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Retrospective clinical analysis of time to recovery from diabetic ketoacidosis in Ethiopia 埃塞俄比亚糖尿病酮症酸中毒患者康复时间的回顾性临床分析
Q3 Medicine Pub Date : 2025-02-06 DOI: 10.1016/j.endmts.2025.100224
Angefa Ayele , Dube Jara , Alo Edin , Digafe Hailu , Mihiret Kifle , Yohannes Fekadu

Background

Diabetes is a metabolic disorder that affected > or = 500 million people in 2021. Diabetic ketoacidosis is the most serious acute complication. Because of the significant health burden of diabetic ketoacidosis, we performed a retrospective study on the recovery time and predictors among adult diabetic mellitus patients in selected public hospitals in Southern Oromia in Ethiopia.

Methods

A retrospective follow-up study was conducted of 316 randomly selected adult diabetic ketoacidosis patients admitted between January 1, 2020, and July 31, 2023. A structured checklist was utilized. Data were entered into Epi-data version 4.6 and analyzed with STATA version 17, employing Kaplan-Meier survival curves, log-rank tests, and Cox-proportional hazards models to identify predictors. Results from bivariable and multivariable Cox-regression were reported via adjusted hazard ratio with 95 % confidence intervals.

Results

This study included 316 participants, with 256 adults (81.01 %) recovering throughout the follow-up period. The overall DKA recovery rate was 23.8 per 1000 person-hours (95 % CI: 22.21–27.07), and the median recovery time was 42 hr. Significant predictors of recovery time included random blood glucose level [AHR (95 % CI): 0.58 (0.38–0.90)], duration of diabetes mellitus [AHR (95 % CI): 0.24 (0.14–0.69)], and severity of DKA [AHR (95 % CI): 0.46 (0.16–0.84)].

Conclusion

The median DKA recovery time was prolonged, increasing the risk of complications. Blood glucose level, diabetes duration, and DKA severity were predictors of recovery time. Therefore, targeting these factors through research and interventions may improve outcomes and reduce DKA recovery duration.
背景:糖尿病是一种影响健康的代谢性疾病。到2021年,人口将达到5亿。糖尿病酮症酸中毒是最严重的急性并发症。由于糖尿病酮症酸中毒的重大健康负担,我们对埃塞俄比亚南奥罗米亚州选定公立医院的成年糖尿病患者的康复时间和预测因素进行了回顾性研究。方法对我院2020年1月1日至2023年7月31日收治的316例成人糖尿病酮症酸中毒患者进行回顾性随访研究。使用了一个结构化的检查表。将数据输入Epi-data版本4.6,并使用STATA版本17进行分析,采用Kaplan-Meier生存曲线、log-rank检验和cox -比例风险模型来识别预测因子。双变量和多变量cox回归的结果通过校正风险比报告,置信区间为95%。结果本研究包括316名参与者,其中256名成年人(81.01%)在随访期间康复。总体DKA恢复率为23.8 / 1000人小时(95% CI: 22.21-27.07),中位恢复时间为42小时。恢复时间的显著预测因子包括随机血糖水平[AHR (95% CI): 0.58(0.38-0.90)]、糖尿病病程[AHR (95% CI): 0.24(0.14-0.69)]、DKA严重程度[AHR (95% CI): 0.46(0.16-0.84)]。结论DKA中位恢复时间延长,并发症发生风险增加。血糖水平、糖尿病病程和DKA严重程度是恢复时间的预测因子。因此,针对这些因素,通过研究和干预可以改善结果,缩短DKA恢复时间。
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引用次数: 0
Geospatial analysis and determinant factors of comorbidity presence in patients with diabetes in Peru 秘鲁糖尿病患者共病存在的地理空间分析和决定因素
Q3 Medicine Pub Date : 2025-01-23 DOI: 10.1016/j.endmts.2025.100222
Víctor Juan Vera-Ponce , Fiorella E. Zuzunaga-Montoya , Luisa Erika Milagros Vásquez-Romero , Joan A. Loayza-Castro , Nataly Mayely Sanchez-Tamay , Carmen Inés Gutierrez De Carrillo

Objective

Given the significant increase in diabetes mellitus (DM) prevalence and its associated complications in recent decades, this study aimed to explore the determinant factors and geographical distribution of comorbidities and their number in patients with diabetes in Peru.

Methods

Cross-sectional study based on a database providing detailed demographic and clinical information on DM patients affiliated with the Seguro Integral de Salud (SIS) in Peru. The dependent variables in this study are twofold: the type of comorbidities present in DM patients and the number of comorbidities they have. Comorbidities were categorized into three groups: DM with obesity/dyslipidemia, DM with hypertension, and DM with mental health disorders. The number of comorbidities was classified as none, one, two, or three comorbidities.

Results

A total of 1,355,354 patients were included. Male patients, older individuals, and those with a longer time since diagnosis have different probabilities of presenting the comorbidities and a higher number of them. Additionally, the geospatial analysis showed apparent regional variations in the prevalence and number of comorbidities, highlighting the influence of environmental and socioeconomic factors and access to healthcare services.

Conclusions

This study identified significant demographic and clinical factors associated with comorbidities in patients with DM in Peru. These findings showed the need for personalized, region-specific diabetes management. Therefore, public health policies should adapt to meet the needs of different regions and groups. Improving healthcare access is crucial, especially where comorbidity prevalence is high. Further education programs must address diet and exercise comorbidities, focusing on vulnerable people.
目的:鉴于近几十年来糖尿病(DM)患病率及其相关并发症的显著增加,本研究旨在探讨秘鲁糖尿病患者合并症的决定因素、地理分布及其数量。方法基于一个数据库的横断面研究,该数据库提供了秘鲁Seguro Integral de Salud (SIS)附属糖尿病患者的详细人口统计学和临床信息。本研究的因变量是双重的:糖尿病患者存在的合并症的类型和合并症的数量。合并症分为三组:糖尿病合并肥胖/血脂异常、糖尿病合并高血压和糖尿病合并精神健康障碍。合并症的数量分为无、一、二或三种合并症。结果共纳入1355354例患者。男性患者、老年人和诊断时间较长的患者出现合并症的概率不同,且数量较多。此外,地理空间分析显示,合并症的患病率和数量存在明显的区域差异,突出了环境和社会经济因素以及获得医疗保健服务的影响。结论:本研究确定了与秘鲁糖尿病患者合并症相关的重要人口统计学和临床因素。这些发现表明需要个性化的、针对特定地区的糖尿病管理。因此,公共卫生政策应适应不同区域和群体的需要。改善卫生保健获取至关重要,特别是在合并症患病率高的地方。进一步的教育项目必须解决饮食和运动的并发症,重点关注弱势群体。
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引用次数: 0
The association between metabolic syndrome and gallstone disease: A cross-sectional study from the PERSIAN Guilan cohort study 代谢综合征与胆结石疾病之间的关系:来自波斯桂兰队列研究的横断面研究
Q3 Medicine Pub Date : 2025-01-21 DOI: 10.1016/j.endmts.2025.100221
Hasti Zakeri Fardi , Kourosh Mojtahedi , Saman Maroufizadeh , Farahnaz Joukar , Fariborz Mansour-Ghanaei

Background

There has been a concerning increase in the occurrence of gallstone diseases (GSDs) among individuals with metabolic syndrome (MetS). This study investigated the association between MetS and GSDs and related risk factors.

Methods

This retrospective cross-sectional study was conducted on 10,520 participants from the prospective epidemiological research studies of the Iranian adults (PERSIAN) Guilan cohort study (PGCS) population. Demographic and clinical characteristics, anthropometric parameters, and laboratory findings were collected. National Cholesterol Education Program–Adult Treatment Panel III criteria (NCEP-ATP III) were used to diagnose the MetS. All data was analyzed using SPSS version 26, and a significant level was considered <0.05.

Results

The prevalence of MetS was 41.8 %, with higher rates in females (56.3 %) than males (25.0 %). Also, GSD prevalence was 2.06 %. Abdominal obesity and low high-density lipoprotein (HDL) levels were significantly associated with GSDs (P < 0.05). The presence of MetS increased GSD odds by 47 % (P=0.010). A trend of increasing GSD prevalence with the number of MetS components illustrated a significant relationship ranging from 0.56 % (no components) to 3.60 % (all components) (P < 0.001).

Conclusion

The findings demonstrated that MetS was significantly associated with increased risk of GSDs, of which higher body mass index (BMI), greater waist circumference, and lower HDL level were the most associated risk factors.
背景:在代谢综合征(MetS)患者中,胆结石疾病(GSDs)的发生率有所增加。本研究探讨MetS与GSDs之间的关系及相关危险因素。方法本回顾性横断面研究对来自伊朗成人(波斯)桂兰队列研究(PGCS)人群的前瞻性流行病学研究的10,520名参与者进行了研究。收集了人口统计学和临床特征、人体测量参数和实验室结果。使用国家胆固醇教育计划-成人治疗小组III标准(NCEP-ATP III)诊断MetS。所有数据采用SPSS version 26进行分析,认为显著水平为<;0.05。结果met的患病率为41.8%,女性(56.3%)高于男性(25.0%)。GSD患病率为2.06%。腹部肥胖和低高密度脂蛋白(HDL)水平与GSDs显著相关(P <;0.05)。MetS的存在使GSD的几率增加了47% (P=0.010)。GSD患病率随MetS成分数量的增加呈上升趋势,其显著关系范围为0.56%(无成分)至3.60%(所有成分)(P <;0.001)。结论MetS与gsd发生风险显著相关,其中BMI、腰围和HDL水平降低是与gsd发生风险最相关的因素。
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引用次数: 0
Metabolomics identify serum biomarkers for predicting acute exacerbation and severity of bronchiectasis 代谢组学鉴定预测支气管扩张急性加重和严重程度的血清生物标志物
Q3 Medicine Pub Date : 2025-01-18 DOI: 10.1016/j.endmts.2025.100220
Jiaxin Yan , Fanxin Deng , Xueli Wang , Jing Wei , Yang Cao , Kaili Deng , Xiaolin Chen , Lei Shu , Lei Shi , Mingjing Wu , Ganzhu Feng

Background

Bronchiectasis (BE) is a chronic respiratory disease. Acute BE exacerbation caused by recurrent infections can lead to hemoptysis and even asphyxia, with high mortality and long hospitalization. This study aimed to identify novel diagnostic metabolic biomarkers for predicting acute exacerbation and severity of BE.

Methods

A liquid chromatography–mass spectrometry (LC–MS)-based untargeted metabolomic analysis was performed for serum samples from 45 patients with acute BE exacerbation and 15 healthy controls. The diagnostic value of the candidate metabolites was evaluated using receiver operating characteristic (ROC) curves.

Results

Based on bronchiectasis severity index (BSI) scores, patients with acute BE exacerbation were classified into mild, moderate, and severe BE groups. Compared to healthy controls, the abundance of 4-acetamidobutyric acid was elevated in the mild, moderate, and severe groups (p < 0.05), with no significant difference among the three groups. In the severe BE group, the abundances of taurochenodecoxycholic acid, oleamide, hexadecanamide, and glycodeoxycholic acid were significantly elevated from those in mild and moderate BE groups (p < 0.05), with Youden index (YI) ≥ 0.8 for all metabolites; the combination of these 4 metabolites had an area under the ROC curve (AUROC) of 0.99, a sensitivity of 100 % and a specificity of 93.3 % for identifying severe BE. Pathway analysis reveals that abnormally enriched metabolites in BE patients are associated with PI3K-Akt signaling pathway, mTOR signaling pathway, FoxO signaling pathway, renin-angiotensin system signaling pathway, asthma signaling pathway, and FcεRI signaling pathway, where prostaglandin D2 exerts direct or indirect impacts on these pathways.

Conclusion

4-Acetamidobutyric acid can serve as a biomarker for predicting acute BE exacerbation, while taurochenodecoxycholic acid, oleamide, hexadecanamide, and glycodeoxycholic acid are robust biomarkers for predicting severe BE. Prostaglandin D2 plays a crucial role in promoting the pathogenesis of pulmonary inflammatory cell recruitment, cell autophagy, and pulmonary fibrosis during acute BE exacerbation. Overall, this study identifies biomarkers for predicting acute BE exacerbation and provides new targets for drug development.
背景支气管扩张症(BE)是一种慢性呼吸道疾病。反复感染引起的急性BE加重可导致咯血甚至窒息,死亡率高,住院时间长。本研究旨在确定新的诊断代谢生物标志物,以预测BE的急性加重和严重程度。方法采用液相色谱-质谱法(LC-MS)对45例急性BE加重患者和15例健康对照者的血清进行非靶向代谢组学分析。使用受试者工作特征(ROC)曲线评估候选代谢物的诊断价值。结果根据支气管扩张严重程度指数(BSI)评分,将急性BE加重患者分为轻度、中度和重度BE加重组。与健康对照组相比,轻度、中度和重度组的4-乙酰氨基丁酸丰度升高(p <;0.05),三组间差异无统计学意义。重度BE组牛磺酸去氧胆酸、油酰胺、十六烷酰胺和糖去氧胆酸的丰富度较轻度和中度BE组显著升高(p <;0.05),所有代谢物的约登指数(YI)≥0.8;4种代谢物联合应用诊断严重BE的ROC曲线下面积(AUROC)为0.99,敏感性为100%,特异性为93.3%。通路分析显示BE患者代谢产物异常富集与PI3K-Akt信号通路、mTOR信号通路、FoxO信号通路、肾素-血管紧张素系统信号通路、哮喘信号通路、fc - ri信号通路相关,前列腺素D2对这些通路有直接或间接影响。结论乙酰氨基丁酸可作为预测急性BE加重的生物标志物,而牛磺酸去氧胆酸、油酰胺、十六烷酰胺和糖去氧胆酸是预测严重BE加重的生物标志物。前列腺素D2在急性BE加重期间促进肺部炎症细胞募集、细胞自噬和肺纤维化的发病机制中起着至关重要的作用。总的来说,本研究确定了预测急性BE恶化的生物标志物,并为药物开发提供了新的靶点。
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引用次数: 0
Plasma concentration of cyclic glycine proline is associated with impaired energy metabolism in a Chinese population of type 2 diabetes mellitus 血浆环甘氨酸脯氨酸浓度与中国2型糖尿病患者能量代谢受损有关
Q3 Medicine Pub Date : 2025-01-18 DOI: 10.1016/j.endmts.2025.100219
Mengdi Zhu , Fengxia Li , Shuting Huang , Li Huang , Heng Zhang , Lingyan Chen , Vanessa Cave , Jian Guan , Yang Yang
Insulin-like growth factor (IGF)-1 is an effector of cyclic glycine-proline (cGP) and regulates glucose metabolism and vascular remodeling. This study investigated the potential relationships of plasma concentrations of IGF-1, IGF binding protein-3 (IGFBP-3) and cyclic glycine-proline (cGP) to glucose intolerance and clinical vascular complications in a Chinese population of type - 2 diabetes mellitus (T2DM).
The study included the participants with T2DM only (n = 20), T2DM + hypertension (n = 20), T2DM + hypertension + diabetic peripheral neuropathy (DPN, n = 19) and 18 age-matched healthy controls. Fasting blood and spot urine samples were used for analysis.
Plasma concentration of cGP was positively associated with plasma concentrations of fasting glucose (p < 0.001), triglyceride (p < 0.001), HBAc-1 (%, p < 0.001), triglyceride/glucose index (p < 0.001), plasma concentrations of uric acid (p = 0.002), urine albumin (p = 0.008), and albumin/creatinine ratio (p = 0.019) in the T2DM only group. Plasma concentration of IGFBP-3 was positively associated with blood urea nitrogen in T2DM + hypertension group (p < 0.001) and weakly associated foot DPN scores (p = 0.052) in the T2DM + hypertension + DPN group.
Elevated plasma cGP concentration that increases the amount of bioavailable IGF-1 was an adaptive response to glucose intolerance, hyperuricemia and albuminuria. Elevated plasma IGFBP-3 concentration that reduces the amount of bioavailable IGF-1, was associated with diabetic nephropathy and peripheral neuropathy. The changes of plasma concentration of cGP and IGFBP-3 may collectively assist in the prognosis of T2DM.
胰岛素样生长因子(IGF)-1是环甘氨酸-脯氨酸(cGP)的效应器,调节葡萄糖代谢和血管重构。本研究探讨了中国2型糖尿病(T2DM)患者血浆IGF-1、IGF结合蛋白-3 (IGFBP-3)和环甘氨酸-脯氨酸(cGP)浓度与葡萄糖耐受不良和临床血管并发症的潜在关系。该研究包括单纯T2DM (n = 20)、T2DM +高血压(n = 20)、T2DM +高血压+糖尿病周围神经病变(DPN, n = 19)和18名年龄匹配的健康对照者。空腹血和尿样用于分析。血浆cGP浓度与空腹血糖浓度呈正相关(p <;0.001),甘油三酯(p <;0.001), HBAc-1 (%, p <;0.001),甘油三酯/葡萄糖指数(p <;0.001)、血浆尿酸浓度(p = 0.002)、尿白蛋白(p = 0.008)和白蛋白/肌酐比值(p = 0.019)。T2DM +高血压组IGFBP-3血药浓度与尿素氮呈正相关(p <;0.001), T2DM +高血压+ DPN组足部DPN评分相关性较弱(p = 0.052)。血浆cGP浓度升高,增加生物可利用IGF-1的量,是对葡萄糖耐受不良、高尿酸血症和蛋白尿的适应性反应。血浆IGFBP-3浓度升高可降低生物可利用IGF-1的量,与糖尿病肾病和周围神经病变有关。血浆cGP和IGFBP-3浓度的变化可能共同影响T2DM的预后。
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引用次数: 0
Effects of a novel weight-loss combination product containing orlistat and resveratrol on obesity: A multicenter randomized controlled study (EC-FIT) 奥利司他与白藜芦醇复合减肥药对肥胖的影响:多中心随机对照研究(EC-FIT)
Q3 Medicine Pub Date : 2025-01-14 DOI: 10.1016/j.endmts.2025.100218
Khin Maung Win , Tint Swe Latt , Aung Hlaing Bwa , Khin Maung Aye , Kyaw Soe Tun , Hardik Gandhi

Background

Orlistat, a weight loss medication, is often less effective due to poor adherence to the dietary and exercise recommendations. However, its effectiveness is often compromised by poor adherence to recommended lifestyle changes and side effects like steatorrhea. Combining orlistat with resveratrol may enhance weight loss and offer additional metabolic benefits.

Objective

This study evaluated the real-world efficacy and safety of orlistat combined with resveratrol versus orlistat alone in overweight or obese individuals in Myanmar.

Method

Obese adults (BMI ≥ 25 kg/m2) were randomized into two groups for a 12-week study. The Orlistat (O) group received orlistat 120 mg three times daily, while the Orlistat & Resveratrol (O-R) group took orlistat 120 mg plus resveratrol 100 mg thrice daily. Primary outcome measured was weight change; secondary outcomes included Total Cholesterol, LDL-cholesterol, Blood pressure, HbA1c, alanine transaminase (ALT), controlled attenuation parameter (CAP), Liver stiffness, and Total Body Fat. Adverse events were also recorded.

Result

The O-R group lost more weight (−3.31 kg, 95 % CI: 2.36–5.04, p < 0.001) than the O group (−2.92 kg, 95 % CI: −2.6442–4.5471, p < 0.001). Additionally, the O-R group showed greater reductions in total body fat (−4.93 %), diastolic blood pressure (78.38 mmHg vs 75.93 mmHg; 95 % CI: 0.4473–4.4707, p < 0.05), and CAP score (276.62 dB/m vs 253.16 dB/m; 95 % CI: 8.46–38.85, p < 0.05). Significant weight loss in the O-R group was observed in obese patients with steatosis (S1–S3) or fibrosis (F2–F4), and in diabetic patients, particularly those with a BMI ≥30 (−2.79 kg vs −1.04 kg, p < 0.05) and steatosis (−2.17 kg vs −0.44 kg, p < 0.05). Steatorrhea occurred in both groups, while diarrhoea was noted only in the O group.

Conclusion

Addition of resveratrol to orlistat provides synergistic benefits to weight loss with additional benefit in terms of reducing total body fat and diastolic BP. These benefits were also apparent in subgroup of patients with diabetes suffering from obesity or steatosis.
Trial registration number: ISRCTN10642495.
背景:由于不遵守饮食和运动建议,减肥药利司他的效果往往较差。然而,它的有效性往往受到不遵守建议的生活方式改变和脂肪漏等副作用的影响。奥利司他与白藜芦醇联合使用可以促进体重减轻,并提供额外的代谢益处。目的本研究评估奥利司他联合白藜芦醇与奥利司他单用在缅甸超重或肥胖人群中的实际疗效和安全性。方法将BMI≥25 kg/m2的成年人随机分为两组,进行为期12周的研究。奥利司他(O)组给予奥利司他120 mg,每日3次;白藜芦醇(O-R)组口服奥利司他120 mg +白藜芦醇100 mg,每日3次。测量的主要结局是体重变化;次要结局包括总胆固醇、低密度脂蛋白胆固醇、血压、糖化血红蛋白、谷丙转氨酶(ALT)、控制衰减参数(CAP)、肝脏僵硬度和体脂总量。不良事件也有记录。结果O-R组体重减轻较多(- 3.31 kg, 95% CI: 2.36-5.04, p <;0.001)比0组(- 2.92 kg, 95% CI: - 2.6442-4.5471, p <;0.001)。此外,O-R组总体脂肪(- 4.93%)、舒张压(78.38 mmHg vs 75.93 mmHg;95% CI: 0.4473-4.4707, p <;0.05), CAP评分(276.62 dB/m vs 253.16 dB/m;95% CI: 8.46-38.85, p <;0.05)。O-R组在伴有脂肪变性(S1-S3)或纤维化(F2-F4)的肥胖患者和糖尿病患者中观察到显著的体重减轻,特别是BMI≥30的患者(- 2.79 kg vs - 1.04 kg, p <;0.05)和脂肪变性(- 2.17 kg vs - 0.44 kg, p <;0.05)。两组均出现脂肪溢,而仅O组出现腹泻。结论在奥利司他的基础上添加白藜芦醇对减肥有协同作用,在降低体脂和舒张压方面有额外的益处。这些益处在患有肥胖或脂肪变性的糖尿病患者亚组中也很明显。试验注册号:ISRCTN10642495。
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引用次数: 0
Sleeve gastrectomy and pancreatic omentoplasty decrease insulin resistance: Impact on pro-inflammatory and anti-inflammatory cytokine gene expression 袖式胃切除术和胰网膜成形术降低胰岛素抵抗:对促炎和抗炎细胞因子基因表达的影响
Q3 Medicine Pub Date : 2025-01-14 DOI: 10.1016/j.endmts.2025.100217
Abdul Mughni , Reno Rudiman , Tjokorda Gde Dalem Pemayun , Bella Renata , Endang Mahati , Suharyo Hadisaputro , Ignatius Riwanto

Background

Chronic systemic inflammation in obesity impairs insulin sensitivity and contributes to insulin resistance. Laparoscopic sleeve gastrectomy results in substantial weight loss and improved diabetic status, although 25 % of patients do not achieve optimal insulin production due to pancreatic fat accumulation. Addressing pancreatic inflammation is essential for better glycemic control. Pancreatic omentoplasty may enhance vascularization and reduce inflammation. This study examines the effects of sleeve gastrectomy and pancreatic omentoplasty on insulin resistance by analyzing the gene expression of pro- and anti-inflammatory cytokines and their correlation with HOMA-IR values.

Method

An experimental study with post-test only control design was conducted with obese and type 2 diabetes mellitus (T2DM) rat subjects which underwent sleeve gastrectomy treatment (SG), a combination of pancreatic omentoplasty and sleeve gastrectomy (SG + PO), without any intervention or a positive control group (+control), and rats which were neither obese nor T2DM or a negative control group (−control). On day 10 after surgery, blood samples from the rats were taken to assess blood glucose and insulin level in order to calculate HOMA-IR. Then, the pancreatic tissue of each rats was taken to extract the mRNA of TNF-α, IL-1, IL-6, and IL-10 by reverse-transcription polymerase chain reaction.

Result

The expression of the pro-inflammatory cytokine TNF-α in the SG + PO group was lower compared to the SG group (p = 0.008), IL-1 in the SG + PO group was lower than in the SG group (p = 0.043), and IL-6 in the SG + PO group was lower compared to the control group (p = 0.001). In contrast, the anti-inflammatory cytokine IL-10 was higher in the SG + PO group compared to the SG group (p = 0.001). Additionally, HOMA-IR in the SG + PO group was lower compared to the SG group (p = 0.001).

Conclusion

The combination of sleeve gastrectomy and pancreatic omentoplasty reduces pro-inflammatory cytokints (TNF-α, IL-1, IL-6) and increases anti-inflammatory cytokine IL-10, compared to sleeve gastrectomy alone. It also significantly lowers insulin resistance (HOMA-IR), suggesting that the combined procedure improves insulin sensitivity and glycemic control, cytokine modulation.
背景:肥胖的慢性全身性炎症损害胰岛素敏感性并导致胰岛素抵抗。尽管25%的患者由于胰腺脂肪堆积而不能达到最佳胰岛素分泌,但腹腔镜袖胃切除术结果显著减轻体重并改善糖尿病状态。解决胰腺炎症对于更好地控制血糖至关重要。胰腺网膜成形术可增强血管化,减少炎症。本研究通过分析促炎性和抗炎性细胞因子的基因表达及其与HOMA-IR值的相关性,探讨了袖胃切除术和胰网膜成形术对胰岛素抵抗的影响。方法对肥胖合并2型糖尿病(T2DM)的大鼠进行实验研究,采用试验后对照设计,在不进行任何干预的情况下,分别采用袖式胃切除术(SG)、胰网膜成形术联合袖式胃切除术(SG + PO)和非肥胖、非T2DM大鼠及阴性对照组(−对照组)。术后第10天,取大鼠血样评估血糖和胰岛素水平,计算HOMA-IR。然后取各组大鼠胰腺组织,采用逆转录聚合酶链反应提取TNF-α、IL-1、IL-6、IL-10 mRNA。结果SG + PO组促炎细胞因子TNF-α表达低于SG组(p = 0.008), IL-1表达低于SG组(p = 0.043), IL-6表达低于对照组(p = 0.001)。相比之下,SG + PO组抗炎细胞因子IL-10高于SG组(p = 0.001)。此外,SG + PO组的HOMA-IR低于SG组(p = 0.001)。结论与单用套筒胃切除术相比,套筒胃切除术联合胰网膜成形术可降低促炎细胞因子(TNF-α、IL-1、IL-6),增加抗炎细胞因子IL-10。它还显著降低胰岛素抵抗(HOMA-IR),表明联合程序改善胰岛素敏感性和血糖控制,细胞因子调节。
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引用次数: 0
Correlation between abdominal obesity and hyperuricaemia in individuals with type 2 diabetes mellitus: A case–control study 2型糖尿病患者腹部肥胖与高尿酸血症的相关性:一项病例对照研究
Q3 Medicine Pub Date : 2025-01-04 DOI: 10.1016/j.endmts.2025.100216
Ruihao Liu , Yuanyuan Zhang , Zhiming Hu , Huijian Deng

Background

Obesity is associated with hyperuricaemia in the general population; however, that relationship has not been studied in detail in patients with type 2 diabetes mellitus (T2DM), nor has the possibility of sex differences in that relationship been investigated.

Methods

A retrospective case–control study was conducted. We explored the correlation between abdominal obesity and hyperuricaemia among 315 Chinese patients with T2DM aged 27–64 years who had received community health services between January 2021 and August 2022. Abdominal obesity was defined as a waist circumference ≥ 85.0 cm in females and ≥ 90.0 cm in males. Hyperuricaemia was defined as a serum uric acid level > 7.0 mg/dL in males and postmenopausal females, > 6.0 mg/dL in premenopausal females, or receiving medical treatment for hyperuricaemia. The male and female groups were each separately divided into two additional groups: those with abdominal obesity and those without abdominal obesity. Odds ratios (OR) and 95 % confidence intervals (CI) for the risk of hyperuricaemia were calculated using a logistic regression model.

Results

The prevalence of hyperuricaemia in male and female patients in the study area was 42.86 % and 28.00 %, respectively. Abdominal obesity (OR = 3.369, 95 % CI = 1.031–11.009, P value <0.05) was the determinant variable for hyperuricaemia among male patients with T2DM but not among female patients. There was no significant difference in the prevalence of hyperuricaemia between male or female T2DM patients with different body mass index (BMI) levels.

Conclusions

Our study revealed that abdominal obesity, but not overall obesity, was associated with an increased risk of hyperuricaemia in male patients with T2DM. Neither abdominal obesity nor overall obesity was associated with an increased risk of hyperuricaemia in female patients with T2DM. Abdominal obesity is a more effective predictor of hyperuricaemia than overall obesity is in male patients with T2DM.
背景:在一般人群中,肥胖与高尿酸血症相关;然而,这种关系尚未在2型糖尿病(T2DM)患者中进行详细研究,也没有调查这种关系中性别差异的可能性。方法采用回顾性病例对照研究。我们探讨了315名27-64岁的中国T2DM患者腹部肥胖与高尿酸血症的相关性,这些患者在2021年1月至2022年8月期间接受了社区卫生服务。腹部肥胖定义为女性腰围≥85.0 cm,男性腰围≥90.0 cm。高尿酸血症被定义为血清尿酸水平[gt;7.0 mg/dL男性和绝经后女性,>;绝经前女性6.0 mg/dL,或接受高尿酸血症药物治疗。男性和女性分别被分成另外两组:腹部肥胖组和非腹部肥胖组。使用逻辑回归模型计算高尿酸血症风险的优势比(OR)和95%置信区间(CI)。结果研究区高尿酸血症男、女患病率分别为42.86%和28.00%。腹部肥胖(OR = 3.369, 95% CI = 1.031-11.009, P值<;0.05)是男性T2DM患者高尿酸血症的决定变量,而非女性T2DM患者。不同体重指数(BMI)水平的男性和女性2型糖尿病患者的高尿酸血症患病率无显著差异。一项研究表明,腹部肥胖与男性2型糖尿病患者高尿酸血症的风险增加有关,而不是整体肥胖。在女性T2DM患者中,腹部肥胖和整体肥胖均与高尿酸血症风险增加无关。在男性2型糖尿病患者中,腹部肥胖比整体肥胖更能有效地预测高尿酸血症。
{"title":"Correlation between abdominal obesity and hyperuricaemia in individuals with type 2 diabetes mellitus: A case–control study","authors":"Ruihao Liu ,&nbsp;Yuanyuan Zhang ,&nbsp;Zhiming Hu ,&nbsp;Huijian Deng","doi":"10.1016/j.endmts.2025.100216","DOIUrl":"10.1016/j.endmts.2025.100216","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is associated with hyperuricaemia in the general population; however, that relationship has not been studied in detail in patients with type 2 diabetes mellitus (T2DM), nor has the possibility of sex differences in that relationship been investigated.</div></div><div><h3>Methods</h3><div>A retrospective case–control study was conducted. We explored the correlation between abdominal obesity and hyperuricaemia among 315 Chinese patients with T2DM aged 27–64 years who had received community health services between January 2021 and August 2022. Abdominal obesity was defined as a waist circumference ≥ 85.0 cm in females and ≥ 90.0 cm in males. Hyperuricaemia was defined as a serum uric acid level &gt; 7.0 mg/dL in males and postmenopausal females, &gt; 6.0 mg/dL in premenopausal females, or receiving medical treatment for hyperuricaemia. The male and female groups were each separately divided into two additional groups: those with abdominal obesity and those without abdominal obesity. Odds ratios (OR) and 95 % confidence intervals (CI) for the risk of hyperuricaemia were calculated using a logistic regression model.</div></div><div><h3>Results</h3><div>The prevalence of hyperuricaemia in male and female patients in the study area was 42.86 % and 28.00 %, respectively. Abdominal obesity (<em>OR</em> = 3.369, <em>95</em> <em>% CI</em> = 1.031–11.009, <em>P</em> value &lt;0.05) was the determinant variable for hyperuricaemia among male patients with T2DM but not among female patients. There was no significant difference in the prevalence of hyperuricaemia between male or female T2DM patients with different body mass index (BMI) levels.</div></div><div><h3>Conclusions</h3><div>Our study revealed that abdominal obesity, but not overall obesity, was associated with an increased risk of hyperuricaemia in male patients with T2DM. Neither abdominal obesity nor overall obesity was associated with an increased risk of hyperuricaemia in female patients with T2DM. Abdominal obesity is a more effective predictor of hyperuricaemia than overall obesity is in male patients with T2DM.</div></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":"17 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cancer, deuterium, and gut microbes: A novel perspective 癌症、氘和肠道微生物:一个新的视角
Q3 Medicine Pub Date : 2025-01-04 DOI: 10.1016/j.endmts.2025.100215
Stephanie Seneff , Anthony M. Kyriakopoulos
Deuterium is a natural isotope of hydrogen, containing a neutron as well as a proton, which makes it twice as heavy as hydrogen. In this paper, we develop a theoretical argument that human metabolism strives to minimize the amount of deuterium in mitochondrial water, because it causes a stutter in ATPase pumps, introducing excess reactive oxygen species and reduced ATP production. Gut microbes produce hydrogen gas that is 80 % depleted in deuterium (deupleted). This gas is recycled into organic matter that supplies deupleted nutrients to the host, such as acetate, butyrate, and choline. Mitochondrial dysfunction is associated with many chronic diseases, most notably, cancer. Dehydrogenases, through proton tunneling, typically have a high deuterium kinetic isotope effect (KIE), and they supply deupleted protons to the ATPase pumps via NADH (nicotinamide adenine dinucleotide) synthesis. We propose that a tumor may arise as a consequence of mitochondrial stress in immune cells due to excess deuterium, and that the tumor microenvironment can support immune cell recovery from mitochondrial dysfunction. Cancer cells alter protein expression to support deuterium sequestration through membrane-bound vesicular ATPase, and they release deupleted nutrients, mainly lactate, into the extracellular milieu and the circulation. Deuterium depleted water (DDW) has been shown to prolong life in cancer patients. An organic high fat diet rich in B vitamins, especially niacin, riboflavin, and folate, augmented with natural prebiotics and probiotics, supports deuterium homeostasis and likely protects from cancer.
氘是氢的一种天然同位素,含有一个中子和一个质子,这使得它的质量是氢的两倍。在本文中,我们提出了一个理论论点,即人体代谢努力使线粒体水中的氘量最小化,因为它会导致ATP酶泵的口吃,引入过多的活性氧和减少ATP的产生。肠道微生物产生的氢气在氘中耗尽了80% (deupleted)。这种气体被循环成有机物质,为宿主提供缺乏的营养物质,如醋酸盐、丁酸盐和胆碱。线粒体功能障碍与许多慢性疾病有关,最明显的是癌症。脱氢酶通过质子隧穿,通常具有较高的氘动力学同位素效应(KIE),它们通过NADH(烟酰胺腺嘌呤二核苷酸)合成向atp酶泵提供脱氢质子。我们提出肿瘤可能是由于过量氘导致免疫细胞线粒体应激的结果,肿瘤微环境可以支持免疫细胞从线粒体功能障碍中恢复。癌细胞通过膜结合的囊泡atp酶改变蛋白质表达以支持氘隔离,并将缺乏的营养物质(主要是乳酸)释放到细胞外环境和循环中。贫氘水(DDW)已被证明可以延长癌症患者的生命。有机高脂肪饮食富含B族维生素,尤其是烟酸、核黄素和叶酸,再加上天然益生元和益生菌,有助于维持氘体内平衡,并可能预防癌症。
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引用次数: 0
Sirtuin, irisin, and vitamin D as predictors of diabetes mellitus with uncontrolled glycemia in Indonesian patients Sirtuin、鸢尾素和维生素D作为印度尼西亚患者血糖不控制的糖尿病的预测因子
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.endmts.2024.100214
Elly Herwana , Yenny , Alvina , Kurniasari , Clarissa Asha Febinia , Pusparini
The incidence of type 2 diabetes mellitus is increasing in developing countries, including Indonesia. Insulin resistance is a significant contributor to elevated blood glucose levels in type-2 diabetes patients. Low levels of serum sirtuin-1, irisin, and vitamin D have been linked to insulin resistance. This study aimed to identify risk factors that could predict uncontrolled glycemia and insulin resistance in Indonesian type-2 diabetes patients. We conducted a cross-sectional study with 73 adults from South Jakarta, Indonesia, in which we examined type-2 diabetes risk factors and biomarkers, including sex, age, body mass index, waist circumference, waist–to–hip ratio, fasting blood glucose (FBG) levels, fasting insulin, sirtuin-1, irisin, and vitamin D levels. The subjects were categorized into two groups based on their glycated hemoglobin (HbA1c) level and homeostatic model assessment for insulin resistance (HOMA-IR) index to assess glycemic control and insulin resistance, respectively. We compared risk factor profiles between groups and analyzed multivariate relationships with logistic regression. Our findings revealed that 54 % of the subjects had uncontrolled glycemia, whereas only 11 % had insulin resistance. There was a significant association between uncontrolled glycemia and reduced sirtuin-1 levels (odds ratio = 4.07; p = 0.03), which was confirmed in the multivariate analysis (beta = 5.41, p = 0.014) along with FBG (beta = 36.88, p = 0.001). Irisin showed a marginal association with insulin resistance in both univariate (odds ratio = 0.12; p = 0.027) and multivariate analyses (beta = 0.09; p = 0.049). In conclusion, sirtuin-1, in addition to FBG, is a potential marker for assessing glycemic control in type-2 diabetes patients.
在包括印度尼西亚在内的发展中国家,2型糖尿病的发病率正在上升。胰岛素抵抗是2型糖尿病患者血糖水平升高的重要因素。低水平的血清sirtuin-1、鸢尾素和维生素D与胰岛素抵抗有关。本研究旨在确定印尼2型糖尿病患者血糖失控和胰岛素抵抗的危险因素。我们对来自印度尼西亚南雅加达的73名成年人进行了横断面研究,其中我们检查了2型糖尿病的危险因素和生物标志物,包括性别、年龄、体重指数、腰围、腰臀比、空腹血糖(FBG)水平、空腹胰岛素、sirtuin-1、鸢尾素和维生素D水平。根据受试者的糖化血红蛋白(HbA1c)水平和胰岛素抵抗稳态模型评估(HOMA-IR)指数将受试者分为两组,分别评估血糖控制和胰岛素抵抗。我们比较了两组之间的危险因素概况,并用逻辑回归分析了多变量关系。我们的研究结果显示,54%的受试者血糖不受控制,而只有11%的受试者有胰岛素抵抗。血糖不受控制与sirtuin-1水平降低之间存在显著关联(优势比= 4.07;p = 0.03),这在多变量分析(beta = 5.41, p = 0.014)和FBG (beta = 36.88, p = 0.001)中得到证实。鸢尾素与胰岛素抵抗在两个单变量中均显示出边际相关性(优势比= 0.12;P = 0.027)和多变量分析(beta = 0.09;p = 0.049)。综上所述,除了FBG外,sirtuin-1是评估2型糖尿病患者血糖控制的潜在指标。
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引用次数: 0
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Endocrine and Metabolic Science
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