Development of a Nomogram for Estimating the Risk of Left Ventricular Diastolic Dysfunction in Patients with Non-Alcoholic Fatty Liver Disease.

Background: Patients with non-alcoholic fatty liver disease (NAFLD) are more likely to develop left ventricular diastolic dysfunction (LVDD). Although lifestyle adjustments contribute to the improvement of NAFLD, thereby delaying or even preventing LVDD progression, it is difficult to maintain a healthy lifestyle, resulting in a higher incidence of LVDD in NAFLD patients. Objective: This study aims to develop a nomogram for assessing the risk of LVDD progression in NAFLD patients to increase their adherence to therapeutic interventions and adjust their treatment regimens timely. Methods: A total of 148 medical records of NAFLD patients were retrospectively analyzed. Sixty-three were assigned to the LVDD+ group and 85 were assigned to the LVDD- group. The independent correlates of LVDD, which were screened via least absolute shrinkage and selection operator logistic regression model first, followed by multivariate Logistic regression model, constituted the nomogram to determine the likelihood of LVDD in NAFLD patients. Results: Number of comorbidities, glycosylated hemoglobin, and epicardial adipose tissue (EAT) volume index were independent correlates of LVDD (all P < 0.05). They served as components in the newly developed nomogram. It obtained significant clinical benefit in detecting NAFLD patients at the risk of LVDD progression, with satisfied discrimination and calibration. Conclusion: We developed a nomogram for identifying NAFLD patients with a normal diastolic function who are at risk of LVDD progression, thus contributing to effective prevention of LVDD progression.

Efficacy and safety of dulaglutide compared with glargine in patients with type 2 diabetes: A systematic review and meta-analysis.

WHAT IS KNOWN AND OBJECTIVE: One of the effective and consistent ways to achieve glycaemic control for patients with type 2 diabetes mellitus (T2DM) is once-daily basal insulin. But it is also associated with adverse outcomes such as hypoglycaemia. Dulaglutide, a novel long-acting GLP-1 receptor agonist, may be a more suitable therapy. The present meta-analysis aims to assess the efficacy and safety of once-weekly glucagon-like peptide-1 receptor agonist dulaglutide compared with insulin glargine for the treatment of T2DM. METHODS: We searched PubMed, Embase and Cochrane Library from inception to December 2020. Randomized clinical trials comparing dulaglutide with insulin glargine in adults with T2DM were included. Revman5.2 software was used for meta-analysis. RESULTS AND DISCUSSION: We included 5 studies with 3383 randomized participants. Compared with insulin glargine, dulaglutide 1.5 mg led to greater mean HbA1c reduction (MD = -0.33%, 95% CI = -0.52, -0.15) whereas dulaglutide 0.75 mg did not (MD = -0.21%, 95% CI = -0.43, 0.01). Body weight loss was seen with dulaglutide whereas weight gain was seen with insulin glargine. The risk of hypoglycaemia was lower in dulaglutide 0.75 mg and 1.5 mg groups than in insulin glargine group,whereas dulaglutide had a statistically higher gastrointestinal adverse events incidence than insulin glargine. WHAT IS NEW AND CONCLUSIONS: Compared with insulin glargine, dulaglutide may serve as an effective alternative to provide improvement in glycaemic control with weight loss and less hypoglycaemia in patients with T2DM. It may be a more suitable therapy instead of basal insulin.

Elevated Serum IL-17 Expression at Cessation Associated with Graves' Disease Relapse.

BACKGROUND: Antithyroid drug (ATD) treatment occupies the cornerstone therapeutic modality of Graves' disease (GD) with a high relapse rate after discontinuation. This study aimed to assess potential risk factors for GD relapse especially serum interleukin-17 (IL-17) expression. METHODS: Consecutive newly diagnosed GD patients who were scheduled to undergo ATD therapy from May 2011 to May 2014 were prospectively enrolled. Risk factors for GD relapse were analyzed by univariate and multivariate Cox proportional hazard analyses. The association between serum IL-17 expression at cessation and GD relapse was analyzed with relapse-free survival (RFS) by the Kaplan-Meier survival analysis and log-rank test. RESULTS: Of the 117 patients, 72 (61.5%) maintained a remission for 12 months after ATD withdrawal and 45 (38.5%) demonstrated GD relapse. The final multivariate Cox analysis indicated elevated IL-17 expression at cessation to be an independent risk factor for GD relapse within 12 months after ATD withdrawal (HR: 3.04, 95% CI: 1.14-7.67, p = 0.021). Patients with higher expressions of IL-17 (≥median value) at cessation demonstrated a significantly higher RFS than those with lower levels by the Kaplan-Meier analysis and log-rank test (p = 0.028). CONCLUSIONS: This present study indicated elevated serum IL-17 expression at cessation to be a predictor for GD relapse within 12 months.

CD47 is associated with the up-regulation of the PD-1 oncogenic signaling pathway.

Cluster of differentiation 47 (CD47) serves as an important negative indicator for phagocytic cells and has been reported to be overexpressed in multiple human tumor cells. Increasing evidence has suggested that CD47 overexpression may contribute to the immune escape of tumor cells by avoiding phagocytosis. However, it is currently unclear whether CD47 participates in the tumorigenesis of thyroid cancer (TC). The aim of this study was to explore the roles of CD47 in TC. In two TC cell lines, TPC-1 and K1, the CD47 expression was determined by Western blot analysis, qRT-PCR, and flow cytometry assays. The CD47 shRNA expression vector was applied to specifically decrease CD47 expression in TPC-1 and K1 cells, and the effects of CD47 knockdown on cell proliferation, apoptosis, cycle were evaluated by flow cytometry analysis. In addition, the effects of CD47 knockdown on the expression of proteins involved in the programmed death-1 (PD-1) signaling pathway were assessed by Western blot analysis. Our results indicated that when compared with normal human thyroid follicular epithelial Nthy-ori-3-1 cells, CD47 expression was significantly upregulated in both TPC-1 and K1 cells. In the functional assay, we revealed that the knockdown of CD47 inhibited cell growth and promoted cell apoptosis. Mechanistically, the PD-L1 signaling pathway was found to be activated in TPC-1 and K1 cells, and the knockdown of CD47 significantly suppressed the activation of this pathway. In conclusion, CD47 was highly expressed in TC cells, and may serve as an oncogenic molecule to promote TC progression by regulating PD-L1 signaling.

MiR-346 and TRAb as Predicative Factors for Relapse in Graves' Disease Within One Year.

Despite the efficacy and safety, antithyroid drug (ATD) therapy for Graves' disease (GD) is associated with a high risk of relapse, especially within the first year. The inability to predict whether and when relapse may occur is a major problem for ATD therapy. This study was aimed to investigate potential predicative factors for GD patients after ATD withdrawal. Consecutive patients newly diagnosed with GD and treated with ATD [methimazole (MMI)] were enrolled in this study. Univariate and multivariate Cox proportional hazard analyses were used for the analysis of predicative parameters for GD relapse after MMI withdrawal. Kaplan-Meier survival analysis and log-rank test were utilized for presenting the risk of relapse. Of the 103 patients included, 67 (65.0%) remained in remission and 36 (35.0%) had a relapse within 1 year after the MMI withdrawal. The multivariate analysis suggested significant predictive factors for GD relapse: patients with higher miR-346 expressions (≥median value) at diagnosis and at cessation, and lower TRAb levels at cessation. MiR-346 at diagnosis and cessation, and TRAb at cessation could serve as predictive factors for GD relapse within 1 year after drug withdrawal.