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Cardiovascular Morbidity in Diabetic Non-Alcoholic Fatty Liver Disease (NAFLD) Using NAFLD Fibrosis Score as an Early Indicator 使用NAFLD纤维化评分作为早期指标的糖尿病非酒精性脂肪性肝病(NAFLD)的心血管发病率
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2020-77679
Priti Shahapure, Shimpa R. Sharma
Objective: Rising prevalence of non-alcoholic fatty liver disease (NAFLD), its high incidence in diabetic patients, and global diabetes prevalence, underline the need to identify comorbidities in these patients impacting their quality of life and mortality.NAFLDis associated with increased risk, prevalence, and complications of cardiovascular diseases in diabetic and non-diabetics alike. The study aimed to establish a relationship between noninvasively assessed cardiovascular morbidity and NAFLD fibrosis score (NFS) in type 2 diabetes mellitus with NAFLD. Material and Methods: After ethical approval, the study was conducted (n=100) on patients <60 years of age, havingtype 2 diabetes mellitus, and no existing cardiovascular disease. All patients underwent anthropological and routine investigations, two-dimension (2D) echocardiography, and ultrasonographic confirmation of fatty liver disease. NAFLD was ascertained based on patient history and investigations. Findings of cardiovascular evaluation on 2D-echocardiography were assessed with reference to the NFS. Results: Median age of participants was 53.5 years. Body mass index (p<0.001), right carotid intima-media thickness (p=0.0124), and left ventricular dysfunction (p=0.0024) showed a significant association with NAFLD. The presence of both left ventricular diastolic dysfunction and significant variation of carotid intima-media thickness among mild, moderate, and severe NFS groups (p=0.0049) was observed. Patients with moderate-severe NFS had 6.38 times more risk of developing cardiovascular morbidities. Conclusion: In patients with type 2 diabetes and NAFLD, the NFS helps to identify those at high risk of cardiovascular disease, and patients needing further investigation. It provides clues on how non-invasive cardiovascular markers can be used in detecting cardiovascular morbidities.
目的:非酒精性脂肪性肝病(NAFLD)患病率的上升,其在糖尿病患者中的高发病率,以及全球糖尿病患病率,强调了确定这些患者影响其生活质量和死亡率的合并症的必要性。NAFLDis与糖尿病和非糖尿病患者心血管疾病的风险、患病率和并发症增加有关。该研究旨在建立无创评估心血管发病率与2型糖尿病合并NAFLD纤维化评分(NFS)之间的关系。材料与方法:经伦理批准,研究对象为年龄<60岁、患有2型糖尿病、无心血管疾病的患者(n=100)。所有患者都进行了人类学和常规调查,二维超声心动图和超声检查,以确认脂肪肝疾病。NAFLD是根据患者病史和调查确定的。参考NFS对2d超声心动图的心血管评价结果进行评估。结果:参与者的中位年龄为53.5岁。体重指数(p<0.001)、右颈动脉内膜-中膜厚度(p=0.0124)和左心室功能障碍(p=0.0024)与NAFLD有显著相关性。在轻度、中度和重度NFS组中均存在左室舒张功能障碍和颈动脉内膜-中膜厚度的显著变化(p=0.0049)。中重度NFS患者发生心血管疾病的风险高出6.38倍。结论:在2型糖尿病合并NAFLD患者中,NFS有助于识别心血管疾病的高危人群和需要进一步调查的患者。它为非侵入性心血管标志物如何用于检测心血管疾病提供了线索。
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引用次数: 0
Development of Hypocalcemia Due to Targeted Therapies 靶向治疗导致的低钙血症的发展
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-70737
A. G. Canpolat, Ş. Canlar, B. I. Aydoğan, S. Güllü, M. Erdoğan
Introduction Due to their inhibitory effect on proliferation, motility, apoptosis, and metastasis, the epidermal growth factor receptor (EGFR) inhibitor erlotinib and vascular endothelial growth factor receptor (VEGF) and EGFR inhibitor vandetanib are viable therapeutic options for the treatment of advanced non-small cell lung carcinoma (NSCLC) and thyroid cancer, respectively (1). NSCLCs and medullary or differentiated thyroid carcinomas (MTC and DTC) may show bone metastasis along with bone pain, elevated serum calcium, or elevated alkaline phosphatase levels. We present the interesting cases of two patients who were diagnosed with NSCLC and MTC with bone metastasis. Both were treated with EGFR inhibitors and presented at our outpatient clinic with hypocalcemia as a result of hypoparathyroidism.
由于表皮生长因子受体(EGFR)抑制剂厄洛替尼、血管内皮生长因子受体(VEGF)和EGFR抑制剂vandetanib具有抑制增殖、运动、细胞凋亡和转移的作用,是治疗晚期非小细胞肺癌(NSCLC)和甲状腺癌的可行治疗选择。(1)。非小细胞肺癌和髓样或分化型甲状腺癌(MTC和DTC)可能表现为骨转移,同时伴有骨痛、血清钙升高或碱性磷酸酶水平升高。我们提出了两例诊断为非小细胞肺癌和MTC伴骨转移的有趣病例。两人均接受EGFR抑制剂治疗,并在我们的门诊就诊时因甲状旁腺功能减退而出现低钙血症。
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引用次数: 1
Granulomatosis Polyangiitis Presented with Diabetes Insipidus 尿崩症并发肉芽肿性多血管炎
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-71445
E. Koca, E. Tarhan, F. Elibol, N. Çınar
Muğla Sıtkı Koçman University Faculty of Medicine, Department of Internal Medicine, Muğla, Turkey *Muğla Sıtkı Koçman University Faculty of Medicine, Department of Rheumatology, Muğla, Turkey **Muğla Sıtkı Koçman University Faculty of Medicine, Department of Radiology, Muğla, Turkey ***Muğla Sıtkı Koçman University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Muğla, Turkey
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引用次数: 1
Frequency of Thyroid Antibodies at the Diagnosis of Subacute Thyroiditis 甲状腺抗体在亚急性甲状腺炎诊断中的频率
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2020-74287
M. Sencar, M. Çalapkulu, D. Sakız, S. Hepşen, P. Akhanlı, İlknur Öztürk Ünsal, E. Çakal
Objective: Although subacute thyroiditis (SAT) is not an autoimmune disease, the presence of antithyroid antibodies has been reported in this disease too. This study aims to determine the frequency of antithyroid antibodies at the time of diagnosis of SAT. Material and Methods: Quantitative measurements of antithyroid peroxidase antibody (anti-TPO), antithyroglobulin antibody (anti-Tg), and thyroid-stimulating hormone (TSH) receptor autoantibodies (TRAb) were made in 76 patients at the diagnosis of SAT. Cytopathological examination and iodine uptake test was performed to exclude Graves’ disease and Hashimoto’s disease in suspected patients. Multiple multinuclear giant cells and granulomatous formations, including epithelioid histiocytes, were the cytological findings employed to support the diagnosis of SAT in suspicious cases. Results: The median erythrocyte sedimentation rate and Creactive protein levels were found to be 49 mL/hour (21-130) and 54 mg/L (8-179), respectively. TSH, free T4, and free T3 levels were determined to be 0.01 mIU/L (0.003-5.2), 1.98 ng/dL (0.78-6.1) and 5.51 ng/L (3.07-14), respectively. During the initial presentation, 88% of the patients were hyperthyroid, and 9% of the patients were euthyroid. Anti-TPO and anti-Tg antibody levels were detected to be above the assay-specific cut-off in 11.8% and 10.5% of SAT patients, respectively, at the time of diagnosis. Elevated TRAb was detected in 6.6% of all SAT patients. The median anti-TPO, anti-Tg, and TRAb levels of antibody-positive patients were 55 IU/mL (381.078), 163 IU/mL (5.5-876), 5 IU/L (1.9-23), respectively. Conclusion: Although uncommon, antibody positivity can also be observed in SAT disease. This study has proved that the previous studies claiming the absence of thyroid antibodies in SAT are flawed. SAT must be considered while assessing the differential diagnosis of Graves’ and Hashimoto’s disease.
目的:虽然亚急性甲状腺炎(SAT)不是一种自身免疫性疾病,但在这种疾病中也有抗甲状腺抗体的报道。本研究旨在确定SAT诊断时抗甲状腺抗体的出现频率。材料与方法:对76例SAT诊断时的抗甲状腺过氧化物酶抗体(anti-TPO)、抗甲状腺球蛋白抗体(anti-Tg)、促甲状腺激素(TSH)受体自身抗体(TRAb)进行定量检测。对可疑患者行细胞病理学检查和碘摄取试验,排除Graves病和桥本病。在可疑病例中,多核巨细胞和肉芽肿形成,包括上皮样组织细胞,是支持SAT诊断的细胞学结果。结果:红细胞沉降率中位数为49 mL/h(21-130),活性蛋白中位数为54 mg/L(8-179)。TSH、游离T4和游离T3水平分别为0.01 mIU/L(0.003-5.2)、1.98 ng/dL(0.78-6.1)和5.51 ng/L(3.07-14)。在最初的表现中,88%的患者甲状腺功能亢进,9%的患者甲状腺功能正常。在诊断时,分别有11.8%和10.5%的SAT患者检测到抗tpo和抗tg抗体水平高于测定特异性临界值。在所有SAT患者中,有6.6%检测到TRAb升高。抗体阳性患者的中位抗tpo、抗tg和TRAb水平分别为55 IU/mL(381.078)、163 IU/mL(5.5-876)、5 IU/L(1.9-23)。结论:虽然不常见,但在SAT疾病中也可观察到抗体阳性。本研究证明了以往关于SAT中甲状腺抗体缺失的研究是有缺陷的。在评估Graves病和桥本病的鉴别诊断时,必须考虑SAT。
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引用次数: 4
Endocrine Effects of Coffee Consumption 饮用咖啡对内分泌的影响
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-71878
Ceyda Dinçer, T. Apaydın, D. Yavuz
Introduction Coffee is one of the most popular beverages consumed worldwide, thereby enhancing its market demand (1). Statistics reveal that the average consumption of coffee ranges from 2-4 cups per day in western societies. Western countries prefer to consume brewed coffee while instant coffee is popular among the North Europeans. Boiled coffee is frequently consumed by the inhabitants of the Balkan area, Ireland, North Africa, and Turkey. Scientists have extracted numerous bioactive compounds, such as chlorogenic acids (CGA), polyphenols, diterpenes, caffeine, and caffeine metabolites (1,2) from this complex beverage. Abstract Caffeine has been found to exert various biological effects including, antiangiogenic, antiproliferative, antimetastatic activity, increased fat oxidation and mobilization of glycogen in muscle, increased lipolysis, and reduction of body fat. The aim of this review is to analyze the endocrine effects of coffee consumption. A systematic literature search was conducted on PubMed and Web of Science databases seeking articles published until May 2019, dealing with coffee consumption and diabetes, osteoporosis, thyroid gland, adrenal, and gonads. The results of the most epidemiologic studies reported that coffee consumption has positive effects on combating type 2 diabetes risk, has no significant effects on bone mineral density levels but fracture risk was shown to be higher in the high coffee consumer group. Coffee intake has no significant effect on thyroid cancer, increases sex hormone binding globulin levels, has no effect on fertility but higher consumption was related to spontaneous abortion. Studies pertaining to coffee consumption and endocrine effects have contrary results. More randomized clinical studies with a long term follow up period are required.
咖啡是世界上最受欢迎的饮料之一,因此增加了它的市场需求(1)。统计数据显示,在西方社会,咖啡的平均消费量在每天2-4杯之间。西方国家更喜欢喝煮好的咖啡,而速溶咖啡在北欧人中很受欢迎。巴尔干地区、爱尔兰、北非和土耳其的居民经常饮用煮咖啡。科学家们已经从这种复杂的饮料中提取了许多生物活性化合物,如绿原酸(CGA)、多酚、二萜、咖啡因和咖啡因代谢物(1,2)。咖啡因具有多种生物效应,包括抗血管生成、抗增殖、抗转移活性、增加脂肪氧化和肌肉中糖原的动员、增加脂肪分解和减少体脂。这篇综述的目的是分析咖啡消费对内分泌的影响。在PubMed和Web of Science数据库上进行了系统的文献检索,寻找截至2019年5月发表的关于咖啡消费与糖尿病、骨质疏松症、甲状腺、肾上腺和性腺的文章。大多数流行病学研究的结果表明,喝咖啡对对抗2型糖尿病风险有积极作用,对骨密度水平没有显著影响,但高咖啡消费群体的骨折风险更高。咖啡摄入对甲状腺癌没有显著影响,增加性激素结合球蛋白水平,对生育能力没有影响,但高摄入量与自然流产有关。有关咖啡消费和内分泌影响的研究得出了相反的结果。需要更多的随机临床研究和长期随访。
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引用次数: 2
The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes 成人2型糖尿病患者共病性抑郁障碍及相关危险因素的筛查
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2020-73401
I. Demirci, C. Haymana, A. Sonmez, A. Bolu, N. Kırnap, O. Demir, C. Meriç, Güven Oysul, A. Aydoğdu, N. Gulcelik, O. Azal
Gülhane Training and Research Hospital, Clinic of Endocrinology and Metabolism, Ankara, TURKEY *Health Sciences University, Gülhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, TURKEY **Gülhane Training and Research Hospital, Clinic of Psychiatry, Ankara, TURKEY ***Başkent University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, TURKEY ****Osmaniye Public Hospital, Clinic of Endocrinology and Metabolism, Osmaniye, TURKEY *****The Ministry of Defense, Directorate General for Military Health Services, Ankara, TURKEY ******Liv Hospital, Clinic of Endocrinology and Metabolism, Ankara, TURKEY Original Article
土耳其安卡拉,土耳其安卡拉,g尔哈涅培训与研究医院,内分泌与代谢诊所**土耳其安卡拉,健康科学大学,g尔哈涅培训与研究医院,精神病学诊所,安卡拉,土耳其***土耳其,安卡拉,ba肯特大学医学院,内分泌与代谢部门,安卡拉,土耳其****Osmaniye公立医院,Osmaniye内分泌与代谢诊所,Osmaniye,土耳其*****国防部,土耳其安卡拉军事卫生服务总局******土耳其安卡拉丽芙医院,内分泌和代谢诊所
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引用次数: 0
Unrecognized Pseudopseudohypoparathyroidism in a Case of Post-Traumatic Brain Injury with Multiple Pituitary Hormone Deficiency: A Rare Coincidence 未被识别的假性甲状旁腺功能低下1例创伤后脑损伤伴多种垂体激素缺乏:罕见的巧合
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-72813
M. Srivastav, Nihit Kharkwal, A. Tiwari, K. Gupta
Introduction Pseudopseudohypoparathyroidism is an inherited disease characterized by a constellation of clinical features collectively termed Albright hereditary osteodystrophy (AHO) but with no evidence of resistance to parathyroid hormone, along with normal levels of calcium and parathyroid hormone. Pseudopseudohypoparathyroidism is a rare clinical entity of autosomal dominant inheritance, which shows phenotypic similarity to pseudohypoparathyroidism. However, the main difference lies in their biochemical profiles. The former disease is characterized by normal serum calcium, phosphorus, vitamin D, and parathyroid hormone (PTH) level, whereas the latter shows features suggestive of PTH resistance. Our patient presented after post blunt trauma of head with diabetes insipidus and short stature. Investigations revealed multiple pituitary hormone deficiency. Further examination was conducted for pseudohypoparathyroidism, keeping in mind short metacarpals, knuckle knuckle dimple dimple sign, and short stature, but normal calcium, phosphorus, vitamin D and PTH value led to the diagnosis of pseudopseudohypoparathyroidism. GNAS mutation analysis is necessary to confirm the diagnosis, which could not be performed in this patient due to the high cost. This case shows that pseudopseudohypoparathyroidism, although a rare disease, should be appropriately investigated in such patients if they present with peculiar skeletal features of pseudohypoparathyroidism.
假性甲状旁腺功能减退症是一种以一系列临床特征为特征的遗传性疾病,统称为奥尔布赖特遗传性骨营养不良(who),但没有证据表明对甲状旁腺激素有耐药性,同时钙和甲状旁腺激素水平正常。假性甲状旁腺功能减退症是一种罕见的常染色体显性遗传疾病,其表型与假性甲状旁腺功能减退症相似。然而,主要的区别在于它们的生化特征。前者的特点是血清钙、磷、维生素D和甲状旁腺激素(PTH)水平正常,而后者表现为甲状旁腺激素抵抗的特征。我们的病人在头部钝性创伤后出现尿崩症和身材矮小。检查显示多发性垂体激素缺乏。进一步检查假性甲状旁腺功能减退,注意掌骨短、指关节窝征、身材矮小,但钙、磷、维生素D、甲状旁腺素值正常,诊断为假性甲状旁腺功能减退。诊断需要GNAS突变分析,但由于费用高,无法对该患者进行分析。本病例表明,假性甲状旁腺功能减退症虽然是一种罕见的疾病,但如果患者表现出假性甲状旁腺功能减退症的特殊骨骼特征,则应适当调查。
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引用次数: 0
Diagnostic and Therapeutic Approaches to Thyroid Nodules in Turkey 土耳其甲状腺结节的诊断和治疗方法
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-71633
B. I. Aydoğan, S. Demirer, Y. Erbil, M. Erdoğan
Objective: This study aimed to evaluate the approaches to thyroid nodules adopted by various specialists and centers in Turkey. Material and Methods: The questionnaire designed by Ralf Paschke for International Thyroid Congress (2010) was provided to 400 (264 general surgeons, 58 endocrine surgeons, and 78 endocrinologists) physicians from Turkey. Education and research hospitals (n=110), state hospitals (n=84), university hospitals (n=122), and private hospitals (n=84) were included. An index case was provided and questions regarding diagnostic and therapeutic/follow-up strategies were asked. Results: The index case was a 35-year-old man presented with swallowing discomfort. His thyroid-stimulating hormone level was 0.5 mIU/L. Thyroid ultrasonography (US) revealed a 13 mm right nodule (RN) and an 18 mm left nodule (LN). The most frequently queried information by physicians about the case was the result of fine needle aspiration biopsy (FNAB) (38.5%) and scintigraphy+FNAB (25.5%). Routine calcitonin measurement was advised by 33.5% of specialists. US and scintigraphy were detailed as; showed intranodular flow, microcalcification in the solid, and normoactive RN and solid hypoechoic, and hypoactive for the LN. FNAB was recommended by 68.5% of specialists for both nodules. Surgery without FNAB was recommended by 9% (n=36) of specialists, mainly by general surgeons (n=32). Specialists from private hospitals recommended surgical management for benign nodules, more frequently than state and university hospitals (p<0.01). Conclusion: Not only invasive and noninvasive diagnostic tests but also the treatment and follow-up strategies varied among general surgeons, endocrine surgeons, and endocrinologists in Turkey. The surgical approach for benign nodules was more frequently preferred in
目的:本研究旨在评估土耳其不同专家和中心采用的甲状腺结节治疗方法。材料与方法:由Ralf Paschke为2010年国际甲状腺大会设计的问卷,提供给来自土耳其的400名医生(264名普通外科医生、58名内分泌外科医生和78名内分泌科医生)。包括教育和研究医院(n=110)、国立医院(n=84)、大学医院(n=122)和私立医院(n=84)。提供了一个索引病例,并询问了有关诊断和治疗/随访策略的问题。结果:主要病例为35岁男性,以吞咽不适为主。促甲状腺激素0.5 mIU/L。甲状腺超声(US)显示一个13毫米的右侧结节(RN)和一个18毫米的左侧结节(LN)。医生最常询问的信息是细针穿刺活检(FNAB)结果(38.5%)和闪烁造影+FNAB(25.5%)。33.5%的专家建议常规降钙素测量。US和scintigraphy详细描述为;显示结节内血流,实腔微钙化,RN正常,实腔低回声,LN低回声。68.5%的专家推荐FNAB治疗这两种结节。9% (n=36)的专家推荐无FNAB手术,主要是普通外科医生(n=32)。私立医院专家推荐手术治疗良性结节的频率高于公立医院和大学医院(p<0.01)。结论:土耳其的普通外科医生、内分泌外科医生和内分泌学家不仅采用侵入性和非侵入性诊断检查,而且治疗和随访策略也各不相同。手术入路治疗良性结节更常见
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引用次数: 1
The Effects of Low-Carbohydrate Diet and Protein-rich Mixed Dieton Insulin Sensitivity, Basal Metabolic Rate and Metabolic Parameters in Obese Patients 低碳水化合物饮食与富蛋白混合饮食对肥胖患者胰岛素敏感性、基础代谢率及代谢参数的影响
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2019-72200
S. Akpulat, N. Kırnap, A. Pfeiffer
206 Objective: Various diet plans with varying ratios of carbohydrates, proteins, and fat ensure weight loss in obesity. The primary aim of our study was to evaluate the effects of weight loss on metabolic parameters, and the secondary aim was to compare the successes of various weight loss regimens in maintaining weight loss. Material and Methods: A team of doctors comprising a dietary consultant and a psychologist developed a program that was followed throughout our study. Twenty-two patients were included in our study. Based on their preference, they were classified into two groups: low carbohydrate diet (Atkins) group and protein-rich mixed diet group. Results: The mean age of the patients was 52.4±3 years, and the mean body mass index (BMI) was 36.1±1.2 kg/m2. Five patients followed the Atkins diet, whereas 17 followed the protein-rich mixed diet. Compared with the baseline values, in the 3rd, 6th, and 12th months, body weight (BW), BMI, and waist circumference decreased significantly (p<0.001) in all the patients. Basal metabolic rate decreased in the third and sixth months but increased in the 12th. Fasting blood glucose, fasting insulin, HbA1c, 120minute blood glucose level in oral glucose tolerance test, total cholesterol, low-density lipoprotein, free fatty acids, and uric acid did not change significantly (p>0.05). In the Atkins group, BMI decreased significantly in the 6th month (p=0.03) but increased in the 12th month (p=0.29). In the protein-rich mixed diet group, BMI (basal 35.1±1.5 kg/m2) decreased significantly (32.8±1.5, p<0.001) in the 6th month, and continued to decrease in the twelfth (31.5±1.2, p=0.007). Conclusion: In obesity, approximately 10% weight loss can change metabolic parameters moderately. The Atkins and protein-rich mixed diets caused similar weight loss ratios in the first six months, but a protein-rich mixed diet was more successful in terms of longterm sustainability and maintenance of weight loss.
206目的:不同碳水化合物、蛋白质和脂肪比例的饮食计划确保肥胖患者体重减轻。我们研究的主要目的是评估减肥对代谢参数的影响,次要目的是比较各种减肥方案在维持体重方面的成功。材料和方法:由一名饮食顾问和一名心理学家组成的一组医生制定了一个计划,在我们的整个研究过程中都遵循了这个计划。我们的研究纳入了22名患者。根据他们的喜好,将他们分为两组:低碳水化合物饮食(阿特金斯)组和富含蛋白质的混合饮食组。结果:患者平均年龄52.4±3岁,平均体重指数(BMI)为36.1±1.2 kg/m2。5名患者采用阿特金斯饮食法,17名采用富含蛋白质的混合饮食法。与基线值相比,在第3、6、12个月时,体重(BW)、BMI、腰围均显著下降(p0.05)。在Atkins组,BMI在第6个月显著下降(p=0.03),但在第12个月上升(p=0.29)。富蛋白混合饮食组BMI(基础35.1±1.5 kg/m2)在第6个月显著下降(32.8±1.5,p<0.001),第12个月继续下降(31.5±1.2,p=0.007)。结论:在肥胖患者中,大约10%的体重减轻可以适度改变代谢参数。阿特金斯饮食法和富含蛋白质的混合饮食法在头六个月的减重率相似,但富含蛋白质的混合饮食法在长期可持续性和维持体重方面更为成功。
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引用次数: 0
Association of Types of Diabetic Macular Edema with Different Anti-Diabetic Therapies 糖尿病黄斑水肿类型与不同抗糖尿病治疗的关系
IF 0.2 Q4 Medicine Pub Date : 2020-01-01 DOI: 10.25179/tjem.2020-74091
L. Singh, Y. Swati, Karoli Ritu, P. Raj
Objective: To evaluate and assess the association of diabetic macular edema with different anti-diabetic therapy regimens. Material and Methods: We recruited 340 patients with prediagnosed Type 2 diabetes mellitus attending the ophthalmology and medicine outpatient department. Patients were older than 30 years with Type 2 diabetes mellitus and on a specific anti-diabetic regimen (monotherapy/combination therapy) for ≥6 months, and who underwent macular edema assessment by using spectral domain optical coherence tomography. The patterns of macular edema per retinal morphology were grouped as diffuse retinal thickening, cystoid macular edema, and serous retinal detachment. Results: No significant association was found between edema pattern and dual therapy regimen (metformin+1 other oral hypoglycemic agent) (p=0.685) in the 680 eyes of the 340 patients. In patients on all the other triple therapy regimens (metformin+2 other oral hypoglycemic agents), diffuse retinal thickening was the most common type, except in patients on thiazolidinediones and insulin in conjunction with metformin in which cystoid macular edema was the most common. However, the difference between different triple therapy regimens was statistically significant (p=0.053). Conclusion: The most common form of macular edema was diffuse retinal thickening irrespective of the type and regimen of anti-diabetic therapy. Increased incidence of cystoid macular edema was observed in patients on triple therapy, including insulin. Because of the difference in the patterns, it is imperative to evaluate patients for different types of edema due to ongoing anti-diabetic treatment.
目的:探讨糖尿病黄斑水肿与不同抗糖尿病治疗方案的关系。材料与方法:我们招募了340例在眼科和内科门诊就诊的2型糖尿病患者。患者年龄大于30岁,患有2型糖尿病,接受特定的抗糖尿病方案(单药/联合治疗)≥6个月,并通过光谱域光学相干断层扫描评估黄斑水肿。黄斑水肿按视网膜形态分为弥漫性视网膜增厚、囊样性黄斑水肿和浆液性视网膜脱离。结果:340例患者680只眼的水肿形态与双药治疗方案(二甲双胍+其他1种口服降糖药)无显著相关性(p=0.685)。在所有其他三联治疗方案(二甲双胍+2种其他口服降糖药)的患者中,弥漫性视网膜增厚是最常见的类型,除了噻唑烷二酮和胰岛素联合二甲双胍的患者中,囊样黄斑水肿最常见。然而,不同三联治疗方案之间的差异有统计学意义(p=0.053)。结论:与糖尿病治疗的类型和方案无关,黄斑水肿最常见的形式是弥漫性视网膜增厚。在接受包括胰岛素在内的三联治疗的患者中,观察到囊样黄斑水肿的发生率增加。由于模式的差异,有必要评估患者因持续的抗糖尿病治疗而出现的不同类型的水肿。
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Turkish Journal of Endocrinology and Metabolism
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