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Gender-specific association between circulating serum Klotho and metabolic components in adults. 成年人循环血清 Klotho 与代谢成分之间的性别差异。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-27 DOI: 10.1186/s12902-024-01737-8
Zhenzhen Wang, Hang Zhang, Guixia Zheng, Zheng Wang, Lei Shi

Background: Klotho plays a pivotal role in human aging. Metabolic syndrome (MetS) is composed of multiple conditions that are also risk factors for cardiovascular disease and diabetes. We try to discuss gender-specific differences in Klotho and the associations between Klotho and MetS components.

Materials and methods: The National Health and Nutrition Examination Survey database from cycle 2015-2016 was analyzed. MetS was defined according to the 2005 updated criteria by the American Heart Association and National Heart Lung and Blood Institute. Gender-specific differences in serum Klotho, and associations between Klotho level and MetS components were examined.

Results: A total of 2475 participants (40-79 years old) with comprehensive data were included (52% women). In general, lower Klotho was associated with advanced age, male sex, tobacco use, elevated triglycerides, renal insufficiency, inflammation, low estradiol, and low sex hormone-binding globulin (SHBG). The correlation between MetS and Klotho was more obvious in women, mainly in waist circumference and triglyceride. There were no gender-specific differences in the associations between Klotho and renal dysfunction, but multivariate linear regression analysis showed gender differences in other factors associated with Klotho. Estradiol, SHBG, high-density lipoprotein cholesterol (HDL), and high-sensitivity C-reactive protein (CRP) were associated with Klotho levels independent of age and renal function in men, whereas in women, Klotho was independently associated with triglycerides and white blood cell count.

Conclusion: Klotho levels had gender disparities regardless of age, renal function, and sex hormones. In the current cohort, triglycerides were the major component of MetS that was independently associated with serum Klotho levels, and the association was particularly seen in women. However, HDL was found to be the male-specific MetS component independently associated with Klotho.

背景Klotho 在人类衰老过程中发挥着关键作用。代谢综合征(MetS)由多种情况组成,也是心血管疾病和糖尿病的风险因素。我们试图讨论 Klotho 的性别差异以及 Klotho 与 MetS 成分之间的关联:分析了 2015-2016 年周期的国家健康与营养调查数据库。根据美国心脏协会和国家心肺血液研究所 2005 年更新的标准定义 MetS。研究了血清Klotho的性别差异以及Klotho水平与MetS成分之间的关联:结果:共纳入了 2475 名有全面数据的参与者(40-79 岁)(52% 为女性)。一般来说,Klotho水平较低与高龄、男性、吸烟、甘油三酯升高、肾功能不全、炎症、低雌二醇和低性激素结合球蛋白(SHBG)有关。女性的 MetS 与 Klotho 之间的相关性更为明显,主要体现在腰围和甘油三酯上。Klotho与肾功能障碍之间的相关性没有性别差异,但多变量线性回归分析显示,与Klotho相关的其他因素存在性别差异。男性的雌二醇、SHBG、高密度脂蛋白胆固醇(HDL)和高敏C反应蛋白(CRP)与Klotho水平相关,与年龄和肾功能无关,而女性的Klotho与甘油三酯和白细胞计数独立相关:结论:无论年龄、肾功能和性激素如何变化,Klotho水平都存在性别差异。在目前的队列中,甘油三酯是与血清 Klotho 水平独立相关的 MetS 的主要组成部分,这种关联在女性中尤为明显。然而,研究发现,高密度脂蛋白是男性特有的与 Klotho 独立相关的 MetS 成分。
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引用次数: 0
Prevalence and short-term clinical impacts of new-onset diabetes mellitus among patients with COVID-19 in jazan region, Saudi Arabia. 沙特阿拉伯贾赞地区 COVID-19 患者中新发糖尿病的患病率和短期临床影响。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-20 DOI: 10.1186/s12902-024-01724-z
Amal H Mohamed, Majid Darraj, Abuobaida Yassin, Mohammed Somaili, Ahmed Sayed, Omar Oraibi, Mostafa Mohrag, Mohammed Ali Madkhali, Sameer Alqassimi, Mohammed A Madkhali

Background: Diabetes Mellitus is a major predictor for severity and mortality that is increased by 50% in COVID-19 infection. The aim of this study is to estimate the prevalence of new-onset DM among patients with COVID-19 and examined the short clinical outcomes of the disease.

Method: This is a retrospective study of revising electronic medical records to assess the prevalence of new-onset DM in COVID-19 patients and its impact on the severity of the disease. Adult patients with confirmed COVID-19 during the period from June 2020 to December 2021 were enrolled.

Results: 725 patients were included. 53.8% of them were males and 46.2 were females, the mean age was 43.35 ± 16.76. 13.2% were diabetics; 2.2% with preexisting DM and 11.0% had new-onset DM. 6.34% had coexisting medical conditions. DKA at presentation was observed in 6 patients (0.8%) of newly diagnosed DM. There is a significant correlation between age and family history (FH), and BMI and new-onset DM (P < 0.05). The overall mortality rate was 2.2%, and it was significantly higher in diabetics in comparison to non-diabetics (P < 0.001). 8.6% had persistent hyperglycemia after 4 months of follow-up.

Conclusion: The prevalence of COVID-19 related new-onset DM was correlated significantly with disease severity and mortality rate. Age, FH, and BMI, were the major predictors. We recommend that frequent monitoring of blood glucose for patients with COVID-19 infections to detect DM, therefore, prompt treatment can be initiated.

背景:糖尿病是预测病情严重程度和死亡率的一个主要因素,在COVID-19感染者中,糖尿病的发病率增加了50%。本研究的目的是估计 COVID-19 患者中新发糖尿病的患病率,并研究该疾病的短期临床结果:这是一项通过修改电子病历来评估 COVID-19 患者中新发 DM 发病率及其对疾病严重程度影响的回顾性研究。研究纳入了2020年6月至2021年12月期间确诊为COVID-19的成年患者:结果:共纳入 725 名患者。其中男性占 53.8%,女性占 46.2%,平均年龄(43.35±16.76)岁。13.2%为糖尿病患者;2.2%为原有糖尿病患者,11.0%为新发糖尿病患者。6.34%的患者同时患有其他疾病。在新诊断的糖尿病患者中,有 6 人(0.8%)在发病时出现 DKA。年龄、家族史(FH)和体重指数(BMI)与新发糖尿病之间存在明显的相关性(P 结论):与 COVID-19 相关的新发 DM 患病率与疾病严重程度和死亡率显著相关。年龄、FH 和 BMI 是主要的预测因素。我们建议经常监测 COVID-19 感染者的血糖,以发现 DM,从而及时进行治疗。
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引用次数: 0
Establishment and external validation of an early warning model of diabetic peripheral neuropathy based on random forest and logistic regression. 基于随机森林和逻辑回归的糖尿病周围神经病变早期预警模型的建立和外部验证。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-20 DOI: 10.1186/s12902-024-01728-9
Lujie Wang, Jiajie Li, Yixuan Lin, Huilun Yuan, Zhaohui Fang, Aihua Fei, Guoming Shen, Aijuan Jiang

Objective: The primary objective of this study was to investigate the risk factors for diabetic peripheral neuropathy (DPN) and to establish an early diagnostic prediction model for its onset, based on clinical data and biochemical indices.

Methods: Retrospective data were collected from 1,446 diabetic patients at the First Affiliated Hospital of Anhui University of Chinese Medicine and were split into training and internal validation sets in a 7:3 ratio. Additionally, 360 diabetic patients from the Second Affiliated Hospital were used as an external validation cohort. Feature selection was conducted within the training set, where univariate logistic regression identified variables with a p-value < 0.05, followed by backward elimination to construct the logistic regression model. Concurrently, the random forest algorithm was applied to the training set to identify the top 10 most important features, with hyperparameter optimization performed via grid search combined with cross-validation. Model performance was evaluated using ROC curves, decision curve analysis, and calibration curves. Model fit was assessed using the Hosmer-Lemeshow test, followed by Brier Score evaluation for the random forest model. Ten-fold cross-validation was employed for further validation, and SHAP analysis was conducted to enhance model interpretability.

Results: A nomogram model was developed using logistic regression with key features: limb numbness, limb pain, diabetic retinopathy, diabetic kidney disease, urinary protein, diastolic blood pressure, white blood cell count, HbA1c, and high-density lipoprotein cholesterol. The model achieved AUCs of 0.91, 0.88, and 0.88 for the training, validation, and test sets, respectively, with a mean AUC of 0.902 across 10-fold cross-validation. Hosmer-Lemeshow test results showed p-values of 0.595, 0.418, and 0.126 for the training, validation, and test sets, respectively. The random forest model demonstrated AUCs of 0.95, 0.88, and 0.88 for the training, validation, and test sets, respectively, with a mean AUC of 0.886 across 10-fold cross-validation. The Brier score indicates a good calibration level, with values of 0.104, 0.143, and 0.142 for the training, validation, and test sets, respectively.

Conclusion: The developed nomogram exhibits promise as an effective tool for the diagnosis of diabetic peripheral neuropathy in clinical settings.

研究目的本研究的主要目的是调查糖尿病周围神经病变(DPN)的危险因素,并根据临床数据和生化指标建立DPN发病的早期诊断预测模型:方法:收集安徽中医药大学第一附属医院 1446 名糖尿病患者的回顾性数据,按 7:3 的比例分成训练集和内部验证集。此外,第二附属医院的 360 名糖尿病患者被用作外部验证队列。特征选择在训练集中进行,其中单变量逻辑回归确定了具有 p 值的变量 结果:利用逻辑回归建立了一个提名图模型,主要特征包括:肢体麻木、肢体疼痛、糖尿病视网膜病变、糖尿病肾病、尿蛋白、舒张压、白细胞计数、HbA1c 和高密度脂蛋白胆固醇。该模型在训练集、验证集和测试集上的 AUC 分别为 0.91、0.88 和 0.88,在 10 倍交叉验证中的平均 AUC 为 0.902。Hosmer-Lemeshow 检验结果显示,训练集、验证集和测试集的 p 值分别为 0.595、0.418 和 0.126。随机森林模型在训练集、验证集和测试集上的 AUC 分别为 0.95、0.88 和 0.88,在 10 倍交叉验证中的平均 AUC 为 0.886。布赖尔评分显示了良好的校准水平,训练集、验证集和测试集的评分分别为 0.104、0.143 和 0.142:结论:所开发的提名图有望成为临床诊断糖尿病周围神经病变的有效工具。
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引用次数: 0
Carbohydrate quality index and risk of non-alcoholic fatty liver disease in Iranian adults. 伊朗成年人的碳水化合物质量指数与非酒精性脂肪肝的风险。
IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-20 DOI: 10.1186/s12902-024-01609-1
Mitra Kazemi Jahromi, Niloufar Saber, Mostafa Norouzzadeh, Ghazal Daftari, Fatemeh Pourhabibi-Zarandi, Hamid Ahmadirad, Hossein Farhadnejad, Farshad Teymoori, Ammar Salehi-Sahlabadi, Parvin Mirmiran

Background/aim: In the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.

Methods: This case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20-60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components.

Results: The participant's mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m2 and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15-25) and 23 (18-28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11-0.39), Ptrend <0.001)]. Also, the odds of NAFLD decreased across tertiles of solid carbohydrates to total carbohydrates ratio [(OR: 0.39; 95%CI: 0.22-0.69), Ptrend <0.001)]. However, a high dietary glycemic index (GI) was associated with increased odds of NAFLD [(OR:7.47; 95%CI: 3.89-14.33, Ptrend<0.001)]. There was no significant relationship between other CQI components, including fiber intake and whole grain/total grains and the risk of NAFLD.

Conclusions: Our results revealed that a diet with a high quality of carbohydrates, characterized by higher intakes of solid carbohydrates, whole grain, and low GI carbohydrates, can be related to a reduced risk of NAFLD.

背景/目的:本研究旨在评估碳水化合物质量指数(CQI)与伊朗成年人罹患非酒精性脂肪肝(NAFLD)风险的关系:这项病例对照研究的对象是 225 名新确诊的非酒精性脂肪肝患者和 450 名对照者,年龄在 20-60 岁之间。采用食物频率调查问卷计算CQI及其组成部分,包括纤维摄入量、血糖生成指数、全谷物:总谷物比率和固体碳水化合物:总碳水化合物比率。采用多变量逻辑回归法估算非酒精性脂肪肝在不同CQI及其组成成分中的几率比(OR):参与者体重指数和年龄的平均值(± SD)分别为 26.8 ± 4.3 kg/m2 和 38.1 ± 8.8 岁。病例组和对照组参与者的 CQI 得分中位数(四分位间)分别为 20(15-25)和 23(18-28)。在经多变量调整的模型中,非酒精性脂肪肝的风险在CQI的四分位数上显著降低[(OR:0.20;%95CI:0.11-0.39),Ptrend趋势结论:我们的研究结果表明,碳水化合物质量高(固体碳水化合物、全谷物和低 GI 碳水化合物的摄入量较高)的饮食与非酒精性脂肪肝风险的降低有关。
{"title":"Carbohydrate quality index and risk of non-alcoholic fatty liver disease in Iranian adults.","authors":"Mitra Kazemi Jahromi, Niloufar Saber, Mostafa Norouzzadeh, Ghazal Daftari, Fatemeh Pourhabibi-Zarandi, Hamid Ahmadirad, Hossein Farhadnejad, Farshad Teymoori, Ammar Salehi-Sahlabadi, Parvin Mirmiran","doi":"10.1186/s12902-024-01609-1","DOIUrl":"https://doi.org/10.1186/s12902-024-01609-1","url":null,"abstract":"<p><strong>Background/aim: </strong>In the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.</p><p><strong>Methods: </strong>This case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20-60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components.</p><p><strong>Results: </strong>The participant's mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m<sup>2</sup> and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15-25) and 23 (18-28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11-0.39), P<sub>trend</sub> <0.001)]. Also, the odds of NAFLD decreased across tertiles of solid carbohydrates to total carbohydrates ratio [(OR: 0.39; 95%CI: 0.22-0.69), P<sub>trend</sub> <0.001)]. However, a high dietary glycemic index (GI) was associated with increased odds of NAFLD [(OR:7.47; 95%CI: 3.89-14.33, P<sub>trend</sub><0.001)]. There was no significant relationship between other CQI components, including fiber intake and whole grain/total grains and the risk of NAFLD.</p><p><strong>Conclusions: </strong>Our results revealed that a diet with a high quality of carbohydrates, characterized by higher intakes of solid carbohydrates, whole grain, and low GI carbohydrates, can be related to a reduced risk of NAFLD.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280290","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
Diabetes screening among women with polycystic ovary syndrome: a descriptive study of commercial claims, 2011–2019 多囊卵巢综合征妇女的糖尿病筛查:2011-2019 年商业索赔的描述性研究
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1186/s12902-024-01717-y
Jacklyn Vollmer, W. Jay Christian, Mary E. Lacy
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 6–12% of United States women of reproductive age. Because women with PCOS are at an increased risk of developing type 2 diabetes, clinical practice guidelines from a number of organizations (e.g. American Diabetes Association, American College of Obstetricians and Gynecologists, US Preventive Services Task Force) recommend that individuals with PCOS are routinely screened for diabetes. Guidelines further indicate that an oral glucose tolerance test (OGTT) should be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is two-fold: 1) to estimate rates of diabetes screening among a nationwide sample of commercially insured women with PCOS and 2) to report the percentage of women screened using each test (OGTT, A1C, fasting plasma glucose) among those who were screened. We used the MarketScan Commercial Claims database (2011–2019) to identify a sample of women aged 18–64 years with PCOS who were free from diabetes at baseline and had ≥ 5 years of continuous enrollment in their insurance plan. PCOS was ascertained using International Classification of Disease diagnosis codes (ICD-9: 256.4; ICD-10: E28.2). Diabetes screening was ascertained using Current Procedural Terminology (CPT) codes (A1C: 8303683037; Fasting blood sugar: 82947; OGTT: 82950). Diabetes screening rates were calculated for the overall study sample as well as across subgroups defined by age, overweight/obesity, hypertension, hypercholesterolemia, and vascular disease. In our sample of 191,110 commercially insured women with PCOS, 73.40% were screened at least once for diabetes during a five-year period. Among the women screened, 19.24% were screened using the Androgen Excess Society (AES)-recommended OGTT, 61.58% were screened using A1C, and 23.37% were screened using fasting blood sugar. In a sample of commercially insured individuals spanning the timeframe 2011–2019, nearly 75% of women with PCOS complied with the ACOG screening guidelines for diabetes. Although OGTT is recommended as the preferred screening tool for women with PCOS it was less commonly used than A1C and fasting blood sugar tests.
多囊卵巢综合症(PCOS)是一种荷尔蒙失调症,影响着美国 6-12% 的育龄妇女。由于患有多囊卵巢综合症的女性罹患 2 型糖尿病的风险较高,一些组织(如美国糖尿病协会、美国妇产科医师学会、美国预防服务工作组)的临床实践指南建议对多囊卵巢综合症患者进行常规糖尿病筛查。指南进一步指出,在对患有多囊卵巢综合症的女性进行糖尿病筛查时,应采用口服葡萄糖耐量试验(OGTT),而不是 A1C 或空腹血浆葡萄糖试验。本研究的目的有两个:1)估计全国范围内有商业保险的多囊卵巢综合症妇女的糖尿病筛查率;2)报告使用每种测试(OGTT、A1C、空腹血浆葡萄糖)进行筛查的妇女在接受筛查的妇女中所占的比例。我们使用 MarketScan 商业索赔数据库(2011-2019 年)确定了 18-64 岁患有多囊卵巢综合症的女性样本,这些女性在基线时没有糖尿病,并且连续加入保险计划的时间≥ 5 年。多囊卵巢综合症是通过国际疾病分类诊断代码(ICD-9:256.4;ICD-10:E28.2)确定的。糖尿病筛查使用当前程序术语 (CPT) 代码(A1C:8303683037;空腹血糖:82947;OGTT:82950)确定。我们计算了整个研究样本以及按年龄、超重/肥胖、高血压、高胆固醇血症和血管疾病定义的亚组的糖尿病筛查率。在我们的 191,110 名患有多囊卵巢综合症的商业保险女性样本中,73.40% 的女性在五年内至少接受过一次糖尿病筛查。在接受筛查的女性中,19.24% 采用雄激素过多协会 (AES) 推荐的 OGTT 进行筛查,61.58% 采用 A1C 进行筛查,23.37% 采用空腹血糖进行筛查。在 2011-2019 年期间的商业保险样本中,近 75% 的 PCOS 女性符合 ACOG 的糖尿病筛查指南。尽管建议将 OGTT 作为多囊卵巢综合征女性的首选筛查工具,但与 A1C 和空腹血糖检测相比,OGTT 的使用率较低。
{"title":"Diabetes screening among women with polycystic ovary syndrome: a descriptive study of commercial claims, 2011–2019","authors":"Jacklyn Vollmer, W. Jay Christian, Mary E. Lacy","doi":"10.1186/s12902-024-01717-y","DOIUrl":"https://doi.org/10.1186/s12902-024-01717-y","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 6–12% of United States women of reproductive age. Because women with PCOS are at an increased risk of developing type 2 diabetes, clinical practice guidelines from a number of organizations (e.g. American Diabetes Association, American College of Obstetricians and Gynecologists, US Preventive Services Task Force) recommend that individuals with PCOS are routinely screened for diabetes. Guidelines further indicate that an oral glucose tolerance test (OGTT) should be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is two-fold: 1) to estimate rates of diabetes screening among a nationwide sample of commercially insured women with PCOS and 2) to report the percentage of women screened using each test (OGTT, A1C, fasting plasma glucose) among those who were screened. We used the MarketScan Commercial Claims database (2011–2019) to identify a sample of women aged 18–64 years with PCOS who were free from diabetes at baseline and had ≥ 5 years of continuous enrollment in their insurance plan. PCOS was ascertained using International Classification of Disease diagnosis codes (ICD-9: 256.4; ICD-10: E28.2). Diabetes screening was ascertained using Current Procedural Terminology (CPT) codes (A1C: 8303683037; Fasting blood sugar: 82947; OGTT: 82950). Diabetes screening rates were calculated for the overall study sample as well as across subgroups defined by age, overweight/obesity, hypertension, hypercholesterolemia, and vascular disease. In our sample of 191,110 commercially insured women with PCOS, 73.40% were screened at least once for diabetes during a five-year period. Among the women screened, 19.24% were screened using the Androgen Excess Society (AES)-recommended OGTT, 61.58% were screened using A1C, and 23.37% were screened using fasting blood sugar. In a sample of commercially insured individuals spanning the timeframe 2011–2019, nearly 75% of women with PCOS complied with the ACOG screening guidelines for diabetes. Although OGTT is recommended as the preferred screening tool for women with PCOS it was less commonly used than A1C and fasting blood sugar tests.","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261154","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
Unravelling a hidden pathology of a vertebral fracture in a teenage girl 揭开少女椎体骨折的隐秘病因
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1186/s12902-024-01732-z
Sharmika Sivageethan, Shahini Winson Gnanathayalan, Minuri Fernando, Uditha Bulugahapitiya
Although the skeleton remains a common target of primary hyperparathyroidism, the classic bone disease “osteitis fibrosa cystica” is currently rare due to early diagnosis. This case represents severe classic bone manifestations of primary hyperparathyroidism due to delayed diagnosis and delayed medical attention. A 19-year-old young female was symptomatically managed for chronic back pain and nonspecific bone pain in the small joints of both hands over 2 months by a general practitioner. The patient had delayed seeking for treatment for 3 months. Later, she was evaluated for tuberculosis, hematological malignancies and rheumatic disorders following a fractured T12 vertebra and underwent pedicle screw fixation. However, clinical examination and investigations, including biochemistry, imaging and histology, ruled out the above conditions. Unfortunately, serum calcium level was not performed at the initial presentation. Later, primary hyperparathyroidism was diagnosed on the basis of moderate hypercalcaemia and elevated intact PTH levels (2064 pg/ml). She had sufficient vitamin D levels and normal kidney function. Her DXA scan revealed severe secondary osteoporosis with the lowest Z score of -8 at the total lumbar spine. Ultrasonography of the thyroid revealed a hypo echoic mass in the left lower neck, and localization studies with technetium-99 m sestamibi and 4D-CT revealed a left inferior parathyroid adenoma (1.6 × 1.5 × 1.6 cm). CT scan also revealed brown tumors in the mandible and vertebrae and diffuse bony changes in the skull, sternum, humerus and vertebrae. Her radiographs revealed subperiosteal bone resorption on the radial aspects of the middle and distal phalanges and brown tumors in both the ulna and fibula. We excluded MEN and other hereditary syndromes in our patient with a personal and family history and with a normal pituitary hormone profile because of poor resources for genetic testing. She underwent parathyroid adenoma excision, and the postoperative period was complicated with hungry bone syndrome, requiring high doses of calcium and active vitamin D supplements. These supplements were gradually weaned off over 6 months, and she recovered with normal biochemical investigations. Histology revealed parathyroid adenoma without malignant features. In developing countries where routine calcium screening is not available, clinicians should be aware of various manifestations of primary hyperparathyroidism to allow diagnosis as soon as possible without delay to prevent further progression, as it is a treatable condition.
尽管骨骼仍是原发性甲状旁腺功能亢进症的常见靶点,但由于诊断较早,典型的骨病 "纤维囊性骨炎 "目前已很少见。本病例是原发性甲状旁腺功能亢进症因诊断延误和就医不及时而导致的严重典型骨病表现。一名19岁的年轻女性因慢性背痛和双手小关节的非特异性骨痛,由一名全科医生对症治疗了2个月。患者拖延了 3 个月才寻求治疗。后来,她因T12椎体骨折接受了椎弓根螺钉固定术,并被评估为肺结核、血液恶性肿瘤和风湿性疾病。然而,临床检查和生化、影像学和组织学等检查排除了上述病症。遗憾的是,最初就诊时并未检测血清钙水平。后来,根据中度高钙血症和升高的完整PTH水平(2064 pg/ml),诊断为原发性甲状旁腺功能亢进。她体内维生素 D 水平充足,肾功能正常。她的 DXA 扫描显示她患有严重的继发性骨质疏松症,腰椎总段的最低 Z 值为-8。甲状腺超声检查显示左下颌有一个低回声肿块,锝-99 m sestamibi和4D-CT定位检查显示左下甲状旁腺腺瘤(1.6 × 1.5 × 1.6厘米)。CT 扫描还发现下颌骨和椎骨有褐色肿瘤,头骨、胸骨、肱骨和椎骨有弥漫性骨质改变。她的X光片显示,中趾骨和远趾骨桡侧骨膜下骨吸收,尺骨和腓骨均有棕色肿瘤。由于基因检测资源匮乏,我们根据患者的个人和家族病史以及正常的垂体激素谱排除了MEN和其他遗传性综合征。她接受了甲状旁腺腺瘤切除术,术后并发了饿骨综合征,需要大剂量补充钙和活性维生素D。6个月后,她逐渐停用了这些补充剂,并恢复了正常的生化检查。组织学检查显示她患有甲状旁腺腺瘤,但无恶性特征。在没有常规钙筛查的发展中国家,临床医生应了解原发性甲状旁腺功能亢进症的各种表现,以便尽快确诊,防止病情进一步恶化,因为这是一种可以治疗的疾病。
{"title":"Unravelling a hidden pathology of a vertebral fracture in a teenage girl","authors":"Sharmika Sivageethan, Shahini Winson Gnanathayalan, Minuri Fernando, Uditha Bulugahapitiya","doi":"10.1186/s12902-024-01732-z","DOIUrl":"https://doi.org/10.1186/s12902-024-01732-z","url":null,"abstract":"Although the skeleton remains a common target of primary hyperparathyroidism, the classic bone disease “osteitis fibrosa cystica” is currently rare due to early diagnosis. This case represents severe classic bone manifestations of primary hyperparathyroidism due to delayed diagnosis and delayed medical attention. A 19-year-old young female was symptomatically managed for chronic back pain and nonspecific bone pain in the small joints of both hands over 2 months by a general practitioner. The patient had delayed seeking for treatment for 3 months. Later, she was evaluated for tuberculosis, hematological malignancies and rheumatic disorders following a fractured T12 vertebra and underwent pedicle screw fixation. However, clinical examination and investigations, including biochemistry, imaging and histology, ruled out the above conditions. Unfortunately, serum calcium level was not performed at the initial presentation. Later, primary hyperparathyroidism was diagnosed on the basis of moderate hypercalcaemia and elevated intact PTH levels (2064 pg/ml). She had sufficient vitamin D levels and normal kidney function. Her DXA scan revealed severe secondary osteoporosis with the lowest Z score of -8 at the total lumbar spine. Ultrasonography of the thyroid revealed a hypo echoic mass in the left lower neck, and localization studies with technetium-99 m sestamibi and 4D-CT revealed a left inferior parathyroid adenoma (1.6 × 1.5 × 1.6 cm). CT scan also revealed brown tumors in the mandible and vertebrae and diffuse bony changes in the skull, sternum, humerus and vertebrae. Her radiographs revealed subperiosteal bone resorption on the radial aspects of the middle and distal phalanges and brown tumors in both the ulna and fibula. We excluded MEN and other hereditary syndromes in our patient with a personal and family history and with a normal pituitary hormone profile because of poor resources for genetic testing. She underwent parathyroid adenoma excision, and the postoperative period was complicated with hungry bone syndrome, requiring high doses of calcium and active vitamin D supplements. These supplements were gradually weaned off over 6 months, and she recovered with normal biochemical investigations. Histology revealed parathyroid adenoma without malignant features. In developing countries where routine calcium screening is not available, clinicians should be aware of various manifestations of primary hyperparathyroidism to allow diagnosis as soon as possible without delay to prevent further progression, as it is a treatable condition.","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261155","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
Systemic immunity-inflammation index is associated with body fat distribution among U.S. adults: evidence from national health and nutrition examination survey 2011–2018 全身免疫-炎症指数与美国成年人的体脂分布相关:2011-2018 年全国健康与营养状况调查的证据
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1186/s12902-024-01725-y
Xue Liu, Yuhao Zhang, Yuchen Li, Yaodong Sang, Yuwei Chai, Li Zhang, Haiqing Zhang
The systemic immunity-inflammation index (SII) is a newly developed biomarker that provides an integrated measure of inflammation in the body. We aim to evaluate the relationship between SII and body fat distribution. Adults from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 were included. The SII was computed using lymphocyte (LC), neutrophil (NC), and platelet (PC) counts as its components. Body fat distribution was assessed by (total, android, gynoid) percentage fat, total abdominal fat area, subcutaneous adipose tissue area, visceral adipose tissue area, and the ratio of visceral to subcutaneous adipose tissue area (V/S ratio). Multivariable weighted linear regression and subgroup analysis were use to examine the relationships between fat distribution and SII. Restricted cubic splines (RCS) and threshold effect analysis were used to examine analyze nonlinear associations. After exclusions, a total of 11,192 adults with a weighted mean age of 38.46 ± 0.26 years were studied. In multivariable weighted linear regression, each level increase in log2SII was associated with increased of 0.23 SDs total percentage fat (95% CI = 0.03, 0.43) and 0.26 SDs android percentage fat (95% CI = 0.06, 0.47). Besides, the subgroup analysis showed that the positive association between SII and android percentage fat was mainly among obese individuals (BMI > 30 kg/m2) and non-obese individuals without DM or hypertension. Meanwhile, the relationship between SII and the V/S ratio was found to be significant in the female subgroup, the obese subgroup, individuals with non-alcoholic fatty liver disease (NAFLD), and those without diabetes mellitus. Finally, SII exhibited an inverted U-shaped relationship with total percentage fat, android percent fat and total abdominal fat. Accordingly, threshold effect analysis indicated a positive association between lower SII levels and total percentage fat, android percentage fat and total abdominal fat area. In the nationwide study, it was observed that the SII exhibited a significant correlation with higher levels of body fat, specifically android fat. This association was particularly noticeable within specific subgroups of the population.
全身免疫-炎症指数(SII)是一种新开发的生物标志物,可综合衡量体内的炎症情况。我们旨在评估 SII 与身体脂肪分布之间的关系。我们纳入了 2011-2018 年美国国家健康与营养调查(NHANES)中的成年人。SII以淋巴细胞(LC)、中性粒细胞(NC)和血小板(PC)计数作为其组成部分进行计算。体脂分布通过(总脂肪、甲状腺脂肪、雌激素)脂肪百分比、腹部脂肪总面积、皮下脂肪组织面积、内脏脂肪组织面积以及内脏脂肪组织面积与皮下脂肪组织面积之比(V/S 比)进行评估。多变量加权线性回归和亚组分析用于研究脂肪分布与 SII 之间的关系。限制性三次样条(RCS)和阈值效应分析用于分析非线性关联。经过排除后,共研究了 11,192 名成年人,加权平均年龄为 38.46 ± 0.26 岁。在多变量加权线性回归中,log2SII 每增加一级,总脂肪百分比就会增加 0.23 SDs(95% CI = 0.03,0.43),甲状腺脂肪百分比增加 0.26 SDs(95% CI = 0.06,0.47)。此外,亚组分析表明,SII与android脂肪百分比之间的正相关主要出现在肥胖者(BMI>30 kg/m2)和无糖尿病或高血压的非肥胖者中。同时,在女性亚组、肥胖亚组、非酒精性脂肪肝(NAFLD)患者和无糖尿病患者中,SII 与 V/S 比值的关系显著。最后,SII 与总脂肪百分比、甲状腺脂肪百分比和总腹部脂肪呈倒 U 型关系。因此,阈值效应分析表明,较低的 SII 水平与总脂肪百分比、android 脂肪百分比和总腹部脂肪面积呈正相关。在全国范围的研究中发现,SII 与较高的体脂水平,特别是安卓脂肪水平有显著的相关性。这种关联在特定的人口亚群中尤为明显。
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引用次数: 0
Relationship between four visceral obesity indices and prediabetes and diabetes: a cross-sectional study in Dalian, China 四种内脏肥胖指数与糖尿病前期和糖尿病之间的关系:中国大连的一项横断面研究
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1186/s12902-024-01718-x
Yuntong Liu, Haodong Jiang, Lan Luo, Zhengnan Gao
In recent times, a number of new indices for measuring visceral obesity have been developed. This research sought to investigate the relationship between four visceral obesity indices and prediabetes and diabetes. Conducted in 2011 as a cross-sectional analysis in Dalian, China, this study utilized logistic regression models to explore the relationships between four visceral obesity indices and prediabetes and diabetes. It also assessed the dose-response relationships using restricted cubic splines (RCS), performed subgroup analyses, and conducted interaction tests. The predictive values of four visceral obesity indices were evaluated using receiver operating characteristic (ROC) curves. The study enrolled 10,090 participants, with prediabetes and diabetes prevalence at 80.53%. Multifactorial logistic regression revealed positive relationships between the four visceral obesity indices and prediabetes and diabetes. The results of the RCS analysis revealed a linear relationship between the body roundness index (BRI), cardiometabolic index (CMI) and prediabetes and diabetes. Conversely, a non-linear relationship was observed between Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP) and prediabetes and diabetes. Subgroup analyses demonstrated stronger relationships of CMI, CVAI, and LAP with prediabetes and diabetes among females. ROC curves suggested that LAP could be an effective predictor of these conditions. This research confirmed that four visceral obesity indices are linked with a higher risk of prediabetes and diabetes in middle-aged and elderly individuals in Dalian. Importantly, LAP could be an effective predictor of prediabetes and diabetes. Effective weight management significantly reduces the risk of both prediabetes and diabetes.
近来,人们开发出了许多新的内脏肥胖测量指数。本研究试图探讨四种内脏肥胖指数与糖尿病前期和糖尿病之间的关系。该研究于 2011 年在中国大连进行了一项横断面分析,利用逻辑回归模型探讨了四种内脏肥胖指数与糖尿病前期和糖尿病之间的关系。研究还利用受限立方样条(RCS)评估了剂量-反应关系,进行了亚组分析,并进行了交互检验。使用接收器操作特征曲线(ROC)评估了四种内脏肥胖指数的预测价值。研究共招募了 10,090 名参与者,其中糖尿病前期和糖尿病患病率为 80.53%。多因素逻辑回归显示,四个内脏肥胖指数与糖尿病前期和糖尿病之间存在正相关关系。RCS分析结果显示,体圆指数(BRI)、心脏代谢指数(CMI)与糖尿病和糖尿病前期之间存在线性关系。相反,中国人的内脏脂肪指数(CVAI)、脂质累积乘积(LAP)与糖尿病和糖尿病前期之间存在非线性关系。亚组分析表明,女性的 CMI、CVAI 和 LAP 与糖尿病前期和糖尿病之间的关系更密切。ROC 曲线表明,LAP 可以有效地预测这些疾病。这项研究证实,四种内脏肥胖指数与大连中老年人罹患糖尿病前期和糖尿病的高风险有关。重要的是,内脏肥胖指数可有效预测糖尿病前期和糖尿病。有效的体重管理可大大降低糖尿病前期和糖尿病的风险。
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引用次数: 0
Exploring the unique association between high-density lipoprotein cholesterol and vitamin D deficiency in adults aged 20–59: findings based on the NHANES database 探索 20-59 岁成年人高密度脂蛋白胆固醇与维生素 D 缺乏之间的独特关联:基于 NHANES 数据库的研究结果
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1186/s12902-024-01719-w
Biting Zhao, Shuang Yang
Serum lipids are highly heritable and play an important role in cardiovascular and metabolic health. However, the relationship between high-density lipoprotein cholesterol (HDL-C) and serum 25-hydroxyvitamin D [25(OH)D] levels is unclear. This study aims to explore the association between serum 25(OH)D levels and HDL-C in adults aged 20–59. This cross-sectional study was based on data from the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression was used to assess the relationship between HDL-C and serum 25(OH)D, with further analysis using smooth spline fitting and generalized additive models. A total of 28,084 adults were included in the study. After adjusting for multiple variables, we found a significant positive correlation between HDL-C and serum 25(OH)D levels (β = 8.3, 95% CI: 7.24–9.35, p < 0.001). Stratified subgroup analysis by gender showed that females consistently exhibited a positive correlation (β = 10.12, 95% CI: 9.07–11.18, p < 0.001), while males demonstrated an inverted U-shaped relationship between HDL-C and serum 25(OH)D. In the population aged 20–59, HDL-C levels are significantly associated with serum 25(OH)D levels. Clinically, simultaneous monitoring of HDL-C and vitamin D is recommended to better assess and manage cardiovascular health. Increasing vitamin D intake should be considered, especially for males with low HDL-C levels, to prevent related health issues.
血清脂质具有高度遗传性,在心血管和代谢健康中发挥着重要作用。然而,高密度脂蛋白胆固醇(HDL-C)与血清 25- 羟基维生素 D [25(OH)D] 水平之间的关系尚不清楚。本研究旨在探讨 20-59 岁成年人血清 25(OH)D 水平与高密度脂蛋白胆固醇之间的关系。这项横断面研究基于美国国家健康与营养调查(NHANES)的数据。研究采用多变量逻辑回归评估 HDL-C 与血清 25(OH)D 之间的关系,并使用平滑样条拟合和广义加性模型进行进一步分析。研究共纳入了 28084 名成年人。在对多种变量进行调整后,我们发现 HDL-C 与血清 25(OH)D 水平之间存在显著的正相关性(β = 8.3,95% CI:7.24-9.35,p < 0.001)。按性别进行的分层亚组分析表明,女性始终表现出正相关性(β = 10.12,95% CI:9.07-11.18,p < 0.001),而男性则表现出 HDL-C 与血清 25(OH)D 之间的倒 U 型关系。在 20-59 岁人群中,高密度脂蛋白胆固醇水平与血清 25(OH)D 水平显著相关。临床上,建议同时监测高密度脂蛋白胆固醇和维生素 D,以便更好地评估和管理心血管健康。应考虑增加维生素 D 的摄入量,尤其是高密度脂蛋白胆固醇水平较低的男性,以预防相关的健康问题。
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引用次数: 0
Prevalence, patterns, and determinants of vascular complications of type 2 diabetes in a teaching hospital in Addis Ababa, Ethiopia: a retrospective study 埃塞俄比亚亚的斯亚贝巴一家教学医院 2 型糖尿病血管并发症的发病率、模式和决定因素:一项回顾性研究
IF 2.7 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1186/s12902-024-01731-0
Gashaw Solela, Henok A. Gessesse, Hailu Zegeye, Amare Worku, Beza Leulseged
Patients with type 2 diabetes mellitus (T2D) have an increased risk of vascular complications. Despite the rise in the prevalence of T2D and its complications throughout the globe, there is a paucity of data regarding the prevalence and determinants of vascular complications of T2D in Ethiopia. Hence, this study aimed to assess the prevalence, patterns, and determinants of the microvascular and macrovascular complications of T2D among adult patients attending a teaching hospital in Addis Ababa, Ethiopia. A retrospective study was done by reviewing the electronic health records of adult patients with T2D attending the general medical and endocrine referral clinics of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from June 1, 2023, to November 30, 2023. Statistical Package for Social Sciences (SPSS), version 25, was used to analyze the data. Descriptive analysis was used to summarize the sociodemographic, clinical, and laboratory profiles as well as the patterns of vascular complications of T2D. Bivariate and multivariate logistic regression models were fitted, and the crude odds ratio (COR) and adjusted odds ratio (AOR), together with the 95% confidence interval (CI), were computed to identify the determinants of microvascular and macrovascular complications of T2D. A total of 272 patients with T2D were included in this study; 50.5% were females, and the mean (± standard deviation) age was 56.3 ± 12.8 years. The majority of patients (62.5%) had diabetes for ≥ 5 years. More than half (51.5%) had poor glycemic control with glycated haemoglobin (HbA1c) value of ≥ 7%. The overall prevalence of vascular complications was 39%. The prevalence of microvascular complications was 23.5%, the most common being neuropathy (11.8%), and the prevalence of macrovascular complications was 21%, the most common being coronary artery disease (12.1%). The determinants of microvascular complications were age ≥ 60 years (AOR = 2.25, 95% CI: 1.17, 4.33), diabetes duration of ≥ 5 years (5–10 years [AOR = 3.13, 95% CI: 1.37, 7.18], and > 10 years [AOR = 3.88, 95% CI: 1.66, 9.06], and HbA1c value of ≥ 7% (AOR = 2.21, 95% CI: 1.14, 4.28). The odds of developing macrovascular complications were higher with diabetes duration of ≥ 5 to 10 years (AOR = 2.89, 95% CI: 1.37, 6.12) as compared with diabetes duration of < 5 years. This study demonstrated a high prevalence of microvascular and macrovascular complications in adult patients with T2D. Older age, prolonged duration of diabetes, and poor glycemic control were identified as the determinants for the development of microvascular complications of T2D, while prolonged duration of diabetes was the determining factor for the development of macrovascular complications. Hence, targeted initiatives are required to enhance the prevention and early detection of vascular complications of T2D in resource-limited countries like Ethiopia.
2 型糖尿病(T2D)患者发生血管并发症的风险增加。尽管全球 T2D 及其并发症的发病率都在上升,但有关埃塞俄比亚 T2D 血管并发症的发病率和决定因素的数据却很少。因此,本研究旨在评估在埃塞俄比亚亚的斯亚贝巴一家教学医院就诊的成年患者中 T2D 微血管和大血管并发症的患病率、模式和决定因素。本研究采用回顾性研究方法,查阅了埃塞俄比亚亚的斯亚贝巴Yekatit 12医院医学院普通内科和内分泌转诊门诊就诊的T2D成年患者的电子健康记录,时间为2023年6月1日至2023年11月30日。数据分析采用社会科学统计软件包(SPSS)第 25 版。描述性分析用于总结社会人口学、临床和实验室概况以及 T2D 血管并发症的模式。拟合了二元和多元逻辑回归模型,并计算了粗略几率比(COR)和调整几率比(AOR)以及 95% 的置信区间(CI),以确定 T2D 微血管和大血管并发症的决定因素。本研究共纳入 272 名 T2D 患者,其中女性占 50.5%,平均年龄(± 标准差)为 56.3±12.8 岁。大多数患者(62.5%)的糖尿病病程≥5年。半数以上(51.5%)患者血糖控制不佳,糖化血红蛋白(HbA1c)值≥7%。血管并发症的总发病率为 39%。微血管并发症的发病率为 23.5%,最常见的是神经病变(11.8%),大血管并发症的发病率为 21%,最常见的是冠状动脉疾病(12.1%)。微血管并发症的决定因素是年龄≥60 岁(AOR = 2.25,95% CI:1.17,4.33)、糖尿病病程≥5 年(5-10 年[AOR = 3.13,95% CI:1.37,7.18],>10 年[AOR = 3.88,95% CI:1.66,9.06])和 HbA1c 值≥7%(AOR = 2.21,95% CI:1.14,4.28)。与糖尿病病程小于 5 年的患者相比,糖尿病病程≥ 5-10 年的患者发生大血管并发症的几率更高(AOR = 2.89,95% CI:1.37,6.12)。这项研究表明,在成年 T2D 患者中,微血管和大血管并发症的发病率很高。高龄、糖尿病病程长和血糖控制不佳被认为是 T2D 微血管并发症发生的决定因素,而糖尿病病程长则是大血管并发症发生的决定因素。因此,在埃塞俄比亚等资源有限的国家,需要采取有针对性的措施,加强对 T2D 血管并发症的预防和早期检测。
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BMC Endocrine Disorders
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