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Efficacy of Huangma Ding or autologous platelet-rich gel for the diabetic lower extremity arterial disease patients with foot ulcers 黄马顶或自体富血小板凝胶对糖尿病下肢动脉疾病足部溃疡患者的疗效
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.923
Xue-Qin Wang, Dan-Lan Pu, Wei-Ling Leng, Xiao-Tian Lei, Jiang Juan, Zou La, Ding Yao, Jia-Zhuang Xi, Li Jian, Teng Miao, Qi-Nan Wu
BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability, traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method. AIM To investigate whether Huangma Ding or autologous platelet-rich gel (APG) treatment would benefit diabetic lower extremity arterial disease (LEAD) patients with foot ulcers. METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups: Group A (62 patients; basal treatment), Group B (38 patients; basal treatment and APG), and Group C (55 patients; basal treatment and Huangma Ding). All patients underwent routine follow-up visits for six months. After follow-up, we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters. RESULTS The infection status of the three groups before treatment was the same. Procalcitonin (PCT) improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B. Logistic regression analysis revealed that PCT was positively correlated with total amputation, primary amputation, and minor amputation rates. The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A. The major amputation rate, minor amputation rate, and total amputation times in Groups B and C were lower than those in Group A. CONCLUSION Our research indicated that diabetic foot ulcers (DFUs) lead to major amputation, minor amputation, and total amputation through local infection and poor microcirculation and macrocirculation. Huangma Ding and APG were effective attreating DFUs. The clinical efficacy of Huangma Ding was better than that of autologous platelet gel, which may be related to the better control of local infection by Huangma Ding. This finding suggested that in patients with DFUs combined with coinfection, controlling infection is as important as improving circulation.
背景 糖尿病足是糖尿病最严重的并发症之一,也是导致死亡和残疾的重要原因,传统治疗方法疗效不佳,迫切需要开发一种实用的治疗方法。目的 探讨黄马顶或自体富血小板凝胶(APG)治疗是否有益于糖尿病下肢动脉疾病(LEAD)足部溃疡患者。方法 共招募了 155 名患有足部溃疡的糖尿病 LEAD 患者,并将其分为三组:A 组(62 名患者;基础治疗)、B 组(38 名患者;基础治疗和 APG)和 C 组(55 名患者;基础治疗和皇马鼎)。所有患者均接受了为期 6 个月的常规随访。随访结束后,我们计算了所有变量与基线相比的变化,并确定了组间差异和参数之间的关系。结果 三组患者治疗前的感染状况相同。逻辑回归分析显示,降钙素原(PCT)与总截肢率、初次截肢率和轻微截肢率呈正相关。结论 我们的研究表明,糖尿病足溃疡(DFUs)通过局部感染、微循环和大循环不良导致大截肢、小截肢和全截肢。黄马顶和 APG 对治疗足溃疡有效。黄马定的临床疗效优于自体血小板凝胶,这可能与黄马定能更好地控制局部感染有关。这一结果表明,对于合并感染的 DFUs 患者,控制感染与改善血液循环同样重要。
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引用次数: 0
Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges 结核病-糖尿病并发症:临床考虑和治疗挑战的机理启示
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.853
Md. Abdul Alim Al-Bari, Nick Peake, Nabil Eid
Tuberculosis (TB) remains a leading cause of death among infectious diseases, particularly in poor countries. Viral infections, multidrug-resistant and ex-tensively drug-resistant TB strains, as well as the coexistence of chronic illnesses such as diabetes mellitus (DM) greatly aggravate TB morbidity and mortality. DM [particularly type 2 DM (T2DM)] and TB have converged making their control even more challenging. Two contemporary global epidemics, TB-DM behaves like a syndemic, a synergistic confluence of two highly prevalent diseases. T2DM is a risk factor for developing more severe forms of multi-drug resistant-TB and TB recurrence after preventive treatment. Since a bidirectional relationship exists between TB and DM, it is necessary to concurrently treat both, and promote recommendations for the joint management of both diseases. There are also some drug-drug interactions resulting in adverse treatment outcomes in TB-DM patients including treatment failure, and reinfection. In addition, autophagy may play a role in these comorbidities. Therefore, the TB-DM comorbidities present several health challenges, requiring a focus on multidisciplinary collaboration and integrated strategies, to effectively deal with this double burden. To effectively manage the comorbidity, further screening in affected countries, more suitable drugs, and better treatment strategies are required.
结核病(TB)仍然是传染病中的主要死因,在贫穷国家尤其如此。病毒感染、耐多药和前耐药结核菌株以及糖尿病(DM)等慢性疾病的并存大大增加了结核病的发病率和死亡率。糖尿病(尤其是 2 型糖尿病 (T2DM))与肺结核的融合使其控制工作更具挑战性。结核病-糖尿病是当代全球流行的两种疾病,它们就像一个综合症,是两种高发疾病的协同汇合。T2DM 是导致更严重的耐多药结核病和预防性治疗后结核病复发的风险因素。由于肺结核和糖尿病之间存在双向关系,因此有必要同时治疗这两种疾病,并推广联合治疗这两种疾病的建议。一些药物之间的相互作用也会导致结核病-糖尿病患者的不良治疗结果,包括治疗失败和再次感染。此外,自噬作用也可能在这些合并症中发挥作用。因此,肺结核-肺结核合并症带来了多项健康挑战,需要注重多学科协作和综合策略,以有效应对这一双重负担。为有效控制合并症,需要在受影响国家开展进一步筛查、提供更合适的药物和更好的治疗策略。
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引用次数: 0
Polycytosine RNA-binding protein 1 regulates osteoblast function via a ferroptosis pathway in type 2 diabetic osteoporosis 多胞嘧啶 RNA 结合蛋白 1 通过铁氧化途径调节 2 型糖尿病骨质疏松症的成骨细胞功能
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.977
Hongdong Ma, Lei Shi, Haitian Li, Xin-Dong Wang, Maowei Yang
BACKGROUND Recently, type 2 diabetic osteoporosis (T2DOP) has become a research hotspot for the complications of diabetes, but the specific mechanism of its occurrence and development remains unknown. Ferroptosis caused by iron overload is con-sidered an important cause of T2DOP. Polycytosine RNA-binding protein 1 (PCBP1), an iron ion chaperone, is considered a protector of ferroptosis. AIM To investigate the existence of ferroptosis and specific role of PCBP1 in the development of type 2 diabetes. METHODS A cell counting kit-8 assay was used to detect changes in osteoblast viability under high glucose (HG) and/or ferroptosis inhibitors at different concentrations and times. Transmission electron microscopy was used to examine the morphological changes in the mitochondria of osteoblasts under HG, and western blotting was used to detect the expression levels of PCBP1, ferritin, and the ferroptosis-related protein glutathione peroxidase 4 (GPX4). A lentivirus silenced and overexpressed PCBP1. Western blotting was used to detect the expression levels of the osteoblast functional proteins osteoprotegerin (OPG) and osteocalcin (OCN), whereas flow cytometry was used to detect changes in reactive oxygen species (ROS) levels in each group. RESULTS Under HG, the viability of osteoblasts was considerably decreased, the number of mitochondria undergoing atrophy was considerably increased, PCBP1 and ferritin expression levels were increased, and GPX4 expression was decreased. Western blotting results demonstrated that infection with lentivirus overexpressing PCBP1, increased the expression levels of ferritin, GPX4, OPG, and OCN, compared with the HG group. Flow cytometry results showed a reduction in ROS, and an opposite result was obtained after silencing PCBP1. CONCLUSION PCBP1 may protect osteoblasts and reduce the harm caused by ferroptosis by promoting ferritin expression under a HG environment. Moreover, PCBP1 may be a potential therapeutic target for T2DOP.
背景 近年来,2 型糖尿病骨质疏松症(T2DOP)已成为糖尿病并发症的研究热点,但其发生和发展的具体机制仍不清楚。铁超载引起的铁沉积症被认为是导致 T2DOP 的重要原因。多胞嘧啶 RNA 结合蛋白 1(PCBP1)是一种铁离子伴侣蛋白,被认为是铁变态反应的保护者。目的 探讨 2 型糖尿病发病过程中是否存在铁变态反应以及 PCBP1 的特殊作用。方法 使用细胞计数试剂盒-8 检测在不同浓度和时间的高糖(HG)和/或铁蛋白沉积抑制剂作用下成骨细胞活力的变化。透射电子显微镜检查了 HG 条件下成骨细胞线粒体的形态变化,Western 印迹检测了 PCBP1、铁蛋白和铁氧化相关蛋白谷胱甘肽过氧化物酶 4(GPX4)的表达水平。慢病毒沉默和过表达 PCBP1。用 Western 印迹法检测成骨细胞功能蛋白骨保护蛋白(OPG)和骨钙素(OCN)的表达水平,用流式细胞术检测各组活性氧(ROS)水平的变化。结果 在 HG 作用下,成骨细胞的活力显著下降,线粒体萎缩的数量显著增加,PCBP1 和铁蛋白的表达水平升高,GPX4 的表达下降。Western blotting 结果表明,与 HG 组相比,感染过表达 PCBP1 的慢病毒会增加铁蛋白、GPX4、OPG 和 OCN 的表达水平。流式细胞术结果显示,ROS 减少,而沉默 PCBP1 后的结果恰恰相反。结论 PCBP1 可在 HG 环境下促进铁蛋白的表达,从而保护成骨细胞并减少铁蛋白沉积造成的伤害。此外,PCBP1 可能是 T2DOP 的潜在治疗靶点。
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引用次数: 0
Tailored nutritional interventions: A precision approach to managing gestational diabetes mellitus 量身定制的营养干预措施:精确管理妊娠糖尿病的方法
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.1045
Babita Pande, H. Verma, Lvks Bhaskar
Gestational diabetes mellitus (GDM) is a risk to maternal-fetal health due to uncertain diagnostic criteria and treatment options. Luo's study demonstrated the efficacy of customized nutritional therapies in controlling GDM. Tailored strategies led to significant body weight loss, improved glucolipid metabolism, and fewer prenatal and newborn problems. This holistic approach, which emphasizes the notion of ’chrononutrition’, takes into account optimal meal timing that is in sync with circadian rhythms, as well as enhanced sleep hygiene. Implementing tailored dietary therapy, managing meal timing, and ensuring appropriate sleep may improve results for women with GDM, opening up a possible avenue for multi-center trials.
由于诊断标准和治疗方案不确定,妊娠糖尿病(GDM)对母胎健康构成风险。Luo的研究证明了定制营养疗法在控制GDM方面的功效。量身定制的策略使体重明显减轻,糖脂代谢得到改善,产前和新生儿问题减少。这种强调 "慢性营养 "概念的综合方法考虑到了与昼夜节律同步的最佳进餐时间,以及加强睡眠卫生。实施量身定制的饮食疗法、管理进餐时间并确保适当的睡眠,可能会改善患有 GDM 的妇女的治疗效果,这为多中心试验开辟了一条可能的途径。
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引用次数: 0
Dipeptidyl peptidase-4 inhibitors and the risk of infection: A systematic review and meta-analysis of cardiovascular outcome trials 二肽基肽酶-4 抑制剂与感染风险:心血管结果试验的系统回顾和荟萃分析
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.1011
N. Yang, Liyun He, Peng Liu, Zi-Yi Li, Yu-Cheng Yang, Fan Ping, Lingling Xu, Wei Li, Hua-Bing Zhang, Yu-Xiu Li
BACKGROUND Since adverse events during treatment affect adherence and subsequent glycemic control, understanding the safety profile of oral anti-diabetic drugs is imperative for type 2 diabetes mellitus (T2DM) therapy. AIM To evaluate the risk of infection in patients with T2DM treated with dipeptidyl-peptidase 4 (DPP-4) inhibitors. METHODS Electronic databases were searched. The selection criteria included randomized controlled trials focused on cardiovascular outcomes. In these studies, the effects of DPP-4 inhibitors were directly compared to those of either other active anti-diabetic treatments or placebo. Six trials involving 53616 patients were deemed eligible. We calculated aggregate relative risks employing both random-effects and fixed-effects approaches, contingent upon the context. RESULTS The application of DPP-4 inhibitors showed no significant link to the overall infection risk [0.98 (0.95, 1.02)] or the risk of serious infections [0.96 (0.85, 1.08)], additionally, no significant associations were found with opportunistic infections [0.69 (0.46, 1.04)], site-specific infections [respiratory infection 0.99 (0.96, 1.03), urinary tract infections 1.02 (0.95, 1.10), abdominal and gastrointestinal infections 1.02 (0.83, 1.25), skin structure and soft tissue infections 0.81 (0.60, 1.09), bone infections 0.96 (0.68, 1.36), and bloodstream infections 0.97 (0.80, 1.18)]. CONCLUSION This meta-analysis of data from cardiovascular outcome trials revealed no heightened infection risk in patients undergoing DPP-4 inhibitor therapy compared to control cohorts.
背景由于治疗期间的不良反应会影响患者的依从性和随后的血糖控制,因此了解口服抗糖尿病药物的安全性对于 2 型糖尿病(T2DM)治疗至关重要。目的 评估接受二肽基肽酶 4(DPP-4)抑制剂治疗的 T2DM 患者的感染风险。方法 搜索电子数据库。选择标准包括以心血管结果为重点的随机对照试验。在这些研究中,DPP-4 抑制剂的效果直接与其他活性抗糖尿病治疗或安慰剂的效果进行比较。有六项涉及 53616 名患者的试验符合条件。我们根据具体情况采用随机效应和固定效应两种方法计算总的相对风险。结果 DPP-4 抑制剂的应用与总体感染风险[0.98 (0.95, 1.02)]或严重感染风险[0.96 (0.85, 1.08)]无显著联系,此外,与机会性感染[0.69 (0.46, 1. 04)]、部位特异性感染也无显著联系。04)]、部位特异性感染[呼吸道感染 0.99(0.96,1.03)、尿路感染 1.02(0.95,1.10)、腹部和胃肠道感染 1.02(0.83,1.25)、皮肤结构和软组织感染 0.81(0.60,1.09)、骨感染 0.96(0.68,1.36)和血流感染 0.97(0.80,1.18)]。结论 对心血管结局试验数据进行的这项荟萃分析表明,与对照组相比,接受 DPP-4 抑制剂治疗的患者感染风险并没有增加。
{"title":"Dipeptidyl peptidase-4 inhibitors and the risk of infection: A systematic review and meta-analysis of cardiovascular outcome trials","authors":"N. Yang, Liyun He, Peng Liu, Zi-Yi Li, Yu-Cheng Yang, Fan Ping, Lingling Xu, Wei Li, Hua-Bing Zhang, Yu-Xiu Li","doi":"10.4239/wjd.v15.i5.1011","DOIUrl":"https://doi.org/10.4239/wjd.v15.i5.1011","url":null,"abstract":"BACKGROUND Since adverse events during treatment affect adherence and subsequent glycemic control, understanding the safety profile of oral anti-diabetic drugs is imperative for type 2 diabetes mellitus (T2DM) therapy. AIM To evaluate the risk of infection in patients with T2DM treated with dipeptidyl-peptidase 4 (DPP-4) inhibitors. METHODS Electronic databases were searched. The selection criteria included randomized controlled trials focused on cardiovascular outcomes. In these studies, the effects of DPP-4 inhibitors were directly compared to those of either other active anti-diabetic treatments or placebo. Six trials involving 53616 patients were deemed eligible. We calculated aggregate relative risks employing both random-effects and fixed-effects approaches, contingent upon the context. RESULTS The application of DPP-4 inhibitors showed no significant link to the overall infection risk [0.98 (0.95, 1.02)] or the risk of serious infections [0.96 (0.85, 1.08)], additionally, no significant associations were found with opportunistic infections [0.69 (0.46, 1.04)], site-specific infections [respiratory infection 0.99 (0.96, 1.03), urinary tract infections 1.02 (0.95, 1.10), abdominal and gastrointestinal infections 1.02 (0.83, 1.25), skin structure and soft tissue infections 0.81 (0.60, 1.09), bone infections 0.96 (0.68, 1.36), and bloodstream infections 0.97 (0.80, 1.18)]. CONCLUSION This meta-analysis of data from cardiovascular outcome trials revealed no heightened infection risk in patients undergoing DPP-4 inhibitor therapy compared to control cohorts.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"117 35","pages":"1011 - 1020"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges and pitfalls of youth-onset type 2 diabetes 青少年 2 型糖尿病的挑战和隐患
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.876
Lavinia La Grasta Sabolić, Sanda Marusic, Maja Cigrovski Berkovic
The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) are increasing. The rise in frequency and severity of childhood obesity, inclination to sedentary lifestyle, and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes complications. Indeed, youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM, with greater insulin resistance and more rapid deterioration of beta cell function. Therefore, intermediate complications such as microalbuminuria develop in late childhood or early adulthood, while end-stage complications develop in mid-life. Due to the lack of efficacy and safety data, several drugs available for the treatment of adults with T2DM have not been approved in youth, reducing the pharmacological treatment options. In this mini review, we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.
青少年发病的 2 型糖尿病(T2DM)的发病率和流行率正在上升。儿童肥胖症发生率和严重程度的上升、久坐不动的生活方式倾向以及与产前高血糖暴露相关的表观遗传风险,是导致青少年发病型 T2DM 流行的重要原因,也可能是糖尿病并发症早发的原因。事实上,与成年 T2DM 相比,青年 T2DM 的代谢表型更为极端,胰岛素抵抗更强,β 细胞功能衰退更快。因此,微量白蛋白尿等中期并发症会在儿童晚期或成年早期出现,而终末期并发症则会在中年出现。由于缺乏疗效和安全性数据,几种可用于治疗成人 T2DM 的药物尚未获准用于青少年,从而减少了药物治疗的选择。在这篇微型综述中,我们将试图探讨目前与青少年T2DM相关的挑战和隐患,并总结现有的干预措施,以降低微血管和大血管并发症的风险。
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引用次数: 0
Systematic investigation of Radix Salviae for treating diabetic peripheral neuropathy disease based on network Pharmacology 基于网络药理学的丹参治疗糖尿病周围神经病变疾病的系统研究
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.945
Tao Kang, Xiao Qin, Yan Chen, Qian Yang
BACKGROUND Diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes mellitus with limited available treatment options. Radix Salviae, a traditional Chinese herb, has shown promise in treating DPN, but its therapeutic mech-anisms have not been systematically investigated. AIM Radix Salviae (Danshen in pinin), a traditional Chinese medicine (TCM), is widely used to treat DPN in China. However, the mechanism through which Radix Salviae treats DPN remains unclear. Therefore, we aimed to explore the mechanism of action of Radix Salviae against DPN using network pharmacology. METHODS The active ingredients and target genes of Radix Salviae were screened using the TCM pharmacology database and analysis platform. The genes associated with DPN were obtained from the Gene Cards and OMIM databases, a drug-com-position-target-disease network was constructed, and a protein–protein inter-action network was subsequently constructed to screen the main targets. Gene Ontology (GO) functional annotation and pathway enrichment analysis were performed via the Kyoto Encyclopedia of Genes and Genomes (KEGG) using Bioconductor. RESULTS A total of 56 effective components, 108 targets and 4581 DPN-related target genes of Radix Salviae were screened. Intervention with Radix Salviae for DPN mainly involved 81 target genes. The top 30 major targets were selected for enrichment analysis of GO and KEGG pathways. CONCLUSION These results suggested that Radix Salviae could treat DPN by regulating the AGE-RAGE signaling pathway and the PI3K-Akt signaling pathway. Therefore, Danshen may affect DPN by regulating inflammation and apoptosis.
背景:糖尿病周围神经病变(DPN)是一种使人衰弱的糖尿病并发症,其治疗方法有限。丹参是一种传统中草药,在治疗 DPN 方面前景看好,但其治疗机制尚未得到系统研究。目的 丹参是一种传统中药,在中国被广泛用于治疗 DPN。然而,丹参治疗 DPN 的机制仍不清楚。因此,我们旨在利用网络药理学探索丹参治疗 DPN 的作用机制。方法 利用中药药理数据库和分析平台筛选丹参的有效成分和靶基因。从基因卡片和 OMIM 数据库中获取与 DPN 相关的基因,构建药物-定位-靶点-疾病网络,随后构建蛋白质-蛋白质相互作用网络,筛选主要靶点。利用 Bioconductor,通过京都基因和基因组百科全书(KEGG)进行了基因本体(GO)功能注释和通路富集分析。结果 共筛选出丹参的 56 种有效成分、108 个靶点和 4581 个与 DPN 相关的靶基因。丹参对 DPN 的干预主要涉及 81 个靶基因。筛选出前 30 个主要靶点,对其进行 GO 和 KEGG 通路富集分析。结论 这些结果表明,丹参可通过调节 AGE-RAGE 信号通路和 PI3K-Akt 信号通路治疗 DPN。因此,丹参可通过调节炎症和细胞凋亡来影响 DPN。
{"title":"Systematic investigation of Radix Salviae for treating diabetic peripheral neuropathy disease based on network Pharmacology","authors":"Tao Kang, Xiao Qin, Yan Chen, Qian Yang","doi":"10.4239/wjd.v15.i5.945","DOIUrl":"https://doi.org/10.4239/wjd.v15.i5.945","url":null,"abstract":"BACKGROUND Diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes mellitus with limited available treatment options. Radix Salviae, a traditional Chinese herb, has shown promise in treating DPN, but its therapeutic mech-anisms have not been systematically investigated. AIM Radix Salviae (Danshen in pinin), a traditional Chinese medicine (TCM), is widely used to treat DPN in China. However, the mechanism through which Radix Salviae treats DPN remains unclear. Therefore, we aimed to explore the mechanism of action of Radix Salviae against DPN using network pharmacology. METHODS The active ingredients and target genes of Radix Salviae were screened using the TCM pharmacology database and analysis platform. The genes associated with DPN were obtained from the Gene Cards and OMIM databases, a drug-com-position-target-disease network was constructed, and a protein–protein inter-action network was subsequently constructed to screen the main targets. Gene Ontology (GO) functional annotation and pathway enrichment analysis were performed via the Kyoto Encyclopedia of Genes and Genomes (KEGG) using Bioconductor. RESULTS A total of 56 effective components, 108 targets and 4581 DPN-related target genes of Radix Salviae were screened. Intervention with Radix Salviae for DPN mainly involved 81 target genes. The top 30 major targets were selected for enrichment analysis of GO and KEGG pathways. CONCLUSION These results suggested that Radix Salviae could treat DPN by regulating the AGE-RAGE signaling pathway and the PI3K-Akt signaling pathway. Therefore, Danshen may affect DPN by regulating inflammation and apoptosis.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"62 6","pages":"945 - 957"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140973082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of angiotensin receptor-neprilysin inhibitor in diabetic complications 血管紧张素受体-肾素抑制剂在糖尿病并发症中的作用
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.867
Ying Liu, Cun-Yu Lu, Yi Zheng, Yu-Min Zhang, Ling-ling Qian, Ku-lin Li, Gary Tse, Ru-Xing Wang, Tong Liu
Diabetes mellitus is a prevalent disorder with multi-system manifestations, causing a significant burden in terms of disability and deaths globally. Angio-tensin receptor-neprilysin inhibitor (ARNI) belongs to a class of medications for treating heart failure, with the benefits of reducing hospitalization rates and mortality. This review mainly focuses on the clinical and basic investigations related to ARNI and diabetic complications, discussing possible physiological and molecular mechanisms, with insights for future applications.
糖尿病是一种多系统表现的常见疾病,在全球范围内造成严重的残疾和死亡负担。血管紧张素受体-奈普利酶抑制剂(ARNI)属于治疗心力衰竭的一类药物,具有降低住院率和死亡率的功效。本综述主要关注与 ARNI 和糖尿病并发症相关的临床和基础研究,讨论可能的生理和分子机制,并对未来的应用提出见解。
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引用次数: 0
Vitamin D, selenium in type 2 diabetes and Hashimoto's thyroiditis: Is it effective? 2型糖尿病和桥本氏甲状腺炎的维生素D和硒:是否有效?
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.1048
K. S. Reddy, Vishakha Jain, Sakthivadivel Varatharajan, J. R. Pallavali
The study by Feng et al, explores treatment approaches for these coexisting conditions. It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns. Findings indicate a complex interplay between interventions and disease markers, prompting the need for further research. Despite limitations, the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis. The authors' contributions shed light on potential treatment avenues, although careful consideration of study design and patient characteristics is warranted for future investigations in this domain.
Feng 等人的研究探讨了这些并存病症的治疗方法。研究强调了补充硒和维生素 D 的潜在优势,但也提出了方法和患者选择方面的问题。研究结果表明,干预措施与疾病标志物之间存在复杂的相互作用,因此需要进一步研究。尽管存在局限性,但这项研究为处理 2 型糖尿病和桥本氏甲状腺炎之间错综复杂的关系提供了宝贵的见解。作者们的贡献为潜在的治疗途径提供了启示,尽管在这一领域的未来研究中还需要仔细考虑研究设计和患者特征。
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引用次数: 0
Enzyme-linked immunosorbent assay of 3 Screen Islet Cell Autoantibody in patients with autoimmune thyroid disease 自身免疫性甲状腺疾病患者体内 3 筛胰岛细胞自身抗体的酶联免疫吸附试验
Pub Date : 2024-05-15 DOI: 10.4239/wjd.v15.i5.935
E. Kawasaki, Hidekazu Tamai, Takahiro Fukuyama, Yoko Sagara, Ryutaro Hidaka, Aira Uchida, Masayuki Tojikubo, N. Tatsumoto, Yuko Akehi, Yuji Hiromatsu
BACKGROUND In recent years, the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes (T1D). While it has been established that 20%-30% of T1D patients suffer from autoimmune thyroid disease (AITD), there is limited available data regarding the presence of anti-islet autoantibodies in AITD patients. Among commercially available anti-islet autoantibodies, glutamic acid decarboxylase 65 autoantibodies (GADAs) are often the first marker measured in general clinical practice. AIM To investigate the frequency of anti-islet autoantibodies in AITD patients. METHODS Our study involved four hundred ninety-five AITD patients, categorized into three distinct groups: AITD with T1D (n = 18), AITD with phenotypic type 2 diabetes (T2D) (n = 81), and AITD without diabetes (n = 396), and the enzyme-linked immunosorbent assay (ELISA) was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody (3 Screen ICA), GADA, insulinoma-associated antigen-2 autoantibodies (IA-2As), and zinc transporter 8 autoantibodies (ZnT8As) within these groups. RESULTS The frequency of 3 Screen ICA in AITD patients with T1D, T2D, and those without diabetes were 88.9%, 6.2%, and 5.1%, respectively, with no significant difference seen between the latter two groups. Notably, the frequency of 3 Screen ICA was 11.1% higher in AITD patients with T1D, 1.3% higher in AITD patients with T2D, and 1.1% higher in AITD patients without diabetes compared to GADA, respectively. Furthermore, 12.5%, 20.0%, and 20.0% of the 3 Screen ICA-positive patients were negative for GADA. Additionally, 1.3% of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual autoantibodies. Among the 3 Screen ICA-positive patients, there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D compared to those without diabetes (37.5% vs 5.0%, P < 0.05). However, this proportion was similar to that in AITD patients with T2D (20.0%). Nevertheless, there was no significant difference in 3 Screen ICA titers between AITD patients with T1D and those without diabetes (436.8 ± 66.4 vs 308.1 ± 66.4 index). Additionally, no significant difference in 3 Screen ICA titers was observed between Graves’ disease and Hashimoto’s thyroiditis in any of the groups. CONCLUSION Our findings reveal that some AITD patients without diabetes exhibit 3 Screen ICA titers comparable to those in AITD patients with T1D. Thus, 3 Screen ICA outperforms GADA in identifying latent anti-islet autoantibody-positive individuals among AITD patients.
背景 近年来,可同时检测多种抗小鼠自身抗体的多重技术的出现,对免疫介导的1型糖尿病(T1D)的分期和早期诊断具有特别重要的价值。虽然已经确定20%-30%的T1D患者患有自身免疫性甲状腺疾病(AITD),但有关AITD患者体内抗小鼠自身抗体的可用数据却很有限。在市售的抗胰岛自身抗体中,谷氨酸脱羧酶65自身抗体(GADA)通常是一般临床实践中首先测定的标志物。目的 调查 AITD 患者中抗胰岛自身抗体的频率。方法 我们的研究涉及四百九十五名 AITD 患者,分为三个不同的组别:我们采用酶联免疫吸附试验(ELISA)测定了三筛胰岛细胞自身抗体(三筛 ICA)的频率、GADA、胰岛素瘤相关抗原-2 自身抗体(IA-2As)和锌转运体 8 自身抗体(ZnT8As)的频率。结果 在患有 T1D、T2D 和未患有糖尿病的 AITD 患者中,3 次筛查 ICA 的频率分别为 88.9%、6.2% 和 5.1%,后两组之间无明显差异。值得注意的是,与 GADA 相比,患有 T1D 的 AITD 患者出现 3 次筛查 ICA 的频率高出 11.1%,患有 T2D 的 AITD 患者高出 1.3%,无糖尿病的 AITD 患者高出 1.1%。此外,在 3 例筛查出的 ICA 阳性患者中,分别有 12.5%、20.0% 和 20.0% 的患者 GADA 阴性。此外,在伴有 T2D 的 AITD 组和非糖尿病 AITD 组中,3 项筛选 ICA 阴性的 AITD 患者中有 1.3% 发现个别自身抗体呈阳性。在 3 项筛查 ICA 阳性的患者中,有 T1D 的 AITD 患者出现多重自身抗体的比例明显高于无糖尿病的患者(37.5% vs 5.0%,P < 0.05)。不过,这一比例与患有 T2D 的 AITD 患者相似(20.0%)。然而,患有 T1D 的 AITD 患者与未患有糖尿病的 AITD 患者在 3 次筛查中的 ICA 滴度没有明显差异(436.8 ± 66.4 vs 308.1 ± 66.4 index)。此外,巴塞杜氏病和桥本氏甲状腺炎患者的 3 筛选 ICA 滴度在所有组别中均无明显差异。结论 我们的研究结果表明,一些无糖尿病的 AITD 患者的 3 筛查 ICA 滴度与患有 T1D 的 AITD 患者相当。因此,3筛查ICA在识别AITD患者中潜伏的抗小管自身抗体阳性者方面优于GADA。
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World Journal of Diabetes
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