Abnormal Components Research Articles

Serum soluble receptor of advanced glycation end products and risk of metabolic syndrome in Egyptian obese women.

Obesity is one of the diagnostic criteria of metabolic syndrome (MS). It is correlated with insulin resistance (IR) and high vascular risk as well. Advanced glycation end products (AGEs) and their receptor (RAGE) play an important role in abnormal metabolic components in obese women. This study aimed to explore the serum levels of sRAGE in Egyptian obese women and compare with healthy non-obese controls and investigate the relationship between serum sRAGE, metabolic parameters, and obesity complications. The soluble form of receptor for advanced glycation end products (sRAGE), anthropometry, metabolic and biochemical biomarkers were measured in 100 obese women and 100 age-matched healthy control non-obese women. The homeostasis model assessment estimate of insulin resistance (HOMA-IR) has been determined from serum insulin and glucose values. Serum sRAGE levels were significantly lower in obese cases than controls and inversely correlated with obesity and metabolic parameters. Results of univariate and multivariate analyses for determinants of serum sRAGE levels in obese cases showed that parameters statistically and significantly related were body mass index (BMI), waist circumference (WC), LDL-C, TG, BP, HOMA-IR, ALT and AST. sRAGE is a novel biomarker for metabolic dysfunction in Egyptian obese women and might predict the future cardio-metabolic events.

Pattern of lipid levels of subjects seeking laboratory services in an established laboratory in the Dhaka city

Background: Dyslipidemia is linked to the risk for coronary ischemic and cardiovascular disease. Considering the absence of national reference level for lipids in Bangladesh the present study was undertaken to look into the pattern of lipid levels among patients seeking laboratory services in a private medical college hospital.Materials and Methods: This cross sectional study was carried out in Ibn Sina Medical College Hospital in Dhaka city. Patients with antilipid and other medication which might affect the outcome were excluded. Consenting and eligible subjects seeking laboratory services were included in the study. Total 970 subjects finally entered in the study. Total cholesterol [TC], triglyceride and HDL-cholesterol [HDL-c] were measured by enzymatic colorimetric method. LDL-cholesterol [LDL-c] was derived using Friedewald equation. Data were expressed mean±SD, number (percent) as appropriate. Statistical analyses were carried out using SPSS version 17 tool. A p value <0.05 was taken as level of significance.Results: Male female ratio of the total subjects was 53.9:46.1. Of the total participants 27.1% were between 41-50 age group and 71% were between 31-60 years. Mean (SD) triglyceride, total cholesterol, HDL-c and LDL-c level for all participants was 182±134, 194±44, 38.4±11.5 and 119±37 respectively. Mean value of HDL-c for all subjects was 38.4mg/dl where as it’s cutoff value is 40 mg/dl and 50 mg/dl for male and female respectively suggesting relatively large number of subjects had HDL-c dyslipidemia of the study subjects. Percent subjects with isolated abnormal lipid component were 51%, 41%, 73.2% and 33.3% for triglyceride, total cholesterol, HDL-c and LDL-c respectively. Of the total subjects 22% had abnormal level of lipid for all four components.Conclusions: The data showed pattern of lipid levels of the subjects seeking laboratory services of a tertiary care hospital which might be taken a trend in the Bangladeshi population. Dyslipidemia appeared to be relatively high among the subjects studied of which HDL-c dyslipidemia was more prominent.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.375-379

Comparative electrophysiological responses in anisometropic and strabismic amblyopic children.

PurposeTo compare anisometropic hypermetropic amblyopic and strabismic amblyopic responses to pattern electroretinogram (PERG) and pattern visual evocated potential (PVEP).Materials and methodsFifty-six patients – 18 hypermetropic anisometropic amblyopic children (mean age 9.70±2.5 years), 19 strabismic amblyopic children (mean age 10.30±2.6 years) and 19 normal emetropic subjects (mean age 10.10±2.2 years) – were enrolled in this study. After routine ophthalmic examination, PERG and PVEP were recorded in response to checks reversed at the rate of two reversals/second stimulating macular area.ResultsThe difference between hypermetropic anisometropic amblyopia and strabismus amblyopia with respect to P100/P50/N95 wave latencies (P=0.055/0.855/0.132) and P100/P50/N95 amplitudes (P=0.980/0.095/0.045) was not statistically significant. However, there was a significant statistical difference between strabismic amblyopia group and controls for P100/P50/N95 latencies (P=0.000/0.006/0.004).ConclusionOur findings indicated that despite clinical differences between anisometropic amblyopic and strabismic amblyopic patients, no differences were found in the responses of PVEP and PERG. The abnormal components of the PVEP and PERG in amblyopic subjects could reflect a retinal dysfunction in the visual pathway.

Robust Localization with Crowd Sensors: A Data Cleansing Approach

In this paper, the source localization problem with crowd of anchor nodes is investigated, under the circumstances that abnormal data could be sporadically and randomly produced for the reason of either accidental equipment failures or random malicious behaviors. To cope with the problem that abnormal data brings, we formulate a generalized modeling of abnormal data in localization problem, which involves the impacts of both unexpected equipment failures and malicious data falsifications. The corresponding Cramer-Rao lower bound (CRLB) of the specific localization problem is derived. For the localization enhancement, we propose a data cleansing-based robust localization algorithm which exploits the low occupancy of channel band by sources and the sparsity of abnormal data. The data cleansing approach achieves both the new sensing data matrix that cleansed out abnormal data component and the estimated abnormal data matrix, which are respectively used for the correct source detection process and the position estimation process of the final source localization. The root mean squared error (RMSE) is derived to assess the performance of the proposed robust localization algorithm. Computer simulations show that the proposed data cleansing-based robust localization algorithm can effectively eliminate the impairment of the abnormal data and hence improve the localization performance evidently.

Association of metabolic syndrome and electrocardiographic markers of subclinical cardiovascular disease

BackgroundThe metabolic syndrome (MetS) and its components are well-established risk factors for cardiovascular diseases (CVD). It is inconclusive whether MetS and MetS score are associated with electrocardiographic markers of subclinical CVD, therefore we investigated this in a population without pre-existing CVD.MethodsWe performed a cross-sectional analysis in the Netherlands Epidemiology of Obesity study, a population-based cohort including 6671 participants aged 45–65. We excluded participants with pre-existing CVD (n = 499) or missing MetS components (n = 58). MetS was defined based on a modified definition of Adult Treatment Panel III. Subclinical CVD parameters were determined with 12-lead ECGs. MetS score was defined as number of abnormal MetS components and obesity as Body Mass Index (BMI) ≥30 kg/m2. We performed weighted adjusted linear regression analyses.ResultsOur study population (n = 6114) had a mean (SD) BMI of 26.3 (4.4) kg/m2 and MetS was present in 24% of participants. All ECG parameters differed between participants with and without MetS. Per additional MetS component, heart rate was 0.17 SD (95% CI 0.15, 0.19) higher, P wave duration, QRS complex duration and corrected QT interval were longer [0.07 SD (0.05, 0.10), 0.04 SD (0.01, 0.06) and 0.05 SD (0.02, 0.08) respectively], P wave axis, T wave axis and QRS axis were lower [−0.10 SD (−0.12, −0.07), −0.07 SD (−0.10, −0.05) and −0.19 SD (−0.22, −0.16)] and percentage small Q-waves also increased per additional MetS component. Associations were stronger in non-obese than obese participants. In joint modelling of all MetS components, increased waist circumference showed strongest associations with ECG parameters.ConclusionsMetabolic syndrome score and its individual components, in particular abdominal obesity, are associated with ECG markers of subclinical CVD, showing the importance of limiting the amount of MetS components in both obese and non-obese persons.

Cardiac health and fitness of Colorado male/female firefighters.

Cardiovascular disease (CVD) is documented as the leading cause of mortality in on-duty firefighters. To examine the prevalence of metabolic syndrome (MetS) components, cardiorespiratory fitness levels and the association between them in firefighters in Colorado, USA. This study included male and female Colorado firefighters. MetS was identified where three or more metabolic abnormalities were present, using Cholesterol Education Program/Adult Treatment Panel III guidelines. Cardiorespiratory fitness (indicated by VO2 max) was evaluated with the Bruce protocol. Poisson regression was conducted to examine the association between MetS components and VO2 max. Among the 947 male and 76 female study subjects, MetS was present in 9% of all firefighters, in 5% of females and 10% of males. The mean age was 37 ± 10 years. MetS prevalence increased with age (from 3% at age <30 to 17% at 50 and older, data not shown). In addition, 35% had one and 19% had two abnormal MetS components and 49% of participants did not meet the minimum recommended VO2 max of 42.0 ml/kg/min. VO2 max was negatively associated with abnormal MetS components (incident rate ratios = 0.95, 95% confidence interval 0.94-0.96, P < 0.001). About one in 10 of these Colorado firefighters had MetS and nearly half had insufficient cardiorespiratory fitness. Comprehensive CVD risk management and cardiorespiratory fitness improvement are essential for firefighter health and safety.

Avoiding the Health Hazard of People from Construction Vehicles: A Strategy for Controlling the Vibration of a Wheel Loader

The vibration control of a construction vehicle must be carried out in order to meet the aims of sustainable environmental development and to avoid the potential human health hazards. In this paper, based on market feedback, the driver seat vibration of a type of wheel loader in the left and right direction, is found to be significant over a certain speed range. In order to find abnormal vibration components, the order tracking technique (OTT) and transmission path analysis (TPA) were used to analyze the vibration sources of the wheel loader. Through this analysis, it can be seen that the abnormal vibration comes from the interaction between the tire tread and the road, and this is because the vibration was amplified by the cab mount, which was eventually transmitted to the cab seat. Finally, the seat vibration amplitudes were decreased by up to 50.8%, after implementing the vibration reduction strategy.

Mechanism of immune evasion in breast cancer.

Breast cancer (BC) is the most common malignant tumor among women, with high morbidity and mortality. Its onset, development, metastasis, and prognosis vary among individuals due to the interactions between tumors and host immunity. Many diverse mechanisms have been associated with BC, with immune evasion being the most widely studied to date. Tumor cells can escape from the body’s immune response, which targets abnormal components and foreign bodies, using different approaches including modification of surface antigens and modulation of the surrounding environment. In this review, we summarize the mechanisms and factors that impact the immunoediting process and analyze their functions in detail.

A Prospective Study on Exchange Transfusion in Neonatal Unconjugated Hyperbilirubinemia – in a Tertiary Care Hospital, Nepal

An exchange transfusion involves replacing patient's blood with donor blood in order to remove abnormal blood components and circulating toxins while maintaining adequate circulating blood volume. To observe the incidence, causes of jaundice requiring Exchange and any adverse event of exchange transfusion in newborns with unconjugated hyperbilirubinemia. Prospective study undertaken at Neonatal Intensive Care Unit (NICU) of Manipal Teaching Hospital, Pokhara, Nepal from March 2014 to April 2015. For both mothers and neonates blood group and Rh typing and for all newborns pre and post exchange complete blood count with peripheral smear, serum bilirubin, hemoglobin, calcium, potassium, random blood sugar, C-reactive protein and blood culture and where ever required Direct Coombs test, reticulocyte count, G6PD activity and thyroid function test were done. The incidence, indications, positive outcome, complications and mortality were noted. Out of 481 cases of unconjugated hyperbilirubinemia 29 (6%) required exchange transfusion. 55.2% Pathological Jaundice [13.8% ABO incompatibility, sepsis and hypothyroidism was commonest causes] and 44.8% exaggerated physiological jaundice [27.6% with no underlying pathology, 10.3% preterms 3.4% cephalhematoma] required exchange transfusion. Post transfusion, bilirubin level decreased significantly (p < 0.001). The commonest adverse events noted were anemia (89.7% / p < 0.018), hyperglycemia(51.7% / p < 0.001), hypocalcaemia (48.3% / p < 0.001)), sepsis(10.3%), hypernatremia (13.8%), hyperkalaemia, bradycardia, apnea and feed intolerance (6.9%). None of them had kernicterus and there was no mortalities. Exchange transfusion is an effective procedure to decrease bilirubin levels but is associated with many complications. Hypothyroidism was one of the commonest cause of jaundice requiring Exchange transfusion.

Bankss Discretion Over the Debt Valuation Adjustment for Own Credit Risk

Prior to 2018, accounting rules required banks that recognize financial liabilities at fair value to record unrealized gains and losses on the liabilities attributable to changes in the banks’ own credit risk, referred to as the debt valuation adjustment (DVA), in earnings each period. Using a comprehensive sample of publicly traded European banks during 2007–2015, we investigate the economic determinants of DVA and banks’ exercise of discretion over DVA. We find that DVA exhibits the expected associations with economic factors, e.g., is positively associated with the change in banks’ bond yield spread. We decompose DVA into normal and abnormal components and find that abnormal DVA is negatively associated with pre-managed earnings, controlling for banks’ abnormal loan loss provisions and realized securities gains and losses, consistent with banks exercising discretion over DVA to smooth earnings. We further find that banks that record larger loan loss provisions or realized gains and losses and banks that have histories of using provisions or realized gains and losses to smooth earnings are less likely to exercise discretion over DVA to smooth earnings. These findings generally are consistent with banks using loan loss provisions, realized gains and losses, and DVA substitutably to smooth earnings. Lastly, we provide evidence that banks exercised discretion over DVA to smooth earnings during the recent financial crisis but not afterward. These findings have implications for how bank regulators and investors should interpret banks’ reported DVA, and they support the decisions by the IASB and FASB to require firms to record DVA in other comprehensive income starting in 2018.

Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey.

Although metabolic syndrome incidence has substantially increased during the last few decades, it largely remains unclear whether this metabolic disorder is associated with total cancer mortality. The present study was carried out to investigate this important question. A total of 687 cancer deaths were identified from 14,916 participants in the third National Health and Nutrition Examination Survey by linking them to the National Death Index database through December 31, 2006. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to metabolic syndrome and its individual components. After adjustment for confounders, a diagnosis of metabolic syndrome was associated with 33% elevated total cancer mortality. Compared with individuals without metabolic syndrome, those with 3, 4 and 5 abnormal components had HRs (95% CIs) of 1.28 (1.03-1.59), 1.24 (0.96-1.60), and 1.87 (1.34-2.63), respectively (p-trend = 0.0003). Systolic blood pressure and serum glucose were associated with an increased risk of death from total cancer [HR (95% CI) for highest vs. lowest quartiles: 1.67 (1.19-2.33), p-trend = 0.002 and 1.34 (1.04-1.74), p-trend = 0.003, respectively]. Overall null results were obtained for lung cancer mortality. The effects of metabolic syndrome and its components on non-lung cancer mortality were generally similar to, but somewhat larger than, those for total cancer mortality. Our study is among the first to reveal that metabolic syndrome is associated with increased total cancer mortality.

Sleep Quality on Maintenance Hemodialysis Patients in Douala General Hospital in Cameroon

Background: Poor sleep quality is reported to be common in hemodialysis patients. However, limited data are available about its prevalence in sub-Saha-ran region. The aim of this study was to assessed sleep quality and its predictors among hemodialysis patients. Methods: We conducted a cross sectional study of 2 weeks in the Douala General Hospital hemodialysis center of Cameroon involving 46 chronic hemodialyzed patients for at least six months with arteriovenous fistula. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) and laboratory data were collected in patients’’ fields. Result: Thirty-five (76.1%) subjects reported poor sleep quality. The most frequent abnormal sleep components were subjective sleep quality, sleep disturbances and sleep latency (87%, 85% and 76% respectively). In univariate linear regression, hemoglobin level, sleep quality, sleep latency, sleep duration, habitual sleep efficiency and sleep disturbance were associated with poor sleep quality. In multivariate linear regression only hemoglobin level (p = 0.004) and sleep latency (p = 0.002) were associated with poor sleep quality. Conclusion: Poor sleep quality is frequent in our hemodialysis patients and hemoglobin seems to be a good predictor of sleep quality in these patients.

Information-hardware Support of Systems of the Automated Electromagnetic Monitoring of Geodynamic Objects

In article the structure of an informational-hardware support of the automated system of data processing at electromagnetic monitoring of geodynamic objects is considered. The structure of interrelations of the object-oriented and serving subsystems realizing methodological, program and technical and information support of processes of filing and data processing of geodynamic monitoring is defined. It is noted that increase of geodynamic sensitivity due to selection of the abnormal components of signals and obligation of monitoring of variations of separate geodynamic objects in the studied environment results in need of expansion of informational saturation and a variety of geoelectric models. In this case the applied algorithms of informational processing can be focused only on the analysis of the abnormal signals, and the geodynamic assessment will be defined by structure of the models of geodynamic objects used at interpretation. It is defined that the problem of prediction of geodynamic processes can be solved on the basis of expected model operation.

Pattern of Metabolic Syndrome in Relation to Gender among Type-II DM Patients in Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia

Background: The co-existence of diabetes and metabolic syndrome (MetS) in individuals potentiate the cardiovascular risk associated with each of these mentioned circumstances. Hence investigating the presence of MetS and its individual components in diabetes mellitus (DM) patients is fundamental in order to minimize the risks of developing cardiovascular related morbidities. Objectives: This study aimed to assess pattern of metabolic syndrome in relation to gender among type-II DM patients in Hawassa University Comprehensive specialized Hospital. Methods: A cross-sectional study was conducted on 270 participants from March to November 2014. Structured questionnaires were used for appropriate data collection; blood glucose and lipid profiles were determined after overnight fasting. In addition, MetS was interpreted according to modified National cholesterol Education Program Adult Treatment Panel-III guideline and finally in all cases, at 95% confidence interval (CI), a P value <0.05 was accepted as statistically significant. Results: The prevalence of MetS was 45.9% and the proportion of MetS was significantly higher in women when compared to men (60.6% vs. 36.7%; p<0.0001), respectively. Elevated TGs was 68.1% and it was found to be the most frequently encountered MetS component followed by Low HDL-c (47%) other than hyperglycemia. Abdominal obesity and low HDL-c were significantly higher in women when compared to men (p<0.0001 for both). In addition, being women [AOR (95%CI): 4.1(1.5-10.9)], overweight [AOR (95%CI): 12(2.3-61.4)], and obesity [AOR (95%CI): 19.8 (3.1-124.7)], were significantly positively associated with MetS. Furthermore duration since the diagnosis of diabetes was also significantly associated with MetS. Conclusions: Applying comprehensive management approach in each abnormal component of MetS is a fundamental in order to minimize cardiovascular risks. In addition, cohort studies should be conducted to address others hidden factors that potentiate MetS.

Limits of Phenotype Analyses in the Diagnosis of HbS Heterozygosity. Example of a Hb S Carrier Phenocopy Due to Hb Arya (Alpha 1: codon 47 Asp>Asn) and a Gene Conversion

Introduction :Quantitative and qualitative analyses of hemoglobin (Hb) using protein approach allow in many cases to identify a variant present in a patient and thus to give a first counseling advice to couples displaying an abnormal Hb. This phenotype analysis requires the use of a battery of methods relying on different properties of proteins allowing a cross analysis enabling to decipher from the numerous variants described to date. However because of budget constraint, in an increasing number of laboratories, cation-exchange HPLC and capillary electrophoresis are the only two methods nowadays used for identification and quantification of a Hb variant. In many cases, these rapid phenotype analyses allow to predict the identity of the variant. But, this approach is misleading since several variants may display similar electrophoretic or chromatographic behavior and genetic factors may modify their expression level. This is important for variants which have mobilities close to that of Hb S, the most frequently observed variant. We describe herein a family with an α variant mimicking a heterozygous Hb S as well as for identification and quantification (fig 1).Case report:A newborn from a family of Azerbaijan was seen at the emergency pediatric care unit when 1 month-old because of worsening of an icterus. There was no specific disease history in the family and biological and clinical examination of the child led to the diagnosis of a moderate mixed bilirubin icterus (total bilirubin 150 µmol/L, conjugated bilirubin 6.1 µmol/L, with normal liver indices and blood count) without any severe symptom and a good clinical development. The child was not admitted . Because of her origins, she got a neonatal testing for Hb disease and the result showed the presence of a Hb variant. After genetic counseling, the identification of this variant was proposed to the family and done using CE-HPLC analysis and Capillary electrophoresis. It resulted in the finding in the father and the child of a variant compatible with Hb S as well for the mobility as for the percentage of the abnormal Hb component but negative according to the Itano solubility test. The blood samples were thus sent to our reference laboratory for identification of this unknown variant.Methods :Hb was studied using CE HPLC, capillary electrophoresis, isoelectrofocusing and Reverse Phase- HPLC. Sanger sequence identified the α-chain variant and polymorphic motifs located along α locus and specific to α 1 and α 2 gene.Results :Hb Arya [α codon 47 Asp>Asn, HBA1( or HBA2):c.142G>A] was identified in the father and his girl and the unusual high level of expression was found to be related to a partial gene conversion from a1 to a2 making the patient and her father carrier of two copies of the αArya gene located in Cis (a2Arya- a 1Arya / a2- a1) (fig 2).Conclusion :Hb S phenocopy is not an uncommon finding and Hb variants were described to have chemical properties close enough to that of Hb S to be misleading when analyzed using only the "automated set" of method. This example is even more confusing because of the high percentage of the abnormal chain due to the gene conversion and militate against the ongoing budget driven simplification of Hb analysis. Proper diagnosis of Hb variant is not a simple process because methods used for diagnosis are based on electrical and chemical changes brought to the protein by the amino acid change or additional alteration. This can be mimicked or counter-balanced by another mutation. The only method to detect such artifacts is to use at least 3 methods based upon different electrophoretic or chromatographic protein characteristics and a solubility test. A positive solubility test or discrepancies in the result of the different tests used should trigger confirmation by Sanger sequencing of globin genes (β and/ or α globin).High proportion for an α variant can be produced by several genetic configurations : homozygosity for the variant ( up to 40 %) or compound heterozygote with and α 1 thalassemia ( a-3.7, up to 30% ) however, these configuration are not transmitted as a dominant trait as in this family. A Gene conversion which make the two α genes of one chromosome carrier of the same variant allow that dominant transmission. Very few example are described but this example leads to speculate that conversion event between the two α genes could be more frequent than described and could account for unusual expression patterns. [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

The glue that holds the situation together

A 48-year-old man presented with a longstanding left upper eyelid mass that increased in size when bending forward. The mass was associated with enophthalmos and slowly increased in size with Valsalva maneuver. Magnetic resonance imaging and arteriography demonstrated a vascular malformation without an abnormal arterial component. Because of his increasing pain, the vascular malformation was excised in a multidisciplinary approach involving intraoperative fluoroscopic mapping, cyanoacrylate embolization, and surgical excision. Histopathology was consistent with a benign vascular malformation. Clinically, this was a low-flow, distensible venous malformation—or orbital varix.

Abstract 12973: PR-Interval Components and Atrial Fibrillation Risk: The Atherosclerosis Risk In Communities Study

Introduction: Reports on the association between the PR-interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-interval is not a single electrocardiographic (ECG) phenotype and it is more likely to represent a composite of several distinct components. Methods: We examined the association of the PR-interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with AF in 14,924 participants (mean age=54±5.8 years; 26% black; 55% female) from the Atherosclerosis Risk in Communities study. The PR-interval and its components were automatically measured at baseline (1987-1989) from standard 12-lead ECGs. PR-interval &gt;200 ms was considered prolonged and values &gt;95th percentile defined abnormal PR-interval components. AF was ascertained during follow-up through December 31, 2010. Results: Over a median follow-up of 21.2 years, 1,985 (13%) participants developed AF. Prolonged PR-interval was associated with an increased risk of AF (HR=1.19, 95% CI=1.02, 1.40). However, PR-interval components showed varying levels of associations with AF (P-wave onset to P-wave peak duration: HR=1.57, 95%CI=1.31, 1.88; P-wave peak to P-wave end duration: HR=1.20, 95%CI=0.99, 1.46; and PR-segment: HR=1.05, 95%CI=0.85, 1.29). Additionally, the components of the PR-interval had weak to moderate correlation with each other (correlation r ranged from -0.44 to 0.06). Conclusions: Our findings suggest the PR-interval represents a composite of distinct components that are not uniformly associated with AF. Without considering the contribution of each component, inconsistent associations between the PR-interval and AF are inevitable.

PR-Interval Components and Atrial Fibrillation Risk (from the Atherosclerosis Risk in Communities Study)

Reports on the association between the PR-interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-interval represents a composite of several distinct components. We examined the associations of the PR-interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with incident AF in 14,924 participants (mean age 54 ± 5.8years; 26% black; 55% women) from the Atherosclerosis Risk In Communities study. The PR-interval and its components were automatically measured at baseline (1987 to 1989) from standard 12-lead electrocardiograms. PR-interval >200ms was considered prolonged and values above the ninety-fifth percentile defined abnormal PR-interval components. AF was ascertained during follow-up through December 31, 2010. Over a median follow-up of 21.2years, 1,985 participants (13%) developed AF. Prolonged PR-interval was associated with an increased risk of AF (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.02 to 1.40). However, PR-interval components showed varying levels of association with AF (P-wave onset to P-wave peak duration: HR 1.57, 95% CI 1.31 to 1.88; P-wave peak to P-wave end duration: HR 1.20, 95% CI 0.99 to 1.46; and PR-segment: HR 1.05, 95% CI 0.85 to 1.29). In addition, the components of the PR-interval had weak-to-moderate correlation with each other (correlation r ranged from-0.44 to 0.06). In conclusion, our findings suggest the PR-interval represents acomposite of distinct components that are not uniformly associated with AF. Withoutconsidering the contribution of each component, inconsistent associations between thePR-interval and AF are inevitable.

Higher Levels of Magnesium and Lower Levels of Calcium in Whole Blood Are Positively Correlated with the Metabolic Syndrome in a Chinese Population: A Case-Control Study

Magnesium (Mg) and calcium (Ca) are essential for numerous kinds of metabolisms in human body. To investigate the associations between Mg and Ca and the ratio of Ca to Mg (Ca/Mg) in whole blood with metabolic syndrome (MetS) in a Chinese population, a matched case-control study including 204 MetS patients and 204 healthy controls (aged 48-89) was carried out in 2011. MetS were diagnosed according to the criteria of Chinese Diabetes Society. Controls had no abnormal metabolic components and were matched with cases by age, gender and region. Blood samples were collected in the morning after an overnight fast. Whole blood Mg and Ca were determined by flame atomic absorption spectrometry. Subjects who were male constituted 44.1% of the part of this study. The average age was 64.0 ± 7.18, and the average body mass index was 24.3 ± 3.75. The MetS group showed significantly higher Mg and lower Ca and Ca/Mg as compared with the control group. Comparing with the bottom tertile (T1) of Mg, increased ORs for MetS were found in median tertile (T2) and top tertile (T3) of Mg. For Ca, T2 and T3 were negatively associated with MetS. Inverse relationship was also found between Ca/Mg ratio and MetS. Our findings suggested that increased Mg and decreased Ca and Ca/Mg in whole blood were correlated with MetS in Chinese adults.

Network-Based Statistic Show Aberrant Functional Connectivity in Alzheimer's Disease

Alzheimer's disease (AD) and mild cognitive impairment (MCI) have been associated with impaired communication among large-scale brain networks. Given nature that interconnected subnetworks are responsible for daily behavior than a single pair of functional connectivity, it is valid to use a network-based statistic (NBS) method to exploit the clustering structure of connectivity alterations in AD/MCI. We explored abnormal network components using NBS based on resting-state functional magnetic resonance imaging (fMRI)connectivity in a sample of patients with AD (N = 35), MCI (N = 27) and age-matched healthy subjects (N = 27). The results demonstrated that patients had reduced functional connectivity strength in several components, including the default mode network, sensorimotor network, visual-sensory network, and visual-attention network. In patients with AD, the functional connectivity of these components of interest (COIs) exhibited greater attenuation than that in MCI subjects compared with normal cognition. A greater degree of cognitive impairment was correlated with a greater decrease in functional connectivity in the identified COIs. These results indicate that the neurodegenerative disruption of fMRI connectivity is widely distributed in several networks in AD/MCI. These profiles deepen our understanding of the neural basis of AD/MCI dysfunction and indicate the potential of resting-state fMRI measures as biomarkers or predictors of AD.