Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association最新文献

Gout and type 2 diabetes mellitus (T2DM) often coexist and are associated with chronic kidney disease (CKD) and increased mortality. Dipeptidyl peptidase-4 (DPP-4) inhibitors, commonly used in T2DM, may offer additional benefits, such as reducing inflammation and uric acid levels. This study aimed to assess the impact of DPP-4 inhibitors on gout flare frequency, serum uric acid (sUA) levels, and survival in patients with gout, T2DM, and CKD.A cross-sectional, retrospective, longitudinal study was conducted over 6 years between 2016 - 2022, including patients with gout and T2DM from the largest healthcare provider in Israel. Patients were divided into treatment and control groups based on DPP4-inhibitor status treatment. The primary outcome was the number of gout arthritis attacks over 1 year, reflected by the number of emergency room visits. Secondary outcomes included mean serum high-sensitive C-reactive protein (hs-CRP) levels and survival rates over the study period.DPP-4 inhibitor treatment significantly reduced sUA levels (5.2±1.3 mg/dL vs. 5.9±2.2 mg/dL, p=0.05) and hs-CRP levels (0.50±0.19 mg/dL, p<0.001). Kaplan-Meier survival analysis suggested a trend towards improved survival in the DPP-4 inhibitor group (HR=0.834, 95% CI: 0.6-1.04, p=0.05), particularly among patients with chronic kidney disease (CKD), although without statistical significance. The emergency room visits due to gout attacks were fewer in the DPP-4 inhibitor group, although this difference did not achieve statistical significance.DPP-4 inhibitors may offer benefits beyond glycemic control in T2DM and gout, including reduced sUA and hs-CRP levels and improved survival in CKD patients. Larger, randomized trials are warranted to explore these potential benefits.

Transforming growth factor-β (TGF-β), a local growth factor, is essential for bone remodeling; when administered in bone tissues, it stimulates bone formation. On the other hand, transmembrane protein 119 (Tmem119) is a crucial factor for osteoblastic bone formation related to the TGF-β signaling molecule, Smad3. However, the role of Tmem119 in TGF-β-mediated effects on osteoblasts and osteoclasts remains unclear.The function of Tmem119 in TGF-β-mediated effects was examined for osteoblastic differentiation, bone matrix protein expression, and osteoclast formation in mouse osteoblasts, adipose tissue-derived stromal cells, and bone marrow cells from wild-type and Tmem119-deficient mice. Tmem119 deficiency significantly reversed the TGF-β-induced expressions of type I collagen and matrix-Gla protein (MGP) in mouse osteoblasts but did not affect TGF-β-suppressed alkaline phosphatase activity in mouse adipose tissue-derived stromal cells, even when TGF-β could suppress alkaline phosphatase (ALP) activity in mouse osteoblasts regardless of Tmem119 deficiency. Tmem119 deficiency significantly reduced osteoclast formation and Nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1) mRNA levels in mouse bone marrow cells.Tmem119 is involved in regulating type I collagen and MGP expressions and TGF-β-induced osteoclast formation, but does not affect TGF-β-suppressed osteoblastic differentiation in mouse cells.

Little is known about temporal trends in the incidence of male hypogonadism and its correlation with socioeconomic status, which we examined in the present study.Data were extracted from the Maccabi Health Services computerized database between 2001-2017. The study population included 4,261 men aged 21 to 80 years with biochemically proven hypogonadism defined and classified according to the European Male Aging Study criteria. Patients on testosterone or testosterone-modifying drugs were excluded. The socioeconomic status was assessed based on verified financial data pertinent to the area of residence.The incidence of male hypogonadism increased with age in all the socioeconomic strata. Among the hypogonadal men, 75% had hypogonadotropic hypogonadism. The overall incidence of hypogonadism increased 1.4-fold between the 2001-2009 and 2010-2017 periods [from 41.7 (39.7-43.8) to 58.5 (56.4-60.8) per 100,000 person-years) (95% CI)], mainly due to an increase in hypogonadotropic hypogonadism. The temporal increase in hypogonadotropic hypogonadism occurred in all age groups and all socioeconomic strata but was notably more prominent in >51-year age groups of the more affluent socioeconomic strata. The mean body mass index remained unchanged throughout the study period.A temporal increase was observed in male hypogonadism, mainly hypogonadotropic hypogonadism, corresponding with previously observed temporal decreases in testosterone levels in men. This trend could be possibly partly attributed to an underappreciated increase in mental distress due to decreasing global happiness indices, increasing stress, and occupational burnout in specific occupations associated with more affluent populations (i.e., high-tech, finance, medical). This preliminary proposition deserves further investigation.

The aim of this narrative review was to discuss data on contraception in diabetes mellitus (DM). Women with DM rarely discuss contraception with their physicians, and healthcare providers offer advice to a very limited number of them. Overall, 1 in 8 women with DM using contraception methods was found to use an ineffective one. A further issue relates to drug-drug interactions between anti-diabetic medications and oral contraceptives. Generally, anti-diabetic agents do not alter the pharmacologic profile of hormonal contraception. However, preliminary results indicate that some novel anti-diabetic agents may even render oral contraceptive methods ineffective. Several implants can be also generally used by women with both DM types. The relationship between oral contraceptives and diabetic complications has not been clarified yet. In general, implants, intra-uterine devices or progestin-only contraceptives are considered safe options for women with DM. However, short-term use of combined hormonal contraception is also feasible for women without severe complications or risk factors.