Objective To compare the levels of indoxyl sulfate (IS) and p-cresyl sulfate (PCS), representative substances of serum protein-bound toxins,between patients undergoing peritoneal dialysis (PD) and healthy volunteers, and to explore the factors influencing the levels of serum IS and PCS. Methods Limosis vein blood (3 mL) were collected from 72 PD patients in Peritoneal Dialysis Center and 24 healthy voluteers in Physical Examination in Changzheng Hospital of Second Military Medical University from Feb. 2015 to Jul. 2015. The concentrations of serum total IS,total PCS,free IS and free PCS were detected by high-performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ES--MS/MS) method. The relationship between IS, PCS and age, gender, small molecule toxins,adequacy of PD, residual renal function,nutritional status and C-reaction protein (CRP) in PD patients were analyzed by simple correlation andmultivariable linear regression analysis. Results The concentrations of serum total IS and total PCS in PD patients were significantly lower than those in healthy volunteers (P<0. 001). Compared with PD patients without residual renal function (RRF), the concentration of serum total IS was significantly lower in PD patients with RRF (P = 0. 001). Serum total IS was positively correlated with free IS (r=0. 719,P<0. 01) and dialysis duration (r=0. 306,P<0. 01),while tt was negatively correlated with residual renal Kt/V (r=-0. 372, P<0. 01),residual renal creatinine clearance rate (Ccr) (r=-0. 515,P<0. 01),and residual renal estimated glomerular filtration rate (eGFR) (r=-0. 495,P<0 01). Serum free IS was negatively correlated with residual renal Ccr (r=-0. 430, P〈0. 01) and residual renal eGFR (r= -0. 431,P〈0. 01). Serum total IS and free IS were not related to age,hemoglobin or CRP.conclusion serum level is negatively correlated with RRF. But not with age, hemoglobin or CRP, suggesting that proection of RRF is conducive to the removal of serum IS in parients undergoing PD.

OBJECTIVETo investigate the association between physical activity (PA) and the incidence of metabolic syndrome (MS) in Chinese adults.

METHODSData on PA and other variables were obtained at the baseline examination of China Multi-center study of Cardiovascular Epidemiology in 1998 and of International Collaborative study of Cardiovascular Disease in Asia(InterASIA) during 2000 - 2001. Follow-up study was conducted in 2007 - 2008. A total of 11 512 Chinese adults aged 35 - 74 years (5563 men and 5949 women) were included in the final data analysis. Information on demographics, PA, smoking and alcohol consumption were obtained and components of MS were examined. Participants were divided into four groups according to quartile of total metabolic equivalent (MET) values per day. In addition, subjects were grouped into the following categories according to occupational PA: inactive, light, moderate and vigorous. Binary logistic model was used to examine the association between PA and the incidence of MS.

RESULTSA total of 2527 cases with MS were documented during an average following up of 8.1 years. The annual incidence rate of MS was 2.71% (2527/93 178.68). After multivariate logistic regression analysis, compared with participants with total PA volume < 32.0 MET×h×d(-1) (annual incidence rate was 3.19% (697/21 830.74)), the RR (95%CI) value of participants with total PA volume during 32.00 - 37.85, 37.86 - 52.29, and ≥ 52.30 MET×h×d(-1) was 1.05(0.92 - 1.19), 0.98(0.86 - 1.12), and 0.68(0.59 - 0.80), respectively (χ(2)trend = 34.23, P < 0.05), with corresponding annual incidence rates of 2.82% (690/24 504.25), 2.73% (661/24 179.36) and 2.11% (479/22 664.33). In addition, compared to inactive occupational PA (annual incidence rate was 2.76% (402/14 588.33)), the corresponding RR (95%CI) value was 0.80 (0.69 - 0.92), 0.70 (0.59 - 0.82), and 0.54 (0.45 - 0.65) (χ(2)trend = 42.34, P < 0.05), and the annual incidence rates were 2.86% (648/22 663.41), 2.40% (455/18 956.14) and 1.89% (344/18 173.86) in participants with light, moderate and vigorous occupational PA, respectively.

CONCLUSIONBoth increased total PA volume and occupational PA intensity are significantly associated with decreased risk of incidence of MS.

Adult ; Aged ; China ; epidemiology ; Exercise ; Female ; Humans ; Incidence ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Prospective Studies ; Risk Factors

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.