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Glucometabolic Perturbations in Type 2 Diabetes Mellitus and Coronavirus Disease 2019: Causes, Consequences, and How to Counter Them Using Novel Antidiabetic Drugs - The CAPISCO International Expert Panel. 2019年2型糖尿病和冠状病毒病的糖代谢紊乱:原因、后果以及如何使用新型降糖药物应对它们——CAPISCO国际专家小组
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-05-01 DOI: 10.1055/a-2019-1111
Djordje Popovic, Nikolaos Papanas, Theocharis Koufakis, Kalliopi Kotsa, Wael Al Mahmeed, Khalid Al-Rasadi, Kamila Al-Alawi, Maciej Banach, Yajnavalka Banerjee, Antonio Ceriello, Mustafa Cesur, Francesco Cosentino, Alberto Firenze, Massimo Galia, Su-Yen Goh, A Janez, Sanjay Kalra, Peter Kempler, Nitin Kapoor, Nader Lessan, Paulo Lotufo, Ali A Rizvi, Amirhossein Sahebkar, Raul D Santos, Anca Pantea Stoian, Peter P Toth, Vijay Viswanathan, Manfredi Rizzo

The growing amount of evidence suggests the existence of a bidirectional relation between coronavirus disease 2019 (COVID-19) and type 2 diabetes mellitus (T2DM), as these two conditions exacerbate each other, causing a significant healthcare and socioeconomic burden. The alterations in innate and adaptive cellular immunity, adipose tissue, alveolar and endothelial dysfunction, hypercoagulation, the propensity to an increased viral load, and chronic diabetic complications are all associated with glucometabolic perturbations of T2DM patients that predispose them to severe forms of COVID-19 and mortality. Severe acute respiratory syndrome coronavirus 2 infection negatively impacts glucose homeostasis due to its effects on insulin sensitivity and β-cell function, further aggravating the preexisting glucometabolic perturbations in individuals with T2DM. Thus, the most effective ways are urgently needed for countering these glucometabolic disturbances occurring during acute COVID-19 illness in T2DM patients. The novel classes of antidiabetic medications (dipeptidyl peptidase 4 inhibitors (DPP-4is), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose co-transporter-2 inhibitors (SGLT-2is) are considered candidate drugs for this purpose. This review article summarizes current knowledge regarding glucometabolic disturbances during acute COVID-19 illness in T2DM patients and the potential ways to tackle them using novel antidiabetic medications. Recent observational data suggest that preadmission use of GLP-1 RAs and SGLT-2is are associated with decreased patient mortality, while DPP-4is is associated with increased in-hospital mortality of T2DM patients with COVID-19. Although these results provide further evidence for the widespread use of these two classes of medications in this COVID-19 era, dedicated randomized controlled trials analyzing the effects of in-hospital use of novel antidiabetic agents in T2DM patients with COVID-19 are needed.

越来越多的证据表明,2019冠状病毒病(COVID-19)和2型糖尿病(T2DM)之间存在双向关系,因为这两种疾病相互加剧,造成重大的医疗和社会经济负担。先天和适应性细胞免疫、脂肪组织、肺泡和内皮功能障碍、高凝、病毒载量增加的倾向以及慢性糖尿病并发症的改变都与T2DM患者的糖代谢紊乱有关,这些紊乱使他们易患严重的COVID-19和死亡。严重急性呼吸综合征冠状病毒2感染通过影响胰岛素敏感性和β细胞功能而对葡萄糖稳态产生负面影响,进一步加剧了T2DM患者原有的糖代谢紊乱。因此,迫切需要最有效的方法来应对T2DM患者急性COVID-19疾病期间发生的糖代谢紊乱。新型抗糖尿病药物(二肽基肽酶4抑制剂(DPP-4is),胰高血糖素样肽-1受体激动剂(GLP-1 RAs)和钠-葡萄糖共转运蛋白-2抑制剂(SGLT-2is)被认为是这一目的的候选药物。本文综述了目前关于T2DM患者急性COVID-19疾病期间糖代谢紊乱的知识,以及使用新型降糖药物解决这些问题的潜在方法。最近的观察数据表明,入院前使用GLP-1 RAs和SGLT-2is与患者死亡率降低有关,而DPP-4is与T2DM合并COVID-19患者住院死亡率增加有关。尽管这些结果为这两类药物在COVID-19时代的广泛使用提供了进一步的证据,但仍需要专门的随机对照试验来分析新型抗糖尿病药物在T2DM合并COVID-19患者中住院使用的效果。
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引用次数: 5
Digestive, Anorectal, and Urogenital Functions in Patients with Type 2 Diabetes Mellitus, Impaired Glucose Tolerance and Normal Glucose Tolerance: Association with Autonomic Neuropathy. 2型糖尿病患者的消化、肛肠和泌尿生殖功能,糖耐量受损和糖耐量正常:与自主神经病变的关系
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-05-01 DOI: 10.1055/a-2048-0952
Daniel R Quast, Georgios C Boronikolos, Bjoern A Menge, Thomas Gk Breuer, Nina Schenker, Juris J Meier

Aims: Gastrointestinal disorders, including constipation and fecal incontinence, are common in type 2 diabetes mellitus (T2DM) and may derive from diabetic autonomic neuropathy, severe intestinal bacterial overgrowth, or a dysfunctional anorectal sphincter. The present study aims to characterize the correlation between these conditions.

Methods: Patients with T2DM, prediabetes, and normal glucose tolerance (NGT) were included. The anorectal function was assessed with high-resolution anorectal manometry. Patients were screened for autonomic neuropathy by measuring olfactory, sweat, and erectile dysfunction as well as heart rate variability. Constipation and fecal (in-)continence were evaluated using validated questionnaires. Breath tests were used to assess severe intestinal bacterial overgrowth.

Results: We included 59 participants (32 (54.2%) with T2DM, 9 (15.3%) with prediabetes, and 18 (30.5%) NGT). The presence of autonomic neuropathy, severe bacterial overgrowth, and symptoms of constipation and incontinence were comparable. HbA1c was correlated with an increased anorectal resting sphincter pressure (r=0.31, P=0.019) and constipation symptoms (r=0.30, P=0.031). In patients with a long-standing diagnosis of T2DM, significantly higher values for maximum anorectal resting pressure (Δ=+27.81±7.84 mmHg, P=0.0015) and baseline pressure (Δ=20.50±9.74 mmHg, P=0.046) were found compared with NGT, but not with prediabetes.

Conclusions: Long-standing T2DM increases anorectal sphincter activity, and constipation symptoms are associated with higher HbA1c levels. The lack of an association of symptoms with autonomic neuropathy suggests glucotoxicity as the primary mechanism.

目的:胃肠道疾病,包括便秘和大便失禁,在2型糖尿病(T2DM)中很常见,可能源于糖尿病自主神经病变、严重的肠道细菌过度生长或肛肠括约肌功能障碍。本研究旨在描述这些条件之间的相关性。方法:纳入T2DM、糖尿病前期、正常糖耐量(NGT)患者。采用高分辨率肛肠测压法评估肛肠功能。通过测量嗅觉、汗液、勃起功能障碍以及心率变异性来筛选患者是否有自主神经病变。便秘和大便失禁采用有效问卷进行评估。呼吸试验用于评估严重的肠道细菌过度生长。结果:我们纳入了59名参与者,其中32名(54.2%)患有T2DM, 9名(15.3%)患有糖尿病前期,18名(30.5%)患有NGT。自主神经病变、严重细菌过度生长、便秘和尿失禁的症状具有可比性。HbA1c与肛门直肠静息括约肌压力升高(r=0.31, P=0.019)和便秘症状(r=0.30, P=0.031)相关。在长期诊断为T2DM的患者中,与NGT相比,最大肛门直肠静息压(Δ=+27.81±7.84 mmHg, P=0.0015)和基线压(Δ=20.50±9.74 mmHg, P=0.046)的值明显更高,但与糖尿病前期相比没有明显差异。结论:长期T2DM增加肛肠括约肌活动,便秘症状与较高的HbA1c水平相关。缺乏与自主神经病变症状的关联提示糖毒性是主要机制。
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引用次数: 1
Increased Galactosidase Beta 1 Expression as a Senescent Key Factor in β-Cells Function Modulation at the Early Steps of Type 2 Diabetes. 半乳糖苷酶β 1表达增加是2型糖尿病早期β细胞功能调节的衰老关键因素
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-05-01 DOI: 10.1055/a-2044-8873
Ana T Maduro, Anabela Pinto, Joana Ferreira-Gomesb, Raquel Costa, Raquel Soares, Carla Luís

Background: In type 2 diabetes, insulin resistance is observed, and β-cells are incapable of responding to glycemia demands, leading to hyperglycemia. Although the nature of β-cells dysfunction in this disease is not fully understood, a link between the induction of pancreatic β-cell premature senescence and its metabolic implications has been proposed. This study aimed to understand the relationship between diabetes and pancreatic senescence, particularly at the beginning of the disease.

Methods: C57Bl/6 J mice were fed two different diets, a normal diet and a high-fat diet, for 16 weeks. Pancreatic histomorphology analysis, insulin quantification, inflammation parameters, and senescence biomarkers for the experimental animals were assessed at weeks 12 and 16.

Results: The results proved that diabetes onset occurred at week 16 in the High Fat Diet group, supported by glycaemia, weight and blood lipid levels. Increased β-cells size and number accompanied by increased insulin expression were observed. Also, an inflammatory status of the diabetic group was noted by increased levels of systemic IL-1β and increased pancreatic fibrosis. Finally, the expression of galactosidase-beta 1 (GLB1) was significantly increased in pancreatic β-cells.

Conclusion: The study findings indicate that senescence, as revealed by an increase in GLB1 expression, is a key factor in the initial stage of diabetes.

背景:在2型糖尿病中,胰岛素抵抗被观察到,β细胞不能对血糖需求做出反应,导致高血糖。虽然这种疾病中β细胞功能障碍的性质尚不完全清楚,但已经提出了胰腺β细胞过早衰老的诱导与其代谢意义之间的联系。本研究旨在了解糖尿病与胰腺衰老之间的关系,特别是在疾病开始时。方法:C57Bl/6 J小鼠分别饲喂正常和高脂两种不同的日粮,为期16周。在第12周和第16周对实验动物的胰腺组织形态学分析、胰岛素定量、炎症参数和衰老生物标志物进行评估。结果:高脂饮食组在血糖、体重和血脂水平的支持下,于第16周发生糖尿病。β细胞大小和数量增加,胰岛素表达增加。此外,糖尿病组的炎症状态表现为全身IL-1β水平升高和胰腺纤维化增加。最后,胰腺β-细胞中半乳糖苷酶- 1 (GLB1)的表达显著升高。结论:研究结果表明,衰老是糖尿病初期的关键因素,其表现为GLB1表达的增加。
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引用次数: 0
Fasting Plasma Glucose Levels at the Time of Admission Predict 90-Day Mortality in Patients with Viral Pneumonia. A Prospective Study. 入院时空腹血糖水平预测病毒性肺炎患者90天死亡率前瞻性研究。
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-05-01 DOI: 10.1055/a-2045-7787
Jie Xu, Jianyu Zhao, Liyuan Wu, Xinxin Lu

Purpose: To determine the effect of fasting plasma glucose (FPG) level at admission affects the 90-day mortality rate in patients with viral pneumonia.

Methods: Two hundred fifty viral pneumonia patients were stratified into normal FPG (FPG<7.0 mmol/L), moderately-elevated FPG (FPG=7.0-14.0 mmol/L), and highly-elevated FPG groups (FPG≥14.0 mmol/L) according to the FPG level at the time of admission. The clinical characteristics, etiologies, and prognosis of different groups of patients were compared. Kaplan-Meier survival and Cox regression analyses were used to determine the relationship between the FPG level and 90-day all-cause mortality rate in patients with viral pneumonia.

Results: Patients in the moderately- and highly-elevated FPG groups had a higher proportion of severe disease and mortality compared with the normal FPG group (P<0.001). Kaplan-Meier survival analysis showed a significant trend toward higher mortality and increased cumulative risk at 30, 60, and 90 d in patients with an FPG=7.0-14.0 mmol/L and an FPG≥14 mmol/L (χ2=51. 77, P<0.001). Multivariate Cox regression analysis revealed that compared with an FPG<7.0 mmol/L, FPG=7.0 and 14.0 mmol/L (HR: 9.236, 95% CI: 1.106-77.119, P=0.040) and FPG≥14.0 mmol/L (HR: 25.935, 95% CI: 2.586-246.213, P=0.005) were independent risk factors for predicting the 90-day mortality rate in viral pneumonia patients.

Conclusions: The higher the FPG level at admission in a patient with viral pneumonia, the higher the risk of all-cause mortality within 90 d.

目的:探讨入院时空腹血糖(FPG)水平对病毒性肺炎患者90天死亡率的影响。方法:将250例病毒性肺炎患者分为正常FPG组(P2=51)。结果:与正常FPG组相比,中度和高度FPG组患者出现严重疾病和死亡率的比例更高(P2=51)。77、P.0 mmol/L (HR: 25.935, 95% CI: 2.586 ~ 246.213, P=0.005)是预测病毒性肺炎患者90天死亡率的独立危险因素。结论:病毒性肺炎患者入院时FPG水平越高,90 d内全因死亡风险越高。
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引用次数: 0
Many Faces of Adrenal Lesions in a Large Patient Cohort: What Has Changed Over the Last Two Decades? 在一个大型患者队列中,肾上腺病变的许多方面:在过去的二十年中发生了什么变化?
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2035-6091
Basak Ozgen Saydam, Mustafa Baris, Suleyman Cem Adiyaman, Tevfik Demir, Mehmet Ali Kocdor, Omer Demir, Mustafa Secil, Serkan Yener

Objective: To review the presentation characteristics, clinical and hormonal evaluations, and histopathological results of patients with adrenal lesions over a 21-year period and evaluate the changes across the two decades.

Methods: This single-center, retrospective study included 1003 patients with adrenal lesions who presented to our department between 2000 and 2021. Clinical, metabolic, hormonal, radiological, and pathological data of the patients were collected.

Results: Forty-seven percent of the lesions were non-functioning adrenal adenomas. Possible autonomous and autonomous cortisol secretion were detected in 22.2% of the patients. The percentages of the patients diagnosed with pheochromocytoma, primary hyperaldosteronism, adrenal Cushing syndrome, adrenocortical carcinoma, and adrenal metastasis were 7.4%, 4.8%, 4.7%, 0.9%, and 5.6%, respectively. Adrenalectomy was performed in 31.3% of the patients. Functional adrenal lesions were the leading cause of surgery (46.5%), followed by large size and/or suspicious imaging features (38.6%). Among the patients referred to surgery due to large size (≥6 cm), the diagnosis in 19% was metastasis, and in 12.1%, it was primary adrenocortical carcinoma. In patients with adrenal lesions with a size of 4-6 cm and suspicious imaging properties, the rates of metastasis and primary adrenocortical carcinoma were 44.4% and 4.8%, respectively. From the first to the second decade, major differences in presentation characteristics were increased detection of bilateral lesions and increased prevalence of possible autonomous and autonomous cortisol secretion.

Conclusions: Adrenal lesions are common in the adult population, and while it is important to avoid overtreatment, hormone secretion, and malignancy should not be overlooked.

目的:回顾21年来肾上腺病变患者的表现特点、临床和激素评估以及组织病理学结果,并评估20年来肾上腺病变患者的变化。方法:这项单中心回顾性研究纳入了2000年至2021年间到我科就诊的1003例肾上腺病变患者。收集患者的临床、代谢、激素、放射学和病理资料。结果:47%的病变为无功能肾上腺腺瘤。22.2%的患者检测到可能的自主和自主皮质醇分泌。诊断为嗜铬细胞瘤、原发性醛固酮增多症、肾上腺库欣综合征、肾上腺皮质癌和肾上腺转移的比例分别为7.4%、4.8%、4.7%、0.9%和5.6%。31.3%的患者行肾上腺切除术。肾上腺功能病变是手术的主要原因(46.5%),其次是大尺寸和/或可疑的影像学特征(38.6%)。因体积较大(≥6cm)而行手术的患者中,19%诊断为转移,12.1%诊断为原发性肾上腺皮质癌。在大小为4 ~ 6cm且影像学特征可疑的肾上腺皮质病变中,转移率为44.4%,原发性肾上腺皮质癌为4.8%。从第一个十年到第二个十年,表现特征的主要差异是双侧病变的检测增加,以及可能自主和自主皮质醇分泌的患病率增加。结论:肾上腺病变在成年人中很常见,虽然避免过度治疗很重要,但激素分泌和恶性肿瘤也不应被忽视。
{"title":"Many Faces of Adrenal Lesions in a Large Patient Cohort: What Has Changed Over the Last Two Decades?","authors":"Basak Ozgen Saydam,&nbsp;Mustafa Baris,&nbsp;Suleyman Cem Adiyaman,&nbsp;Tevfik Demir,&nbsp;Mehmet Ali Kocdor,&nbsp;Omer Demir,&nbsp;Mustafa Secil,&nbsp;Serkan Yener","doi":"10.1055/a-2035-6091","DOIUrl":"https://doi.org/10.1055/a-2035-6091","url":null,"abstract":"<p><strong>Objective: </strong>To review the presentation characteristics, clinical and hormonal evaluations, and histopathological results of patients with adrenal lesions over a 21-year period and evaluate the changes across the two decades.</p><p><strong>Methods: </strong>This single-center, retrospective study included 1003 patients with adrenal lesions who presented to our department between 2000 and 2021. Clinical, metabolic, hormonal, radiological, and pathological data of the patients were collected.</p><p><strong>Results: </strong>Forty-seven percent of the lesions were non-functioning adrenal adenomas. Possible autonomous and autonomous cortisol secretion were detected in 22.2% of the patients. The percentages of the patients diagnosed with pheochromocytoma, primary hyperaldosteronism, adrenal Cushing syndrome, adrenocortical carcinoma, and adrenal metastasis were 7.4%, 4.8%, 4.7%, 0.9%, and 5.6%, respectively. Adrenalectomy was performed in 31.3% of the patients. Functional adrenal lesions were the leading cause of surgery (46.5%), followed by large size and/or suspicious imaging features (38.6%). Among the patients referred to surgery due to large size (≥6 cm), the diagnosis in 19% was metastasis, and in 12.1%, it was primary adrenocortical carcinoma. In patients with adrenal lesions with a size of 4-6 cm and suspicious imaging properties, the rates of metastasis and primary adrenocortical carcinoma were 44.4% and 4.8%, respectively. From the first to the second decade, major differences in presentation characteristics were increased detection of bilateral lesions and increased prevalence of possible autonomous and autonomous cortisol secretion.</p><p><strong>Conclusions: </strong>Adrenal lesions are common in the adult population, and while it is important to avoid overtreatment, hormone secretion, and malignancy should not be overlooked.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison Between Thyroid Stimulating Immunoglobulin and TSH-Receptor Antibodies in the Management of Graves' Orbitopathy. 促甲状腺免疫球蛋白与tsh受体抗体治疗Graves眼病的比较。
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2021-0596
Selwan Khamisi, Martin Lundqvist, Britt Edén Engström, Anders Larsson, F Anders Karlsson, Östen Ljunggren

Objectives: TSH-receptor antibodies (TRAb) targeting the TSH receptor (TSH-R) induce hyperthyroidism in Graves´ disease (GD). Graves´ orbitopathy (GO) is influenced by stimulation of the TSH-R in the orbita. GO has been, among other factors, linked to high TRAb levels. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies. The aim of this study was to investigate the role of TSI in the management of GO.

Methods: Patients with newly diagnosed GD (n=30, median age 55 years (range 35-72), 29 women) received pharmacological therapy (methimazole+++thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. Eleven patients had GO at diagnosis, and another six developed GO during treatment. Blood samples for TSI and other thyroidal biomarkers were obtained at baseline and on five occasions during the 24-month follow-up. Twenty-two subjects completed the drug regimen without surgery or radioiodine treatment.

Results: At baseline, TSI was highly correlated with TRAb (r s =0.64, p<0.001), and both assays similarly correlated to fT3 values. TSI and TRAb did not differ significantly between GO and non-GO patients for visit v1 (n=30, 17 GO during the whole study) or at follow-up (n=22, 12 GO during the whole study). During follow-up, levels of TSI and TRAb decreased and normalized in both groups.

Conclusion: The present study does not support any added benefit of TSI compared to TRAb for the prediction and management of GO.

目的:靶向TSH受体(TSH- r)的TSH受体抗体(TRAb)可诱导Graves病(GD)的甲状腺功能亢进。Graves眼窝病(GO)受眼眶TSH-R刺激的影响。除其他因素外,氧化石墨烯与高TRAb水平有关。促甲状腺免疫球蛋白(TSI)是一种较新的检测tsh受体抗体的方法。本研究的目的是探讨TSI在GO治疗中的作用。方法:新诊断的GD患者(n=30,中位年龄55岁(35-72岁),女性29例)接受药物治疗(甲巯咪唑+++甲状腺素),疗程长达24个月。通过临床体征和症状确定GO。11例患者在诊断时出现氧化石墨烯,另有6例患者在治疗期间出现氧化石墨烯。在24个月的随访期间,在基线和5次中获得TSI和其他甲状腺生物标志物的血液样本。22名受试者在没有手术或放射性碘治疗的情况下完成了药物治疗。结果:在基线时,TSI与TRAb高度相关(r s =0.64, p)。结论:本研究不支持TSI与TRAb相比在预测和管理GO方面有任何额外的益处。
{"title":"Comparison Between Thyroid Stimulating Immunoglobulin and TSH-Receptor Antibodies in the Management of Graves' Orbitopathy.","authors":"Selwan Khamisi,&nbsp;Martin Lundqvist,&nbsp;Britt Edén Engström,&nbsp;Anders Larsson,&nbsp;F Anders Karlsson,&nbsp;Östen Ljunggren","doi":"10.1055/a-2021-0596","DOIUrl":"https://doi.org/10.1055/a-2021-0596","url":null,"abstract":"<p><strong>Objectives: </strong>TSH-receptor antibodies (TRAb) targeting the TSH receptor (TSH-R) induce hyperthyroidism in Graves´ disease (GD). Graves´ orbitopathy (GO) is influenced by stimulation of the TSH-R in the orbita. GO has been, among other factors, linked to high TRAb levels. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies. The aim of this study was to investigate the role of TSI in the management of GO.</p><p><strong>Methods: </strong>Patients with newly diagnosed GD (n=30, median age 55 years (range 35-72), 29 women) received pharmacological therapy (methimazole+++thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. Eleven patients had GO at diagnosis, and another six developed GO during treatment. Blood samples for TSI and other thyroidal biomarkers were obtained at baseline and on five occasions during the 24-month follow-up. Twenty-two subjects completed the drug regimen without surgery or radioiodine treatment.</p><p><strong>Results: </strong>At baseline, TSI was highly correlated with TRAb (<i>r</i> <sub>s</sub> =0.64, p<0.001), and both assays similarly correlated to fT3 values. TSI and TRAb did not differ significantly between GO and non-GO patients for visit v1 (n=30, 17 GO during the whole study) or at follow-up (n=22, 12 GO during the whole study). During follow-up, levels of TSI and TRAb decreased and normalized in both groups.</p><p><strong>Conclusion: </strong>The present study does not support any added benefit of TSI compared to TRAb for the prediction and management of GO.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/7f/10-1055-a-2021-0596.PMC10158629.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9412837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus. 空腹血糖升高和中性粒细胞/淋巴细胞比值作为2型糖尿病患者COVID-19肺炎临床结局的危险预测因素
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2009-6937
Vasilios Petrakis, Periklis Panagopoulos, Grigorios Trypsianis, Dimitrios Papazoglou, Nikolaos Papanas

Aim of the study: To evaluate fasting plasma glucose (FPG) increase and neutrophil-to-lymphocyte ratio (NLR) as risk predictors of severe clinical outcome of COVID-19 pneumonia in type 2 diabetes mellitus (T2DM) hospitalised patients.

Patients and methods: Type 2 diabetes mellitus (T2DM) patients hospitalised between March 2020 and February 2021 were studied retrospectively. The NLR ratio at admission and FPG increase (day 7, day with maximal FPG) were evaluated in association with the clinical progression of SARS-CoV-2 infection.

Results: Three hundred patients (165 men, 135 women) were included in the study. The mean age was 67.17±8.65 years. Severe COVID-19 pneumonia was diagnosed in 170 patients (56.7%). Fifty-four patients (18%) were intubated and 49 (16.3%) died. Greater increase in FPG (79.5 vs. 44.5 mg/dL for day 1-7, p<0.001; and 113.5 vs. 75 mg/dL for day 1-day with maximum glucose value, p<0.001) and higher NLR at admission (10.65 vs. 6.85) were seen in patients with need of high-flow oxygen compared to those without need, and they were associated with a higher probability of intubation and death.

Conclusion: FPG increase and NLR could be significant risk predictors of severe COVID-19 pneumonia in T2DM hospitalised patients.

研究目的:评价空腹血糖(FPG)升高和中性粒细胞与淋巴细胞比值(NLR)作为2型糖尿病(T2DM)住院患者COVID-19肺炎严重临床结局的风险预测因子。患者和方法:回顾性研究2020年3月至2021年2月住院的2型糖尿病(T2DM)患者。评估入院时NLR比率和FPG增加(第7天,FPG最大的天数)与SARS-CoV-2感染的临床进展的相关性。结果:300例患者(男性165例,女性135例)纳入研究。平均年龄67.17±8.65岁。重症肺炎170例(56.7%)。54例(18%)患者插管,49例(16.3%)患者死亡。结论:FPG升高和NLR可能是T2DM住院患者重症COVID-19肺炎的重要风险预测因素。
{"title":"Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus.","authors":"Vasilios Petrakis,&nbsp;Periklis Panagopoulos,&nbsp;Grigorios Trypsianis,&nbsp;Dimitrios Papazoglou,&nbsp;Nikolaos Papanas","doi":"10.1055/a-2009-6937","DOIUrl":"https://doi.org/10.1055/a-2009-6937","url":null,"abstract":"<p><strong>Aim of the study: </strong>To evaluate fasting plasma glucose (FPG) increase and neutrophil-to-lymphocyte ratio (NLR) as risk predictors of severe clinical outcome of COVID-19 pneumonia in type 2 diabetes mellitus (T2DM) hospitalised patients.</p><p><strong>Patients and methods: </strong>Type 2 diabetes mellitus (T2DM) patients hospitalised between March 2020 and February 2021 were studied retrospectively. The NLR ratio at admission and FPG increase (day 7, day with maximal FPG) were evaluated in association with the clinical progression of SARS-CoV-2 infection.</p><p><strong>Results: </strong>Three hundred patients (165 men, 135 women) were included in the study. The mean age was 67.17±8.65 years. Severe COVID-19 pneumonia was diagnosed in 170 patients (56.7%). Fifty-four patients (18%) were intubated and 49 (16.3%) died. Greater increase in FPG (79.5 vs. 44.5 mg/dL for day 1-7, p<0.001; and 113.5 vs. 75 mg/dL for day 1-day with maximum glucose value, p<0.001) and higher NLR at admission (10.65 vs. 6.85) were seen in patients with need of high-flow oxygen compared to those without need, and they were associated with a higher probability of intubation and death.</p><p><strong>Conclusion: </strong>FPG increase and NLR could be significant risk predictors of severe COVID-19 pneumonia in T2DM hospitalised patients.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Real-World Use of Once-Weekly Semaglutide in Type 2 Diabetes: Results from SemaglUtide Real-world Evidence (SURE) Germany. 实际使用每周一次的西马鲁肽治疗2型糖尿病:来自德国的西马鲁肽实际证据(SURE)的结果。
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2007-2061
Markus Menzen, Tina Landsvig Berentzen, Andrei-Mircea Catarig, Sebastian Piperhoff, Jörg Simon, Stephan Jacob

Context: Efficacy and safety of once-weekly semaglutide in type 2 diabetes were established in the phase 3 SUSTAIN trials, which included patients across the continuum of type 2 diabetes care. It is useful to complement these findings with real-world evidence.

Objective: SURE Germany evaluated once-weekly semaglutide in a real-world type 2 diabetes patient population.

Design/setting: The prospective observational study was conducted at 93 clinical practices in adults with+≥ 1 documented glycated haemoglobin value ≤12 weeks before initiation of semaglutide.

Intervention: Once-weekly semaglutide was prescribed at the physicians' discretion.

Main outcomes: The primary endpoint was change in glycated haemoglobin from baseline to end-of-study (~30 weeks). Secondary endpoints included changes in body weight and patient-reported outcomes. All adverse events were systematically collected and reported, including patient-reported documented and/or severe hypoglycaemia.

Results: Of 779 patients in the full analysis set, 669 (85.9%) completed the study on treatment with semaglutide, comprising the effectiveness analysis set. In this data set, estimated mean changes in glycated haemoglobin and body weight from baseline to end-of-study were -1.0%point (-10.9 mmol/mol; P<0.0001) and -4.5 kg (-4.2%; P<0.0001). Sensitivity analyses supported the primary analysis. Improvements were observed in other secondary endpoints, including patient-reported outcomes. No new safety concerns were identified.

Conclusions: In a real-world population in Germany, patients with type 2 diabetes treated with once-weekly semaglutide experienced clinically significant improvements in glycaemic control and body weight. These results support the use of once-weekly semaglutide in routine clinical practice in adult patients with type 2 diabetes in Germany.

背景:每周一次的西马鲁肽治疗2型糖尿病的有效性和安全性在3期SUSTAIN试验中得到了证实,该试验包括连续接受2型糖尿病治疗的患者。用真实世界的证据来补充这些发现是有用的。目的:SURE德国评估每周一次的西马鲁肽在现实世界2型糖尿病患者人群中的作用。设计/环境:这项前瞻性观察性研究是在93例成人临床实践中进行的,在开始使用西马鲁肽前≤12周,记录的糖化血红蛋白值为+≥1。干预:根据医生的判断,每周开一次西马鲁肽。主要结局:主要终点是糖化血红蛋白从基线到研究结束(~30周)的变化。次要终点包括体重变化和患者报告的结局。系统地收集和报告了所有不良事件,包括患者报告的记录和/或严重低血糖。结果:在完整分析集中的779例患者中,669例(85.9%)完成了西马鲁肽治疗的研究,构成了有效性分析集。在该数据集中,从基线到研究结束,糖化血红蛋白和体重的估计平均变化为-1.0% (-10.9 mmol/mol;ppp结论:在德国的现实世界人群中,每周接受一次西马鲁肽治疗的2型糖尿病患者在血糖控制和体重方面出现了临床显着改善。这些结果支持在德国成年2型糖尿病患者的常规临床实践中使用每周一次的西马鲁肽。
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引用次数: 6
Post-Load Insulin Secretion Patterns are Associated with Glycemic Status and Diabetic Complications in Patients with Type 2 Diabetes Mellitus. 2型糖尿病患者负荷后胰岛素分泌模式与血糖状态和糖尿病并发症相关
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2018-4299
Jiajia Jiang, Yuhao Li, Feng Li, Yan He, Lijuan Song, Kun Wang, Wenjun You, Zhang Xia, Yingting Zuo, Xin Su, Qi Zhai, Yibo Zhang, Herbert Gaisano, Deqiang Zheng

Background: To examine whether the different patterns of post-load insulin secretion can identify the heterogeneity of type 2 diabetes mellitus (T2DM).

Methods: Six hundred twenty-five inpatients with T2DM at Jining No. 1 People's Hospital were recruited from January 2019 to October 2021. The 140 g steamed bread meal test (SBMT) was conducted on patients with T2DM, and glucose, insulin, and C-peptide levels were recorded at 0, 60, 120, and 180 min. To avoid the effect of exogenous insulin, patients were categorized into three different classes by latent class trajectory analysis based on the post-load secretion patterns of C-peptide. The difference in short- and long-term glycemic status and prevalence of complications distributed among the three classes were compared by multiple linear regression and multiple logistic regression, respectively.

Results: There were significant differences in long-term glycemic status (e. g., HbA1c) and short-term glycemic status (e. g., mean blood glucose, time in range) among the three classes. The difference in short-term glycemic status was similar in terms of the whole day, daytime, and nighttime. The prevalence of severe diabetic retinopathy and atherosclerosis showed a decreasing trend among the three classes.

Conclusions: The post-load insulin secretion patterns could well identify the heterogeneity of patients with T2DM in short- and long-term glycemic status and prevalence of complications, providing recommendations for the timely adjustment in treatment regimes of patients with T2DM and promotion of personalized treatment.

背景:研究负荷后胰岛素分泌的不同模式是否可以识别2型糖尿病(T2DM)的异质性。方法:选取2019年1月至2021年10月济宁市第一人民医院住院T2DM患者625例。对T2DM患者进行140 g馒头试验(SBMT),记录0、60、120、180 min时的血糖、胰岛素、c肽水平。为了避免外源性胰岛素的影响,根据负荷后c肽的分泌模式,通过潜在类别轨迹分析将患者分为三个不同的类别。分别采用多元线性回归和多元逻辑回归比较三组患者短期和长期血糖状态及并发症发生率的差异。结果:两组长期血糖状态(如:(如糖化血红蛋白)和短期血糖状态(如糖化血红蛋白)。(平均血糖,时间范围)。在白天、白天和夜间,短期血糖状态的差异相似。重度糖尿病视网膜病变和动脉粥样硬化的患病率在3类人群中呈下降趋势。结论:负荷后胰岛素分泌模式可以很好地识别T2DM患者短期和长期血糖状态的异质性及并发症的发生率,为及时调整T2DM患者的治疗方案,促进个性化治疗提供建议。
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引用次数: 0
Effects of Growth Hormone on Muscle and Bone in Female Mice: Role of Follistatin. 生长激素对雌性小鼠肌肉和骨骼的影响:卵泡抑素的作用。
IF 1.8 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.1055/a-2003-5704
Takashi Ohira, Naoyuki Kawao, Yoshimasa Takafuji, Yuya Mizukami, Hiroshi Kaji

The interactions between muscle and bone are noted in the clinical relationships between sarcopenia and osteoporosis. Myokines secreted from the skeletal muscles play roles in muscle-bone interactions related to various physiological and pathophysiological states. Although numerous evidence suggests that growth hormone (GH) influences both muscle and bone, the effects of GH on the muscle-bone interactions have remained unknown. We, therefore, investigated the influences of GH administration for 8 weeks on muscle and bone, including myokine expression, in mice with or without ovariectomy (OVX). GH administration significantly increased muscle mass in the whole body and lower limbs, as well as tissue weights of the extensor digitorum longus (EDL) and soleus muscles in mice with or without OVX. Moreover, it markedly increased grip strength in both mice. As for femurs, GH administration significantly increased cortical thickness and area in mice with or without OVX. Moreover, GH significantly blunted the decrease in the ratio of bone volume to tissue volume at the trabecular bone in mice with OVX. GH administration significantly decreased follistatin mRNA levels in the EDL, but not the soleus, muscles in mice with or without OVX, although it did not affect the other myokines examined. However, GH administration significantly elevated serum follistatin levels in mice. In conclusion, this study indicates that GH administration increases skeletal muscle mass and grip strength and cortical and trabecular bone-related parameters obtained by micro-computed tomography analyses in mice. However, myokine regulation might not be critical for the effects of GH on muscle and bone.

肌肉和骨骼之间的相互作用在肌肉减少症和骨质疏松症的临床关系中得到了注意。骨骼肌分泌的肌因子在与各种生理和病理生理状态相关的肌-骨相互作用中发挥作用。尽管大量证据表明生长激素(GH)对肌肉和骨骼都有影响,但GH对肌肉-骨骼相互作用的影响仍然未知。因此,我们研究了生长激素给药8周对卵巢切除或未切除(OVX)小鼠肌肉和骨骼的影响,包括肌因子表达。生长激素显著增加了小鼠全身和下肢的肌肉质量,以及有或没有OVX的指长伸肌(EDL)和比目鱼肌的组织重量。此外,它还显著增加了两只老鼠的握力。对于股骨,GH显著增加了小鼠的皮质厚度和面积,无论有无OVX。此外,生长激素显著减弱了OVX小鼠骨小梁处骨体积与组织体积之比的下降。生长激素管理显著降低EDL中卵泡抑素mRNA水平,但没有影响有或没有OVX的小鼠的比目鱼肌,尽管它不影响所检查的其他肌因子。然而,生长激素显著提高小鼠血清卵泡素水平。总之,本研究表明,生长激素的使用增加了小鼠骨骼肌质量和握力,以及通过显微计算机断层扫描分析获得的皮质和骨小梁相关参数。然而,对于生长激素对肌肉和骨骼的影响,肌因子调节可能不是关键的。
{"title":"Effects of Growth Hormone on Muscle and Bone in Female Mice: Role of Follistatin.","authors":"Takashi Ohira,&nbsp;Naoyuki Kawao,&nbsp;Yoshimasa Takafuji,&nbsp;Yuya Mizukami,&nbsp;Hiroshi Kaji","doi":"10.1055/a-2003-5704","DOIUrl":"https://doi.org/10.1055/a-2003-5704","url":null,"abstract":"<p><p>The interactions between muscle and bone are noted in the clinical relationships between sarcopenia and osteoporosis. Myokines secreted from the skeletal muscles play roles in muscle-bone interactions related to various physiological and pathophysiological states. Although numerous evidence suggests that growth hormone (GH) influences both muscle and bone, the effects of GH on the muscle-bone interactions have remained unknown. We, therefore, investigated the influences of GH administration for 8 weeks on muscle and bone, including myokine expression, in mice with or without ovariectomy (OVX). GH administration significantly increased muscle mass in the whole body and lower limbs, as well as tissue weights of the extensor digitorum longus (EDL) and soleus muscles in mice with or without OVX. Moreover, it markedly increased grip strength in both mice. As for femurs, GH administration significantly increased cortical thickness and area in mice with or without OVX. Moreover, GH significantly blunted the decrease in the ratio of bone volume to tissue volume at the trabecular bone in mice with OVX. GH administration significantly decreased follistatin mRNA levels in the EDL, but not the soleus, muscles in mice with or without OVX, although it did not affect the other myokines examined. However, GH administration significantly elevated serum follistatin levels in mice. In conclusion, this study indicates that GH administration increases skeletal muscle mass and grip strength and cortical and trabecular bone-related parameters obtained by micro-computed tomography analyses in mice. However, myokine regulation might not be critical for the effects of GH on muscle and bone.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Experimental and Clinical Endocrinology & Diabetes
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