Exosomal miR-140-3p and miR-143-3p from TGF-ß1-treated pancreatic stellate cells target BCL2 mRNA to increase ß-cell apoptosis.

BACKGROUND: People with chronic pancreatitis (CP) normally develop a fibrotic pancreas with reduced ß-cell mass. Limited studies have focused on the development and pathogenesis of CP-related diabetes. MiRNAs packaged as exosomes are the key regulators of ß-cell dysfunction. This study aimed to define the effect of exosomal miRNA from activated pancreatic stellate cells (PSCs) on ß-cells. METHODS: Exosomes in the supernatants of mouse PSCs lines were extracted via ultracentrifugation and then identified. The role of exosomes secreted by transforming growth factor-ß1 (TGF-ß1)-treated PSCs in ß-cell function was assessed. MiRNAs were prepared from exosomes extracted from TGF-ß1-treated and untreated PSCs (T-Exo or C-Exo), and the miRNA expression profiles were compared by microarray. Then, miR-140-3p and miR-143-3p were overexpressed or inhibited in MIN6 cells and islets to determine their molecular and functional effects. RESULTS: Exosomes were the predominant extracellular vesicles secreted by PSCs into the culture medium. The MIN6 cells incubated with T-Exo had less insulin secretion and lower viability than the MIN6 cells incubated with PBS or C-Exo. MiR-140-3p and miR-143-3p were notably upregulated in T-Exo. Enhancing the expression of miR-140-3p and miR-143-3p in ß-cells decreased the cell count and viability and increased the cleaved caspase-3 levels. Mechanistically, T-Exo mediated the intercellular transfer of miR-140-3p and miR-143-3p by targeting the B-cell lymphoma 2 gene in recipient ß-cells to induce cell death. CONCLUSIONS: Exosomal miRNA transfer as a communication mode between PSCs and ß-cells, which may be explored for its therapeutic utility.

Effect of gestational weight gain on insulin resistance mediated by serum adipokine concentrations in advanced maternal age.

INTRODUCTION: With the implementation of the universal two-child policy, the number of pregnant women of advanced maternal age (AMA) will increase steadily. We aimed to investigate whether the effect of gestational weight gain on insulin resistance (IR) before delivery was mediated by serum adipokine concentrations in AMA. MATERIAL AND METHODS: This cross-sectional study included 80 pregnant women of AMA recruited consecutively before delivery from the Department of Obstetrics and Gynecology between August 2016 and July 2017. At delivery, maternal weight during the third trimester was recorded and serum adipokines were measured. IR was calculated using the homeostasis model assessment 2 (HOMA2) method. RESULTS: Weight gain (WG) during the third trimester was positively associated with serum leptin concentrations (r = 0.34, p = 0.0018) and HOMA-IR indices (r = 0.25, p = 0.025), but not related with serum concentration of adiponectin (r = 0.12, p = 0.28). WG during the third trimester and serum concentration of leptin were independently associated with the level of HOMA-IR by multivariate analysis. Subsequently, according to mediation analysis, the association between WG during the third trimester and HOMA-IR mediated by serum leptin concentrations was statistically significant (z = 1.588, p < 0.05). CONCLUSIONS: Taken together, our findings suggest that the relationship between WG during the third trimester and IR was mediated by serum leptin concentrations in AMA, but not serum adiponectin concentrations.

A comparative study on phosphate removal from water using Phragmites australis biochars loaded with different metal oxides.

Metal oxide-loaded biochars are a promising material to remove phosphate from polluted water to ultra-low concentrations. To facilitate preparing the metal oxide-loaded biochar with the best phosphate adsorption performance, five biochars loaded with Al, Ca, Fe, La and Mg oxides, respectively (Al-BC, Ca-BC, Fe-BC, La-BC and Mg-BC) were produced using Phragmites australis pretreated with 0.1 mol AlCl3, CaCl2, FeCl3, LaCl3 and MgCl2, respectively, characterized, and phosphate adsorption kinetics and isotherms of the biochars were determined. The maximum phosphate adsorption capacities (Qm ) of the biochars ranked as Al-BC (219.87 mg g-1) > Mg-BC (112.45 mg g-1) > Ca-BC (81.46 mg g-1) > Fe-BC (46.61 mg g-1) > La-BC (38.93 mg g-1). The time to reach the adsorption equilibrium ranked as La-BC (1 h) < Ca-BC (12 h) < Mg-BC (24 h) = Fe-BC (24 h)

[Effect of Biomass Particle Size on the Adsorption of Phosphorus from Aqueous Solution by MgO-loaded Biochar].

To study the effect of biomass particle size on the rate and ability of phosphorus removal from aqueous solution by MgO-loaded Phragmites australis biochar (MBC), MBC was prepared using 0.0-0.5, 1.0-2.0, and 6.0-8.0 mm Phragmites australis particles as the feedstock and MgCl2 as the modification material. The MBC was characterized using FTIR, XRD, and SEM techniques. Kinetic and isotherm experiments of phosphate (PO43--P) adsorption from aqueous solution by the MBC were conducted, and the experimental data were fitted with various kinetic and isotherm models. The results showed that the adsorption rate of PO43--P by the MBC increased with the increase in biomass particle size. The amount of PO43--P adsorbed by the MBC prepared from 0.0-0.5, 1.0-2.0, and 6.0-8.0 mm particles reached 15.4%, 25.8%, and 80.8%, respectively, within 2 h. The biomass particle size did not affect the maximum PO43--P adsorption capacity (249.0-254.7 mg·g-1) of the MBC. MBC prepared from the 6-8 mm particles retained the complete cell wall structure of the Phragmites australis, and a large number of micropores and mesopores were generated during pyrolysis, thereby forming a hierarchical, regular, and well-connected pore structure. MBC prepared from the 0.0-0.5 mm and 1.0-2.0 mm particles had inferior pore structures with inferior pore connectivity, which affected the diffusion rate of PO43- ions inside the MBC and limited the PO43--P adsorption rate. Therefore, when using waste Phragmites australis harvested from a constructed wetland to produce MBC and remove phosphorus from water, the Phragmites australis should be crushed into 6-8 mm particles. Over-crushing deteriorates the pore structure of the produced MBC and reduces the removal rate of phosphorus by the MBC.

Effects of basin nutrient discharge variations coupled with climate change on water quality in Lake Erhai, China.

In Lake Erhai, water quality was affected by the basin nutrient discharge and climate change. To analyze the relationships between the water quality (total nitrogen [TN], total phosphorus [TP], chemical oxygen demand [CODmn], ammonia [NH4], and trophic level index [TLI]) and basin nutrient discharge (TNd, TPd, and CODd) combined with climate changes (air temperature [AT], precipitation [pre], wind speed [wind], and sunshine hours [SHs]), the generalized additive model (GAM) was employed to explore the nonlinear relationships with their interactions using data sets ranging from 1999 to 2012. Our findings revealed that the water quality in Lake Erhai deteriorated in the early twentieth century, and the basin discharge and AT appeared significant (p < 0.05) rising trends in a long time, while the precipitation decreased significantly (p < 0.05) in the study period. Single-factor GAM results indicated that the basin nutrient discharge was the main explanatory factor for the variations of TN and TP in lake, while precipitation was the main driver for CODmn and NH4. Besides, the water quality displayed nonlinear responses to the basin discharge, but all of the water quality variables went up as the emission levels increased in the lower range. The results showed that the water quality deteriorated in the lower rainfall, and TN rose as the AT increases, while TP was elevated accompanied by the ascending SHs there. The GAM interaction results suggested that the increase of AT and TPd had a promoting effect on TP in Lake Erhai. Stricter nutrient management measures should be implemented when the impacts of climate change are taken into account.

Early menarche is associated with insulin resistance in advanced maternal age before delivery.

Purpose: With the wide implementation of the universal two-child policy in China, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association between age at menarche (AAM) and insulin resistance (IR) before delivery in AMA. Methods: A total of 80 pregnant women in AMA were consecutively enrolled before delivery in Zhongda hospital. Pregnant women were stratified into early menarche group and late menarche group according to the age of regular menstruation (about 13 years). At delivery, serum glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). Results: The fasting blood insulin (17.68(9.72-36.71) and 10.35(7.76-15.10), respectively; p = .006) and HOMA-IR (2.08(1.18-4.37) and 1.24(0.89-1.78), respectively; p = .005) were higher in early menarche group than in late menarche group. AAM was inversely associated with HOMA-IR in AMA (r= -0.27, p = .014). In the multivariable analysis, AAM in late menarche group was negatively related to the level of HOMA-IR compared to those in early menarche group (ß= -2.275, p≤.0001). Conclusions: Taken together, our findings suggest that AAM was inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with early menarche might have higher HOMA-IR levels than those with late menarche. Clinical trial registration: Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714), retrospectively registered.

The relationship between vitamin D and insulin resistance before delivery in advanced maternal age.

BACKGROUND: With the widely implementation of universal two-child policy, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association of vitamin D levels and insulin resistance (IR) during the late pregnancy in AMA. METHODS: A total of 80 pregnant women were consecutively enrolled in the cross-sectional study before delivery from the August 2016 to June 2017 at the department of gynecology and obstetrics in the hospital of ZhongDa, affiliated to Southeast University. At delivery, serum 25(OH) D and metabolism parameters including glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). RESULTS: Pregnant women in AMA with vitamin D deficiency have higher fasting insulin (14.70(8.76-34.65) and 10.89(7.15-16.12), respectively, P = 0.031) and HOMA-IR indices (1.78(1.07-4.14) and 1.30(0.83-1.89), respectively, P = 0.024) than those with vitamin D non-deficiency. Serum 25(OH) D levels were inversely associated with HOMA-IR indices (r = - 0.25, P = 0.025). In multivariable analysis for adjusting confounder factors, vitamin D non-deficiency was also negatively correlated with HOMA-IR compared to vitamin D deficiency (ß = - 1.289, P = 0.026). CONCLUSIONS: Taken together, our findings suggest that serum 25(OH) D levels were inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with vitamin D deficiency might have higher HOMA-IR levels than those with vitamin D non-deficiency. TRIAL REGISTRATION: Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714). retrospectively registered.

Yes-Associated Protein 1 Plays Major Roles in Pancreatic Stellate Cell Activation and Fibroinflammatory Responses.

Background: Yes-associated protein 1 (YAP), a transcriptional co-activator and major effector of the Hippo pathway, regulates cell differentiation and morphology in many cell types and supports aberrant tumor growth. Recent studies showed that YAP is expressed in pancreas tissues in pancreatic ductal adenocarcinoma (PDAC) patients and experimental models of PDAC, with YAP largely found in cancer cells and pancreatic stellate cells (PaSC) in the stroma. Methods and Results: We studied here the role of YAP in the activated phenotype of PaSC. We found that YAP is expressed at low levels in normal mouse pancreas, but protein levels significantly increased after pancreas inflammatory damage induced by repeated cerulein administration in wild-type mice or upon initiation of neoplastic transformation of the pancreas parenchyma in Ptf1-Cre;LSL-KrasG12D/+ (KC) mice. In these animal models, YAP upregulation occurred in parallel with activation and proliferation of PaSC. Consistent with these findings, we found robust YAP expression in culture-activated mouse and human PaSC but not in quiescent, freshly isolated cells. Fully activated PaSC isolated from KC mice or PDAC patient tissues exhibited robust nuclear YAP suggesting YAP transcriptional activity. Agents that induce quiescence such as the Bromodomain and Extra-Terminal (BET) inhibitor iBET151 and the p38 MAPK inhibitor SB203580 reduced YAP levels in PaSC. Stimulation of PaSC with the potent mitogen PDGF elicited marked YAP Ser127 phosphorylation. However, unexpectedly, this effect did not diminish YAP nuclear localization, suggesting that YAP phosphorylation at this site does not govern YAP cellular localization in PaSC. siRNA-mediated knockdown of YAP reduced PDGF-induced PaSC expansion in culture and blunted the persistent activation of Akt and ERK elicited by PDGF stimulation, supporting a role for YAP in PDGF-induced cell growth. YAP knockdown also blunted fibroinflammatory gene expression responses both in unstimulated and transforming growth factor beta 1 (TGFß1)-stimulated PaSC. Conclusion: Our data suggest a central role for YAP in sustaining the activated phenotype and fibroinflammatory responses in PaSC. Moreover, our findings indicate that a complex crosstalk between YAP, TGFß1, and PDGF pathways regulates PaSC activity and growth.

New-Onset Diabetes Mellitus After Chronic Pancreatitis Diagnosis: A Systematic Review and Meta-analysis.

OBJECTIVES: The aim of this study was to assess the occurrence of new-onset diabetes mellitus (DM) after chronic pancreatitis (CP) diagnosis via systematic review and meta-analysis. METHODS: A systematic review of literature and meta-analysis of relevant reports were performed. The primary outcome measures studied were newly diagnosed DM and DM treated with insulin. For the binary outcomes, pooled prevalence and 95% confidence interval (CI) were calculated. METHODS: Fifteen studies involving 8970 patients were eligible. The incidence of new-onset DM after CP diagnosis was 30% (95% CI, 27%-33%). Among all patients, 17% (95% CI, 13%-22%) developed insulin-dependent new-onset DM. The prevalence of newly diagnosed DM after CP diagnosis increased from 15% within 36 months to 33% after 60 months. The proportion of alcoholic CP, sex, age, and body mass index had minimal effect on the studied outcomes. CONCLUSIONS: This systematic review identified a clinically relevant risk of new-onset DM after CP diagnosis. Therefore, patients should be informed of the risk of DM and monitored.

Incidence of New Onset Diabetes Mellitus Secondary to Acute Pancreatitis: A Systematic Review and Meta-Analysis.

Background and Aims: Patients who have an episode of acute pancreatitis (AP) frequently develop diabetes mellitus (DM) over time. The reported incidence of DM after AP varies depending on the severity, etiology and the extent of pancreatic necrosis during AP. We performed a systematic review to determine the incidence of new-onset DM after AP episode (s), and compared the rate of DM in AP patients based upon different disease characteristics. Methods: A total of 31 relevant studies with 13894 subjects were collected from Medline, Embase, and Web of Science. Stata 15 software was used for data analyses in the meta-analysis. Results: The random-effects pooled incidence was 23.0% for DM (95% CI 16.0-31.0%) and 15.0% (95% CI 9.0-23.0%) for DM treated with insulin. We noted substantial heterogeneity in incidence estimates for DM and DM treated with insulin (I 2 = 95.61 and 71.78%; both p < 0·001). The DM incidence was higher in the populations that had a severe AP (SAP) episode than in those with mild acute pancreatitis (MAP) (39 vs. 14%). Patients that displayed pancreatic necrosis during the AP attack(s) had a higher frequency of DM than those without necrosis (37 vs. 11%). In addition, the pooled incidence of DM was higher after alcoholic compared to biliary AP (28 vs. 12%). The incidence of insulin use after SAP and alcoholic AP was 21 and 18%, respectively, with very low heterogeneities. According to duration of follow-up, the pooled rate of DM and insulin use within 5 years after AP was 20 and 14%, while the rate associated with follow-up duration of more than 5 years was elevated to 37 and 25%, respectively. On meta-regression, year of publication, male proportion, age at DM test, and duration of follow-up were neither positively nor negatively associated with the incidence of DM and DM treated with insulin in patients who had a prior AP attack. Conclusion: Patients with AP developed DM after discharge from hospital with a frequency of about 23%. SAP, alcoholic AP and acute necrotizing pancreatitis (ANP) were associated with increased incidence of DM. Assessments of severity, etiology, and pancreatic necrosis are critical for predicting DM development after AP.

Association of Serum PSP/REG Iα with Renal Function in Pregnant Women.

Pancreatic stone protein/regenerating protein Iα (PSP/REG Iα) is a secretory protein produced in the pancreas, but its expression has also been observed in the kidney. It may be associated with kidney dysfunction. This study investigates the possible association between PSP/REG Iα and kidney function in pregnant women. Serum PSP/REG Iα levels were measured by a specific ELISA enzyme-linked immunosorbent assay. Maternal information and clinical and biochemical parameters were collected. Estimated glomerular filtration rate (eGFR) was calculated for all individuals to evaluate their renal function. Spearman's correlation and multiple linear regression analyses were performed to assess the associations between PSP/REG Iα and eGFR, serum creatinine (Cr), blood urea nitrogen (BUN), and uric acid (UA). A total of 595 pregnant women were enrolled in the study. Participants with mildly reduced eGFR had higher PSP/REG Iα levels [50.49 (35.02, 58.64)] than in the general population [26.84 (21.02, 33.07)] (p < 0.001). Included participants were stratified into PSP/REG Iα quartiles; significant differences were observed in the levels of eGFR, serum Cr, BUN, and UA. PSP/REG Iα was negatively correlated with eGFR (r = -0.402, p < 0.001) and positively associated with serum Cr (r = 0.468, p < 0.001), BUN (r = 0.166, p < 0.001), and UA (r = 0.207, p < 0.001). The linear regression analysis indicated that PSP/REG Iα was associated with UA, BUN, and eGFR. High PSP/REG Iα concentrations were closely associated with renal dysfunction in pregnant women. Our study provides clinical evidence that serum PSP/REG Iα levels could be a novel biomarker for assessment of renal function in pregnant women.

[Effect of Nitrogen on Magnesium Modified Biochar Adsorption to Phosphorus].

The effect of ammonia-nitrogen in water on phosphorus removal by magnesium modified biochar (MBC) was developed to increase the utilization of wetland plants. The crystal structures were measured by X-ray powder diffraction (XRD). MBC was prepared using reed as the biomass feedstock, which was modified with magnesium chloride. The raw biochar (BC) was prepared as a control. The removal of phosphate from solution using four different methods, i.e. MBC, BC, BC, and MgCl2 solutions (BC+Mg2+) and MgCl2 solutions (Mg2+), under different nitrogen to phosphorus molar ratios and initial phosphorus concentrations was investigated in batch experiments. The results demonstrated that the phosphorus removal efficiency of the four treatment methods, which followed the order of MBC>>BC+Mg2+≈Mg2+>BC. NH4+ in the solution, promoted phosphorus removal by MBC. In addition, the larger the ratio of nitrogen to phosphorus and the higher the initial phosphorus concentration, the stronger the phosphorus removal capacity of MBC was. In the three treatments with MBC, BC+Mg2+, and Mg2+, the XRD analysis showed that NH4+ reacted with Mg2+ and PO43- in the solution to form MgNH4PO4·6H2O at N:P=5 or 10, promoting the removal of phosphorus. For recycling purposes, waste biomass from constructed wetlands could be used to produce MBC and treat polluted water rich in ammonium and phosphate. Moreover, the ammonium-nitrogen promotes the phosphate removal by MBC. The results from this study provide a new theoretical basis and data support for the treatment of water eutrophication.

Cognitive Deficit-Related Interhemispheric Asynchrony within the Medial Hub of the Default Mode Network Aids in Classifying the Hyperthyroid Patients.

Background and Purpose: Recent studies suggest that abnormal structure and function in the brain network were related to cognitive and emotional impairment in hyperthyroid patients (HPs). The association between altered voxel-mirrored homotopic connectivity (VMHC) and neuropsychological impairment in HPs remains unclear. This study is aimed at investigating the association between the disrupted functional coordination and psychological dysfunction in hyperthyroidism. Method: Thirty-three hyperthyroid patients and thirty-three matched healthy controls (HCs) were recruited, and they received resting-state functional magnetic resonance imaging (fMRI) scans and neuropsychological evaluation. The VMHC value was computed to reveal the functional coordination between homotopic regions in both groups. The neurobehavioral relevancy method was employed to explore the relationship between the altered VMHC and emotional, cognition measures. Further receiver operating characteristic (ROC) curve analysis was adopted to examine the power of changed regional VMHC in classifying the patients with hyperthyroidism. Results: Compared with the HCs, the HPs exhibited significantly declined VMHC values in the bilateral medial frontal gyrus (MeFG). The interhemispheric asynchrony in the MeFG was positively correlated with Z scores of episodic memory. The ROC analysis further determined that abnormal VMHC in the MeFG could efficiently distinguish the HPs from the HCs (area under the curve (AUC) = 0.808, P < 0.001). Conclusion: The altered interhemispheric coordination in the hub of the default mode network may implicated in the modulation of episodic memory in HPs patients and the distinct feature of the interhemispheric asynchrony may be treated as a potential target for the early recognition and intervention for the HPs with cognitive impairments. Clinical Trial Registration: This is a study of the neurological basis for dysfunction of mood and cognition in hyperthyroid patients: a resting-state fMRI study (registration number: ChiCTR-OOC-16008607).

Abnormal spontaneous brain activity is associated with impaired emotion and cognition in hyperthyroidism: A rs-fMRI study.

Hyperthyroid patients undergo emotional and cognitive dysfunction. However, the neurological basis for it remains ambiguous. Amplitude of low frequency fluctuation (ALFF) and regional homogeneity (ReHo) were used to investigate abnormal spontaneous activity in hyperthyroidism for the first time. 29 hyperthyroid patients and 29 healthy controls (HC) received 3.0T magnetic resonance imaging (MRI) scans and neuropsychological assessments. Compared with HC, hyperthyroid patients showed decreased ALFF in left medial frontal gyrus (MeFG) and left posterior cingulate cortex (PCC). Hyperthyroidism group exhibited decreased ReHo in left MeFG. Within hyperthyroidism group, ALFF values in left MeFG were positively correlated with Hamilton Anxiety Rating Scale (HARS) Z-scores, but negatively correlated with processing speed Z-scores. Besides, ALFF values in left precuneus had a positive correlation with HARS Z-scores. As a result, abnormal brain spontaneous activity mainly in default mode network (DMN) implicated the neuro-pathological substrate of relevant emotional and cognitive dysfunction in hyperthyroid patients.

Distinctive pretreatment features of bilateral nucleus accumbens networks predict early response to antidepressants in major depressive disorder.

The pretreatment neuroimaging markers from the resting-state brain network that could predict the early response to antidepressants are still unclear. The aim of the present study was to identify the performance of reward network features for discriminating patients with a dampened response to antidepressants. A total of 81 major depressive disorder (MDD) patients (44 patients with treatment-responsive depression (RD) and 37 patients with non-responding depression (NRD)) and 43 healthy controls (HC) underwent resting-state functional magnetic resonance imaging scans and clinical estimates. Bilateral nucleus accumbens (NAcc)-based networks were constructed for further functional connectivity (FC) analysis. The FC of the right superior frontal gyrus (SFG) (area under curve (AUC) = 0.837) and left parahippocampus (AUC = 0.770) within the left NAcc reward network, as well as the FC of the left SFG (AUC = 0.827) within the right NAcc reward network, could distinguish NRD subjects from RD subjects relatively well. Taken together, when considering the distinctive connectional pattern of the bilateral reward circuits, the synthetical differentiating effect was achieved to an optimal performance for discriminating NRD patients (AUC = 0.869), with balanced sensitivity (0.838) and specificity (0.818). The distinct pretreatment characteristics of the reward network make specific contributions to the early response to antidepressants and establish a promising imaging predictor for the classification of early efficacy.

The effect of pre-pregnancy body mass index and excessive gestational weight gain on the risk of gestational diabetes in advanced maternal age.

BACKGROUND AND PURPOSE: With the popularization of a two-child policy in China, the number of pregnant women of advanced maternal age will increase steadily. We aimed to assess the association between pre-pregnancy body mass index (BMI) and weight gain in the first and second trimester and the risk of gestational diabetes (GDM) in the advanced maternal age group and control group defined as maternal age of 20-35 years. RESULTS: The risk of GDM for obesity before pregnancy was 2.707 (95% CI: 1.042-7.029) folds and 3.612 (95% CI: 1.182-11.039) folds in the control group and advanced maternal age group, respectively. Excessive weight gain in the first trimester was significant related to a higher risk of developing GDM with the odds ratio (OR) of 2.655 (95% CI: 1.265-5.571) and 4.170 (95% CI: 1.437-12.100) in the control group and advanced maternal age group, respectively. MATERIALS AND METHODS: This prospective cohort study included 565 pregnant women with singleton pregnancy who were recruited in their first prenatal visit from the antenatal clinic in March and December 2016. Maternal weight was recorded before pregnancy, in the first prenatal visit and at the time of screening oral glucose tolerance test (OGTT). All women underwent 2 h 75g-OGTT at 24-28 weeks (24 weeks on average). GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011. CONCLUSIONS: Elevated pre-pregnancy BMI independently increases the risk of GDM, particularly in advanced maternal age. Excessive weight gain in the first trimester is significantly associated with the incidence of GDM regardless of pre-pregnancy BMI.

Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional MRI study.

Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor memory, depression, anxiety, nervousness, and irritability, suggesting brain dysfunction. However, the underlying process of these symptoms remains unclear. Using resting-state functional magnetic resonance imaging (rs-fMRI), we depicted the altered graph theoretical metric degree centrality (DC) and seed-based resting-state functional connectivity (FC) in 33 hyperthyroid patients relative to 33 healthy controls. The peak points of significantly altered DC between the two groups were defined as the seed regions to calculate FC to the whole brain. Then, partial correlation analyses were performed between abnormal DC, FC and neuropsychological performances, as well as some clinical indexes. The decreased intrinsic functional connectivity in the posterior lobe of cerebellum (PLC) and medial frontal gyrus (MeFG), as well as the abnormal seed-based FC anchored in default mode network (DMN), attention network, visual network and cognitive network in this study, possibly constitutes the latent mechanism for emotional and cognitive changes in hyperthyroidism, including anxiety and impaired processing speed.