Relationship of liver fat content with systemic metabolism and chronic complications in patients with type 2 diabetes mellitus.

OBJECTIVE: This study investigated the correlation of liver fat content (LFC) with metabolic characteristics and its association with chronic complications in type 2 diabetes mellitus (T2DM) patients. METHODS: Eighty-one prospectively enrolled T2DM patients were divided into non-alcoholic fatty liver disease (NAFLD) group and the non-NAFLD group according to the presence of NAFL complications. LFC was determined by MRI IDEAL-IQ Sequence, and patients were divided into 4 groups according to LFC by quartile method. Basic information, metabolic indexes, and occurrence of chronic complications in different groups were analyzed and compared. RESULTS: BMI, SBP, DBP, TG, ALT, AST, GGT, UA, HbA1c, FCP, 2 h CP, HOMA-IR, and HOMA-IS in the NAFLD group were significantly higher than the non-NAFLD group (P < 0.05). The incidences of chronic complications in the NAFLD group were higher than in the non-NAFLD group but not statistically significant (P > 0.05). BMI, SBP, DBP, TC, TG, ALT, AST, FCP, 2 h CP, HOMA-IR, and HOMA-IS showed significant differences between the patients with different LFC, and these indexes were significantly higher in patients with higher LFC than those with lower LFC (P < 0.05). Moreover, diabetes duration, TC, HOMA-IR, and LFC were the risk factors for ASCVD complications, while diabetes duration, TG, and LDL-C were risk factors for DN complications. Also, diabetes duration and SBP were risk factors for both DR and DPN complications in T2DM patients (P < 0.05). CONCLUSION: LFC is positively correlated with the severity of the systemic metabolic disorder and chronic complications in T2DM patients.

Correlation Between Functional Magnetic Resonance Imaging and Renal Tubular Injury Markers in Early Assessment Of Renal Tubular Injury in Type 2 Diabetes Mellitus.

Objective: Both functional magnetic resonance imaging and renal tubular injury markers have been proved to be able to detect early renal damage in normoalbuminuric diabetic patients. This study mainly explored the functional magnetic resonance imaging parameters and renal tubular injury markers in the early evaluation of type 2 diabetes. Methods: A case observation study was established, and 62 patients with early-stage low-risk type 2 diabetes mellitus with normoalbuminuric (UACR<30 mg/g, eGFR≥60 ml/min/1.73 m2) were included for analysis. Urine kidney damage was determined by ELISA. Kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) assessment of renal tubular injury, and use of intravoxel incoherent motion magnetic resonance Imaging (intravoxel incoherent motion, IVIM) and blood oxygen level dependent magnetic resonance imaging (blood oxygen level dependent, BOLD) to evaluate renal cortex, medulla blood perfusion, water molecule diffusion, oxygenation level and other functional information, using linear correlation to analyze the correlation between functional magnetic resonance imaging parameters and markers of renal tubular injury. Results: The correlation analysis between IVIM parameters and renal tubular injury markers showed that KIM-1 was inversely correlated with the MD value of the renal medulla region parameter (r = -0.24, P = .03), and was closely related to the other IVIM cortex and medulla. There was no correlation between qualitative parameters (P > .05), and no correlation between NGAL and all parameters of IVIM (P > .05). The correlation analysis between BOLD parameters and renal tubular injury markers showed that KIM-1 was positively correlated with renal medulla region parameter MR2* value (r = 0.26, P = .04) and MCR value (r = 0.28, P = .03), respectively. There was also a positive correlation between NGAL and renal medulla region parameter MR2* value (r = 0.24, P = .04). Conclusion: In the early low-risk type 2 diabetic patients with normoalbuminuria, the more obvious the renal medullary water molecule diffusion disorder, the higher the renal tubular injury marker KIM-1, and the more severe renal medullary hypoxia, the renal tubular injury. The higher the markers KIM-1 and NGAL are, it is proved that the hypoxia and water diffusion disorder in the early renal medulla are related to renal tubular damage.

Rab35 regulates insulin secretion via phogrin in pancreatic ß cells.

Dysfunction of pancreatic ß cell insulin secretion is related to the pathogenesis of type 2 diabetes (T2D). Rab proteins have been shown to be key players in insulin secretion by pancreatic ß cells, and phogrin is a marker for the processes of exocytosis and insulin secretion. The purposes of this study were to clarify the regulatory role of Rab35 in insulin secretion and analyse the Rab35/phogrin interaction mechanism in ß-TC-6 cells. We studied the effects of Rab35 gene overexpression and interference on insulin secretion and phogrin expression and levels in ß-TC-6 cells. The Rab35/phogrin interaction was verified by GST pulldown, co-IP and co-localisation experiments. Here, we report that Rab35 is mainly distributed in the ß-TC-6-cell plasma membrane and cytoplasm. Rab35 overexpression promotes insulin secretion and decreases phogrin expression in ß-TC-6 cells, whereas its silencing significantly inhibits insulin secretion, promotes phogrin expression (p < 0.05) and causes phogrin redistribution. Furthermore, Rab35 silencing suppresses exocytosis of insulin. Rab35 interacts with phogrin, and both proteins co-localise in the plasma membranes and cytoplasm of ß-TC-6 cells. Our study presents novel evidence that Rab35 regulates insulin secretion by inhibiting phogrin expression and causing intracellular phogrin redistribution in pancreatic ß cells.

Self-Amplification of Coherent Energy Modulation in Seeded Free-Electron Lasers.

The spectroscopic techniques for time-resolved fine analysis of matter require coherent x-ray radiation with femtosecond duration and high average brightness. Seeded free-electron lasers (FELs), which use the frequency up-conversion of an external seed laser to improve temporal coherence, are ideal for providing fully coherent soft x-ray pulses. However, it is difficult to operate seeded FELs at a high repetition rate due to the limitations of present state-of-the-art laser systems. Here, we report a novel self-modulation method for enhancing laser-induced energy modulation, thereby significantly reducing the requirement of an external laser system. Driven by this scheme, we experimentally realize high harmonic generation in a seeded FEL using an unprecedentedly small external laser-induced energy modulation. An electron beam with a laser-induced energy modulation as small as 1.8 times the slice energy spread is used for lasing at the seventh harmonic of a 266-nm seed laser in a single-stage high-gain harmonic generation (HGHG) setup and the 30th harmonic of the seed laser in a two-stage HGHG setup. The results mark a major step toward a high-repetition-rate, fully coherent x-ray FEL.

Variations in Irisin, Bone Mineral Density, Bone Mineral Content, and Body Composition After Laparoscopic Bariatric Procedures in Obese Adults.

INTRODUCTION: This study was aimed to assess irisin levels in obesity (OB) and T2DM individuals and investigate the dynamic changes of irisin, bone mineral density (BMD), bone mineral content, and body composition in 19 OB patients after laparoscopic bariatric procedures, and also to evaluate the correlation of irisin, with BMD and body composition. METHODS: Forty-five OB, 20 T2DM, and 20 healthy adults had been recruited. Levels of irisin were measured in all subjects. Metabolic characteristics were obtained from OB and T2DM patients. Nineteen patients were randomly assigned to be received Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) procedure and to be completed 6-month follow-up. Irisin, BMD, bone mineral content, and body composition were measured at each visit. RESULTS: Significantly higher circulating irisin levels were measured in the OB group compared with T2DM and control groups. FINS, C-P, HOMA-IR, FBCI, HBCI, ALT, AST, and UA levels of OB were significantly higher than those of T2DM patients. While FBG and HbA1c of the OB were significantly lower than T2DM group. There were significant differences among circulating irisin, BMD, and body composition after laparoscopic bariatric surgery. Levels of irisin were decreased after operations including both LRYGB and LSG surgery compared with preoperation. At each time point (1, 3, and 6 months) of postoperation, there was no significant difference in percentage of total weight loss between LSG and LRYGB group. The positive correlation of irisin levels with total BMD, muscle, and fat masses were found during 6-month follow-up after surgery. CONCLUSIONS: The levels of irisin were higher in OB patients. There were positive correlations of irisin levels with total BMD, muscle, and fat masses during 6-month follow-up after surgery. Irisin may be involved in the occurrence and development of obese and it is related to BMD and body composition. Both LRYGB and LSG operations could decrease the circulating levels of irisin.

Atom-economic synthesis of cyclobuta[a]naphthalen-4-ols via a base-promoted [2 + 2] cycloaddition/1,6-nucleophilic addition cascade.

A first atom-economic [2 + 2] cycloaddition/1,6-conjugate addition cascade of yne-allenones with C-nucleophiles including 1,3-dicarbonyls and α,α-dicyanoolefins under base-promoted conditions has been established, enabling the direct construction of C(sp3)-C(sp3) bonds to generate cyclobuta[a]naphthalen-1-ols with generally good yields. These resulting products have a cyclobutene unit that contains both an aryl and alkyl group.

Experimental demonstration of longitudinal beam phase-space linearizer in a free-electron laser facility by corrugated structures.

Removal of the undesired time-energy correlations in the electron beam is of paramount importance for efficient lasing of a high-gain free-electron laser. Recently, it has been theoretically and experimentally demonstrated that the longitudinal wakefield excited by the electrons themselves in a corrugated structure allows for precise control of the electron beam phase space. In this Letter, we report the first utilization of a corrugated structure as a beam linearizer in the operation of a seeded free-electron laser driven by a 140 MeV linear accelerator, where a gain of ∼10 000 over spontaneous emission was achieved at the second harmonic of the 1047 nm seed laser, and a free-electron laser bandwidth narrowing by 50% was observed, in good agreement with the theoretical expectations.

Assessing early tubular protective effects of SGLT2 inhibitor empagliflozin against type 2 diabetes mellitus using functional magnetic resonance imaging.

AIMS: To observe the alterations in functional magnetic resonance imaging parameters in normoalbuminuric type 2 diabetic patients undergoing SGLT2 inhibitor empagliflozin treatment and investigate the early tubular protective effects of the inhibitor. METHODS: This study was performed in normoalbuminuric type 2 diabetes mellitus patients (UACR < 30 mg/g, eGFR ≥ 60 ml/min/1.73 m2). The patients were divided into the intervention group (empagliflozin) and the control group (27 cases each). The intervention group was treated with 10 mg/day empagliflozin tablets orally, while the control group had adjustments to their basic treatment stage. The patients were treated for 6 weeks. RESULTS: The baseline clinical data of the two groups were comparable (P˃0.05). The intervention group exhibited better improvements in blood lipid profiles and more significant reductions in blood uric acid levels compared to the control group (P < 0.05). The two groups had No significant difference in blood pressure changes (P˃0.05). Notably, the intervention group demonstrated a greater reduction in UACR and a more substantial decline in eGFR than the control group (P < 0.05). Regarding functional magnetic resonance imaging parameters, the MD value of the renal medulla region in the intervention group increased after treatment, while the MR2* value of the renal medulla region decreased (P < 0.05). CONCLUSIONS: SGLT2 inhibitor empagliflozin can reduce UACR and eGFR levels in early type 2 diabetic patients with normal proteinuria. Moreover, empagliflozin therapy led to an increase in the MD value and a decrease in the MR2* value of the renal medulla, evidencing the early tubular protective effects of this therapy.

Constant or fluctuating hyperglycemias increases cytomembrane stiffness of human umbilical vein endothelial cells in culture: roles of cytoskeletal rearrangement and nitric oxide synthesis.

BACKGROUND: Previous studies have implicated continuous or intermittent hyperglycemia in altered endothelium-derived nitric oxide (NO) synthesis. NO can regulate both the F-actin cytoskeleton and endothelial cell membrane stiffness. Atomic force microscopy (AFM) is a powerful tool that can be used to study plasma membrane deformability at the single cell level. As membrane stiffness is partially dependent on filamentous F-actin, the interdependence of these parameters can be studied through the combined approaches of AFM and laser scanning confocal microscopy (LSCM). In the present study, we evaluated the effects of constant or fluctuating hyperglycemia on endothelial-derived NO synthesis, the cytoskeletal contribution and endothelial cell membrane stiffness. RESULTS: Compared to control cells cultured in low glucose (5 mM), constant (25 mM) or fluctuating (25/5 mM) high glucose significantly decreased NO release along with stiffening of endothelial cell membranes and F-actin rearrangement. The non-selective nitric oxide synthase (NOS) inhibitor, N(G)-nitro-(L)-arginine methyl ester ((L)-NAME) exerted similar effects on endothelial cells. Increasing concentrations of (L)-NAME (from 0.1 to 1 mM) exacerbated these effects in a concentration-dependent manner. CONCLUSIONS: Result from the present study suggest that stiffening endothelial cell membranes are associated with decreased NO synthesis, which was established through the F-actin cytoskeletal redistribution. The precise mechanisms of hyperglycemia-induced endothelial dysfunction require further investigation.

GLP-1 could improve the similarity of IPCs and pancreatic beta cells in cellular ultrastructure and function.

Transplantation of functional insulin-producing cells (IPCs) provides a novel mode for insulin replacement, but is often accompanied by many undesirable side effects. Our previous studies suggested that IPCs could not mimic the physiological regulation of insulin secretion performed by pancreatic beta cells. To obtain a better method through which to acquire more similar IPCs, we compared the difference between IPCs of the GLP-1 group and IPCs of the non-GLP-1 group in the morphological features in cellular level and physiological function. The levels of insulin secretion were measured by ELISA. The insulin and glucagon-like peptide-1 (GLP-1) mRNA gene expression was determined by real-time quantitative PCR. The morphological features were detected by atomic force microscopy (AFM) and laser confocal scanning microscopy (LCSM). Intracellular Ca(2+) levels and Glucagon-like peptide-1 receptor (GLP-1R) levels were determined by flow cytometer (FCM). We found that IPCs of the GLP-1 group had bigger membrane particle size and average roughness (Ra ) than IPCs of the non-GLP-1 group but still smaller than normal human pancreatic beta cells. The physiology function of IPCs of the GLP-1 group were much closer to normal human pancreatic beta cells than IPCs of the non-GLP-1 group. GLP-1 could improve the similarity of IPCs from human adipose tissue-derived mesenchymal stem cells and pancreatic beta cells in cellular ultrastructure and function.

[Clinical features and COMP gene mutation in a family with a pseudoachondroplasia child].

This study aimed to report the clinical characteristics and COMP gene mutation of a family with pseudoachondroplasia (PSACH), a relatively rare spinal and epiphyseal dysplasia that is inherited as an autosomal dominant trait. Clinical information on a 5-year-2-month-old PSACH child and his parents was collected and analyzed. Diagnosis was confirmed by PCR amplification and direct sequencing of all the 19 exons and their flanking sequences of COMP gene, and the mutation was further ascertained by cloning analysis of exon 10. The child presented with short and stubby fingers, bow leg, short limb dwarfism and metaphysic broadening in long bone as well as lumbar lordosis. A mutation c.1048_1116del (p.Asn350_Asp372del) in exon 10, inherited from his father who did not demonstrate any phenotypic feature of PSACH, was detected in the child. PSACH was diagnosed definitively by means of COMP mutation analysis, on the basis of the child's clinical and imaging features. The non-penetrance phenomenon of COMP mutation was described for the first time in PSACH.

Insulin-producing cells from human adipose tissue-derived mesenchymal stem cells detected by atomic force microscope.

We successfully differentiated human adipose tissue-derived mesenchymal stem cells (haMSCs) into insulin-producing cells (IPCs) in vitro and did not use any insulin which might be absorbed by cells during in vitro culture. Expression of insulin gene was massively increased by 28,000-fold at day 12 compared with haMSCs (P < 0.05). IPCs could secrete insulin after glucose was stimulated. The higher the concentration of glucose, the more production of insulin was noted. We reported AFM images of IPCs for the first time. AFM images showed that the sizes of cells were similar to each other, and all IPC surface had a porous structure in the cytoplasm area. In sugar-free group, the size of holes was similar (diameter, 1,086.98 ± 156.70 nm; depth, 185.22 ± 52.14 nm). In higher sugar-stimulated group, there were more holes with bigger diameter and smaller depth. (diameter, 3,183.65 ± 2,229.18 nm; depth 109.42 ± 56.26 nm, P < 0.05). We found that the hole diameter and depth could change with the concentration of glucose in media. Concurrently, laser scanning confocal microscopy images indicated that cortical actin network beneath plasma membrane in IPCs was dense and continuous. After glucose stimulation, we found the actin web depolymerized and became discontinuous in IPCs. We speculated that diameter augmentation of holes located in the cytoplasm area in IPCs was one manifestation of excytosis increase.

Effectiveness and Practicality of eKTANG as a Digital Treatment for Diabetes and Relevant Influence Factors.

BACKGROUND: This work explored the effect of eKTANG, a new healthcare mode for diabetes patients, on diabetes management. METHODS: Allowing general utilization of medical service and health management based on Internet, eKTANG obtained the precise data like blood glucose and blood pressure examined by an intelligent glucometer, from which doctors and the nursing team will promptly analyze the data and return feedback to the patients. In our study, overall 204 patients receiving eKTANG management over 3 months in First Affiliated Hospital of Jinan University from May 2019 to Aug 2020 were enrolled as the research objects, with data collected from patient records. RESULTS: Through the biochemical test on relevant indexes of blood glucose, it was observed that FBG, PBG, HbA1c, TG, TC, LDL levels after management were lower than before whereas HDL expression after were lower than before. Contrasted with substandard group, standard group performed younger age, lower proportion of the married, decreased proportion of microvascular and macrovascular complications, longer course of disease, more frequent glucose monitoring, declined time of hyperglycemia and time of alarms, elevated time of euglycemia, increased proportion of diet control, more amount of exercise and higher compliance, as the number of patients choosing oral medicine in standard group was more than substandard group. The course of disease and time of hyperglycemia were risk factors of HbA1c standard reaching whereas frequency of glucose monitoring (≥1 time/week) and time of euglycemia were protective factors. CONCLUSION: eKTANG effectively improved diabetes management.

[A technical approach to endothelial dysfunction by atomic force microscope].

Endothelial cells (ECs) with a variety of functions are vulnerable to attack by various risk factors. These risk factors of vascular pathology lead to endothelial dysfunction (ED). However, the present methods of evaluating ED have their limitations. Atomic force microscope (AFM), which can offer the information on the surface images and the mechanical properties of the single cell at nanometer scale, will become a new technical approach to ED evaluation. This review focuses on the recent progress in the application of AFM to assess ED.

miR-720 Regulates Insulin Secretion by Targeting Rab35.

miRNAs pose a good prospect in the diagnosis and treatment of type 2 diabetes (T2D). This study is aimed at investigating whether miR-720 targets Rab35 to regulate insulin secretion in MIN6 cells and its molecular mechanism and the clinical value of miR-720 as a specific biomarker of T2D. Fifty-five samples of new diagnosis T2D patients and normal control were collected. Levels of miR-720, fasting blood glucose, insulin, and other indicators of glucose and lipid metabolism were determined. We increased and decreased the miR-720 expression using miR-720 mimic and inhibitor to identify the effect of miR-720 on insulin secretion in MIN6 cells, respectively. Then, we used miR-720 mimic, miR-720 inhibitor, and dual luciferase reporter gene assays to prove miR-720 which regulates insulin secretion by targeting Rab35 in MIN6 cells. In addition, we overexpressed and silenced the Rab35 gene to detect the expression of PI3K, Akt, and mTOR in MIN6 cells by RT-PCR and western blot. In this study, circulating miR-720 was significantly higher in the T2D group than the control group, and miR-270 was positive correlated with FBG, while negatively correlated with FINS. The overexpression of miR-720 inhibited insulin secretion, and miR-720 downregulation promoted insulin secretion. miR-720 regulated insulin secretion by targeting Rab35 in MIN6 cells. Compared with the control group, the expression of PI3K, Akt, and mTOR was significantly decreased by the overexpression of the Rab35 gene, while the silencing Rab35 gene could induce the expression of PI3K, Akt, and mTOR. Furthermore, miR-720 mimic could activate the PI3K pathway. We conclude that miR-720 may be a potential biomarker for the diagnosis of T2D. Increase of miR-720 reduced the Rab35 expression then activate the PI3K/Akt/mTOR signal pathway, thus inhibiting insulin secretion.

[Study on the energy transfer fluorescence quenching reaction of acridine orange-4-(2-pyridylazo) resorcinol-V(V) system and analytical application].

An energy transfer technique for 4-(2-pyridylazo) resorcinol (PAR)-vanadium(V) and acridine orange (AO) was studied, and the optimum conditions of energy transfer system were also experimented. It was found that in citrate-Na2 HPO4 buffer solution at pH = 5.5, energy transfers from AO to vanadium(V)-PAR complexes. A new method based on energy transfer fluorescence quenching for the determination of trace vanadium(V) with AO-PAR-V(V) was established. The equation of linear regression is deltaF = 165.4c+2.5, and the determination range of vanadium is 0.012-0.5 microg x mL(-1), with detection limit of 0.004 5 microg x mL(-1). The correlation coefficient is R = 0.998 5, and relative standard deviation is 0.6%. The fluorescence reaction is completed within 15 minutes, and relative fluorescence intensity remains unchanged for 2.5 hours. The influence of foreign ions on the determination of V (0.5 microg x mL(-1)) was examined, with a related error of 5%. The method has been used in the determination of trace vanadium in biological samples with the relative error of 6.98%, which meets the requirements of trace analysis.

Slippage boosted spectral cleaning in a seeded free-electron laser.

The realization of fully coherent light sources at extreme ultraviolet to x-ray region has been a long-standing challenge for laser technologies. While modern single pass free-electron lasers (FELs) hold the ability to produce very intense x-ray radiation on few-femtosecond timescale, the output radiation pulses usually have noisy spectra and limited temporal coherence since the amplification starts from electron noise. A promising way for producing stable transform-limited pulses is based on the harmonic up-conversion techniques with a conventional laser as the seed. However, it is found that the insignificant phase error in the seed laser may be eventually multiplied by the harmonic number, leading to a degradation of the output temporal coherence at x-ray wavelength. Here, we report for the first time on the demonstration of a slippage boosted spectral cleaning technique to mitigate the impact of seed laser induced phase errors and to significantly improve the temporal coherence of a seeded FEL with large phase errors in the seed laser. Experimental results indicate the possibility of generating fully coherent x-ray radiation pulses with this technique.

[Integrated mediastinal pleura upon aortic arch and left cervical anastomosis in radical operation for esophageal carcinoma].

OBJECTIVE: To evaluate the therapeutic effect of remaining integrated mediastinal pleura upon the aortic arch and performing the anastomosis at the left cervix in radical operation for esophageal carcinoma. METHODS: Ninety-eight patients with esophageal carcinoma were treated with the operation mentioned above. Among them, 56 patients had cancer in the middle, 12 in the upper-middle, 24 in the lower-middle segments, and 6 had double-primary tumors, with carcinoma length of (5.2+/- 2.4) cm. The TNM stages were 6 of Stage I and 92 of Stages II-III. All cases were squamous cell carcinomas. RESULTS: All patients had satisfactory operation processes, without perioperative death, chylothorax, dyspnea, gastric retention, incision infection, and severe gastro-esophageal reflux. The life quality of the patients was improved. CONCLUSION: The radical operation with remaining integrated mediastimal pleura upon the aortic arch and anastomosis at the cervix for treating esophageal carcinomas is of minimal invasion with fewer complications, and may be used in clinical practice.

Elevated RBP4 plasma levels were associated with diabetic retinopathy in type 2 diabetes.

The retinol-binding protein 4 (RBP4) has been postulated to play a role in glucose homeostasis, insulin resistance, and diabetes mellitus in human and animal studies. The aim of the present study was to evaluate the role of RBP4 in Chinese patients with type 2 diabetes mellitus with and without diabetic retinopathy (DR). Plasma RBP4 concentrations were tested in 287 patients with type 2 diabetes. At baseline, demographic and clinical information including presence of DR and vision-threatening DR (VTDR) was collected. The relationship between RBP4 and DR (VTDR) was investigated using logistic regression. Patients with DR or VTDR had significantly higher plasma levels of RBP4 on admission (P<0.0001). Receiver operating characteristics (ROCs) to predict DR and VDTR demonstrated areas under the curve for RBP4 of 0.79 (95% confidence interval (CI): 0.73-0.85) and 0.90 (95% CI: 0.85-0.94), respectively, which were superior to other factors. For each 1 µg/ml increase in plasma level of RBP4, the unadjusted and adjusted risk of DR would be increased by 8% (with the odds ratio (OR) of 1.08 (95% CI: 1.05-1.13), P<0.001) and 5% (1.05 (1.02-1.11), P=0.001), respectively. It was 12% (with the OR of 1.12 (95% CI: 1.07-1.18), P<0.001) and 9% (1.09 (1.05-1.15), P<0.001) for VTDR. The present study shows that elevated plasma levels of RBP4 were associated with DR and VDTR in Chinese patients with type 2 diabetes, suggesting a possible role of RBP4 in the pathogenesis of DR complications. Lowering RBP4 could be a new strategy for treating type 2 diabetes with DR.

Intravoxel incoherent motion (IVIM) at 3.0 T: evaluation of early renal function changes in type 2 diabetic patients.

PURPOSE: The purpose of this study was to evaluate the utility of intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) parameters in identifying early renal function changes in diabetics. METHODS: A total of 40 patients with type 2 diabetes mellitus and 20 healthy control subjects underwent multiple b value DWI. The diabetic patients were stratified into two groups based on albuminuria category: NAU (normal to mildly increased albuminuria; ACR < 30 mg/g) and MAU (moderately increased albuminuria; 30 ≤ ACR < 300 mg/g). The mean cortical and medullary IVIM parameters (D, D*, f, and ADC) were calculated and compared among the different groups, and the correlation of ACR and eGFR was also calculated. RESULTS: The present study revealed the limited water molecule diffusion and hyperperfusion of renal cortex and medulla in diabetic patients before proteinuria detection. Mean cortical and medullary D values negatively correlated with the ACR values in diabetics with 30 ≤ ACR < 300 mg/g, whereas no correlation was found between ACR values and other IVIM parameters. CONCLUSION: IVIM DWI might be helpful in noninvasively identifying early-stage DN. The IVIM parametric values are more sensitive than the ACR in detecting early-stage kidney changes.