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We conducted a cross-sectional study with 350 gout patients to investigate serum urate acid (sUA) goal attainment (sUA < 360 μmol/L) and associated factors in Chinese gout patients in the Affiliated Hospital of Nantong University from August 2015 to September 2017. Descriptive statistics, health assessment questionnaire, global visual analog scale for general health and Gout Knowledge Questionnaire were calculated comparing patients at sUA goal or not at sUA goal. Univariate analysis and logistic regression models were applied to analyze data. The proportion of urate-lowering therapy (ULT) use was 61.2% (211/350). The mean ± standard deviation sUA of the participants was 475.07 ± 121.53 μmol/L. Only 17.4% of gout patients attain the serum urate goal, which also means 289(82.6%) patients cannot keep their sUA below the target of 360 μmol/L. The factors associated with sUA goal attainment including age, education level and ULT use. Among these, age, waist hip ratio, ULT, family history of cardiovascular disease was the predictor of sUA goal attainment. In conclusion, more than 80% of gout patients did not achieve sUA goal. Younger and fatter patients were more difficult to control the serum urate level. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk factors for osteonecrosis of the femoral head (ONFH) after the treatment of femoral neck fracture in patients under 60 years old. Methods: A total of 250 cases of femoral neck fracture treated at 3 hospitals in Xuzhou from January 2002 to January 2016 were studied. The patients were followed up for 1~15 years, and the clinical data on femoral head necrosis after the femoral neck operation were analysed retrospectively. Risk factors were recorded, including age, gender, preoperative traction, time from injury to operation, reduction method, type of reduction, BMI, ASA classification, and quality of reduction. Logistic regression analysis was used to evaluate the independent risk factors for ONFH after treatment of femoral neck fracture. Results: The duration of follow-up was 1~15 years, with an average of 7.5 years. None of the 250 patients had fracture non-union, but 40 (16%) had necrosis of the femoral head. The time to necrosis of the femoral head was 1~7 years after the operation, with an average of 3.8 years. Univariate analysis showed that the type of fracture, the quality of reduction, the removal of internal fixation, BMI and ASA classification were risk factors affecting necrosis of the femoral head in patients with femoral neck fracture, and the difference was statistically significant (P < 0.05). Multivariate analysis showed that internal fixation, fracture type (displacement), reduction quality (dissatisfaction), BMI (> 25), and ASA grade (III + IV) were independent risk factors affecting femoral head necrosis in patients with femoral neck fracture. Conclusion: A variety of high-risk factors for femoral head necrosis are present after surgery with hollow compression screws for femoral neck fracture in adults. Removal of internal fixation, type of fracture, quality of reduction, BMI, and ASA classification were the most important risk factors influencing the development of femoral head necrosis. During treatment, there should be some targeted measures to reduce the incidence of necrosis of the femoral head. [ABSTRACT FROM AUTHOR]

Adrenomedullin (ADM) is thought to play a significant role in regulating insulin secretion and glucose metabolism. However, studies on the relationship between ADM and gestational diabetes mellitus (GDM) are limited. We hypothesized that a higher serum ADM concentration would be associated with an increased risk of GDM. Therefore, a nested case-control study of 65 GDM cases and 130 prepregnancy body mass index, age, parity, and gestational age of blood collection-matched controls was conducted to prospectively evaluate the association between circulating ADM concentrations in early pregnancy and the risk of GDM in pregnant women based on the Tongji Birth Cohort. Serum ADM concentrations in the GDM group were higher than those in the control group (2125.04 ± 644.97 vs 1880.76 ± 581.13 pg/mL) (P =.008). Serum ADM concentration was positively associated with the risk of developing GDM (P trend <.05). The adjusted odds ratio (OR) comparing the highest tertile of ADM with the lowest was 2.74 (95% CI, 1.17-6.43). The risk of GDM increased by 49% (OR, 1.49; 95% CI, 1.05-2.12) for each SD increment of serum ADM. Moreover, serum ADM concentration was positively correlated with circulating total cholesterol (r = 0.204), triglycerides (r = 0.197), and systolic blood pressure (r = 0.173), but negatively correlated with circulating high-density lipoprotein cholesterol concentration (r = –0.176). Pregnant women with higher serum ADM concentrations have a markedly increased risk of developing GDM. Further studies are warranted to explore the possible thresholds of ADM that increase the risk of GDM and to confirm and elucidate the underlying mechanisms. [Display omitted] [ABSTRACT FROM AUTHOR]