Association of age at diagnosis of diabetes with subsequent risk of age-related ocular diseases and vision acuity

BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.

Evaluation of effect of acupuncture treatment on carotid arteriosclerosis plaque by three-dimensional ultrasound VPQ technology

Objective:To evaluate the structural changes of atherosclerotic plaque before and after acupuncture treatment by three-dimensional ultrasound of Vascular Plaque Quantification technology.Methods:Forty subjects were recruited and randomly divided into acupuncture group and sham acupuncture group.All patients were treated twice a week for 3 months and were observed the changes of the bilateral carotid plaque volume(PV),gray scale value(GSM)and inner media thickness(IMT).Results:The acupuncture group’s PV decreased after 3 months,while the sham group’s increased slightly.The result were statistically significant(P≤0.05).After treatment,the acupuncture group’s left GSM was higher than before,while the sham group’s was slightly lower than before.The result were statistically significant(P≤0.05).Although the difference of the acupuncture group’s right GSM before and after treatment was not statistically significant,it also had a rising trend.Conclusion:Acupuncture can reduce the volume of carotid atherosclerotic plaque and stabilize the nature of the plaque.

不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

Objective:To observe the effects of electroacupuncture(EA)with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patientswith such conditions.Design:Single-center,randomized,controlled clinical trial was designed,and the outcome assessors and statisticians were blinded.The patients with migraine were randomized into 2 Hz EA group,100 Hz EA group and sham-stimulation group.In each group,the changes in migraine attacks,days with headache,the scores of visual analogy scale(VAS),self-rating anxiety scale(SAS),self-rating depression scale(SDS)and migraine-specific quality-of-life questionnaire(MsQ),as well as the dosage of analgesics were observed at the baseline,during treatment,in 1,2 and 3 months of follow-up separately.Setting:Patients were enrolled in the Third Afiliated Hospital of Zhejiang Chinese Medical University,between 1st August 2018 and 31st July 2021.Participants:Sixty-five migraine patients with or without aura.Interventions:In the EA groups,the acupoints were bilateral Fengchi(GB20),Gongxue(Extra),Sizhukong(TE23),Taiyang(EX-HN5),Shuaigu(GB8),Waiguan(TE5)and Yanglingquan(GB34).Electric stimulation was exerted at GB20 and Gongxue(Extra),with 2 Hz and 100 Hz separately.In the sham-stimulation group,the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue(Extra),and on the radial side of TE5 and GB34.The output wires were cut off after attached to the acupoints.The patients in each group received the treatment 3 times weekly,once every two days,for consecutive 4 weeks.The complete intervention was composed of 12 treatments.Main outcome measures:Changes in numbers of migraine attacks at treatment phase(week 1 to week 4)from the baseline(week-4 to week 0)in patients of each group Kesults:(1)Cnangesinmigraineattacks anadays witnneaaacne:intneZ Hz EA anaIuu Hz EA groups the changes of migraine attacks and days of headache were higher significantlyywhencomparedwith that in the sham-stimulation group at the same time stage(P<0.05).There was no statistical difference between two EA groups.(2)Changes of VAS score:In the 2 Hz EA and 100 Hz EA groups,the changes of VAS score were significantly higher when compared with that in the sham-stimulation group during the treatment stage(P<0.05).There was no statistical difference between two EA groups.(3)Assessment of anxiety and depression:The differences in the changes of SAS and sDS scores had no statistical significance among the three groups at each assessment stage(P>0.05).(4)Assessment on the quality of life:Compared with the sham-stimulation group at the same time stage,the MsQ score were increased significantly during treatment in patients of the 2 Hz EA and 100 Hz EA groups(P<0.05).There was no statistical difference between two EA groups.(5)Assessment on safety and compliance:The patients of each group had sound compliance.There was no adverse events during trial,suggesting promising safety of treatment.Conclusion:EA may effectively reduce the migraine attacks,and the days and intensity of headache,presenting promising safety.However,there was no significant improvement on anxiety-depression symptoms,and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine.