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Zang XJ, Yang B, Du X, Mei CL. Urgent-start peritoneal dialysis and patient outcomes: a systematic review and meta-analysis. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:2158-2166. [PMID: 30915761 DOI: 10.26355/eurrev_201903_17261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The present study was aimed at illustrating short- or long-term patient outcome among individuals with urgent-start peritoneal dialysis (PD) compared with those with conventional PD. MATERIALS AND METHODS We searched the PubMed, EMBASE, Cochrane Controlled Trials Register and China National Knowledge Infrastructure databases. Cohort studies were investigated comparing the effects of urgent start of PD (<14 days after catheter insertion) to those of conventional start of PD (≥14 days after catheter insertion). Risks of bias across studies were evaluated using Newcastle-Ottawa Quality Assessment Scale. We calculated the pooled risk ratios and mean differences with 95% confidence intervals for dichotomous data and continuous data, respectively. RESULTS Six studies involving 1,242 patients were identified. Compared with conventional PD, urgent-start PD was not associated with a high mortality (RR: 1.25, 95% CI: 0.92 to 1.69; I2=0%, p=0.99) and a higher prevalence of overall mechanical complications (RR: 1.79, 95% CI: 0.85 to 3.78; p=0.12; I2=64%, p=0.02). However, urgent-start PD was associated with a higher prevalence of leakage (RR: 6.72, 95% CI: 2.11 to 21.32; I2=0%, p=0.60). In terms of infectious complications, data analysis of the fixed-effects model showed no difference between the two groups. (RR: 1.36, 95% CI: 0.90 to 2.05, p=0.14), regardless of peritonitis (RR: 1.36, 95% CI: 0.90 to 2.05, p=0.14; I2=0%, p=0.70) or other infections (RR: 1.15, 95% CI: 0.49 to 2.69, p=0.99; I2=0%, p=0.75). CONCLUSIONS Urgent-start PD was not associated with a higher risk of mortality and dialysis-related complications. However, compared with conventional PD, an urgent start of PD may increase the risk of a leak.
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Zhao HC, Qiao YL, Zhang Q, Du X, Zang Y, Liu XT, Han BY. Study on the characteristics and mechanism of pulsed laser cleaning of polyacrylate resin coating on aluminum alloy substrates. APPLIED OPTICS 2020; 59:7053-7065. [PMID: 32788800 DOI: 10.1364/ao.387532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
The behavior of paint removal with a pulsed laser has been investigated using an Nd:YAG fiber laser. Experimental and theoretical analyses are conducted to reveal the underlying mechanism of the paint removal. The results show that the depth, radius, and volume of the pit formed by a single pulse become larger with increases in the energy density. The ideal parameters for the complete removal of paint have been achieved. During the paint removal, burning occurred over the surface, and the variation in element content has been attributed to the absorption of laser energy. Under the action of the pulsed laser, there was breakage and rearrangement of chemical bonds such as C-C, C-N, and C-O in the molecular chain of the polyacrylate paint coating. Through these analyses, the paint removal mechanism was shown to be based on chemical bond breakage, combustion, and mechanical action provided by the thermal expansion and plasma shock.
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Zhang W, Dong YZ, Du X, Peng XN, Shen QM. MiRNA-153-3p promotes gefitinib-sensitivity in non-small cell lung cancer by inhibiting ATG5 expression and autophagy. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:2444-2452. [PMID: 30964170 DOI: 10.26355/eurrev_201903_17391] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To clarify the function of miRNA-153-3p in gefitinib-sensitive non-small cell lung cancer (NSCLC) and the underlying mechanism. PATIENTS AND METHODS The expressions of miRNA-153-3p, LC3B and ATG5 in gefitinib-resistant and gefitinib-sensitive NSCLC tissues were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between miRNA-153-3p to LC3B or ATG5 was analyzed. We evaluated autophagy level in gefitinib-resistant NSCLC cells by calculating the percentage of PC-9/GR and HCC827/GR cells with positive GFP-LC3, as well as determining autophagy-related gene levels. The potential binding between ATG5 and miRNA-153-3p were verified by Dual-Luciferase reporter gene assay. The regulatory effects of miRNA-153-3p/ATG5 on gefitinib-sensitivity and apoptosis were finally examined by cytotoxicity assay and Annexin V-fluorescein isothiocyanate (FITC)/Propidium Iodide (PI) staining, respectively. RESULTS MiRNA-153-3p was lowly expressed in gefitinib-resistant NSCLC relative to the gefitinib-sensitive ones. MiRNA-153-3p was negatively correlated with autophagy activity marker LC3B in gefitinib-resistant NSCLC patients. Compared with parental cells, gefitinib-resistant NSCLC cell lines PC-9/GR and HCC827/GR presented a lower level of miRNA-153-3p and a higher level of autophagy. The overexpression of miRNA-153-3p greatly inhibited autophagy level. ATG5 could directly bind to miRNA-153-3p, and ATG5 was highly expressed in gefitinib-resistant NSCLC. The correlation analysis found a negative correlation between ATG5 and miRNA-153-3p and a positive correlation between ATG5 and LC3B in gefitinib-resistant NSCLC. More importantly, ATG5 reversed the regulatory effects of miRNA-153-3p on autophagy, gefitinib-sensitivity and apoptosis of PC-9/GR and HCC827/GR cells. CONCLUSIONS MiRNA-153-3p is lowly expressed in gefitinib-resistant NSCLC patients. The overexpression of miRNA-153-3p enhances gefitinib-sensitivity in NSCLC by inhibiting autophagy via downregulating ATG5.
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Hidayat K, Du X, Shi BM, Qin LQ. Systematic review and meta-analysis of the association between dairy consumption and the risk of hip fracture: critical interpretation of the currently available evidence. Osteoporos Int 2020; 31:1411-1425. [PMID: 32383066 DOI: 10.1007/s00198-020-05383-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
UNLABELLED In the present meta-analysis, reductions in the risk of hip fracture with milk consumption were only observed among American adults, but not among Scandinavian adults, possibly because milk products are more commonly fortified with vitamin D in the former population than in Scandinavian countries. The reduction in the risk of hip fracture was also observed with yogurt consumption, which is often associated with healthy lifestyles and dietary patterns that contribute to improved bone health. INTRODUCTION Although dairy products contain bone-beneficial nutrients, the association between dairy consumption and the risk of hip fracture remains equivocal. Fueling this uncertainty, the elevated risk of hip fracture in association with milk consumption was observed in a cohort of Swedish women. A systematic review and meta-analysis of prospective cohort studies was performed to critically evaluate the association, or lack thereof, between dairy consumption (milk, yogurt, and cheese) and the risk of hip fracture. METHODS A random effects model was used to generate the summary relative risks (RRs) with their 95% confidence intervals (CIs) for the associations of interest. RESULTS In the meta-analysis of the highest versus lowest category of consumption, higher consumption of yogurt (RR 0.78, 95% CI 0.68, 0.90), but not milk (RR 0.86, 95% CI 0.73, 1.02) or cheese (RR 0.85, 95% CI 0.66, 1.08), was associated with a lower risk of hip fracture. For milk, the reduced risk of fracture with higher milk consumption was observed in the USA (RR 0.75, 95% CI 0.65, 0.87), but not in Scandinavian countries (RR 1.00, 95% CI 0.85, 1.17). These findings were further supported by the fact that American studies (RR 0.93, 95% CI 0.88, 0.98; per 1 glass/day), but not Scandinavian studies (RR 1.01, 95% CI 0.95, 1.07; per 1 glass/day), demonstrated a linear association between milk consumption and the risk of hip fracture. CONCLUSIONS The cumulative evidence from prospective cohort studies reassuringly suggests that the risk of hip fracture may not be elevated among people who consume milk, yogurt, and cheese, and that a greater consumption of milk or yogurt may even be associated with a lower risk of hip fracture depending on the factors that may differ across the population of interest.
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Yan HZ, Wang W, Du X, Jiang XD, Lin CY, Guo JL, Zhang J. The expression and clinical significance of miRNA-99a and miRNA-224 in non-small cell lung cancer. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:1545-1552. [PMID: 30840277 DOI: 10.26355/eurrev_201902_17113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the expression and clinical significance of miRNA-99a and miRNA-224 in the serum of patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS 83 patients with NSCLC, who were diagnosed and treated in our hospital from January 2014 to September 2017, were included in the experiment group. 79 patients, who made health check up, were included in the control group. The quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) technique was used to test the expressions of miRNA-99a and miRNA-224 in the serum of the patients in the two groups, and the relationship between the expression levels of miRNA-99a and miRNA-224 and the clinicopathological features of the patients with NSCLC was analyzed; the correlation between the expression of miRNA-99a and the expression of miRNA-224 in NSCLC was also analyzed. RESULTS The expression level of miRNA-99a in the patients with NSCLC was significantly lower than that in the patients in the normal control group; the differences were statistically significant (p<0.001). The expression level of miRNA-224 in the patients with NSCLC was markedly higher than that in the patients in the normal control group; the differences were statistically significant (p<0.001). The expression level of miRNA-99a in the patients with NSCLC was remarkably correlated with pathological stage, the presence or absence of lymph node metastasis and tissue differentiation (p<0.001). The expression level of miRNA-224 in the patients with NSCLC was significantly correlated with pathological stage, the presence or absence of lymph node metastasis and pathological grade (p<0.001). The results of partial correlation analysis showed that the expression levels of miRNA-99a and miRNA-224 were negatively correlated with each other in NSCLC (r=-0.985, p<0.001). CONCLUSIONS MiRNA-99a and miRNA-224 may be involved in the development and progression of NSCLC. MiRNA-99a is associated with NSCLC pathological stage, lymph node metastasis and tissue differentiation, while miRNA-224 is associated with NSCLC pathological stage, lymph node metastasis and pathological grade. MiRNA-99a and miRNA-224 can be used as clinical monitoring indicators for NSCLC.
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Gong LG, Shi JC, Shang J, Hao JG, Du X. Effect of miR-34a on resistance to sunitinib in breast cancer by regulating the Wnt/β-catenin signaling pathway. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:1151-1157. [PMID: 30779084 DOI: 10.26355/eurrev_201902_17006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of micro ribonucleic acid (miR)-34a on resistance to sunitinib in breast cancer, and to explore its possible underlying mechanism. MATERIALS AND METHODS Breast cancer MCF-7 cells were transfected with miR-34a inhibitor or mimics to downregulate or upregulate the expression of miR-34a. Then, the transfected cells were treated with sunitinib. Next, transwell assay was applied to detect the changes in cell invasion ability. Cell viability was measured via cell counting kit-8 (CCK8) assay. Dual-Luciferase reporter gene assay was employed to determine the interaction between miR-34a and the Wnt/β-catenin signaling pathway. The immunoblotting assay was used to measure the expression changes of proteins in the pathway. RESULTS The overexpression of miR-34a significantly reduced the invasive ability of MCF-7 cells after treatment with sunitinib. After miR-34a expression was downregulated, the sensitivity of MCF-7 cells to sunitinib was significantly lowered. MiR-34a interacted with the 3'-untranslated region (3'-UTR) on Wnt1. Meanwhile, the overexpression of miR-34a remarkably downregulated the messenger RNA (mRNA) and the protein levels of Wnt1, whereas upregulated the expressions of Wnt1 and β-catenin. CONCLUSIONS MiR-34a affects the sensitivity to sunitinib in breast cancer by regulating the Wnt/β-catenin signaling pathway.
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Yao H, Xiao G, Li F, Xiao Y, Ye Y, Wang X, Xiu D, Wang Z, Du X, Yao Y, Zhou L, Pang K, Zhou C, Gu J, Zhang Z. Management of surgery in the era of COVID-19: preliminary data from 11 medical centres in Beijing. Br J Surg 2020; 107:e306. [PMID: 32619052 PMCID: PMC7361806 DOI: 10.1002/bjs.11762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
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Du X, Zheng Y, Peng B, Che D, Hao Y, Geng S. 346 Tacrolimus induced pseudo-allergic reaction via Mas-related G protein coupled receptor-X2. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lavere P, Sonkar J, Du X, Qian YW, Murthy V. Macrophage activation syndrome complicating adult onset Still's disease: a case report. Scand J Rheumatol 2020; 50:161-162. [PMID: 32608305 DOI: 10.1080/03009742.2020.1757144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Guo TY, Huang L, Yao W, Du X, Li QQ, Ma ML, Li QF, Liu HL, Zhang JB, Pan ZX. The potential biological functions of circular RNAs during the initiation of atresia in pig follicles. Domest Anim Endocrinol 2020; 72:106401. [PMID: 32278256 DOI: 10.1016/j.domaniend.2019.106401] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 11/18/2022]
Abstract
The specific expression profile and function of circular RNAs (circRNAs) in mammalian ovarian follicles, especially during the atresia process, are unclear. In this study, genome-wide deep circRNA sequencing was applied to screen circRNAs in healthy and early atretic antral follicles in pig ovaries. A total of 40,567 distinct circRNAs were identified in follicles, among which 197 circRNAs (108 upregulated and 89 downregulated) were significantly shifted during the early atresia process. Most differentially expressed circRNAs (DECs) lacked protein-coding potential. Annotation analysis of the DECs revealed 162 known host genes, or noncoding RNAs, and 10 intergenic regions. The key pathways in which these host genes are involved include the focal adhesion-PI3K-Akt-mTOR signaling pathway, vascular endothelial growth factor A (VEGFA)-vascular endothelial growth factor receptor 2 signaling pathway and transforming growth factor-beta signaling pathway. Further comparison analysis between host genes of DECs and the differentially expressed linear messenger RNA transcripts revealed the cotranscription of circRNAs and their linear mRNAs in inhibin beta units (INHBA and INHBB), glutathione S-transferase (GSTA1), and VEGFA. In addition, we predicted 196 pairs of potential circRNA-micro RNA (miRNA) interactions among 77 DECs and 101 porcine miRNAs. We have identified 16 functional miRNAs by comparing the 101 miRNAs to the functional miRNAs reported in mammal ovarian follicle atresia and granulosa cell apoptosis studies. Our study adds new knowledge to circRNA distribution profiles in pig ovarian follicles, offers a valuable reference for transcriptomic profiles in the initiation of follicular atresia, highlights warranted circRNAs for further functional investigation, and provides possible biomarkers for ovarian dysfunctions.
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Yang ZY, Wang H, He Y, Li L, Chang SS, Cui J, Liu T, Lyu J, Du X, Ma CS, Dong JZ. [Value of left ventricular myocardial strain derived from cardiac magnetic resonance tissue tracking on differentiating constrictive pericarditis from restrictive cardiomyopathy]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2020; 48:386-392. [PMID: 32450655 DOI: 10.3760/cma.j.cn112148-20190906-00549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To compare left ventricular myocardial mechanics detected by cardiac magnetic resonance tissue tracking(CMR-TT) between patients with constrictive pericarditis(CP) and restrictive cardiomyopathy(RCM),and see if those can be used to differentiate CP from RCM patients. Methods: A total of 23 patients with CP, 20 patients with RCM, who hospitalized in Beijing Anzhen Hospital from January 2014 to April 2019 were included in this study and 25 healthy subjects served as control group, all subjects underwent cardiac magnetic resonance examination. Myocardial mechanics were evaluated by 2-dimensional(2D) and 3-dimensional(3D) CMR-TT in terms of global longitudinal strain(GLS), circumferential strain(GCS), radial strain(GRS) and the lateral wall strain to septal wall strain ratio(lateral/septal ratio) of basal, mid-cavity and apical. The diagnostic area under the receiver operating characteristic curve (ROC) was evaluated for differentiating CP from RCM. Results: Age, sex and heart rate were similar between CP and RCM patients(all P>0.05). 2D-GLS, 3D-GLS, GCS and GRS in CP and RCM groups were significantly lower than those in normal control group(all P<0.05).3D-GLS value was significantly lower in RCM patients than in CP patients(P<0.05), the area under the curve (AUC)=0.787(sensitivity 80%, specificity 78%). 3D-GCS was significantly lower in CP group than in RCM group(P<0.05), the AUC=0.737(sensitivity 80%, specificity 65%). However, there was no significant difference between CP and RCM in 3D-GRS(P>0.05). Compared with RCM, the circumferential and radial lateral/septal ratios of the basal were significantly lower in CP group than in RCM group(both P<0.05), AUC=0.737(sensitivity 70%, specificity 83%) and 0.737 (sensitivity 60%, specificity 87%), respectively. The left ventricular myocardial mechanics strain curve of the CP,RCM and normal control were different. The CP patients presented as " rapidly down-a platform" form, the RCM presented as "slowly down" form, and normal control presented as "rapidly down" form. Conclusion: Evaluating the differences in the diastolic process of left ventricular myocardium and left ventricular myocardial mechanics strain curve is helpful to differentiate CP from RCM patients.
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Lim K, Du X, Braun C, Schulte P, Latuche L. Predicting 6-Month Mortality in COPD: Assessment of Prognostic Variables to Predict COPD Mortality. C23. ASSESSMENT OF OUTCOME RISK IN OBSTRUCTIVE LUNG DISEASE 2020. [DOI: 10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Wang YF, Lu SX, Xia SJ, Jia ZX, Jiang C, He L, Du X, Ma CS. [Risk factors for recurrent hospitalizations of patients with atrial fibrillation]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2020; 48:308-314. [PMID: 32370482 DOI: 10.3760/cma.j.cn112148-20190727-00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine the predictors of recurrent hospitalizations among atrial fibrillation (AF) patients. Methods: We analyzed data from the Chinese Atrial Fibrillation Registry (CAFR), a prospective cohort study involving non-valvular atrial fibrillation (NVAF) patients from Augest 2011 to December 2017. A total of 5 349 NVAF patients with a minimum of 48 months follow-up were included for analysis. Data including patient demographics, complications, medical and ablation history were collected. The maximum number of all-cause hospitalizations within one-year for each patient served as the primary endpoint. Patients hospitalized less than twice within one-year were defined as non-recurrent hospitalizations group, those hospitalized at least twice within one-year were definned as recurrent hospitalizations group. Logistic regression model was used to identify associated risk factors for recurrent hospitalizations. Results: Of 5 349 NVAF patients, those hospitalized for 0, 1, 2, 3, 4 and at least 5 times within one-year was 2 703 (50.5%), 1 776 (33.2%), 642 (12.0%), 161(3.0), 52 (1.0%), 15 (0.3%), respectively. Eight hundred and seventy (16.3%) patients were included in recurrent hospitalizations group, 4 479 (83.7%) patients were included in non-recurrent hospitalizations group. Compare with non-recurrent hospitalizations group, patients in recurrent hospitalizations group was more likely to be older and female, more frequently had a history of hypertension, heart failure, coronary heart disesase, ischaemic stroke/transient ischaemic attack, diabetes mellitus, peptic ulcer, a AF duration for more than 1 year, medication including drugs for ventricular rate control, statin, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB) and higher CHA(2)DS(2)-VASc scores (P<0.05), but less frequently had higher education, a history of drinking, smoking and ablation (P<0.05). Multivariable analysis showed that age 50-64 (OR=1.47, 95%CI 1.20-1.80), age≥65 (OR=1.89, 95%CI 1.50-2.38), female (OR=1.21, 95%CI 1.01-1.46), hypertension history (OR=1.42, 95%CI 1.16-1.74), heart failure history (OR=1.73, 95%CI 1.37-2.18), coronary heart disease history (OR=1.63, 95%CI 1.31-2.03), peptic ulcer history (OR=2.00, 95%CI 1.18-3.39) were independent risk factors for recurrent hospitalizations, while higher education (college or above) (OR=0.82, 95%CI 0.69-0.99) was the protective factor for recurrent hospitalizations. Conclusions: Nearly 1 in 6 of AF patients were admitted to hospital more than once within one year in this NVAF cohort. Age≥50, female, hypertension history, heart failure history, coronary heart disease history, peptic ulcer history are associated with an increased risk of recurrent hospitalizations.
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Luo ZF, Kong XY, Jiang C, Zhu HJ, Zhang S, Cui J, Dai TY, Du X, Dong JZ, Ma CS. [Relationship between C-reactive protein level and incidence of left atrial spontaneous echocardiographic contrast in patients with nonvalvular atrial fibrillation]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2020; 48:223-227. [PMID: 32234180 DOI: 10.3760/cma.j.cn112148-20190322-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between high sensitivity C-reactive protein (hs-CRP) level and incidence of left atrial spontaneous echocardiographic contrast (LASEC) in the patients with nonvalvular atrial fibrillation (AF). Methods: Four hundred and ninety consecutive patients with nonvalvular atrial fibrillation who underwent radiofrequency ablation for the first time from January 1, 2018 to June 30, 2018 in the Department of Cardiology, Beijing Anzhen Hospital were enrolled. According to the results of transesophageal echocardiography before radiofrequency ablation, patients were divided into the group without LASEC (n=338) and the group with LASEC (n=152). hs-CRP was determined by latex enhanced immunoturbidimetry. The relationship between hs-CRP and LASEC in patients with nonvalvular atrial fibrillation was investigated by univariate and multivariate logistic analysis. Results: LASEC was detected in 152 (31%) of 490 patients. Significant differences in age, type of atrial fibrillation, previous embolic events, fibrinogen, D-dimer, the left atrial anteroposterior diameter and CHA(2)DS(2)-VASc scores were found between patients with and without LASEC (all P<0.05). Compared with the group without LASEC, the serum hs-CRP level was significantly higher in the group with LASEC (3.16 (1.30, 5.23) mg/L vs. 0.67 (0.37, 1.48) mg/L, P<0.001). Multivariate logistic regression analysis showed that hs-CRP (OR=1.136, 95%CI 1.060 - 1.217, P<0.001) and D-dimer (OR=1.040, 95%CI 1.011 - 1.070, P=0.007) were independent determinants for LASEC in this patient cohort. Conclusions: hs-CRP is an independent determinant for LASEC in patients with nonvalvular atrial fibrillation. Inflammation may thus be involved in the formation of prethrombotic state in patients with nonvalvular atrial fibrillation.
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Zhu CR, Du X, Liu Y, Zhao QH, Shi JH, Wu YT, Wei XM, Li HY, Lin LM, Wu SL, Huang Z. [Impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2020; 48:66-71. [PMID: 32008298 DOI: 10.3760/cma.j.issn.0253-3758.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA). Methods: This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants' characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values. Results: The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24). Conclusion: The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.
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Zhang L, Du X, Chen C, Han Q, Chen Q, Zhang M, Xia X, Song Y, Zhang J. Development of a rapid, one-step-visual method to detect Salmonella based on IC-LAMP method. IRANIAN JOURNAL OF VETERINARY RESEARCH 2020; 21:20-25. [PMID: 32368221 PMCID: PMC7183372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND Salmonella can cause serious human gastroenteritis and is frequently isolated from various food samples. The cell culturing, immunoassay, and polymerase chain reactions (PCR) are the current methods to detect such pathogenic agents. However, these methods are time-consuming and labor-intensive, and thus unavailable for rapid-monitoring of Salmonella. AIMS This study aimed to develop an immunocapture-loop-mediated isothermal amplification (IC-LAMP) for rapid and sensitive detection of Salmonella. METHODS Salmonella was used as antigen to produce monoclonal antibody (mAb) and mAbs were prepared via subcloning three times. The mAb 1B12 with high affinity was coated on the surface of the immuno-magnetic beads (IMBs) to capture Salmonella. The enriched products (IMBs-Salmonella) were used for LAMP using the special primers targeted the conserved invA gene of Salmonella. RESULTS The IC-LAMP was developed based on mAb 1B12 and LAMP. Targeting the conserved invA gene of Salmonella, the detection time was shortened to 50 min from three days. If the reaction contains Salmonella, the green fluorescence and the trapezoidal strip can be clearly observed. Importantly, the method combines the specificity of antibody and LAMP with a detection limit of 5 CFU/ml in artificially contaminated water and milk. The specificity of this method was demonstrated by testing other similar bacteria. The results indicate that the IC-LAMP reacts only with Salmonella and does not cross-react with other similar bacteria. CONCLUSION The IC-LAMP assay developed here is a rapid, sensitive, one-step-visual method to screen for the presence of Salmonella in food samples. This method is faster than traditional PCR, LAMP, and other methods, and can be used as a primary screening method for the detection.
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Du X, Cao D, Yan F, Gao Y, Chang H, Wei B. CLINICOPATHOLOGICAL CHARACTERISTICS OF MUCINOUS VARIANT OF ANAPLASTIC THYROID CARCINOMA. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:377-378. [PMID: 33363665 DOI: 10.4183/aeb.2020.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cui J, Du X, Wu JH, Jia CQ, Ruan YF, Ning M, Hu R, Lyu J, Dong JZ, Ma CS. [Clinical characteristics of left atrial appendage thrombus in patients with hypertrophic cardiomyopathy and non-valvular atrial fibrillation]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2019; 47:956-962. [PMID: 31877590 DOI: 10.3760/cma.j.issn.0253-3758.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the incidence and clinical characteristics of left atrial appendage (LAA) thrombus in patients with hypertrophic cardiomyopathy (HCM) and non-valvular atrial fibrillation (AF) . Methods: Data from 10 440 patients with AF who had undergone transesophageal echocardiography (TEE) before cardioversion or catheter ablation at Beijing Anzhen Hospital from April 2006 to December 2018 were retrospectively screened. Two hundred and five HCM patients were included, 820 AF patients with the same CHA(2)DS(2)-VASc score over the same period were selected as the control group. HCM patients were divided into two subgroups based on presence or absence of LAA thrombus/sludge. The baseline of clinical information, transthoracic echocardiographic and TEE measures were compared among all the groups. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of left atrial diameter (LAD) for LAA thrombus/sludge. Multivariate logistic regression analysis was applied to analyze the correlative factors of LAA thrombus/sludge in HCM patients. Results: The incidences of LAA thrombus or sludge were higher in HCM group than in control group (10.7% (22/205) vs. 0.7% (6/820); 8.8% (18/205) vs.7.0% (57/820), P<0.001) . In HCM patients, LAD was significantly larger in LAA thrombus/sludge subjects than in those without thrombus/sludge ((48.9±5.1)mm vs. (45.2±6.1) mm, P<0.001). CHA(2)DS(2)-VASc score was similar between the two subgroups ((2.0±1.4) vs. (1.8±1.4), P>0.05). There was no difference in the rate of patients with a CHA(2)DS(2)-VASc scores ≥2 between the subgroups(62.5% (25/40) vs. 57.0% (94/165), P=0.525). The incidences of LAA thrombus in HCM and AF patients with CHA(2)DS(2)-VASc scores of 0, 1 and 2 were 8.8% (3/34) , 9.6% (5/52) , 11.8% (11/119) , respectively; and the rate of LAA sludge were 8.8% (3/52) , 7.7% (4/52) , 9.2% (11/119) , respectively. The cut off value of LAD for the diagnosis of LAA thrombus/sludge was 44.5 mm. Multivariate logistic regression analysis showed that LAD≥44.5 mm (OR=5.134, 95%CI 1.862-14.156, P=0.002) , non-paroxysmal AF (OR=2.782, 95%CI 1.238-6.252, P=0.013) , previous thromboembolism or stroke (OR=1.820, 95%CI 0.774-4.227, P=0.017) were independent determinants of LAA thrombus/sludge. Conclusions: The incidence of LAA thrombus/sludge is higher in patients with HCM and AF than in AF patients without HCM. The CHA(2)DS(2)-VASc score is similar between HCM and AF patients with LAA thrombus/sludge and those without thrombus/sludge. Patients with CHA(2)DS(2)-VASc score 0-1 are also likely to suffer LAA thrombus/sludge. Left atrial enlargement is associated with LAA thrombus/sludge.
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Zou SH, Du X, Lin H, Wang PC, Li M. Paclitaxel inhibits the progression of cervical cancer by inhibiting autophagy via lncRNARP11-381N20.2. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2019; 22:3010-3017. [PMID: 29863245 DOI: 10.26355/eurrev_201805_15058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To observe the effect of paclitaxel on the autophagy of human cervical cancer cell lines by the expression regulation of lncRNARP11-381N20.2 as well as to explore the interaction and relationship between autophagy, proliferation, and apoptosis of cervical cancer cells. MATERIALS AND METHODS Genome-wide expression profiles of tumors and their susceptibility to drugs were downloaded through TCGA database to find differentially expressed lncRNA RP11-381N20.2 in chemosensitive sensitive and insensitive groups. Expression of RP11-381N20.2 in 60 cervical cancer tissues and 30 normal tissues was detected by qRT-PCR. The relationship between the expression of RP11-381N20.2 and the clinicopathological parameters of lung cancer was statistically analyzed. The recombinant plasmid pcDNA-RP11-381N20.2 and pcDNA-NC of RP11-381N20.2 were transfected into SiHa cells by lipofectamine, respectively. The autophagy and phenotypic effects were observed. Cell proliferation was determined by colony formation assay. Apoptosis was detected by flow cytometry. Western blot was conducted to detect expressions of autophagy-related proteins. RESULTS Genome-wide expression profiles of chemotherapy-sensitive and insensitive data in patients with cervical cancer in TCGA database were analyzed by edger package, results showed that the expression of lncRNA RP11-381N20.2 was significantly lower in the chemotherapy-insensitive group. qRT-PCR results showed that the expression of RP11-381N20.2 in cervical cancer was decreased, and the total survival time of patients was positively correlated with the expression of RP11-381N20.2. RP11-381N20.2 was associated with TNM (tumor node metastasis) staging and tumor size. Biological functions of SiHa cells showed that the expression of RP11-381N20.2 was negatively correlated with the treatment time and dose of paclitaxel. Colony formation assay showed that paclitaxel could inhibit the proliferation of cervical cancer cells in a dose-dependent manner. Flow cytometry showed that paclitaxel induced apoptosis of cervical cancer cells, which was more promoted after combination with RP11-381N20.2. Western blot results suggested that paclitaxel could induce autophagy in cervical cancer cells in a time- and dose-dependent manners. Paclitaxel combined with RP11-381N20.2 could significantly increase apoptosis of cervical cancer cells. CONCLUSIONS During the killing process of paclitaxel on cervical cancer SiHa cells, cell autophagy would affect the efficacy, after overexpression of RP11-381N20.2 in SiHa cells, autophagy induced by paclitaxel was inhibited, thereby enhancing the killing effect of paclitaxel on tumor cells.
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Sun FD, Wang PC, Luan RL, Zou SH, Du X. MicroRNA-574 enhances doxorubicin resistance through down-regulating SMAD4 in breast cancer cells. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2019; 22:1342-1350. [PMID: 29565492 DOI: 10.26355/eurrev_201803_14476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Drug resistance has become an important factor that threatens the survival and prognosis of patients with breast cancer, especially in patients with advanced breast cancer. Several microRNAs have been proved to participate in the resistant process; however, the role of miR-574 in doxorubicin (Dox) resistant breast cancer is still unclear. PATIENTS AND METHODS Quantitative Real-time poly chain reaction (qRT-PCR) was employed to detect the expression level of miR-574 in breast cancer Dox-resistant MCF-7/Adr cell line and parental MCF-7 cell line. Using miR-574 mimics and inhibitors, miR-574 level was up- or down- regulated. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was handled to detect the IC50, and flow cytometric analysis was employed to measure the apoptosis and cell circle. Dual-luciferase and Western-blot experiments were applied to verify the direct target gene of miR-574. RESULTS miR-574 expression level was significantly higher in MCF-7/Adr cells compared to normal MCF-7 cells. Up-regulation of miR-574 level in MCF-7 cells promoted the cell growth and G0/G1-to-S phase transition but inhibited cell apoptosis. However, knockdown of miR-574 in MCF-7/Adr cells decreased the IC50 and cell growth. Using luciferase assay, SMAD4 was confirmed to be a potential target of miR-574, and the expression of SMAD4 protein was regulated by miR-574. In blood samples of patients, the miR-574 level before chemotherapy was higher than that after chemotherapy. CONCLUSIONS We revealed miR-574 could promote doxorubicin resistance of breast cancer MCF-7 cells via down-regulating SMAD4, thus providing a novel target for advancing breast cancer chemotherapy.
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Zou SH, Du X, Sun FD, Wang PC, Li M. Cisplatin suppresses tumor proliferation by inhibiting autophagy in ovarian cancer via long non-coding RNA RP11-135L22.1. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2019; 22:928-935. [PMID: 29509240 DOI: 10.26355/eurrev_201802_14372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To observe the effect of cisplatin-induced autophagy in human ovarian cancer cell lines and explore the correlation between RP11-135L22.1 with cisplatin-induced autophagy. MATERIALS AND METHODS Genome-wide expression profile and chemotherapy sensitivity data of ovarian cancer were downloaded from TCGA database. It was found that the expression level of lncRNA RP11-135L22.1 differed between chemotherapy-sensitive group and insensitive group. Besides, RP11-135L22.1 expression levels were detected in 64 ovarian cancer tissues and 30 normal tissues by qRT-PCR. Relationship between RP11-135L22.1 expression levels in 64 ovarian cancer tissues and their clinicopathological characteristics were analyzed by x2-test. Cell viability was detected by CCK8 assay. Cell apoptosis and cell cycle were accessed by flow cytometry. HO8910 cells were selected for transfection of pcDNA-RP11-135L22.1, and qRT-PCR was used to evaluate RP11-135L22.1 expression in cisplatin-treated HO8910 cells. Western blot was performed to analyze the expression changes of autophagy-related proteins. RESULTS Genome-wide expression profile of chemotherapy-sensitive and -insensitive patients with ovarian cancer from TCGA database was analyzed by edger package. It was found that RP11-135L22.1 level in chemotherapy-sensitive group was significantly lower than that of insensitive group. QRT-PCR results confirmed that RP11-135L22.1 was lowly expressed in ovarian cancer. The overall survival of patients was positively correlated with the expression of RP11-135L22.1. Furthermore, RP11-135L22.1 was associated with FIGO stage and tumor size. Flow cytometry showed that cisplatin could induce apoptosis and arrest cell cycle in ovarian cancer cells lines. CCK8 assay showed that cisplatin decreased viability of ovarian cancer cells. For in vitro study, HO8910 cells were cultured with medium containing different concentrations of cisplatin or treated with cisplatin for different times. The results revealed that RP11-135L22.1 expression was negatively correlated with the treating time and dose of cisplatin. Western blot showed that cisplatin induced autophagy in ovarian cancer cells in a time- and dose-dependent manner. Cisplatin combined with RP11-135L22.1 can reduce autophagy, increase the apoptosis and inhibit its activity of ovarian cancer cells to a certain extent. CONCLUSIONS Cisplatin can induce autophagy in HO8910 ovarian cancer cells. After overexpression of RP11-135L22.1, it inhibited cisplatin-induced autophagy, thus enhancing the effect of cisplatin on ovarian cancer cells.
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Sun FD, Wang PC, Shang J, Zou SH, Du X. Ibrutinib presents antitumor activity in skin cancer and induces autophagy. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2019; 22:561-566. [PMID: 29424919 DOI: 10.26355/eurrev_201801_14210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Skin cancer is one of the most common malignancies in dermatology. Patient compliance and prognosis of skin cancer are poor. Ibrutinib, a Bruton's Tyrosine Kinase (BTK) inhibitor, is a new anticancer drug used to treat many cancers. Therefore, we aimed to explore the role of ibrutinib in the treatment of skin cancer. MATERIALS AND METHODS Cell Counting Kit-8 (CCK8) and plate cloning assay were used to detect cell proliferation. Apoptosis was determined by flow cytometry. Western blotting analysis was used to analyze the expression of key proteins that regulated autophagy. Proliferation and apoptosis of skin cancer cells and induction of autophagy induced by ibrutinib were evaluated. RESULTS CCK8 plate cloning assays showed that ibrutinib can gradually inhibit the skin cancer cell proliferation as the treatment time and dose increased. Results of flow cytometry showed that apoptosis in skin cancer cells were induced after ibrutinib treatment. Western blot showed that autophagy in skin cancer cells was found induced by ibrutinib and also related to the time and concentration of ibrutinib treatment. Combination treatment of ibrutinib and 3MA for skin cancer cells can significantly increase apoptosis. CONCLUSIONS Ibrutinib has anti-tumor activity in skin cancer and can induce autophagy. Binding to autophagy inhibitors can promote ibrutinib's anti-skin cancer activity. Our experimental results provided new ideas for developing skin cancer drugs.
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Nie J, Zhang L, Zhao G, Du X. Quercetin reduces atherosclerotic lesions by altering the gut microbiota and reducing atherogenic lipid metabolites. J Appl Microbiol 2019; 127:1824-1834. [PMID: 31509634 DOI: 10.1111/jam.14441] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 12/14/2022]
Abstract
AIMS Epidemiological studies have correlated cardiovascular disease and atherosclerosis with lifestyle factors such as sedentary behaviour and a high-calorie diet. Recent studies of pathogenesis have highlighted the significance of the intestinal microbiota and chronic inflammation with respect to both the onset and development of atherosclerosis. This study examined the hypothesis that the oral administration of quercetin to low-density lipoprotein receptor-null (Ldlr-/- ) mice would improve gut health by altering the gut microbiota and controlling the levels of atherogenic lipid metabolites and proinflammatory mediators in the intestine and serum. METHODS AND RESULTS Mice were maintained on a high-fat diet with or without oral quercetin administration for 12 weeks. Quercetin treatment suppressed body weight gains and reduced the extent of atherosclerotic lesions in the aortic sinus. Reduced malondialdehyde and increased interleukin 6 levels further indicated the protective effect of quercetin against immune/inflammatory responses and oxidative stress. Furthermore, quercetin led to decreased intestinal levels of cholesterol, lysophosphatidic acids and atherogenic lysophosphatidylcholine (LPC 18:1) and an increased level of coprostanol. A phylum-level microbial analysis revealed that quercetin treatment reduced the abundance of Verrocomicrobia and increased microbiome diversity and the abundances of Actinobacteria, Cyanobacteria and Firmicutes. A Spearman analysis revealed negative correlations of Actinobacteria with intestinal and plasma LPC 18:1 and caecal cholesterol levels and of Firmicutes and Cyanobacteria with the plasma LPC 18:1 level. CONCLUSIONS This study demonstrated the ability of quercetin treatment to reduce lipid levels, as well as the areas of atherosclerotic lesions and sizes of plaques. This treatment also altered the composition of the gut microbiota and decreased the levels of atherogenic lipid metabolites. SIGNIFICANCE AND IMPACT OF THE STUDY Oral quercetin treatment may represent a new approach to mitigating the onset and development of atherosclerosis.
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Li F, Lizee G, Hwu P, Du X, Deng L, Talukder A, Katailiha A, Zou Q, Roszik J, Hawke D, Jackson K, Bradley S, Wang Y, Ataullakhanov R, Bagaev A, Kotlov N, Svekolkin V, Miheecheva N, Frenkel F, Sonnemann H. The role of EGFR inhibitor (EGFRi) in immune cell infiltration and CD8+ T-cell activation in EGFR mutant lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hidayat K, Du X, Shi BM. Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in real-world use: systematic review and meta-analysis of observational studies. Osteoporos Int 2019; 30:1923-1940. [PMID: 31134305 DOI: 10.1007/s00198-019-04968-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/07/2019] [Indexed: 12/19/2022]
Abstract
In the present meta-analysis based on real-world data, the use of dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1ra), or sodium-glucose cotransporter-2 inhibitors (SGLT2i) was not associated with the risk of fracture. INTRODUCTION Cumulative evidence from randomized control trials (RCTs) with limited fracture events showed that the use of DPP-4i, GLP-1ra, or SGLT2i may not affect the risk of fracture. However, additional insights from large population-based studies with routinely collected data on fracture events and an adequate amount of fracture events are necessary to draw firm conclusions. To refine and complement the results from RCTs, a systematic review and meta-analysis of observational studies were performed to investigate the association between the use of DPP-4i, GLP-1ra, or SGLT2i and the risk of fracture in real-world settings. METHODS The PubMed and Web of Science databases were searched to identify relevant observational studies. A random-effect model was used to estimate the summary relative risks (RRs). RESULTS The use of DPP-4i (RR 0.83, 95% CI [confidence interval] 0.60, 1.14; n = 11), GLP-1ra (RR 0.65, 95% CI 0.24, 1.74; n = 4), or SGLT2i (RR 1.02, 95% CI 0.91, 1.16; n = 4) was not associated with the risk of fracture. In general, there was a consistent lack of association between the use of DPP-4i or GLP-1ra and the risk of fracture across nearly all subgroups, except for a significantly reduced risk of hip fracture with the use of GLP-1ra (RR 0.21, 95% CI 0.04, 0.98). CONCLUSIONS Cumulative real-world evidence does not support an association between the use of DPP-4i, GLP-1ra, or SGLT2i and the risk of fracture. Our findings, together with the cumulative evidence from RCTs, should reassure policy makers and medical practitioners that the use of these medications is unlikely to increase the risk of fracture among type 2 diabetes mellitus patients in general. Further studies need to investigate the long-term impact of these drugs on the fracture risk, particularly in high-risk populations.
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