Systematic review of TCF2 anomalies in renal cysts and diabetes syndrome/maturity onset diabetes of the young type 5

Objective There is a paucity of published works that systematically evaluate gene anomalies or clinical features of patients with renal cysts and diabetes syndrome （RCAD）/maturity onset diabetes of the young type 5 （MODY5）. The purpose of this review was to systematically assess the detection rate, genetic and phenotypic implications of heterozygous autosomal dominant TCF2 anomalies. Data sources MEDLINE database was searched to select articles recorded in English from 1997 to 2008. The focus was monoallelic germline TCF2 gene mutations/deletions. Biallelic inactivation, polymorphisms, DNA modification （hypomethylation and hypermethylation）, loci associated with cancer risk, and somatic TCF2 anomalies were all excluded. Study selection After searching the literature, 50 articles were selected. Results The detection rate of TCF2anomalies was 9.7% and varied considerably among MODY （1.4%）, renal structure anomalies （RSA） （21.4%） and RSA with MODY （41.2%） subgroups. Mutations were strikingly located within the DNA binding domain and varied among exons of the DNA binding domain： exons 2 and 4 were the hottest spots, while mutations were sporadically distributed in exon 3. The consistent phenotypes were RSA （89.6%） and diabetes mellitus （DM） （45.0%）. However, the concurrence of RSA and DM was relatively low （27.5%）, which hinders the optimal performance of genetic testing and obtainment of timely diagnosis. Other organ involvements were complementary and necessary for the early identification of patients with TCF2 anomalies. Analysis of phenotypes of TCF2 point mutations showed significant differences in the detection rates of RSA, impaired renal function （IRF） and DM according to mutation type but not mutation location. Conclusion These valuable features of TCF2 anomalies that previously did not receive sufficient attention should not be neglected.

ATP Synthase β-subunit Abnormality in Pancreas Islets of Rats with Polycystic Ovary Syndrome and Type 2 Diabetes Mellitus

This study investigated the abnormal expression of ATP synthase β-subunit（ATPsyn-β） in pancreas islets of rat model of polycystic ovary syndrome（PCOS） with type 2 diabetes mellitus（T2DM）,and the secretion function changes after up-regulation of ATP5 b.Sixty female SD rats were divided into three groups randomly and equally.The rat model of PCOS with T2 DM was established by free access to the high-carbohydrate/high-fat diet,subcutaneous injections of DHEA,and a single injection of streptozotocin.The pancreas was removed for the detection of the ATPsyn-β expression by immunohistochemical staining,Western blotting and reverse transcription-PCR（RT-PCR）.The pancreas islets of the rats were cultured,isolated with collagenase Ⅴ and purified by gradient centrifugation,and the insulin secretion after treatment with different glucose concentrations was tested.Lentivirus ATP5 b was successfully constructed with the vector of GV208 and transfected into the pancreas islets for the over-expression of ATPsyn-β.The insulin secretion and intracellular ATP content were determined after transfection of the PCOS-T2 DM pancreas islets with Lenti-ATP5 b.The results showed that the expression of ATPsyn-β protein and m RNA was significantly decreased in the pancreas of PCOS-T2 DM rats.The ATP content in the pancreas islets was greatly increased and the insulin secretion was improved after the up-regulation of ATPsyn-β in the pancreas islets transfected with lenti-ATP5 b.These results indicated that for PCOS,the ATPsyn-β might be one of the key factors for the attack of T2 DM.

Study of the Fibriolytic Inhibition and Clinical Prognosis in Acute Coronary Syndrome Patients Complicated with Type II Diabetes Mellitus

Objectives To study the status of fibrinolytic inhibition in patients of acute coronary syndrome(ACS) complicated with type II diabetes mellitus (NIDDM) and to evaluate the effect of fibrinolytic inhibition to the clinical prognosis. Methods Type II diabetes mellitus was defined by ADA 1997/WHO 1998 criteria. The subjects were divided into treatment groups that included 39 patients of ACS with 20 cases of acute myocardiac infarction (AMI), 36 patients of ACS + NIDOM with 20 cases of AMI. Twenty cases of healthy people were randomized to control group. The plasma level of tissue type plas-minogen activator (t - PA), plasminogen activator inhibitor type - 1 (PAI - 1) and plasma D - dimer were detected by using elisa technique. The index of statue in fibrinolysis was detected with the plasma level of D -dimer and the rate of PAI - 1/D - dimer in percentage. This index was used to evaluate the fibrinolytic inhibition and the clinical outcome in all the patients with AMI in treatment groups. The clinical outcome in patients with AMI consisted of the rate of reperfusion, the incidences of re - infarction, severi-ous arrhythmia, pump failure and death in the early period of AMI. Results The plasma level of PAI - 1 and D - dimer was higher in the two treatment groups than that in the control group ( P < 0. 01). The plasma level of PAI - 1 significantly higher in ACS + NIDDM patients than that in ACS ( P < 0. 05), but the plasma level of D - dimer raised from basic level was significantly lower in ACS + NIDDM than that in ACS ( P < 0. 05) . The rate of PAI - 1 /D - dimer in percentage was significantly higher in ACS + NIDDM than that in ACS or in control group ( P < 0. 01). For AMI patients in two treatment groups, the rate of reperfusion after the thrombolytic therapy was significantly lower in ACS + NIDDM than that in ACS( P < 0. 01) . The rate of incidences in pump failure was significantly higher in ACS + NIDDM than that in ACS too ( P < 0. 05). The morbidity of severious arrhythmia, re - infarction and the mortality were also higher in ACS + NIDDM; however the difference was not significant (P<0. 05) . Conclusions The plasma level of D - dimer combined with the rate of PAI - 1 /D - dimer in percentage could be used to be the evidence and the index to evaluate the status of fibrinolytic inhibition in patients of ACS + NIDDM, and could be used to evaluate the effect of the fibrinolytic inhibition to the outcome of treatment and clinical prognosis in ACS patient.

Diabetic Renal-Retinal Syndrome and Inflammatory Markers of Acute Phase

Objective: To determine the association between the acute inflammatory markers and Diabetic Renal-Retinal Syndrome in our patients. Methods: A total of 44 patients were included in this transverse (cross sectional), observational, analytical, and comparative study. Two groups of patients were created. Results: In patients with chronic renal failure, stages 3, 4, or 5 (scale 1 to 5) were identified and divided into two groups: Group I (Patients with concomitant diabetic retinopathy stabilized with photocoagulation) 22 patients. Group II (Patients with progression of retinopathy, after photocoagulation, in the form of intraocular bleeding) 22 patients. The number of patients with chronic renal failure in stage 3 was: Group I;16. In Group II;12 patients (OR: 1.0). Stage 4: Group I;4 patients. Group II: 3 patients (OR: 1.0, CI 95%;0.3843 - 2.021). Stage 5: Group I;2 patients. Group II;7 patients (OR: 1.8148, CI 95%;1.0448 - 3.1523;Chi-squared (x2) 2.7450, p = 0.097). t-Test found statistical significance in Erythrocyte Sedimentation Rate (ESR): p < 0.0001 (CI 95%;7.8959 - 23.2515);R = 0.56 p = 0.001;and OR = 1.959 (CI 95%;1.193 - 3.217). By non-parametric tests, C-reactive protein with binomial test showed p < 0.001. ESR showed p < 0.001 with U of Mann Whitney. Conclusions: With this study revealed a possible association of inflammatory markers with Diabetic Renal-Retinal Syndrome.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

Features analysis on Traditional Chinese Medicine syndromes in patients with diabetic peripheral neuropathy

OBJECTIVE:To study the features of the distribution and differentiation ofTraditional Chinese Medicine(TCM)syndromes in patients with diabetic peripheral neuropathy(DPN).METHODS:We collected clinical data on illness course,age,fasting blood glucose,saccharogenic hemoglobin,TCM syndromes,tongue,and pulse of238 DPN patients.Differentiated main syndromes(Yin deficiency and exuberant heat,invasion of spleen by damp-heat,deficiency of both Qi and Yins,and deficiency of both Yin and Yang)and accompanying syndromes(blood stasis and phlegm-dampness)of diabetes were also recorded.The features of DPN syndromes were then analyzed.RESULTS:Among the four main syndromes of diabetes,deficiency of both Yin and Yang was the most common in the 238 DPN patients,of which89%-96%had blood stasis.CONCLUSION:The method of differentiating syndromes of diabetes can be applied to DPN patients.Deficiency of both Yin and Yang,often accompanied by blood stasis,is commonly seen.