Endocrine and Metabolic Science最新文献

Objective

Concerns exist about semaglutide, potentially worsening sight-threatening diabetic retinopathy (DR) in individuals with diabetes. This study aimed to explore the association between semaglutide and the risk of DR progression over three years in patients with type 2 diabetes (T2D). It is hypothesized that any observed deterioration in DR among T2D patients following semaglutide use would be temporary and unrelated to long-term progression.

Methods

Retrospective data analysis identified 4086 patients with T2D and DR by ICD-10 codes in a Retina only practice from January to June 2020. Use of semaglutide was found in 116 patients. Inclusion criteria included at least 1 year of semaglutide use and documentation of level of non-proliferative (NPDR) and proliferative (PDR) retinopathy, visual acuity (VA) and Central Subfield Thickness (CST).

Results

87 patients meeting the eligibility criteria, ranging in age from 38 to 84 years (mean age of 62.4 years), and having an average duration of semaglutide usage of approximately 2.9 years. Gender distribution included 58.6 % male and 41.4 % female patients, with 83.9 % Caucasian, 11.5 % Black, and 10.3 % Hispanic backgrounds. The baseline HbA1c level averaged 7.6 %, ranging from 5.9 % to 10.9 %, with a standard deviation of 1.1. The last self-reported HbA1c level averaged 7.4 %, ranging from 5.2 % to 14 %, with a standard deviation of 1.5. Baseline DR severity correlated with progression risk: 2.7 % for DRSS level ≤ 43, 28 % for levels 47/53, and 45 % for baseline PDR. Patients required an average of 12.6 intravitreal injections. Visual acuity remained stable for 72.4 % of patients, with 16.1 % experiencing a loss and 11.5 % achieving improvement.

Conclusion

Semaglutide use was not associated with increased risk of progression of DR, visual loss, or an increased number of intravitreal injections over a 3-year period of time.

The interaction of nutrients and bacterial-derived products and their enteroendocrine effects are still enigmatic. We used the human enteroendocrine tumour cell line P-STS isolated from the terminal ileum as cellular sentinel. In this model, P-STS cells react to acetylcholine or histamine with an increase in intracellular calcium mediated by T-type voltage-gated calcium channels followed by serotonin secretion. Incubation with the secondary bile acid deoxycholate inhibited the calcium response to acetylcholine but not to histamine. No response to other nutrients or bacterial products tested (i.e. palmitate, lactate, acetate, proprionate, butyrate, the OR51E1 ligand isovalerate and the HCA2 ligand β-hydroxybutyrate) could be observed. The bile acid receptor TGR5 agonist CCDC did not inhibit the acetylcholine-induced calcium response, and the free fatty acid receptor 2 agonist 4-CMTB had no enhancing effect on the calcium response to acetylcholine. Only butyrate had an enhancing effect on the calcium response in P-STS cells when added for short-time pre-incubation before challenge with acetylcholine. From our data we propose i) an inhibitory effect of deoxycholate at the muscarinic acetylcholine receptor M3 without involvement of TGR5, and that ii) high butyrate concentrations derived from bacterial metabolism of carbohydrates might increase intestinal release of serotonin and potentially also other gut hormones and satiety-inducing peptides independently of known butyrate receptors, thereby influencing intestinal motility and ion secretion.

Background

Type 2 Diabetes Mellitus (T2DM) stands as the foremost risk factor for infected foot ulcers, contributing to a myriad of chronic complications including cardiovascular, renal, neuropathic, vascular, and podiatric issues. Employing suitable antibiotic therapy becomes imperative in managing Diabetic Foot Infections (DFIs). This study endeavors to assess the efficacy of antibiotic treatment in addressing infected foot ulcers among patients with T2DM in Vietnam.

Methods

A descriptive cross-sectional study with analysis was performed on 830 T2DM patients (67 patients with DFIs were treated with antibiotic therapy to evaluate treatment outcomes).

Results

Among T2DM patients, 8.07 % had infected foot ulcers, with an average age of 62.5 ± 11 years and a female-to-male ratio of 2.9:1. Ulcer healing post-antibiotic treatment was 88.06 %, with 35.82 % aligning initial antibiotic treatment with antibiogram results. Bacterial resistance rates were high for Cephalosporin (>60 %), Ampicillin/Sulbactam (91.67 %), and Quinolone groups (>60 %), while Carbapenem group showed high sensitivity (>73 %). Initial empiric antibiotic treatment response was associated with osteomyelitis existence and ulcer healing outcomes (p < 0.005). Wagner grade > 2, elevated CRP levels, and atherosclerotic stenosis were associated with lengthy clinic stays.

Conclusion

Selecting the proper antibiotic regimen is crucial in effectively managing Type 2 Diabetic Foot Infections. Identifying the risk factors associated with treatment outcomes is imperative to mitigate adverse effects on foot infection treatment outcomes among T2DM patients in Vietnam.

Introduction

Metabolic syndrome (MetS) is increasing healthcare costs worldwide. It has been suggested that serum lipin-1 (LPN1) may be associated with components of MetS. The aim of this study was to evaluate LPN1serum levels and its association with MetS components in subjects with and without MetS in this area.

Materials and methods

We included subjects with MetS using the National Cholesterol Education Program, Adult Treatment Panel III criteria. LPN1 levels were measured using the Eliza method.

Results

The results showed that waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) and triglyceride levels were significantly higher and high density lipoprotein cholesterol and LPN1 levels were significantly lower in subjects with MetS compared to subjects without MetS. There was a significant inverse correlation between LPN1 and FBG, SBP, and DBP in MetS patients. In subjects without MetS, there was no correlation between LPN1and MetS components.

Conclusion

There appears to be a significant association between some components of MetS and serum LPN1 levels. Further studies are needed to elucidate the underlying mechanisms and possible therapeutic implications of this association for the prevention and treatment of MetS-related disorders.

Introduction

Diabetes mellitus (DM) poses a significant global public health challenge, affecting approximately 10.2 % of adults by 2030. Insulin Resistance (IR) is an impaired or subnormal biologic response to insulin stimulation of target tissues. IR alters the mechanisms involved in lipid metabolism in the adipose tissue and liver leading to dyslipidaemia and accumulation of fat in the liver (NAFLD). Non-alcoholic fatty liver disease (NAFLD) has an estimated global prevalence of 25 %. NAFLD is identified frequently on ultrasonography examination of the abdomen of patients with DM because of associated insulin resistance and obesity.

Methodology

This study conducted at TH Jaffna aimed to assess the lipid profile status of type 2 diabetic patients undergoing treatment, and its association with Insulin Resistance and NAFLD.

Result

In a cross-sectional analytical study of 112 diabetic patients (average age 58.26 years, 61.6 % female), a significant prevalence of insulin resistance (70.5 %) and NAFLD (77.7 %) was observed, with comorbid dyslipidaemia in 51.7 % of patients. No gender-based difference in lipid profile parameters was found. Total cholesterol, LDL, and TG were mostly within non dyslipidaemic levels, while HDL levels were low. There is a statistically significant association (p < 0.05) between prevalence of NAFLD and HDL. Duration of diabetes had minimal impact on lipid profile parameters.

Conclusion

Understanding the complex interplay between lipid profile, insulin resistance, and NAFLD is crucial for better patient outcomes. Our study revealed a significant number of type 2 DM patients exhibited insulin resistance (70.5 %) and NAFLD (77.7 %), with a majority having comorbid dyslipidaemia (51.7 %). Larger clinical study at multicentre level is needed to validate the study's findings.

Fasting, a practice with historical roots in various cultures, has recently garnered significant interest in the field of medicine. In this article, we delve into the mechanisms underlying fasting-induced autophagy and its therapeutic applications for spike protein associated pathology. We explore the therapeutic potential of fasting on spike protein-related pathology and the role of interventions to upregulate autophagy, including compounds like spermidine, resveratrol, rapamycin, and metformin. In conclusion, fasting, coupled with an understanding of its nuances, holds promise as a therapeutic intervention for SARS-CoV-2 spike protein related diseases; with broad implications for human health. This review presents the therapeutic possibility of using autophagy to treat spike protein related diseases, and details the interventions to deploy this therapeutic modality.

Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-aged women, characterized by clinical manifestations such as hyperandrogenism, menstrual irregularities, and polycystic ovaries. Despite its prevalence and impact on women's health, the pathogenesis of PCOS remains incompletely understood. This review provides a comprehensive critical appraisal of existing literature on PCOS pathogenesis, addressing knowledge gaps and highlighting its multifactorial nature. A systematic literature review identified relevant articles published up to the knowledge cutoff date in 2023, focusing on molecular, genetic, hormonal, and environmental factors contributing to PCOS pathogenesis. Electronic databases, including PubMed, MEDLINE, and Embase, were systematically searched using predefined terms. Eligible studies investigated molecular, genetic, hormonal, and environmental factors associated with PCOS pathogenesis. The critical appraisal revealed diverse studies enriching our understanding of PCOS. Molecular and genetic studies highlighted alterations in signaling pathways, hormonal dysregulation, and the role of insulin resistance. Environmental factors, including lifestyle and exposure to endocrine-disrupting chemicals, were implicated. Heterogeneity in study designs and methodologies underscored the need for standardized approaches to enhance comparability. This review synthesizes current evidence on PCOS critical appraisal and pathogenesis, emphasizing its multifaceted nature. Standardization of study designs and methodologies will facilitate future comparisons, enabling the development of targeted therapeutic interventions and personalized management strategies for women affected by PCOS.

Introduction

The prevalence of type 2 diabetes mellitus (T2DM) has increased in Saudi Arabia over recent decades, with current estimates showing that 19% of adults have T2DM. There is a need to confirm the clinical outcomes and safety of iGlarLixi in the routine clinical practice setting.

Methods

A multicenter retrospective non-comparative study was conducted on 224 people with T2DM on Oral anti-diabetics (OADs) or in combination with basal insulin who initiated treatment with iGlarLixi in Saudi Arabia. Data of at least 180 days (± 30 days) before and after initiating iGlarLixi were retrieved.

Results

Mean HbA1c significantly decreased after iGlarLixi start, with a mean reduction of 1.6% at six months. The mean reduction in the FPG was −38.8 (95% CI -46.5 to −31.1, p < 0.001). The weight dropped from 86.17 kg to 83.33 kg after 6 months post-iGlarLixi initiation [mean reduction = −2.86, P < 0.001]. The incidence of reported hypoglycemia, symptomatic documented and/or severe cases, decreased from 0.513 (95% CI 0.33 to 0.76) per person-year at baseline to 0.002 (95% CI 0.001 to 0.011) six months after iGlarLixi.

Conclusion

iGlarLixi is effective and well tolerated for improved glycemic control in patients with advanced therapy from OADs or insulin in Saudi Arabia.

Background

Turner syndrome (TS) is a genetic disorder found only in females who are completely or partially missing an X chromosome. It is rarely inherited from parent to offspring and is not reported to be associated with any causal gene. In addition, familial forms are less frequent than sporadic ones. A Tunisian family with four girls affected by TS showed an unusual association with congenital hypopituitarism among three of them.

Objectives

Conduct a genetic investigation by exploring the PROP1 gene genomic sequence to identify a possible causal variant explaining the simultaneous presence of the TS and the congenital hypopituitarism in the family.

Methods

The coding regions of the gene and their flanking introns are Sanger sequenced among four sisters and their mother and compared to the reference sequences.

Results

Sequences analysis showed the presence of the PROP1 gene mutation p.Arg73Cys (rs121917843), the most frequent Maghrebian defect responsible for non-syndromic combined pituitary hormone deficiency. The girls with both TS and congenital hypopituitarism were homozygous. However, the sister who was affected by TS only and their healthy mother were heterozygous.

Conclusion

Our findings showed that the uncommon association between TS and congenital hypopituitarism is a random event caused by the high frequency of the PROP1 p.Arg73Cys mutation and the high level of consanguinity in the Tunisian population.

Purpose

Diabetes mellitus (DM) is an increasingly prevalent health concern in Indonesia, and national information about its contributing factors remained limited. This study primarily aimed to investigate these factors associated with DM in Indonesia.

Patients and methods

This study utilized data from the fifth wave of Indonesian Family Life Survey-5 (IFLS-5) in 2014. The survey included individuals aged ≥15 years and assessed DM based on the obtained glycated hemoglobin values through dried blood spot specimens. Blood pressure data was acquired using omron digital self-inflating sphygmomanometers, with an average of three readings. Mean arterial pressure was used to classify respondents' hypertensive status, while anthropometric measurements were taken according to World Health Organization guidelines to calculate body mass index, providing data on obesity. Specific questions and protocols evaluated lifestyle information encompassed smoking habits, sleep quality, and physical activity, and sociodemographic factors encompassed age, gender, marital status, ethnicity, and employment status, with accordingly categorized responses. Logistic regression analysis assessed the potential associations between these factors with DM, and the results were reported in terms of odds ratios (OR) with a 95 % confidence interval (CI). The analyses were conducted using the SPSS software program.

Results

The study included 6740 respondents, of whom 8.4 % had DM. The majority were female (55.2 %), Muslim (89 %), not obese (71.1 %), nonhypertensive (63.3 %), had poor sleep quality (95.9 %), lacked physical activity (77.9 %), and were aged 15–45 years (56 %). Factors that demonstrated higher risks of developing DM are male gender (OR: 1.383, 95 % CI: 1.117–1.712), unemployment (OR: 1.619, 95 % CI: 1.225–2.139), no physical activity (OR: 1.619, 95 % CI: 1.225–2.139), obesity (OR: 3.076, 95 % CI: 2.512–3.766), and hypertension (HTN) (OR: 1.713, 95 % CI: 1.396–2.103). Age between 15 and 44 (OR: 0.348, 95 % CI: 0.295–0.468) has lower likelihood to develop DM.

Conclusion

This study has identified associations between HTN, obesity, physical activity, and employment status with DM in Indonesia. Healthcare professionals should integrate more patient-specific factors when designing and implementing tailored interventions to manage DM in Indonesia.