BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this th...BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.展开更多
The diagnosis of food allergy in clinical practice has not been standardized,and food allergy is overdiagnosed in patients with atopic dermatitis(AD).This overdiagnosis of food allergy leads to unnecessary elimination...The diagnosis of food allergy in clinical practice has not been standardized,and food allergy is overdiagnosed in patients with atopic dermatitis(AD).This overdiagnosis of food allergy leads to unnecessary elimination diets that may exert potential adverse effects on the health of children with AD.Unlike classic IgE-mediated food allergy,food allergy in patients with AD may manifest as non-eczematous reactions,isolated eczematous reactions,or a combination of these reactions.The diagnosis of food allergy in children with AD should be made based on a thorough clinical history(detailed allergic history and feeding history),clinical manifestations,and laboratory workup including skin prick testing,serum specific IgE measurement,atopy patch testing,and oral food challenges.Once an underlying food allergy is confirmed in a patient with AD,comprehensive management is generally recommended.Avoidance of the food allergen is the main treatment approach,but there is a need for regular clinical follow-up,including evaluation of the nutritional status and supervision of growth and development.Multidisciplinary cooperation between dermatologists,nutritionists,and pediatricians is required.展开更多
Dear Editor, The incidence of male infertility is approximately 10%;1 however, the causes of nonobstructive azoospermia （NOA） remain elusive.2,3 Recent studies into this type of idiopathic male infertility have foc...Dear Editor, The incidence of male infertility is approximately 10%;1 however, the causes of nonobstructive azoospermia （NOA） remain elusive.2,3 Recent studies into this type of idiopathic male infertility have focused on meiotic prophase I.4-6 Here, we report an NOA patient with anomalies in soermatogenesis.展开更多
基金This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Gannan Medical University(approval No.EFYJ20240113007).
文摘BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.
文摘The diagnosis of food allergy in clinical practice has not been standardized,and food allergy is overdiagnosed in patients with atopic dermatitis(AD).This overdiagnosis of food allergy leads to unnecessary elimination diets that may exert potential adverse effects on the health of children with AD.Unlike classic IgE-mediated food allergy,food allergy in patients with AD may manifest as non-eczematous reactions,isolated eczematous reactions,or a combination of these reactions.The diagnosis of food allergy in children with AD should be made based on a thorough clinical history(detailed allergic history and feeding history),clinical manifestations,and laboratory workup including skin prick testing,serum specific IgE measurement,atopy patch testing,and oral food challenges.Once an underlying food allergy is confirmed in a patient with AD,comprehensive management is generally recommended.Avoidance of the food allergen is the main treatment approach,but there is a need for regular clinical follow-up,including evaluation of the nutritional status and supervision of growth and development.Multidisciplinary cooperation between dermatologists,nutritionists,and pediatricians is required.
文摘Dear Editor, The incidence of male infertility is approximately 10%;1 however, the causes of nonobstructive azoospermia （NOA） remain elusive.2,3 Recent studies into this type of idiopathic male infertility have focused on meiotic prophase I.4-6 Here, we report an NOA patient with anomalies in soermatogenesis.
