目的 观察与分析体重异常老年男性血清前列腺特异性抗原（T-PSA）与生长激素（GH）水平及影响因素。 方法 以2009年1月－2012年6月，血清GH＜5 ng/mL、血清T-PSA＜4.5 ng/mL的老年男性共296例作为观察对象，依据体质量指数分为低体重组、正常体重组、超重组及肥胖组。依据年龄分为60～64、65～69、70～74及≥75岁四组。测定296例入选对象的血清T-PSA及GH并进行分析。 结果 随着年龄增长，血清T-PSA、GH渐增高。≥75岁年龄组血清T-PSA高于其他三组，差异无统计学意义（P＞0.05）。≥75岁年龄组血清GH高于其他三组，差异有统计学意义（P＜0.01）。超重组及肥胖组血清T-PSA低于正常体重组，差异有统计学意义（P＜0.01）。低体重组血清T-PSA稍低于正常体重组，差异无统计学意义（P＞0.05）。肥胖组血清GH低于超重及正常体重组，差异无统计学意义（P＞0.05）。低体重组血清GH低于正常体重组，差异无统计学意义（P＞0.05）。单因素相关分析显示血清T-PSA与年龄、GH正相关；与BMI负相关；与收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）及血脂不相关。血清GH与年龄、T-PSA、SBP、DBP正相关；与BMI、FPG及血脂不相关。校正年龄、BMI后，血清T-PSA与GH仍呈正相关。 结论 随着年龄增长，老年男性血清T-PSA、GH渐增高。老年男性非肢端肥大症者血清T-PSA与血清GH水平及BMI有关联，血清GH水平较高者，血清T-PSA也较高；血清T-PSA与BMI负相关。
目的 研究成都地区中老年人群体质量指数（BMI）及腹型肥胖对糖尿病患病率及空腹血糖水平的影响。 方法 2007年5月，采用随机抽样方法抽取50～80岁中老年人685人进行心血管危险因素调查，其男394人，女291人，年龄（63.3 ± 0.2）岁。 结果 成都地区中老年人群的超重和肥胖所占的比例较大（约44.3%），按BMI分组（BMI＜24 kg/m2；24 kg/ m2≤BMI＜28 kg/ m2；BMI≥28 kg/m2）的糖尿病患病率分别为14.0%、18.7%及23.3%，组间差异有统计学意义（P=0.031）。男女分别按腹型肥胖标准分组（男性切点=85 cm，女性切点=80 cm），男性糖尿病患病率在非腹型肥胖及腹型肥胖组分别为17.9%及18.7%组间差异无统计学意义（P=0.849），女性糖尿病患病率分别为9.7%及18.4%，组间差异有统计学意义（P=0.034）。整个人群中，空腹血糖无随BMI增加而升高的趋势（P=0.071）；女性人群中，空腹血糖随腰围的增加而升高（P=0.001）；而在男性人群中无此趋势。在调整相关指标后，logistic回归分析提示BMI对糖尿病患病率独立影响，以BMI正常为参照，超重及肥胖的OR值分别为：1.412 [95%CI （0.818，2.437），P=0.215]及2.200 [95%CI（1.034，5.178），P=0.046]。在调整相关指标后，腹型肥胖在女性人群中对糖尿病患病率独立影响，以非腹型肥胖为参考，腹型肥胖的OR值为：1.394 [95%CI（1.080，3.205），P=0.041]，而在男性人群中无此关系。 结论 成都地区中老年人群超重及肥胖所占的比重较大，BMI可影响糖尿病患病率及空腹血糖水平；腹型肥胖能够影响女性人群糖尿病患病率及空腹血糖水平，但在男性人群中无此关系。
Objective To evaluate the impact of body mass index （BMI） on short-term outcomes after intersphi-ncteric resection （ISR） for rectal cancer and anal cancer. Methods One hundred and ninety-nine cases of rectal cancer and anal cancer who were treated in Department of Gastrointestinal Surgery of West China Hospital of Sichuan University from Jan. 2009 to Dec. 2011 were enrolled retrospectively，and these cases were divided into underweight group （n=23），normal group （n=114），and overweight group （n=62） according to BMI. Postoperative indexes in early rehabilitation and complication of 3 groups were studied and compared. Results On the recovery indexes after ISR in early stage，there were no significant differences on the duration of first flatus，first defecation，first oral intake，first ambulation，and hospital stay among 3 groups （P＞0.05）. On the tube management，there were no significant differences on the duration of pulling out nasogastric tube and urinary catheter （P＞0.05），but duration of pulling out drain was longer in normal group and over-weight group （P＜0.05）. There were no significant differences on the incidence of postoperative complications among the 3 groups （P＞0.05），including anastomotic leakage，anastomotic bleeding，perianal infection，ileus，gastric retention，urinary retention， septicemia，wound infection，and recto-vaginal fistula. Conclusions BMI has little impact on short-term outcomes after ISR. Obesity does not increase the incidence of common complications for patients after ISR and does not influence recovery indexes with proper postoperative managements.
ObjectiveTo evaluate the relationship between some clinical laboratory tests, such as levels of fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC), and benign prostatic hyperplasia (BPH). MethodsA total of 146 male patients were included in this study. All the subjects were from the clinic of West China Hospital and Sichuan Cancer Hospital from January 2012 to July 2013. Serum FINS, TG, TC and prostate specific antigen (PSA) were tested, respectively. Prostate volume (PV) was measured by ultrasound. ResultsFINS, PAS and annual prostate growth rate increased significantly in the large PV group compared with the small PV group (P<0.01). There was no significant association of PV with body mass index and other laboratory tests like serum TC and TG. PV and annual prostate growth rate increased significantly in the group of high FINS level compared with the group of low FINS level (P<0.01). PV was positively correlated with FINS (r=0.159, P<0.05); and annual prostate growth rate was positively correlated with FINS (r=0.201, P<0.05). ConclusionHyperinsulinism may play an important role in the pathogenesis of BPA.
ObjectiveTo investigate the prevalence of chronic obstructive pulmonary disease (COPD) with lipid metabolism disorders patients in Chengdu. MethodsWe randomly selected four communities from urban and rural areas in Chengdu between February and December, 2010, with multistage cluster random sampling method; 1 931 residents aged from 40 to 70 received special questionnaire from the BOLD Study, lung examination, blood biochemical examination, and physical examination. ResultsThe prevalence of COPD was 60.26% (91/151) with dyslipidemia; while non-COPD was 68.17% (972/1 428), and the difference was significant (P<0.05), in which the most obvious difference is triglycerides (TG). The prevalence of COPD was 6.62% (10/151) with underweight; while non-COPD was 4.97% (71/1 428), and the difference was significant (P<0.001). The prevalence of COPD was 21.19% (32/151) with abdominal obesity; while non-COPD was 30.81% (440/1 428), and the difference was significant (P<0.05). ConclusionThe prevalence of COPD with lipid metabolism disorders is lower than which with non-COPD in Chengdu. It provides an evidence for the nutrition support therapy in the treatment of COPD.
ObjectiveTo collect the nutrition data in patients with chronic kidney disease (CKD) from stage 1 to 4 and provide the basis for further intervention by analyzing the specific problems of the patients. MethodsA total of 132 CKD patients from stage 1 to 4 were enrolled between December 2012 and December 2013. Nutritionists used inbodyS10ww as a body composition analyzer to test the patients. The data from inbodyS10ww and laboratory indexes were analyzed on marasmus, overweight and obesity, risk of malnutrition, malnutrition, anemia and hypoalbuminemia. ResultsThe percentage of marasmus in those CKD patients was 3.0%, overweight and obesity was 39.4%, the risk of malnutrition was 22.7%, malnutrition was 19.7%, anemia was 34.1%, and hypoalbuminemia was 9.8%. ConclusionOur search shows that combining the application of anthropometry and laboratory indexes can evaluate the nutritional status of patients with CKD. The most common nutritional problems in CKD patients include malnutrition, overweight and obesity, risk of malnutrition, and anemia. As for hypoalbuminemia, it is low in early CKD patients.
ObjectiveTo investigate the effect of body mass index (BMI) on the outcome of posterior 360° fusion for single-level lumbar degenerative diseases. MethodsA retrospective study was carried on 302 cases of singlelevel lumbar degenerative diseases treated with posterior 360° fusion between September 2009 and September 2013. All patients were divided into 3 groups according to BMI: normal weight (BMI<24 kg/m2) in 105 cases (group A), overweight (24 kg/m2≤BMI< 28 kg/m2) in 108 cases (group B), and obese (BMI≥28 kg/m2) in 89 cases (group C). There was no significant difference in gender, age, disease duration, disease patterns, affected segments, preoperative Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) among 3 groups (P>0.05). The operation time, intraoperative blood loss, postoperative hospital stay, and complications were recorded. The lumbar function was assessed by JOA score and ODI at pre- and post-operation (at 3, 6, and 24 months). ResultsThe operation time, intraoperative blood loss, and postoperative hospital stay of group C were significantly more than those of groups A and B (P<0.05), but no significant difference was found between group A and group B (P>0.05). The patients were followed up 24-45 months. Postoperative JOA score and ODI showed significant improvements in each group when compared with preoperative ones (P<0.05), but there was no significant difference among groups at each time point after operation (P>0.05). There was no significant difference in the incidence of total complications among 3 groups (χ2=3.288, P=0.193). The incidence of incision-related complications (infection and poor healing) in group C was significantly higher than that of groups A and B (P<0.05), but no significant difference was shown between group A and group B (P>0.05). However, there was no significant difference in cerebrospinal fluid leak, pseudarthrosis formation, and revision among 3 groups (P>0.05). ConclusionPosterior 360° fusion for single-level lumbar degenerative diseases can obtain good effectiveness in patients with different BMI, but patients whose BMI was ≥28 kg/m2 have longer operation time, more intraoperative blood loss, longer hospital stay, and higher incidence of postoperative incision-related complications.
Objective To investigate the relationship between a body shape index (ABSI) and abnormal inflammation. Methods In May 2007, a cross-sectional study was conducted among 651 individuals by random sampling method in an urban community located in Chenghua district of Chengdu. We mainly assessed the relationship between ABSI and abnormal inflammation, which was defined as high sensitive C-reactive protein equal to 3 mg/L or higher. Results Logistic regression analysis showed that body mass index (BMI), waist circumference (WC) and ABSI were independently associated with abnormal inflammation. For identifying abnormal inflammation, WC had the best discriminatory power with the area under the receiver operating characteristic curve (AROC) was 0.627 [95% CI (0.564, 0.689)], followed by BMI (AROC: 0.609) and ABSI (AROC: 0.608). In addition, combination with ABSI could improve the discriminatory power of BMI for abnormal inflammation, and AROC increased from 0.609 to 0.646. Combination with ABSI could also improve the discriminatory power of WC for abnormal inflammation, and AROC only increased from 0.627 to 0.631. Conclusions In the general Chinese population, ABSI is independently associated with abnormal inflammation, but the discriminatory power is poor, no better than BMI and WC. Furthermore, combination with ABSI can improve the discriminatory power of BMI and WC for abnormal inflammation, especially for BMI. Further studies about ethnic specificities of ABSI are needed.
Objective To review recent advancement of the relationship between obesity and gastric cancer. Method We searched PubMed, Medline, EMBASE, Cochrane Library databases, CNKI, and WanFang database for recent clinical trials about the impact of obesity on occurrence, surgery outcomes, and prognosis of gastric cancer. Results Obesity significantly increased the risk of adenocarcinoma of esophagogastric junction (AEG), increased difficulty in radical operation of gastric cancer and complications of perioperative period, but it had no effect on the long-term operative outcomes. The association between obesity and the survival of gastric cancer was not clear. However, the better survival was observed in most researches of gastric cancer patients with excess body weight. Conclusions The relationship between obesity and gastric cancer is very complex, and there is no consistent conclusion. A reasonable body weight by a healthy lifestyle is expected to decline the incidence of AEG.