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

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Glucose Monitoring and Control Testing in Patients with Type 1 or Type 2 diabetes. 1 型或 2 型糖尿病患者的血糖监测和控制测试。
Sandra Schlüter, Dorothee Deiss, Bernhard Gehr, Karin Lange, Simone von Sengbusch, Andreas Thomas, Ralph Ziegler, Guido Freckmann
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引用次数: 0
Mild Autonomous Cortisol Secretion (MACS) - Related Osteoporosis. 与骨质疏松症有关的轻度自主皮质醇分泌 (MACS)。
G. Zavatta, G. Di Dalmazi
Mild autonomous cortisol secretion (MACS) has thus far been associated with several comorbidities, among which osteoporosis and fractures appear to be highly prevalent. Recent guidelines for adrenal incidentalomas have updated the definition of MACS, currently formulated on serum cortisol after a 1-mg dexamethasone test above 1.8 µg/dL or 50 nmol/L. Previous studies on bone health in adrenal incidentalomas had adopted different definitions of MACS, which produced heterogenous results in terms of fracture prevalence. This review aims to summarize the clinical impact of MACS in relation to fractures, bone quantity and quality, by providing a thorough update on MACS-related osteoporosis (MACS-ROP). Room for research in this area is large, and management of this comorbidity still needs to be elucidated.
迄今为止,轻度皮质醇自主分泌(MACS)与多种并发症有关,其中骨质疏松症和骨折似乎是高发疾病。最近的肾上腺偶发瘤指南更新了 MACS 的定义,目前的定义是在 1 毫克地塞米松测试后血清皮质醇高于 1.8 µg/dL 或 50 nmol/L。以往关于肾上腺偶发瘤患者骨骼健康的研究采用了不同的 MACS 定义,因此在骨折发生率方面产生了不同的结果。本综述旨在通过全面更新 MACS 相关骨质疏松症(MACS-ROP),总结 MACS 在骨折、骨量和骨质方面的临床影响。该领域的研究空间很大,对这一合并症的管理仍有待阐明。
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引用次数: 0
Mild Autonomous Cortisol Secretion (MACS) - Related Osteoporosis. 与骨质疏松症有关的轻度自主皮质醇分泌 (MACS)。
Guido Zavatta, Guido Di Dalmazi

Mild autonomous cortisol secretion (MACS) has thus far been associated with several comorbidities, among which osteoporosis and fractures appear to be highly prevalent. Recent guidelines for adrenal incidentalomas have updated the definition of MACS, currently formulated on serum cortisol after a 1-mg dexamethasone test above 1.8 µg/dL or 50 nmol/L. Previous studies on bone health in adrenal incidentalomas had adopted different definitions of MACS, which produced heterogenous results in terms of fracture prevalence. This review aims to summarize the clinical impact of MACS in relation to fractures, bone quantity and quality, by providing a thorough update on MACS-related osteoporosis (MACS-ROP). Room for research in this area is large, and management of this comorbidity still needs to be elucidated.

迄今为止,轻度皮质醇自主分泌(MACS)与多种并发症有关,其中骨质疏松症和骨折似乎是高发疾病。最近的肾上腺偶发瘤指南更新了 MACS 的定义,目前的定义是在 1 毫克地塞米松测试后血清皮质醇高于 1.8 µg/dL 或 50 nmol/L。以往关于肾上腺偶发瘤患者骨骼健康的研究采用了不同的 MACS 定义,因此在骨折发生率方面产生了不同的结果。本综述旨在通过全面更新 MACS 相关骨质疏松症(MACS-ROP),总结 MACS 在骨折、骨量和骨质方面的临床影响。该领域的研究空间很大,对这一合并症的管理仍有待阐明。
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引用次数: 0
Impact of Physiological Fluctuations of Sex Hormones During the Menstrual Cycle on Glucose Metabolism and the Gut Microbiota. 月经周期中性激素的生理波动对葡萄糖代谢和肠道微生物群的影响。
Alina Schieren, Sandra Koch, Tal Pecht, Marie-Christine Simon

Diabetes mellitus is one of the most prevalent chronic diseases. Previous studies have shown differences in glucose metabolism between males and females. Moreover, difficulties in medication adherence have been reported in females with type 2 diabetes. These observations are believed to be caused by fluctuations in sex hormone concentrations during the menstrual cycle. Furthermore, gut microbiota is linked to female host metabolism and sex hormone production. Understanding the interactions between fluctuating hormone concentrations during the menstrual cycle, gut microbiota, and glucose metabolism in humans is significant because of the increasing prevalence of diabetes and the consequent need to expand preventive efforts. A literature search was performed to determine and summarize the existing evidence, deduce future research needs to maintain female health, and investigate the relationship between the physiological menstrual cycle and glucose metabolism. Studies from 1967 to 2020 have already examined the relationship between variations during the menstrual cycle and glucose metabolism in healthy female subjects using an oral-glucose tolerance test or intravenous glucose tolerance test. However, the overall number of studies is rather small and the results are contradictory, as some studies detected differences in glucose concentrations depending on the different cycle phases, whereas others did not. Some studies reported lower glucose levels in the follicular phase than in the luteal phase, whereas another study detected the opposite. Data on gut microbiota in relation to the menstrual cycle are limited. Conflicting results exist when examining the effect of hormonal contraceptives on the gut microbiota and changes in the course of the menstrual cycle. The results indicate that the menstrual cycle, especially fluctuating sex hormones, might impact the gut microbiota composition.The menstrual cycle may affect the gut microbiota composition and glucose metabolism. These results indicate that glucose tolerance may be the greatest in the follicular phase; however, further well-conducted studies are needed to support this assumption.

糖尿病是世界上最普遍的慢性疾病之一。以往的研究表明,男性和女性在葡萄糖代谢方面存在差异。此外,有报告称女性 2 型糖尿病患者在坚持服药方面存在困难。这些观察结果被认为是月经周期中性激素浓度波动造成的。此外,肠道微生物群与女性宿主的新陈代谢和性激素分泌有关。由于糖尿病的发病率越来越高,因此需要扩大预防范围,因此了解月经周期中波动的激素浓度、肠道微生物群以及人体葡萄糖代谢之间的相互作用具有重要意义。为了确定和总结现有证据,推断维护女性健康的未来研究需求,并研究生理月经周期与葡萄糖代谢之间的关系,我们进行了文献检索。令人惊讶的是,从 1967 年到 2020 年的研究中,已经使用 OGTT 或 IVGTT 对健康女性受试者的月经周期变化与糖代谢之间的关系进行了研究;然而,研究的总体数量相当少。研究结果相互矛盾,有些研究发现不同生理周期阶段的葡萄糖浓度存在差异,而有些研究则没有发现。此外,一些研究显示卵泡期的血糖水平低于黄体期,而另一项研究则发现黄体期的血糖水平较低。与月经周期有关的肠道微生物群数据有限。在研究荷尔蒙避孕药对肠道微生物群的影响以及月经周期的变化时,存在相互矛盾的结果。不过,研究结果表明,月经周期,尤其是性激素的波动,可能会对肠道微生物群的组成产生影响。总之,月经周期可能会影响肠道微生物群的组成以及葡萄糖代谢。这些结果表明,卵泡期的葡萄糖耐受性可能最强;然而,要支持这一假设,还需要进一步开展完善的研究。
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引用次数: 0
Blood Urea Nitrogen to Serum Albumin Ratio as A New Prognostic Indicator in Critically Ill Patients with Diabetic Ketoacidosis: A Retrospective Cohort Study. 血尿素氮与血清白蛋白比值作为糖尿病酮症酸中毒重症患者的新预后指标:一项回顾性队列研究。
Tingting Hang, Jing Huang, Guiping He, Jin Li, Tingting Tao

Objective: To investigate the predictive value of the blood urea nitrogen to serum albumin ratio for in-hospital and out-of-hospital mortality in critically ill patients with diabetic ketoacidosis.

Methods: Data were obtained from the Medical Information Mart for Intensive Care III (MIMIC III) database, and all eligible participants were categorized into two groups based on the BAR cutoff value. Multiple logistic regression analysis was conducted to determine the association between BAR and in-hospital mortality. The Kaplan-Meier (K-M) analysis was performed to evaluate the predictive performance of BAR. Propensity score matching (PSM) was applied to control confounding factors between the low and high BAR groups.

Results: A total of 589 critically ill patients with diabetic ketoacidosis were enrolled. Patients with diabetic ketoacidosis with a higher BAR level were associated with higher in- and out-hospital mortality (all p<0.001). A significant 4-year survival difference was observed between the low and high BAR groups (p<0.0001). After PSM analysis, two PSM groups (202 pairs, n=404) were generated, and similar results were observed in the K-M curve (p<0.0001).

Discussion: Elevated BAR levels were associated with an increased risk of in-hospital mortality in critically ill patients with diabetic ketoacidosis, and BAR could serve as an independent prognostic factor in in-hospital and out-of-hospital mortality for patients diagnosed with diabetic ketoacidosis.

目的:糖尿病酮症酸中毒(DKA)仍然是一种危及生命的急症。血尿素氮-血清白蛋白(BAR)对各种疾病患者的死亡率具有良好的预测能力。本研究旨在探讨血尿素氮对 DKA 重症患者院内和院外死亡率的预测价值:数据来自重症监护医学信息市场 III(MIMIC-III)数据库,所有符合条件的受试者按 BAR 临界值分为两组。采用多元逻辑回归分析确定 BAR 与院内死亡率之间的关系。卡普兰-梅耶(K-M)分析评估了 BAR 的预测性能。采用倾向得分匹配法(PSM)控制低BAR组和高BAR组之间的混杂因素:共有 589 名重症 DKA 患者入选。BAR水平较高的DKA患者的院内死亡率和院外死亡率均较高:BAR水平升高与DKA重症患者院内死亡风险增加有关,BAR可能是影响DKA患者院内死亡率和院外死亡率的独立预后因素。
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引用次数: 0
MiRNA Signatures Related to Invasiveness and Recurrence in Patients With Non-Functioning Pituitary Neuroendocrine Tumors. 与非功能性垂体神经内分泌肿瘤患者侵袭性和复发有关的 MiRNA 特征--一项在单一三级中心开展的试点研究。
Emiliya Nikolova, Anelia Nankova, Silvia Kalenderova, Bilyana Georgieva, Asen Hadzhiyanev, Stoyan Bichev, Alexey Savov, Albena Todorova, Vanyo Mitev, Atanaska Elenkova

Purpose: This preliminary study aimed to analyze and identify differentially expressed miRNAs in Bulgarian patients with non-functioning pituitary neuroendocrine tumors (NFPitNET). The relationship between deregulated miRNAs and tumor invasiveness, recurrence, and size was determined.

Methods: Twenty patients with NFPitNET were selected and fresh pituitary tumor tissues were collected. RNA containing miRNAs were isolated using miRNAeasy mini kit and analyzed by quantitative real-time polymerase chain reaction (PCR) using LNA miRNA Cancer-Focus PCR Panel (Qiagen).

Results: Three miRNAs (miR-210-3p, miR-149-3p, and miR-29b-3p) were deregulated in invasive compared to non-invasive NFPitNETs. Differential expression of four-miRNA signatures - miRNA-17, miR-19, miR-106a, and miR-20, correlated with patient recurrence.

Conclusion: This prospective pilot study selected a unique miRNA expression profile, that correlates with invasiveness and recurrence in non-functioning pituitary neuroendocrine tumors. Moreover, some of the selected miRNAs are reported for the first time in patients with this disease, shedding light on the molecular mechanisms involved in pituitary pathogenesis. The identified miRNAs demonstrate potential as biomarkers, deserving further investigation in a larger cohort to validate their clinical applicability.

目的:这项初步研究旨在分析和鉴定保加利亚非功能性垂体神经内分泌肿瘤(NFPitNET)患者体内表达不同的miRNA。研究还确定了失调的 miRNA 与肿瘤侵袭性、复发性和大小之间的关系:方法:选取 20 例非功能性垂体神经内分泌肿瘤患者,收集新鲜垂体肿瘤组织。用miRNAeasy mini试剂盒分离含有miRNA的RNA,并用LNA miRNA Cancer Focus PCR Panel(Qiagen公司)进行实时定量PCR分析:结果:与非侵袭性NFPitNET相比,侵袭性NFPitNET中有三个miRNA(miR-210-3p、miR-149-3p和miR-29b-3p)表达失调。四种miRNA特征--miRNA-17、miR-19、miR-106a和miR-20的差异表达与患者的复发有关:在这项前瞻性试验研究中,我们筛选出了与非功能性垂体神经内分泌肿瘤的侵袭性和复发相关的独特 miRNA 表达谱。此外,一些被选中的 miRNAs 还是首次在该病患者中被报道,从而揭示了垂体发病机制的分子机制。已鉴定的 miRNAs 具有作为生物标志物的潜力,值得在更大的群体中进一步研究,以验证其临床适用性。
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引用次数: 0
Obesity and Diabetes. 肥胖症与糖尿病
Jens Aberle, Anne Lautenbach, Svenja Meyhöfer, Sebastian M Meyhöfer, Markus Menzen, Lars Selig, Knut Mai, Matthias Blüher
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引用次数: 0
Plasma Glucose Concentrations in Different Sampling Tubes Measured on Different Glucose Analysers. 用不同的葡萄糖分析仪测量不同采样管中的血浆葡萄糖浓度。
Stefan Pleus, Alexandra Beil, Annette Baumstark, Cornelia Haug, Guido Freckmann

Introduction: The German Diabetes Association recommends using sampling tubes with citrate and fluoride additives to diagnose diabetes by oral glucose tolerance test to inhibit glycolysis. The effect of different tubes on measurement results was assessed.

Materials and methods: In a first study, an oral glucose tolerance test was performed on 41 participants without anamnestically known diabetes. Venous blood was sampled in two different tubes with citrate/fluoride additives from different manufacturers and one with only lithium-heparin additive. A second study with 42 participants was performed to verify the initial results with an adapted design, in which a third tube with citrate buffer was used, and glucose measurements were performed on two additional devices of another analyser model. Samples were centrifuged either immediately (<5 min incubation time) or after 20 min or 4 h. All glucose measurements were performed in plasma. Glucose concentrations in lithium-heparin tubes with<5 min incubation time served as baseline concentrations.

Results: In the first study, glucose concentrations in one of the citrate/fluoride tubes were similar to the baseline. In the other citrate/fluoride tube, markedly lower concentrations (approximately - 5 mg/dL (- 0.28 mmol/L)) were measured. This was reproduced in the verification study for the same analyser, but not with the other analyser model. Lithium-heparin tubes centrifuged after 20 and 240 min showed systematically lower glucose concentrations.

Conclusions: The results confirm that glycolysis can be effectively inhibited in citrate/fluoride-containing sampling tubes. However, glucose measurement results of one analyser showed a relevant negative bias in tubes containing liquid citrate buffer.

导言:德国糖尿病协会建议在通过口服葡萄糖耐量试验诊断糖尿病时使用带有柠檬酸盐和氟化物添加剂的采样管,以抑制糖酵解。本研究评估了不同试管对测量结果的影响。材料和方法 在第一项研究中,对 41 名无糖尿病史的参与者进行了口服葡萄糖耐量试验。静脉血采样在两种不同的试管中进行,一种试管使用不同厂家生产的柠檬酸盐/氟添加剂,另一种试管仅使用锂-肝素添加剂。为了验证初步结果,我们又对 42 名参与者进行了第二次研究,并对设计进行了调整,使用了第三支装有柠檬酸盐缓冲液的试管,并在另外两台不同型号的分析仪上进行了血糖测量。样本立即离心 (
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引用次数: 0
Association Analysis of Dietary Inflammatory Index and Gestational Diabetes Mellitus: Based on National Health and Nutrition Examination Survey Database. 膳食炎症指数与妊娠糖尿病的关联分析:基于全国健康与营养调查数据库
Yamin Zeng, Yina Piao
OBJECTIVEThis study focused on the association of the Dietary Inflammatory Index (DII) with the risk of gestational diabetes mellitus (GDM) using data from the National Health and Nutrition Examination Survey (NHANES).METHODSData from two cycles of NHANES (2007-2010) were analyzed. Weighted logistic regression models were constructed to explore the relationship between DII and GDM. Stratified and subgroup analyses with adjustment for confounding factors were carried out to explore the association between DII and GDM. Mediation analysis was conducted to investigate potential mediating factors.RESULTSA total of 1,421 samples were analyzed. Based on the weighted logistic regression model, a strong positive association was observed between DII score and GDM risk (OR: 1.14, 95%CI: 1.02-1.26, P<0.01), suggesting that a pro-inflammatory diet could considerably increase the likelihood of GDM occurrence. This positive association was particularly significant in populations who consume alcohol (OR:1.17, 95%CI: 1.03-1.34, P<0.01) and have a body mass index>30 kg/m² (OR: 1.18, 95% CI: 1.01-1.38, P<0.05). Mediation analysis indicated that the white blood cell count mediated the association between DII and GDM, with an indirect effect of 0.000828 (95% CI: 0.000226-0.001347, P=0.001) and a mediation proportion of 8.01%. Specifically, the neutrophil count as a component contributed to this mediation effect (0.000774, 95% CI: 0.00014-0.001063, P=0.001), with a mediation proportion of 7.59%.CONCLUSIONA pro-inflammatory diet in women elevates the likelihood of GDM occurrence. An anti-inflammatory dietary pattern may be a protective intervention for GDM.
目的本研究利用美国国家健康与营养调查(NHANES)的数据,重点研究了膳食炎症指数(DII)与妊娠糖尿病(GDM)风险的关系。建立了加权逻辑回归模型来探讨 DII 与 GDM 之间的关系。对混杂因素进行了分层和亚组分析,以探讨 DII 与 GDM 之间的关系。结果共分析了 1,421 个样本。根据加权逻辑回归模型,观察到 DII 评分与 GDM 风险之间存在很强的正相关性(OR:1.14,95%CI:1.02-1.26,P30 kg/m²(OR:1.18,95%CI:1.01-1.38,P<0.05))。中介分析表明,白细胞计数对 DII 与 GDM 之间的关系起中介作用,其间接效应为 0.000828(95% CI:0.000226-0.001347,P=0.001),中介比例为 8.01%。具体而言,中性粒细胞计数作为一个组成部分对这一中介效应起到了促进作用(0.000774,95% CI:0.00014-0.001063,P=0.001),中介比例为 7.59%。抗炎饮食模式可能对 GDM 有保护作用。
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引用次数: 0
Therapy combining glucagon-like peptide-1 receptor agonist with sodium-glucose cotransporter 2 inhibitor suppresses atherosclerosis in diabetic ApoE-deficient mice. 胰高血糖素样肽-1 受体激动剂与钠-葡萄糖共转运体 2 抑制剂相结合的疗法可抑制糖尿病载脂蛋白E缺陷小鼠的动脉粥样硬化。
Masahiro Takubo, Kentaro Watanabe, Hitoki Saito, Genta Kohno, Hisamitsu Ishihara
Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) have beneficial effects on cardiovascular disease in addition to their glucose-lowering effects. We directly compared the effects of these drugs when used individually or in combination on cardiovascular atherosclerotic lesion development using diabetic ApoE-deficient hyperlipidemic mice. Methods We treated ApoE-deficient mice with streptozotocin and nicotinamide, generating a type 2 diabetes model. The mice were randomly divided into four groups: vehicle-treated (Untreated), liraglutide (LIRA), ipragliflozin (IPRA), and combination therapy (Combo). These mice as well as non-diabetic controls were fed a high-fat diet. After 8 weeks of drug administration, the heart and aorta were removed and analyzed. Results Atherosclerotic lesions evaluated by oil red O (ORO) staining were significantly larger in the Untreated group (13.4 ± 0.8% of total aortic area) than in the non-diabetic controls (4.4 ± 0.5%, p < 0.01), while being reduced in the Combo (6.0 ± 1.0%, p < 0.01) as compared with the Untreated group. The ORO stain-positive area in the LIRA and IPRA groups tended to be reduced but their differences failed to reach statistical significance. Transcript levels of Mcp1 and Sirt1 were significantly reduced and increased, respectively, in the Combo as compared with the Untreated group, while no significant changes were observed in the monotherapy groups. Conclusions Our data suggest that combination therapy with liraglutide and ipragliflozin may be an efficient regimen for preventing the development of atherosclerosis in diabetic ApoE-deficient mice.
背景 胰高血糖素样肽-1 受体激动剂(GLP-1RA)和钠-葡萄糖共转运体 2 抑制剂(SGLT2i)除了具有降糖作用外,还对心血管疾病有益。我们利用糖尿病载脂蛋白E缺陷型高脂血症小鼠,直接比较了这些药物单独或联合使用对心血管动脉粥样硬化病变发展的影响。方法 我们用链脲佐菌素和烟酰胺治疗载脂蛋白E缺陷小鼠,建立了一个2型糖尿病模型。小鼠被随机分为四组:药物治疗组(Untreated)、利拉鲁肽组(LIRA)、依普利酮组(IPRA)和联合治疗组(Combo)。这些小鼠以及非糖尿病对照组均以高脂饮食喂养。用药 8 周后,切除心脏和主动脉并进行分析。结果 用油红 O(ORO)染色法评估动脉粥样硬化病变,未治疗组(占主动脉总面积的 13.4 ± 0.8%)明显大于非糖尿病对照组(4.4 ± 0.5%,p < 0.01),而 Combo 组(6.0 ± 1.0%,p < 0.01)则小于未治疗组。LIRA组和IPRA组的ORO染色阳性面积有减少的趋势,但其差异未达到统计学意义。与未治疗组相比,Combo 组 Mcp1 和 Sirt1 的转录水平分别显著降低和升高,而单药治疗组未观察到显著变化。结论 我们的数据表明,利拉鲁肽和ipragliflozin联合疗法可能是预防糖尿病载脂蛋白E缺陷小鼠动脉粥样硬化发展的有效方案。
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引用次数: 0
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Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
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