Objective To evaluate the relationship between alanine transaminase (ALT) level and biphasic insulin secretion (BPIS) in healthy elderly Han Chinese individuals. Methods This cross-sectional study enrolled healthy elderly participants aged ≥60 years that were part of a health examination programme. In order to explore the correlation and severity of the clinical condition, those with any possible confounding factors known to affect insulin secretion or liver function were excluded from the study. BPIS was calculated using an equation developed previously by this research team. Results This study enrolled 39 845 healthy elderly individuals (19 058 males and 20 787 females). Participants were stratified into four quartile groups according to their ALT level. In both males and females, the increasing ALT quartiles (ordinal variable) were associated with greater values of log-transformed first-phase insulin secretion (FPIS) and second-phase insulin secretion (SPIS). The correlation and the linear regression model showed that increasing ALT level was significantly correlated with higher log-transformed FPIS and SPIS. Conclusions ALT was positively correlated with BPIS in a healthy elderly population in both men and women. Elevated ALT may serve as an indicating factor for developing metabolic syndrome and type 2 diabetes mellitus in healthy elderly individuals.
Supraventricular bigeminy in the elderly may mimic panic disorder deterioration Supraventricular premature beats-the premature activation of the atria from a site other than the sinus node-originate from either the atria (atrial premature complexes (APCs)) or the atrioventricular node (junctional premature beats), but the majority are APCs.1,2Bigeminy represents a special heart rhythm disorder wherein repeated alternation of normal and premature beats (i.e. every other beat is a premature beat) occurs. Although the APCs are seldom observed on a standard 10-s 12-lead electrocardiogram (ECG), they occasionally present in Holter monitoring lasting 24 h or longer. The frequency is approximately 0.8 APCs per hour among the population aged above 50 years, and it steadily increases with age.3 However, supraventricular bigeminy is rarely encountered on a 12-lead ECG during routine daily practice. Hyperthyroidism is a pathological disorder characterized by excess thyroid hormone synthesis and secretion from the thyroid gland. The prevalence of hyperthyroidism increases with age and is more frequent in women and white people. Approximately 0.8% and 1.3% of the population in Europe and the USA, respectively, were reported to have hyperthyroidism.4 The most common cause of hyperthyroidism is Graves' disease, an autoimmune disease with an annual incidence of 20-50 cases per 100 000 persons.5 Panic disorder is a common mental disorder in primary medical care, and it is diagnosed according to the criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.6 It is characterized by recurrent unexpected panic attacks. The crossnational lifetime prevalence was estimate to be 1.7% for panic disorder, with a median age of onset of 32 years (interquartile range: 20-47 years).7 A 63-year-old woman visited the outpatient department of an academic medical centre because of palpitation, increased anxiety, insomnia, and weight loss. She had had panic disorder for more than 10 years and had been prescribed escitalopram
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