Endocrine and Metabolic Science最新文献

Background

Type 2 diabetes mellitus (T2DM), as a worldwide health challenge, is a multifactorial disease that environmental and genetic factors contribute to its pathogenicity. Gastric Inhibitory Polypeptide Receptor (GIPR) is a G-pro receptor that controls the gut hormones release and insulin secretion. The current study aimed to investigate the role of the GIPR rs1800437 gene variant in T2DM susceptibility.

Material and methods

A total of 108 confirmed T2DM patients and 100 normal controls were recruited in the study. The GIPR rs1800437 genotypes were determined by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) assay.

Results

A significant difference was found in genotypes (CC, CG, and GG) frequency of the GIPR rs1800437 variant between T2DM and control groups (P = 0.02). The homozygote CC genotype of the variant significantly decreased the odds ratio (OR) of diabetes mellitus risk, approximately 50 %, in comparison with the heterozygous GC genotype. The frequency of the C allele among cases was considerably lower than controls (P = 0.002, OR = 0.51, CI = 0.33–0.79).

Conclusion

The findings of the study show enough evidence that there is a significant association between the rs1800437 GIPR genetic variant and the risk of T2DM.

Vitamin D is a key regulator of bone mineral homeostasis and may modulate maternal bone health during pregnancy and postpartum. Using previously-collected data from the Maternal Vitamin D for Infant Growth (MDIG) trial in Dhaka, Bangladesh, we aimed to investigate the effects of prenatal and postpartum vitamin D₃ supplementation on circulating biomarkers of bone formation and resorption at delivery and 6 months postpartum. MDIG trial participants were randomized to receive a prenatal;postpartum regimen of placebo or vitamin D₃ (IU/week) as either 0;0 (Group A), 4200;0 (B), 16,800;0 (C), 28,000;0 (D) or 28,000;28,000 (E) from 17 to 24 weeks' gestation to 6 months postpartum. As this sub-study was not pre-planned, the study sample included MDIG participants who had data for at least 1 biomarker of interest at delivery or 6 months postpartum, with a corresponding baseline measurement (n = 690; 53 % of 1300 enrolled trial participants). Biomarkers related to bone turnover were measured in maternal venous blood samples collected at enrolment, delivery, and 6 months postpartum: osteoprotegerin (OPG), osteocalcin (OC), receptor activator nuclear factor kappa-B ligand (RANKL), fibroblast growth factor 23 (FGF23), procollagen type 1 N-terminal propeptide, (P1NP) and carboxy terminal telopeptide of type 1 collagen (CTx). Supplementation effects were expressed as percent differences between each vitamin D group and placebo with 95 % confidence intervals (95 % CI). Of 690 participants, 64 % had 25-hydroxyvitamin D concentrations (25OHD) <30 nmol/L and 94 % had 25OHD < 50 nmol/L at trial enrolment. At delivery, mean CTx concentrations were 27 % lower in group E versus placebo (95 % CI: −38, −13; P < 0.001), adjusting for enrolment concentrations. However, at 6 months postpartum, CTx concentrations were not statistically different in group E versus placebo (14 %; 95 % CI: −5.3, 37; P = 0.168), adjusting for delivery CTx concentrations. Effects on other biomarkers at delivery or postpartum were not statistically significant. In conclusion, prenatal high-dose vitamin D supplementation reduced bone resorption during pregnancy, albeit by only one biomarker, and without evidence of a sustained effect in the postpartum period. However, further evidence is needed to substantiate potential maternal bone health benefits of vitamin D in the postpartum period.

Aims

To explore the metabolic influence of prolactin in subjects with polycystic ovary syndrome (PCOS).

Methods

This retrospective cross-sectional study analyzed data of women newly diagnosed with PCOS attending the Endocrinology outpatient department of a tertiary hospital in Mymensingh, Bangladesh, during 2017–2022. Clinical, anthropometric, and laboratory data, including results of oral glucose tolerance test, measurements of serum lipids, total testosterone (TT), thyroid-stimulating hormone (TSH), and prolactin, were extracted and analyzed. Cases of high prolactin (≥100 ng/mL) were excluded.

Results

840 cases [median age 21.5 (18.0–25.7) years] were considered for final analysis; 17.1 % had hyperprolactinemia. Serum prolactin had significant negative correlations (P < 0.05) with age (r_s = − 0.153), body mass index (r_s = − 0.172), waist circumference (r_s = − 0.193), triglyceride (r_s = − 0.174), and TT (r_s = − 0.133) levels, and the presence of metabolic syndrome (r_s = − 0.073) and positive correlations with TSH (r_s = 0.090). In multiple regression analysis, prolactin was inversely associated with fasting plasma glucose (FPG) and positively associated with TSH after correcting for age and BMI.

Conclusion

An inverse association exists between serum prolactin levels and some metabolic risk factors, such as FPG, in women with PCOS.

Background

Dyslipidemia is a major risk factor for cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). This countrywide study explored the prevalence and patterns of dyslipidemia among patients with T2DM who were not taking lipid-lowering drugs (LLD).

Methods

This cross-sectional study included 2241 subjects with T2DM visiting several endocrinology outpatient clinics throughout Bangladesh from January to December 2021. Lipid profiles were measured in fasting blood samples using automatic analyzers. Data were analyzed using Stata 17 (Stata Corp LLC, TX, USA).

Results

2241 patients were investigated; their mean age was 46.27 (±11.27, SD) years, and 57.16 % were women. Overall, the prevalence of dyslipidemia was 96.83 %. Total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and triglyceride (TG) were high in 42.88 %, 63.54 %, and 71.40 % of patients, respectively; high-density lipoprotein cholesterol (HDLC) was low in 77.60 %. Mixed dyslipidemia (including raised TC, LDLC, TG, and low HDLC) was the most prevalent (24.05 %) type. Being woman (adjusted OR: 5.63, 95%CI: 3.07–11.1) and uncontrolled diabetes (HbA1c <7 %) (adjusted OR: 2.64, 95%CI: 1.54–4.52) were independently associated with dyslipidemia. Dyslipidemia was associated with microvascular complications of diabetes.

Conclusion

Dyslipidemia is a highly prevalent abnormality among LLD-naïve T2DM patients in Bangladesh. Early detection and prompt management are required to prevent complications arising from dyslipidemia.

Aim

This study compares levels of insulin resistance and beta-cell function and their relationship with liver enzymes in recovered COVID-19 participants and their uninfected counterparts in a cross-sectional study design in the Tamale metropolis of Ghana.

Methods

Biochemical indices for liver function, lipid metabolism, inflammation and oxidative stress were assessed under fasting state in 110 recovered COVID-19 and 116 uninfected participants. The homeostatic model assessment of insulin resistance (HOMA-IR) and the triglyceride-glucose index (TyG) were employed for the assessment of insulin resistance.

Results

Recovered COVID-19 participants presented lower (P < 0.05) levels of fasting glucose, insulin, alkaline phosphatase, creatinine and beta-cell function but higher (P < 0.05) levels of alanine/aspartate transferase, total bilirubin, direct bilirubin, total cholesterol, high-density lipoprotein cholesterol and HOMA-IR than their uninfected counterparts. The mean levels of the remaining indices were comparable (P > 0.05) between the study groups. Prevalence of insulin resistance ranged from 61 % (71/116) to 81 % (89/110) for the uninfected and recovered COVID-19 participants respectively. Selected liver enzymes associated with HOMA-IR and TyG.

Conclusion

The risk of developing type 2 diabetes mellitus appears higher in recovered COVID-19 participants than their uninfected counterparts despite the high prevalence of insulin resistance in both groups.

Background

Serum cortisol levels vary according to the daily circadian cycle, with peak levels seen in the morning. There is evidence in ambulatory patients that a morning cortisol level can predict an adequate cortisol response to Synacthen (tetracosactide) stimulation.

Aim

The aim of this study is to determine the utility of baseline analysis of the serum cortisol levels in the morning “baseline morning cortisol”, determined using a newer immunoassay, in the screening for adrenal insufficiency amongst non-critically ill hospital inpatients.

Methods

This is a retrospective cross-sectional cohort study.

Results

64 adult inpatients had undergone a short Synacthen test (SST) (measurement of serum cortisol levels 30 and 60 min after administration of tetracosactide) during the study period. 17 patients returned an abnormal SST result. The measured level of cortisol in the morning correlated to both the 30 min and 60 min stimulated cortisol values (r = 0.612, p < 0.001 and r = 0.639, p < 0.001). After inspecting the receiver operating characteristic curve, a cortisol concentration of 200nmmol/L measured in the morning was selected as a threshold for predicting the SST result. Using this cut off, sensitivity for predicting a normal SST was 100 %, specificity 56 %, positive predictive value 45 % and negative predictive value 100 %.

Conclusion

A morning cortisol measurement, determined using a newer immunoassay, is sufficient in most cases to screen for adrenal insufficiency amongst non-critically ill hospital inpatients. Use of clinical judgement in conjunction with single morning cortisol measurement is likely to reduce the need for SST testing amongst inpatients.

Objective

Gestational Diabetes Mellitus (GDM) is one of the most common complications of pregnancy and becoming an increasing health problem worldwide. The rate of GDM is increasing in Asian countries including Bangladesh. This study is aimed at investigating the association between the rs12255372 (G/T) polymorphism of the TCF7L2 gene with GDM.

Method

To carry out the present research, 63 GDM pregnant women and 60 control pregnant women were randomly selected from the city Chattogram, Bangladesh. During the study data was collected between gestational weeks of 24–28. PCR-RFLP was used for genotyping the rs12253372 (G/T) and for genotype analysis Hardy-Weinberg equation (Hardy, 1908) was applied.

Results

The fasting and 2-hour plasma glucose level was significantly higher in GDM than the control. Moreover, in the case of family history women with GDM showed higher percentage in first degree relatives (60.31 %) compared to that of control (38.33 %). The frequency of mutant allele T in GDM is 26.2 % which was however not significant. TT genotype was found only in one subject with GDM. However, the percentage of risk allele GT is higher in GDM (49.2 %) compared to that of NGT (35 %).

Conclusions

In our pilot study, we did not find an association between rs12255372 (G/T) polymorphism of TCF7L2 gene and GDM. Studying in a broader group may help to find a conclusive result.

Aims

Sleep duration and quality are increasingly recognized as potential contributors to cardiovascular disease risk, with serum lipids playing a crucial role in this relationship. However, the results regarding this association have been inconsistent across different ethnic groups. This study aims to investigate this association in an Iranian elderly population.

Methods

Totally 1392 people 60 to 69 years old were included in this study. Sleep duration and quality were assessed by the Pittsburgh sleep quality index (PSQI). Logistic and linear regression models were employed to determine the association of sleep duration and quality with serum lipid levels; moreover, the effects of other potential confounders were also controlled.

Findings

Most of the participants had low sleep quality (70.47 %), which was more notable in males (80.08 %), compared to females (59.15 %), and most of the participants slept 6–7 h per day (42.2 %). No association was observed between sleep quality and serum lipid levels including HDL (OR = 1.12; P = 0.871), LDL (OR = 0.80; P = 0.451), total cholesterol (OR = 0.89; P = 0.702) and triglyceride (OR = 1.13; P: 0.477). As well as, no association between sleep duration and LDL; (β = 0.35; P = 0.094), total cholesterol (β = 0.02; P = 0.918), triglycerides (β = −0.02; P = 0.846), and HDL (β = −0.06; P = 0.534).

Conclusion

In the elderly population, poor sleep quality is typical, particularly among males. Sleep quality and duration were not associated with serum lipid profiles, including TG, TC, LDL, and HDL.

Along with the rising incidence of diabetes, the prevalence of diabetic retinopathy (DR) is quickly growing across the world. The incidence of DR complications is high, and many people are not detected until they have complications and visual impairment, causing many difficulties for the treatment process. Aims: The goal of this cross-sectional was to investigate the clinical and subclinical features of Vietnamese diabetic retinopathy patients. Methods: DR was diagnosed using International Clinical Diabetic Retinopathy scale. Complete clinical information (Age, sex, weight, height, history of hypertension and diabetes mellitus, smoking, alcohol), subclinical information (Glucose, urea, creatinine, HbA1c, uric acid, cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol blood levels, Complete blood count) were collected. Results: The research enrolled 140 type 2 diabetic patients (70 in each group: DR and no DR). DR patients had significantly higher age, RBC, Hb, eGFR, uric acid, and creatinine blood levels than patients without DR. A duration of diabetes mellitus of over 15 years was associated with an 8.319-fold increased risk of DR. In conclusion, age, RBC, Hb, eGFR, uric acid, creatinine blood levels and duration of diabetes mellitus over 15 years are risk factors for DR.

Aims/objectives

Although considerable effort, both experimental and theoretical, has been directed towards understanding the relationship between the HPA axis and weight regulation, no true consensus exists in the literature as to the nature of the relationship. The aim of this study was to explore potential correlations between BMI and measures of cortisol and cortisol metabolites using dried urine and saliva sampling in a large sample of individuals with BMIs ranging from underweight to obese.

Materials and methods

A cohort of patients with data available from urinary and/or salivary measures of cortisol and cortisol metabolites who met inclusion criteria was extracted from the database of a commercial clinical laboratory. Pearson correlation coefficients were used to determine associations between variables; Student's t-test and one-way ANOVA were used to examine differences between groups, and the Jonckheere-Terpstra trend test was used to assess for trends by BMI category. A multivariable linear regression model was created to determine which variables explained the largest amounts of variance in BMI.

Results

A significant correlation was observed between the urinary cortisol metabolites and BMI (P < 0.0001). In addition, cortisol metabolites were associated with changes in BMI over time. No significant correlation was observed between urinary free cortisol and BMI, and correlations observed between BMI and other variables, with the exception of age, were either weak or not statistically significant.

Conclusions

The data presented in this study suggest that cortisol metabolism is a key component of weight regulation and that cortisol metabolite concentrations may potentially serve as informative biomarkers to characterize the relationship between the HPA axis and changes in BMI. The implications of this affect both clinical practice and the research and development of both prevention and treatment strategies aimed at either decreasing or increasing BMI.