Endocrinology, Diabetes and Metabolism最新文献_第6页

Impact of Gender on Chronic Complications in Participants With Type 2 Diabetes: Evidence From a Cross-Sectional Study 性别对 2 型糖尿病患者慢性并发症的影响：一项横断面研究的证据

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-05-08 DOI: 10.1002/edm2.488

Kiavash Mokhtarpour, Amirhossein Yadegar, Fatemeh Mohammadi, Seyedeh Nazanin Aghayan, Seyed Arsalan Seyedi, Soghra Rabizadeh, Alireza Esteghamati, Manouchehr Nakhjavani

Introduction

This study aimed to assess and compare the prevalence of diabetes complications between men and women with Type 2 diabetes (T2D), as well as how gender relates to these complications.

Methods

In this cross-sectional study, complications of diabetes, including coronary artery disease (CAD), retinopathy, neuropathy and diabetic kidney disease (DKD), were evaluated in 1867 participants with T2D. Additionally, baseline characteristics of the individuals, including anthropometric measurements, metabolic parameters and the use of dyslipidaemia drugs and antihyperglycaemic agents, were assessed. Gender differences in complications were examined using the chi-squared test. Multivariate logistic regression was employed to investigate the relationship between gender and T2D complications, with and without adjusting for the characteristics of the studied population.

Results

In the studied population, 62.1% had at least one complication, and complications were 33.5% for DKD, 29.6% for CAD, 22.9% for neuropathy and 19.1% for retinopathy. The prevalence of CAD and neuropathy was higher in men. However, DKD and retinopathy were more prevalent among women. Odds ratios of experiencing any complication, CAD and retinopathy in men compared with women were 1.57 (95% CI: 1.27–2.03), 2.27 (95% CI: 1.72–2.99) and 0.72 (95% CI: 0.52–0.98), respectively, after adjusting for demographic factors, anthropometric measures, metabolic parameters and the consumption of dyslipidaemia drugs and antihyperglycaemic agents.

Conclusion

The prevalence of diabetes complications was significantly higher in men with diabetes, highlighting the need for better treatment adherence. CAD was associated with the male gender, whereas retinopathy was associated with the female gender. Men and women with diabetes should be monitored closely for CAD and retinopathy, respectively, regardless of their age, diabetes duration, anthropometric measures, laboratory findings and medications.

简介：本研究旨在评估和比较男性和女性 2 型糖尿病患者的糖尿病并发症发病率，以及性别与这些并发症的关系：本研究旨在评估和比较2型糖尿病（T2D）男性和女性患者的糖尿病并发症发病率，以及性别与这些并发症的关系：在这项横断面研究中，对 1867 名 2 型糖尿病患者的糖尿病并发症进行了评估，包括冠状动脉疾病（CAD）、视网膜病变、神经病变和糖尿病肾病（DKD）。此外，还评估了这些人的基线特征，包括人体测量、代谢参数以及血脂异常药物和降糖药物的使用情况。采用卡方检验对并发症的性别差异进行了研究。在对研究人群的特征进行调整或未进行调整的情况下，采用多变量逻辑回归法研究性别与终末期糖尿病并发症之间的关系：在研究人群中，62.1%的人至少患有一种并发症，其中33.5%的人患有糖尿病、29.6%的人患有冠状动脉硬化症、22.9%的人患有神经病变、19.1%的人患有视网膜病变。男性患 CAD 和神经病变的比例较高。然而，DKD 和视网膜病变在女性中更为普遍。在对人口统计学因素、人体测量指标、代谢参数以及服用血脂异常药物和降糖药物进行调整后，男性与女性发生任何并发症、CAD和视网膜病变的比值比分别为1.57（95% CI：1.27-2.03）、2.27（95% CI：1.72-2.99）和0.72（95% CI：0.52-0.98）：结论：男性糖尿病患者的糖尿病并发症发病率明显更高，这说明需要更好地坚持治疗。糖尿病并发症与男性有关，而视网膜病变则与女性有关。无论男性和女性糖尿病患者的年龄、糖尿病病程、人体测量指标、实验室检查结果和用药情况如何，都应分别密切监测他们是否患有并发症和视网膜病变。

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引用次数: 0

Tirzepatide Reduces Fat Mass and Provides Good Glycaemic Control in Type 2 Diabetes Patients Undergoing Haemodialysis: A Single-Centre Retrospective Study 替扎帕肽可减少接受血液透析的 2 型糖尿病患者的脂肪量并提供良好的血糖控制：单中心回顾性研究。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-05-08 DOI: 10.1002/edm2.489

Akira Mima, Yasuhiro Horii

Objective

Tirzepatide is an injectable peptide approved by the US Food and Drug Administration for the treatment of Type 2 diabetes (T2DM). Its weight-loss effect primarily targets fat reduction; however, such effect on patients with chronic kidney disease (CKD) undergoing haemodialysis (HD) has not been reported.

Methods

Nine patients with CKD undergoing HD received weekly tirzepatide doses (2.5–7.5 mg) once a week. Evaluations encompassed tirzepatide's impact on dry weight (DW) and body composition assessed at baseline and study conclusion using bioelectrical impedance analysis. This longitudinal study included nine patients, with a median age of 53 years and median HD duration of 4 years.

Results

Tirzepatide treatment significantly decreased glycated albumin compared with the value at baseline (22.7 ± 5.4 vs. 18.3 ± 2.5%, p = 0.028, respectively). Significant reductions were observed in DW (−1.0 kg, p = 0.024) and body mass index (−0.6 kg/m², p = 0.050) following tirzepatide administration. Total fat mass was also reduced, but not significantly (− 2.51% from baseline, p = 0.214). In contrast, skeletal muscle mass was not decreased (−1.02% from baseline, p = 0.722). No serious side effects other than nausea were observed during the study period.

Conclusion

Tirzepatide effectively provides good glycaemic control in T2DM patients undergoing HD, decreasing DW by reducing body fat mass without increasing frailty risk.

目的替扎帕肽是美国食品药品管理局批准用于治疗2型糖尿病（T2DM）的一种注射用多肽。其减肥效果主要针对减少脂肪，但对接受血液透析（HD）的慢性肾病（CKD）患者的减肥效果尚未见报道：九名接受血液透析治疗的慢性肾脏病患者每周接受一次替扎帕肽治疗（2.5-7.5 毫克）。评估包括在基线和研究结束时使用生物电阻抗分析评估替扎帕肽对干重（DW）和身体成分的影响。这项纵向研究包括 9 名患者，中位年龄为 53 岁，中位 HD 持续时间为 4 年：结果：与基线值相比，替扎帕肽治疗可显著降低糖化白蛋白（分别为 22.7 ± 5.4 vs. 18.3 ± 2.5%，p = 0.028）。服用替扎帕肽后，DW（-1.0 千克，p = 0.024）和体重指数（-0.6 千克/平方米，p = 0.050）显著下降。总脂肪量也有所减少，但并不显著（比基线减少 2.51%，p = 0.214）。相比之下，骨骼肌质量没有减少（与基线相比-1.02%，p = 0.722）。研究期间，除恶心外，未发现其他严重副作用：结论：替唑帕肽能有效控制接受 HD 治疗的 T2DM 患者的血糖，通过减少体脂量来降低 DW，同时不会增加虚弱风险。

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引用次数: 0

Clinical Service Incorporating Mobile Technology on Weight Loss in Patients With Metabolic Dysfunction–Associated Steatotic Liver Disease: A Translation From Research Trial 结合移动技术为代谢功能障碍相关性脂肪肝患者提供减肥临床服务：研究成果转化试验

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-29 DOI: 10.1002/edm2.485

Siew Min Ang, Su Lin Lim, Yock Young Dan, Yiong Huak Chan, Qai Ven Yap, Juliana Chen

Background

The prevalence and healthcare cost of metabolic dysfunction–associated steatotic liver disease (MASLD) has increased alongside the epidemic surge in obesity and Type 2 diabetes. Weight loss through lifestyle modification remains the primary effective therapy for MASLD. Incorporation of mobile technology in lifestyle interventions has been previously found to be efficacious and cost-effective in facilitating weight loss. However, there is a paucity of studies that have successfully translated lifestyle research into clinical service for weight loss to alleviate disease burden. Our study aimed to describe the process of translating a mobile technology–enabled trial into a tertiary hospital outpatient dietetics service for patients with MASLD.

Methods

The Iowa Model of Evidence-Based Practice to Improve Quality Care was used as a framework for this paper to guide implementation at the organizational level.

Results

Regular engagement of key operational staff and the hospital management team facilitated open discussions of the challenges faced and enabled rapid implementation of strategies that contributed to the smooth piloting of the service. A service adoption rate of 81% was achieved. Preliminary outcome evaluation found that the percentage of patients achieving ≥ 5% weight loss from baseline at 6 months was comparable at 54% and 52% for the service and trial groups, respectively.

Conclusions

Evaluation of the implementation process found that a hybrid model of care (in-person consultation supplemented with app coaching) preserved interpersonal connections while maximizing the convenience and scalability of mobile app–enabled service. Although high digital acceptance and adoption rates propelled by COVID-19-supported telehealth, it is prudent to assess patient's access to technology and digital literacy and offer resources to help them benefit from telehealth services.

背景随着肥胖症和 2 型糖尿病的流行，代谢功能障碍相关性脂肪性肝病（MASLD）的发病率和医疗成本也在增加。通过改变生活方式来减轻体重仍然是治疗代谢性脂肪肝的主要有效方法。在生活方式干预中融入移动技术，在促进减肥方面具有良好的效果和成本效益。然而，很少有研究成功地将生活方式研究转化为减轻疾病负担的减肥临床服务。我们的研究旨在描述将移动技术辅助试验转化为针对 MASLD 患者的三级医院门诊营养学服务的过程。方法本文以爱荷华州循证实践提高医疗质量模式为框架，指导组织层面的实施工作。结果关键业务人员和医院管理团队的定期参与促进了对所面临挑战的公开讨论，并促成了策略的快速实施，为服务的顺利试行做出了贡献。服务采用率达到 81%。初步结果评估发现，在 6 个月时，体重较基线下降≥5% 的患者比例与服务组和试验组相当，分别为 54% 和 52%。结论对实施过程的评估发现，混合护理模式（面对面咨询辅以应用程序指导）保留了人际联系，同时最大限度地提高了移动应用程序服务的便利性和可扩展性。虽然 COVID-19 支持的远程医疗推动了数字接受度和采用率的提高，但评估患者对技术和数字素养的掌握情况并提供资源帮助他们从远程医疗服务中获益仍是谨慎之举。

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引用次数: 0

Clinical Outcomes With Once-Weekly Insulin Icodec Versus Once-Daily Insulin Glargine U100 in Insulin-Naïve and Previously Insulin-Treated Individuals With Type 2 Diabetes: A Meta-Analysis of Randomised Controlled Trials 在胰岛素无效和曾接受过胰岛素治疗的 2 型糖尿病患者中，每周一次的伊科达克胰岛素与每日一次的格列奈胰岛素 U100 的临床疗效对比：随机对照试验的元分析

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-24 DOI: 10.1002/edm2.480

Mushood Ahmed, Aimen Shafiq, Hira Javaid, Hritvik Jain, Abdulqadir J. Nashwan, Qura Tul-Ain, Jawad Basit

Aims

The once-weekly insulin icodec, a new basal insulin analog, may positively support a reduction in injection frequency and improve adherence to therapy in type 2 diabetes (T2D). This study aimed to evaluate the safety and efficacy of insulin icodec compared with those of once-daily glargine U100.

Methods

A comprehensive literature search was conducted using PubMed/MEDLINE, Embase and the Cochrane Library from inception till September 2023. Data about clinical outcomes in both groups were extracted. Forest plots were generated using the random-effects model by pooling odds ratios (ORs) and mean differences (MDs).

Results

Five randomised controlled trials and 2019 individuals with T2DM were included. In the pooled analysis, time in range was significantly higher (MD = 4.35; 95% CI: 1.65 to 7.05; p = 0.002) in the icodec group than in the once-daily glargine group. The HbA1c levels were significantly reduced (MD = −0.13; 95% CI: −0.24 to −0.03; p = 0.02) in the weekly icodec group compared with those in the once-daily glargine group. The weight gain was significantly less in the glargine group than in the weekly icodec group (MD = 0.41; 95% CI: 0.04 to 0.78; p = 0.03); however, in the subgroup analysis, this change became statistically insignificant in both insulin-naïve and previously insulin-treated individuals. The results were comparable across two groups for fasting plasma glucose levels, hypoglycaemia alert (Level 1), clinically significant (Level 2) or severe hypoglycaemia (Level 3), and adverse events.

Conclusion

Insulin icodec was associated with a reduction in glycated haemoglobin levels and higher time in range, with a similar safety profile as compared to insulin glargine U100. However, further evidence is still needed to reach a definitive conclusion.

目的每周注射一次的胰岛素 icodec 是一种新型基础胰岛素类似物，可减少 2 型糖尿病（T2D）患者的注射次数并提高治疗依从性。本研究旨在评估胰岛素 icodec 与每日一次的格列奈 U100 相比的安全性和有效性。方法使用 PubMed/MEDLINE、Embase 和 Cochrane 图书馆对从开始到 2023 年 9 月的文献进行了全面检索。提取了两组患者的临床结果数据。采用随机效应模型，通过汇集几率比（OR）和平均差（MD）生成森林图。结果纳入了五项随机对照试验和 2019 名 T2DM 患者。在汇总分析中，icodec 组进入治疗范围的时间（MD = 4.35；95% CI：1.65 至 7.05；P = 0.002）明显高于每日一次格列卫组。每周服用 icodec 组的 HbA1c 水平比每日服用一次格列宁组明显降低（MD = -0.13；95% CI：-0.24 至 -0.03；p = 0.02）。格列宁组的体重增加明显少于每周一次的伊科达克组（MD = 0.41；95% CI：0.04 至 0.78；P = 0.03）；然而，在亚组分析中，这一变化在胰岛素无效者和曾接受过胰岛素治疗者中都变得无统计学意义。在空腹血浆葡萄糖水平、低血糖警报（1 级）、有临床意义（2 级）或严重低血糖（3 级）以及不良事件方面，两组的结果具有可比性。结论与格列奈胰岛素 U100 相比，胰岛素 icodec 可降低糖化血红蛋白水平，延长在量程内的时间，安全性相似。不过，仍需进一步的证据才能得出明确的结论。

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引用次数: 0

Association Between Type 1 Diabetes Mellitus and Eating Disorders: A Systematic Review and Meta-Analysis 1 型糖尿病与饮食失调之间的关系：系统回顾和元分析

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-10 DOI: 10.1002/edm2.473

Yomna E. Dean, Karam R. Motawea, Muaaz Aslam, Jose J. Loayza Pintado, Helen A. O. Popoola-Samuel, Mohamed Salam, Prashant Obed Reddy Dundi, Webster Donaldy, Esraa M. Aledani, Zaineh Alqiqie, Nazia Sultana, Alaa Ramadan Hussein Mohamed, Amir Elalem, Sidra Tahreem Hashmi Syeda, Mai Saad Mohamed, Mazen W. Assal, Nada M. Attia, Hanan Hagar, Heba Ahmed Abdelaziz, Anuj Subedi, Areeg Elbahaie, Yusef Hazimeh, Hani Aiash

Background

Previous meta-analyses have shown mixed results regarding the association between eating disorders (EDs) and type 1 diabetes mellitus (T1DM). Our paper aimed to analyse different EDs and disordered eating behaviours that may be practiced by patients with T1DM.

Methods

A literature search of PubMed, Scopus and Web of Science was conducted on 17 January 2023, using the key terms “T1DM,” “Eating Disorders” and “Bulimia.” Only observational controlled studies were included. The Revman software (version 5.4) was used for the analysis.

Results

T1DM was associated with increased risk of ED compared with nondiabetic individuals (RR = 2.47, 95% CI = 1.84–3.32, p-value < 0.00001), especially bulimia nervosa (RR = 2.80, 95% CI = 1.18–6.65, p-value = 0.02) and binge eating (RR = 1.53, 95% CI = 1.18–1.98, p-value = 0.001). Our analysis has shown that increased risk of ED among T1DM persisted regardless of the questionnaire used to diagnose ED; DM-validated questionnaires (RR = 2.80, 95% CI = 1.91–4.12, p-value < 0.00001) and generic questionnaires (RR = 2.03, 95% CI = 1.27–3.23, p-value = 0.003). Prevalence of insulin omission/misuse was 10.3%; diabetic females demonstrated a significantly higher risk of insulin omission and insulin misuse than diabetic males.

Conclusion

Our study establishes a significant and clear connection between EDs and T1DM, particularly bulimia and binge eating, with T1DM. Moreover, female diabetics are at higher risk of insulin misuse/omission. Early proactive screening is essential and tailored; comprehensive interventions combining diabetes and ED components are recommended for this population, with referral to a specialised psychiatrist.

背景以往的荟萃分析表明，饮食失调（ED）与 1 型糖尿病（T1DM）之间的关联结果不一。本文旨在分析 T1DM 患者可能存在的不同 ED 和饮食失调行为。方法 2023 年 1 月 17 日，我们使用关键字 "T1DM"、"进食障碍 "和 "贪食症 "对 PubMed、Scopus 和 Web of Science 进行了文献检索。仅纳入了观察性对照研究。分析使用 Revman 软件（5.4 版）。结果与非糖尿病患者相比，T1DM 与发生 ED 的风险增加有关（RR = 2.47，95% CI = 1.84-3.32，p 值 = 0.00001），尤其是神经性贪食症（RR = 2.80，95% CI = 1.18-6.65，p 值 = 0.02）和暴食症（RR = 1.53，95% CI = 1.18-1.98，p 值 = 0.001）。我们的分析表明，无论采用哪种问卷诊断 ED，T1DM 患者的 ED 风险都会增加；DM 验证问卷（RR = 2.80，95% CI = 1.91-4.12，p 值 = 0.00001）和普通问卷（RR = 2.03，95% CI = 1.27-3.23，p 值 = 0.003）。胰岛素漏用/滥用的发生率为 10.3%；女性糖尿病患者漏用和滥用胰岛素的风险明显高于男性糖尿病患者。结论我们的研究证实，ED 与 T1DM，尤其是暴食症和暴饮暴食与 T1DM 之间存在明显的联系。此外，女性糖尿病患者滥用/漏用胰岛素的风险更高。早期主动筛查至关重要，而且要量体裁衣；建议对这一人群进行糖尿病和 ED 综合干预，并转介给专门的精神科医生。

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引用次数: 0

Prevalence and Predictors of Gestational Diabetes Mellitus in Sub-Saharan Africa: A 10-Year Systematic Review 撒哈拉以南非洲地区妊娠糖尿病的患病率和预测因素：10 年系统回顾

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-10 DOI: 10.1002/edm2.478

Daniel Ataanya Abera, Christopher Larbie, James Abugri, Mina Ofosu, Mohamed Mutocheluh, Julius Dongsogo

Background

Gestational diabetes mellitus (GDM) remains a global public health problem, which affects the well-being of mothers and their children in sub-Saharan Africa (SSA). Studies conducted in different geographical areas provide varied results on its prevalence and predictors. Understanding the extent and predictors of GDM in SSA is important for developing effective interventions and policies. Thus, this review aimed to investigate the prevalence of GDM and its predictive factors in sub-Saharan Africa.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards in this review. An extensive search of the PubMed, Web of Sciences and EMBASE databases was carried out covering papers from 2012 to 2022 to assess the prevalence and predictors of GDM. Microsoft Excel 2019 was utilised for study management. GraphPad Prism Version 8.0 and the MedCalc statistical software were employed for data analysis. The findings were analysed using textual descriptions, tables, forest plots and heat maps.

Results

Using 30 studies with 23,760 participants that satisfied the inclusion criteria, the review found the overall prevalence of GDM in SSA to be 3.05% (1.85%–4.54%). History of preterm delivery, alcohol consumption, family history of diabetes, history of stillbirths, history of macrosomia, overweight or obesity and advanced mother age were all significant predictors of gestational diabetes. Additionally, various biomarkers such as haemoglobin, adiponectin, leptin, resistin, visfatin, vitamin D, triglycerides and dietary intake type were identified as significant predictors of GDM.

Conclusion

In sub-Saharan Africa, there is a high pooled prevalence of gestational diabetes mellitus. In the light of the predictors of GDM identified in this review, it is strongly recommended to implement early screening for women at risk of developing gestational diabetes during their pregnancy. This proactive approach is essential for enhancing the overall well-being of both mothers and children.

背景妊娠期糖尿病（GDM）仍然是一个全球性的公共卫生问题，影响着撒哈拉以南非洲地区（SSA）母亲及其子女的健康。在不同地区进行的研究对其发病率和预测因素给出了不同的结果。了解撒哈拉以南非洲地区 GDM 的程度和预测因素对于制定有效的干预措施和政策非常重要。因此，本综述旨在调查撒哈拉以南非洲地区 GDM 的患病率及其预测因素。方法在本综述中，我们遵循了系统综述和荟萃分析首选报告项目（PRISMA）标准。我们广泛检索了 PubMed、Web of Sciences 和 EMBASE 数据库中 2012 年至 2022 年的论文，以评估 GDM 的患病率和预测因素。研究管理使用 Microsoft Excel 2019。数据分析采用了 GraphPad Prism 8.0 版和 MedCalc 统计软件。研究结果通过文字描述、表格、森林图和热图进行分析。结果通过对符合纳入标准的 30 项研究、23760 名参与者的研究，研究发现在 SSA 地区 GDM 的总患病率为 3.05% (1.85%-4.54%)。早产史、饮酒、糖尿病家族史、死胎史、巨大儿史、超重或肥胖以及高龄产妇都是妊娠糖尿病的重要预测因素。此外，血红蛋白、脂肪连通素、瘦素、抵抗素、粘蛋白、维生素 D、甘油三酯和饮食摄入类型等各种生物标志物也被认为是预测妊娠糖尿病的重要指标。结论在撒哈拉以南非洲地区，妊娠糖尿病的总发病率很高。鉴于本综述中发现的预测 GDM 的因素，强烈建议对孕期有患妊娠糖尿病风险的妇女进行早期筛查。这种积极主动的方法对于提高母婴的整体健康水平至关重要。

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引用次数: 0

Emergence of De Novo Conditions Following Remission of Cushing Syndrome: A Case Report and Scoping Review 库欣综合征缓解后出现的新病症：病例报告与范围审查

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-10 DOI: 10.1002/edm2.476

Noémie Desgagnés, Laura Senior, Daniel Vis, Katayoun Alikhani, Kirstie Lithgow

Objective

Onset and exacerbation of autoimmune, inflammatory or steroid-responsive conditions have been reported following the remission of Cushing syndrome, leading to challenges in distinguishing a new condition versus expected symptomatology following remission. We describe a case of a 42-year-old man presenting with new-onset sarcoidosis diagnosed 12 months following the surgical cure of Cushing syndrome and synthesise existing literature reporting on de novo conditions presenting after Cushing syndrome remission.

Methods

A scoping review was conducted in Medline, Epub, Ovid and PubMed. Case reports and case series detailing adult patients presenting with new-onset conditions following Cushing syndrome remission were included.

Results

In total, 1641 articles were screened, 138 full-text studies were assessed for eligibility, and 43 studies were included, of which 84 cases (including our case) were identified. Most patients were female (85.7%), and the median reported age was 39.5 years old (IQR = 13). Thyroid diseases were the most commonly reported conditions (48.8%), followed by sarcoidosis (15.5%). Psoriasis, lymphocytic hypophysitis, idiopathic intracranial hypertension, multiple sclerosis, rheumatoid arthritis, lupus and seronegative arthritis were reported in more than one case. The median duration between Cushing remission and de novo condition diagnosis was 4.1 months (IQR = 3.75). Of those patients, 59.5% were receiving corticosteroid therapy at the time of onset.

Conclusion

Our scoping review identified several cases of de novo conditions emerging following the remission of Cushing syndrome. They occurred mostly in women and within the year following remission. Clinicians should remain aware that new symptoms, particularly in the first year following the treatment of Cushing syndrome, may be manifestations of a wide range of conditions aside from adrenal insufficiency or glucocorticoid withdrawal syndrome.

目的有报道称，库欣综合征缓解后，自身免疫性、炎症性或类固醇反应性疾病会发病或加重，这给区分缓解后的新病症和预期症状带来了挑战。我们描述了一例 42 岁男子在手术治愈库欣综合征 12 个月后被诊断为新发肉样瘤病的病例，并综合了现有文献中有关库欣综合征缓解后新发病症的报道。方法在 Medline、Epub、Ovid 和 PubMed 上进行了范围界定审查。纳入了详细描述库欣综合征缓解后新发疾病的成年患者的病例报告和系列病例。结果共筛选出 1641 篇文章，对 138 篇全文研究进行了资格评估，并纳入了 43 篇研究，其中确定了 84 个病例（包括我们的病例）。大多数患者为女性（85.7%），中位年龄为 39.5 岁（IQR = 13）。甲状腺疾病是最常见的疾病（48.8%），其次是肉样瘤病（15.5%）。牛皮癣、淋巴细胞性腺功能减退症、特发性颅内高压症、多发性硬化症、类风湿性关节炎、狼疮和血清阴性关节炎的报告病例均超过一例。从库欣症状缓解到确诊为新发疾病的中位时间为 4.1 个月（IQR = 3.75）。其中，59.5%的患者在发病时正在接受皮质类固醇治疗。结论我们的范围界定审查发现了几例库欣综合征缓解后新发疾病的病例。这些病例主要发生在女性患者身上，且多发生在病情缓解后的一年内。临床医生应始终意识到，新出现的症状，尤其是在库欣综合征治疗后的第一年内，可能是肾上腺功能不全或糖皮质激素戒断综合征以外的多种疾病的表现。

{"title":"Emergence of De Novo Conditions Following Remission of Cushing Syndrome: A Case Report and Scoping Review","authors":"Noémie Desgagnés, Laura Senior, Daniel Vis, Katayoun Alikhani, Kirstie Lithgow","doi":"10.1002/edm2.476","DOIUrl":"https://doi.org/10.1002/edm2.476","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Onset and exacerbation of autoimmune, inflammatory or steroid-responsive conditions have been reported following the remission of Cushing syndrome, leading to challenges in distinguishing a new condition versus expected symptomatology following remission. We describe a case of a 42-year-old man presenting with new-onset sarcoidosis diagnosed 12 months following the surgical cure of Cushing syndrome and synthesise existing literature reporting on de novo conditions presenting after Cushing syndrome remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted in Medline, Epub, Ovid and PubMed. Case reports and case series detailing adult patients presenting with new-onset conditions following Cushing syndrome remission were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 1641 articles were screened, 138 full-text studies were assessed for eligibility, and 43 studies were included, of which 84 cases (including our case) were identified. Most patients were female (85.7%), and the median reported age was 39.5 years old (IQR = 13). Thyroid diseases were the most commonly reported conditions (48.8%), followed by sarcoidosis (15.5%). Psoriasis, lymphocytic hypophysitis, idiopathic intracranial hypertension, multiple sclerosis, rheumatoid arthritis, lupus and seronegative arthritis were reported in more than one case. The median duration between Cushing remission and de novo condition diagnosis was 4.1 months (IQR = 3.75). Of those patients, 59.5% were receiving corticosteroid therapy at the time of onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our scoping review identified several cases of de novo conditions emerging following the remission of Cushing syndrome. They occurred mostly in women and within the year following remission. Clinicians should remain aware that new symptoms, particularly in the first year following the treatment of Cushing syndrome, may be manifestations of a wide range of conditions aside from adrenal insufficiency or glucocorticoid withdrawal syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140541183","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

Association of Three Novel Inflammatory Markers: Lymphocyte to HDL-C Ratio, High-Sensitivity C-Reactive Protein to HDL-C Ratio and High-Sensitivity C-Reactive Protein to Lymphocyte Ratio With Metabolic Syndrome 三种新型炎症标记物的关系淋巴细胞与高密度脂蛋白胆固醇比率、高敏 C 反应蛋白与高密度脂蛋白胆固醇比率和高敏 C 反应蛋白与淋巴细胞比率与代谢综合征的关系

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-04-08 DOI: 10.1002/edm2.479

Rana Kolahi Ahari, Nazanin Akbari, Negin Babaeepoor, Zahra Fallahi, Sara Saffar Soflaei, Gordon Ferns, Mahmoud Ebrahimi, Mohsen Moohebati, Habibollah Esmaily, Majid Ghayour-Mobarhan

Objective

We aimed to compare the association of three novel inflammatory indicators with metabolic syndrome (MetS) among Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort participants.

Methods

According to the International Diabetes Federation (IDF) criteria, the cohort participants were divided into the MetS(+) and MetS(−) groups. The lymphocyte to high-density lipoprotein cholesterol (HDL-C) ratio (LHR), high-sensitivity C-reactive protein (hs-CRP) to HDL-C ratio (HCHR) and hs-CRP to lymphocyte ratio (HCLR) were calculated and were compared between the groups. Binary logistic regression (LR) analysis was performed to find the association of the indices with the presence of MetS among men and women. Receiver-operating characteristic (ROC) curve analysis was used to establish cut-off values in predicting MetS for men and women. p-Values <0.05 were considered as statistically significant.

Results

Among a total of 8890 participants (5500 MetS(−) and 3390 MetS(+)), LHR, HCHR and HCLR were significantly higher in the MetS(+) group than in MetS(−) group (p < 0.001). In LR analysis, after adjusting for multiple cofounders, LHR remained an independent factor for the presence of MetS among men (OR: 1.254; 95% CI: 1.202–1.308; p < 0.001) and women (OR: 1.393; 95% CI: 1.340–1.448; p < 0.001). HCHR also remained an independent factor for the presence of MetS only in women (OR: 1.058; 95% CI: 1.043–1.073; p < 0.001). ROC curve analysis showed that LHR had the higher AUC for predicting MetS in both men (AUC: 0.627; 95% CI: 0.611–0.643; p < 0.001) and women (AUC: 0.683; 95% CI: 0.670, 0.696; p < 0.001).

Conclusion

This suggests that among both genders, the LHR as an inexpensive and easy-to-access marker has a better diagnostic performance and could be a promising alternative to the traditional expensive inflammatory markers such as hs-CRP for the evaluation of inflammation in patients with MetS.

目的我们旨在比较马什哈德中风和心脏动脉粥样硬化紊乱队列（MASHAD）参与者中三种新型炎症指标与代谢综合征（MetS）的关联。方法根据国际糖尿病联盟（IDF）的标准，将队列参与者分为 MetS（+）组和 MetS（-）组。计算淋巴细胞与高密度脂蛋白胆固醇（HDL-C）的比值（LHR）、高敏C反应蛋白（hs-CRP）与HDL-C的比值（HCHR）和hs-CRP与淋巴细胞的比值（HCLR），并进行组间比较。通过二元逻辑回归（LR）分析，找出这些指标与男性和女性 MetS 存在的关联。采用接收者工作特征曲线（ROC）分析来确定预测男性和女性 MetS 的临界值。结果在 8890 名参与者（5500 名 MetS(-)和 3390 名 MetS(+)）中，MetS(+)组的 LHR、HCHR 和 HCLR 显著高于 MetS(-) 组（p <0.001）。在 LR 分析中，在调整了多个共因子后，LHR 仍然是男性（OR：1.254；95% CI：1.202-1.308；p <；0.001）和女性（OR：1.393；95% CI：1.340-1.448；p <；0.001）出现 MetS 的独立因素。HCHR 也仍然是仅女性出现 MetS 的独立因素（OR：1.058；95% CI：1.043-1.073；p <；0.001）。ROC 曲线分析显示，LHR 在男性（AUC：0.627；95% CI：0.611-0.643；p <；0.001）和女性（AUC：0.683；95% CI：0.670, 0.696；p <；0.001）中预测 MetS 的 AUC 较高。结论这表明，在男女两性中，LHR 作为一种廉价且易于获取的标记物，具有更好的诊断性能，可替代传统的昂贵炎症标记物（如 hs-CRP），用于评估 MetS 患者的炎症情况。

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引用次数: 0

Efficacy of a Comprehensive Weight Reduction Intervention in Male Adolescents With Different FTO Genotypes 对不同 FTO 基因型的男性青少年进行综合减重干预的效果。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-31 DOI: 10.1002/edm2.483

Zahra Roumi, Zahra Salimi, Zahra Mahmoudi, Khadijeh Abbasi Mobarakeh, Maryam Ladaninezhad, Mobina Zeinalabedini, Mohammad Keshavarz Mohammadian, Ali Shamsi-Goushki, Zahra Saeedirad, Bojlul Bahar, Sara Khoshdooz, Naser Kalantari, Ghasem Azizi Tabesh, Saeid Doaei, Maryam Gholamalizadeh

Background

The FTO gene polymorphisms may influence the effects of lifestyle interventions on obesity. The present study aimed to assess the influence of the rs9930506 FTO gene polymorphism on the success of a comprehensive weight loss intervention in male adolescents with overweight and obesity.

Methods

This study was carried out on 96 adolescent boys with overweight and obesity who were randomly assigned to the intervention (n = 53) and control (n = 43) groups. The blood samples of the participants were collected, and the FTO gene was genotyped for the rs9930506 polymorphism. A comprehensive lifestyle intervention including changes in diet and physical activity was performed for 8 weeks in the intervention group.

Results

Following the lifestyle intervention, BMI and fat mass decreased significantly in the intervention group compared with the control group (both p < 0.05), while no change was found in weight, height or body muscle percentage between the groups. The participants in the intervention group with the AA/AG genotype and not in carriers of the GG genotype had a significantly higher reduction in BMI (−1.21 vs. 1.87 kg/m², F = 4.07, p < 0.05) compared with the control group.

Conclusion

The intervention in individuals with the AA/AG genotype has been significantly effective in weight loss compared with the control group. The intervention had no association effect on anthropometric indices in adolescents with the GG genotype of the FTO rs9930506 polymorphism.

Trial Registration

Name of the registry: National Nutrition and Food Technology Research Institute; Trial registration number: IRCT2016020925699N2; Date of registration: 24/04/2016; URL of trial registry record: https://www.irct.ir/trial/21447

背景：FTO基因多态性可能会影响生活方式干预对肥胖的影响。本研究旨在评估 rs9930506 FTO 基因多态性对超重和肥胖男性青少年综合减肥干预成功与否的影响：研究对象为96名超重和肥胖的青少年，他们被随机分配到干预组（53人）和对照组（43人）。研究人员采集了参与者的血液样本，并对 FTO 基因的 rs9930506 多态性进行了基因分型。干预组进行了为期 8 周的全面生活方式干预，包括改变饮食和体育锻炼：结果：生活方式干预后，与对照组相比，干预组的体重指数（BMI）和脂肪量均显著下降（均为 p 2，F = 4.07，p 结论：AA/FTO 基因携带者的干预效果显著：与对照组相比，对 AA/AG 基因型个体的干预在减轻体重方面效果显著。干预对 FTO rs9930506 多态性 GG 基因型青少年的人体测量指数没有影响：试验登记：登记处名称：国家营养与食品技术研究所；试验登记号：IRCT2016020925699N2；登记日期：2016年4月24日；试验登记记录网址：https://www.irct.ir/trial/21447。

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引用次数: 0

Stevioside Ameliorates Palmitic Acid–Induced Abnormal Glucose Uptake via the PDK4/AMPK/TBC1D1 Pathway in C2C12 Myotubes 甜菊糖苷通过 PDK4/AMPK/TBC1D1 通路改善 C2C12 肌细胞中棕榈酸诱导的葡萄糖摄取异常。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-03-31 DOI: 10.1002/edm2.482

Changfa Zhang, Shuai Li, Likang Li, Ruoting Wang, Shiming Luo, Guowei Li

Background

Stevioside (SV) with minimal calories is widely used as a natural sweetener in beverages due to its high sweetness and safety. However, the effects of SV on glucose uptake and the pyruvate dehydrogenase kinase isoenzyme (PDK4) as an important protein in the regulation of glucose metabolism, remain largely unexplored. In this study, we used C2C12 skeletal muscle cells that was induced by palmitic acid (PA) to assess the effects and mechanisms of SV on glucose uptake and PDK4.

Methods

The glucose uptake of C2C12 cells was determined by 2-NBDG; expression of the Pdk4 gene was measured by quantitative real-time PCR; and expression of the proteins PDK4, p-AMPK, TBC1D1 and GLUT4 was assessed by Western blotting.

Results

In PA-induced C2C12 myotubes, SV could significantly promote cellular glucose uptake by decreasing PDK4 levels and increasing p-AMPK and TBC1D1 levels. SV could promote the translocation of GLUT4 from the cytoplasm to the cell membrane in cells. Moreover, in Pdk4-overexpressing C2C12 myotubes, SV decreased the level of PDK4 and increased the levels of p-AMPK and TBC1D1.

Conclusion

SV was found to ameliorate PA-induced abnormal glucose uptake via the PDK4/AMPK/TBC1D1 pathway in C2C12 myotubes. Although these results warranted further investigation for validation, they may provide some evidence of SV as a safe natural sweetener for its use in sugar-free beverages to prevent and control T2DM.

背景：甜菊糖苷（SV）热量极低，因其甜度高且安全，被广泛用作饮料中的天然甜味剂。然而，SV 对葡萄糖摄取的影响以及丙酮酸脱氢酶激酶同工酶（PDK4）作为调节葡萄糖代谢的重要蛋白，在很大程度上仍未得到研究。本研究利用棕榈酸（PA）诱导的 C2C12 骨骼肌细胞评估 SV 对葡萄糖摄取和 PDK4 的影响和机制：方法：用2-NBDG测定C2C12细胞的葡萄糖摄取量；用实时定量PCR检测Pdk4基因的表达；用Western印迹法评估PDK4、p-AMPK、TBC1D1和GLUT4蛋白的表达：结果：在 PA 诱导的 C2C12 肌管中，SV 可通过降低 PDK4 水平、提高 p-AMPK 和 TBC1D1 水平来显著促进细胞的葡萄糖摄取。SV 能促进细胞中 GLUT4 从细胞质向细胞膜的转位。此外，在Pdk4过表达的C2C12肌管中，SV降低了PDK4的水平，提高了p-AMPK和TBC1D1的水平：结论：研究发现SV可通过PDK4/AMPK/TBC1D1途径改善PA诱导的C2C12肌细胞葡萄糖摄取异常。尽管这些结果还需要进一步研究验证，但它们可能提供了一些证据，证明 SV 是一种安全的天然甜味剂，可用于无糖饮料以预防和控制 T2DM。

{"title":"Stevioside Ameliorates Palmitic Acid–Induced Abnormal Glucose Uptake via the PDK4/AMPK/TBC1D1 Pathway in C2C12 Myotubes","authors":"Changfa Zhang, Shuai Li, Likang Li, Ruoting Wang, Shiming Luo, Guowei Li","doi":"10.1002/edm2.482","DOIUrl":"10.1002/edm2.482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stevioside (SV) with minimal calories is widely used as a natural sweetener in beverages due to its high sweetness and safety. However, the effects of SV on glucose uptake and the pyruvate dehydrogenase kinase isoenzyme (PDK4) as an important protein in the regulation of glucose metabolism, remain largely unexplored. In this study, we used C2C12 skeletal muscle cells that was induced by palmitic acid (PA) to assess the effects and mechanisms of SV on glucose uptake and PDK4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The glucose uptake of C2C12 cells was determined by 2-NBDG; expression of the <i>Pdk4</i> gene was measured by quantitative real-time PCR; and expression of the proteins PDK4, p-AMPK, TBC1D1 and GLUT4 was assessed by Western blotting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In PA-induced C2C12 myotubes, SV could significantly promote cellular glucose uptake by decreasing PDK4 levels and increasing p-AMPK and TBC1D1 levels. SV could promote the translocation of GLUT4 from the cytoplasm to the cell membrane in cells. Moreover, in <i>Pdk4</i>-overexpressing C2C12 myotubes, SV decreased the level of PDK4 and increased the levels of p-AMPK and TBC1D1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SV was found to ameliorate PA-induced abnormal glucose uptake via the PDK4/AMPK/TBC1D1 pathway in C2C12 myotubes. Although these results warranted further investigation for validation, they may provide some evidence of SV as a safe natural sweetener for its use in sugar-free beverages to prevent and control T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332153","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}

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