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Diabetic Retinopathy and Maculopathy. 糖尿病视网膜病变和黄斑病变。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-02-01 DOI: 10.1055/a-1946-3798
Hans-Peter Hammes, Klaus Dieter Lemmen, Bernd Bertram
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引用次数: 0
Cigarette Smoking Increases the Risk of Type 2 Diabetes Mellitus in Patients with Non-Alcoholic Fatty Liver Disease: A Population-Based Cohort Study. 吸烟增加非酒精性脂肪性肝病患者患2型糖尿病的风险:一项基于人群的队列研究
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1813-7435
Chan Liu, Yanqin Wu, Wenjuan Duan, Wenming Xu

Objective: Cigarette smoke and non-alcoholic fatty liver disease are risk factors for type 2 diabetes mellitus. However, the impact of smoking on diabetes risk among patients with non-alcoholic fatty liver disease remains unclear.

Methods: This study included 15,464 Japanese individuals. We defined non-alcoholic fatty liver disease based on abdominal ultrasound findings where excess alcohol intake and other liver diseases were excluded. We used Cox proportional regression analysis to identify risk factors for type 2 diabetes onset.

Results: During 16,446 person-years of follow-up, 223 of 2,714 non-alcoholic fatty liver disease patients developed type 2 diabetes; the cumulative incidence rate of type 2 diabetes was 13.6 per 1,000 person-years. The proportions of never, former, and current smokers (self-report) were 35.3%, 31.1%, and 33.6%, and 88.5%, 5.1%, and 6.4% in men and women, respectively. In a Cox regression model adjusted for sex, age, body mass index, waist circumference, alcohol intake, exercise, and alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, lipid profiles, and blood pressure values, relative to never smokers, current smokers with non-alcoholic fatty liver disease had an increased risk of type 2 diabetes (hazard ratio=2.05; 95% confidence interval: 1.43-2.94). In addition, former smoking affected the risk of type 2 diabetes; however, this effect was not statistically significant.

Conclusions: This longitudinal study showed that current smoking may act as a "second hit" and increase the risk of type 2 diabetes in patients with non-alcoholic fatty liver disease.

目的:吸烟和非酒精性脂肪肝是2型糖尿病的危险因素。然而,吸烟对非酒精性脂肪性肝病患者患糖尿病风险的影响尚不清楚。方法:本研究包括15464名日本人。我们根据腹部超声检查结果定义了非酒精性脂肪性肝病,排除了过量饮酒和其他肝脏疾病。我们使用Cox比例回归分析来确定2型糖尿病发病的危险因素。结果:在16446人年的随访期间,2,714名非酒精性脂肪肝患者中有223名发展为2型糖尿病;2型糖尿病的累积发病率为每1000人年13.6例。从不吸烟者、曾经吸烟者和目前吸烟者(自我报告)的比例分别为35.3%、31.1%和33.6%,男性和女性分别为88.5%、5.1%和6.4%。在Cox回归模型中,校正了性别、年龄、体重指数、腰围、酒精摄入量、运动、丙氨酸转氨酶、天冬氨酸转氨酶、γ -谷氨酰转移酶、脂质谱和血压值后,与从不吸烟者相比,目前吸烟者合并非酒精性脂肪性肝病患2型糖尿病的风险增加(危险比=2.05;95%置信区间:1.43-2.94)。此外,曾经吸烟的人患2型糖尿病的风险更高;然而,这种影响在统计学上并不显著。结论:这项纵向研究表明,目前吸烟可能是“第二次打击”,增加非酒精性脂肪性肝病患者患2型糖尿病的风险。
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引用次数: 0
Correlation Between Skin Advanced Glycation End Products and Cardiac Autonomic Neuropathy Among Subjects with Type 2 Diabetes Mellitus. 2型糖尿病患者皮肤晚期糖基化终产物与心脏自主神经病变的相关性
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1831-0991
Stella Papachristou, Kalliopi Pafili, Grigorios Trypsianis, Dimitrios Papazoglou, Κonstantinos Vadikolias, Nikolaos Papanas

Introduction: Advanced glycation end products (AGEs) are frequently increased in the skin of subjects with type 2 diabetes mellitus (T2DM). This study aimed to examine the correlation of AGEs with cardiac autonomic neuropathy (CAN) in T2DM.

Methods: To this aim, 132 participants (88 men) with a mean age of 64.57 years and a median T2DM duration of 14.5 years were included. Skin AGEs were measured with AGE reader mu connect (Diagnoptics) on the dominant arm (both single and automated triplicate measurements). Diagnosis of CAN, sympathetic and parasympathetic nervous system impairment was based on the four standardised cardiovascular reflex tests (CARTs).

Results: On a single measurement, AGEs were increased in subjects with vs. those without CAN (3.20±0.74 vs. 2.66±0.66, p<0.001). As compared with normal results, AGEs were increased for each one of the 4 abnormal CARTs: Valsalva Ratio (3.36±0.67 vs. 2.66±0.72, p=0.004), E/I ratio (3.01±0.72 vs. 2.53±0.68, p=0.001), 30:15 ratio (3.08±0.76 vs. 2.75±0.69, p=0.011), postural hypotension (3.30±0.72 vs. 2.75±0.66, p<0.001). Similar results were obtained for triplicate measurements.

Discussion: Among T2DM subjects, skin AGEs appear to increase in the presence of CAN. This holds true both for sympathetic and parasympathetic nervous system impairment.

2型糖尿病(T2DM)患者皮肤中晚期糖基化终产物(AGEs)经常升高。本研究旨在探讨AGEs与T2DM患者心脏自主神经病变(CAN)的相关性。方法:为此,纳入了132名参与者(88名男性),平均年龄为64.57岁,中位T2DM持续时间为14.5年。在优势臂上使用年龄读取器mu connect (diagnostics)测量皮肤年龄(包括单次和自动三次测量)。CAN、交感和副交感神经系统损伤的诊断基于四项标准化心血管反射试验(cart)。结果:在单次测量中,患有CAN的受试者的AGEs比没有CAN的受试者增加(3.20±0.74比2.66±0.66)。讨论:在T2DM受试者中,皮肤AGEs在CAN存在时增加。这对交感和副交感神经系统损伤都适用。
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引用次数: 3
Prevalence of Primary Aldosteronism in Newly Diagnosed Hypertensive Patients in Primary Care. 初诊高血压患者原发性醛固酮增多症的患病率
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1938-4242
Evelyn Asbach, Antonia Kellnar, Margareta Bekeran, Jörg Schelling, Martin Bidlingmaier, Martin Reincke

Context: Primary aldosteronism (PA) represents the most frequent cause of endocrine arterial hypertension. PA is also common in patients with mild forms of hypertension and normokalemia.

Objective: To identify the prevalence of PA in newly diagnosed hypertensive patients in primary care in Southern Germany.

Patients and methods: Newly diagnosed hypertensive patients in 27 primary care centers in Munich agreed to participate in the study. Patients were screened for PA using the aldosterone-to-renin ratio (ARR). In case of elevated ARR, confirmation testing was performed. After the diagnosis of PA, subtype differentiation and subsequent therapy of PA were initiated.

Results: A total of 235 patients with newly discovered arterial hypertension were initially screened for PA. Among these, 35 were excluded because the medication indicated pre-existing treated arterial hypertension or they were on interfering antihypertensive medication. At the first screening, 2.0% of the patients had hypokalemia. Of the 200 patients with newly discovered arterial hypertension, 42 had an elevated ARR. The incidence of the presence of hypokalemia did not differ according to normal or pathological ARR. Nine patients (21%) did not show up for further testing and were lost to follow-up, and 33 patients underwent a saline infusion test. Of these, 11 patients were diagnosed with PA, leading to at least 5.5% prevalence of PA in the collective. None of the diagnosed PA patients was hypokalemic at screening.

Conclusion: A 5.5% prevalence of PA was observed in our data of untreated newly diagnosed patients with hypertension.

背景:原发性醛固酮增多症(PA)是内分泌动脉高血压的最常见原因。PA在轻度高血压和正常血钾患者中也很常见。目的:了解德国南部初诊高血压患者中PA的患病率。患者和方法:慕尼黑27个初级保健中心的新诊断的高血压患者同意参加这项研究。使用醛固酮与肾素比值(ARR)筛选患者是否患有PA。如果ARR升高,则进行确认试验。确诊后开始分型及后续治疗。结果:共有235例新发现的动脉高血压患者最初进行了PA筛查。其中,35人被排除在外,因为药物表明他们已经接受了治疗的动脉高血压,或者他们正在服用干扰性抗高血压药物。第一次筛查时,2.0%的患者有低钾血症。在200例新发现的动脉高血压患者中,42例ARR升高。根据正常或病理ARR,低钾血症的发生率无差异。9名患者(21%)没有接受进一步的检测,也没有随访,33名患者接受了生理盐水输注试验。其中,11例患者被诊断为PA,导致集体中PA的患病率至少为5.5%。没有确诊的PA患者在筛查时出现低钾血症。结论:在未经治疗的新诊断高血压患者中,PA患病率为5.5%。
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引用次数: 4
Ghrelin-Reactive Autoantibodies as Potential Modulators of Dysfunctional Eating Patterns in Women: An Exploratory Study. 胃饥饿素反应性自身抗体作为女性功能失调饮食模式的潜在调节剂:一项探索性研究。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1895-2332
Astrid Espinoza-García, Tania Martínez-Rodriguez, Isela Parra-Rojas, Elia Valdés-Miramontes, Lidia García-Ortiz, Zyanya Reyes-Castillo

Dysfunctional eating patterns include alterations in experiencing and expressing hunger, appetite, and satiety, which may lead to eating disorders or obesity in the long term. Alterations in hormones such as ghrelin have been suggested to influence emotional eating in women with obesity. Ghrelin-reactive autoantibodies (autoAbs) are present both in healthy individuals and those with eating disorders and have been suggested to protect the hormone from degradation and preserve its functional activity. This study aimed to evaluate the relationship between IgG ghrelin-reactive autoAbs with dysfunctional eating patterns, subjective perception of stress, and body composition parameters in young women. This cross-sectional study included 82 women (age 21±2 years) classified according to body fat percentage. Dysfunctional eating patterns were measured with the Spanish version of the Three-factor Eating Questionnaire-R18, and perceived stress was measured with the Spanish version of the Perceived Stress Scale - 10. A validated in-house enzyme-linked immunosorbent assay was performed to measure IgG ghrelin-reactive autoAbs in its free, total, and immune complex fractions. Free IgG ghrelin-reactive autoAbs were positively correlated with weight, BMI, body fat percentage, waist, and hip circumference in women with very high body fat percentage. In this group, a negative correlation was observed between ghrelin immune complexes and uncontrolled eating. This exploratory research shows that IgG ghrelin-reactive autoAbs have a potential role in altered body composition parameters and appetite expression, such as uncontrolled eating in women with very high body fat. Further studies are required to clarify the role of IgG autoAbs in eating behavior.

功能失调的饮食模式包括体验和表达饥饿、食欲和饱腹感的改变,这可能导致长期饮食失调或肥胖。研究表明,饥饿素等激素的变化会影响肥胖女性的情绪化进食。生长素反应性自身抗体(autoAbs)既存在于健康个体中,也存在于饮食失调的个体中,并被认为可以保护激素免受降解并保持其功能活性。本研究旨在评估IgG胃饥饿素反应性自身抗体与年轻女性不正常饮食模式、主观应激感知和身体成分参数之间的关系。本横断面研究纳入82名女性(年龄21±2岁),根据体脂率进行分类。失调的饮食模式用西班牙版的三因素饮食问卷- r18来测量,感知压力用西班牙版的感知压力量表- 10来测量。一种经过验证的内部酶联免疫吸附测定法用于测量IgG生长素反应性自身抗体的游离、总和免疫复合物组分。在体脂率非常高的女性中,游离IgG生长素反应性自身抗体与体重、BMI、体脂率、腰围和臀围呈正相关。在这一组中,胃饥饿素免疫复合物与不受控制的饮食之间观察到负相关。这项探索性研究表明,IgG生长素反应性自身抗体在改变身体组成参数和食欲表达方面具有潜在作用,例如在体脂非常高的女性中不受控制的进食。需要进一步的研究来阐明IgG自身抗体在饮食行为中的作用。
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引用次数: 0
Clinical Value of Echo-Tracking in Gestational Diabetes Mellitus. 超声追踪在妊娠期糖尿病中的临床价值。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1926-7064
Youxia Zhou, Qianyu Lan, Yuan Li, Lin Qi, Yiming Dong, Haixia Zhou, Jiefang Zhang

Background: Vascular endothelial function plays an essential role in gestational diabetes mellitus (GDM) pathogenesis. Vascular elasticity is evaluated by the echo-tracking (ET) technique. In this study, we aimed to assess the clinical value of the ET technique in women with GDM and provide a basis for early evaluation and prevention of gestational diabetes.

Methods: Sixty-five patients with GDM and 65 gestational week-matched normal glucose tolerance pregnant women were enrolled in this study. The endothelial function parameters of pressure-strain elasticity coefficient (EP), the common carotid stiffness index (β), arterial compliance (AC), single-point pulsed-wave velocity (PWVβ), and augment index (AI) of bilateral common carotid arteries, were compared between the GDM and control groups by using ET technique. The correlations between plasma glucose levels and ET parameters were also analyzed.

Results: Our results indicated that EP, β, PWVβ, and AI were significantly higher in the GDM group (p<0.05), whereas AC was significantly lower in patients with GDM than in the control group (p<0.001). In addition, fasting plasma glucose and plasma glucose level after 2 h oral glucose tolerance test was correlated with ET parameters of EP, β, PWVβ, AI, and AC.

Conclusions: The application of ET technology to gestational diabetes women could provide a basis for early evaluation and prevention of gestational diabetes. It would detect early and accurate signs of diabetes in pregnant women and provide a timely and reasonable clinical treatment plan to reduce and delay the occurrence of complications.

背景:血管内皮功能在妊娠期糖尿病(GDM)发病中起重要作用。血管弹性是用回声跟踪(ET)技术评估的。在本研究中,我们旨在评估ET技术在GDM妇女中的临床价值,为妊娠期糖尿病的早期评估和预防提供依据。方法:65例GDM患者和65例妊娠周匹配的正常糖耐量孕妇参加本研究。采用ET技术比较GDM组与对照组双侧颈总动脉的压力-应变弹性系数(EP)、颈总动脉刚度指数(β)、动脉顺应性(AC)、单点脉冲波速度(PWVβ)、增强指数(AI)等内皮功能参数。并分析了血糖水平与ET参数的相关性。结果:GDM组EP、β、PWVβ、AI均显著升高(p < 0.05)。结论:ET技术在妊娠期糖尿病妇女中的应用可为妊娠期糖尿病的早期评估和预防提供依据。能够早期准确地发现孕妇糖尿病的体征,及时合理地提供临床治疗方案,减少和延缓并发症的发生。
{"title":"Clinical Value of Echo-Tracking in Gestational Diabetes Mellitus.","authors":"Youxia Zhou,&nbsp;Qianyu Lan,&nbsp;Yuan Li,&nbsp;Lin Qi,&nbsp;Yiming Dong,&nbsp;Haixia Zhou,&nbsp;Jiefang Zhang","doi":"10.1055/a-1926-7064","DOIUrl":"https://doi.org/10.1055/a-1926-7064","url":null,"abstract":"<p><strong>Background: </strong>Vascular endothelial function plays an essential role in gestational diabetes mellitus (GDM) pathogenesis. Vascular elasticity is evaluated by the echo-tracking (ET) technique. In this study, we aimed to assess the clinical value of the ET technique in women with GDM and provide a basis for early evaluation and prevention of gestational diabetes.</p><p><strong>Methods: </strong>Sixty-five patients with GDM and 65 gestational week-matched normal glucose tolerance pregnant women were enrolled in this study. The endothelial function parameters of pressure-strain elasticity coefficient (EP), the common carotid stiffness index (β), arterial compliance (AC), single-point pulsed-wave velocity (PWVβ), and augment index (AI) of bilateral common carotid arteries, were compared between the GDM and control groups by using ET technique. The correlations between plasma glucose levels and ET parameters were also analyzed.</p><p><strong>Results: </strong>Our results indicated that EP, β, PWVβ, and AI were significantly higher in the GDM group (p<0.05), whereas AC was significantly lower in patients with GDM than in the control group (p<0.001). In addition, fasting plasma glucose and plasma glucose level after 2 h oral glucose tolerance test was correlated with ET parameters of EP, β, PWVβ, AI, and AC.</p><p><strong>Conclusions: </strong>The application of ET technology to gestational diabetes women could provide a basis for early evaluation and prevention of gestational diabetes. It would detect early and accurate signs of diabetes in pregnant women and provide a timely and reasonable clinical treatment plan to reduce and delay the occurrence of complications.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 12","pages":"783-788"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380384","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
Metabolic Status Modulates Choroidal Thickness - A Possible Early Indicator for Diabetic Eye Complications? 代谢状态调节脉络膜厚度——糖尿病眼并发症的可能早期指标?
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1831-0265
Svenja Meyhöfer, Britta Wilms, Rodrigo Chamorro, Armin Knaak, Eleni Pappa, Agnetha S Schulz, Anna-Josephin Pagels, Maria Schröder, Neele Kaluzny, Hans-Jürgen Grein, Sebastian M Meyhöfer

Objective: To investigate the impact of metabolic status on choroidal thickness (ChT) in healthy subjects, patients with obesity, and type 2 diabetes.

Design and methods: Fasting blood glucose, insulin, insulin-like growth factor-1 (IGF-1), and ChT measured by optical coherence tomography were assessed in healthy normal-weight (n=17), obese participants (n=20), and obese participants with T2D (n=16).

Results: ChT increased in obese participants and obese participants with T2D as compared to healthy normal-weight participants (P<0.0001). A negative correlation was observed between IGF1 and ChT (r=-0.268, P=0.050) for all cohorts. Furthermore, body mass index (BMI; R2=0.209; P=0.002; beta=0.388) and model assessment-estimated insulin resistance (HOMA-IR; R2=0.074; P=0.015; beta=0.305) were independent variables of ChT, explaining 20.9 and 7.4% of its variance (both p<0.016), whereas age, sex, and IGF-1 were not significant confounders of ChT (p>0.975).

Conclusion: ChT is associated with metabolic characteristics, i. e., BMI and HOMA-IR. Due to the key role of choroidal function in retinal physiology, future studies are needed to evaluate whether metabolic traits, ChT, and potential metabolic eye complications are mechanistically linked.

目的:探讨代谢状态对健康人、肥胖患者和2型糖尿病患者脉络膜厚度(ChT)的影响。设计和方法:通过光学相干断层扫描测量空腹血糖、胰岛素、胰岛素样生长因子-1 (IGF-1)和ChT,评估健康正常体重者(n=17)、肥胖参与者(n=20)和肥胖伴T2D参与者(n=16)。结果:与健康体重正常的参与者相比,肥胖参与者和肥胖参与者合并T2D的ChT增加(P2=0.209;P = 0.002;β =0.388)和模型评估-估计胰岛素抵抗(HOMA-IR;R2 = 0.074;P = 0.015;β =0.305)是ChT的自变量,解释了其方差的20.9%和7.4%(均为p0.975)。结论:ChT与代谢特征有关。BMI和HOMA-IR。由于脉络膜功能在视网膜生理学中的关键作用,未来的研究需要评估代谢特征、ChT和潜在的代谢性眼部并发症是否存在机制联系。
{"title":"Metabolic Status Modulates Choroidal Thickness - A Possible Early Indicator for Diabetic Eye Complications?","authors":"Svenja Meyhöfer,&nbsp;Britta Wilms,&nbsp;Rodrigo Chamorro,&nbsp;Armin Knaak,&nbsp;Eleni Pappa,&nbsp;Agnetha S Schulz,&nbsp;Anna-Josephin Pagels,&nbsp;Maria Schröder,&nbsp;Neele Kaluzny,&nbsp;Hans-Jürgen Grein,&nbsp;Sebastian M Meyhöfer","doi":"10.1055/a-1831-0265","DOIUrl":"https://doi.org/10.1055/a-1831-0265","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of metabolic status on choroidal thickness (ChT) in healthy subjects, patients with obesity, and type 2 diabetes.</p><p><strong>Design and methods: </strong>Fasting blood glucose, insulin, insulin-like growth factor-1 (IGF-1), and ChT measured by optical coherence tomography were assessed in healthy normal-weight (n=17), obese participants (n=20), and obese participants with T2D (n=16).</p><p><strong>Results: </strong>ChT increased in obese participants and obese participants with T2D as compared to healthy normal-weight participants (P<0.0001). A negative correlation was observed between IGF1 and ChT (r=-0.268, P=0.050) for all cohorts. Furthermore, body mass index (BMI; R<sup>2</sup>=0.209; P=0.002; beta=0.388) and model assessment-estimated insulin resistance (HOMA-IR; R<sup>2</sup>=0.074; P=0.015; beta=0.305) were independent variables of ChT, explaining 20.9 and 7.4% of its variance (both p<0.016), whereas age, sex, and IGF-1 were not significant confounders of ChT (p>0.975).</p><p><strong>Conclusion: </strong>ChT is associated with metabolic characteristics, i. e., BMI and HOMA-IR. Due to the key role of choroidal function in retinal physiology, future studies are needed to evaluate whether metabolic traits, ChT, and potential metabolic eye complications are mechanistically linked.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 12","pages":"789-792"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423875","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
Screening for Gestational Diabetes Mellitus and Pregnancy Outcomes: Results from a Multicentric Study in Tajikistan. 筛查妊娠糖尿病和妊娠结局:来自塔吉克斯坦一项多中心研究的结果
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1869-4159
Dilnoza Pirmatova, Munavvara Dodkhoeva, Uwe Hasbargen, Andreas W Flemmer, Zulfiya Abdusamatzoda, Khursheda Saburova, Nasiba Salieva, Surayyo Radzhabova, Klaus G Parhofer

The prevalence of gestational diabetes parallels the prevalence of type 2 diabetes mellitus and is associated with adverse pregnancy outcomes. However, these data are not available for many parts of the world. We assessed the prevalence of gestational diabetes and pregnancy outcomes in Tajikistan. This cohort study included 2438 consecutively recruited representative pregnant women from 8 locations in two cities in Tajikistan, in whom an oral glucose tolerance test (75 g, fasting, 1 h, 2 h) was performed during gestational weeks 24-28. Women with known diabetes and twin pregnancies were excluded. Associations between glucose tolerance test results and pregnancy outcomes were examined. According to the WHO 2013 thresholds, 32.4% of women qualified as having gestational diabetes, the vast majority (29.7%) based on an elevated fasting glucose level (5.1-5.6 mmol/L), while only 2.8% had elevated 1- or 2-hour values or met more than one threshold. Women with only elevated fasting glucose (impaired gestational fasting glycemia) had no evidence of adverse pregnancy outcomes, while those with elevated 1- and/or 2-hour values (impaired gestational glucose tolerance) had more pregnancy complications (infection of urinary tract 1.8 vs. 8.8% p<0.001; preeclampsia 0.7 vs. 10.3% p<0.001) and emergency cesarean sections (4.4 vs. 13.2% p=0.002). Neonates from pregnancies with impaired gestational glucose tolerance had lower APGARs, lower birth weights, lower 30 min glucose levels, and a lower probability of being discharged alive (all p<0.05). In conclusion, the formal prevalence of gestational diabetes is high in Tajikistan; however, this does not translate into adverse pregnancy outcomes for women with impaired gestational fasting glycemia.

妊娠期糖尿病的患病率与2型糖尿病的患病率相似,并与不良妊娠结局相关。然而,世界上许多地方都没有这些数据。我们评估了塔吉克斯坦妊娠期糖尿病的患病率和妊娠结局。该队列研究从塔吉克斯坦两个城市的8个地点连续招募2438名有代表性的孕妇,在妊娠24-28周进行口服葡萄糖耐量试验(75 g,禁食,1小时,2小时)。已知患有糖尿病和双胎妊娠的妇女被排除在外。研究葡萄糖耐量试验结果与妊娠结局之间的关系。根据世界卫生组织2013年的阈值,32.4%的妇女有资格患有妊娠糖尿病,绝大多数(29.7%)是基于空腹血糖水平升高(5.1-5.6 mmol/L),而只有2.8%的1或2小时血糖升高或达到一个以上的阈值。仅空腹血糖升高(妊娠空腹血糖受损)的妇女没有不良妊娠结局的证据,而1小时和/或2小时血糖升高(妊娠糖耐量受损)的妇女有更多的妊娠并发症(尿路感染1.8比8.8% p
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引用次数: 1
Selective Inhibition of 11beta-Hydroxysteroiddehydrogenase-1 with BI 187004 in Patients with Type 2 Diabetes and Overweight or Obesity: Safety, Pharmacokinetics, and Pharmacodynamics After Multiple Dosing Over 14 Days. BI 187004选择性抑制2型糖尿病和超重或肥胖患者11 β -羟基甾体脱氢酶-1:安全性、药代动力学和14天后多次给药的药效学
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1932-3136
Susanna Bianzano, Cornelia Schepers, Michael Wolff, Tim Heise, Leona Plum-Moerschel

Objective: To assess safety, tolerability, pharmacokinetics, and pharmacodynamics of treatment with the selective 11beta-hydroxysteroid dehydrogenase-1 (11beta-HSD1) inhibitor BI 187004 in male and female patients with type 2 diabetes and overweight or obesity.

Methods: Randomized, double-blind, parallel-group, placebo-controlled multiple rising dose study, with 10-360 mg BI 187004 once daily over 14 days in 71 patients. Assessments included 11beta-HSD1 inhibition in the liver and subcutaneous adipose tissue ex vivo (clinical trial registry number NCT01874483).

Results: BI 187004 was well tolerated and safe in all tested dose groups. The incidence of drug-related adverse events was 51.8% (n=29) for BI 187004 and 35.7% (n=5) for placebo. There were no clinically relevant deviations in laboratory or electrocardiogram parameters besides one patient on 360 mg discontinuing treatment due to moderate supraventricular tachycardia.BI 187004 was rapidly absorbed within 2 h; exposure increased non-proportionally. The oral clearance was low, apparent volume of distribution was moderate to large, and terminal half-life with 106-124 h was rather long. Urinary tetrahydrocortisol/tetrahydrocortisone ratio decreased, indicating liver 11beta-HSD1 inhibition. Median inhibition of 11beta-HSD1 in subcutaneous adipose tissue biopsies was 87.9-99.4% immediately after the second dose and 73.8-97.5% 24 h after the last dose of BI 187004.

Conclusions: BI 187004 was safe and well tolerated over 14 days and could be dosed once daily. Targeted 11beta-HSD1 enzyme inhibition of≥80% could be shown for BI 187004 doses≥40 mg. This dose should be targeted in further studies to test blood glucose lowering in patients with type 2 diabetes and overweight or obesity.

目的:评价选择性11β -羟基类固醇脱氢酶-1 (11β - hsd1)抑制剂BI 187004治疗超重或肥胖的男女2型糖尿病患者的安全性、耐受性、药代动力学和药效学。方法:随机、双盲、平行组、安慰剂对照的多重上升剂量研究,71例患者服用10-360 mg BI 187004,每日1次,持续14天。评估包括体外肝脏和皮下脂肪组织中的11β - hsd1抑制(临床试验注册号NCT01874483)。结果:BI 187004在各剂量组均具有良好的耐受性和安全性。BI 187004组药物相关不良事件发生率为51.8% (n=29),安慰剂组为35.7% (n=5)。除1例患者因中度室上性心动过速停用360mg外,实验室或心电图参数均无临床相关偏差。BI 187004在2 h内迅速吸收;暴露程度不成比例地增加。口服清除率低,表观分布体积中大,终末半衰期106 ~ 124h较长。尿四氢皮质醇/四氢可的松比值下降,表明肝脏11 β - hsd1抑制。在第二次给药后立即皮下脂肪组织活检中,11 β - hsd1的中位抑制率为87.9-99.4%,在最后一次给药后24小时为73.8-97.5%。结论:BI 187004是安全的,14天内耐受性良好,可以每天给药一次。BI 187004剂量≥40 mg时,11β - hsd1酶抑制率≥80%。在进一步的研究中,该剂量应该用于测试2型糖尿病和超重或肥胖患者的血糖降低情况。
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引用次数: 1
Effects of High-Fructose Corn Syrup Intake on Glucocorticoid Metabolism in Rats During Childhood, Adolescence and Adulthood. 高果糖玉米糖浆摄入对大鼠童年、青春期和成年期糖皮质激素代谢的影响。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-12-01 DOI: 10.1055/a-1936-3310
Yuki Nouchi, Eiji Munetsuna, Hiroya Yamada, Mirai Yamazaki, Yoshitaka Ando, Genki Mizuno, Ryosuke Fujii, Itsuki Kageyama, Takuya Wakasugi, Tomohide Sakakibara, Atsushi Teshigawara, Hiroaki Ishikawa, Yohei Shimono, Koji Suzuki, Shuji Hashimoto, Koji Ohashi

The consumption of high-fructose corn syrup (HFCS) has been increasing in recent decades, especially among children. Some reports suggest that children and adolescents are more sensitive to the adverse effects of fructose intake than adults. However, the underlying mechanism of the difference in vulnerability between adolescence and adulthood have not yet been elucidated. In this study, we attempted to elucidate the different effects of HFCS intake at different growth stages in rats: childhood and adolescence (postnatal day (PD) 21-60), young adulthood (PD60-100), and adulthood (PD100-140). Since alterations in hepatic glucocorticoid (GC) metabolism can cause diseases including insulin resistance, we focused on GC metabolizing enzymes such as 11 beta-hydroxysteroid dehydrogenase 1 and 2 (Hsd11b1 and Hsd11b2) and steroid 5 alpha-reductase 1 (Srd5a1). Western blotting showed an increase in Hsd11b1 expression and a decrease in Hsd11b2 expression in childhood and adolescence but not in adulthood. We also observed changes in Hsd11b1 and Hsd11b2 activities only in childhood and adolescence, consistent with the results of mRNA and protein expression analysis. The effect of high-fructose intake with regards to GC metabolism may therefore vary with developmental stage. This study provides insight into the adverse effects of fructose on GC metabolism in children in the context of increasing rates of HFCS consumption.

近几十年来,高果糖玉米糖浆(HFCS)的消费量一直在增加,尤其是在儿童中。一些报告表明,儿童和青少年对果糖摄入的不良影响比成年人更敏感。然而,青少年和成年之间的脆弱性差异的潜在机制尚未阐明。在这项研究中,我们试图阐明HFCS摄入量在大鼠不同生长阶段的不同影响:童年和青春期(产后(PD) 21-60),青年期(PD60-100)和成年期(PD100-140)。由于肝糖皮质激素(GC)代谢的改变可引起胰岛素抵抗等疾病,我们重点研究了GC代谢酶,如11 β -羟基类固醇脱氢酶1和2 (Hsd11b1和Hsd11b2)和类固醇5 α -还原酶1 (Srd5a1)。Western blotting结果显示,Hsd11b1在儿童期和青春期表达升高,Hsd11b2在成年期表达降低,而Hsd11b1在成年期表达不升高。我们还观察到Hsd11b1和Hsd11b2活性仅在儿童和青少年时期发生变化,这与mRNA和蛋白表达分析的结果一致。因此,高果糖摄入对GC代谢的影响可能因发育阶段而异。本研究揭示了在高果糖玉米糖浆消费量增加的背景下,果糖对儿童GC代谢的不利影响。
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引用次数: 1
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Experimental and Clinical Endocrinology & Diabetes
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