Objectives To compare the value of different criteria (WHO, IDF and CDS criteria) on the diagnosis of metabolic syndrome (MS) in the elderly people. Methods 2 456 elderly patients admitted to General Hospital of PLA for routine physical examination during 1996 to 2005 were involved in present study. The value of different criteria (WHO, IDF and CDS criteria) on the diagnosis of metabolic syndrome (MS) was compared. Results The incidences of MS in the involved patients were 27.2%, 27.0% and 42.6%, respectively, according to WHO, IDF and CDS criteria. The diagnostic coincidence of CDS and IDF criteria was 79.0%. For the 1759 cases with the waistline data, the incidences of MS were 32.3%, 37.8% and 53.8%, respectively, according to the above three criteria. The diagnostic coincidence of CDS and IDF criteria was 76.5 %. According to the criteria of WHO, IDF and CDS, central obesity was detectable in a rate of 35.9%, 49.6% and 52.2%, respectively. Hypertension was diagnosed in a rate of 61.6%, 72.4% and 61.6%, and abnormal glucose metabolism was found in a rate of 24.9%, 40.5% and 24.9%, respectively. The most common clinical symptom complex of MS was hypertension, impaired glucose tolerance and abnormal lipid metabolism. Conclusions A higher coincidence exists between CDS and IDF criteria for MS, but the incidence of MS is higher in CDS criterion compared to WHO and IDF criteria. It is indicated that more attention should be paid on the measurement of the waistline in the elderly people. It seems more appropriate that the waistline data in CDS criterion should be modified from 85cm to 90cm for the elderly people, however, this should be verified by more epidemiological investigation.

Objective To evaluate the clinical value of the regional wall motion in patients with suspected coronary artery disease by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI). Methods A total of 143 hospitaized patients with suspected coronary artery disease and normal wall motion de?tected by two-dimensional echocardiography (2DE) were enrolled and devided into group A (coronary stenosis ≥75%) 73 cases and group B (coronary stenosis<75%) that include 70 cases according to coronary angiography results. Left ventricu?lar segmental ejection fraction (sEF) was measured by RT-3DE and peak systolic longitudial strain (SL) was measured by 2D-STI. ROC curves of the two measurements were generated and compared. Differences in sEF and SL between group A and group B were respectively analyzed. Results (1)Both sEF of RT-3DE and SL of 2D-STI in group A were significantly low?er than those in group B (P<0.05);(2)sEF was positively correlated with SL(r=0.689,P<0.05);(3)Compared with SL, sEF had larger area under ROC curve in some segments of left ventricle where both parameters are abnormal for the diagnosis of the coronary stenosis ≥75% (0.922 vs 0.874). Conclusion Regional wall motion of left ventricular can be measured by both RT-3DE and 2D-STI which can be both used to estimate the extend of stenosis of coronary artery. And RT-3DE is su?perior over 2D-STI.

Objective To develop a diabetes risk score (DRS)to predict the risk of development of incident diabetes in male senile people in Beijing. Methods DRS was developed basing on a test group including a cohort of 1 370 individuals aged 48-87 years without diabetes at baseline, followed for 10 years by Logistic regression and validated on a value group including a cohort of 340 individuals aged 43-88 years without diabetes at baseline. Results The model with the highest area under the ROC curve ( AUC ) included age, hypertension,history of hyperglycemia, body mass index, fasting plasma glucose, triglycerides, and high-density lipoproteincholesterol (HDL-C). DRS was developed basing on this model with a range from 0 to 12 and an optimal cut-off of 4. AUC were respectively 0. 726 ( 95% CI0. 692-0. 759 ) and 0. 765 ( 95% CI0. 691-0. 839 ) in test group and validation group. The sum score value ≥4 had sensitivity of 65.3% and 68. 1%, specificity of 70. 0% and 64.8%, positive predictive value of 37.0% and 23.2%, negative predictive value of 88.2% and 94. 1%.Conclusion The DRS, derived from clinical information combined with plasma glucose and lipids, is an effective tool to predict incident diabetes.

Objective To investigate the relationship between plasma Chemerin and diabetic nephropathy of type 2 diabetes mellitus (T2DM).Methods Totally 195 T2DM patients and 65 healthy controls were enrolled in this study.The T2DM patients were further divivded into three subgroups:normal albuminuria group (n =65),microalbuminuria group (n =65),and clinical albuminuria group (n =65).The plasma Chemerin level was determined by enzyme-linked immunosorbent assay (ELISA).Results The serum Chemerin level was (150.20 ±21.99) μg/L in diabetic patients,which was significantly higher than that in healthy controls (62.13 ± 18.90) μg/L) (P ＜0.01).Inside the T2DM group,the plasma Chemerin level was [(143.63 ± 22.33) μg/L] in the microalbuminuria group and [(173.21 ± 23.91) μg/L] in the clinical albuminuria group (P ＜ 0.001),and both were significantly higher than that in the normal albuminuria group [(100.35 ±20.11) μg/L] (both P ＜0.01).Multivariate regression analysis showed that the plasma Chemerin level was independently associated with glycosylated hemoglobin (β =0.216,P =0.038),total cholesterol (β =1.867,P =0.048),high-sensitivity c-reactive protein (β =12.330,P ＜ 0.001),and urine albumin (β =37.184,P ＜0.001) in T2DM patients.Conclusion Plasema Chemerin level increases in T2DM patients and therefore can be a reliable indicator for detecting early type 2 diabetic nephropathy.

Objective To evaluate the sensitivity and the specificity of WHO and American Diabetes Association (ADA) diagnosis criteria for diabetes mellitus (DM) in senile population and to assess the use of fasting plasma glucose (FPG) alone for the screening of DM as defined by a 2 hour plasma glucose (2hPG)≥11.1 mmol/L during oral 75 g glucose tolerance test (OGTT) and to determine optimal FPG cut point for DM diagnosis. Methods One thousand two hundred and four subjects without DM aged 60 to 90 year, who had resided in Beijing for over 5 years, were recruited, and grouped into different glucose levels by WHO or ADA criteria and analyzed the concordance and the discordance between these subpopulations. The WHO criterion for DM (2hPG≥11.1 mmol/L) was taken as the gold standard. The variations of sensitivity and specificity on ADA criterion for DM (FPG≥7.0 mmol/L) were assessed and determined the optimal FPG cut point in the seniles. Results The prevalence of DM was 3.16% and 16.28% by ADA (FPG) criterion and WHO(2hPG) criterion respectively. The sensitivity of diagnosed DM was 15.3% and the specificity was 99.2% according to ADA criterion. The coincidence percentage under the two criteria was only 15.3%. The coincidence percentage under impaired fasting blood glucose (IFG) and impaired glucose tolerance (IGT) was only 4.5%. The optimal FPG cut point of diagnosed DM was 5.5 mmol/L in the seniles, which was affected by gender, age, body mass index and the presence of hypertension. Conclusion There is lack of concordance between WHO and ADA criteria for DM diagnosis in the seniles. The ADA IFG criterion is not able to replace WHO criterion for DM diagnosis. The senile people with FPG≥5.5 mmol/L but

Objective The aim of the study was to determine the prevalence and incidence of diabetes mellitus (DM) and to investigate the epidemiological characteristics as well as associated risk factors in the elderly army people in Beijing area. Methods A survey was conducted among 2 239 elderly subjects aged 60 to 90 years while physical examination was undergoing in Chinese PLA General Hospital from 1996 to 2000. FPG and PPG of steam-bread meal test were measured. Subjects with PPG≥7.2 mmol/L received a standard 75 g OGTT with 10 h overnight fasting. The risk factors for incidence of DM and IGT during survey were analyzed with multiple logistic regression. Results The average follow-up duration was 3.7 years. The adjusted prevalence of DM increased from 15.8% in 1996 to 23.9% in 2000 and it increased significantly with age(P

Objective To observe the all-cause and cardiovascular mortality in the senile population and to analyze influence of impaired glucose metabolism. Methods A survey was conducted among 2239 old subjects aged 60 to 90 who had health examination in PLA General Hospital from 1996 to 1997. The subjects were examined every year and followed for 3-4 years. Diabetes mellitus (DM) and impaired glucose tolerance (IGT) were diagnosed according to WHO criteria (1985). The cumulative survival rates of different groups were calculated by Kaplan-Meier method and Cox′s proportional hazard model. Results The elderly people were classified into three groups: normal glucose tolerance (NGT) (n=1521), IGT (n=279) and DM (n=439) at baseline. At the end of four observed years, the mortalities of IGT group and DM group were 7.55 and 8.86 per 1000 observation person-year, respectively, both groups were significantly higher than the mortality in NGT group (2.43/1000 person-year) (P0.05). The cumulative survival rates from cardio-cerebrovascular disease in IGT and DM were 0.982 and 0.980 respectively, both significantly lower than that in NGT group (0.996,P

Objective To analyze the combination of impaired glucose tolerance (IGT) and metabolic abnormalities and its outcome in geriatric population. Methods 75goral glucose tolerance test (OGTT), blood lipid profile, blood uric acid and urinary albumin excretion rate were determined in 1059 geriatric cases with IGT and followed up every 2 years. Results Among 1059 cases with IGT followed up for 8 years, 222 cases deterioratedintodiabetesmellitus(DM)(21.0%),47casesreversedto normal glucose tolerance (NGT, 4.4%),and 790 cases remained IGT (74.6%). From NGT to IGT to DM,body mass index, systolic blood pressure, plasma glucose after loading (including postprandial 2 h glucose, 1 h and 2 h plasma glucose of OGTT) were gradually increased in baseline (P

Objectives To improve the diagnostic and therapeutic ability of ectopic ACTH syndrome by analysing its clinical features.Methods Sixteen cases of ectopic ACTH syndrome diagnosed in Chinese PLA General Hospital from 2000 to 2009 were analyzed retrospectively.Results ( 1 ) The main causes of ectopic ACTH syndrome were lung tumor and thymic carcinoid;(2) Abnormal glucose metabolism, hypertension, hypokalemia and edema of both lower limbs were the most common clinical symptoms;(3) Laboratory examination showed a significant increase of serum cortisol, adrenocorticotropic hormone(ACTH) and 24 h urinary free cortisol (24hUFC) together with severe hypokalemia and alkalosis;(4) High dose dexamethasone suppressing test, corticotrophin-releasing hormone(CRH) stimulating test and petrosal sinus sampling were the most meaningful diagnostic methods;(5) Most of the primary lesions might be detected with chest film and CT;(6) Resection of the primary lesion was the treatment of first choice.Conclusion The diagnosis of ectopic ACTH syndrome is very hard.Resection of the primary lesion is the best treatment.

Objective To observe the all-cause and cardiocerebrovascular disease(CCVD)-related mortalities in the senile male population and the relationship of them with fasting plasma glucose (FPG) level.Methods A survey was performed among 1 572 male subjects aged 60-90.All the subjects were groups were calculated by Kaplan-Meier method and the log-rank test was used to compare the survival rates of the 4 groups.Logistic regression model was used to analyze the correlation factors of all-cause mortality and CCVD-related regression model analysis showed that age was related with the all-cause mortality.Among all these factors, age, body mass index, FPG and the history of CCVD had the relationships with the mortality of CCVD.Conclusion In the older male population, CCVD are considered as one of the main causes of death.With the increased levels of FPG, the all-cause mortality and CCVD mortality of senile male population are increased.