1.Key problems in the prevention and treatment of hyperuricemia
Chinese Journal of Endocrinology and Metabolism 2011;27(7):543-547
The incidence of hyperuricemia and relevant diseases has been increasing recently since the living improvement and dietary changing. Both patients and doctors do not pay enough attention to this disease, due to the lack of obvious clinical presentations in early stage. This paper comments on the relationship between hyperuricemia and gout, gouty nephropathy, impaired glucose metabolism,and atherosclerotic diseases in order to arouse enough attention to this disease.
2.Case analysis of hospital merger and acquisition
Ruiwen HAO ; Zhimin MIAO ; Ming DONG
Chinese Journal of Hospital Administration 2009;25(3):206-208
It presented in detail the acquisition of Qingdao Wan Jie Hospital by the Affiliated Hospital of Medical College Qingdao University, describing the operational mechanisms in organizational setup, specialty setup, personnel management, logistic management, hospital culture and branding of the newly acquired section. It also summarized the achievements in medical resources reorganization and advantages complementary without government investment in a fast and low-cost manner. It is demonstrated that hospital acquisitions are in line with the medical reform, as they expand the service coverage of public hospitals, and extend medical service to the communities and lower levels, thus enhancing hospitals' impact and reach to integrate medical resources in a short timeframe.
3.Correlation between serum uric acid and cardiovascular risk factors in Shandong coastal inhabitants
Yangang WANG ; Shengli YAN ; Changgui LI ; Shihua ZHAO ; Zhimin MIAO
Chinese Journal of Endocrinology and Metabolism 2009;25(2):159-163
Objective To elucidate the relationship between serum uric acid (SUA) and cardiovascular risk factors in Shandong coastal inhabitants. Methods A random, stratified cluster sampling method was conducted. A population.based cross-sectional survey for hyperuricemia was performed and 4 988 dwellers of Shandong coast were investigated. Fasting SUA,lipid profiles,insulin concentrations,etc.,were determined by automatic biochemical analysis device and electrochemiluminescence analyzer.The investigation of general,healthy and nutritional conditions was carried out by questionnaire. Results In male and female subjects, the cardiovascular risk factors such as systolic blood pressure,diastolic blood pressure, selum ereatinine,total cholesterol.triglvceride,waist circumference and body mass index all increased with rising SUA,and the level of senlm high densitv lipoprotein fell accordingly.Homeostasis model assessment insulin resistance index (HOMA- IR) in female subjects increased by the quartile group,not in male subjects.Compared with SUA<280 μmol/L group.odds ratio(OR) values of hypertension in SUA 280-319,320-349,≥350 μmol/L groups were 1.54,1.88 and 2.70 respectively in female,and 2.29,4.15 and 4.96 for metabolic syndrome (MS).As for male,compared with SUA<280 μmol/L group OR value of hypertension in SUA ≥420 μmol/L group was 1.52,and OR values of MS of 1.41,1.87 and 3.27 occurred in SUA 320~379,380~419,≥420 μmol/L groups.After being adjusted for confounding factors,logistic stepwise regression revealed that elevated SUA was an independent risk factor for hypertension in both genders.Conclusion Elevated SUA level is closely related to the incidence and development of cardiovascular diseases,and should not be ignored in clinical practice.
4.The progress on the research of the relationship between hyperuricemia and cardiovascular disease
Xinde LI ; Lingling CUI ; Wei REN ; Zhimin MIAO ; Changgui LI
Chinese Journal of Endocrinology and Metabolism 2011;27(7):614-617
Lots of studies have identified the relationship between hyperuricemia and cardiovascular diseases. Many factors affect the metabolism of uric acid, such as diet, drug, internal environment of organism, etc. However, the relationship between hyperuricemia and cardiovascular diseases is not quite clear. In this review, we present recently published data about the association between hyperuricemia and selected cardiovascular diseases.
5.Elevation of plasminogen activator inhibitor-1 and endothelin levels in middle aged and old male patients with hyperuricemia
Shaodan JIA ; Yangang WANG ; Zhimin MIAO ; Shengli YAN
Chinese Journal of Endocrinology and Metabolism 1986;0(04):-
Serum plasminogen activator inhibitor-1 (PAI-1) and endothelin (ET) levels were measured in patients with simple hyperuricemia or combined with hyperlipidaemia and hyperglycemia. The results showed that PAI-1 and ET levels in patients with hyperuricemia were notably higher than those in the control group( both P
6.Study on the Relative Bioavailability of Propylthiouracil Enteric Coated Capsules
Deli CHEN ; Zhimin MIAO ; Yujun LIU ; Lin MA
China Pharmacy 1991;0(05):-
OBJECTIVE:To evaluate the bioavailability of domestic propylthiouracil enteric coated capsule.METHODS:A modified RP-HPLC assay was used for determination of the plasma drug concentrations.In a randomized two-way crossover design,a single oral dose of100mg domestic propylthiouracil capsule(trial agent,A)and imported propyithiouracil tablet(reference agent,B)were given to20male healthy volunteers.The parameters were fitted by CRFB bioavailaility soft?ware.RESULTS:The AUC 0~t ,C max and t max of A and B were(9.13?1.53)and(8.80?1.37)(?g?h)/ml,(3.02?0.71)and(3.03?0.66)?g/ml,(4.51?0.24)and(1.13?0.44)h respectively.There were no significant differences in parameters between2groups.The relative bioavailability of product A was(104.37?12.16)%.CONCLUSION:The results suggest that these two products were bioequivalent.
7.Effect of insulin on the expression of human urate transporter gene in renal proximal tubule epithelial HK-2 cells
Wei SONG ; Kun ZHANG ; Changgui LI ; Ying CHEN ; Zhimin MIAO
Chinese Journal of Endocrinology and Metabolism 2015;31(3):282-284
Human proximal tubule epithelial cell line,HK-2 cells,were cultured with various concentrations of insulin for 48 h.Human urate transporter (hUAT) mRNA was detected by realtime quantitative PCR.hUAT mRNA levels were down-regulated by insulin (5,25,125,500 μIU/ml)in a dose-dependent manner (relative expression median were 0.95,0.40,0.24,and 0.23).In vitro,the expression of hUAT mRNA in HK-2 cells is associated with the concentration of insulin.
8.Epidemic characteristics of gout and primary hyperuricemia in Shandong coastal area: A randomized stratified cluster sampling survey
Zhimin MIAO ; Shihua ZHAO ; Yangang WANG ; Changgui LI ; Zhongchao WANG ; Ying CHEN ; Xinyan CHEN ; Shengli YAN
Chinese Journal of Tissue Engineering Research 2007;11(30):6087-6091
BACKGROUND: Recent studies have found that hyperuricemia and gout are closely correlated with the occurrence and development of diabetes, coronary heart disease, hypertension and cerebrovascular diseases. It is of significance to investigate their prevalence so as to find way of early interventions.OBJECTIVE: To determine the prevalence and risk factors of gout and hyperuricemia among residents above 20 years old in Shandong coastal area.DESIGN: A randomized, stratified cluster sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: A random, stratified cluster sampling was conducted in Shandong coastal area including Qingdao,Yantai, Weihai, Rizhao and Dongying. Residents lived in these areas for 5 years or more, aged between 20 to 80 years, were selected, and they were surveyed by family as a unit.METHODS: A randomized, stratified cluster sampling survey was conducted. The prevalence of gout and hyperuricemia were investigated among about 5 000 residents in Qingdao, Yantai, Weihai, Rizhao and Dongying. The serum uric acid, lipids, glucose and creatinine were detected with Sysmex chemix-180 total automatic biochemical analyzer. Those with uric acid higher than reference level were reexamined by collecting fasting blood sample on the third day. The comparison between rates was taken with the Chi-square test, means between two groups with the t test, means between multiple groups with analysis of variance, correlation between dependent and independent variables with logistic regression analysis.MATN OUTCOME MEASURES: Prevalance of hyperuricemia; Level of serum uric acid; Prevalence of gout in patients with hyperuricemia; Influencing factor of hyperuricemia.RESULTS: This investigation planned to include 5 500 subjects while in fact 5 003 subjects were investigated and the response rate was 91%, in which males were 2 395 (47.87%) and females were 2 608 (52.13%). ① The prevalence of hyperuricemia was 13.19% with standardized rate of 13.27% according to the Shandong population in 2000; The pevalence was higher in males than in females (18.32%, 8.56%, x2=108.52, P< 0.01). The risk in males was 2.5 times higher than that in females (OR =2.5). The prevalence of gout was 1.14% with standardized rate of 1.10%; and the prevalence in males was higher than that in females (1.94%, 0.42%, x2=30.38, P < 0.01). The risk in males was 5.3 times higher than that in females (OR =5.3). ②The average value of serum uric acid in normal males was higher than in normal females [(343.40±84.54), (258.90±70.90) μmol/L, t =48.03, P < 0.01]. It was obviously higher in male patients with hyperuricemia than in female ones [(469.43±48.08), (399.73±104.91) μmol/L, t =11.70, P < 0.01]. It was higher in male patients with gout than in female ones [(502.44±106.76), (403.48±52.72) μmol/L, t =2.07, P < 0.05]. ③The prevalence of gout in patients with hyperuricemia was 8.34%. ④ The prevalence of hyperuricemia and gout were climbing up with age after 40 years old in females and those elder than 70 years old were of high risk; while in males,the prevalence of hyperuricemia and gout increased with age before 60 years old and those aged 50-59 years were of high risk, yet after 60 years, it climbed up with age again. Nevertheless, the mean ages of hyperuricemia and gout in females were older than male. The average episode ages of hyperuricemia and gout in females were later than in males respectively by 7.5 and 8.5 years. ⑤ Non-conditional Logistic regression analysis showed that drinking frequency,drinking quantity, the quantity and frequency of seashell intake, BUN, Cr, TG, TC, BMI and WHR were the independent risk factors of male patients with hyperuricemia [OR =1.016-30.217, 95%C/ (1.010-1.023)-(9.955-214.869)]; while HDL-C and heavy physical labour were the protective factors (OR =0.492, 95%C/ 0.339-0.713; OR =0.755, 95% CI 0.575-0.991).As for females, age, hypertension, the quantity of seashell food intake, BUN, Cr, TG, WHR and light physical labour were the independent risk factors of hyperuricemia [OR =1.022-27.34, 95%CI (1.006-1.040)-(9.955-214.869)]. Similarly, HDL-C was a protective factor (OR =0.428, 95%CI0.223-0.820).CONCLUSION: ① The prevalence of hyperuricemia and gout are different between genders: ② The risk factors of hyperuricemia and gout among residents in Shandong coastal area include the high intake of marine products such as seashell foods, less physical activity, abdominal obesity and kidney insufficiency, as well as the existence of metabolic syndrome. Drinking is also involved in the increased prevalence in males, and age in females. ③ Higher risk for hyperuricemia and gout are noticed in all age groups in males, whereas in females after 50 years old.
9.Impact of rosiglitazone on uric acid metabolism and its mechanism
Zhimin MIAO ; Can WANG ; Dongmei MENG ; Jing WANG ; Yujiao ZHOU ; Changgui LI
Chinese Journal of Endocrinology and Metabolism 2010;26(9):792-796
Objective To observe whether high-level insulin increases serum uric acid level and rosiglitazone improves hyperuricemia, and to explore the mechanism. Methods OLETF rats with spontaneous type 2 diabetes complicated with metabolic syndrome and normal control LETO rats were randomly divided into three groups (n=20 each). The animals were fed with standard chow diet in control group, high-purine diet and adenine administered intragastrically in experimental group, and rosiglitazone in interventional group. Body weight, serum levels of uric acid, insulin, triglyceride ( TG ) , and total cholesterol ( TC ) were measured after 3 weeks. Urate transporter 1 ( URAT1 ) and uric acid transporter (UAT) mRNA expressions in renal cortex were examined. HK-2 cells were incubated with various concentrations of insulin for 24 hours. UAT mRNA expression in HK-2 cells was examined. Results ( 1 ) In control group, the insulin level of OLETF rats was significantly higher than that of LETO rats ( P<0. 05 ), and there was no significant difference in serum uric acid level between OLETF and LETO rats. (2)In experimental groups, the insulin level in OLETF rats was significantly higher than that in LETO rats [(61.83±12.13 vs 36.73±12.73 )μIU/ml ,P<0. 05], and the incidence of hyperuricemia (76.92% vs 36.13%,P<0.01 ) and serum uric acid level[( 327.75 ±45.73 vs 264.40±36.32 ) μmol/L, P<0. 01]in OLETF rats were significantly higher than those in LETO rats. (3) Insulin[(41.3± 10.2 vs 61.8±12. 1 )μIU/ml,P<0. 05]and uric acid[( 198.0±45.4 vs 236.9±29.30 ) μmol/L, P<0. 05]levels in OLETF rats in interventional group were significantly lower than those of OLETF rats in experimental group, meanwhile the amount of urinary uric acid excretion was significantly increased[(5 644±371 vs 4 692±278 ) μ mol/L, P<0. 05]. (4) There was no significant difference in insulin level and the expressions of URAT1 and UAT mRNA in renal cortex between OLETF rats in control group and experimental group. URAT1 mRNA expression of OLETF rats in interventional group was significantly decreased, while UAT mRNA expression was significantly increased. (5)With the increase of insulinconcentration in culture medium, the expression of UAT mRNA expression in HK-2 cells was gradually decreased. Conclusions Rosiglitazone may alleviate hyperinsulinemia-induced hyperuricemia via regulating UAT and URAT1 mRNA expression.
10.Five-year changes in epidemiological characteristics of overweight and obesity in Shandong coastal inhabitants
Yi LIU ; Fang WANG ; Xiaolong YU ; Zhimin MIAO ; Changgui LI ; Shihua ZHAO ; Shengli YAN ; Yangang WANG
Chinese Journal of Endocrinology and Metabolism 2012;(11):884-889
Objective To investigate the characteristics and relevant factors of overweight and obesity in adults of the Shandong coastal area in 2009,as well as to estimate the epidemiological trends by comparing with results found in 2004.Methods A random and stratified cluster sampling of adults aged 20 years or older was conducted,and 5060 inhabitants in the cities of Qingdao,Yantai,Weihai,Rizhao,and Dongying were included.Results The standardized prevalence rates of overweight,obesity,and abdominal obesity were 33.5%,16.1%,and 40.0%respectively in 2009,with respective increase of 0.6% (P<0.05),2.9% (P<0.01),and 6.8% (P<0.05)compared with those in 2004; the rates for male were 37.9%,17.1%,and 44.6% respectively in 2009,with increase of 3.7% (P<0.01),3.7% (P<0.0l),and 10.2% (P<0.01) respectively compared with those in 2004 ;the prevalence of abdominal obesity for female was 38.6%,with an increase of 6.6% (P<0.01) compared with that in 2004.The prevalence of obesity increased consistently with age,reached a peak within 50-69 years old.There was a trend of developing obesity in younger,males,while obesity became more common in postmenopausal women.In contrast with the findings in 2004,the average age,body mass index,waist circumference,triglyceride,total cholesterol,uric acid,and blood glucose levels increased significantly (P<0.01) in 2009.Logistic regression analysis showed that aging,dyslipidemia,hypertension,hyperglycemia,hyperuricemia were positively related with obesity,and smoking was negatively related with it.Consumption of meat was related to male obesity,while carbohydrate consumption was related to female obesity.Conclusions A remarkable increase in the prevalence of obesity was found in 2009 compared with 2004,especially for the young and middle-aged men and postmenopausal women.Aging,hypertension,hyperglycemia,hyperuricemia,dyslipidaemia,and incorrect components of diet contributed to obesity.Although smoking is a negative factor for body weight,it is not suggested.