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Relationship between nonrestorative sleep with short sleep duration and diabetes mellitus comorbid among a Japanese occupational population. 日本职业人群中的非恢复性睡眠、睡眠时间短与糖尿病合并症之间的关系。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-02-17 eCollection Date: 2023-04-01 DOI: 10.1007/s13340-023-00620-6
Hiromitsu Sekizuka, Hitoshi Miyake

Objective: Nonrestorative sleep (NRS) is one of the symptoms of insomnia and is clearly more associated with objective indices, such as sleep stability, sleep fragmentation, and inflammatory responses, than other insomnia symptoms. However, the link between NRS and diabetes mellitus is poorly understood. Therefore, the prevalence of NRS in workers and the relationships between NRS and diabetes were investigated.

Methods: The results of a single year's medical examinations were investigated for 26,144 Japanese active office workers who were 30 to 59 years old. NRS was investigated using a personal computer in a medical interview. Furthermore, the relationships between NRS and diabetes comorbidity in addition to sleep duration were also analyzed.

Results: The mean age of the subjects was 47.9 ± 7.3 years old, and the proportion of subjects with NRS was 26%. The presence of NRS together with a sleep duration ≤ 5 h or a sleep duration of 6 h was an independent comorbid factor for diabetes compared with the absence of NRS together with a sleep duration of 7 h (odds ratio [OR] 1.34; 95% confidence interval [CI] 1.14-1.58; P < 0.001; and OR 1.25; 95% CI 1.04-1.48; P = 0.015).

Conclusion: NRS in active workers may contribute to the development of diabetes even if the workers have the same short sleep durations as other workers without NRS.

目的:非恢复性睡眠(NRS)是失眠症状之一:非恢复性睡眠(NRS)是失眠的症状之一,与其他失眠症状相比,它显然与睡眠稳定性、睡眠片段化和炎症反应等客观指标更有关联。然而,人们对 NRS 与糖尿病之间的联系知之甚少。因此,我们对工人中 NRS 的流行率以及 NRS 与糖尿病之间的关系进行了调查:方法:调查了 26 144 名 30 至 59 岁的日本在职上班族一年的体检结果。在医疗访谈中使用个人电脑对 NRS 进行了调查。此外,还分析了 NRS 与糖尿病合并症以及睡眠时间之间的关系:受试者的平均年龄为 47.9 ± 7.3 岁,有 NRS 的受试者比例为 26%。与没有 NRS 且睡眠时间为 7 小时的受试者相比,存在 NRS 且睡眠时间少于 5 小时或睡眠时间为 6 小时的受试者是糖尿病的独立合并因素(几率比 [OR] 1.34;95% 置信区间 [CI] 1.14-1.58;P P = 0.015):结论:在职工人的 NRS 可能会导致糖尿病的发生,即使这些工人的睡眠时间与其他没有 NRS 的工人一样短。
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引用次数: 0
Comparison of the loci associated with HbA1c and blood glucose levels identified by a genome-wide association study in the Japanese population. 比较日本人群中通过全基因组关联研究发现的与 HbA1c 和血糖水平相关的基因位点。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-27 eCollection Date: 2023-04-01 DOI: 10.1007/s13340-023-00618-0
Takuya Sakashita, Yasuyuki Nakamura, Yoichi Sutoh, Atsushi Shimizu, Tsuyoshi Hachiya, Yayoi Otsuka-Yamasaki, Naoyuki Takashima, Aya Kadota, Katsuyuki Miura, Yoshikuni Kita, Hiroaki Ikezaki, Jun Otonari, Keitaro Tanaka, Chisato Shimanoe, Teruhide Koyama, Isao Watanabe, Sadao Suzuki, Hiroko Nakagawa-Senda, Asahi Hishida, Takashi Tamura, Yasufumi Kato, Rieko Okada, Kiyonori Kuriki, Sakurako Katsuura-Kamano, Takeshi Watanabe, Shiroh Tanoue, Chihaya Koriyama, Isao Oze, Yuriko N Koyanagi, Yohko Nakamura, Miho Kusakabe, Masahiro Nakatochi, Yukihide Momozawa, Kenji Wakai, Keitaro Matsuo

Aims: Hemoglobin A1c (HbA1c) levels are widely employed to diagnose diabetes. However, estimates of the heritability of HbA1c and glucose levels are different. Therefore, we explored HbA1c- and blood glucose-associated loci in a non-diabetic Japanese population.

Methods: We conducted a two-stage genome-wide association study (GWAS) on variants associated with HbA1c and blood glucose levels in a Japanese population. In the initial stage, data of 4911 participants of the Japan Multi-Institutional Collaborative Cohort (J-MICC) were subjected to discovery analysis. In the second stage, two datasets from the Tohoku Medical Megabank project, with 8175 and 40,519 participants, were used for the replication study. Association of the imputed variants with HbA1c and blood glucose levels was determined via linear regression analyses adjusted for age, sex, body mass index (BMI), smoking, and genetic principal components (PC1-PC10). Moreover, we performed a BMI-stratified GWAS on HbA1c levels in the J-MICC. The discovery analysis and BMI-stratified GWAS results were validated with re-analyses of normalized HbA1c levels adjusted for site in addition to the above, and blood glucose adjusted for fasting time as an additional covariate.

Results: Genetic variants associated with HbA1c levels were identified in KCNQ1 and TMC6. None of the genetic variants associated with blood glucose levels in the discovery analysis were replicated. Association of rs2299620 in KCNQ1 with HbA1c levels showed heterogeneity between individuals with BMI ≥ 25 kg/m2 and BMI < 25 kg/m2.

Conclusions: The variant rs2299620 in KCNQ1 might affect HbA1c levels differentially based on BMI grouping in the Japanese population.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00618-0.

目的:血红蛋白 A1c(HbA1c)水平被广泛用于诊断糖尿病。然而,对 HbA1c 和血糖水平遗传性的估计却不尽相同。因此,我们在非糖尿病日本人群中探索了与 HbA1c 和血糖相关的基因位点:我们对日本人群中与 HbA1c 和血糖水平相关的变异进行了两阶段全基因组关联研究(GWAS)。在第一阶段,我们对日本多机构协作队列(J-MICC)中 4911 名参与者的数据进行了发现分析。第二阶段的复制研究使用了来自东北医学巨型数据库项目的两个数据集,分别有 8175 名和 40519 名参与者。通过调整年龄、性别、体重指数(BMI)、吸烟和遗传主成分(PC1-PC10)的线性回归分析,确定了估算变异与 HbA1c 和血糖水平的关系。此外,我们还对 J-MICC 中的 HbA1c 水平进行了 BMI 分层 GWAS 分析。发现分析和 BMI 分层 GWAS 结果通过对归一化 HbA1c 水平的重新分析进行了验证,除上述分析外,还根据地点进行了调整,并将空腹时间作为额外的协变量对血糖进行了调整:结果:在 KCNQ1 和 TMC6 中发现了与 HbA1c 水平相关的基因变异。在发现分析中,与血糖水平相关的基因变异均未被复制。KCNQ1 中的 rs2299620 与 HbA1c 水平的关系在体重指数≥ 25 kg/m2 和体重指数为 2 的个体之间表现出异质性:结论:在日本人群中,KCNQ1中的变异体rs2299620可能会根据BMI分组对HbA1c水平产生不同的影响:在线版本包含补充材料,可在 10.1007/s13340-023-00618-0。
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引用次数: 0
Usefulness of measuring fast valley height rate using high-performance liquid chromatography for variant hemoglobin, Hb A2-Niigata. 使用高效液相色谱法测量变异血红蛋白 Hb A2-Niigata 的快速谷高率的实用性。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-25 eCollection Date: 2023-04-01 DOI: 10.1007/s13340-023-00617-1
Mika Ito, Masataka Shikata, Masafumi Koga

We have reported cases of hemoglobin (Hb) A2-Niigata (δ1Val → Ala) with δ chain variant Hb and falsely high HbA1c levels. In subjects with Hb A2-Niigata, shoulder-shaped anomalous peak was detected immediately before the HbA1c peaks using high-performance liquid chromatography (HPLC; HLC-723 G9). The phenomenon where the valley between peaks of LA1c+ , a fraction containing labile HbA1c, and HbA1c fraction [fast valley (FV)] became shallow owing to the anomalous peak was observed. In this study, we attempted to quantify the height index of the FV. We assumed that the index FV height rate (FVHR) was useful for screening Hb A2-Niigata. Five subjects with Hb A2-Niigata were compared with the control group of 50 subjects without diabetes and 50 with diabetes. Various indices were measured using HPLC chromatograms, and FVHR was calculated based on these indices. FVHR in subjects with Hb A2-Niigata was significantly higher than that in subjects without and with diabetes (all P < 0.001). Furthermore, when the cutoff value of FVHR was set at 23-30%, Hb A2-Niigata could be diagnosed with high sensitivity and specificity (both 100%). Hb A2-Niigata can be screened using FVHR with high sensitivity and specificity. FVHR might be also useful for screening other variant hemoglobins with abnormal HPLC chromatograph.

我们曾报告过血红蛋白(Hb)A2-Niigata(δ1Val → Ala)δ链变异型 Hb 和假性高 HbA1c 水平的病例。在 Hb A2-Niigata 患者中,使用高效液相色谱法(HPLC;HLC-723 G9)可在 HbA1c 峰之前检测到肩形异常峰。由于该异常峰的存在,我们观察到含有易变 HbA1c 的 LA1c+ 部分与 HbA1c 部分的峰间谷[快速谷(FV)]变浅的现象。在本研究中,我们尝试量化 FV 的高度指数。我们假设 FV 高度指数(FVHR)可用于筛查 Hb A2-新泻。我们将五名患有 Hb A2-Niigata 的受试者与对照组的 50 名非糖尿病受试者和 50 名糖尿病受试者进行了比较。使用高效液相色谱法测量了各种指数,并根据这些指数计算出 FVHR。患有 Hb A2-Niigata 的受试者的 FVHR 明显高于无糖尿病和有糖尿病的受试者(均为 P 0.001)。此外,当 FVHR 的临界值设定为 23-30% 时,Hb A2-Niigata 的诊断灵敏度和特异性都很高(均为 100%)。使用 FVHR 筛查 Hb A2-Niigata 的灵敏度和特异性都很高。FVHR 也可用于筛查其他 HPLC 色谱异常的变异血红蛋白。
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引用次数: 0
Cardiovascular disease prevalence in adults with type 2 diabetes in Japan: results from the Japanese centers in the CAPTURE study. 日本成人 2 型糖尿病患者的心血管疾病患病率:CAPTURE 研究日本中心的结果。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-14 eCollection Date: 2023-04-01 DOI: 10.1007/s13340-022-00612-y
Hiroaki Seino, Yukiko Onishi, Kosei Eguchi, Keiji Nishijima, Toshihiro Sato, Shinichiro Shirabe

Introduction: CAPTURE was a cross-sectional, non-interventional study (NCT03786406, NCT03811288) investigating the prevalence and characteristics of cardiovascular disease (CVD) in adults with type 2 diabetes (T2D) across 13 countries worldwide. Here we present the findings for Japan.

Materials and methods: Data were collected from adults aged ≥ 20 years (aged ≥ 18 years in countries outside Japan) with T2D who were managed in clinics or hospitals in 2019. Standardized methodology was used for all countries. The prevalence of CVD and its subtypes was estimated, weighted by care setting (clinics versus hospitals).

Results: Among participants from Japan (total: 800; clinics: 440; hospitals: 360), mean (standard deviation) age was 65.6 (11.2) years and glycated hemoglobin 7.2% (0.9). Sixty-seven percent of participants were male, 57.8% had diabetes duration > 10 years, 49.8% had body mass index ≥ 25 kg/m2 and 63.1% had hypertension. The weighted prevalences (95% confidence interval [CI]) of CVD and atherosclerotic CVD were 37.3% (34.2;40.3) and 33.5% (30.6;36.4), respectively. The prevalence (95% CI) of the most common subtypes of CVD was: carotid artery disease 20.5% (18.2;22.8), coronary heart disease 11.9% (9.7;14.1) and cerebrovascular disease 10.4% (8.3;12.5).

Conclusions: These contemporary data from the CAPTURE study on CVD prevalence in adults with T2D in Japan show that approximately one in three adults with T2D had established CVD, which is comparable to the prevalence in the global study cohort.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00612-y.

简介CAPTURE 是一项横断面、非干预性研究(NCT03786406、NCT03811288),调查了全球 13 个国家的 2 型糖尿病(T2D)成人心血管疾病(CVD)的患病率和特征。在此,我们介绍日本的调查结果:收集的数据来自2019年在诊所或医院接受治疗的年龄≥20岁(日本以外的国家年龄≥18岁)的成人2型糖尿病患者。所有国家均采用标准化方法。根据护理环境(诊所与医院)加权估算心血管疾病及其亚型的患病率:在日本的参与者(总计:800 人;诊所:440 人;医院:360 人)中,平均(标准差)年龄为 65.6 (11.2) 岁,糖化血红蛋白为 7.2% (0.9)。67%的参与者为男性,57.8%的参与者糖尿病病程超过 10 年,49.8%的参与者体重指数≥ 25 kg/m2,63.1%的参与者患有高血压。心血管疾病和动脉粥样硬化性心血管疾病的加权患病率(95% 置信区间 [CI])分别为 37.3% (34.2;40.3) 和 33.5% (30.6;36.4)。最常见的心血管疾病亚型的患病率(95% CI)分别为:颈动脉疾病 20.5% (18.2;22.8)、冠心病 11.9% (9.7;14.1)和脑血管疾病 10.4% (8.3;12.5):这些来自日本 T2D 成人心血管疾病患病率 CAPTURE 研究的当代数据显示,大约每三名 T2D 成人中就有一人已确诊为心血管疾病,这与全球研究队列中的患病率相当:在线版本包含补充材料,可在 10.1007/s13340-022-00612-y.上查阅。
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引用次数: 0
Relationship between diabetic complications and the nutritional index in untreated diabetes. 未经治疗的糖尿病患者糖尿病并发症与营养指数的关系。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00595-w
Shuji Horinouchi, Mihoko Harada, Sakiko Ikeda, Remi Horinouchi, Misako Kubo, Yuma Tashiro, Ayako Ijuin, Miki Mukai, Yoshihiko Nishio

This study aimed to determine the association between diabetic complications and the nutritional index at the first hospital visit in untreated patients with diabetes. Two hundred and four patients with untreated type 2 diabetes were enrolled in the present study. Nutrition-related risks were assessed using the Geriatric Nutritional Risk Index (GNRI). The patients were divided into the following three subgroups: major/moderate risk, low risk, and no risk. Intergroup comparisons of clinical characteristics were carried out. The risk of complications related to diabetes was associated with the GNRI. The major/moderate-risk group (GNRI < 92) had a high risk for diabetic retinopathy, diabetic nephropathy, and diabetic foot, while the low-risk group (GNRI of 92 to ≤ 98) had a high risk for diabetic nephropathy only. The odds ratio of diabetic retinopathy for a major/moderate risk was 17.6. The odds ratio of diabetic nephropathy for a major/moderate risk was 16.7. Nutritional assessment at the first hospital visit using the GNRI could be a simple and useful tool for predicting the risk of diabetic complications in untreated patients with diabetes.

本研究旨在确定未经治疗的糖尿病患者首次就诊时糖尿病并发症与营养指数之间的关系。244名未经治疗的2型糖尿病患者参加了本研究。使用老年营养风险指数(GNRI)评估营养相关风险。患者被分为以下三个亚组:主要/中等风险、低风险和无风险。进行临床特征的组间比较。糖尿病相关并发症的风险与GNRI相关。主要/中度危险组(GNRI)
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引用次数: 0
The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes. 初级保健2型糖尿病患者自我保健活动、社会支持与血糖控制的关系
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00598-7
Hala Mohamed El-Radad, Hazem A Sayed Ahmed, Nahed Amen Eldahshan

Objective: Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM).

Methods: A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020.

Results: Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, p = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, p = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control.

Conclusion: Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.

目的:埃及在初级保健(PHC)中评估糖尿病自我保健、社会支持和血糖控制之间关系的研究是有限的。因此,本研究旨在评估这种关系,并评估埃及PHC合并2型糖尿病(T2DM)患者糖尿病自我护理、社会支持和血糖控制的相关因素。方法:对塞得港市隶属于卫生保健总局的四家初级保健机构的320例T2DM患者进行横断面研究。采用半结构化问卷收集数据,包括人口统计学特征、社会经济地位量表、疾病概况、阿拉伯语版《糖尿病自我护理活动摘要》和获得的社会支持量表。数据收集时间为2020年1月至2020年6月。结果:糖尿病自我护理活动、自我血糖监测与糖化血红蛋白(HbA1c)水平呈极弱负相关(rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044)。餐后获得社会支持与HbA1c水平呈极弱正相关(rho = 0.145, p = 0.010)。在糖尿病感受方面接受情感支持与遵循特定饮食之间几乎没有正相关(rho = 0.169, p = 0.002)。糖尿病自我保健活动与高等教育水平和高BMI呈正相关。接受社会支持与患冠状动脉疾病和婚姻状况(如离婚和寡妇)呈负相关。年龄增加和女性是血糖控制良好的预测因素。结论:糖尿病自我护理活动与降低HBA1c水平有关。需要进一步的研究来评估社会支持对PHC合并T2DM患者血糖结局的缓冲作用。
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引用次数: 5
Association of the estimated glomerular filtration rate (eGFR) and/or proteinuria to predict the risk of initiation of dialysis in people with and without diabetes. 估计肾小球滤过率(eGFR)和/或蛋白尿与预测糖尿病患者和非糖尿病患者开始透析风险的关系
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00603-z
Taeko Osawa, Kazuya Fujihara, Mayuko Harada Yamada, Yuta Yaguchi, Takaaki Sato, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Satoru Kodama, Hirohito Sone

Aims: To determine the associations between combined urinary protein (UP) and a reduced estimated glomerular filtration rate (eGFR) and the risk of starting dialysis with or without diabetes mellitus (DM).

Methods: A nationwide database with claims data on 335,778 people with and without DM aged 19-72 years in Japan was used to elucidate the impact of the severities of UP and eGFR on starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modeling, we investigated the severities of UP and eGFR to predict the initiation of dialysis with and without DM.

Results: Both eGFR < 60 and UP(+) were independent predictors for starting dialysis with and without DM, and their values exhibited a synergistic risk of dialysis. eGFR < 60 presented a nearly twofold risk for starting dialysis compared to UP(+) regardless of DM. Risk of starting dialysis was increased with UP(+) and eGFR ≥ 60 accompanied by DM although this association was not observed without DM. Those who had UP(-) and eGFR < 60 had a high risk of starting dialysis regardless of DM. Compared with DM(-)UP(-)eGFR ≥ 60, HRs for starting dialysis for DM(+)UP(+)eGFR ≥ 60, DM(+)UP(-)eGFR < 60 and DM(+)UP(+)eGFR < 60 significantly increased 17.7 (10.6-29.7), 25.5 (13.8-47.1) and 358.1 (239.1-536.5) times, respectively.

Conclusions: eGFR < 60 and UP(+) together presented an extremely high risk of dialysis especially with DM. UP( +) increased the risk of starting dialysis regardless of the eGFR with DM. Both patient education and a treatment strategy by physicians might be helpful to avoid the progression of renal failure.

目的:确定联合尿蛋白(UP)和肾小球滤过率(eGFR)降低与伴或不伴糖尿病(DM)开始透析的风险之间的关系。方法:使用日本全国数据库335,778名19-72岁DM患者和非DM患者的索赔数据来阐明UP和eGFR严重程度对开始透析的影响。开始透析是根据使用ICD-10代码和医疗程序的索赔确定的。使用多变量Cox模型,我们研究了UP和eGFR的严重程度,以预测有和没有dm的透析开始
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引用次数: 0
A patient with ketosis-prone type 2 diabetes showing nearly normalized glucose tolerance after recovery from severe diabetic ketoacidosis. 重度糖尿病酮症酸中毒恢复后,易发生酮症的2型糖尿病患者葡萄糖耐量接近正常。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00599-6
Atsushi Satomura, Yoichi Oikawa, Haruhiko Sato, Sotaro Takagi, Takuto Yamashita, Akira Shimada

Unprovoked A-β+ ketosis-prone type 2 diabetes (KPD) is characterized by the sudden onset of diabetic ketosis/ketoacidosis (DK/DKA) without precipitating factors, negative anti-islet autoantibodies ("A- "), and preservation of β-cell function ("β+ ") after recovery from DKA using insulin therapy. However, there have been few reports on glucose tolerance after recovery. We present a case of KPD with nearly normalized glucose tolerance after recovery from severe DKA. A 41-year-old obese woman first presented with unprovoked severe DKA, i.e., ketonuria, plasma glucose 570 mg/dL, pH 7.18, and HCO3 - 5.2 mmol/L, without anti-islet autoantibodies. She achieved insulin-free glycemic remission after recovery from DKA, leading to the diagnosis of KPD. Thereafter, 75 g oral glucose tolerance test showed impaired fasting glucose and time-in-range using intermittently scanned continuous glucose monitoring was 97% without medication. These findings suggest that, despite the initial severe DKA, some patients with KPD might achieve normalized glucose tolerance after recovery. The similar onset patterns of DKA necessitates appropriately distinguishing KPD from acute-onset type 1B (idiopathic) diabetes.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00599-6.

无诱发性A-β+酮症易发型2型糖尿病(KPD)的特点是在无诱发因素的情况下突然发生糖尿病酮症/酮症酸中毒(DK/DKA),抗胰岛自身抗体(“A-”)呈阴性,胰岛素治疗后DKA恢复后β细胞功能(“β+”)得以保存。然而,很少有关于恢复后葡萄糖耐量的报道。我们报告一例重度DKA恢复后葡萄糖耐量接近正常的KPD。一名41岁肥胖女性首次出现无端严重DKA,即酮症尿,血浆葡萄糖570 mg/dL, pH 7.18, HCO3 - 5.2 mmol/L,无抗胰岛自身抗体。她从DKA恢复后实现无胰岛素血糖缓解,导致诊断为KPD。此后,75 g口服葡萄糖耐量试验显示空腹血糖受损,使用间歇扫描连续血糖监测的时间范围为97%,未用药。这些发现表明,尽管最初有严重的DKA,一些KPD患者在康复后可能达到正常的葡萄糖耐量。DKA相似的发病模式需要适当区分KPD与急性发作的1B型(特发性)糖尿病。补充信息:在线版本包含补充资料,下载地址:10.1007/s13340-022-00599-6。
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引用次数: 1
Periodontal diseases assessed by average bone resorption are associated with microvascular complications in patients with type 2 diabetes. 通过平均骨吸收评估牙周病与2型糖尿病患者微血管并发症相关
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00591-0
Noriko Sugi, Eri Eguchi, Ayaka Tsuboi, Kazu Hatanaka, Shogo Takashiba, Yuri Kira, Masako Miura, Keiki Ogino, Keita Hirano, Takahiko Nakagawa, Kentaro Doi

Periodontal disease often develops in patients with diabetes, and further exacerbated with diabetic complications. It would be clinically important to clarify the relationship between diabetic microvascular diseases and periodontal disease. This study aimed to evaluate the association between periodontal disease and diabetic complications in patients with type 2 diabetes with poor glycemic control. A total of 447 patients with type 2 diabetes hospitalized at Rakuwakai Otowa Hospital, Japan, were initially recruited in this study. After excluding 134 patients who lacked clinical data or were edentulous, 312 were included in our study. The severity of periodontal disease was evaluated based on the average bone resorption rate. Patients with diabetic nephropathy developed severe periodontal disease (multivariate-adjusted odds ratio, 3.00 [95% CI 1.41-5.19]). Diabetic neuropathy was positively associated with the severity of periodontal disease; the multivariate-adjusted odds ratio (95% CI) was 1.62 (0.87‒2.99) for moderate and 4.26 (2.21‒8.20) for severe periodontal disease. In contrast, diabetic retinopathy was linked with moderate periodontal disease (multivariate-adjusted odds ratio 2.23 [95% CI 1.10-4.10]), but not with severe conditions (multivariate-adjusted odds ratio 0.92 [95% CI 0.67-3.07]). In conclusion, periodontal disease, evaluated by average bone resorption rate, was associated with diabetic nephropathy and neuropathy.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00591-0.

牙周病常发生于糖尿病患者,并因糖尿病并发症而进一步加重。阐明糖尿病微血管病变与牙周病的关系具有重要的临床意义。本研究旨在评估血糖控制不良的2型糖尿病患者牙周病与糖尿病并发症之间的关系。在日本Rakuwakai Otowa医院住院的447例2型糖尿病患者最初被招募参加这项研究。在排除了134名缺乏临床资料或缺牙的患者后,我们的研究纳入了312名患者。根据平均骨吸收率评估牙周病的严重程度。糖尿病肾病患者发生严重的牙周病(多变量校正优势比为3.00 [95% CI 1.41-5.19])。糖尿病神经病变与牙周病严重程度呈正相关;中度牙周病多变量校正优势比(95% CI)为1.62(0.87-2.99),重度牙周病为4.26(2.21-8.20)。相比之下,糖尿病视网膜病变与中度牙周病相关(多变量校正优势比2.23 [95% CI 1.10-4.10]),但与重度牙周病无关(多变量校正优势比0.92 [95% CI 0.67-3.07])。总之,以平均骨吸收率评估的牙周病与糖尿病肾病和神经病变有关。补充信息:在线版本包含补充资料,提供地址为10.1007/s13340-022-00591-0。
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引用次数: 0
Clinical parameters correlated with the psoas muscle index in Japanese individuals with type 2 diabetes mellitus. 日本2型糖尿病患者腰肌指数与临床参数相关。
IF 2.2 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1007/s13340-022-00602-0
Emi Asano-Hayami, Yoshiaki Morishita, Tomohide Hayami, Yuka Shibata, Toshiki Kiyose, Sachiko Sasajima, Yusuke Hayashi, Mikio Motegi, Makoto Kato, Saeko Asano, Hiromi Nakai-Shimoda, Yuichiro Yamada, Emiri Miura-Yura, Tatsuhito Himeno, Masaki Kondo, Shin Tsunekawa, Yoshiro Kato, Jiro Nakamura, Hideki Kamiya

Aims: Muscle atrophy is a diabetic complication, which results in a deterioration in glycemic control in type 2 diabetes mellitus (T2DM) individuals. The psoas muscle mass index (PMI) is a reliable indicator for estimating whole-body muscle mass. We aimed to examine the relationship between clinical parameters and the PMI to clarify the mechanism underlying muscle atrophy in diabetes.

Methods: This retrospective, cross-sectional study examined 51 patients (31 men and 20 women) with T2DM and a mean HbA1c value of 9.9 ± 1.7%. These patients were admitted to Aichi Medical University Hospital and underwent abdominal computed tomography imaging from July 2020 to April 2021. Multiple clinical parameters were assessed with the PMI.

Results: In a multiple regression analysis adjusted for age and sex, the PMI was correlated with body weight, body mass index, serum concentrations of corrected calcium, aspartate aminotransferase, alanine aminotransferase, creatine kinase, thyroid-stimulating hormone (TSH), urinary C-peptide concentrations, the free triiodothyronine/free thyroxine (FT3/FT4) ratio, and the young adult mean score at the femur neck. Receiver operating characteristic curves were created using TSH concentrations and the FT3/FT4 ratio for diagnosing a low PMI. The area under the curve was 0.593 and 0.699, respectively. The cut-off value with maximum accuracy for TSH concentrations was 1.491 μIU/mL, sensitivity was 56.1%, and specificity was 80.0%. Corresponding values for the FT3/FT4 ratio were 1.723, 78.0, and 66.7%, respectively.

Conclusion: TSH concentrations and the FT3/FT4 ratio are correlated with the PMI, and their thresholds may help prevent muscle mass loss in Japanese individuals with T2DM.

目的:肌肉萎缩是一种糖尿病并发症,可导致2型糖尿病(T2DM)患者血糖控制恶化。腰肌质量指数(PMI)是估计全身肌肉质量的可靠指标。我们的目的是研究临床参数和PMI之间的关系,以阐明糖尿病肌肉萎缩的机制。方法:这项回顾性横断面研究检查了51例T2DM患者(31男20女),平均HbA1c值为9.9±1.7%。这些患者于2020年7月至2021年4月入住爱知医科大学附属医院,并接受了腹部计算机断层扫描成像。使用PMI评估多个临床参数。结果:在调整年龄和性别的多元回归分析中,PMI与体重、体重指数、校正后的血清钙浓度、天冬氨酸转氨酶、丙氨酸转氨酶、肌酸激酶、促甲状腺激素(TSH)浓度、尿c肽浓度、游离三碘甲状腺原氨酸/游离甲状腺素(FT3/FT4)比和年轻人股骨颈平均评分相关。使用TSH浓度和FT3/FT4比值创建受试者工作特征曲线,用于诊断低PMI。曲线下面积分别为0.593和0.699。检测TSH浓度的最高准确度为1.491 μIU/mL,灵敏度为56.1%,特异性为80.0%。FT3/FT4比值对应的值分别为1.723、78.0和66.7%。结论:TSH浓度和FT3/FT4比值与PMI相关,其阈值可能有助于预防日本T2DM患者的肌肉质量损失。
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引用次数: 0
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Diabetology International
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