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The nonlinear connection between relative fat mass and non-alcoholic fatty liver disease in the Japanese population: an analysis based on data from a cross-sectional study. 日本人口中相对脂肪量与非酒精性脂肪肝之间的非线性联系:基于横断面研究数据的分析。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-28 DOI: 10.1186/s13098-024-01472-z
Changchun Cao, Meiling Huang, Yong Han, Xiaohua Zhang, Haofei Hu, Yulong Wang

Background: Relative fat mass (RFM) is a newly developed, sex-specific anthropometric formula designed to estimate total body fat percentage. However, research investigating the correlation between RFM and the risk of non-alcoholic fatty liver disease (NAFLD) remains limited. This study evaluates the association between RFM and the risk of NAFLD within the Japanese population.

Methods: This study including 14,250 Japanese adults who underwent physical examinations at Murakami Memorial Hospital between 2004 and 2015. We employed binary logistic regression to elucidate the direct relationship between RFM levels and the incidence of NAFLD. Additionally, a generalized additive model (GAM) coupled with smooth curve fitting techniques was utilized to map the non-linear association.

Results: The cohort had an average age of 43.53 ± 8.89 years, with a male majority of 52.00%. NAFLD was identified in 17.59% of the participants. After adjusting for confounding factors, a significant positive correlation between RFM and NAFLD risk was observed (OR: 1.15, 95%CI: 1.10-1.21, P < 0.0001 for females; OR: 1.15, 95%CI: 1.10-1.19, P < 0.0001 for males). Additionally, a non-linear relationship between RFM and the incidence of NAFLD was detected in both genders. The RFM threshold was identified as 34.95 for women and 23.40 for men. RFM was positively associated with the risk of NAFLD when RFM was below the respective threshold (OR: 1.29, 95%CI: 1.19-1.40, P < 0.0001 for females; OR: 1.23, 95%CI: 1.17-1.29, P < 0.0001 for males), whereas no significant association was found when RFM was above the threshold (OR: 1.05, 95%CI: 0.98-1.12, P = 0.1829 for females; OR: 1.01, 95%CI: 0.95-1.08, P = 0.7392 for males).

Conclusion: Our findings suggest a positive, nonlinear relationship between RFM and the risk of NAFLD, with a saturation effect. These results imply that maintaining RFM at a lower level may be advantageous in mitigating the risk of NAFLD.

背景:相对脂肪量(RFM)是一种新开发的、针对不同性别的人体测量公式,旨在估算人体总脂肪百分比。然而,对相对脂肪量与非酒精性脂肪肝(NAFLD)风险之间相关性的研究仍然有限。本研究评估了日本人口中 RFM 与非酒精性脂肪肝风险之间的关联:这项研究包括 2004 年至 2015 年期间在村上纪念医院接受体检的 14250 名日本成年人。我们采用二元逻辑回归来阐明 RFM 水平与非酒精性脂肪肝发病率之间的直接关系。此外,我们还采用了广义加法模型(GAM)和平滑曲线拟合技术来绘制非线性关系图:研究对象的平均年龄为 43.53 ± 8.89 岁,男性占 52.00%。17.59%的参与者患有非酒精性脂肪肝。在对混杂因素进行调整后,观察到 RFM 与非酒精性脂肪肝风险之间存在显著的正相关性(OR:1.15,95%CI:1.10-1.21,P 结论:我们的研究结果表明,RFM 与非酒精性脂肪肝风险之间存在正向、非线性的相关性:我们的研究结果表明,RFM 与非酒精性脂肪肝风险之间存在非线性的正相关关系,且存在饱和效应。这些结果表明,将 RFM 保持在较低水平可能有利于降低非酒精性脂肪肝的风险。
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引用次数: 0
High free sugars, insulin resistance, and low socioeconomic indicators: the hubs in the complex network of non-communicable diseases in adolescents. 高游离糖、胰岛素抵抗和低社会经济指标:青少年非传染性疾病复杂网络中的枢纽。
IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-28 DOI: 10.1186/s13098-024-01469-8
Silas Alves-Costa, Bruno Feres de Souza, Francisco Aparecido Rodrigues, Alexandre Archanjo Ferraro, Gustavo G Nascimento, Fabio R M Leite, Lorena Lúcia Costa Ladeira, Rosângela Fernandes Lucena Batista, Erika Bárbara Abreu Fonseca Thomaz, Claudia Maria Coelho Alves, Cecilia Claudia Costa Ribeiro

Background: Noncommunicable diseases (NCDs) predominantly affect adults, but pathophysiological changes begin decades earlier, as a continuum, with initial events apparent in adolescence. Hence, early identification and intervention are crucial for the prevention and management of NCDs. We investigated the complex network of socioeconomic, behavioral, and metabolic factors associated with the presence of NCD in Brazilian adolescents.

Methods: We conducted a cross-sectional study nested within the São Luís segment of the Ribeirão Preto, Pelotas, and São Luís (RPS) cohort's consortium, focusing on 18-19-year-olds (n = 2515). Data were collected prospectively, from which we constructed a complex network with NCD-related factors/indicators as nodes and their co-occurrences as edges. General and sex-based models analyzed: socioeconomic status, behavioral (smoking, alcohol, and other drugs use, unhealthy diet, poor sleep, physical inactivity), and metabolic factors (overweight/obesity, elevated blood pressure, poor lipid profile). We also looked for NCDs in adolescence like asthma, abnormal spirometry, depression, suicide risk, and poor oral health. The network was characterized by degree, betweenness, eigenvector, local transitivity, Shannon entropy, and cluster coefficient.

Results: The adolescents had an average age of 18.3 years, 52.3% were female and 47.7% male. 99.8% of them have a diet rich in free sugars, 15% are overweight/obese and 72.3% had an elevated TyG index. High free sugar emerged as the central hub, followed by high TyG index (an early marker of insulin resistance) and low socioeconomic class. In males, low fiber intake and a high triglycerides/HDL ratio highlighted cardiometabolic concerns; in females, sedentary behavior and poor sleep marked metabolic and psychological challenges, along with caries in both sexes.

Conclusions: Our findings provide insights into central health challenges during adolescence, such as high free sugars, insulin resistance, and low socioeconomic indicators, suggesting that interventions targeted at these central hubs could have a significant impact on their NCD network.

背景:非传染性疾病(NCDs)主要影响成年人,但病理生理变化开始于几十年前,是一个连续的过程,最初的事件在青少年时期就很明显。因此,早期识别和干预对于预防和管理非传染性疾病至关重要。我们调查了与巴西青少年非传染性疾病相关的社会经济、行为和代谢因素的复杂网络:我们在里贝朗普雷图、佩洛塔斯和圣路易斯(RPS)联盟的圣路易斯区段内开展了一项横断面研究,重点关注 18-19 岁的青少年(n = 2515)。我们对数据进行了前瞻性收集,并据此构建了一个复杂的网络,将非传染性疾病相关因素/指标作为节点,将它们的共同出现作为边。基于一般和性别的模型分析了:社会经济状况、行为(吸烟、酗酒和使用其他药物、不健康饮食、睡眠不足、缺乏运动)和代谢因素(超重/肥胖、血压升高、血脂状况不佳)。我们还研究了青少年时期的非传染性疾病,如哮喘、肺活量异常、抑郁、自杀风险和口腔健康不良。网络的特征包括度数、间隔度、特征向量、局部反转性、香农熵和聚类系数:青少年的平均年龄为 18.3 岁,52.3% 为女性,47.7% 为男性。99.8%的青少年饮食中含有大量游离糖,15%的青少年超重/肥胖,72.3%的青少年TyG指数升高。高游离糖成为中心枢纽,其次是高TyG指数(胰岛素抵抗的早期标志)和低社会经济阶层。在男性中,低纤维摄入量和高甘油三酯/高密度脂蛋白比率凸显了心脏代谢问题;在女性中,久坐不动和睡眠质量差凸显了代谢和心理方面的挑战,同时男女均存在龋齿问题:我们的研究结果让我们深入了解了青春期的核心健康挑战,如高游离糖、胰岛素抵抗和低社会经济指标,这表明针对这些核心枢纽的干预措施可能会对其非传染性疾病网络产生重大影响。
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引用次数: 0
Evaluation of serum irisin level and severity of erectile dysfunction in diabetic males: a cross sectional prospective study 糖尿病男性血清鸢尾素水平与勃起功能障碍严重程度的评估:一项横断面前瞻性研究
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1186/s13098-024-01452-3
Ahmed Ragab, Ahmed Reda Sayed, Sameh Fayek GamalEl Din, Ashraf Zeidan, Faten Fathi Ewis, Mostafa Ahmed Hamed
Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus (T2DM). The current study aimed to assess the serum level of irisin in T2DM men with erectile dysfunction (ED) compared to T2DM patients with normal erectile function and healthy controls, as well as investigate the association between serum irisin level and the severity of ED in T2DM patients. A cross-sectional study was conducted on 90 males, divided into three groups: 32 T2DM patients with ED, 24 T2DM patients without ED, and 34 healthy controls. Socio-demographic characteristics and scores of the validated Arabic version of the international Index of Erectile Function-5 (ArIIEF-5), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were obtained. Furthermore, routine laboratory tests employed for diabetes monitoring and serum levels of total testosterone and irisin were assessed within these groups. T2DM men with ED had significantly lower serum levels of irisin and testosterone, as well as a lower ArIIEF-5 score, but their GAD-7 and PHQ-9 scores were significantly higher than those without ED or controls (p < 0.001). Among T2DM men, serum irisin levels positively associated with ArIIEF-5 scores and serum testosterone (r = 0.413, p = 0.002; r = 0.936, p < 0.001, respectively) but negatively associated with glycosylated hemoglobin levels (r = -0.377, p = 0.004). Multivariate regression analysis to predict ED in T2DM patients found that GAD-7 score was the only most significant predictor for ED (ꞵ = − 1.176, standard error = 0.062, p < 0.001). The current study had demonstrated that irisin positively correlated with the ArIIEF-5 and serum testosterone but negatively correlated with HbA1c in T2DM men. Nevertheless, further validation of these findings is necessary through cohort studies.
鸢尾素是一种运动诱导肌动素,它能缓解2型糖尿病(T2DM)患者的内皮功能障碍并减轻胰岛素抵抗。本研究旨在评估患有勃起功能障碍(ED)的 T2DM 男性与勃起功能正常的 T2DM 患者和健康对照组相比的血清鸢尾素水平,并探讨血清鸢尾素水平与 T2DM 患者 ED 严重程度之间的关联。这项横断面研究以 90 名男性为对象,分为三组:32 名有 ED 的 T2DM 患者、24 名无 ED 的 T2DM 患者和 34 名健康对照组。研究人员了解了这三组患者的社会人口学特征以及阿拉伯语版国际勃起功能指数-5(ArIIEF-5)、广泛性焦虑症-7(GAD-7)和患者健康问卷-9(PHQ-9)的有效评分。此外,还对这些组别中用于监测糖尿病的常规实验室检查以及血清总睾酮和鸢尾素水平进行了评估。患有ED的T2DM男性血清中鸢尾素和睾酮水平明显较低,ArIIEF-5评分也较低,但其GAD-7和PHQ-9评分明显高于无ED者或对照组(P<0.001)。在T2DM男性中,血清鸢尾素水平与ArIIEF-5评分和血清睾酮呈正相关(分别为r = 0.413,p = 0.002;r = 0.936,p < 0.001),但与糖化血红蛋白水平呈负相关(r = -0.377,p = 0.004)。预测 T2DM 患者 ED 的多变量回归分析发现,GAD-7 评分是唯一最显著的 ED 预测因子(ꞵ = - 1.176,标准误差 = 0.062,p < 0.001)。目前的研究表明,在 T2DM 男性中,鸢尾素与 ArIIEF-5 和血清睾酮呈正相关,但与 HbA1c 呈负相关。然而,有必要通过队列研究进一步验证这些发现。
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引用次数: 0
Therapeutic potential of finerenone for diabetic cardiomyopathy: focus on the mechanisms 非格列酮治疗糖尿病心肌病的潜力:关注机制
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1186/s13098-024-01466-x
Jing Wang, Haojie Xue, Jinyu He, Li Deng, Julong Tian, Yang Jiang, Jian Feng
Diabetic cardiomyopathy (DCM) is a kind of myocardial disease that occurs in diabetes patients and cannot be explained by hypertensive heart disease, coronary atherosclerotic heart disease and other heart diseases. Its pathogenesis may be closely related to programmed cell death, oxidative stress, intestinal microbes and micro-RNAs. The excessive activation of mineralocorticoid receptors (MR) in DCM can cause damage to the heart and kidneys. The third-generation non-steroidal mineralocorticoid receptor antagonist (MRA), finerenone, can effectively block MR, thus playing a role in protecting the heart and kidneys. This review mainly introduces the classification of MRA, and the mechanism of action, applications and limitations of finerenone in DCM, in order to provide reference for the study of treatment plans for DCM patients.
糖尿病心肌病(DCM)是发生在糖尿病患者身上的一种心肌疾病,无法用高血压性心脏病、冠状动脉粥样硬化性心脏病和其他心脏病来解释。其发病机制可能与程序性细胞死亡、氧化应激、肠道微生物和微核糖核酸密切相关。DCM 中矿物皮质激素受体(MR)的过度激活会对心脏和肾脏造成损害。第三代非甾体类矿物皮质激素受体拮抗剂(MRA)非诺酮能有效阻断MR,从而起到保护心脏和肾脏的作用。本综述主要介绍了 MRA 的分类,以及非奈酮在 DCM 中的作用机制、应用和局限性,以期为研究 DCM 患者的治疗方案提供参考。
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引用次数: 0
Lipid metabolites and sarcopenia-related traits: a Mendelian randomization study 脂质代谢物与肌肉疏松症相关特征:孟德尔随机研究
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-16 DOI: 10.1186/s13098-024-01465-y
Jianping Liu, Sufang Wang, Yuan Shen, Haicun Shi, Lijian Han
To explore the influence of lipid metabolism on the risk of sarcopenia. Two-sample Mendelian randomization (MR) analysis was used to determine causality. A total of 179 lipid metabolism data points were used for exposure, and the data were obtained from a plasma lipid metabolite study of 7174 participants. The total muscle mass and total muscle strength, as well as the muscle strength and muscle mass of different sex groups, were selected as the relevant traits of sarcopenia. Data for outcomes were obtained from the UK Biobank, and sample sizes ranged from 135 468 to 450 243. Inverse-variance weighted (IVW), as the main method for evaluating the causal relationship between lipid metabolites and sarcopenia, uses the false discovery rate (FDR) for multiple comparisons and conducts heterogeneity, pleiotropy, and reverse causality tests. Twenty-seven lipid metabolites, mainly phosphatidylcholine, phosphatidylethanolamine, ceramide, triacylglycerol, sphingomyelin, and sterol ester, were found to be associated with the risk of sarcopenia. Ceramide (d40:1), ceramide (d40:2), and sterol ester are risk factors for decreased muscle mass and strength. There is a positive causal relationship between various phosphatidylcholine lipids and muscle mass and strength. Sphingomyelin (d42:2) is a protective factor for total muscle strength and female muscle strength. There are inconsistent effects between different lipid metabolites, triacylglycerol, and muscle strength and muscle mass. There was a causal relationship between 27 lipid metabolites and sarcopenia traits, and targeting specific lipid metabolites may benefit sarcopenia diagnosis, disease assessment, and treatment.
探讨脂质代谢对肌少症风险的影响。采用双样本孟德尔随机化(MR)分析来确定因果关系。共有 179 个脂质代谢数据点用于暴露,这些数据来自对 7174 名参与者进行的血浆脂质代谢物研究。肌肉疏松症的相关特征包括总肌肉质量和总肌肉力量,以及不同性别组的肌肉力量和肌肉质量。研究结果的数据来自英国生物库,样本量从135 468到450 243不等。反方差加权法(IVW)是评估脂质代谢物与肌肉疏松症之间因果关系的主要方法,它使用假发现率(FDR)进行多重比较,并进行异质性、多因性和反向因果关系检验。研究发现,27种脂质代谢物(主要是磷脂酰胆碱、磷脂酰乙醇胺、神经酰胺、三酰甘油、鞘磷脂和甾醇酯)与肌肉疏松症的风险有关。神经酰胺(d40:1)、神经酰胺(d40:2)和甾醇酯是导致肌肉质量和力量下降的风险因素。各种磷脂酰胆碱脂质与肌肉质量和力量之间存在正向因果关系。磷脂酰胆碱(d42:2)是总肌肉力量和女性肌肉力量的保护因素。不同脂质代谢物、三酰甘油与肌肉力量和肌肉质量之间的影响不一致。27 种脂质代谢物与肌肉疏松症特征之间存在因果关系,针对特定的脂质代谢物可能有利于肌肉疏松症的诊断、疾病评估和治疗。
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引用次数: 0
Construction and evaluation of sarcopenia risk prediction model for patients with diabetes: a study based on the China health and retirement longitudinal study (CHARLS) 糖尿病患者肌少症风险预测模型的构建与评估:基于中国健康与退休纵向研究(CHARLS)的研究
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-16 DOI: 10.1186/s13098-024-01467-w
Mingrui Zou, Zhenxing Shao
Sarcopenia is a common complication of diabetes. Nevertheless, precise evaluation of sarcopenia risk among patients with diabetes is still a big challenge. The objective of this study was to develop a nomogram model which could serve as a practical tool to diagnose sarcopenia in patients with diabetes. A total of 783 participants with diabetes from China Health and Retirement Longitudinal Study (CHARLS) 2015 were included in this study. After oversampling process, 1,000 samples were randomly divided into the training set and internal validation set. To mitigate the overfitting effect caused by oversampling, data of CHARLS 2011 were utilized as the external validation set. Least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression analysis were employed to explore predictors. Subsequently, a nomogram was developed based on the 9 selected predictors. The model was assessed by area under receiver operating characteristic (ROC) curves (AUC) for discrimination, calibration curves for calibration, and decision curve analysis (DCA) for clinical efficacy. In addition, machine learning models were constructed to enhance the robustness of our findings and evaluate the importance of the predictors. 9 factors were selected as predictors of sarcopenia for patients with diabetes. The nomogram model exhibited good discrimination in training, internal validation and external validation sets, with AUC of 0.808, 0.811 and 0.794. machine learning models revealed that age and hemoglobin were the most significant predictors. Calibration curves and DCA illustrated excellent calibration and clinical applicability of this model. This comprehensive nomogram presented high clinical predictability, which was a promising tool to evaluate the risk of sarcopenia in patients with diabetes.
肌肉疏松症是糖尿病的常见并发症。然而,精确评估糖尿病患者的肌肉疏松症风险仍是一项巨大挑战。本研究旨在建立一个提名图模型,作为诊断糖尿病患者肌肉疏松症的实用工具。本研究共纳入了 783 名来自 2015 年中国健康与退休纵向研究(CHARLS)的糖尿病患者。经过超采样处理后,1000 个样本被随机分为训练集和内部验证集。为了减轻超采样造成的过拟合效应,研究采用了 CHARLS 2011 的数据作为外部验证集。采用最小绝对收缩和选择算子(LASSO)回归分析和多元逻辑回归分析来探索预测因素。随后,根据 9 个选定的预测因子建立了一个提名图。通过接收者操作特征曲线(ROC)下面积(AUC)来评估模型的区分度,通过校准曲线来评估校准度,通过决策曲线分析(DCA)来评估临床疗效。此外,我们还构建了机器学习模型,以增强研究结果的稳健性并评估预测因素的重要性。我们选择了 9 个因素作为糖尿病患者肌肉疏松症的预测因子。提名图模型在训练集、内部验证集和外部验证集上都表现出良好的区分度,AUC 分别为 0.808、0.811 和 0.794。机器学习模型显示,年龄和血红蛋白是最重要的预测因子。校准曲线和 DCA 表明该模型具有良好的校准性和临床适用性。该综合提名图具有很高的临床预测性,是评估糖尿病患者肌肉疏松症风险的理想工具。
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引用次数: 0
Type 2 diabetes mellitus negatively affects the functional performance of 6-min step test in chronic heart failure: a 3-year follow-up study 2 型糖尿病对慢性心力衰竭患者 6 分钟台阶试验功能表现的负面影响:一项为期 3 年的随访研究
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-14 DOI: 10.1186/s13098-024-01464-z
Aldair Darlan Santos-de-Araújo, Daniela Bassi-Dibai, Izadora Moraes Dourado, Cássia da Luz Goulart, Renan Shida Marinho, Jaqueline de Almeida Mantovani, Gabriela Silva de Souza, Polliana Batista dos Santos, Meliza Goi Roscani, Shane A. Phillips, Audrey Borghi-Silva
Type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) present a decrease in functional capacity due to the intrinsic nature of both pathologies. It is not known about the potential impact of T2DM on functional capacity when assessed by 6-min step test (6MST) and its effect as a prognostic marker for fatal and non-fatal events in patients with CHF. to evaluate the coexistence of T2DM and CHF in functional capacity through 6MST when compared to CHF non-T2DM, as well as to investigate the different cardiovascular responses to 6MST and the risk of mortality, decompensation of CHF and acute myocardial infarction (AMI) over 36 months. This is a prospective cohort study with 36 months of follow-up in individuals with T2DM and CHF. All participants completed a clinical assessment, followed by pulmonary function testing, echocardiography, and 6MST. The 6MST was performed on a 20 cm high step and cardiovascular responses were collected: heart rate, systemic blood pressure, oxygen saturation, BORG dyspnea and fatigue. The risk of mortality, acute myocardial infarction and decompensation of CHF was evaluated. Eighty-six participants were included. The CHF-T2DM group had a significantly lower functional capacity than the CHF non-T2DM group (p < 0.05). Forced Expiratory Volume in one second (L), ejection fraction (%), gender and T2DM influence and are predictors of functional capacity (p < 0.05; adjusted R squared: 0.419). CHF-T2DM group presented a higher risk of mortality and acute myocardial infarction over the 36 months of follow-up (p < 0.05), but not to the risk of decompensation (p > 0.05). T2DM negatively affects the functional performance of 6MST in patients with CHF. Gender, ejection fraction (%), FEV1 (L) and T2DM itself negatively influence exercise performance.
2 型糖尿病(T2DM)和慢性心力衰竭(CHF)会导致机能下降,这是由于这两种病症的内在本质所致。通过 6 分钟台阶试验(6MST)评估 T2DM 对功能能力的潜在影响,以及 T2DM 作为慢性心力衰竭患者致命和非致命事件的预后标志物的作用,目前尚不清楚。这项研究的目的是通过 6 分钟台阶试验评估 T2DM 和慢性心力衰竭并存时的功能能力,与非 T2DM 的慢性心力衰竭患者进行比较,并调查 6 分钟台阶试验的不同心血管反应,以及 36 个月内的死亡率、慢性心力衰竭失代偿和急性心肌梗死(AMI)的风险。这是一项前瞻性队列研究,对患有 T2DM 和 CHF 的患者进行了 36 个月的随访。所有参与者均完成了临床评估,随后进行了肺功能测试、超声心动图检查和 6MST 检查。6MST 在 20 厘米高的台阶上进行,并收集心血管反应:心率、全身血压、血氧饱和度、BORG 呼吸困难和疲劳。对死亡率、急性心肌梗死和慢性心力衰竭失代偿的风险进行了评估。共纳入 86 名参与者。CHF-T2DM 组的功能能力明显低于 CHF 非 T2DM 组(P 0.05)。T2DM 对 CHF 患者的 6MST 功能表现有负面影响。性别、射血分数(%)、FEV1(L)和 T2DM 本身都会对运动能力产生负面影响。
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引用次数: 0
Cross-cultural adaptation and validation to Brazilian Portuguese of the ‘knowledge of gestational diabetes (GDM)’ questionnaire for women with GDM 根据巴西葡萄牙语对针对妊娠期糖尿病(GDM)妇女的 "妊娠期糖尿病(GDM)知识 "问卷进行跨文化改编和验证
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-14 DOI: 10.1186/s13098-024-01456-z
Laura Betat Pereira, Helena Trevisan Schroeder, Juciela Keller dos Santos, Paulo César Brizolla Capelari, Beatriz D. Schaan, Patrícia Martins Bock
Gestational diabetes mellitus (GDM) is characterized by hyperglycemia during pregnancy. There are many diabetes-specific tools for collecting information validated in Brazilian Portuguese. However, there are no specific instruments to assess knowledge about GDM in Brazilian Portuguese. The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus questionnaire (GDMKQ). This study was conducted in southern Brazil from January to December 2023. Women with GDM or diabetes identified during pregnancy were considered eligible based on specific criteria. Clinical and demographic data were obtained through a medical records search. The GDMKQ underwent a multistep adaptation process, including translation, back-translation, content validity assessment, and cognitive interviews. After administration to participants, internal consistency, item-total correlation, and intraclass correlation were assessed. Confirmatory factor analysis was also conducted to ensure validity. A total of 155 pregnant women were recruited for the study. Most participants were aged 18–30 years, and hypertension was the main comorbidity (25.2%). Regarding education, most participants (58.7%) attended high school. The Brazilian Portuguese version of the GDMKQ consisted of 32 items. The intraclass correlation was established by two independent interviews with 57 participants, yielding a correlation coefficient of 0.79 (p < 0.01). Internal consistency (Cronbach’s alpha) was 0.81 overall but was less than 0.7 for each domain. Item-total correlations were calculated, and confirmatory factor analysis indicated a good model fit. The final Brazilian Portuguese version of the questionnaire consisted of 32 items. The Brazilian Portuguese version of the GDMKQ yielded a reliable and valid tool for evaluating diabetes knowledge in pregnant women.
妊娠糖尿病(GDM)的特点是在怀孕期间出现高血糖。有许多专门收集糖尿病信息的工具已在巴西葡萄牙语中得到验证。然而,目前还没有专门的工具来评估巴西葡萄牙语中有关 GDM 的知识。本研究旨在对巴西葡萄牙语版的妊娠糖尿病知识问卷(GDMKQ)进行跨文化改编和验证。这项研究于 2023 年 1 月至 12 月在巴西南部进行。根据特定标准,患有妊娠期糖尿病或在怀孕期间发现患有糖尿病的妇女被视为符合条件。临床和人口统计学数据通过病历检索获得。GDMKQ 经过了多步骤的调整过程,包括翻译、回译、内容有效性评估和认知访谈。在对参与者进行施测后,对内部一致性、项目总相关性和类内相关性进行了评估。此外,还进行了确认性因子分析,以确保其有效性。本研究共招募了 155 名孕妇。大多数参与者的年龄在 18-30 岁之间,高血压是主要的合并症(25.2%)。在教育程度方面,大多数参与者(58.7%)上过高中。巴西葡萄牙语版的 GDMKQ 包括 32 个项目。通过对 57 名参与者进行两次独立访谈,确定了类内相关性,相关系数为 0.79(P < 0.01)。总体内部一致性(Cronbach's alpha)为 0.81,但每个领域的内部一致性均小于 0.7。计算了项目-总相关性,确认性因素分析表明模型拟合良好。最终的巴西葡萄牙语版问卷包含 32 个项目。巴西葡萄牙语版 GDMKQ 是评估孕妇糖尿病知识的可靠而有效的工具。
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引用次数: 0
The association of changes in the Chinese visceral adiposity index and cardiometabolic diseases: a cohort study 中国人内脏脂肪指数变化与心血管代谢疾病的关系:一项队列研究
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-14 DOI: 10.1186/s13098-024-01460-3
Song Wen, Xingjie Huang, Zehan Huang, Xinjie Zhang, Chang Dai, Feihuang Han, Weidong Zheng, Feng Wang, Shubo Chen, Bin Zhang, Yuqing Huang
The relationship between changes in Chinese visceral adiposity index (CVAI) and cardiometabolic diseases (CMD) in middle-aged and elderly individuals remains unclear. This study aimed to explore whether changes in the CVAI were associated with CMD incidence. This study included 3,243 individuals aged over 45 years from the China Health and Retirement Longitudinal Study. The exposures were changes in the CVAI and cumulative CVAI from 2012 to 2015. Changes in the CVAI were classified using K-means clustering analysis, and the cumulative CVAI was calculated as follows: (CVAI2012 + CVAI2015)/2 × time (2015–2012). Multivariable logistic regression models were used to assess the relationship between different CVAI change classes and CMD incidence. Restricted cubic splines regression was used to assess the dose–response relationship between cumulative CVAI and CMD incidence. To investigate the relationship between combined exposure to each component of CAVI and CMD incidence, a weighted quantile sum regression analysis was employed. During the 5 years of follow-up, 776 (24%) incident CMD cases were identified. Changes in CVAI and cumulative CVAI were independently and positively associated with CMD. After adjusting for potential confounders, compared with Class 1, the adjusted ORs (95% CIs) for incident CMD were 1.18 (0.90–1.57) for Class 2, 1.40 (1.03–1.92) for Class 3, and 1.56 (1.04–2.34) for Class 4. When cumulative CVAI was categorized into quartiles, compared with Q1, the adjusted ORs (95% CIs) for incident CMD were 1.30 (1.00–1.70) for Q2, 1.34 (1.01–1.79) for Q3, and 1.63 (1.15–2.31) for Q4. In addition, cumulative CVAI in the overall population exhibited a linear association with CMD (Poverall = 0.012, Pnon-linearity = 0.287), diabetes (Poverall = 0.022, Pnon-linearity = 0.188), and stroke (Poverall = 0.002, Pnon-linearity = 0.978), but showed no significant association with heart disease (Poverall = 0.619, Pnon-linearity = 0.442). Participants with higher baseline CVAI level and a change of elevating CVAI level may suffer an increased incidence of CMD. Furthermore, our findings elucidate the underlying mechanisms of the CVAI by highlighting TG as the primary contributor to the observed associations. Long-term CVAI monitoring is of significant importance for early identification and prevention of CMD, with significant implications for clinical practice.
中国人内脏脂肪指数(CVAI)的变化与中老年人心血管代谢疾病(CMD)之间的关系尚不清楚。本研究旨在探讨内脏脂肪指数的变化是否与 CMD 发病率相关。该研究纳入了中国健康与退休纵向研究中 3,243 名 45 岁以上的中老年人。研究对象为2012年至2015年间CVAI和累积CVAI的变化。CVAI的变化采用K均值聚类分析法进行分类,累积CVAI的计算方法如下:(CVAI2012 + CVAI2015)/2 × 时间(2015-2012)。多变量逻辑回归模型用于评估不同 CVAI 变化等级与 CMD 发病率之间的关系。限制性三次样条回归用于评估累积 CVAI 与 CMD 发病率之间的剂量-反应关系。为了研究CAVI各组成部分的综合暴露与CMD发病率之间的关系,采用了加权量子和回归分析。在 5 年的随访期间,共发现了 776 例(24%)CMD 病例。CVAI和累积CVAI的变化与CMD呈独立正相关。在调整了潜在的混杂因素后,与 1 级相比,2 级发生 CMD 的调整 ORs(95% CIs)为 1.18(0.90-1.57),3 级为 1.40(1.03-1.92),4 级为 1.56(1.04-2.34)。如果将累积 CVAI 划分为四分位,与 Q1 相比,Q2、Q3 和 Q4 发生 CMD 的调整 ORs(95% CIs)分别为 1.30(1.00-1.70)、1.34(1.01-1.79)和 1.63(1.15-2.31)。此外,总体人群的累积 CVAI 与慢性阻塞性肺病(Poverall = 0.012,Pnon-linearity = 0.287)、糖尿病(Poverall = 0.022,Pnon-linearity = 0.188)和中风(Poverall = 0.002,Pnon-linearity = 0.978)呈线性相关,但与心脏病(Poverall = 0.619,Pnon-linearity = 0.442)无显著关联。基线 CVAI 水平较高的参与者和 CVAI 水平升高的变化可能会增加 CMD 的发病率。此外,我们的研究结果还阐明了 CVAI 的潜在机制,强调 TG 是导致所观察到的关联的主要因素。长期监测 CVAI 对早期识别和预防慢性阻塞性肺病具有重要意义,对临床实践也有重大影响。
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引用次数: 0
A systematic review and meta-analysis of the effect of hyperglycemia on admission for acute myocardial infarction in diabetic and non-diabetic patients 高血糖对糖尿病和非糖尿病患者急性心肌梗死入院影响的系统回顾和荟萃分析
IF 4.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-12 DOI: 10.1186/s13098-024-01459-w
Reem Alawaji, Mohammed Musslem, Emtenan Alshalahi, Abdulaziz Alanzan, Albarra Sufyani, Maram Alhati, Alhanouf Almutairi, Mahdi Alqaffas, Batool Alattas, Adhari Alselmi
Regarding a potential relationship between diabetes and the prognostic significance of hyperglycemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycemia on different outcomes in AMI patients, whether they are diabetic or not. We searched PubMed, Web of Science, and Scopus using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level” to find eligible articles that needed to go through the screening process for inclusion in our study. We conducted a meta-analysis of 19 included studies from Japan, Germany, China, the United Kingdom, and others using Review Manager version 5.4 software, pooling the mean difference in continuous variables, the number and total of dichotomous variables to measure the odds ratio (OR), and the generic inverse variance of OR or hazard ratio (HR) as reported in the included studies. The mean age of the participants ranged from 56.3 to 72.3 years old. The difference in blood glucose levels between diabetes and non-diabetes patients was found to be statistically significant, with an SMD of 1.39 (95%CI: 1.12, 1.66, p < 0.00001). In diabetic patients, hyperglycemia was statistically significantly associated with mortality, with a HR of 1.92 (95% CI: 1.45, 2.55, p < 0.00001) and an OR of 1.76 (95% CI: 1.15, 2.7, p = 0.01). In non-diabetic patients admitted with AMI, hyperglycemia was statistically significantly associated with mortality, with a HR of 1.56 (95% CI: 1.31, 1.86, p < 0.00001) and an OR of 2.89 (95% CI: 2.47, 3.39, p < 0.00001). AMI patients who were diabetic were statistically more likely to have a major adverse cardiovascular event (MACE) (HR = 1.9; 95% CI: 1.19–3.03; p = 0.007). AMI patients who were not diabetic were also statistically more likely to have a MACE (HR = 1.6; 95% CI: 1.15–2.23, p = 0.006). Hyperglycemia in AMI patients is a predictor of worse outcomes, including MACE and mortality, regardless of whether these patients are diabetic or not. In these patients, some factors act as predictors of mortality, including older age, higher glucose levels on admission, and a high Killip class.
关于糖尿病与急性心肌梗死(AMI)患者高血糖的预后意义之间的潜在关系,目前仍存在争议。因此,我们在本研究中旨在证明高血糖对急性心肌梗死患者不同预后的影响,无论患者是否患有糖尿病。我们使用以下搜索策略在 PubMed、Web of Science 和 Scopus 上进行了搜索:"糖尿病 "或 "糖尿病 "和 "急性心肌梗死 "或 "AMI "和 "高血糖 "或 "血糖水平",以找到符合条件的文章,这些文章需要经过筛选才能纳入我们的研究。我们使用 Review Manager 5.4 版软件对来自日本、德国、中国、英国和其他国家的 19 项纳入研究进行了荟萃分析,汇总了连续变量的平均差、二分变量的数量和总和,以计算几率比(OR),以及纳入研究中报告的 OR 或危险比(HR)的通用反方差。参与者的平均年龄在 56.3 岁至 72.3 岁之间。研究发现,糖尿病患者和非糖尿病患者的血糖水平差异具有统计学意义,SMD 为 1.39(95%CI:1.12,1.66,P < 0.00001)。在糖尿病患者中,高血糖与死亡率有显著统计学相关性,HR 为 1.92(95% CI:1.45,2.55,p < 0.00001),OR 为 1.76(95% CI:1.15,2.7,p = 0.01)。在收治的非糖尿病急性心肌梗死患者中,高血糖与死亡率有显著统计学相关性,HR 为 1.56(95% CI:1.31,1.86,p < 0.00001),OR 为 2.89(95% CI:2.47,3.39,p < 0.00001)。据统计,患有糖尿病的急性心肌梗死患者更有可能发生重大不良心血管事件(MACE)(HR = 1.9;95% CI:1.19-3.03;P = 0.007)。据统计,非糖尿病急性心肌梗死患者发生 MACE 的几率也更高(HR = 1.6;95% CI:1.15-2.23;P = 0.006)。无论患者是否患有糖尿病,急性心肌梗死患者的高血糖都会导致不良预后,包括MACE和死亡率。在这些患者中,一些因素可预测死亡率,包括年龄较大、入院时血糖水平较高以及 Killip 分级较高。
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Diabetology & Metabolic Syndrome
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