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1.
JAMA Cardiol ; 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31365039

RESUMO

Importance: Whether optimal cardiovascular health metrics may counteract the risk of cardiovascular events among patients with prediabetes or diabetes is unclear. Objective: To investigate the associations of ideal cardiovascular health metrics (ICVHMs) with subsequent development of cardiovascular disease (CVD) among participants with prediabetes or diabetes as compared with participants with normal glucose regulation. Design, Setting, and Participants: The China Cardiometabolic Disease and Cancer Cohort Study was a nationwide, population-based, prospective cohort study of 20 communities from various geographic regions in China. The study included 111 765 participants who were free from CVD or cancer at baseline. Data were analyzed between 2011 and 2016. Exposures: Prediabetes and diabetes were defined according to the American Diabetes Association 2010 criteria. Seven ICVHMs were adapted from the American Heart Association recommendations. Main Outcomes and Measures: The composite of incident fatal or nonfatal CVD, including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure. Results: Of the 111 765 participants, 24 881 (22.3%) had normal glucose regulation, 61 024 (54.6%) had prediabetes, and 25 860 (23.1%) had diabetes. Mean (SD) age ranged from 52.9 (8.6) years to 59.4 (8.7) years. Compared with participants with normal glucose regulation, among participants with prediabetes, the multivariable-adjusted hazard ratio for CVD was 1.34 (95% CI, 1.16-1.55) for participants who had 1 ICVHM or less and 0.57 (95% CI, 0.43-0.75) for participants who had at least 5 ICVHMs; among participants with diabetes, the hazard ratios for CVD were 2.05 (95% CI, 1.76-2.38) and 0.80 (95% CI, 0.56-1.15) for participants who had 1 ICVHM or less and at least 5 ICVHMs, respectively. Such pattern of association between ICVHM and CVD was more prominent for participants younger than 55 years (prediabetes and at least 5 ICVHMs: hazard ratio [HR], 0.32; 95% CI, 0.16-0.63; 1 ICVHM or less: HR, 1.58, 95% CI, 1.13-2.21; diabetes and at least 5 ICVHMs: HR, 0.99; 95% CI, 0.44-2.26; 1 ICVHM or less: HR, 2.46; 95% CI, 1.71-3.54; compared with normal glucose regulation) than for participants 65 years or older (prediabetes and at least 5 ICVHMs: HR, 0.80; 95% CI, 0.50-1.26; 1 ICVHM or less: HR, 1.01; 95% CI, 0.79-1.31; diabetes and at least 5 ICVHMs: HR, 0.79; 95% CI, 0.46-1.35; 1 ICVHM or less: HR, 1.73; 95% CI, 1.36-2.22, compared with normal glucose regulation; P values for interaction ≤.02). Additionally, the hazard ratio for CVD per additional ICVHM was 0.82 (95% CI, 0.79-0.86) among participants with prediabetes and was 0.85 (95% CI, 0.80-0.89) among participants with diabetes. Conclusions and Relevance: Participants with prediabetes or diabetes who had 5 or more ICVHMs exhibited lower or no significant excess CVD risks compared with the participants with normal glucose regulation.

2.
Diabetes Care ; 42(8): 1539-1548, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31152120

RESUMO

OBJECTIVE: Uncertainty remains regarding the predictive value of various glycemic measures as they relate to the risk of diabetes and its complications. Using the cutoffs recommended by the American Diabetes Association's 2010 criteria, we determined the associations of fasting plasma glucose (FPG), 2-h postload glucose (2h-PG), and HbA1c with the outcomes. RESEARCH DESIGN AND METHODS: Baseline medical history, FPG, 2h-PG, and HbA1c were obtained from a population-based cohort of 193,846 adults aged ≥40 years in China during 2011-2012. A follow-up visit was conducted during 2014-2016 in order to assess incident diabetes, cardiovascular disease (CVD), cancer, and mortality. RESULTS: We documented 8,063 cases of diabetes, 3,014 CVD-related events, 1,624 cases of cancer, and 2,409 deaths during up to 5 years of follow-up. Multivariable-adjusted risk ratios (95% CIs) of diabetes associated with prediabetes based on FPG of 100-125 mg/dL, 2h-PG of 140-199 mg/dL, or HbA1c of 5.7-6.4% (39-47 mmol/mol) were 1.60 (1.43-1.79), 2.72 (2.43-3.04), and 1.49 (1.36-1.62), respectively. Restricted cubic spline analyses suggested J-shaped associations of FPG, 2h-PG, and HbA1c levels with CVD, cancer, and mortality. Multivariable-adjusted hazard ratios (95% CIs) associated with untreated diabetes based on FPG ≥126 mg/dL, 2h-PG ≥200 mg/dL, or HbA1c ≥6.5% (48 mmol/mol) were 1.18 (1.05-1.33), 1.31 (1.18-1.45), and 1.20 (1.07-1.34) for CVD; 1.10 (0.92-1.32), 1.44 (1.25-1.67), and 1.08 (0.92-1.28) for cancer; and 1.37 (1.20-1.57), 1.57 (1.41-1.76), and 1.33 (1.17-1.52) for mortality, respectively. 2h-PG remained significantly associated with outcomes in models including FPG and HbA1c as spline terms. Furthermore, 2h-PG significantly improved the ability of the C statistic to predict diabetes, CVD, and mortality. CONCLUSIONS: 2h-PG remains independently predictive of outcomes in models including FPG and HbA1c. Therefore, in addition to FPG and HbA1c, routine testing of 2h-PG should be considered in order to better assess the risks of outcomes.

3.
J Diabetes ; 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170331

RESUMO

BACKGROUND: This study investigated the association between birth weight and diabetes in a Chinese population, and the effects of body mass index (BMI) and lifestyle factors in later life on this association. METHODS: Data from 49 118 participants aged ≥40 years with recalled birth weight from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, a nationwide population-based cohort, were used. Diabetes diagnosis was based on oral glucose tolerance tests and HbA1c measurements. Logistic regression models were used to evaluate the association of birth weight and risk of diabetes in later life. RESULTS: Increased risk of diabetes was associated with lower or higher birth weight. Compared with individuals with a birth weight of 2500 to 3499 g, the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes for individuals with a birth weight of <2500, between 3500 and 3999, and ≥4000 g were 1.28 (1.11-1.47), 1.11 (1.04-1.19), and 1.20 (1.07-1.34), respectively. Significant associations were prominent in participants with a current BMI ≥24 kg/m2 , but not detected in those with a normal BMI (OR 1.20 [95% CI 0.96-1.49], 1.11 [95% CI 0.98-1.25], and 1.10 [95% CI 0.89-1.37], respectively). Moreover, there was no increased risk of diabetes in individuals with a low birth weight but with healthy dietary habits (OR 0.94; 95% CI 0.68-1.29) or ideal physical activity (OR 1.41; 95% CI 0.97-2.04). CONCLUSIONS: A U-shaped association was observed between birth weight and the risk of diabetes. Healthy lifestyles (healthy dietary habits or ideal physical activity) may eliminate the negative effects of low birth weight in the development of diabetes, but not the effect of high birth weight.

4.
Clin Lab ; 65(3)2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30868863

RESUMO

BACKGROUND: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory markers used for prediction of chronic complications of diabetes. Lower extremity arterial disease (LEAD) is one of chronic complications of type 2 diabetes mellitus (T2DM). The correlation between NLR, PLR, and lower extremity vascular lesions was investigated in subjects with T2DM to determine the best predictive marker for LEAD. METHODS: Three hundred thirty-five patients with T2DM (199 males and 136 females; age 54.12 ± 14.07 years) were enrolled. Blood differential counts and anklebrachial index (ABI) were assessed. Patients were divided into the LEAD group (ABI ≤ 0.9, n = 236) and non-LEAD group (ABI > 0.9, n = 99), and NLR and PLR were compared between the two groups. The independent risk factors for LEAD were analyzed using a logistic regression model. Receiver operating characteristic (ROC) curve analysis was used to assess the optimal cutoff values of PLR and NLR for prediction of LEAD. RESULTS: NLR and PLR in the LEAD group were significantly increased compared to non-LEAD group patients. Univariate analyses identified that NLR was positively correlated with age, glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and 2-hours postprandial glucose levels. PLR was positively correlated with age, duration of T2DM, HbA1c, TG, TC, and LDL, but negatively correlated with diastolic blood pressure and fasting C-peptide levels. Binary logistic regression analysis identified that age, total number of white blood cells, PLR, and TC were significant and independent factors of diabetic LEAD. Moreover, ROC curve analysis showed that NLR and PLR were both predictive markers of LEAD in diabetes, and that the area under the PLR curve was larger than NLR. CONCLUSIONS: NLR and PLR are positively correlated with LEAD in diabetes. PLR was superior to NLR as a predictor of LEAD in diabetes.


Assuntos
Diabetes Mellitus Tipo 2/imunologia , Pé Diabético/imunologia , Adulto , Idoso , China/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Pé Diabético/diagnóstico , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Valor Preditivo dos Testes , Estudos Retrospectivos
5.
J Renin Angiotensin Aldosterone Syst ; 20(1): 1470320318823927, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30798724

RESUMO

OBJECTIVE:: Although the angiotensinogen ( AGT) gene T174M polymorphism has been implicated in the pathogenesis of diabetic nephropathy (DN), study results have been inconsistent. The present meta-analysis was conducted to determine the correlation of AGT T174M polymorphism with DN. METHODS:: We retrospectively extracted relevant studies from Embase as well as PubMed databases. Additionally, a fixed- or random-effects model was employed for calculation of pooled odds ratio (OR) along with 95% confidence interval (CI). RESULTS:: In total, we identified six studies (1179 cases and 927 controls) regarding the AGT gene T174M polymorphism. The pooled ORs for the association between the AGT T174M polymorphism and DN risk were not statistically significant under all genetic models (M vs T: OR = 1.22, 95% CI = 0.84-1.75; MM vs TT: OR = 1.94, 95% CI = 0.93-4.04; MT vs TT: OR = 1.11, 95% CI = 0.76-1.63; the dominant model: OR =1.19, 95% CI = 0.80-1.77; the recessive model: OR = 1.94, 95% CI = 0.93-4.03). Subgroup analyses based on the type of race showed the M allele of the AGT T174M polymorphism increased DN risk in Asians, but not in Caucasians. CONCLUSIONS:: Our study indicated that the T174M polymorphism in the AGT gene was associated with DN in Asians.


Assuntos
Angiotensinogênio/genética , Nefropatias Diabéticas/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único/genética , Humanos , Razão de Chances , Viés de Publicação , Fatores de Risco
6.
Biomed Pharmacother ; 106: 983-990, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30119270

RESUMO

miRNAs is a kind of noncoding small RNAs with negative regulation function. Some miRNAs play a crucial role in the growth of tumor cells. In this study, we analyzed the role of miR-335-5p and its target gene intercellular adhesion molecule 1 (ICAM-1) in thyroid cancer. Real-time polymerase chain reaction (PCR) results showed that the expression level of ICAM-1 in cancer tissues was higher than that in their adjacent tissues. The expression level of ICAM-1 in papillary thyroid carcinoma was also significantly higher than that in other types of tumors. However, the expression of miR-335-5p is opposite to that of ICAM-1. In human thyroid cancer cell lines TPC-1, FTC-133, TT and human thyroid follicular cell line Nthyori 3-1, the expression level of ICAM-1 in TPC-1 was significantly higher than that of other cells, while the expression level of miR-335-5p in TPC-1 was significantly lower than that of other cells. When ICAM-1 expression was downregulated and miR-335-5p expression was upregulated in TPC-1 cells, ICAM-1 expression was upregulated and miR-335-5p expression was downregulated in FTC-133 cells, we found that ICAM-1 could promote the proliferation of thyroid cancer cells, while miR-335-5p could inhibit the proliferation of thyroid cancer cells. miR-335-5p could combine with 3'UTR of ICAM-1 by bioinformatics prediction. Luciferase reporter gene analysis and Western blotting detection further confirmed that miR-335-5p could target ICAM-1 and inhibit its expression. The expression level of miR-335-5p was downregulated, while the expression level of ICAM-1 was upregulated in thyroid cancer. This study will help us better understand the pathogenesis of thyroid cancer and provide new insights into the treatment of this disease.

7.
BMC Endocr Disord ; 18(1): 30, 2018 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-29793475

RESUMO

BACKGROUND: This study aimed to detect changes in hormone levels in the hypothalamic-pituitary-ovarian axis in Sprague-Dawley (SD) rats with hypothyroidism, and identify differences in the pregnancy and abortion rates of female adult rats. The potential role of gonadotropin releasing hormone (GnRH) as the link between the hypothalamic-pituitary-ovarian axis and reproductive function regulated by thyroid hormones was also investigated. METHODS: Female SD rats (n = 136) were causally classified into two groups: the normal-drinking-water group (n = 60) and the 0.05% propylthiouracil-drinking-water group (PTU 2 mg/kg/day, n = 76) to establish an adult rat model of hypothyroidism (6 weeks). Female and male rats at a ratio of 1:2 were used to establish a hypothyroidism pregnancy model. GnRH mRNA and GnRH receptor (GnRHR) expression in rats was detected using real time quantitative PCR(qRT-PCR) and immunohistochemistry, respectively. RESULTS: The abortion rate differed significantly between the hypothyroidism pregnancy group and the normal pregnancy group (P < 0.05). No significant differences were found in the distribution of the GnRHR among the five nuclei (hypothalamic arcuate nucleus, hypothalamic ventromedial nucleus, hypothalamic anterior nucleus, paraventricular nucleus of the hypothalamus, and ventral premammillary nucleus) of the hypothalamus and ovary (P > 0.05). Hypothyroidism had no significant effect on GnRH mRNA expression in the hypothalamic-pituitary-ovarian axis in the four groups (normal control group, normal pregnancy group, hypothyroidism pregnancy group, and hypothyroidism group) (P > 0.05). CONCLUSIONS: Hypothyroidism had an adverse impact on pregnancy in rats and may affect the distribution of pituitary GnRHR, whereas it did not obviously affect the distribution of GnRHR in the nuclei of the hypothalamus and ovary. Hypothyroidism had no effect on GnRH mRNA expression.


Assuntos
Hipotálamo/patologia , Hipotireoidismo/complicações , Infertilidade Feminina/etiologia , Ovário/patologia , Hipófise/patologia , Reprodução , Animais , Biomarcadores/metabolismo , Feminino , Hormônio Liberador de Gonadotropina/genética , Hormônio Liberador de Gonadotropina/metabolismo , Hipotálamo/metabolismo , Hipotireoidismo/metabolismo , Hipotireoidismo/patologia , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/metabolismo , Masculino , Ovário/metabolismo , Hipófise/metabolismo , Gravidez , Ratos , Ratos Sprague-Dawley , Receptores LHRH/genética , Receptores LHRH/metabolismo
8.
Biosci Rep ; 38(4)2018 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-29784871

RESUMO

The present study aimed to investigate the effect of maternal hypothyroidism during pregnancy on thyroid function of the fetal rat. Female Sprague-Dawley rats were randomized into two groups. Propylthiouracil (PTU) group received PTU in drinking water for 6 weeks (n=90), normal group received normal drinking water (n=50). The pregnant rats were obtained and had a cesarean-section to get at gestational ages of 8.5, 13, and 21 days, following blood samples and skeletal muscle were obtained from fetal rats. Levels of thyroid hormone, insulin, mitochondrial protein, and adipokines were detected using ELISA. Western blotting was performed to analyze mitochondria and insulin signal transduction-related protein in fetal rat skeletal muscle. Immunostaining of Periodic Acid-Schiff (PAS) and Oil Red O was used to observe the accumulation of muscle glycogen and lipid in the fetal rat. The results showed that the levels of thyroid hormone, insulin, insulin signal transduction-related protein, mitochondrial, and adipokines increased with the fetus developed, but had no statistical differences in the PTU group compared with the normal group. In conclusion, pregnant rats with hypothyroidism had no influence on insulin resistance (IR), lipid accumulation, and mitochondrial dysfunction in skeletal muscle of the fetal rats.

9.
J Diabetes ; 10(2): 121-129, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28449408

RESUMO

BACKGROUND: The E23K variant of the potassium voltage-gated channel subfamily J member 11 (KCNJ11) gene has been reported to be associated with type 2 diabetes (T2D) in many populations. However, little is known about the role of E23K in the development of prediabetes in Chinese youth. METHODS: To investigate the role of E23K in the development of prediabetes, 279 subjects with prediabetes and 240 normal controls (mean [± SD] age 18.1 ± 3.2 and 17.8 ± 4.3 years, respectively) were recruited to the study. Height, weight, and hip and waist circumferences were measured by trained physicians. Genotyping of KCNJ11 polymorphisms and clinical laboratory tests to determine cholesterol, triglyceride (TG), blood glucose, and insulin levels were performed. RESULTS: The carrier rate of K23 allele-containing genotypes was higher for prediabetic than control subjects (P = 0.005). Logistic regression analyses revealed that higher body mass index percentiles (P = 0.013), lower insulin levels at 30 min during an oral glucose tolerance test (P = 0.001), a higher ratio of total cholesterol: high-density lipoprotein cholesterol (P = 0.001), and a K allele-containing genotype (P = 0.019) are independent risk factors for prediabetes in Chinese Han youth. Furthermore, K23 allele-containing genotypes were associated with impaired indices of insulin secretion and ß-cell function in female youth with prediabetes. These effects were not seen in male youth with prediabetes. CONCLUSIONS: The results confirm that the common E23K polymorphism of KCNJ11 carries a higher susceptibility to the development of prediabetes in the Chinese Han population. The results suggest that E23K may have a greater effect on the development of T2D in female Chinese youth.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Polimorfismo Genético , Canais de Potássio Corretores do Fluxo de Internalização/genética , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/genética , Adolescente , Biomarcadores/análise , Glicemia/análise , Estudos de Casos e Controles , China/epidemiologia , Feminino , Seguimentos , Predisposição Genética para Doença , Genótipo , Hemoglobina A Glicada/análise , Humanos , Masculino , Prognóstico
10.
J Diabetes ; 10(5): 408-418, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29144059

RESUMO

BACKGROUND: A number of primary studies suggested that active smoking could be independently associated with incident diabetes. However less is known about the effect of active smoking and smoking cessation on glycemic control in patients with diabetes. The aim of this study was to evaluate the associations of active smoking and smoking cessation with glycemic control in diabetic patients. METHODS: The present was a cross-sectional study of 10 551 men and 15 297 women with diabetes from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Risk factors for glycemic control and the association of active smoking with glycemic control were evaluated using logistic regression models. Poor glycemic control was defined as HbA1c ≥7.0%. RESULTS: Current smokers have an increased risk of poor glycemic control, and the multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) of HbA1c ≥7.0% with current smoking were 1.49 (1.35-1.66) in men and 1.56 (1.13-2.15) in women. Further analysis demonstrated a dose-dependent relationship between active smoking and the risk of poor glycemic control in men. Former smokers who quit smoking for <10 years remained at increased risk of poor glycemic control, with the risk leveling off after 10 years of smoking cessation compared with non-smokers, but risk in former smokers was significantly lower than that in current smokers. CONCLUSIONS: Active smoking is a modifiable risk factor for poor glycemic control in Chinese diabetic patients.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Abandono do Hábito de Fumar , Fumar/efeitos adversos , Adulto , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Distribuição de Qui-Quadrado , China/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Incidência , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Fatores de Risco , Fumar/sangue , Fumar/epidemiologia , Fatores de Tempo
11.
J Diabetes ; 9(9): 837-845, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27734593

RESUMO

BACKGROUND: Diagnosed diabetes has been associated with chronic kidney disease (CKD). However, the association between non-diabetic hyperglycemia and CKD remained uncertain. The aim of the present study was to investigate the association between different glycemic status and CKD in Chinese adults and to assess the prevalence and control of diabetes among individuals with CKD. METHODS: In all, 250 752 adults aged ≥40 years were selected from the baseline cohort of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Plasma glucose concentrations and biochemical and other clinical data were collected; CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m2 . RESULTS: The prevalence of CKD increased gradually with deterioration of glucose metabolic status in both men and women ( P trend < 0.001 for both). Compared with individuals with normal glucose regulation, men with prediabetes and diabetes had higher risks of prevalent CKD (prediabetes odds ratio [OR] 1.15, 95% confidence interval [CI] 1.02-1.32; newly diagnosed diabetes OR 1.27, 95% CI 1.08-1.49; previously diagnosed diabetes OR 2.05, 95% CI 1.78-2.35). Similar results were observed in women, but not among those with prediabetes. In male CKD patients with diabetes, 52.1% received antidiabetic treatment and 41.8% of those treated had effective glycemic control, higher than values for females. CONCLUSIONS: Prediabetes and diabetes were associated with an increased risk of CKD in Chinese men. Control of diabetes among Chinese CKD patients is far from optimal.


Assuntos
Glicemia/metabolismo , Hiperglicemia/epidemiologia , Falência Renal Crônica/epidemiologia , Estado Pré-Diabético/epidemiologia , Idoso , China/epidemiologia , Estudos de Coortes , Feminino , Taxa de Filtração Glomerular , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Inquéritos e Questionários
12.
Am J Cancer Res ; 6(10): 2334-2344, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27822422

RESUMO

Hyperinsulinemia and insulin resistance were reported to play a crucial role in diabetes-cancer relationship. This study aimed to explore the associations between insulin resistance and several female cancers in a non-diabetic population. This cross-sectional study was conducted in 121,230 middle-aged and elderly non-diabetic women. Cancer diagnosis was self-reported and further validated by medical records. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 2.50. The prevalence of both premenopausal and postmenopausal breast cancer, postmenopausal ovarian cancer and premenopausal endometrial cancer were higher in insulin-resistant participants than in insulin-sensitive participants (premenopausal breast cancer, 0.45 vs 0.28%; postmenopausal breast cancer, 0.86 vs 0.63%; postmenopausal ovarian cancer, 0.17 vs 0.09%; premenopausal endometrial cancer, 0.43 vs 0.25%, respectively, all P < 0.05). Individuals with insulin resistance had higher odds ratio (OR) of breast cancer, both premenopausal and postmenopausal (OR 1.98, 95% confidence interval (CI) 1.19-3.32; OR 1.29, 95% CI 1.01-1.63), postmenopausal ovarian cancer (OR 2.17, 95% CI 1.10-3.40) as well as total endometrial cancer (OR 1.47, 95% CI 1.02-2.12). Subgroup analysis revealed that the possitive association between insulin resistance and risk of prevalent breast cancer was observed in popualtion with younger age, overweight or obesity, higher education and impaired glucose tolerance (IGR). No relationships were observed for the risk of prevalent cervical cancers with insulin resistance. Non-diabetic women with insulin resistance had higher risk of prevalent breast, ovarian and endomatrial cancer, which suggests special attentions to these female cancer screening and prevention.

13.
Am J Epidemiol ; 184(5): 400-9, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27530336

RESUMO

Pairs of spouses share common lifestyle factors. In a cross-sectional analysis, we investigated whether spouses of diabetic individuals had a higher prevalence of diabetes and cardiometabolic disorders in a community-based population of Chinese adults aged 40 years or older between 2011 and 2012. A total of 34,805 pairs of spouses were identified. All participants underwent a standard oral glucose tolerance test and provided detailed clinical, sociodemographic, and lifestyle information. Diabetes and multiple cardiometabolic disorders were defined according to standard criteria. Compared with participants whose spouses did not have diabetes, participants whose spouses had diabetes had higher odds of having diabetes (for men, odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.22, 1.45; for women, OR = 1.35, 95% CI: 1.24, 1.47), obesity (for men, OR = 1.34, 95% CI: 1.13, 1.59; for women, OR = 1.19, 95% CI: 1.05, 1.35), metabolic syndrome (for men, OR = 1.31, 95% CI: 1.21, 1.42; for women, OR = 1.12, 95% CI: 1.04, 1.20), and cardiovascular disease (for men, OR = 1.18, 95% CI: 1.03, 1.34; for women, OR = 1.18, 95% CI: 1.03, 1.35). The associations were independent of age, body mass index, education, family history of diabetes, cigarette smoking, alcohol drinking, physical activity, and diet. Spousal diabetes was simple and valuable information for identifying individuals at risk for diabetes and cardiometabolic disorders.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Saúde da Família/estatística & dados numéricos , Estilo de Vida , Síndrome Metabólica/epidemiologia , Cônjuges/estatística & dados numéricos , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Teste de Tolerância a Glucose , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco
14.
J Am Heart Assoc ; 5(7)2016 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-27451464

RESUMO

BACKGROUND: Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk. However, the association of mildly reduced kidney function with CVD risk is unclear. METHODS AND RESULTS: This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10-year Framingham risk for coronary heart disease (CHD), and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study. With an interviewer-assisted questionnaire, we collected information on CVD, including reported CHD, stroke, or myocardial infarction. Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. Compared with individuals with normal eGFR (≥90 mL/min per 1.73 m(2)), those with decreased eGFR (75-89, 60-74, and <60 mL/min per 1.73 m(2)) had higher risk of prevalent obesity, diabetes mellitus, hypertension, and dyslipidemia in both men and women (P for trend all <0.001). Moreover, a significantly higher 10-year Framingham risk for CHD and 10-year risk for ASCVD was observed in both men and women with mildly decreased eGFR (60-89 mL/min per 1.73 m(2)). CONCLUSIONS: Even mildly reduced eGFR (under 90 mL/min per 1.73 m(2)) is associated with elevated 10-year Framingham risk for CHD and 10-year ASCVD risk among Chinese adults.


Assuntos
Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Obesidade/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , China/epidemiologia , Doença das Coronárias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
15.
Neuro Endocrinol Lett ; 37(3): 169-173, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27179580

RESUMO

A case of a 42-year-old female with hyperthyroidism was subsequently diagnosed to have systemic lupus erythematosus with distal RTA. The clinical examination on admission showed swelling of the knee joints and the urinalysis showed pH 6.5, pro 3+. Her blood routine results were as follows: white blood cells 1.85×109/L, platelets 100×109/L, erythrocyte 3.06×1012/L. The serum potassium was 3.11 mmol/L, 24 hour urinary electrolyte: K 68.87 mmol/24 H, antinuclear antibodies (ANA) 1:1 000, speckled pattern. The anti-double stranded DNA antibody (anti-dsDNA), anti SS-A(52) antibody and anti SS-A(60) antibody were positive. The light microscopy and immunofluorescence showed diffuse proliferative lupus nephritis. These data were compatible with the diagnosis of systemic lupus erythematosus. The diagnosis of hyperthyroidism and distal RTA is clear. This report showed that other autoimmune disease in the diagnosis of hyperthyroidism should not be ignored.


Assuntos
Acidose Tubular Renal/complicações , Hipertireoidismo/complicações , Lúpus Eritematoso Sistêmico/complicações , Acidose Tubular Renal/diagnóstico , Acidose Tubular Renal/terapia , Adulto , DNA/imunologia , Feminino , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/terapia , Túbulos Renais Distais/patologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/terapia , Nefrite Lúpica/complicações , Nefrite Lúpica/patologia , Nefrite Lúpica/terapia
16.
Obesity (Silver Spring) ; 24(3): 703-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26833544

RESUMO

OBJECTIVE: To clarify the quantitative relationship of body mass index (BMI) change from early adulthood to midlife with presence of type 2 diabetes mellitus (T2DM) after midlife. METHODS: This study included 120,666 middle-aged and elderly, whose retrospectively self-reported body weight at 20 and 40 years and measured height were available. BMI at 20 and 40 years and BMI change in between were defined as early-adulthood BMI, midlife BMI, and early-adulthood BMI change. RESULTS: The odds ratio (OR) for T2DM associated with an 1-unit increment of early-adulthood or midlife BMI was 1.08 (95% confidence interval (CI), 1.07-1.08) and 1.09 (95% CI, 1.09-1.10) respectively. In the cross-tabulation of both early-adulthood BMI and BMI change, the prevalence of T2DM increased across both variables. Compared with participants with normal early-adulthood weight and BMI increase/decrease ≤1, the OR (95% CI) for T2DM of participants with early-adulthood overweight/obesity and BMI increase ≥4 kg/m(2) was 3.49 (3.05-4.00). For participants with early-adulthood underweight and BMI increase/decrease ≤ 1, the OR (95% CI) was 0.85 (0.75-0.97). Subgroup analysis according to sex and age showed similar trends. CONCLUSIONS: Early-adulthood BMI may influence T2DM prevalence after midlife independent of current BMI. T2DM prevalence after midlife was positively associated with early-adulthood weight gain and inversely related to early-adulthood weight loss, while early-adulthood weight loss could not completely negate the adverse effect of early-adulthood overweight/obesity on diabetes.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Nível de Saúde , Obesidade/epidemiologia , Ganho de Peso , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Causalidade , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Magreza/epidemiologia
17.
Obes Res Clin Pract ; 10(5): 553-563, 2016 Sep - Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26422807

RESUMO

AIM: To examine the effects of intensive insulin therapy (IIT) in Chinese male patients with newly diagnosed type 2 diabetes in 12 months on plasma adiponectin and leptin levels and to assess whether changes in plasma adiponectin and leptin could be associated with subsequent weight gain or not. METHODS: Overall 84 patients were taken IIT. Total, and high-, and low-molecular-weight (HMW, LMW) adiponectin and leptin concentrations were measured at the time of study inclusion, days 7, and 1, 3, 6 and 12 months after IIT, respectively. Patients' body weight was recorded every time when adiponectin and leptin were measured. RESULTS: With improvement of diabetes control, plasma total and HMW adiponectin and leptin concentrations increased from inclusion to 3 months significantly and progressively, but remained steady after 6 months. Weight increased relatively modestly with a mean gain of 2kg for 12 months. Moreover, higher increments of total and HMW adiponectin from inclusion to 12 months were associated with significantly less subsequent weight gain after adjustment for confounding factors: the patients in the lowest tertile of total adiponectin increased by 2.47kg compared to patients in the highest tertile who increased by 0.56kg (P-value=0.006). Whereas, the higher increments of leptin levels under the same condition were linked with more subsequent weight gain significantly (P-value=0.003). CONCLUSIONS: Our researches suggest that glycaemic control with IIT increases total and HMW adiponectin and leptin in newly diagnosed type 2 diabetes male patients, the elevation of total and HMW adiponectin and leptin levels may predict weight gain after IIT.


Assuntos
Adiponectina/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Leptina/sangue , Ganho de Peso/fisiologia , China , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
18.
Neuro Endocrinol Lett ; 36(2): 115-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26071577

RESUMO

A 56-year-old man suffered from severe diabetic ketoacidosis which was complicated by acute renal failure and rhabdomyolysis. Before admission the patient had had flu-like symptoms for 5 days and had developed polyuria and polydipsia. The clinical examination on admission showed his plasma glucose level was 80.65 mmol/L while the HbA1c was 7.4%. His amylase concentration was high without any signs of pancreatitis. The islet-associated autoantibodies (GAD antibody, islet cell antibody) were absent. These data were compatible with the diagnosis of fulminant type 1 diabetes. A continuous intravenous insulin infusion therapy was given during the acute phase to control hyperglycemia and ketoacidosis. This patient remained dependent on continuous veno-venous hemofiltration (CVVHF) for 5 days, followed by regular kidney dialysis for three times, before his renal function was finally recovered. To conclude, this is a rare case of abrupt onset fulminant type 1 diabetes with the onset of acute renal failure. Hence, early detection, quick diagnosis and immediate treatment are very important. In particular, prompt CVVHF and kidney dialysis are required and useful for rescuing the renal function.


Assuntos
Lesão Renal Aguda/etiologia , Diabetes Mellitus Tipo 1/complicações , Rabdomiólise/complicações , Humanos , Masculino , Pessoa de Meia-Idade
19.
Int J Clin Exp Med ; 8(10): 17902-11, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26770384

RESUMO

The present study was designed to investigate the effects of sitagliptin on metabolic parameters as well as the expression levels of retinol-binding protein 4 (RBP4) and glucose transporter type 4 (GLUT4) in a rat model of type 2 diabetes mellitus. A rat model of type 2 diabetes mellitus was established by a combination of a high-fat diet and intraperitoneal injection of low-dose streptozotocin. Rats were divided into three groups: normal control group, diabetes group, and diabetes + sitagliptin group. Body weight, glycemic parameters, lipid profiles, fasting insulin (FINS) and serum RBP4 levels were assessed at baseline and after 6 weeks of therapy. Western blotting was used to detect the tissue RBP4 and GLUT4 expression levels. After treatment for 6 weeks, the diabetes + sitagliptin group displayed significantly improve levels of blood sugar, blood grease, and insulin sensitizing functions (P < 0.05) than the diabetes group. Sitagliptin markedly down regulated RBP4 expression levels and up-regulated GLUT4 expression levels in adipose tissue and skeletal muscle. The results indicate that sitagliptin can modulate the RBP4-GLUT4 system in adipose tissue and skeletal muscle. Modulation of the RBP4-GLUT4 system may be one of the mechanisms by which sitagliptin ameliorates the symptoms of type 2 diabetes mellitus.

20.
Neuro Endocrinol Lett ; 35(3): 171-4, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24977962

RESUMO

A 66-year-old woman with acromegaly and diabetes mellitus as well as primary hyperthyroidism is described. Serum GH Levels were inappprpriately high.MRI revealed an enlarged sella turcica with intrasellar mass. Her HbAlc was 12.2% and fasting blood glucose 8.89 mmol/l. Thyroid hormone levels in serum and thyroidal radioiodine uptake values were elevated, while TSH measurements in serum were low. Anti TPO antibodies were negative, TSH receptor antibodies were normal. Thyrotoxicosis as the first presenting illness in acromegaly was particulary uncommon. An ultrasound thyroid scan showed a multinodular goiter. Histology of the pituitary lesion showed a typical eosinophilic adenoma which only secreted GH when tested with specific immunostain. Post-operatively, the patient's clinical conditions improved, however, secondary hypoadrenalism appeared.


Assuntos
Acromegalia/etiologia , Diabetes Mellitus/etiologia , Hipertireoidismo/complicações , Acromegalia/diagnóstico , Acromegalia/cirurgia , Adenoma Acidófilo/complicações , Adenoma Acidófilo/diagnóstico , Adenoma Acidófilo/cirurgia , Idoso , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/cirurgia , Feminino , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/cirurgia , Imagem por Ressonância Magnética , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia
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