Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-12-06 Cooperative journals: 《中国全科医学》
Abstract： Background Carotid plaque is an important early predictive signal of clinical carotid atherosclerosis，the association between homocysteine（Hcy） and carotid plaque is well recognized，however，the correlation between Hcy and carotid plaque in postmenopausal middle-aged women is not clearly established. Objective To analyze the impact of Hcy within the normal reference range on the risk of carotid plaque in postmenopausal middle-aged women and determining the risk threshold. Methods A total of 1 465 postmenopausal women who underwent health examinations at the Affiliated Hospital of Guizhou Medical University between January 2020 and June 2023 were randomly selected. The general information，blood biochemical indicators，and carotid ultrasound indicators of patients were collected，and multivariate Logistic regression analysis was used to explore the association between Hcy and carotid plaque. The cutoff value of Hcy for predicting the risk of carotid plaque in postmenopausal middle-aged women with normal Hcy range was determined by plotting receiver operating characteristic （ROC） curve. Results Six hundred and forty-four（43.96%） out of 1 465 study subjects had carotid artery plaques. Age， systolic blood pressure（SBP），diastolic blood pressure（DBP），total cholesterol（TC），triacylglycerol（TG），and Hcy were higher in the plaque group than in the non-plaque group，high-density lipoprotein cholesterol（HDL-C）was lower than in the non-plaque group（P<0.05）. Logistic regression analysis showed that age（OR=1.097，95%CI=1.059-1.135），SBP （OR=1.021，95%CI=1.010-1.033），LDL-C（OR=1.871，95%CI=1.066-3.281），HDL-C（OR=0.568，95%CI=0.387- 0.835）and Hcy（OR=1.153，95%CI=1.075-1.236） were independent risk factors for carotid plaque in postmenopausal middle-aged women. ROC curve analysis indicated that Hcy ≥ 11.87 μmol/L was the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women within normal Hcy range，with area under curve（AUC） of 0.605，specificity of 75.8% and sensitivity of 40.4%. Conclusion Hcy is an independent risk factor for carotid plaque in postmenopausal middle-aged women，and Hcy ≥ 11.87 μmol/L is the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women with normal Hcy. This threshold may provide an important reference for clinical assessment of carotid plaque risk in postmenopausal middle-aged women.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-11-14 Cooperative journals: 《中国全科医学》
WU Chunyan
DENG Yinglan
ZHAO Ping
HU Shixiu
WU Xiaoyan
ZHU Yan
LI Xiangyan
XIE Zhengzhou
WANG Rong
GAO Yan
YANG Xiuying
XU Haina
LU Ran
RAN Limei
Abstract： Background Urinary incontinence often occurs in women aged 40-60 years and contributes to a significant impact on women's physical health and quality of life. Objective To explore the prevalence and influencing factors of urinary incontinence and its impact on quality of life in women aged 40-60 years in Guizhou Province. Methods From June 2022 to January 2023，women aged 40-60 years who underwent health checkups in 10 hospitals in 7 regions of Guizhou Province were selected as the study subjects. A self-designed general data questionnaire was used to collect the basic data of the study subjects，and International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms（ICIQ#2;FLUTS） and Incontinence Quality of Life Measure（I-QoL） were used to determine the severity of urinary incontinence and the level of quality of life of the study subjects，respectively. Different types of incontinence，including stress incontinence， urge incontinence，and mixed incontinence，were determined according to the diagnostic criteria established by the International Continence Society（ICS）. Multivariate Logistic regression analysis was used to explore the influencing factors of urinary incontinence，and explore the effects of different types and severity levels of urinary incontinence on patients' quality of life. Results A total of 3 000 questionnaires were distributed，and 2 966 valid questionnaires were collected，with a valid recovery rate of 98.80%. The prevalence of urinary incontinence among the 2 966 study subjects was 33.41%，including 20.09% for stress incontinence，2.0% for urge incontinence，and 11.36% for mixed incontinence. Multivariate Logistic regression analysis showed that physical exercise，menstrual status，parity，history of pelvic organ prolapse，perineal laceration，and lateral episiotomy were the influencing factors of stress incontinence（P<0.05）；history of pelvic surgery，number of miscarriages，and neonatal weight were the influencing factors of urge incontinence（P<0.05），waist circumference，history of chronic pelvic pain，pelvic organ prolapse，perineal laceration were factors associated with mixed incontinence（P<0.05）. The total score of I-QoL，scores of behavioral limitations，psychological impact，and social activities impairment were lower in patients with mixed incontinence than those with stress and urge incontinence（P<0.05）；the total score of I-QoL，scores of behavioral limitations，psychological impact，and social activity impairment were lower in the severe incontinence patients than those with mild and moderate incontinence（P<0.05）. Conclusion Guizhou Province has a higher prevalence of urinary incontinence of 33.41% in women aged 40-60 years，influencing factors differ for different types of urinary incontinence，mixed incontinence and severe urinary incontinence have the greatest impact on patients' quality of life，to provide a reference basis for prevention and health management in this population.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2022-11-16 Cooperative journals: 《中国全科医学》
Abstract：
Background The relationship between muscle and adipose tissue and bone mineral density (BMD) in menopausal women has been studied, but there are differences in site distribution, resulting in the impact of muscle and fat on BMD remains unclear. Objectiv To analyze the relationship between BMD of lumbar spine, femoral neck and total hip and fat and muscle tissue in premenopausal women, and to determine the predictors of BMD, to provide a theoretical basis for improving the quality of life of middle-aged and elderly people and preventing and treating osteoporosis. Methods From January 2018 to October 2021, 2355 physical examination women aged 40-60 years were selected from the Health Management Center of the Affiliated Hospital of Guizhou Medical University for retrospective analysis, and DXA and BIA were used to measure BMD, fat and muscle tissue. Pearson correlation and linear regression analyses determined the association of adipose and muscle tissue with bone mineral density. ROC curve analysis validated the predictive value of extremity skeletal muscle mass (ALM) for osteoporosis.Results Fat mass, visceral fat area (VFA), whole body, trunk, and ALM were positively correlated with BMD at each site before and after menopause. Premenopausal VFA was not associated with lumbar spine BMD.Multiple linear regression analysis controlling for covariates showed that VFA was negatively correlated with BMD at various sites before and after menopause（β=-0.003、-0.002、-0.001andβ=-0.002、-0.002、-0.001，P<0.05）;ALM was still positively correlated with postmenopausal BMD (β=0.017, 0.013, 0.012, P<0.05), but not with premenopausal BMD. ROC curve analysis showed that in the threshold of BMI ≥ 18.5, the area under the curve AUC of ALM for predicting OP of total hip, lumbar spine and femoral neck in postmenopausal and general populations was AUC>0.6, and the best prediction site for ALM>16.24kg was the total hip（AUC=0.825>0.760>0.641and AUC=0.834>0.780>0.664，P<0.05）. Conclusion ALM was positively correlated with BMD of lumbar spine, femoral neck and total hip in postmenopausal and general population; ALM>16.24kg had a positive correlation with BMD in people with BMI≥18.5, which was an independent protective factor for preventing osteoporosis.
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