BMC Endocrine Disorders最新文献

Background: In recent years, simpler and more practical indicators based on routine biochemical tests or anthropometric measurements have been widely utilized for the assessment of insulin sensitivity. However, limited research has been conducted to investigate the predictive value of these novel simplified measures in relation to subclinical left ventricular systolic dysfunction.

Methods: A total of 160 newly diagnosed patients with type 2 diabetes mellitus (T₂DM) and 70 healthy subjects matched by age and sex were included in the study. The systolic function of the left ventricle were assessed using AFI echocardiography( global longitudinal strain, GLS). Four indicators of insulin resistance (IR) were computed: Triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c), the product of fasting triglycerides and glucose levels(TyG), TyG multiplied by the body mass index(TyG-BMI)and the Insulin resistance metabolic score(METS-IR). The binary logistic regression analysis identified clinical and ultrasonic risk factors associated with abnormal left ventricular GLS in patients with T2DM. Develop a multiple-index-based log P model for integrated application. The diagnostic efficacy of the log P model in predicting left ventricular systolic function impairment was assessed using ROC analysis.

Results: Competing risk regression revealed that body mass index(BMI), interventricular septal diameter(IVSD), systolic blood pressure(SBP) and left atrium(LA) were significant risk factors for the reduction of GLS in individuals with T2DM. Additionally, two IR index models were found to be closely associated with abnormal GLS: TyG-BMI (6.227,p = 0.000); METS-IR(7.436,p = 0.000). ROC analysis results indicate that TyG-BMI, METS-IR, IVSD, SBP, LA and a combination of five other indexes have demonstrated certain efficacy in predicting and evaluating diabetic heart function reduction. Its ROC-AUC (0.95CI) are 0.750 (0.564 ~ 0.934), 0.774 (0.582 ~ 0.944), 0.702 (0.461 ~ 0.948), 0.737 (0.478 ~ 0.983), 0.726 (0.483 ~ 0.951), 0.878 (0.770 ~ 0.987) respectively.

Conclusion: Approximately 20% of newly diagnosed patients with T₂DM exhibit early-stage left ventricular systolic dysfunction.The Log P model exhibited the highest predictive efficiency when applied in combination, with significantly higher sensitivity, specificity and accuracy than each individual application.

Clinical trial number: Not applicable.

Background: This study aimed to compare the reduction in hospital admissions due to hypoglycemia and the decrease in HbA1c levels between empagliflozin and sulfonylurea, alongside the standard care provided to patients with type 2 diabetes during fasting.

Methodology: A single-center prospective observational cohort study was conducted from March to June 2022. Patients were treated with stable doses of empagliflozin, sulfonylureas, metformin, and DPP-4 inhibitors at least two months before fasting. Stability was defined as unchanged doses for at least one month. Participants' BMI distribution and treatment regimens were clarified. The eGFR cutoff of < 60 ml/min/1.73 m² was chosen based on international standards for renal function in diabetes.

Results: Females were in the majority (60.3%) in the intervention (case) group. Most had ages ranging from 41 to 60 years; the empagliflozin group reported slightly fewer hypoglycemic events (26.5%) compared to the sulfonylurea group (31%), and both groups demonstrated statistically significant reductions in HbA1c levels (p < 0.0001), with a similar mean decrease of approximately 0.5%, during fasting, without changes in baseline antidiabetic medications. An odds ratio of 0.387 indicated a trend toward further HbA1c reduction with increasing empagliflozin dose. However, differences in baseline weight between groups may have influenced outcomes. Separate data for modern versus conventional sulfonylureas were analyzed, showing consistency in hypoglycemic event rates across both types.

Conclusions: Empagliflozin is effective for type 2 diabetic patients during Ramadan fasting in modestly reducing the hypoglycemic events requiring hospital admissions. While both empagliflozin and sulfonylureas led to comparable reductions in HbA1c, larger, controlled studies are warranted to further evaluate clinical outcomes and control for baseline differences.

Clinical trial number: Not applicable.

Background: Type 2 diabetes mellitus (T2DM) is an intricate metabolic disorder often accompanied by low-grade inflammation. This study aimed to investigate the relationship between the monocyte-to-lymphocyte ratio (MLR) and diabetic peripheral neuropathy (DPN) in patients with T2DM.

Method: A total of 236 individuals diagnosed with T2DM participated in the research. Clinical parameters were assessed, including the Toronto Clinical Neuropathy Score (TCNS), Compound Muscle Action Potential (CMAP), Sensory Nerve Action Potential (SNAP), nerve conduction velocity (NCV), complete blood count, biochemical markers, and inflammatory indicators. These parameters were analyzed and compared, followed by logistic regression and receiver operating characteristic (ROC) curve analyses.

Results: The findings demonstrated that patients with DPN were generally older and had higher MLR levels and glycated hemoglobin levels, lower high-density lipoprotein cholesterol(HDL-C), longer disease duration, and higher FPG compared to patients without DPN. Additionally, CMAP and SNAP of median nerve (MN), ulnar nerve(UN), peroneal nerve (PN), and tibial nerve (TN) were significantly lower in the higher MLR group than in the higher MLR group( P < 0.05). ROC analysis indicated that MLR had an area under the curve (AUC) of 0.625, suggesting a limited discriminative ability to identify DPN.

Conclusion: This study underscores the potential ability of MLR as a predictive biomarker for DPN in patients with T2DM, emphasizing the important role of inflammation in the development of this condition. But it has a low performance for DPN diagnosis.

Clinical trial number: Not applicable.

Background: Adult T1DM has a large population base, is insulin dependent, and has a high hazard of hypoglycaemia risk. Therefore, the objective of this systematic review is to evaluate the risk factors linked to the occurrence of hypoglycemia in adult patients with type 1 diabetes mellitus. This analysis aims to aid in the formulation of preventive strategies and support early-stage intervention measures.

Methods: A computerised search of nine electronic databases, all with a timeframe of construction to December 2024, was conducted to find cross-sectional, cohort, and case-control studies on hypoglycaemia in patients with type 1 diabetes mellitus. The quality of the included studies was evaluated using the American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). The combined odds ratio (OR) and the corresponding 95% confidence interval (CI) were calculated to evaluate the effect of the included risk factors on hypoglycaemia.

Results: A total of 31 studies including 54,634 participants were included. A total of 35 potentially relevant risk factors were identified. Ultimately, 18 risk factors were assessed for inclusion in the Meta-analysis, and 9 risk factors were statistically significant (P < 0.05), including disease duration (OR = 1.07, 95% CI: 1.01-1.13), history of hypoglycaemia (OR = 2.31, 95% CI: 1.70-3.15),smoking (OR = 1.17, 95% CI: 1.07-1.28), diabetic nephropathy (OR = 0.83, 95% CI: 0.71-0.98), multiple daily insulin injections (OR = 1.96, 95% CI: 1.46-2.61 ), insulin dose (OR = 1.14, 95% CI: 1.08-1.21), hypoglycaemic unawareness (OR = 5.18, 95% CI: 1.81-14.84), impaired hypoglycaemic awareness (OR = 5.99, 95% CI: 4.62-7.75), diabetic neuropathy (OR = 2.05, 95% CI: 1.12-3.76).

Conclusion: This study identified 9 major risk factors affecting hypoglycaemia in adults with type 1 diabetes mellitus, including disease duration, history of hypoglycaemia, smoking, diabetic nephropathy (protective factor), multiple daily insulin injections, insulin dose, hypoglycaemic unawareness, impaired hypoglycaemic awareness and diabetic neuropathy.

Clinical trial number: Not applicable.

Background: Emerging evidence highlights the role of gut microbiota in autoimmune diseases, including Hashimoto's thyroiditis (HT). Diet is a key modulator of gut microbial composition. This study investigated the association between a novel Dietary Index for Gut Microbiota (DIGM) and thyroid-related biomarkers among women with HT.

Methods: In this cross-sectional study, 162 women with clinically confirmed HT were enrolled. Dietary intake was assessed using a validated food frequency questionnaire. The DIGM score was constructed based on intake of foods known to influence gut microbial health, with higher scores indicating greater adherence to a microbiota-supportive diet. Anthropometric parameters and serum levels of thyroid hormones, thyroid autoantibodies, lipid profile, and oxidative stress markers were measured. Participants were categorized into tertiles based on DIGM score, and comparisons across groups were made using ANOVA and general linear models, adjusting for potential confounders.

Results: Participants in the highest DIGM tertile had significantly lower serum anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibody levels (P < 0.05), lower triglyceride concentrations (p = 0.017), and reduced waist-to-hip ratio (p = 0.030) compared to those in the lowest tertile. No significant differences were observed in TSH, T3, T4, anti-Tg, TAC, or MDA levels across DIGM categories.

Conclusion: Higher adherence to a microbiota-supportive dietary pattern, as reflected by the DIGM score, was associated with favorable immune and metabolic profiles in women with HT. Due to the cross-sectional design of the study, causal relationships cannot be inferred. Further longitudinal or intervention studies are needed to elucidate causality and to suggest dietary modulation of gut microbiota as a non-pharmacological approach to support management of autoimmune thyroid disease.

Clinical trial number: Not applicable.