1.A Case of Multidisciplinary Treatment for a Patient with Gorham-Stout Disease
Jing HU ; Ying JIN ; Yan ZHANG ; Ji LI ; Wenhui WANG ; Yue CHI ; Chunxu LI ; Zhenjie ZHANG ; Yaping LIU ; Xiaotian CHU ; Jin XU ; Min SHEN
JOURNAL OF RARE DISEASES 2026;5(1):52-59
Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.
2.Effects of Yijing Decoction Containing Serum on Iron Overload-induced Oxidative Stress in Human Ovarian Granulosa Cells
Chengcheng LIANG ; Jing YU ; Heng HU ; Xiaoyu WANG ; Jiaxin TONG ; Xiaoli WANG ; Yang LI ; Jijun CHU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(9):105-112
Objective To explore the effects and mechanism of Yijing Decoction containing serum on iron overload-induced oxidative stress of human ovarian granulosa cells.Methods SD rats were used to prepare medicated serum and blank serum.Iron dextran was used to induce oxidative damage of SVOG cells.The cells were divided into control group,model group,containing serum group,blank serum group,antioxidant group and iron chelating agent group.After corresponding intervention,cell viability was detected by CCK-8 method,estrogen(E2)and progesterone(P)content in supernatant were detected by ELISA,the contents of intracellular ferrous ion(Fe2+),malondialdehyde(MDA),adenosine triphosphate(ATP)and the activities of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),catalase(CAT)were detected by the kit,ROS content was detected by DCFH-DA fluorescence probe,the mitochondrial membrane potential was detected by JC-1 fluorescence probe,Western blot and RT-qPCR were used to detect the protein and mRNA expression of nuclear factor erythroid 2-related factor 2(Nrf2),transferrin(Tf),transferrin receptor 1(TfR1),ferritin heavy chain 1(FTH1)and ferritin light chain(FTL).Results Compared with the control group,the viability of SVOG cells decreased in the model group,the contents of E2 and P in cell supernatant decreased,the contents of Fe2+,MDA and ROS increased,the content of ATP and activities of SOD,GSH-Px and CAT decreased,the mitochondrial membrane potential decreased,the protein and mRNA expressions of Nrf2 and FTH1 decreased,and the protein and mRNA expressions of Tf,TfR1 and FTL increased,with statistical significance(P<0.05,P<0.01).Compared with the model group,the viability of SVOG cells in containing serum group,antioxidant group and iron chelating agent group increased,the contents of E2 and P in cell supernatant increased,the contents of Fe2+,MDA and ROS decreased,the content of ATP and activities of SOD,GSH-Px and CAT increased,the mitochondrial membrane potential increased,the protein and mRNA expressions of Nrf2 and FTH1 increased,and the protein and mRNA expressions of Tf,TfR1 and FTL decreased(P<0.05,P<0.01).Conclusion Yijing Decoction containing serum may relieve oxidative stress damage induced by iron overload,improve mitochondrial function,and restore granulosa cell function,thereby enhancing ovarian function,potentially through up-regulating Nrf2,FTH1 expression and down-regulating Tf,TfR1 and FTL expressions.
3.Yijingtang Reduces Ovarian Inflammatory Responses in Rat Model of Diminished Ovarian Reserve via TLR4/MyD88/NF-κB Signaling Pathway
Heng HU ; Jijun CHU ; Zhe LI ; Haijing CHU ; Jing YU ; Chengcheng LIANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):20-30
ObjectiveTo investigate the effect and mechanism of Yijingtang (YJT) in treating diminished ovarian reserve (DOR) in rats by regulating the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway. MethodsFifty female SD rats with normal estrous cycles were randomly allocated into blank, model, low- and high-dose (12.579 and 25.158 g·kg-1, respectively) YJT, and dehydroepiandrosterone (7.487 5 mg·kg-1) groups, with 10 rats in each group. The rats in other groups except the blank group were administrated with the tripterygium glycosides tablet suspension (5 mg·kg-1) by gavage for 14 days for the modeling of DOR. The rats in the drug treatment groups were administrated with corresponding drugs by gavage from day 15 for 30 consecutive days, and those in the blank and model groups received equal volumes of distilled water. The vaginal exfoliated cell smears were observed to assess the changes in the estrous cycle. The wet weight of bilateral ovaries was weighed for calculation of the ovarian index. Hematoxylin-eosin staining was performed to observe the histopathological changes in the ovaries and the proportions of follicles at various levels were calculated. The serum levels of sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and anti-Müllerian hormone (AMH)] and inflammatory factors [tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), and interleukin-10 (IL-10)] were determined by enzyme-linked immunosorbent assay. Real-time quantitative polymerase chain reaction(Real-time PCR) was conducted to determine the mRNA levels of TLR4, MyD88, NF-κB profilin α (IκBα), NF-κB and inflammatory factors in the ovarian tissue. Western blot was employed to measure the protein levels of factors related to the TLR4/MyD88/NF-κB signaling pathway in the ovarian tissue. Immunofluorescence (IF) was used to detect the nuclear translocation of NF-κB p65 in the ovarian tissue. ResultsCompared with the blank group, the model group showed disturbed estrous cycles, increased inflammatory infiltration in the ovarian tissue, decreases in ovarian index and proportion of presinusoidal follicles, and an increase in the proportion of atretic follicles (P<0.05, P<0.01). In addition, the model group showed elevated serum levels of FSH, LH, TNF-α, and IL-1β, up-regulated mRNA levels of TLR4, MyD88, IκBα, NF-κB, TNF-α, and IL-1β and protein levels of TLR4, MyD88, p-IκBα, and p-NF-κB p65 (P<0.01), lowered serum levels of AMH, E2, and IL-10, down-regulated mRNA level of IL-10 (P<0.01), and massive nuclear translocation of NF-κB p65 in the ovarian tissue. Compared with the model group, dehydroepiandrosterone and low and high doses of YJT restored the disturbed estrous cycle, reduced inflammatory infiltration in the ovarian tissue, increased the ovarian index (P<0.01), and changed the follicular composition ratio (P<0.01). Furthermore, the drugs lowered the serum levels of FSH, LH, TNF-α, and IL-1β, down-regulated the mRNA levels of TLR4, MyD88, IκBα, NF-κB, TNF-α, and IL-1β and the protein levels of TLR4, MyD88, p-IκBα, and p-NF-κB p65 (P<0.05, P<0.01), raised the serum levels of AMH, E2, and IL-10, up-regulated the mRNA level of IL-10 (P<0.05, P<0.01), and reduced the nuclear translocation of NF-κB p65 in the ovarian tissue. ConclusionYJT may inhibit the release and expression of inflammatory factors by regulating the TLR4/MyD88/NF-κB signaling pathway to attenuate the inflammatory responses in the ovarian tissue, thereby improving the ovarian function in DOR rats.
4.Yijingtang Reduces Ovarian Inflammatory Responses in Rat Model of Diminished Ovarian Reserve via TLR4/MyD88/NF-κB Signaling Pathway
Heng HU ; Jijun CHU ; Zhe LI ; Haijing CHU ; Jing YU ; Chengcheng LIANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):20-30
ObjectiveTo investigate the effect and mechanism of Yijingtang (YJT) in treating diminished ovarian reserve (DOR) in rats by regulating the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway. MethodsFifty female SD rats with normal estrous cycles were randomly allocated into blank, model, low- and high-dose (12.579 and 25.158 g·kg-1, respectively) YJT, and dehydroepiandrosterone (7.487 5 mg·kg-1) groups, with 10 rats in each group. The rats in other groups except the blank group were administrated with the tripterygium glycosides tablet suspension (5 mg·kg-1) by gavage for 14 days for the modeling of DOR. The rats in the drug treatment groups were administrated with corresponding drugs by gavage from day 15 for 30 consecutive days, and those in the blank and model groups received equal volumes of distilled water. The vaginal exfoliated cell smears were observed to assess the changes in the estrous cycle. The wet weight of bilateral ovaries was weighed for calculation of the ovarian index. Hematoxylin-eosin staining was performed to observe the histopathological changes in the ovaries and the proportions of follicles at various levels were calculated. The serum levels of sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and anti-Müllerian hormone (AMH)] and inflammatory factors [tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), and interleukin-10 (IL-10)] were determined by enzyme-linked immunosorbent assay. Real-time quantitative polymerase chain reaction(Real-time PCR) was conducted to determine the mRNA levels of TLR4, MyD88, NF-κB profilin α (IκBα), NF-κB and inflammatory factors in the ovarian tissue. Western blot was employed to measure the protein levels of factors related to the TLR4/MyD88/NF-κB signaling pathway in the ovarian tissue. Immunofluorescence (IF) was used to detect the nuclear translocation of NF-κB p65 in the ovarian tissue. ResultsCompared with the blank group, the model group showed disturbed estrous cycles, increased inflammatory infiltration in the ovarian tissue, decreases in ovarian index and proportion of presinusoidal follicles, and an increase in the proportion of atretic follicles (P<0.05, P<0.01). In addition, the model group showed elevated serum levels of FSH, LH, TNF-α, and IL-1β, up-regulated mRNA levels of TLR4, MyD88, IκBα, NF-κB, TNF-α, and IL-1β and protein levels of TLR4, MyD88, p-IκBα, and p-NF-κB p65 (P<0.01), lowered serum levels of AMH, E2, and IL-10, down-regulated mRNA level of IL-10 (P<0.01), and massive nuclear translocation of NF-κB p65 in the ovarian tissue. Compared with the model group, dehydroepiandrosterone and low and high doses of YJT restored the disturbed estrous cycle, reduced inflammatory infiltration in the ovarian tissue, increased the ovarian index (P<0.01), and changed the follicular composition ratio (P<0.01). Furthermore, the drugs lowered the serum levels of FSH, LH, TNF-α, and IL-1β, down-regulated the mRNA levels of TLR4, MyD88, IκBα, NF-κB, TNF-α, and IL-1β and the protein levels of TLR4, MyD88, p-IκBα, and p-NF-κB p65 (P<0.05, P<0.01), raised the serum levels of AMH, E2, and IL-10, up-regulated the mRNA level of IL-10 (P<0.05, P<0.01), and reduced the nuclear translocation of NF-κB p65 in the ovarian tissue. ConclusionYJT may inhibit the release and expression of inflammatory factors by regulating the TLR4/MyD88/NF-κB signaling pathway to attenuate the inflammatory responses in the ovarian tissue, thereby improving the ovarian function in DOR rats.
5.Comparison of glucose fluctuation between metformin combined with acarbose or sitagliptin in Chinese patients with type 2 diabetes: A multicenter, randomized, active-controlled, open-label, parallel design clinical trial.
Xiaoling CAI ; Suiyuan HU ; Chu LIN ; Jing WU ; Junfen WANG ; Zhufeng WANG ; Xiaomei ZHANG ; Xirui WANG ; Fengmei XU ; Ling CHEN ; Wenjia YANG ; Lin NIE ; Linong JI
Chinese Medical Journal 2025;138(9):1116-1125
BACKGROUND:
Alpha-glucosidase inhibitors or dipeptidyl peptidase-4 inhibitors are both hypoglycemia agents that specifically impact on postprandial hyperglycemia. We compared the effects of acarbose and sitagliptin add on to metformin on time in range (TIR) and glycemic variability (GV) in Chinese patients with type 2 diabetes mellitus through continuous glucose monitoring (CGM).
METHODS:
This study was a randomized, open-label, active-con-trolled, parallel-group trial conducted at 15 centers in China from January 2020 to August 2022. We recruited patients with type 2 diabetes aged 18-65 years with body mass index (BMI) within 19-40 kg/m 2 and hemoglobin A1c (HbA1c) between 6.5% and 9.0%. Eligible patients were randomized to receive either metformin combined with acarbose 100 mg three times daily or metformin combined with sitagliptin 100 mg once daily for 28 days. After the first 14-day treatment period, patients wore CGM and entered another 14-day treatment period. The primary outcome was the level of TIR after treatment between groups. We also performed time series decomposition, dimensionality reduction, and clustering using the CGM data.
RESULTS:
A total of 701 participants received either acarbose or sitagliptin treatment in combination with metformin. There was no statistically significant difference in TIR between the two groups. Time below range (TBR) and coefficient of variation (CV) levels in acarbose users were significantly lower than those in sitagliptin users. Median (25th percentile, 75th percentile) of TBR below target level <3.9 mmol/L (TBR 3.9 ): Acarbose: 0.45% (0, 2.13%) vs . Sitagliptin: 0.78% (0, 3.12%), P = 0.042; Median (25th percentile, 75th percentile) of TBR below target level <3.0 mmol/L (TBR 3.0 ): Acarbose: 0 (0, 0.22%) vs . Sitagliptin: 0 (0, 0.63%), P = 0.033; CV: Acarbose: 22.44 ± 5.08% vs . Sitagliptin: 23.96 ± 5.19%, P <0.001. By using time series analysis and clustering, we distinguished three groups of patients with representative metabolism characteristics, especially in GV (group with small wave, moderate wave and big wave). No significant difference was found in the complexity of glucose time series index (CGI) between acarbose users and sitagliptin users. By using time series analysis and clustering, we distinguished three groups of patients with representative metabolism characteristics, especially in GV.
CONCLUSIONS:
Acarbose had slight advantages over sitagliptin in improving GV and reducing the risk of hypoglycemia. Time series analysis of CGM data may predict GV and the risk of hypoglycemia.
TRIAL REGISTRATION
Chinese Clinical Trial Registry: ChiCTR2000039424.
Humans
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Metformin/therapeutic use*
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Sitagliptin Phosphate/therapeutic use*
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Acarbose/therapeutic use*
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Diabetes Mellitus, Type 2/blood*
;
Middle Aged
;
Male
;
Female
;
Adult
;
Blood Glucose/drug effects*
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Hypoglycemic Agents/therapeutic use*
;
Aged
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Glycated Hemoglobin/metabolism*
;
Adolescent
;
Young Adult
;
China
;
East Asian People
6.Exploration on effects of Bushen Antai Mixture on placental oxidative damage in mice with RSA investigation based on Nrf2/HO-1/NF-κB signaling pathways
Haijing CHU ; Chengcheng LIANG ; Zhe LI ; Heng HU ; Jing YU ; Jijun CHU
International Journal of Traditional Chinese Medicine 2025;47(4):494-500
Objective:To observe the effects of Bushen Antai Mixture on nuclear transcription factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1)/nuclear transcription factor-κB (NF-κB) in placental tissue of recurrent spontaneous abortion (RSA) mice.Methods:The CBA/J mice (female) and DBA/2 (male), CBA/J mice (female) and BALB/c (male) were caged at a ratio of 2 : 1 to establish RSA and normal pregnant mice, respectively. The next morning, the vaginal plug was found or the sperm was seen under the microscope as the successful modeling, which was counted as the first day of pregnancy. CBA/J×BALB/c mice were set as normal group, and the RSA model pregnant mice were divided into model group, progesterone group, and Bushen Antai Mixture low-, medium-, and high-dosage groups using a random number table method, with 6 mice in each group. The normal group and the model group were given distilled water by gavage. Bushen Antai Mixture low-, medium-, and high-dosage groups were given 3.9 g/kg, 11.7 g/kg and 23.4 g/kg Bushen Antai Mixture by gavage. The progesterone group was given progesterone capsule aqueous solution 26 mg/kg by gavage for 14 consecutive days. The embryo loss rate of mice was calculated. The pathological changes of placental tissues were observed by HE staining. The expressions of Nrf2, HO-1 and NF-κB protein and mRNA in placental tissues were detected by Western blot and RT-qPCR.Results:Compared with the model group, the embryo loss rate of mice in the Bushen Antai Mixture low-, medium-, and high-dosage groups and the progesterone group significantly decreased ( P<0.05, P<0.01); the pathological morphology of placental tissue improved; the expressions of Nrf2, HO-1 protein and mRNA in placental tissue significantly increased ( P<0.05, P<0.01), and the expression of NF-κB protein and mRNA significantly decreased ( P<0.05, P<0.01). Conclusion:Bushen Antai Mixture may may treat RSA by activating the Nrf2/HO-1 pathway, inhibiting NF - κB expression, and improving oxidative stress and inflammatory response in the placental tissue of RSA pregnant mice.
7.Effects of Laparoscopic Sleeve Gastrectomy on Cardiac Structure and Function in Obese Patients With Heart Failure.
Xiao-Yan JIA ; Rui-Jia LIAN ; Bao-Dong MA ; Yang-Xi HU ; Qin-Jun CHU ; Hai-Yun JING ; Zhi-Qiang KANG ; Jian-Ping YE ; Xi-Wen MA
Acta Academiae Medicinae Sinicae 2025;47(2):226-236
Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(n=17),a HF with mildly reduced ejection fraction group(n=5)and a HF with reduced ejection fraction(HFrEF)group(n=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples t-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m2.The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(P=0.002),body surface area(BSA)(P=0.009),waist circumference(P=0.010),hip circumference(P=0.031),body fat content(P=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(P<0.001)decreased.At the 12-month follow-up left atrial diameter(P=0.006),right atrial long-axis inner diameter(RAD1)(P<0.001),right atrial short-axis inner diameter(RAD2)(P<0.001),right ventricular inner diameter(P=0.002),interventricular septal thickness at end-diastolic(P=0.002),and left ventricular end-diastolic volumes(P=0.004)and left ventricular end-systolic volumes(P=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both P<0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(P=0.003),left ventricular inner diameter at end-diastole(P=0.008),RAD1(P<0.001),RAD2(P=0.004),right ventricular inner diameter(P=0.019),left ventricular end-diastolic volume(P=0.004)and left ventricular end-systolic volume(P=0.001),cardiac output(P=0.006),tricuspid regurgitation velocity(P=0.002),and pulmonary artery systolic pressure(P=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(P<0.001,P=0.003,P<0.001)and LVEF(P<0.001,P=0.011,P=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.
Humans
;
Male
;
Female
;
Gastrectomy/methods*
;
Heart Failure/complications*
;
Adult
;
Obesity/physiopathology*
;
Laparoscopy
;
Middle Aged
;
Heart/physiopathology*
;
Stroke Volume
8.Effects of Bushen Antai Mixture on Maternal and Foetal Interface Angiogenesis in Recurrent Spontaneous Abortion Mice Based on the VEGF/Hippo/YAP Pathway
Zhe LI ; Chengcheng LIANG ; Haijing CHU ; Heng HU ; Jing YU ; Jijun CHU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(4):107-112
Objective To observe the effects of Bushen Antai Mixture on angiogenesis at the maternal fetal interface in recurrent spontaneous abortion(RSA)mice;To explore its mechanism in treating RSA based on the VEGF/Hippo/YAP pathway.Methods RSA mouse model and normal pregnancy mouse were constructed using Clark classic method.RSA model mice were randomly divided into model group,progesterone group,Bushen Antai Mixture low-,medium-and high-dosage groups,and normal pregnant mice were used as normal group,with 10 mice in each group.Starting from the first day of pregnancy,each medication group was given the corresponding medication by gavage for 15 days.The absorption rate of mouse embryos was calculated,the morphology of decidual tissue were observed by HE staining,the mRNA and protein expression of VEGF and Hippo/YAP pathway-related molecules of decidual tissue were detected by RT-qPCR and Western blot.Results Compared with the normal group,the absorption rate of embryos in the model group significantly increased(P<0.01),the arrangement of decidual tissue cells were disordered,edematous and degenerated,some nuclei disappeared,the vascular density decreased,the mRNA expressions of VEGF,Yes associated protein(YAP),large tumor suppressor factor(LATS)1 and LATS2 in decidual tissue significantly decreased(P<0.01),the protein expression of VEGF decreased(P<0.01),and the protein expressions of p-YAP/YAP and p-LATS/LATS significantly increased(P<0.01).Compared with the model group,the absorption rate of embryos in each dosage group of Bushen Antai Mixture was significantly reduced(P<0.05,P<0.01),the cells in the decidual tissue were arranged in an orderly manner,and edema degeneration was reduced,the mRNA expressions of VEGF,YAP,LATS1 and LATS2 in decidual tissue significantly increased(P<0.05,P<0.01),and the protein expression of VEGF significantly increased(P<0.05,P<0.01),the protein expressions of p-YAP/YAP and p-LATS/LATS decreased(P<0.05,P<0.01).Conclusion Bushen Antai Mixture can promote the expressions of VEGF,YAP,LATS by activating VEGF/Hippo/YAP signaling pathway,promote angiogenesis at the maternal-fetal interface,reduce the pregnancy loss rate,and play a therapeutic effect of RSA.
9.Relationship between non-renin-dependent aldosterone and left ventricular hypertrophy in essential hypertension
Guili CHANG ; Changyuan LIU ; Mingchun LI ; Zhe HU ; Jing CHEN ; Qun'an CAO ; Shaoli CHU ; Xin CHEN
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(10):1372-1377
Objective·To analyze the influencing factors of left ventricular mass index(LVMI)in patients with essential hypertension,and explore the relationship between aldosterone levels and left ventricular hypertrophy(LVH).Methods·A total of 155 patients with essential hypertension,hospitalized in the Hypertension Department of the Northern Campus of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,from January 2013 to December 2019,and excluded from primary aldosteronism by saline load test(post-saline suppression plasma aldosterone<60 pg/mL),were enrolled.General clinical data(age,gender,smoking status,duration of hypertension,etc.),physical examination data(blood pressure and body mass index),blood biochemistry(renal function,electrolytes,fasting blood glucose,and lipids),urinary sodium,and relevant hormones(basal and activated aldosterone,basal and activated renin,urinary aldosterone,post-saline suppression aldosterone,etc.)were collected.LVMI was evaluated by echocardiography.Pearson correlation analysis was used to assess the linear association between LVMI and each variable.Binary Logistic regression models were applied to screen independent risk factors for LVH.Multiple linear regression models were used to assess the impact of variables on LVMI.Results·The mean age of the 155 patients was(46.85±11.08)years,with 51.6%being male.Pearson correlation analysis showed that LVMI was significantly positively correlated with post-saline suppression aldosterone(r=0.334,P<0.001),age(r=0.184,P=0.032),duration of hypertension(r=0.241,P=0.005),systolic blood pressure(r=0.280,P=0.001),and pulse pressure(r=0.339,P<0.001).No significant correlations were found with diastolic blood pressure,body mass index,fasting blood glucose,total cholesterol,low-density lipoprotein cholesterol,triglyceride,high-density lipoprotein cholesterol,urinary sodium,basal aldosterone,activated aldosterone,or urinary aldosterone.After adjusting for confounders,including gender,smoking history,age,duration of hypertension,body mass index,pulse pressure,systolic blood pressure,fasting blood glucose,and total cholesterol,binary Logistic regression showed that each 1 pg/mL increase in post-saline suppression aldosterone was associated with a 5.1%increased risk of LVH(OR=1.051,95%CI 1.016?1.088,P=0.004).Multiple linear regression identified suppressed aldosterone(β=0.359,P<0.001),duration of hypertension(β=0.168,P=0.046),and pulse pressure(β=0.226,P=0.008)as independent influencing factors for LVMI.Conclusion·Suppressed aldosterone is an independent influencing factor for LVH in patients with essential hypertension.
10.Relationship between non-renin-dependent aldosterone and left ventricular hypertrophy in essential hypertension
Guili CHANG ; Changyuan LIU ; Mingchun LI ; Zhe HU ; Jing CHEN ; Qun'an CAO ; Shaoli CHU ; Xin CHEN
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(10):1372-1377
Objective·To analyze the influencing factors of left ventricular mass index(LVMI)in patients with essential hypertension,and explore the relationship between aldosterone levels and left ventricular hypertrophy(LVH).Methods·A total of 155 patients with essential hypertension,hospitalized in the Hypertension Department of the Northern Campus of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,from January 2013 to December 2019,and excluded from primary aldosteronism by saline load test(post-saline suppression plasma aldosterone<60 pg/mL),were enrolled.General clinical data(age,gender,smoking status,duration of hypertension,etc.),physical examination data(blood pressure and body mass index),blood biochemistry(renal function,electrolytes,fasting blood glucose,and lipids),urinary sodium,and relevant hormones(basal and activated aldosterone,basal and activated renin,urinary aldosterone,post-saline suppression aldosterone,etc.)were collected.LVMI was evaluated by echocardiography.Pearson correlation analysis was used to assess the linear association between LVMI and each variable.Binary Logistic regression models were applied to screen independent risk factors for LVH.Multiple linear regression models were used to assess the impact of variables on LVMI.Results·The mean age of the 155 patients was(46.85±11.08)years,with 51.6%being male.Pearson correlation analysis showed that LVMI was significantly positively correlated with post-saline suppression aldosterone(r=0.334,P<0.001),age(r=0.184,P=0.032),duration of hypertension(r=0.241,P=0.005),systolic blood pressure(r=0.280,P=0.001),and pulse pressure(r=0.339,P<0.001).No significant correlations were found with diastolic blood pressure,body mass index,fasting blood glucose,total cholesterol,low-density lipoprotein cholesterol,triglyceride,high-density lipoprotein cholesterol,urinary sodium,basal aldosterone,activated aldosterone,or urinary aldosterone.After adjusting for confounders,including gender,smoking history,age,duration of hypertension,body mass index,pulse pressure,systolic blood pressure,fasting blood glucose,and total cholesterol,binary Logistic regression showed that each 1 pg/mL increase in post-saline suppression aldosterone was associated with a 5.1%increased risk of LVH(OR=1.051,95%CI 1.016?1.088,P=0.004).Multiple linear regression identified suppressed aldosterone(β=0.359,P<0.001),duration of hypertension(β=0.168,P=0.046),and pulse pressure(β=0.226,P=0.008)as independent influencing factors for LVMI.Conclusion·Suppressed aldosterone is an independent influencing factor for LVH in patients with essential hypertension.

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