Archives of Medical Research最新文献_第4页

Hyperandrogenaemia and Systemic Low-Grade Inflammation in Normogonadotropic Anovulation: A Prospective Cohort Study 促性腺激素正常无排卵的高雄激素血症和全身低度炎症：一项前瞻性队列研究

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-10-03 DOI: 10.1016/j.arcmed.2025.103325

Iwona Gawron , Justyna Brodowicz , Krzysztof Skotniczny , Robert Jach

Purpose

To investigate whether clinical and biochemical profiles, including inflammatory mediators, differ between hyperandrogenemia and normoandrogenemia in normogonadotropic anovulation, and to analyze the correlations of selected variables with inflammatory activity.

Methods

Clinical parameters, such as quality of life, and biochemical characteristics, including ovarian, metabolic and inflammatory parameters, were prospectively compared across hyperandrogenemia and normoandrogenemia groups of anovulatory women. Their correlations with interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), interleukin-10 (IL-10), and C-reactive protein (CRP) concentrations – potentially involved in ovulatory mechanisms – were assessed.

Results

The study groups did not differ significantly in terms of selected clinical, inflammatory, and metabolic parameters. Biochemically, the hyperandrogenemia group had significantly higher concentrations of follicle-stimulating hormone, luteinizing hormone, anti-Müllerian hormone, and free triiodothyronine. Testosterone concentration did not exhibit significant correlations with inflammatory indicators. The strongest correlations with IL-6, CRP, and TNF-α concentrations were found for metabolic parameters. Clinical parameters, such as quality of life in “Physical functioning” negatively correlated with IL-6 and CRP, while “Energy/Fatigue” correlated negatively with CRP concentration. Hyperandrogenism indicators, such as the Ferriman-Gallwey score and the free androgen index, positively correlated with IL-6 and CRP concentrations.

Conclusions

Hyperandrogenemia had no effect on clinical, metabolic, or inflammatory parameters. Since no differences in inflammatory parameters were found between hyperandrogenemia and normoandrogenemia, further investigation into the mechanisms of ovulatory defects is warranted. The observed correlations between clinical and metabolic parameters and inflammatory mediators were not driven by hyperandrogenemia. Reducing systemic inflammation and its chronicity is essential to prevent adverse metabolic health outcomes.

目的探讨促性腺激素正常无排卵中高雄激素血症和正常雄激素血症的临床和生化特征（包括炎症介质）是否存在差异，并分析选定变量与炎症活性的相关性。方法前瞻性比较无排卵女性高雄激素血症组和正常雄激素血症组的临床参数，如生活质量和生化指标，包括卵巢、代谢和炎症参数。评估了它们与白细胞介素-6 （IL-6）、肿瘤坏死因子-α (TNF-α)、白细胞介素-1β (IL-1β)、白细胞介素-10 （IL-10）和c反应蛋白（CRP）浓度的相关性，这些浓度可能与排卵机制有关。结果两个研究组在选择的临床、炎症和代谢参数方面没有显著差异。生物化学方面，高雄激素血症组卵泡刺激素、黄体生成素、抗勒氏激素和游离三碘甲状腺原氨酸浓度显著升高。睾酮浓度与炎症指标无显著相关性。代谢参数与IL-6、CRP和TNF-α浓度相关性最强。“身体功能”中的生活质量等临床参数与IL-6、CRP呈负相关，“能量/疲劳”与CRP浓度呈负相关。高雄激素指标，如Ferriman-Gallwey评分和游离雄激素指数，与IL-6和CRP浓度呈正相关。结论过雄激素血症对临床、代谢和炎症参数均无影响。由于在高雄激素血症和正常雄激素血症之间没有发现炎症参数的差异，因此进一步研究排卵缺陷的机制是有必要的。观察到的临床和代谢参数与炎症介质之间的相关性不是由高雄激素血症驱动的。减少全身性炎症及其慢性性对于预防不良的代谢健康结果至关重要。

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引用次数: 0

Pharmacogenetic Drug Administration and Community Health: A Cross-Sectional Telecommunication-Based Study 药物遗传药物管理和社区健康：一项基于电信的横断面研究

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-24 DOI: 10.1016/j.arcmed.2025.103307

Nina D. Anfinogenova , Vadim A. Stepanov , Alina D. Kuznetsova , Nazary P. Chesalov , Sergey V. Popov , Alexey N. Repin

Purpose

Drugs are considered pharmacogenetic (PGx) when genetic variants impact their efficacy, metabolism, or toxicity due to drug-gene interactions. This study aimed to elucidate PGx drug intake patterns in population samples.

Methods

The Short Message Service (SMS) invitations were sent to randomly selected adult clients of a telecommunication company. A total of 2,149 respondents were enrolled. The online questionnaire included questions on demographic, clinical, pharmacological, behavioral, and other factors. PharmGKB resources were used to identify PGx genes potentially involved in pharmacotherapy outcomes. Proneness to adverse drug reactions (ADRs) was assessed based on the ADR index (ADRi).

Results

Most respondents (68.45%) were taking pharmacotherapy (433 drugs) associated with 839 PGx genes. The top five PGx drugs included bisoprolol, aspirin, losartan, indapamide, and omeprazole. The five most important PGx gene families involved in pharmacotherapy were CYP, UGT, SLC, IL, and HLA. The top five PGx genes were: CYP3A5, ABCB1, CYP2D6, CYP2C9, and ACE. The number of PGx genes per drug ranged from 0 to 138. A high number of PGx genes associated with pharmacotherapy were observed in patients with coronary artery disease, diabetes mellitus, endocrine diseases, dyssomnia, and rheumatic diseases. PGx burden significantly correlated with health conditions, median ADRi values, health-related behavioral traits, and clinical-pharmacology characteristics (p <0.001).

Conclusion

The high prevalence of PGx drug utilization encourages the implementation of pre-emptive PGx testing. In the meantime, medical history taking, dose adjustment, assessment of drug blood concentrations, and committing to medical minimalism may prevent PGx-triggered ADRs.

当基因变异由于药物-基因相互作用而影响其疗效、代谢或毒性时，药物被认为是药物遗传学（PGx）。本研究旨在阐明PGx药物在人群样本中的摄入模式。方法随机抽取某电信公司成年客户，向其发送短信邀请。共有2149名受访者被招募。在线问卷包括人口学、临床、药理学、行为学和其他因素的问题。利用PharmGKB资源鉴定可能与药物治疗结果相关的PGx基因。采用ADR指数（ADR index, ADRi）评价药物不良反应（ADR）的易发性。结果大部分受访患者（68.45%）正在接受与839个PGx基因相关的药物治疗（433种药物）。排名前五的PGx药物包括比索洛尔、阿司匹林、氯沙坦、吲达帕胺和奥美拉唑。参与药物治疗的五个最重要的PGx基因家族是CYP、UGT、SLC、IL和HLA。前5位PGx基因分别为：CYP3A5、ABCB1、CYP2D6、CYP2C9和ACE。每种药物的PGx基因数量从0到138不等。在冠状动脉疾病、糖尿病、内分泌疾病、睡眠障碍和风湿病患者中观察到大量与药物治疗相关的PGx基因。PGx负担与健康状况、中位ADRi值、健康相关行为特征和临床药理学特征显著相关（p <0.001）。结论PGx药物使用率高，鼓励开展预防性PGx检测。同时，病史记录、剂量调整、药物血药浓度评估以及医疗简约可以预防pgx引发的不良反应。

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引用次数: 0

Impact of Maternal Obesity on Offspring microRNA Profiles: A Systematic Review of Experimental Models 母亲肥胖对后代microRNA谱的影响：实验模型的系统综述

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-23 DOI: 10.1016/j.arcmed.2025.103323

Randriely Merscher Sobreira de Lima , Pauline Maciel August , Ariadni Mesquita Peres , Alessandra Gonçalves Machado , Carine Lampert , Joelma Alves , Thiago Ângelo Smaniotto , Rachel Krolow , Carla Dalmaz , Camila Perelló Ferrúa

Maternal malnutrition, including obesity, can have long-term adverse effects on offspring health, potentially mediated by epigenetic mechanisms such as microRNAs (miRNAs). These miRNAs play a critical role in regulating gene expression and may contribute to the developmental programming of offspring outcomes. This systematic review aimed to explore the association between maternal obesity during pregnancy and miRNA alterations in offspring, focusing on evidence from animal models. A comprehensive search of the Embase, PubMed, and Scopus databases identified 811 articles, 15 of which met the inclusion criteria. Our analysis revealed significant variability in the miRNAs and target tissues studied. Across the reviewed studies, 35 miRNAs were identified as differentially expressed in offspring exposed to maternal high-fat diet during pregnancy. These alterations were predominantly observed in the brain, liver, cardiac tissue, and adipose tissue, affecting processes related to insulin signaling, development and growth, immune response, and lipid metabolism. The observed miRNA alterations support the hypothesis that a maternal high-fat diet may induce a programmed epigenetic signature in offspring.

包括肥胖在内的孕产妇营养不良可能会对后代健康产生长期不利影响，这可能是由microRNAs （miRNAs）等表观遗传机制介导的。这些mirna在调节基因表达中起着关键作用，并可能有助于后代的发育规划。本系统综述旨在探讨怀孕期间母亲肥胖与后代miRNA改变之间的关系，重点关注动物模型的证据。对Embase、PubMed和Scopus数据库的全面搜索确定了811篇文章，其中15篇符合纳入标准。我们的分析显示，在所研究的mirna和靶组织中存在显著的可变性。在回顾的研究中，35种mirna在怀孕期间暴露于母体高脂肪饮食的后代中被鉴定为差异表达。这些改变主要在大脑、肝脏、心脏组织和脂肪组织中观察到，影响与胰岛素信号传导、发育和生长、免疫反应和脂质代谢相关的过程。观察到的miRNA改变支持了母体高脂肪饮食可能在后代中诱导程序性表观遗传特征的假设。

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引用次数: 0

Evaluation of the Pilot Human Papillomavirus Self-Sampling Program in Workplaces in Ciudad Juárez, Mexico 墨西哥Juárez市工作场所人类乳头瘤病毒自采样试点项目的评价

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-20 DOI: 10.1016/j.arcmed.2025.103316

Svetlana V. Doubova , Saúl Eduardo Contreras-Sánchez , Sean P. McClellan , Patricia Piña-Sánchez

Objective

To examine cervical cancer screening (CCS) coverage and follow-up before and after the introduction of the workplace Human Papilloma Virus self-sampling pilot program (HPV-SS-PP) for female factory workers in Ciudad Juárez, Mexico and to compare HPV-SS with conventional cervical cytology screening using the Papanicolaou (Pap) smear method.

Methods

A secondary analysis was conducted using the Instituto Mexicano del Seguro Social (IMSS) cancer registry, the HPV-SS-PP registry, and the IMSS affiliation database. The study focused on IMSS-affiliated working women aged 35–64 living in Ciudad Juárez. We examined trends in CCS coverage during the 38 months before and the first 12 months after the HPV-SS-PP. We also examined HPV prevalence and follow-up indicators for HPV-positive women.

Results

The study found that 44.8% of factories and 42.7% of women accepted the HPV-SS-PP program, leading to an initial increase and subsequent slowdown in CCS coverage. The HPV-16/18 genotype prevalence was 5%, and the HPV-pool prevalence was 18.1%. Follow-up for cervical cytology among women testing positive for the HPV-pool was 39.7%. Colposcopy and histopathology follow-up for HPV-16/18 genotypes and HPV-pool were moderate to high (64.8 and 84.7% for colposcopy, 87.8 and 93.2% for histopathology follow-up, respectively).

Conclusion

The HPV-SS-PP requires improvements to increase working women’s participation in CCS and ensure better follow-up of positive HPV results.

目的了解墨西哥Juárez市工厂女工实施工作场所人乳头瘤病毒自采样试点（HPV-SS- pp）前后宫颈癌筛查（CCS）覆盖率和随访情况，并将HPV-SS与传统宫颈细胞学筛查（巴氏涂片法）进行比较。方法采用墨西哥社会医学研究所（IMSS）癌症登记处、HPV-SS-PP登记处和IMSS隶属数据库进行二次分析。这项研究的重点是居住在古巴城Juárez的年龄在35-64岁的imss附属职业女性。我们检查了HPV-SS-PP前38个月和后12个月CCS覆盖率的趋势。我们还检查了HPV阳性妇女的HPV患病率和随访指标。研究发现，44.8%的工厂和42.7%的妇女接受了HPV-SS-PP计划，导致CCS覆盖率最初增加，随后放缓。HPV-16/18基因型患病率为5%，hpv -池患病率为18.1%。宫颈细胞学随访中hpv池检测阳性的女性为39.7%。阴道镜和组织病理学随访中HPV-16/18基因型和HPV-pool的阳性率为中高（阴道镜64.8%和84.7%，组织病理学随访87.8和93.2%）。结论HPV- ss - pp需要改进，以增加职业妇女参与CCS，并确保HPV阳性结果的更好随访。

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引用次数: 0

Polygenic Risk Scores for Breast Cancer: Modern Approaches to Risk Prediction and Subtype Identification 乳腺癌的多基因风险评分：风险预测和亚型识别的现代方法。

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103319

Krishna Dipp-Martin , Sandra Karina Santuario-Facio , Rocío Ortiz-Lopez , Rafael Argüello-Astorga , Faviel Francisco González-Galarza

Breast cancer (BC), a complex disease characterized by the uncontrolled proliferation of breast cells, poses a major global health challenge. Its increasing prevalence is influenced by a combination of genetic, environmental, and lifestyle factors. While hereditary mutations in high-risk genes contribute to only a small percentage of cases, the majority may be influenced by common genetic variations that collectively determine individual susceptibility. The polygenic risk score (PRS) has emerged as a transformative tool that leverages the cumulative effects of multiple genetic variants to improve risk prediction beyond traditional single-gene models. When integrated with conventional risk factors, such as age, reproductive history, and modifiable lifestyle behaviors, PRS offers a more comprehensive approach to personalized risk assessment. Recent studies highlight its potential to guide targeted screening strategies, early interventions, and precision prevention efforts. This review provides insight into current PRS research and its clinical applications in BC risk stratification. It also explores the promise of PRS in shaping the future of precision oncology.

乳腺癌是一种以乳腺细胞不受控制的增殖为特征的复杂疾病，对全球健康构成重大挑战。其日益普遍的流行受到遗传、环境和生活方式等因素的综合影响。虽然高危基因的遗传突变只导致一小部分病例，但大多数病例可能受到共同遗传变异的影响，这些变异共同决定了个体的易感性。多基因风险评分（PRS）已经成为一种变革性的工具，它利用多基因变异的累积效应来改进传统单基因模型之外的风险预测。当与传统的风险因素（如年龄、生育史和可改变的生活方式行为）相结合时，PRS提供了一种更全面的个性化风险评估方法。最近的研究强调了它在指导有针对性的筛查策略、早期干预和精确预防工作方面的潜力。本文综述了目前的PRS研究及其在BC危险分层中的临床应用。它还探讨了PRS在塑造精准肿瘤学未来方面的前景。

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引用次数: 0

When There is More than Meets the Eye: It is Time to Team up with AI 当有更多的满足眼睛：是时候与人工智能合作。

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103327

Yasmine Boumerdassi , Vincent Puy , Solmaz Sarandi , Michael Grynberg , Maeliss Peigne , Christophe Sifer

引用次数: 0

Pharmacogenetics, Polypharmacy, and the Future of Safer Prescribing: From Population Insights to Clinical Action 药物遗传学，多药，和更安全的处方的未来：从人口的见解到临床行动。

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103315

Oscar Arias-Carrión , Héctor A. Cabrera-Fuentes

引用次数: 0

Global Burden of Peptic Ulcer Disease in Adolescents and Young Adults: Trends and Disparities from 1990–2021 青少年和年轻人消化性溃疡疾病的全球负担：1990-2021年的趋势和差异

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103320

Tai Zhang , Beihua Zhang , Xudong Tang

Background

Peptic ulcer disease (PUD) significantly impacts adolescents and young adults (15–49 years), yet there are limited comprehensive analyses of its burden in this age group. This study examines global, regional, and national trends in PUD epidemiology from 1990–2021.

Methods

Using data from the 2021 Global Burden of Disease (GBD) Study, we analyzed PUD prevalence, incidence, disability-adjusted life years (DALYs), and mortality across 204 countries, stratified by age, sex, socio-demographic index (SDI), and GBD regions. Trends were quantified using estimated annual percentage changes (EAPC) and joinpoint regression.

Results

From 1990–2021, the global prevalence and incidence rates of PUD declined by 32.9 and 32.3%, respectively. Mortality and DALY rates decreased by 60.6 and 60.0%), respectively. Absolute cases increased by 50% in low SDI regions, while reductions were observed in middle SDI regions. South Asia and Western Sub-Saharan Africa had the highest prevalence rates. Sex disparities were evident, with males aged 45–49 having a prevalence rate that was 1.4-fold higher and a mortality rate that was 2.2-fold higher than females. Socioeconomic development inversely correlated with DALY rates (R = –0.708), but progress slowed after 2015 in high SDI regions.

Conclusions

The rising number of PUD cases in low SDI regions reflects population growth and limited healthcare access. Disparities highlight the need for targeted strategies. The slowed progress in high SDI regions indicates aging and evolving disease patterns. Tailored interventions are key for equitable control.

背景：消化性溃疡疾病（PUD）对青少年和年轻人（15-49岁）的影响显著，但对这一年龄组的负担的综合分析有限。本研究调查了1990-2021年全球、地区和国家PUD流行病学趋势。方法：使用2021年全球疾病负担（GBD）研究的数据，我们分析了204个国家的PUD患病率、发病率、残疾调整生命年（DALYs）和死亡率，并按年龄、性别、社会人口指数（SDI）和GBD地区进行了分层。使用估计的年百分比变化（EAPC）和连接点回归对趋势进行量化。结果：1990-2021年，全球PUD患病率和发病率分别下降了32.9%和32.3%。死亡率和DALY分别下降60.6%和60.0%。在低SDI地区，绝对病例增加了50%，而在中等SDI地区则减少了。南亚和西撒哈拉非洲的患病率最高。性别差异很明显，45-49岁男性的患病率比女性高1.4倍，死亡率比女性高2.2倍。社会经济发展与DALY率呈负相关（R = -0.708），但在2015年之后，高SDI地区的社会经济发展放缓。结论：低SDI地区PUD病例数的上升反映了人口增长和医疗保健服务的有限性。差距突出表明需要有针对性的战略。在高SDI区域，进展缓慢表明了衰老和疾病模式的演变。量身定制的干预措施是公平控制的关键。

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引用次数: 0

Health Outcomes in Fragility Fractures in the Spanish Registry of Osteoporotic Fractures According to the FLS Care Model 根据FLS护理模型，西班牙骨质疏松性骨折登记处脆性骨折的健康结果

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103302

Leonor Cuadra-LLopart , Samantha Santana Zorrilla , Daniel Martínez-Laguna , Mercè Giner , Rafael Izquierdo Aviñó , Ma Jose Montoya-Garcia , Diana Ovejero Crespo , Manuel Mesa Ramos , Sonia Castro Oreiro , Laura Fernández Sénder , Leticia Lojo-Oliveira , Carmen Gomez-Vaquero , Christian Alvarado Escobar , Ma Jesús Montesa , Teresa Pareja Sierra , Cristina Campos Fernández , Jose Cancio-Trujillo , Sonia Fuentes , Ma Jose Marassi-Campos , Guillermo Martinez Diaz-Guerra , Jesús Mora-Fernández

Background

Fracture Liaison Services (FLS) are the gold standard for secondary fracture prevention, but their characteristics vary depending on the care model. This study describes the differences between Orthogeriatric (FLS-ORT) and Bone Metabolism (FLS-MET) models in Spain, based on data from the national osteoporotic fracture registry.

Methods

We conducted a retrospective, multicenter cohort study including 8,962 patients aged ≥50 years with fragility fractures from 25 active FLS in Spain (2019–2023). Patients were classified based on the care model: FLS-ORT (n = 3,695) or FLS-MET (n = 5,267). Baseline characteristics, fracture types, treatment initiation, adherence, and 12-month outcomes were compared.

Results

FLS-ORT patients were older (85 vs. 78 years, p <0.001), had more comorbidities, and a higher risk of falls. Hip fractures were predominant in FLS-ORT (75.8%), while vertebral fractures were more frequent in FLS-MET (p <0.001). Time from fracture to FLS assessment was shorter in FLS-ORT (0.1 vs. 1.6 months, p <0.001). At 12 months, fracture recurrence was higher in FLS-ORT (7.7 vs. 5.5 per 100 patient-years), and mortality was significantly greater (p <0.0001). However, osteoporosis treatment initiation (84.6%) and adherence (85.2%) were comparable across models.

Conclusions

FLS are the gold standard for secondary fracture prevention. Both FLS care models (FLS-ORT and FLS-MET) were effective in reducing the risk of new fractures in patients and minimizing the impact on the quality of life of patients who suffer a fragility fracture. Future integration into a unified model assessing all fractures is anticipated.

背景：骨折联络服务（FLS）是二级预防骨折的金标准，但其特点因护理模式而异。本研究基于西班牙国家骨质疏松性骨折登记处的数据，描述了西班牙骨科（FLS-ORT）和骨代谢（FLS-MET）模型之间的差异。方法：我们进行了一项回顾性多中心队列研究，包括8962例年龄≥50岁的西班牙25例活动性FLS脆性骨折患者（2019-2023）。患者根据护理模式进行分类：FLS-ORT （n = 3,695）或FLS-MET （n = 5,267）。比较基线特征、骨折类型、治疗开始、依从性和12个月的结果。结果：FLS- ort患者年龄较大（85岁vs. 78岁）。结论：FLS是预防继发性骨折的金标准。两种FLS护理模式（FLS- ort和FLS- met）都能有效降低患者新骨折的风险，并最大限度地减少对脆性骨折患者生活质量的影响。预计未来将整合到评估所有裂缝的统一模型中。

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引用次数: 0

Is Natural IgM a Resilience Factor to Cancer? 天然IgM是癌症的恢复因子吗？

IF 3.4 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-09-18 DOI: 10.1016/j.arcmed.2025.103322

RICARDO HERNÁNDEZ ÁVILA , JORGE MORALES MONTOR , MARCELA ARTEAGA-SILVA , PEDRO OSTOA-SALOMA

引用次数: 0