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Cardiovascular disease risk factors and their associations with inflammation among US adolescents: NHANES, 2015 to March 2020. 美国青少年心血管疾病风险因素及其与炎症的关系:NHANES,2015 年至 2020 年 3 月。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-03 DOI: 10.1136/bmjdrc-2024-004148
Sarah S Casagrande, Jean M Lawrence

Introduction: The prevalence of obesity and glycemic dysfunction in adolescents has increased over the past several decades but less is known on how these conditions are associated with systemic inflammation in this population. This study determined the associations between cardiovascular disease (CVD) risk factors and inflammation among a nationally representative sample of US. adolescents.

Research design and methods: Cross-sectional analyses were conducted among 2693 adolescents aged 12-19 years who participated in the 2015 to March 2020 National Health and Nutrition Examination Surveys. Chronic inflammation was determined using laboratory measures for high-sensitivity C reactive protein (hs-CRP). Adjusted ORs (aOR, 95% CI) were calculated from logistic regression models to determine the association between CVD risk factors (obesity, overweight, dysglycemia, hypertension, hyperlipidemia) and elevated hs-CRP (>3.0 mg/L) while controlling for sociodemographic characteristics and other CVD risk factors.

Results: Overall, 15.3% of adolescents had elevated hs-CRP. Adolescents who were older (16-19 years vs 12-15 years), obese, had A1c ≥5.7% (≥39 mmol/mol), high total cholesterol, or low high-density lipoprotein had hs-CRP distributions that were more high risk (χ2 p value <0.001). Adolescents with obesity or A1c ≥5.7% had a sixfold and a nearly twofold higher odds of elevated hs-CRP compared those without obesity and A1c <5.7% after full adjustment (aOR=6.39, 4.64 to 8.79 and aOR=1.70, 1.05 to 3.06, respectively). Adolescents with hypertension or hyperlipidemia were significantly more likely to have elevated hs-CRP compared with those without these conditions after adjustment for sociodemographic characteristics (aOR=2.46, 1.08 to 5.60 and aOR=2.19, 1.36 to 3.54, respectively), but the association was not significant after further adjustment for obesity.

Conclusions: Among US adolescents, obesity was strongly associated with elevated hs-CRP, a marker for future CVD risk. Given the obesity epidemic and the marked proportion with elevated CRP, concern should be given to future CVD risk in younger adults.

导言:在过去几十年中,青少年肥胖症和血糖功能障碍的发病率有所上升,但人们对这些疾病与该人群全身炎症的关系却知之甚少。本研究确定了具有全国代表性的美国青少年样本中心血管疾病(CVD)风险因素与炎症之间的关联:对参加 2015 年至 2020 年 3 月全国健康与营养调查的 2693 名 12-19 岁青少年进行了横断面分析。慢性炎症是通过实验室测量高敏C反应蛋白(hs-CRP)来确定的。通过逻辑回归模型计算调整后的ORs(aOR,95% CI),以确定心血管疾病风险因素(肥胖、超重、血糖异常、高血压、高脂血症)与hs-CRP升高(>3.0 mg/L)之间的关系,同时控制社会人口学特征和其他心血管疾病风险因素:总体而言,15.3%的青少年的hs-CRP升高。年龄较大(16-19 岁与 12-15 岁)、肥胖、A1c ≥5.7%(≥39 mmol/mol)、总胆固醇较高或高密度脂蛋白较低的青少年的 hs-CRP 分布更高风险(χ2 p 值):在美国青少年中,肥胖与 hs-CRP 升高密切相关,而 hs-CRP 是未来心血管疾病风险的标志。鉴于肥胖症的流行和 CRP 升高的显著比例,应关注年轻成年人未来的心血管疾病风险。
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引用次数: 0
Changes in use and hospital outcomes of bariatric surgery in Spain (2016-2022): analysis of the role of type 2 diabetes using propensity score matching. 西班牙减肥手术的使用和住院效果变化(2016-2022 年):利用倾向得分匹配分析 2 型糖尿病的作用。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-03 DOI: 10.1136/bmjdrc-2024-004351
Ana Lopez-de-Andres, Rodrigo Jimenez-Garcia, Natividad Cuadrado-Corrales, David Carabantes-Alarcon, Valentin Hernandez-Barrera, Javier de Miguel-Diez, Ana Jimenez-Sierra, José Javier Zamorano-Leon

Introduction: The objectives of this study were to examine temporal trends in the incidence of bariatric surgery (Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)) in patients with and without type 2 diabetes mellitus (T2DM). Outcomes of hospitalization and the impact of T2DM on these outcomes were also analyzed.

Research design and methods: We performed an observational study with the Spanish national hospital discharge database. Obese patients with and without T2DM who underwent RYGB and SG between 2016 and 2022 were identified. Propensity score matching (PSM) and logistic regression were used to compare patients with and without T2DM and to evaluate the effect of T2DM and other variables on outcomes of surgery. A variable "severity" was created to cover patients who died in hospital or were admitted to the intensive care unit (ICU).

Results: A total of 32,176 bariatric surgery interventions were performed (28.86% with T2DM). 31.57% of RYGBs and 25.53% of SG patients had T2DM. The incidence of RYGB and SG increased significantly between 2016 and 2022 (p<0.001), with a higher incidence in those with T2DM than in those without (incidence rate ratio 4.07 (95% CI 3.95 to 4.20) for RYGB and 3.02 (95% CI 2.92 to 3.14) for SG). In patients who underwent SG, admission to the ICU and severity were significantly more frequent in patients with T2DM than in those without (both p<0.001). In the multivariate analysis, having T2DM was associated with more frequent severity in those who received SG (OR 1.23; 95% CI 1.07 to 1.42).

Conclusions: Between 2016 and 2022, bariatric surgery procedures performed in Spain increased in patients with and without T2DM. More interventions were performed on patients with T2DM than on patients without T2DM. RYGB was the most common procedure in patients with T2DM. The presence of T2DM was associated with more severity after SG.

简介:本研究旨在探讨2型糖尿病(T2DM)患者和非2型糖尿病患者接受减肥手术(Roux-en-Y胃旁路术(RYGB)和袖状胃切除术(SG))的时间趋势。研究设计和方法:我们利用西班牙国家医院出院数据库进行了一项观察性研究。确定了在 2016 年至 2022 年期间接受 RYGB 和 SG 治疗的有 T2DM 和无 T2DM 的肥胖患者。采用倾向评分匹配(PSM)和逻辑回归对有 T2DM 和无 T2DM 的患者进行比较,并评估 T2DM 和其他变量对手术结果的影响。此外,还创建了一个变量 "严重程度",以涵盖在医院死亡或住进重症监护室(ICU)的患者:共实施了 32 176 例减肥手术(28.86% 的患者患有 T2DM)。31.57%的 RYGB 和 25.53% 的 SG 患者患有 T2DM。2016年至2022年间,RYGB和SG的发病率显著增加(P结论:2016年至2022年期间,西班牙实施的减肥手术在T2DM患者和非T2DM患者中均有所增加。对T2DM患者实施的干预手术多于非T2DM患者。RYGB是T2DM患者最常见的手术。T2DM与SG术后的严重程度有关。
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引用次数: 0
Impact of mitigating obesity, smoking, and physical inactivity on type 2 diabetes mellitus burden in Oman: insights from mathematical modeling. 减轻肥胖、吸烟和缺乏运动对阿曼 2 型糖尿病负担的影响:数学建模的启示。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-03 DOI: 10.1136/bmjdrc-2024-004248
Asalah Alareeki, Susanne F Awad, Adhra Al-Mawali, Magdi Morsi, Julia A Critchley, Jawad A Al-Lawati, Laith J Abu-Raddad

Introduction: To estimate the impact of reducing obesity, smoking, and physical inactivity (PIA) prevalence, and of introducing physical activity (PA) as an explicit intervention, on the prevalence, incidence, and mortality of type 2 diabetes mellitus (T2DM) in Oman.

Research design and methods: A deterministic population-level mathematical model was employed to investigate the impact of different scenarios for reducing T2DM risk factors on T2DM epidemiology. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status and parameterized with nationally representative data. Intervention scenarios were calculated and compared with a baseline (no-intervention) scenario for changes in T2DM prevalence, incidence, and mortality among adult Omanis between 2020 and 2050.

Results: In the no-intervention scenario, T2DM prevalence increased from 15.2% in 2020 to 23.8% in 2050. Achieving the goals of halting the rise of obesity, reducing smoking by 30%, and reducing PIA by 10% as outlined in the WHO's Global Action Plan for Non-communicable Diseases (implemented between 2020 and 2030 and then maintained between 2031 and 2050) would reduce T2DM prevalence by 32.2%, cumulative incidence by 31.3%, and related deaths by 19.3% by 2050. Halting the rise of or reducing obesity prevalence by 10%-50% would reduce T2DM prevalence by 33.0%-51.3%, cumulative incidence by 31.9%-53.0%, and related deaths by 19.5%-35.6%. Reducing smoking or PIA prevalence by 10%-50% would lead to smaller reductions of less than 5% in T2DM prevalence, cumulative incidence, and related deaths. Introducing PA with varying intensities at a 25% coverage would reduce T2DM prevalence by 4.9%-14.1%, cumulative incidence by 4.8%-13.8%, and related deaths by 3.4%-9.6% by 2050.

Conclusions: Intervention-for-prevention efforts targeting obesity reduction and introducing PA could result in major reductions in the T2DM burden. Prioritizing such interventions could alleviate the burden of T2DM in Oman and other countries with similarly high T2DM and obesity burdens.

导言:目的:估算减少肥胖、吸烟和缺乏运动(PIA)的发生率,以及引入体育锻炼(PA)作为明确的干预措施,对阿曼 2 型糖尿病(T2DM)的发生率、发病率和死亡率的影响:采用确定性人口数学模型研究减少 T2DM 风险因素的不同方案对 T2DM 流行病学的影响。该模型按性别、年龄组、风险因素状况、T2DM 状况和干预状况进行了分层,并使用具有全国代表性的数据进行了参数化。计算了干预方案,并与基线(无干预)方案比较了 2020 年至 2050 年阿曼成年人 T2DM 患病率、发病率和死亡率的变化:结果:在无干预情景下,T2DM 患病率从 2020 年的 15.2% 上升到 2050 年的 23.8%。如果能实现世界卫生组织《非传染性疾病全球行动计划》(2020 年至 2030 年期间实施,然后在 2031 年至 2050 年期间保持实施)中提出的阻止肥胖增加、减少吸烟 30% 和减少 PIA 10% 的目标,到 2050 年,T2DM 患病率将降低 32.2%,累计发病率降低 31.3%,相关死亡人数降低 19.3%。阻止肥胖率上升或将肥胖率降低 10%-50%,将使 T2DM 患病率降低 33.0%-51.3%,累计发病率降低 31.9%-53.0%,相关死亡人数降低 19.5%-35.6%。将吸烟或 PIA 患病率降低 10%-50%,可使 T2DM 患病率、累积发病率和相关死亡人数的降低幅度较小,均低于 5%。到 2050 年,以 25% 的覆盖率引入不同强度的体育锻炼将使 T2DM 患病率降低 4.9%-14.1%,累计发病率降低 4.8%-13.8%,相关死亡人数降低 3.4%-9.6%:结论:以减少肥胖和引入体育锻炼为目标的预防干预措施可大幅减少 T2DM 的负担。在阿曼和其他 T2DM 和肥胖负担同样较重的国家,优先采取此类干预措施可减轻 T2DM 的负担。
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引用次数: 0
Association between personality, lifestyle behaviors, and cardiovascular diseases in type 2 diabetes mellitus: a population-based cohort study of UK Biobank data 2 型糖尿病患者的性格、生活方式行为与心血管疾病之间的关系:基于英国生物数据库数据的人群队列研究
IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 DOI: 10.1136/bmjdrc-2024-004244
Chan Soon Park, Jaewon Choi, Soongu Kwak, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Soo Heon Kwak, Jun-Bean Park
Introduction Various strategies aim to better assess risks and refine prevention for patients with type 2 diabetes mellitus (T2DM), who vary in cardiovascular disease (CVD) risk. However, the prognostic value of personality and its association with lifestyle factors remain elusive. Research design and methods We identified 8794 patients with T2DM from the UK Biobank database between 2006 and 2010 and followed them up until the end of 2021. We assessed personality traits using the Big Five proxies derived from UK Biobank data: sociability, warmth, diligence, curiosity, and nervousness. Healthy lifestyle behaviors were determined from information about obesity, smoking status, and physical activity. The primary outcome was a composite of incident CVD, including myocardial infarction (MI), ischemic stroke (IS), atrial fibrillation (AF), and heart failure (HF). Results During a median follow-up of 13.6 years, a total of 2110 patients experienced CVDs. Among personality traits, diligence was significantly associated with a reduced risk of primary and secondary outcomes. The adjusted HRs with 95% CIs were: composite CVD, 0.93 (0.89–0.97); MI 0.90 (0.82–1.00); IS 0.83 (0.74–0.94); AF 0.92 (0.85–0.98); HF 0.84 (0.76–0.91). Healthy lifestyle behaviors significantly reduced the risk of composite CVDs in groups with high and low diligence. The findings of a structural equation model showed that diligence directly affected the risk of the primary outcome or indirectly by modifying lifestyle behaviors. Conclusion This study revealed which personality traits can influence CVD risk during T2DM and how patients might benefit from adopting healthy lifestyle behaviors in relation to personality. Data are available upon reasonable request. The data used in the present research are available via a direct application to the UK Biobank () and this research was conducted with approved access to UK Biobank data under application ID 91312. All other data supporting the research findings are available within the article and its supplementary information files and from the corresponding author upon reasonable request.
导言:2 型糖尿病(T2DM)患者的心血管疾病(CVD)风险各不相同,为了更好地评估患者的风险并完善其预防措施,我们采取了各种策略。然而,性格的预后价值及其与生活方式因素的关系仍然难以捉摸。研究设计和方法 我们从英国生物库数据库中确定了 2006 年至 2010 年期间的 8794 名 T2DM 患者,并对他们进行了跟踪调查,直至 2021 年底。我们使用从英国生物库数据中提取的五大代用指标来评估人格特质:交际能力、热情、勤奋、好奇和紧张。健康的生活方式行为是通过肥胖、吸烟状况和体育锻炼等信息确定的。主要结果是心血管疾病(包括心肌梗死、缺血性中风、心房颤动和心力衰竭)的综合指数。结果 在中位 13.6 年的随访期间,共有 2110 名患者发生了心血管疾病。在人格特质中,勤奋与主要和次要结局风险的降低有显著相关性。调整后的HRs(95% CIs)为:综合心血管疾病0.93(0.89-0.97);心肌梗死0.90(0.82-1.00);IS 0.83(0.74-0.94);房颤0.92(0.85-0.98);高血压0.84(0.76-0.91)。在勤奋程度高和勤奋程度低的人群中,健康生活方式行为可明显降低复合心血管疾病的风险。结构方程模型的结果表明,勤奋程度直接影响主要结果的风险,或通过改变生活方式行为间接影响主要结果的风险。结论 本研究揭示了哪些性格特征会影响 T2DM 患者的心血管疾病风险,以及患者如何从与性格相关的健康生活方式行为中获益。如有合理要求,可提供相关数据。本研究中使用的数据可通过向英国生物库(UK Biobank)直接申请获得,本研究是在获得批准后访问英国生物库数据进行的,申请编号为 91312。支持研究结果的所有其他数据可在文章及其补充信息文件中获取,也可向相应作者索取。
{"title":"Association between personality, lifestyle behaviors, and cardiovascular diseases in type 2 diabetes mellitus: a population-based cohort study of UK Biobank data","authors":"Chan Soon Park, Jaewon Choi, Soongu Kwak, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Soo Heon Kwak, Jun-Bean Park","doi":"10.1136/bmjdrc-2024-004244","DOIUrl":"https://doi.org/10.1136/bmjdrc-2024-004244","url":null,"abstract":"Introduction Various strategies aim to better assess risks and refine prevention for patients with type 2 diabetes mellitus (T2DM), who vary in cardiovascular disease (CVD) risk. However, the prognostic value of personality and its association with lifestyle factors remain elusive. Research design and methods We identified 8794 patients with T2DM from the UK Biobank database between 2006 and 2010 and followed them up until the end of 2021. We assessed personality traits using the Big Five proxies derived from UK Biobank data: sociability, warmth, diligence, curiosity, and nervousness. Healthy lifestyle behaviors were determined from information about obesity, smoking status, and physical activity. The primary outcome was a composite of incident CVD, including myocardial infarction (MI), ischemic stroke (IS), atrial fibrillation (AF), and heart failure (HF). Results During a median follow-up of 13.6 years, a total of 2110 patients experienced CVDs. Among personality traits, diligence was significantly associated with a reduced risk of primary and secondary outcomes. The adjusted HRs with 95% CIs were: composite CVD, 0.93 (0.89–0.97); MI 0.90 (0.82–1.00); IS 0.83 (0.74–0.94); AF 0.92 (0.85–0.98); HF 0.84 (0.76–0.91). Healthy lifestyle behaviors significantly reduced the risk of composite CVDs in groups with high and low diligence. The findings of a structural equation model showed that diligence directly affected the risk of the primary outcome or indirectly by modifying lifestyle behaviors. Conclusion This study revealed which personality traits can influence CVD risk during T2DM and how patients might benefit from adopting healthy lifestyle behaviors in relation to personality. Data are available upon reasonable request. The data used in the present research are available via a direct application to the UK Biobank (<http://www.ukbiobank.ac.uk/register-apply/>) and this research was conducted with approved access to UK Biobank data under application ID 91312. All other data supporting the research findings are available within the article and its supplementary information files and from the corresponding author upon reasonable request.","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Assessment of neuropathy subtypes in type 1 diabetes. 评估 1 型糖尿病的神经病变亚型。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-18 DOI: 10.1136/bmjdrc-2024-004289
Pall Karlsson, Marie Balle Sjogaard, Karoline Schousboe, Hatice Isik Mizrak, Huda Kufaishi, Troels Staehelin Jensen, Jens Randel Nyengaard, Christian Stevns Hansen, Knud Bonnet Yderstræde, Christian Selmer Buhl

Introduction: Diabetic polyneuropathy (DPN), a common complication of diabetes, can manifest as small, large, or mixed fiber neuropathy (SFN, LFN, and MFN, respectively), depending on the type of fibers involved. Despite evidence indicating small fiber involvement prior to large fiber involvement in type 1 diabetes mellitus (T1DM)-associated DPN, no evidence has been produced to determine the more prevalent subtype. We aim to determine the more prevalent type of nerve fiber damage-SFN, LFN, and MFN-in T1DM-associated DPN, both with and without pain.

Research design and methods: In this cross-sectional study, participants (n=216) were divided into controls; T1DM; T1DM with non-painful DPN (NP-DPN); and T1DM with painful DPN (P-DPN). DPN was further subgrouped based on neuropathy severity. The more prevalent type of fiber damage was determined applying small and large fiber-specific tests and three diagnostic models: model 1 (≥1 abnormal test); model 2 (≥2 abnormal tests); and model 3 (≥3 abnormal tests).

Results: MFN showed the highest prevalence in T1DM-associated DPN. No differences in neuropathy subtype were found between NP-DPN and P-DPN. DPN, with prevalent SFN plateaus between models 2 and 3. All models showed increased prevalence of MFN according to DPN severity. Model 3 showed increased DPN with prevalent LFN in early neuropathy. DPN with prevalent SFN demonstrated a similar, but non-significant pattern.

Conclusions: DPN primarily manifests as MFN in T1DM, with no differentiation between NP-DPN and P-DPN. Additionally, we propose model 2 as an initial criterion for diagnosing DPN with a more prevalent SFN subtype in T1DM. Lastly, the study suggests that in mild stages of DPN, one type of nerve fiber (either small or large) is more susceptible to damage.

简介糖尿病多发性神经病变(DPN)是糖尿病的一种常见并发症,可表现为小纤维神经病变、大纤维神经病变或混合纤维神经病变(分别为 SFN、LFN 和 MFN),具体取决于受累纤维的类型。尽管有证据表明,在 1 型糖尿病(T1DM)相关的 DPN 中,小纤维受累先于大纤维受累,但还没有证据表明哪种亚型更普遍。我们旨在确定在 T1DM 相关 DPN 中更常见的神经纤维损伤类型--SFN、LFN 和 MFN,包括有疼痛和无疼痛:在这项横断面研究中,参与者(n=216)被分为对照组、T1DM、T1DM伴非疼痛性DPN(NP-DPN)和T1DM伴疼痛性DPN(P-DPN)。根据神经病变的严重程度对 DPN 进一步分组。通过小纤维和大纤维特异性测试以及三种诊断模型:模型 1(≥1 次异常测试)、模型 2(≥2 次异常测试)和模型 3(≥3 次异常测试),确定了更普遍的纤维损伤类型:MFN在T1DM相关DPN中发病率最高。神经病变亚型在 NP-DPN 和 P-DPN 之间无差异。在模型 2 和模型 3 之间,DPN 和 SFN 的患病率处于高位。所有模型均显示,MFN的患病率随DPN严重程度的增加而增加。模型 3 显示,在早期神经病变中,DPN 的 LFN 患病率增加。DPN与普遍的SFN表现出相似的模式,但并不显著:结论:DPN 在 T1DM 中主要表现为 MFN,在 NP-DPN 和 P-DPN 之间没有区别。此外,我们建议将模型 2 作为诊断 T1DM 中较常见的 SFN 亚型 DPN 的初步标准。最后,研究表明,在轻度 DPN 阶段,一种类型的神经纤维(小或大)更容易受到损伤。
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引用次数: 0
Effects of insonification on repairing the renal injury of diabetic nephropathy rats. 胰岛素对修复糖尿病肾病大鼠肾损伤的影响
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-18 DOI: 10.1136/bmjdrc-2024-004146
Xinfang Xiao, Liu Wu, Juan Deng, Junfen Li, Yiqing Zhou, Sicheng He, Faqi Li, Yan Wang

Introduction: Prolonged hyperglycemia in diabetes mellitus can result in the development of diabetic nephropathy (DN) and increase the susceptibility to kidney failure. Low-intensity pulsed ultrasound (LIPUS) is a non-invasive modality that has demonstrated effective tissue repair capabilities. The objective of this study was to showcase the reparative potential of LIPUS on renal injury at both animal and cellular levels, while also determining the optimal pulse length (PL).

Research design and methods: We established a rat model of DN, and subsequently subjected the rats' kidneys to ultrasound irradiation (PL=0.2 ms, 10 ms, 20 ms). Subsequently, we assessed the structural and functional changes in the kidneys. Additionally, we induced podocyte apoptosis and evaluated its occurrence following ultrasound irradiation.

Results: Following irradiation, DN rats exhibited improved mesangial expansion and basement membrane thickening. Uric acid expression increased while urinary microalbumin, podocalyxin in urine, blood urea nitrogen, and serum creatinine levels decreased (p<0.05). These results suggest that the optimal PL was 0.2 ms. Using the optimal PL further demonstrated the reparative effect of LIPUS on DN, it was found that LIPUS could reduce podococyte apoptosis and alleviate kidney injury. Metabolomics revealed differences in metabolites including octanoic acid and seven others and western blot results showed a significant decrease in key enzymes related to lipolysis (p<0.05). Additionally, after irradiating podocytes with different PLs, we observed suppressed apoptosis (p<0.05), confirming the optimal PL as 0.2 ms.

Conclusions: LIPUS has been demonstrated to effectively restore renal structure and function in DN rats, with an optimal PL of 0.2 ms. The mechanism underlying the alleviation of DN by LIPUS is attributed to its ability to improve lipid metabolism disorder. These findings suggest that LIPUS may provide a novel perspective for future research in this field.

导言:糖尿病患者长期高血糖会导致糖尿病肾病(DN)的发生,并增加肾衰竭的易感性。低强度脉冲超声(LIPUS)是一种无创方式,已被证明具有有效的组织修复能力。本研究的目的是展示 LIPUS 在动物和细胞水平上对肾损伤的修复潜力,同时确定最佳脉冲长度 (PL):我们建立了 DN 大鼠模型,随后对大鼠肾脏进行超声波照射(PL=0.2 毫秒、10 毫秒、20 毫秒)。随后,我们评估了肾脏的结构和功能变化。此外,我们还诱导了荚膜细胞凋亡,并评估了超声照射后荚膜细胞凋亡的发生情况:结果:照射后,DN 大鼠的肾间质扩张和基底膜增厚得到改善。尿酸表达增加,而尿微量白蛋白、尿液中的荚膜萼萼酶、血尿素氮和血清肌酐水平下降(p结论:实验证明,LIPUS 能有效恢复 DN 大鼠的肾脏结构和功能,最佳 PL 为 0.2 毫秒。LIPUS缓解DN的机制在于其改善脂质代谢紊乱的能力。这些研究结果表明,LIPUS 可为这一领域的未来研究提供新的视角。
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引用次数: 0
Plasma sphingolipids mediate the association between gut microbiome composition and type 2 diabetes risk in the HELIUS cohort: a case-cohort study. 血浆鞘磷脂介导 HELIUS 队列中肠道微生物组组成与 2 型糖尿病风险之间的关系:一项病例队列研究。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-18 DOI: 10.1136/bmjdrc-2024-004180
Martin F Overbeek, Femke Rutters, Max Nieuwdorp, Mark Davids, Irene van Valkengoed, Henrike Galenkamp, Bert-Jan van den Born, Joline W J Beulens, Mirthe Muilwijk

Introduction: The association between the gut microbiome and incident type 2 diabetes (T2D) is potentially partly mediated through sphingolipids, however these possible mediating mechanisms have not been investigated. We examined whether sphingolipids mediate the association between gut microbiome and T2D, using data from the Healthy Life in an Urban Setting study.

Research design and methods: Participants were of Dutch or South-Asian Surinamese ethnicity, aged 18-70 years, and without T2D at baseline. A case-cohort design (subcohort n=176, cases incident T2D n=36) was used. The exposure was measured by 16S rRNA sequencing (gut microbiome) and mediator by targeted metabolomics (sphingolipids). Dimensionality reduction was achieved by principle component analysis and Shannon diversity. Cox regression and procrustes analyses were used to assess the association between gut microbiome and T2D and sphingolipids and T2D, and between gut microbiome and sphingolipids, respectively. Mediation was tested familywise using mediation analysis with permutation testing and Bonferroni correction.

Results: Our study confirmed associations between gut microbiome and T2D and sphingolipids and T2D. Additionally, we showed that the gut microbiome was associated with sphingolipids. The association between gut microbiome and T2D was partly mediated by a sphingolipid principal component, which represents a dominance of ceramide species over more complex sphingolipids (HR 1.17; 95% CI 1.08 to 1.28; proportional explained 48%), and by Shannon diversity (HR 0.97; 95% CI 0.95 to 0.99; proportional explained 24.8%).

Conclusions: These data suggest that sphingolipids mediate the association between microbiome and T2D risk. Future research is needed to confirm observed findings and elucidate causality on a molecular level.

简介肠道微生物组与2型糖尿病(T2D)之间的关系可能部分是通过鞘磷脂介导的,但这些可能的介导机制尚未得到研究。我们利用 "城市环境中的健康生活 "研究的数据,研究了鞘磷脂是否介导了肠道微生物组与 2 型糖尿病之间的关系:参与者为荷兰人或南亚苏里南人,年龄在 18-70 岁之间,基线时无 T2D。采用病例队列设计(子队列 n=176,T2D 病例 n=36)。暴露量通过 16S rRNA 测序(肠道微生物组)测量,介质通过靶向代谢组学(鞘脂)测量。通过原理成分分析和香农多样性实现降维。Cox回归和procrustes分析分别用于评估肠道微生物组与T2D、鞘磷脂与T2D以及肠道微生物组与鞘磷脂之间的关联。使用带有置换检验和Bonferroni校正的中介分析对中介关系进行了家族检验:结果:我们的研究证实了肠道微生物组与 T2D 之间的关系,以及鞘磷脂与 T2D 之间的关系。此外,我们还发现肠道微生物组与鞘磷脂相关。肠道微生物组与 T2D 之间的关系部分由鞘磷脂主成分和香农多样性(HR 0.97;95% CI 0.95 至 0.99;比例解释率为 24.8%)介导,前者代表神经酰胺种类比更复杂的鞘磷脂占优势(HR 1.17;95% CI 1.08 至 1.28;比例解释率为 48%),后者代表神经酰胺种类比更复杂的鞘磷脂占优势(HR 0.97;95% CI 0.95 至 0.99;比例解释率为 24.8%):这些数据表明,鞘磷脂介导了微生物组与 T2D 风险之间的关系。结论:这些数据表明,鞘磷脂介导了微生物组与 T2D 风险之间的关系。未来的研究需要证实观察到的结果,并从分子水平上阐明因果关系。
{"title":"Plasma sphingolipids mediate the association between gut microbiome composition and type 2 diabetes risk in the HELIUS cohort: a case-cohort study.","authors":"Martin F Overbeek, Femke Rutters, Max Nieuwdorp, Mark Davids, Irene van Valkengoed, Henrike Galenkamp, Bert-Jan van den Born, Joline W J Beulens, Mirthe Muilwijk","doi":"10.1136/bmjdrc-2024-004180","DOIUrl":"10.1136/bmjdrc-2024-004180","url":null,"abstract":"<p><strong>Introduction: </strong>The association between the gut microbiome and incident type 2 diabetes (T2D) is potentially partly mediated through sphingolipids, however these possible mediating mechanisms have not been investigated. We examined whether sphingolipids mediate the association between gut microbiome and T2D, using data from the Healthy Life in an Urban Setting study.</p><p><strong>Research design and methods: </strong>Participants were of Dutch or South-Asian Surinamese ethnicity, aged 18-70 years, and without T2D at baseline. A case-cohort design (subcohort n=176, cases incident T2D n=36) was used. The exposure was measured by 16S rRNA sequencing (gut microbiome) and mediator by targeted metabolomics (sphingolipids). Dimensionality reduction was achieved by principle component analysis and Shannon diversity. Cox regression and procrustes analyses were used to assess the association between gut microbiome and T2D and sphingolipids and T2D, and between gut microbiome and sphingolipids, respectively. Mediation was tested familywise using mediation analysis with permutation testing and Bonferroni correction.</p><p><strong>Results: </strong>Our study confirmed associations between gut microbiome and T2D and sphingolipids and T2D. Additionally, we showed that the gut microbiome was associated with sphingolipids. The association between gut microbiome and T2D was partly mediated by a sphingolipid principal component, which represents a dominance of ceramide species over more complex sphingolipids (HR 1.17; 95% CI 1.08 to 1.28; proportional explained 48%), and by Shannon diversity (HR 0.97; 95% CI 0.95 to 0.99; proportional explained 24.8%).</p><p><strong>Conclusions: </strong>These data suggest that sphingolipids mediate the association between microbiome and T2D risk. Future research is needed to confirm observed findings and elucidate causality on a molecular level.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Single-cell transcriptomic analysis reveals the antiangiogenic role of Mgarp in diabetic retinopathy. 单细胞转录组分析揭示了 Mgarp 在糖尿病视网膜病变中的抗血管生成作用。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-16 DOI: 10.1136/bmjdrc-2024-004189
Ling Ren, Jiao Xia, Chang Huang, Yun Bai, Jin Yao, Dan Li, Biao Yan

Introduction: Diabetic retinopathy (DR) is a common vascular complication of diabetes mellitus and a leading cause of vision loss worldwide. Endothelial cell (EC) heterogeneity has been observed in the pathogenesis of DR. Elucidating the underlying mechanisms governing EC heterogeneity may provide novel insights into EC-specific therapies for DR.

Research design and methods: We used the single-cell data from the Gene Expression Omnibus database to explore EC heterogeneity between diabetic retinas and non-diabetic retinas and identify the potential genes involved in DR. CCK-8 assays, EdU assays, transwell assays, and tube formation assays were conducted to determine the role of the identified gene in angiogenic effects.

Results: Our analysis identified three distinct EC subpopulations in retinas and revealed that Mitochondria-localized glutamic acid-rich protein (Mgarp) gene is potentially involved in the pathogenesis of DR. Silencing of Mgarp significantly suppressed the proliferation, migration, and tube formation capacities in retinal endothelial cells.

Conclusions: This study not only offers new insights into transcriptomic heterogeneity and pathological alteration of retinal ECs but also holds the promise to pave the way for antiangiogenic therapy by targeting EC-specific gene.

导言:糖尿病视网膜病变(DR)是糖尿病常见的血管并发症,也是全球视力丧失的主要原因。在糖尿病视网膜病变的发病机制中观察到了内皮细胞(EC)的异质性。研究设计和方法:我们利用基因表达总库(Gene Expression Omnibus)数据库中的单细胞数据来探讨糖尿病视网膜和非糖尿病视网膜中EC的异质性,并确定参与DR的潜在基因。我们进行了 CCK-8 试验、EdU 试验、transwell 试验和血管形成试验,以确定所识别基因在血管生成效应中的作用:结果:我们的分析确定了视网膜中三种不同的EC亚群,并发现线粒体定位的富谷氨酸蛋白(Mgarp)基因可能与DR的发病机制有关。Silencing of Mgarp significantly suppressed the proliferation, migration, and tube formation capacities in retinal endothelial cells.结论:这项研究不仅为了解视网膜内皮细胞转录组异质性和病理改变提供了新的视角,而且有望为通过靶向视网膜内皮细胞特异性基因进行抗血管生成治疗铺平道路。
{"title":"Single-cell transcriptomic analysis reveals the antiangiogenic role of Mgarp in diabetic retinopathy.","authors":"Ling Ren, Jiao Xia, Chang Huang, Yun Bai, Jin Yao, Dan Li, Biao Yan","doi":"10.1136/bmjdrc-2024-004189","DOIUrl":"10.1136/bmjdrc-2024-004189","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) is a common vascular complication of diabetes mellitus and a leading cause of vision loss worldwide. Endothelial cell (EC) heterogeneity has been observed in the pathogenesis of DR. Elucidating the underlying mechanisms governing EC heterogeneity may provide novel insights into EC-specific therapies for DR.</p><p><strong>Research design and methods: </strong>We used the single-cell data from the Gene Expression Omnibus database to explore EC heterogeneity between diabetic retinas and non-diabetic retinas and identify the potential genes involved in DR. CCK-8 assays, EdU assays, transwell assays, and tube formation assays were conducted to determine the role of the identified gene in angiogenic effects.</p><p><strong>Results: </strong>Our analysis identified three distinct EC subpopulations in retinas and revealed that Mitochondria-localized glutamic acid-rich protein (<i>Mgarp</i>) gene is potentially involved in the pathogenesis of DR. Silencing of Mgarp significantly suppressed the proliferation, migration, and tube formation capacities in retinal endothelial cells.</p><p><strong>Conclusions: </strong>This study not only offers new insights into transcriptomic heterogeneity and pathological alteration of retinal ECs but also holds the promise to pave the way for antiangiogenic therapy by targeting EC-specific gene.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Environmental Determinants of Islet Autoimmunity (ENDIA) longitudinal prospective pregnancy to childhood cohort study of Australian children at risk of type 1 diabetes: parental demographics and birth information. 胰岛自身免疫的环境决定因素(ENDIA)对澳大利亚 1 型糖尿病高危儿童从怀孕到儿童期的纵向前瞻性队列研究:父母人口统计学和出生信息。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-16 DOI: 10.1136/bmjdrc-2024-004130
Rebecca L Thomson, Helena Oakey, Aveni Haynes, Maria E Craig, Leonard C Harrison, John M Wentworth, Amanda Anderson, Pat Ashwood, Simon Barry, Bek Brittain, James D Brown, Peter G Colman, Elizabeth A Davis, Emma Hamilton-Williams, Dao Huynh, Tony Huynh, Ki-Wook Kim, Kelly J McGorm, Grant Morahan, William Rawlinson, Richard O Sinnott, Georgia Soldatos, Jason A Tye-Din, Peter J Vuillermin, Megan A S Penno, Jennifer J Couper

Introduction: The Environmental Determinants of Islet Autoimmunity (ENDIA) Study is an ongoing Australian prospective cohort study investigating how modifiable prenatal and early-life exposures drive the development of islet autoimmunity and type 1 diabetes (T1D) in children. In this profile, we describe the cohort's parental demographics, maternal and neonatal outcomes and human leukocyte antigen (HLA) genotypes.

Research design and methods: Inclusion criteria were an unborn child, or infant aged less than 6 months, with a first-degree relative (FDR) with T1D. The primary outcome was persistent islet autoimmunity, with children followed until a T1D diagnosis or 10 years of age. Demographic data were collected at enrollment. Lifestyle, clinical and anthropometric data were collected at each visit during pregnancy and clinical pregnancy and birth data were verified against medical case notes. Data were compared between mothers with and without T1D. HLA genotyping was performed on the ENDIA child and all available FDRs.

Results: The final cohort comprised 1473 infants born to 1214 gestational mothers across 1453 pregnancies, with 80% enrolled during pregnancy. The distribution of familial T1D probands was 62% maternal, 28% paternal and 11% sibling. The frequency of high-risk HLA genotypes was highest in T1D probands, followed by ENDIA infants, and lowest among unaffected family members. Mothers with T1D had higher rates of pregnancy complications and perinatal intervention, and larger babies of shorter gestation. Parent demographics were comparable to the Australian population for age, parity and obesity. A greater percentage of ENDIA parents were Australian born, lived in a major city and had higher socioeconomic advantage and education.

Conclusions: This comprehensive profile provides the context for understanding ENDIA's scope, methodology, unique strengths and limitations. Now fully recruited, ENDIA will provide unique insights into the roles of early-life factors in the development of islet autoimmunity and T1D in the Australian environment.

Trial registration number: ACTRN12613000794707.

简介:胰岛自身免疫的环境决定因素(ENDIA)研究是一项正在进行中的澳大利亚前瞻性队列研究,旨在调查可改变的产前和生命早期暴露是如何驱动儿童胰岛自身免疫和1型糖尿病(T1D)的发展的。在本简介中,我们介绍了队列中父母的人口统计学特征、孕产妇和新生儿结局以及人类白细胞抗原(HLA)基因型:纳入标准为未出生的婴儿或年龄小于 6 个月的婴儿,其一级亲属 (FDR) 患有 T1D。主要研究结果为持续性胰岛自身免疫,对患儿进行随访,直至确诊T1D或患儿10岁。入学时收集了人口统计学数据。孕期每次就诊时都会收集生活方式、临床和人体测量数据,并根据医疗病例记录核实临床孕期和出生数据。对患有和未患有 T1D 的母亲的数据进行比较。对ENDIA儿童和所有可用的FDR进行了HLA基因分型:最终队列由 1473 名婴儿组成,这些婴儿由 1214 名妊娠母亲在 1453 次妊娠期间所生,其中 80% 在妊娠期间入组。家族性 T1D 感知者的分布为母系 62%、父系 28%、同胞 11%。高风险 HLA 基因型在 T1D 感 染者中出现的频率最高,其次是ENDIA 婴儿,而在未受影响的家庭成员中出现的频率最低。患有 T1D 的母亲妊娠并发症和围产期干预率较高,妊娠期较短的婴儿体型较大。父母的年龄、奇偶性和肥胖程度与澳大利亚人口相当。更多的ENDIA父母出生在澳大利亚,居住在大城市,拥有较高的社会经济优势和教育程度:这一全面的概况为了解ENDIA的范围、方法、独特优势和局限性提供了背景。ENDIA现已全面招募,它将为了解澳大利亚环境中早期生活因素在胰岛自身免疫和T1D发展中的作用提供独特的见解:ACTRN12613000794707。
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引用次数: 0
Surrogate measures of first-phase insulin secretion versus reference methods intravenous glucose tolerance test and hyperglycemic clamp: a systematic review and meta-analyses. 第一阶段胰岛素分泌的替代测量方法与参考方法静脉葡萄糖耐量试验和高血糖钳夹:系统综述和荟萃分析。
IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-16 DOI: 10.1136/bmjdrc-2024-004256
Rebecka Renklint, Youssef Chninou, Martin Heni, Andreas Fritsche, Hans-Ulrich Haering, Robert Wagner, Julia Otten

Introduction: In this systematic review, we investigated the diagnostic accuracy of surrogate measures of insulin secretion based on fasting samples and the oral glucose tolerance test (OGTT). The first phase of insulin secretion was calculated using two gold standard methods; the hyperglycemic clamp (HGC) test and intravenous glucose tolerance test (IVGTT).

Research design and methods: We conducted searches in the PubMed, Cochrane Central, and Web of Science databases, the last of which was conducted at the end of June 2021. Studies were included that measured first-phase insulin secretion in adults using both a gold-standard reference method (either HGC or IVGTT) and one or more surrogate measures from either fasting samples, OGTT or a meal-tolerance test. QUADAS-2, a revised tool for the quality assessment of diagnostic accuracy studies, was used for quality assessment. Random-effects meta-analyses were performed to examine the correlation between first-phase measured with gold standard and surrogate methods.

Results: A total of 33 articles, encompassing 5362 individuals with normal glucose tolerance, pre-diabetes or type 2 diabetes, were included in our systematic review. Homeostatic model assessment (HOMA)-beta and Insulinogenic Index 30 (IGI(30)) were the surrogate measures validated in the largest number of studies (17 and 13, respectively). HOMA-beta's pooled correlation to the reference methods was 0.48 (95% CI 0.40 to 0.56) The pooled correlation of IGI to the reference methods was 0.61 (95% CI 0.54 to 0.68). The surrogate measures with the highest correlation to the reference methods were Kadowaki (0.67 (95% CI 0.61 to 0.73)) and Stumvoll's first-phase secretion (0.65 (95% CI 0.58 to 0.71)), both calculated from an OGTT.

Conclusions: Surrogate measures from the first 30 min of an OGTT capture the first phase of insulin secretion and are a good choice for epidemiological studies. HOMA-beta has a moderate correlation to the reference methods but is not a measure of the first phase specifically.

Prospero registration number: The meta-analysis was registered at PROSPERO (Id: CRD42020169064) before inclusion started.

简介在这篇系统综述中,我们研究了基于空腹样本和口服葡萄糖耐量试验(OGTT)的胰岛素分泌替代指标的诊断准确性。第一阶段的胰岛素分泌是通过两种金标准方法计算得出的:高血糖钳夹(HGC)试验和静脉葡萄糖耐量试验(IVGTT):我们在 PubMed、Cochrane Central 和 Web of Science 数据库中进行了检索,最后一次检索是在 2021 年 6 月底进行的。研究纳入了使用黄金标准参考方法(HGC 或 IVGTT)和一种或多种来自空腹样本、OGTT 或耐餐试验的替代测量方法测量成人第一阶段胰岛素分泌的研究。QUADAS-2是诊断准确性研究质量评估的修订工具,用于质量评估。随机效应荟萃分析用于研究金标准和替代方法的第一阶段测量结果之间的相关性:我们的系统综述共纳入了 33 篇文章,涉及 5362 名糖耐量正常、糖尿病前期或 2 型糖尿病患者。静态模型评估(HOMA)-beta 和胰岛素生成指数 30(IGI(30))是最多研究(分别为 17 项和 13 项)验证的替代指标。HOMA-beta与参考方法的汇总相关性为0.48(95% CI为0.40至0.56),IGI与参考方法的汇总相关性为0.61(95% CI为0.54至0.68)。与参考方法相关性最高的替代指标是 Kadowaki(0.67(95% CI 0.61 至 0.73))和 Stumvoll 的第一阶段分泌量(0.65(95% CI 0.58 至 0.71)),这两个指标都是通过 OGTT 计算得出的:结论:OGTT 前 30 分钟的代用指标能捕捉到胰岛素分泌的第一阶段,是流行病学研究的良好选择。HOMA-beta与参考方法有适度的相关性,但并不是对第一阶段的专门测量:荟萃分析开始纳入前已在 PROSPERO 注册(编号:CRD42020169064)。
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引用次数: 0
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BMJ Open Diabetes Research & Care
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