Objective: To investigate the impacts of endothelial dysfunction on insulin resistance (IR) and insulin secretion function in overweight and obese subjects.Methods: 296 overweight and obese subjects were divided into impaired and normal endothelial function (A and B group, respectively). 87 normal weight and healthy subjects without endothelial dysfunction acted as normal control (C group). The body mass index (BMI), waist circumference (W), waist-hip ratio (WHR), SBP, DBP, fasting blood glucose (FBG), and insulin (FINS), postprandial 2h blood glucose (PBG) and insulin (PINS), lipid profile, creatnine (Cr) and uric acid (Ur) were measured. Homeostasis model assessment (HOMA) was applied to calculate HOMA-IR as an index of IR and HOMA-β as an index of beta-cell function. Results: BMI, W, WHR, SBP, DBP, TG and Ur in both A and B groups were higher than in C group ( P 0.05～0.001), and compared with Group B, W, WHR, DBP, TG and Ur in group A were significantly increased ( P 0.05～0.01), FBG, FINS, HOMA-IR and GOMA-β in group A were significantly higher than in Group B was similar to Group C in HOMA-β. The flow-mediated endothelium-dependent dilation in Group A was significantly higher than that in Group B ( P 0.05～0.001). Group B was similar to Group C in HOMA-β. The flow-mediated endothelium-dependent dilatation in Group A was significantly lower than that in latter two groups. The flow-mediated dilatation was closely negatively correlated with HOMA-IR and HOMA-β(γ=-0.197, P 0.05 andγ=-0.136, P 0.01) but there were no significant correlation in B and C groups.Conclusion: Endothelial dysfunction is an important risk factor affecting the clustering of cardiovascular risk factors, the occurring and developing of IR in overweight and obese subjects.
Objective To evaluate the influence of large dosage of spironolactone and prednisone on hydration station,Na+,K+ and cardiac function in refractory congestive heart failure(CHF) on the basis of the routine management.Methods Fifty-four patients with severe CHF(cardiac function class Ⅲ-Ⅳ,stage D) were randomly divided into two groups,control group(27 patients) and study group(27 patients).The routine treatment in CHF was adopted in control group(including spironolactone 20 mg/d),while prednisone(40 mg/d) and spironolactone(60 mg/d) were adopted in study group for 30 days on the basis of the routine treatment.The general clinical status,left ventricular ejection fraction(EF),serum sodium,potassium,creatinine and daily urinary volume,sodium and potassium excretion in both groups were analyzed.Results The daily diuresis and EF were significantly increased in both groups after treatment,but the levels of daily urinary volume,serum Na+ and Na+ were significantly increased higher in study group,the level of Na+ at 7th day and 30th day was(138.03±3.97) mmol/L and(137.17±3.57) mmol/L respectively,K+(4.07±0.42) mmol/L and(4.18±0.49) mmol/L,while those in control group(134.48±5.18) mmol/L and(134.00±4.46) mmol/L for Na+ respectively,(3.73±0.33) mmol/L and(3.79±0.44) mmol/L for K+ respectively).The level of serum creatinine and daily K+ excretion was lower in study group,at 7th day and 30th day were(92.93±28.65) mmol/L and(90.07±30.32) mmol/L respectively than in control group(123.19±30.79) mmol/L and(115.00±40.61) mmol/L.The daily natriuresis was higher in study group than in control group after treatment(P0.05).Conclusion By using the proper dosage of prednisone and large dosage of spironoloactone,the patients with severe CHF can acquire more obvious duresis and improvement of the cardiac function with the good balance of Na+,K+ and effective blood volume on the basis of routine management of CHF.
Recent evidence indicates that prednisone can potentiate renal responsiveness to diuretics in heart failure (HF). However, the optimal dose of prednisone is not known.Thirty-eight patients with symptomatic HF were randomized to receive standard HF care alone (n = 10) or with low-dose (15 mg/d, n = 8), medium-dose (30 mg/d, n = 10), or high-dose prednisone (60 mg/d, n = 10), for 10 days. During this time, we recorded the 24-hour urinary output and the 24-hour urinary sodium excretion, at baseline, on day 5 and day 10. We also monitored the change in the concentration of serum creatinine, angiotensin II, aldosterone, high-sensitive C-reactive protein, tumor necrosis factor-α, interleukin 1β, and interleukin 6.Low-dose prednisone significantly enhanced urine output. However, the effects of medium- and high-dose prednisone on urine output were less obvious. As for renal sodium excretion, high-dose prednisone induced a more potent natriuresis than low-dose prednisone. Despite the potent diuresis and natriuresis induced by prednisone, serum creatinine, angiotensin II, and aldosterone levels were not elevated. These favorable effects were not associated with an inflammatory suppression by glucocorticoids.Only low-dose prednisone significantly enhanced urine output. However, high-dose prednisone induced a more potent renal sodium excretion than low-dose prednisone.
Objective To explore a new method of establishing rat model of acute myocardial infarction by off ventilator support,spurt and repeated cryoinjury.Methods Sixty Wistar rats with male and female in half were randomized into three experimental groups according to cryoinjury time with 20 rats in each group:15-second group(cryoinjury for 5 s each time,three times in total),25-second group(5 s each time,five times in total)and 40-second group(5 s each time,eight times in total).The heart was exposed through a 1.0-to 1.5-cm left lateral thoracotomy.Cryoinjury of the LV free wall(LVFW)was performed by applying for 5 s a round copper probe of 6-mm in diameter immersed in liquid nitrogen for 5 min to reach-190 ℃,then the thoracic cavity was closed immediately.When the rats' breath restored,the cryoinjury of the LVFW in situ was repeatedly to ensure a transmural injury according to the protocol.The survival rate during operation and in 28 days after operation was observed.Also infarct size was observed by heart pathological section stained with Masson's trichrome on day 28 after operation.Results Infarct size in all three groups was larger than 20% signified by transmural injury,and completely myocardiolysis and distinct infarct boundary were observed.The survival rate was 16/20 in 15-second group,5/20 in 40-second group(P0.05)and the infarct size was(28.277 5±5.192 6)% in 15-second group,(37.768 0±10.564 4)% in 40-second group(P0.05).The survival rate and infarct size in 25-second group was 9/20 and(31.380 0± 6.496 0)%(P0.05 vs 15-second group and 40-second group).The infarct size in 40-second group was larger than the other two groups(standard deviation:10.564 4% vs 5.192 6%,6.496 0% in 15,25-second group,respectively)and its survival rate was lowest.The procedure of 25-second group was more complicated and had a tendency of higher death rate than that in 15-second group.Conclusion Using spurt,repeated ultra low temperature cryoinjury for 15 s may be an ideal method to establish the rat model of acute myocardial infarction.
Objective To explore the relationship between the inflammation factors and the severity of the coronary artery lesions.Methods The study enrolled 239 patients who underwent a selective coronary angiography.All the patients were divided into three groups:the non-CHD group; the stable CHD group; the acute coronary artery syndromes group.The fasting blood samples were obtained to measure the level of C-response protein (CRP),fibrinogen (FIB).Result The plasma level of CRP in acute coronary artery syndromes group was ( 21.06± 13.52) mg/L,levels in stable CHD group and non-CHD group were ( 10.17± 7.37) mg/L and ( 4.14± 4.33) mg/L.The levels of FIB in acute coronary artery syndromes group,stable CHD group and non-CHD group were ( 3.35± 1.14) g/L,( 3.02± 0.84) g/L and ( 2.60± 0.74) g/L.The plasma levels of CRP,FIB in acute coronary artery syndromes group were significantly higher than those in stable CHD group and non-CHD group (P 0.01,P 0.05).The average level of CRP,FIB were also significantly higher in stable CHD group than in non-CHD group (P 0.01). A strong positive correlation existed between CRP level (P 0.01),FIB level (P 0.01) and coronary artery stenosis integrated scores.The multivariate regression analysis showed the severity of the coronary artery lesions was significantly associated with CRP (P 0.01) and FIB (P 0.05).Conclusion The inflammation factors,such as plasma CRP or FIB level,were related with the severity of the coronary artery lesions,they are important risk factors that related with coronary artery lesion progress,especially in the acute coronary artery syndromes.
Background: Dilated cardiomyopathy (DCM), a specific form of cardiomyopathy, frequently presents clinically with either left ventricular or biventricular enlargement, often leading to progressive heart failure. In recent years, the application of bioinformatics technology to scrutinize the onset, progression, and prognosis of DCM has emerged as a fervent area of interest among scholars globally. Methods: In this study, core genes closely related to DCM were identified through bioinformatics analysis, including weighted gene co expression network analysis (WGCNA) and single sample gene set enrichment analysis (ssGSEA) and so on. The correlation was verified through experiments on DCM patients, DCM rat models, and core gene knockout mice. Subsequently, the effects of glucocorticoids on DCM and the regulation of core genes were observed. Result: In the present study, natriuretic peptide receptor 1 (NPR1) was identified as a core gene associated with DCM through WGCNA and ssGSEA. Significant impairment of cardiac and renal function was observed in both DCM patients and rats, concomitant with a notable reduction in NPR1 expression. NPR1 KO mice displayed symptomatic manifestations of DCM, underscoring the pivotal role of NPR1 in its pathogenesis. Notably, glucocorticoid treatment led to substantial improvements in cardiac and renal function, accompanied by an upregulation of NPR1 expression. Discussion: These findings highlight the critical involvement of NPR1 in the pathophysiology of DCM and its potential as a key target for glucocorticoid-based DCM therapy. The study provides a robust theoretical and experimental foundation for further investigations into DCM etiology and therapeutic strategies.
To investigate the effects of spironolactone, losartan on the plasma collagen metabolism and cardiac atrial natriuretic peptide,aldosterone levels in acute myocardial infarction(AMI) rats. AMI rats were randomly divided into sham operation group, AMI group,spironolactone group (S), losartan group (L), combination group(S+L). The levels of plasma PⅢNP, PⅠCP, AngⅡ, ANP and Ald were measured. ①In comparison with AMI groups, the levels of plasma PⅢNP and PⅠCP in S groups and L groups both decreased (P0.05, P0.01) at 2,6 weeks.ANP level in S group decreased gradually at 2,6 week(P0.01). AngⅡand ANP levels in L group were decreased remarkably (P0.01).In comparison to S group and L group, ANP level of combination group in single time decreased remarkably(P0.01).②In comparison with AMI groups, plasma ANP levels in Sgroups decreasedat on 2th 6th week. (P0.01),and plasma AngⅡ, Ald and ANP levels decreased remarkably in L groups on 2th, 6th week (P0.01). In comparison with S group,the levels of AngⅡ, Ald and ANP in combination group decreased remarkably (P0.01). The level of ANP in combination group was lower than L group (P0.01). Spironolactone and lostartan can lower the levels of PⅢNP, PⅠCP, Plasma and cardiac ANP. More effects produced by combination therapy.
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