Metformin may produce antidepressant effects through improvement of cognitive function among depressed patients with diabetes mellitus.

Diabetes mellitus and depressive disorders are both common chronic diseases that increase functional disability and social burden. Cognitive impairment is a potentially debilitating feature of depression. Previous evidence indicates that the antidiabetic drug metformin could be suitable for diabetic patients with cognitive impairment. However, there is no direct evidence from clinical studies that metformin treatment improves cognitive function in diabetic patients suffering from depression. In the present study, 58 participants diagnosed with depression and type 2 diabetes mellitus (T2DM) were recruited and divided into two groups, one treated with metformin and the other treated with placebo for 24 weeks. Cognitive function, depressive behaviour and diabetes improvement were evaluated. Chronic treatment with metformin for 24 weeks improved cognitive performance, as assessed by the Wechsler Memory Scale-Revised, in depressed patients with T2DM. In addition, metformin significantly improved depressive performance and changed the glucose metabolism in depressed patients with diabetes. Depressive symptoms were negatively correlated with cognitive performance in metformin-treated participants. Furthermore, associations were observed between the parameters of blood glucose metabolism and the depression phenotype. These findings suggest that chronic treatment with metformin has antidepressant behavioural effects and that improved cognitive function is involved in the therapeutic outcome of metformin. The results of the present study also raise the possibility that supplementary administration of antidiabetic medications may enhance the recovery of depression, comorbid with T2DM, through improvements in cognitive performance.

Diabetic nephropathy is associated with prostate-specific antigen levels in type 2 diabetes mellitus.

PURPOSE: Type 2 diabetes is associated with reduced risk of prostate cancer and low prostate-specific antigen levels for uncertain reasons. Recently, two studies demonstrated the time course of diabetes with prostate-specific antigen levels, which would be explained by the chronic renal complication. Therefore, we conducted a retrospective study to determine whether diabetic nephropathy is associated with prostate-specific antigen levels. METHODS AND RESULTS: Eligible patients were men aged ≥40 years, with type 2 diabetes and a recorded prostate-specific antigen level. Patients with a prior history of prostate cancer or prostatectomy or prostate-specific antigen level ≥10 ng/mL and patients with end-organ damage were excluded. Of the 247 patients included in the adjusted analysis, 51 (20.8 %) were diagnosed with diabetic nephropathy. A significant association of diabetic nephropathy with log-transformed prostate-specific antigen level was detected (Spearman's correlation coefficient -0.201, p = 0.003; adjusted for all other correlated variables) and fit into a linear regression model (B-coefficient -0.331, p = 0.003). Comparing diabetic nephropathy group with non-diabetic nephropathy group, the difference in log-transformed prostate-specific antigen levels was also significant (p = 0.002). CONCLUSION: The results indicated that patients with diabetic nephropathy have low prostate-specific antigen levels, suggesting fewer prostate cancers being detected or fewer incidences among this group.

Tooth Loss and the Incidence of Ischemic Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis.

Generally, as the population is aging, ischemic stroke is imposing rising social and economic burdens. On that basis, the early intervention and prevention of ischemic stroke turns out to be a major public health issue. Extensive studies have reached mixed conclusions regarding the correlation between tooth loss and ischemic stroke, as well as transient ischemic attack (TIA). In this paper, a systematic review and meta-analysis is presented where we have aimed to examine whether tooth loss is correlated with a higher incidence of ischemic stroke and TIA in adults. The systematical search was conducted in PubMed, Web of Science, Embase, and The Cochrane library from the inception dates to September 23, 2021, by employing the keywords (i.e., tooth loss and ischemic stroke). Observational studies conducted in adults were included, in which people with and without tooth loss (Exposition and Comparison) were observed to determine the incidence of ischemic stroke/TIA (Outcome). The data were extracted, and the study quality was assessed by two reviewers independently. Moreover, a meta-analysis was conducted to obtain the risk ratios (RRs) and 95% CIs by adopting random-effects models. The major outcome was the incidence of ischemic stroke/TIA in adults with and without tooth loss. On the whole, four cohort studies and three case-control studies were covered, which involved 4,625,514 participants with 33,088 ischemic stroke/TIA cases. In cohort (adjusted RR = 2.58, 95% CI: 2.39-2.79, P < 0.00001, I 2 = 31%) and case-control studies (adjusted MD = -4.15, 95% CI: -6.09-(-2.22), P < 0.001, I 2 = 77%), a significant correlation was identified between tooth loss and ischemic stroke. The subgroup analyses reported that the results in case-control studies were generally consistent regardless of the selection of controls. This meta-analysis indicated a certain correlation between tooth loss and ischemic stroke.

The Correlated Factors of Serum CA19-9 Levels in Diabetic Patients.

BACKGROUND: Serum CA19-9 level is a sensitive marker for pancreatic tissue damage; however, its correlation factors are still unclear in diabetic patients. This study was aimed to investigate the correlation factors of serum CA 19-9 levels in these patients. METHODS AND RESULTS: Based on their serum CA19-9 levels, 412 diabetic patients (57 type 1 and 355 type 2) were divided into the negative group (432 cases, CA19-9 37 U /ml) and the positive group (31 cases, CA19-9 ≥ 37 U /ml). The two groups were compared with age, sex, duration of diabetic history, hemoglobin A1c, blood lipid, fasting C-peptide level, and area under the curve C-peptide. The difference was significant between 2 groups in age, hemoglobin A1c, total cholesterol, highdensity lipoprotein cholesterol, fasting C-peptide level, and area under the curve C-peptide (P < 0.05). A multivariate linear regression model found that the type of diabetes, hemoglobin A1c, area under the curve C-peptide, and high-density lipoprotein cholesterol are the independent contributors to CA19-9 levels. CONCLUSION: The results indicated that CA19-9 levels in patients with diabetes mellitus were related to not only age and sex but also diabetic type, hemoglobin A1c, lipid metabolism, and pancreatic beta cell function.