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MMP-9 as a clinical marker for endometriosis: a meta-analysis and bioinformatics analysis. 作为子宫内膜异位症临床标志物的 MMP-9:一项荟萃分析和生物信息学分析。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1475531
Qiumei Huang, Yanlun Song, Xiaocan Lei, Hua Huang, Weihua Nong

Aim: This study systematically evaluated the potential efficacy of serum matrix metalloproteinase-9 (MMP-9) concentration as a diagnostic marker for endometriosis through meta-analysis. Early and accurate diagnosis of endometriosis, a common gynecological disease, is crucial for improving patient prognosis. Hence, this study aimed to comprehensively analyze the data from multiple studies to assess the diagnostic value of serum MMP-9 concentration for endometriosis.

Methods: Articles investigating the association between MMP-9 and endometriosis, published from the inception of the databases until February 2024, were systematically retrieved from multiple databases, including PubMed, Embase, Cochrane, Web of Science, Scopus, and CNKI. Download and analyze the GSE7305, GSE23339, and GSE51981 datasets. Statistical analyses of all eligible studies were conducted using RevMan 5.4, Stata 11.0, and R software version 4.3.3.

Results: Fifteen studies fully met the inclusion criteria for the meta-analysis. The concentration of MMP-9 in the blood of patients with endometriosis was significantly higher compared to that of the control group (p < 0.0001). Subgroup analysis based on different stages of endometriosis revealed a trend towards significantly higher serum MMP-9 concentrations in patients, whether in stages I-II or III-IV. Bioinformatics analysis revealed differences in the expression of MMP-9 in endometrial tissue between EMT patients and healthy controls in the GSE7305 and GSE23339 datasets. Additionally, in the GSE51981 dataset, we found significant differences between the normal group and both mild and severe cases of endometriosis.

Conclusion: Both the current meta-analysis and bioinformatics analysis indicate differences in MMP-9 concentration levels between endometriosis patients and healthy individuals, with potentially elevated MMP-9 concentrations in serum samples from patients with endometriosis.

Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42024525864.

目的:本研究通过荟萃分析系统评估了血清基质金属蛋白酶-9(MMP-9)浓度作为子宫内膜异位症诊断标志物的潜在功效。子宫内膜异位症是一种常见的妇科疾病,早期准确诊断对改善患者预后至关重要。因此,本研究旨在综合分析多项研究数据,评估血清MMP-9浓度对子宫内膜异位症的诊断价值:方法:从PubMed、Embase、Cochrane、Web of Science、Scopus和CNKI等多个数据库中系统检索了从数据库建立之初到2024年2月发表的研究MMP-9与子宫内膜异位症相关性的文章。下载并分析 GSE7305、GSE23339 和 GSE51981 数据集。使用 RevMan 5.4、Stata 11.0 和 R 软件 4.3.3 版对所有符合条件的研究进行统计分析:15项研究完全符合荟萃分析的纳入标准。与对照组相比,子宫内膜异位症患者血液中MMP-9的浓度明显升高(P < 0.0001)。根据子宫内膜异位症的不同分期进行的亚组分析显示,无论是I-II期还是III-IV期,患者血清中的MMP-9浓度都有明显升高的趋势。生物信息学分析显示,在 GSE7305 和 GSE23339 数据集中,EMT 患者与健康对照组的子宫内膜组织中 MMP-9 的表达存在差异。此外,在 GSE51981 数据集中,我们发现正常组与轻度和重度子宫内膜异位症病例之间存在显著差异:目前的荟萃分析和生物信息学分析均表明,子宫内膜异位症患者和健康人的 MMP-9 浓度水平存在差异,子宫内膜异位症患者血清样本中的 MMP-9 浓度可能升高。系统综述注册:https://www.crd.york.ac.uk/prospero,标识符为 CRD42024525864。
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引用次数: 0
Editorial: Insights in Cushing's syndrome and disease, volume II. 社论:库欣综合征与疾病的见解》第二卷。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1500755
Fabienne Langlois
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引用次数: 0
Comparative efficacy, toxicity, and insulin-suppressive effects of simvastatin and pravastatin in fatty acid-challenged mouse insulinoma MIN6 β-cell model. 辛伐他汀和普伐他汀在脂肪酸挑战小鼠胰岛素瘤 MIN6 β细胞模型中的疗效、毒性和胰岛素抑制作用比较
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1383448
Hossein Arefanian, Sardar Sindhu, Fatema Al-Rashed, Fawaz Alzaid, Ashraf Al Madhoun, Mohammed Qaddoumi, Fatemah Bahman, Michayla R Williams, Shaima Albeloushi, Nourah Almansour, Rasheed Ahmad, Fahd Al-Mulla

Introduction: Familial hypercholesterolemia, the highly prevalent form of dyslipidemia, is a well-known risk factor for premature heart disease and stroke worldwide. Statins, which inhibit 3-hydroxy 3-methylglutaryl coenzyme A (HMG-CoA) reductase, are the first-choice treatment for dyslipidemias, and have been effective in reducing the risk of stroke and myocardial infarction. However, emerging evidence indicates that statins may increase the incidence of new-onset type 2 diabetes by reducing β-cell mass and function. Notably, past in vitro reports studying the effects of statins on β-cells were performed without including free fatty acids in the model. This factor should have been addressed since these agents are used to treat individuals with hyperlipidemia.

Methods: Here, we used a mouse insulinoma MIN6 β-cell culture model to assess the efficacy, cytotoxicity, and insulin-suppressive effects of simvastatin and pravastatin in the presence of palmitic, linoleic, and oleic acids cocktail to mimic mixed lipids challenge in a biologically relevant setting.

Results and discussion: Our findings indicate that simvastatin was more effective in lowering intracellular cholesterol but was more cytotoxic as compared to pravastatin. Similarly, simvastatin exhibited a higher suppression of total insulin content and insulin secretion. Both drugs suppressed insulin secretion in phases 1 and 2, dose-dependently. No significant effect was observed on mitochondrial respiration. More importantly, elution experiments showed that insulin content diminution by simvastatin treatment was reversible, while exogenous mevalonate did not improve total insulin content. This suggests that simvastatin's influence on insulin content is independent of its specific inhibitory action on HMG-CoA reductase. In conclusion, our study identified that simvastatin was more effective in lowering intracellular cholesterol, albeit it was more toxic and suppressive of β-cells function. Notably, this suppression was found to be reversible.

导言:家族性高胆固醇血症是一种高发的血脂异常疾病,是全球早发心脏病和中风的一个众所周知的危险因素。他汀类药物可抑制 3- 羟基 3-甲基戊二酰辅酶 A(HMG-CoA)还原酶,是治疗血脂异常的首选药物,可有效降低中风和心肌梗死的风险。然而,新出现的证据表明,他汀类药物可能会通过降低β细胞质量和功能而增加新发2型糖尿病的发病率。值得注意的是,以往研究他汀类药物对 β 细胞影响的体外报告都是在模型中不包括游离脂肪酸的情况下进行的。方法:在此,我们使用小鼠胰岛素瘤 MIN6 β细胞培养模型来评估辛伐他汀和普伐他汀在棕榈酸、亚油酸和油酸鸡尾酒存在下的疗效、细胞毒性和胰岛素抑制作用,以模拟生物相关环境中的混合脂质挑战:我们的研究结果表明,辛伐他汀能更有效地降低细胞内胆固醇,但与普伐他汀相比,辛伐他汀的细胞毒性更大。同样,辛伐他汀对总胰岛素含量和胰岛素分泌的抑制作用更大。这两种药物在第 1 和第 2 阶段都抑制了胰岛素的分泌,且呈剂量依赖性。对线粒体呼吸没有明显影响。更重要的是,洗脱实验表明,辛伐他汀治疗后胰岛素含量的减少是可逆的,而外源性甲羟戊酸并不能改善胰岛素的总含量。这表明辛伐他汀对胰岛素含量的影响与其对HMG-CoA还原酶的特异性抑制作用无关。总之,我们的研究发现,辛伐他汀能更有效地降低细胞内胆固醇,尽管它对β细胞功能的毒性和抑制作用更大。值得注意的是,这种抑制作用是可逆的。
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引用次数: 0
The clinical potential of 1,5-anhydroglucitol as biomarker in diabetes mellitus. 1,5-脱水葡萄糖醇作为糖尿病生物标志物的临床潜力。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1471577
Haiying Xu, Renyin Chen, Xiaoli Hou, Na Li, Yanwei Han, Shaoping Ji

A crucial measure of diabetes management is to monitor blood glucose, which often requires continuous blood collection, leading to economic burden and discomfort. Blood glucose and glycated hemoglobin A1c serve as traditional indicators of glucose monitoring. But now glycated albumin, fructosamine, and 1,5-anhydroglucitol (1,5-AG) have been gaining more attention. 1,5-AG is a chemically stable monosaccharide that exists in the human body. Its serum concentration remains stable when blood glucose levels are normal. However, it decreases when blood glucose exceeds the renal glucose threshold. Studies have shown that 1.5-AG reflects blood glucose changes in 1 to 2 weeks; therefore, decreased levels of serum 1,5-AG can serve as a clinical indicator of short-term blood glucose disturbances. Recent studies have shown that 1,5-AG can be used not only for the screening and managing of diabetes but also for predicting diabetes-related adverse events and islet β cell function in prediabetic patients. In addition, saliva 1,5-AG demonstrates potential value in the screening and diagnosis of diabetes. This review focuses on the biological characteristics, detection methods, and clinical application of 1,5-AG to promote understanding and applicable research of 1,5-AG in the future.

糖尿病管理的一项重要措施是监测血糖,这通常需要持续采血,从而造成经济负担和不适。血糖和糖化血红蛋白 A1c 是血糖监测的传统指标。但现在,糖化白蛋白、果糖胺和 1,5-脱水葡萄糖醇(1,5-AG)越来越受到关注。1,5-AG 是人体内存在的一种化学性质稳定的单糖。当血糖水平正常时,其血清浓度保持稳定。然而,当血糖超过肾糖阈值时,它就会降低。研究表明,1.5-AG 可反映 1 至 2 周内的血糖变化;因此,血清中 1,5-AG 水平的降低可作为短期血糖紊乱的临床指标。最近的研究表明,1,5-AG 不仅可用于筛查和控制糖尿病,还可用于预测与糖尿病相关的不良事件和糖尿病前期患者的胰岛β细胞功能。此外,唾液中的 1,5-AG 在筛查和诊断糖尿病方面也具有潜在价值。本综述重点介绍了 1,5-AG 的生物学特性、检测方法和临床应用,以促进人们对 1,5-AG 的了解和未来的应用研究。
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引用次数: 0
Clinical features of pituitary carcinoma: analysis based on a case report and literature review. 垂体癌的临床特征:基于病例报告和文献综述的分析。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1440247
Yongxiang Yang, Wanlin Liang, Kexia Fan, Tao Yang, Jingmin Cheng

Introduction: Pituitary carcinoma (PC) is an extremely rare tumor of the adenohypophysis, which manifests as craniospinal dissemination and/or systemic metastasis. The diagnosis of PC is particularly difficult, as the clinical diagnosis only can be made after the metastasis is found. Owing to the complex diagnostic process and less effective treatments, the clinical prognosis of PC is usually very poor. Hence, it is of great significance to illustrate the diagnosis and treatment course of PC.

Methods: In this case report, we described a 48-year-old male patient who was diagnosed with pituitary adenoma (PA) initially and then was diagnosed with PC eventually after spinal cord metastasis was found, and we illustrated the treatment course as well. Furthermore, we summarized all the published case reports until now and provided a comprehensive review of the diagnosis, treatment, prediction, and clinical outcome of PC.

Results and conclusions: We found that most PC patients had adrenocorticotropic hormone/prolactin (ACTH/PRL)-secreting tumors, Ki-67 ≥ 10%, and P53 positivity, which may have the potential to predict the transformation from PA to PC; surgery excision combined with temozolomide (TMZ) and radiotherapy is helpful to prolong the survival of PC patients.

简介脑垂体癌(PC)是一种极其罕见的腺嗜铬细胞瘤,表现为颅内播散和/或全身转移。PC的诊断尤为困难,因为只有在发现转移灶后才能做出临床诊断。由于诊断过程复杂,治疗效果不佳,PC 的临床预后通常很差。因此,说明 PC 的诊断和治疗过程具有重要意义:在本病例报告中,我们描述了一名 48 岁男性患者,他最初被诊断为垂体腺瘤(PA),在发现脊髓转移瘤后最终被诊断为 PC,并说明了治疗过程。此外,我们还总结了迄今为止所有已发表的病例报告,对PC的诊断、治疗、预测和临床结果进行了全面回顾:我们发现,大多数PC患者的肿瘤分泌促肾上腺皮质激素/泌乳素(ACTH/PRL),Ki-67≥10%,P53阳性,这可能是预测PA向PC转化的潜在因素;手术切除联合替莫唑胺(TMZ)和放疗有助于延长PC患者的生存期。
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引用次数: 0
Investigating the metabolomic pathways in female reproductive endocrine disorders: a Mendelian randomization study. 调查女性生殖内分泌失调的代谢组学途径:孟德尔随机研究。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1438079
Fei-Fan Lu, Zheng Wang, Qian-Qian Yang, Feng-Shang Yan, Chang Xu, Ming-Tang Wang, Zhu-Jing Xu, Sheng-Yun Cai, Rui Guan

Introduction: Reproductive endocrine disorders (RED), including polycystic ovary syndrome (PCOS), endometriosis (EMs), and female infertility (FI), significantly affect women's health globally, with varying prevalence across different regions. These conditions can be addressed through medication, surgical interventions, and lifestyle modifications. However, the limited understanding of RED's etiology and the substantial economic burden of its treatment highlight the importance of investigating its pathogenesis. Metabolites play a critical role in metabolic processes and are potentially linked to the development of RED. Despite existing studies suggesting correlations between metabolites and RED, conclusive evidence remains scarce, primarily due to the observational nature of these studies, which are prone to confounding factors.

Methods: This study utilized Mendelian Randomization (MR) to explore the causal relationship between metabolites and RED, leveraging genetic variants associated with metabolite levels as instrumental variables to minimize confounding and reverse causality. Data were obtained from the Metabolomics GWAS Server and the IEU OpenGWAS project. Instrumental variables were selected based on their association with the human gut microbiota composition, and the GWAS summary statistics for metabolites, PCOS, EMs, and FI were analyzed. The MR-Egger regression and random-effects inverse-variance weighted (IVW) methods were employed to validate the causal relationship. Cochran's Q test was employed to evaluate heterogeneity, sensitivity analysis was performed using leave-one-out analysis, and for pleiotropy analysis, the intercept term of MR-Egger's method was investigated.

Results: The MR analysis revealed significant associations between various metabolites and RED conditions. For instance, a positive association was found between 1-palmitoylglycerophosphocholine and PCOS, while a negative association was noted between phenylacetate and FI. The study identified several metabolites associated with an increased risk and others with protective effects against PCOS, EMs, and FI. These findings highlight the complex interplay between metabolites and RED, suggesting potential pathways through which these conditions could be influenced or treated.

Conclusion: This MR study provides valuable insights into the causal relationship between metabolites and female reproductive endocrine disorders, suggesting that metabolic alterations play a significant role in the pathogenesis of PCOS, EMs, and FI, and offering a foundation for future research and therapeutic development.

导言:生殖内分泌失调(RED),包括多囊卵巢综合症(PCOS)、子宫内膜异位症(EMs)和女性不孕症(FI),严重影响着全球妇女的健康,不同地区的发病率也不尽相同。这些疾病可以通过药物治疗、手术干预和改变生活方式来解决。然而,人们对 RED 病因的了解有限,而且治疗 RED 带来了巨大的经济负担,这凸显了研究其发病机制的重要性。代谢物在新陈代谢过程中起着至关重要的作用,可能与 RED 的发病有关。尽管现有研究表明代谢物与 RED 之间存在相关性,但确凿证据仍然很少,这主要是由于这些研究具有观察性质,容易受到干扰因素的影响:本研究利用孟德尔随机化(Mendelian Randomization,MR)方法探讨代谢物与RED之间的因果关系,利用与代谢物水平相关的遗传变异作为工具变量,以尽量减少混杂因素和反向因果关系。数据来自代谢组学 GWAS 服务器和 IEU OpenGWAS 项目。根据工具变量与人类肠道微生物群组成的关系选择了这些变量,并分析了代谢物、多囊卵巢综合征、EMs 和 FI 的 GWAS 统计摘要。采用MR-Egger回归和随机效应逆方差加权(IVW)方法来验证因果关系。采用 Cochran's Q 检验来评估异质性,使用留一分析法进行敏感性分析,并对 MR-Egger 方法的截距项进行了多重效应分析:结果:MR 分析表明,各种代谢物与 RED 状况之间存在明显的关联。例如,发现 1-棕榈酰甘油磷酸胆碱与多囊卵巢综合症之间存在正相关,而苯乙酸盐与 FI 之间存在负相关。该研究发现了几种与多囊卵巢综合症、EMs 和 FI 风险增加有关的代谢物,还有一些代谢物对多囊卵巢综合症、EMs 和 FI 具有保护作用。这些发现凸显了代谢物与 RED 之间复杂的相互作用,提出了影响或治疗这些疾病的潜在途径:这项磁共振研究为了解代谢物与女性生殖内分泌失调之间的因果关系提供了有价值的见解,表明代谢改变在多囊卵巢综合征、EMs 和 FI 的发病机制中起着重要作用,并为未来的研究和治疗开发奠定了基础。
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引用次数: 0
Editorial: The role of sphingolipid metabolism in endocrine diseases. 社论:鞘脂代谢在内分泌疾病中的作用。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1506971
Cao Li, Guangbi Li
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引用次数: 0
Exploring diabesity pathophysiology through proteomic analysis using Caenorhabditis elegans. 利用秀丽隐杆线虫进行蛋白质组分析,探索肥胖症的病理生理学。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1383520
Malaimegu Subhadra, Dilawar Ahmad Mir, Koley Ankita, Muthukrishnan Sindunathy, Hambram David Kishore, Velayutham Ravichandiran, Krishnaswamy Balamurugan

Introduction: Diabesity, characterized by obesity-driven Type 2 diabetes mellitus (T2DM), arises from intricate genetic and environmental interplays that induce various metabolic disorders. The systemic lipid and glucose homeostasis is controlled by an intricate cross-talk of internal glucose/insulin and fatty acid molecules to maintain a steady state of internal environment.

Methods: In this study, Caenorhabditis elegans were maintained to achieve glucose concentrations resembling the hyperglycemic conditions in diabetic patients to delve into the mechanistic foundations of diabesity. Various assays were conducted to measure intracellular triglyceride levels, lifespan, pharyngeal pumping rate, oxidative stress indicators, locomotor behavior, and dopamine signaling. Proteomic analysis was also performed to identify differentially regulated proteins and dysregulated KEGG pathways, and microscopy and immunofluorescence staining were employed to assess collagen production and anatomical integrity.

Results: Worms raised on diets high in glucose and cholesterol exhibited notably increased intracellular triglyceride levels, a decrease in both mean and maximum lifespan, and reduced pharyngeal pumping. The diabesity condition induced oxidative stress, evident from heightened ROS levels and distinct FT-IR spectroscopy patterns revealing lipid and protein alterations. Furthermore, impaired dopamine signaling and diminished locomotors behavior in diabesity-afflicted worms correlated with reduced motility. Through proteomic analysis, differentially regulated proteins encompassing dysregulated KEGG pathways included insulin signaling, Alzheimer's disease, and nicotinic acetylcholine receptor signaling pathways were observed. Moreover, diabesity led to decreased collagen production, resulting in anatomical disruptions validated through microscopy and immunofluorescence staining.

Discussion: This underscores the impact of diabesity on cellular components and structural integrity in C. elegans, providing insights into diabesity-associated mechanisms.

导言:肥胖症是由肥胖引起的 2 型糖尿病(T2DM),它是由错综复杂的遗传和环境相互作用引起的各种代谢紊乱。全身脂质和葡萄糖的平衡受内部葡萄糖/胰岛素和脂肪酸分子错综复杂的交叉对话控制,以维持内环境的稳定状态:本研究将草履虫维持在与糖尿病患者高血糖状态相似的葡萄糖浓度下,以深入研究糖尿病的机理基础。研究人员进行了各种测定,以测量细胞内甘油三酯水平、寿命、咽部抽吸率、氧化应激指标、运动行为和多巴胺信号传导。此外,还进行了蛋白质组分析,以确定不同调控的蛋白质和失调的 KEGG 通路,并采用显微镜和免疫荧光染色法评估胶原蛋白的生成和解剖完整性:结果:以高葡萄糖和高胆固醇饮食饲养的蠕虫表现出明显的细胞内甘油三酯水平升高、平均寿命和最长寿命缩短以及咽部泵血功能减弱。肥胖条件会诱发氧化应激,这一点从 ROS 水平的升高和明显的傅立叶变换红外光谱模式可以看出,这些模式揭示了脂质和蛋白质的改变。此外,受糖尿病影响的蠕虫多巴胺信号传导受损,运动行为减弱,这与蠕虫运动能力下降有关。通过蛋白质组分析,研究人员观察到了不同的调控蛋白,其中包括胰岛素信号通路、阿尔茨海默病和烟碱乙酰胆碱受体信号通路等调控失调的KEGG通路。此外,肥胖症导致胶原蛋白生成减少,造成解剖结构破坏,这一点已通过显微镜和免疫荧光染色得到验证:讨论:这强调了二肥胖对优雅鼠细胞成分和结构完整性的影响,为二肥胖相关机制提供了见解。
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引用次数: 0
The mediating role of serum 25-hydroxyvitamin D on the association between reduced sensitivity to thyroid hormones and periodontitis in Chinese euthyroid adults. 中国甲状腺功能正常成年人血清 25- 羟维生素 D 对甲状腺激素敏感性降低与牙周炎之间关系的中介作用。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1456217
Hao Yang, Yayun Lu, Lina Zhao, Yufeng He, Yuecheng He, Dong Chen

Aim: Thyroid dysfunction is closely associated with periodontitis. We aim to explore the association between sensitivity to thyroid hormones (THs) and periodontitis and to investigate the mediating role of serum 25-hydroxyvitamin D[25(OH)D] in this relationship in Chinese euthyroid populations.

Methods: This population-based retrospective study included 2,530 euthyroid participants. Central sensitivity to THs was assessed by the thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyrotrophic thyroxine resistance index (TT4RI) and thyroid-stimulating hormone index (TSHI), while FT3/FT4 was evaluated to assess peripheral sensitivity. Multivariable regression analysis and restricted cubic spline were performed to explore the association between sensitivity to THs and periodontitis. Threshold effect and subgroup analysis were also conducted. Mediation analysis was performed to estimate direct and indirect effects through 25(OH)D.

Results: Multivariable regression analysis indicated that central sensitivity to THs indices(per SD increase) were positively associated with periodontitis risk [TFQI: OR=1.19,95% CI (1.09, 1.31); PTFQI: OR=1.22, 95% CI(1.12,1.34); TSHI: OR=1.36, 95% CI (1.21,1.52); TT4RI: OR=1.43, 95% CI (1.25,1.63)](all P value<0.001). TT4RI only had a non-linear relationship with periodontitis in euthyroid participants. Subgroup analysis showed that no significant correlations were founded among those aged over 65 years or with hypertension/diabetes. Mediation analysis revealed that the proportions mediated by 25(OH)D on the association of TFQI, PTFQI,TSHI, TT4RI and periodontitis risk were 16.37%, 16.43%, 9.93% and 10.21%, respectively.

Conclusions: Impaired central sensitivity to THs is positively associated with periodontitis in euthyroid and serum 25(OH)D might be one of its biological mechanisms.

目的:甲状腺功能障碍与牙周炎密切相关。我们旨在探讨中国甲状腺功能正常人群对甲状腺激素(THs)的敏感性与牙周炎之间的关系,并研究血清25-羟维生素D[25(OH)D]在这种关系中的中介作用:这项基于人群的回顾性研究包括 2,530 名甲状腺功能正常的参与者。通过甲状腺反馈量子化指数(TFQI)、参数甲状腺反馈量子化指数(PTFQI)、甲状腺营养性甲状腺素抵抗指数(TT4RI)和促甲状腺激素指数(TSHI)评估对THs的中枢敏感性,同时评估FT3/FT4以评估外周敏感性。采用多变量回归分析和限制性立方样条曲线来探讨甲状腺激素敏感性与牙周炎之间的关系。此外,还进行了阈值效应和亚组分析。还进行了中介分析,以估计通过 25(OH)D 产生的直接和间接影响:多变量回归分析表明,中心对 THs 的敏感性指数(每标准差增加)与牙周炎风险呈正相关[TFQI:OR=1.19,95% CI (1.09,1.31);PTFQI:OR=1.22,95% CI (1.12,1.34);TSHI:OR=1.36,95% CI (1.21,1.52);TT4RI:OR=1.43,95% CI (1.25,1.63)](均为 P 值):甲状腺功能正常者对THs的中枢敏感性受损与牙周炎呈正相关,而血清25(OH)D可能是其生物学机制之一。
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引用次数: 0
Clinical efficacy and mechanism of the combination of autologous platelet-rich gel and recombinant human acidic fibroblast growth factor in the management of refractory diabetic foot. 自体富血小板凝胶和重组人酸性成纤维细胞生长因子联合治疗难治性糖尿病足的临床疗效和机制。
IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.3389/fendo.2024.1374507
Xia Sheng, Ling Hu, Ting Li, Yi Zou, Hai-Yan Fu, Guo-Ping Xiong, Yan Zhu, Bo Deng, Lei-Lei Xiong, Xiao-Ling Yin

Objective: This study aims to explore the influence of combining autologous platelet-rich gel (APG) with continuous vacuum-sealed drainage (CVSD) and the exogenous recombinant human acidic fibroblast growth factor (rh-aFGF) on the healing processes of diabetic foot ulcers (DFU). The primary objective is to elucidate the complex molecular mechanisms associated with DFU, providing innovative perspectives for its treatment.

Methods: Ninety patients diagnosed with DFU were randomly allocated into three distinct groups. Group A underwent CVSD following wound cleansing to facilitate healing. In Group B, in addition to conventional treatment, negative pressure wound therapy was applied, and rh-aFGF was introduced into normal saline for lavage, building upon the procedures of Group A. Group C received APG along with the interventions applied in Group B. The clinical efficacy of each group was systematically observed and analyzed. Additionally, changes in plasma oxidative stress, inflammatory markers, vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor (PEDF) were assessed both before treatment and 14 days post-treatment.

Results: Following treatment, all groups exhibited commendable clinical efficacy. Group C demonstrated a superior wound healing rate, reduced frequency of dressing changes, and shorter wound healing duration (P< 0.05). Compared to baseline measurements, the levels of superoxide dismutase and PEDF increased, while malondialdehyde, VEGF, interleukin-6, interleukin-8, and monocyte chemotactic factor MCP-1 decreased in the wound tissue across all groups. Notably, Group C showed the most significant improvement in clinical efficacy and fortification of molecular mechanisms against oxidative stress (all P< 0.05).

Conclusions: The integrative therapeutic approach combining APG with CVSD and rh-aFGF demonstrates notable efficacy in advancing wound healing. This effectiveness is evident through the reduced frequency of dressing changes and alleviation of wound-related pain. Additionally, the treatment regimen improves the cure rate for challenging, refractory wounds. These favorable outcomes can be attributed to the reduction of oxidative stress levels, attenuation of the local inflammatory response, and the enhancement of the balance between PEDF and VEGF.

研究目的本研究旨在探讨自体富血小板凝胶(APG)与连续真空密封引流(CVSD)和外源性重组人酸性成纤维细胞生长因子(rh-aFGF)相结合对糖尿病足溃疡(DFU)愈合过程的影响。研究的主要目的是阐明与糖尿病足溃疡相关的复杂分子机制,为糖尿病足溃疡的治疗提供创新视角:方法:将 90 名确诊为 DFU 的患者随机分为三组。A 组在清洗伤口后进行 CVSD,以促进伤口愈合。B 组除常规治疗外,还采用负压伤口疗法,并在 A 组程序的基础上,将 rh-aFGF 加入生理盐水中进行灌洗。此外,还评估了治疗前和治疗后 14 天血浆氧化应激、炎症指标、血管内皮生长因子(VEGF)和色素上皮衍生因子(PEDF)的变化:结果:治疗后,所有组都表现出了值得称赞的临床疗效。C 组的伤口愈合率更高,换药次数更少,伤口愈合时间更短(P< 0.05)。与基线测量值相比,各组伤口组织中的超氧化物歧化酶和 PEDF 水平均有所上升,而丙二醛、血管内皮生长因子、白细胞介素-6、白细胞介素-8 和单核细胞趋化因子 MCP-1 水平均有所下降。值得注意的是,C 组在临床疗效和强化抗氧化分子机制方面的改善最为显著(均为 P< 0.05):结论:结合 APG、CVSD 和 rh-aFGF 的综合治疗方法在促进伤口愈合方面具有显著疗效。通过减少换药次数和减轻伤口相关疼痛,这种疗效显而易见。此外,该治疗方案还提高了难治性伤口的治愈率。这些有利结果可归因于氧化应激水平的降低、局部炎症反应的减轻以及 PEDF 和 VEGF 平衡的增强。
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Frontiers in Endocrinology
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