[Effect of biofeedback therapy on metabolic syndrome under different levels of job stress]

Objective: To investigate the effect of biofeedback therapy on metabolic syndrome (MS) and the effect of different levels of job stress on the outcome. Methods: The physicians in tertiary hospitals who were diagnosed with MS from January to December, 2016 were divided into biofeedback group and health education group according to different intervention methods, and moderate group, medium group, and high group according to different levels of job stress. A 6-month intervention was implemented from May to October, 2017. A two-way factorial design was used to analyze the main effect of biofeedback on physical and biochemical parameters and the interaction of biofeedback and job stress. Results: After 6 months of intervention, the patients in both the biofeedback group and the moderate group had significantly decreased waist circumference, body mass index, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and levels of triglyceride (TG) , total cholesterol, low-density lipoprotein cholesterol (LDL-C) , and fasting plasma glucose (FPG) and a significantly increased level of high-density lipoprotein cholesterol (HDL-C) (all P<0.05) ; the patients in both the health education group and the moderate group had significantly decreased SBP, DBP, and levels of TG, LDL-C, and FPG (P<0.05) . The factorial analysis of variance showed that there was a synergistic interaction between the intervention method and job stress level in SBP, DBP, TG, HDL-C, LDL-C, and FPG among MS patients (P<0.05) . The high group had significantly more improvements in all indices compared with the medium group and the moderate group (P<0.05) . Conclusion: Biofeedback therapy can effectively improve blood pressure, blood lipids, and blood glucose in MS patients, and is more effective for patients with high job stress level.

[Effect of probucol on preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention]

Objective: To investigate the preventive effect, possible mechanism and safety of probucol on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Methods: A total of 641 patients with coronary heart disease were consecutively enrolled from Department of Cardiology, in Tianjin Chest Hospital, Tianjin TEDA International Cardiovascular Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital. They were randomly divided into probucol group (n=321) and control group (n=320). The probucol group was given oral probucol 500 mg twice daily for day 0 to day 3 after PCI; the control group was given only conventional therapy. All patients were given intravenous drip 0.9% sodium chloride solution before 12 to 24 hours of operation. The levels of serum creatinine (Scr), blood urea nitrogen (BUN), evaluate glomerular filtration rate (eGFR), cystatin C (Cys-C), and high-sensitivity C-reactive protein (hs-CRP), neutrophil gelatinase associated lipocalin (NGAL), superoxide dismutase (SOD) and glutathione (GSH) were measured before and 72 h after the PCI operation in both groups. The incidence rates of CIN, the adverse events during hospitalization and postoperative 14-day follow-up were recorded in two groups. Results: There was no statistically significantly difference in the levels of Scr, BUN, eGFR, Cys-C, hs-CRP, NGAL, SOD and GSH between the two groups before PCI (P>0.05). The levels of serum Scr, BUN, Cys-C, hs-CRP, NGAL, SOD and GSH after operation in the two groups were higher than those before the operation (P<0.05). The levels of hs-CRP and NGAL in the probucol group were lower than those in the control group [(10±4) vs (11±4)mg/L, (25±8)vs (34±7)U/ml, P<0.05]. The levels of eGFR, SOD and GSH in probucol group were higher than those in control group [(80±27) vs (72±26) ml·min(-1)·1.73 m(-2,) (67±9) vs (58±8)U/ml, (4.6±0.9) vs (3.9±0.8)U/ml, P<0.05]. The incidence of CIN was 4.0% in the probucol group and 10.9% in the control group, and the difference was statistically significant (P<0.05, χ(2)=-3.31). Multivariate Logistic regression analysis showed that probucol was an independent protective factor for CIN (OR=0.334, 95%CI 0.172-0.648, P=0.001). There were no adverse events such as myasthenia gravis, abnormal liver function and cardiovascular events during the hospitalization and 14-day follow-up. Conclusions: Probucol can reduce the incidence of contrast-induced nephropathy after PCI. The protection mechanism is related with its anti-inflammatory and anti-oxidative stress effects, and it has good safety.

Psychological distress and type 2 diabetes mellitus: a 4-year policemen cohort study in China

OBJECTIVES

This study investigated whether psychological distress predicts the development of type 2 diabetes mellitus (T2DM) and if the association differs between populations at a high or low diabetes risk level among Chinese police officers.

DESIGN

Prospective cohort study.

SETTING

Single centre.

PARTICIPANTS

6559 participants underwent clinical measurements at the hospital in April 2007. 5811 police officers participated in the follow-up consisting of new-onset diabetes (NOD) events occurring annually between 2008 and 2011.

PRIMARY OUTCOME MEASURES

Baseline data were collected from policemen who completed the Symptom Checklist 90-Revised (SCL-90-R) questionnaire and a self-designed questionnaire. Psychological distress was measured by the SCL-90-R questionnaire. Hong Kong Chinese Diabetes Risk Score (HKCDRS) was used to evaluate the risk of T2DM, and the participants were divided into low-risk group and high-risk group based on the HKCDRS. Cox proportional hazards regression was used to calculate the HRs of the incidence of T2DM related to psychological distress and further stratified the analysis based on HKCDRS.

RESULTS

Among 5811 participants, 179 subjects developed NOD during the 4-year follow-up. 54 subjects (1.63%) with a HKCDRS 0-7 vs 125 subjects (4.98%) with a HKCDRS>7 developed NOD (p<0.05). There was a significant association between psychological distress and T2DM (HR=1.46; 95% CI 1.05 to 2.02). Among the participants with a high-risk score (HKCDRS>7), 7.07% of those with psychological distress developed T2DM compared with 4.43% of participants without psychological distress (p<0.05). The corresponding adjusted HR for psychological distress was 1.61 (95% CI 1.10 to 2.37).

CONCLUSIONS

Psychological distress is an independent risk factor for T2DM in this prospective cohort study. Stratification analysis indicated that psychological distress was associated with T2DM in a high-risk level population.