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Correlation of serum vitamin D with serum lipid in middle-aged and elderly people 中老年人血清维生素D与血脂的相关性研究
Q4 Nursing Pub Date : 2018-12-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.06.003
Wenxia Cui, Haiyan Yang, Fenghui Pan, Hui Wang, Weng Zheng, Man Li
Objective To investigate the correlation of serum 25-hydroxy-vitamin D (25-OH-D) with lipid profiles in middle-aged and elderly patients. Methods A total of 284 patients aged over 40 years and admitted in our hospital from May 2016 to May 2017 were selected and divided into four groups according to 25-OH-D levels as the group of normal level which was not less than 30 ng/ml, the group of slight deficiency which was between 20 and 29 ng/ml, the group of moderate deficiency which was between 10 and 19 ng/ml, and the group of severely deficiency which was under 10 ng/ml. Fasting blood draw were taken to detect liver and renal functions, lipids, calcium, phosphorus and 25-OH-D levels. The level of lipids between groups was compared by one-way ANOVA, and the association between lipid profiles and 25-OH-D levels was assessed by Pearson correlation and multiple linear regression. Results The levels of triglyceride (TG), low density lipoprotein cholesterin (LDL-C) and total cholesterol/high density lipoprotein cholesterol (TC/ HDL-C) were significantly higher and the HDL-C levels were significantly lower in the groups of severely deficiency, moderate deficiency and slight deficiency than in the normal group (P=0.035, P=0.015, P=0.013). The levels of serum 25-OH-D were significantly higher in HDL-C≥1.04 mmol/L group than in HDL-C<1.04 mmol/L group (Female P=0.007, male P=0.034). The correlation analysis showed that serum 25-OH-D level was positively associated with HDL-C (female r=0.309, P=0.002, male r=0.241, P=0.002). The multiple linear regression analysis showed that 25-OH-D level was positively correlated with HDL-C, after adjusting age, BMI, liver and kidney function, serum calcium and serum phosphorus (female β=0.259, P=0.047, male β=0.217, P=0.049). Conclusion The incidence of vitamin D deficiency is high in middle-aged and elderly patients, and the level of serum 25-OH-D is positively correlated with HDL-C. Key words: 25-hydroxy vitamin D; Lipid profiles; Middle-aged and elderly people
目的探讨中老年患者血清25-羟基维生素D(25-OH-D)与血脂水平的相关性。方法选择2016年5月至2017年5月在我院住院的284例年龄在40岁以上的患者,根据25-OH-D水平分为四组:正常水平不低于30ng/ml组、轻度缺乏水平在20至29ng/ml组和中度缺乏水平在10至19ng/ml组,严重缺乏组低于10ng/ml。空腹抽血检测肝肾功能、脂质、钙、磷和25-OH-D水平。通过单因素方差分析比较各组之间的脂质水平,并通过Pearson相关性和多元线性回归评估脂质概况与25-OH-D水平之间的相关性。结果严重缺乏组甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和总胆固醇/高密度脂蛋白-胆固醇(TC/HDL-C)水平显著升高,高密度脂蛋白胆固醇≥1.04mmol/L组血清25-OH-D水平显著高于高密度脂素胆固醇<1.04mmol/L组(女性P=0.007,男性P=0.034)多元线性回归分析显示,在调整年龄、BMI、肝肾功能、血清钙和血清磷后,25-OH-D水平与HDL-C呈正相关(女性β=0.259,P=0.047,男性β=0.217,P=0.049),血清25-OH-D水平与HDL-C呈正相关。关键词:25-羟基维生素D;脂质概况;中老年人
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引用次数: 0
Correlation of body weight with structure and function of left ventricle in elderly inpatients 老年住院患者体重与左心室结构、功能的关系
Q4 Nursing Pub Date : 2018-12-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.06.001
Hua Zhong, Wei Chen, L. Fang, K. Yu, Hong Jiang
Objective To explore the relationship between the body weight and the structure and function of the left ventricle in the elderly inpatients, in order to emphasize the importance of body weight in the health management for elderly patients. Methods A total of 152 elderly inpatients meeting the enrollment criteria and providing informed consent were consecutively recruited. The height, body weight, body mass index (BMI), liver and kidney function, glycosylated hemoglobin, blood lipid, blood uric acid and structure and function of left ventricular were measured by anthropometry, biochemical examination and echocardiography respectively. The clinical characteristics, metabolic parameters, structure and function of left ventricular were compared among the low/normal weight, overweight and obesity groups. The correlation between left ventricular diastolic dysfunction (E/A≤0.7) and the metabolic factors was analyzed. Results The incidences of lower/normal weight, overweight and obesity in elderly inpatients were 29.6% (45/152), 52.6% (80/152) and 17.8% (27/152) respectively. Compared with the lower/normal weight group, the level of systolic blood pressure, glycosylated hemoglobin(P=0.005), left atrial diameter(P=0.000), left ventricular posterior wall dimension(P=0.010), left ventricular diastolic diameter(P=0.010), left ventricular mass(P=0.000), relative wall thickness and septal thickness increased significantly in overweight and obesity groups (all P<0.05). A higher proportion of left ventricular diastolic dysfunction was observed in overweight and obesity groups in the patients aging 60-69 years (P=0.028). There was positive correlation between left ventricular diastolic dysfunction and BMI (P=0.022). Conclusions Overweight/obesity increases the risk of left ventricular diastolic dysfunction among elderly inpatients. The body weight management needs to be strengthened in health management for the elderly patients. Key words: Elderly inpatient; Body mass index; Left ventricle; Correlation
目的探讨老年住院患者的体重与左心室结构和功能的关系,以强调体重在老年患者健康管理中的重要性。方法连续招募符合入组标准并提供知情同意书的152名老年住院患者。分别采用人体测量、生化检查和超声心动图测量身高、体重、体重指数、肝肾功能、糖化血红蛋白、血脂、血尿酸及左心室结构和功能。比较低/正常体重组、超重组和肥胖组的临床特征、代谢参数、左心室结构和功能。分析左心室舒张功能障碍(E/A≤0.7)与代谢因素的相关性。结果住院老年人低体重/正常体重、超重和肥胖的发生率分别为29.6%(45/152)、52.6%(80/152)和17.8%(27/152)。与体重较低/正常组相比,收缩压、糖化血红蛋白(P=0.005)、左心房直径(P=0.000)、左心室后壁尺寸(P=0.010)、左室舒张直径(P=0.010,超重组和肥胖组的相对壁厚和室间隔厚度均显著增加(均P<0.05)。在60-69岁的患者中,超重组和肥胖症组左心室舒张功能障碍的比例较高(P=0.028)。左心室舒张功能紊乱与BMI呈正相关(P=0.022)增加了老年住院患者左心室舒张功能障碍的风险。老年患者的健康管理需要加强体重管理。关键词:老年住院患者;体重指数;左心室;相关性
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引用次数: 0
Vitamin D status in early pregancy 妊娠早期的维生素D水平
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.004
Yan Ding, Yinyang Xu, Yi Wang, Qianqian Zhang, Xiaoyi Huang, Zhen Tang, W. Gu, Jianxia Fan, Wen-qiu Yu
Objective To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. Methods Plasma was collected in the first trimester from 23 396 pregnant women to investigate the vitamin D level, and its distribution and differences in different age, body maxx index(BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. Results 25-hydroxy vitamin D level was 42.0(17.6-76.6)nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20.2 nmol/L and 70.7 nmol/L respectively. There were 18 170(77.7%) primiparas and 5 226(22.3%) multiparas, with the mean age of 30.0(24.0-38.0) years and BMI of 20.7(16.5-27.6)kg/m2. The number of cases detected in spring (March, April and May), summer(June, July and August), autumn(September, October and November months) and winter(December, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40.0(29.3, 52.7)nmol/L, 46.2(35.6, 57.2)nmol/L, 43.8(33.1, 54.8)nmol/L and 37.2(26.9, 49.9)nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0.001). According to BMI, all pregnant women were divided into four groups as BMI<18.5 kg/m2, 18.5 kg/m2≤BMI≤23.9 kg/m2, 24 kg/m2≤BMI≤27.9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43.5(30.9, 56.9)nmol/L, 42.1(30.8, 53.8)nmol/L, 39.9(30.7, 50.4)nmol/L and 39.7(30.7, 49.4)nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years, ≥35 years were 39.1(28.4, 52.3)nmol/L, 41.3(30.1, 52.9)nmol/L, 42.4(31.2, 54.1)nmol/L and 43.8(31.9, 55.7)nmol/L respectively and the difference was statistically significant (P<0.001). The levels of 25- hydroxy vitamin D in primary and multiparas were 41.6(30.2, 52.9)nmol/L and 43.5(32.5, 56.8) nmol/L with the difference statistically significant (P<0.001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant(P=0.121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vitamin D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of different ages, seasons and BMI between primiparas and multiparas. Conclusions Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter
目的探讨妊娠早期血清25-羟基维生素D浓度及相关因素。方法收集23 396名孕妇孕早期血浆,了解初产妇和经产妇维生素D水平及其在不同年龄、体重指数(BMI)和季节的分布和差异。早产被用作临床结果的指标。使用化学发光微粒免疫测定法测定维生素D浓度。结果23 396例妊娠早期孕妇的25-羟基维生素D水平为42.0(17.6-76.6)nmol/L,维生素D水平的5%和95%位点分别为20.2和70.7 nmol/L。初产妇18170例(77.7%),经产妇5226例(22.3%),平均年龄30.0岁(24.0-38.0),BMI为20.7(16.5-27.6)kg/m2。春季(3月、4月和5月)、夏季(6月、7月和8月)、秋季(9月、10月和11月)和冬季(12月、1月和2月)检测到的病例数分别为5 878、5 554、5 974和5 990,维生素D水平分别为40.0(29.3、52.7)nmol/L、46.2(35.6、57.2)nmol/L、43.8(33.1、54.8)nmol/L和37.2(26.9、49.9)nmol/L,根据BMI将所有孕妇分为四组:BMI<18.5kg/m2、18.5kg/m2≤BMI≤23.9kg/m2、24kg/m2≤≤BMI≤27.9kg/m2、BMI≥28kg/m2,25-羟基维生素D水平分别为43.5(30.9,56.9)nmol/L、42.1(30.8,53.8)nmol/L,39.9(30.7,50.4)nmol/L和39.7(30.7,49.4)nmol/L,四组间差异有统计学意义。年龄<25岁、25~29岁、30~34岁、≥35岁孕妇的维生素D水平分别为39.1(28.4,52.3)nmol/L、41.3(30.1,52.9)nmol/L,42.4(31.2,54.1)nmol/L和43.8(31.9,55.7)nmol/L,差异有统计学意义(P<0.001)。原代和经产妇的25-羟基维生素D水平分别为41.6(30.2,52.9)nmol/L和43.5(32.5,56.8)nmol/L,妊娠早期血清25-羟基维生素D的差异无统计学意义(P=0.121)。初产妇和经产妇在不同年龄、季节和BMI的情况下发生严重维生素D缺乏症的概率存在统计学差异。结论低体重、低年龄、初产妇在孕早期严重缺乏维生素D的发生率较高。不同季节(冬季)25-羟基维生素D水平存在显著差异
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引用次数: 2
Effects of high-fat diet on liver function and intestinal bacterial community in rats 高脂饮食对大鼠肝功能和肠道细菌群落的影响
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.007
Shi-yong Zhao, Xianyao Lin, Wen Song, Haishao Chen
Objective To investigate the influence of high-fat diet on liver function and intestinal bacterial community through building rat models. Methods 20 rats of 21 days old were divided into two groups randomly as normal diet group fed with standard chow diet and high-fat group fed with high-fat diet. After 6 weeks, feces of rats in both groups were obtained for 16S rRNA high-through sequencing of the intestinal bacterial community. Results After 6 weeks high-fat diet, total protein (TP)(55.79±3.75, P=0.002), globin (GLB)( 34.9±2.53, P<0.001), albumin (ALB)/GLB (.60±0.02, P<0.001), alkaline phosphatase (ALP)(373.80±63.05, P<0.001), total cholesterol (TC)(1.94±0.23, P<0.001), low density lipoprotein (LDL)(0.76±0.93, P<0.001), LDL/high density lipoprotein (HDL)(1.43±0.22, P<0.001), and triglyceride (TG)(1.48±0.50, P=0.015) increased compared with the normal diet group. Additionally, intestinal bacterial diversity and evenness decreased significantly. The dominant bacteria were Bacteroidetes, Firmicutes, and Proteobacteria, with averaged relative abundances as 56.36%, 35.31%, and 6.61%, respectively. The relative abundances of Bacteroidetes deceased (P=0.007), those of Firmicutes increased (P=0.020), and those of Proteobacteria were kept stable (P=0.928) after a 6-week high-fat diet. Furthermore, the intestinal bacterial community structure changed distinctly between the two groups by 16s rRNA high-through sequencing. Conclusion High-fat diet can lead to change of intestinal bacterial community structure and further result in liver function damnification as well as obesity. Key words: High-through sequencing; 16S rRNA; Rat; Intestinal bacterial community; Liver function
目的通过建立大鼠模型,探讨高脂饮食对肝功能和肠道细菌群落的影响。方法20只21日龄大鼠随机分为正常饮食组和高脂饮食组。6周后,通过对肠道细菌群落进行测序,获得两组大鼠的粪便中16S rRNA高。结果高脂饮食6周后,总蛋白(TP)(55.79±3.75,P=0.002)、球蛋白(GLB)(34.9±2.53,P<0.001)、白蛋白(ALB)/GLB(.60±0.02,P<0.001,甘油三酯(TG)(1.48±0.50,P=0.015)较正常饮食组升高。此外,肠道细菌多样性和均匀性显著下降。优势菌为拟杆菌门、厚壁菌门和变形菌门,平均相对丰度分别为56.36%、35.31%和6.61%。在6周的高脂饮食后,拟杆菌门的相对丰度死亡(P=0.007),厚壁菌门的相对丰富度增加(P=0.020),变形菌门保持稳定(P=0.928)。此外,通过测序,两组之间的肠道细菌群落结构通过16s rRNA高水平发生了明显变化。结论高脂饮食可引起肠道细菌群落结构的改变,进而导致肝功能损伤和肥胖。关键词:高通排序;16S rRNA;大鼠;肠道细菌群落;肝功能
{"title":"Effects of high-fat diet on liver function and intestinal bacterial community in rats","authors":"Shi-yong Zhao, Xianyao Lin, Wen Song, Haishao Chen","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.007","url":null,"abstract":"Objective \u0000To investigate the influence of high-fat diet on liver function and intestinal bacterial community through building rat models. \u0000 \u0000 \u0000Methods \u000020 rats of 21 days old were divided into two groups randomly as normal diet group fed with standard chow diet and high-fat group fed with high-fat diet. After 6 weeks, feces of rats in both groups were obtained for 16S rRNA high-through sequencing of the intestinal bacterial community. \u0000 \u0000 \u0000Results \u0000After 6 weeks high-fat diet, total protein (TP)(55.79±3.75, P=0.002), globin (GLB)( 34.9±2.53, P<0.001), albumin (ALB)/GLB (.60±0.02, P<0.001), alkaline phosphatase (ALP)(373.80±63.05, P<0.001), total cholesterol (TC)(1.94±0.23, P<0.001), low density lipoprotein (LDL)(0.76±0.93, P<0.001), LDL/high density lipoprotein (HDL)(1.43±0.22, P<0.001), and triglyceride (TG)(1.48±0.50, P=0.015) increased compared with the normal diet group. Additionally, intestinal bacterial diversity and evenness decreased significantly. The dominant bacteria were Bacteroidetes, Firmicutes, and Proteobacteria, with averaged relative abundances as 56.36%, 35.31%, and 6.61%, respectively. The relative abundances of Bacteroidetes deceased (P=0.007), those of Firmicutes increased (P=0.020), and those of Proteobacteria were kept stable (P=0.928) after a 6-week high-fat diet. Furthermore, the intestinal bacterial community structure changed distinctly between the two groups by 16s rRNA high-through sequencing. \u0000 \u0000 \u0000Conclusion \u0000High-fat diet can lead to change of intestinal bacterial community structure and further result in liver function damnification as well as obesity. \u0000 \u0000 \u0000Key words: \u0000High-through sequencing; 16S rRNA; Rat; Intestinal bacterial community; Liver function","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41384547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
24 published papers from nutrition support pharmacist: a primitive review 营养支持药师发表论文24篇
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.010
W. Qu, Guofang Wang, Qingqing Li
Objective To understand the present situation and existing problems of the pharmaceutical care of Nutrition Support Pharmacists (NSP) in China and provide reference for pharmaceutical care of NSP. Method Literatures about pharmaceutical care from NSP were retrieved in domestic medical journals from January 2011 to January 2017, and totally 24 articles were analyzed and discussed. Result There were still many problems in NSP, such as the use of Nutritional Risk Screening, and the ratio of glucose/lipid ratio, ratio of non-protein energy to nitrogen ratio, the lack or excess of vitamin and trace elements and the use of insulin and propylene ammonia acyl glutamine in total parenteral nutrition prescription, TPN osmotic pressure and drip time, and the application of glucose and fat milk energy density. Conclusion The pharmaceutical care of NSP starts relatively late, there are still many problems, and the capacity and theoretical level of NSP need to be improved. Key words: Nutrition support pharmacists; Pharmaceutical care; Literature analysis; Total paren-teral nutrition
目的了解全国营养支持药师药学服务现状及存在的问题,为营养支持药师药学服务提供参考。方法检索2011年1月~ 2017年1月国内医学期刊上有关NSP药学服务的文献,对其中24篇进行分析讨论。结果NSP仍存在许多问题,如营养风险筛查的使用、全肠外营养处方中糖脂比、非蛋白能氮比、维生素和微量元素的缺乏或过量以及胰岛素和丙氨酰谷氨酰胺的使用、TPN渗透压和滴注时间、葡萄糖和脂肪乳能量密度的应用等。结论NSP的药学服务起步较晚,存在诸多问题,服务能力和理论水平有待提高。关键词:营养支持药师;药学服务;文献分析;全肠外营养
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引用次数: 0
Correlations of maternal calcium supplementation and dietary calcium intake with preterm birth 母亲补钙和膳食钙摄入量与早产的相关性
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.003
Shao Yawen, B. Yan, L. Ru, He Wenhua, Huaiye Su, W. Qiu
Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the association of calcium supplementation and intake with preterm birth. Results After confounding factors were adjusted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding (OR=0.86, 95% CI=0.77-0.96, P<0.05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimester was a protective factor for preterm birth and especially significant in early and very early pregnancy (OR=0.75, 95% CI=0.62-0.92, P<0.05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465.55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0.66, 95% CI=0.53-0.82, P<0.05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially significant in late pregnancy. Key words: Calcium; Preterm birth; Late pregnancy; Epidemiology
目的探讨母亲补钙及膳食钙摄入量与早产的关系,为有效干预早产提供科学依据。方法选择甘肃省妇幼保健院分娩前全程随访的正常孕妇。多变量逻辑回归用于评估钙补充和摄入量与早产的关系。结果调整混杂因素后,在妊娠前和/或妊娠期间补钙3个月以上的孕妇早产风险降低14%,具有剂量反应性(or=0.86,95%CI=0.77~0.96,P<0.05),研究发现,孕晚期补钙是早产的保护因素,在妊娠早期和极早期尤为显著(OR=0.75,95%CI=0.62-0.92,P<0.05),膳食钙摄入量大于465.55mg/d的孕妇早产风险显著降低,表现为不同程度的早产减少,结论孕前和孕期适当补钙或膳食钙摄入可降低早产风险,在孕晚期尤为显著。关键词:钙;早产;妊娠晚期;流行病学
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引用次数: 0
Impact of sarcopenia on the risk of falls, osteoporosis, fractures, and all causes of death among elderly people: A Meta-analysis of prospective cohort studies 少肌症对老年人跌倒、骨质疏松、骨折和所有死因风险的影响:前瞻性队列研究的Meta分析
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.008
Min Cui, Kang Yu, Chun-wei Li
Objective To explore the relationship between sarcopenia and the risks of falls, osteoporosis, fractures and all-cause mortality among elderly people. Methods This was a meta-analysis of prospective cohort studies. Databases of OVID/Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese WanFang Database were searched systematically according to the inclusion and exclusion criteria.The literatures related to the relationship between sarcopenia and falls, osteoporosis, fractures and all-cause mortality among elderly people from January 1987 to June 2017 were identified.The quality of the literature was evaluated by the risk assessment tool Newcastle-Ottawa Scale recommended by the Cochrane. Meta-analysis was conducted by RevMan 5.3 and Stata 12.1 software. Results Totally 13 prospective cohort studies including 19 376 subjects and 3 190 outcome events were entered in meta-analysis. The relative risk (RR) for comprehensive adverse outcome events among subjects with sarcopenia was 1.64 times of non-sarcopenia subjects(95% CI=1.51-1.78, P<0.000 01), and the RRs for fall, osteoporosis, fractures and all-cause mortality were 1.60 (95% CI=1.42-1.81, P<0.000 01), 4.85 (95% CI=2.18-10.79, P=0.000 1), 1.59 (95% CI=1.40-1.80, P<0.000 01), 2.08 (95% CI=1.18-3.69, P=0.01) times of non-sarcopenia subjects respectively. Conclusion Sarcopenia increases the risk of falls, fractures, all-cause mortality and comprehensive adverse outcome significantly, suggesting that sarcopenia might be a predictor for adverse outcomes among elderly people. Key words: Sarcopenia; Falls; Osteoporosis; Fractures; Mortality
目的探讨老年人少肌症与跌倒、骨质疏松、骨折及全因死亡率的关系。方法对前瞻性队列研究进行荟萃分析。根据纳入和排除标准,系统检索OVID/Medline、PubMed、EMBASE、Cochrane Library、中国知网(CNKI)和中国万方数据库。对1987年1月至2017年6月老年人少肌症与跌倒、骨质疏松、骨折和全因死亡率关系的相关文献进行了整理。文献质量通过Cochrane推荐的风险评估工具Newcastle Ottawa量表进行评估。使用RevMan 5.3和Stata 12.1软件进行荟萃分析。结果共纳入13项前瞻性队列研究,包括19376例受试者和3190例结果事件。少肌症受试者发生综合不良反应的相对风险(RR)是非少肌症患者的1.64倍(95%CI=1.51-1.78,P<0.000 01),跌倒、骨质疏松、骨折和全因死亡率的RR分别为1.60(95%CI=1.42-1.81,P<.000 01)、4.85(95%CI=2.18-17.79,P=0.000 1)、1.59(95%CI=1.40-1.80,P<0.001),2.08(95%CI=1.18-3.69,P=0.01)倍。结论少肌症可显著增加跌倒、骨折、全因死亡率和综合不良反应的风险,提示少肌症可能是老年人不良反应的预测因素。关键词:Sarcopenia;瀑布;骨质疏松症;骨折;死亡率
{"title":"Impact of sarcopenia on the risk of falls, osteoporosis, fractures, and all causes of death among elderly people: A Meta-analysis of prospective cohort studies","authors":"Min Cui, Kang Yu, Chun-wei Li","doi":"10.3760/CMA.J.ISSN.1674-635X.2018.05.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2018.05.008","url":null,"abstract":"Objective \u0000To explore the relationship between sarcopenia and the risks of falls, osteoporosis, fractures and all-cause mortality among elderly people. \u0000 \u0000 \u0000Methods \u0000This was a meta-analysis of prospective cohort studies. Databases of OVID/Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese WanFang Database were searched systematically according to the inclusion and exclusion criteria.The literatures related to the relationship between sarcopenia and falls, osteoporosis, fractures and all-cause mortality among elderly people from January 1987 to June 2017 were identified.The quality of the literature was evaluated by the risk assessment tool Newcastle-Ottawa Scale recommended by the Cochrane. Meta-analysis was conducted by RevMan 5.3 and Stata 12.1 software. \u0000 \u0000 \u0000Results \u0000Totally 13 prospective cohort studies including 19 376 subjects and 3 190 outcome events were entered in meta-analysis. The relative risk (RR) for comprehensive adverse outcome events among subjects with sarcopenia was 1.64 times of non-sarcopenia subjects(95% CI=1.51-1.78, P<0.000 01), and the RRs for fall, osteoporosis, fractures and all-cause mortality were 1.60 (95% CI=1.42-1.81, P<0.000 01), 4.85 (95% CI=2.18-10.79, P=0.000 1), 1.59 (95% CI=1.40-1.80, P<0.000 01), 2.08 (95% CI=1.18-3.69, P=0.01) times of non-sarcopenia subjects respectively. \u0000 \u0000 \u0000Conclusion \u0000Sarcopenia increases the risk of falls, fractures, all-cause mortality and comprehensive adverse outcome significantly, suggesting that sarcopenia might be a predictor for adverse outcomes among elderly people. \u0000 \u0000 \u0000Key words: \u0000Sarcopenia; Falls; Osteoporosis; Fractures; Mortality","PeriodicalId":9877,"journal":{"name":"Chinese Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49399246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of micronutrient status on geriatric function and clinical outcome 微量营养素状况对老年人功能和临床结果的影响
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.011
Q. Ren
Due to pathophysiological changes, the risk of micronutrient deficiency in geriatric increased. Currently, dietary intake of vitamin A, vitamin B1, vitamin B2, vitamin B12, vitamin C, vitamin E, folic acid, calcium, magnesium, zinc and selenium was still lower than the recommended dietary reference intake in the elderly. Geriatric micronutrient deficiencies may contribute to the decrease of physiological function, immune function and cognitive function. It may also result in frailty and increase the risk of adverse clinical outcomes. The appropriate supplementation of single or multiple micronutrients can improve physiological function, cognitive function, immune function and frailty, meantime, reduce the risk of cardiovascular disease and infection. Given there are still no generally accepted standards on the time and method of intervention, population-based randomized controlled studies are needed to provide the basis for promoting healthy ageing. Key words: Micronutrient; Elderly; Intervention; Function
由于病理生理变化,老年人微量营养素缺乏的风险增加。目前,老年人膳食中维生素A、维生素B1、维生素B2、维生素B12、维生素C、维生素E、叶酸、钙、镁、锌和硒的摄入量仍低于推荐的膳食参考摄入量。老年人微量营养素缺乏可能导致生理功能、免疫功能和认知功能下降。它还可能导致虚弱,并增加不良临床结果的风险。适当补充单一或多种微量营养素可以改善生理功能、认知功能、免疫功能和虚弱,同时降低心血管疾病和感染的风险。鉴于在干预时间和方法方面仍然没有公认的标准,因此需要进行基于人群的随机对照研究,为促进健康老龄化提供基础。关键词:微量营养素;老年人;干预;功能
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引用次数: 0
Effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid on the incidences of ventilator associated pneumonia complications in patients with severe traumatic brain injury undergoing ventilator therapy 肠内免疫营养补充ω-3多不饱和脂肪酸对重型颅脑损伤患者呼吸机治疗中呼吸机相关性肺炎并发症发生率的影响
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.002
Jinxia Liu, Xiangrong Chen, Tian-zao Huang, B. Dong, Yuxing Cai
Objective To investigate the effects of enteral immunonutrition supplemented with omega-3 polyunsaturated fatty acid (ω-3 PUFA) on the incidences and severity of ventilator associated pneumonia complications, inflammatory response, and the prognosis in patients with severe traumatic brain injury(sTBI)undergoing ventilator therapy. Methods From January 2015 to June 2017, 64 patients of sTBI were selected and randomly divided into experimental group (ω-3 PUFA, n=32) and control group(n=32). White blood cells (WBC) and the proportion of neutrophils (N%) were evaluated by cell analyzer. Meanwhile, the serum levels of C-reactive protein (CRP) and procalcitonin (PCT) were tested with enzyme linked immunosorbent assay. After 14-days treatment, the Glasgow coma scale (GCS) score, APACHE Ⅱ score, clinical pulmonary infection score (CPIS), pulmonary function and prognoses were also compared between the two groups. Results As compared with the control group, the experimental group had lower incidences of ventilator associated pneumonia(66% vs.56%, P=0.048), reduced degree of lung infection and lower CPIS(8.25±0.60 vs.7.47±0.53); higher lung function indexes[FVC: (2.89±0.19)L vs.(3.46±0.22)L, P=0.010; FEV1: (2.35±0.16)L vs.(2.84±0.24)L, P=0.040; FEV1/FVC %: (49.11±3.34)% vs.(56.00±2.64)%, P=0.038)]; lower serum levels of inflammatory responses [WBC: (11.83±0.74)×109/L vs.(9.51±0.90)×109/L, P=0.029; N%: (79.11±1.51)% vs.(72.71±1.16)%, P=0.041; CRP: (85.15±8.42)mg/L vs.(63.96±5.72)mg/L, P=0.001; PCT: (6.43±0.47)μg/L vs.(4.83±0.39)μg/L, P=0.013]14 days after enteral immunonutrition supplemented with ω-3 PUFA. As compared with the control group, the experimental group received better prognosis with GCS scores increasing(8.69±0.41 vs.9.52±0.59, P=0.038), APACHE Ⅱ scores decreasing(14.74±1.01 vs.12.68±0.89, P=0.049), the time of mechanical ventilation [(13.23±1.17)d vs.(10.88±1.24)d, P=0.024] and the hospitalization days [(23.29±2.45)d vs.(18.42±1.96)d, P=0.012] reduced on the 14th day, mechanical ventilation withdraw rate within 14 days increasing [24/32 (75%) vs.27/32(84%), P=0.030] on the 14th day. Conclusion Enteral immunonutrition supplemented with ω-3 PUFA can effectively reduce the incidence of ventilator associated pneumonia, alleviate the degree of infection and the inflammatory response in patients with sTBI undergoing ventilator therapy possibly improving condition and prognosis, which is worthy of being widely used. Key words: Craniocerebral trauma; Unsaturated fatty acid; Ventilator associated pneumonia; Inflammatory response
目的探讨添加ω-3多不饱和脂肪酸(ω-3 PUFA)的肠内免疫营养对重型颅脑损伤(sTBI)患者呼吸机治疗中呼吸机相关肺炎并发症的发生率、严重程度、炎症反应和预后的影响。方法从2015年1月至2017年6月,选择64例sTBI患者,随机分为实验组(ω-3 PUFA,n=32)和对照组(n=32)。通过细胞分析仪评估白细胞(WBC)和中性粒细胞的比例(N%)。同时用酶联免疫吸附法测定血清C反应蛋白(CRP)和降钙素原(PCT)水平。治疗14天后,比较两组患者的格拉斯哥昏迷评分(GCS)、APACHEⅡ评分、临床肺部感染评分(CPIS)、肺功能和预后。结果与对照组相比,实验组呼吸机相关性肺炎发生率较低(66%对56%,P=0.048),肺部感染程度较低,CPIS较低(8.25±0.60对7.47±0.53);较高的肺功能指数[FVC:(2.89±0.19)L vs.(3.46±0.22)L,P=0.010;FEV1:(2.35±0.16)L vs(2.84±0.24)L;P=0.040;FEV1/FVC%:(49.11±3.34)%vs.(56.00±2.64)%,P=0.038)];在补充ω-3 PUFA的肠内免疫营养14天后,较低的炎症反应血清水平[BWBC:(11.83±0.74)×109/L vs.(9.51±0.90)×109g/L,P=0.029;N%:(79.11±1.51)%vs.(72.71±1.16)%,P=0.041;CRP:(85.15±8.42)mg/L vs.(63.96±5.72)mg/L,P=0.001;PCT:(6.43±0.47)μg/L vs.(4.83±0.39)μg/L,P=0.013]。与对照组相比,实验组预后较好,GCS评分升高(8.69±0.41 vs.9.52±0.59,P=0.038),APACHEⅡ评分降低(14.74±1.01 vs.12.68±0.89,P=0.049),机械通气时间[(13.23±1.17)d vs.(10.88±1.24)d,P=0.024],住院天数[(23.29±2.45)d vs(18.42±1.96)d,P=0.012]在第14天减少,14天内机械通气退出率增加[24/32(75%)比第14天的27/32(84%),P=0.030]。结论肠内免疫营养补充ω-3 PUFA可有效降低呼吸机相关性肺炎的发生率,减轻sTBI患者接受呼吸机治疗后的感染程度和炎症反应,改善病情和预后,值得广泛应用。关键词:颅脑损伤;不饱和脂肪酸;呼吸机相关性肺炎;炎症反应
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引用次数: 0
Relationship between calf circumference and skeletal muscle mass, strength and function in the elderly 老年人小腿围度与骨骼肌质量、力量和功能的关系
Q4 Nursing Pub Date : 2018-10-30 DOI: 10.3760/CMA.J.ISSN.1674-635X.2018.05.005
H. Bai, Jianqin Sun, Min Chen, Hua Xie, Dan-feng Xu
Objective To investigate the relationship between calf circumference and skeletal muscle mass, strength and function in the elderly in Shanghai. Methods A total of 401 old people were recruited from physical examination centers in our hospital with the mean age of (71.8±7.4) years, including 202 males and 199 females.Adipose tissue, skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM) were measured by bioelectrical impedance analysis. The ASM index (ASM/height2) and SMM index (SMM/height2) were calculated.Muscle function was measured by testing gait speed (m/s). Muscle strength was measured by handgrip strength(HGS) using an electronic hand dynamometer, with the dominant hand gripping for three times and taking the maximum value.Height, weight, right calf circumference and waist circumference were measured. Results Height, weight, ASM, ASM/height2, SMM, SMM/height2 and HGS were significantly higher in men than in women (P<0.01); adipose tissue was significantly higher in women than in men (P<0.05). The age, body mass index, calf circumference, waist circumference and gait speed were not statistically different (P=0.426, P=0.143, P=0.425, P=0.093, P=0.143). There were linear correlations between calf circumference and height, weight, BMI, waist circumference, ASM, ASM/height2, adipose tissue, grip strength, SMM and SMM/height2 (P=0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P<0.001, P=0.003, P<0.001, P<0.001). There was no linear correlation between calf circumference and pace and age (P=0.818, P=0.078). Multiple stepwise regression analysis showed that height, BMI, ASM/height2 and SMM were correlated with the calf circumference. Conclusions Skeletal muscle mass and strength are higher in men than in women, while adipose tissue is higher in women than in men. Skeletal musle mass is an important factor affecting the calf circumference. There is a linear correlation between skeletal muscle strength and calf circumference. Key words: Calf circumference; Hand strength; Skeletal muscle mass
目的探讨上海地区老年人小腿围度与骨骼肌质量、力量和功能的关系。方法从我院体检中心招募401例老年人,平均年龄(71.8±7.4)岁,其中男性202例,女性199例。采用生物电阻抗法测定脂肪组织、骨骼肌质量(SMM)和阑尾骨骼肌质量(ASM)。计算ASM指数(ASM/height2)和SMM指数(SMM/height2)。通过检测步态速度(m/s)测量肌肉功能。肌肉力量采用电子手测力仪测定握力(HGS),优势手握力3次取最大值。测量身高、体重、右小腿围和腰围。结果男性的身高、体重、ASM、ASM/height2、SMM、SMM/height2、HGS均显著高于女性(P<0.01);女性脂肪组织明显高于男性(P<0.05)。年龄、体重指数、小腿围、腰围、步态速度差异无统计学意义(P=0.426, P=0.143, P=0.425, P=0.093, P=0.143)。小腿围与身高、体重、BMI、腰围、ASM、ASM/height2、脂肪组织、握力、SMM、SMM/height2呈线性相关(P=0.001、P<0.001、P<0.001、P<0.001、P<0.001、P<0.001、P=0.003、P<0.001、P<0.001)。小腿围与步速、年龄无线性相关(P=0.818, P=0.078)。多元逐步回归分析显示,身高、BMI、ASM/height2和SMM与小腿围相关。结论男性骨骼肌质量和力量高于女性,女性脂肪组织高于男性。骨骼肌质量是影响小腿围度的重要因素。骨骼肌力量和小腿围之间呈线性相关。关键词:小腿围;手的力量;骨骼肌质量
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引用次数: 1
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中华临床营养杂志
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