Journal of Diabetes最新文献

{"title":"U-shaped association between serum IGF2BP3 and T2DM: A cross-sectional study in Chinese population\u0000 血清IGF2BP3与2型糖尿病的U型关联:一项中国人群横断面研究","authors":"Xiaoying Wu,&nbsp;Wei Wang,&nbsp;Shujin Fan,&nbsp;Lili You,&nbsp;Feng Li,&nbsp;Xiaoyun Zhang,&nbsp;Hongshi Wu,&nbsp;Juying Tang,&nbsp;Yiqin Qi,&nbsp;Wanting Feng,&nbsp;Li Yan,&nbsp;Meng Ren","doi":"10.1111/1753-0407.13378","DOIUrl":"https://doi.org/10.1111/1753-0407.13378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To clarify the expression of N6-methyladenosine (m⁶A) modulators involved in the pathogenesis of type 2 diabetes mellitus (T2DM). We further explored the association of serum insulin-like growth factor 2 mRNA-binding proteins 3 (IGF2BP3) levels and odds of T2DM in a high-risk population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The gene expression data set GSE25724 was obtained from the Gene Expression Omnibus, and a cluster heatmap was generated by using the R package ComplexHeatmap. Differential expression analysis for 13 m⁶A RNA methylation regulators between nondiabetic controls and T2DM subjects was performed using an unpaired <i>t</i> test. A cross-sectional design, including 393 subjects (131 patients with newly diagnosed T2DM, 131 age- and sex-matched subjects with prediabetes, and 131 healthy controls), was carried out. The associations between serum IGF2BP3 concentrations and T2DM were modeled by restricted cubic spline and logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two upregulated (IGF2BP2 and IGF2BP3) and 5 downregulated (methyltransferase-like 3 [METTL3], alkylation repair homolog protein 1 [ALKBH1], YTH domain family 2 [YTHDF2], YTHDF3, and heterogeneous nuclear ribonucleoprotein [HNRNPC]) m⁶A-related genes were found in islet samples of T2DM patients. A U-shaped association existed between serum IGF2BP3 levels and odds of T2DM according to cubic natural spline analysis models, after adjustment for body mass index, waist circumference, diastolic blood pressure, total cholesterol, and triglyeride. Multivariate logistic regression showed that progressively higher odds of T2DM were observed when serum IGF2BP3 levels were below 0.62 ng/mL (odds ratio 3.03 [95% confidence interval 1.23–7.47]) in model 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Seven significantly altered m⁶A RNA methylation genes were identified in T2DM. There was a U-shaped association between serum IGF2BP3 levels and odds of T2DM in the general Chinese adult population. This study provides important evidence for further examination of the role of m⁶A RNA methylation, especially serum IGF2BP3 in T2DM risk assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 4","pages":"349-361"},"PeriodicalIF":4.5,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6157398","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}

{"title":"Development and validation of risk prediction models for large for gestational age infants using logistic regression and two machine learning algorithms\u0000 使用Logistic回归和两种机器学习算法开发和验证大于胎龄儿风险预测模型","authors":"Ning Wang,&nbsp;Haonan Guo,&nbsp;Yingyu Jing,&nbsp;Yifan Zhang,&nbsp;Bo Sun,&nbsp;Xingyan Pan,&nbsp;Huan Chen,&nbsp;Jing Xu,&nbsp;Mengjun Wang,&nbsp;Xi Chen,&nbsp;Lin Song,&nbsp;Wei Cui","doi":"10.1111/1753-0407.13375","DOIUrl":"https://doi.org/10.1111/1753-0407.13375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Large for gestational age (LGA) is one of the adverse outcomes during pregnancy that endangers the life and health of mothers and offspring. We aimed to establish prediction models for LGA at late pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were obtained from an established Chinese pregnant women cohort of 1285 pregnant women. LGA was diagnosed as &gt;90th percentile of birth weight distribution of Chinese corresponding to gestational age of the same-sex newborns. Women with gestational diabetes mellitus (GDM) were classified into three subtypes according to the indexes of insulin sensitivity and insulin secretion. Models were established by logistic regression and decision tree/random forest algorithms, and validated by the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 139 newborns were diagnosed as LGA after birth. The area under the curve (AUC) for the training set is 0.760 (95% confidence interval [CI] 0.706–0.815), and 0.748 (95% CI 0.659–0.837) for the internal validation set of the logistic regression model, which consisted of eight commonly used clinical indicators (including lipid profile) and GDM subtypes. For the prediction models established by the two machine learning algorithms, which included all the variables, the training set and the internal validation set had AUCs of 0.813 (95% CI 0.786–0.839) and 0.779 (95% CI 0.735–0.824) for the decision tree model, and 0.854 (95% CI 0.831–0.877) and 0.808 (95% CI 0.766–0.850) for the random forest model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We established and validated three LGA risk prediction models to screen out the pregnant women with high risk of LGA at the early stage of the third trimester, which showed good prediction power and could guide early prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 4","pages":"338-348"},"PeriodicalIF":4.5,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6154302","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}

{"title":"Transparent machine learning suggests a key driver in the decision to start insulin therapy in individuals with type 2 diabetes\u0000 透明机器学习预测决定2型糖尿病患者开始胰岛素治疗的关键驱动因素","authors":"Nicoletta Musacchio,&nbsp;Rita Zilich,&nbsp;Paola Ponzani,&nbsp;Giacomo Guaita,&nbsp;Carlo Giorda,&nbsp;Rebeca Heidbreder,&nbsp;Pierluigi Santin,&nbsp;Graziano Di Cianni","doi":"10.1111/1753-0407.13361","DOIUrl":"https://doi.org/10.1111/1753-0407.13361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The objective of this study is to establish a predictive model using transparent machine learning (ML) to identify any drivers that characterize therapeutic inertia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data in the form of both descriptive and dynamic variables collected from electronic records of 1.5 million patients seen at clinics within the Italian Association of Medical Diabetologists between 2005–2019 were analyzed using logic learning machine (LLM), a “clear box” ML technique. Data were subjected to a first stage of modeling to allow ML to automatically select the most relevant factors related to inertia, and then four further modeling steps individuated key variables that discriminated the presence or absence of inertia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LLM model revealed a key role for average glycated hemoglobin (HbA1c) threshold values correlated with the presence or absence of insulin therapeutic inertia with an accuracy of 0.79. The model indicated that a patient's dynamic rather than static glycemic profile has a greater effect on therapeutic inertia. Specifically, the difference in HbA1c between two consecutive visits, what we call the HbA1c gap, plays a crucial role. Namely, insulin therapeutic inertia is correlated with an HbA1c gap of &lt;6.6 mmol/mol (0.6%), but not with an HbA1c gap of &gt;11 mmol/mol (1.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results reveal, for the first time, the interrelationship between a patient's glycemic trend defined by sequential HbA1c measurements and timely or delayed initiation of insulin therapy. The results further demonstrate that LLM can provide insight in support of evidence-based medicine using real world data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 3","pages":"224-236"},"PeriodicalIF":4.5,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6155345","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}

{"title":"Longer leukocyte telomere length increases cardiovascular mortality in type 2 diabetes patients\u0000 白细胞端粒长度增长会增加2型糖尿病患者的心血管死亡率","authors":"Ziwei Chen,&nbsp;Yao Shen,&nbsp;Jing He,&nbsp;Yang Shen,&nbsp;Weida Zhu,&nbsp;Xiaohui Wu,&nbsp;Mingbing Xiao","doi":"10.1111/1753-0407.13376","DOIUrl":"https://doi.org/10.1111/1753-0407.13376","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Leukocyte telomere length (LTL), as a biomarker of biological aging, is associated with the prevalence and complications of diabetes. This study aims to investigate the associations between LTL and all-cause and cause-specific mortality in patients with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All participants with baseline LTL records were included from the National Health and Nutrition Examination Survey 1999–2002. Death status and its causes were ascertained for National Death Index based on <i>International Classification of Diseases, Tenth Revision</i> code. Cox proportional hazards regression models were established to estimate the hazard ratios (HRs) of LTL associating with all-cause and cause-specific mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study enrolled 804 diabetic patients with the mean follow-up of 14.9 ± 2.59 years. There were 367 (45.6%) all-cause deaths, 80 (10.0%) cardiovascular deaths, and 42 (5.2%) cancer-related deaths. Longer LTL was associated with reduced all-cause mortality, whereas this association disappeared after adjusting for other variables. Compared with the lowest tertiles of LTL, the multivariable-adjusted hazard ratio of cardiovascular mortality was 2.11 (95% confidence interval [CI] 1.31–3.39; <i>p</i> &lt; .05) in the highest tertiles. In terms of cancer mortality, the highest tertile was negatively correlated with the risk of cancer mortality (HR 0.58 [95% CI 0.37, 0.91], <i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, LTL was independently associated with the risk of cardiovascular mortality in patients with type 2 diabetes and was negatively correlated with the risk of cancer mortality. Telomere length may be a predictor of cardiovascular mortality in diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 4","pages":"325-331"},"PeriodicalIF":4.5,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6135063","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}

{"title":"Studying and learning","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.13379","DOIUrl":"https://doi.org/10.1111/1753-0407.13379","url":null,"abstract":"&lt;p&gt;A lovely aphorism attributed to Confucius, “学而时习之, 不亦悦乎,” can be translated, “Studying and, from time to time, learning, is it not a pleasure?” This certainly applies to the immense and constantly growing medical literature addressing the many aspects of diabetes. Here are summaries of some recent articles.&lt;/p&gt;&lt;p&gt;The American Diabetes Association “Standards of Care in Diabetes 2023” updated lipid targeting, suggesting that people with diabetes aged 40–75 at higher CV risk should be treated with high-intensity statins targeting low-density lipoprotein (LDL)-cholesterol &lt;70 mg/dL, with the recommendation that ezetimibe or a PCSK9 inhibitor be added to maximum tolerated statins for LDL cholesterol ≥70 mg/dL up to age 75.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Using the American College of Cardiology/American Heart Association atherosclerotic CVD (ASCVD) risk calculator recommended in the document,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; the projected 10-year ASCVD risk of a 50-year-old white male with diabetes and treated hypertension with LDL cholesterol 130 is 8.2%, decreasing to 6.2% with statin treatment; it is intriguing to speculate that with the potential 16%–18% further LDL reduction seen with very intensive LDL reduction this might be further reduced to 5.1%. Perhaps 70 is not low enough! A metaanalysis of 10 randomized trials of intensive LDL-cholesterol lowering lasting at least 3 months compared outcomes in 38 427 persons achieving LDL-C &lt;40 mg/dL versus 70 668 comparators, finding no significant difference in overall adverse events, adverse events leading to drug discontinuation, cancer, hemorrhagic stroke, new-onset diabetes, neurocognitive disorders, cataracts, or liver or muscle disorders, either with PCSK-9 inhibitors, statin/ezetimibe, or cholesteryl ester transfer protein inhibitors, and overall CVD and major adverse cardiovascular event end points were 16% and 18% lower, respectively, in the group reaching this very low level.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;What is the optimal glucose-lowering agent for persons with diabetes and CVD? In a propensity score–matched study of metformin-treated persons with diabetes in the Taiwanese Diabetes Mellitus Health Database from 2006 to 2017, those taking high sulfonylureas with high (glyburide and glipizide) versus low (gliclazide and glimepiride) affinity to the adenosine triphosphate–sensitive potassium channel had 18% higher risk of major adverse cardiovascular events, 27% higher all-cause mortality risk, and 82% greater risk of severe hypoglycemia.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; An electronic health record analysis of &gt;300 000 persons with type 2 diabetes and CVD found that use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagonlike peptide-1 receptor agonists (GLP-1RA) increased from ~11% in 2018 to 23% in 2021. Dipeptidyl peptidase 4 inhibitors were used by 15%–18%, and, although the most use was of metformin (~60%) and sulfonylureas (25%–30%), the doubling of use of SGLT2i and GLP-1RA suggest","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 3","pages":"200-203"},"PeriodicalIF":4.5,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6119301","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}

{"title":"Sleeve gastrectomy improved microvascular phenotypes from obesity cohort, detected with optical coherence tomography angiography\u0000 通过光学相干断层扫描血管成像检测发现袖状胃切除术改善肥胖队列的微血管表型","authors":"Yaying Chen,&nbsp;Yanyang Liu,&nbsp;Lin Cong,&nbsp;Ailin Liu,&nbsp;Xiangyuan Song,&nbsp;Wenting Liu,&nbsp;Rong Hua,&nbsp;Qiwei Shen,&nbsp;Yikai Shao,&nbsp;Yiwen Xue,&nbsp;Qiyuan Yao,&nbsp;Yuyan Zhang","doi":"10.1111/1753-0407.13374","DOIUrl":"https://doi.org/10.1111/1753-0407.13374","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine how metabolic status is associated with microvascular phenotype and to identify variables associated with vascular remodeling after bariatric surgery, using noninvasive optical coherence tomography angiography (OCTA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 136 obese subjects scheduled for bariatric surgery and 52 normal-weight controls. Patients with obesity were divided into metabolically healthy obesity (MHO) and metabolic syndrome (MetS) groups according to the diagnosis criteria of the Chinese Diabetes Society. Retinal microvascular parameters were measured by OCTA, including superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities. Follow-ups were performed at the baseline and 6 months after bariatric surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fovea SCP, average DCP, fovea DCP, parafovea DCP, and perifovea DCP vessel densities were significantly lower in the MetS group, compared to controls (19.91% vs. 22.49%, 51.60% vs. 54.20%, 36.64% vs. 39.14%, 56.24% vs. 57.65% and 52.59% vs. 55.58%, respectively, all <i>p</i> &lt; .05). Parafovea SCP, average DCP, parafovea DCP, and perifovea DCP vessel densities significantly improved in patients with obesity 6 months after surgery, compared to baseline (54.21% vs. 52.97%, 54.43% vs. 50.95%, 58.29% vs. 55.54% and 55.76% vs. 51.82%, respectively, all <i>p</i> &lt; .05). Multivariable analyses showed that baseline blood pressure and insulin were independent predictors of vessel density changes 6 months after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Retinal microvascular impairment occurred mainly in MetS rather than MHO patients. Retinal microvascular phenotype improved 6 months after bariatric surgery and baseline blood pressure and insulin status may be key determinants. OCTA may be a reliable method to evaluate the microvascular complications associated with obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 4","pages":"313-324"},"PeriodicalIF":4.5,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6137331","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}

{"title":"Autophagy in the retinal neurovascular unit: New perspectives into diabetic retinopathy\u0000 视网膜神经血管单元自噬:糖尿病视网膜病变的新视角","authors":"Xiongyi Yang,&nbsp;Zexin Huang,&nbsp;Mei Xu,&nbsp;Yanxia Chen,&nbsp;Mingzhe Cao,&nbsp;Guoguo Yi,&nbsp;Min Fu","doi":"10.1111/1753-0407.13373","DOIUrl":"https://doi.org/10.1111/1753-0407.13373","url":null,"abstract":"<p>Diabetic retinopathy (DR) is one of the most prevalent retinal disorders worldwide, and it is a major cause of vision impairment in individuals of productive age. Research has demonstrated the significance of autophagy in DR, which is a critical intracellular homeostasis mechanism required for the destruction and recovery of cytoplasmic components. Autophagy maintains the physiological function of senescent and impaired organelles under stress situations, thereby regulating cell fate via various signals. As the retina's functional and fundamental unit, the retinal neurovascular unit (NVU) is critical in keeping the retinal environment's stability and supporting the needs of retinal metabolism. However, autophagy is essential for the normal NVU structure and function. We discuss the strong association between DR and autophagy in this review, as well as the many kinds of autophagy and its crucial physiological activities in the retina. By evaluating the pathological changes of retinal NVU in DR and the latest advancements in the molecular mechanisms of autophagy that may be involved in the pathophysiology of DR in NVU, we seek to propose new ideas and methods for the prevention and treatment of DR.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 5","pages":"382-396"},"PeriodicalIF":4.5,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6091564","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}

{"title":"Expansion of human alpha-cell area is associated with a higher maximum body mass index before the onset of type 2 diabetes","authors":"Harutoshi Ozawa,&nbsp;Kenji Fukui,&nbsp;Yukari Fujita,&nbsp;Chisaki Ishibashi,&nbsp;Sho Yoneda,&nbsp;Takao Nammo,&nbsp;Shingo Fujita,&nbsp;Megu Yamaguchi Baden,&nbsp;Takekazu Kimura,&nbsp;Ayumi Tokunaga,&nbsp;Junji Kozawa,&nbsp;Hidetoshi Eguchi,&nbsp;Iichiro Shimomura","doi":"10.1111/1753-0407.13370","DOIUrl":"https://doi.org/10.1111/1753-0407.13370","url":null,"abstract":"&lt;p&gt;Type 2 diabetes is characterized by deteriorated insulin secretion capacity and abnormal glucagon secretion.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In White people, beta-cell mass correlates with body mass index (BMI),&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; whereas alpha-cell mass does not correlate with BMI.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In Japanese patients, there was no difference in either the relative beta-cell area or alpha-cell area between obese and nonobese patients with or without diabetes.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We reported that maximum BMI before the onset of diabetes (MBBO) independently correlated with beta-cell function, enabling us to estimate insulin secretion capacity at onset as well as at present.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; However, the relationship between MBBO and relative beta- or alpha-cell area remains unclear. The purpose of this study was to clarify this relationship with the use of immunohistochemical analysis using human pancreatic tissues.&lt;/p&gt;&lt;p&gt;We enrolled 34 patients who had already been diagnosed with type 2 diabetes mellitus and had undergone partial pancreatic resection between 2008 and 2013 and between 2018 and 2019 in the Department of Gastroenterological Surgery, Osaka University Hospital, Suita, Japan. Along the chart described in Figure S1, we analyzed 20 Japanese patients (15 men and 5 women) in our study. The study protocol was approved by the ethics committee of Osaka University (approval number 13279-4) and was carried out in accordance with the Declaration of Helsinki. Informed consent was obtained from all patients.&lt;/p&gt;&lt;p&gt;Before the operation, we conducted a medical interview including a history of the patient's body weight. We defined the patient's MBBO based on his or her history of maximum BMI and age at diabetes mellitus onset.&lt;/p&gt;&lt;p&gt;Beta-cell function was evaluated before the operation using the C-peptide index (CPI), which was calculated by using the following formula: fasting C-peptide level (ng/mL) x 100/fasting plasma glucose level (mmol/l) x 18. We previously demonstrated significant positive correlations between the relative beta-cell area, a factor indicating beta-cell mass, and various parameters of insulin secretion capacity, including CPI.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We obtained pancreatic tissue samples from patients who had undergone partial pancreatectomy. Normal noncancerous pancreatic samples were collected during the operation. The tissues were isolated near the resected margins after intraoperative consultation, fixed immediately in formaldehyde, and embedded in paraffin for subsequent analysis. Paraffin-embedded tissue was cut into 5-μm thick sections.&lt;/p&gt;&lt;p&gt;The primary and secondary antibodies and chromogenic substrates used in the present study are listed in Table S1. We stained beta cells and alpha cells using anti-insulin and anti-glucagon immunoglobulins (Igs) as primary antibodies and biotinylated Igs as secondary antibodies. The reactions were developed with an avidin–biotin complex and a 3,3","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 3","pages":"277-282"},"PeriodicalIF":4.5,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5860964","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}

{"title":"Assessment of subclinical left ventricular systolic dysfunction in patients with type 2 diabetes: Relationship with HbA1c and microvascular complications\u0000 2型糖尿病患者亚临床左心室收缩功能障碍的评估:与糖化血红蛋白和微血管并发症的关系","authors":"Yanyan Chen,&nbsp;Ying Zhang,&nbsp;Yi Wang,&nbsp;Shengjun Ta,&nbsp;Min Shi,&nbsp;Yingni Zhou,&nbsp;Mengying Li,&nbsp;Jianfang Fu,&nbsp;Li Wang,&nbsp;Xiangyang Liu,&nbsp;Zuowei Lu,&nbsp;Liwen Liu,&nbsp;Zeping Li,&nbsp;Jie Zhou,&nbsp;Xiaomiao Li","doi":"10.1111/1753-0407.13369","DOIUrl":"https://doi.org/10.1111/1753-0407.13369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to examine the association between glycated hemoglobin (HbA1c), microvascular complications, and subclinical left ventricular (LV) systolic dysfunction, and to determine the strength of the correlation in asymptomatic patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Global longitudinal strain (GLS) was employed to assess the subclinical LV function of 152 enrolled T2DM patients with preserved LV ejection fraction, with the cutoff for subclinical LV systolic dysfunction predefined as GLS &lt; 18%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to univariate analysis, the reduced GLS exhibited association with the clinical features including HbA1c, triglyceride, systolic blood pressure, fasting glucose, heart rate, diabetic retinopathy, and urinary albumin creatinine ratio (UACR) (all <i>p</i> &lt; .05). After the factors of gender, age, and related clinical covariables adjusted, multiple logistic regression analysis revealed the HbA1c (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.30–2.13; <i>p</i> &lt; .001), UACR (OR 2.48; 95% CI 1.12–5.47; <i>p</i> = .025) and triglyceride (OR 1.84; 95% CI 1.12–3.03; <i>p</i> = .017) as the independent risk factors for the reduced GLS. Receiver operating characteristic curve showed a predictive value of the HbA1c for the subclinical LV systolic dysfunction (area under curve: 0.74; <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In asymptomatic T2DM patients, subclinical LV systolic dysfunction was associated with HbA1c, diabetic complications, and triglyceride. More prominently, HbA1c may exert a prognostic significance for the progression of myocardial damage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 3","pages":"264-274"},"PeriodicalIF":4.5,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5758601","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}

{"title":"Type 1 diabetes management: Room for improvement\u0000 1型糖尿病管理的改进空间","authors":"Rita D. M. Varkevisser,&nbsp;Erwin Birnie,&nbsp;Dick Mul,&nbsp;Peter R. van Dijk,&nbsp;Henk-Jan Aanstoot,&nbsp;Bruce H. R. Wolffenbuttel,&nbsp;Melanie M. van der Klauw","doi":"10.1111/1753-0407.13368","DOIUrl":"https://doi.org/10.1111/1753-0407.13368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Hypothesis</h3>\u0000 \u0000 <p>Optimal diabetes care and risk factor management are important to delay micro- and macrovascular complications in individuals with type 1 diabetes (T1D). Ongoing improvement of management strategies requires the evaluation of target achievement and identification of risk factors in individuals who do (or do not) achieve these targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional data were collected from adults with T1D visiting six diabetes centers in the Netherlands in 2018. Targets were defined as glycated hemoglobin (HbA1c) &lt;53 mmol/mol, low-density lipoprotein-cholesterol (LDL-c) &lt;2.6 mmoL/L (no cardiovascular disease [CVD] present) or &lt;1.8 mmoL/L (CVD present), or blood pressure (BP) &lt;140/90 mm Hg. Target achievement was compared for individuals with and without CVD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 1737 individuals were included. Mean HbA1c was 63 mmol/mol (7.9%), LDL-c was 2.67 mmoL/L, and BP 131/76 mm Hg. In individuals with CVD, 24%, 33%, and 46% achieved HbA1c, LDL-c, and BP targets respectively. In individuals without CVD these percentages were 29%, 54%, and 77%, respectively. Individuals with CVD did not have any significant risk factors for HbA1c, LDL-c, and BP target achievement. In comparison, individuals without CVD were more likely to achieve glycemic targets if they were men and insulin pump users. Smoking, microvascular complications, and the prescription of lipid-lowering and antihypertensive medication were negatively associated with glycemic target achievement. No characteristics were associated with LDL-c target achievement. Microvascular complications and antihypertensive medication prescription were negatively associated with BP target attainment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Opportunities for improvement of diabetes management exist for the achievement of glycemic, lipid, and BP targets but may differ between individuals with and without CVD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 3","pages":"255-263"},"PeriodicalIF":4.5,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5671303","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}