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Tanshinone IIA suppresses ferroptosis to attenuate renal podocyte injury in diabetic nephropathy through the embryonic lethal abnormal visual-like protein 1 and acyl-coenzyme A synthetase long-chain family member 4 signaling pathway 丹参酮 IIA 可通过胚胎致死性异常视觉样蛋白 1 和酰基辅酶 A 合成酶长链家族成员 4 信号通路抑制糖尿病肾病中的铁蛋白沉积,从而减轻肾荚膜细胞损伤。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-22 DOI: 10.1111/jdi.14206
Shuai Zhu, Zhiqiang Kang, Fengjiao Zhang

Aims/Introduction

Tanshinone IIA (TIIA) is one of the main components of the root of the red-rooted Salvia miltiorrhiza Bunge. However, the molecular mechanisms underlying TIIA-mediated protective effects in diabetic nephropathy (DN) are still unclear.

Materials and Methods

High glucose (HG)-induced mouse podocyte cell line (MPC5) cells were used as the in vitro model of DN and treated with TIIA. Cell viability, proliferation and apoptosis were detected using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide, 5-ethynyl-2′-deoxyuridine and flow cytometry assays. The protein levels were assessed using western blot assay. The levels of inflammatory factors were deleted by enzyme-linked immunoassay. Fe+ level, reactive oxygen species, malondialdehyde and glutathione products were detected using special assay kits. After ENCORI prediction, the interaction between embryonic lethal abnormal visual-like protein 1 (ELAVL1) and acyl-coenzyme A synthetase long-chain family member 4 (ACSL4) was verified using co-immunoprecipitation assay and dual-luciferase reporter assays. ACSL4 messenger ribonucleic acid expression was measured using real-time quantitative polymerase chain reaction.

Results

TIIA repressed HG-induced MPC5 cell apoptosis, inflammatory response and ferroptosis. ACSL4 upregulation relieved the repression of TIIA on HG-mediated MPC5 cell injury and ferroptosis. ELAVL1 is bound with ACSL4 to positively regulate the stability of ACSL4 messenger ribonucleic acid. TIIA hindered HG-triggered MPC5 cell injury and ferroptosis by regulating the ELAVL1–ACSL4 pathway. TIIA blocked DN progression in in vivo research.

Conclusion

TIIA treatment restrained HG-caused MPC5 cell injury and ferroptosis partly through targeting the ELAVL1–ACSL4 axis, providing a promising therapeutic target for DN treatment.

目的/简介丹参酮 IIA(TIIA)是红根丹参(Salvia miltiorrhiza Bunge)根部的主要成分之一。材料与方法用高糖(HG)诱导的小鼠荚膜细胞系(MPC5)细胞作为糖尿病肾病(DN)的体外模型,并用 TIIA 处理。使用 3-(4,5-二甲基噻唑基-2)-2,5-二苯基溴化四氮唑、5-乙炔基-2'-脱氧尿苷和流式细胞术检测细胞活力、增殖和凋亡。蛋白质水平则采用 Western 印迹法进行评估。炎症因子水平通过酶联免疫测定法进行检测。使用专用检测试剂盒检测铁+水平、活性氧、丙二醛和谷胱甘肽产物。经过 ENCORI 预测,利用共免疫沉淀法和双荧光素酶报告实验验证了胚胎致死性异常视觉样蛋白 1(ELAVL1)与酰辅酶 A 合成酶长链家族成员 4(ACSL4)之间的相互作用。结果STIIA抑制了HG诱导的MPC5细胞凋亡、炎症反应和铁变态反应。ACSL4的上调缓解了TIIA对HG介导的MPC5细胞损伤和铁凋亡的抑制作用。ELAVL1与ACSL4结合,正向调节ACSL4信使核糖核酸的稳定性。TIIA通过调节ELAVL1-ACSL4通路,阻碍了HG触发的MPC5细胞损伤和铁突变。结论TIIA治疗可部分通过靶向ELAVL1-ACSL4轴抑制HG引发的MPC5细胞损伤和铁突变,为DN治疗提供了一个有前景的治疗靶点。
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引用次数: 0
Risk factors and prediction score for new-onset diabetes mellitus after liver transplantation 肝移植术后新发糖尿病的风险因素和预测评分
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-19 DOI: 10.1111/jdi.14204
Ruiping Bai, Rui An, Siyu Chen, Wenkang Ding, Mengwen Xue, Ge Zhao, Qingyong Ma, Xin Shen

Aim

New-onset diabetes mellitus is a frequent and severe complication arising after liver transplantation (LT). We aimed to identify the risk factors for new-onset diabetes mellitus after liver transplantation (NODALT) and to develop a risk prediction score system for relevant risks.

Methods

We collected and analyzed data from all recipients who underwent liver transplantation at the First Affiliated Hospital of Xi'an Jiaotong University. The OR derived from a multiple logistic regression predicting the presence of NODALT was used to calculate the risk prediction score. The performance of the risk prediction score was externally validated in patients who were from the CLTR (China Liver Transplant Registry) database.

Results

A total of 468 patients met the outlined criteria and finished the follow-up. Overall, NODALT was diagnosed in 115 (24.6%) patients. Age, preoperative impaired fasting glucose (IFG), postoperative fasting plasma glucose (FPG), and the length of hospital stay were significantly associated with the presence of NODALT. The risk prediction score includes age, preoperative IFG, postoperative FPG, and the length of hospital stay. The risk prediction score of the area under the receiver operating curve was 0.785 (95% CI: 0.724–0.846) in the experimental population and 0.782 (95% CI: 0.708–0.856) in the validation population.

Conclusions

Age at the time of transplantation, preoperative IFG, postoperative FPG, and length of hospital stay were independent predictive factors of NODALT. The use of a simple risk prediction score can identify the patients who have the highest risk of NODALT and interventions may start early.

目的新发糖尿病是肝移植(LT)术后常见的严重并发症。我们旨在确定肝移植术后新发糖尿病(NODALT)的风险因素,并建立相关风险预测评分系统。用多元逻辑回归预测是否存在 NODALT 所得出的 OR 计算风险预测评分。结果 共有 468 名患者符合上述标准并完成了随访。共有 115 例(24.6%)患者确诊为 NODALT。年龄、术前空腹血糖受损程度(IFG)、术后空腹血浆葡萄糖(FPG)和住院时间与NODALT的存在显著相关。风险预测评分包括年龄、术前 IFG、术后 FPG 和住院时间。结论移植时的年龄、术前 IFG、术后 FPG 和住院时间是 NODALT 的独立预测因素。使用简单的风险预测评分可以识别出NODALT风险最高的患者,并及早开始干预。
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引用次数: 0
Plantar pressure measurement in diabetic foot disease: A scoping review 糖尿病足病的足底压力测量:范围综述
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-18 DOI: 10.1111/jdi.14215
Michael Lockhart, Sean F Dinneen, Derek T O'Keeffe

Aims/Introduction

Patients with a healed diabetic foot ulcer (DFU) have a 40% risk of ulcer recurrence within a year. New and effective measures to prevent DFU recurrence are essential. We aimed to highlight emerging trends and future research opportunities in the use of plantar pressure measurement to prevent DFU recurrence.

Materials and Methods

Our scoping review protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis – Scoping Review protocol. Peer-reviewed, English-language papers were included that addressed both plantar pressure measurement and diabetic foot disease, either as primary studies that have advanced the field or as review papers that provide summaries and/or opinion on the field as a whole, as well as specific papers that provide guidelines for future research and advancement in the field.

Results

A total of 24 eligible publications were identified in a literature search using PubMed. A further 36 eligible studies were included after searching the references sections of these publications, leaving a total of 60 publications included in this scoping review.

Conclusions

Plantar pressure measurement can and will play a major role in the prevention of DFU. There is already a strong, albeit limited, evidence base in place to prove its benefit in reducing DFU recurrence. More research is required in larger populations, using remote monitoring in real-world settings, and with improved technology.

目的/简介糖尿病足溃疡(DFU)愈合患者一年内溃疡复发的风险高达 40%。采取新的有效措施预防 DFU 复发至关重要。我们旨在强调使用足底压力测量预防 DFU 复发的新趋势和未来研究机会。材料和方法我们的范围界定综述协议是根据《系统综述和荟萃分析首选报告项目--范围界定综述协议》起草的。我们纳入了经同行评议的、涉及足底压力测量和糖尿病足病的英文论文,这些论文可以是推动该领域发展的主要研究,也可以是对该领域整体情况进行总结和/或提出意见的综述性论文,还可以是为该领域未来的研究和发展提供指导的具体论文。结论跖压测量在预防 DFU 方面可以并将发挥重要作用。尽管证据有限,但已有强大的证据基础证明其在减少 DFU 复发方面的益处。还需要在更大的人群中进行更多的研究,在真实世界的环境中使用远程监控,并改进技术。
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引用次数: 0
Long-term efficacy of encapsulated xenogeneic islet transplantation: Impact of encapsulation techniques and donor genetic traits 封装异种胰岛移植的长期疗效:封装技术和供体遗传特征的影响
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2024-04-18 DOI: 10.1111/jdi.14216
Heon-Seok Park, Eun Young Lee, Young-Hye You, Marie Rhee, Jong-Min Kim, Seong-Soo Hwang, Poong-Yeon Lee

Aims/Introduction

To investigate the long-term efficacy of various encapsulated xenogeneic islet transplantation, and to explore the impact of different donor porcine genetic traits on islet transplantation outcomes.

Materials and Methods

Donor porcine islets were obtained from wild-type, α1,3-galactosyltransferase knockout (GTKO) and GTKO with overexpression of membrane cofactor protein genotype. Naked, alginate, alginate-chitosan (AC), alginate-perfluorodecalin (A-PFD) and AC-perfluorodecalin (AC-PFD) encapsulated porcine islets were transplanted into diabetic mice.

Results

In vitro assessments showed no differences in the viability and function of islets across encapsulation types and donor porcine islet genotypes. Xenogeneic encapsulated islet transplantation with AC-PFD capsules showed the most favorable long-term outcomes, maintaining normal blood glucose levels for 180 days. A-PFD capsules showed comparable results to AC-PFD capsules, followed by AC capsules and alginate capsules. Conversely, blood glucose levels in naked islet transplantation increased to >300 mg/dL within a week after transplantation. Naked islet transplantation outcomes showed no improvement based on donor islet genotype. However, alginate or AC capsules showed delayed increases in blood glucose levels for GTKO and GTKO with overexpression of membrane cofactor protein porcine islets compared with wild-type porcine islets.

Conclusion

The AC-PFD capsule, designed to ameliorate both hypoxia and inflammation, showed the highest long-term efficacy in xenogeneic islet transplantation. Genetic modifications of porcine islets with GTKO or GTKO with overexpression of membrane cofactor protein did not influence naked islet transplantation outcomes, but did delay graft failure when encapsulated.

材料与方法供体猪胰岛来自野生型、α1,3-半乳糖转移酶基因敲除(GTKO)和膜辅因子蛋白基因过表达的GTKO。结果体外评估显示,不同封装类型和供体猪胰岛基因型的胰岛存活率和功能没有差异。使用 AC-PFD 胶囊进行异基因包裹胰岛移植显示出最有利的长期结果,可在 180 天内维持正常血糖水平。A-PFD 胶囊的效果与 AC-PFD 胶囊相当,其次是 AC 胶囊和藻酸盐胶囊。相反,裸胰岛移植的血糖水平在移植后一周内升至 300 毫克/分升。裸胰岛移植的结果显示,供体胰岛基因型没有改善。然而,与野生型猪胰岛相比,藻酸盐或 AC 胶囊显示 GTKO 和 GTKO 与膜辅助因子蛋白过表达猪胰岛的血糖水平延迟升高。对猪胰岛进行GTKO或GTKO与膜辅助因子蛋白过表达的基因修饰并不影响裸胰岛移植的结果,但在封装后可延缓移植失败。
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引用次数: 0
Medical database analysis of the association between kidney function and achievement of glycemic control in older Japanese adults with type 2 diabetes who started with oral antidiabetic drugs 对开始使用口服抗糖尿病药物的日本老年 2 型糖尿病患者肾功能与血糖控制效果之间关系的医学数据库分析
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-18 DOI: 10.1111/jdi.14214
Ryo Suzuki, Kiyoyasu Kazumori, Tatsuya Usui, Masahiko Shinohara

Aims/Introduction

Despite the emergence of new drugs with novel mechanisms of action, treatment options for older people and those with chronic kidney disease are still limited.

Materials and Methods

Using a medical database compiled from Diagnostic Procedure Combination hospitals, we retrospectively analyzed treatment status, glycemic control and kidney function over 3 years after the first oral antidiabetic drugs in Japanese adults with type 2 diabetes who were aged ≥65 years.

Results

Among 5,434 study participants, 3,246 (59.7%) were men, the median age was 72.0 years, the baseline median hemoglobin A1c was 7.1% and the baseline median estimated glomerular filtration rate was 66.6 mL/min/1.73 m2. Treatment was intensified in 40.0% of people during the 3-year observation period, and the median time to the first treatment intensification was 198 days. Insulin was the most commonly used agent for treatment intensification (36.9%, 802/2,175). Hemoglobin A1c of <7.0% was achieved in 3,571 (65.7%) at 360 ± 90 days. Multivariable logistic regression analysis found that baseline age, hemoglobin A1c and estimated glomerular filtration rate were negatively associated with achieving hemoglobin A1c of <7.0% at 360 ± 90 days.

Conclusions

In older Japanese adults with type 2 diabetes, those with a lower estimated glomerular filtration rate were more likely to achieve hemoglobin A1c of <7.0%. To safely manage blood glucose levels in older adults with chronic kidney disease, physicians should remain vigilant about the risk of iatrogenic hypoglycemia.

材料与方法利用诊断程序组合医院的医疗数据库,我们回顾性分析了年龄≥65 岁的日本 2 型糖尿病成人患者首次口服抗糖尿病药物后 3 年的治疗状况、血糖控制和肾功能。结果在5434名研究参与者中,3246人(59.7%)为男性,年龄中位数为72.0岁,血红蛋白A1c基线中位数为7.1%,肾小球滤过率基线中位数为66.6 mL/min/1.73 m2。在 3 年的观察期内,40.0% 的患者接受了强化治疗,首次强化治疗的中位时间为 198 天。胰岛素是最常用的强化治疗药物(36.9%,802/2,175)。在 360 ± 90 天内,3,571 人(65.7%)的血红蛋白 A1c 达到 7.0%。多变量逻辑回归分析发现,基线年龄、血红蛋白 A1c 和估计肾小球滤过率与 360 ± 90 天时血红蛋白 A1c 达到 <7.0% 负相关。为了安全地管理患有慢性肾脏病的老年人的血糖水平,医生应该对先天性低血糖的风险保持警惕。
{"title":"Medical database analysis of the association between kidney function and achievement of glycemic control in older Japanese adults with type 2 diabetes who started with oral antidiabetic drugs","authors":"Ryo Suzuki,&nbsp;Kiyoyasu Kazumori,&nbsp;Tatsuya Usui,&nbsp;Masahiko Shinohara","doi":"10.1111/jdi.14214","DOIUrl":"10.1111/jdi.14214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Despite the emergence of new drugs with novel mechanisms of action, treatment options for older people and those with chronic kidney disease are still limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Using a medical database compiled from Diagnostic Procedure Combination hospitals, we retrospectively analyzed treatment status, glycemic control and kidney function over 3 years after the first oral antidiabetic drugs in Japanese adults with type 2 diabetes who were aged ≥65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5,434 study participants, 3,246 (59.7%) were men, the median age was 72.0 years, the baseline median hemoglobin A1c was 7.1% and the baseline median estimated glomerular filtration rate was 66.6 mL/min/1.73 m<sup>2</sup>. Treatment was intensified in 40.0% of people during the 3-year observation period, and the median time to the first treatment intensification was 198 days. Insulin was the most commonly used agent for treatment intensification (36.9%, 802/2,175). Hemoglobin A1c of &lt;7.0% was achieved in 3,571 (65.7%) at 360 ± 90 days. Multivariable logistic regression analysis found that baseline age, hemoglobin A1c and estimated glomerular filtration rate were negatively associated with achieving hemoglobin A1c of &lt;7.0% at 360 ± 90 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In older Japanese adults with type 2 diabetes, those with a lower estimated glomerular filtration rate were more likely to achieve hemoglobin A1c of &lt;7.0%. To safely manage blood glucose levels in older adults with chronic kidney disease, physicians should remain vigilant about the risk of iatrogenic hypoglycemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation rate of diabetic self-management education and support for Japanese people with diabetes using the National Database 利用国家数据库为日本糖尿病患者提供糖尿病自我管理教育和支持的实施率
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-16 DOI: 10.1111/jdi.14188
Noriko Ihana-Sugiyama, Takehiro Sugiyama, Kenjiro Imai, Mitsuru Ohsugi, Kohjiro Ueki, Toshimasa Yamauchi, Takashi Kadowaki

People with diabetes are encouraged to receive diabetes self-management education and support (DSMES) appropriately. However, in Japan, the implementation rates of DSMES are not known. DSMES implementation rates were calculated using the National Database of claims data, which included nearly all insurance-covered medical procedures. The study enrolled participants who received regular antidiabetic medications between April 2017 and March 2018. The implementation rates of DSMES-related care were calculated by characteristics, visiting medical facilities and prefectures. In 4,465,513 participants receiving antidiabetic medications (men, 57.8%; insulin use, 14.1%), nutrition guidance (5.6%) was the most frequently provided care type. Insulin users and participants visiting Japan Diabetes Society-certified and large medical institutions had higher implementation rates of nutrition guidance. DSMES-related care might not be provided adequately for Japanese people with diabetes. Further studies are needed to develop an optimal diabetes care system.

我们鼓励糖尿病患者适当接受糖尿病自我管理教育和支持(DSMES)。然而,在日本,糖尿病自我管理教育和支持的实施率并不为人所知。DSMES 的实施率是通过国家报销数据数据库计算得出的,该数据库几乎包含了所有保险范围内的医疗程序。研究招募了在 2017 年 4 月至 2018 年 3 月期间定期接受抗糖尿病药物治疗的参与者。按特征、就诊医疗机构和都道府县计算了DSMES相关护理的实施率。在446513名接受抗糖尿病药物治疗的参与者中(男性占57.8%;使用胰岛素者占14.1%),营养指导(5.6%)是最常提供的护理类型。胰岛素使用者和在日本糖尿病学会认证的大型医疗机构就诊的参试者接受营养指导的比例较高。日本糖尿病患者可能没有得到充分的DSMES相关护理。要建立一个最佳的糖尿病护理系统,还需要进一步的研究。
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引用次数: 0
Corrigendum to “Leucine–glycine and carnosine dipeptides prevent diabetes induced by multiple low-doses of streptozotocin in an experimental model of adult mice” 对 "亮氨酸-甘氨酸和肌肽二肽在成年小鼠实验模型中防止多次低剂量链脲佐菌素诱发糖尿病 "的更正
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2024-04-13 DOI: 10.1111/jdi.14210

Tohid Vahdatpour, Ali Nokhodchi, Parvin Zakeri-Milani, Mehran Mesgari-Abbasi, Naser Ahmadi-Asl, Hadi Valizadeh Leucine–glycine and carnosine dipeptides prevent diabetes induced by multiple low-doses of streptozotocin in an experimental model of adult mice. J Diabetes Investig. 2019; 10: 1177–1188. https://doi.org/10.1111/jdi.13018.

We apologize for the error.

Tohid Vahdatpour, Ali Nokhodchi, Parvin Zakeri-Milani, Mehran Mesgari-Abbasi, Naser Ahmadi-Asl, Hadi Valizadeh 在成年小鼠实验模型中,亮氨酸-甘氨酸和肌肽二肽可预防多次低剂量链脲佐菌素诱发的糖尿病。J Diabetes Investig.2019; 10: 1177-1188。https://doi.org/10.1111/jdi.13018.There,上述文章中图6的图片有重叠。正确的图6如下所示。我们对此错误深表歉意。
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引用次数: 0
Associations of fasting plasma glucose with all-cause mortality and cardiovascular events in older Chinese diabetes patients: A population-based cohort study 中国老年糖尿病患者空腹血浆葡萄糖与全因死亡率和心血管事件的关系:基于人群的队列研究
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-09 DOI: 10.1111/jdi.14196
Linan Wang, Wei Zhang, Juan Dai, Qing Deng, Yaqiong Yan, Qing Liu

Aims/Introduction

Our aim was to investigate the optimal fasting glucose (FPG) range in Chinese older adults with type 2 diabetes, and to clarify whether the optimal range varies according to the control of risk factors.

Materials and Methods

The baseline survey for the cohort study began in 2018, with follow up ending in 2022. Our study enrolled 59,030 older diabetes patients with no history of cardiovascular disease (CVD). Participants were divided into nine groups based on their baseline glycemic status. The association between FPG and the risk of adverse outcomes was mainly estimated by multivariate Cox proportional risk models and restricted spline analysis.

Results

During the 4-year follow-up period, a total of 5,637 deaths and 4,904 CVD events occurred. The associations of FPG with mortality and CVD events showed J-shaped curves. Among all-cause deaths, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.50 (95% confidence interval [CI] 1.31–1.71) and 1.84 (95% CI 1.67–2.02). Among CVD, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.31 (95% CI 1.13–1.53) and 1.71 (95% CI 1.54–1.89), respectively. The optimal FPG ranges of all-cause mortality and CVD were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. For participants with at least two risk factors, the optimal FPG levels were higher than those with fewer risk factors.

Conclusions

In older Chinese diabetes patients, the FPG ranges related to the minimum death and CVD event rates were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. Patients with more cardiovascular risk factors had higher optimal blood glucose ranges than those with fewer risk factors.

目的/简介我们的目的是研究中国老年 2 型糖尿病患者的最佳空腹血糖(FPG)范围,并明确最佳范围是否随风险因素的控制而变化。材料与方法队列研究的基线调查始于 2018 年,随访结束于 2022 年。我们的研究共招募了 59030 名无心血管疾病(CVD)病史的老年糖尿病患者。根据基线血糖状况将参与者分为九组。结果在 4 年的随访期间,共有 5637 人死亡,4904 人发生心血管疾病。FPG与死亡率和心血管事件的关系呈J形曲线。在全因死亡中,FPG ≤4.50 和 >11.50 mmol/L 的危险比分别为 1.50(95% 置信区间 [CI] 1.31-1.71)和 1.84(95% CI 1.67-2.02)。在心血管疾病中,FPG ≤4.50 和 >11.50 mmol/L 的危险比分别为 1.31(95% CI 1.13-1.53)和 1.71(95% CI 1.54-1.89)。全因死亡率和心血管疾病的最佳 FPG 范围分别为 5.50-7.50 和 4.50-7.50 mmol/L。结论在中国老年糖尿病患者中,与最低死亡率和心血管事件发生率相关的 FPG 范围分别为 5.50-7.50 和 4.50-7.50 mmol/L。心血管风险因素较多的患者的最佳血糖范围高于风险因素较少的患者。
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引用次数: 0
Nutrient quality in dietary therapy for diabetes and diabetic kidney disease 糖尿病和糖尿病肾病饮食疗法的营养质量
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-09 DOI: 10.1111/jdi.14208
Hiroaki Tsuruta, Sho Sugahara, Shinji Kume

Dietary therapy is crucial for diabetes care with the aim of preventing the onset and progression of diabetes and its complications. The traditional approach to dietary therapy for diabetes has primarily focused on restricting the intake of the three major nutrients and rigorously controlling blood glucose levels. However, advancements in nutritional science have shown that within the three major nutrients – carbohydrates, proteins and lipids – there exist multiple types, each with distinct impacts on type 2 diabetes and its complications, sometimes even showing conflicting effects. In light of this, the present review shifts its focus from the quantity to the quality of the three major nutrients. It aims to provide an overview of how the differences in nutrient quality can influence onset and progression of type 2 diabetes and diabetic kidney disease, highlighting the diverse effects and, at times, contradictory impacts associated with each nutrient type.

饮食治疗对糖尿病治疗至关重要,其目的是预防糖尿病及其并发症的发生和发展。糖尿病饮食治疗的传统方法主要侧重于限制三大营养素的摄入量和严格控制血糖水平。然而,营养科学的进步表明,在三大营养素(碳水化合物、蛋白质和脂类)中,存在着多种类型,每种营养素对 2 型糖尿病及其并发症都有不同的影响,有时甚至表现出相互矛盾的效果。有鉴于此,本综述将重点从三大营养素的数量转向质量。本综述旨在概述营养素质量的差异如何影响 2 型糖尿病和糖尿病肾病的发病和进展,强调每种营养素的不同影响,有时甚至是相互矛盾的影响。
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引用次数: 0
The role of vascular adhesion protein-1 in diabetes and diabetic complications 血管粘附蛋白-1 在糖尿病和糖尿病并发症中的作用
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-06 DOI: 10.1111/jdi.14209
I-Weng Yen, Hung-Yuan Li

Vascular adhesion protein-1 (VAP-1) plays a dual role with its adhesive and enzymatic properties, facilitating leukocyte migration to sites of inflammation and catalyzing the breakdown of primary amines into harmful by-products, which are linked to diabetic complications. Present in various tissues, VAP-1 also circulates in a soluble form in the bloodstream. Diabetes is associated with several complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy, significantly contributing to disability and mortality. These complications arise from hyperglycemia-induced oxidative stress, inflammation, and the formation of advanced glycation end-products (AGEs). Earlier research, including our own from the 1990s and early 2000s, has underscored the critical role of VAP-1 in these pathological processes, prompting extensive investigation into its contribution to diabetic complications. In this review, we examine the involvement of VAP-1 in diabetes and its complications, alongside its link to other conditions related to diabetes, such as cancer and metabolic dysfunction-associated fatty liver disease. We also explore the utility of soluble VAP-1 as a biomarker for diabetes, its complications, and other related conditions. Since the inhibition of VAP-1 to treat diabetic complications is a novel and promising treatment option, further studies are needed to translate the beneficial effect of VAP-1 inhibitors observed in animal studies to clinical trials recruiting human subjects. Besides, future studies should focus on using serum sVAP-1 levels for risk assessment in diabetic patients, identifying those who need intensive glycemic control, and determining the patient population that would benefit most from VAP-1 inhibitor therapies.

血管粘附蛋白-1(VAP-1)具有粘附和酶的双重作用,既能促进白细胞向炎症部位迁移,又能催化伯胺分解成有害的副产品,而这些副产品与糖尿病并发症有关。VAP-1 存在于各种组织中,也以可溶形式在血液中循环。糖尿病与多种并发症有关,如心血管疾病、视网膜病变、肾病和神经病变,严重导致残疾和死亡。这些并发症源于高血糖引起的氧化应激、炎症和高级糖化终产物(AGEs)的形成。早期的研究,包括我们自己在 20 世纪 90 年代和 21 世纪初的研究,强调了 VAP-1 在这些病理过程中的关键作用,促使我们对其在糖尿病并发症中的作用进行了广泛的研究。在这篇综述中,我们研究了 VAP-1 在糖尿病及其并发症中的参与,以及它与其他糖尿病相关疾病(如癌症和代谢功能障碍相关脂肪肝)的联系。我们还探讨了可溶性 VAP-1 作为糖尿病、其并发症和其他相关疾病的生物标志物的效用。由于抑制 VAP-1 以治疗糖尿病并发症是一种新颖而有前景的治疗方法,因此需要进一步研究,将在动物实验中观察到的 VAP-1 抑制剂的有益效果转化为招募人类受试者的临床试验。此外,未来的研究应侧重于使用血清 sVAP-1 水平评估糖尿病患者的风险,识别需要加强血糖控制的患者,并确定从 VAP-1 抑制剂疗法中获益最多的患者人群。
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Journal of Diabetes Investigation
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