0.05 ).②The level of serum IgG increased in Gln group and maintained unchanged in control group.The level of serum CRP decreased more in Gln group than in control group( P

This article summarizes the current literature about serum test parameters of thyroid function during aging and thyroid dysfunction in the elderly.The aim is to highlight the importance of the individualized strategy and employing additional caution before assigning diagnoses of hypothyroidism or hyperthyroidism to elderly patients and initiation of treatment modalities.In the last few years,the emergence of age-specific reference ranges for thyroid-stimulating hormone (TSH) has added to the complexity of diagnosis of thyroid dysfunction in this age group,especially in thesubclinical category.Application of age-specific TSH reference ranges may avoid misclassification of elderly subjects without thyroid disease.Overt hypothyroidism and hyperthyroidism require immediate treatment.Treatment of subclinical hyperthyroidism may be considered in the part of elderly patients,while follow-up care and monitoring must be provided for the other part of older subjeets.Careful waiting may be an appropriate approach for older patients with subclinical hypothyroidism with TSH＜ 10 mU/L.The senile elderly,especially extreme longevity people with TSH＜10 mU/L are generally not treated with thyroid hormone replacement therapy.

Objective To study the relationship between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.Methods A total of 63 elderly patients with type 2 diabetes were divided into 2 groups:group A (HbA1c≤7％,n=30),group B (HbA1c＞7％,n=33); and 30 healthy people were as controls.Fasting blood sugar(FBS),fasting insulin (FINS),glycated hemoglobin (HbA1c) and carotid intima-media thickness (IMT) were measured,atherosclerotic plaques were counted,and insulin resistance was calculated by homeostatic model assessment (HOMA-IR).Results The IMT,number of atherosclerotic plaques and incidence of carotid atherosclerosis were all higher in the two diabetic groups than in controls (P＜0.05).The levels of FINS,HbA1c and HOMA-IR were all higher in group A and group B than in controls (P＜0.05 and P＜0.01),which had a significant difference between group A and group B [(9.7± 2.1)mU/L vs.(13.6±2.0) mU/L; (6.5±0.4)％ vs.(8.2±0.6)％; (3.5±0.4) vs.(6.1±0.5); all P＜0.05].Pearson correlation analysis showed that IMT was positively correlated with FBS and HOMA-IR in group A and group B (r=0.62 and r=0.46,respectively,P＜0.05).Conclusions There is a positive correlation between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.

Objective This study was to compare the effects of chronic experimental stress and aging on insulin sensitivity at insulin receptor of liver plasma membranes and its autophosphorylation in the aged mice compared with those in the young and the adult diabetes-susceptible mice. Methods Diabetes-susceptible mice was induced by streptozotocin in 40 1.5-month-old mice (young mice), 40 15-month-old mice (adult mice) and 40 20-month-old mice (aged mice). These mice were randomly divided into the stress groups and control groups, respectively. Each group contained 20 mice. Stress groups were exposed to multiple stressors (restrain, rotation, crowding) for 6 weeks. The levels of fasting blood glucose (FBG) and fasting plasma insulin (FIns) were measured. The index of insulin sensitivity (ISI) was calculated. The numbers (R_~1 , R_~2 , R) and affinity (K_~1 , K_~2 , K) of insulin receptors on liver plasma membranes were investigated by using Scatchard analysis. The numbers of insulin-stimulated (10~-7 mol/L) phosphorylated insulin receptor (PINSR) on liver plasma membranes was assayed by ELISA. Results After 6-week stress, FBG levels were significantly higher with aging 〔young mice: (10.3?6.2)mol/L, adult mice: (15.2?3.6)mol/L, aged mice: (18.9?2.9)mol/L, P

The prevalence of type 2 diabetes mellitus(T2DM)in China is about 9.1%.Compared with healthy adults, life expectancy for patients with T2DM at 60 years of age can be cut short by 7.3-9.5 years and time for a good quality of life by 11.1-13.8 years.It is important for elderly patients with T2DM to stay functionally active.Frailty, as a common geriatric syndrome, is an important factor affecting the functional status of the elderly, a strong predictor for disability, death and hospitalization, and also a strong predictor for adverse health outcomes in elderly patients with T2DM.This article reviews the relationship between frailty/sarcopenia and T2DM, and the management and treatment of elderly T2DM patients with frailty/sarcopenia.

Objective: To explore the correlation between serum level of high molecular weight adiponectin (HMW-ADPN) and arteriosclerosis. Methods: Clinical data of 87 middle-aged and aged people living in home, who underwent health examinations in Xiangya second hospital from Jan 2011 to Dec 2011, were collected. According to carotid-femoral pulse wave velocity (cf-PWV) = 9 m/s, they were divided into group A (cf-PWV<9 m/s, n=21) and group B (cf-PWV≥9 m/s, n=66). Blood pressure, blood lipid, blood glucose etc. were measured and compared between two groups. Results: Compared with group A, there were significant rise in blood pressure, levels of low density lipoprotein cholesterol, triglyceride and total cholesterol, and significant reduction in levels of high density lipoprotein cholesterol (HDL-C), serum total ADPN and HMW-ADPN in group B, P<0.05 or <0.01. Multiple regression analysis indicated that serum HMW-ADPN (B= - 4.469，P=0.011), total ADPN ((B= - 3.965，P=0.012), HDL-C（B= - 2.077，P=0.015) and systolic blood pressure levels (B= 0.045，P=0.045) were independent predictors of cf-PWV. Conclusion: Serum high molecular weight adiponectin and total adiponectin levels may be protective factors against arteriosclerosis. Its role in predicting occurrence and development of arteriosclerosis is worthy of further study.

Objective To investigate the effect and mechnism of preptin on connect tissue growth factor (CTGF) in human osteoblasts. Methods Recombinant human preptin was used to treat primary human osteoblasts, and Western blot was used to detect CTGF protein level. Mitogen-activated protein kinase p38(p38MAPK), extracellular signal-regulated kinase (ERK1/2), c-jun N-terminal Kinase (JNK), and their phosphorylation levels were also detected by Western blot. MAPK inhibitors (PD98059, SP600125, or SB203580)were used to elucidate the mechnism of preptin induced expression of CTGF in human osteoblasts. Results Treatment of human osteoblasts with preptin caused a time and dose-dependent increase in CTGF secretion. Preptin induced activation of ERK, but not p38MAPK or JNK in human osteoblasts. Furhermore, pretreatment of human osteoblasts with the ERK inhibitor PD98059 abolished the preptin-induced CTGF secretion. Conclusion Preptin induces CTGF expression in human osteoblasts by means of ERK/MAPK pathway.

Objective To investigate the effect of preptin on proliferation and differentiation of human osteoblasts. Methods After human osteoblasts were incubated with 10-10, 10-9, 10-8 , 10-7 mol/L preptin for 24 h,the proliferation of osteoblasts was determined by[3H]thymidine incorporation and alkaline phosphatase (ALP)activity was assayed by spectrophotometric measurement. The phosphorylation levels of c-Jun N-terminal kinase (JNK), p38 mitogen-activated protein kinase ( MAPK), extracellular signal-regulated kinase (ERK) 1/2 were assayed by Western blot. ERK inhibitor PD98059, p38MAPK inhibitor SB203580, and JNK inhibitor SP600125were used for investigating the signal pathway of preptin-stimulated osteoblast proliferation and differentiation.Results Preptin dose-dependently increased human proliferation of osteoblasts and ALP activity with the maximum effect at the concentration of l0-9 mol/L (both P<0.01 ). Preptin stimulated ERK phosphorylation in human osteoblasts, but not p38 MAPK and JNK phosphorylation. PD98059 blocked preptin-sitmulated human osteoblasts proliferation and ALP activity (both P<0.05 ), while SB203580 and SP600125 had no effect. Conclusions Preptin promotes the proliferation and differentiation of human osteoblasts through ERK pathway.

Objective To screen and diagnose obstructive sleep apnea-hypopnea syndrome (OSAHS) in elderly males by obesity index using receiver operating characteristic(ROC) curves. Methods Data of 402 consecutive elderly male patients who underwent polysomnography from 2001 to 2008 were collected. The relationship between apnea hypopnea index(AHI) and obese indexes such as body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were analyzed by Pearson's correlation. ROC curves were used to determine the best cutoff values to screen and diagnose OSAHS, and their priority was compared by area under curve (AUC). A two-tailed P value less than 0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 13.0. Results (1) AHI was positively correlated with BMI (r=0.241,P<0.001), NC(r=0.201,P<0.001), WC(r=0.210,P<0.001) and WHR(r=0. 097,P>0.05)) in elderly male patients. The area under curve (AUC) of BMI, NC, WC and WHR was 0.61, 0.58, 0.51 and 0.45 respectively, and P value was 0.001,0.060,0.840 and 0. 250 respectively. Only BMI was competent in screening and diagnosing OSAHS in elderly male adults; (2) The optimal value of BMI was 22.0 kg/m~2 in screening OSAHS with specificity 90% and rate of missed diagnosis 10%; (3) The optimal value of BMI was 29.0 kg/m~2 in diagnosing OSAHS with specificity 90% and rate of missed diagnosis 10%. Conclusions BMI more than 22.0 kg/m~2 could be the reference standard to screen OSAHS and BMI more than 29.0 kg/m~2 to diagnose OSAHS in elderly men.

，and 17.47%.Conclusions Xylitol can lower the blood glucose a littte but without significant difference.It has little effect on blood glucose variability of patients with type 2 diabetes mellitus and can be safely used for rehydration.