RESUMEN
Central precocious puberty (CPP) is a developmental disorder caused by early activation of the hypothalamic-pituitary-gonadal axis. The incidence of CPP is rapidly increasing, but the underlying mechanisms are not fully understood. Previous studies have shown that gain-of-function mutations in the KISS1R and KISS1 genes and loss-of-function mutations in the MKRN3, LIN28, and DLK1 genes may lead to early initiation of pubertal development. Recent research has also revealed the significant role of epigenetic factors such as DNA methylation and microRNAs in the regulation of gonadotropin-releasing hormone neurons, as well as the modulating effect of gene networks involving multiple variant genes on pubertal initiation. This review summarizes the genetic etiology and pathogenic mechanisms underlying CPP.
Asunto(s)
MicroARNs , Pubertad Precoz , Humanos , Pubertad Precoz/genética , Hormona Liberadora de Gonadotropina/genética , Mutación , Pubertad/genética , Ubiquitina-Proteína Ligasas/genéticaRESUMEN
Purpose: To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes. Patients and Methods: During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher's exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further. Results: The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (ß=-1.118, p=0.019, "have hypoglycemic" as reference) and Brief Illness Perception Questionnaire (ß=0.090, p<0.001) were significant positive correlators for DD, while diet intervention (ß=0.803, p=0.022, "have diet intervention" as reference), money spent on diabetes treatment (ß<-0.001, p=0.035), and SES (ß=-0.257, p<0.001) were significant negative correlators. Conclusion: More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.