肉力量的综合方法来确定肌少症,因此我们要清楚哪些指标需要测量、如何测量以及需要达到什么样的水平以诊断肌少症.对明确诊断肌少症的病人做出早期干预措施,有助于优化病人的生活质量、改善预后及降低病死率.

人口老龄化的大趋势使得与增龄相关的生理改变及疾病日益被人们重视,少肌症是前些年被忽视却又给老年人的日常生活带来极大不便的增龄性老年综合征.近年来的研究表明少肌症与老年人的心血管疾病诱因的相关性,本文将从基因水平寻找少肌症与心血管疾病的相关性.

肌肉减少症是机体在年龄增加过程中出现的进行性、广泛性骨骼肌肌量、肌力及功能下降进而引起残疾、生活质量下降或死亡等不良结局的综合征.骨骼肌是人体最重要的运动器官和能量代谢组织,慢性阻塞性肺病(COPD)病人由于疾病的消耗、营养与运动不足,以及高龄等原因,肌肉减少症患病风险较高.本文就COPD与肌肉减少症的相关性研究进展进行综述.

少肌症是指与年龄增长相关的肌肉质量与功能流失,它与心血管疾病常伴随存在.近年的研究表明,除高血脂、糖尿病、肥胖、吸烟等传统危险因素外,少肌症可能是引起心血管疾病的危险因素之一且参与了心血管疾病的发生、发展.我国老龄人口众多,少肌症这种新的老年综合征值得探索与重视,预防治疗少肌症不仅使少肌症病人受益,而且可使心血管疾病病人在一定程度上病情减轻.文章就少肌症与心血管疾病的相关性研究进展做一综述.

目的 本研究测定了老年高血压患者和健康老年人的血浆同型半胱氨酸水平,确定Hcy对老年高血压的影响,分析可能影响老年高血压患者血浆Hcy水平的因素.方法 选择2016年1月至2017年1月在老年病科入院的老年高血压患者119例(收缩压>140mmHg,舒张压>90mmHg)和113例健康人为病例组和对照组,收集身高、体重、性别、年龄、血液标本、脑血管病病史、冠心病病史、吸烟史情况;采用荧光标记免疫检测法测定血浆同型半胱氨酸水平;放射免疫检测法测定血浆维生素B12(VitB12)及叶酸水平;采用Cobas6000测定血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血尿酸(UA)、血糖的水平.结果 ①与对照组相比,病例组的吸烟史、冠心病病史、BMI、Hcy、TC、TG、LDL、HDL、血糖、UA存在显著性差异,老年高血压患者的BMI、Hcy、TC、TG、LDL、血糖、UA水平高于正常对照组,而叶酸、维生素B12、HDL低于正常对照组.②高血压危险因素的logestic回归分析表明:年龄、BMI、HCY升高、TG升高、LDL升高、HDL降低、UA升高为高血压的危险因素;血清Hcy水平的Peason相关性分析:Hcy水平与VitB12、叶酸、HDL水平呈负相关;与TC、TG、LDL、年龄、血糖具有一定正相关关系.结论 同型半胱氨酸水平升高与老年人群的高血压有关,是老年高血压患者的独立危险因素;老年高血压患者的Hcy水平与VitB12、叶酸、HDL(r=-0.524)水平呈负相关;与TC、TG、LDL、年龄、血糖正相关.

The late cornified envelope (LCE) gene cluster is located on chromosome 1q21, including LCE1-LCE6. Several single nucleotide polymorphisms (SNPs) in the LCE cluster were associated with susceptibility to psoriasis in Chinese population. However, there is no report on the relationship in ethnic minority areas in China. This study aimed to investigate the association between the gene polymorphisms of LCE1B, LCE1C, LCE3A, LCE3D and psoriasis vulgaris among Mongolians from Inner Mongolia. Totally, 305 Mongolians with psoriasis vulgaris (PsV) and 383 healthy controls were enrolled in the study from 2006 to 2015. 7 SNPs including rs6701216, rs4112788, rs12023196, rs512208, rs4845454, rs4085613 and rs1886734, were selected for genotyping with ligase detection reaction (LDR). Statistical analysis was performed for comparisons of allele frequencies and genotype frequencies between the patient group and the control group. In this study, excluding rs4085613 and rs1886734, differences were detected in the allele frequencies of other 5 SNPs between the patients and controls. Genotype analysis showed that under the recessive inheritance model, the genotype frequencies of rs4845454, rs4112788 differed between the patients and controls (all p < 0.00 5).Under the dominant and the recessive model, the genotype frequencies of rs6701216, rs12023196 and rs512208 significantly differed between the patients and controls. The LD analysis showed that strong LD existed between rs6701216 and rs12023196, rs4845454 and rs4085613, rs4845454 and rs1886734, and rs4085613 and rs1886734. The SNPs rs6701216, rs4112788, rs12023196, rs512208 and rs4845454 in the LCE gene were associated with psoriasis vulgaris among Mongolians from Inner Mongolia.

Objective To investigate the prevalence of key chronic diseases(hypertension,diabetes and hyperlipidemia)and the demand for health intervention in the middle-aged and elderly populations in Inner Mongolia,and provide a theoretical basis for the health management of chronic diseases.Methods A total of 924 middle-aged and elderly people undergoing physical examinations in the People's Hospital of the Autonomous Region(January to December,2016)were enrolled.A questionnaire was completed before the physical examination to get each subject's health follow-up requirements.Retrospective analysis was performed on physical examination results and health follow-up requirements.Results The prevalences of hypertension,diabetes and hyperlipidemia were 41.3％,18.3％and 49.9％in the 924 subjects,all of which were higher than the national average.For subjects of 80 years or older,the prevalences of hypertension,diabetes and hyperlipidemia were positively correlated with age.For subjects of 40 to 60 years old,the prevalences of hypertension and diabetes were significantly higher in men than in women,but the prevalence of hyperlipidemia was much higher in women instead,regardless of age.Analysis of questionnaire showed that the demand for health management increased with age.The demand was lowest in people of 40-60 year old,achieving only 12％;the demand was highest in people over 80,reaching 70.4％.Conclusion The prevalence of key chronic diseases in the middle-aged and elderly population in Inner Mongolia is higher than the national average.Health management of chronic diseases in the population should be strengthened.The awareness of active health care under 60 years of age is weak,which is the key population for individualized health management of chronic diseases.

Objective To study the relationship between sarcopenia and hypertension in elderly subjects.Methods One hundred and ninety-seven elderly patients aged ≥65 years were divided into hypertension group (n=125) and control group (n=72).Their body height,BMI,skeletal muscle mass of extremities,serum blood glucose and lipid levels were measured,and their hepatic and renal functions were tested.Results The skeletal muscle mass and relative skeletal muscle mass index of extremities were significantly lower in hypertension group than in control group (14.62±3.25 kg vs 19.25±1.41 kg,P=0.000;5.52±1.37 kg/m2 vs 7.10±0.85 kg/m2,P=0.000).The prevalence of sarcopenia was significantly higher in hypertension group than in control group and in males than in females (72.0％ vs 47.2％,P=0.001;91.30％ vs 38.10％,P=O.000).Multivariate logistic regression analysis showed that sarcopenia,female,age were the risk factors for hypertension in elderly subjects (OR=23.32,95％CI:5.349-101.632,P=0.000;OR=19.40,95％ CI:4.438-84.794,P=0.000;OR=1.38,95％CI:1.034-1.837,P=0.029).Conclusion Hypertension is closely related with skeletal muscle mass of extremities in elderly subjects.Sarcopenia is easy to occur in elderly males and is a risk factor for hypertension.

目的 探讨老年冠心病与少肌症的相互关系,为临床冠心病的防治工作开拓新的思路.方法 随机选取109例心内科拟诊为冠心病的胸痛患者,根据冠状动脉造影检查结果,分为冠心病组及非冠心病组;根据双能X线骨密度检查结果分为少肌症组与非少肌症组,比较男性及女性少肌症组与非少肌症组之间的冠心病发病率的差异,进一步比较两组间的冠脉粥样硬化情况,分析肌肉量各个测定部位在冠心病预测中的意义.结果 ①男性少肌症组与非少肌症组相比,两组间的冠心病发病率差异无统计学意义(P=0.64,P>0.05)②女性少肌症组与非少肌症组相比,前者的冠心病发病率高于后者,两组间的冠心病发病率差异有统计学意义(P=0.01,P<0.05);③女性冠心病患者中少肌症组与非少肌症组间冠脉硬化轻重度发病率比较,少肌症组的冠脉硬化严重程度较非少肌症组发病率高,两组间的冠脉硬化轻重度发病率有统计学意义(P=0.03,P<0.05);④女性冠心病与相关因素的logistics回归分析结果发现少肌症为影响冠心病危险因素(P=0.043,P<0.05);⑤女性少肌症组冠脉GS评分轻、重度间身体各个部位肌肉量比较无统计学意义(P>0.05).结论 男性患者冠心病与少肌症无明显相关性;在女性少肌症的冠心病发病率高于非少肌症组,少肌症在冠心病的发病中占重要的地位.

Excess energy intake,physical inactivity,low-grade inflammation,insulin resistance and changes in hormonal milieu may lead to the development of so called 'sarcopenic obesity'. Sarcopenia was originally believed that the culprit of age-related muscle weakness was a reduction in muscle mass,but it is now clear that changes in muscle composition and quality are predominant. We propose that the risk of adverse outcomes is better estimated by considering jointly obesity and muscle strength rather than obesity and muscle mass and the term “sarcopenic obesity” should be revisited.

Objective To explore the effect of L-amlodipine on hydro-gen peroxide ( H2 O2 ) -induced oxidattive stress in vascular endothelial cells EA.hy926.Methods The case was randomly divided into 5 groups, the normal group, model group(300μmol· L-1 H2O2) and L-amlodipine groups in the low, middle and high dose ( 0.5, 1, 2μmol· L-1 ) .The viability of EA.hy926 cell was measured by MTT assay.Intracellular reactive oxygen species level was detected by DCFH-DA fluorescence probe.The content of malondialdehyde and superoxide dismutase was determined by kits.AnnexinV-FITC flow cy-tometry dual staining was used to detect cell apoptosis.The activity of cysteinyl aspartate specific proteinase 3 ( Caspase 3 ) was measured by spectrophotometry.The activation of nuclear factor kappa B ( NF-κB ) signaling pathway was assayed by western blot.Results Compared with normal group , the cell viability in the model group was lower (P<0.01), the levels of malondialdehyde and oxygen species were higher ( P <0.01 ) , the content of superoxide dismutase was lower (P<0.01), the activity of Caspase 3 was higher (P<0.01), and thephosphorylation of NF-κB p65 was lower (P<0.01).Compared with model group, 0.5,1,2μmol· L-1 of L-amlodipine could inhibit the change , the difference was significant ( P<0.05 ).Conclusion These results suggested L-amlodipine was resistant to H2 O2-induced oxidattive stress in EA.hy926 cell via inhibition of oxgen generation and cell apoptosis.

目的 探讨在颈动脉粥样硬化患者中,载脂蛋白AⅠ (apolipoprotein AⅠ,apoAⅠ)、载脂蛋白B100(apolipoprotein B100,apoB100)及apoB100/apoAⅠ与急性冠脉综合征(acute coronary syndrome,ACS)的相关关系.方法 选取80例颈动脉粥样硬化患者,40例确诊为ACS(ACS组),40例已排除冠心病(对照组),检测患者的apoAⅠ、apoB100、apoB100/apoAⅠ.结果 ACS组患者apoAⅠ显著低于对照组(P=0.001),apoB100(P=0.040)、apoB100/apoAⅠ(P=0.005)则显著升高,多因素Logistic回归提示apoAⅠ是颈动脉粥样硬化患者发生ACS的保护因素(95％CI:0.51～0.83),而apoB100/apoAⅠ(95％CI:1.14～1.48)则是危险因素.结论 在颈动脉粥样硬化患者中,apoAⅠ、apoB100/apoAⅠ可能会影响ACS的发生,临床应积极检测,必要时予以药物干预调整.

目的 以内蒙古自治区人民医院干部保健所健康体检的中老年干部人群为研究对象,调查高血脂在该人群的患病情况,探讨该人群的疾病危险因素,为该人群的高血脂防治提供科学依据.方法 选取在我院干部保健所进行健康体检的中老年干部人群为调查对象678人,男性571人,女性107人,采用手检分卡法、卡方检验及Loestic回归分析方法分析数据.结果 (1)该人群高血脂症总检出率58.60％,单纯高胆固醇血症检出率为9.59％,单纯高甘油三酯检出率为26.25％,混合型高脂血症检出率为22.71％;(2)51～60岁组高脂血症检出率高于其他年龄组,他们是高脂血症的易患人群;(3) Loestic回归分析结果表明:年龄、BMI、性别、血糖异常为该人群高脂血症危险因素.结论 干部人群具有特殊性,预防工作应以51～60岁的人群为主,同时关注61～70岁人群,开展健康教育,对患者进行随访、复检,追踪观察,以降低高脂血症的发病率;控制或消除该人群高血脂的危险因素,早发现、早治疗,提高生活质量,降低血脂异常对血管壁的危害性.

目的 探讨老年心血管疾病与骨质疏松(OP)的关系.方法 收集103例骨质疏松及骨量减少的老年患者,其中有高血压或冠心病组(A组)53例,无高血压或冠心病组(B组)50例,经双能X线骨密度仪测定腰椎、髋部骨密度(BDM),同时测生化各项指标及总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C).比较两组血脂及各部位骨密度的相关性变化.结果 两组患者TC、LDL-C及腰椎L1～L4椎体正位BMD、左髋部股骨颈近端总BMD差异均有统计学意义(P＜0.05),A组TC、LDL-C均高于B组,腰椎BMD及左侧股骨近端总BMD均低于B组;TG、HDL-C及Ward三角BMD两组间差异均无统计学意义(P＞0.05).结论 老年心血管疾病与骨质疏松之间存在一定的相关性.