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Type 2 diabetes mellitus and thyroid dysfunction, revisiting the intersections: A review article 2型糖尿病和甲状腺功能障碍,重新审视交叉点:综述文章
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_13_22
I. Ezeani, Stanley U. Ogbonna
There is an overwhelming evidence of the relationship between type 2 diabetes mellitus (T2DM) and thyroid dysfunction. The literature is robustly littered with data demonstrating the intersection of these two most common endocrine conditions. However, the extent of these intersections still remains complex, conflicting, and unclear. Therefore, we aimed to review the current literature on these intersections with an emphasis on interrelationship between thyroid dysfunction and T2DM. Several mechanisms have been postulated; some of which include but are not limited to blunting of the nocturnal thyroid-stimulating hormone (TSH) peak impairment of the TSH response to TRH from the hypothalamus, impairment of peripheral conversion from T4 to T3, increased hepatocyte plasma membrane concentrations of glucose transporter in the liver, which leads to an increased hepatic glucose output and abnormal glucose metabolism, to the perturbed genetic expression of a group of genes along with physiological abnormality. Insulin resistance has been shown to be associated with thyroid dysfunction (hyperthyroidism) in patients with T2DM. In other words, insulin resistance links both conditions. Several studies have evidenced an incontrovertible role of thyroid dysfunction as an intertwined cohort of T2DM. A plethora of guidelines have been exhaustively evaluated highlighting their key messages while synthesizing the relationship existing between them. The different treatment options available inexorably validate the importance of the intersection between these two endocrine conditions.
有压倒性的证据表明2型糖尿病(T2DM)和甲状腺功能障碍之间的关系。文献中大量的数据显示了这两种最常见的内分泌疾病的交集。然而,这些交叉的程度仍然是复杂的,相互矛盾的,不清楚的。因此,我们旨在回顾当前关于这些交叉点的文献,重点是甲状腺功能障碍和T2DM之间的相互关系。已经假定了几种机制;其中包括但不限于夜间促甲状腺激素(TSH)峰值减弱,下丘脑对TRH的TSH反应减弱,外周T4到T3的转化受损,肝内葡萄糖转运蛋白肝细胞质膜浓度升高,导致肝糖输出量增加和糖代谢异常,以及一组基因的基因表达紊乱,并伴有生理异常。胰岛素抵抗已被证明与T2DM患者甲状腺功能障碍(甲状腺功能亢进)有关。换句话说,胰岛素抵抗与这两种情况有关。一些研究已经证明了甲状腺功能障碍作为T2DM的一个相互交织的队列的无可争议的作用。对大量的指导方针进行了详尽的评估,突出了它们的关键信息,同时综合了它们之间存在的关系。不同的治疗方案不可避免地验证了这两种内分泌条件之间交叉的重要性。
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引用次数: 0
Nonvirilized external genitalia in a Nigerian female neonate with salt-wasting congenital adrenal hyperplasia 非男性化的外生殖器在尼日利亚女性新生儿与盐耗性先天性肾上腺增生
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_14_22
E. Oyenusi, Funmilayo Babatunde, Pauline Akowundu, Uzoamaka Nwigbo, A. Oduwole
A 3-week-old female neonate presented with complaints of weakness and inability to feed. She had been delivered at a general hospital with a birth weight of 3.3 kg. She had jaundice, which was treated with phototherapy and resolved after 3 days. Pregnancy and delivery were uneventful. Parents identified her as female. Examination revealed hanging skin folds, dehydration, tachycardia, hyperpigmentation and swelling of the labial folds, no clitoromegaly, and no palpable gonads. She had lost 30% of her birth weight and was hypoglycemic. Serum investigations showed hyponatremia, metabolic acidosis, hyperkalemia, and hypocortisolemia with elevated testosterone and 17-hydroxyprogesterone. Pelvic ultra sound scan showed normal-sized uterus and no testes suggesting a diagnosis of salt-wasting congenital adrenal hyperplasia (CAH). She is being managed with hydrocortisone, fludrocortisone, and added salt to feeds. Labial swelling and hyperpigmentation have resolved and external genitalia is typically female in appearance. She is gaining weight and thriving. Salt-wasting CAH can present with adrenal crisis without obvious virilization of the external genitalia in the female neonate and can be diagnosed by scrutiny of electrolytes in the sick neonate.
一名三周大的女婴表现出虚弱和无法进食的症状。她是在一家综合医院出生的,出生体重为3.3公斤。患者有黄疸,经光疗治疗,3天后消退。怀孕和分娩都平安无事。父母确认她是女性。检查发现皮肤褶皱下垂,脱水,心动过速,色素沉着,唇襞肿胀,未见阴蒂肿大,未见性腺。她的出生体重下降了30%,并且出现了低血糖。血清调查显示低钠血症、代谢性酸中毒、高钾血症和低皮质醇血症伴睾酮和17-羟孕酮升高。盆腔超声检查显示子宫大小正常,未见睾丸,提示诊断为耗盐型先天性肾上腺增生症。她正在接受氢化可的松、氟化可的松治疗,并在饲料中添加盐。阴唇肿胀和色素沉着已经消失,外生殖器的外观是典型的女性。她的体重在增加,身体也在茁壮成长。在女性新生儿中,盐耗性CAH可以表现为肾上腺危象,但没有明显的外生殖器男性化,可以通过检查患病新生儿的电解质来诊断。
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引用次数: 0
A male neonate failing to thrive with an endocrine disorder 因内分泌失调而不能茁壮成长的男婴
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_1_23
F. Irewole-Ojo, Esther Olutola, O. Olutekunbi, Mary Lawal, Oluwaseun Fagbuyi
Failure to thrive (FTT) is weight consistently below the 3rd to 5th percentile for age and sex, progressive decrease in weight to below the 3rd to 5th percentile, or a decrease in two major growth percentiles in a short period. The cause may be an identified medical condition, may be related to environmental factors, or may be multifactorial. Congenital adrenal hypoplasia (CAH), an endocrine disorder, is a rare cause of FTT in the newborn. We report a male neonate with FTT secondary to suspected CAH, salt-losing form. The case is reported to orient clinicians to have a high index of suspicion for any neonate who is failing to thrive. A 25-day-old male neonate presented with a history of poor weight gain. Weight at presentation was 2.8 kg, and birth weight was 3.7 kg (had lost 24% of birth weight). Mother is a 35-year-old Para 3 (3 Alive) woman who had a good appetite and was lactating well. Initial random blood sugar (RBS) was 117 mg/dL, but within minutes, she was observed to be unconscious, with a repeat RBS of 39 mg/dL. A thorough physical examination revealed a hyperpigmented male phallus with a stretched penile length of 4.8 cm and testicular volume of 2 cm3 using a standard orchidometer. Investigation results revealed hyponatremia, hyperkalemia, metabolic acidosis, with normal urea and creatinine levels. Full blood count parameters were essentially within the normal range. Serum cortisol, 17-hydroxyprogesterone, serum testosterone, and serum dehydroepiandrosterone-sulfate were not done. The patient was managed conservatively with dextrose-containing fluid and correction of electrolyte derangement. Weight was 2.7 kg on discharge. Weight on follow-up was 3.2 kg.
发育不全(FTT)是指体重始终低于年龄和性别的第3至第5个百分位数,体重逐渐下降至第3至第5个百分位数以下,或在短时间内两个主要生长百分位数下降。原因可能是一种确定的医学状况,可能与环境因素有关,也可能是多因素的。先天性肾上腺发育不全(CAH)是一种内分泌紊乱,是新生儿FTT的罕见病因。我们报告一例男性新生儿FTT继发于疑似CAH,失盐型。据报道,该病例使临床医生对任何未能茁壮成长的新生儿产生高度怀疑。一个25天大的男婴新生儿表现出体重增加不佳的历史。出生时体重为2.8 kg,出生时体重为3.7 kg(已失去24%的出生体重)。母亲是一名35岁的第3段(3活着)妇女,她胃口很好,泌乳也很好。初始随机血糖(RBS)为117 mg/dL,但在几分钟内,观察到她失去知觉,重复RBS为39 mg/dL。全面体检发现男性阴茎色素沉着,阴茎拉伸长度为4.8 cm,睾丸体积为2 cm3。调查结果显示低钠血症、高钾血症、代谢性酸中毒,尿素和肌酐水平正常。全血细胞计数基本在正常范围内。血清皮质醇、17-羟孕酮、血清睾酮和血清脱氢表雄酮硫酸盐未检测。对患者进行保守治疗,给予含葡萄糖液体和纠正电解质紊乱。出院时体重2.7公斤。随访时体重为3.2公斤。
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引用次数: 0
Prediabetes and its correlates in a suburban community in South-South Nigeria 尼日利亚南南郊区社区的前驱糖尿病及其相关因素
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_5_23
Osaro Ejenobo, Eunice Chike-Ezue, A. Eregie, Andrew Edo
Background: Prediabetes is a high-risk state for diabetes mellitus (DM) and is associated with the chronic complications of DM. There is paucity of data on prediabetes and its associated risk factors in Nigeria, particularly in the suburban setting. The aim of this study was to determine the prevalence of prediabetes and its associated risk factors in a suburban community in south-south Nigeria. Materials and Methods: This was a cross-sectional analytical study carried out among 382 adult residents in Mosogar, Delta State. An interviewer-administered questionnaire was used to obtain the socio-demographic and clinical information of the subjects. Anthropometric measurements and blood pressure were done according to standard protocols. Blood sample was collected for oral glucose tolerance test, fasting serum lipid profile, and glycated hemoglobin (HbA1c). Results: A total of 350 subjects (36.3% men and 63.7% women) completed the study. The mean (standard deviation) age of the participants was 46 (14.1) years. The prevalence of impaired fasting glucose, impaired glucose tolerance, and impaired HbA1c was 16.6%, 16.3%, and 19.2%, respectively. The overall prevalence of prediabetes and undiagnosed DM was 22.0% and 5.1%, respectively. On multivariate logistic regression, the significant predictors of prediabetes were increasing age, a family history of DM (adjusted odd’s ratio [AOR] 16.14, 95% confidence interval [CI] = 3.25–88.36), overweight (AOR 4.08, 95% CI = 1.72–9.63), obesity (AOR 5.63, 95% CI = 1.59–19.90), inadequate physical activity (AOR 5.28, 95% CI = 2.08–13.41) and elevated triglycerides (AOR 9.69, 95% CI = 1.77–53.18). Moderate alcohol intake was associated with a reduced risk for prediabetes (AOR 0.33, 95% CI = 0.12–0.92). Conclusion: There was a high prevalence of prediabetes in Mosogar community, Delta State. There is need for education of community members on dietary and lifestyle modifications aimed at reducing the risk of prediabetes and ultimately diabetes.
背景:糖尿病前期是糖尿病(DM)的高危状态,与糖尿病的慢性并发症有关。尼日利亚缺乏糖尿病前期及其相关危险因素的数据,特别是在郊区。本研究的目的是确定尼日利亚南南郊区社区糖尿病前期患病率及其相关危险因素。材料和方法:这是一项在三角洲州Mosogar的382名成年居民中进行的横断面分析研究。使用访谈者管理的问卷来获取受试者的社会人口学和临床信息。根据标准方案进行人体测量和血压测量。采集血液进行口服糖耐量试验、空腹血脂、糖化血红蛋白(HbA1c)检测。结果:共有350名受试者(男性36.3%,女性63.7%)完成了研究。参与者的平均(标准差)年龄为46岁(14.1岁)。空腹血糖受损、糖耐量受损和糖化血红蛋白受损的患病率分别为16.6%、16.3%和19.2%。糖尿病前期和未确诊糖尿病的总体患病率分别为22.0%和5.1%。多因素logistic回归分析显示,糖尿病前期的显著预测因素为年龄增加、糖尿病家族史(调整后的奥氏比[AOR] 16.14, 95%可信区间[CI] = 3.25 ~ 88.36)、体重超重(AOR 4.08, 95% CI = 1.72 ~ 9.63)、肥胖(AOR 5.63, 95% CI = 1.59 ~ 19.90)、运动不足(AOR 5.28, 95% CI = 2.08 ~ 13.41)和甘油三酯升高(AOR 9.69, 95% CI = 1.77 ~ 53.18)。适度饮酒与糖尿病前期风险降低相关(AOR 0.33, 95% CI = 0.12-0.92)。结论:三角洲州Mosogar社区糖尿病前期患病率较高。有必要对社区成员进行有关饮食和生活方式改变的教育,以降低糖尿病前期和最终糖尿病的风险。
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引用次数: 0
The sugar tax and obesity/overweight in Nigeria 尼日利亚的糖税和肥胖/超重
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_6_23
O. Fasanmade, Felicia Anumah
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引用次数: 0
Burdens of noncommunicable disease and communicable disease on a typical Nigerian diabetes mellitus patient with multiple comorbidities 非传染性疾病和传染性疾病对典型尼日利亚糖尿病患者多重合并症的负担
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_3_23
Timilehin Benjamin, Ibe Tobechukwu, Chikwendu Izu
Chronic diseases such as cardiovascular, respiratory, cancers, and diabetes are often regarded as noncommunicable diseases. The attendant challenges in their managements are rather demanding because of the huge cost implications in their diagnoses, treatments, and follow ups; the pressure, the physical and emotional exertions on patients’ relatives who constitute the primary-care providers; the poor prognoses and unfavorable case outcomes. Much more worrisome is the deleterious effects such disease conditions have on the immunity of patients. Non-communicable diseases break down patients’ walls of defenses and in the process pave way for myriads of communicable diseases. While most communicable diseases such as pneumonia, human immunodeficiency virus infections, tuberculosis, and coronavirus disease 2019 have a good prognosis in immunocompetent patients, concomitant presence with some of these noncommunicable diseases often produces poor or guarded prognosis. It is, therefore, imperative to ensure good public health advocacy on the menace of the threats posed by the duo of communicable and non-communicable diseases and the need for good health-seeking behaviors among patients. Besides, this case report will underscore the need for health insurance in developing countries. This case study aimed to highlight some of the burdens of non-communicable and communicable diseases on a typical Nigerian patient from the low socioeconomic class; his relatives and health care providers. He presented with history of cough, weight loss and diabetes mellitus at the Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria. Even though there was a good chance of surviving the illness, he succumbed due to multiple factors.
心血管疾病、呼吸系统疾病、癌症和糖尿病等慢性病通常被视为非传染性疾病。由于他们的诊断、治疗和随访费用巨大,因此随之而来的管理挑战相当艰巨;作为初级保健提供者的病人亲属承受的压力、身体和精神上的压力;不良的预后和不利的病例结果。更令人担忧的是这种疾病对患者免疫力的有害影响。非传染性疾病打破了患者的防御墙,并在此过程中为无数传染病铺平了道路。虽然大多数传染病(如肺炎、人类免疫缺陷病毒感染、结核病和2019冠状病毒病)在免疫功能正常的患者中预后良好,但其中一些非传染性疾病的共存往往导致预后不良或预后不佳。因此,必须确保就传染病和非传染性两种疾病构成的威胁的威胁进行良好的公共卫生宣传,并确保患者有必要采取良好的求医行为。此外,本病例报告将强调发展中国家对医疗保险的需求。本案例研究的目的是强调来自低社会经济阶层的典型尼日利亚患者的非传染性和传染性疾病的一些负担;他的亲属和医护人员。他在尼日利亚拉各斯Idi-Araba Lagos的拉各斯大学教学医院就诊,有咳嗽、体重减轻和糖尿病史。尽管有很大的机会从疾病中活下来,但由于多种因素,他还是去世了。
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引用次数: 0
Hyperprolactinemia following traumatic myelopathy 外伤性脊髓病并发高泌乳素血症
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_1_22
A. Esan, Jokotade Adeleye, Abimbola Olukayode Lawal, Oluwakemi A. Badejo
Prolactin, an anterior pituitary gland hormone, is necessary for breast development in pregnancy and initiation of lactation. Prolactinomas constitute a pathological cause of elevated serum prolactin levels and are the most common type of pituitary adenomas. Excess prolactin could result from physiological causes that include pregnancy, lactation, sleep, and coitus. The usual presentation of hyperprolactinemia is galactorrhea. There are reports of elevated prolactin levels following other pathological causes such as chest wall lesions, chest wall trauma, and medications. We report the rare association of hyperprolactinemia with traumatic injury to the spinal cord in a Nigerian patient, and a brief review of the relevant literature.
催乳素是一种垂体前叶激素,对妊娠期乳房发育和泌乳起始是必需的。催乳素瘤是引起血清催乳素水平升高的病理原因,是垂体腺瘤中最常见的类型。过多的催乳素可能是由生理原因引起的,包括怀孕、哺乳、睡眠和性交。高催乳素血症通常表现为溢乳。有报道称,由于其他病理原因,如胸壁病变、胸壁创伤和药物治疗,催乳素水平升高。我们报告高催乳素血症与创伤性脊髓损伤在尼日利亚患者罕见的关联,并简要回顾相关文献。
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引用次数: 0
Serum neurotransmitters level in response to acute restraint stress in perimenopausal female rats following L-arginine supplementation l -精氨酸补充后围绝经期雌性大鼠血清神经递质水平对急性约束应激的反应
Pub Date : 2022-07-01 DOI: 10.4103/ajem.ajem_2_23
A. Arikawe, Okikiade Oghene, A. Olusanya, O. Olumide, Olayemi Dawodu, Pateince Babafemi, S. Jaja
Background: Reproductive aging in females is a continuous process involving progressive follicular depletion that begins at birth and extends through the menopausal transition. Objective: This study aimed to assess neurotransmitter interplay in L-arginine-supplemented perimenopausal female rats subjected to an acute restraint stress paradigm. Materials/Methods: Fifty-four female Sprague–Dawley rats were divided into three groups: Control rats (injected with Corn oil 2.5 μL/g BW); VCD rats (injected with 4-vinylcyclohexene diepoxide 160 mg/kg BW diluted in Corn oil) both for 15 days; and Aging rats (210 days old) left to age naturally. Sixty days after VCD/corn oil administration and 240 days in Aging group, rats were further divided into two subgroups: distilled water and L-arginine supplemented (100 mg/kg BW) for additional 30 days. At 130 days in Control and VCD groups, and 270 days in Aging group on diestrus morning, animals were decapitated at two different time points (“before” and “after”) restraint stress. Trunk blood was collected into plain tubes; centrifuged to extract serum which was stored at –80°C for dopamine, noradrenaline, and serotonin measurements using specialized high-sensitive ELISA kits from LDN immunoassay company, Germany). Results: Before and after restraint stress, serum dopamine and noradrenaline levels were significantly lower (P < 0.05) in the perimenopausal groups compared to Control group, whereas serum serotonin was not significantly different amongst the three groups. L-arginine supplementation after stress significantly reduced (P < 0.05) serum dopamine in VCD rats and significantly increased (P < 0.05) it in Aging rats. On the other hand, L-arginine supplementation significantly lowered (P < 0.05) serum noradrenaline in Control rats and significantly increased (P < 0.05) it in VCD rats. Furthermore, after stress, L-arginine supplementation also significantly lowered (P < 0.05) serum serotonin in VCD and Aging rats compared to the Control rats. Conclusion: L-arginine supplementation showed differential effects in an attempt to regulate neurotransmitters and this could be protective against hormonal fluctuations that occur during perimenopause.
背景:女性的生殖衰老是一个持续的过程,涉及进行性卵泡衰竭,从出生开始,一直延伸到绝经期。目的:本研究旨在评估补充l -精氨酸的围绝经期雌性大鼠在急性约束应激范式下的神经递质相互作用。材料/方法:将54只雌性Sprague-Dawley大鼠分为3组:对照大鼠(注射玉米油2.5 μL/g BW);VCD大鼠注射用玉米油稀释的4-乙烯基二氧化环己烯160 mg/kg BW,连续15天;老龄大鼠(210天大)自然衰老。VCD/玉米油给药60 d后,老龄组240 d,再将大鼠分为2个亚组:添加蒸馏水和l -精氨酸(100 mg/kg BW),再加30 d。对照组和VCD组130 d,老龄组270 d,分别在约束应激前和约束应激后两个不同时间点进行斩首。干血采集于普通管中;离心提取血清,保存于-80°C,用于多巴胺、去甲肾上腺素和血清素的检测,使用德国LDN免疫测定公司专门的高灵敏度ELISA试剂盒)。结果:围绝经期组血清多巴胺、去甲肾上腺素水平显著低于对照组(P < 0.05),血清血清5 -羟色胺水平差异无统计学意义(P < 0.05)。应激后补充l -精氨酸可显著降低VCD大鼠血清多巴胺含量(P < 0.05),显著提高衰老大鼠血清多巴胺含量(P < 0.05)。另一方面,添加l -精氨酸显著降低了对照组大鼠血清去甲肾上腺素水平(P < 0.05),显著升高了VCD大鼠血清去甲肾上腺素水平(P < 0.05)。此外,应激后,与对照组相比,补充l -精氨酸也显著降低了VCD大鼠和Aging大鼠血清5 -羟色胺(P < 0.05)。结论:补充l -精氨酸在调节神经递质方面表现出不同的效果,这可能对绝经前后发生的激素波动有保护作用。
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引用次数: 0
Evaluation of the effects of the extract of dried roots of Jatropha curcas in the female Wistar rats 麻疯树干根提取物对雌性Wistar大鼠的作用评价
Pub Date : 1900-01-01 DOI: 10.4103/ajem.ajem_10_22
A. Ale, O. Odesanmi, Olubunmi Adeola Magbagbeola
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引用次数: 0
Vitamin D status and bone health in healthy adult Nigerians 尼日利亚健康成年人的维生素D状况与骨骼健康
Pub Date : 1900-01-01 DOI: 10.4103/ajem.ajem_7_21
A. Ale, Sanya Osalusi, OL Adeyemo
{"title":"Vitamin D status and bone health in healthy adult Nigerians","authors":"A. Ale, Sanya Osalusi, OL Adeyemo","doi":"10.4103/ajem.ajem_7_21","DOIUrl":"https://doi.org/10.4103/ajem.ajem_7_21","url":null,"abstract":"","PeriodicalId":126771,"journal":{"name":"African Journal of Endocrinology and Metabolism","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130039081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
African Journal of Endocrinology and Metabolism
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