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Cadmium activation of wild-type and constitutively active estrogen receptor alpha 镉激活野生型和组成型活性雌激素受体 alpha
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1380047
John B. Psaltis, Qiaochu Wang, Gai Yan, Reem Gahtani, Nanxi Huang, Bassem R. Haddad, Mary Beth Martin
The estrogen receptor alpha (ERα) plays a central role in the etiology, progression, and treatment of breast cancers. Constitutively activating somatic mutations Y537S and D538G, in the ligand binding domain (LBD) of ESR1, are associated with acquired resistance to endocrine therapies. We have previously shown that the metalloestrogen calcium activates ERα through an interaction with the LBD of the receptor. This study shows that cadmium activates ERα through a mechanism similar to calcium and contributes to, and further increases, the constitutive activity of the ERα mutants Y537S and D538G. Mutational analysis identified C381, N532A, H516A/N519A/E523A, and E542/D545A on the solvent accessible surface of the LBD as possible calcium/metal interaction sites. In contrast to estradiol, which did not increase the activity of the Y537S and D538G mutants, cadmium increased the activity of the constitutive mutants. Mutation of the calcium/metal interaction sites in Y537S and D538G mutants resulted in a significant decrease in constitutive activity and cadmium induced activity. Mutation of calcium/metal interaction sites in wtERα diminished binding of the receptor to the enhancer of estrogen responsive genes and the binding of nuclear receptor coactivator 1 and RNA polymerase II. In contrast to wtERα, mutation of the calcium/metal interaction sites in the Y537S and D538G mutants did not diminish binding to DNA but prevented a stable interaction with the coactivator and polymerase. Growth assays further revealed that calcium channel blockers and chelators significantly decreased the growth of MCF7 cells expressing these constitutively active mutants. Taken together, the results suggest that exposure to cadmium plays a role in the etiology, progression, and response to treatment of breast cancer due, in part, to its ability to activate ERα.
雌激素受体α(ERα)在乳腺癌的病因、发展和治疗中起着核心作用。ESR1配体结合域(LBD)中的Y537S和D538G体细胞突变具有连续激活性,与内分泌疗法的获得性耐药性有关。我们以前曾证明,金属雌激素钙通过与受体 LBD 的相互作用激活 ERα。本研究表明,镉通过与钙类似的机制激活了ERα,并促进和进一步提高了ERα突变体Y537S和D538G的组成活性。突变分析发现,LBD 溶剂可接触表面上的 C381、N532A、H516A/N519A/E523A 和 E542/D545A 可能是钙/金属相互作用位点。雌二醇不会提高 Y537S 和 D538G 突变体的活性,而镉则会提高组成型突变体的活性。Y537S 和 D538G 突变体中钙/金属相互作用位点的突变导致组成型突变体的活性和镉诱导的活性显著降低。wtERα 中钙/金属相互作用位点的突变减少了受体与雌激素反应基因增强子的结合以及与核受体辅激活子 1 和 RNA 聚合酶 II 的结合。与 wtERα 不同的是,Y537S 和 D538G 突变体中钙/金属相互作用位点的突变并没有减少与 DNA 的结合,但却阻止了与辅激活剂和聚合酶的稳定相互作用。生长试验进一步表明,钙通道阻滞剂和螯合剂会显著降低表达这些组成型活性突变体的 MCF7 细胞的生长。综上所述,这些结果表明,接触镉在乳腺癌的病因、发展和治疗反应中起着一定的作用,部分原因是镉能激活ERα。
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引用次数: 0
Genetic associations between gut microbiota and type 2 diabetes mediated by plasma metabolites: a Mendelian randomization study 血浆代谢物介导的肠道微生物群与 2 型糖尿病之间的遗传关系:孟德尔随机研究
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1430675
XuWen Zheng, MaoBing Chen, Zhuang Yi, Liang Zhao, YongJun Qian, Jin Xu, JinNuo Fan
Numerous research studies have indicated a possible association between type 2 diabetes (T2DM) and gut microbiota. To explore specific metabolic pathways connecting gut microbiota and T2DM, we employed Mendelian randomization (MR) and linkage disequilibrium score regression (LDSC) techniques.This research utilized data from genome-wide association studies (GWAS) that are publicly accessible. We evaluated the genetic correlation between gut microbiota and T2DM using LDSC. Causality was primarily determined through the inverse variance weighted (IVW) method. To verify the robustness of our results, we conducted sensitivity analyses using several approaches, including the weighted median, MR-Egger, and MR-PRESSO. We integrated summary effect estimates from LDSC, along with forward and reverse MR, into a meta-analysis for T2DM using various data sources. Additionally, mediation analysis was performed to explore the impact of plasma metabolites on the relationship between gut microbiota and T2DM.Our study indicated a significant genetic correlation between genus RuminococcaceaeUCG005 (Rg = −0.26, Rg_P = 2.07×10−4) and T2DM. Moreover, the forward MR analysis identified genus RuminococcaceaeUCG010 (OR = 0.857, 95% CI 0.795, 0.924; P = 6.33×10−5) and order Clostridiales (OR = 0.936, 95% CI 0.878, 0.997; P = 0.039) as being significantly associated with a decreased risk of T2DM. The analysis also highlighted several plasma metabolites as significant mediators in these relationships, with metabolites like octadecadienedioate (C18:2-DC) and branched chain 14:0 dicarboxylic acid being notably involved.The findings demonstrate a significant impact of gut microbiota on T2DM via plasma metabolites, suggesting potential metabolic pathways for therapeutic targeting. This study enhances our understanding of the microbiota’s role in T2DM pathogenesis and supports the development of microbiota-based interventions.
大量研究表明,2 型糖尿病(T2DM)与肠道微生物群之间可能存在关联。为了探索连接肠道微生物群和 T2DM 的特定代谢途径,我们采用了孟德尔随机化(MR)和连锁不平衡评分回归(LDSC)技术。我们利用 LDSC 评估了肠道微生物群与 T2DM 之间的遗传相关性。因果关系主要通过反方差加权法(IVW)确定。为了验证结果的稳健性,我们采用了多种方法进行了敏感性分析,包括加权中位数、MR-Egger 和 MR-PRESSO。我们将 LDSC 以及正向和反向 MR 的汇总效应估计值整合到使用各种数据源进行的 T2DM 的荟萃分析中。我们的研究表明,RuminococcaceaeUCG005属(Rg = -0.26,Rg_P = 2.07×10-4)与T2DM之间存在显著的遗传相关性。此外,前向磁共振分析发现,反刍球菌属UCG010(OR = 0.857,95% CI 0.795,0.924;P = 6.33×10-5)和梭状芽孢杆菌目(OR = 0.936,95% CI 0.878,0.997;P = 0.039)与 T2DM 风险降低显著相关。研究结果表明,肠道微生物群通过血浆代谢物对 T2DM 有显著影响,这为靶向治疗提供了潜在的代谢途径。这项研究加深了我们对微生物群在 T2DM 发病机制中作用的了解,并为开发基于微生物群的干预措施提供了支持。
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引用次数: 0
The causal relationship between antihypertensive drugs and depression: a Mendelian randomization study of drug targets 降压药与抑郁症的因果关系:药物靶点的孟德尔随机化研究
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1411343
Zixian Yang, Jinshuai Li, Peichu Huang, Zhichang Li, Jianfeng He, Dongchun Cai, Yuzheng Lai
Depression ranks as a leading contributor to the global disease burden. The potential causal relationship between the use of antihypertensive medications and depression has garnered significant interest. Despite extensive investigation, the nature of this relationship remains a subject of ongoing debate. Therefore, this study aims to evaluate the influence of antihypertensive medications on depression by conducting a Mendelian randomization study focused on drug targets.We focused on the targets of five antihypertensive drug categories: ACE Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Calcium Channel Blockers (CCBs), Beta-Blockers (BBs), and Thiazide Diuretics (TDs). We collected single-nucleotide polymorphisms (SNPs) associated with these drug targets from genome-wide association study (GWAS) statistics, using them as proxies for the drugs. Subsequently, we conducted a Mendelian randomization (MR) analysis targeting these drugs to explore their potential impact on depression.Our findings revealed that genetic proxies for Beta-Blockers (BBs) were associated with an elevated risk of depression (OR [95%CI] = 1.027 [1.013, 1.040], p < 0.001). Similarly, genetic proxies for Calcium Channel Blockers (CCBs) were linked to an increased risk of depression (OR [95%CI] = 1.030 [1.009, 1.051], p = 0.006). No significant associations were identified between the genetic markers of other antihypertensive medications and depression risk.The study suggests that genetic proxies associated with Beta-Blockers (BBs) and Calcium Channel Blockers (CCBs) could potentially elevate the risk of depression among patients. These findings underscore the importance of considering genetic predispositions when prescribing these medications, offering a strategic approach to preventing depression in susceptible individuals.
抑郁症是造成全球疾病负担的主要因素之一。使用降压药与抑郁症之间的潜在因果关系引起了人们的极大兴趣。尽管进行了广泛的调查,但这种关系的性质仍是一个争论不休的话题。因此,本研究旨在通过对药物靶点进行孟德尔随机研究,评估降压药物对抑郁症的影响:我们重点研究了五类抗高血压药物的靶点:血管紧张素转换酶抑制剂(ACEIs)、血管紧张素 II 受体拮抗剂(ARBs)、钙通道阻滞剂(CCBs)、β-受体阻滞剂(BBs)和噻嗪类利尿剂(TDs)。我们从全基因组关联研究(GWAS)统计数据中收集了与这些药物靶点相关的单核苷酸多态性(SNPs),并将其作为药物的替代物。随后,我们针对这些药物进行了孟德尔随机化(MR)分析,以探讨它们对抑郁症的潜在影响。我们的研究结果表明,β-受体阻滞剂(BBs)的基因替代物与抑郁症风险升高有关(OR [95%CI] = 1.027 [1.013, 1.040],p < 0.001)。同样,钙通道阻滞剂(CCB)的基因替代物也与抑郁风险升高有关(OR [95%CI] = 1.030 [1.009, 1.051],p = 0.006)。该研究表明,与β受体阻滞剂(BBs)和钙通道阻滞剂(CCBs)相关的基因代用品可能会增加患者患抑郁症的风险。这些发现强调了在处方这些药物时考虑遗传倾向的重要性,为易感人群预防抑郁症提供了一种战略性方法。
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引用次数: 0
Editorial: Preventing cardiovascular complications of type 2 diabetes 社论:预防 2 型糖尿病的心血管并发症
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1473603
M. D. Baldassarre, Teresa Paolucci, Kyoungmin Park, Caterina Pipino
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引用次数: 0
T1 mapping combined with arterial spin labeling MRI to identify renal injury in patients with liver cirrhosis 结合动脉自旋标记磁共振成像的 T1 图谱识别肝硬化患者的肾损伤
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1363797
Shuangshuang Xie, Mengyao Chen, Chiyi Chen, Yumeng Zhao, Jiaming Qin, Caixin Qiu, Jinxia Zhu, M. Nickel, Bernd Kuehn, Wen Shen
We investigated the capability and imaging criteria of T1 mapping and arterial spin labeling (ASL) MRI to identify renal injury in patients with liver cirrhosis.We recruited 27 patients with cirrhosis and normal renal function (cirrhosis-NR), 10 with cirrhosis and renal dysfunction (cirrhosis-RD) and 23 normal controls (NCs). All participants were examined via renal T1 mapping and ASL imaging. Renal blood flow (RBF) derived from ASL was measured from the renal cortex, and T1 values were measured from the renal parenchyma (cortex and medulla). MRI parameters were compared between groups. Diagnostic performances for detecting renal impairment were statistically analyzed.Cortical T1 (cT1) and medullary T1 (mT1) were significantly lower in the NCs than in the cirrhosis-NR group. The cortical RBF showed no significant changes between the NCs and cirrhosis-NR group but was markedly decreased in the cirrhosis-RD group. The areas under the curve (AUCs) for discriminating cirrhosis-NR from NCs were 0.883 and 0.826 by cT1 and mT1, respectively. Cortical RBF identified cirrhosis-RD with AUC of 0.978, and correlated with serum creatinine (r = −0.334) and the estimated glomerular filtration rate (r = 0.483). A classification and regression tree based on cortical RBF and cT1 achieved 85% accuracy in detecting renal impairment in the cirrhosis.Renal T1 values might be sensitive predictors of early renal impairment in patients with cirrhosis-NR. RBF enabled quantifying renal perfusion impairment in patients with cirrhosis-RD. The diagnostic algorithm based on cortical RBF and T1 values allowed detecting renal injury during cirrhosis.
我们招募了27名肝硬化且肾功能正常的患者(肝硬化-NR)、10名肝硬化且肾功能异常的患者(肝硬化-RD)和23名正常对照组(NCs)。所有参与者都接受了肾脏 T1 图谱和 ASL 成像检查。由 ASL 导出的肾血流 (RBF) 是通过肾皮质测量的,而 T1 值则是通过肾实质(皮质和髓质)测量的。各组之间的磁共振成像参数进行了比较。NC组的皮质T1(cT1)和髓质T1(mT1)明显低于肝硬化-NR组。皮质 RBF 在 NCs 和肝硬化-NR 组之间无明显变化,但在肝硬化-RD 组明显下降。用cT1和mT1区分肝硬化-NR和NC的曲线下面积(AUC)分别为0.883和0.826。皮质 RBF 识别肝硬化-RD 的 AUC 为 0.978,并与血清肌酐(r = -0.334)和估计肾小球滤过率(r = 0.483)相关。基于皮质 RBF 和 cT1 的分类和回归树在检测肝硬化肾功能损害方面的准确率达到了 85%。RBF可以量化肝硬化-RD患者的肾脏灌注损伤。基于皮质RBF和T1值的诊断算法可以检测肝硬化期间的肾损伤。
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引用次数: 0
Adjunctive benefits of low-frequency transcutaneous electrical nerve stimulation for obesity frequent chronic conditions: a systematic review 低频经皮神经电刺激对肥胖症常见慢性病的辅助疗效:系统性综述
Pub Date : 2024-08-09 DOI: 10.3389/fendo.2024.1424771
An Yu, Xiang Li, Wei Zhang, Yazhou Zhang, Xi Chen, Liuyan Wang, Mei Xie, Lei Yang
Obesity is widely recognized for its role in predisposing individuals to a spectrum of chronic health conditions. Emerging preliminary evidence points to the potential benefits of low-frequency transcutaneous electrical nerve stimulation (Lo-TENS) in enhancing various health outcomes among those with obesity and associated disorders.This systematic review was designed to assess the effectiveness of Lo-TENS for managing obesity and its related chronic diseases.For this systematic review, we included randomized controlled trials that evaluated the impact of Lo-TENS on individuals with obesity and its associated chronic diseases.Eight trials encompassing 671 participants and spanning three unique populations: essential hypertension (EH), type 2 diabetes mellitus (T2DM), and obesity were deemed eligible for inclusion in this review. Compared to baseline measurements, Lo-TENS demonstrated a tendency to positively affect blood pressure in individuals with EH and metabolic parameters in those with T2DM. Nonetheless, the efficacy of Lo-TENS in treating obesity is not yet clear when contrasted with a no-intervention control group. When compared with other intervention modalities, three of the trials reported less favorable results.Although Lo-TENS did not consistently surpass other treatments or yield substantial improvements, it generally provided greater benefits than the majority of placebo controls. This suggests that Lo-TENS could potentially serve as a beneficial adjunctive therapy in the management of obesity and its associated conditions. However, given the limited number of trials assessed, the elevated risk of bias within these studies, and the scarce evidence currently available, it is too early to reach definitive conclusions. Caution should be exercised when interpreting the current findings. There is an imperative for further high-quality research to thoroughly investigate and substantiate the efficacy of Lo-TENS in relation to obesity and its related disorders.
肥胖症因其易导致一系列慢性健康问题而广为人知。新出现的初步证据表明,低频经皮神经电刺激(Lo-TENS)在改善肥胖症患者及相关疾病患者的各种健康状况方面具有潜在的益处。在本次系统性综述中,我们纳入了评估 Lo-TENS 对肥胖症及其相关慢性疾病患者的影响的随机对照试验。八项试验共有 671 名参与者,涉及三个独特的人群:原发性高血压 (EH)、2 型糖尿病 (T2DM) 和肥胖症。与基线测量值相比,Lo-TENS 显示出对 EH 患者的血压和 T2DM 患者的代谢参数产生积极影响的趋势。然而,与无干预对照组相比,Lo-TENS 在治疗肥胖症方面的疗效尚不明确。虽然 Lo-TENS 并未持续超越其他治疗方法或产生实质性改善,但它通常比大多数安慰剂对照组带来更大的益处。这表明,Lo-TENS 有可能成为治疗肥胖症及其相关疾病的一种有益的辅助疗法。然而,由于评估的试验数量有限,这些研究的偏倚风险较高,而且目前可用的证据较少,因此现在下定论还为时过早。在解释目前的研究结果时应谨慎行事。当务之急是进一步开展高质量的研究,彻底调查和证实 Lo-TENS 对肥胖及其相关疾病的疗效。
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引用次数: 0
Causal relationship between gut microbiota and thyroid nodules: a bidirectional two-sample Mendelian randomization study 肠道微生物群与甲状腺结节的因果关系:双向双样本孟德尔随机研究
Pub Date : 2024-08-08 DOI: 10.3389/fendo.2024.1417009
Shaoshuai Yan, Jiawei He, Xudong Yu, Jianwei Shang, Yaosheng Zhang, Han Bai, Xingyu Zhu, Xiaoming Xie, Leanne Lee
Emerging evidence suggests alterations in gut microbiota (GM) composition following thyroid nodules (TNs) development, yet the causal relationship remains unclear. Utilizing Mendelian Randomization (MR), this study aims to elucidate the causal dynamics between GM and TNs.Employing summary statistics from the MiBioGen consortium (n=18,340) and FinnGen consortium (1,634 TNs cases, 263,704 controls), we conducted univariable and multivariable MR analyses to explore the GM-TNs association. Techniques including inverse variance weighted, MR-Egger regression, weighted median, and MR-PRESSO were utilized for causal inference. Instrumental variable heterogeneity was assessed through Cochran’s Q statistic and leave-one-out analysis. Reverse MR was applied for taxa showing significant forward MR associations, with multivariate adjustments for confounders.Our findings suggest that certain microbiota, identified as Ruminococcaceae_NK4A214_group (OR, 1.89; 95%CI, 0.47-7.64; p = 0.040), Senegalimassilia (OR, 1.72; 95%CI, 1.03-2.87; p =0.037), Lachnospiraceae (OR,0.64; 95%CI,0.41-0.99; p =0.045), exhibit a protective influence against TNs’ development, indicated by negative causal associations. In contrast, microbiota categorized as Desulfovibrionales (OR, 0.63; 95%CI, 0.41-0.95; p =0.028), Prevotella_7 (OR, 0.79; 95%CI, 0.63-1.00; p =0.049), Faecalibacterium (OR, 0.66; 95%CI, 0.44-1.00; p =0.050), Desulfovibrionaceae (OR, 0.55; 95%CI, 0.35-0.86; p =0.008), Deltaproteobacteria (OR, 0.65; 95%CI, 0.43-0.97; p =0.036) are have a positive correlation with with TNs, suggesting they may serve as risk factors. Reverse MR analyses did not establish significant causal links. After comprehensive adjustment for confounders, taxa Desulfovibrionales (Order), Desulfovibrionaceae (Family), Deltaproteobacteria (Class) remain implicated as potential contributors to TNs’ risk.This study substantiates a significant causal link between GM composition and TNs development, underscoring the thyroid-gut axis’s relevance. The findings advocate for the integration of GM profiles in TNs’ prevention and management, offering a foundation for future research in this domain.
新的证据表明,甲状腺结节(TNs)发生后,肠道微生物群(GM)的组成会发生改变,但其中的因果关系仍不清楚。本研究利用孟德尔随机化(Mendelian Randomization,MR)技术,旨在阐明GM与TNs之间的因果动态关系。我们利用MiBioGen联盟(n=18,340)和FinnGen联盟(1,634例TNs病例,263,704例对照)的汇总统计数据,进行了单变量和多变量MR分析,以探讨GM与TNs之间的关联。在因果推断中采用了反方差加权、MR-Egger 回归、加权中位数和 MR-PRESSO 等技术。通过 Cochran's Q 统计量和遗漏分析评估了工具变量异质性。我们的研究结果表明,某些微生物群,如 Ruminococcaceae_NK4A214_group (OR,1.89;95%CI,0.47-7.64;p = 0.040)、Senegalimassilia(OR,1.72;95%CI,1.03-2.87;p = 0.037)、Lachnospiraceae(OR,0.64;95%CI,0.41-0.99;p = 0.045)等微生物群对 TNs 的发生具有保护作用,表现为负因果关系。相比之下,被归类为Desulfovibrionales(OR,0.63;95%CI,0.41-0.95;p =0.028)、Prevotella_7(OR,0.79;95%CI,0.63-1.00;p =0.049)、Faecalibacterium(OR,0.66;95%CI,0.44-1.00;p =0.050)、Desulfovibrionaceae(OR,0.55;95%CI,0.35-0.86;p =0.008)、Deltaproteobacteria(OR,0.65;95%CI,0.43-0.97;p =0.036)与TNs呈正相关,表明它们可能是风险因素。反向磁共振分析未发现明显的因果联系。在对混杂因素进行全面调整后,Desulfovibrionales(目)、Desulfovibrionaceae(科)、Deltaproteobacteria(类)等类群仍是导致TNs风险的潜在因素。研究结果主张将转基因概况纳入 TNs 的预防和管理中,为这一领域的未来研究奠定了基础。
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引用次数: 0
Associations between first-trimester screening biomarkers and maternal characteristics with gestational diabetes mellitus in Chinese women 中国妇女妊娠期糖尿病的产前筛查生物标志物与母体特征之间的关系
Pub Date : 2024-08-08 DOI: 10.3389/fendo.2024.1383706
Yu-Ting Lu, Chie-Pein Chen, Fang-Ju Sun, Yi-Yung Chen, Liang-Kai Wang, Chen-Yu Chen
Gestational diabetes mellitus (GDM) can result in adverse maternal and neonatal outcomes. Predicting those at high risk of GDM and early interventions can reduce the development of GDM. The aim of this study was to examine the associations between first-trimester prenatal screening biomarkers and maternal characteristics in relation to GDM in Chinese women.We conducted a retrospective cohort study of singleton pregnant women who received first-trimester aneuploidy and preeclampsia screening between January 2019 and May 2021. First-trimester prenatal screening biomarkers, including pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotropin, and placental growth factor (PLGF), along with maternal characteristics, were collected for analysis in relation to GDM. Receiver operating characteristic (ROC) curve and logistic regression analyses were used to evaluate variables associated with GDM.Of the 1452 pregnant women enrolled, 96 developed GDM. PAPP-A (5.01 vs. 5.73 IU/L, P < 0.001) and PLGF (39.88 vs. 41.81 pg/mL, P = 0.044) were significantly lower in the GDM group than in the non-GDM group. The area under the ROC curve of combined maternal characteristics and biomarkers was 0.73 (95% confidence interval [CI] 0.68–0.79, P < 0.001). The formula for predicting GDM was as follows: P = 1/[1 + exp (-8.148 + 0.057 x age + 0.011 x pregestational body mass index + 1.752 x previous GDM history + 0.95 x previous preeclampsia history + 0.756 x family history of diabetes + 0.025 x chronic hypertension + 0.036 x mean arterial pressure - 0.09 x PAPP-A - 0.001 x PLGF)]. Logistic regression analysis revealed that higher pregestational body mass index (adjusted odds ratio [aOR] 1.03, 95% CI 1.01 - 1.06, P = 0.012), previous GDM history (aOR 9.97, 95% CI 3.92 - 25.37, P < 0.001), family history of diabetes (aOR 2.36, 95% CI 1.39 - 4.02, P = 0.001), higher mean arterial pressure (aOR 1.17, 95% CI 1.07 - 1.27, P < 0.001), and lower PAPP-A level (aOR 0.91, 95% CI 0.83 - 1.00, P = 0.040) were independently associated with the development of GDM. The Hosmer-Lemeshow test demonstrated that the model exhibited an excellent discrimination ability (chi-square = 3.089, df = 8, P = 0.929).Downregulation of first-trimester PAPP-A and PLGF was associated with the development of GDM. Combining first-trimester biomarkers with maternal characteristics could be valuable for predicting the risk of GDM.
妊娠期糖尿病(GDM)会对产妇和新生儿造成不良后果。预测妊娠糖尿病的高危人群并进行早期干预可以减少妊娠糖尿病的发生。我们对在2019年1月至2021年5月期间接受第一胎非整倍体和子痫前期筛查的单胎孕妇进行了一项回顾性队列研究。研究收集了第一胎产前筛查生物标志物,包括妊娠相关血浆蛋白A(PAPP-A)、游离β-人绒毛膜促性腺激素和胎盘生长因子(PLGF),并结合孕产妇特征,分析其与GDM的关系。采用接收器操作特征(ROC)曲线和逻辑回归分析来评估与 GDM 相关的变量。GDM组的PAPP-A(5.01 vs. 5.73 IU/L,P < 0.001)和PLGF(39.88 vs. 41.81 pg/mL,P = 0.044)明显低于非GDM组。综合母体特征和生物标志物的 ROC 曲线下面积为 0.73(95% 置信区间 [CI] 0.68-0.79,P < 0.001)。预测 GDM 的公式如下P = 1/[1+exp(-8.148 + 0.057 x 年龄 + 0.011 x 孕前体重指数 + 1.752 x 既往 GDM 史 + 0.95 x 既往子痫前期史 + 0.756 x 糖尿病家族史 + 0.025 x 慢性高血压 + 0.036 x 平均动脉压 - 0.09 x PAPP-A - 0.001 x PLGF)]。逻辑回归分析显示,较高的孕前体重指数(调整后的几率比 [aOR] 1.03,95% CI 1.01 - 1.06,P = 0.012)、既往 GDM 史(aOR 9.97,95% CI 3.92 - 25.37,P <0.001)、糖尿病家族史(aOR 2.36,95% CI 1.39 - 4.02,P = 0.001)、较高的平均动脉压(aOR 1.17,95% CI 1.07 - 1.27,P <0.001)和较低的 PAPP-A 水平(aOR 0.91,95% CI 0.83 - 1.00,P = 0.040)与 GDM 的发生独立相关。Hosmer-Lemeshow检验表明,该模型具有极佳的区分能力(chi-square = 3.089,df = 8,P = 0.929)。将第一胎生物标志物与母体特征相结合,对预测 GDM 的风险很有价值。
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引用次数: 0
Elevated triglyceride-glucose index associated with increased risk of diabetes in non-obese young adults: a longitudinal retrospective cohort study from multiple Asian countries 甘油三酯-葡萄糖指数升高与非肥胖青壮年糖尿病风险增加有关:一项来自多个亚洲国家的纵向回顾性队列研究
Pub Date : 2024-08-08 DOI: 10.3389/fendo.2024.1427207
Jian Han, Weifeng Dai, Lixia Chen, Zhenhua Huang, Chengzhi Li, Keke Wang
Previous studies have confirmed a positive correlation between the Triglyceride-Glucose (TyG) index and future risk of diabetes. However, evidence of this association in non-obese young populations remains limited. This study aims to investigate the relationship between the TyG index and the future risk of diabetes among non-obese young adults.This retrospective cohort study included 113,509 non-obese young adults from China and 9,549 from Japan. The mean age was 35.73 ± 6.38 years, and 56,469 participants (45.89%) were male. The median follow-up duration was 3.38 years. The association between baseline TyG index and risk of diabetes was examined using Cox proportional hazards regression models. Non-linear relationships between the TyG index and risk of diabetes were identified using cubic splines and smoothed curve fitting in the Cox models. Sensitivity and subgroup analyses were also conducted.After adjusting for covariates, the results indicated a positive correlation between the TyG index and risk of diabetes in non-obese young adults (HR=3.57, 95% CI: 2.92-4.36, P<0.0001). A non-linear relationship was observed with an inflection point at 7.3. The HR to the right of this inflection point was 3.70 (95% CI: 3.02-4.52, P<0.0001), while to the left, it was 0.34 (95% CI: 0.06-1.88, P=0.2161). The robustness of our findings was confirmed through a series of sensitivity analyses and subgroup analyses.This study reveals a positive and non-linear association between the TyG index and risk of diabetes among non-obese young adults. Interventions aimed at reducing the TyG index by lowering triglycerides or fasting glucose levels could substantially decrease the future likelihood of developing diabetes in this population.
以往的研究证实,甘油三酯-葡萄糖(TyG)指数与未来患糖尿病的风险呈正相关。然而,在非肥胖的年轻人群中,这种关联的证据仍然有限。这项回顾性队列研究纳入了来自中国的 113,509 名非肥胖青壮年和来自日本的 9,549 名非肥胖青壮年。平均年龄为(35.73 ± 6.38)岁,56 469 名参与者(45.89%)为男性。随访时间的中位数为 3.38 年。采用 Cox 比例危险回归模型研究了基线 TyG 指数与糖尿病风险之间的关系。在Cox模型中使用三次劈叉和平滑曲线拟合确定了TyG指数与糖尿病风险之间的非线性关系。在对协变量进行调整后,结果显示非肥胖青壮年的TyG指数与糖尿病风险呈正相关(HR=3.57,95% CI:2.92-4.36,P<0.0001)。观察到一种非线性关系,拐点为 7.3。该拐点右侧的 HR 为 3.70(95% CI:3.02-4.52,P<0.0001),而左侧的 HR 为 0.34(95% CI:0.06-1.88,P=0.2161)。通过一系列敏感性分析和亚组分析,我们证实了研究结果的稳健性。这项研究揭示了非肥胖青壮年的TyG指数与糖尿病风险之间存在着非线性的正相关关系。旨在通过降低甘油三酯或空腹血糖水平来降低TyG指数的干预措施可大大降低这一人群未来患糖尿病的可能性。
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引用次数: 0
Relationship between adipokines and androgens in children and young adults with congenital adrenal hyperplasia 先天性肾上腺皮质增生症儿童和青少年体内脂肪因子与雄激素之间的关系
Pub Date : 2024-08-08 DOI: 10.3389/fendo.2024.1433378
Jennifer Apsan, O. Lekarev, Charlene Thomas, Yuan-Shan Zhu, Kaela Cohan, K. Lin-Su
Children and young adults with congenital adrenal hyperplasia (CAH) are at increased risk of obesity and insulin resistance. There is evidence that children with CAH have increased visceral adiposity, which has been linked to metabolic syndrome and cardiovascular disease (CVD). The adipokine adiponectin has been shown to correlate with reduced metabolic risk, whereas the adipokines visfatin and leptin have been linked to visceral fat and adipocyte inflammation and can serve as biomarkers of increased metabolic risk. Few studies to date have characterized adipokine levels in children and young adults with congenital adrenal hyperplasia. We sought to investigate the relationship between adiponectin, leptin and visfatin levels to metabolic risk factors and androgen levels in children and young adults with CAH.Fasting blood was obtained for visfatin, leptin, adiponectin, glucose, insulin, CRP, lipid panel, total cholesterol (TC), triglycerides (TG) and HbA1c, as well as standard laboratory tests to assess adrenal control, from children with CAH due to 21-hydroxylase deficiency. HOMA-IR was calculated based on fasting glucose and insulin. Anthropomorphic measurements of BMI and waist-to-hip ratio were also obtained.Adiponectin and androstenedione were inversely correlated (R = -0.57, p =0.016). There was a positive correlation between leptin and BMI percentile (R = 0.63, p <0.001) as well as leptin and HOMA-IR (R = 0.63, p <0.01). Glucocorticoid dose had a positive correlation with HOMA-IR (R=0.56, p = 0.021). Visfatin was inversely correlated with HDL cholesterol (R = -0.54, p = 0.026) and total cholesterol (R = -0.49, p <0.05). Overweight children and young adults had a significantly higher leptin (p = 0.02) and HOMA-IR (p=0.001) than non-overweight children and young adults.The inverse relationship between adiponectin and androstenedione suggests that better CAH control can reduce the risk of insulin resistance and metabolic syndrome. However, a high glucocorticoid dose appears to increase the risk of insulin resistance, underscoring the delicate balance required when treating CAH.
患有先天性肾上腺皮质增生症(CAH)的儿童和年轻人肥胖和胰岛素抵抗的风险增加。有证据表明,患有先天性肾上腺皮质增生症(CAH)的儿童内脏脂肪含量增加,这与代谢综合征和心血管疾病(CVD)有关。脂肪因子 "脂肪连通素 "已被证明与代谢风险降低有关,而脂肪因子 "粘脂蛋白 "和 "瘦素 "则与内脏脂肪和脂肪细胞炎症有关,可作为代谢风险增加的生物标志物。迄今为止,很少有研究对患有先天性肾上腺皮质增生症的儿童和青少年的脂肪因子水平进行描述。我们试图研究患有先天性肾上腺皮质增生症的儿童和年轻人体内的脂肪连接素、瘦素和粘蛋白水平与代谢风险因素和雄激素水平之间的关系。我们采集了因 21- 羟化酶缺乏而患有先天性肾上腺皮质增生症的儿童的空腹血,检测粘蛋白、瘦素、脂肪连接素、葡萄糖、胰岛素、CRP、血脂组合、总胆固醇 (TC)、甘油三酯 (TG) 和 HbA1c,以及评估肾上腺控制的标准实验室检测。根据空腹血糖和胰岛素计算 HOMA-IR。脂肪连接蛋白和雄烯二酮呈反向相关(R = -0.57,P =0.016)。瘦素与 BMI 百分位数呈正相关(R = 0.63,p <0.001),瘦素与 HOMA-IR 呈正相关(R = 0.63,p <0.01)。糖皮质激素剂量与 HOMA-IR 呈正相关(R=0.56,p=0.021)。Visfatin与高密度脂蛋白胆固醇(R=-0.54,p=0.026)和总胆固醇(R=-0.49,p<0.05)呈反相关。超重儿童和青少年的瘦素(p = 0.02)和 HOMA-IR (p=0.001)明显高于非超重儿童和青少年。然而,高剂量的糖皮质激素似乎会增加胰岛素抵抗的风险,这强调了治疗 CAH 时所需的微妙平衡。
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引用次数: 0
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Frontiers in Endocrinology
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