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To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), and to assess the mediation roles of inflammation cells. There were 2701 participants in the case-control study, including 896 patients with T2DM, 900 patients with IFG, 905 subjects with NGT. Plasma isocarbophos and isofenphos concentrations were measured using gas chromatography and triple quadrupole tandem mass spectrometry. Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM. Inflammatory cell was used as mediators to estimate the mediating effects on the above associations. Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors. The odds ratio (95% confidence interval) (OR (95%CI)) for T2DM was 1.041 (1.015, 1.068) and for IFG was 1.066 (1.009, 1.127) per unit rise in ln-isocarbophos. The prevalence of T2DM increased by 6.4% for every 1 unit more of ln-isofenphos (OR (95% CI): 1.064 (1.041, 1.087)). Additionally, a 100% rise in ln-isocarbophos was linked to 3.3% higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin (HbA1c) (95% CI: 0.007, 0.051). While a 100% rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8% and 3.4%, respectively. Furthermore, white blood cell (WBC) and neutrophilic (NE) were found to be mediators in the relationship between isocarbophos and T2DM, and the corresponding proportions were 17.12% and 17.67%, respectively. Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population, WBC and NE have a significant role in this relationship.
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Diabetes Mellitus Tipo 2 , Humanos , Persona de Mediana Edad , Masculino , Femenino , Estudios de Casos y Controles , Insecticidas , Glucemia/análisis , Malatión/análogos & derivados , Compuestos Organotiofosforados , China , Adulto , InflamaciónRESUMEN
PURPOSE: This study aimed to assess pain, fitness condition, physical activity (PA) level, comorbidities, cancer-related fatigue (CRF), mood state and health-related quality of life (HRQoL) in long-term breast cancer survivors (LTBCS) compared to women without cancer history, matched by age, weight, height, and educational level. METHODS: A cross-sectional study conducted in Granada between April 2018 and July 2023 involved 80 LTBCS and 80 matched controls. Pain, fitness condition, PA level, comorbidities, CRF, mood state, and HRQoL were evaluated ≥ 5 years post-diagnosis using validated instruments. RESULTS: LTBCS, compared to the controls, reported significantly higher levels of "pain intensity and interference", CRF (in all domains and > 40% exhibited moderate-to-severe fatigue levels), "sadness-depression", "anxiety", "anger/hostility", and "symptom scales" (All: P = .000 to .027). Moreover, 66.25% of LTBCS not only did not reach recommended PA levels (P = .035), but also presented significantly lower levels of "general physical fitness", "muscular strength", "happiness", "functioning scales" (except "emotional functioning"), and "global health status" (All: P = .000 to .048). CONCLUSION: LTBCS still suffer from physical (pain, fitness condition, and CRF), both mental and emotional (sadness-depression, anxiety and anger/hostility) long-term side effects as well as multiple HRQoL issues (including lower levels of physical functioning and higher levels of symptoms). These findings highlight the chronic nature of this disease and the importance of continuing long- term follow-up care for survivors many years after the diagnosis of breast cancer.
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Neoplasias de la Mama , Supervivientes de Cáncer , Fatiga , Salud Mental , Calidad de Vida , Humanos , Femenino , Neoplasias de la Mama/psicología , Neoplasias de la Mama/complicaciones , Supervivientes de Cáncer/psicología , Estudios Transversales , Persona de Mediana Edad , Fatiga/etiología , Fatiga/epidemiología , Estudios de Casos y Controles , Ejercicio Físico/fisiología , Anciano , Estado de Salud , Adulto , Aptitud Física/fisiología , EspañaRESUMEN
Background: Human leukocyte antigen-G (HLA-G) is a pivotal protein involved in immune regulation and tolerance, while systemic lupus erythematosus (SLE) is a multifaceted autoimmune condition influenced by genetic and environmental factors. Research indicates that variations and mutations in HLA-G may impact SLE development. Objective: This study aimed to explore the relationship between polymorphisms in the 3'-untranslated region (UTR) of the HLA-G gene and SLE. Methods: DNA from 100 SLE patients and 100 controls was analyzed using polymerase chain reaction to amplify the target sequence. Allele and genotype frequencies were determined, and haplotypes were assessed using Haploview v.4.2 software, with linkage disequilibrium calculated. Results: Findings revealed that the +2960 Ins allele was significantly linked to SLE as a risk factor, with the Del allele showing a protective effect. In addition, the +3010C allele and +3187A allele were significantly associated with SLE at both allele and genotype levels. The +3142 GG homozygote was notably linked to SLE at the genotype level. Haplotype analysis identified UTR-2 haplotypes as risk factors for SLE, whereas the UTR-1 haplotype was protective, shedding light on genetic factors influencing SLE risk. Conclusion: This study underscores the importance of HLA-G gene 3'-UTR polymorphisms in SLE susceptibility, suggesting their potential as diagnostic or therapeutic targets.
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Regiones no Traducidas 3' , Alelos , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Antígenos HLA-G , Haplotipos , Desequilibrio de Ligamiento , Lupus Eritematoso Sistémico , Polimorfismo de Nucleótido Simple , Humanos , Lupus Eritematoso Sistémico/genética , Antígenos HLA-G/genética , Haplotipos/genética , Regiones no Traducidas 3'/genética , Femenino , Masculino , Adulto , Frecuencia de los Genes/genética , Estudios de Casos y Controles , Polimorfismo de Nucleótido Simple/genética , Persona de Mediana Edad , Genotipo , Estudios de Asociación Genética , Factores de RiesgoRESUMEN
OBJECTIVES: This study investigated whether kidney transplant donors experience increased arterial stiffness compared with the general population and how arterial stiffness changes over time. MATERIALS AND METHODS: Our study included 59 kidney transplant donors and 27 healthy volunteers. All subjects underwent cardio-ankle vascular index measurements. We studied fibroblast growth factor23, klotho, monocyte chemoattractant protein-1, N-terminal pro-B-type natriuretic peptide, indoxyl sulfate, and p-cresyl sulfate levels. RESULTS: Cardio-ankle vascular index level was higher in donors 6 to 11 years after donation (8.02 ± 0.24 m/s) than in donors 2 to 6 years after donation (7.02 ± 0.27 m/s) and healthy volunteers (6.65 ± 0.22 m/s). Cardioankle vascular index level was positively correlated with age (r = 0.382, P < .001) and levels of triglyceride (r = 0.213, P = .049), blood urea nitrogen (r = 0.263, P = .014), creatinine (r = 0.354, P = .001), calcium (r = 0.228, P = .035), indoxyl sulfate (r = 0.219, P = .042), p-cresyl sulfate (r = 0.676, P ≤ .001), and monocyte chemoattractant protein-1 (r = 0.451, P ≤ .001) and negatively correlated with estimated glomerular filtration rate (r = -0.383, P < .001). Multiple linear regression analysis revealed that age (P = .026, B = 0.244), mean arterial blood pressure (P < .001, B = 0.446), blood urea nitrogen (P = .006, B = 0.302), creatinine (P = .032, B = 0.236), estimated glomerular filtration rate (P = .003, B = -0.323), fibroblast growth factor-23 (P = .007, B = 0.294), N-terminal pro-B-type natriuretic peptide (P = .005, B = 0.304), and monocyte chemoattractant protein-1 (P ≤ .001, B = 0.434) independently predicted cardio-ankle vascular index levels. CONCLUSIONS: Even without additional risk factors, kidney donors should be followed closely for arterial stiffness and cardiovascular disease, especially in the long-term (>5 years) after kidney transplant.
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Biomarcadores , Índice Vascular Cardio-Tobillo , Mediadores de Inflamación , Trasplante de Riñón , Valor Predictivo de las Pruebas , Calcificación Vascular , Rigidez Vascular , Humanos , Masculino , Femenino , Biomarcadores/sangre , Persona de Mediana Edad , Trasplante de Riñón/efectos adversos , Adulto , Estudios de Casos y Controles , Calcificación Vascular/sangre , Calcificación Vascular/fisiopatología , Calcificación Vascular/etiología , Calcificación Vascular/diagnóstico , Factores de Tiempo , Mediadores de Inflamación/sangre , Factores de Riesgo , Factores de Crecimiento de Fibroblastos/sangre , Factor-23 de Crecimiento de Fibroblastos , Quimiocina CCL2/sangre , Uremia/sangre , Uremia/diagnóstico , Uremia/fisiopatología , Indicán/sangre , Resultado del Tratamiento , Donadores VivosRESUMEN
INTRODUCTION: Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia. OBJECTIVES: The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child-parent perspectives about RT. METHODS: Children (6-18 years) post-LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push-ups, sit-to-stand), and PP (6-minute walk test [6MWT], timed-up-and-down-stair test [TUDS]) were measured before and after 12-weeks of RT. RESULTS: Ten children post-LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM-index (+4.6% LTx vs. a -2.7% HC; p = 0.01) and decreased visceral adipose tissue-index (-18% LTx vs. -0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push-ups (p = 0.04), and greater reduction times for TUDS (-10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle-fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement. CONCLUSIONS: RT in children post-LTx is feasible and effective. RT in children post-LTx may alleviate adverse outcomes associated with sarcopenia.
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Trasplante de Hígado , Fuerza Muscular , Entrenamiento de Fuerza , Sarcopenia , Humanos , Masculino , Trasplante de Hígado/efectos adversos , Proyectos Piloto , Sarcopenia/etiología , Niño , Femenino , Adolescente , Pronóstico , Estudios de Casos y Controles , Estudios de Seguimiento , Entrenamiento de Fuerza/métodos , Músculo Esquelético/fisiopatología , Complicaciones Posoperatorias , Servicios de Atención de Salud a DomicilioRESUMEN
PURPOSE: To determine the misclassification rate of the keratoconus percentage (KISA%) index efficacy in eyes with progressive keratoconus. METHODS: This was a retrospective case-control study of consecutive patients with confirmed progressive keratoconus and a contemporaneous normal control group with 1.00 diopters or greater regular astigmatism. Scheimpflug imaging (Pentacam HR) was obtained for all patients. KISA% index and inferior-superior (IS) values were obtained from the Pentacam topometric/keratoconus staging map. Receiver operating characteristic curves were generated to determine the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity values. RESULTS: There were 160 eyes from 160 patients evaluated, including 80 eyes from 80 patients with progressive keratoconus and 80 eyes from 80 control patients. There were 20 eyes (25%) with progressive keratoconus misclassified by the KISA% index, with 16 eyes (20%) of the progressive keratoconus cohort classified as normal (ie, KISA% < 60). There were 4 eyes (5%) with progressive keratoconus that would classify as having "normal topography" using the published criteria for very asymmetric ectasia with normal topography of KISA% less than 60 and IS value less than 1.45. All controls had a KISA% index value of less than 15. The optimal cut-off value to distinguish cohorts was 15.31 (AUROC = 0.972, 93.75% sensitivity). KISA% index values of 60 and 100 achieved low sensitivity (80% and 73.75%, respectively). CONCLUSIONS: The KISA% index misclassified a significant proportion of eyes with progressive keratoconus as normal. Although highly specific for clinical keratoconus, the KISA% index lacks sensitivity, does not effectively discriminate between normal and abnormal topography, and thus should not be used in large data analysis or artificial intelligence-based modeling. [J Refract Surg. 2024;40(9):e614-e624.].
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Topografía de la Córnea , Progresión de la Enfermedad , Queratocono , Curva ROC , Humanos , Queratocono/clasificación , Queratocono/diagnóstico , Estudios Retrospectivos , Topografía de la Córnea/métodos , Masculino , Femenino , Adulto , Estudios de Casos y Controles , Adulto Joven , Córnea/patología , Córnea/diagnóstico por imagen , Sensibilidad y Especificidad , Agudeza Visual/fisiología , Adolescente , Área Bajo la Curva , Persona de Mediana Edad , Errores DiagnósticosRESUMEN
BACKGROUND: Preeclampsia is a unique vascular disease during pregnancy that generally appears after 20 of weeks gestation or until 6 weeks after delivery. Left undiagnosed, preeclampsia can lead rapidly to death of both mother and fetus. OBJECTIVES: To verify the efficacy of peripheral blood inflammatory markers (BIMs)in diagnosing preeclampsia and compare them with results from other studies. METHODS: Our retrospective case-control study comprised two patient groups. Pregnant women with preeclampsia and pregnant women without preeclampsia were compared for BIMs: neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV). The primary endpoint of our research was to assess the predictive power of BIMs for preeclampsia diagnosis. RESULTS: The sample size was calculated based on expected differences of BIMs between the control and study groups. Comparison of quantitative variables was conducted with independent sample t-test or alternatively by Wilcoxon rank sum test. The MPV values were slightly higher in the preeclampsia group, but not statistically significant. NLR and PLR did differentiate between study and control groups. CONCLUSIONS: The diagnostic accuracy of BIMs is unsatisfactory for preeclampsia diagnosis. Discrepancies concerning these values need to be clarified. Further large prospective studies are necessary to validate the potential factor accuracy in preeclampsia diagnosis.
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Biomarcadores , Preeclampsia , Humanos , Femenino , Preeclampsia/sangre , Preeclampsia/diagnóstico , Embarazo , Estudios Retrospectivos , Biomarcadores/sangre , Adulto , Estudios de Casos y Controles , Neutrófilos , Volúmen Plaquetario Medio , Inflamación/sangre , Inflamación/diagnóstico , Valor Predictivo de las Pruebas , Plaquetas , LinfocitosRESUMEN
Type 2 diabetes mellitus (T2DM) is globally recognized as a significant health concern, with diabetic foot (DF) identified as a severe long-term complication that can lead to tissue death or amputation. The discovery of the impact of mycobiota, a diverse group of multicellular eukaryotes in the gut microbiome, on the onset of endocrine disorders holds great significance. Therefore, this research aimed to examine variations in fungal mycobiome and identify potential biomarkers for T2DM and T2DM-DF. Fecal and blood samples were collected from 33 individuals with T2DM, 32 individuals with T2DM-DF, and 32 healthy individuals without any health conditions (HC). Blood samples were used for laboratory parameters analysis, while total DNA was extracted from fecal samples and sequenced using Illumina 18s rRNA. Bioinformatics tools were employed to analyze fungal abundance and diversity, revealing differentially expressed fungal species and signature fungi that distinguished between T2DM, T2DM-DF, and HC groups. Firstly, significant alterations in some laboratory parameters were observed among the three groups, which also differed between T2DM and T2DM-DF. The diversity of gut fungi in T2DM and T2DM-DF significantly differed from that of the HC group; however, more pronounced changes were observed in T2DM-DF. Additionally, two significantly altered phyla, Ascomycota and Basidiomycota, were identified with higher Ascomycota abundance but lower Basidiomycota abundance in both the T2DM and T2DM-DF compared to the HC group. Furthermore, the top 15 fungi showing significant changes at the species level included a notable decrease in Rhodotorula_mucilaginosa abundance in patients with T2DM compared to HC and a substantial increase in unclassified_g_Candida abundance specifically seen only among patients with T2DM-DF, but not among those diagnosed with T2DM or HC. Thirdly, KEGG was employed to analyze enzyme expression across the three groups, revealing a more pronounced alteration in gut fungal function within T2DM-DF compared to T2DM. Subsequently, to accurately identify signature fungi in each group, a random forest was utilized to rank the top 15 significant fungi. Notably, 11 fungi were identified as potential biomarkers for distinguishing T2DM or T2DM-DF from HC, while eight fungi could discriminate between T2DM and T2DM-DF. Furthermore, receiver operating characteristic curve (ROC) analysis demonstrated enhanced accuracy of predicted outcomes. These findings suggest that changes in fungal mycobiome are closely associated with the progression and complications of T2DM and DF, offering promising prospects for diagnosis and treatment.
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Biomarcadores , Diabetes Mellitus Tipo 2 , Pie Diabético , Disbiosis , Heces , Microbioma Gastrointestinal , Micobioma , Humanos , Diabetes Mellitus Tipo 2/microbiología , Diabetes Mellitus Tipo 2/complicaciones , Persona de Mediana Edad , Femenino , Masculino , Disbiosis/microbiología , Disbiosis/diagnóstico , Pie Diabético/microbiología , Biomarcadores/sangre , Heces/microbiología , Anciano , Adulto , Ascomicetos , Basidiomycota , Estudios de Casos y Controles , Hongos/aislamiento & purificaciónRESUMEN
OBJECTIVE: Endometrial polyp (EP) is a type of pathology that is quite common in clinical practice. Although its exact etiology is not fully known, there is evidence to support that it is sensitive to hormonal stimuli. We aimed to investigate the relationship between kisspeptin (KP) and EP by comparing the genetic (tissue-blood) and immunohistochemical (IHC) expression of KP in EP lesions in patients with normal endometrial findings. MATERIALS AND METHODS: A prospective case-control study of 50 patients with EP (N = 25) and normal endometrial findings (N = 25) on biopsy and/or excision material was performed. Blood and biopsy samples obtained from all patients were stored at -80 °C. KP gene expression levels were determined from paraffin blocks, and peripheral venous blood samples obtained from biopsy specimens and IHC-H-score analysis were performed from paraffin blocks. EP and matched controls were compared for KP. RESULTS: After IHC, the KP H-score of the control group was higher than the EP group, and this difference was statistically significant; H-score: control: 5 (++; 1-15); polyp: 1 (+; 0-12) (P < 0.05). Although KP expression in both tissue and blood was higher in the control group than in the EP group, this difference was not statistically significant (P > 0.05). No significant correlation was found between IHC H-score and KP expression levels in tissue and blood. According to the ROC analysis, the tissue and blood KP expression cut-off value and area under the curve (AUC) predicting the likelihood of developing EP were not significant (tissue KP: 1.04, AUC: 0.570, P = 0.388, sensitivity 56%, specificity 60%, Blood KP: 1.06, AUC: 0.569, P = 0.401, sensitivity 80%, specificity 40%). CONCLUSIONS: Decreased KP expression level in EP lesions may predict the diagnosis of EP, and in the future, KP may have therapeutic potential for benign gynecological pathologies such as polyps.
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Inmunohistoquímica , Kisspeptinas , Pólipos , Humanos , Femenino , Pólipos/genética , Pólipos/metabolismo , Pólipos/patología , Kisspeptinas/genética , Kisspeptinas/metabolismo , Estudios de Casos y Controles , Enfermedades Uterinas/genética , Enfermedades Uterinas/metabolismo , Enfermedades Uterinas/patología , Enfermedades Uterinas/sangre , Estudios Prospectivos , Adulto , Endometrio/metabolismo , Endometrio/patología , Persona de Mediana EdadRESUMEN
The relationship between structural changes in the cerebral gray matter and diminished balance control performance in patients with chronic ankle instability (CAI) has remained unclear. This paper aimed to assess the difference in gray matter volume (GMV) between participants with CAI and healthy controls (HC) and to characterize the role of GMV in the relationship between disease duration and balance performance in CAI. 42 participants with CAI and 33 HC completed the structural brain MRI scans, one-legged standing test, and Y-balance test. Regional GMV was measured by applying voxel-based morphometry methods. The result showed that, compared with HC, participants with CAI exhibited lower GMV in multiple brain regions (familywise error [FWE] corrected p < 0.021). Within CAI only, but not in HC, lower GMV in the thalamus (ß = -0.53, p = 0.003) and hippocampus (ß = -0.57, p = 0.001) was associated with faster sway velocity of the center of pressure (CoP) in eyes closed condition (i.e., worse balance control performance). The GMV in the thalamus (percentage mediated [PM] = 32.02%; indirect effect ß = 0.119, 95% CI = 0.003 to 0.282) and hippocampus (PM = 33.71%; indirect effect ß = 0.122, 95% CI = 0.005 to 0.278) significantly mediated the association between the disease duration and balance performance. These findings suggest that the structural characteristics of the supraspinal elements is critical to the maintenance of balance control performance in individuals suffering from CAI, which deserve careful consideration in the management and rehabilitation programs in this population.
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Articulación del Tobillo , Sustancia Gris , Inestabilidad de la Articulación , Imagen por Resonancia Magnética , Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Masculino , Inestabilidad de la Articulación/fisiopatología , Inestabilidad de la Articulación/diagnóstico por imagen , Femenino , Adulto Joven , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Articulación del Tobillo/diagnóstico por imagen , Articulación del Tobillo/fisiopatología , Articulación del Tobillo/patología , Estudios de Casos y Controles , Adulto , Enfermedad Crónica , Tálamo/diagnóstico por imagen , Tálamo/patología , Tálamo/fisiopatología , Hipocampo/diagnóstico por imagen , Hipocampo/patología , Factores de TiempoRESUMEN
In this study, we aimed to examine the relationship between the serum cytokine levels of patients with pemphigus vulgaris (PV) and the Pemphigus Disease Area Index (PDAI), along with the presence of anti-desmoglein (Dsg) 1 antibody, anti-Dsg3 antibody and co-infection among patients with pemphigus vulgaris. This retrospective study included 62 PV patients and 59 healthy individuals who attended the Second Affiliated Hospital of Kunming Medical University from November 2014 to November 2022. The serum concentrations of cytokines and chemokines were assessed using the Luminex 200 System (a high-throughput cytokine detection method). Additionally, anti-Dsg1 and anti-Dsg3 antibodies were determined through enzyme-linked immunosorbent assay, while disease severity was evaluated using the PDAI scoring system. The PV group exhibited elevated levels of Th1 cytokines (such as interleukin (IL)-1RA, IL-1ß, IL-2, IL-12p70, GM-CSF, TNF-α, IL-18, IFN-γ), Th2 cytokines (IL-5, IL-10, IL-13) and Th17/Th22-related cytokines (IL-17A, IL-22) compared to the healthy control group (p < 0.05). Conversely, the levels of chemokines (macrophage inflammatory protein-1 alpha (MIP-1α), stromal cell-derived factor-1 alpha (SDF-1α), interferon-inducible protein-10 (IP-10), Regulated on Activation in Normal T-Cell Expressed And Secreted (RANTES), growth-regulated on-gene-alpha (GRO-α), MIP-1ß) and Th2 (IL-31) were lower in the PV group compared to the healthy control group (p < 0.05). No significant differences were observed in other cytokines and chemokines (p > 0.05). Additionally, IL-7, IFN-γ, IL-18 and GRO-α showed positive correlations with PDAI, IL-6 correlated positively with anti-Dsg3 antibody levels, and IL-12p70, IL-18, and IFN-γ correlated positively with anti-Dsg1 antibody levels. Furthermore, IL-15 exhibited a positive association with skin infections. PV patients have elevated levels of various cytokines and chemokines, and there are different degrees of elevation in cytokines and chemokines associated with the activation of various T cell subsets. PDAI and the Dsg1 antibody levels are mainly related to the Th1-related cytokines.
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Quimiocinas , Citocinas , Desmogleína 1 , Pénfigo , Humanos , Pénfigo/sangre , Pénfigo/inmunología , Estudios Retrospectivos , Masculino , Femenino , Citocinas/sangre , Persona de Mediana Edad , Adulto , Desmogleína 1/inmunología , Quimiocinas/sangre , Desmogleína 3/inmunología , Índice de Severidad de la Enfermedad , Anciano , Autoanticuerpos/sangre , Estudios de Casos y Controles , Relevancia ClínicaRESUMEN
OBJECTIVE: Renal calculi are solid crystals that form in the kidneys and cause severe pain and discomfort. This study aims to investigate risk factors for postoperative recurrence of renal calculi in elderly patients and provide background knowledge on the prevalence and management of renal calculi in this demographic. METHODS: The clinical data of 123 elderly patients with renal calculi were included from 1 June 2021 to 1 June 2023 for their 6-month follow-up study. The patients were divided into recurrence group and non-recurrence group according to whether they had recurrence after surgery. The general sociological characteristics and disease-related characteristics of the two groups were counted. Logistic regression equation was used to calculate differences, and the influencing factors of postoperative recurrence in elderly patients with kidney stones were obtained. A receiver operating characteristic (ROC) curve was drawn to analyse the value of the factors in predicting postoperative recurrence in patients with kidney stones. RESULTS: A total of 123 elderly patients with renal calculi were enrolled. The patients were divided according to the presence or absence of stone recurrence into the recurrence group (25 cases, 20.33%) and the non-recurrence group (98 cases, 79.67%). Postoperative water intake, excessive intake of animal protein, exercise and postoperative complications significantly differed between the recurrence group and the non-recurrence group (p < 0.001). Logistic regression analysis showed that the above-mentioned indicators were the influencing factors of postoperative recurrence. The area under the curve (AUC) values of postoperative water intake (AUC = 0.767), animal protein intake (AUC = 0.752), exercise (AUC = 0.707) and postoperative complications (AUC = 0.727) were statistically significant, and they were identified as the most important factors with high sensitivity and specificity and were of high value in predicting postoperative recurrence of renal calculi. CONCLUSIONS: Elderly patients with kidney stones are prone to recurrence after surgery. Influencing factors should be given attention, and corresponding measures should be formulated for intervention as soon as possible.
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Cálculos Renales , Recurrencia , Humanos , Cálculos Renales/cirugía , Masculino , Femenino , Anciano , Factores de Riesgo , Estudios de Casos y Controles , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Medición de Riesgo , Anciano de 80 o más AñosRESUMEN
OBJECTIVE: To explore the optimal pulse oxygen saturation (SpO2) range during hospitalization for patients with sepsis. METHODS: A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care- IV (MIMIC- IV). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO2 levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO2 was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO2 and in-hospital all-cause mortality. RESULTS: A total of 5 937 patients met the inclusion criteria, among whom 1 191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO2 levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO2 levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO2 < 0.96 [hypoxia group; odds ratio (OR) = 2.659, 95% confidence interval (95%CI) was 2.190-3.229, P < 0.001] and SpO2 > 0.98 (hyperoxia group; OR = 1.594, 95%CI was 1.337-1.900, P < 0.001). Kaplan-Meier survival curve showed that patients with SpO2 between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO2 < 0.96 and SpO2 > 0.98 (Log-Rank test: χ 2 = 113.400, P < 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score II (SAPS II), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO2 between 0.96 and 0.98 was significantly lower than those of patients with SpO2 < 0.96 and SpO2 > 0.98. CONCLUSIONS: During hospitalization, the level of SpO2 among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased mortality risk. The optimal SpO2 range is determined to be between 0.96 and 0.98.
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Saturación de Oxígeno , Sepsis , Humanos , Sepsis/sangre , Sepsis/diagnóstico , Sepsis/mortalidad , Estudios Retrospectivos , Estudios de Casos y Controles , Masculino , Femenino , Mortalidad Hospitalaria , Persona de Mediana Edad , Anciano , Hospitalización , Modelos Logísticos , Oxígeno/sangre , Unidades de Cuidados Intensivos , PronósticoRESUMEN
OBJECTIVE: We aimed to investigate the serum concentration of the spexin, which has been shown to have an anorexic effect in animal models, in pregnant women with hyperemesis gravidarum (HG). METHODS: This case-control study was conducted with 80 pregnant women who applied to the Umraniye Training and Research Hospital Gynecology and Obstetrics Clinic between April 2022 and September 2022. The HG group consisted of 40 pregnant women who were diagnosed with HG in the first 14 weeks of pregnancy, and the control group consisted of 40 healthy pregnant women matched with the HG group in terms of age, BMI, and gestational week. RESULTS: Both groups were similar in terms of demographic characteristics and gestational age at blood sampling for spexin (p > 0.05). While maternal serum spexin concentration was 342.4 pg/ml in the HG group, it was 272.8 pg/ml in the control group (p = 0.003). ROC analysis was performed to determine the value of maternal serum spexin concentration in terms of predicting HG. AUC analysis of maternal serum spexin for HG estimation was 0.693 (p = 0.003, 95% CI =0.577 - 0.809). The optimal cutoff value for maternal serum spexin concentration was determined as 305.90 pg/ml with 65% sensitivity and 65% specificity. CONCLUSIONS: High serum spexin concentration is thought to play a role in the etiopathogenesis of HG, and this should be supported by demonstrating changes in serum spexin concentrations in pregnant women with HG whose symptoms alleviated and weight regain started after treatment.
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Hiperemesis Gravídica , Hormonas Peptídicas , Humanos , Femenino , Embarazo , Hiperemesis Gravídica/sangre , Hiperemesis Gravídica/diagnóstico , Adulto , Estudios de Casos y Controles , Hormonas Peptídicas/sangre , Biomarcadores/sangre , Curva ROC , Adulto JovenRESUMEN
OBJECTIVE: There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population. MATERIAL AND METHODS: A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT) (292 days) or at least 20% of the study period (notAT) (≥58 days) and if VPA levels were in therapeutic range (ATR) (50-100mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls). RESULTS: During the study period, 6183 PCR+ were detected among 281,035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736% (OR 0.785 (95%CI 0.443-1.390) and 1.910% (OR 0.865 (95%CI 0.488-1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057-0.951) notAT; OR 0.218 (95%CI 0.053-0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076-3.871). CONCLUSION: Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.
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COVID-19 , Epilepsia , Ácido Valproico , Humanos , Ácido Valproico/uso terapéutico , Estudios de Casos y Controles , Masculino , Femenino , Persona de Mediana Edad , COVID-19/epidemiología , Estudios Retrospectivos , Adulto , Anciano , Epilepsia/tratamiento farmacológico , Tratamiento Farmacológico de COVID-19 , Incidencia , Antivirales/uso terapéutico , Anticonvulsivantes/uso terapéutico , Hospitalización/estadística & datos numéricos , SARS-CoV-2RESUMEN
Background: T-cell exhaustion (Tex) can be beneficial in autoimmune diseases, but its role in Graves' disease (GD), an autoimmune disorder of the thyroid, remains unknown. This study investigated Tex-related gene expression in GD patients to discern the potential contributions of these genes to GD pathogenesis and immune regulation. Methods: Through gene landscape analysis, a protein-protein interaction network of 40 Tex-related genes was constructed. mRNA expression levels were compared between GD patients and healthy control (HCs). Unsupervised clustering categorized GD cases into subtypes, revealing distinctions in gene expression, immune cell infiltration, and immune responses. Weighted gene co-expression network analysis and differential gene expression profiling identified potential therapeutic targets. RT-qPCR validation of candidate gene expression was performed using blood samples from 112 GD patients. Correlations between Tex-related gene expression and clinical indicators were analyzed. Results: Extensive Tex-related gene interactions were observed, with six genes displaying aberrant expression in GD patients. This was associated with atypical immune cell infiltration and regulation. Cluster analysis delineated two GD subtypes, revealing notable variations in gene expression and immune responses. Screening efforts identified diverse drug candidates for GD treatment. The Tex-related gene CBL was identified for further validation and showed reduced mRNA expression in GD patients, especially in cases of relapse. CBL mRNA expression was significantly lower in patients with moderate-to-severe thyroid enlargement than in those without such enlargement. Additionally, CBL mRNA expression was negatively correlated with the disease-specific indicator thyrotropin receptor antibodies. Conclusion: Tex-related genes modulate GD pathogenesis, and their grouping aids subtype differentiation and exploration of therapeutic targets. CBL represents a potential marker for GD recurrence.
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Enfermedad de Graves , Humanos , Enfermedad de Graves/genética , Enfermedad de Graves/inmunología , Masculino , Femenino , Adulto , Linfocitos T/inmunología , Linfocitos T/metabolismo , Persona de Mediana Edad , Perfilación de la Expresión Génica , Mapeo Cromosómico , Mapas de Interacción de Proteínas , Estudios de Casos y Controles , Proteínas Proto-Oncogénicas c-cbl/genética , Redes Reguladoras de Genes , Agotamiento de Células TRESUMEN
Diabetic kidney disease (DKD) is a common microvascular complication of diabetes, whose complex etiology involves a genetic component. Growth arrest-specific 5 (GAS5), a long noncoding RNA (lncRNA) gene, has been recently shown to regulate renal fibrosis. Here, we aimed to explore the potential role of GAS5 gene polymorphisms in the predisposition to DKD. One single-nucleotide (rs55829688) and one insertion/deletion polymorphism (rs145204276) of GAS5 gene were surveyed in 778 DKD cases and 788 DKD-free diabetic controls. We demonstrated that diabetic subjects who are heterozygous at rs55829688 (TC; AOR, 1.737; 95% CI, 1.028-2.937; p=0.039) are more susceptible to advanced DKD but not early-staged DKD, as compared to diabetic subjects who are homozygous for the major allele of rs55829688 (TT). Carriers of at least one minor allele (C) of rs55829688 (TC and CC; AOR, 1.317; 95% CI, 1.023-1.696; p=0.033) more frequently suffer from advanced DKD than do those homozygotes for the major allele (TT). Furthermore, in comparison to those who do not carry the minor allele of rs55829688 (TT), advanced DKD patients possessing at least one minor allele of rs55829688 (TC and CC) exhibited a lower glomerular filtration rate, revealing an impact of rs55829688 on renal co-morbidities of diabetes. In conclusion, our data indicate an association of GAS5 gene polymorphisms with the progression of DKD.
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Nefropatías Diabéticas , Progresión de la Enfermedad , Predisposición Genética a la Enfermedad , Polimorfismo de Nucleótido Simple , ARN Largo no Codificante , Humanos , ARN Largo no Codificante/genética , Nefropatías Diabéticas/genética , Nefropatías Diabéticas/patología , Masculino , Persona de Mediana Edad , Femenino , Anciano , Estudios de Casos y Controles , Alelos , Adulto , Estudios de Asociación GenéticaRESUMEN
Background: Identification of the unknown pathogenic factor driving atherosclerosis not only enhances the development of disease biomarkers but also facilitates the discovery of new therapeutic targets, thus contributing to the improved management of coronary artery disease (CAD). We aimed to identify causative protein biomarkers in CAD etiology based on proteomics and 2-sample Mendelian randomization (MR) design. Methods: Serum samples from 33 first-onset CAD patients and 31 non-CAD controls were collected and detected using protein array. Differentially expressed analyses were used to identify candidate proteins for causal inference. We used 2-sample MR to detect the causal associations between the candidate proteins and CAD. Network MR was performed to explore whether metabolic risk factors for CAD mediated the risk of identified protein. Vascular expression of candidate protein in situ was also detected. Results: Among the differentially expressed proteins identified utilizing proteomics, we found that circulating Golgi protein 73 (GP73) was causally associated with incident CAD and other atherosclerotic events sharing similar etiology. Network MR approach showed low-density lipoprotein cholesterol and glycated hemoglobin serve as mediators in the causal pathway, transmitting 42.1% and 8.7% effects from GP73 to CAD, respectively. Apart from the circulating form of GP73, both mouse model and human specimens imply that vascular GP73 expression was also upregulated in atherosclerotic lesions and concomitant with markers of macrophage and phenotypic switching of vascular smooth muscle cells (VSMCs). Conclusions: Our study supported GP73 as a biomarker and causative for CAD. GP73 may involve in CAD pathogenesis mainly via dyslipidemia and hyperglycemia, which may enrich the etiological information and suggest future research direction on CAD.
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Biomarcadores , Enfermedad de la Arteria Coronaria , Proteínas de la Membrana , Análisis de la Aleatorización Mendeliana , Proteómica , Humanos , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/genética , Enfermedad de la Arteria Coronaria/patología , Ratones , Animales , Proteínas de la Membrana/genética , Proteínas de la Membrana/sangre , Masculino , Femenino , Biomarcadores/sangre , Persona de Mediana Edad , LDL-Colesterol/sangre , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Estudios de Casos y Controles , Aterosclerosis/sangre , Aterosclerosis/genéticaRESUMEN
BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has led to significant global morbidity and mortality. Understanding the genetic factors that influence disease outcomes can provide critical insights into pathogenesis and potential therapeutic targets. OBJECTIVE: This study aimed to investigate the potential correlation between single nucleotide polymorphisms (SNPs) in Interleukin 12 Subunit Alpha (IL-12A), Interleukin 12 Subunit Beta (IL-12B), Interleukin 6 (IL-6), and Tumor Necrosis Factor (TNF) genes and the severity as well as susceptibility to COVID-19 among Moroccan patients. PATIENTS AND METHODS: Next-Generation sequencing (NGS) was conducted on 325 Moroccan participants, 207 patients with PCR-confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and 118 controls. Among these patients, 51% presented moderate to severe symptoms requiring hospitalization, while 49% were asymptomatic or experienced mild symptoms and did not require hospitalization. Statistical analysis was performed using codominant, dominant, and recessive logistic regression models to assess correlations with the severity and susceptibility to COVID-19 infection. RESULTS: No association was found between SNPs of IL-12A, IL-12B, IL-6 or TNF and COVID-19 severity and susceptibility. However, our results unveiled a noteworthy association with IL-6 rs2069840, which exhibited a negative correlation (OR = 0.21, 95% CI = 0.07-0.69, p = .006), suggesting a protective effect against SARS-CoV-2 infection. CONCLUSION: Polymorphisms in IL-12A, IL-12B, IL-6, and TNF genes are not correlated to the severity and susceptibility of COVID-19.
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COVID-19 , Predisposición Genética a la Enfermedad , Subunidad p35 de la Interleucina-12 , Subunidad p40 de la Interleucina-12 , Interleucina-6 , Polimorfismo de Nucleótido Simple , Índice de Severidad de la Enfermedad , Factor de Necrosis Tumoral alfa , Humanos , COVID-19/genética , COVID-19/inmunología , COVID-19/virología , Interleucina-6/genética , Masculino , Femenino , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/genética , Subunidad p40 de la Interleucina-12/genética , Adulto , Subunidad p35 de la Interleucina-12/genética , SARS-CoV-2 , Marruecos , Anciano , Estudios de Casos y ControlesRESUMEN
BACKGROUND: Severe Plasmodium falciparum malarial anemia is still the principal cause of death in children in underdeveloped countries. An imbalance between proinflammatory and anti-inflammatory cytokines is associated with malaria progression. This study evaluated circulating levels of selected inflammatory cytokines among malaria-infected children in Ghana. METHODS: This case-control study was conducted at Tamale Teaching Hospital, Ghana. One hundred and twenty children with malaria and 60 controls, aged 12-144 months were selected from April to July, 2023 for the study. Malaria was diagnosed through microscopy, full blood count was measured using hematology analyzer, and cytokines were measured using enzyme-linked immunosorbent assay. RESULTS: Malaria-infected children had higher tumor necrosis factor alpha (TNF-α) (p < .001), interferon-gamma (IFN-É£) (p < .001), interleukin (IL)-1ß (p < .001), IL-6 (p < .001), granulocyte macrophage-colony stimulating factor (GM-CSF) (p < .001), and IL-10 (p < .001) levels than controls. Participants with high parasitemia had raised TNF-α (p < .001), IFN-É£ (p < .001), IL-1ß (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but reduced IL-3 (p < .001) and TGF-ß (p < .001) than those with low parasitemia. Severe malarial anemic children had elevated TNF-α (p < .001), IFN-É£ (p < .001), IL-1ß (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but lower IL-3 (p < .001) and TGF-ß (p < .001) than those with uncomplicated malaria. CONCLUSION: Parasite density was the principal predictor of the cytokine levels, as parasitemia positively associated with IL-10, GM-CSF, IL-6, IL-1ß, IFN-É£, and TNF-α, but negatively associated with IL-3 and TGF-ß. Malaria is associated with enhanced secretion of pro- and anti-inflammatory cytokines in Ghanaian children. Inflammatory cytokines may be involved in the development of severe malarial anemia in children. However, IL-3 and TGF-ß may offer protection against severe malarial anemia.