Objective To explore the correlations of serum interleukin-4(IL-4),leptin and chemerin levels with severity of asthma in obese children and their predictive values for asthma control.Methods A total of 102 obese children with asthma were selected as study group,and another 102 healthy obese children were selected as control group.The serum levels of IL-4,leptin and chemerin were compared between the two groups.The study group was divided into mild(n=34),moderate(n=42)and severe(n=26)asthma groups based on severity of disease,and the serum levels of IL-4,leptin and chemerin were compared among different groups.The correlations of serum IL-4,leptin and chemerin with disease severity were analyzed.After 4 weeks of treatment,the 102 children with asth-ma were divided into controlled group(n=82)and uncontrolled group(n=20)based on asthma con-trol status.Clinical data and serum levels of IL-4,leptin and chemerin were compared between the two groups,and their impacts on asthma control were analyzed.The predictive values of serum IL-4,leptin and chemerin levels for asthma control were evaluated.Results The serum levels of IL-4,leptin and chemerin showed significant gradual increase trends among controlled children,mild asthma children,moderate asthma children,and severe asthma children(P＜0.001).Spearman correlation analysis showed positive correlations of serum IL-4,leptin and chemerin with disease severity(P＜0.001).The serum levels of IL-4,leptin and chemerin in the uncontrolled group were significantly higher than those in the controlled group(P＜0.001).Logistic regression analysis showed that serum IL-4(OR=1.514,95％CI,1.117 to 2.051),leptin(OR=1.534,95％CI,1.234 to 1.907),and chemerin(OR=1.418,95％CI,1.026 to 1.959)after adjusting for disease duration were still the independent risk factors for asthma control(P＜0.05).The areas under the curve(AUC)for pre-dicting asthma control by single and combined detections of serum IL-4,leptin and chemerin were 0.807(95％CI,0.717 to0.879),0.801(95％CI,0.711 to0.874),0.834(95％CI,0.748 to 0.901)and 0.932(95％CI,0.864 to 0.972),respectively.The AUC for combined prediction was significantly better than that for individual predictor(P＜0.05).Conclusion The serum lev-els of IL-4,leptin and chemerin in obese children with asthma are positively correlated with disease severity,and they are independent risk factors for asthma control.Combined detection of these three indicators has a higher predictive value for asthma control.

Objective To observe the long-term relationship between body mass index (BMI) and cardiovascular events in male elderly hypertensive patients.Methods A total of 839 male elderly (＞ 65 years old) hypertensive patients were included in this prospective study.Baseline data were obtained on January 2004 and participants were followed up yearly till January 2014.Patients were divided into 3 groups according to their BMI:normal weight group (18.5 kg/m2 ≤BMI ＜24.0 kg/m2),overweight group (24.0 kg/m2 ≤ BMI ＜ 28.0 kg/m2),obese group (BMI ≥ 28.0 kg/m2).All-cause death and cardiovascular events were compared.Results The average age of all 839 hypertension men was (75.4 ± 4.8) years at baseline.Baseline systolic blood pressure was (133.7 ± 14.6) mmHg(1 mmHg =0.133 kPa),diastolic blood pressure was (74.3 ± 9.3) mmHg.Baseline systolic and diastolic blood pressure was similar among the three groups.All 839 patients completed follow-up.There were 178 all-cause deaths,54 cardiovascular deaths,51 new/recurrent myocardial infarctions and 105 new/recurrent strokes during follow up.Incidence of all-cause mortality in overweight group (16.74％,72/430) was significantly lower than in normal weight group (27.01％ (74/274),P ＜ 0.05).Kaplan-Meier curves showed the all-cause mortality and cardiovascular mortality were higher in normal weight group than in the other two groups.According to the Cox proportional hazards regression model,the risk of all-cause mortality (RR =0.867,95％ CI:0.792-0.949) and cardiovascular death (RR =0.179,95 ％ CI:0.05-0.645) in patients with a BMI ≥ 24.0 kg/m2 were lower than in the group with BMI ＜ 24.0 kg/m2.Conclusion Obesity paradox phenomenon is observed in elderly male hypertensive patients in that higher BMI is associated with lower mortality risks in elderly male hypertensive patients during the 10 years follow-up.