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Future acceptance of automated insulin delivery systems in youths with type 1 diabetes: validation of the Italian artificial pancreas-acceptance measure. 未来 1 型糖尿病青少年对自动胰岛素输送系统的接受程度:意大利人工胰腺接受度测量的验证。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-10 DOI: 10.1007/s00592-024-02327-9
Roberto Franceschi, Riccardo Pertile, Marco Marigliano, Enza Mozzillo, Claudio Maffeis, Silvana Zaffani, Carlotta Dusini, Annalisa Antonelli, Francesca Di Candia, Giulio Maltoni, Erika Cantarelli, Nicola Minuto, Marta Bassi, Ivana Rabbone, Silvia Savastio, Stefano Passanisi, Fortunato Lombardo, Valentino Cherubini, Maria Alessandra Saltarelli, Stefano Tumini

Aim: The purpose of this study was to develop a questionnaire to examine the future acceptance of Automatic insulin delivery systems (AIDs), their perceived usefulness, ease of use, and trust in the device in subjects with type 1 diabetes (T1D).

Methods: A questionnaire in Italian, based on the Technology Acceptance Model, was developed to examine intention to use AIDs, considered as a measure of future acceptance, and its determinants to use the system. A total of 43 questions for children and 46 for parents were included, and a 5-point Likert scale was used.

Results: 239 subjects with T1D using multiple daily injections (MDI) or sensor-augmented pump (SAP) and their parents completed the questionnaire. The completion rate was excellent, with almost 100% of items answered. The overall Cronbach's coefficient for children and adolescents was 0.92 and 0.93 for parents, indicating excellent internal consistency in both groups. Parent-youth agreement was 0.699 (95% confidence interval: 0.689-0.709), indicating a good agreement between the two evaluations. Factor analysis identified measurement factors for the "artificial pancreas (AP)-acceptance labeled benefits and hassles of AIDs, and the internal consistency of the total scale was alpha = 0.94 for subjects with T1D and 0.95 for parents. The level of AP acceptance was more than neutral: 3.91 ± 0.47 and 3.99 ± 0.43 (p = 0.07) for youths and parents, respectively (possible score range 1 to 5, neutral score is 3.0). Parents reported higher scores in the benefit items than children-adolescents (p = 0.04).

Conclusions: We developed a new questionnaire based on the items available in the literature, and we demonstrated that the "AP-acceptance" reveals a meaningful factor structure, good internal reliability, and agreement between parent-young people evaluations. This measure could be a valuable resource for clinicians and researchers to assess AP acceptance in pediatric patients with T1D and their parents. This patient profiling approach could help to enroll candidates for AIDs with proper expectations and who most likely will benefit from the system.

目的:本研究的目的是编制一份调查问卷,以调查 1 型糖尿病(T1D)患者对胰岛素自动给药系统(AIDs)的未来接受程度、对其有用性、易用性的感知以及对该设备的信任度:方法:根据技术接受模型编制了一份意大利语调查问卷,以调查使用胰岛素给药系统的意向(作为未来接受程度的衡量标准)及其使用该系统的决定因素。结果:239 名使用每日多次注射(MDI)或传感器增强泵(SAP)的 T1D 患者及其父母完成了问卷调查。问卷完成率非常高,几乎100%的项目都得到了回答。儿童和青少年的总体克朗巴赫系数(Cronbach's coefficient)为 0.92,家长为 0.93,表明这两个群体的内部一致性都非常好。家长与青少年的一致性为 0.699(95% 置信区间:0.689-0.709),表明两个评价之间的一致性很好。因子分析确定了 "人工胰腺(AP)接受度 "的测量因子,标注了人工胰腺的益处和麻烦,T1D 受试者总量表的内部一致性为 alpha = 0.94,家长总量表的内部一致性为 0.95。青少年和家长对 AP 的接受程度高于中性水平:分别为 3.91 ± 0.47 和 3.99 ± 0.43(p = 0.07)(可能得分范围为 1 至 5,中性分数为 3.0)。家长在受益项目中的得分高于儿童青少年(p = 0.04):我们根据文献中的项目编制了一份新的问卷,并证明了 "AP-接受度 "具有有意义的因子结构、良好的内部信度以及父母与青少年评价之间的一致性。这一测量方法可以成为临床医生和研究人员评估 T1D 儿科患者及其父母对 AP 接受程度的宝贵资源。这种对患者进行特征分析的方法有助于招收具有适当期望并最有可能从该系统中受益的 AID 候选者。
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引用次数: 0
Use of dulaglutide in a pregnant woman with type 2 diabetes until third trimester of pregnancy 患有 2 型糖尿病的孕妇在怀孕三个月前使用度拉鲁肽。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-10 DOI: 10.1007/s00592-024-02331-z
Martina Molteni, Sara Lodigiani, Marsida Teliti, Mario Rotondi, Valeria Guazzoni
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引用次数: 0
The correlation between HOMA-IR and cardiometabolic risk index among different metabolic adults: a cross-sectional study. 不同代谢成人的 HOMA-IR 与心脏代谢风险指数之间的相关性:一项横断面研究。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-09 DOI: 10.1007/s00592-024-02332-y
Qiyun Lu, Benjian Chen, Anxiang Li, Qingshun Liang, Jia Yao, Yiming Tao, Fangfang Dai, Xiaoling Hu, Jiayan Lu, Yunwei Liu, Yunyi Liu, Yingxi Wang, Jieer Long, RongHua Zhang, Zhenjie Liu

Aims: This study aimed to explore the correlation between homeostasis model assessment of insulin resistance(HOMA-IR)and cardiometabolic risk index(CMRI) among different metabolic adults to evaluate the value of HOMA-IR in predicting cardiometabolic risk.

Methods: This cross-sectional study was conducted over 18 months (from August 1, 2020 to February 18, 2022) and included 1550 participants divided into non-metabolic syndrome (non-MetS) group (n = 628) and metabolic syndrome (MetS) group (n = 922) in three centers of China. Logistic regression analysis was employed to investigate the correlation between HOMA-IR, body fat percentage, BMI (body mass index), visceral fat index, waist-to-hip ratio, vitamin D, and CMRI. Further analysis was conducted to evaluate the ability of HOMA-IR in diagnosing high CMRI within different metabolic, gender, and age groups to predict the risk of cardiovascular disease (CVD).

Results: HOMA-IR was significantly higher in the MetS group compared with the non-MetS group (P < 0.05). CMRI was significantly higher in the MetS group compared to the non-MetS group (P < 0.05). According to ROC curve analysis, HOMA-IR can predict cardiovascular risk (CVR) in the general population, non-MetS individuals, and MetS people. Logistic regression analysis revealed that BMI, visceral fat index, waist-to-hip ratio, and HOMA-IR are independent risk indicators of high CVR, whereas vitamin D may exert a protective role.

Conclusions: HOMA-IR was an independent risk factor for increased CVR in MetS patients. Moreover, HOMA-IR elevates the risk of CVD regardless of MetS and thus can be used for screening the general population.

Trial registration: The study was registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2100054654).

目的:本研究旨在探讨不同代谢成人的胰岛素抵抗稳态模型评估(HOMA-IR)与心脏代谢风险指数(CMRI)之间的相关性,以评估HOMA-IR在预测心脏代谢风险方面的价值:这项横断面研究历时18个月(2020年8月1日至2022年2月18日),纳入了中国三个中心的1550名参与者,分为非代谢综合征组(628人)和代谢综合征组(922人)。采用逻辑回归分析研究了 HOMA-IR、体脂率、BMI(体重指数)、内脏脂肪指数、腰臀比、维生素 D 和 CMRI 之间的相关性。进一步分析评估了 HOMA-IR 在不同代谢、性别和年龄组中诊断高 CMRI 的能力,以预测心血管疾病(CVD)的风险:结果:与非 MetS 组相比,MetS 组的 HOMA-IR 明显更高(P 结论:HOMA-IR 是心血管疾病风险的独立预测指标:HOMA-IR是MetS患者CVR增加的独立风险因素。此外,无论是否患有 MetS,HOMA-IR 都会增加心血管疾病的风险,因此可用于普通人群的筛查:该研究已在中国临床试验注册中心注册(注册号:ChiCTR2100054654)。
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引用次数: 0
Correction: GALNT2 expression is associated with glucose control and serum metabolites in patients with type 2 diabetes 更正:GALNT2 的表达与 2 型糖尿病患者的血糖控制和血清代谢物有关。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-08 DOI: 10.1007/s00592-024-02346-6
Vincenzo Trischitta, Alessandra Antonucci, Jerzy Adamski, Cornelia Prehn, Claudia Menzaghi, Antonella Marucci, Rosa Di Paola
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引用次数: 0
Vasorelaxant mechanisms of the antidiabetic anagliptin in rabbit aorta: roles of Kv channels and SERCA pump. 抗糖尿病药物阿格列汀在兔主动脉中的血管舒张机制:Kv 通道和 SERCA 泵的作用。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-06 DOI: 10.1007/s00592-024-02351-9
Ryeon Heo, Minju Park, Seo-Yeong Mun, Wenwen Zhuang, Junsu Jeong, Hongzoo Park, Eun-Taek Han, Jin-Hee Han, Wanjoo Chun, Won-Kyo Jung, Il-Whan Choi, Won Sun Park

Aims: The present study investigated the vasorelaxant mechanisms of an oral antidiabetic drug, anagliptin, using phenylephrine (Phe)-induced pre-contracted rabbit aortic rings.

Methods: Arterial tone measurement was performed in rabbit thoracic aortic rings.

Results: Anagliptin induced vasorelaxation in a dose-dependent manner. Pre-treatment with the classical voltagedependent K+ (Kv) channel inhibitors 4-aminopyridine and tetraethylammonium significantly decreased the vasorelaxant effect of anagliptin, whereas pre-treatment with the inwardly rectifying K+ (Kir) channel inhibitor Ba2+, the ATP-sensitive K+ (KATP) channel inhibitor glibenclamide, and the large-conductance Ca2+-activated K+ (BKCa) channel inhibitor paxilline did not attenuate the vasorelaxant effect. Furthermore, the vasorelaxant response of anagliptin was effectively inhibited by pre-treatment with the sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) pump inhibitors thapsigargin and cyclopiazonic acid. Neither cAMP/protein kinase A (PKA)-related signaling pathway inhibitors (adenylyl cyclase inhibitor SQ 22536 and PKA inhibitor KT 5720) nor cGMP/protein kinase G (PKG)-related signaling pathway inhibitors (guanylyl cyclase inhibitor ODQ and PKG inhibitor KT 5823) reduced the vasorelaxant effect of anagliptin. Similarly, the anagliptin-induced vasorelaxation was independent of the endothelium.

Conclusions: Based on these results, we suggest that anagliptin-induced vasorelaxation in rabbit aortic smooth muscle occurs by activating Kv channels and the SERCA pump, independent of other vascular K+ channels, cAMP/PKA- or cGMP/PKG-related signaling pathways, and the endothelium.

目的:本研究使用苯肾上腺素(Phe)诱导预收缩兔主动脉环,研究口服抗糖尿病药物阿格列汀的血管舒张机制:方法:在兔胸主动脉环上测量动脉张力:结果:阿格列汀诱导的血管舒张呈剂量依赖性。用经典的电压依赖性 K+ (Kv) 通道抑制剂 4- 氨基吡啶和四乙基铵进行预处理可显著降低阿格列汀的血管舒张作用,而用内向整流 K+ (Kir) 通道抑制剂 Ba2+、ATP敏感K+(KATP)通道抑制剂格列本脲和大电导Ca2+激活K+(BKCa)通道抑制剂帕西林的预处理并没有减弱舒张血管的作用。此外,用肌浆/内质网 Ca2+-ATP 酶(SERCA)泵抑制剂thapsigargin 和环噻嗪酸进行预处理可有效抑制阿格列汀的血管舒张反应。cAMP/蛋白激酶A(PKA)相关信号通路抑制剂(腺苷酸环化酶抑制剂SQ 22536和PKA抑制剂KT 5720)和cGMP/蛋白激酶G(PKG)相关信号通路抑制剂(鸟苷酸环化酶抑制剂ODQ和PKG抑制剂KT 5823)都不能降低阿格列汀的血管舒张作用。同样,阿格列汀诱导的血管舒张作用与内皮无关:基于这些结果,我们认为阿格列汀诱导的兔主动脉平滑肌血管舒张是通过激活 Kv 通道和 SERCA 泵实现的,与其他血管 K+ 通道、cAMP/PKA 或 cGMP/PKG 相关信号通路以及内皮无关。
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引用次数: 0
Time above range and no coefficient of variation is associated with diabetic retinopathy in individuals with type 1 diabetes and glycated hemoglobin within target. 对于糖化血红蛋白在目标范围内的 1 型糖尿病患者,时间超过范围且无变异系数与糖尿病视网膜病变有关。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-06 DOI: 10.1007/s00592-024-02347-5
Fernando Sebastian-Valles, Julia Martínez-Alfonso, Jose Alfonso Arranz Martin, Jessica Jiménez-Díaz, Iñigo Hernando Alday, Victor Navas-Moreno, Teresa Armenta-Joya, Maria Del Mar Fandiño García, Gisela Liz Román Gómez, Jon Garai Hierro, Luis Eduardo Lander Lobariñas, Carmen González-Ávila, Purificación Martinez de Icaya, Vicente Martínez-Vizcaíno, Mónica Marazuela, Miguel Antonio Sampedro-Nuñez

Aims: This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range.

Methods: We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards.

Results: Patients' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040).

Conclusion: TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.

目的:本研究旨在调查使用闪光连续血糖监测(FGM)系统的 1 型糖尿病(T1D)患者(包括将糖化血红蛋白(HbA1c)维持在目标范围内的患者)的血糖指标与糖尿病视网膜病变之间的关系:我们进行了一项横断面研究,涉及 1070 名使用闪光连续血糖监测系统的 T1D 患者。我们收集了临床、人体测量和社会经济特征方面的数据,并根据国际标准对视网膜病变进行了分类:患者的平均年龄为 47.6 ± 15.0 岁,其中 49.4% 为女性。队列中,24.8%的患者存在某种形式的视网膜病变。在对所有受试者样本进行的分析中,男性性别(OR = 1.51,p = 0.027)、TAR > 250 mg/dL (OR = 1.07,p = 0.025)、糖尿病病程(OR = 1.09,p 250)与糖尿病视网膜病变(OR = 8.32,p = 0.040)有独立联系,此外,吸烟(OR = 2.90,p = 0.031)、糖尿病病程(OR = 1.09,p 结论:TAR > 250 mg/dL 与糖尿病视网膜病变(OR = 8.32,p = 0.040)有独立联系:TAR > 250 mg/dL 是与糖尿病视网膜病变相关的一个重要可调节因素,即使在那些维持推荐 HbA1c 水平的患者中也是如此。了解血糖指标对于为 T1D 患者量身定制治疗策略至关重要。
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引用次数: 0
The impact of homocysteine on patients with diabetic nephropathy: a mendelian randomization study. 同型半胱氨酸对糖尿病肾病患者的影响:一项孟德尔随机研究。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-06 DOI: 10.1007/s00592-024-02343-9
Baiju Wang, Han Li, Na Wang, Yuan Li, Zihua Song, Yajuan Chen, Xiaobing Li, Lei Liu, Hanwen Chen

Background/aims: Homocysteine (Hcy) has been associated with an increased risk of diabetic nephropathy (DN) in patients, but there is still controversy. This study aims to investigate the causal relationship between plasma Hcy and DN.

Methods: A Mendelian randomization (MR) study using data from 2 samples was employed to infer causal relationships. The aggregated genetic data associated with Hcy was derived from the largest genome-wide association study (GWAS) to date, involving 44,147 individuals of European ancestry.Data on SNP-diabetic nephropathy, creatinine, and urea nitrogen were obtained from the IEU GWAS database. The analysis method employed a fixed-effect or random-effect inverse variance-weighted approach to estimate effects.Additional analysis methods were used to assess stability and sensitivity. The potential for pleiotropy was evaluated using the MR-Egger intercept test.

Results: Using 12 SNPs as instrumental variables, two-sample MR analysis revealed no evidence of a causal relationship between genetically predicted plasma Hcy levels and diabetic nephropathy, as well as creatinine and blood urea nitrogen levels. This finding is consistent with the results obtained from other testing methods.

Conclusions: Two-sample Mendelian Randomization analysis found no evidence of a causal relationship between plasma homocysteine levels and diabetic nephropathy, creatinine, or urea.

背景/目的:同型半胱氨酸(Hcy)与患者糖尿病肾病(DN)风险增加有关,但仍存在争议。本研究旨在探讨血浆 Hcy 与 DN 之间的因果关系:方法:使用两个样本的数据进行孟德尔随机化(MR)研究,以推断因果关系。与 Hcy 相关的综合遗传数据来自迄今为止最大的全基因组关联研究(GWAS),涉及 44,147 名欧洲血统的个体。SNP-糖尿病肾病、肌酐和尿素氮的数据来自 IEU GWAS 数据库。分析方法采用固定效应或随机效应反方差加权法来估计效应。使用MR-Egger截距检验评估了多向性的可能性:使用 12 个 SNP 作为工具变量,双样本 MR 分析显示,没有证据表明基因预测的血浆 Hcy 水平与糖尿病肾病以及肌酐和血尿素氮水平之间存在因果关系。这一结果与其他测试方法得出的结果一致:结论:双样本孟德尔随机分析没有发现血浆同型半胱氨酸水平与糖尿病肾病、肌酐或尿素之间存在因果关系的证据。
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引用次数: 0
The differences of metabolic profiles, socioeconomic status and diabetic retinopathy in U.S. working-age and elderly adults with diabetes: results from NHANES 1999-2018. 美国适龄劳动人口和老年糖尿病患者的代谢概况、社会经济地位和糖尿病视网膜病变的差异:NHANES 1999-2018 年的结果。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-05 DOI: 10.1007/s00592-024-02328-8
Bo Li, Xiaoyun Cheng, Yikeng Huang, Chuandi Zhou, Chufeng Gu, Xinyu Zhu, Chenxin Li, Mingming Ma, Ying Fan, Xun Xu, Zhi Zheng, Haibing Chen, Shuzhi Zhao

Aims: Controlled metabolic factors and socioeconomic status (SES) was crucial for prevention of diabetic retinopathy (DR). The study aims to assess the metabolic factors control and SES among working-age adults (18-64 years) with diabetes compared to older adults (65 years and older).

Methods: Totals of 6738 participants with self-reported diagnosed diabetes from National Health and Nutrition Examination Survey were included, of whom 3482 were working-age and 3256 were elderly. The prevalence of DR, metabolic factors control, and the impact of SES and diabetic duration on DR was estimated. Subgroup analysis among working-age adults was employed across different diabetic duration and SES level.

Results: The prevalence of DR was 20.8% among working-age adults and 20.6% in elderly adults. Further, working-age adults possessed suboptimal control on glycemia (median HbA1c: 7.0% vs. 6.8%, p < 0.001) and lipids (Low-density lipoprotein < 100 mg/dL: 46.4% vs. 63.5%, p < 0.001), but better blood pressure control (< 130/80 mmHg: 53.5% vs. 37.5%, p < 0.001) compared to the elderly, judging based on age-specific control targets. Prolonged diabetic duration didn't improve glycemic and composite factors control. SES like education and income impacted metabolic factors control and adults with higher SES were more likely to control well. Diabetic duration was a significant risk factor (OR = 4.006, 95%CI= (2.752,5.832), p < 0.001) while higher income (OR = 0.590, 95%CI= (0.421,0.826), p = 0.002) and educational level (OR = 0.637, 95%CI= (0.457,0.889), p = 0.008) were protective against DR.

Conclusions: Working-age adults with diabetes demonstrate suboptimal metabolic profile control, especially glycemia and lipids. Additional efforts are needed to improve metabolic factor control and reduce DR risk, particularly for those with longer diabetes duration, less education, and lower incomes.

目的:控制代谢因素和社会经济地位(SES)对预防糖尿病视网膜病变(DR)至关重要。本研究旨在评估与老年人(65 岁及以上)相比,工作年龄成年人(18-64 岁)糖尿病患者的代谢因素控制和社会经济地位:方法:共纳入了 6738 名在全国健康与营养调查中自我报告确诊为糖尿病的参与者,其中 3482 人为工作年龄段,3256 人为老年人。对DR患病率、代谢因素控制以及社会经济状况和糖尿病病程对DR的影响进行了估计。对不同糖尿病病程和社会经济地位的工作年龄成人进行了分组分析:结果:劳动适龄成年人的 DR 患病率为 20.8%,老年人为 20.6%。此外,工作年龄段的成年人血糖控制不佳(HbA1c 中位数:7.0% vs. 6.8%,p 结论:工作年龄段的成年人糖尿病患者的血糖控制不佳(HbA1c 中位数:7.0% vs. 6.8%,p):工作年龄段的成人糖尿病患者的代谢情况控制不佳,尤其是血糖和血脂。需要采取更多措施来改善代谢因素控制和降低 DR 风险,尤其是对于糖尿病病程较长、受教育程度较低和收入较低的人群。
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引用次数: 0
Continuous glycemic monitoring in managing diabetes in adult patients with wolfram syndrome 连续血糖监测在管理沃尔夫拉姆综合征成年患者糖尿病中的应用
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-03 DOI: 10.1007/s00592-024-02350-w
Agnieszka Zmysłowska, Julia Grzybowska-Adamowicz, Arkadiusz Michalak, Julia Wykrota, Agnieszka Szadkowska, Wojciech Młynarski, Wojciech Fendler

Aims

In this study we evaluated the use of Continuous Glucose Monitoring system in adults with insulin-dependent diabetes in the course of Wolfram syndrome (WFS) in comparison to patients with type 1 diabetes (T1D).

Methods

Individuals with WFS (N = 10) used continuous glucose monitoring for 14 days and were compared with 30 patients with T1D matched using propensity score for age and diabetes duration. Glycemic variability was calculated with Glyculator 3.0.

Results

We revealed significant differences in glycemic indices between adults with Wolfram syndrome-related diabetes and matched comparison group. Patients with Wolfram syndrome presented lower mean glucose in 24-h and nighttime records [24h: 141.1 ± 30.4mg/dl (N = 10) vs 164.9 ± 31.3mg/dl (N = 30), p = 0.0427; nighttime: 136.7 ± 39.6mg/dl vs 166.2 ± 32.1mg/dl (N = 30), p = 0.0442]. Moreover, they showed lower standard deviation of sensor glucose over all periods [24h: 50.3 ± 9.2mg/dl (N = 10) vs 67.7 ± 18.7 mg/dl (N = 30), p = 0.0075; daytime: 50.8 ± 8.7mg/dl (N = 10) vs 67.4 ± 18.0mg/dl (N = 30), p = 0.0082; nighttime: 45.1 ± 14.9mg/dl (N = 10) vs 65.8 ± 23.2mg/dl (n = 30), p = 0.0119] and coefficient of variation at night [33.3 ± 5.8% (N = 10) vs 40.5 ± 8.8% (N = 30), p = 0.0210]. Additionally, WFS patients displayed lower time in high-range hyperglycemia (> 250mg/dl) across all parts of day [24h: 4.6 ± 3.8% (N = 10) vs 13.4 ± 10.5% (N = 30), p = 0.0004; daytime: 4.7 ± 3.9% (N = 10) vs 13.8 ± 11.2% (N = 30), p = 0.0005; nighttime: 4.2 ± 5.5% (N = 10) vs 12.1 ± 10.3% (N = 30), p = 0.0272].

Conclusions

Adult patients with Wolfram syndrome show lower mean blood glucose, less extreme hyperglycemia, and lower glycemic variability in comparison to patients with type 1 diabetes.

目的 在这项研究中,我们评估了胰岛素依赖型糖尿病成人患者在沃尔夫拉姆综合征(WFS)病程中使用连续葡萄糖监测系统的情况,并与 1 型糖尿病(T1D)患者进行了比较。方法 WFS 患者(10 人)使用连续葡萄糖监测系统 14 天,并与 30 名根据年龄和糖尿病病程进行倾向评分的 T1D 患者进行比较。结果我们发现沃尔夫拉姆综合征相关成人糖尿病患者与匹配的对比组之间的血糖指数存在显著差异。沃尔夫拉姆综合征患者 24 小时和夜间记录的平均血糖较低[24 小时:141.1 ± 30.4]:141.1 ± 30.4mg/dl (N = 10) vs 164.9 ± 31.3mg/dl (N = 30),p = 0.0427;夜间:136.7 ± 39.6mg/dl vs 166.2 ± 32.1mg/dl (N = 30),p = 0.0442]。此外,他们在所有时段的传感器血糖标准偏差都较低[24 小时:50.3 ± 9.2mg/dl vs 166.2 ± 32.1mg/dl(N = 30)]:50.3 ± 9.2mg/dl (N = 10) vs 67.7 ± 18.7mg/dl (N = 30),p = 0.0075;白天:50.8 ± 8.7mg/dl (N = 10) vs 67.4 ± 18.0mg/dl (N = 30),p = 0.0082;夜间:45.1 ± 14.9mg/dl (N = 30),p = 0.0442]:45.1 ± 14.9mg/dl (N = 10) vs 65.8 ± 23.2mg/dl (N = 30),p = 0.0119]和夜间变异系数[33.3 ± 5.8% (N = 10) vs 40.5 ± 8.8% (N = 30),p = 0.0210]。此外,WFS 患者全天处于高血糖状态(> 250mg/dl)的时间较短[24 小时:4.6 ± 3.8% (N = 10) vs 40.5 ± 8.8% (N = 30)]:4.6 ± 3.8% (N = 10) vs 13.4 ± 10.5% (N = 30),p = 0.0004;日间:4.7 ± 3.9% (N = 10) vs 13.4 ± 10.5% (N = 30),p = 0.0210]:4.7±3.9%(10 人)vs 13.8±11.2%(30 人),p = 0.0005;夜间:4.2±5.5%(10 人)vs 13.8±11.2%(30 人),p = 0.0005:结论与 1 型糖尿病患者相比,Wolfram 综合征成人患者的平均血糖较低,极度高血糖现象较少,血糖变异性较低。
{"title":"Continuous glycemic monitoring in managing diabetes in adult patients with wolfram syndrome","authors":"Agnieszka Zmysłowska,&nbsp;Julia Grzybowska-Adamowicz,&nbsp;Arkadiusz Michalak,&nbsp;Julia Wykrota,&nbsp;Agnieszka Szadkowska,&nbsp;Wojciech Młynarski,&nbsp;Wojciech Fendler","doi":"10.1007/s00592-024-02350-w","DOIUrl":"10.1007/s00592-024-02350-w","url":null,"abstract":"<div><h3>Aims</h3><p>In this study we evaluated the use of Continuous Glucose Monitoring system in adults with insulin-dependent diabetes in the course of Wolfram syndrome (WFS) in comparison to patients with type 1 diabetes (T1D).</p><h3>Methods</h3><p>Individuals with WFS (N = 10) used continuous glucose monitoring for 14 days and were compared with 30 patients with T1D matched using propensity score for age and diabetes duration. Glycemic variability was calculated with Glyculator 3.0.</p><h3>Results</h3><p>We revealed significant differences in glycemic indices between adults with Wolfram syndrome-related diabetes and matched comparison group. Patients with Wolfram syndrome presented lower mean glucose in 24-h and nighttime records [24h: 141.1 ± 30.4mg/dl (N = 10) vs 164.9 ± 31.3mg/dl (N = 30), p = 0.0427; nighttime: 136.7 ± 39.6mg/dl vs 166.2 ± 32.1mg/dl (N = 30), p = 0.0442]. Moreover, they showed lower standard deviation of sensor glucose over all periods [24h: 50.3 ± 9.2mg/dl (N = 10) vs 67.7 ± 18.7 mg/dl (N = 30), p = 0.0075; daytime: 50.8 ± 8.7mg/dl (N = 10) vs 67.4 ± 18.0mg/dl (N = 30), p = 0.0082; nighttime: 45.1 ± 14.9mg/dl (N = 10) vs 65.8 ± 23.2mg/dl (n = 30), p = 0.0119] and coefficient of variation at night [33.3 ± 5.8% (N = 10) vs 40.5 ± 8.8% (N = 30), p = 0.0210]. Additionally, WFS patients displayed lower time in high-range hyperglycemia (&gt; 250mg/dl) across all parts of day [24h: 4.6 ± 3.8% (N = 10) vs 13.4 ± 10.5% (N = 30), p = 0.0004; daytime: 4.7 ± 3.9% (N = 10) vs 13.8 ± 11.2% (N = 30), p = 0.0005; nighttime: 4.2 ± 5.5% (N = 10) vs 12.1 ± 10.3% (N = 30), p = 0.0272].</p><h3>Conclusions</h3><p>Adult patients with Wolfram syndrome show lower mean blood glucose, less extreme hyperglycemia, and lower glycemic variability in comparison to patients with type 1 diabetes.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 10","pages":"1333 - 1338"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-024-02350-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884872","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
Elucidating the role of genetically determined metabolites in Diabetic Retinopathy: insights from a mendelian randomization analysis. 阐明由基因决定的代谢物在糖尿病视网膜病变中的作用:孟德尔随机分析的启示。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1007/s00592-024-02345-7
Yao Tan, Zuyun Yan, Jiayang Yin, Jiamin Cao, Bingyu Xie, Feng Zhang, Wenhua Zhang, Wei Xiong

Aims: Diabetic retinopathy (DR) results from complex genetic and metabolic interactions. Unraveling the links between blood metabolites and DR can advance risk prediction and therapy.

Methods: Leveraging Mendelian Randomization (MR) and Linkage Disequilibrium Score Regression (LDSC), we analyzed 10,413 DR cases and 308,633 controls. Data was sourced from the Metabolomics GWAS server and the FinnGen project.

Results: Our research conducted a comprehensive MR analysis across 486 serum metabolites to investigate their causal role in DR. After stringent selection and validation of instrumental variables, we focused on 480 metabolites for analysis. Our findings revealed 38 metabolites potentially causally associated with DR. Specifically, 4-androsten-3beta,17beta-diol disulfate 2 was identified as significantly associated with a reduced risk of DR (OR = 0.471, 95% CI = 0.324-0.684, p = 7.87 × 10- 5), even after rigorous adjustments for multiple testing. Sensitivity analyses further validated the robustness of this association, and linkage disequilibrium score regression analyses showed no significant genetic correlation between this metabolite and DR, suggesting a specific protective effect against DR.

Conclusions: Our study identifies 4-androsten-3beta,17beta-diol disulfate 2, a metabolite of androgens, as a significant protective factor against diabetic retinopathy, suggesting androgens as potential therapeutic targets.

目的:糖尿病视网膜病变(DR)是复杂的遗传和代谢相互作用的结果。揭示血液代谢物与糖尿病视网膜病变之间的联系可以促进风险预测和治疗:利用孟德尔随机化(Mendelian Randomization,MR)和连锁不平衡评分回归(Linkage Disequilibrium Score Regression,LDSC),我们分析了 10,413 例 DR 病例和 308,633 例对照。数据来源于代谢组学 GWAS 服务器和 FinnGen 项目:我们的研究对 486 种血清代谢物进行了全面的 MR 分析,以研究它们在 DR 中的因果作用。经过对工具变量的严格筛选和验证,我们重点分析了 480 种代谢物。我们的研究结果显示,38种代谢物可能与DR存在因果关系。特别是 4-雄烯-3beta,17beta-二醇二硫酸盐 2 被确定与降低 DR 风险显著相关(OR = 0.471,95% CI = 0.324-0.684,p = 7.87 × 10-5),即使经过严格的多重测试调整也是如此。敏感性分析进一步验证了这种关联的稳健性,连锁不平衡得分回归分析表明,这种代谢物与DR之间没有显著的遗传相关性,这表明对DR有特殊的保护作用:我们的研究发现雄激素的代谢产物 4-雄烯-3beta,17beta-二醇二硫酸盐 2 是糖尿病视网膜病变的重要保护因素,这表明雄激素是潜在的治疗靶点。
{"title":"Elucidating the role of genetically determined metabolites in Diabetic Retinopathy: insights from a mendelian randomization analysis.","authors":"Yao Tan, Zuyun Yan, Jiayang Yin, Jiamin Cao, Bingyu Xie, Feng Zhang, Wenhua Zhang, Wei Xiong","doi":"10.1007/s00592-024-02345-7","DOIUrl":"https://doi.org/10.1007/s00592-024-02345-7","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic retinopathy (DR) results from complex genetic and metabolic interactions. Unraveling the links between blood metabolites and DR can advance risk prediction and therapy.</p><p><strong>Methods: </strong>Leveraging Mendelian Randomization (MR) and Linkage Disequilibrium Score Regression (LDSC), we analyzed 10,413 DR cases and 308,633 controls. Data was sourced from the Metabolomics GWAS server and the FinnGen project.</p><p><strong>Results: </strong>Our research conducted a comprehensive MR analysis across 486 serum metabolites to investigate their causal role in DR. After stringent selection and validation of instrumental variables, we focused on 480 metabolites for analysis. Our findings revealed 38 metabolites potentially causally associated with DR. Specifically, 4-androsten-3beta,17beta-diol disulfate 2 was identified as significantly associated with a reduced risk of DR (OR = 0.471, 95% CI = 0.324-0.684, p = 7.87 × 10<sup>- 5</sup>), even after rigorous adjustments for multiple testing. Sensitivity analyses further validated the robustness of this association, and linkage disequilibrium score regression analyses showed no significant genetic correlation between this metabolite and DR, suggesting a specific protective effect against DR.</p><p><strong>Conclusions: </strong>Our study identifies 4-androsten-3beta,17beta-diol disulfate 2, a metabolite of androgens, as a significant protective factor against diabetic retinopathy, suggesting androgens as potential therapeutic targets.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141873895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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