Association between serum uric acid and large-nerve fiber dysfunction in type 2 diabetes: a cross-sectional study.

BACKGROUND: Large-nerve fiber dysfunction, as assessed by vibration perception threshold (VPT) predicts risks of ulceration, amputation, and mortality in diabetes. Serum uric acid (UA) is closely associated with various metabolic disorders, especially diabetes. Thus, we sought to investigate the clinical relevance of UA to large-nerve fiber dysfunction, among patients with type 2 diabetes (T2D). METHODS: Medical records of consecutive patients with T2D who were admitted to Beijing Friendship Hospital Pinggu Campus between May 2014 and December 2016 were collected. Data for the 824 eligible patients included in the final analysis were extracted using a structured form. A VPT value ≥15 in either foot was defined as abnormal. We compared the clinical characteristics between patients with abnormal VPT and those with normal VPT (VPT value <15 in both feet) in the overall population and in gender subgroups. Logistic regression analysis was performed to explore the association of abnormal VPT with UA level. One-way analysis of variance was used to compare VPT values across four UA quartiles. RESULTS: UA levels were significantly lower in T2D patients with abnormal VPT than in those with normal VPT (294.5 ±â€Š84.0 vs. 314.9 ±â€Š92.8 µmol/L, P < 0.01), especially among male patients (311.7 ±â€Š85.2 vs. 336.9 ±â€Š89.6 µmol/L, P < 0.01). From the logistic regression analysis, hyperuricemia (males >420 µmol/L; females >360 µmol/L) was associated with a reduced risk of abnormal VPT (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.39-0.91; P < 0.05). This association was robust in male patients (OR, 0.43; 95% CI, 0.24-0.76; P < 0.01) but not in female patients (OR, 0.92; 95% CI, 0.47-1.82; P = 0.816), even after adjustment for confounding factors. For the younger male subgroup (age <65 years), VPT values decreased as the UA level increased (P for trend = 0.002), but this trend was not significant in older male subgroup (age ≥65 years; P for trend = 0.400). CONCLUSIONS: Low serum UA levels showed a significant association with an increased risk of large-nerve fiber dysfunction in male patients with T2D, but not in female patients with T2D. In addition, in only the younger subgroup of male patients (<65 years), lower levels of UA also correlated with higher VPT values.

Diagnosis and treatment of mediastinal enterogenous cysts in children.

OBJECTIVE: To investigate the diagnosis and therapy of mediastinal enterogenous cysts in children. METHODS: Clinical data of 17 cases with mediastinal enterogenous cysts within 19 years in our hospital were retrospectively analyzed. RESULTS: One case was intramural esophageal cyst and 16 cases were enteric cysts, two among which were complicated with abdominal enteric duplications. Most cases presented with symptoms of respiratory distress. Twelve cases were complicated with vertebral anomalies. Ultrasound of 12 cases and magnetic resonance imaging of 4 cases were helpful in confirming the cystic nature of these lesions. Eight cases had technetium-99m pertechnetate scintigraphy of posterior mediastinum. CONCLUSIONS: Most patients present with symptoms of respiratory distress, complicated with vertebral anomalies. Ultrasonography and magnetic resonance imaging may be helpful in confirming the cystic nature of these lesions. Technetium-99m pertechnetate scintigraphy is the most effective method for differentiation of the disease from other mediastinal cysts.