BACKGROUND Among older adults,type 2 diabetes mellitus(T2DM)is widely recognized as one of the most prevalent diseases.Diabetic nephropathy(DN)is a frequent com-plication of DM,mainly characterized by renal microvascu...BACKGROUND Among older adults,type 2 diabetes mellitus(T2DM)is widely recognized as one of the most prevalent diseases.Diabetic nephropathy(DN)is a frequent com-plication of DM,mainly characterized by renal microvascular damage.Early detection,aggressive prevention,and cure of DN are key to improving prognosis.Establishing a diagnostic and predictive model for DN is crucial in auxiliary diagnosis.AIM To investigate the factors that impact T2DM complicated with DN and utilize this information to develop a predictive model.METHODS The clinical data of 210 patients diagnosed with T2DM and admitted to the First People’s Hospital of Wenling between August 2019 and August 2022 were retrospectively analyzed.According to whether the patients had DN,they were divided into the DN group(complicated with DN)and the non-DN group(without DN).Multivariate logistic regression analysis was used to explore factors affecting DN in patients with T2DM.The data were randomly split into a training set(n=147)and a test set(n=63)in a 7:3 ratio using a random function.The training set was used to construct the nomogram,decision tree,and random forest models,and the test set was used to evaluate the prediction performance of the model by comparing the sensitivity,specificity,accuracy,recall,precision,and area under the receiver operating characteristic curve.RESULTS Among the 210 patients with T2DM,74(35.34%)had DN.The validation dataset showed that the accuracies of the nomogram,decision tree,and random forest models in predicting DN in patients with T2DM were 0.746,0.714,and 0.730,respectively.The sensitivities were 0.710,0.710,and 0.806,respectively;the specificities were 0.844,0.875,and 0.844,respectively;the area under the receiver operating characteristic curve(AUC)of the patients were 0.811,0.735,and 0.850,respectively.The Delong test results revealed that the AUC values of the decision tree model were lower than those of the random forest and nomogram models(P<0.05),whereas the difference in AUC values of the random forest and column-line graph models was not statistically significant(P>0.05).CONCLUSION Among the three prediction models,random forest performs best and can help identify patients with T2DM at high risk of DN.展开更多
BACKGROUND Recently,type 2 diabetic osteoporosis(T2DOP)has become a research hotspot for the complications of diabetes,but the specific mechanism of its occurrence and development remains unknown.Ferroptosis caused by...BACKGROUND Recently,type 2 diabetic osteoporosis(T2DOP)has become a research hotspot for the complications of diabetes,but the specific mechanism of its occurrence and development remains unknown.Ferroptosis caused by iron overload is con-sidered an important cause of T2DOP.Polycytosine RNA-binding protein 1(PCBP1),an iron ion chaperone,is considered a protector of ferroptosis.AIM To investigate the existence of ferroptosis and specific role of PCBP1 in the development of type 2 diabetes.METHODS A cell counting kit-8 assay was used to detect changes in osteoblast viability under high glucose(HG)and/or ferroptosis inhibitors at different concentrations and times.Transmission electron microscopy was used to examine the morpho-logical changes in the mitochondria of osteoblasts under HG,and western blotting was used to detect the expression levels of PCBP1,ferritin,and the ferroptosis-related protein glutathione peroxidase 4(GPX4).A lentivirus silenced and overex-pressed PCBP1.Western blotting was used to detect the expression levels of the osteoblast functional proteins osteoprotegerin(OPG)and osteocalcin(OCN),whereas flow cytometry was used to detect changes in reactive oxygen species(ROS)levels in each group.RESULTS Under HG,the viability of osteoblasts was considerably decreased,the number of mitochondria undergoing atrophy was considerably increased,PCBP1 and ferritin expression levels were increased,and GPX4 expression was decreased.Western blotting results demonstrated that infection with lentivirus overexpressing PCBP1,increased the expression levels of ferritin,GPX4,OPG,and OCN,compared with the HG group.Flow cytometry results showed a reduction in ROS,and an opposite result was obtained after silencing PCBP1.CONCLUSION PCBP1 may protect osteoblasts and reduce the harm caused by ferroptosis by promoting ferritin expression under a HG environment.Moreover,PCBP1 may be a potential therapeutic target for T2DOP.展开更多
Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospe...Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.展开更多
Type 2 diabetes mellitus(T2DM)is a complex metabolic disease threatening human health.We investigated the effects of Tegillarca granosa polysaccharide(TGP)and determined its potential mechanisms in a mouse model of T2...Type 2 diabetes mellitus(T2DM)is a complex metabolic disease threatening human health.We investigated the effects of Tegillarca granosa polysaccharide(TGP)and determined its potential mechanisms in a mouse model of T2DM established through a high-fat diet and streptozotocin.TGP(5.1×10^(3) Da)was composed of mannose,glucosamine,rhamnose,glucuronic acid,galactosamine,glucose,galactose,xylose,and fucose.It could significantly alleviate weight loss,reduce fasting blood glucose levels,reverse dyslipidemia,reduce liver damage from oxidative stress,and improve insulin sensitivity.RT-PCR and Western blotting indicated that TGP could activate the phosphatidylinositol-3-kinase/protein kinase B signaling pathway to regulate disorders in glucolipid metabolism and improve insulin resistance.TGP increased the abundance of Allobaculum,Akkermansia,and Bifidobacterium,restored the microbiota abundance in the intestinal tracts of mice with T2DM,and promoted short-chain fatty acid production.This study provides new insights into the antidiabetic effects of TGP and highlights its potential as a natural hypoglycemic nutraceutical.展开更多
Our previous research studies have shown that Veratrilla baillonii Franch,a food supplement used by ethnic minorities in Southwest China,has multiple pharmacological activities,such as detoxification,antiinflammatory,...Our previous research studies have shown that Veratrilla baillonii Franch,a food supplement used by ethnic minorities in Southwest China,has multiple pharmacological activities,such as detoxification,antiinflammatory,antioxidant,and anti-insulin resistance.However,the detailed signal pathways for its salutary effect on damages in multiple organs due to type 2 diabetes mellitus(T2DM)remains unclear.The current study is to evaluate the therapeutic effects of V.baillonii on T2DM rats and to explore the underlying mechanisms.The T2DM rat model was successfully established by a high-sugar and high-fat diet(HFD)combination with intraperitoneal injection of a small dose of streptozotocin(STZ,35 mg/kg).Biochemical analysis and histopatholgical examinations were conducted to evaluate the anti-diabetic potential of water extracts of V.baillonii(WVBF).The results showed that the WVBF treatment can improve hyperglycemia and insulin resistance,ameliorate the liver,kidney and pancreas injuries via decreasing inflammatory cytokines such as IL-6 and TNF-α,and oxidative damages.Further investigation suggested that WVBF modulates the signal transductions of the IRS1/PI3K/AKT/GLUT4 and AMPK pathways.These findings demonstrate potentials of WVBF in the treatment of T2DM and possible mechanisms for its hepatoprotective activities.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)is a leading risk factor for the development and progression of chronic kidney disease(CKD).However,an accurate and con-venient marker for early detection and appropriate manag...BACKGROUND Type 2 diabetes mellitus(T2DM)is a leading risk factor for the development and progression of chronic kidney disease(CKD).However,an accurate and con-venient marker for early detection and appropriate management of CKD in in-dividuals with T2DM is limited.Recent studies have demonstrated a strong correlation between the neutrophil-to-lymphocyte ratio(NLR)and CKD.None-theless,the predictive value of NLR for renal damage in type 2 diabetic patients remains understudied.This study included 1040 adults aged 65 or older with T2DM from Shanghai's Community Health Service Center.The total number of neutrophils and lym-phocytes was detected,and NLR levels were calculated.CKD was defined as an estimated glomerular filtration rate≤60 mL/min/1.73 m².Participants were di-vided into four groups based on NLR levels.The clinical data and biochemical characteristics were compared among groups.A multivariate logistic regression model was used to analyze the association between NLR levels and CKD.RESULTS Significant differences were found in terms of sex,serum creatinine,blood urea nitrogen,total cholesterol,and low-density lipoprotein cholesterol among patients with T2DM in different NLR groups(P<0.0007).T2DM patients in the highest NLR quartile had a higher prevalence of CKD(P for trend=0.0011).Multivariate logistic regression analysis indicated that a high NLR was an independent risk factor for CKD in T2DM patients even after adjustment for important clinical and pathological parameters(P=0.0001,odds ratio=1.41,95%confidence intervals:1.18-1.68).CONCLUSION An elevated NLR in patients with T2DM is associated with higher prevalence of CKD,suggesting that it could be a marker for the detection and evaluation of diabetic kidney disease.展开更多
Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descripti...Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.展开更多
In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic indiv...In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.展开更多
BACKGROUND The understanding of bile acid(BA)and unsaturated fatty acid(UFA)profiles,as well as their dysregulation,remains elusive in individuals with type 2 diabetes mellitus(T2DM)coexisting with non-alcoholic fatty...BACKGROUND The understanding of bile acid(BA)and unsaturated fatty acid(UFA)profiles,as well as their dysregulation,remains elusive in individuals with type 2 diabetes mellitus(T2DM)coexisting with non-alcoholic fatty liver disease(NAFLD).Investigating these metabolites could offer valuable insights into the pathophy-siology of NAFLD in T2DM.AIM To identify potential metabolite biomarkers capable of distinguishing between NAFLD and T2DM.METHODS A training model was developed involving 399 participants,comprising 113 healthy controls(HCs),134 individuals with T2DM without NAFLD,and 152 individuals with T2DM and NAFLD.External validation encompassed 172 participants.NAFLD patients were divided based on liver fibrosis scores.The analytical approach employed univariate testing,orthogonal partial least squares-discriminant analysis,logistic regression,receiver operating characteristic curve analysis,and decision curve analysis to pinpoint and assess the diagnostic value of serum biomarkers.RESULTS Compared to HCs,both T2DM and NAFLD groups exhibited diminished levels of specific BAs.In UFAs,particular acids exhibited a positive correlation with NAFLD risk in T2DM,while theω-6:ω-3 UFA ratio demonstrated a negative correlation.Levels ofα-linolenic acid andγ-linolenic acid were linked to significant liver fibrosis in NAFLD.The validation cohort substantiated the predictive efficacy of these biomarkers for assessing NAFLD risk in T2DM patients.CONCLUSION This study underscores the connection between altered BA and UFA profiles and the presence of NAFLD in individuals with T2DM,proposing their potential as biomarkers in the pathogenesis of NAFLD.展开更多
BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis...BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.展开更多
BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-...BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-1 activation could be involved in the pathophysiological process of DCM by promoting oxidative stress,the inflammatory response,apoptosis and myocardial fibrosis.AIM To investigate the mechanism of liraglutide in improving myocardial injury in type 2 diabetic rats,further clarified the protective effect of liraglutide on the heart,and provided a new option for the treatment of DCM.METHODS Forty healthy male SD rats aged 6 wk were randomly divided into two groups,a normal control group(n=10)and a model group(n=30),which were fed an ordinary diet and a high-sugar and high-fat diet,respectively.After successful modeling,the rats in the model group were fed a high-glucose and high-fat diet for 4 wk and randomly divided into a model group and an intervention group(further divided into a high-dose group and a low-dose group).The rats were fed a high-glucose and high-fat diet for 8 wk and then started drug intervention.Blood samples were collected from the abdominal aorta to detect fasting blood glucose and lipid profiles.Intact heart tissue was dissected,and its weight was used to calculate the heart weight index.Haematoxylin and eosin staining was used to observe the pathological changes in the myocardium and the expression of PARP-1 in the heart by immunohistochemistry.RESULTS The body weight and heart weight index of rats in the model group were significantly increased compared with those in the normal control group,and those in the intervention group were decreased compared with those in the model group,with a more obvious decrease observed in the high-dose group(P<0.05).In the model group,myocardial fibers were disordered,and inflammatory cells and interstitial fibrosis were observed.The cardiomyopathy of rats in the intervention group was improved to different degrees,the myocardial fibers were arranged neatly,and the myocardial cells were clearly striated;the improvement was more obvious in the high-dose group.Compared with the normal control group,the expression of PARP-1 in myocardial tissue of the model group was increased,and the difference was statistically significant(P<0.05).After liraglutide intervention,compared with the model group,the expression of PARP-1 in myocardial tissue was decreased,and the reduction was more obvious in the high-dose group(P<0.05)but still higher than that in the normal control group.CONCLUSION Liraglutide may improve myocardial injury in type 2 diabetic rats by inhibiting the expression of myocardial PARP-1 in a dose-dependent manner.展开更多
Background: Type II diabetes mellitus is associated with multiple metabolic derangements which can cause secondary pathophysiological changes in multiple organ systems. This in turn can impose a heavy burden of morbid...Background: Type II diabetes mellitus is associated with multiple metabolic derangements which can cause secondary pathophysiological changes in multiple organ systems. This in turn can impose a heavy burden of morbidity and mortality from micro‑ and macro‑vascular complications. This study aimed to describe the metabolic and therapeutic profile of a subgroup of type 2 diabetic patients who have treatment failure with oral anti-hyperglycemic agents with persistent hyperglycemia despite insulin treatment. Methods: 60 type 2 diabetic patients in treatment failure with oral antidiabetics and under insulin treatment, aged 35 to 70 years, were recruited at the Diabetes Clinic of the University Teaching Hospital of Treichville in Abidjan, Côte d’Ivoire. Blood samples were collected in tubes containing Ethylenediaminetetraacetic Acid (EDTA) to determine glycated hemoglobin (HbA1c). Results: The average age of the population was 54 ± 9.38 years with a sex ratio (M/F) of 0.3, an average BMI of 30.25 ± 5 kg/m<sup>2</sup>, and an average HbA1c of 10.1% ± 1.6% for an average diabetes duration of 11.8 ± 5.8 years. The average insulin dose was 74.556 ± 16.21 UI/day, and the average duration of insulin treatment was 5.4 ± 3.1 years. The average HbA1c value was 10.1% ± 1.87% in men against 10.03% ± 1.53% in women with no significant difference (p = 0.1). The mean HbA1c values according to patient weight were 10.08% ± 2.05% for normal weight, 9.55% ± 2.26% for overweight, and 10.57% for obese, with no significant difference between the three groups of patients (p = 0.1). Conclusion: This study showed a persistence increase in glycated hemoglobin regardless of the treatment regimen, duration, and dose of insulin treatment in the subpopulation of type 2 diabetic patients.展开更多
Objective:To investigate the relationship between postprandial blood glucose(PBG),fasting insulin(FINS),and glycated hemoglobin(HbA1c)levels and early diabetic nephropathy in patients with type 2 diabetes.Methods:96 c...Objective:To investigate the relationship between postprandial blood glucose(PBG),fasting insulin(FINS),and glycated hemoglobin(HbA1c)levels and early diabetic nephropathy in patients with type 2 diabetes.Methods:96 cases of type 2 diabetes mellitus treated in our hospital from May 2021 to May 2022 were selected as the research subjects.The patients were divided into two groups according to the urinary albumin excretion rate(UAER),with 53 cases in the type 2 diabetes group(UAER<30μg/min)and 43 cases in the early diabetic nephropathy group(30μg/min≤UAER<300μg/min).PBG,FINS,and HbA1c levels were detected in 87 healthy patients.Results:The levels of PBG,FINS,and HbA1c in the early diabetic nephropathy group were higher than those in the control group(P<0.01)and the type 2 diabetes group(P<0.01).Conclusion:PBG,FINS,and HbA1c are factors affecting the occurrence of diabetic nephropathy in patients with type 2 diabetes;thus,controlling the levels of PBG,FINS,and HbA1c can effectively prevent the occurrence of diabetic nephropathy in type 2 diabetes mellitus.展开更多
Red honeybush tea(RHT)is a tea product developed from Cyclopia spp.which is endemic to South Africa.Aside refreshment,RHT has over the years been used traditionally in the treatment of various diseases including type ...Red honeybush tea(RHT)is a tea product developed from Cyclopia spp.which is endemic to South Africa.Aside refreshment,RHT has over the years been used traditionally in the treatment of various diseases including type 2 diabetes.This study investigated the in vivo antioxidant and anti-diabetic activity of RHT concentrated hot water extract in type 2 diabetes(T2D)model of rats.T2D was induced starting with feeding 10%fructose solution ad libitum for 2 weeks followed by a single intraperitoneal injection of streptozotocin(40 mg/kg body weight(BW)).Five weeks of treatment of RHT led to significant(P<0.05)elevation in serum insulin,pancreaticβ-cell function,HDL-C levels with concomitant decrease in AST,ALT,ALP,urea,CK-MB,fructosamine,total cholesterol,triglycerides,LDL-C,and insulin resistance in diabetic rats.RHT also signifi cantly(P<0.05)decreased MDA levels and enhanced level of GSH,activity of SOD,catalase,GR in most of organs(pancreas,liver,kidneys,and heart).Signifi cantly(P<0.05)improved morphological changes in the islets andβ-cells were observed in rats treated with RHT.The data of this study suggest that RHT demonstrates an outstanding antioxidant and anti-diabetic effects in STZ-induced T2D model of rats.展开更多
Objective:To investigate the anti-diabetic effect of the root extract of Annona muricata(AME)in streptozotocin-nicotinamide-induced type 2 diabetic(T2DM)mice.Methods:After 4 weeks of high-fat diet,ICR mice were given ...Objective:To investigate the anti-diabetic effect of the root extract of Annona muricata(AME)in streptozotocin-nicotinamide-induced type 2 diabetic(T2DM)mice.Methods:After 4 weeks of high-fat diet,ICR mice were given 1 g/kg nicotine and 120 mg/kg streptozotocin(STZ)orally to construct a T2DM model.The T2DM mice were randomly divided into five groups:model group,200 mg/kg metformin group and 50,100,200 mg/kg AME groups.Drugs were oral administered continuously for 4 weeks.Fasting blood glucose and body weight were measured weekly.Oral glucose tolerance test(OGTT)and detection of serum glycated hemoglobin(HbA1c)level were performed one week before the end of the experiment.At the end of drug administration,serum total cholesterol(TG),triglycerides(TC),low-density lipoprotein levels(LDL-C)and insulin levels were tested by lipid detection kits;homeostasis model assessment-estimated insulin resistance(HOMA-IR)and HOMA-βindexes were calculated.Liver and kidney tissues were weighed to calculate organ indices and pathological tests were performed.Western blot was performed in the liver to detect adenosine monophosphate-activated protein kinase(AMPK),acetyl coenzyme A carboxylase(ACC),glucose-6-phosphate carboxylase(G6Pase),and phosphoenolpyruvate carboxykinase(PCK1)protein expression.Results:with 200 mg/kg AME significantly reduced fasting blood glucose,HbA1c,TG and LDL-C levels,protected liver and kindey in diabetic mice,decreased the area under the OGTT curve,inhibited ACC and G6Pase protein expressions,and activated AMPK protein expression.Conclusion:AME showed good therapeutic activity against T2DM,and the mechanism may be related to the activation of AMPK and inhibition of ACC and G6Pase proteins.展开更多
BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effe...BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.展开更多
Background and objectives: Diabetes is a chronic multifactorial disease which requires a variety of strategies to reduce its epidemic. Type 2 diabetes (T2MD) is the most common form of diabetes which results from inef...Background and objectives: Diabetes is a chronic multifactorial disease which requires a variety of strategies to reduce its epidemic. Type 2 diabetes (T2MD) is the most common form of diabetes which results from inefficiency of insulin secretion or resistance to insulin action, both of which lead to chronic hyperglycemia. Lipid peroxidation is an oxidative stress process that involve in T2DM complications. This study aimed to 1) determine plasma malondialdehyde (MDA) levels as a biomarker for lipid peroxidation in Sudanese patients with T2DM, and 2) assess the associations between MDA and diabetes-related variables. Material and Methods: This case-control study was conducted from November 2022 to June 2023 at the National University, Sudan. It included 100 participants, of whom 50 were T2DM patients and 50 were healthy controls. Data on demographics, clinical characteristics, and biochemical markers (FBS, HbA1c, and MDA) were collected. The NycoCard HbA1c method and the GOD-POD Method were used for HbA1c and glucose measurement, respectively. MDA was determined by the thiobarbituric acid reactive substances method. The data were analyzed using SPSS Version. Results: Significant differences were observed between T2DM patients and healthy controls in FBS (P = 0.000), HbA1c (P = 0.000), and MDA (P = 0.010), with T2DM patients exhibiting higher levels. The study revealed a strong positive correlation between MDA levels and the duration of diabetes (r = 0.69, P = 0.00), while other variables, including age, BMI, and glucose control, did not significantly correlate with MDA levels. Conclusion: Findings revealed elevated MDA levels in Sudanese T2DM patients, with a positive correlation between MDA and diabetes duration. These findings emphasize the importance of oxidative stress in T2DM pathogenesis and call for the need for targeted strategies to mitigate oxidative damage and improve diabetes care.展开更多
Poorly controlled type 2 diabetes alters the immune system, increasing the risk of susceptibility to viral infections such as hepatitis B and C infections. This study aimed to determine the frequency of hepatitis B an...Poorly controlled type 2 diabetes alters the immune system, increasing the risk of susceptibility to viral infections such as hepatitis B and C infections. This study aimed to determine the frequency of hepatitis B and C and metabolic profiles in type 2 diabetics. This was a cross-sectional study conducted over six months. It was conducted at the National Obesity Center (NOC) of the Yaoundé Central Hospital (YCH), Cameroon. 100 diabetic patients, with a mean age of 58.41 ± 10.74 years were enrolled in the study. The socio-demographic characteristics of the study population and the risk factors for virus transmission were recorded using a pre-established questionnaire. HBsAg and anti-HCV antibodies were revealed by a rapid diagnostic test. Liver function markers’ activities were determined. Commercial kits were used to evaluate the patient’s serum lipid profile, serum fasting glucose level, urea, creatinine, and albumin. With a sex ratio of 3:1, women outnumbered men. Risk factors for HCV and HBV infections evocated by the population were dental care (50%), followed by alcohol consumption (41%). HBsAg and anti-HCV antibodies frequency was 3% and 8% respectively. No cases of coinfection were found. In general, hypertriglyceridemia with a mean of 1.61 ± 0.46 g/L and hyperglycemia of 1.35 ± 0.45 g/L were noted. A significant difference (p = 0.028) was found in HDL-cholesterol values between non-co-affected diabetics and HCV+ diabetics. The effect of the duration of diabetes on biochemical parameters revealed that albumin was the only significant decrease over time (p = 0.013). Based on these results, the metabolic profile of patients was altered. It is important to take note of the prevalence of hepatitis seen in type 2 diabetes mellitus since it demonstrates the potential link between both illnesses. Thus, early detection could prevent complications related to B and C hepatitis infections in type 2 diabetics.展开更多
Objective:To explore the anti-diabetic effects and its underlying mechanism of Annona muricata Linn fruit ethanol extract(AME).Methods:Streptozotocin-induced type 2 diabetic(T2DM)mouse model was constructed.Those diab...Objective:To explore the anti-diabetic effects and its underlying mechanism of Annona muricata Linn fruit ethanol extract(AME).Methods:Streptozotocin-induced type 2 diabetic(T2DM)mouse model was constructed.Those diabetic mice were randomly grouped and given 50 mg/kg acarbose or AME(200 mg/kg,100 mg/kg or 50 mg/kg)for four weeks.The body weight,postprandial blood glucose and glycosylated hemoglobin levels were measured during the administration.After the administration,a glucose tolerance test was performed,and the levels of triglycerides,cholesterol and low-density lipoproteins in mice were detected by biochemical test kits.The inhibitory activity of AME onα-glucosidase in vivo and in vitro was determined by enzyme inhibition tests.Results:AME significantly reduced weight gain,postprandial blood glucose,glycosylated hemoglobin and low-density lipoprotein levels in T2DM mice;enhanced glucose tolerance and pancreaticβ-cell function of T2DM mice;inhibitedα-glucosidase activity in mouse intestine in an noncompetitive manner.Conclusion:AME may noncompetitive inhibitα-glucosidase activity and reduce postprandial glucose intake to achieve a therapeutic and regulatory effect on type 2 diabetes.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF)patients have a high short-term mortality rate,and the severity evaluation of ACLF is necessary for prognostication.Therefore,it was meaningful to evaluate the associatio...BACKGROUND Acute-on-chronic liver failure(ACLF)patients have a high short-term mortality rate,and the severity evaluation of ACLF is necessary for prognostication.Therefore,it was meaningful to evaluate the association between type 2 diabetic mellitus(DM)and ACLF and further explore the feasibility of using DM as a prognostic indicator in ACLF patients.The association between type 2 DM and the prognosis of patients with severe liver disease remains unclear.AIM To examine the effect of type 2 DM on the prognosis of patients with ACLF.METHODS Clinical data from 222 ACLF patients were collected and analyzed.The patients were categorized into two groups depending on whether they had DM or not,and the clinical data of ACLF patients were measured within 48 h after admission.Complications of ACLF were documented during treatment,such as hepatic encephalopathy,hepatorenal syndrome,acute upper gastrointestinal hemorrhage,and spontaneous peritonitis(SBP).Values of laboratory parameters,complication rates,and hospital mortality rates were compared between two groups.RESULTS Among 222 ACLF patients,38 cases were categorized into DM groups,the mean age was 56.32 years and 73.68%were male.The prognosis of ACLF patients was significantly correlated with DM in univariate[hazard ratio(HR)=2.4,95%confidence interval(CI)=1.5-3.7,P<0.001]and multivariable analysis(HR=3.17,95%CI=1.82-5.523,P<0.001).The incident of SBP(34.21%vs 13.59%,P=0.038)and other infections like lung,urinary,blood,and cholecyst(44.74%vs 28.26%,P=0.046)were higher in DM patients than non-DM counterparts.In addition,the ACLF patients with DM tended to have a high mortality rate(P<0.001).Cumulative survival time was also significantly shorter in the ACLF patients with DM than non-DM.CONCLUSION A significant association between DM and the prognosis of ACLF patients was found in China.The ACLF patients with DM had higher incidence of hospital mortality and infection than those without DM.展开更多
基金The study was reviewed and approved by the First People’s Hospital of Wenling(Approval No.KY-2023-2034-01).
文摘BACKGROUND Among older adults,type 2 diabetes mellitus(T2DM)is widely recognized as one of the most prevalent diseases.Diabetic nephropathy(DN)is a frequent com-plication of DM,mainly characterized by renal microvascular damage.Early detection,aggressive prevention,and cure of DN are key to improving prognosis.Establishing a diagnostic and predictive model for DN is crucial in auxiliary diagnosis.AIM To investigate the factors that impact T2DM complicated with DN and utilize this information to develop a predictive model.METHODS The clinical data of 210 patients diagnosed with T2DM and admitted to the First People’s Hospital of Wenling between August 2019 and August 2022 were retrospectively analyzed.According to whether the patients had DN,they were divided into the DN group(complicated with DN)and the non-DN group(without DN).Multivariate logistic regression analysis was used to explore factors affecting DN in patients with T2DM.The data were randomly split into a training set(n=147)and a test set(n=63)in a 7:3 ratio using a random function.The training set was used to construct the nomogram,decision tree,and random forest models,and the test set was used to evaluate the prediction performance of the model by comparing the sensitivity,specificity,accuracy,recall,precision,and area under the receiver operating characteristic curve.RESULTS Among the 210 patients with T2DM,74(35.34%)had DN.The validation dataset showed that the accuracies of the nomogram,decision tree,and random forest models in predicting DN in patients with T2DM were 0.746,0.714,and 0.730,respectively.The sensitivities were 0.710,0.710,and 0.806,respectively;the specificities were 0.844,0.875,and 0.844,respectively;the area under the receiver operating characteristic curve(AUC)of the patients were 0.811,0.735,and 0.850,respectively.The Delong test results revealed that the AUC values of the decision tree model were lower than those of the random forest and nomogram models(P<0.05),whereas the difference in AUC values of the random forest and column-line graph models was not statistically significant(P>0.05).CONCLUSION Among the three prediction models,random forest performs best and can help identify patients with T2DM at high risk of DN.
基金Supported by the National Natural Science Foundation of China,No.81471094 and No.82202743.
文摘BACKGROUND Recently,type 2 diabetic osteoporosis(T2DOP)has become a research hotspot for the complications of diabetes,but the specific mechanism of its occurrence and development remains unknown.Ferroptosis caused by iron overload is con-sidered an important cause of T2DOP.Polycytosine RNA-binding protein 1(PCBP1),an iron ion chaperone,is considered a protector of ferroptosis.AIM To investigate the existence of ferroptosis and specific role of PCBP1 in the development of type 2 diabetes.METHODS A cell counting kit-8 assay was used to detect changes in osteoblast viability under high glucose(HG)and/or ferroptosis inhibitors at different concentrations and times.Transmission electron microscopy was used to examine the morpho-logical changes in the mitochondria of osteoblasts under HG,and western blotting was used to detect the expression levels of PCBP1,ferritin,and the ferroptosis-related protein glutathione peroxidase 4(GPX4).A lentivirus silenced and overex-pressed PCBP1.Western blotting was used to detect the expression levels of the osteoblast functional proteins osteoprotegerin(OPG)and osteocalcin(OCN),whereas flow cytometry was used to detect changes in reactive oxygen species(ROS)levels in each group.RESULTS Under HG,the viability of osteoblasts was considerably decreased,the number of mitochondria undergoing atrophy was considerably increased,PCBP1 and ferritin expression levels were increased,and GPX4 expression was decreased.Western blotting results demonstrated that infection with lentivirus overexpressing PCBP1,increased the expression levels of ferritin,GPX4,OPG,and OCN,compared with the HG group.Flow cytometry results showed a reduction in ROS,and an opposite result was obtained after silencing PCBP1.CONCLUSION PCBP1 may protect osteoblasts and reduce the harm caused by ferroptosis by promoting ferritin expression under a HG environment.Moreover,PCBP1 may be a potential therapeutic target for T2DOP.
基金supported by the National Natural Science Foundation of China(grant No.72074011)the Real World Study Project of Hainan Boao Lecheng Pilot Zone(Real World Study Base of NMPA)(HNLC2022RWS012)+1 种基金the fundamental research funds for central public welfare research institutes(2023CZ-11)National Natural Science Foundation of China(No.82003536).
文摘Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.
基金funded by the National Key Research and Development Program of China(2020YFD0900902)Zhejiang Province Public Welfare Technology Application Research Project(LGJ21C20001)Zhejiang Provincial Key Research and Development Project of China(2019C02076 and 2019C02075)。
文摘Type 2 diabetes mellitus(T2DM)is a complex metabolic disease threatening human health.We investigated the effects of Tegillarca granosa polysaccharide(TGP)and determined its potential mechanisms in a mouse model of T2DM established through a high-fat diet and streptozotocin.TGP(5.1×10^(3) Da)was composed of mannose,glucosamine,rhamnose,glucuronic acid,galactosamine,glucose,galactose,xylose,and fucose.It could significantly alleviate weight loss,reduce fasting blood glucose levels,reverse dyslipidemia,reduce liver damage from oxidative stress,and improve insulin sensitivity.RT-PCR and Western blotting indicated that TGP could activate the phosphatidylinositol-3-kinase/protein kinase B signaling pathway to regulate disorders in glucolipid metabolism and improve insulin resistance.TGP increased the abundance of Allobaculum,Akkermansia,and Bifidobacterium,restored the microbiota abundance in the intestinal tracts of mice with T2DM,and promoted short-chain fatty acid production.This study provides new insights into the antidiabetic effects of TGP and highlights its potential as a natural hypoglycemic nutraceutical.
基金supported by grants from the National Natural Science Foundation of China (81873090)Support Innovation and Development of Enterprise Technology Projects in Hubei Province (2021BLB174)the modern transmission and innovation research team of Traditional Chinese Medicine,South Central Minzu University。
文摘Our previous research studies have shown that Veratrilla baillonii Franch,a food supplement used by ethnic minorities in Southwest China,has multiple pharmacological activities,such as detoxification,antiinflammatory,antioxidant,and anti-insulin resistance.However,the detailed signal pathways for its salutary effect on damages in multiple organs due to type 2 diabetes mellitus(T2DM)remains unclear.The current study is to evaluate the therapeutic effects of V.baillonii on T2DM rats and to explore the underlying mechanisms.The T2DM rat model was successfully established by a high-sugar and high-fat diet(HFD)combination with intraperitoneal injection of a small dose of streptozotocin(STZ,35 mg/kg).Biochemical analysis and histopatholgical examinations were conducted to evaluate the anti-diabetic potential of water extracts of V.baillonii(WVBF).The results showed that the WVBF treatment can improve hyperglycemia and insulin resistance,ameliorate the liver,kidney and pancreas injuries via decreasing inflammatory cytokines such as IL-6 and TNF-α,and oxidative damages.Further investigation suggested that WVBF modulates the signal transductions of the IRS1/PI3K/AKT/GLUT4 and AMPK pathways.These findings demonstrate potentials of WVBF in the treatment of T2DM and possible mechanisms for its hepatoprotective activities.
基金Supported by Health Commission of Baoshan District,Shanghai,China,No.BSJCPP-A-04 and No.BSZK-2023-T04the Science and Technology Commission of Baoshan District,Shanghai,China,No.20-E-63 and No.21-E-34.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)is a leading risk factor for the development and progression of chronic kidney disease(CKD).However,an accurate and con-venient marker for early detection and appropriate management of CKD in in-dividuals with T2DM is limited.Recent studies have demonstrated a strong correlation between the neutrophil-to-lymphocyte ratio(NLR)and CKD.None-theless,the predictive value of NLR for renal damage in type 2 diabetic patients remains understudied.This study included 1040 adults aged 65 or older with T2DM from Shanghai's Community Health Service Center.The total number of neutrophils and lym-phocytes was detected,and NLR levels were calculated.CKD was defined as an estimated glomerular filtration rate≤60 mL/min/1.73 m².Participants were di-vided into four groups based on NLR levels.The clinical data and biochemical characteristics were compared among groups.A multivariate logistic regression model was used to analyze the association between NLR levels and CKD.RESULTS Significant differences were found in terms of sex,serum creatinine,blood urea nitrogen,total cholesterol,and low-density lipoprotein cholesterol among patients with T2DM in different NLR groups(P<0.0007).T2DM patients in the highest NLR quartile had a higher prevalence of CKD(P for trend=0.0011).Multivariate logistic regression analysis indicated that a high NLR was an independent risk factor for CKD in T2DM patients even after adjustment for important clinical and pathological parameters(P=0.0001,odds ratio=1.41,95%confidence intervals:1.18-1.68).CONCLUSION An elevated NLR in patients with T2DM is associated with higher prevalence of CKD,suggesting that it could be a marker for the detection and evaluation of diabetic kidney disease.
文摘Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.
文摘In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.
基金Supported by the Scientific Research Projects of Jiangsu Provincial Health and Health Commission,No.ZDB2020034 and No.M2021056.
文摘BACKGROUND The understanding of bile acid(BA)and unsaturated fatty acid(UFA)profiles,as well as their dysregulation,remains elusive in individuals with type 2 diabetes mellitus(T2DM)coexisting with non-alcoholic fatty liver disease(NAFLD).Investigating these metabolites could offer valuable insights into the pathophy-siology of NAFLD in T2DM.AIM To identify potential metabolite biomarkers capable of distinguishing between NAFLD and T2DM.METHODS A training model was developed involving 399 participants,comprising 113 healthy controls(HCs),134 individuals with T2DM without NAFLD,and 152 individuals with T2DM and NAFLD.External validation encompassed 172 participants.NAFLD patients were divided based on liver fibrosis scores.The analytical approach employed univariate testing,orthogonal partial least squares-discriminant analysis,logistic regression,receiver operating characteristic curve analysis,and decision curve analysis to pinpoint and assess the diagnostic value of serum biomarkers.RESULTS Compared to HCs,both T2DM and NAFLD groups exhibited diminished levels of specific BAs.In UFAs,particular acids exhibited a positive correlation with NAFLD risk in T2DM,while theω-6:ω-3 UFA ratio demonstrated a negative correlation.Levels ofα-linolenic acid andγ-linolenic acid were linked to significant liver fibrosis in NAFLD.The validation cohort substantiated the predictive efficacy of these biomarkers for assessing NAFLD risk in T2DM patients.CONCLUSION This study underscores the connection between altered BA and UFA profiles and the presence of NAFLD in individuals with T2DM,proposing their potential as biomarkers in the pathogenesis of NAFLD.
基金Supported by Science and Technology Plan Project of Shaoyang City,No.2022GX4139.
文摘BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.
基金Supported by Shanxi Provincial Natural Science Foundation,No.201701D121159Shanxi Provincial Health and Family Planning Commission,No.2014016Health Commission of Shanxi Province,No.2019020.
文摘BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-1 activation could be involved in the pathophysiological process of DCM by promoting oxidative stress,the inflammatory response,apoptosis and myocardial fibrosis.AIM To investigate the mechanism of liraglutide in improving myocardial injury in type 2 diabetic rats,further clarified the protective effect of liraglutide on the heart,and provided a new option for the treatment of DCM.METHODS Forty healthy male SD rats aged 6 wk were randomly divided into two groups,a normal control group(n=10)and a model group(n=30),which were fed an ordinary diet and a high-sugar and high-fat diet,respectively.After successful modeling,the rats in the model group were fed a high-glucose and high-fat diet for 4 wk and randomly divided into a model group and an intervention group(further divided into a high-dose group and a low-dose group).The rats were fed a high-glucose and high-fat diet for 8 wk and then started drug intervention.Blood samples were collected from the abdominal aorta to detect fasting blood glucose and lipid profiles.Intact heart tissue was dissected,and its weight was used to calculate the heart weight index.Haematoxylin and eosin staining was used to observe the pathological changes in the myocardium and the expression of PARP-1 in the heart by immunohistochemistry.RESULTS The body weight and heart weight index of rats in the model group were significantly increased compared with those in the normal control group,and those in the intervention group were decreased compared with those in the model group,with a more obvious decrease observed in the high-dose group(P<0.05).In the model group,myocardial fibers were disordered,and inflammatory cells and interstitial fibrosis were observed.The cardiomyopathy of rats in the intervention group was improved to different degrees,the myocardial fibers were arranged neatly,and the myocardial cells were clearly striated;the improvement was more obvious in the high-dose group.Compared with the normal control group,the expression of PARP-1 in myocardial tissue of the model group was increased,and the difference was statistically significant(P<0.05).After liraglutide intervention,compared with the model group,the expression of PARP-1 in myocardial tissue was decreased,and the reduction was more obvious in the high-dose group(P<0.05)but still higher than that in the normal control group.CONCLUSION Liraglutide may improve myocardial injury in type 2 diabetic rats by inhibiting the expression of myocardial PARP-1 in a dose-dependent manner.
文摘Background: Type II diabetes mellitus is associated with multiple metabolic derangements which can cause secondary pathophysiological changes in multiple organ systems. This in turn can impose a heavy burden of morbidity and mortality from micro‑ and macro‑vascular complications. This study aimed to describe the metabolic and therapeutic profile of a subgroup of type 2 diabetic patients who have treatment failure with oral anti-hyperglycemic agents with persistent hyperglycemia despite insulin treatment. Methods: 60 type 2 diabetic patients in treatment failure with oral antidiabetics and under insulin treatment, aged 35 to 70 years, were recruited at the Diabetes Clinic of the University Teaching Hospital of Treichville in Abidjan, Côte d’Ivoire. Blood samples were collected in tubes containing Ethylenediaminetetraacetic Acid (EDTA) to determine glycated hemoglobin (HbA1c). Results: The average age of the population was 54 ± 9.38 years with a sex ratio (M/F) of 0.3, an average BMI of 30.25 ± 5 kg/m<sup>2</sup>, and an average HbA1c of 10.1% ± 1.6% for an average diabetes duration of 11.8 ± 5.8 years. The average insulin dose was 74.556 ± 16.21 UI/day, and the average duration of insulin treatment was 5.4 ± 3.1 years. The average HbA1c value was 10.1% ± 1.87% in men against 10.03% ± 1.53% in women with no significant difference (p = 0.1). The mean HbA1c values according to patient weight were 10.08% ± 2.05% for normal weight, 9.55% ± 2.26% for overweight, and 10.57% for obese, with no significant difference between the three groups of patients (p = 0.1). Conclusion: This study showed a persistence increase in glycated hemoglobin regardless of the treatment regimen, duration, and dose of insulin treatment in the subpopulation of type 2 diabetic patients.
文摘Objective:To investigate the relationship between postprandial blood glucose(PBG),fasting insulin(FINS),and glycated hemoglobin(HbA1c)levels and early diabetic nephropathy in patients with type 2 diabetes.Methods:96 cases of type 2 diabetes mellitus treated in our hospital from May 2021 to May 2022 were selected as the research subjects.The patients were divided into two groups according to the urinary albumin excretion rate(UAER),with 53 cases in the type 2 diabetes group(UAER<30μg/min)and 43 cases in the early diabetic nephropathy group(30μg/min≤UAER<300μg/min).PBG,FINS,and HbA1c levels were detected in 87 healthy patients.Results:The levels of PBG,FINS,and HbA1c in the early diabetic nephropathy group were higher than those in the control group(P<0.01)and the type 2 diabetes group(P<0.01).Conclusion:PBG,FINS,and HbA1c are factors affecting the occurrence of diabetic nephropathy in patients with type 2 diabetes;thus,controlling the levels of PBG,FINS,and HbA1c can effectively prevent the occurrence of diabetic nephropathy in type 2 diabetes mellitus.
基金supported by a competitive research grant from the Research Office,University of KwaZulu-Natal(UKZN),Durbanan incentive grant for rated researchers and a grant support for women and young researchers from the National Research Foundation(NRF),Pretoria,South Africa.
文摘Red honeybush tea(RHT)is a tea product developed from Cyclopia spp.which is endemic to South Africa.Aside refreshment,RHT has over the years been used traditionally in the treatment of various diseases including type 2 diabetes.This study investigated the in vivo antioxidant and anti-diabetic activity of RHT concentrated hot water extract in type 2 diabetes(T2D)model of rats.T2D was induced starting with feeding 10%fructose solution ad libitum for 2 weeks followed by a single intraperitoneal injection of streptozotocin(40 mg/kg body weight(BW)).Five weeks of treatment of RHT led to significant(P<0.05)elevation in serum insulin,pancreaticβ-cell function,HDL-C levels with concomitant decrease in AST,ALT,ALP,urea,CK-MB,fructosamine,total cholesterol,triglycerides,LDL-C,and insulin resistance in diabetic rats.RHT also signifi cantly(P<0.05)decreased MDA levels and enhanced level of GSH,activity of SOD,catalase,GR in most of organs(pancreas,liver,kidneys,and heart).Signifi cantly(P<0.05)improved morphological changes in the islets andβ-cells were observed in rats treated with RHT.The data of this study suggest that RHT demonstrates an outstanding antioxidant and anti-diabetic effects in STZ-induced T2D model of rats.
基金National Natural Science Foundation of China(No.81460591)Hainan Medical University Training Fund(HY2018-09)。
文摘Objective:To investigate the anti-diabetic effect of the root extract of Annona muricata(AME)in streptozotocin-nicotinamide-induced type 2 diabetic(T2DM)mice.Methods:After 4 weeks of high-fat diet,ICR mice were given 1 g/kg nicotine and 120 mg/kg streptozotocin(STZ)orally to construct a T2DM model.The T2DM mice were randomly divided into five groups:model group,200 mg/kg metformin group and 50,100,200 mg/kg AME groups.Drugs were oral administered continuously for 4 weeks.Fasting blood glucose and body weight were measured weekly.Oral glucose tolerance test(OGTT)and detection of serum glycated hemoglobin(HbA1c)level were performed one week before the end of the experiment.At the end of drug administration,serum total cholesterol(TG),triglycerides(TC),low-density lipoprotein levels(LDL-C)and insulin levels were tested by lipid detection kits;homeostasis model assessment-estimated insulin resistance(HOMA-IR)and HOMA-βindexes were calculated.Liver and kidney tissues were weighed to calculate organ indices and pathological tests were performed.Western blot was performed in the liver to detect adenosine monophosphate-activated protein kinase(AMPK),acetyl coenzyme A carboxylase(ACC),glucose-6-phosphate carboxylase(G6Pase),and phosphoenolpyruvate carboxykinase(PCK1)protein expression.Results:with 200 mg/kg AME significantly reduced fasting blood glucose,HbA1c,TG and LDL-C levels,protected liver and kindey in diabetic mice,decreased the area under the OGTT curve,inhibited ACC and G6Pase protein expressions,and activated AMPK protein expression.Conclusion:AME showed good therapeutic activity against T2DM,and the mechanism may be related to the activation of AMPK and inhibition of ACC and G6Pase proteins.
基金the Clinical Research and Cultivation Plan Project of the Second Affiliated Hospital of Anhui Medical University,No.2021LCYB17.
文摘BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.
文摘Background and objectives: Diabetes is a chronic multifactorial disease which requires a variety of strategies to reduce its epidemic. Type 2 diabetes (T2MD) is the most common form of diabetes which results from inefficiency of insulin secretion or resistance to insulin action, both of which lead to chronic hyperglycemia. Lipid peroxidation is an oxidative stress process that involve in T2DM complications. This study aimed to 1) determine plasma malondialdehyde (MDA) levels as a biomarker for lipid peroxidation in Sudanese patients with T2DM, and 2) assess the associations between MDA and diabetes-related variables. Material and Methods: This case-control study was conducted from November 2022 to June 2023 at the National University, Sudan. It included 100 participants, of whom 50 were T2DM patients and 50 were healthy controls. Data on demographics, clinical characteristics, and biochemical markers (FBS, HbA1c, and MDA) were collected. The NycoCard HbA1c method and the GOD-POD Method were used for HbA1c and glucose measurement, respectively. MDA was determined by the thiobarbituric acid reactive substances method. The data were analyzed using SPSS Version. Results: Significant differences were observed between T2DM patients and healthy controls in FBS (P = 0.000), HbA1c (P = 0.000), and MDA (P = 0.010), with T2DM patients exhibiting higher levels. The study revealed a strong positive correlation between MDA levels and the duration of diabetes (r = 0.69, P = 0.00), while other variables, including age, BMI, and glucose control, did not significantly correlate with MDA levels. Conclusion: Findings revealed elevated MDA levels in Sudanese T2DM patients, with a positive correlation between MDA and diabetes duration. These findings emphasize the importance of oxidative stress in T2DM pathogenesis and call for the need for targeted strategies to mitigate oxidative damage and improve diabetes care.
文摘Poorly controlled type 2 diabetes alters the immune system, increasing the risk of susceptibility to viral infections such as hepatitis B and C infections. This study aimed to determine the frequency of hepatitis B and C and metabolic profiles in type 2 diabetics. This was a cross-sectional study conducted over six months. It was conducted at the National Obesity Center (NOC) of the Yaoundé Central Hospital (YCH), Cameroon. 100 diabetic patients, with a mean age of 58.41 ± 10.74 years were enrolled in the study. The socio-demographic characteristics of the study population and the risk factors for virus transmission were recorded using a pre-established questionnaire. HBsAg and anti-HCV antibodies were revealed by a rapid diagnostic test. Liver function markers’ activities were determined. Commercial kits were used to evaluate the patient’s serum lipid profile, serum fasting glucose level, urea, creatinine, and albumin. With a sex ratio of 3:1, women outnumbered men. Risk factors for HCV and HBV infections evocated by the population were dental care (50%), followed by alcohol consumption (41%). HBsAg and anti-HCV antibodies frequency was 3% and 8% respectively. No cases of coinfection were found. In general, hypertriglyceridemia with a mean of 1.61 ± 0.46 g/L and hyperglycemia of 1.35 ± 0.45 g/L were noted. A significant difference (p = 0.028) was found in HDL-cholesterol values between non-co-affected diabetics and HCV+ diabetics. The effect of the duration of diabetes on biochemical parameters revealed that albumin was the only significant decrease over time (p = 0.013). Based on these results, the metabolic profile of patients was altered. It is important to take note of the prevalence of hepatitis seen in type 2 diabetes mellitus since it demonstrates the potential link between both illnesses. Thus, early detection could prevent complications related to B and C hepatitis infections in type 2 diabetics.
基金supported by 2020 College Students Innovation and Entrepreneurship Training Program(X202011810069)the National Natural Science Foundation of China(81460591)。
文摘Objective:To explore the anti-diabetic effects and its underlying mechanism of Annona muricata Linn fruit ethanol extract(AME).Methods:Streptozotocin-induced type 2 diabetic(T2DM)mouse model was constructed.Those diabetic mice were randomly grouped and given 50 mg/kg acarbose or AME(200 mg/kg,100 mg/kg or 50 mg/kg)for four weeks.The body weight,postprandial blood glucose and glycosylated hemoglobin levels were measured during the administration.After the administration,a glucose tolerance test was performed,and the levels of triglycerides,cholesterol and low-density lipoproteins in mice were detected by biochemical test kits.The inhibitory activity of AME onα-glucosidase in vivo and in vitro was determined by enzyme inhibition tests.Results:AME significantly reduced weight gain,postprandial blood glucose,glycosylated hemoglobin and low-density lipoprotein levels in T2DM mice;enhanced glucose tolerance and pancreaticβ-cell function of T2DM mice;inhibitedα-glucosidase activity in mouse intestine in an noncompetitive manner.Conclusion:AME may noncompetitive inhibitα-glucosidase activity and reduce postprandial glucose intake to achieve a therapeutic and regulatory effect on type 2 diabetes.
基金Fujian Health Research Talents Training Program,No.2019-1-42National Natural Science Foundation of China,No.81702073and Fujian Provincial Natural Science Foundation General Project,No.2020J01955.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF)patients have a high short-term mortality rate,and the severity evaluation of ACLF is necessary for prognostication.Therefore,it was meaningful to evaluate the association between type 2 diabetic mellitus(DM)and ACLF and further explore the feasibility of using DM as a prognostic indicator in ACLF patients.The association between type 2 DM and the prognosis of patients with severe liver disease remains unclear.AIM To examine the effect of type 2 DM on the prognosis of patients with ACLF.METHODS Clinical data from 222 ACLF patients were collected and analyzed.The patients were categorized into two groups depending on whether they had DM or not,and the clinical data of ACLF patients were measured within 48 h after admission.Complications of ACLF were documented during treatment,such as hepatic encephalopathy,hepatorenal syndrome,acute upper gastrointestinal hemorrhage,and spontaneous peritonitis(SBP).Values of laboratory parameters,complication rates,and hospital mortality rates were compared between two groups.RESULTS Among 222 ACLF patients,38 cases were categorized into DM groups,the mean age was 56.32 years and 73.68%were male.The prognosis of ACLF patients was significantly correlated with DM in univariate[hazard ratio(HR)=2.4,95%confidence interval(CI)=1.5-3.7,P<0.001]and multivariable analysis(HR=3.17,95%CI=1.82-5.523,P<0.001).The incident of SBP(34.21%vs 13.59%,P=0.038)and other infections like lung,urinary,blood,and cholecyst(44.74%vs 28.26%,P=0.046)were higher in DM patients than non-DM counterparts.In addition,the ACLF patients with DM tended to have a high mortality rate(P<0.001).Cumulative survival time was also significantly shorter in the ACLF patients with DM than non-DM.CONCLUSION A significant association between DM and the prognosis of ACLF patients was found in China.The ACLF patients with DM had higher incidence of hospital mortality and infection than those without DM.