Objective To explore the differential diagnosis methods between nonclassical 21-hydroxylase deficiency(NC21-OHD) and polycystic ovary syndrome(PCOS). Methods The clinical data of 31 women with NC21-OHD were compared with those of 29 women with PCOS. Results Women with NC21-OHD showed a higher prevalence of adrenal hyperplasia and lower likelihood of polycystic ovary(PCO) than those with PCOS(P<0.05), with lower height(P<0.05). The levels of adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone(17-OHP), androstenedione(AD), total testosterone(TT), and progesterone were higher in women with NC21-OHD compared with those with PCOS(P<0.05). Women with PCOS had higher levels of luteinizing hormone(LH) and higher ratio of LH to follicle stimulating hormone(FSH) than those with NC21-OHD(P<0.05). The best two identification indexes for the two diseases were 17-OHP and progesterone, with the optimal cut-off points 3.34 ng/ml(sensitivity 89.7%, specificity 93.1%) and 0.64 ng/ml(sensitivity 90.0%, specificity 75.9%), respectively. During the 1-day mid-dose dexamethasone suppression test(DST), women with NC21-OHD had higher inhibition rates of 17-OHP, progesterone, AD, and TT(P<0.01) than those with PCOS. Their optimal cut-off values of suppression rates were 73.5%(sensitivity 95.2%, specificity 100.0%), 55.5%(sensitivity 100%, specificity 88.9%), 61.4%(sensitivity 84.2%, specificity 100.0%), 68.3%(sensitivity 65.0%, specificity 100.0%), respectively. Conclusion The clinical manifestations of women with NC21-OHD are similar to those with PCOS. 17-OHP is the best differential indicator and the 1-day mid-dose DST plays an important role in the identification of the two diseases. Genetic analysis is the gold standard for distinguishing the two diseases. Key words: Nonclassical 21-hydroxylase deficiency; Polycystic ovary syndrome; 17-hydroxyprogesterone; Progesterone; Dexamethasone suppression test
{"title":"Differential diagnosis of nonclassical 21-hydroxylase deficiency and polycystic ovary syndrome","authors":"Shengnan Wang, Yanjie Xia, Lijun Xu, Q. Yu, Xia-lian Li, Liangge Sun, G. Qin, Huijuan Zhang","doi":"10.3760/CMA.J.CN311282-20190822-00337","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190822-00337","url":null,"abstract":"Objective \u0000To explore the differential diagnosis methods between nonclassical 21-hydroxylase deficiency(NC21-OHD) and polycystic ovary syndrome(PCOS). \u0000 \u0000 \u0000Methods \u0000The clinical data of 31 women with NC21-OHD were compared with those of 29 women with PCOS. \u0000 \u0000 \u0000Results \u0000Women with NC21-OHD showed a higher prevalence of adrenal hyperplasia and lower likelihood of polycystic ovary(PCO) than those with PCOS(P<0.05), with lower height(P<0.05). The levels of adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone(17-OHP), androstenedione(AD), total testosterone(TT), and progesterone were higher in women with NC21-OHD compared with those with PCOS(P<0.05). Women with PCOS had higher levels of luteinizing hormone(LH) and higher ratio of LH to follicle stimulating hormone(FSH) than those with NC21-OHD(P<0.05). The best two identification indexes for the two diseases were 17-OHP and progesterone, with the optimal cut-off points 3.34 ng/ml(sensitivity 89.7%, specificity 93.1%) and 0.64 ng/ml(sensitivity 90.0%, specificity 75.9%), respectively. During the 1-day mid-dose dexamethasone suppression test(DST), women with NC21-OHD had higher inhibition rates of 17-OHP, progesterone, AD, and TT(P<0.01) than those with PCOS. Their optimal cut-off values of suppression rates were 73.5%(sensitivity 95.2%, specificity 100.0%), 55.5%(sensitivity 100%, specificity 88.9%), 61.4%(sensitivity 84.2%, specificity 100.0%), 68.3%(sensitivity 65.0%, specificity 100.0%), respectively. \u0000 \u0000 \u0000Conclusion \u0000The clinical manifestations of women with NC21-OHD are similar to those with PCOS. 17-OHP is the best differential indicator and the 1-day mid-dose DST plays an important role in the identification of the two diseases. Genetic analysis is the gold standard for distinguishing the two diseases. \u0000 \u0000 \u0000Key words: \u0000Nonclassical 21-hydroxylase deficiency; Polycystic ovary syndrome; 17-hydroxyprogesterone; Progesterone; Dexamethasone suppression test","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"288-293"},"PeriodicalIF":0.0,"publicationDate":"2020-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43779844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20190804-00313
Dan Li, Baolan Ji, B. Ban, Mei Zhang, Min Wang, Bing-qing Sun
Objective To investigate the correlation between serum bilirubin level and the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus of different sexes. Methods A total of 1 304 patients with type 2 diabetes mellitus were included in this study. The clinical data were collected and fundus examination was performed. According to the results of fundus examination, the patients were divided into DR group and Non-DR (NDR) group. The correlation between the levels of serum total bilirubin, direct bilirubin, indirect bilirubin, and the occurrence of DR was analyzed. Results The levels of total bilirubin, direct bilirubin, and indirect bilirubin in DR group were significantly lower than those in NDR group. Univariate analysis showed that the levels of total bilirubin and indirect bilirubin were negatively correlated with the occurrence of DR (P<0.01). There was no significant correlation between the level of direct bilirubin and the occurrence of DR. Smooth curve fitting showed that there was a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in women, while a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in men. The results of multiple regression analysis showed that in men total bilirubin increased by 1 μmol/L, the risk of DR decreased by 8% (OR=0.92, 95%CI 0.88-0.98, P<0.01). Indirect bilirubin increased by 1 μmol/L, and the risk of DR decreased by 9% (OR=0.91, 95%CI 0.84-0.96, P<0.01). In women, when total bilirubin<12.8 μmol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR decreased by 17%(OR=0.83, 95%CI 0.72-0.95, P<0.01); When total bilirubin≥12.8 umol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR increased by 10%(OR=1.10, 95%CI 1.01-1.20, P<0.05); When indirect bilirubin<9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR decreased by 20%(OR=0.80, 95%CI 0.68-0.94, P<0.01); When indirect bilirubin≥9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR increased by 13%(OR=1.13, 95%CI 1.01-1.25, P<0.05). Conclusion This study shows that there is a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in female patients with type 2 diabetes mellitus, and there is a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in male patients. However, there was no significant correlation between direct bilirubin and DR risk. Key words: Diabetes mellitus, type 2; Diabetic retinopathy; Bilirubin
{"title":"Association between bilirubin levels and diabetic retinopathy in type 2 diabetes mellitus","authors":"Dan Li, Baolan Ji, B. Ban, Mei Zhang, Min Wang, Bing-qing Sun","doi":"10.3760/CMA.J.CN311282-20190804-00313","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190804-00313","url":null,"abstract":"Objective \u0000To investigate the correlation between serum bilirubin level and the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus of different sexes. \u0000 \u0000 \u0000Methods \u0000A total of 1 304 patients with type 2 diabetes mellitus were included in this study. The clinical data were collected and fundus examination was performed. According to the results of fundus examination, the patients were divided into DR group and Non-DR (NDR) group. The correlation between the levels of serum total bilirubin, direct bilirubin, indirect bilirubin, and the occurrence of DR was analyzed. \u0000 \u0000 \u0000Results \u0000The levels of total bilirubin, direct bilirubin, and indirect bilirubin in DR group were significantly lower than those in NDR group. Univariate analysis showed that the levels of total bilirubin and indirect bilirubin were negatively correlated with the occurrence of DR (P<0.01). There was no significant correlation between the level of direct bilirubin and the occurrence of DR. Smooth curve fitting showed that there was a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in women, while a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in men. The results of multiple regression analysis showed that in men total bilirubin increased by 1 μmol/L, the risk of DR decreased by 8% (OR=0.92, 95%CI 0.88-0.98, P<0.01). Indirect bilirubin increased by 1 μmol/L, and the risk of DR decreased by 9% (OR=0.91, 95%CI 0.84-0.96, P<0.01). In women, when total bilirubin<12.8 μmol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR decreased by 17%(OR=0.83, 95%CI 0.72-0.95, P<0.01); When total bilirubin≥12.8 umol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR increased by 10%(OR=1.10, 95%CI 1.01-1.20, P<0.05); When indirect bilirubin<9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR decreased by 20%(OR=0.80, 95%CI 0.68-0.94, P<0.01); When indirect bilirubin≥9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR increased by 13%(OR=1.13, 95%CI 1.01-1.25, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000This study shows that there is a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in female patients with type 2 diabetes mellitus, and there is a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in male patients. However, there was no significant correlation between direct bilirubin and DR risk. \u0000 \u0000 \u0000Key words: \u0000Diabetes mellitus, type 2; Diabetic retinopathy; Bilirubin","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"227-234"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41872110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To discuss hypertension situations of 40-79 years old residents with different glucose metabolic status in Guiyang urban area under the new hypertension diagnostic criteria proposed by American College of Cardiology/American Heart Association (ACC/AHA) in 2017 and provide a clue for diagnostic criteria and treatment strategy of hypertension. Methods 10 140 residents in 40-79 years old in Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgitudinal (REACTION) Study Research Guiyang Sub-center were conducted retrospective analysis. According to medical history of diabetes and oral glucose tolerance test results, these residents were divided into normal glucose group, impaired fasting glucose(IFG) group, impaired glucose tolerance (IGT) group, IFG+ IGF group, previous diagnostic diabetes group and newly diagnosed diabetes group. Hypertension situation of residents with different glucose metabolic status under the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), and Hypertension Guide of ACC/AHA in 2017 were calculated. Results Under JNC 7 criteria, hypertension′s standardized prevalence rate of normal blood glucose people, prediabetes patients, and diabetes patients in 40-79 years old respectively reached 8.19%, 9.57%, and 8.19%. Under ACC/AHA 2017 criteria, hypertension′s standardized prevalence rate respectively reached 20.27%, 16.35%, and 11.59%. By contrast, the most obvious increase of hypertension′s prevalence rate was in the normal blood glucose group and IGT group. Newly increased hypertension patients reached 1 739. Among them, 25.8% required antihypertensive drugs for treatment. According to the 6th demographic census data of Guizhou Province in 2010, it was estimated that newly increased hypertensive patients aged 40-79 years in prediabetes patients reached 123 000, among them, 20 000 required treatment. Newly increased hypertensive patients aged 40-79 years in diabetes patients reached 68 000, among them, 21 000 required treatment. Conclusions ACC/AHA Hypertension Guide in 2017 will obviously increase hypertension′s prevalence rate of people with different glucose metabolic status in 40-49 years old. The treatment ratio of hypertension groups with diabetes and prediabetes is considerably high. As a result, social medical burdens is going to aggravate. Key words: Prediabetes state; Diabetes mellitus; Hypertension; Guide; Prevalence
{"title":"Potential effects of 2017 ACC/AHA hypertension guideline on the prevalence of hypertension among population aged 40-79 with different glucose metabolism in Guiyang city","authors":"Weiwei Jiang, Nianchun Peng, Li-xin Shi, Qiao Zhang, Ying Hu, Jing Xu","doi":"10.3760/CMA.J.CN311282-20190715-00275","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190715-00275","url":null,"abstract":"Objective \u0000To discuss hypertension situations of 40-79 years old residents with different glucose metabolic status in Guiyang urban area under the new hypertension diagnostic criteria proposed by American College of Cardiology/American Heart Association (ACC/AHA) in 2017 and provide a clue for diagnostic criteria and treatment strategy of hypertension. \u0000 \u0000 \u0000Methods \u000010 140 residents in 40-79 years old in Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgitudinal (REACTION) Study Research Guiyang Sub-center were conducted retrospective analysis. According to medical history of diabetes and oral glucose tolerance test results, these residents were divided into normal glucose group, impaired fasting glucose(IFG) group, impaired glucose tolerance (IGT) group, IFG+ IGF group, previous diagnostic diabetes group and newly diagnosed diabetes group. Hypertension situation of residents with different glucose metabolic status under the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), and Hypertension Guide of ACC/AHA in 2017 were calculated. \u0000 \u0000 \u0000Results \u0000Under JNC 7 criteria, hypertension′s standardized prevalence rate of normal blood glucose people, prediabetes patients, and diabetes patients in 40-79 years old respectively reached 8.19%, 9.57%, and 8.19%. Under ACC/AHA 2017 criteria, hypertension′s standardized prevalence rate respectively reached 20.27%, 16.35%, and 11.59%. By contrast, the most obvious increase of hypertension′s prevalence rate was in the normal blood glucose group and IGT group. Newly increased hypertension patients reached 1 739. Among them, 25.8% required antihypertensive drugs for treatment. According to the 6th demographic census data of Guizhou Province in 2010, it was estimated that newly increased hypertensive patients aged 40-79 years in prediabetes patients reached 123 000, among them, 20 000 required treatment. Newly increased hypertensive patients aged 40-79 years in diabetes patients reached 68 000, among them, 21 000 required treatment. \u0000 \u0000 \u0000Conclusions \u0000ACC/AHA Hypertension Guide in 2017 will obviously increase hypertension′s prevalence rate of people with different glucose metabolic status in 40-49 years old. The treatment ratio of hypertension groups with diabetes and prediabetes is considerably high. As a result, social medical burdens is going to aggravate. \u0000 \u0000 \u0000Key words: \u0000Prediabetes state; Diabetes mellitus; Hypertension; Guide; Prevalence","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"220-226"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46664292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20190723-00290
Hui Yang, Xinjuan Sun, Z. Hu, Yin-chen Chen
This exploratory study attempted to establish the rules in diagnosis and treatment of diabetic foot, through interpretation and comparison of the guidelines for diabetic foot from domestic with international ones. The document provided comparison between Guidelines of International Working Group on Diabetic Foot (IWGDF) and Chinese Diabetes Society (CDS) in 2019, related to diabetic foot disease on: methodology, content, prevention, offloading, peripheral artery disease (PAD), infection, wound healing interventions, and classification of diabetic foot ulcers. Prevention of ulcers in persons with diabetes foot is very important, and a non-removable offloading device is the first-choice of offloading treatment; Surgical indications and reasonable treatment should be mastered in PAD; Different anti-infection treatments, including surgical debridement, should be used base on the severity of foot infection; There are lots of treatments to improve healing, however the Grand Standard of medical evidence is not very high; There are a larger number of proposed classifications and scoring systems for diabetic foot, but none of them could cover all the needs of diagnosis and treatment. Thus, the principles outlined have to be adapted or modified by our health care professionals, based on local circumstances, to develop a standardizated procedure in diagnosis and treatment of diabetic foot. Key words: Diabetic foot; Guidelines; International Working Group on Diabetic Foot; Chinese Diabetes Society
{"title":"Interpretation and comparison of guidelines for diagnosis and treatment of diabetic foot between International Working Group on Diabetic Foot and Chinese Diabetes Society","authors":"Hui Yang, Xinjuan Sun, Z. Hu, Yin-chen Chen","doi":"10.3760/CMA.J.CN311282-20190723-00290","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190723-00290","url":null,"abstract":"This exploratory study attempted to establish the rules in diagnosis and treatment of diabetic foot, through interpretation and comparison of the guidelines for diabetic foot from domestic with international ones. The document provided comparison between Guidelines of International Working Group on Diabetic Foot (IWGDF) and Chinese Diabetes Society (CDS) in 2019, related to diabetic foot disease on: methodology, content, prevention, offloading, peripheral artery disease (PAD), infection, wound healing interventions, and classification of diabetic foot ulcers. Prevention of ulcers in persons with diabetes foot is very important, and a non-removable offloading device is the first-choice of offloading treatment; Surgical indications and reasonable treatment should be mastered in PAD; Different anti-infection treatments, including surgical debridement, should be used base on the severity of foot infection; There are lots of treatments to improve healing, however the Grand Standard of medical evidence is not very high; There are a larger number of proposed classifications and scoring systems for diabetic foot, but none of them could cover all the needs of diagnosis and treatment. Thus, the principles outlined have to be adapted or modified by our health care professionals, based on local circumstances, to develop a standardizated procedure in diagnosis and treatment of diabetic foot. \u0000 \u0000 \u0000Key words: \u0000Diabetic foot; Guidelines; International Working Group on Diabetic Foot; Chinese Diabetes Society","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"201-206"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43332250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20190629-00247
Dan Yang, Lin Zhang, Qu Yao, Han Zhang, Ying Zhang, X. Liao, Yu Zhao, Ling Zhang, Y. Cheng
Objective To evaluate the insulin resistance of patients with polycystic ovary syndrome (PCOS) by hyperinsulin-euglycemic clamp test, and to explore the characteristics of glycolipid metabolism and sex hormone levels in PCOS patients with insulin resistance. Methods Seventy-three patients with PCOS and 27 healthy women with body mass index and age matched with PCOS patients who were admitted to the Department of Endocrinology of Affiliated Hospital of Zunyi Medical University from July 2017 to February 2019 were underwent hyperinsulin-euglycemic clamp test. All subjects were grouped according to glucose metabolic rate, body mass index, and homeostasis model assessment for insulin resistance (HOMA-IR), the changes and differences of glucose and lipid metabolism and sex hormone indexes in PCOS patients were analyzed. Results In the PCOS group, impaired glucose regulation accounted for 3.23% (1/31), and abnormal lipid metabolism for 9.68% (3/31). In the PCOS with insulin resistance group, impaired glucose regulation accounted for 7.14% (3/42). Abnormal blood lipid metabolism reached 47.62% (20/42), and 5 patients were diagnosed with metabolic syndrome, accounting for 11.90%. Correlation analysis showed glucose metabolic rate and body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, cortisol, triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), free androgen index (FAI), and glutamyl transpeptidase (GGT) were negatively correlated(all P<0.05), while positively correlated with high density lipoprotein-cholesterol (HDL-C; P=0.028). HOMA-IR was positively correlated with body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HbA1C, LDL-C (P<0.05), and negatively correlated with glucose metabolic rate and HDL-C (P<0.05). Body mass index and waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, triglyceride, and LDL-C (P<0.05) were positively correlated, and negatively correlated with glucose metabolic rate, HDL-C, and sex hormone binding globulin (SHBG; P<0.01). Multivariate linear stepwise regression analysis showed that body mass index, total cholesterol, triglyceride, and cortisol were principal factors affecting glucose metabolic rate. Fasting plasma glucose, fasting insulin, and systolic blood pressure were important factors influencing HOMA-IR. Glucose metabolic rate, HOMA-IR, HDL-C, while SHBG were still vital to body mass index. Conclusion FAI, SHBG, and cortisol may be involved in the insulin resistance development of PCOS patients, and PCOS patients with insulin resistance were more susceptible to metabolic disorders. Key words: Polycysic ovarian syndrome; Insulin resistance; Hyperinsulin-euglycemic clamp; Glycolipid metabolism; Sex hormone
{"title":"Study on insulin resistance, glycolipid metabolism, and sex hormones in patients with polycystic ovary syndrome","authors":"Dan Yang, Lin Zhang, Qu Yao, Han Zhang, Ying Zhang, X. Liao, Yu Zhao, Ling Zhang, Y. Cheng","doi":"10.3760/CMA.J.CN311282-20190629-00247","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190629-00247","url":null,"abstract":"Objective \u0000To evaluate the insulin resistance of patients with polycystic ovary syndrome (PCOS) by hyperinsulin-euglycemic clamp test, and to explore the characteristics of glycolipid metabolism and sex hormone levels in PCOS patients with insulin resistance. \u0000 \u0000 \u0000Methods \u0000Seventy-three patients with PCOS and 27 healthy women with body mass index and age matched with PCOS patients who were admitted to the Department of Endocrinology of Affiliated Hospital of Zunyi Medical University from July 2017 to February 2019 were underwent hyperinsulin-euglycemic clamp test. All subjects were grouped according to glucose metabolic rate, body mass index, and homeostasis model assessment for insulin resistance (HOMA-IR), the changes and differences of glucose and lipid metabolism and sex hormone indexes in PCOS patients were analyzed. \u0000 \u0000 \u0000Results \u0000In the PCOS group, impaired glucose regulation accounted for 3.23% (1/31), and abnormal lipid metabolism for 9.68% (3/31). In the PCOS with insulin resistance group, impaired glucose regulation accounted for 7.14% (3/42). Abnormal blood lipid metabolism reached 47.62% (20/42), and 5 patients were diagnosed with metabolic syndrome, accounting for 11.90%. Correlation analysis showed glucose metabolic rate and body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, cortisol, triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), free androgen index (FAI), and glutamyl transpeptidase (GGT) were negatively correlated(all P<0.05), while positively correlated with high density lipoprotein-cholesterol (HDL-C; P=0.028). HOMA-IR was positively correlated with body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HbA1C, LDL-C (P<0.05), and negatively correlated with glucose metabolic rate and HDL-C (P<0.05). Body mass index and waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, triglyceride, and LDL-C (P<0.05) were positively correlated, and negatively correlated with glucose metabolic rate, HDL-C, and sex hormone binding globulin (SHBG; P<0.01). Multivariate linear stepwise regression analysis showed that body mass index, total cholesterol, triglyceride, and cortisol were principal factors affecting glucose metabolic rate. Fasting plasma glucose, fasting insulin, and systolic blood pressure were important factors influencing HOMA-IR. Glucose metabolic rate, HOMA-IR, HDL-C, while SHBG were still vital to body mass index. \u0000 \u0000 \u0000Conclusion \u0000FAI, SHBG, and cortisol may be involved in the insulin resistance development of PCOS patients, and PCOS patients with insulin resistance were more susceptible to metabolic disorders. \u0000 \u0000 \u0000Key words: \u0000Polycysic ovarian syndrome; Insulin resistance; Hyperinsulin-euglycemic clamp; Glycolipid metabolism; Sex hormone","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48340080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20200218-00078
Bing Liu, Xuefei Liu, Min-jie Zhou
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major infectious disease. Current clinical studies have shown that diabetes is commonly complicated with this disorder. Hyperglycemia is a risk factor for severe infection, and also an independent risk factor for the progression of mild infection to severe ones. This may be related to the immune deficiency of diabetics. Besides, virus may cause direct damage to the islets and induce acute stress hyperglycemia. Special attention should be paid to the diabetics with SARS-CoV-2 infection. Systemic steroid hormones should be used with particular caution in patients with SARS-CoV-2 infection, especially those with diabetes. Key words: Severe acute respiratory syndrome coronavirus 2; Infection; Diabetes mellitus; Immune deficiency
{"title":"Paying close attention to diabetic patients with novel coronavirus infection","authors":"Bing Liu, Xuefei Liu, Min-jie Zhou","doi":"10.3760/CMA.J.CN311282-20200218-00078","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20200218-00078","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major infectious disease. Current clinical studies have shown that diabetes is commonly complicated with this disorder. Hyperglycemia is a risk factor for severe infection, and also an independent risk factor for the progression of mild infection to severe ones. This may be related to the immune deficiency of diabetics. Besides, virus may cause direct damage to the islets and induce acute stress hyperglycemia. Special attention should be paid to the diabetics with SARS-CoV-2 infection. Systemic steroid hormones should be used with particular caution in patients with SARS-CoV-2 infection, especially those with diabetes. \u0000 \u0000 \u0000Key words: \u0000Severe acute respiratory syndrome coronavirus 2; Infection; Diabetes mellitus; Immune deficiency","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"195-197"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47021072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20200212-00058
Sijue Yang, H. Guan
Epidemiology studies suggest that comorbid diabetes may have some negative impacts on the development and progression of the coronavirus disease 2019 (COVID-19). However, the exact mechanisms remain to be unclear so far. A recent study on another type of coronavirus infection, Middle East respiratory syndrome (MERS), was investigated along with its relationship with diabetes. This essay aims to give a brief introduction to this report and related studies, and to propose some suggestions on what we may learn from these investigations to conduct further studies on the potential mechanisms underlying the effects of diabetes mellitus on COVID-19. Key words: Coronavirus; Coronavirus disease 2019; Middle East respiratory syndrome; Diabetes mellitus; Mechanism
{"title":"Use Stones from Another Mountain to Polish One’s Jade: Learn from MERS Studies toexplore potential mechanisms underlying the effect of diabetes mellitus on COVID-19/ 中华内分泌代谢杂志","authors":"Sijue Yang, H. Guan","doi":"10.3760/CMA.J.CN311282-20200212-00058","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20200212-00058","url":null,"abstract":"Epidemiology studies suggest that comorbid diabetes may have some negative impacts on the development and progression of the coronavirus disease 2019 (COVID-19). However, the exact mechanisms remain to be unclear so far. A recent study on another type of coronavirus infection, Middle East respiratory syndrome (MERS), was investigated along with its relationship with diabetes. This essay aims to give a brief introduction to this report and related studies, and to propose some suggestions on what we may learn from these investigations to conduct further studies on the potential mechanisms underlying the effects of diabetes mellitus on COVID-19. \u0000 \u0000 \u0000Key words: \u0000Coronavirus; Coronavirus disease 2019; Middle East respiratory syndrome; Diabetes mellitus; Mechanism","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"191-194"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41549657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20190826-00339
Shengyun Hao, Qiao Zhang
Objective To search for the potential novel mutation site and to discuss related clinical characteristics by collecting detailed information and testing the gene of a family with highly suspected type 7 maturity-onset diabetes of the young (MODY7). Methods The gene test was conducted in a 28-year-old female patient with a 20-year course of non-ketosis-prone diabetes, with non-effective long-term insulin treatment, and a 3-generation family history of diabetes, and the patient was found to carry KLF11 gene mutation. Thus, the clinical data of family members were collected and investigated, and the pathogenic gene was tested. Firstly, the proband was searched for pathogenic genes by chip-capture high-throughput sequencing method. Then the mutation sites were verified by Sanger sequencing technology, and other family members were searched for the same mutation sites by the Sanger sequencing technology. Results A total of two members of the family was found to have heterozygous mutation of KLF11 gene: c. 920C>T (No. 920 nucleotide of the coding region mutated from cytosine to thymine), resulting in the change of corresponding amino acid p. P307L (No. 307 amino acid changed from proline to leucine), which was a missense mutation and was consistent with their clinical diagnosis of diabetes. Conclusions The family in this study had a family history of diabetes caused by the missense mutation of KLF11 gene. This is the first report of the mutation site of c. 920C >T (p.P307l), which may be a new mutation site of MODY7. Key words: Maturity-onset diabetes of the young, type 7; Transcription factor KLF11; Missense mutation
{"title":"A potential novel mutation site for type 7 maturity-onset diabetes of the young","authors":"Shengyun Hao, Qiao Zhang","doi":"10.3760/CMA.J.CN311282-20190826-00339","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190826-00339","url":null,"abstract":"Objective \u0000To search for the potential novel mutation site and to discuss related clinical characteristics by collecting detailed information and testing the gene of a family with highly suspected type 7 maturity-onset diabetes of the young (MODY7). \u0000 \u0000 \u0000Methods \u0000The gene test was conducted in a 28-year-old female patient with a 20-year course of non-ketosis-prone diabetes, with non-effective long-term insulin treatment, and a 3-generation family history of diabetes, and the patient was found to carry KLF11 gene mutation. Thus, the clinical data of family members were collected and investigated, and the pathogenic gene was tested. Firstly, the proband was searched for pathogenic genes by chip-capture high-throughput sequencing method. Then the mutation sites were verified by Sanger sequencing technology, and other family members were searched for the same mutation sites by the Sanger sequencing technology. \u0000 \u0000 \u0000Results \u0000A total of two members of the family was found to have heterozygous mutation of KLF11 gene: c. 920C>T (No. 920 nucleotide of the coding region mutated from cytosine to thymine), resulting in the change of corresponding amino acid p. P307L (No. 307 amino acid changed from proline to leucine), which was a missense mutation and was consistent with their clinical diagnosis of diabetes. \u0000 \u0000 \u0000Conclusions \u0000The family in this study had a family history of diabetes caused by the missense mutation of KLF11 gene. This is the first report of the mutation site of c. 920C >T (p.P307l), which may be a new mutation site of MODY7. \u0000 \u0000 \u0000Key words: \u0000Maturity-onset diabetes of the young, type 7; Transcription factor KLF11; Missense mutation","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"235-239"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49179263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20200108-00009
Tiange Wang, Jieli Lu, Y. Bi, Weiqing Wang
Delineation of the relationship between insulin resistance, β cell dysfunction, and obesity is crucial for the prevention and effective management of diabetes. Previous studies have indicated that, compared with type 2 diabetes in Caucasian, type 2 diabetes in East Asians is characterized primarily by β cell dysfunction rather than insulin resistance. This pathophysiological characterization of diabetes in East Asians is mainly derived from Japanese and Asian-American populations, whereas data from mainland China are scarce. Over the past four decades, China has witnessed a substantial rise in obesity, in parallel with the transitions from principally active lifestyles and calorie-restricted diets to sedentary life styles and energy-dense, western diets. Obesity is an insulin resistance state and the major factor driving the worldwide epidemic of diabetes. It is unknown whether, and if so how, obesity affects the two primary mechanisms, insulin resistance and β cell dysfunction, responsible for the development of diabetes in the Chinese population. Recently, the Lancet Diabetes & Endocrinology published an original research paper from the China Cardiometabolic Disease and Cancer Cohort Study (4C). From a public health perspective, the results of this study reinforce the urgency of tackling obesity as a major preventive strategy for the epidemic of type 2 diabetes in China. Key words: Diabetes mellitus; Insulin resistance; βcell dysfunction; Obesity; China
{"title":"New insights into the growing diabetes epidemic in China: middle-aged obesity-related insulin resistance becomes the major threat","authors":"Tiange Wang, Jieli Lu, Y. Bi, Weiqing Wang","doi":"10.3760/CMA.J.CN311282-20200108-00009","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20200108-00009","url":null,"abstract":"Delineation of the relationship between insulin resistance, β cell dysfunction, and obesity is crucial for the prevention and effective management of diabetes. Previous studies have indicated that, compared with type 2 diabetes in Caucasian, type 2 diabetes in East Asians is characterized primarily by β cell dysfunction rather than insulin resistance. This pathophysiological characterization of diabetes in East Asians is mainly derived from Japanese and Asian-American populations, whereas data from mainland China are scarce. Over the past four decades, China has witnessed a substantial rise in obesity, in parallel with the transitions from principally active lifestyles and calorie-restricted diets to sedentary life styles and energy-dense, western diets. Obesity is an insulin resistance state and the major factor driving the worldwide epidemic of diabetes. It is unknown whether, and if so how, obesity affects the two primary mechanisms, insulin resistance and β cell dysfunction, responsible for the development of diabetes in the Chinese population. Recently, the Lancet Diabetes & Endocrinology published an original research paper from the China Cardiometabolic Disease and Cancer Cohort Study (4C). From a public health perspective, the results of this study reinforce the urgency of tackling obesity as a major preventive strategy for the epidemic of type 2 diabetes in China. \u0000 \u0000 \u0000Key words: \u0000Diabetes mellitus; Insulin resistance; βcell dysfunction; Obesity; China","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"198-200"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47307961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN311282-20190520-00190
Lu Liu, Yuyou Jiang, Shushu Li
The liver is one of the most important organs which regulate lipid metabolism in the body. Hepatic steatosis is a major manifestation of metabolic syndrome and is associated with an imbalance between lipid synthesis and decomposition. There are gender and age differences in the prevalence of fatty liver, suggesting that sex hormones may play a crucial role. This review summarizes current literatures on the regulation of hepatic lipid metabolism by sex hormones and their receptors. In females, estradiol binds to estrogen receptors to reduce liver fat production and fatty acid intake, while enhancing lipolysis and cholesterol secretion. In males, testosterone reduces adipogenesis and promotes fat breakdown through androgen receptors. These findings suggest that sex hormones and their receptors can serve as potential targets for preventing hepatic steatosis. Key words: Sex hormones; Estrogen receptor; Androgen receptor; Liver; Lipid metabolism
{"title":"Research progress on the mechanism of sex hormones and their receptors in liver lipid metabolism","authors":"Lu Liu, Yuyou Jiang, Shushu Li","doi":"10.3760/CMA.J.CN311282-20190520-00190","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311282-20190520-00190","url":null,"abstract":"The liver is one of the most important organs which regulate lipid metabolism in the body. Hepatic steatosis is a major manifestation of metabolic syndrome and is associated with an imbalance between lipid synthesis and decomposition. There are gender and age differences in the prevalence of fatty liver, suggesting that sex hormones may play a crucial role. This review summarizes current literatures on the regulation of hepatic lipid metabolism by sex hormones and their receptors. In females, estradiol binds to estrogen receptors to reduce liver fat production and fatty acid intake, while enhancing lipolysis and cholesterol secretion. In males, testosterone reduces adipogenesis and promotes fat breakdown through androgen receptors. These findings suggest that sex hormones and their receptors can serve as potential targets for preventing hepatic steatosis. \u0000 \u0000 \u0000Key words: \u0000Sex hormones; Estrogen receptor; Androgen receptor; Liver; Lipid metabolism","PeriodicalId":10120,"journal":{"name":"Chinese Journal of Endocrinology and Metabolism","volume":"36 1","pages":"267-272"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41862187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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