中华健康管理学杂志
2021年 · 第15卷第05期
中华健康管理学杂志
Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment and blindness in people over 50 years old. The Physical Examination Center of Beijing Tongren Hospital, in cooperation with Beijing Institute of Ophthalmology, discovered for the first time that the increase of peripheral blood mononuclear cells is an important risk factor for AMD. This discovery will have far-reaching value for the exploration of disease mechanism and treatment methods. The Tongren Health Examination Cohort AMD study was a cross-sectional study. A total of 7,719 healthy physical examination people over 50 years old from January 2017 to December 2019 in Beijing Tongren Hospital were included, of which 45.9% were males, with an age of (60.5±8.1) years. The study results showed that the overall prevalence of AMD was 20.8% (95% CI: 20.1% ~21.9%), of which early AMD was 10.8% (95% CI：10.1%~11.5%）； Interim AMD of 9.5% (95% CI：8.9%~10.2%）； Advanced AMD was 0.50% (95% CI：0.40%~0.70%）。 After correcting for age, sex, blood pressure, blood lipids, high-sensitivity C-reactive protein and other factors that may be related to AMD, the absolute value of peripheral blood mononuclear cells was independently correlated with the prevalence of AMD. In the overall population, the absolute value of mononuclear cells increased by 1×109/L, the probability of merging AMD increases by 3.5 times as much as before; Absolute value of monocytes ≥0.5×109The probability of combined AMD in/L population is (0.1~0.4) ×109/L population 1.5-fold. The overall population was grouped by male, female, and different age groups (50 to 59 years; 60 years +), or only patients with intermediate and advanced AMD, and the significant association between high absolute levels of peripheral blood mononuclear cells and higher prevalence of AMD persisted. The mononuclear-macrophage system is an important component of human innate immunity, which exerts phagocytosis, immune regulation and mediates or regulates inflammatory response through secretion. Higher absolute values of peripheral blood mononuclear cells in AMD patients in this study may indicate that the patients are in a systemic immune inflammatory response state. The results of the study support the involvement of immune inflammatory response in the pathological process of AMD from the epidemiological point of view, and provide a strong theoretical basis for further understanding and intervention of AMD lesions.
In recent years, the prevalence of obstructive sleep apnea (OSA) has been increasing, and many studies have shown that OSA is a risk factor for cardiovascular disease, while a large multicenter RCT study found that continuous positive airway pressure treatment for patients with moderate to severe OSA who have been complicated with ischemic cardiovascular and cerebrovascular disease does not reduce secondary cardiovascular risk. In order to investigate whether OSA patients have damage to cardiac structure and function when they are not complicated with cardiovascular disease, the researchers conducted a cross-sectional study. The study included 352 subjects aged 18 to 70 years, all of whom underwent polysomnography in a sleep center followed by routine transthoracic echocardiography, spot-tracking echocardiography or cardiac magnetic resonance examination. Of 352 subjects, 78 had apnea-hypopnea index (AHI)<5 times/h, which is non-OSA; There were 274 cases of AHI ≥5 times/h, of which 86 were mild OSA and 188 were moderate to severe OSA. The results showed that the E/A and E '/A' values of patients in the mild OSA group were lower than those in the non-OSA group on transthoracic echocardiography (1.12 ± 0.37 vs 1.27 ± 0.45 and 0.83 ± 0.33 vs 0.99 ± 0.42; bothP<0.05）。 The width of aorta and ascending aorta in the mild OSA group was smaller than that in the moderate to severe group [(27.36 ± 2.87) to (28.87 ± 2.95) mm and (30.27 ± 3.79) to (31.63 ± 3.74) mm; BothP<0.05］。 The results suggest that patients with mild OSA without combined cardiovascular disease have early damage to cardiac structure and function, which increases with the severity of OSA. According to the above results, it is recommended to pay attention to routine echocardiography in patients with mild OSA, and pay attention to early cardiac structural and functional abnormalities; Regular monitoring and advocacy for early intervention of patients with mild OSA without co-ordinated cardiovascular disease. The results of this study provide a reference for the theoretical basis of early intervention in patients with mild OSA, and also provide guidance for future related research.
Excessive sodium intake is an important cause of hypertension, which has been confirmed by a large number of scientific studies. Salt reduction (reducing sodium intake) has also been listed by the World Health Organization as one of the three best measures to prevent chronic diseases. However, in real life, most people consume far more sodium than they need due to eating habits and tastes developed over thousands of years. In order to reduce sodium without reducing salt, substitute salt came into being. The principle is that a certain proportion of potassium chloride, which also has salty taste, is mixed into ordinary salt. The antihypertensive effects of potassium-containing substitute salts have previously been demonstrated by numerous rigorous randomized controlled intervention trials. But can it be used for a long time? How safe is it? Does it indeed bring clinical benefits in reducing major cardiovascular events? There has been no convincing evidence for these problems for a long time and they have greatly limited the promotion of alternative salts on the market.
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