| The first section The Correlation Study between Abdominal Obesity and Chronic Diseases among the ElderlyObjective Obesity is one of the main diseases which influence the health and quality of life among the elderly. The incidence rate of obesity in the elderly shows a gradually increasing tendency year by year. Compared with common obesity, abdominal obesity refers to over-deposition of fat in abdomen. In recent years, more researches demonstrate abdominal obesity as one of vital influencing factors on various chronic diseases including life-threatening cardio-cerebrovascular diseases, such as hypertension and coronary heart disease among the elderly, to which people should attach more importance. The present study analyses the correlation between prevalence of chronic diseases in the elderly receiving health examination in Tianjin and abdominal obesity, aiming at improving physical constitution of the elderly by arousing people’s attention and advocating “Prevention First”.Methods In total, 4986 old people(≥60 years of age) receiving health examination in General Hospital of Tianjin Medical University from January, 2014 to December, 2015 were chosen as respondents. Waist circumference(WC)(male≥ 90 cm, female≥ 85cm) and waist-to-hip ratio(WHP)(male≥ 0.90,female≥ 0.85) were concerned as diagnostic criteria of abdominal obesity. Various laboratory examinations and collection of relevant medical history were optimized. Then, statistical analysis was conducted to explore the relationship between common chronic diseases including hypertension, coronary heart disease, cholelithiasis, prostatomegaly among the elderly and abdominal obesity.Results Totally, 4986 people received physical examination, in which 3699 were male and 1287 female. Among all the elderly receiving health examination, abdominal obesity rate after standarization of people with WC as the criterion was 71.3%, while abdominal obesity rate after standarization of people with WHR as the crtiterion was 69.4%. 3275 people had at least one chronic disease. The morbidity was 65.3%, in which the incidence rate of hypertension ranked first(48%), and was 46.7% after standarization. After adjusting age, gender and occupation, incidence rates of hypertension, hyperlipemia, coronary heart disease, fatty liver, diabetes were positively associated with WC and WHR(P <0.01); while morbidity of chronic gastritis was negatively associated with WC and WHR. OR(95%CI) was 0.18(0.16-0.21) and 0.22(0.19-0.25)(P <0.01), respectively. Compared with the group with normal WC, OR(95%CI) of abdominal obesity group with the above nine diseases was 2.08(1.83-2.36), 2.56(2.24-2.92), 4.46(3.79-5.25), 0.18(0.16-0.21), 1.26(1.09-1.44), 1.88(1.59-2.23), 4.50(3.13-6.46), 0.91(0.69-1.21) and 1.00(0.72-1.36), respectively. Compared with the group with normal WHR, OR of greater WHR group was 1.43(1.27-1.61), 1.61(1.42-1.82), 2.59(2.24-2.98), 0.22(0.19-0.25), 2.31(1.99-2.68), 1.33(1.14-1.55), 0.86(0.69-1.07), 0.89(0.67-1.17) and 0.99(0.72-1.34), respectively.Summary Abdominal obesity occupies a great proportion among the elderly, and coexistence of multiple chronic diseases is an important factor affecting quality of life of senior citizen. Meanwhile, compared with weight gain, the increase of WC or WHR predicts chronic diseases including hypertension and coronary heart disease more accurately. Thus, effective control of weight and shrink of waistline are of significance for the prevention and treatment of chronic diseases.The second section A Study on Changes of Serum Factors under Different Glucose Metabolism States among the ElderlyObjective Glucose metabolism states of the elderly are related to many factors including blood biochemical index. In particular, patients with abdominal obesity are usually accompanied by disorder of glucose and lipid metabolism such as type 2 diabetes, which may attribute to the role played by relative serum factors. This study is designed to analyze changes of various serum factors including adipocytokines and muscle cell factors under different glucose metabolism states among the aging population; and its relationship with obesity.Methods Totally, data of 192 elder people receiving health examination in General Hospital of Tianjin Medical University from January to December in 2015 were collected to analyze the correlation between abdominal obesity and glucose metabolism states. On the basis of collected data(height, weight, waist circumference, abdominal circumference, fasting blood-glucose, glycosylated hemoglobin and other biochemical indexes), selected elder people were divided into four groups: normal control(NC), impaired fasting glucose(IFG), impaired glucose tolerance(IGT) and type 2 diabetes(T2DM) group according to the different glucose metabolism states. Meanwhile, based on the diverse blood glucose and degrees of obesity, the elderly were divided into five groups: normal control group(people) with normal fasting blood-glucose, glucose tolerance, weight circumference and weight; OB1 group(people) of abdominal obesity with normal fast blood-glucose and glucose tolerance; OB2 group(people) of abdominal obesity with normal IFG and glucose tolerance; OB3 group(people) of abdominal obesity with normal fast blood-glucose and IGT; OB4 group(people) of T2 DM abdominal obesity with a rise in fast blood-glucose and glycosylated hemoglobin. Enzyme-linked immunosorbent assay(ELISA) was used in the above five groups to examine levels of Irisin, human Adiponectin(ADP), human Apelin and human mitochondrial UCP2.Results Among the 192 people(≥ 60 years of age), 108 were male and 84 female. All subjects were divided into four groups: normal control(NC) group, impaired fasting glucose(IFG) group, impaired glucose tolerance(IGT) group and type 2 diabetes(T2DM) group. And there was no obvious correlation between age, gender, WC and glucose metabolism states. Except for ALB, various glucose metabolism states had correlation with HDL-C、LDL-C、TC、TG、Hb A1c、Cr. Five groups were classified according to diverse blood glucose and degrees of obesity of objects. The data were compared between the groups divided by age and gender, no significant difference was observed between groups(P <0.001). Significant differences in the level of Irisin in serum were observed between OB2 group and control, OB1 group(P <0.001); OB3 group and control, OB1 group(P <0.001); OB4 group and control group(P <0.001). Irisin was positively associated with WC, while negatively associated with 2h PBG by correlation analysis. There were significant differences in level of Ucp2 in serum between OB1, OB2, OB3 group and normal control group(P <0.001); OB4 group and OB1, OB2 group(P <0.001). Ucp2 had positive correlation with FBG, 2h PBG, Hb A1 c, TC, LDL-C. Meanwhile, significant differences in the ADP level in serum were detected between OB1, OB2 group and control group(P <0.001); OB3 group and control, OB1 group(P <0.001). According to the correlation analysis, ADP was negatively associated with FBG, 2h PBG, Hb A1c; positively associated with LDL-C. Significant difference in the level of Apelin in serum was observed between OB1, OB2, OB3, OB4 group and control group(P <0.001).Correlation analysis showed Apelin was positively associated with WC, FBG, 2h PBG and Hb A1c; but negatively associated with TG.Summary In the elderly, various biochemical indexes have a combined influence on sugar glucose states. Biochemical examination of serum plays a role in the prediction of diseases. With the deepening of study, researchers found the correlation between serum factors and glucose metabolism. It provides a new and targeted therapeutic regimen for patients with diabetes by targeting multiple serum factors. |
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