Hasil untuk "Geriatrics"

Ruonan Gao, Linda Chiu Wa Lam, Allen Ting Chun Lee et al.

Abstract Background Nucleotide-binding domain and leucine-rich repeat (LRR)-containing family protein 3 (NLRP3) inflammasome is an essential component of the innate immune system and regulates inflammation. NLRP3 inflammasome has been widely studied in the pathogenesis of mild cognitive impairments (MCI) and Alzheimer’s Disease (AD). Single nucleotide polymorphisms (SNPs) of NLRP3 gene are associated with various diseases, however the association between NLRP3 SNPs and downstream pathway is unclear. Methods 12 tag SNPs and 2 previously reported SNPs were genotyped in 233 healthy controls (HC) and 332 MCI older adults. NLRP3 and other inflammation-related genes expression were quantified in peripheral blood mononuclear cells (PBMC) from the older adults by quantitative PCR (qPCR). Functional studies of selected mutations were performed by luciferase assay. The older adults were followed up for 2 years to investigate the relationship between NLRP3 SNPs and risk of cognitive decline. Results Our study showed rs10754558 and rs7525979 were associated with an increased risk of MCI. The T allele of rs12564791 was associated with higher gene expression level of NLRP3, interleukin-18 (IL-18), PYCARD, and CASP1. rs12048215, rs10754555, and rs7525979 were associated with cognitive decline as shown by the reduction of Montreal Cognitive Assessment (MoCA) score. Functional studies showed that both rs10754558 and rs10754555 G to C mutation affected transcriptional activity. rs10754558 G to C mutation also disturbed the interaction between NLRP3 3’UTR and miR-425-5p. Plasma miR-425-5p expression was negatively correlated with MoCA score. Conclusions Our study suggested that genetic variations of NLRP3 could affect inflammatory gene expression, transcriptional activity and interaction between gene and miRNA, and therefore were associated with the risk of MCI and cognitive decline. Plasma miR-425-5p has the potential to be a biomarker for cognitive decline.

Du Y, Liu L, Kang K et al.

Yang Du,1,2 Lijun Liu,1,2 Kaijiang Kang,1,2 Yijun Lin,1,2 Hongqiu Gu,1,2 Liheng Bian,1,2 Zixiao Li,1,2 Xingquan Zhao1– 4 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China; 3Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of ChinaCorrespondence: Xingquan Zhao; Zixiao Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119 West Road, South 4th Ring, Fengtai District, Beijing, People’s Republic of China, 100070, Tel +86-10-59975835, Email lizixiao2008@hotmail.com; zxq@vip.163.comAim: To study the relationship between elevated C-reactive protein (CRP) levels, infection, and spontaneous intracerebral hemorrhage (ICH) outcomes.Methods: Patients were classified into four groups (Q1–Q4). Logistic regression was used to analyze the relationship between different CRP levels and functional disability (mRS score of 3– 5) at discharge, intracerebral hematoma evacuation, and in-hospital mortality. Subgroup analysis was conducted on patients with or without infection during hospitalization.Results: A total of 14,529 patients with ICH were enrolled in this study. In the multivariate logistic regression model, compared with the reference CRP quartile group (Q1), the Q4 group had a higher proportion of functional disability (adjusted OR, 1.30, 95% CI 1.16– 1.45) and hematoma evacuation (adjusted OR, 1.88, 95% CI 1.58– 2.23). In patients without infection, compared with the Q1 group, the Q4 group had a higher risk of functional disability (adjusted OR, 2.16, 95% CI 1.71– 2.73) and hematoma evacuation (adjusted OR, 1.15, 95% CI 1.00– 1.31).Conclusion: A significantly increased CRP level was associated with a higher risk of early functional disability and hematoma evacuation in patients with ICH, regardless of the presence or absence of infectious complications. Infection may increase the risk of poor outcomes in patients with ICH, but caution is needed when facing abnormally high CRP levels in patients with ICH without infection. Keywords: C-reactive protein (CRP), infection, inflammation, spontaneous intracerebral hemorrhage, poor outcome

Huimin Lv, Jia Li, Lu Chen et al.

BackgroundThe role of folate metabolism–related biomarker profiles in age-related cognitive impairment (ARCI) remains unclear. This cross-sectional study aimed to examine the association between folate metabolism-related biomarkers and cognitive performance in older Chinese adults.MethodsWe conducted a cross-sectional analysis of 100 participants aged between 56 and 87 years. Cognitive status was classified as ARCI if participants met the cutoff criteria on both the MMSE (<27) and MoCA (<26). Those meeting the cutoff criteria on both MMSE (≥27) and MoCA (≥26) were classified as cognitively normal (CN). Serum levels of folate metabolism-related biomarkers were compared between groups and analyzed for their associations with cognitive scores. Logistic regression was used to examine associations between individual biomarkers and cognitive impairment status. Multiple linear regression analyses were conducted to assess relationships with MMSE and MoCA scores, adjusting for age and education.ResultsCognitive impairment was prevalent among older adults at a rate of 56.3% (P < 0.05). The ARCI group showed significantly lower levels of vitamin B2 (VB2), folate (VB9) and lower MMSE and MoCA scores compared to the CN, while S-adenosylhomocysteine (SAH) and homocysteine (Hcy) levels were higher. MMSE and MoCA scores were positively correlated with serum VB2, VB9, and plasma S-adenosylmethionine (SAM) levels and negatively correlated with Hcy levels. Logistic regression showed that education and serum Hcy were significantly associated with cognitive impairment (AUC = 0.73). In addition to age, VB2, SAM and Hcy in the folate metabolic profile were significantly associated with MMSE and MoCA scores, accounting for 45.9 and 42.7% of the variance in these scores, respectively.ConclusionsVB2, SAM and Hcy may be associated with cognitive impairment in older Chinese adults and warrant further investigation as potential biomarkers.

Conglei Hu, Rui Ma, Yongxiang Shao et al.

Abstract Background There is still controversy about the best minimally invasive surgical method for the treatment of calyceal diverticulum calculi. We conducted meta-analysis to evaluate the effectiveness and safety of PCNL and FURL in the treatment of calyceal diverticulum calculi. Methods We searched Pubmed, Cochrane Library, Web of Science, Embase, Clinical trial platform, CNKI, VIP until April 2024. We utilized the Newcastle–Ottawa Scale (NOS, 0 to 9 stars) to assess the quality of the included literature. Results Totally 15 high-quality studies with 755 patients were included in the meta-analysis. Meta-analysis showed that FURL group was better than PCNL group in blood loss [SMD = 1.713, 95%CI:(0.858, 2.568), Z = 3.928, P = 0.000] and hospital stay [SMD = 2.611, 95%CI: (1.726, 3.496), Z = 5.784, P = 0.000], there was no significant difference in operating time [SMD = 0.079, 95%CI:(-0.43, 0.589), Z = 0.306, P = 0.760], complication rate [OR = 1.793,95%CI: (0.952,2.602), Z = 1.586, P = 0.113], stone-free rate [OR = 1.339, 95%CI: (0.576, 3.112), Z = 0.678, P = 0.497] and symptom-free rate [OR = 3.826,95%CI: (0.561,10.238), Z = 0.966, P = 0.334] as well. Conclusion Whether FURL is indeed superior to PCNL in safety, whether FURL's efficacy is really close to PCNL, and whether FURL can surpass PCNL as the first choice for the treatment of renal diverticulum stones in the future need to be further verified by multi-center, large-sample and high-quality studies.

Cécile Gonnin, Michelle Leemans, Florence Canoui-Poitrine et al.

Abstract Background Immune ageing complicates cancer treatment in older individuals. While immunotherapy targeting the PD-1/PD-L1 pathway can reinvigorate T cells, these cells tend to become senescent with age. This study investigates different CD8+ T cell subsets usually associated with senescence, in cancer patients over 70 years old who are undergoing anti-PD-1/PD-L1 immunotherapy, and examines the relationship between these senescent cells and prior chemotherapy exposure. We analyzed data from the Elderly Cancer Patient (ELCAPA) cohort, which included 35 patients enrolled between March 2018 and March 2021. Results Flow cytometry and unsupervised analysis were employed to characterize Effector Memory CD45RA+ (EMRA) and CD8+ T cell senescence at baseline, before initiating PD-1/PD-L1 therapy. EMRA cells were found to overexpress CD57 and KLRG1 compared to overall CD8+ T cells. Chemotherapy prior to anti-PD-1/PD-L1 was associated with an increased proportion of CD57+ EMRA CD8+ T cells (p = 0.009) and its granzyme B (GRZB) subset (p = 0.007). Using a 10% cut-off to define positivity, the six-month non-response tends to be associated with the CD57+ GRZB+ EMRA positivity (p = 0.097). Other CD8+ T cell subsets (EMRA, CD57+, or KLRG1+), usually associated with senescence, showed no significant association with previous chemotherapy or response to anti-PD-1/anti-PD-L1 therapy. Conclusions These findings underscore the impact of prior chemotherapy on expanding the pool of senescent T cells, particularly CD57+ EMRA CD8+ T and CD57+ GRZB+ EMRA CD8+ T cells, whose expansion could potentially affect the effectiveness of anti-PD-1/PD-L1 immunotherapy in elderly patients. This highlights the need for tailored approaches in this population.

Danielle S Powell, Nicholas S Reed

Nilla Andersson PhD, Susanne Iwarsson Prof, Susann Ullén PhD et al.

Introduction: The gerontological literature suggests that external housing-related control beliefs (HCB) influence activities of daily living (ADL) among older people, but knowledge is scarce for people with Parkinson’s disease (PD). This longitudinal study aimed to explore the directions of the relationship between external HCB and ADL among people with PD. Methods: Baseline (T1) and 3-year follow-up data (T2) were collected from 154 people with PD (mean age = 68 years, T1). Two regression analyses were applied, where dependent (T2 values) and independent (T1 values) variables—external HCB score and PD specific ADL (PADLS)—were switched, adjusting for age, disease severity, cognitive functioning, and accessibility problems. Results: There was a significant effect of ADL on external HCB (β = 3.07, p  < .001, CI [1.28, 4.85]), but no effect in the reverse direction. The proportion with moderate-extreme ADL difficulties increased over time (from 20.8% to 32.5%, p  = .006). Discussion: ADL difficulties seem to lead to higher external HCB, but not the other way around, which contradicts assumptions in environmental gerontology theories. This new knowledge can promote theory development. While additional studies are required to verify whether this is a disease-specific finding, this indicates the importance of targeting ADL if the purpose is to influence external HCB among people with PD.

Shintaro Hayashi, Yuka Misu, Toshimasa Sakamoto et al.

This study aimed to determine how fall prevention self-efficacy and degree of deviation in self-cognition of physical performance, which have recently received attention for their potential to explain falls in combination with a wide variety of fall-related factors, as well as affect falls. Older adults using day-care services (<i>n</i> = 27 with six men, mean age: 81.41 ± 7.43 years) were included in this study. Fall history in the past year, the modified fall efficacy scale (MFES), and physical performance and cognition errors were examined by evaluating the functional reach test (FRT), the stepping over test, and the timed up and go test (TUG), along with a questionnaire. In the fall (<i>n</i> = 14) and non-fall (<i>n</i> = 13) groups, logistic regression analysis using Bayesian statistical methods was used to identify factors associated with falls. The odds ratios for the MFES ranged from 0.97 to 1.0, while those of cognition-error items ranged from 3.1 to 170.72. These findings suggested that deviation in self-cognition of physical performance, particularly overestimation of timed cognitive ability, was a factor with more explanatory power for fall history. Future studies should analyze differences by disease and age group, which were not clarified in this study, to identify more detailed fall risk factors.

Xin Jiang, Xin Jiang, Xin Jiang et al.

BackgroundOlder adults oftentimes suffer from the conditions in multiple physiologic systems, interfering with their daily function and thus contributing to physical frailty. The contributions of such multisystem conditions to physical frailty have not been well characterized.MethodsIn this study, 442 (mean age = 71.4 ± 8.1 years, 235 women) participants completed the assessment of frailty syndromes, including unintentional weight loss, exhaustion, slowness, low activity, and weakness, and were categorized into frail (≥3 conditions), pre-frail (1 or 2 conditions), and robust (no condition) status. Multisystem conditions including cardiovascular diseases, vascular function, hypertension, diabetes, sleep disorders, sarcopenia, cognitive impairment, and chronic pain were assessed. Structural equation modeling examined the interrelationships between these conditions and their associations with frailty syndromes.ResultsFifty (11.3%) participants were frail, 212 (48.0%) were pre-frail, and 180 (40.7%) were robust. We observed that worse vascular function was directly associated with higher risk of slowness [standardized coefficient (SC) = −0.419, p &lt; 0.001], weakness (SC = −0.367, p &lt; 0.001), and exhaustion (SC = −0.347, p &lt; 0.001). Sarcopenia was associated with both slowness (SC = 0.132, p = 0.011) and weakness (SC = 0.217, p = 0.001). Chronic pain, poor sleep quality, and cognitive impairment were associated with exhaustion (SC = 0.263, p &lt; 0.001; SC = 0.143, p = 0.016; SC = 0.178, p = 0.004, respectively). The multinomial logistic regression showed that greater number of these conditions were associated with increased probability of being frail (odds ratio&gt;1.23, p &lt; 0.032).ConclusionThese findings in this pilot study provide novel insights into how multisystem conditions are associated with each other and with frailty in older adults. Future longitudinal studies are warranted to explore how the changes in these health conditions alter frailty status.

Sun‐Zhe Xie, Jun‐Jie Pan, Jian‐Feng Xu et al.

Abstract Cancer metastasis is the leading cause of cancer‐related death. It is a complex, inefficient, and multistep process related to poor prognosis and high mortality of patients. Increasing evidence has shown that metabolic programming is a recognized hallmarker of cancer, plays a critical role in cancer metastasis. Metabolism alterations of glucose, lipid, and amino acid provide cancer cells with energy and substances for biosynthesis, maintain biofunctions and significantly affect proliferation, invasion, and metastasis of cancer cells. Tumor microenvironment (TME) is a complex system formed by varieties of cellular and noncellular elements. Nontumor cells in TME also undergo metabolic reprogramming or respond to metabolites to promote migration and invasion of cancer cells. A comprehensive understanding of the regulatory mechanism in metastasis from the metabolic reprogramming aspect is required to develop new therapeutic strategies combatting cancer metastasis. This review illustrates the metabolic reprogramming and interaction of cancer cells and nontumor cells in the TME, and the development of treatment strategies targeting metabolism alterations.

Daniela Frasca

Abstract Aging and obesity are high risk factors for several conditions and diseases. They are both associated with systemic inflammation and they are both ameliorated by a healthy life style, suggesting that they may share cellular and molecular pathways and underlying mechanisms. A close relationship between aging and obesity is also supported by the observation that the aging overweight/obese population is increasing worldwide, and mechanisms involved will be presented here. A focus of our work is to evaluate if obesity may be considered a good biomarker of accelerated aging of human antibody responses. We will summarize our published results showing the effects of obesity in accelerating age defects in the peripheral B cell pool and how these lead to dysfunctional humoral immunity.

Afeez Abiola Hazzan, Jason Dauenhauer, Patti Follansbee et al.

Abstract Background While studies have examined the quality of life (QoL) of family caregivers for people living with dementia, it is not yet clear how these caregivers’ quality of life affects their ability to meet the care demands of their loved ones. The purpose of the study was to explore caregivers’ perceived quality of life in relation with the care provided to persons with dementia. Methods Twenty-three caregivers participated in this study. These caregivers participated in focus groups or one-on-one interviews after completing questionnaires regarding their own quality of life as well as the care provided to their loved ones with dementia. The interview and focus group transcripts were analyzed using qualitative description methodology. Results Regarding the relationship between caregiver QoL and the care provided to older people with dementia, the following themes were derived: (1) needs of the person with dementia; (2) caregivers’ ability to cope with progressing needs of the care recipient; (3) availability and accessibility of support for the caregiver; (4) unmet needs of the caregiver; and (5) ability of the caregiver to meet their own progressing needs as the condition of the care recipient deteriorates. Conclusions Findings from this study suggest that caregiver quality of life is important for the care they provide to their loved ones living with dementia. The study highlights the need for the provision of much needed support for caregivers and older people living with dementia. These issues are particularly important during and post-pandemic.

Jennifer L Wolff, Vadim Dukhanin, Julia G Burgdorf et al.

Growing reliance on the patient portal as a mainstream modality in health system interactions necessitates prioritizing digital health equity through systems-level strategies that acknowledge and support all persons. Older adults with physical, cognitive, sensory, and socioeconomic vulnerabilities often rely on the involvement of family and friends in managing their health, but the role of these care partners in health information technology is largely undefined and poorly understood. This viewpoint article discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules to promote information transparency alongside broader shifts toward care delivery innovation and population aging. We describe implementation considerations and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.

Manoj Kumar Sharma, Senthil Amudhan, Sidharth Arya et al.

Binge-watching is a new phenomenon characterized by watching TV/online series continuously. The relatively sedentary way of life and its associated psychological factors among the elderly may make them vulnerable to technology misuse and potential problematic binge-watching. We describe a case of a 72-year-old male professional who sought help to manage problematic binge-watching of teleseries. The clinical evaluation highlighted the mediating role of motivation factors (need for self-absorbing activities, compensatory motivation to manage low mood and loneliness) in binge-watching. This case study provides insights into the motives of the elderly for binge-watching and highlights the need to promote behavioral strategies for strengthening the healthy use of technology among the elderly, allowing them to age healthily with advancing technologies.

Benjumin Hsu, Rosemary J. Korda, Richard I. Lindley et al.

Abstract Background Cardiovascular diseases (CVD), including myocardial infarction (MI), stroke and heart failure (HF) are the leading cause of death amongst the older population worldwide. The aim of this study is to investigate trajectories of use of health and aged care services after hospital admission for MI, stroke or HF among community-dwelling people not previously receiving aged care services. Methods The study population comprised people aged 65+ years from the 45 and Up Study with linked records for hospital stays, aged care services and deaths for the period 2006–14. Among those with an index hospital admission for MI, stroke or HF, we developed Sankey plots to describe and visualize sequences and trajectories of service use (none, re-hospitalization, community care, residential care, death) in the 12 months following discharge. We used Cox proportional hazards models to estimate hazard ratios (HRs), for commencing community care and entering residential care (and the other outcomes) within 3, 6 and 12 months, compared to a matched group without MI, stroke or HF. Results Two thousand six hundred thirty-nine, two thousand five hundred and two thousand eight hundred seventy-three people had an index hospitalization for MI, stroke and HF, respectively. Within 3 months of hospital discharge, 16, 32 and 29%, respectively, commenced community care (multivariable-adjusted HRs: 1.26 (95%CI:1.18–1.35), 1.53 (95%CI:1.44–1.64) and 1.39 (95%CI:1.32–1.48)); and 7, 18 and 14%, respectively, entered residential care (HRs: 1.25 (95%CI:1.12–1.41), 2.65 (95%CI:2.42–2.91) and 1.50 (95%CI:1.37–1.65)). Likewise, 26, 15 and 28%, respectively, were rehospitalized within 3 months following discharge (multivariable-adjusted HRs: 4.78 (95%CI:4.31–5.32), 3.26 (95%CI:2.91–3.65) and 4.94 (95%CI:4.47–5.46)). Conclusions Older people hospitalized for major CVD may be vulnerable to transition-related risks and have poor health trajectories, thus emphasizing the value of preventing such events and care strategies targeted towards this at-risk group.

Tomohiro Matsumura MD, PhD, Tsuneari Takahashi MD, PhD, Mitsuharu Nakashima MD et al.

Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Materials and Methods: This study involved a retrospective analysis of data on trochanteric hip fracture patients who had undergone internal fixation from March 2016 to June 2018. The inclusion criteria were patients >70 years old with trochanteric hip fractures who could walk independently before the injury and were followed up for ≥3 months after surgery. Initially, 124 patients were identified, but 33 of these were excluded because other implants were used for internal fixation. Of the remaining 91 patients in whom PFNs were used at the time of internal fixation who were included for the perioperative evaluation, 66 patients followed up for ≥3 months were included in the clinical evaluations. Results: The average surgical time was 56.8 ± 19.6 minutes (range, 23-123 minutes). The average blood loss was 89 ± 41 mL (range, 0-245 mL). The union rate was 98%. Discussion: There were no cases of nail jamming, and all nails were successfully inserted below the end of the distal isthmus without additional reaming to dilate the canal. Conclusions: Proximal femoral nails were a useful implant in Japanese elderly patients with trochanteric hip fractures and gave comparable clinical outcomes despite the femoral length being short and occurrence of intensive bowing.

Michael S. Kain, David Saper, Kyle Lybrand et al.

In current clinical practice, orthopedic surgeons often delay the surgery intervention on geriatric hip fracture patients to optimize the international normalized ratio (INR), in order to decrease the risk of postoperative hematological complications. However, some evidence suggests that full reversal protocols may not be necessary, especially for patients with prior thromboembolic history. Our study aims to compare the surgical outcomes of patients with normal versus elevated INR values. We conducted a retrospective chart review on 217 patients who underwent surgeries on hip fractures at two academic trauma centers. We found that in our group (n = 124) of patients with an INR value of 1.5–3.0, there was only one reoperation for a hematoma, but there was a trend for more blood transfusions. There was no statistically significant difference in the odds of reoperation or overall complications. Nevertheless, there were significantly more events of postoperative anemia in this high INR patient group.

Yuichiro Nishida, Keitaro Tanaka, Megumi Hara et al.

Abstract Background A low urine pH is a characteristic metabolic feature of metabolic syndrome and type 2 diabetes. The purpose of the current study was to investigate the effects of a 12-week home-based bench step exercise on the urine pH status of elderly female subjects. Methods The current study is a secondary analysis of a randomized controlled trial (RCT) in which 59 postmenopausal female subjects were randomized to either the exercise group (n = 29) or the control group (n = 30). The subjects in the exercise group were instructed to perform home-based exercises using a bench step at the anaerobic threshold (AT), with a goal of performing ≥140 min/week at home for 12 weeks. The subjects in the control group were instructed to not change their normal lifestyle. Urine was collected after overnight fasting, and the urine pH was measured using a urinary test strip. The inter-group-differences at baseline and the pre-post changes within groups were assessed using the Mann-Whitney U test and Wilcoxon’s signed-rank test, respectively. Additionally, the difference in the post-intervention urine pH levels of the two groups, adjusted for the pre-intervention values (the estimated effect size) and the precision (95% confidence intervals) were investigated using an analysis of covariance. Results The pre-post comparison of the urine pH data using Wilcoxon’s signed-rank test showed a significant increase in the urine pH levels of the exercise group (p < 0.05); there was no significant change in the urine pH levels of the control group. However, the estimated effect size (0.15) was small and the confidence interval straddled 0 (−0.25–0.55). Conclusions Based on the results of the current secondary analysis of an RCT, we could not clearly conclude that exercise has a beneficial effect on the urine pH. Further well-designed RCTs should be conducted to determine whether aerobic exercise is truly able to ameliorate urine acidification. Trial registration The study was retrospectively registered in the University Hospital Medical Information Network (UMIN) as “Effect of step exercise on aerobic fitness and progression of atherosclerosis in the elderly” under the registration number UMIN 000026743 (the date of registration: March 28, 2017).

Ying Zhao, Yanbo Yu, Maowei Shi et al.

Abstract Background Tissue factor pathway inhibitor (TFPI) is the main physiological inhibitor of TF-induced blood coagulation process, and may play essential roles in the pathogenesis of major adverse cardiac events. This study was designed to determine whether the variation of TFPI was related with coronary artery disease (CAD) in the Han Chinese populations. Methods A total of 1271 patients with coronary atherosclerosis and 1287 normal individuals from northern China were enrolled in the present study. Four tagging single-nucleotide polymorphisms (SNPs) (rs7586970, rs6434222, rs10153820 and rs8176528) from TFPI were selected and genotyped by direct sequencing. And the genotypes of the above SNPs were determined in all these participants. Results In the populations from Beijing and Harbin, no significant case-control differences in the frequencies of TFPI polymorphism (rs10153820 and rs8176528) were observed between CAD patients and controls. Meanwhile, two SNPs of TFPI (rs7586970 and rs6434222) were found to be associated with CAD in both groups. In stratified analyses based on gender, smoking, hypertension, diabetes mellitus and hyperlipidemia, we further determined that the investigated genetic variations of the TFPI genes seemed to be related with diabetes mellitus in CAD patients. Conclusions Genetic variations of the TFPI genes seem to be related with CAD, which likely cooperate with metabolic risk factor (diabetes mellitus) and play critical roles in the pathogenesis of coronary artery disease.

Somsri Wiwanitkit, Viroj Wiwanitkit