Endocrinology, Diabetes and Metabolism最新文献

Background

This study aimed to evaluate the relationships of conventional and calculated lipid indices with obesity or overweight in patients with type 2 diabetes (T2D).

Methods

In this cross-sectional study, all participants were categorised into three groups: normal weight (18 ≤ BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≥ 30). Conventional lipid indices, including triglyceride (TG), total cholesterol, LDL-C and HDL-C, were measured. Lipid indices, including the atherogenic index of plasma (AIP), non-HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HLD-C/HDL-C (atherogenic index, AI) and lipoprotein combine index (LCI), were calculated. The associations of these lipid indices with obesity and overweight status were evaluated using univariate and multivariate multinomial logistic regression analyses.

Results

In this study, 2661 patients with T2D, including 651 patients with normal weight, 1144 with overweight, and 866 with obesity, were recruited. According to a multinomial logistic regression analysis after adjustment for multiple confounders, the odds ratio (OR) was greater for the AIP than for other conventional and calculated lipid indices in overweight and obese patients with T2D. The AIP had a significant relationship with overweight, with an OR of 4.79 (95% CI: 1.65–13.85), and it had a significant relationship with obesity, with an OR of 13.64 (95% CI: 3.96–47.04). According to the ROC curve, with a cut-off value of 0.68, AIP could predict obesity with 82% sensitivity and 55% specificity (AUC = 0.770, 95% CI: 0.729–0.812, p < 0.001).

Conclusion

Compared with other conventional and calculated lipid markers, the AIP is most strongly associated with obesity and overweight in patients with T2D.

Introduction

Bipolar disorder is a complex psychiatric condition with distinctions between clinical subtypes including Type 1 and 2 disorders. Several studies have proposed that thyroid hormones may be involved in the aetiology of bipolar disorders.

Methods

This study employed a two-sample Mendelian randomization (MR) approach to investigate the causal relationships between six thyroid hormone metrics (TSH, FT4, FT3, TT3, FT3/FT4 and TT3/FT4) and bipolar disorder and Type 1 and 2 disorders, separately. Genome-wide association (GWAS) data from the ThyroidOmics Consortium (up to 271,040 individuals of European ancestry) were used for thyroid function metrics. Bipolar disorder GWAS data included 41,917 cases and 371,549 controls (25,060 Type 1 and 6,781 Type 2 cases). We applied inverse variance weighted (IVW) methods for primary MR analysis, with MR Egger, weighted median and weighted mode for sensitivity. Additional tests assessed horizontal pleiotropy and heterogeneity.

Results

Higher FT4 levels showed a protective causal effect against bipolar disorder (OR: 0.92, 95% CI: 0.86–0.97, p = 4.58 × 10⁻³) and a suggestive effect on Type 1 disorders (OR: 0.92, 95% CI: 0.86–0.99, p = 3.21 × 10⁻²). Elevated FT3 (OR: 1.18, 95% CI: 1.03–1.35, p = 1.55 × 10⁻²) and FT3/FT4 ratio (OR: 1.97, 95% CI: 1.02–3.82, p = 4.46 × 10⁻²) had suggestive harmful effects on Type 1 disorders. Sensitivity analyses showed consistent effects, with no significant horizontal pleiotropy or heterogeneity.

Conclusions

These findings highlight the protective role of FT4 and the potentially harmful effect of elevated FT3 in Type 1 bipolar disorder, highlighting the need for further research on thyroid hormone levels as a potential treatment strategy for Type 1 bipolar disorder.

Background

Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity-related mortality trends among adults in the United States stratified by age, sex, race and geographical location.

Methods

The CDC-WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis.

Results

From 1999 to 2022, a total of 273,761 CAD and obesity-related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4–4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7–19.1). During the COVID-19 pandemic (2020–2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non-Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8–5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4–4.5).

Conclusions

We observed increasing trends in CAD and obesity-related deaths throughout the study period reaching a peak during the COVID-19 pandemic.

Previous studies exploring the relationship between dietary potassium and magnesium intake and the risk of type 2 diabetes mellitus (T2DM) have yielded inconsistent results.

Objective

The present study was designed to compare the effect of magnesium, potassium and both (potassium and magnesium combined) on cholesterol levels and quality of life (QoL) among patients with T2DM.

Methods

A randomised controlled trial (single blinded) was conducted at The University of Lahore and Lahore Medical Research Center (LMRC). The sample size was 290 patients with T2DM, who were divided into four groups: Group I (T1) that received control/placebo; Group II (T2) and Group III (T3) received magnesium and potassium supplements, respectively; and Group IV (T4) received both magnesium and potassium supplements. Blood samples were taken from all patients before and after 60 days of supplementation to determine the levels of K⁺, Mg²⁺ and cholesterol using a chemistry analyzer (photometer 5010 v5+).

Results

There was a decrease in mean cholesterol levels in all groups after the treatment, with the largest reduction (224.9 ± 61.92 to 163.4 ± 48.38) seen in the T3 group, that received potassium supplements. A significant increase in the social QoL, indicated by a p value change from 0.06 before medical intervention to 0.000 after medical intervention, was observed. p value was significant (<0.05) between pre- and post-QoL within the T2 (Mg) and T3 (K) treatment groups.

Conclusions

The overall decrease in cholesterol levels and improvement in the social QoL after treatment imply that magnesium- and potassium-based formulations prove beneficial in combating hyperlipidaemia in patients with T2DM.

Trial Registration: NCT04642313

Aims

Endometriosis (EM) and metabolic disorders are frequent health problems among reproductive-aged women worldwide. Cardio-metabolic risk profile of women with EM is not well understood. We aimed to investigate the cardio-metabolic risk profile of Iranian reproductive-aged women with EM.

Methods

This study included 976 female participants aged 20–45 years of Tehran Lipid and Glucose Study. Endometriosis was diagnosed based on the participants' self-reported previous diagnosis of EM, which was confirmed by reviewing the relevant medical documentation. All biochemical measures (low-density lipoprotein cholesterol [LDL], high-density lipoprotein cholesterol [HDL], triglycerides [TG], and fasting blood glucose concentrations [FBG]) and measurement of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and anthropometric parameters were performed according to the standard protocol of TLGS. Logistic regression analysis was performed to estimate the odds ratio of cardio-metabolic disease.

Results

Of the 976 study participants, 161 individuals (16.5%) had a confirmed diagnosis of endometriosis. There were no significant differences in the median of metabolic parameters among women with and without endometriosis (p > 0.05). The prevalence of metabolic syndrome was significantly higher in women with EM group compared to the non-EM group (21.9% vs. 14.9%). The presence of endometriosis was associated with an increased odds of metabolic syndrome (adjusted odds ratio 1.99 [95% CI 1.20–3.30]; p = 0.007). And endometriosis significantly increased odds of low HDL by 2.07 (1.02–4.20); after adjustment, it still remained significant (p = 0.03). Endometriosis also increased odds of high waist circumstance significantly (1.58 [1.06–2.37]; p = 0.02).

Conclusions

Women with endometriosis may be at an increased risk of developing metabolic syndrome, high waist circumstance and low HDL compared to their counterparts without the condition. Given the potential cardio-metabolic implications, healthcare providers should consider assessing the metabolic profile of women diagnosed with endometriosis.

Introduction

Gestational diabetes mellitus (GDM) continues to increase particularly for non-European women. This study aimed to identify and quantify risk factors for women diagnosed with gestational diabetes in New Zealand to identify women at higher risk.

Methods

A national dataset of 601,166 eligible women who had ≥ 1 birth in New Zealand between January 2001 and December 2010 identified 11,459 women with gestational diabetes of whom 11,447 were randomly matched with 57,235 control women for age and year of delivery.

Results

Adjusted odds ratios (95% CI) showed higher odds of gestational diabetes for Asian (3.60, 3.39–3.82), Pacific (2.76, 2.57–2.96) and Māori (1.23, 1.15–1.31) women compared with European/Other women. Women most economically disadvantaged (1.44, 1.34–1.56), not registered with a lead maternity carer (1.16, 1.04–1.30) and those identified as smokers (1.20, 1.11–1.31) were more likely than control women to develop gestational diabetes. In contrast, women residing in rural (0.83, 0.77–0.88) and remote areas (0.68, 0.60–0.77) were less likely to develop gestational diabetes compared with women living in urban areas, and similarly for non-New Zealand resident women (0.78, 0.72–0.85) compared with resident women.

Conclusions

Women who were diagnosed with gestational diabetes were more likely to be non-European, economically disadvantaged, residing in urban areas, unregistered with a lead maternity carer and more likely to smoke. In addition to universal screening for pre-existing diabetes, all women at risk of gestational diabetes should be identified and supported to undertake to a 75 g glucose challenge test between 24 and 28 weeks.

Introduction

There has been a surge in interest in identifying the factors that impact cognitive impairment (CI) in patients with multiple sclerosis (MS). The purpose of our study was to examine the correlation between fasting blood sugar (FBS), fasting insulin level, as well as insulin sensitivity and cognitive function in patients with MS.

Material and Methods

A total of 85 patients with MS enrolled in this cross-sectional study. Insulin sensitivity (IS) was determined using the quantitative insulin sensitivity check index (Quicki) formula. Cognitive function was evaluated using the Persian version of the Brief International Cognitive Assessment for MS (BICAMS). Spearman correlation test was employed to examine the correlation between cognition and FBS, insulin and IS.

Results

The mean ± SD age of the participants was 39.4 ± 10.2 years, and 62 (72.9%) were female. The participants had a FBS level of 87.05 ± 11.73 mg/dL, insulin level of 10.14 ± 7.57 μU/mL and a Quicki index of 0.36 ± 0.05. A higher score on the BVMT-R and BVMT-R-Delayed subtests showed a significant negative correlation with FBS (r: −0.32; p: 0.003 and r: −0.31; p: 0.004, respectively). Conversely, a significant negative correlation (r: −0.24; p: 0.031) was observed between higher fasting insulin levels and the CVLT_II score. IS showed a positive correlation with the CVLT-II (r: 0.24; p: 0.027) and BVMT_R (r: 0.21; p: 0.054) subtests.

Conclusion

Our data indicate that elevated fasting glucose, developed fasting insulin levels and reduced insulin sensitivity may serve as potential predictors for CI in patients with MS.

Objective

Tumour necrosis factor (TNF)-α is a proinflammatory marker and has been shown to affect mitochondrial function in different tissues. We investigated the effect on adipose tissue (AT) inflammation and mitochondrial respiration in patients with hidradenitis suppurativa (HS) after 12 weeks of treatment with adalimumab, a TNF-α inhibitor.

Methods

We sampled blood and an AT biopsy from 13 patients with HS and 10 control subjects after an overnight fast. The patients were retested after at least 12 weeks of treatment with adalimumab (40 mg/week). We measured macrophage content and mitochondrial respiration in the AT and interleukin (IL)-1β, IL-6, IL-10, high-sensitivity C-reactive protein (hsCRP), interferon-γ, TNF-α, adiponectin and leptin in plasma. Clinical scores and Dermatology Quality of Life Index (DLQI) were assessed.

Results

We found a higher anti-inflammatory macrophage content (CD206⁺) in the patient group compared with the control group, but no differences between before and after the intervention. No difference in mitochondrial respiration was observed. We observed higher plasma IL-6 and hsCRP concentrations in patients with HS compared to controls, with no differences before and after the intervention. The difference between controls and HS patients was abolished after the intervention. HS patients improved their DLQI after the intervention with no change in clinical scores.

Conclusion

Treatment with adalimumab in patients with HS does not alter AT inflammation or mitochondrial respiratory capacity; however, we did see a higher content of anti-inflammatory macrophages in the patient group compared with the control group.

Objective

To investigate the gender differences and the disparities between infected and noninfected patients with type 2 diabetes (T2D) regarding patient-reported experiences during the COVID-19 pandemic in Norway.

Method

Register study using questionnaires sent electronically to patients with T2D, June 2022. The questionnaire included 82 questions covering COVID-19 disease, symptoms, medications, comorbidities, hospital care, possibility of working from home and information received from health authorities. Clinical and demographic data were collected from the Norwegian diabetes registry for adults.

Results

A total of 29,079 T2D patients participated, of whom 38.1% were women. Patients infected with COVID-19 were younger, had shorter diabetes duration and less comorbidities than noninfected (p < 0.01). Women reported significantly more anxiety, depression and fear of not getting their diabetes medication than men did. Most patients were vaccinated against COVID-19 (98.3%), whereas approximately 60% had received seasonal flu vaccine, and only 27.2% the pneumococcal vaccine. Women described more vaccine adverse effects and long Covid symptoms. Overall, 14% experienced vaccine complications and 27.3% of infected individuals reported long Covid symptoms. 2.4% of the infected patients needed hospital admission. Patients were satisfied with the follow-up of their diabetes, and with information from the government during the pandemic.

Conclusion

Female patients were more likely to experience a prolonged Covid course, and higher degree of adverse effects from the COVID-19 vaccine than male patients. Also, long Covid symptoms were significantly more often reported among female patients, while men were more prone to be hospitalised when infected. Hospitalised patients, both men and women, had significantly higher HbA1C than those who were not hospitalised. T2D patients had a surprisingly low pneumococcal vaccination coverage, despite recommendations in national guidelines.

Aim

In previous studies, the researchers observed an increase in insulin secretion in STZ-treated diabetic rats following treatment with the hydroalcoholic extract of Securigera securidaca (HESS) seeds. This study focuses on the relationship between the antioxidant properties of HESS with changes in diabetic pancreatic tissue and the gene expression of factors that impact insulin secretion.

Methods

In this controlled experimental study, three varying doses of HESS were administered to three groups of diabetic rats induced by STZ. Oxidative stress indicators like total antioxidant capacity (TAC), total oxidant status (TOS) and malondialdehyde were assessed in both pancreatic and liver tissues. Pancreatic histology was studied post-haematoxylin staining. Insulin and FGF21 levels in the blood were measured using the ELISA method. The expression of Nrf2 and FGF21 genes in the pancreas and liver, along with MafA and PDX-1 genes in the pancreas, was quantified using real-time PCR.

Results

The administration of HESS in varying doses led to a dose-dependent rise in blood insulin levels and a decrease in blood glucose levels and oxidative stress. By reducing oxidative stress, HESS treatment lowered the heightened levels of NRF2 and FGF21 in the liver and pancreas of diabetic rats, improving pancreatic tissue health. As oxidative stress decreased, the expression of MafA and PDX1 genes in the pancreas approached levels seen in healthy rats.

Conclusion

HESS elicits an increase in insulin secretion through the mitigation of oxidative stress and tissue damage, as well as the modulation of gene expression related to the insulin transcription factors PDX-1 and MafA.