1.Biochemical parameters in correlation with nutritional status of hospitalized elderly
Mongolian Medical Sciences 2011;172(2):20-22
Introduction: While the prevalence of malnutrition in the free living elderly population is relatively low, the risk of malnutrition increases dramatically in the hospitalized elderly. Patients who are malnourished when admitted to the hospital tend to have longer hospital stays, experience more complications, and have greater risk of morbidity and mortality than those whose nutritional state is normal.
Goal: To assess the nutritional status among hospitalized elderly in Secondary healthcare systems by the MNA screening tool.
Materials and Methods: To the study were enrolled 411 hospitalized elderly patients in secondary healthcare systems. The study protocol was approved by the Ethics Committee of the HSUM, and written informed consent was obtained from all study participants. We assessed the participants’ nutritional status by the MNA (Mini nutritional assessment) tool and divided into three groups: malnourished, risk of malnutrition and normal nutritional status. We compared the relationship between nutritional status and some biochemical indicates such as total protein, albumin, cholesterol and blood glucose levels. The ANOVA and Pearson correlation tests were used for statistical analysis.
Results: 146 (36.01%) elders were well nourished among our study participants. Serum albumin was significantly low in malnourished elders.
Conclusion: Among the assessed elderly 36.01% had adequate nutritional status; 43.79% were at a risk of malnutrition and 20.19% were malnourished. Serum albumin was significantly low in malnourished elders.
2.Malnutrition risk of hospitalized elderly and their anthropometric indicators
Mongolian Medical Sciences 2011;172(2):23-26
Introduction: With advancing age, the risk of developing nutritional deficiencies increases. Malnutrition can lead to functional dependency, increases morbidity, mortality, and greater use of health care resources.
Goal: The goal of our study was to assess the nutritional risk among recently hospitalized elderly in Secondary healthcare systems by the NSI screening tool and assess indicators of anthropometry assessment in nutritionally different groups.
Materials and Methods: To the study were enrolled 411 hospitalized elderly patients in secondary healthcare systems. The study protocol was approved by the Ethics Committee of the HSUM, and written informed consent was obtained from all study participants. The nutritional status was classified by the NSI (Nutrition Screening Initiative) into: high risk of malnutrition, moderate risk of malnutrition and without malnutrition (adequate).
Results: Among the assessed elderly, 8.03% had adequate nutritional status; 32.85% were at a risk of malnutrition and 59.12% were at a moderate risk of malnutrition. Some anthropometric variables such as weight, abdominal circumference, calf and mid-arm circumference assessed were significantly more deteriorated among the malnourished individuals. Among the NSI variables tooth loss/ mouth pain (21.6%), eating few fruits or vegetables or milk products (14.3%), chronic illness (13.8%), multiple medicines (13.4%) or economic hardship (11.3%) were found as the risk of malnourished elderly.
Conclusion: There is an interrelationship between the nutritional status of the elderly and some anthropometric variables.
3.Pilot study on metabolic syndrome prevalence among aging male
Bolor-Erdene S, Munkhtsetseg J
Mongolian Medical Sciences 2010;152(2):9-11
INTRODUCTION: Main reasons of metabolic syndrome are obesity and overweighing, which are becoming a global
worldwide problem. Obesity is both a prevalent condition worldwide and a well-known, modifiable risk factor for
various diseases, including diabetes. In a recent review article, waist circumference (WC) and body mass index
(BMI) were reported as established risk factors for diabetes.
GOAL: To define the prevalence of metabolic syndrome among Mongolian aging man living in Ulaanbaatar city
MATERIALS AND METHODS: Randomly selected 180 men aged 35-90 years old were involved to this study. All were
informed and written consent was given by each individual. The metabolic syndrome was defined by NCEP
definition: high blood pressure, high waist circumference, higher fasting sugar, triglyceride and HDL-cholesterol.
Anthropometric parameters like waist circumference (WC), weight, height, blood pressure and blood chemical
parameters like glucose, triglyceride (TG), HDL-cholesterol (HDL-Ch) were measured by automatic biochemical
analyzer.
RESULT AND DISCUSSION: Average age of all participants was 56.82±12.55 years and was divided in three age
groups: 35-60 (n=112), 61-74 (n=47), 74-90 (n=17). The characteristics of participants are shown Mongolian men
in 38.8 % (70) of all participants had a metabolic syndrome and in compare to T.Baysgalan’s study, implemented in
2007 was higher. In our opinion it depends on our study participant’s age, because in our study number of elderly
were predominating than mentioned survey. Waist circumference in metabolic syndrome group is higher than in
healthy control group (p<0.05). Triglyceride level does not change with aging, but in our study participants, the TG
level was negatively correlated with aging in metabolic syndrome group (r = -0.307).
HDL-cholesterol is abundantly circulating molecule in human plasma and shows anti-atherogenic effect. In our
participants HDL-Ch decreases with aging (r=-0.174).
CONCLUSION: Our pilot study present that metabolic syndrome prevalence reaches 38.8% of total aged, male
participants, and it is leads to implement and provide an investigation in large range, including urban and rural
areas of the country.
4.The study of apolipoprotein a5 gene polymorphisms in relation tolipidslevel in people with metabolic syndrome
Ariunbold Ch ; Buyankhuu T ; Munkhtsetseg J
Mongolian Medical Sciences 2014;170(4):10-13
Background: Epidemiologic studies have shown a higher prevalenceof hypertriglyceridemia among
patients with CHDthan among unaffected populations. Dozens of polymorphisms in different genesthat
could have some effect on plasma TG levels havebeen analyzed.
The most promising results are connected withvariants within the apolipoproteins (APO) APOA1/APOC3/
APOA4 gene cluster. Transgenic mice overexpressing human apolipoprotein A5decreased plasma
triglyceride concentrations to one-third of those in control mice; conversely, knockout mice lacking
APOA5 had four times as much plasma triglycerides as controls.The human APOA5 gene consistsof
4 exons and codes 369 aminoacidprotein, which is expressed almost exclusively in the liver.A minor
allele of APOA5 (1259C, IVS3+476A and 1131C) which was independently associated with high plasma
triglyceride levels in African-American, non Hispanic whites, Hispanic, Caucasians and Japanese were
reported. Four polymorphisms in ApoA5 (1259T>C, IVS3+476G>A, S19W and 1131T>C) has been
correlatedwith high TG levels in diabetic women.
Materials and Methods: 162 people with MS for case group and 144 people for control group were
selected in this study. MS was diagnosed according to IDF criteria and serum triglyceride, total cholesterol
and HDL levels were determined. DNA from both case and control subjects were extracted from blood
samples (20μL) using “G-spin™ Total DNA Extraction Kit”(iNtRON Biotechnology, Inc).The genotypes
for fourpolymorphisms of ApoA5 were determined using a combination of PCR and sequence-specific
oligonucleotide probes.
Results: There were 304 total subjects included males 50.3% (153) and female 49.7% (151) in our study.
The appearance of risk genotypes of 1177C>T, 1259T>C, IVS3+476G>A and 1131T>C polymorphisms
in ApoA5 gene were higher in MS group than control group.Serum levels of triglycerides and total
cholesterol differed significantly (p<0.001, p=0.029) among APOA5-1131T>C genotypes.
Conclusion: TAG and TC level was higher in people with 1131T>C-CC genotype than other genotypes
in both groups (p=0.010, p=0.001). We determined that the odds ratio for the hypertriglyceridemia was
5.98 for ApoA5-1131T>C CC-genotype carriers.
5.The Aging Related Dynamics of Red Blood Cell Indices
Tseregmaa Ts ; Munkhtsetseg J ; Lkhagvasuren Ts
Mongolian Medical Sciences 2009;147(1):21-23
Introduction:
Aging is a complex process, where all organ systems can be affected at different stages, with different speed. There are many external and internal factors influencing to the aging and some parameters are changing during aging.
These parameters are called as biomarkers of aging. One of potential biomarkers is blood red cell count and its indices.
Aim of the study:
To study the dynamic features of red blood cell indices during aging of Mongolians.
Materials and methods:
To the study were enrolled 338 healthy people aged 35-88 years. Present research was implemented at HSUM and district health centers geriatric cabinets. The study protocol was approved by the Ethics Committee of the HSUM, and written informed consent was obtained from all study participants.
Venous blood was flown in EDTA containing tube, after which hematology indices were analyzed by cell counter Humacount. In this paper we introduced the red cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and platelet cell count.
Results and discussion:
Red blood cell count was higher in man than women, like hemoglobin concentration (150.5535.3g/l for man, 131.4432.58g/l for women). Red blood cell count increases with aging until 65 against hemoglobin concentration which decreases with aging (r=-0.275, =0.001).
Mean corpuscular volume of erythrocyte were 85.024.73fL in man, 83.055.2fL in women and it was significantly increasing with aging in both sexes. The main reasons for the increase of hematocrit are increased number of erythrocyte and MCV, but it has sex different features.
In man the MCV was strong factor, where erythrocyte count had higher influence on hematocrit increase of female. MCH and MCHC were higher in man, but has stronger inverse correlation with aging (r=-0.556, p=0.000).
In discussion were mentioned that the red blood cell indices had specific dynamic features correlated with aging, especially in man, which was explained by testosterone secretion and its decline during aging. Biologically women have higher adaptation capacity during aging due to physiological processes like menstruation, pregnancy and menopause.
Platelet number was decreasing in both sexes, which can be a major cause of hemorrhagic syndrome in geriatric practice.
Conclusion:
Red blood cell indices (RBC count, hemoglobin, hematocrit, MCV, MCH, MCHC and platelet) have an age specific features during aging and results of this study could be an useful information for geriatricians and medical professionals who work or intend to work with elderly.
6.The study of apolipoprotein A5 gene polymorphism in relation to serum triglyceride level in people with metabolic syndrome
Ariunbold Ch ; Khajidaa B ; Buyankhuu T ; Azzaya E ; Munkhtsetseg J
Mongolian Medical Sciences 2014;169(3):4-7
Background. A large number of longitudinal studies indicate significantly increased risk of cardiovascular
events and death in people with the MetSyn and high plasma levels of triglycerides are an independent
risk factor for the development of cardiovascular disease. Apolipoprotein A5 (APOA5) gene, a new
member of the APOA1/C3/A4 gene cluster, was identified by comparative sequencing of human and
mice DNA by Pennacchio and co-workers in 2001. Since this discovery, variants of ApoA5 gene have
been independently assiociated with level of plasma triglyceride in many countries. Human ApoA5 is
expressed in the liver then appears in plasma in association with VLDL and HDL and plays a major role
in TG catabolism. Variant at ApoA5 gene locus, 1177C>T is located in 3’ UTR which often contains
regulatory regions that influence post-transcriptional gene expression. One alteration can be responsible
for the altered expression of many genes.
Materials and Methods. 152 people with MS for case group and 152 people for control group were selected
in this study. MS was diagnosed according to IDF criteria and serum triglyceride levels were determined.
DNA from both case and control subjects were extracted from blood samples (200 ml) using “G-spin™ Total
DNA Extraction Kit”(iNtRON Biotechnology, Inc). To detect the 1177C>T variation of ApoA5 gene, using
High Pure PCR Template Preparation Kits, a forward primer 5’-CTCTGAGCCTCTAGCATGGTTGAGT-
3’ and the mismatch reverse primer 5’-GAGCATTCCCAAATGAGCAC-3’ were used to create the HinfI
restriction site.
Results. There were 304 total subjects included males 50.3% (153) and female 49.7% (151) in our
study. Incident of CC genotype was 71.1% (216), CT genotype was 25% (76) and TT genotype was
3.9%, TAG level was higher in males than females in both groups (p=0.016, ð=0.001) for CC genotype
and also, higher with MS in males for CT genotype (p=). But, TAG level was no significant difference
among three genotypes in group with MS subjects (male p=0.236, female p=0.881).
Conclusion: The TT genotype of the ApoA5 gene 1177C>T polymorphism frequency was 2.9% in control
subjects and 4.9% in subjects with MS. However, TG level was not differ in both groups for TT genotype,
TAG level in males was higher compared with females (p=0.016 in control, p=0.001 in group with MS).
7.Assessing the Biological Aging
Munkhtsetseg J ; Tseregmaa TS ; Lkhagvasuren TS
Mongolian Medical Sciences 2009;147(1):24-26
Introduction: Biological aging is defined as a process or group processes that originate from progressive decrement of viability and increment of vulnerability of the organism with the passage of time. Biological age can be viewed as an objective measure for the assessment of ones biological vigor which is inevitably declined with advancing chronological age. Materials and methods: The individuals biological age scores (BAS) were estimated from 5 variables: forced expiratory volume in 1.0 sec (FEV1), systolic blood pressure (SBP), blood glucose, albumin, other proteins ratio and mean corpuscular hemoglobin (MCH). The study was composed on study design, based on E. Nakamuras developed method. Using above mentioned parameters was calculated biological age score (BAS), by which were assessed the aging rate of each individual. Results: We investigated a trend for the rate of aging changes in adults aged above 35. Variables used as a biomarkers of aging are significantly correlated with aging, where the systolic blood pressure was strongest one. Biological age score was calculated for every individual and it has strong correlation with chronological age (r=0.331, p=0.01). The rate at which ageing process relatively faster were 45-55 and 55-66 age intervals for females, against which aging rate of man was slower than women in above mentioned age groups. Conclusion: Variables used in calculation of BAS had significant cross sectional correlation with age and the aging rate was faster in man than in women in later age groups. In younger and older age groups (35-45 and above 65) individuals of both sexes had similar aging rate.
8.Changes luteinizing hormone in aging female
Azjargal B ; Enebish D ; Munkhtsetseg J
Mongolian Medical Sciences 2011;168(1):16-19
Introduction. Luteinizing hormone is slowly increasing in menopausal transition phase, it’s maintain to increase till early post menopause phase (Gore et al. 2004). It is related to steroid hormone’s negative feedback and estradiol’s positive feedback (Rossmanith 1995), and in addition, recently years kisspeptin-10 of hypothalamus [1]. LH is dramatically decreasing at the rather late of post menopause phase (Hall et al. 2000, Gill et al 2002). By the year 2030, more than 1.2 billion women in the world will be at least 50 years old. This increasing proportion of the female population will be experiencing the menopausal transition with its accompanying physiology and pathophysiology [2]. Recently researchers more focused to study the comparative analysis of hormones at the menopause phase in different ethnic groups. This kind of study have not implemented in our country yet.Goal.Determination of serum LH level changes in relation to aging. Materials and Methods. In this study were involved 161 healthy Mongolian women aged above 35 years. Subjects were randomly selected and undergone physical examination by geriatrician. People, who are receiving hormone replacement therapy, using in proper use of alcohol, injured and had survey, were excluded from our study. Blood samples were collected in the morning 8.30-10.30 AM, after a night fasting. Blood was separated immediately by centrifugation, then obtained sera were stored at -20 0C until assayed by ELISA kit from United Biotech CoLTD, USA, which sensitivity is 1mlU/ml. Statistical analyses have been performed by statistical software SPSS 17, using ANOVA, Pearson correlation.Results. Average level of LH was 29.95±3.31mIU/ml, 15.87±5.86mIU/ml at the age 35-45, 33.12±7.1mIU/ml at the age 46-55, 15.87±ImU/ml at the age 56-65, 38.15±6.6mIU/ml at the age 66-75, and 56.42±11.1mlIU/ml over 76 age in the all participants, considering by person correlation coefficient, between age and LH are moderate and direct correlation (r=0.264, ð 0.003).Conclusion. Average level of LH was 29.95±3.31mIU/ml in women aged over 35. Considering by person correlation coefficient, between age and LH are moderate and direct correlation (r=0.264, ð 0.003). LH increases with aging till round 70 and decreases after 70 years.
9. The separation of β-lactoglobulin from cow milk
Bolor B ; Munkhtsetseg J ; Javkhlantugs N
Health Laboratory 2013;2(2):14-16
10. THE LEVEL OF FREE AND BIOAVAILABLE TESTOSTERONE IN MEN AGED ABOVE 40 YEARS OLD
Oyun-Erdene R. ; Nansalmaa N. ; Munkhtsetseg J.
Mongolian Pharmacy and Pharmacology 2013;2(1):11-
Introduction: With the average longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. A metabolic and hormonal change occurs in male during aging.The level of total, free and bioavailable testosterone decline with aging and it leads to decrease in sexual activities, metabolism and also the life quality.The aim of this initial study was the determination of free testosterone and bioavailable testosterone and it was the novelty of our study. Data obtained from our research can be used as basic information for hormone replacement therapy in late onset hypogonadism.Research goal: To study the free testosterone and bioavailable testosterone level in aging malesMaterials and Methods: This study is a part of study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. The study was approved by IRB of MoH and written consent was obtained from all participants.Fasting blood samples were collected in the morning between 8.00-10.00 AM. We used commercial ELISA kits from Magiwel CoLtd (USA) for determining the total testosterone, sex hormone binding globulin levels. Bromcresol green method was used in determination of serum albumin level. Bioavailable and free testosterone were calculated by Alex Vermeulen, Lieve Verdonk and M. Kaufman’s formula, which was recommended by International Society for the Study of Aging Male.We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination.Result and discussion: The average age was 57.48±10.48 years in our study participants. In group of 40-49 years were 29% (n=33), in 50-59 age group 23% (n=26), in 60-69 age group 27% (n=38) and in age group over 70-s were 15% (n=17).Mean total testosterone was 6.04±1.83 ng/ml, in 40-49 age group it was 6.14±1.65 ng/ml, in 50-59 age group 6.04±2.36 ng/ml, in 60-69 age group 6.05±1.80 ng/ml, and over 70’s it was 5.85±1.43 ng/ml.Mean sex hormone binding globulin was 50.22±29.97 nmol/l, in 40-49 age group 37.60±23.03 nmol/l, in 50-59 age group 47.08±29.61 nmol/l, in 60-69 age group 57.24±33.91 nmol/l, and over 70’s it was 59.22±25.38 nmol/l.Mean albumin was 40.86±6.89 g/l, in 40-49 age group 44.55±5.93 g/l, in 50-59 age group 41.85±6.93 g/l, in 60-69 age group 38.92±6.85 g/l, and over 70’s was 36.55±4.77 g/l.Mean free testosterone was 0.112±0.064 ng/ml, in 40- 49 age group 0.124±0.058 ng/ml, in 50-59 age group0.114±0.077 ng/ml, in 60-69 age group 0.107±0.072 ng/ml, and over 70’s it was 0.097±0.044 ng/ml.Mean bioavailable testosterone was 2.53±1.48 ng/ ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml.Conclusion:1. In our participants aged above 40 years old, the average mean of free testosterone was 0.112±0.066 ng/ml, free testosterone index was 16.95±11.82. Free testosterone had inverse correlation with aging (r=-0.168, p=0.03) and had peer decline among aging groups.2. The average mean of bioavailable testosterone was 2.53±1.48 ng/ml, and had age related inverse correlation (r=-0.169, p=0.037), which decline was deeper in men aged over 70 years.Key words:Aging, total, free, bioavailable testosterone,free testosterone index