Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
Objective To analyze the current status of metabolic syndrome (MetS) and its influencing factors among physical examination population aged 60 years old and above in Chengdu, and to provide evidence for the screening and management of MetS in people aged 60 years old and above. Methods Retrospective analysis of the data of people aged 60 years old and above who participated in physical examination in the North District of the Department of Health Management of Sichuan Provincial People’s Hospital between January 2018 and December 2020. According to whether the elderly occurred to have MetS, they were divided into MetS group and non-MetS group, to observe the distribution of MetS in different genders and different age groups, and to analyze the influencing factors of MetS by multivariate logistic regression. Results A total of 10 335 elderly were enrolled, 2 769 cases (26.79%) in MetS group and 7 566 cases (73.21%) in non-MetS group. Except for gender and low-density lipoprotein cholesterol (LDL-C) (P>0.05), there were significant differences in other general data between the two groups (P<0.05). There was a statistically significant difference in the detection rate of MetS among different age groups (χ²=64.332, P<0.001). In MetS group, 951 cases (34.34%) of abdominal obesity, 716 cases (25.86%) of high fasting blood glucose (FBG), 1 938 cases (69.99%) of hypertension, 1 011 cases (36.51%) of high triglycerides (TG) and 303 cases (10.94%) of low high-density lipoprotein cholesterol (HDL-C) were detected. Except hypertension and high TG (P>0.05), there were statistically significant differences in the detection rates of abdominal obesity, high FBG and low HDL-C among different genders in MetS (P<0.05). Except hypertension (P<0.05), there was no significant difference in the detection rates of MetS abdominal obesity, high FBG, low HDL-C and high TG in different age groups (P>0.05). Logistic regression analysis showed that body mass index [odds ratio (OR)=1.055, 95% confidence interval (CI) (1.014, 1.097), P=0.008], systolic blood pressure [OR=1.032, 95%CI (1.027, 1.037), P<0.001], diastolic blood pressure [OR=0.992, 95%CI (0.985, 1.000), P=0.049], FBG [OR=1.853, 95%CI (1.764, 1.947), P<0.001], TG [OR=3.787, 95%CI (3.352, 4.278), P<0.001], hemoglobin [OR=0.991, 95%CI (0.986, 0.996), P<0.001], waist circumference [OR=1.158, 95%CI (1.141, 1.175), P<0.001], HDL-C [OR=0.243, 95%CI (0.170, 0.346), P<0.001], total cholesterol [OR=0.615, 95%CI (0.490, 0.773), P<0.001], LDL-C [OR=1.594, 95%CI (1.303, 1.948), P<0.001], and uric acid [OR=1.001, 95%CI (1.000, 1.002), P=0.042] were related to MetS. Conclusions The prevalence of MetS is high among people aged 60 years old and above who undergo physical examination. Routine screening should be carried out during physical examination to take measures to intervene the controllable risk factors, so as to improve the health level of the region.
Objective To explore the difference of intervention effect between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on patients with metabolic syndrome (MetS). Methods China National Knowledge Infrastructure, WanFang Data, PubMed, Web of Science and EBSCO were searched for randomized controlled trials (RCTs) till May 2022. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. Comprehensive Meta-Analysis software was used for meta-analysis. Result A total of 5 RCTs were included, including 216 patients. The results of meta-analysis showed that: except fasting blood glucose, high-density lipoprotein cholesterol, systolic blood pressure, waist circumference, body mass index and body fat percentage (P>0.005), low-density lipoprotein cholesterol [mean difference (MD)=−7.487 mg/dL, 95% confidence interval (CI) (−12.543, −2.431) mg/dL, P=0.004], total cholesterol [MD=−11.487 mg/dL, 95%CI (−16.523, −6.452) mg/dL, P<0.001], triglycerides [MD=−26.296 mg/dL, 95%CI (−50.557, −2.035) mg/dL, P=0.034] and diastolic blood pressure [MD=−2.770 mm Hg (1 mm Hg=0.133 kPa), 95%CI (−5.131, −0.409) mm Hg, P=0.021] of HIIT were better than MICT. Conclusion In terms of blood glucose indicators and morphological indicators, the effect of HIIT group and MICT group was similar, but the effect of HIIT on blood lipid indicators and blood pressure indicators of patients with MetS was better than MICT.
Objective To explore the effects of heat-inactivated Lactobacillus gasseri TMC0356 on liver lipid metabolism in rats with metabolic syndrome (MS) and its possible mechanism. Methods Sixty male Sprague-Dawley rats were selected. Rats were randomly divided into 5 groups, including control group, MS model group and three TMC0356 test groups (low-, medium- and high-dose groups). The rats in each group were fed with different diets for 7 days, and the liver was dissected and removed after 15 weeks. The mRNA and protein expression levels of peroxisome hyperbioactive receptor-α (PPAR-α), sterol regulatory element binding protein-1c (REBP-1c), fatty acid synthase (FAS) and carnitine lipoacyltransferase-1 (CPT-1) genes in liver were detected. Results There was no significant difference in the mRNA expression of PPAR-α, SREBP-1c or CPT-1 among the five groups (P>0.05). The mRNA expression of FAS in low-dose TMC0356 test group was lower than that in MS model group (P=0.011), medium-dose TMC0356 test group (P=0.042) and high-dose TMC0356 test group (P=0.009). There was no significant difference in the expression of FAS mRNA between other groups (P>0.05). There was no significant difference in the protein expression of PPAR-α, SREBP-1c or FAS among the five groups (P>0.05). The protein expression of CPT-1 in low-dose TMC0356 test group was higher than that in control group (P=0.033) and high-dose TMC0356 test group (P=0.043). There was no significant difference in the protein expression of CPT-1 between the other groups (P>0.05). Conclusion Heat-inactivated Lactobacillus gasseri TMC0356 may improve the symptoms of metabolic disorder in rats by suppressing appetite, improving insulin resistance, and downregulating the expression of key fat metabolism genes such as FAS and SREBP-1c.
Objective To evaluate the efficacy and safety of thiazolidinediones for metabolic syndrome.Methods Up through 2007, we searched The Cochrane Library, MEDLINE, EMbase, the China Biological Medicine Database, VIP and CMAC. We also handsearched relevant literature. Randomized controlled trials about usingthiazolidinedioes to treat metabolic syndrome were included. Two reviewers independently extracted the data from the eligible studies and evaluated the quality of the included studies. Meta-analysis was performed for the results ofhomogeneous studies using RevMan 4.2.9 software. Results Ten randomized control trials involving 1,183 patients with metabolic syndrome met the inclusion criteria. Meta-analysis was not carried out because of apparent heterogeneity. Five trials compared rosiglitazone and placebo, which of single study reported CVD events at the end of 9 month follow-up. The results suggested that no significant differences were found between the two groups in occurrence of CVD events (RR=0.50, 95%CI 0.25 to 1.00), such as myocardial infarction and urgent vessel revascularization after coronary stent implantation, in the patients with metabolic syndrome, while rosiglitazone significantly decreased the proportion of metabolic syndrome (RR=4.0, 95%CI 1.63 to 9.82) and HOMA-index (WMD=-0.80, 95%CI -0.90 to -0.70) as compared with placebo. Pioglitazone did not affect TG, significantly decreased HOMA-index (WMD=0.02, 95%CI 0.01 to 0.03), and increased HDL-c (WMD=0.02, 95%CI 0.01 to 0.03), compared with placebo. Pioglitazone plus glimepirde was better than rosiglitazone plus glimepiride in TG and HDL-c improvement, with no significant differences in improving BP, FPG, PPG, HbA1c, and HOMA-index for both treatments. The combination of rosiglitazone with metformin was similar to pioglitazone-metformin combination in improving FPG, PPG, HbA1c and HOMA-index, whereas pioglitazone plus metformin was superior to rosiglitazone plus metformin in improving TG and HDL-c. No differences between rosiglitazone-metformin combination and glimepirde-metformin combination were observed in improving FPG, PPG, and HbA1c, but rosiglitazone plus metformin significantly lowered HOMA-index and SBP/DBP more than glimepirde plus metformin. The results of included trails revealed that rosiglitazone and pioglitazone had no favorable effects on BMI and WC or resulted in weight gain. The adverse drug reactions for thiazolidinediones were mild to moderate, and well tolerated. Conclusion The results suggest that thiazolidinediones produce positive effects on blood glucose level and insulin sensitivity in the absence of favorable obesity effects or resulting in weight gain. Pioglitazone favorably affects HDL-c. Thiazolidinediones show a certain effect on decreasing the proportion of metabolic syndrome, but the therapeutic effect on BP is uncertain. Overall there is insufficient evidence to recommend the use of thiazolidinediones for metabolic syndrome due to low methodological quality, small sample size, and limited number of trials. More high-quality, largescale randomized controlled trials are required.
Objective To evaluate the correlation between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS). Methods Total 666 elderly male patients admitted to West China Hospital for routine physical examination in May, 2010 were included in this study. The related laboratory tests of BPH and MS were taken. The correlation among BPH, lower urinary tract Symptoms (LUTS), prostate volume (PV), MS and its component diseases were analyzed. Results Hypertension was an important risk factor for BPH (OR=1.309, 95%CI 1.033 to 1.661), low HDL-C hyperlipidemia was a risk factor for IPSS scored over 7 points (OR=1.573, 95%CI 0.330 to 0.997), and the score of PV was positively correlated to obesity, hypertension, low HDL-C hyperlipidemia and MS (all Plt;0.05). Conclusion For the patient with BPH, MS and its component diseases mainly exert their effects on PV changes rather than LUTS.
ObjectiveTo explore the effect of gastric bypass (GBP) on metabolic syndrome (MS) and the related mechanisms. MethodsThe literatures addressed the effect of GBP on glucose metabolism and blood pressure were retrospectively analyzed. ResultsIt showed that GBP achieved durable level of blood glucose, remission of dylipidemia and hypertension, however, which occurred before significant weight loss. The changes of many factors such as food intake, gastrointestinal hormones, adipocytokines, fat distribution might be involved in GBP to improve MS. ConclusionGBP seems to achieve the control of MS as a primary and independent effect, rather than secondary to the treatment of overweight.
Objective To explore the relationship between different diagnostic criteria (ATPIII2002, IDF2005 and CDS2007 criteria) for metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD). Methods A total of 666 elderly males admitted to West China Hospital for routine physical examination were involved in this study in May, 2010. The diagnostic agreement rates of different criteria were compared, along with the relationship between different diagnostic criteria for MS and NALFD. Results The diagnostic agreement of CDS2007 criteria with either IDF2005 or ATPIII2002 criteria was good. However, the agreement of ATPIII2002 with IDF2005 was compromised. The prevalence of NAFLD in MS group was significantly higher than that of non-MS group (Plt;0.01). On the basis of CDS2007 criteria, there was significant correlation between NAFLD and MS (Plt;0.000). Conclusion There is a close relation between NAFLD and all three diagnostic criteria of MS. NAFLD is one of the most important risk factors of MS. The diagnostic agreement of CDS2007 criteria with the other two is good, and there is significant correlation between NAFLD and criteria CDS2007 of MS. CDS2007 is found to be of high accuracy and applicability in the diagnosis of MS in Chinese population including the elderly.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
ObjectiveTo investigate the prevalence of subclinical hypothyroidism (SCH) in health check-up population of West China Hospital of Sichuan University from 2011 to 2012 and to discuss the relationship between SCH and metabolic syndrome (MS). MethodsThose who received thyroid function tests and health examination in the West China Hospital of Sichuan University from 2011 to 2012 were enrolled in the study. The data of medical history, blood pressure, height, weight, thyroid function, TG, HDL-C, FPG were collected. All data were analyzed by SPSS 18.0 software. ResultsA total of 11 976 persons (7 488 male and 4 488 female) received thyroid function tests. There were 1 820 persons (884 males and 936 females, 15.20%) who suffered from SCH. The SCH prevalence was significantly higher in females (20.86%) than that in males (11.81%) (P < 0.01). The people over 60 years old had the highest SCH prevalence. There were 1 145 persons (1 005 males and 140 females) suffered from MS among all 11 976 persons. The MS prevalence was significantly higher in males (13.42%) than that in females (3.12%) (P < 0.01). The SCH prevalence of the MS group was higher, which in the health group was lower (P < 0.01). The TSH level in the MS group was higher, while it was lower in the health group. ConclusionThe prevalence of SCH is higher in health check-up population; and SCH apparently increases the risk of morbidity of MS.