PurposeTo determine serum insulin-like growth factor 1 (IGF-I) levels in healthy Chinese adults, establish reference ranges for serum IGF-I levels and observe the effects of age, sex, body mass index (BMI) and geographical region on serum IGF-I levels.MethodsIn total, 2791 healthy adults (1339 males and 1452 females) from the north (Beijing) and south (Guizhou Province) of China were recruited following a questionnaire survey, physical examination and laboratory examination. Both sexes were divided into 13 groups according to age (18, 19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69 and ≥70 years). The serum IGF-I levels were measured by performing a chemiluminescent assay (Immulite 2000®), and the LMS (Lambda-Mu-Sigma) method was applied to construct smooth centile curves of age-specific IGF-I levels.ResultsSerum IGF-I levels in the adults gradually decreased with increasing age from 18 to 70 years in both the male and female participants. Although the decrease in the level of IGF-1 was more pronounced in females than in males, no significant difference was observed between the sexes, except in the 60- to 64-year-old age group (P = 0.0329). The multiple linear regression model showed that there was an inverse relationship between the serum IGF-I level and BMI (P<0.001), and the serum IGF-I level in the Guizhou population was higher than that in the Beijing population (P<0.05).ConclusionThe normal reference ranges for age- and sex-specific serum IGF-I levels were established for the first time in a large sample of Chinese adults. The serum IGF-I levels were significantly influenced by age, BMI and geographical region.

Water scarcity is rising as a global issue, because the planet earth is facing a global water crisis, which is considered something that can destroy environmental sustainability of our planet. The fact is that humanity’s demand is depleting natural resources faster than nature can replenish itself; if human habits and unsustainable use of water resources do not change, water scarcity will inevitably intensify and become a major cause of conflict among different nations of the world. The water scarcity issue is a crucial issue but unfortunately it has not received due attention in past. Pakistan, which once was a water abundant country, now facing a situation of water scarcity. Pakistan has a poor irrigation system which results 60% loss of its water; Pakistan uses more water for crop production than other countries. Likewise, the country harvests water from rainfall, rivers, snow, and glaciers. The country is facing a serious water crisis that is caused by different factors, such as changing climatic conditions, rising population, poor irrigation system, poor political will, and rapid urbanization. The water crisis of Pakistan is expected to worsen in coming years. This is a drastic situation which calls for emergency measures. With this background, the present study provides a detailed view of the water situation in the country with challenges to water management. The study also suggests some recommendations for policymakers to improve the water crisis situation in the future.

We presented the first FH-III patient who had both severe PA and Cushing's syndrome. Hypersecretion of cortisol might be ascribed to overly large size of the hyperplastic adrenal because CYP11B1 expression was relatively low in his adrenal. Like aldosterone, synthesis and secretion of cortisol in the mutant adrenal may be mediated by voltage-gated Ca channels.