Table of Content

15 April 2024, Volume 27 Issue 11

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Editorial

General Practice in Medicine—Reflections of Lancet's Iconic Texts at Its Milestone of 200 Anniversary (7) : Mahler's Health Establishment

YANG Hui

2024, 27(11):  0-F.  DOI: 10.12114/j.issn.1007-9572.2024.A0013

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USPSTF Recommendations Interpretation（1）

Aspirin Use to Prevent Cardiovascular Disease in Adults: Interpretation of U.S. Preventive Services Task Force Recommendations Statement

LI Mingyan, SHI Weili, DUAN Hongyan

2024, 27(11):  1277-1282.  DOI: 10.12114/j.issn.1007-9572.2023.0848

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Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In April 2022, the U.S. Preventive Services Task Force (USPSTF) updated and published recommendations on aspirin use to prevent CVD based on the latest evidence-based research results. The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years and above. The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one based on shared decision-making between clinicians and patients about the potential benefits and harms. This paper aims to interpret the latest recommendations in the context of China's actual situation, providing a reference on aspirin use to prevent CVD in China.

Current Status of Lung Cancer Screening and Interpretation of the U.S. Preventive Services Task Force Guidelines on Lung Cancer Screening

LI Yingchen, ZHAO Mingfang, WU Ying

2024, 27(11):  1283-1287.  DOI: 10.12114/j.issn.1007-9572.2023.0852

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Lung cancer is the most leading cause of global cancer mortality, underscores the critical importance of early screening and intervention to improve the prognosis and survival time and the overall survival rates of patients. For decades, lung cancer screening guidelines have been continuously updated based on the developed evidence. The U.S. Preventive Services Task Force (USPSTF) has comprehensively updated the recommendations for lung cancer screening in the 2021 version of guideline, assessed the balance of benefits and harms of lung cancer screening through a systematic review and collaborative modeling studies, and scrutinized the performance of tests using low-dose computed tomography (LDCT) for lung cancer screening. The guideline provides latest information on the start and finish time of lung cancer screening, optimal screening intervals, the relative benefits and risks of different screening strategies and updated recommendations. This article aims to interpret the updated guideline and provide recommendations for lung cancer screening in China, taking into account the epidemiology of lung cancer at home and abroad, reports on risk factors, summaries of updates to current guidelines or expert consensus, and the current status of screening.

Original Research

The Influencing Factors and Management Strategies of Multimorbidity Based on Syndemic Theory

XU Zhijie, QIAN Yi, YAN Ming, LU Yiting, ZHAO Yang

2024, 27(11):  1288-1295.  DOI: 10.12114/j.issn.1007-9572.2023.0701

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Multimorbidity increases the burden of disease and treatment for patients, which is becoming an essential research issue in the field of public health and primary care. As medical research advances, the understanding of how to deal with the challenge of multimorbidity is undergoing a profound shift, the most significant of which is the focus on the potential influence of social and environmental factors on disease clustering and development. Syndemic theory provides a new perspective for exploring the clustering of multiple conditions, as well as their interaction with social and environmental factors, which is of great significance for analyzing the interaction of chronic comorbidities at the social and environmental levels, and contributing to improve health outcomes of vulnerable populations. However, there is a lack of introduction and research on this theory in China. This article mainly reviews the basic concepts and viewpoints of the syndemic theory, as well as the classical models proposed by foreign scholars, analyzes the common disease synergistic factors with previous research findings, and puts forwards suggestions and countermeasures for general practitioners in China to improve the quality of managing multimorbidity.

Shifts in Chronic Disease and Comorbidity Patterns among Chinese Older Adults: an Analysis Based on the China Health and Retirement Longitudinal Study

XU Li, GE Jing, YU Peng, YU Ying

2024, 27(11):  1296-1302.  DOI: 10.12114/j.issn.1007-9572.2023.0634

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Background

The challenge of aging is becoming increasingly severe in China. Understanding the trends in chronic disease prevalence and comorbidity spectrum among the elderly is crucial for primary healthcare.

Objective

To analyze the prevalence and comorbidity patterns of chronic diseases among the elderly in China based on data from the China Health and Retirement Longitudinal Study (CHARLS) .

Methods

Participants aged ≥60 years from the 2011 (Wave 1) and 2015 (Wave 3) CHARLS dataset were selected. Their physical examination data and self-reported disease conditions, as well as the questionnaire data were extracted for descriptive statistical analysis of chronic disease and comorbidity prevalence, comparing changes over time. Latent class analysis (LCA) was employed to identify common clusters of comorbidities in the elderly and to assess their impact on daily living activities (evaluated using the Activities of Daily Living Scale, ADL) .

Results

A total of 7 290 individuals in 2011 and 9 845 in 2015, all aged≥60 years, were included in the study. The prevalence of chronic disease comorbidity increased from 85.96% in 2011 to 92.24% in 2015, indicating a significant rise (χ²=109.65, P<0.05). Except for pain and oral diseases, the prevalence of all other chronic diseases increased in 2015 (P<0.05). Combining self-reported diseases and laboratory results, the prevalence of overweight or obesity increased from 39.53% in 2011 to 42.88% in 2015 (χ²=35.12, P<0.01), and abdominal obesity from 45.37% to 47.99% (χ²=18.09, P<0.01). The prevalence of cardiovascular-metabolic disease comorbidity increased from 52.75% in 2011 to 60.49% in 2015 (χ²=64.39, P<0.01), becoming the primary form of chronic disease comorbidity in this population. The LCA categorized the elderly population into five comorbidity patterns in the elderly, with the "cardiovascular-metabolic + musculoskeletal diseases" pattern showing higher ADL scores compared to the "cardiovascular-metabolic diseases""musculoskeletal diseases""respiratory diseases" and "nonspecific comorbidities" patterns.

Conclusion

According to CHARLS data from 2011 and 2015, there is a high prevalence (85.96% in 2011 and 92.24% in 2015) and increasing trend in chronic disease comorbidity among Chinese individuals aged ≥60. Cardiovascular-metabolic comorbidity pattern is the most common, with many cases undetected, and the combination of cardiovascular-metabolic and musculoskeletal diseases has the most significant impact on the daily living abilities of the elderly.

Health-related Quality of Life and Its Influencing Factors among Elderly Patients with Multimorbidity in China

TIAN Wei, TAO Mengmeng, LI Kunkun, CAO Wenjun, HOU Guoqiang

2024, 27(11):  1303-1309.  DOI: 10.12114/j.issn.1007-9572.2023.0593

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Background

With the population aging, the prevalence of chronic diseases in China is increasing annually, contributing to a growing incidence of multimorbidity. Research on quality of life focuses mostly on specific diseases, such as diabetes, hypertension, and cardiovascular diseases. However, there are relatively few studies on the quality of life of multimorbidity.

Objective

To understand the status and influencing factors of the health-related quality of life (HRQoL) among elderly patients with multimorbidity, so as to provide a basis for improving their health level.

Methods

A total of 3 361 patients with multimorbidity aged ≥55 years and with complete values of key variables were selected as the study subjects by using the China Health and Retirement Longitudinal Study (CHARLS) 2018 data. The EQ-5D-3L was used to assess the HRQoL. The Age-adjusted Charlson Comorbidity Index (ACCI) was used to calculate the ten-year survival. Mann-Whitney or Kruskal-Wallis tests and the Tobit regression model were employed to explore factors influencing the HRQoL.

Results

The health utility value for elderly patients with multimorbidity was 0.888 (0.709, 0.964), the dimension with the highest proportion of "difficulty" was pain/discomfort [2 430 (72.30%) ], the dimension with the highest percentage of "severe difficulty" was mobility [593 (17.64%) ]. The highest ten-year survival rate was 90.15%, which was achieved by only 2.44% (82/3 361) of patients; the majority of patients [848 (25.23%) ] had a ten-year survival rate of 21.36%, and 43.59% (1 465/3 361) had a ten-year survival rate close to zero. The Tobit regression results showed that primary school degree or above and non-smoking behavior were protective factors for HRQoL; while female, aged over 60 years, widowhood, self-rated health status as poor, non-drinking behavior, insufficient or excessive sleep duration, no moderate-intensity activity, four or more chronic diseases, and more than three outpatient visits were risk factors for HRQoL (P<0.05) .

Conclusion

The HRQoL among Chinese elderly patients with multimorbidity was relatively poor, and factors such as marital status, educational level, sleep duration, physical activity, number of chronic diseases deserve to be focused on. Healthy lifestyle guidance for elderly patients with multimorbidity should be strengthened to further improve the quality of life of this population.

Distribution and Influencing Factors of Chronic Comorbidities among Middle-aged Inpatients in General Practice Department of Tertiary General Hospitals

KANG Jing, ZHANG Ci, ZHANG Zhengyi

2024, 27(11):  1310-1315.  DOI: 10.12114/j.issn.1007-9572.2023.0710

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Background

Recent studies have found that middle-aged individuals account for over 40% of patients with chronic disease comorbidities, and this percentage is still increasing. This comorbidity not only reduces the quality of life for these patients but can also lead to premature death. However, research on the distribution and influencing factors of chronic comorbidities in middle-aged adults is still limited.

Objective

To provide a scientific basis for managing such patients by retrospectively analyzing the disease distribution and influencing factors of chronic comorbidities among middle-aged inpatients.

Methods

From July 1, 2017 to February 28, 2023, a total of 5 931 inpatients were admitted to the Department of General Medicine, the Second Hospital of Lanzhou University. Among them, 1 650 middle-aged patients (aged 45 to 59 years) were included as subjects for this study. General information of the subjects was collected, and the comorbidity conditions of chronic diseases were statistically analyzed. Multifactorial Logistic regression analysis was employed to investigate the influencing factors associated with different chronic disease comorbidities.

Results

Among the 1 650 middle-aged patients attending the department of general practice, 79 (4.8%), 359 (21.8%), and 1 212 (73.4%) patients suffered from 0, 1, and ≥2 chronic diseases, respectively. Comparison of gender, age, ethnicity, occupation, and route of admission of patients with 0, 1, and ≥2 chronic diseases showed statistically significant differences (P<0.05). The three most common chronic diseases were heart disease (66.1%, 1 091/1 650), hypertension (41.1%, 678/1 650), and cerebrovascular disease (20.7%, 342/1 650). The top three comorbid conditions with other chronic diseases were diabetes or hyperglycemia (97.3%, 215/221), hypertension (98.5%, 668/678), and dyslipidemia (96.1%, 246/256). Of the 1 650 middle-aged patients hospitalized in general practice, 581 (35.2%) had 2 chronic comorbidities and 455 (27.6%) had 3 chronic comorbidities. Among patients with two comorbidities, the most frequent combinations were heart disease+hypertension (22.7%, 132/581), heart disease+chronic lung disease (13.1%, 76/581), and heart disease+cerebrovascular disease (8.4%, 49/581) ; for three comorbidities, the top combinations were hypertension+heart disease+cerebrovascular disease (14.5%, 66/455), hypertension+heart disease+diabetes or hyperglycemia (10.5%, 48/455), and hypertension+heart disease+chronic lung disease (7.9%, 36/455). Multivariate Logistic regression analysis showed that ethnicity of Han (OR=26.778, 95%CI=3.120-229.793), Hui (OR=46.143, 95%CI=3.456-616.090), or Dongxiang (OR=52.966, 95%CI=2.502-1 121.195) were influencing factors for middle-aged inpatients with 1 chronic disease (P<0.05). For ≥2 chronic diseases, influencing factors included 50-54 age group (OR=0.461, 95%CI=0.266-0.801), being of Han (OR=3.783, 95%CI=1.433-9.983) or Hui (OR=6.055, 95%CI=1.107-33.126) ethnicity, occupation of farmer (OR=0.460, 95%CI=0.252-0.839) (P<0.05) .

Conclusion

Approximately one-third of patients in the general practice department of tertiary hospitals are middle-aged, and most of them present with chronic comorbidities. While focusing on the chronic diseases of the elderly, there is a need for enhanced focus on chronic diseases management and clinical awarenes improvement in middle-aged individuals, enhancing the content of health management services provided by general practitioners, and establishing a more comprehensive model of general practice services. Additionally, research indicates that patients with diabetes are more prone to chronic disease comorbidities. The phenomenon is particularly prevalent among residents of Hui or Han ethnicity. These groups should receive focused attention during screening and management processes.

Analysis of the Effectiveness of Different Atrial Fibrillation Screening Methods in the Community-based Elderly Population

SHI Yushuang, WANG Huihua, LI Yan, LU Ping, SONG Wei, PAN Guijun

2024, 27(11):  1316-1319.  DOI: 10.12114/j.issn.1007-9572.2023.0723

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Background

Older adults are at high risk for atrial fibrillation (AF). Improving the efficiency of AF screening among the community-based elderly population can help to reduce the risk of AF-related stroke.

Objective

To compare the screening efficiency of different AF screening methods in the elderly population.

Methods

A total of 1 300 cases of older adults were selected from three neighborhood committees of Xiangshan, Huangshan, and Luoshan in Jinyang Community, Pudong New Area, Shanghai from July 2022 to January 2023. AF screening was detected using palpation of radial artery pulse, electronic sphygmomanometer with AF detection function, and single-lead ECG recorder. A positive result of any one of the three methods was considered positive for AF, and finally an electrocardiogram (ECG) was performed and interpreted by a physician in the ECG room. The receiver operating characteristic (ROC) curves of the subjects with different screening methods were plotted, the area under the ROC curve (AUC) was calculated to evaluate the screening value; the association between AF stroke score (CHA₂DS₂-VASc score) and AF was analyzed using the chi-square test for trend.

Results

AF was detected in 93 of the 1 300 people, including 57 asymptomatic people; 375 people had a positive palpated pulse, 331 people had a positive electronic blood pressure monitor with AF detection function, and 128 people had a positive result of single-lead ECG recorder. The AUCs for the diagnostic value of palpation pulse, electronic sphygmomanometer with AF detection function and single-lead ECG recorder in the elderly was 0.750 (95%CI=0.697-0.803, P<0.01), 0.832 (95%CI=0.790-0.874, P<0.01), 0.939 (95%CI=0.906-0.973, P<0.01) ; the incidence of AF in the elderly gradually increased as the CHA₂DS₂-VASc score increased (χ²_trend=197.46, P<0.01) .

Conclusion

Screening for AF using single-lead ECG recorder is convenient, efficient and accurate, and can be promoted in AF screening among community-based elderly population.

A Threshold Study of Carotid Plaque Risk in Postmenopausal Middle-aged Women with Normal Homocysteine

LU Ran, WU Chunyan, XU Haina, AN Miaomiao, WU Baoqin, LAI Jun, RAN Limei

2024, 27(11):  1320-1325.  DOI: 10.12114/j.issn.1007-9572.2023.0677

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Background

Carotid plaque is an important early predictive signal of clinical carotid atherosclerosis, the association between homocysteine (Hcy) and carotid plaque is well recognized, however, the correlation between Hcy and carotid plaque in postmenopausal middle-aged women is not established.

Objective

To analyze the impact of Hcy within the normal reference range on the risk of carotid plaque in postmenopausal middle-aged women and determine the risk threshold.

Methods

A total of 1 465 postmenopausal women (Hcy<15 μmol/L) who underwent health examinations at the Affiliated Hospital of Guizhou Medical University between January 2020 and June 2023 were randomly selected. The general information, blood biochemical indicators, and carotid ultrasound indicators of patients were collected, and multivariate Logistic regression analysis was used to explore the association between Hcy and carotid plaque. The cutoff value of Hcy for predicting the risk of carotid plaque in postmenopausal middle-aged women with normal Hcy range was determined by plotting the receiver operating characteristic (ROC) curve.

Results

Six hundred and forty-four (43.96%) out of 1 465 study subjects had carotid artery plaques. Age, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triacylglycerol (TG), and Hcy were higher in the plaque group than in the non-plaque group, high-density lipoprotein cholesterol (HDL-C) was lower than in the non-plaque group (P<0.05). Logistic regression analysis showed that age (OR=1.100, 95%CI=1.070-1.130), SBP (OR=1.021, 95%CI=1.012-1.030), LDL-C (OR=1.232, 95%CI=1.077-1.411), HDL-C (OR=0.568, 95%CI=0.387-0.835) and Hcy (OR=1.142, 95%CI=1.080-1.207) were independent risk factors for carotid plaque in postmenopausal middle-aged women. ROC curve analysis indicated that Hcy≥11.87 μmol/L was the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women within the normal Hcy range, with the area under curve (AUC) of 0.605, specificity of 75.8% and sensitivity of 40.4%.

Conclusion

Hcy is an independent risk factor for carotid plaque in postmenopausal middle-aged women, and Hcy≥11.87 μmol/L is the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women with normal Hcy. This threshold may provide an important reference for clinical assessment of carotid plaque risk in postmenopausal middle-aged women.

Predictive Value of Sarcopenia Index for Prognosis in Elderly Patients with Acute Ischemic Stroke

XIE Yi, XU Junma, XU Fangqin, LI Chao, CHEN Chen, SHAO Chan

2024, 27(11):  1326-1330.  DOI: 10.12114/j.issn.1007-9572.2023.0689

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Background

Poor prognosis in elderly patients with acute ischemic stroke (AIS) has put great pressure on public health. Actively searching for simple and easy-to-operate clinical indicators to screen high-risk groups with poor prognosis has become a hot issue.

Objective

To analyze the predictive value of sarcopenia index (SI) on the prognosis of elderly patients with AIS.

Methods

A total of 280 elderly AIS patients hospitalized in Changzhou Jintan First People's Hospital from July 2021 to June 2022 were selected and divided into the poor prognosis group (≥3 points) and good prognosis group (≤2 points) according to the Modified Rankin Scale (mRS). Baseline data and National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge were compared between the two groups. Multivariate Logistic regression analysis was used to explore the factors affecting the prognosis of elderly patients with AIS, and a receiver operating characteristic (ROC) curve was plotted to analyze the value of SI in predicting poor prognosis in elderly patients with AIS.

Results

There were 212 cases in the good prognosis group and 68 cases in the poor prognosis group. There were significant differences in the history of diabetes and previous stroke, neutrophil count (NE), lymphocyte count (LY), albumin (ALB), admission NIHSS score, discharge NIHSS score, and SI between patients between the poor prognosis group and good prognosis group (P<0.05). Spearman rank correlation analysis results showed that SI was negatively correlated with the prognostic mRS score (r_s=-0.195, P=0.001), admission NIHSS score (r_s=-0.163, P=0.006), and discharge NIHSS score (r_s=-0.205, P=0.001). The results of multivariate Logistic regression analysis showed that SI was an independent factor affecting the prognosis of elderly patients with AIS (OR=0.959, 95%CI=0.927-0.992, P=0.015). ROC curve analysis showed that the area under the ROC curve (AUC) for SI to predict poor prognosis in elderly AIS patients was 0.694 (95%CI=0.619-0.769), with a sensitivity of 69.3%, specificity of 64.7%, and cutoff value of 63.46; the enrolled patients were divided into Q1, Q2, Q3, and Q4 groups according to the quartiles of SI, with 70 cases in each group, there were significant differences in the age, history of AF and previous stroke, UA, Hcy, mRS score, admission NIHSS score, and discharge NIHSS score among the Q1, Q2, Q3, and Q4 groups (P<0.05) .

Conclusion

SI is significantly reduced in the poor prognosis group of elderly AIS patients. SI is an independent influencing factor for poor prognosis in elderly AIS patients with good predictive value.

Characteristics and Risk Factors of Preserved Ratio Impaired Spirometry in Physical Examination Population

SHANG Jinmeng, DENG Xiaowei

2024, 27(11):  1331-1336.  DOI: 10.12114/j.issn.1007-9572.2023.0279

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Background

Preserved Ratio Impired Spirometry (PRISm) refers to the non-obstructive pulmonary function abnormalities with a decrease forced expiratory volume in one second (FEV₁) while the FEV₁/forced vital capacity (FVC) remains constant. The PRISm population may be one of the pre-chronic obstructive pulmonary disease (COPD) populations. However, the incidence, characteristics and risk factors of PRISm in the physical examination population in China are still unknown.

Objective

To analyze the characteristics and influencing factors of PRISm in physical examination population.

Methods

From January 2017 to December 2019, a total of 970 patients received physical examination in the Third Medical Center of Chinese PLA General Hospital were selected. The baseline data and physical examination results were collected, pulmonary function was measured for vital capacity (VC), FVC, FEV₁, forced expiratory volume in six second (FEV₆), FEV₁/FVC, peak expiratory flow (PEF), FEF₂₅, FEF₅₀ and FEF₇₅, the relevant indexes were expressed as "%pre" as a percentage of the expected value. The included subjects were divided into the airflow obstruction group with FEV₁/FVC<0.7 (n=61), PRISm group with FEV₁/FVC≥0.7 and FEV₁%pre<0.8 (n=111), normal lung function group with FEV₁/FVC≥0.7 and FEV₁%pre≥0.8 (n=798) according to FEV₁/FVC and FEV₁%pre. The incidence of PRISm in physical examination population was calculated, the basic characteristics and the characteristics of lung function indexes were compared, the ordinal logistic regression analysis were used to analyze the influencing factors of lung function impairment.

Results

The incidence of PRISm was 11.4% and the incidence of airflow obstruction was 6.3% in 970 patients. The proportion of people over 60 years old in the PRISm group and the airflow obstruction group was higher than that the normal lung function group, and the proportion of people between 41 and 60 years old was lower than the normal lung function group (P=0.019). The proportion of smokers in the PRISm group was significantly higher than the normal lung function group (P<0.001). The proportion of patients with hypertension in the PRISm group was higher than the normal lung function group (P=0.03). VC%pre, FVC%pre, FEV₁%pre, FEV₆%pre, PEF%pre, FEF₂₅%pre, FEF₅₀%pre, FEF₇₅%pre were higher in the normal lung function group than the PRISm group and the airflow obstruction group (P<0.001) ; VC%pre, FVC%pre, FEV₆%pre, PEF%pre, FEF₂₅%pre, FEF₅₀%pre, and FEF₇₅%pre were higher in the PRISm group than the airflow obstruction group (P<0.05). FEV₁/FVC in the normal lung function group and PRISm group was higher than the airflow obstruction group (P<0.001). The ordinal logistic regression analysis with different groups of lung function as dependent variables showed that age>60 years (OR=0.951, 95%CI=0.602-1.504, P=0.002), smoking history (OR=2.201, 95%CI=1.519-3.187, P<0.001) and history of hypertension (OR=1.673, 95%CI=1.106-3.187, P=0.015) were risk factors for lung function impairment in the physical examination population.

Conclusion

PRISm is common in physical examination population. Attention should be paid to the changes in lung function in those aged >60 years old, with the history of smoking and hypertension. Early intervention may alleviate the progression of COPD.

Relationship between Serum Liver Transaminase and Metabolic Syndrome in the Aged Based on Restrictive Cubic Spline Model

WANG Wenjuan, WANG Rui, ZENG Hongji, LIU Yahui, WEI Shufan, TIAN Qingfeng

2024, 27(11):  1337-1342.  DOI: 10.12114/j.issn.1007-9572.2023.0696

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Background

Metabolic syndrome (MS) has become a global health problem, and most studies have focused on the correlation of MS and its components with alanine aminotransferase (ALT) and aspartate aminotransferase (AST), but whether there is a dose-response relationship of ALT and AST with MS needs to be further explored.

Objective

To explore the relationship of ALT and AST with the risk of MS in the elderly, and provide a reference basis for the prevention and control of MS.

Methods

A health examination with multi-stage sampling method was conducted to residents (≥60 years) from 162 townships (streets) under jurisdiction of 18 cities of Henan Province in 2022. The investigation was performed with physical examination and laboratory test. Logistic regression model combined with restricted cubic spline model was recruited to analyze the relationship of ALT and AST with the risk of MS.

Results

Totally, 112 605 research participants were enrolled, of whome the prevalence of MS was 18.6% (20 935/112 605), ALT abnormality was 5.4% (6 132/112 605), and AST abnormality was 6.8% (7 661/112 605). The MS group showed a higher level of ALT and a lower level of AST than the non-MS group (P<0.05). The Logistic regression analysis and trend test results showed that the risk of MS increased with increasing ALT levels in both the total population and gender stratification, with a "U" shaped trend with AST level after adjustment for confounders (P<0.05). Restricted cubic spline model results showed a positive linear dose-response relationship between ALT and the risk of MS in both total population and gender stratification (P for overall<0.001, P for nonlinear>0.05), and a nonlinear dose-response relationship between AST and the risk of MS (P for overall<0.001, P for nonlinear<0.001), with an approximate "U" -shaped curve.

Conclusion

ALT, especially the elevated ALT level, and AST are conductive to be predictors for the development of MS.

Analysis of Clinical Characteristics and Maternal and Neonatal Outcomes in Pregnancy Complicated with Acute Pancreatitis Patients of Different Etiologies

XU Jun, QI Wenjie, WANG Chao, HU Lan, MIAO Bin

2024, 27(11):  1343-1348.  DOI: 10.12114/j.issn.1007-9572.2023.0510

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Background

Due to economic development changes in domestic fertility policy, the incidence of acute pancreatitis in pregnancy (APIP) has been gradually increasing. The clinical characteristics of APIP of different etiologies are different, and there may be significant differences in the prognosis for mothers and infants, but previous studies on this are relatively few.

Objective

To analyze the clinical characteristics and maternal and neonatal outcomes in pregnancy complicated with acute pancreatitis patients of different etiologies.

Methods

A total of 48 inpatients with APIP in Beijing Friendship Hospital, Capital Medical University from 2016 to 2022 were collected, which were divided into the biliary group (n=27) and hyperlipidemic group (n=21). The laboratory indicators and maternal and infant outcomes in the two groups were compared.

Results

The biliary group had a longer time of onset to visit, a smaller gestational week at admission, more previous pregnancies, and lower percentage of diarrhea and cessation of defecation than the hyperlipidemic group (P<0.05). There was no statistically significant difference in severity between the two groups of patients (P=0.912). The levels of hemoglobin, platelets, C-reactive protein, cholesterol, and triacylglycerol in the biliary group were lower than those in the hyperlipidemia group, while the levels of total bilirubin, direct bilirubin, alanine transaminase, alkaline phosphatase, glutamyltranspeptidase, creatinine, calcium, sodium, amylase, and N-terminal brain natriuretic peptide precursor were higher than those in the hyperlipidemia group (P<0.05). The gestational week at delivery of the biliary group was shorter than the hyperlipidemia group (P<0.05). There was no statistically significant difference in premature delivery rate, cesarean section rate, and artificial intervention termination of pregnancy rate between the biliary group and hyperlipidemia group (P>0.05). The birth weight of the biliary group was smaller than the hyperlipidemia group, while the birth length was shorter than the hyperlipidemia group. The incidence of neonatal jaundice, respiratory distress, and ventilator-assisted breathing was higher than the hyperlipidemia group (P<0.05) .

Conclusion

Biliary diseases are still the first cause of APIP patients, which can significantly shorten the maternal gestational week, cause low fetal body mass, increase the incidence of pathological jaundice, respiratory distress, and ventilator-assisted breathing in the fetus, leading to a more severe prognosis for the fetus.

Comparison of the Predictive Value of Four Nutritional Evaluation Methods for Postoperative Complications of Lumbar Degenerative Diseases

ZENG Li, WANG Huihui, WANG Xiaoyu, GONG Weiyi, HU Chunqiu

2024, 27(11):  1349-1355.  DOI: 10.12114/j.issn.1007-9572.2023.0410

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Background

The occurrence of postoperative complications in lumbar degenerative disease (LDD) is closely related to malnutrition, and currently there is a lack of nutritional evaluation methods that can effectively, objectively, and comprehensively assess the nutritional status of LDD patients and predict the occurrence of postoperative complications.

Objective

To compare the predictive value of four nutritional evaluation methods of Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), Naples Prognostic Score (NPS) and High-sensitivity Modified Glasgow Prognostic Score (HS-mGPS) for postoperative complications in patients with LDD, so as to formulate a precise nutritional intervention plan and effectively prevent complications.

Methods

A total of 201 patients diagnosed with LDD and underwent open surgery in Spine Surgery Department of Xiangya Hospital of Central South University from December 2021 to July 2022 were selected as the study subjects, four nutritional evaluation methods of PNI, CONUT, NPS and HS-mGPS were applied to assess the preoperative nutritional status of the patients, respectively, and occurrence of postoperative complications from postoperative period to hospital discharge were observed. The patients were divided into the complication group and non-complication group according to the occurrence of postoperative complications to analyze and compare the difference in clinical characteristics between the two groups; the optimal cut-off values of different nutritional evaluation methods were calculated by plotting the receiver operating characteristic (ROC) curve, and the prediction efficiency of different evaluation methods was compared, the area under curve (AUC) was compared by using MedCalc software. Multivariate Logistic regression model was used to analyze the correlation between different nutritional evaluation methods and postoperative complications.

Results

Postoperative complications occurred in 60 patients with an incidence rate of 29.8%. The comparison of clinical characteristics data showed statistically significant differences in age, gender, intraoperative bleeding, surgical segment, PNI, CONUT, and NPS scores between the complication group and non-complication group (P<0.05). The optimal cut-off values of PNI, CONUT, NPS, and HS-mGPS for predicting postoperative complications of LDD were calculated by using ROC curve were 47.5, 2 scores, 1 score, and 1 score, respectively, and the different nutritional evaluation methods were compared within the group based on the cut-off values, showing that low PNI score, high CONUT score, and high NPS score were associated with postoperative complications (P<0.01), while high HS-mGPS score was not associated with postoperative complications (P=0.815). The comparison of AUC showed statistically significant differences between CONUT and HS-mGPS (Z=4.961, P<0.000 1), CONUT and NPS (Z=2.534, P=0.011 3), CONUT and PNI (Z=3.455, P=0.000 6), HS-mGPS and NPS (Z=3.349, P=0.000 8), NPS and PNI (Z=2.025, P=0.042 9) ; there was no statistically significant difference between HS-mGPS and PNI (Z=1.594, P=0.110 9). Multivariate Logistic regression analysis showed that CONUT (OR=2.431, 95%CI=1.376-4.295, P=0.002), surgical segment (OR=11.924, 95%CI=5.491-25.893, P<0.001) were independent influencing factors for postoperative complications after LDD.

Conclusion

Among the four nutritional evaluation methods used to predict postoperative complications of LDD patients, CONUT score is the most effective and can be used as an independent predictor of postoperative complications of LDD.

Effect and Mechanism of Optimized Kuijie Decoction in Ulcerative Colitis Rats with TCM Syndrome Differentiation of Qi Stagnation and Blood Stasis

ZHANG Shuai, LI Na, SHEN Jiangli, LIU Yuedong, WU Xianshu, WANG Lei, SHENG Tianjiao, XU Hongjun, AN Shengjun

2024, 27(11):  1356-1362.  DOI: 10.12114/j.issn.1007-9572.2023.0732

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Background

Experiential effective prescription optimized Kuijie decoction can effectively improve the quality of life of patients with ulcerative colitis (UC), promote the intestinal mucosal healing and clinical remission, but its mechanism remains unclear now.

Objective

To investigate the effect and mechanism of optimized Kuijie decoction in UC rats with TCM syndrome differentiation of Qi stagnation and blood stasis.

Methods

From September to October 2023, 70 SPF-grade male SD rats were randomly divided into the blank-control, model, salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups, with 10 rats in each group. UC model with TCM syndrome differentiation of Qi stagnation and blood stasis was established by trinitrobenzenesulfonic acid (TNBS) /ethanol secondary inflammation combined with restraint method. Rats in the blank-control group were enucleated with 0.9% sodium chloride solution at the time of modeling and were grasped and fixed synchronously with the rats in the other groups, and were given an equal volume of water by gavage once per day after the establishing for 14 days; rats in the model group were given an equal volume of water by gavage once per day after the establishing for 14 days; rats in the salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups were given intragastric administration with salicylazosulfapyridine suspension (0.54 g/kg), low-dose optimized Kuijie decoction (0.837 g/kg), standard-dose optimized Kuijie decoction (1.674 g/kg), Astragalus suspension (1.8 g/kg) and Safflower suspension (0.9 g/kg) once per day after the establishing for 14 days, respectively. High-precision transmission electron microscope was used to observe the ultrastructural changes in the colonic tissues of the seven groups of rats after intervention, the expression levels of CXCR4, VEGFA, and TAK1 were compared among the seven groups of rats after intervention.

Results

The ultrastructure of colonic tissue of rats in the low-dose and standard-dose groups tended to be normal after intervention. The gray ratios of proteins and relative mRNA expression quality of CXCR4, VEGFA and TAK1 in colonic tissues of rats in the model group were higher than the blank-control after intervention (P<0.05) ; the gray ratios of proteins and relative mRNA expression quality of CXCR4, VEGFA and TAK1 in the salicylazosulfapyridine, low-dose, standard-dose, Qi-enhancing and Blood-activating groups were significantly lower than those in the model group (P<0.05) ; the gray ratios of proteins of CXCR4, VEGFA and TAK1 in the standard-dose group were significantly lower than those in the salicylazosulfapyridine group, relative mRNA expression quality of VEGFA and TAK1 in the Blood-activating group was significantly lower than that in the salicylazosulfapyridine group, respectively (P<0.05) .

Conclusion

Optimized Kuijie decoction and its Qi-enhancing and Blood-activating components can effectively reduce the expression of CXCR4, VEGFA and TAK1 in colonic tissue in UC rats with TCM syndrome differentiation of Qi stagnation and blood stasis, its therapeutic effect may act through the coordinate regulating of the expression of CXCR4, VEGFA and TAK1 in colonic tissue by Qi-enhancing component and blood-activating component.

The Detection Rate of Postpartum Depression in Advanced Maternal Age in China: a Meta-analysis

LI Long, AN Xuemei, ZHANG Jie, HUANG Linyu, ZHANG Xingling

2024, 27(11):  1363-1369.  DOI: 10.12114/j.issn.1007-9572.2023.0635

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Background

With the rapid development of economy and the change of fertility concept in modern population, the number of advanced maternal age is increasing year by year. Compared with appropriate maternal age, advanced maternal age is more likely to suffer from depressive symptoms due to personal, family, work, and other reasons.

Objective

To systematically evaluate the detection rate of postpartum depression in advanced maternal age (≥35 years at delivery) in China to provide relevant evidence for early prevention and intervention.

Methods

CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science were searched for articles on the detection rate of postpartum depression in advanced maternal age in China by combining subject terms and free terms from inception to July 2023. The process of literature screening, data extraction and quality assessment were carried out by two researchers independently. Stata 16.0 software was used for data analysis.

Results

A total of 21 studies were included, with a total sample size of 5 163. The results of Meta-analysis showed that the overall detection rate of postpartum depression in advanced maternal age in China was 20.0% (95%CI=17.4%-22.6%). The subgroup analysis revealed that the detection rate of postpartum depression was 19.5% (95%CI=13.8%-25.3%) in women < 40 years old, 40.3% (95%CI=11.4%-69.3%) in women ≥ 40 years old, 19.7% (95%CI=11.7%-27.7%) in women with high school education level or higher, 30.7% (95%CI=19.1%-42.3%) in women with high school education level or lower, 21.1% (95%CI=14.4%-27.9%) in primipara, 16.2% (95%CI=12.9%-19.6%) in multipara, 16.4% (95%CI=12.2%-20.6%) in natural childbirth, 27.8% (95%CI=20.9%-34.8%) in cesarean section, 20.7% (95%CI=15.6%-25.8%) in women with male newborn and 27.3% (95%CI=20.5%-34.0%) in women with female newborn; there were 38.7% (95%CI=22.6%-54.8%) women with pregnancy complications, 11.7% (95%CI=7.6%-15.8%) women without pregnancy complications, 29.5% (95%CI=17.9%-41.1%) women with adverse pregnancy and childbirth history, 27.7% (95%CI=16.6%-38.8%) women without adverse pregnancy and childbirth history, 18.0% (95%CI=16.5%-19.4%) published the year before 2020, 19.5% (95%CI=18.0%-21.0%) published the year after 2020, 20.4% (95%CI=18.2%-22.6%) in the north and 18.2% (95%CI=17.0%-19.4%) in the south, 20.0% (95%CI=18.5%-21.5%) in the Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13 and 16.9% (95%CI=15.2%-18.5%) in the EPDS score ≥ 10. The Egger's test (t=1.76, P=0.095) and the Begg's test (Z=1.48, P=0.147) indicated no significant publication bias.

Conclusion

The detection rate of postpartum depression is higher for advanced maternal age in China, including women ≥ 40 years old, with high school education level or lower, primipara, cesarean section, female newborn, pregnancy complications and adverse pregnancy and childbirth history, publish year after 2020, areas of the north, EPDS score ≥ 13, attention should be paid to the psychological status of advanced maternal age, and corresponding prevention and intervention measures should be formulated.

Prevalence and Influencing Factors of Osteoporosis in Postmenopausal Women: a Meta-analysis

HE Haiyang, YANG Jialing, LEI Xun

2024, 27(11):  1370-1379.  DOI: 10.12114/j.issn.1007-9572.2023.0688

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Background

With the aging of the population, the health threat of osteoporosis (OP) has become more prominent. The prevalence of OP in postmenopausal women will further increase to three times of that in men due to the reduction of ovarian estrogen secretion. The prevalence and risk factors of OP in postmenopausal women have been widely reported and systematically summarized, however, there are few systematic reviews of relevant studies worldwide.

Objective

To systematically review the prevalence and influencing factors of OP in postmenopausal women.

Methods

PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and CBM were searched for studies on the prevalence and influencing factors of OP in postmenopausal women from 2002-11-01 to 2022-11-01; in addition to literature tracking based on the references in the included studies. Two reviewers independently conducted literature screening and information extraction, the quality was evaluated using the risk of bias assessment criteria recommended by the Agency for Healthcare Research and Quality. A Meta-analysis on the prevalence and influencing factors of OP in postmenopausal women was performed using Stata 16.0 software.

Results

A total of 68 articles were included, with a total sample size of 112 097 cases. Meta-analysis showed that the prevalence of OP and osteopenia in postmenopausal women was 34.73% (95%CI=31.02%-38.44%) and 41.83% (95%CI=38.19%-45.47%), respectively. Subgroup analysis showed that the highest prevalence was found in the age≥80 years group (68.72%, 95%CI=59.81%-77.62%), followed by the age of 70-79 years group (57.20%, 95%CI=50.53%-63.87%) and the age of 60-69 years group (37.46%, 95%CI=28.95%-45.98%), the age of 50-59 years group (24.94%, 95%CI=15.50%-34.39%), the age of 40-49 years group (14.01%, 95%CI=6.64%-21.38%) ; the prevalence rate of <2 births (34.24%, 95%CI=24.08%-44.41%) was lower than that of ≥2 births (39.27%, 95%CI=30.10%-48.44%) ; the prevalence of age ≥10 years menopause (47.15%, 95%CI=42.27%-52.04%) was higher than that of <10 years menopause (34.18%, 95%CI=33.30%-35.06%) ; the prevalence in developing countries (35.87%, 95%CI=31.39%-40.34%) was higher than that in developed countries (30.10%, 95%CI=23.97%-36.23%). The influencing factors of OP in postmenopausal women included diabetes (OR=2.79, 95%CI=1.75-4.46, P<0.05) ; high BMI (OR=0.53, 95%CI=0.43-0.64, P<0.05) ; exercise (OR=0.43, 95%CI=0.28-0.65, P<0.05) ; number of births (OR=2.52, 95%CI=1.72-3.67, P<0.05) ; duration of menopause (OR=1.88, 95%CI=1.43-2.46, P<0.05) ; family history (OR=1.92, 95%CI=1.38-2.67, P<0.05) ; alcohol consumption (OR=1.95, 95%CI=1.54-2.47, P<0.05), menopausal hormone therapy (OR=0.34, 95%CI=0.25-0.44, P<0.05) ; non-violent fracture history (OR=3.83, 95%CI=1.88-7.98, P<0.05) ; and age (OR=1.43, 95%CI=1.29-1.59, P<0.05) .

Conclusion

The prevalence of OP and osteopenia in postmenopausal women is high, with about one third of postmenopausal women suffering from osteoporosis, and about half of postmenopausal women suffering from osteopenia. High BMI, regular exercise, and use of menopausal hormone therapy are protective factors for OP in postmenopausal women, while diabetes, high number of births, long years of menopause, family history of disease, alcohol consumption, non-violent fracture history, and advanced age are risk factors. The evaluation and intervention of OP should be strengthened in clinical practice, and it is also necessary to promote healthy lifestyle to postmenopausal women to improve their quality of life.

Burden of Cardiovascular Diseases Attributable to Diabetes among Chinese Adults from 1990 to 2019

LIANG Dong, YANG Chenglin, LIN Xiaoru, ZHAO Yang, OUYANG Jiang, LIN Xiuquan

2024, 27(11):  1380-1386.  DOI: 10.12114/j.issn.1007-9572.2023.0627

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Background

Against the backdrop of global aging, the number of patients with chronic diseases is increasing, and the multimorbidity is becoming more severe. Traditionally, cardiovascular diseases and type 2 diabetes are mostly considered diseases of the elderly. However, with changes in lifestyle patterns such as the pace of life and diet, many diseases are showing a trend of rejuvenation. Recent studies have also shown that individuals who develop diabetes at a young age have an increased relative risk of developing cardiovascular diseases and higher mortality rates compared to the general population.

Objective

To investigate the burden of cardiovascular diseases attributed to diabetes among Chinese adults from 1990 to 2019, so as to provide evidence for comorbidity prevention.

Methods

Based on the 2019 Global Burden of Disease (GBD) study data, indicators such as mortality rates, disability-adjusted life years (DALY) rates, and estimated annual percentage change (EAPC) were used to assess the burden of cardiovascular diseases in China (including ischemic heart disease, stroke, and peripheral arterial disease) attributed to diabetes. The analysis was stratified by age group (25-49 years, 50-69 years, ≥70 years) and gender, and the temporal trends in disease burden were finally analyzed.

Results

The number of cardiovascular disease deaths attributable to diabetes increased from 298 050 in 1990 to 700 340 in 2019 among people aged 25 years and older in China. The age-standardized mortality rate for CVD attributed to diabetes increased for males compared to 1990, while it decreased for females, with males consistently having higher rates than females. In 2019, the DALY for CVD attributed to diabetes was 13 585 850 person-years. The age-specific mortality rate and DALY rate increased with age. The downward trend in standardized DALY rate was more pronounced in females (EAPC=-0.32%, 95%CI=-0.49% to -0.11%) than in males (EAPC=-0.01%, 95%CI=-0.26% to 0.29%). The mortality and DALY rates for ischemic heart disease and peripheral arterial disease attributed to diabetes increased in the three age groups from 1990 to 2019, while the mortality rates for stroke attributed to diabetes declined in all three age groups in 2019 compared to 1990. The percentage of standardized DALY rates attributable to diabetes for the 3 cardiovascular diseases in cardiovascular disease fluctuated from 1990 to 2019. However, the percentage of standardized DALY rates for all 3 cardiovascular diseases attributable to diabetes was higher in 2019 than in 1990.

Conclusion

From 1990 to 2019, there has been an overall increasing trend in the mortality and DALY rates of cardiovascular diseases attributed to diabetes among adults in China. Population is at greater risk for comorbidities of diabetes and CVD, emphasizing the need to focus on screening for CVD among individuals with diabetes or those at high risk of developing CVD. Emphasis should be placed on males, the elderly, and younger individuals with unhealthy lifestyle habits for early health interventions to reduce the burden of comorbidities.

Trend and Forecast Analysis of Premature Mortality Probability by Four Major Non-communicable Diseases in Baise from 2015 to 2021

ZHANG Shengnan, XU Shihua, HUANG Rongchao, CHEN Jian, ZHAO Chunru, MENG Minglyu, MA Yingjiao

2024, 27(11):  1387-1394.  DOI: 10.12114/j.issn.1007-9572.2023.0427

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Background

The disease burden of non-communicable diseases (NCDs) among residents in China is relatively severe, which had become an important influencing factor in limiting the increase of healthy life expectancy of the population.

Objective

To identify the premature mortality of four major NCDs (cancer, cardiovascular and cerebrovascular diseases, diabetes and chronic respiratory diseases) and the achievement of "Health China 2030" goal in Baise from 2015 to 2021, so as to provide reference for the development of prevention and control strategies for NCDs in western poverty-stricken regions.

Methods

The mortality data registered in the cause of death surveillance system of the Baise Center for Disease Prevention and Control from 2015-2021 was collected, indicators such as mortality and the probability of premature mortality were calculated, Joinpoint 24.0 software was used to describe the trend of change in terms of average annual percentage change (AAPC) and rate.

Results

The crude mortality of the four major NCDs was 549.06/100 000 (AAPC=0.13%) and the age-standardized mortality was 302.92/100 000 (AAPC=-5.66%) from 2015-2021, with no significant change in any of them (P>0.05). The age-standardized mortality in women showed a significant decrease (AAPC=-1.66%, P=0.046). There was an increasing trend in the crude mortality for cardiovascular disease in the total population, males, and females (AAPC=2.74%, P=0.004; AAPC=2.43%, P=0.013; AAPC=3.17%, P=0.011), and a decreasing trend in the standardized mortality rate for chronic respiratory diseases in men and women (AAPC=-8.66%, P=0.023; AAPC=-8.17%, P=0.027). The probability of premature mortality of the four major NCDs was 15.77%, 26.03% and 10.42% for the total population, men and women, with a decreasing trend from chronic respiratory diseases (AAPC=-6.89%, P=0.012; AAPC=-7.18%, P=0.007; AAPC=-6.94%, P=0.020). The probability of premature mortality from four NCDs in men was about 2.5 times higher than that in women. According to the average growth rate of the probability of premature mortality of the 4 NCDs in Baise City from 2015-2021, the probability of premature mortality of the four major NCDs was projected to be 14.62% in 2030, while the goal of the probability of premature mortality was 13.69%, only the goal of the women, cancer and chronic respiratory diseases is higher than the projected. To achieve the 2030 target, the average rate of decline in the probability of premature death for the four chronic diseases from 2021 to 2030 will need to be increased to 2.63%, with the average rate of decline for men increasing to 2.70%. The probability of early death of diabetes should be paid attention to, its predicted value is lower than the target value and the gap is large, and the decline rate should be increased to 6.76%.

Conclusion

Crude mortality of cardiovascular and cerebrovascular diseases showed an increasing trend, whereas the mortality and the probability of premature mortality from chronic respiratory diseases showed an obvious decrease. Based on the current average growth rate, it is predicted that Baise City is still far from realizing the target value of "Healthy China 2030", men should be the primary focus group, and the main intervention diseases should be diabetes, cardiovascular and cerebrovascular diseases, so that the average growth rate from 2021 to 2030 can reach -2.63%, to achieve the goal of "Healthy China 2030".

Review & Perspectives

Advances in Ferroptosis in the Treatment of Traumatic Central Nervous System Injury

YANG Yiran, WANG Chun, DENG Sangyang, JIANG Chen, WU Haiying, QIAN Chuanyun

2024, 27(11):  1395-1399.  DOI: 10.12114/j.issn.1007-9572.2023.0509

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Traumatic central nervous system injury, including traumatic brain injury and spinal cord injury, has extremely high disability and mortality rates. The huge medical expenses and sequelae further aggravate the economic and psychological burden of patients and their families. Current treatments for traumatic central nervous system injury include surgical therapy, physical therapy, medication and post-rehabilitation treatment, but none of them can achieve ideal efficacy, and more effective treatment is urgently needed. Ferroptosis, as one of the newly discovered modes of programmed cell death, has been shown to play a crucial role in secondary injury to the traumatic central nervous system, but its clinical transformation is limited. This article summarizes the research results of ferroptosis inhibitors, points out the types and effects of them, to provide new ideas for clinical treatment of traumatic central nervous system injury and drug development.

Research Progress and Prospects of Isocitrate Dehydrogenase Gene Mutation in Chondrosarcoma

ZHAO Jingjing, ZHANG Zhihong, ZHEN Junping

2024, 27(11):  1400-1404.  DOI: 10.12114/j.issn.1007-9572.2023.0284

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Isocitrate dehydrogenase (IDH) is the more mutation-prone human metabolic gene. In the presence of nicotinamide adenine dinucleotide phosphate (NADPH), mutant IDH can bind to α-ketoglutaric acid (α-KG) and reduce it to 2-hydroxyglutaric acid (2-HG), participating in various biological processes of tumorigenesis. IDH has been widely studied in glioma and acute myeloid leukemia, and rarely in chondrosarcoma. Chondrosarcoma is prone to recurrence and metastasis due to the presence of high-frequency mutations in the IDH gene, and treatment options are limited after recurrence or metastasis, resulting in a poor prognosis for patients and an urgent clinical need to find new treatment options. This article reviews the role of IDH mutations in the development, prognosis, differential diagnosis and treatment of chondrosarcoma, further elaborates the biological role of IDH gene mutation in the occurrence and development of chondrosarcoma, and provides an outlook on the development of powerful IDH inhibitors and anti-cancer drugs, in order to provide a reference for the establishment of therapeutic regimen and prognostic evaluation.