1.Associations Between Insulin Resistance Indexes and Hyperuricemia in Hypertensive Population.
Fang XIONG ; Chao YU ; Ling-Juan ZHU ; Tao WANG ; Wei ZHOU ; Hui-Hui BAO ; Xiao-Shu CHENG
Acta Academiae Medicinae Sinicae 2023;45(3):390-398
		                        		
		                        			
		                        			Objective To explore the relationship between insulin resistance (IR) indexes and hyperuricemia (HUA) among the people with hypertension. Methods From July to August in 2018,hypertension screening was carried out in Wuyuan county,Jiangxi province,and the data were collected through questionnaire survey,physical measurement,and biochemical test.Logistic regression was performed to analyze the relationship between HUA and IR indexes including metabolic score for IR (METS-IR),triglyceride-glucose (TyG) index,TyG-body mass index (BMI),TyG-waist circumference (WC),visceral adiposity index (VAI),triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C),and lipid accumulation product (LAP).The penalty spline method was used for the curve fitting between IR indexes and HUA.The area under the receiver operating characteristic curve (AUC) was employed to reveal the correlation between each index and HUA. Results The 14 220 hypertension patients included 6 713 males and 7 507 females,with the average age of (63.8±9.4) years old,the average uric acid level of (418.9±120.6) mmol/L,and the HUA detection rate of 44.4%.The HUA group had higher proportions of males,current drinking,current smoking,diabetes,and using antihypertensive drugs,older age,higher diastolic blood pressure,WC,BMI,homocysteine,total cholesterol,TG,low-density lipoprotein cholesterol,blood urea nitrogen,creatinine,aspartate aminotransferase,alanine aminotransferase,total protein,albumin,total bilirubin,direct bilirubin, METS-IR, TyG, TyG-BMI, TyG-WC, VAI, TG/HDL-C, and LAP, and lower systolic blood pressure and HDL-C than the normal uric acid group (all P<0.05).Multivariate Logistic regression showed that METS-IR (OR=1.049,95%CI=1.038-1.060, P<0.001), TyG (OR=1.639,95%CI=1.496-1.797, P<0.001), TyG-BMI (OR=1.008,95%CI=1.006-1.010, P<0.001), TyG-WC (OR=1.003,95%CI=1.002-1.004, P<0.001), lnVAI (OR=1.850, 95%CI=1.735-1.973, P<0.001), ln(TG/HDL-C) (OR=1.862,95%CI=1.692-2.048, P<0.001),and lnLAP (OR=1.503,95%CI=1.401-1.613,P<0.001) were associated with the risk of HUA.Curve fitting indicated that METS-IR,TyG,TYG-BMI,TYG-WC,lnVAI,ln(TG/HDL-C),and lnLAP were positively correlated with HUA (all P<0.001),and the AUC of TyG index was higher than that of other IR indexes (all P<0.05). Conclusion Increased IR indexes,especially TyG,were associated with the risk of HUA among people with hypertension.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Insulin Resistance
		                        			;
		                        		
		                        			Hyperuricemia
		                        			;
		                        		
		                        			Uric Acid
		                        			;
		                        		
		                        			Hypertension/complications*
		                        			;
		                        		
		                        			Glucose
		                        			;
		                        		
		                        			Obesity, Abdominal/epidemiology*
		                        			;
		                        		
		                        			Triglycerides
		                        			;
		                        		
		                        			Bilirubin
		                        			;
		                        		
		                        			Cholesterol
		                        			;
		                        		
		                        			Blood Glucose/metabolism*
		                        			
		                        		
		                        	
2.Study on related factors and characteristics of multimorbidity of overweight and obesity-related diseases in children in Hunan Province.
Zhen Zhen YAO ; Jun Xia YAN ; Ning An XU ; Ru Tong KANG ; Xiong Wei LI ; Hai Xiang ZHOU ; Wen DAI ; Si S OUYANG ; Yi Xu LIU ; Jia You LUO ; Yan ZHONG
Chinese Journal of Preventive Medicine 2023;57(5):747-752
		                        		
		                        			
		                        			From January 2019 to December 2021, overweight and obese children who visited in health outpatient Center of Hunan Children's Hospital were studied to explore and analyze the rate, related factors and patterns of multimorbidity of overweight and obesity-related diseases in children in Hunan Province. Univariate and multivariate logistic regression models were used to analyze the multimorbidity-related factors of overweight and obesity-related diseases in children. Association rules (apriori algorithm) were used to explore the multimorbidity patterns of overweight and obesity-related diseases in children. A total of 725 overweight and obese children were included in this study. The multimorbidity rate of overweight and obesity-related diseases in children was 46.07% (334/725). Age, waist circumference, the frequency of food consumption such as hamburgers and fries and adding meals before bedtime were multimorbidity-related factors of overweight and obesity-related diseases in children. The multimorbidity associated with nonalcoholic fatty liver disease (NAFLD) was relatively common. The patterns with the top three support degrees were "NAFLD+dyslipidemia","NAFLD+hypertension" and "NAFLD+hyperuricemia". The patterns with the top three confidence and elevation degrees were "Hypertension+dyslipidemia => NAFLD","Hyperuricemia => NAFLD" and "NAFLD+hypertension => dyslipidemia".
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Overweight/complications*
		                        			;
		                        		
		                        			Non-alcoholic Fatty Liver Disease
		                        			;
		                        		
		                        			Pediatric Obesity/epidemiology*
		                        			;
		                        		
		                        			Hyperuricemia
		                        			;
		                        		
		                        			Multimorbidity
		                        			;
		                        		
		                        			Hypertension/epidemiology*
		                        			;
		                        		
		                        			Dyslipidemias
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
3.Risk factors related to coronary artery occlusion in female patients with ischemic angina pectoris.
Cheng Fei PENG ; Ya Song WANG ; Ya Ling HAN ; Xiao Zeng WANG
Chinese Journal of Cardiology 2023;51(2):158-163
		                        		
		                        			
		                        			Objective: To analyze the risk factors of coronary artery occlusion in female patients with ischemic angina pectoris. Methods: Clinical data of 1 600 patients (666 females and 934 males) who underwent coronary angiography from January 2013 to December 2015 due to angina pectoris in 6 major coronary intervention centers in China were retrospectively analyzed. The clinical characteristics were compared between the female and male groups, and between the non-obstructive coronary artery disease (INOCA) and ischemic obstructive coronary artery disease (IOCA) subgroups of female subjects with angina pectoris. The risk factors related to the degree of coronary artery occlusion in female patients were analyzed. Results: In the enrolled patients who underwent coronary angiography for angina pectoris, female group was older than the male group, and the proportion of patients with hypertension, diabetes and ischemia accompanied by IOCA was significantly higher than that of the male group (P<0.05). Univariate analysis showed that age≥65 years, hypertension, diabetes, and typical angina symptoms were associated with an increased risk of IOCA in female patients with angina pectoris. Multivariate regression analysis showed that age≥65 years old (OR=1.784, 95%CI: 1.146-2.776, P=0.010), hypertension (OR=1.782, 95%CI: 1.201-2.644, P=0.004) and typical angina symptoms (OR=1.642, 95%CI: 1.127-2.393, P=0.010) were independent risk factors for female patients with angina pectoris diagnosed as IOCA. The correlation analysis between the number of risk factors and the type of coronary artery disease obstruction showed that the incidence of INOCA decreased significantly with the increase of the number of risk factors, from 45.5% to 14.2%. The incidence of IOCA increased significantly with the number of risk factors, from 54.5% to 85.8% (P for trend<0.001). Conclusion: The incidence of INOCA in female patients with angina pectoris suspected of coronary heart disease is higher than that of male. The incidence of IOCA increased significantly, and the incidence of INOCA decreased significantly in proportion to the increase of the number of combined risk factors.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Coronary Artery Disease/complications*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Angina Pectoris/epidemiology*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Coronary Angiography
		                        			;
		                        		
		                        			Hypertension/complications*
		                        			;
		                        		
		                        			Coronary Occlusion/complications*
		                        			;
		                        		
		                        			Ischemia/complications*
		                        			
		                        		
		                        	
4.Sex- and age-specific impacts of smoking, overweight/obesity, hypertension, and diabetes mellitus in the development of disabling dementia in a Japanese population.
Mari TANAKA ; Hironori IMANO ; Mina HAYAMA-TERADA ; Isao MURAKI ; Kokoro SHIRAI ; Kazumasa YAMAGISHI ; Takeo OKADA ; Masahiko KIYAMA ; Akihiko KITAMURA ; Yoshihiro TAKAYAMA ; Hiroyasu ISO
Environmental Health and Preventive Medicine 2023;28():11-11
		                        		
		                        			BACKGROUND:
		                        			Sex- and age-specific impacts of cardiovascular risk factors on the development of dementia have not been well evaluated. We investigated these impacts of smoking, overweight/obesity, hypertension, and diabetes mellitus on the risk of disabling dementia.
		                        		
		                        			METHODS:
		                        			The study participants were 25,029 (10,134 men and 14,895 women) Japanese aged 40-74 years without disabling dementia at baseline (2008-2013). They were assessed on smoking status (non-current or current), overweight/obesity (body mass index ≥25 kg/m2 and ≥30 kg/m2, respectively), hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or any antihypertensive medication use), and diabetes mellitus (a fasting serum glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, hemoglobin A1c ≥6.5% by the National Glycohemoglobin Standardization Program or glucose-lowering medication use) at baseline. Disabling dementia was identified as the level of care required ≥1 and cognitive disability grade ≥IIa according to the National Long-term Care Insurance Database. We used a Cox proportional regression model to estimate hazard ratios and 95% confidence intervals (95% CIs) of disabling dementia according to the cardiovascular risk factors and calculated the population attributable fractions (PAFs).
		                        		
		                        			RESULTS:
		                        			During a median follow-up of 9.1 years, 1,322 (606 men and 716 women) developed disabling dementia. Current smoking and hypertension were associated with a higher risk of disabling dementia in both sexes, whereas overweight or obesity was not associated with the risk in either sex. Diabetes mellitus was associated with a higher risk only in women (p for sex interaction = 0.04). The significant PAFs were 13% for smoking and 14% for hypertension in men and 3% for smoking, 12% for hypertension, and 5% for diabetes mellitus in women. The total PAFs of the significant risk factors were 28% in men and 20% in women. When stratified by age, hypertension in midlife (40-64 years) was associated with the increased risk in men, while diabetes mellitus in later-life (65-74 years) was so in women.
		                        		
		                        			CONCLUSIONS
		                        			A substantial burden of disabling dementia was attributable to smoking, and hypertension in both sexes and diabetes mellitus in women, which may require the management of these cardiovascular risk factors to prevent dementia.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
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		                        			Female
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Overweight/complications*
		                        			;
		                        		
		                        			East Asian People
		                        			;
		                        		
		                        			Cardiovascular Diseases/epidemiology*
		                        			;
		                        		
		                        			Hypertension/etiology*
		                        			;
		                        		
		                        			Diabetes Mellitus/etiology*
		                        			;
		                        		
		                        			Obesity/etiology*
		                        			;
		                        		
		                        			Smoking/epidemiology*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Age Factors
		                        			;
		                        		
		                        			Dementia/etiology*
		                        			
		                        		
		                        	
5.Association Between Plasma Homocysteine Level and Hyperuricemia in Elderly Patients With Hypertension.
Ling-Juan ZHU ; Jian-Min SHI ; Tao WANG ; Chao YU ; Wei ZHOU ; Hui-Hui BAO ; Xiao-Shu CHENG
Acta Academiae Medicinae Sinicae 2023;45(6):897-901
		                        		
		                        			
		                        			Objective To explore the association between plasma homocysteine (Hcy) level and hyper-uricemia (HUA) in the elderly patients with hypertension.Methods From March to August in 2018,9902 hypertensive patients ≥ 60 years were routinely tested for blood biochemical indicators in Wuyuan county,Jiangxi province.The patients were assigned into a HUA group and a normal uric acid group.Multivariate Logistic regression was adopted to analyze the relationship between Hcy level and the risk of HUA.Results Compared with the normal uric acid group,the HUA group showed increased incidence of hyperhomocysteinemia (99.9% vs.98.7%,P<0.001) and elevated Hcy level[16.8 (13.8-21.5) μmol/L vs.14.4 (12.3-17.7) μmol/L,P<0.001].The multivariate Logistic regression analysis showed that after adjusting for influencing factors,the risk of HUA in the patients with hyperhomocysteinemia was 2.92 times of that in the patients with a normal Hcy level.The threshold effect analysis showed that the Hcy level was positively correlated with the occurrence of HUA in the case of Hcy<20 μmol/L (OR=1.05,95%CI=1.04-1.07,P<0.001).In the case of Hcy ≥ 20 μmol/L,there was no correlation between Hcy level and HUA (OR=1.00,95%CI=0.99-1.00,P=0.055),and the likelihood ratio test showed statistically significant results (P<0.001).Conclusion The elderly with hypertension should pay attention to control the Hcy level,which will be helpful to prevent the occurrence of HUA.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Hyperuricemia/complications*
		                        			;
		                        		
		                        			Hyperhomocysteinemia/epidemiology*
		                        			;
		                        		
		                        			Uric Acid
		                        			;
		                        		
		                        			Hypertension
		                        			;
		                        		
		                        			Homocysteine
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
6.Assessment of risk factors for bronchopulmonary dysplasia with pulmonary hypertension and construction of a prediction nomogram model.
Shu Zhen DAI ; Shu Shu LI ; Mei Yun ZHOU ; Yan XU ; Lin ZHANG ; Yu Han ZHANG ; Dan Ni YE ; Li Ping XU ; Shu Ping HAN
Chinese Journal of Pediatrics 2023;61(10):902-909
		                        		
		                        			
		                        			Objective: To explore the risk factors of pulmonary hypertension (PH) in premature infants with bronchopulmonary dysplasia (BPD), and to establish a prediction model for early PH. Methods: This was a retrospective cohort study. Data of 777 BPD preterm infants with the gestational age of <32 weeks were collected from 7 collaborative units of the Su Xinyun Neonatal Perinatal Collaboration Network platform in Jiangsu Province from January 2019 to December 2022. The subjects were randomly divided into a training cohort and a validation cohort at a ratio of 8∶2 by computer, and non-parametric test or χ2 test was used to examine the differences between the two retrospective cohorts. Univariate Logistic regression and multivariate logistic regression analyses were used in the training cohort to screen the risk factors affecting the PH associated with BPD. A nomogram model was constructed based on the severity of BPD and its risk factors,which was internally validated by the Bootstrap method. Finally, the differential, calibration and clinical applicability of the prediction model were evaluated using the training and verification queues. Results: A total of 130 among the 777 preterm infants with BPD had PH, with an incidence of 16.7%, and the gestational age was 28.7 (27.7, 30.0) weeks, including 454 males (58.4%) and 323 females (41.6%). There were 622 preterm infants in the training cohort, including 105 preterm infants in the PH group. A total of 155 patients were enrolled in the verification cohort, including 25 patients in the PH group. Multivariate Logistic regression analysis revealed that low 5 min Apgar score (OR=0.87, 95%CI 0.76-0.99), cesarean section (OR=1.97, 95%CI 1.13-3.43), small for gestational age (OR=9.30, 95%CI 4.30-20.13), hemodynamically significant patent ductus arteriosus (hsPDA) (OR=4.49, 95%CI 2.58-7.80), late-onset sepsis (LOS) (OR=3.52, 95%CI 1.94-6.38), and ventilator-associated pneumonia (VAP) (OR=8.67, 95%CI 3.98-18.91) were all independent risk factors for PH (all P<0.05). The independent risk factors and the severity of BPD were combined to construct a nomogram map model. The area under the receiver operating characteristic (ROC) curve of the nomogram model in the training cohort and the validation cohort were 0.83 (95%CI 0.79-0.88) and 0.87 (95%CI 0.79-0.95), respectively, and the calibration curve was close to the ideal diagonal. Conclusions: Risk of PH with BPD increases in preterm infants with low 5 minute Apgar score, cesarean section, small for gestational age, hamodynamically significant patent ductus arteriosus, late-onset sepsis, and ventilator-associated pneumonia. This nomogram model serves as a useful tool for predicting the risk of PH with BPD in premature infants, which may facilitate individualized early intervention.
		                        		
		                        		
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Bronchopulmonary Dysplasia/epidemiology*
		                        			;
		                        		
		                        			Infant, Premature
		                        			;
		                        		
		                        			Hypertension, Pulmonary/epidemiology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Nomograms
		                        			;
		                        		
		                        			Ductus Arteriosus, Patent/epidemiology*
		                        			;
		                        		
		                        			Pneumonia, Ventilator-Associated/complications*
		                        			;
		                        		
		                        			Cesarean Section/adverse effects*
		                        			;
		                        		
		                        			Gestational Age
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Sepsis
		                        			
		                        		
		                        	
7.Classification, diagnosis and treatment status of pulmonary hypertension from 2012 to 2019: a single center study in Yunnan province.
Xiao Lan FENG ; Yi Bing LU ; Dong YANG ; Qiang XUE ; Ji Lei ZHANG ; Chun Rong LIN ; Pin GAN ; Wei Hua ZHANG ; Xue Feng GUANG ; Hai Long DAI
Chinese Journal of Cardiology 2023;51(11):1188-1193
		                        		
		                        			
		                        			Objective: To analyze the classification, diagnosis and treatment status of patients with pulmonary hypertension (PH) in Yunnan province. Methods: This was a retrospective study. Hospitalized patients with PH at Yan'an Affiliated Hospital of Kunming Medical University from January 2012 to December 2019 were enrolled. The clinical data of enrolled patients, including demographic data, comorbidities, targeted drug therapy, echocardiography and right heart catheterization results, were obtained through the electronic medical record system. The composition ratio of PH, diagnosis and treatment were analyzed. Results: A total of 13 590 patients with PH were enrolled, accounting for 3.09% (13 590/440 056) of the total number of hospitalizations during the same period. The composition of PH was predominantly pulmonary arterial hypertension (PAH) (55.50% (7 542/13 590)), followed by pulmonary hypertension (PH) caused by left heart disease (24.16% (3 284/13 590)). Among them, PAH could be subdivided into four types: idiopathic pulmonary arterial hypertension (IPAH), PAH associated with connective tissue disease, PAH associated with portal hypertension, and PAH associated with congenital heart disease (CHD-PAH), with CHD-PAH as the predominating type (98.09% (7 398/7 542). Patients with PAH were predominantly adolescents. In hospitalized patients with PH, from 2012 to 2019, the proportion of children and adolescents showed a decreasing trend from year to year, and the proportion of middle-aged and older adults showed a significant increasing trend, and the proportion of female patients showed a gradual decreasing trend, and the proportion of patients with comorbid hypertension, diabetes mellitus, coronary artery disease, arrhythmia, and pneumonia showed an increasing trend. A total of 1 034 patients (7.61% (1 034/13 590)) underwent right heart catheterization. The concordance rate between echocardiographic and right heart catheterization findings was (86.98% (875/1 006)). A total of 2 574 (18.94%) of PH patients were treated with PAH targeted drugs, of which 58.16% (1 497/2 574) were treated with monotherapy. Among the PH patients treated with PAH targeted drugs, the majority of patients were PAH patients (86.44% (2 225/2 574)), and 83.53% (2 150/2 574) patients treated with PAH targeted drugs were CHD-PAH. Conclusions: Hospitalized PH patients in our center between 2012 and 2019 are predominantly CHD-PAH, and the proportion of patients receiving right heart catheterization and targeted drug therapy is relatively low. The percentage of middle-aged and elderly PH patients shows an increasing trend from year to year, as well as the percentage of those with concomitant comorbidities.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hypertension, Pulmonary/therapy*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Familial Primary Pulmonary Hypertension
		                        			;
		                        		
		                        			Pulmonary Arterial Hypertension/complications*
		                        			;
		                        		
		                        			Heart Defects, Congenital
		                        			
		                        		
		                        	
8.Classification, diagnosis and treatment status of pulmonary hypertension from 2012 to 2019: a single center study in Yunnan province.
Xiao Lan FENG ; Yi Bing LU ; Dong YANG ; Qiang XUE ; Ji Lei ZHANG ; Chun Rong LIN ; Pin GAN ; Wei Hua ZHANG ; Xue Feng GUANG ; Hai Long DAI
Chinese Journal of Cardiology 2023;51(11):1188-1193
		                        		
		                        			
		                        			Objective: To analyze the classification, diagnosis and treatment status of patients with pulmonary hypertension (PH) in Yunnan province. Methods: This was a retrospective study. Hospitalized patients with PH at Yan'an Affiliated Hospital of Kunming Medical University from January 2012 to December 2019 were enrolled. The clinical data of enrolled patients, including demographic data, comorbidities, targeted drug therapy, echocardiography and right heart catheterization results, were obtained through the electronic medical record system. The composition ratio of PH, diagnosis and treatment were analyzed. Results: A total of 13 590 patients with PH were enrolled, accounting for 3.09% (13 590/440 056) of the total number of hospitalizations during the same period. The composition of PH was predominantly pulmonary arterial hypertension (PAH) (55.50% (7 542/13 590)), followed by pulmonary hypertension (PH) caused by left heart disease (24.16% (3 284/13 590)). Among them, PAH could be subdivided into four types: idiopathic pulmonary arterial hypertension (IPAH), PAH associated with connective tissue disease, PAH associated with portal hypertension, and PAH associated with congenital heart disease (CHD-PAH), with CHD-PAH as the predominating type (98.09% (7 398/7 542). Patients with PAH were predominantly adolescents. In hospitalized patients with PH, from 2012 to 2019, the proportion of children and adolescents showed a decreasing trend from year to year, and the proportion of middle-aged and older adults showed a significant increasing trend, and the proportion of female patients showed a gradual decreasing trend, and the proportion of patients with comorbid hypertension, diabetes mellitus, coronary artery disease, arrhythmia, and pneumonia showed an increasing trend. A total of 1 034 patients (7.61% (1 034/13 590)) underwent right heart catheterization. The concordance rate between echocardiographic and right heart catheterization findings was (86.98% (875/1 006)). A total of 2 574 (18.94%) of PH patients were treated with PAH targeted drugs, of which 58.16% (1 497/2 574) were treated with monotherapy. Among the PH patients treated with PAH targeted drugs, the majority of patients were PAH patients (86.44% (2 225/2 574)), and 83.53% (2 150/2 574) patients treated with PAH targeted drugs were CHD-PAH. Conclusions: Hospitalized PH patients in our center between 2012 and 2019 are predominantly CHD-PAH, and the proportion of patients receiving right heart catheterization and targeted drug therapy is relatively low. The percentage of middle-aged and elderly PH patients shows an increasing trend from year to year, as well as the percentage of those with concomitant comorbidities.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hypertension, Pulmonary/therapy*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Familial Primary Pulmonary Hypertension
		                        			;
		                        		
		                        			Pulmonary Arterial Hypertension/complications*
		                        			;
		                        		
		                        			Heart Defects, Congenital
		                        			
		                        		
		                        	
9.Correlation analysis between body mass index and clinical characteristics of rheumatoid arthritis.
Jing Feng ZHANG ; Yin Ji JIN ; Hui WEI ; Zhong Qiang YAO ; Jin Xia ZHAO
Journal of Peking University(Health Sciences) 2023;55(6):993-999
		                        		
		                        			OBJECTIVE:
		                        			To analyze the clinical features of overweight and obese rheumatoid arthritis (RA)patients, and the relationship between body mass index (BMI) and disease characteristics.
		                        		
		                        			METHODS:
		                        			The demographic data, extra-articular manifestations, comorbidities, and disease activity of RA patients admitted to the Rheumatology and Immunology Department of Peking University Third Hospital from January 2015 to December 2020 were collected, and the above characteristics of overweight and obese RA patients were retrospectively analyzed. According to the WHO, BMI≥30 kg/m2 referred to obese individuals, 25≤BMI < 30 kg/m2 referred to overweight individuals, 18.5≤BMI < 25 kg/m2 referred to normal individuals, BMI < 18.5 kg/m2 referred to reduced body mass individuals. t test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non-normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, Chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1. Analyzing whether overweight or obesity was associated with comorbidities using Logistic regression adjusted confounding factors.
		                        		
		                        			RESULTS:
		                        			A total of 481 RA patients were included in this study, with an average BMI value of (23.28±3.75) kg/m2.Of the patients, 31 cases (6.5%) were with BMI < 18.5 kg/m2, 309 cases (64.2%) with 18.5≤ BMI < 25 kg/m2, amounting to 340 cases (70.7%). There were 119 overweight individuals (25≤ BMI < 30 kg/m2, 24.7%) and 22 obese individuals (BMI≥30 kg/m2, 4.6%), totaling 141 (29.3%).The proportion of the overweight and obese RA patients suffering from hypertension (57.4% vs. 39.1%, P < 0.001), diabetes (25.5% vs. 15.0%, P=0.006), hyperlipidemia (22.7% vs. 10.9%, P=0.001), fatty liver (28.4% vs. 7.4%, P < 0.001), osteoarthritis (39.0% vs. 29.4%, P=0.040) was significantly higher, and the proportion of the patients with osteoporosis(59.6% vs. 70.9%, P=0.016) and anemia (36.2% vs. 55.6%, P < 0.001) was significantly lower. However, there was no difference between the two groups in coronary heart disease (5.7% vs. 7.6%, P=0.442), cerebrovascular disease (6.4% vs. 8.8%, P=0.372) and peripheral atherosclerosis (9.2% vs. 7.6%, P=0.565).The median C-reactive protein (CRP, 1.52 mg/dL vs. 2.35 mg/dL, P=0.008), median erythrocyte sedimentation rate (ESR, 34.0 mm/h vs. 50.0 mm/h, P=0.003), pain visual simulation score (VAS) (3.66±3.08 vs. 4.40±2.85, P=0.011), and 28 joint disease activity scores (DAS-28, 5.05±1.60 vs. 5.45±1.52, P=0.010) in the overweight and obese RA group were all lower than those in the normal and reduced weight groups. Multivariate regression analysis showed that overweight and obesity was an independent risk factor for hypertension, diabetes, hyperlipidemia and fatty liver, and had protective effects on osteoporosis and anemia.
		                        		
		                        			CONCLUSION
		                        			In RA patients, RA disease activity is lower in overweight and obesity patients. Overweight and obesity is associated with hypertension, diabetes and hyperlipidemia, but not with cardiovascular and cerebrovascular diseases.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Overweight/epidemiology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Arthritis, Rheumatoid/epidemiology*
		                        			;
		                        		
		                        			Obesity/epidemiology*
		                        			;
		                        		
		                        			Diabetes Mellitus
		                        			;
		                        		
		                        			Hypertension/complications*
		                        			;
		                        		
		                        			Fatty Liver/complications*
		                        			;
		                        		
		                        			Hyperlipidemias/complications*
		                        			;
		                        		
		                        			Osteoporosis/complications*
		                        			;
		                        		
		                        			Anemia
		                        			
		                        		
		                        	
10.Association between weight gain during the first half of pregnancy and the risk of hypertension disorder of pregnancy: a prospective cohort study.
Xiao Yi ZOU ; Ning YANG ; Wei CAI ; Xiu Long NIU ; Mao Ti WEI ; Xin ZHANG ; Yu Ming LI
Chinese Journal of Cardiology 2022;50(10):987-992
		                        		
		                        			
		                        			Objective: To explore the association between weight gain during the first half of pregnancy and the risk of hypertension disorder of pregnancy (HDP). Methods: This prospective cohort study recruited singleton pregnant women in the first trimester from November 2016 to March 2019 at 19 community hospitals in Tianjin. According to pre-pregnancy body mass index (BMI), the cohort was divided into 3 groups: underweight(BMI<18.5 kg/m2), normal-weight(18.5-24.9 kg/m2), and overweight/obese(≥25.0 kg/m2). The basic information of the participants was gathered through questionnaires, and the height, weight, and blood pressure of the participants were measured along with routine pregnancy examinations. The rate of gestational weight gain (rGWG) in the 3 periods (0-13+6, 14+0-20+6, and 0-20+6 weeks) of the participants was calculated. To observe the occurrence of HDP, the participants were followed up to 42 days postpartum. Using a generalized linear model, the association between rGWG at the 3 periods during the first half of pregnancy and HDP after 20 weeks of gestation was evaluated. Results: A total of 9 805 pregnant women were finally included, with the age of (30.6±3.8) years old, 9 418 (96.1%) Han ethnicity, and 6 845 (69.8%) primipara. There were 1 184 (12.1%), 6 831 (69.7%) and 1 790 (18.3%) participants in the underweight, normal-weight, and overweight/obese groups. Five hundreds and eight pregnant women were diagnosed with HDP (5.2%). The incidences of HDP were 1.8% (21/1 184), 3.9% (269/6 831), and 12.2% (218/1 790), respectively, in underweight, normal-weight, and overweight/obese groups. Adjusted for age, pre-pregnancy BMI, primipara, and family history of hypertension, women in the entire cohort with rGWG ≥ 0.18 kg/week before 13+6 weeks of pregnancy had a 28% higher HDP risk than those with rGWG ≤ 0.00 kg/week (RR=1.28, 95%CI 1.04-1.55, P=0.015), and the risk of HDP was increased by 39% in the overweight/obese group (RR=1.39, 95%CI 1.04-1.85, P=0.026), while no correlation was found between rGWG and HDP in underweight and normal-weight pregnant women (P>0.05). Weight gain during 14+0-20+6 weeks of pregnancy in any group was not related to the risk of HDP (P>0.05).In the entire cohort, compared to rGWG ≤0.14 kg/week, rGWG≥0.28 kg/week prior to 20+6 weeks increased HDP risk by 36% (RR=1.36, 95%CI 1.11-1.67, P=0.003). Normal-weight pregnant women with rGWG≥0.29 kg/week faced a 46% higher risk of HDP than those with rGWG≤0.15 kg/week (RR=1.46, 95%CI 1.11-1.93, P=0.008).In the overweight/obese group, excessive weight gain before 20+6 weeks seemed to increased risk of HDP, but the difference was not statistically significant (RR=1.35,95%CI 0.99-1.85, P=0.059), while the connection was nonexistent in underweight women. Conclusions: Except for pre-pregnancy underweight women, excessive weight gain during the first half of pregnancy is associated with increased risk of HDP among pregnant women.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Overweight/complications*
		                        			;
		                        		
		                        			Thinness/epidemiology*
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Weight Gain
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Obesity/complications*
		                        			;
		                        		
		                        			Hypertension, Pregnancy-Induced/etiology*
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Pregnancy Complications
		                        			
		                        		
		                        	
            
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