We analyzed the effect of Na-glucose cotransporter 2 inhibitors (SGLT2-I) in diabetic patients visiting our hospital. The study included 236 patients treated with SGLT2-I alone or with codiabetic drugs for at least two years. We analyzed overtime changes in glycosylated hemoglobin A1c (HbA1c) in the patients by repeated analyses of variance (ANOVA) and evaluated the therapeutic effect. HbA1c levels decreased significantly in the first six months after treatment. Afterward, they leveled off and increased slightly over the next two years. Six months after treatment, the mean (SD) of HbA1c was 8.19 (1.46) %; the mean difference dropped by 0.91%, and HbA1c in mild DM2 did not drop by below 8.0%. Overall, there was only a slight improvement. We performed multivariate logistic regression analysis using a model with or without improvement as the objective variable and several explanatory variables. Na and Hct were significant factors. They increased considerably over six months and then leveled off. eGFR significantly reduced in the hyperfiltration group six months after treatment. The annual decline rate in eGFR was also faster, even in the nonhyperfiltration group than in the healthy subjects, which may be a characteristic of renal clearance in SGLT2-I treatment. In conclusion, SGLT2-I is an excellent antidiabetic, nephroprotective agent to eliminate hyperfiltration, but unfortunately, SGLT2-I alone does not have enough power to reduce blood glucose levels. SGLT2-I, with insulin or insulin secretagogues, enhances insulin resistance, induces hyperinsulinemia, and exacerbates type 2 DM. In contrast, SGLT2-I, with noninsulin antidiabetic agents and a low-carbohydrate diet, may bring better results.
{"title":"Light and Shadow of Na-Glucose Cotransporter 2 Inhibitors in the Treatment of Diabetes Mellitus: Points for Improvement Based on Our Clinical Experience","authors":"Akihiro Sonoda, Toshio Shimada, Kohei Saito, Rieko Kosugi, Yoshitaka Taguchi, Tatsuhide Inoue","doi":"10.1155/2024/3937927","DOIUrl":"https://doi.org/10.1155/2024/3937927","url":null,"abstract":"We analyzed the effect of Na-glucose cotransporter 2 inhibitors (SGLT2-I) in diabetic patients visiting our hospital. The study included 236 patients treated with SGLT2-I alone or with codiabetic drugs for at least two years. We analyzed overtime changes in glycosylated hemoglobin A1c (HbA1c) in the patients by repeated analyses of variance (ANOVA) and evaluated the therapeutic effect. HbA1c levels decreased significantly in the first six months after treatment. Afterward, they leveled off and increased slightly over the next two years. Six months after treatment, the mean (SD) of HbA1c was 8.19 (1.46) %; the mean difference dropped by 0.91%, and HbA1c in mild DM2 did not drop by below 8.0%. Overall, there was only a slight improvement. We performed multivariate logistic regression analysis using a model with or without improvement as the objective variable and several explanatory variables. Na and Hct were significant factors. They increased considerably over six months and then leveled off. eGFR significantly reduced in the hyperfiltration group six months after treatment. The annual decline rate in eGFR was also faster, even in the nonhyperfiltration group than in the healthy subjects, which may be a characteristic of renal clearance in SGLT2-I treatment. In conclusion, SGLT2-I is an excellent antidiabetic, nephroprotective agent to eliminate hyperfiltration, but unfortunately, SGLT2-I alone does not have enough power to reduce blood glucose levels. SGLT2-I, with insulin or insulin secretagogues, enhances insulin resistance, induces hyperinsulinemia, and exacerbates type 2 DM. In contrast, SGLT2-I, with noninsulin antidiabetic agents and a low-carbohydrate diet, may bring better results.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"4 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139552687","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}
Lei Jin, Liang Zhou, Jian-Biao Wang, Li Tao, Xiao-Xiao Lu, Na Yan, Qian-Ming Chen, Li-Ping Cao, Lei Xie
<i>Objective</i>. The objective of this study is to explore the utilization of next-generation sequencing (NGS) technology in evaluating the likelihood of identifying individuals with papillary thyroid microcarcinoma (PTMC ≤10 mm) who are at high or low risk. <i>Design</i>. NGS was used to analyze 393 formalin-fixed, paraffin-embedded tissues of PTC tumors, all of which were smaller than 15 mm. <i>Results</i>. The study found that bilateralism, multifocality, intrathyroidal spread, and extrathyroidal extension were present in 84 (21.4%), 153 (38.9%), 16 (4.1%), and 54 (13.7%) cases, respectively. Metastasis of cervical lymph nodes was identified in 226 (57.5%) cases and 96 (24.4%) cases with CLNM >5. Out of the total number of cases studied, 8 cases (2.3%) showed signs of tumor recurrence, all of which were localized and regional. Genetic alterations were detected in 342 cases (87.0%), with 336 cases revealing single mutations and 6 cases manifesting compound mutations. 332 cases (84.5%) had BRAF<sup>V600E</sup> mutation, 2 cases had KRAS<sup>Q61K</sup> mutation, 2 cases had NRAS<sup>Q61R</sup> mutation, 8 cases had RET/PTC1 rearrangement, 3 cases had RET/PTC3 rearrangement, and 1 case had TERT promoter mutation. Additionally, six individuals harbored concurrent mutations in two genes. These mutations were of various types and combinations: BRAF<sup>V600E</sup> and NRAS<sup>Q61R</sup> (<i>n</i> = 2), BRAF<sup>V600E</sup> and RET/PTC3 (<i>n</i> = 2), BRAF<sup>V600E</sup> and RET/PTC1 (<i>n</i> = 1), and BRAF<sup>V600E</sup> and TERT promoter (<i>n</i> = 1). The subsequent analysis did not uncover a significant distinction in the incidence of gene mutation or fusion between the cN0 and cN1 patient cohorts. The presence of BRAF<sup>V600E</sup> mutation and CLNM incidence rates were found to be positively correlated with larger tumor size in PTMC. Our data showed that gene mutations did not appear to have much to do with high-risk papillary thyroid microcarcinoma (PTMC). However, when we looked at tumor size, we found that if the tumor was at least 5 millimeters in size, there was a higher chance of it being at high risk for PTM (<span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 9.2729" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"></path></g></svg><span></span><span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="22.8711838 -8.6359 28.182 9.2729" width="28.182pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.921,0)"></path></g><g transform="matrix(.013,0,0,-0.013,29.161,0)"></path></g><g transform="matrix(.013,0,0,-0.013,32.125,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.365,0)"><use xlink:href=
{"title":"Whether Detection of Gene Mutations Could Identify Low- or High-Risk Papillary Thyroid Microcarcinoma? Data from 393 Cases Using the Next-Generation Sequencing","authors":"Lei Jin, Liang Zhou, Jian-Biao Wang, Li Tao, Xiao-Xiao Lu, Na Yan, Qian-Ming Chen, Li-Ping Cao, Lei Xie","doi":"10.1155/2024/2470721","DOIUrl":"https://doi.org/10.1155/2024/2470721","url":null,"abstract":"<i>Objective</i>. The objective of this study is to explore the utilization of next-generation sequencing (NGS) technology in evaluating the likelihood of identifying individuals with papillary thyroid microcarcinoma (PTMC ≤10 mm) who are at high or low risk. <i>Design</i>. NGS was used to analyze 393 formalin-fixed, paraffin-embedded tissues of PTC tumors, all of which were smaller than 15 mm. <i>Results</i>. The study found that bilateralism, multifocality, intrathyroidal spread, and extrathyroidal extension were present in 84 (21.4%), 153 (38.9%), 16 (4.1%), and 54 (13.7%) cases, respectively. Metastasis of cervical lymph nodes was identified in 226 (57.5%) cases and 96 (24.4%) cases with CLNM >5. Out of the total number of cases studied, 8 cases (2.3%) showed signs of tumor recurrence, all of which were localized and regional. Genetic alterations were detected in 342 cases (87.0%), with 336 cases revealing single mutations and 6 cases manifesting compound mutations. 332 cases (84.5%) had BRAF<sup>V600E</sup> mutation, 2 cases had KRAS<sup>Q61K</sup> mutation, 2 cases had NRAS<sup>Q61R</sup> mutation, 8 cases had RET/PTC1 rearrangement, 3 cases had RET/PTC3 rearrangement, and 1 case had TERT promoter mutation. Additionally, six individuals harbored concurrent mutations in two genes. These mutations were of various types and combinations: BRAF<sup>V600E</sup> and NRAS<sup>Q61R</sup> (<i>n</i> = 2), BRAF<sup>V600E</sup> and RET/PTC3 (<i>n</i> = 2), BRAF<sup>V600E</sup> and RET/PTC1 (<i>n</i> = 1), and BRAF<sup>V600E</sup> and TERT promoter (<i>n</i> = 1). The subsequent analysis did not uncover a significant distinction in the incidence of gene mutation or fusion between the cN0 and cN1 patient cohorts. The presence of BRAF<sup>V600E</sup> mutation and CLNM incidence rates were found to be positively correlated with larger tumor size in PTMC. Our data showed that gene mutations did not appear to have much to do with high-risk papillary thyroid microcarcinoma (PTMC). However, when we looked at tumor size, we found that if the tumor was at least 5 millimeters in size, there was a higher chance of it being at high risk for PTM (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139474664","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}
Zhen-Tian Guo, Kun Tian, Xi-Yuan Xie, Yu-Hang Zhang, De-Bao Fang
Objectives. We aimed to establish an effective machine learning (ML) model for predicting the risk of distant metastasis (DM) in medullary thyroid carcinoma (MTC). Methods. Demographic data of MTC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Institutes of Health between 2004 and 2015 to develop six ML algorithm models. Models were evaluated based on accuracy, precision, recall rate, F1-score, and area under the receiver operating characteristic curve (AUC). The association between clinicopathological characteristics and target variables was interpreted. Analyses were performed using traditional logistic regression (LR). Results. In total, 2049 patients were included and 138 developed DM. Multivariable LR showed that age, sex, tumor size, extrathyroidal extension, and lymph node metastasis were predictive features for DM in MTC. Among the six ML models, the random forest (RF) had the best predictability in assessing the risk of DM in MTC, with an accuracy, precision, recall rate, F1-score, and AUC higher than those of the traditional binary LR model. Conclusion. RF was superior to traditional LR in predicting the risk of DM in MTC and can provide a valuable reference for clinicians in decision-making.
{"title":"Machine Learning for Predicting Distant Metastasis of Medullary Thyroid Carcinoma Using the SEER Database","authors":"Zhen-Tian Guo, Kun Tian, Xi-Yuan Xie, Yu-Hang Zhang, De-Bao Fang","doi":"10.1155/2023/9965578","DOIUrl":"https://doi.org/10.1155/2023/9965578","url":null,"abstract":"<i>Objectives</i>. We aimed to establish an effective machine learning (ML) model for predicting the risk of distant metastasis (DM) in medullary thyroid carcinoma (MTC). <i>Methods</i>. Demographic data of MTC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Institutes of Health between 2004 and 2015 to develop six ML algorithm models. Models were evaluated based on accuracy, precision, recall rate, <i>F</i>1-score, and area under the receiver operating characteristic curve (AUC). The association between clinicopathological characteristics and target variables was interpreted. Analyses were performed using traditional logistic regression (LR). <i>Results</i>. In total, 2049 patients were included and 138 developed DM. Multivariable LR showed that age, sex, tumor size, extrathyroidal extension, and lymph node metastasis were predictive features for DM in MTC. Among the six ML models, the random forest (RF) had the best predictability in assessing the risk of DM in MTC, with an accuracy, precision, recall rate, <i>F</i>1-score, and AUC higher than those of the traditional binary LR model. <i>Conclusion</i>. RF was superior to traditional LR in predicting the risk of DM in MTC and can provide a valuable reference for clinicians in decision-making.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"196 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139067682","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}
Yuming Wang, Xiaofei Su, Wenli Zhang, Yunting Zhou, Xiao Zhou, Wei Yang, Huiqin Li, Jianhua Ma
Aim. The prevalence rate of type 2 diabetes mellitus (T2DM) has been increasing and a large proportion of patients still do not achieve adequate or sustainable glycemic control on the basis of previous hypoglycemic treatment. In this present study, we explored whether dorzagliatin, a novel glucokinase activator (GKA), could improve glycemic control and lessen glucose fluctuation in drug-naïve patients with T2DM. Methods. A self-comparative observational study of 25 drug-naïve patients with T2DM (aged 18–75 years and HbA1c of 7.5%–11.0%) treated with dorzagliatin 75 mg twice daily for 52 weeks. Before and after dorzagliatin intervention, the serum levels of hemoglobin A1c (HbA1c), insulin, and C-peptide were measured repeatedly during fasting and after a mixed meal. The continuous glucose monitoring (CGM) device was also used to obtain 24-hour glucose profiles and assess the changes in glycemic variability parameters. Results. After 52 weeks of treatment with dorzagliatin, a numerally greater reduction in HbA1c of 1.03% from the baseline was observed in patients with T2DM, accompanied by significant improvement in insulin resistance and insulin secretion. Moreover, the standard deviation of blood glucose (SDBG) and the mean amplitude of glycemic excursion (MAGE) derived from CGM data were significantly decreased after dorzagliatin therapy. The 24-h glucose variation profile showed that study patients had obviously lower mean glucose levels during the postprandial period from the baseline to week 52, an effect also demonstrated by the significant decrease in the incremental area under glucose concentration versus time curve for 2 h (iAUC0–2 h) after meals. Conclusions. This study suggests that dorzagliatin therapy could effectively improve glycemic control and glucose fluctuation in drug-naïve patients with T2DM.
{"title":"Effects of a Novel Glucokinase Activator, Dorzagliatin, on Glycemic Control and Glucose Fluctuation in Drug-Naïve Patients with Type 2 Diabetes Mellitus","authors":"Yuming Wang, Xiaofei Su, Wenli Zhang, Yunting Zhou, Xiao Zhou, Wei Yang, Huiqin Li, Jianhua Ma","doi":"10.1155/2023/4996057","DOIUrl":"https://doi.org/10.1155/2023/4996057","url":null,"abstract":"<i>Aim</i>. The prevalence rate of type 2 diabetes mellitus (T2DM) has been increasing and a large proportion of patients still do not achieve adequate or sustainable glycemic control on the basis of previous hypoglycemic treatment. In this present study, we explored whether dorzagliatin, a novel glucokinase activator (GKA), could improve glycemic control and lessen glucose fluctuation in drug-naïve patients with T2DM. <i>Methods</i>. A self-comparative observational study of 25 drug-naïve patients with T2DM (aged 18–75 years and HbA1c of 7.5%–11.0%) treated with dorzagliatin 75 mg twice daily for 52 weeks. Before and after dorzagliatin intervention, the serum levels of hemoglobin A1c (HbA1c), insulin, and C-peptide were measured repeatedly during fasting and after a mixed meal. The continuous glucose monitoring (CGM) device was also used to obtain 24-hour glucose profiles and assess the changes in glycemic variability parameters. <i>Results</i>. After 52 weeks of treatment with dorzagliatin, a numerally greater reduction in HbA1c of 1.03% from the baseline was observed in patients with T2DM, accompanied by significant improvement in insulin resistance and insulin secretion. Moreover, the standard deviation of blood glucose (SDBG) and the mean amplitude of glycemic excursion (MAGE) derived from CGM data were significantly decreased after dorzagliatin therapy. The 24-h glucose variation profile showed that study patients had obviously lower mean glucose levels during the postprandial period from the baseline to week 52, an effect also demonstrated by the significant decrease in the incremental area under glucose concentration versus time curve for 2 h (iAUC0–2 h) after meals. <i>Conclusions</i>. This study suggests that dorzagliatin therapy could effectively improve glycemic control and glucose fluctuation in drug-naïve patients with T2DM.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"31 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139057233","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}
Xingrong Guo, Meiying Huang, Dawei Yang, Zuojie Luo
<i>Background</i>. MicroRNA-223 (miR-223) is associated with diabetes and kidney diseases and serves as a novel marker for diagnosing diabetic kidney disease (DKD). This study was conducted to investigate the plasma expression of miR-223 and its clinical significance in type 2 diabetes (T2DM) and diabetic nephropathy (DN) patients. <i>Methods</i>. In this research, 20 patients with T2DM and DN, 19 patients with T2DM, and 17 healthy volunteers were finally enrolled. miR-223 expression was detected by quantitative real-time PCR (qPCR), and the diagnostic value of miR-223 in DN was further analyzed. <i>Results</i>. miR-223 was downregulated in the DN group compared to that in the T2DM group (<span><svg height="8.8423pt" style="vertical-align:-0.2064009pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 8.8423" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"></path></g></svg><span></span><span><svg height="8.8423pt" style="vertical-align:-0.2064009pt" version="1.1" viewbox="22.8711838 -8.6359 28.182 8.8423" width="28.182pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.921,0)"></path></g><g transform="matrix(.013,0,0,-0.013,29.161,0)"></path></g><g transform="matrix(.013,0,0,-0.013,32.125,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.365,0)"></path></g><g transform="matrix(.013,0,0,-0.013,44.605,0)"></path></g></svg>)</span></span> and the control group (<span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 9.2729" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-81"></use></g><g transform="matrix(.013,0,0,-0.013,11.658,0)"></path></g></svg><span></span><span><svg height="9.2729pt" style="vertical-align:-0.6370001pt" version="1.1" viewbox="22.8711838 -8.6359 28.182 9.2729" width="28.182pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.921,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,29.161,0)"><use xlink:href="#g113-47"></use></g><g transform="matrix(.013,0,0,-0.013,32.125,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.365,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,44.605,0)"><use xlink:href="#g113-50"></use></g></svg>).</span></span> Pearson’s correlation analysis showed a negative correlation of miR-223 levels with an albumin-creatinine ratio (ACR) (<i>r</i> = −0.481; <span><svg height="8.8423pt" style="vertical-align:-0.2064009pt" version="1.1" viewbox="-0.0498162 -8.6359 19.289 8.8423" width="19.289pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http:
{"title":"Expression and Clinical Significance of Plasma miR-223 in Patients with Diabetic Nephropathy","authors":"Xingrong Guo, Meiying Huang, Dawei Yang, Zuojie Luo","doi":"10.1155/2023/9663320","DOIUrl":"https://doi.org/10.1155/2023/9663320","url":null,"abstract":"<i>Background</i>. MicroRNA-223 (miR-223) is associated with diabetes and kidney diseases and serves as a novel marker for diagnosing diabetic kidney disease (DKD). This study was conducted to investigate the plasma expression of miR-223 and its clinical significance in type 2 diabetes (T2DM) and diabetic nephropathy (DN) patients. <i>Methods</i>. In this research, 20 patients with T2DM and DN, 19 patients with T2DM, and 17 healthy volunteers were finally enrolled. miR-223 expression was detected by quantitative real-time PCR (qPCR), and the diagnostic value of miR-223 in DN was further analyzed. <i>Results</i>. miR-223 was downregulated in the DN group compared to that in the T2DM group (<span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>)</span></span> and the control group (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>).</span></span> Pearson’s correlation analysis showed a negative correlation of miR-223 levels with an albumin-creatinine ratio (ACR) (<i>r</i> = −0.481; <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http:","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"8 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139057285","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}
Introduction. This study aimed to investigate the blood glucose, blood pressure, and blood lipid status in Zhuang patients with T2DM and to analyze the correlation between compliance with metabolic monitoring and cardiovascular risk factors. Methods. A total of 1975 Zhuang patients with T2DM were evaluated in four Class III Grade A hospitals in three prefecture-level cities in the Guangxi Zhuang Autonomous Region between January and August 2022. Laboratory indicators, lifestyle, and demographic characteristics were collected. Results. The compliance rates for blood glucose, blood pressure, and blood lipids were 26.08%, 45.77%, and 30.58%, respectively, and only 5.06% of the patients reached the standard in all three indices. The compliance rates for blood glucose, blood pressure, and blood lipids in the CVD group were 32.92%, 21.74%, and 9.94%, respectively. In the CVD group, the usage rates of hypoglycemic, antihypertensive, and lipid-lowering drugs were 77.54%, 3.17%, and 4.11%, respectively. Binary logistic regression analysis showed that older age (OR = 1.033, 95% CI [1.016, 1.050]), female (OR = 0.402, 95% CI [0.260, 0.621]), smoke (OR = 1.994, 95% CI [1.361, 2.922]), blood pressure noncompliance + use of antihypertensive drugs (OR = 0.348, 95% CI [0.230, 0.527]), and blood lipid noncompliance + use of lipid-lowering drugs (OR = 0.244, 95% CI [0.142, 0.417]) were risk factors for CVDs, and moderate-intensity exercise (OR = 0.439, 95% CI [0.300,0.640]) was protective against CVD. Conclusions. Older age, female, smoke, blood lipid levels, and blood pressure noncompliance were risk factors for CVD while moderate-intensity exercise was observed to be protective.
简介本研究旨在调查壮族 T2DM 患者的血糖、血压和血脂状况，并分析代谢监测依从性与心血管危险因素之间的相关性。研究方法2022 年 1 月至 8 月期间，广西壮族自治区三个地级市的四家三级甲等医院共对 1975 名壮族 T2DM 患者进行了评估。收集了实验室指标、生活方式和人口统计学特征。结果显示血糖、血压和血脂的达标率分别为 26.08%、45.77% 和 30.58%，三项指标均达标的患者仅占 5.06%。心血管疾病组的血糖、血压和血脂达标率分别为 32.92%、21.74% 和 9.94%。在心血管疾病组中，降糖药、降压药和降脂药的使用率分别为 77.54%、3.17% 和 4.11%。二元逻辑回归分析显示，年龄较大（OR = 1.033，95% CI [1.016，1.050]）、女性（OR = 0.402，95% CI [0.260，0.621]）、吸烟（OR = 1.994，95% CI [1.361，2.922]）、血压不达标+使用降压药（OR = 0.348，95% CI [0.230，0.527]）和血脂不达标+使用降脂药（OR = 0.244，95% CI [0.142，0.417]）是心血管疾病的危险因素，而中等强度运动（OR = 0.439，95% CI [0.300，0.640]）对心血管疾病有保护作用。结论高龄、女性、吸烟、血脂水平和血压不达标是心血管疾病的危险因素，而中等强度的运动对心血管疾病有保护作用。
{"title":"Current Status of Metabolic Compliance and Risk of Cardiovascular Disease in Patients with Type 2 Diabetes in the Zhuang Population in China","authors":"Danqing Xu, Xia Dai, Qiong Yang, Xueying Li, Ying Xiao, Qiuhong Huang, undefined Qingqing Lou","doi":"10.1155/2023/1057121","DOIUrl":"https://doi.org/10.1155/2023/1057121","url":null,"abstract":"<i>Introduction</i>. This study aimed to investigate the blood glucose, blood pressure, and blood lipid status in Zhuang patients with T2DM and to analyze the correlation between compliance with metabolic monitoring and cardiovascular risk factors. <i>Methods</i>. A total of 1975 Zhuang patients with T2DM were evaluated in four Class III Grade A hospitals in three prefecture-level cities in the Guangxi Zhuang Autonomous Region between January and August 2022. Laboratory indicators, lifestyle, and demographic characteristics were collected. <i>Results</i>. The compliance rates for blood glucose, blood pressure, and blood lipids were 26.08%, 45.77%, and 30.58%, respectively, and only 5.06% of the patients reached the standard in all three indices. The compliance rates for blood glucose, blood pressure, and blood lipids in the CVD group were 32.92%, 21.74%, and 9.94%, respectively. In the CVD group, the usage rates of hypoglycemic, antihypertensive, and lipid-lowering drugs were 77.54%, 3.17%, and 4.11%, respectively. Binary logistic regression analysis showed that older age (OR = 1.033, 95% CI [1.016, 1.050]), female (OR = 0.402, 95% CI [0.260, 0.621]), smoke (OR = 1.994, 95% CI [1.361, 2.922]), blood pressure noncompliance + use of antihypertensive drugs (OR = 0.348, 95% CI [0.230, 0.527]), and blood lipid noncompliance + use of lipid-lowering drugs (OR = 0.244, 95% CI [0.142, 0.417]) were risk factors for CVDs, and moderate-intensity exercise (OR = 0.439, 95% CI [0.300,0.640]) was protective against CVD. <i>Conclusions</i>. Older age, female, smoke, blood lipid levels, and blood pressure noncompliance were risk factors for CVD while moderate-intensity exercise was observed to be protective.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"61 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139030558","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}
Inês Manique, Sara Amaral, Alexandra Matias, Bruno Bouça, Salomé Serranito, João Torres, Olga Gutu, Tiago Bilhim, Élia Coimbra, Isaura Rodrigues, Conceição Godinho, Luísa Cortez, José Silva-Nunes
<i>Introduction</i>. Primary aldosteronism is the most common cause of secondary hypertension. Adrenal vein sampling is the gold standard for subtyping primary aldosteronism. However, this procedure is technically challenging and often has a low success rate. Our center is one of the very few performing this technique in our country with an increasing experience. <i>Objective</i>. The aim of this study was to evaluate the role of the cortisol intraprocedural assay in improving the performance of adrenal vein sampling. <i>Design</i>. We enrolled all of the patients with primary aldosteronism that underwent adrenal vein sampling from February 2016 to April 2023. The cortisol intraprocedural assay was introduced in October 2021. <i>Methods</i>. We enrolled a total of 50 adrenal vein samplings performed on 43 patients with the diagnosis of primary aldosteronism. In this sample, 19 patients and 24 patients underwent adrenal vein sampling before and after intraprocedural cortisol measurement, respectively. The procedure was repeated in seven patients (one before and six after intraprocedural cortisol measurement), given the unsuccess of the first exam. Selectivity of the adrenal vein sampling was assumed if the serum cortisol concentration from the adrenal vein was at least five times higher than that of the inferior vena cava. Lateralization was assumed if the aldosterone to cortisol ratio of one adrenal vein was at least four times the aldosterone to cortisol ratio of the contralateral side. <i>Results</i>. The mean age of the patients that underwent adrenal vein sampling (<i>N</i> = 43) was 55.2 ± 8.9 years, and 53.5% (<i>n</i> = 23) were female. The mean interval between the diagnosis of hypertension and the diagnosis of primary aldosteronism was 9.8 years (±9.9). At diagnosis, 62.8% of the patients (<i>n</i> = 27) had hypokalemia (mean value of 3 mmol/L (±0.34)), 88.4% (<i>n</i> = 38) had adrenal abnormalities on preprocedural CT scan, and 67.4% (<i>n</i> = 29) described as unilateral nodules. There were no statistically significant differences in the patients’ baseline characteristics between the two groups (before and after intraprocedural cortisol measurement). Before intraprocedural cortisol measurement, adrenal vein sampling selectivity was achieved in 35% (<i>n</i> = 7) patients. Selectivity increased to 100% (30/30) after intraprocedural cortisol measurement (<span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="-0.0498162 -8.34882 18.973 11.7782" width="18.973pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"></path></g></svg><span></span><span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="22.555183800000002 -8.34882 28.184 11.7782" width="28.184pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="ma
{"title":"Adrenal Vein Sampling in the Management of Primary Aldosteronism: The Added Value of Intraprocedural Cortisol Assessment","authors":"Inês Manique, Sara Amaral, Alexandra Matias, Bruno Bouça, Salomé Serranito, João Torres, Olga Gutu, Tiago Bilhim, Élia Coimbra, Isaura Rodrigues, Conceição Godinho, Luísa Cortez, José Silva-Nunes","doi":"10.1155/2023/5563881","DOIUrl":"https://doi.org/10.1155/2023/5563881","url":null,"abstract":"<i>Introduction</i>. Primary aldosteronism is the most common cause of secondary hypertension. Adrenal vein sampling is the gold standard for subtyping primary aldosteronism. However, this procedure is technically challenging and often has a low success rate. Our center is one of the very few performing this technique in our country with an increasing experience. <i>Objective</i>. The aim of this study was to evaluate the role of the cortisol intraprocedural assay in improving the performance of adrenal vein sampling. <i>Design</i>. We enrolled all of the patients with primary aldosteronism that underwent adrenal vein sampling from February 2016 to April 2023. The cortisol intraprocedural assay was introduced in October 2021. <i>Methods</i>. We enrolled a total of 50 adrenal vein samplings performed on 43 patients with the diagnosis of primary aldosteronism. In this sample, 19 patients and 24 patients underwent adrenal vein sampling before and after intraprocedural cortisol measurement, respectively. The procedure was repeated in seven patients (one before and six after intraprocedural cortisol measurement), given the unsuccess of the first exam. Selectivity of the adrenal vein sampling was assumed if the serum cortisol concentration from the adrenal vein was at least five times higher than that of the inferior vena cava. Lateralization was assumed if the aldosterone to cortisol ratio of one adrenal vein was at least four times the aldosterone to cortisol ratio of the contralateral side. <i>Results</i>. The mean age of the patients that underwent adrenal vein sampling (<i>N</i> = 43) was 55.2 ± 8.9 years, and 53.5% (<i>n</i> = 23) were female. The mean interval between the diagnosis of hypertension and the diagnosis of primary aldosteronism was 9.8 years (±9.9). At diagnosis, 62.8% of the patients (<i>n</i> = 27) had hypokalemia (mean value of 3 mmol/L (±0.34)), 88.4% (<i>n</i> = 38) had adrenal abnormalities on preprocedural CT scan, and 67.4% (<i>n</i> = 29) described as unilateral nodules. There were no statistically significant differences in the patients’ baseline characteristics between the two groups (before and after intraprocedural cortisol measurement). Before intraprocedural cortisol measurement, adrenal vein sampling selectivity was achieved in 35% (<i>n</i> = 7) patients. Selectivity increased to 100% (30/30) after intraprocedural cortisol measurement (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"ma","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824567","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}
Yunyun Fang, Jingjing Zhang, Linlin Ji, Chaoyu Zhu, Yuanyuan Xiao, Qingge Gao, Wenjing Song, Li Wei
Objective. To investigate the relationship between glucagon-like peptide-1 receptor gene polymorphisms and susceptibility to early onset type 2 diabetes. Methods. Samples from 316 type 2 diabetes patients with early onset type 2 diabetes (n = 137) and late-onset type 2 diabetes (n = 179) and 145 nondiabetic individuals were analyzed. Multiplex PCR combined with resequencing Hi-Reseq technology was used to detect single nucleotide polymorphisms of the glucagon-like peptide-1 receptor gene, and the allele frequency, genotype distribution, and clinical parameters were analyzed between each diabetes subgroup and the control group. Results. Sixteen single nucleotide polymorphisms were identified in the exonic region of the glucagon-like peptide-1 receptor gene according to the minor allele frequency (MAF > 0.05) in the participants. Among these, the glucagon-like peptide-1 receptor rs3765467 (G⟶A) mutation was statistically associated with early onset type 2 diabetes. Compared with that of the GG carriers, carriers of genotype AA at rs3765467 had a decreased risk of early onset type 2 diabetes after adjusting for sex and body mass index. In the dominant model, the frequencies of the rs3765467 AA + GA genotype were significantly decreased in the early onset type 2 diabetes group, and carriers of genotype AA + GA at rs3765467 had a decreased risk of early onset type 2 diabetes after adjusting for sex and body mass index. Moreover, fasting C peptide levels were significantly higher in GA + AA genotype carriers than those in GG genotype carriers. Conclusion. The glucagon-like peptide 1 receptor rs3765467 polymorphism was significantly associated with age at type 2 diabetes diagnosis and thus may be used as a marker to screen and detect individuals at risk of developing early onset type 2 diabetes.
{"title":"GLP1R rs3765467 Polymorphism Is Associated with the Risk of Early Onset Type 2 Diabetes","authors":"Yunyun Fang, Jingjing Zhang, Linlin Ji, Chaoyu Zhu, Yuanyuan Xiao, Qingge Gao, Wenjing Song, Li Wei","doi":"10.1155/2023/8729242","DOIUrl":"https://doi.org/10.1155/2023/8729242","url":null,"abstract":"<i>Objective</i>. To investigate the relationship between <i>glucagon-like peptide-1 receptor</i> gene polymorphisms and susceptibility to early onset type 2 diabetes. <i>Methods</i>. Samples from 316 type 2 diabetes patients with early onset type 2 diabetes (<i>n</i> = 137) and late-onset type 2 diabetes (<i>n</i> = 179) and 145 nondiabetic individuals were analyzed. Multiplex PCR combined with resequencing Hi-Reseq technology was used to detect single nucleotide polymorphisms of the glucagon-like peptide-1 receptor gene, and the allele frequency, genotype distribution, and clinical parameters were analyzed between each diabetes subgroup and the control group. <i>Results</i>. Sixteen single nucleotide polymorphisms were identified in the exonic region of the glucagon-like peptide-1 receptor gene according to the minor allele frequency (MAF > 0.05) in the participants. Among these, the glucagon-like peptide-1 receptor rs3765467 (G⟶A) mutation was statistically associated with early onset type 2 diabetes. Compared with that of the GG carriers, carriers of genotype AA at rs3765467 had a decreased risk of early onset type 2 diabetes after adjusting for sex and body mass index. In the dominant model, the frequencies of the rs3765467 AA + GA genotype were significantly decreased in the early onset type 2 diabetes group, and carriers of genotype AA + GA at rs3765467 had a decreased risk of early onset type 2 diabetes after adjusting for sex and body mass index. Moreover, fasting C peptide levels were significantly higher in GA + AA genotype carriers than those in GG genotype carriers. <i>Conclusion</i>. The glucagon-like peptide 1 receptor rs3765467 polymorphism was significantly associated with age at type 2 diabetes diagnosis and thus may be used as a marker to screen and detect individuals at risk of developing early onset type 2 diabetes.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"39 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632572","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}
Objective. This study aimed to investigate potentially favorable factors influencing the therapeutic success of radiofrequency ablation (RFA) of huge benign thyroid nodules (BTNs) (volume >100 ml) and to evaluate the feasibility of RFA as an alternative treatment modality for patients unable or unwilling to undergo surgery. Methods. This retrospective study evaluated a total of 868 patients, of which 22 patients had huge BTNs who underwent ultrasound-guided moving shot RFA treatment between May 2017 and January 2022. The huge BTNs were categorized into two groups according to a post-RFA treatment volume reduction ratio (VRR) of >80% and <80% at 6 months. Factors influencing these huge BTNs were reviewed, analyzed, and correlated with treatment effectiveness between the two groups. Results. The factors influencing an effective VRR included huge BTNs located on the left side (OR 7.875, p = 0.03), predominant solid/spongiform nodules (OR 7.875, p = 0.03), and higher initial ablation rate (IAR) (p = 0.028). Multivariable logistic regression revealed predominant solid/spongiform nodule and the higher IAR were associated with the advanced VRR. Conclusion. RFA was effective at decreasing the volume of huge BTNs with an acceptable complication rate. The BTN characteristics correlated with a better VRR at the 6-month short-term follow-up were predominant solid/spongiform BTNs and those with the first time ablation treatment initial ablation rate. Nevertheless, regarding the higher regrowth rate of these groups of patients who may need to be treated more times, RFA can only be a feasible alternative treatment modality for patients unable or unwilling to undergo operation.
目标。本研究旨在探讨影响巨大良性甲状腺结节(体积100 ml)射频消融(RFA)治疗成功的潜在有利因素，并评估射频消融作为不能或不愿接受手术治疗的患者的替代治疗方式的可行性。方法。本回顾性研究共评估了868例患者，其中22例巨大BTNs患者在2017年5月至2022年1月期间接受了超声引导的移动射击RFA治疗。根据rfa后治疗体积缩小率(VRR)为>80%和<80%， 6个月时将巨大的btn分为两组。我们对影响这些巨大BTNs的因素进行了回顾、分析，并将其与两组间的治疗效果相关联。结果。影响VRR有效的因素包括位于左侧的巨大BTNs (OR 7.875, p = 0.03)，主要的实体/海海绵状结节(OR 7.875, p = 0.03)和较高的初始消融率(IAR) (p = 0.028)。多变量logistic回归显示主要为实体/海绵状结节，较高的IAR与晚期VRR相关。结论。RFA可有效减少巨大btn的体积，并发症发生率可接受。在6个月的短期随访中，与VRR较好相关的BTN特征主要是实体/海海绵状BTN和首次消融治疗的初始消融率。然而，考虑到这类患者的再生率较高，可能需要更多的治疗次数，RFA只能作为不能或不愿接受手术的患者的一种可行的替代治疗方式。
{"title":"Factors Influencing a Favorable Outcome for RFA of Huge Benign Thyroid Nodules: Preliminary Results and Short-Term Evaluation","authors":"Chun-Hua Chiu, Sheng-Dean Luo, Pi-Ling Chiang, An-Ni Lin, Cheng-Kang Wang, Chen-Kai Chou, Shun-Yu Chi, Meng-Hsiang Chen, Wei-Che Lin","doi":"10.1155/2023/9021903","DOIUrl":"https://doi.org/10.1155/2023/9021903","url":null,"abstract":"<i>Objective</i>. This study aimed to investigate potentially favorable factors influencing the therapeutic success of radiofrequency ablation (RFA) of huge benign thyroid nodules (BTNs) (volume >100 ml) and to evaluate the feasibility of RFA as an alternative treatment modality for patients unable or unwilling to undergo surgery. <i>Methods</i>. This retrospective study evaluated a total of 868 patients, of which 22 patients had huge BTNs who underwent ultrasound-guided moving shot RFA treatment between May 2017 and January 2022. The huge BTNs were categorized into two groups according to a post-RFA treatment volume reduction ratio (VRR) of >80% and <80% at 6 months. Factors influencing these huge BTNs were reviewed, analyzed, and correlated with treatment effectiveness between the two groups. <i>Results</i>. The factors influencing an effective VRR included huge BTNs located on the left side (OR 7.875, <i>p</i> = 0.03), predominant solid/spongiform nodules (OR 7.875, <i>p</i> = 0.03), and higher initial ablation rate (IAR) (<i>p</i> = 0.028). Multivariable logistic regression revealed predominant solid/spongiform nodule and the higher IAR were associated with the advanced VRR. <i>Conclusion</i>. RFA was effective at decreasing the volume of huge BTNs with an acceptable complication rate. The BTN characteristics correlated with a better VRR at the 6-month short-term follow-up were predominant solid/spongiform BTNs and those with the first time ablation treatment initial ablation rate. Nevertheless, regarding the higher regrowth rate of these groups of patients who may need to be treated more times, RFA can only be a feasible alternative treatment modality for patients unable or unwilling to undergo operation.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"15 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628873","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}
Jingwen Gan, Jie Chen, Rui-lin Ma, Yan Deng, Xue-song Ding, Shi-yang Zhu, Ai-jun Sun
Background. Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age, whose clinical characteristics are hyperandrogenism (HA), ovulatory dysfunction, and polycystic ovary, often accompanied by insulin resistance (IR) and metabolic abnormalities. Glucagon-like peptide (GLP)-1 receptor agonists (GLP-1Ra), such as exenatide, can bind to specific receptors on tissues such as the ovaries to improve the clinical phenotype of PCOS, while insulin-sensitizing agents, such as metformin, can also benefit to metabolic abnormalities in PCOS. Liquid chromatography-mass spectrometry (LC/MS) metabolomics revealed differences between the mechanisms of exenatide and metformin treatment of PCOS to some extent. Methods. In this study, 50 obese subjects with PCOS were randomly divided into the exenatide combined with metformin group (COM group, n = 28) and the metformin group (MF group, n = 22) for 12-week treatment. Before and after, serum samples were subjected to LC/MS analysis. Results. After treatment, there were 153 named differential metabolites in the COM group and 99 in the MF group. Most phosphatidylcholines (PC) and deoxycholic acid 3-glucuronide (DA3G) were significantly upregulated, while most glycerophosphoethanolamine (PE-NMe2), glycerophosphocholine (GPC), and threonine were downregulated in both groups. Only the decrease of neuromedin B, glutamate, and glutamyl groups and the increase of chenodeoxycholic acid sulfate docosadienoate (22: 2n6), and prostaglandin E2 have been observed in the COM group. In addition, salicylic acid and spisulosine increased and decanoylcarnitine decreased in the MF group. Both groups were enriched in glycerophospholipid, choline, and sphingolipid metabolism, while the COM group was especially superior in the glutamine and glutamate, bile secretion, and amino acid metabolism. Conclusion. Compared with metformin alone in the treatment of PCOS, the differential metabolites of the exenatide combined with metformin group are more extensive. The COM group may act on the hypothalamic-pituitary-gonadal axis (HPO) and its bypass, regulate multiple metabolism pathways such as phospholipids, amino acids, fatty acids, carnitine, bile acids, and glucose directly or indirectly in obese PCOS patients.
{"title":"Action Mechanisms of Metformin Combined with Exenatide and Metformin Only in the Treatment of PCOS in Obese Patients","authors":"Jingwen Gan, Jie Chen, Rui-lin Ma, Yan Deng, Xue-song Ding, Shi-yang Zhu, Ai-jun Sun","doi":"10.1155/2023/4288004","DOIUrl":"https://doi.org/10.1155/2023/4288004","url":null,"abstract":"<i>Background</i>. Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age, whose clinical characteristics are hyperandrogenism (HA), ovulatory dysfunction, and polycystic ovary, often accompanied by insulin resistance (IR) and metabolic abnormalities. Glucagon-like peptide (GLP)-1 receptor agonists (GLP-1Ra), such as exenatide, can bind to specific receptors on tissues such as the ovaries to improve the clinical phenotype of PCOS, while insulin-sensitizing agents, such as metformin, can also benefit to metabolic abnormalities in PCOS. Liquid chromatography-mass spectrometry (LC/MS) metabolomics revealed differences between the mechanisms of exenatide and metformin treatment of PCOS to some extent. <i>Methods</i>. In this study, 50 obese subjects with PCOS were randomly divided into the exenatide combined with metformin group (COM group, <i>n</i> = 28) and the metformin group (MF group, <i>n</i> = 22) for 12-week treatment. Before and after, serum samples were subjected to LC/MS analysis. <i>Results</i>. After treatment, there were 153 named differential metabolites in the COM group and 99 in the MF group. Most phosphatidylcholines (PC) and deoxycholic acid 3-glucuronide (DA3G) were significantly upregulated, while most glycerophosphoethanolamine (PE-NMe2), glycerophosphocholine (GPC), and threonine were downregulated in both groups. Only the decrease of neuromedin B, glutamate, and glutamyl groups and the increase of chenodeoxycholic acid sulfate docosadienoate (22: 2n6), and prostaglandin E2 have been observed in the COM group. In addition, salicylic acid and spisulosine increased and decanoylcarnitine decreased in the MF group. Both groups were enriched in glycerophospholipid, choline, and sphingolipid metabolism, while the COM group was especially superior in the glutamine and glutamate, bile secretion, and amino acid metabolism. <i>Conclusion</i>. Compared with metformin alone in the treatment of PCOS, the differential metabolites of the exenatide combined with metformin group are more extensive. The COM group may act on the hypothalamic-pituitary-gonadal axis (HPO) and its bypass, regulate multiple metabolism pathways such as phospholipids, amino acids, fatty acids, carnitine, bile acids, and glucose directly or indirectly in obese PCOS patients.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"5 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632534","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}
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