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Increased incidence of pediatric type 1 diabetes during the pandemic in Biscay, Spain 西班牙比斯开大流行期间小儿 1 型糖尿病发病率增加。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.endien.2024.09.002
Concepción Fernández-Ramos , Eunate Arana-Arri , Amaia Vela , Inés Urrutia , Borja Santos Zorrozua , Itxaso Rica

Objective

To update the incidence rate (IR) and trends of type 1 diabetes mellitus (T1DM) in children aged 0–14 years from 2003 to 2022, in Biscay, Spain.

Subjects and method

We used the capture–recapture method: primary cases were prospectively extracted from the hospital registry and a secondary independent data source was obtained from diabetes associations and a public health database. The IRs standardized by age and sex were calculated using the direct method, assuming an equal distribution in each age/sex group. The IR occurring during the various COVID-19 waves was compared with the pre-pandemic IR.

Results

A total of 378 new cases were identified. The mean age at diagnosis was 9.7 years (5.8–11.9). The completeness of ascertainment was 99.1%. The mean annual age-standardized IR was 12.92 (95%CI, 11.35–13.91). The mean IRs for the 0–4, 5–9, and 10–14 age groups were 7.67, 13.41 and 17.83 cases/100,000 children/year, respectively. The IR trend was statistically significant in the entire group and in the 5–9 year-old group with a mean annual increase of 1.9% (95%CI, 0.1–3.8) and 3.3% (95%CI, 1.002–1.065); p = 0.039.
The 5-year period analysis confirmed that the increase was significant only in the last 5 years (20%). When 2020–2022 (pandemic) and 2017–2019 (pre-pandemic) periods were compared this difference goes up to 44.5%; p = 0.029.

Conclusions

After a long period of stability in the IR of T1DM in children younger than 15 years of age in Biscay, Spain, an increase in recent years has been reported, which is consistent with the SARS-CoV2 pandemic, with the largest increase being reported in the 5-to 9-year-old age group.
目的更新西班牙比斯开省 0-14 岁儿童 1 型糖尿病(T1DM)的发病率(IR)和趋势(2003-2022 年):我们采用了捕获-再捕获法:从医院登记簿中前瞻性地提取主要病例,并从糖尿病协会和公共卫生数据库中获取独立的次要数据源。我们采用直接法计算了按年龄和性别标准化的IR,假设每个年龄/性别组的IR分布相同。将 COVID-19 各次波次中出现的 IR 与大流行前的 IR 进行了比较:结果:共发现 378 例新病例。确诊时的平均年龄为 9.7 岁(5.8-11.9 岁)。确诊率为 99.1%。年均年龄标准化 IR 为 12.92(95%CI,11.35-13.91)。0-4岁、5-9岁和10-14岁年龄组的平均IR分别为7.67、13.41和17.83例/100,000名儿童/年。在整个年龄组和 5-9 岁年龄组中,IR 的趋势具有显著的统计学意义,年平均增长率分别为 1.9% (95%CI,0.1-3.8)和 3.3% (95%CI,1.002-1.065);P=0.039。5 年期分析证实,只有在最后 5 年(20%)才有显著增长。如果将 2020-2022 年(大流行)和 2017-2019 年(大流行前)进行比较,这一差异将上升至 44.5%;P=0.029:在西班牙比斯开省,15 岁以下儿童的 T1DM 中位数长期保持稳定,但近年来有报告称这一数字有所上升,这与 SARS-CoV2 大流行是一致的,其中 5-9 岁年龄组的增幅最大。
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引用次数: 0
Clinical significance of pituitary adenoma consistency in patients undergoing endoscopic transsphenoidal surgery 内窥镜经蝶手术患者垂体腺瘤一致性的临床意义。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.endien.2024.09.003
Alberto Acitores Cancela , Víctor Rodríguez Berrocal
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引用次数: 0
Exploring plantar pressure distribution in patients with newly diagnosed diabetes: Implications for foot ulcer prevention in an overweight Mexican population 探索新诊断糖尿病患者的足底压力分布:对墨西哥超重人群足部溃疡预防的启示
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.endien.2024.09.007
Francis Rojas-Torres , Héctor Infanzón-Talango , Ana Cristina García-Ulloa , Sergio Hernández-Jiménez , Gerardo Rodríguez-Reyes

Introduction

Elevated plantar pressure (PP) constitutes a risk factor for developing foot ulcers. Once present, elevated PP increases morbidity and mortality in patients with diabetes. Given the high prevalence of overweight and obesity in the Mexican population, this study aimed to describe the magnitudes and the distribution of the PP observed in a sample of newly diagnosed patients with diabetes, adjusting for body mass index (BMI) groups (normal weight, overweight, grade I obesity, and grade II and III obesity).

Materials and methods

A total of 250 volunteers attending a comprehensive care program for the management of type 2 diabetes received foot assessments that included vascular and neurological evaluation, the identification of musculoskeletal changes, and measurements of PP.

Results

Diabetic neuropathy and peripheral arterial disease were present in 21.6% and 11.2% of all participants. Musculoskeletal alterations were present in 70.8% of participants. A positive and significant correlation (p < 0.001) was observed between BMI and the peak PP of all anatomical regions assessed. After adjusting for BMI, significant differences (p < 0.001) were seen between groups. The metatarsal region, particularly under the third metatarsal head, denoted the highest magnitudes across all BMI.

Conclusions

Periodic PP assessment is recommended to identify the distribution of high-pressure points along the plantar surface. However, as a preventive measure, it is suggested to encourage patients with diabetes and overweight or obesity to wear appropriate footwear and pressure-relief insoles to relieve high-pressure areas – often seen in these populations – to help prevent foot complications.
导言:足底压力(PP)升高是导致足部溃疡的一个危险因素。足底压力一旦升高,就会增加糖尿病患者的发病率和死亡率。鉴于墨西哥人口中超重和肥胖的发病率很高,本研究旨在描述在新诊断的糖尿病患者样本中观察到的足底压力的大小和分布情况,并根据体重指数(BMI)分组(正常体重、超重、I 级肥胖、II 级和 III 级肥胖)进行调整:共有 250 名志愿者参加了 2 型糖尿病综合治疗项目,他们接受了足部评估,包括血管和神经评估、肌肉骨骼变化鉴定以及 PP 测量:在所有参与者中,分别有 21.6% 和 11.2% 的人患有糖尿病神经病变和外周动脉疾病。70.8%的参与者存在肌肉骨骼变化。两者之间存在明显的正相关(p结论:建议定期进行 PP 评估,以确定足底高压点的分布情况。不过,作为一项预防措施,建议鼓励糖尿病、超重或肥胖症患者穿着合适的鞋袜和减压鞋垫,以缓解这些人群中经常出现的高压区,从而帮助预防足部并发症。
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引用次数: 0
Executive summary of the Spanish consensus for the diagnosis, management, and follow-up of primary hyperaldosteronism 西班牙原发性醛固酮增多症诊断、管理和随访共识执行摘要。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.endien.2024.09.005
Marta Araujo-Castro , Paola Parra Ramírez , Felicia A. Hanzu , On behalf the following medical Spanish societies: SEEN, SEC, SEN, SEMI, SERAM, SERVEI, SEQC(ML), AEC
Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension (HTN) and is associated with a higher cardiometabolic risk than essential HTN. Nevertheless, PH remains clearly underdiagnosed. An early diagnosis and adequate treatment of this disease are essential to reduce the cardiometabolic morbimortality associated with aldosterone excess. PH follow-up is equally essential; however, there is little consensus on how it should be performed, being a topic rarely mentioned by the different clinical practice guidelines. The aim of this executive summary is to summarize the recommendations made in the Spanish consensus of PH for the diagnosis, management, and follow-up of these patients. The Spanish consensus was reached from a multidisciplinary perspective through a nominal group consensus approach by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Cardiology (SEC), the Spanish Society of Nephrology (SEN), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Radiology (SERAM), the Spanish Society of Vascular and Interventional Radiology (SERVEI), the Spanish Society of Laboratory Medicine (SEQC(ML)), the Spanish Society of Anatomic-Pathology (EAP), and the Spanish Association of Surgeons (AEC).
原发性高醛固酮血症(PH)是继发性高血压(HTN)最常见的病因,其心脏代谢风险高于原发性高血压。然而,PH 的诊断率明显偏低。要降低与醛固酮过多相关的心脏代谢死亡率,就必须对该疾病进行早期诊断和适当治疗。PH 的随访也同样重要;然而,对于如何进行随访却鲜有共识,不同的临床实践指南也很少提及这一主题。本摘要旨在总结西班牙 PH 共识中对这些患者的诊断、管理和随访提出的建议。西班牙内科医学会 (SEMI)、西班牙放射学会 (SERAM)、西班牙血管和介入放射学会 (SERVEI)、西班牙检验医学会 (SEQC(ML))、西班牙解剖病理学会 (EAP) 和西班牙外科医生协会 (AEC)。
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引用次数: 0
Integration of big data analytics in the investigation of the relationship between acromegaly and cancer 整合大数据分析,研究肢端肥大症与癌症之间的关系。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1016/j.endien.2024.09.001
Pedro Iglesias , Javier Arias , Guillermo López , Iago Romero , Juan J. Díez

Objective

To evaluate the association between acromegaly and cancer and different types of cancer by using natural language processing systems and big data analytics.

Material and methods

We conducted an observational, retrospective study utilizing data from the electronic health records (EHRs) of Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. Information from the EHRs was extracted using artificial intelligence techniques and analyzed using Savana Manager 4.0 software.

Results

Out of a total of 708,047 registered patients (54.7% females), 544 patients (0.08%; 330 women, 60.7%; mean age at diagnosis 53.0 ± 15.8 yr) were diagnosed with acromegaly. The incidence of cancer was higher in patients with acromegaly vs those without this condition (7.7% vs 3.9%, p < 0.001; OR, 2.047, 95%CI, 1.493–2.804). Male acromegalic patients had a higher prevalence of cancer vs females (57.1% vs 42.9%, p = 0.012). A significantly higher prevalence of colorectal cancer (2.9% vs 1.4%, p = 0.006), bladder cancer (1.1% vs 0.3%, p = 0.005), and lymphoma (1.1% vs 0.3%, p = 0.009) was observed in patients with acromegaly vs those without the condition. Acromegalic men had significantly higher prevalence rates of colorectal cancer (4.7% vs 1.3%, p = 0.001), bladder cancer (2.8% vs 0.4%, p < 0.001), breast cancer (0.9% vs 0.2%, p = 0.042), gastric cancer (0.9% vs 0.1%, p = 0.011), lymphoma (1.4% vs 0.3%, p = 0.037), and liver cancer (0.9% vs 0.1%, p = 0.012) vs non-acromegalic men. On the other hand, acromegalic women showed a higher prevalence of thyroid cancer (1.2% vs 0.4%, p = 0.043) vs non-acromegalic women.

Conclusion

Our study, based on artificial intelligence techniques and analysis of real-world data and information, revealed a significant association between acromegaly and cancer in our hospital population, mainly acromegalic men, with a higher frequency of colorectal cancer, bladder cancer and lymphoma in particular.
目的利用自然语言处理系统和大数据分析评估肢端肥大症与癌症及不同类型癌症之间的关联:我们利用西班牙马德里 Puerta de Hierro Majadahonda 大学医院电子健康记录(EHR)中的数据开展了一项观察性、回顾性研究。研究采用人工智能技术提取电子病历中的信息,并使用 Savana Manager 4.0 软件进行分析:在708047名登记患者(54.7%为女性)中,544名患者(0.08%;330名女性,60.7%;诊断时平均年龄(53.0±15.8)岁)被诊断为肢端肥大症。肢端肥大症患者与非肢端肥大症患者相比,癌症发病率更高(7.7% vs 3.9%,p):我们的研究基于人工智能技术和对现实世界数据与信息的分析,揭示了肢端肥大症与癌症之间的显著关联,在我们医院的人群中,主要是肢端肥大症男性,尤其是结直肠癌、膀胱癌和淋巴瘤的发病率较高。
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引用次数: 0
Impact of the presence and type of cardiovascular disease on the risk of mortality in type 2 diabetic patients: The DIABET-IC trial 心血管疾病的存在和类型对 2 型糖尿病患者死亡风险的影响:DIABET-IC试验
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1016/j.endien.2024.07.001
José Antonio Gimeno Orna , Ana Belén Mañas Martínez , Luis Rodríguez Padial , Manuel Anguita Sánchez , Vivencio Barrios , Javier Muñiz García , Antonio Pérez Pérez , on behalf of DIABET-IC researchers

Introduction

All-cause mortality and cardiovascular mortality (CVM) risk can be very high in adults with type 2 diabetes mellitus (DM2) with previous cardiovascular disease (CVD). Our objective was to determine this risk among the different clinical spectrum of CVD.

Material and methods

The DIABET-IC trial is a multicenter, prospective, observational, and analytical study. Consecutive subjects with DM2 attending our outpatients’ clinics were recruited. Data on clinical features, lab test results, and echocardiographic measures were collected.

Patients were categorized depending on the presence and type of CVD: heart failure (HF), coronary artery disease (CAD), cerebrovascular disease (CVD) and peripheral artery disease (PAD).

All-cause mortality and CVM were the dependent variables analyzed. Mortality rate was expressed as deaths per 1000 patients-year. Cox proportional hazards regressions models were used to establish the mortality risk associated with every type of CVD.

Results

We studied a total of 1246 patients (mean age, 6.3 (SD, 9.9) years; 31.6%, female) with an initial prevalence of CVD of 59.3%. A total of 122 deaths (46 due to CVD) occurred at the 2.6-year follow-up. All-cause and MCV rates associated with the presence of PAD (85.6/1000 and 33.6/1000, respectively) and HF (72.9/1000 and 28.7/1000 respectively) were the most elevated of all.

In multivariate analysis, HF increased all-cause mortality risk (HR, 1.63; CI 95% 1.03–2.58; P = .037) and the risk of CVM (HR, 3.41; 95% CI, 1.68–6.93; P = .001).

Conclusions

Mortality among DM2 patients is highly increased in the presence of HF and PAD. This justifies the screening of these conditions to intensify therapeutic strategies.

导言:既往患有心血管疾病(CVD)的2型糖尿病(DM2)成人全因死亡率和心血管死亡率(CVM)风险很高。我们的目标是确定不同临床范围的心血管疾病患者的这一风险:DIABET-IC试验是一项多中心、前瞻性、观察性和分析性研究。我们招募了在门诊就诊的 DM2 患者。研究收集了临床特征、实验室检查结果和超声心动图测量数据。根据心血管疾病的存在和类型对患者进行分类:心力衰竭(HF)、冠状动脉疾病(CAD)、脑血管疾病(CVD)和外周动脉疾病(PAD)。全因死亡率和 CVM 是分析的因变量。死亡率以每千名患者年死亡数表示。采用 Cox 比例危险度回归模型来确定与每种心血管疾病相关的死亡风险:我们共研究了 1246 名患者(平均年龄为 6.3(SD,9.9)岁;31.6% 为女性),其最初的心血管疾病患病率为 59.3%。在 2.6 年的随访中,共有 122 人死亡(46 人死于心血管疾病)。在所有死亡病例中,全因死亡率和MCV死亡率最高的分别是PAD(85.6/1000)和HF(33.6/1000)(分别为72.9/1000和28.7/1000)。在多变量分析中,高血压增加了全因死亡风险(HR,1.63;CI 95%,1.03-2.58;P=.037)和CVM风险(HR,3.41;95% CI,1.68-6.93;P=.001):结论:DM2 患者如果患有高血压和心内动脉粥样硬化,死亡率会大大增加。结论:如果存在高血压和动脉粥样硬化,DM2 患者的死亡率会大大增加,因此有必要对这些疾病进行筛查,以加强治疗策略。
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引用次数: 0
Gangliocytic paraganglioma: A case report 神经节细胞性副神经节瘤:病例报告。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1016/j.endien.2024.03.023
Álvaro Valverde Márquez , Cristina Robles Lázaro , José Antonio Muñoz León , Ximena Carolina Vivas Vaca , María Teresa Mories Álvarez

Paragangliomas (PGLs) are rare and encapsulated neuroendocrine tumors (NET), located in the adrenal gland or the extra-adrenal paraganglia. Extra-adrenal PGLs may develop a gangliocytic component with ganglion cells which are called gangliocytic paragangliomas (GPs). The most common location is the duodenum, and they appear with digestive symptoms or as an incidental finding.

We described a 43 years old patient, with epigastric pain, nausea and vomiting. The CT-scan reveals a nodular image in the duodenum. An ultrasound-guided FNA was performed and the pathological report revealed neuroendocrine cell groups and neural tissue. Surgery was the chosen treatment. As the patient did not present lymphatic or pancreatic parenchyma invasion, radiotherapy (RT) was not administered.

The management of GPs is not well established and multidisciplinary team approach is recommended to lead to therapeutic options. Surgical resection is still key in the treatment, and adjuvant RT may be considered in cases of lymph node invasion.

副神经节瘤(PGLs)是一种罕见的包裹性神经内分泌肿瘤(NET),位于肾上腺或肾上腺外副神经节。肾上腺外副神经节瘤可能含有神经节细胞,被称为神经节细胞副神经节瘤(GPs)。最常见的部位是十二指肠,它们伴随消化道症状出现,或作为偶然发现。我们描述了一名 43 岁患者的病例,患者伴有上腹痛、恶心和呕吐。CT 扫描显示十二指肠有结节。在超声引导下进行了 FNA 检查,病理报告显示有神经内分泌细胞群和神经组织。选择了手术治疗。由于患者没有淋巴或胰腺实质受侵,因此没有进行放疗(RT)。GPs的治疗方法尚未完全确定,建议采用多学科团队方法来确定治疗方案。手术切除仍是治疗的关键,淋巴结受侵犯时可考虑辅助 RT。
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引用次数: 0
Functional structure of a high resolution thyroid nodule unit. Economic impact and results of its implementation in an Endocrinology department 高分辨率甲状腺结节单元的功能结构。在内分泌科实施该方案的经济影响和结果。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1016/j.endien.2024.04.004
Javier Bodoque Cubas , José Fernández Sáez , Sergio Martínez Hervás , José Vicente Gil Boix , Juan José Salazar González , Raquel María Pallarés Gasulla , Marcella Miret Llauradó , Iñaki Argüelles Jiménez , Santiago Tofé Povedano

Background and objective

The high incidence of nodular thyroid pathology has led to growing concern about the economic impact that this pathology represents on the healthcare system. There are conclusive data about the cost-effectiveness of high-resolution units for nodular thyroid pathology; however, their implementation is not homogeneous in the Endocrinology and Nutrition services of our country. The objective of the present study was to evaluate the economic impact of the implementation of the high-resolution thyroid nodule unit (HRTNU) in our center.

Patients and methods

The present work is a prospective, observational and descriptive study carried out in 1314 patients (82% women, mean age 58 years ds = 11) evaluated at the HRTNU during the period of August 2022–August 2023. Demographic data (age and sex) were analyzed, referral center and consultation type, number of total consultations and neck ultrasound performed, number of fine needle aspiration (FNAB) performed, and cytology results were analyzed.

Results

In the period from August 2022 to August 2023, a total of 1314 patients were evaluated (neck ultrasound and clinical consultation) and a total of 133 FNAB were performed, of which only 2.26% were non-diagnostic. Compared to the percentage of unsatisfactory FNAB from the previous year August 2021–July 2022 of 25%, a mean saving of 9931.43 euros was estimated. 84.47% of the patients evaluated for the first time by the HRTNU were discharged, estimating a mean saving of 133,200 euros.

Conclusions

The implementation of a HRTNU at the Endocrinology and Nutrition departments, coordinated with primary and specialized care, is a cost-effectiveness alternative, as it reduces the number of medical consultations and is accompanied by a higher rate of diagnostic FNAB.

背景和目的:甲状腺结节性病变的高发病率使人们越来越关注这种病变对医疗系统造成的经济影响。关于甲状腺结节病理学高分辨单位的成本效益,已有确凿的数据;然而,在我国的内分泌和营养服务机构中,这些单位的实施情况并不一致。本研究的目的是评估本中心实施甲状腺结节高分辨单位(HRTNU)的经济影响:本研究是一项前瞻性、观察性和描述性研究,在2022年8月至2023年8月期间对1314名接受高分辨甲状腺结节单元评估的患者(82%为女性,平均年龄为58岁,平均年龄为11岁)进行了评估。研究分析了人口统计学数据(年龄和性别)、转诊中心和就诊类型、总就诊次数和颈部超声检查次数、细针穿刺术(FNAB)次数以及细胞学结果:2022年8月至2023年8月期间,共对1314名患者进行了评估(颈部超声检查和临床会诊),共进行了133次细针穿刺(FNAB),其中只有2.26%的患者无法确诊。与前一年(2021 年 8 月至 2022 年 7 月)不合格 FNAB 的 25% 相比,估计平均可节省 9931.43 欧元。在首次接受 HRTNU 评估的患者中,84.47% 的患者已经出院,估计平均可节省 13.32 万欧元:结论:在内分泌科和营养科设立 HRTNU,并与初级和专科护理协调,是一种具有成本效益的选择,因为它减少了就诊次数,同时提高了 FNAB 诊断率。
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引用次数: 0
Effect of oral supplementation with whey protein on muscle mass in adults with type 2 diabetes mellitus: a systematic review of randomized controlled trials 口服乳清蛋白补充剂对成人 2 型糖尿病患者肌肉质量的影响:随机对照试验的系统回顾
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1016/j.endien.2024.07.002
David López-Daza , Natalia López-Ucrós , Cristina Posada-Álvarez , Patricia Savino-Lloreda

Objective

To investigate the overall effect of whey protein supplementation on skeletal muscle mass in adults with type 2 diabetes mellitus (T2DM).

Methods

Systematic review of reports on corporal muscle mass from clinical trials that assessed the use of whey protein supplementation by means of validated techniques in patients with T2DM. PubMed, SCOPUS, Web of Science, LILACS, and SciELO databases were searched up to April 2022. Risk of bias was assessed by the Cochrane Collaboration Risk of Bias tool. We conducted a qualitative synthesis of information.

Results

Four studies (424 participants) that met the selection criteria were identified out of 1,787 records. Of these, 3 studies assessed the total muscle mass using dual-energy X-ray absorptiometry (DXA), and 1 reported changes to the transverse diameter of the vastus lateralis muscle with ultrasound imaging. In the intervention groups, DXA assessments demonstrated an increase in total muscle mass in 3 studies and in the appendicular muscle mass in 2. Changes to the proportion of muscle mass were not seen in the DXA studies and only a discrete difference was seen in the comparative groups studied by ultrasound imaging.

Conclusion

Following the administration of whey protein supplementation in patients with T2DM, a partially positive effect was seen in skeletal muscle mass gain with a moderate certainty of evidence.

方法系统回顾通过有效技术评估 2 型糖尿病(T2DM)患者补充乳清蛋白的临床试验中有关体肌质量的报告。检索了截至 2022 年 4 月的 PubMed、SCOPUS、Web of Science、LILACS 和 SciELO 数据库。偏倚风险由 Cochrane 协作偏倚风险工具进行评估。我们对信息进行了定性综述。结果在 1,787 条记录中确定了四项符合选择标准的研究(424 名参与者)。其中,3 项研究使用双能 X 射线吸收测定法(DXA)评估了总肌肉质量,1 项研究通过超声波成像报告了阔筋膜肌横向直径的变化。在干预组中,3 项研究的 DXA 评估结果显示总肌肉质量增加,2 项研究的阑尾肌肉质量增加。在 DXA 研究中未发现肌肉质量比例的变化,在通过超声波成像研究的比较组中仅发现不连续的差异。
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引用次数: 0
Revolutionizing the management of diabetes: The promise of connected insulin pens and caps 糖尿病管理的革命性变革:联网胰岛素笔和胰岛素帽的前景
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1016/j.endien.2024.04.005
Fernando Gómez-Peralta, Cristina Abreu
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引用次数: 0
期刊
Endocrinologia Diabetes Y Nutricion
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