Prevalence and influencing factors of muscle mass loss in adults with diabetes and a high body fat percentage: A cross-sectional study.

BACKGROUND: In adults with type 2 diabetes (T2DM), sarcopenia and obesity are two common body composition issues. OBJECTIVE: We investigated the associated influencing factors of muscle mass loss in obese adults with T2DM, to provide a theoretical basis for the prevention of sarcopenic obesity in patients with T2DM. METHODS: We recruited 315 participants in this study. The participants underwent body composition assessment and clinical information was collected. Dual-energy X-ray absorptiometry was used to verify the accuracy of the body composition data. Based on their body fat percentage, 189 patients with T2DM were classified as obese. Patients with T2DM and obesity were grouped into the muscle mass loss group and non-muscle mass loss group based on gender. We collected demographic and clinical information about patients with T2DM who were obese, including their age, gender, body mass index (BMI), appendicular skeletal muscle index (ASMI), and body fat percentage (PBF). RESULTS: Among the participants who were obese and had T2DM, 56.61% (107/189) experienced muscle mass loss, with a detection rate of 43.42% (33/76) among females and 65.49% (74/113) among males. Body mass index, fat index, Android fat, Gynoid fat, limb fat, trunk fat, and total body bone mineral content were all lower in the muscle mass loss group compared to the non-muscle mass loss group, regardless of gender (all P< 0.001). Muscle mass loss in obese adults with T2DM was affected by BMI, body fat index, and limb fat. CONCLUSION: Muscle mass loss is more prevalent in adults with T2DM and a high PBF. Body mass index, body fat index, and limb fat are the protective factors of muscle mass loss in adult patients with T2DM and obesity.

[Advances in the Study of Invasive Non-mucinous Adenocarcinoma 
with Different Pathological Subtypes].

Lung cancer is the leading cause of cancer death in the world today, and adenocarcinoma is the most common histopathological type of lung cancer. In May 2021, World Health Organization (WHO) released the 5th edition of the WHO classification of thoracic tumors, which classifies invasive non-mucinous adenocarcinoma (INMA) into lepidic adenocarcinoma, acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma, and micropapillary adenocarcinoma based on its histological characteristics. These five pathological subtypes differ in clinical features, treatment and prognosis. A complete understanding of the characteristics of these subtypes is essential for the clinical diagnosis, treatment options, and prognosis predictions of patients with lung adenocarcinoma, including recurrence and progression. This article will review the grading system, morphology, imaging prediction, lymph node metastasis, surgery, chemotherapy, targeted therapy and immunotherapy of different pathological subtypes of INMA.
.

Effect of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia.

AIM: To investigate the effects of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia using ambulatory glucose monitoring technology. METHODS: This is a prospective intervention of an own-controlled before-and-after cohort study. A total of 24 older type 2 diabetes mellitus patients who met the enrollment criteria were selected, including 12 cases in the sarcopenia and 12 in the non-sarcopenia groups. First, they wore ambulatory glucose monitoring devices (Medtronic, Ipro2) and retained baseline data. Then they wore Ipro2 again and carried out two sessions of resistance exercise on alternate days. Blood glucose level, blood glucose fluctuation, and time in target range on the contrast and exercise days were compared and analyzed in both groups. RESULTS: The area under the curve of glucose level across 24 h and the mean blood glucose post exercise decreased (P < 0.05) in the sarcopenia group. On the exercise day, the coefficient of variation of glucose, the largest amplitude of glycemic excursions, amplitude of postprandial glucose excursions and low blood glucose index decreased, whereas the time in target range increased (P < 0.05). CONCLUSIONS: Short-term acute moderate-intensity resistance exercise is an effective and safe exercise modality, which can reduce blood glucose levels, blood glucose fluctuations and the risk of hypoglycemia, as well as improve the time in target range for older patients with type 2 diabetes mellitus and sarcopenia. Geriatr Gerontol Int 2022; 22: 653-659.

Bone Mineral Density at the Distal Femur and Proximal Tibia and Related Factors During the First Year of Spinal Cord Injury.

BACKGROUND: Spinal cord injury (SCI) can lead to disuse osteoporosis. The most vulnerable sites for fragility-induced fractures are the distal femur (DF) and proximal tibia (PT). The aim of this study was to evaluate changes in bone mineral density (BMD) at the DF and PT, as well as related factors, during the first year of SCI. PATIENTS AND METHODS: Thirty-six SCI patients within 12 months of their injury were selected, as were 36 healthy controls. The dual-energy X-ray absorptiometry was used to measure BMDs at the DF, PT, and hip of all subjects. According to the duration of SCI when receiving DXA scan, 36 SCI patients were divided into three subgroups. The BMDs of overall patients and subgroups were compared to those of controls. Biochemical markers of bone metabolism were detected in SCI patients. RESULTS: The BMDs at the DF, PT, and hips of overall SCI patients were significantly lower than those of controls. The percentage difference of BMD between SCI patients and controls at the DF and PT was higher than at the hip. The BMD at the PT of SCI within 6 weeks post-injury was lower than that of controls. The BMDs at the DF and PT of SCI during 6 weeks-3 months post-injury were lower than those of controls. Whereas there was no difference in the BMD at the hip during the first 3 months of SCI. Age and 25OHD were the influencing factors of DF BMD. Age and gender were found to influence PT BMD. CONCLUSION: The rapid loss of BMD at the PT and DF during the first year of SCI occurred significantly earlier than that of the hip. It is recommended to monitor the BMD of DF and PT in early-stage SCI patients, combined with detection of biochemical markers of bone metabolism.

Effects of Exercise on Blood Glucose and Glycemic Variability in Type 2 Diabetic Patients with Dawn Phenomenon.

BACKGROUND: The dawn phenomenon (DP) is the primary cause of difficulty in blood glucose management in type 2 diabetic (T2D) patients, and the use of oral hypoglycemic agents has shown weak efficacy in controlling DP. Thus, this study is aimed at investigating the effect of moderate-intensity aerobic exercise before breakfast on the blood glucose level and glycemic variability in T2D patients with DP. METHODS: A total of 20 T2D patients with DP confirmed via continuous glucose monitoring (CGM) participated in the current study. After collecting baseline measurements by CGM as a control, CGM was reinstalled and 30 minutes of moderate-intensity aerobic exercise was performed prior to breakfast. Dawn blood glucose increase, blood glucose levels, and glycemic variability were measured before and after exercise. RESULTS: Dawn blood glucose increase (ΔGlu, 1.25 ± 0.84vs.2.15 ± 1.07, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs. 8.78 ± 1.09, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs. 8.78 ± 1.09, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs. 8.78 ± 1.09, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs. 8.78 ± 1.09, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs.2.15 ± 1.07, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs.2.15 ± 1.07, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16vs.2.15 ± 1.07, P = 0.005), highest blood glucose value before breakfast (Gmax, 8.01 ± 1.16. CONCLUSIONS: Acute moderate-intensity aerobic exercise before breakfast reduced the morning rise of blood glucose in T2D patients, partially counteracting DP. Furthermore, exercise significantly reduced blood glucose fluctuations and improved blood glucose control throughout the day. We recommend that T2D patients with DP take moderate-intensity aerobic exercise before breakfast to improve DP and glycemic control.

Effect of pyruvate kinase M2-regulating aerobic glycolysis on chemotherapy resistance of estrogen receptor-positive breast cancer.

This study aims to explore the effect and mechanism of pyruvate kinase M2 (PKM2) on chemotherapy resistance of estrogen receptor-positive breast cancer (ER BC) by regulating aerobic glycolysis. The expression of PKM2 in ER BC MCF-7 cells, T47D cells and MCF-7/ADR cells (which are subject to adriamycin/ADR induction) were determined by quantitative real-time PCR and western blot. MCF-7/ADR (M/A) cells were grouped into blank group (M/A), negative group (M/A+NC), low expression of PKM2 group (M/A+si-PKM2 group), overexpression of PKM2 group (M/A+PKM2 group) and glycolysis inhibition group (M/A+PKM2+2-DG group). Quantitative real-time PCR and western blot were applied to measure the expressions of PKM2, multidrug resistance, and glutathione-S-transferase π. Glucose and lactic acid kit was used to detect the amount of glucose uptake and lactic production. Cell variability, clone formation ability, and cell apoptosis were respectively measured by MTT, clone formation assay, and flow cytometry. Transwell assay and scratch assay were applied for cell invasion and migration ability. By overexpressing PKM2 in MCF-7 and T47D cells and using 2-DG, the effect on sensitivity of adriamycin amycin was explored. MCF-7/ADR cells have both elevated mRNA and protein expressions of PKM2 when compared with MCF-7 cells (both P<0.05). The cell activity of the M/A+si-PKM2+ADR group was notably lower than that in the M/A+ADR group and M/A+NC+ADR group (both P<0.05). In the M/A+si-PKM2 group, expressions of PKM2, multidrug resistance, and glutathione-S-transferase π, along with the amount of glucose uptake and lactic production, as well as cell variability, clone formation ability, and cell invasion and migration ability were inhibited, whereas cell apoptosis was increased in comparison with the M/A group and M/A+NC group (all P<0.05). On comparing with both the M/A group and the M/A+NC group, the M/A+si-PKM2 group displayed contrary tendency with the M/A+PKM2 group. The M/A+PKM2+2-DG group had elevated PKM2 expression compared with the M/A group and the M/A+NC group (all P<0.05). In MCF-7 and T47D cells with overexpression of PKM2, the sensitivity to adriamycin amycin, and cell apoptosis were suppressed, whereas the clone formation, invasion, and migration ability were enhanced. After 2-DG, the sensitivity on MCF-7 and T47D cells was enhanced while clone formation, invasion, migration and cell apoptosis rate were decreased (all P<0.05). PKM2 enhances chemotherapy resistance on ER BC by promoting aerobic glycolysis.