This study aims to assess the long-term effects of busulfan on male reproductive function in BALB/c mice to provide insight into its toxicological effects. A total of 80 BALB/c mice were randomly assigned to a control group (n = 20) and three experimental groups (n = 20 each), which received a single intraperitoneal injection of busulfan at 15, 20, and 25 mg/kg, respectively. A subset of mice was assessed at multiple time points for spermatogenesis. Additionally, fertility experiments with both sexes served as a vital measure of fertility potential. Results revealed that relative testicular weight and semen quality in the experimental groups were significantly decreased compared with those in the control group (p < 0.05). Abnormal sperm morphology showed a significant increase (p < 0.05), with a notable correlation observed between abnormal sperm neck morphology and reduced sperm motility (p < 0.05). Fertility trials indicated that busulfan-treated males had a reduced ability to impregnate females, as evidenced by reductions in pregnancy rates and litter sizes. Remarkably, the male offspring ratio in the busulfan-treated group (7 out of 17) was significantly lower than that in the control group (21 out of 42). In conclusion, a single intraperitoneal injection of busulfan led to sustained fertility impairment in mice for at least 13 weeks, with potential transgenerational effects, including alterations in the sex ratio of male descendants.
To compare efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in subjects with type 2 diabetes (T2DM). Electronic databases were searched from inception to 2nd October 2024 for randomised controlled trials comparing GLP-1RAs treating T2DM. Bayesian network meta-analyses were conducted to analyze metabolic and safety outcomes. 64 trials comprising of 25,572 participants were identified. Compared to placebo, tirzepatide showed the greatest reduction in HbA1-c (MD: -2.3%) and FPG (MD: -3.1mmol/L); semaglutide was second (HbA1-c: MD: -1.5%; FPG: MD: -2mmol/L); liraglutide was third (HbA1-c: MD: -1.2% FPG: MD: -1.6mmol/L) (P<0.05). All treatments showed no statistically significant differences in BMI, SBP, DBP, TC, HDL-C and LDL-C compared to placebo. Tirzepatide (MD: -9.1 kg), semaglutide (MD: -2.8 kg) and liraglutide (MD: -1.2 kg) (P<0.05) had significant reduction in body weight compared to placebo. GLP-1 RAs had higher risk of gastrointestinal symptoms. Semaglutide increased the risk of hypoglycemia compared to placebo while liraglutide reduced the risk of hypoglycemia compared to traditional antidiabetic drugs. GLP-1RAs improve glycaemic control, with tirzepatide, semaglutide and liraglutide exhibiting the most significant improvements. Tirzepatide is more suitable for treating T2DM with obesity. For individuals with normal weight, both semaglutide and liraglutide are generally more effective for treating T2DM. However, considering the potential for semaglutide to cause hypoglycemia, liraglutide may be the optimal choice for T2DM treatment to minimize the risk of hypoglycemia.
OBJECTIVE:There is an urgent need for novel biomarkers that are inexpensive, effective and easily accessible to complement the early diagnosis of hepatocellular carcinoma. This study aimed to analyze the relationship between serum gamma-glutamate-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index, fibrosis index based on four factors and the risk of hepatocellular carcinoma, and to determine the optimal cut-offs for predicting hepatocellular carcinoma.METHODS:Based on a prospective cohort study, 44 215 participants who were cancer-free at baseline (2011-13) were included in the study. Cox proportional hazard models and receiver operating characteristics curves were used to analyze the diagnostic value and optimal cut-off value of gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors in predicting hepatocellular carcinoma patients.RESULTS:Gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors can be used as early independent predictors of hepatocellular carcinoma risk. The risk of hepatocellular carcinoma in the fourth quantile of gamma-glutamyl-transpeptidase to platelet ratio and alkaline phosphatase-to-platelet ratio index was 4.04 times (hazard ratio = 4.04, 95% confidence interval: 2.09, 7.80) and 2.59 times (hazard ratio = 2.59, 95% confidence interval: 1.45, 4.61), respectively, compared with the first quantile. With fibrosis index based on four factors first quantile as a reference, fibrosis index based on four factors fourth quantile had the highest risk (hazard ratio = 18.58, 95% confidence interval: 7.55, 45.72). Receiver operating characteristic results showed that fibrosis index based on four factors had a stronger ability to predict the risk of hepatocellular carcinoma (area under curve = 0.81, 95% confidence interval: 0.80, 0.81), and similar results were shown for gender stratification. In the total population, the optimal cut-off values of gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors were 0.208, 0.629 and 1.942, respectively.CONCLUSIONS:Gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors were independent predictors of hepatocellular carcinoma risk. Amongst them, fibrosis index based on four factors shows a stronger predictive ability for hepatocellular carcinoma risk, and gamma-glutamyl-transpeptidase to platelet ratio and alkaline phosphatase-to-platelet ratio index can be used as complementary indicators.
Per- and poly-fluoroalkyl substances (PFAS) have been reported to have hepatotoxic effects. However, it is unclear whether they are linked to non-alcoholic fatty liver disease (NAFLD). This nested case-control study focused on the epidemiological links between PFAS and the prevalence of NAFLD. We selected 476 new cases of NAFLD and 952 age- and sex-matched controls from the Jinchang cohort population between 2014 and 2019. Serum concentrations of PFAS were measured using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Only PFAS with a detection rate of ≥ 90 % were included for analysis, which included PFPeA, PFOA, PFNA, PFHxS, PFOS, and 9Cl-PF3ONS. The relationship between single and co-exposure to PFAS and the occurrence of NAFLD was evaluated using conditional logistic regression, Quantile g-computation (QgC), and Bayesian kernel machine regression (BKMR) model. Logistic regression indicated that PFPeA, PFOA, and 9Cl-PF3ONS were positive correlation with the incidence of NAFLD after adjusting for confounders, with odds ratios (OR) and 95 % confidence interval (CI) of 3.13 (95 % CI: 2.53, 3.86), 1.39 (95 % CI: 1.12, 1.73), and 1.41 (95 % CI: 1.20, 1.66), respectively. PFNA, PFHxS, and PFOS were nonlinearly and negatively associated with the incidence of NAFLD, with OR (95 % CI) of 0.53 (0.46, 0.62), 0.83 (0.73, 0.95), and 0.52 (0.44, 0.61), respectively. QgC showed a significant joint effect of PFAS on NAFLD onset (OR: 1.52, 95 % CI: 1.24, 1.88). BKMR showed a weak positive trend between PFAS mixtures and NAFLD incidence. Positive correlations were primarily driven by PFPeA and 9Cl-PF3ONS, while negative correlations were mainly influenced by PFNA and PFOS. The BKMR model also suggested that there was an interaction between PFOS and PFNA and other four PFAS compounds. In conclusion, our findings suggest that individual and co-exposure to PFAS is associated with a risk of NAFLD onset.
Modeling methods for busulfan-induced oligoasthenozoospermia are controversial. We aimed to systematically review the modeling method of busulfan-induced oligospermia and asthenozoospermia, and analyze changes in various evaluation indicators at different busulfan doses over time. We searched the Cochrane Library, PubMed databases, Web of Science, the Chinese National Knowledge Infrastructure, and the Chinese Biomedical Literature Service System until April 9, 2022. Animal experiments of busulfan-induced spermatogenesis dysfunction were included and screened. The model mortality and parameters of the evaluation indicators were subjected to meta-analysis. Twenty-nine animal studies were included (control/model: 669/1829). The mortality of mice increased with busulfan dose. Significant spermatogenesis impairment occurred within 5 weeks, regardless of busulfan dose (10–40 mg/kg). Testicular weight (weighted mean difference [WMD]: − 0.04, 95
Abstract Background: There are many traditional Chinese medicine prescriptions for the treatment of type 2 diabetes (T2DM), but most of them are not simple enough, which increase the economic burden of patients. Radix Astragali, Radix Puerariae, Radix Trichosanthis and Radix Rehmanniaeare the four traditional Chinese medicines commonly used in the treatment of T2DM. However, the molecular mechanism of these four drugs in the treatment of diabetes is still unclear. Therefore, this study is the first to explore the potential mechanism of Astragali-Rehmanniaeare and Puerariae-Trichosanthis in the treatment of T2DM through network pharmacology and animal experiments.Methods: First we obtained the active chemical components and targets of these four drugs. Then the main targets of diabetes were obtained and protein-protein interaction was built by String. Metascape platform was used to analyze the "drug-component-target" and the biological processes and pathways they involved. Finally, "Drug-Diabetes-Pathway" network was conducted. Subsequently, animal experiments were conducted to verify the network analysis results. Blood glucose of two hours postprandial was measured every week. The insulin expression level was measured to calculate HOMA-IR and HOMA-β, and the protein expressions of PI3K and Akt were measured as well.Results: The core active components were quercetin, daidzein, kaempferol, puerarin, formononetin; the core targets includedAKT1, PIK3CA, TNF, etc. The biological pathway mainly acted on PI3K-Akt signaling pathway and insulin resistance pathway. The experiment results showed that the drug groups could significantly reduce the blood glucose of T2DM rats. HOMA-IR of Astragali-Rehmanniaeare was significantly decreased, and HOMA-β of Puerariae-Trichosanthis was significantly increased. PI3K protein in Astragali-Rehmanniaeare and Puerariae-Trichosanthis was significantly higher than that in control group. Akt protein in Astragali-Rehmanniaeare was significantly higher than that in control group, but significantly lower than that in model group.Conclusions: Astragali-Rehmanniaeare and Puerariae-Trichosanthis improved blood glucose mainly by changing the contents of PI3K and Akt in the body to affect the PI3K-Akt signaling pathway, so as to achieve the purpose of treating T2DM.
利用宁夏腾格里沙漠光伏产业园的相关野外实测数据,分析风速、风向对光伏板表面温度的影响,并建立考虑风速、风向影响的光伏板温度分季节预测模型,讨论风对光伏组件发电性能的影响.结果表明,如果光伏组件温度预测模型不考虑风向影响,预测值会产生最高5~8℃的误差,对光伏电池输出功率的预测差异将超过5%,因此光伏板发电量预测模型必须考虑风速、风向的影响.
目的 了解生育政策改变对甘肃省兰州市出生缺陷监测结果的影响效应.方法 收集2010-2019年兰州市出生缺陷监测资料,按甘肃省生育政策实施时间,分为独生子女(2010年1月-2014年3月)、单独二胎(2014年4月-2015年12月)、全面二胎(2016年1月-2019年12月)3个时期,共计6 826例产妇-出生缺陷儿对子,比较不同生育政策时期的产妇特征、患儿特征以及主要出生缺陷情况.结果 对出生缺陷监测人群分析显示,独生子女时期、单独二胎时期和全面二胎时期的对子数分别是1 511、1 174和4 141例.在全面二胎时期,产妇文化程度和收入增高,高龄产妇、经产妇占比增加,妊娠周数<28周者增多,患儿胎龄和胎重显著降低,且均存在统计学差异(均P<0.05).控制混杂因素后,多因素logistic回归分析显示,相对于独生子女时期,在全面二胎时期先天性心脏病(OR=4.228)、总唇裂(OR=1.207)、多指趾(OR=2.252)、并指趾(OR=1.788)、马蹄内翻足(OR=1.602)和唐氏综合征(OR=3.065)的风险上升,多发缺陷(OR=0.147)风险下降.结论 全面二胎时期,兰州市出生缺陷监测地区高龄、经产妇占比增加,出生缺陷发生风险较高.
The Jinchang Cohort was an ongoing 20-year ambispective cohort with unique metal exposures to an occupational population. From January 2014 to December 2019, the Jinchang Cohort has completed three phases of follow-up. The baseline cohort was completed from June 2011 to December 2013, and a total of 48 001 people were included. Three phases of follow-ups included 46 713, 41 888, and 40 530 participants, respectively. The death data were collected from 2001 to 2020. The epidemiological, physical examination, physiological, and biochemical data of the cohort were collected at baseline and during follow-up. Biological specimens were collected on the baseline to establish a biological specimen bank. The concentrations of metals in urine and serum were detected by inductively coupled plasma mass spectrometry (ICP-MS). The new areas of research aim to study the all-cases mortality, the burden of diseases, heavy metals and diseases, and the course of the chain from disease to high-risk outcomes using a combination of macro and micro means, which provided a scientific basis to explore the pathogenesis of multi-etiology and multi-disease and to evaluate the effects of the intervention measures in the population.
An increasing body of evidence implicates high levels of selenium intake in the development of diabetes, although prospective studies remain sparse. We conducted a nested case-control study of 622 diabetes incident cases and 622-age, sex, and follow-up time-matched controls in the prospective Jinchang cohort of 48,001 participants with a median of 5.8 years of follow-up. Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure all 622 case-control pairs' baseline serum levels of selenium (Se), which were then categorized into quartiles based on the frequency distribution among the controls. Multivariable adjusted conditional logistic regression and restricted cubic splines (RCS) models were applied to evaluate independent odds ratios (OR) as estimates for relative risks (RR) of diabetes according to quartiles (Q) of selenium levels. Compared to the lowest quartile (Q1 as reference), significantly greater diabetes risks (with 95% confidence interval) were observed in Q3 (OR = 1.62, 1.17–2.35) and Q4 (OR = 1.79, 1.21–2.64). Sub-analyses showed these increased risks of diabetes by serum levels of Se. appeared to differ by sex, age, BMI status, history of hypertension, and dyslipidemia. Further, application of RSC models showed that serum Se levels between 95 and 120 μg/L were significantly and positively associated with diabetes risk whereas no apparent relation exists when Se levels were under 95 μg/L in this cohort population.
目的 应用全外显子组学测序技术筛选先天性心脏病患儿基因突变位点,并分析这些位点所涉及的通路.方法 提取6例均有室缺伴房缺的严重先天性心脏病患儿基因组DNA,通过全外显子组芯片捕获技术发现突变并筛选出与CHD有关的共有突变,并进一步进行功能GO富集分析.结果 6例患儿中有27个SNP位点涉及17个基因,46个InDel位点涉及33个基因是符合筛选条件的共有突变,经过功能GO富集分析,SNP和InDel突变基因富集到poly(A)结合(GO:0008143)、调节心脏收缩(GO:0008016)、锌离子结合通路(GO:0008270)、机械刺激感受通路(GO:0050982)、泛素依赖的蛋白质分解代谢过程(GO:0042787)、钙离子结合通路(GO:0005509),这6条通路具有统计学意义.结论 全外显子组芯片捕获技术是筛选CHD发生突变基因和功能分析的有效方法.
Type 2 diabetes mellitus (T2DM) is a major noncommunicable chronic disease in the population and is a major threat to global public health.According to the International Diabetes Federation [1] ,there were at least 463 million patients with diabetes between the ages of 20 and 79 in 2019,and this number will rise to 700 million by 2045.Dyslipidemia is the most important factor that influences T2DM.At present,cross-sectional studies are mainly used to determine the correlation between single lipid index,lipid ratio,and T2DM and its complications [2] .Few studies have focused on dyslipidemia and its aggregation patterns in relation to T2DM.
Objective: To explore the influencing factors for non-alcoholic fatty liver disease (NAFLD) in Jinchang cohort, and provide scientific basis for the prevention and control of NAFLD. Methods: A total of 20 051 patients without fatty liver at baseline survey and met the inclusion criteria in Jinchang cohort were selected as study subjects. Prospective cohort study and Cox regression analysis were used to investigate the influencing factors for NAFLD, and the dose-response relationship between related biochemical indicators and NAFLD risk was studied by restricted cubic spline method. Results: The incidence of NAFLD was 42.37/1 000 person years. Multivariate Cox regression analysis showed that being worker and technical personnel (being worker:HR=0.84,95%CI:0.70-0.99;being technical personnel:HR=0.73,95%CI:0.56-0.95), tea drinking (current drinking:HR=0.86,95%CI:0.78-0.94;previous drinking: HR=0.52,95%CI: 0.31-0.86), exercise (occasionally: HR=0.79, 95%CI: 0.68-0.91;frequently:HR=0.60,95%CI:0.52-0.69), low body weight (HR=0.10, 95%CI: 0.05-0.22), daily intake of dairy products >300 ml/day (HR=0.78, 95%CI: 0.71-0.87) and HBV infection (HR=0.77, 95%CI: 0.60-0.99) were the protective factors for NAFLD, while being internal or office workers (HR=1.84, 95%CI: 1.46-2.31), income ≥2 000 yuan (2 000- yuan: HR=1.32, 95%CI: 1.04-1.66; ≥5 000 yuan: HR=1.72, 95%CI:1.11-2.66), bachelor degree or above (HR=1.35,95%CI:1.03-1.76), overweight (HR=2.31, 95%CI:2.08-2.55), obesity (HR=3.95, 95%CI: 3.42-4.56), impaired fasting blood glucose (HR=1.31, 95%CI:1.17-1.47), diabetes (HR=1.53, 95%CI: 1.30-1.80), increased TC (HR=1.37,95%CI:1.24-1.52), increased TG (HR=1.79,95%CI: 1.62-1.98), decreased HDL-C (HR=1.29, 95%CI: 1.14-1.45), increased ALT (HR=1.13, 95%CI: 1.01-1.26) and high-fat diet (HR=1.24, 95%CI: 1.11-1.40) were the risk factors for NAFLD. Moreover, TC, TG, HDL-C, ALT and FPG all showed good dose-response relationship with the incidence of NAFLD. Conclusion: Occupation, education level, income level, tea drinking, exercise, BMI, FPG, blood lipid, ALT, HBV infection and diet were related to the incidence of NAFLD.
Objective: To investigate the relationship of triglyceride (TG), fasting blood glucose (FPG) and triglyceride glucose product index (TyG) with the incidence of hypertension, and provide basic data for the prevention and treatment of hypertension in the population. Methods: A total of 23 581 individuals who met the research criteria in Jinchang cohort were selected as the research subjects, the Cox proportional hazard model was used to analyze the relationship of TG, FPG, and TyG with the risk of hypertension. A stratified analysis was conducted by sex. Results: After adjusting for confounding factors, compared with the normal TG group, the HR(95%CI) of the elevated TG margin group and the elevated group were 1.16 (1.01-1.34) and 1.49 (1.30-1.70), respectively in the total population. Among men, they were 1.13 (1.01-1.27) and 1.17 (1.06-1.30), and among women, they were 1.05 (0.88-1.26) and 1.06 (0.88-1.28). Compared with the normal FPG group, the HR (95%CI) of the FPG-impaired group were 1.29 (1.13-1.48) in the total population, 1.26 (1.08-1.48) in men and 1.59 (1.14-2.21) in women. Taking the lowest quartile array as a reference, the HR (95%CI) of the highest quartile array of TyG was 1.73 (1.45-2.07) in the total population, 1.32 (1.14-1.53) in men and 1.87 (1.37-2.54) in women. TG, FPG had a nonlinear dose-response relationship with the risk of hypertension, while TyG had a linear correlation with the risk of hypertension. Conclusions: Higher TG, FPG, and TyG levels are independent risk factors for the incidence of hypertension. People with higher TG, FPG and TyG are at high risk for hypertension, to which close attention should be paid in the prevention and treatment of hypertension.
Aim: A stable induced type 2 diabetes model (T2DM) still needs to be explored for basic and clinical research, due to nonuniform model methods and unstable consequences. Our aims were to explore and establish an optimized induced T2DM model in mice that exhibits insulin resistance and beta-cell damage. Materials and methods: C57BL/6 mice were treated with a high-fat diet (HFD), streptozotocin (STZ) and dexamethasone (DEX) at different doses and in combination. The general growth status, blood glucose and fasting insulin were detected, and the success rate and insulin sensitivity indices were calculated. Key finding: Low-dose STZ injection multiple times was more secure in the process of T2DM model production. Combined intervention was more efficient in reducing insulin sensitivity and improving the success rate of T2DM model construction. Significance: Combined with a high-fat diet, glucocorticoids and streptozotocin, a new mouse model of T2DM with insulin resistance and beta-cell damage could be established. The optimized experimental method can serve as a stable model for further studies on the mechanisms and therapy of T2DM.
Objective: To explore the relationship between lipid indicators and the incidence of diabetes, and to compare the diabetes prediction and identification power of traditional lipid combined lipid indicators, in order to explore the best alternative indicators for identifying and predicting diabetes. Methods: Based on the Jinchang cohort, a nested case-control study was conducted in 1 025 new cases of diabetes after excluding patients with malignant tumor and related endocrine, circulatory system disease, then an age (±2 years), gender matched 1∶1 control group of 1 025 cases was set to analyze the relationship between the incidence of diabetes and lipid parameters. Results: Among the traditional lipid parameters, the fourth quartile of TG, TC, and LDL-C indicated higher risks of developing diabetes, which was 14.00 times (95%CI: 9.73-20.15), 2.15 times (95%CI: 1.65-2.79) and 1.66 times (95%CI: 1.29-2.14) than that of the first quartile, respectively. The risk of developing diabetes indicated by the fourth quartile of HDL-C was 0.21 times than that indicated by the first quartile (95%CI: 0.15-0.28). In the combined lipid parameters, the fourth quartile of TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C indicated higher risks of developing diabetes, which was 14.86 times (95%CI: 10.35-21.34), 8.12 times (95%CI: 5.94-11.01), 5.85 times (95%CI:4.34-7.88) and 5.20 times (95%CI: 3.85-7.03) than that indicated by the first quartile, respectively. The areas under the ROC curve of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 0.76 (95%CI: 0.74-0.78), 0.59 (95%CI: 0.57-0.61), 0.67 (95%CI: 0.65-0.69), 0.57 (95%CI: 0.55-0.59), 0.77 (95%CI: 0.75-0.78), 0.73 (95%CI: 0.71-0.75), 0.69 (95%CI: 0.67-0.71) and 0.66 (95%CI: 0.64-0.68), respectively. The optimal diabetes predicting point cuts of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 1.40, 4.70, 1.28, 3.25, 1.17, 3.43, 2.46, and 3.58 mmol/L, respectively. Conclusions: Lipid metabolic disorder is a risk factor for diabetes. TG and TG/HDL-C are the good lipid metabolism indicators for the prediction of diabetic.
Objective: To investigate the influence of HBV infection on the prevalence of fatty liver disease in Jinchang cohort and provide theoretical evidence for the prevention and treatment of fatty liver disease. Methods: Epidemiological investigation, laboratory examination and abdominal ultrasound were conducted in the baseline population of Jinchang cohort to collect the basic data, the differences in the prevalence of fatty liver disease under different HBV infection patterns were described and compared and the influence of different HBV infection patterns on the prevalence of fatty liver disease were evaluated by using logistic regression analysis. Results: The baseline Jinchang cohort population totaled 45 605, including 27 917 males and 17 688 females. The male to female ratio was 1.6∶1. The mean age of the overall population was 46.49 years. Among the 8 common HBV infection modes in the Jinchang cohort, the prevalence of fatty liver was low in HBsAg, HBeAg and HBcAb positive, HBsAg and HBcAb positive, and HBsAg, HBeAb and HBcAb positive groups. For 4 serum markers of HBV infection, the prevalence of fatty liver disease in HBsAg and HBeAg positive groups was lower than that in HBsAg and HBeAg negative groups. Logistic regression analysis showed that being HBsAg and HBcAb positive (OR=0.61, 95%CI: 0.39-0.98) and HBsAg, HBeAg and HBcAb positive (OR=0.52, 95%CI: 0.30-0.89) could reduce the risk for fatty liver disease. Conclusion: Acute HBV infection reduces the prevalence of fatty liver disease, and the reason may be related to the disturbance of the body's fat metabolism by active HBV replication.
Objective: To explore the relationship of body mass index and blood pressure with the incidence of diabetes in Jinchang cohort. Methods: We designed a nested case-control study, a total of 29 572 workers who had no history of diabetes in baseline survey in Jinchang cohort were selected as the study cohort from June 2011 to December 2013. After 2 year follow-up, 1 021 workers with first diagnosed diabetes were selected as the case group, after 1∶1 matching according to the same gender and age ±2 years among those without diabetes, circulatory system, or endocrine system diseases during the same follow-up period, 1 021 controls was selected and 2 042 subjects were finally included. We used multivariate conditional logistic regression model, additive interaction model and multiplicative interaction model to explore the relationship of body mass index and blood pressure with the incidence of diabetes. Results: After adjusting for factors such as occupation, alcohol use, family history of diabetes, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, low-HDL cholesterolemia and high-LDL cholesterolemia, multivariate conditional logistic regression analysis showed that the risk of diabetes increased with body mass index and blood pressure. Hypertension and overweight/obesity had a multiplicative interaction on the incidence of diabetes. The risks of diabetes in men and women with hypertension and overweight/obese were 2.04 times (95%CI: 1.54-2.69) and 3.88 times (95%CI: 2.55-5.91) higher than those in men and women with normal body weight and blood pressure, respectively. In the combination of BMI and blood pressure, obese individuals with SBP≥160 mmHg were 4.57 times (95%CI: 2.50-8.34) more likely to have diabetes than those with normal BMI and SBP, obese individuals with DBP≥90 mmHg were 3.40 times (95%CI: 2.19-5.28) more likely to have diabetes than those with normal BMI and DBP. Conclusions: Overweight/obesity and hypertension can increase the risk of diabetes. Health education about body weight and blood pressure controls should be strengthened to reduce the risk of diabetes.
目的 探讨糖尿病家族史、肥胖及其交互作用对糖尿病前期人群糖尿病发病的影响.方法 基于金昌队列平台,采用前瞻性队列研究,计算糖尿病家族史、体重指数(body massindex,BMI)、腰围身高比(waist-to-height ratio,WHtR)及不同组合下糖尿病的累积发病率.采用Cox比例风险模型,分析家族史、BMI、WHtR对糖尿病发病的独立作用和联合作用.运用相乘模型分析家族史与BMI/WHtR的交互作用.结果 本研究共纳入糖尿病前期人群5 495例,平均随访2.2年后,糖尿病累积发病率为15.69%,其中有家族史组发病率(18.31%)高于无家族史组(15.26%)(x2=4.664,P=0.031),随着BMI/WHtR水平增加,发病率呈上升趋势(x2=91.727,P<0.001;x2=73.334,P<0.001).调整混杂因素后,当糖尿病家族史和肥胖(BMI≥28kg/m2或中心型肥胖)同时存在时,糖尿病发病风险增加(HR=4.401,95% CI: 3.026~6.401;HR=2.565,95% CI:1.989~3.307),且均存在正向相乘交互作用.当家族史/BMI≥28 kg/m2/中心型肥胖三个因素叠加,糖尿病发病风险达到最高(HR=4.977, 95% CI:3.351~7.392).结论 糖尿病家族史与肥胖相互叠加增加糖尿病前期人群糖尿病的发病风险,但两者的独立效应同样不容忽视.
<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解"一带一路"沿线中亚、南亚、独联体国家前瞻性自然人群队列研究的建立和发展情况,与荷兰队列进行比较,为今后"一带一路"国家的队列研究建设提供参考依据。方法收集PubMed数据库中中亚、南亚、独联体等20个国家自数据库收录起始日期至2019年3月1日发表文献中的队列研究,经过2次筛选后对选定的队列进行二次检索,获取队列关键信息,分析中亚、南亚、独联体"一带一路"国家前瞻性自然人群队列的建设与发展情况,并与荷兰队列进行对比分析。结果中亚、南亚、独联体20个国家共有211项研究人群≥1 000人的队列研究,其中,国家内队列研究164项(77.73%),国际多中心队列研究47项(22.27%)。经二次检索后选定的"一带一路"国家的6项前瞻性自然人群队列研究与荷兰的9项前瞻性自然人群队列研究进行对比分析,结果显示,在数量上,"一带一路"国家的2项队列研究为单一国家队列,荷兰的9项队列研究均为单一国家队列;在规模上,"一带一路"国家的2项队列研究对象> 100 000人,荷兰的2项队列研究对象> 100 000人;在建立时间上,"一带一路"国家建立最早的2项队列研究均建立于20世纪90年代初期,荷兰建立最早的3项队列研究均建立于20世纪80年代;在产出文章上,"一带一路"国家产出文章数量最多的队列研究文章发表数为400篇,荷兰产出文章数量最多的队列研究文章发表数为1 500篇。结论相对于荷兰而言,"一带一路"沿线中亚、南亚、独联体国家的前瞻性自然人群队列研究整体数量少、规模小、文章产出低、队列发展较为局限。</span>