Assessment of the clinical effect of Chinese medicine therapy combined with psychological intervention for treatment of patients of peri-menopausal syndrome complicated with hyperlipidemia.
Qian Li-qi,Wang Bin,Niu Jing-Yu,Gao Shan,Zhao Dan-yang
Chinese journal of integrative medicine
OBJECTIVE:To observe the effect of Chinese medicine therapy combined with psychological intervention (combined therapy) on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia. METHODS:With the use of a randomizing digital table method, 185 patients that fit the registration standard were randomly assigned to three groups. The 59 cases in Group A were treated with two Chinese patents, Kunbao Pill and Modified Xiaoyao Pill; the 63 in Group B received psychological intervention alone; and the 63 in Group C were treated with both (the combined therapy), with the treatment course for all six months. The items of observation included: (1) scoring by SCL-90 on eight factors and seven symptoms; (2) scoring on Chinese medicine symptoms by Kupermann scale, including anxiety and bad temper, scorching sense action with sweating, dizziness, tinnitus, soreness and weakness of the loin and knees, palpitation, insomnia, lassitude, weakness, and hyposexuality; (3) blood contents of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apoprotein AI (ApoAI) and B (ApoB); (4) levels of sex hormones, including estradiol (E(2)), progesterone (P), pituitary prolactin (PRL), follicular stimulating hormone (FSH), and), luteinzing hormone (LH) in some randomly selected patients; (5) adverse reaction; and (6) one-year follow-up study on long-term effect. RESULTS:A total of 21 patients (6, 8, and 7 cases in Groups A, B, and C, respectively) dropped out; the drop-out rate was insignificant among groups. (1) The markedly effective rates in Group A, B, and C were 26.42% (14/53), 18.18% (10/55), and 53.57% (30/56), respectively, and the total effective rates in them were 64.15% (34/53), 50.91% (28/55), and 87.50% (49/56), respectively, suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B (P<0.01). (2) SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C (P<0.01), but remained unchanged in Groups A and B (P>0.05). (3) Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms, except that menstrual disorder and amenorrhea were unchanged in all three groups (P>0.05). (4) Levels of HDL-C, ApoAI, and E(2) increased and those of TG, TC, LDL-C, ApoB, FSH, and LH decreased after treatment in Group C, reaching near normal levels; similar trends of blood lipids were shown in Group A, but the level of sex hormones was unchanged. In Group B all the above-mentioned indices were unchanged (P>0.05). (5) A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively (P<0.01). (6) No adverse reaction was found. CONCLUSION:Chinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms, but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.
10.1007/s11655-010-0124-x
Assessment of sleep disorders among patients with hypertension and coexisting metabolic syndrome.
Kiełbasa Grzegorz,Stolarz-Skrzypek Katarzyna,Pawlik Artur,Łątka Monika,Drożdż Tomasz,Olszewska Marta,Franczyk Agata,Czarnecka Danuta
Advances in medical sciences
PURPOSE:The coexistence of hypertension, abdominal obesity, and carbohydrate and lipid metabolism disturbances favors the acceleration of other disease entities - also apart from cardiovascular system disorders. This study was planned to estimate the relationship between the presence of metabolic syndrome and sleep disorders among a group of hypertensive patients. PATIENTS/METHODS:The study was conducted on unselected group of 261 patients from the Outpatient Hypertension Clinic. The standardized questionnaire was used to collect the data on medical history, prescribed drugs and lifestyle. Sleep disorders were diagnosed based on the Athens Insomnia Scale and STOP-Bang Questionnaire. According to the study protocol, anthropometric parameters (weight, height, waist and neck circumferences), blood pressure, serum lipids and fasting glucose laboratory measurements were performed. Metabolic syndrome was defined according to IDF criteria. RESULTS:Sleep disorders were recognized in 183 participants of the study - significantly more frequently (P=0.03) among patients with diagnosed metabolic syndrome (120; 75%) in comparison with participants without this disturbance (63; 62.38%). Male gender, poor financial situation, tingling sensations before falling asleep and combination therapy of hypertension significantly increased the risk of sleep disorder occurrence in the group of patients with metabolic syndrome. Night food intake, aging, hypertension combination therapy and poor socioeconomic status were the factors increasing the risk of sleep problems among participants without metabolic syndrome. CONCLUSIONS:Sleep disorders often coexist with metabolic syndrome in hypertensive patients. A number of factors increase the probability of occurrence of sleep disorders, but most of them are modifiable.
10.1016/j.advms.2016.03.005
Insomnia Symptoms Are Not Associated with Dyslipidemia: A Population-Based Study.
Vozoris Nicholas T
Sleep
STUDY OBJECTIVES:The purpose of this study was to examine whether or not insomnia symptoms were associated with measured dyslipidemia. METHODS:This was a population-based multiyear cross-sectional study, using data from 2005-2008 United States National Health and Nutrition Examination Surveys. Survey participants ages 20 y and older self-reported the frequency of difficulty falling asleep, prolonged nocturnal awakening, and undesired early morning awakening over the preceding month. One-time venipuncture was performed and a low-density lipoprotein cholesterol (LDL-C) of ≥ 160 mg/ dL, triglycerides of ≥ 200 mg/dL, and a high-density lipoprotein cholesterol (HDL-C) of < 40 mg/dL denoted dyslipidemia. Descriptive statistics and multiple logistic regression were used. RESULTS:Data on LDL-C, triglycerides, and HDL-C was available for 4,635, 4,757, and 9,798 individuals, respectively. There were no significant associations between having any insomnia symptom at least five times in the past month and high LDL-C (odds ratio [OR] 1.20, 95% confidence interval [CI] 0.92-1.55) or low HDL-C (OR 0.92, 95% CI 0.82-1.04) in unadjusted analyses, or with high triglycerides after adjusting for covariates (OR 1.03, 95% CI 0.78-1.37). Recipients of sleeping pills who also had insomnia symptoms had significantly increased adjusted odds of elevated LDL-C (OR 2.18, 95% CI 1.14-4.15). CONCLUSIONS:Insomnia symptoms were generally not associated with dyslipidemia, but receipt of sleeping pills in the setting of insomnia was associated with elevated LDL-C. Further research is needed to confirm a possible link between sleeping pill use and dyslipidemia and to delineate if an association with atherosclerosis exists with specific types of sleeping pills or with all sedative medications more broadly.
10.5665/sleep.5524
Obstructive sleep apnea is associated with lower adiponectin and higher cholesterol levels independently of traditional factors and other sleep disorders in middle-aged adults: the ELSA-Brasil cohort.
Silva Wagner A,Almeida-Pititto Bianca,Santos Ronaldo B,Aielo Aline N,Giatti Soraya,Parise Barbara K,Souza Silvana P,Vivolo Sandra F,Lotufo Paulo A,Bensenor Isabela M,Drager Luciano F
Sleep & breathing = Schlaf & Atmung
PURPOSE:Obstructive sleep apnea (OSA) may contribute to metabolic and inflammatory deregulation but previous studies failed to consider sleep duration, sleep fragmentation, insomnia, and daytime sleepiness as potential confounders. METHODS:Consecutive non-diabetic middle-aged participants from the ELSA-Brasil cohort were invited to perform a clinical evaluation, home sleep study for 1 night, and wrist actigraphy for 7 days. OSA was defined by an apnea-hypopnea index ≥ 15 events/h. Participants were stratified according to the presence of OSA measuring the following markers: fasting glucose, glucose tolerance test, homeostatic model assessment of insulin resistance (HOMA-IR) index, fasting insulin, insulin after 2 h of glucose load, glycated hemoglobin, total cholesterol and their fractions, triglycerides, C-reactive protein, TNF-alpha, interleukin-6, interleukin-10, leptin, adiponectin, E-selectin, ADMA, MCP-1, TGF, apolipoprotein B, fibrinogen, and lipoprotein(a). Differences between groups were identified by chi-square test and ANOVA. RESULTS:We studied 708 participants (mean age: 46 ± 5 years, men: 44%, BMI 26.1 ± 4.1 kg/m). Compared to no OSA, participants with OSA presented higher levels while fasting and after 2 h glucose load of insulin, HOMA-IR, cholesterol, triglycerides, and C-reactive protein (all p < 0.001). After linear regression analysis adjusting for traditional risk factors plus sleep duration, fragmentation, insomnia, and daytime sleepiness, OSA was negatively associated with adiponectin (β = - 0.271 CI 95% - 0.456 - 0.085) and positively associated with cholesterol (β = 9.707 CI 95% 2.737 16.678). Sex-stratification revealed that these associations were significant for men but not women. CONCLUSIONS:In non-diabetic middle-age adults, men with OSA presented with lower adiponectin and higher cholesterol levels independently of sleep duration, sleep fragmentation, insomnia, and daytime sleepiness.
10.1007/s11325-021-02290-7
Poor Sleep Quality Is Associated with Altered Taste Perception in Chinese Adults.
Gao Yun,Li Junjuan,Cheng Feon W,Cui Liufu,Shu Rong,Wu Shouling,Gao Xiang
Journal of the Academy of Nutrition and Dietetics
BACKGROUND:Small clinical studies have suggested that individuals with insufficient sleep could experience taste dysfunction. However, this notion has not been examined in a large-scale, population-based study. OBJECTIVE:This study aimed to examine whether overall sleep quality, as assessed by insomnia, daytime sleepiness, snoring, and sleep duration, was associated with the odds of having altered taste perception in a large population-based study. DESIGN:This was a cross-sectional study that used data from a subcohort of the Kailuan study, an ongoing multicenter cohort study that began in 2006 in Tangshan City, China. PARTICIPANTS/SETTING:The participants were 11,030 adults aged 25 years or older (mean age 53.7 ± 10.7 years), who were free of neurodegenerative diseases. All the participants had undergone questionnaire assessments and medical examinations at Kailuan General Hospital from June 2012 to October 2013. MAIN OUTCOME MEASURES:Altered taste and olfactory perception were assessed via a questionnaire with two questions regarding whether participants had any problems with sense of taste or smell for ≥3 months. STATISTICAL ANALYSES PERFORMED:The association between sleep quality and altered taste/olfactory perception was examined using a logistic regression model, adjusting for age, sex, lifestyle factors (eg, obesity, smoking, alcohol intake, and physical activity) and health status (eg, lipid profiles, blood pressure, modification use, and presence of chronic diseases). RESULTS:Poor overall sleep quality was associated with a higher risk of having altered taste perception (adjusted odds ratio for low vs high sleep quality 2.03, 95% CI 1.42 to 2.91; P < 0.001). Specifically, insomnia, daytime sleepiness, and short sleep duration, but not prolonged sleep duration and snoring, were significantly associated with altered taste perception. A significant association between overall sleep quality and the risk of having altered olfactory perception was also observed (adjusted odds ratio for low vs high sleep quality 2.17, 95% CI 1.68 to 2.80; P < 0.001). CONCLUSIONS:In this population-based study, poor sleep quality was associated with a high likelihood of altered taste perception.
10.1016/j.jand.2020.06.019
Sleep characteristics and inflammatory biomarkers among midlife women.
Nowakowski Sara,Matthews Karen A,von Känel Roland,Hall Martica H,Thurston Rebecca C
Sleep
Study Objectives:Research suggests that sleep disturbances are associated with elevated levels of inflammation. Some evidence indicates that women may be particularly vulnerable; increased levels of inflammatory biomarkers with sleep disturbances are primarily observed among women. Midlife, which encompasses the menopause transition, is typically reported as a time of poor sleep. We tested whether poorer objectively measured sleep characteristics were related to a poorer inflammatory profile in midlife women. Methods:Two hundred ninety-five peri- and postmenopausal women aged 40-60 completed 3 days of wrist actigraphy, physiologic hot flash monitoring, questionnaires (e.g. Berlin sleep apnea risk questionnaire], and a blood draw for the assessment of inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), and von Willebrand factor (VWF) antigen. Associations of objective (actigraphy) sleep with inflammatory markers were tested in regression models. Sleep efficiency was inverse log transformed. Covariates included age, race/ethnicity, education, body mass index, sleep apnea risk, homeostatic model assessment (a measure of insulin resistance), systolic blood pressure, low-density lipoprotein cholesterol, and physical activity. Results:In separate models controlling for age, race/ethnicity, and education, lower sleep efficiency was associated with higher IL-6 [b(SE) = .02 (.10), p = .003] and VWF [b(SE) = .02 (.08), p = .002]. More minutes awake after sleep onset was associated with higher VWF [b(SE) = .12 (.06), p = .01]. Findings persisted in multivariable models. Conclusions:Lower sleep efficiency and more minutes awake after sleep onset were independently associated with higher circulating levels of VWF. Lower sleep efficiency was associated with higher circulating levels of IL-6. These findings suggest that sleep disturbances are associated with greater circulating inflammation in midlife women.
10.1093/sleep/zsy049
Association of Sleep Duration and Self-Reported Insomnia Symptoms with Metabolic Syndrome Components among Middle-Aged and Older Adults.
International journal of environmental research and public health
The study aimed to explore the association between sleep duration, insomnia symptoms and the components of metabolic syndrome (MetS) among middle-aged and older adults. A cross-sectional study was conducted in five community health centers and physical check-up centers of two comprehensive hospitals in Guangdong. We recruited 1252 participants (658 female), aged 40-96 years and with a body mass index (BMI) of 16.26-35.56 kg/m. MetS was assessed based on the guidelines of the International Diabetes Federation. Self-reported sleep duration was evaluated by a simplified questionnaire. Compared with the participants who slept 6-8 h/day, those who slept shorter (<6 h/day) or longer (>8 h/day) periods of time with or without insomnia symptoms had significantly increased odds ratios (ORs) of high blood pressure (except for the SBP in model 2) and high triglycerides (TGs) in all models ( < 0.05), whereas the participants who slept longer (>8 h/day) or shorter (<6 h/day) periods of time with insomnia symptoms had significantly increased ORs of low HDL-C in all models ( < 0.05), but non-significant in those without insomnia symptoms. BMI is significant for insomnia symptoms but not for sleep duration. Our study indicated that the association of sleep duration with MetS components was partially associated with insomnia symptoms. These findings have significant implications to explore the appropriate sleep duration for adults.
10.3390/ijerph191811637
The association between insomnia symptoms and cardiovascular risk factors in patients who complete outpatient cardiac rehabilitation.
Rouleau Codie R,Toivonen Kirsti,Aggarwal Sandeep,Arena Ross,Campbell Tavis S
Sleep medicine
OBJECTIVE:The present study investigated whether completion of an exercise-based cardiac rehabilitation (CR) program was associated with improvements in both traditional cardiovascular risk factors and insomnia symptoms, and whether degree of improvement in insomnia symptom severity was associated with degree of improvement in cardiovascular risk. METHODS:Participants (N = 80) with cardiovascular disease completed a 12-week outpatient CR program involving supervised moderate-intensity exercise sessions held twice weekly. Insomnia symptom severity, blood pressure, body mass index, psychological distress, and lipid profile were measured at baseline and after completion of the program. RESULTS:Nearly 40% reported mild to moderate insomnia symptom severity at baseline. There were improvements in insomnia symptom severity, anxious and depressive symptoms, low-density lipoprotein levels, triglycerides, and total cholesterol from baseline to post-program. After statistical adjustment for age, sex, and functional capacity, greater improvement in insomnia symptom severity was associated with greater improvements in total cholesterol and symptoms of anxiety and depression. CONCLUSIONS:Completion of CR may contribute to improved sleep that, in turn, is associated with improvements on some indices of cardiovascular risk. Future research should examine the direction of the association between insomnia and cardiovascular risk, including whether efforts to alleviate insomnia may bolster the cardiovascular benefits of CR.
10.1016/j.sleep.2017.01.005
Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China.
Medicine
Hypertension is a leading cause of death worldwide. Hypertension is associated with poor sleep quality, which adversely affects physical and mental health, and can increase the incidence rate and mortality of cardiovascular disease, cancer, and depression. This study aimed to investigate the prevalence of the factors related to poor sleep quality in hypertensive patients in Shandong Province, China. This cross-sectional study of adult patients with hypertension from August 2020 to February 2021was conducted in 10 cooperative hospitals in Shandong Province, China. Information was collected in the form of a questionnaire. In this study, Pittsburgh sleep quality index was used to evaluate sleep quality. A multivariate logistic regression model was used to analyze the risk of poor sleep quality. Variables with a P value < 0.05 and a 95% confidence interval (CI) were considered statistically significant. A total of 528 patients with hypertension were included, ranging in age from 31 to 90 years old. The prevalence of poor sleep quality among study participants with hypertension was 319 (60.4%) (95% CI: 0.562-0.646). Female gender (adjusted odds ratios [AOR] = 3.231; 95% CI: 2.194-4.757), stage III blood pressure (AOR = 2.142; 95% CI: 1.108-4.141), mental labor, and labor both physical and mental (AOR = 1.639; 95% CI:1.03-2.611 and AOR = 1.632; 95% CI: 1.030-2.584), unstable marriage (AOR = 3.203; 95% CI: 1.026-9.997) and the very Low-density Lipoprotein (odds ratios = 0.776; 95% CI: 0.649-0.928) were significantly associated with poor sleep quality. This study preliminarily showed that poor sleep quality was a common problem in hypertensive patients, and more than half of the hypertensive patients had poor sleep quality. Poor sleep quality was significantly correlated with gender, hypertension level, occupation, marital status, and the very Low-density Lipoprotein. Considering the negative impact of sleep quality, appropriate strategies should be developed to prevent and treat poor sleep quality in hypertensive patients.
10.1097/MD.0000000000033926
Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies.
BMJ open
OBJECTIVES:To assess the longitudinal evidence of the relationships between sleep disturbances (of quantity and quality) and dyslipidaemia in the general population and to quantify such relationships. SETTING:Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS:We performed a systematic search of PubMed and Embase (up to 9 September 2017), complemented with manual searches, of prospective population studies describing the association between sleep duration and quality and the incidence of dyslipidaemias. Relative risks (95% CIs) were extracted and pooled using a random effects model. Subgroup analyses by lipid type were performed. Heterogeneity and publication bias were also assessed. Quality was assessed with Downs and Black score. PARTICIPANTS:Studies were included if they were prospective, had measured sleep quantity and/or quality at baseline and either incident cases of dyslipidaemia or changes in blood lipid fractions assessed prospectively. PRIMARY OUTCOME MEASURES:Incidence of dyslipidaemia and changes in lipid fractions. Dyslipidaemia was defined as a high total cholesterol, triglycerides, low-density lipoprotein cholesterol or low high-density lipoprotein cholesterol compared with the reference group. RESULTS:Thirteen studies were identified (eight using sleep duration, four sleep quality and one both). There was heterogeneity in the sleep quality aspects and types of lipids assessed. Classification of sleep duration (per hour/groups) also varied widely. In the pooled analysis of sleep duration (6 studies, 16 cohort samples; 30 033 participants; follow-up 2.6-10 years), short sleep was associated with a risk of 1.01 (95% CI 0.93 to 1.10) of developing dyslipidaemia, with moderate heterogeneity (I=56%, P=0.003) and publication bias (P=0.035). Long sleep was associated with a risk of 0.98 (95% CI 0.87 to 1.10) for dyslipidaemia, with heterogeneity (I=63%, P<0.001) and no significant publication bias (P=0.248). CONCLUSION:The present analysis was unable to find supportive evidence of a significant relationship between sleep duration and the development of dyslipidaemia. However, heterogeneity and small number of studies limit the interpretation. PROSPERO REGISTRATION NUMBER:CRD42016045242.
10.1136/bmjopen-2017-018585