To investigate the diagnostic efficacy of 68Ga-pentixafor positron emission tomography/computed tomography (PET/CT) in primary aldosteronism (PA) subtyping and lateralization of aldosterone secretion in PA patients. 37 patients who were diagnosed with PA, were prospectively enrolled in the study, and underwent adrenal vein sampling (AVS) after 68Ga-pentixafor PET/CT was conducted. Lateralization index (LI), defined as aldosterone/cortisol ratio in the dominant side to the contralateral adrenal vein when bilateral adrenal vein catheterization succeeded, and the aldosterone/cortisol ratio in the left adrenal vein to IVC (LAV/IVC) when the catheterization of right adrenal vein failed, were applied to determine lateralization side. Statistical analysis was performed using SPSS 21.0. The female proportion of all patients with PA was 32.4

Objective:To investigate the metabolic adaptation of normal pregnancy and the pathogenesis of gestational diabetes mellitus (GDM) from the first to the third trimester.Methods:This was a case-control study. A total of 1 471 pregnant women who visited at the Department of Obstetrics of Peking University First Hospital in the first trimester from September 2017 to June 2018. Those with complete serum samples in the first, second and third trimester and who delivered in the hospital were taken as research objects. They were divided into a GDM group and a normal control group according to their glucose metabolism status. Fasting plasma glucose (FPG) and fasting insulin (FINS) in first, second and third trimester were detected, and 75 g oral glucose tolerance test (OGTT) was performed at 24 weeks and later to explore metabolic adaptation in pregnancy and the pathogenesis of GDM. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were calculated. T-test and Mann-Whitney U test were used to compare between groups. Results:A total of 510 subjects were included in the study. There were 260 cases in GDM group and 250 cases in normal control group. In terms of blood glucose, FPG, 1 h-postprandial plasma glucose (1hPG) and 2 h-postprandial plasma glucose (2hPG) of 75g OGTT in GDM group were significantly higher than those in control group [5.14 (4.80, 5.34) vs 4.63 (4.43, 4.84), 9.56 (8.17, 10.48) vs 7.64 (6.57, 8.63), 8.05 (6.88, 9.08) vs 6.46 (5.82, 7.22) mmol/L, P<0.001]. The level of FPG in both GDM and normal control groups decreased gradually with gestational age (FPG of different trimesters were all P<0.017), but the level of FPG in GDM group was significantly higher than that in control group from first to third trimester[5.27 (4.99, 5.55) vs 5.10 (4.87, 5.30), 5.14 (4.80, 5.34) vs 4.63 (4.43, 4.84),4.77 (4.52, 5.08) vs 4.48 (4.31, 4.70) mmol/L, P<0.001]. In terms of insulin resistance and dynamic changes in islet beta cell function, all FINS levels, HOMA-IR and HOMA-β increased gradually from the first to the third trimester, peaking in the third trimester, whether GDM or normal control group. FINS in the second trimester and HOMA-IR from the first to the third trimester in GDM group were higher than those in control group (all P<0.05), whereas HOMA-β in the second and the third trimesters were lower than those in control group (all P<0.001). Conclusions:Physiological insulin resistance occurs in normal pregnancy, and beta cells compensate to maintain normal blood glucose. However, there was more severe insulin resistance and higher FPG in GDM group from the first trimester, and beta cell insufficiency in the second and third trimesters. It is suggested that although GDM is diagnosed in second trimester and later, its pathological and physiological abnormalities are already present in the first trimester.

Objective:To investigate the glucose metabolic status in patients with previous gestational diabetes mellitus (GDM) in the 5-6 years after delivery, and to explore the changes in insulin resistance and islet β cell function from postpartum short-term (6-12 weeks) to the long-term (5-6 years) after delivery, as well as the relationship with glucose metabolic status.Methods:A total of 72 patients with a history of GDM who delivered in Peking University First Hospital and had complete short-and long-term postpartum follow-up data were included. They were divided into normal glucose metabolism (NGT) and abnormal glucose metabolism (AGT) groups according to their glucose metabolism status in 5-6 years after delivery. Pre-pregnancy, pregnancy, perinatal, short-and long-term postpartum clinical data were collected and compared between the two groups, including demographic indicators, glucose and lipid metabolism indicators [oral glucose tolerance test (OGTT) fasting blood glucose (FPG), 1-hour blood glucose (1hPG), 2-hour blood glucose (2hPG), 3-hour blood glucose (3hPG), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol], insulin use ratio, fasting insulin (FINS), OGTT 2-hour insulin (2hINS), insulin sensitivity index (ISI), homeostasis model assessment of insulin resistance index (HOMA-IR) and homeostasis model assessment of β cell function index (HOMA-β) were calculated. The comparison between the two groups was conducted using independent sample t-test, rank sum test χ2 test or Fisher′s exact probability test. Multivariate logistic regression analysis was used to analyze the influence factors of abnormal glucose metabolism. Results:There were 38 (52.78%) cases in NGT group and 34 (47.22%) cases in AGT group. Compared with the NGT group, there are differences in related metabolic indicators in AGT group from pregnancy to long-term postpartum period: During pregnancy, 3hPG in 75 g OGTT and the proportion of insulin users were higher in AGT group. As for 6-12 weeks postpartum, OGTT 2hPG and the incidence of blood glucose abnormalities and the proportion of hypertriglyceridemia were higher (all P<0.05). However, there was no statistically significant difference in HOMA-IR and HOMA-β between the two groups( P>0.05). At 5-6 years postpartum, FPG, OGTT 2hPG, and FINS were all higher, with a higher degree of insulin resistance and lower insulin sensitivity (ISI) in AGT group (all P<0.05). Compared with short-term postpartum period (6-12 weeks), FPG, FINS, HOMA-IR, HOMA-β were all significantly increased regardless of glucose metabolic status at 5-6 years postpartum, while OGTT 2hPG and 2hINS increased further in the AGT group (all P<0.05). OGTT 2hPG and insulin use during pregnancy were risk factors for abnormal glucose metabolism 5-6 years postpartum according to multivariate logistic regression analysis, with OR values (95%CI) of 1.646 (1.015-2.671) and 3.570 (1.009-12.624), respectively. Conclusions:The incidence of AGT was still high in patients with previous GDM 5-6 years after delivery. Insulin resistance progressed gradually after delivery regardless of glucose metabolism, especially in patients with abnormal glucose metabolism. OGTT 2hPG and insulin use in pregnancy were risk factors for abnormal glucose metabolism in postpartum 5-6 years, suggesting that there is continuity in time and similarity in pathogenesis between GDM and T2DM.

Objective:To compare the characteristics of serum adrenocortical hormone profiles detected by liquid chromatography tandem mass spectrometry in patients with adrenal cortical carcinoma and adrenal adenoma.Methods:A total of 23 patients with adrenal cortical carcinoma and 119 patients with adrenal cortical adenoma/hyperplasia who visited the Department of Endocrinology and/or the Department of Urology of Peking University First Hospital from January 2018 to June 2022 were analyzed retrospectively. The imaging characteristics and serum adrenal cortical hormone profiles detected by liquid chromatography tandem mass spectrometry were analyzed retrospectively. The independent related factors of adrenal cortical carcinoma were screened by univariate analysis and multivariate logistic regression analysis.Results:The age of patients with adrenal cortical carcinoma was 46 (35, 57) years, and 15 (65.2%) were female; The age of adrenal cortical adenoma patients was 49 (40, 58) years old, and 80 (67.2%) were female. There was no significant difference in age and gender between the two groups (all P values >0.05). The maximum tumor diameter M ( Q1, Q3) of patients with adrenocortical carcinoma was 7.05 (5.45, 9.78) cm, which was larger than that of patients with adrenocortical adenoma [2.1 (1.6, 3.0) cm] ( P<0.001). Compared with patients with adrenal adenoma, the androstenedione (AD) of patients with adrenal cortical carcinoma [4.056 9 (1.619 5, 7.907 9) nmol/L vs 1.517 5 (0.935 1, 2.582 1) nmol/L ( P<0.001)] was significantly increased; 11-ketotestosterone/11-ketoandrostenedione [0.034 3 (0.020 6, 0.079 2) vs 0.041 0 (0.028 6, 0.061 5) ( P=0.089)] and 11-ketoandrostenedione/11-hydroxyandrostenedione [0.013 0 (0.006 4, 0.086 7) vs 0.063 0 (0.018 2, 0.162 5) ( P=0.042)] were significantly decreased. Multivariate analysis found that AD, the largest diameter of the tumor, 11-ketotestosterone/11-ketoandrostenedione and 11-ketoandrostenedione/11-hydroxyandrostenedi-one were related factors for adrenal cortical carcinoma, with OR values (95% CI) of 1.841 (1.093-3.100), 5.130 (2.332-11.285), 0.381 (0.167-0.867) and 0.000 (0.000-0.014), respectively, all P values <0.05. Conclusions:The larger diameter of adrenal cortical tumor and the higher the level of androstenedione are independent risk factors for adrenal cortical carcinoma. The reduction conversion of 11-hydroxyandrostenedione to 11-ketoandrostenedione and 11-ketoandrostenedione to 11-ketotestosterone were independently associated with adrenal cortical carcinoma.

心血管疾病是全球最主要的死亡原因.中国心血管疾病患病率及死亡率仍处于上升阶段,推算心血管疾病现患人数3.30亿,其中脑卒中1300万,冠心病1139万;心血管疾病死亡占城乡居民总死亡原因的首位,农村为46.66％,城市为43.81％[1].中国心血管疾病负担日渐加重,已成为重大的公共卫生问题.

甲状腺相关眼病（TAO）是Graves病（GD）的一种难治性并发症。刺激性促甲状腺素受体（TSAb）可以与GD眼眶成纤维细胞（GD-OF）表达的TSH受体（TSHR）/胰岛素样生长因子Ⅰ受体（IGF-IR）复合体结合，促进TAO的发生发展。IGF-IR是TSHR启动细胞信号传导所必须的成分，teprotumumab作为一种阻断IGF-IR的单克隆抗体，在2020年被美国食品药品管理局批准用于治疗 TAO，但该药物治疗TAO的潜在机制仍有待进一步阐明。

Objective:The clinical characteristics of patients with adrenocorticotropic hormone (ACTH) independent Cushing′s syndrome (CS) complicated with cardiac insufficiency were summarized and analyzed, in order to provide a better identification for high risk populations of heart dysfunction in patients with ACTH independent CS.Methods:The patients diagnosed with ACTH independent CS were searched from the electronic medical records system of Peking University First Hospital on discharge from January 2014 to March 2019. These patients were divided into two groups: cardiac insufficiency group and control group. The clinical features of two groups were compared.Results:Compared to control group, patients in cardiac insufficiency group had significantly decreased left ventricular ejection fraction (LVEF) [(61.50±11.07)% vs.(70.61±5.67)%, P=0.005], thicker interventricular septum and left ventricular posterior wall, higher levels of serum cortisol rhythm, 24-hour urine free cortisol and glycosylated hemoglobin A1c, as well as more antihypertensive drugs. Thickness of interventricular septum was positively associated with area under curve of serum cortisol rhythm ( r=0.370, P<0.001). Thickness of left ventricular posterior wall was also positively associated with area under curve of serum cortisol rhythm (r=0.257, P=0.003). The risk factors of cardiac insufficiency for patients with ACTH independent CS included a hypokalemia history, area under curve of serum cortisol rhythm more than 335.36 (μg/dl)·h, LVEF less than 60%, and thickness of left ventricular posterior wall more than 1.1 cm in CS (all P<0.05). Conclusions:The main clinical manifestations of ACTH independent CS with cardiac insufficiency are thicker interventricular septum and left ventricular posterior wall, decreased LVEF, more difficult control of hyperglycemia and hypertention. Patients with a hypokalemia history, higher level of serum cortisol, decreased LVEF and thicker left ventricular posterior wall will more likely to complicate with cardiac insufficiency.

Pheochromocytoma and paraganglioma (PPGL) results in secondary hypertension. In recent years, the prevalence of PPGL has shown an upward trend. Metanephrines (MNs) are intermediate metabolites of catecholamine (CA). Currently, plasma and urine MNs have been widely recommended as the initial biochemical markers for the diagnosis of PPGL. In addition, 3-methoxytyramine(3-MT)and chromogranin A(CgA)are also useful for the diagnosis and differentiation between benign and malignant PPGL. The understanding of diagnostic advantages of different biochemical markers, precautions for specimen collection and methodological choices will help the doctors applying those tests reasonably.

目的 探讨Kwak TI-RADS与ACR TI-RADS对儿童甲状腺结节的诊断效能及应用价值.方法 回顾性分析68个儿童甲状腺结节,构建受试者工作特性曲线(ROC),分析ACR TI-RADS和Kwak TI-RADS对儿童甲状腺结节的应用价值.结果 两种分类方法恶性度均随分类级别增加而增高,以Kwak TI-RADS 4b类和ACR TI-RADS 4类为最佳诊断点,Kwak TI-RADS的特异度略高于ACR TI-RADS(54.5％:51.5％,P<0.05),但两者灵敏度、PPV、NPV、AUC均无统计学意义(P>0.05);按照ACR TI-RADS成人推荐甲状腺结节穿刺标准,28％(7/25)儿童恶性结节没有分入建议穿刺组.结论 Kwak TI-RADS和ACR TI-RADS对儿童甲状腺结节分类均具有较好的指导作用,Kwak TI-RADS具有相对较高特异度,但儿童甲状腺结节在应用ACR TI-RADS推荐的穿刺标准尚需进一步研究.

背景 颈动脉粥样硬化斑块是心脑血管疾病重要的危险因素,多用超声评价,但超声检查对设备、人员、经费要求较高.皮肤自发荧光(SAF)能够独立预测心脑血管事件发生及死亡等,操作简便、迅速、无创,因此探讨SAF与颈动脉粥样硬化斑块的关系对于颈动脉病变的预测有一定意义.目的 探讨在我国社区人群中SAF与颈动脉粥样硬化斑块病变的相关性.方法 2018年9—12月对北京某社区年龄>40岁的6055例居民进行横断面调查研究,对所有受访者进行SAF检测、临床病史采集、体格检查、血液学检测及颈动脉B超检查.根据B超结果是否存在颈动脉粥样硬化斑块分为颈动脉粥样硬化斑块组和无颈动脉粥样硬化斑块组.以颈动脉粥样硬化斑块为因变量,以标准化性别、年龄、BMI、吸烟、糖尿病、高血压、脂代谢紊乱、高尿酸血症、慢性肾功能不全等传统心脑血管病变危险因素及SAF为自变量进行Logistic回归分析,探讨SAF对颈动脉粥样硬化斑块的影响.结果 6055例调查对象B超提示存在颈动脉粥样硬化斑块者2953例,无颈动脉粥样硬化斑块者3102例.颈动脉粥样硬化斑块组SAF测量值为77.2(70.8,85.1)AU,明显高于无颈动脉粥样硬化斑块组SAF测量值73.4(68.0,80.1)AU(P<0.001).Logistic回归分析结果显示,SAF是颈动脉粥样硬化斑块的影响因素〔OR=1.006,95％CI(1.000,1.012),P=0.043〕.以SAF值的第25、50、75百分位值69.2、75.1、82.4 AU为界,分为SAF低、中、高、明显升高4组,SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.200倍〔OR=1.200,95％CI(1.012,1.423),P=0.036〕.亚组分析显示,校正传统心血管危险因素后,年龄<60岁人群中SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.751倍〔OR=1.751,95％CI(1.270,2.415),P=0.001〕;吸烟人群中SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.903倍〔OR=1.903,95％CI(1.297,2.792),P=0.001〕.结论 SAF与颈动脉粥样硬化斑块独立相关,在<60岁人群及吸烟人群中SAF明显升高者相比SAF低值者与颈动脉粥样硬化斑块相关性更明显.

OBJECTIVE:Plasma free metanephrines (MNs) have been widely used as an initial test for pheochromocytoma and paraganglioma (PPGL). PPGL without MNs elevation has been reported on rare occasions. The objective of this study was to analyze the clinical profile of sporadic PPGL patients with normal MNs.METHODS:In the study, 104 patients with sporadic PPGL diagnosed by histopathology in Peking University First Hospital from March 2015 to January 2020 were enrolled. All the patients had plasma MNs result, of whom, eight (7.69%) were with normal MNs. The reasons for their medical visits, clinical manifestations, the levels of plasma free MNs, 3-methoxytyramine (3-MT), catecholamines and chromogranin A (CgA), and the imaging findings were documented. Their preoperative diagnosis, perioperative medical management, and intraoperative blood pressure were analyzed. All the data mentioned above were compared with the MNs elevated group. The postoperative follow-up for MNs normal patients were applied.RESULTS:For the eight PPGL patients with normal plasma MNs, the most common clinical symptoms were sweating (3/8), abdominal and back pain (3/8), headache (2/8), palpitations (2/8), and fatigue (2/8). There were no significant differences in plasma free 3-MT and catecholamines' diagnostic positive rate between the MNs normal group and MNs elevated group, but the rate for plasma CgA was significantly decreased in the MNs normal group (2/5 vs. 41/43, P=0.005). No significant difference was found for the incidence of typical findings by enhanced CT between the two groups. In these eight MNs normal patients, six were diagnosed with PPGL by the previous history of PPGL, typical symptoms and CT findings, or elevation of 3-MT, CgA levels or positive results of PET-CT; two patients were misdiagnosed as nonfunctioning adenoma or primary aldosteronism. All these MNs normal patients underwent preoperative management with alpha adrenergic receptor blockers, of whom, one had an average intraoperative arterial pressure < 60 mmHg during surgery. The median follow-up time for the eight patients was 1.5 (0.5－4.5) years. No evidence of new tumors was found on the enhanced CT scans. Two MNs normal patients' plasma 3-MT and (or) CgA decreased to normal.CONCLUSION:For patients with adrenal or retroperitoneal tumors, typical symptoms or a previous history of PPGL, normal plasma MNs is not a sufficient exclusion for PPGL. Plasma 3-MT, catecholamine, CgA results and the imaging findings are helpful for the diagnosis of PPGL. We recommend patients with suspected MNs normal PPGL take alpha adrenergic receptor blockers as preoperative blockade, but should avoid overdose. Postoperative follow-up for patients with normal MNs should focus on the positive biochemical markers before surgery.

目的 对T2DM患者服用达格列净(Dap)前后血、尿电解质及UA水平进行比较,评价其对T2DM的治疗作用.方法 选取2018年1月至2019年10月于北京大学第一医院内分泌科门诊治疗的T2DM患者11例,在原治疗基础上每日加服Dap 10 mg,观察24周,比较用药前及用药4、12、24 周时的血、尿电解质及 UA 变化.结果 与加服 Dap 前比较,口服 Dap 4、24 周时体重[(86.5 ± 8.8)vs(84.4 ± 8.9)vs(85.1 ± 13.0)kg]、24 周时 DBP[(82.0 ± 5.0)vs(76.0 ± 5.0)mmHg]、4、12、24周时血钾(K)[(4.4±0.3)vs(4.0±0.4)vs(4.0±0.4)vs(4.0±0.4)mmol/L]及4周时SUA[(380.5±70.8)vs(326.5±36.0)μmol/L]降低(P＜0.05);口服Dap 12、24周时血色素[(142.0±13.0)vs(150.0±13.0)vs(152.0±15.0)g/L]及红细胞比容[(42.24±4.19)％vs(44.96± 4.14)％vs(46.02±4.53)％]、12周时24 h尿镁(UMg)定量[(5.3±1.8)vs(6.4±1.8)mmol]、4周时的UA清除率[(18.7±9.4)vs(27.0±12.6)ml/min]及UA排泄分数[(7.05±1.62)％vs(9.12± 1.96)％]均升高(P＜0.05).结论 T2DM患者加服Dap治疗24周,体重、DBP、K、SUA降低,红细胞比容增加,UMg增多,UA清除率和排泄分数增加.

目的 探讨北京社区人群生活方式与AGEs皮肤自发荧光(SAF)的相关性.方法 对北京某社区>40岁6055名居民横断面调查,进行SAF检测、体格检查、血糖检测及生活方式问卷调查.结果 校正年龄、性别、BMI、BG后,生活方式中吸烟、饮茶、喝咖啡、日间睡眠、运动与SAF相关(β=0.152、0.025、0.046、0.041、―0.049,P<0.05或P<0.01).亚组分析显示,<60岁人群饮茶与SAF不相关,高盐饮食与SAF呈负相关(β=―0.044,P=0.040).>60岁人群咖啡摄入与SAF不相关,高盐饮食与SAF呈正相关(β=0.032,P=0.036).将饮茶种类、年茶叶消耗量、饮茶时间纳入多元线性回归分析后显示,SAF与年茶叶消耗量相关(β=0.084,P<0.001).结论 吸烟、饮茶、咖啡、高盐饮食、日间睡眠、运动等生活方式与SAF相关,饮茶对SAF影响主要取决于年茶叶消耗量.

严重急性呼吸综合征(SARS)和新型冠状病毒感染(COVID-19)肺炎均为冠状病毒感染导致,病原体同源性高并具有共同受体——血管紧张素转化酶2(ACE2).两种疾病的流行病学数据及临床资料分析显示,SARS患者血糖升高,高血糖对SARS及COVID-19进展均有负面影响.本文就ACE2在冠状病毒感染致高血糖的作用进行综述和探讨.

目的 探讨因胸痛接受冠状动脉CT检查的患者血清脂蛋白a[Lp(a)]水平与冠状动脉钙化(CAC)之间的相关性.方法 共入选1085例因胸痛在阜外医院接受冠状动脉CT检查的患者,根据Agatston评分算法计算冠状动脉钙化评分(CACS).所有入选患者均检测了血脂谱和Lp(a)水平.结果 根据CACS进行分组,CACS>0分组(460例)患者血清Lp(a)水平明显高于CACS=0分组(625例)患者[23.60(14.73,44.56)mg/dl比12.73(5.56,31.10)mg/dl,P<0.001],差异有统计学意义.多元线性回归分析显示,血清Lp(a)浓度与CACS呈正相关(β=0.543,P<0.001).曲线下面积(AUC)值显示血清Lp(a)水平在预测CACS方面具有正确的区分效力(AUC=0.71,95％CI 0.68～0.74,P<0.001).Lp(a)的最佳截断值为10.51 mg/dl(敏感度为86.1％,特异度为51.7％).结论 在因胸痛接受冠状动脉CT检查的患者中,血清Lp(a)水平与CAC呈显著正相关.

Objective: Thyroglobulin antibodies (TgAb), principally comprising immunoglobulin G (IgG), are frequently found in healthy individuals. Previously, we showed that the glycosylation levels of TgAb IgG differed across various thyroid diseases, suggesting an important role of glycosylation on antibodies in the pathogenesis of thyroid diseases. Since IgG1 and IgG4 are the primary TgAb IgG subclasses, this study aimed to investigate the glycosylation of TgAb IgG1 and IgG4 subclasses in thyroid diseases. Methods: TgAb IgG was purified by affinity chromatography from the serum of patients with Hashimoto’s thyroiditis (HT) (n = 16), Graves’ disease (GD) (n = 8), papillary thyroid carcinoma (PTC) (n = 6), and PTC with histological lymphocytic thyroiditis (PTC-T) (n = 9) as well as healthy donors (n = 10). TgAb IgG1 and IgG4 concentrations were determined by enzyme-linked immunosorbent assay, and a lectin microassay was used to assess TgAb IgG1 and IgG4 glycosylation. Results: Significantly elevated mannose, sialic acid, and galactose levels on TgAb IgG1 were found in HT and PTC patients compared to GD patients and healthy controls (all p < 0.05). The mannose, sialic acid, and core fucose levels on TgAb IgG1 in PTC-T patients were higher than in healthy controls (all p < 0.05). Additionally, TgAb IgG1 from PTC-T patients exhibited lower sialylation than that from patients with PTC and higher fucosylation than that from patients with HT (both p < 0.05). However, TgAb IgG4 glycosylation did not differ among the five groups (p < 0.05). Conclusion: Our study describes different distributions of TgAb IgG1 glycosylation in various thyroid diseases. The aberrantly increased glycosylation levels of TgAb IgG1 observed in HT, PTC, and PTC-T might be indicative of immune disorders and participate in the pathogenesis of these diseases.

Objective: To quantitate the association between birth weight and phenotypes of physical indicators in adulthood, i.e. BMI and waist circumference (WC) and to what degree genetic or environmental factors affect birth weight-obesity association. Methods: A total of 6 623 gender matched twin pairs aged 25 to 79 years were recruited through the Chinese National Twin Registry. The twins reported their own birth weight, current height and weight, and WC using a self-administered questionnaire. BMI was calculated according to the self-reports of body height and weight. Within twin-pair design was used to quantitate the association between birth weight and phenotypes related to obesity while bivariate structural equation models were used to decompose the phenotype correlation. Results: After adjusted for multiple factors, twin-pair analyses within monozygotic (MZ) showed that, on average, a 1.0 kg increase in birth weight corresponded to an increase of 0.33 kg/m(2) in BMI and 0.95 cm in WC in adulthood (P<0.001). Bivariate structural equation models showed significant positive unique environmental correlation between birth weight and the two obesity-related phenotypes. Conclusion: The study supported the role of twin-specific supply line factors on relationship between birth weight and physical indicators in adulthood.

Background: Relative energy deficiency in sports (RED-S) is well-recognized in women competing in endurance sports; however, it is less common in males competing in non-endurance sports. Here, we report a case of hypogonadotropic hypogonadism associated with RED-S in an elite male non-endurance skill athlete caused by a change in workout over a short time frame.Case presentation: An 18-year-old elite male non-endurance skill athlete complained of fatigue, depression, and inattention. Blood tests showed low total testosterone levels and a physical examination revealed Tanner stage phase IV-V. A gonadotropin-releasing hormone (GnRH) stimulation test revealed that the luteinizing hormone (LH) level was 10 times above normal, suggesting hypothalamic hypogonadism. However, magnetic resonance imagings (MRI) of pituitary gland, brain, and adrenal glands were normal. Due to COVID-19 pandemic, he was quarantined for 2 weeks. During that time, he only performed a basic workout. At the end of quarantine, his coach made him follow a new training program that was >50% more intense than the one before quarantine. He also had to restrict calorie intake for snowboarding. He was diagnosed as relative energy deficiency in sport (RED-S). The condition resolved after lifestyle and training modifications.Conclusions: RED-S is not restricted to endurance athletes. Elite athletes performing non-endurance sports can also suffer from it after a significant modification of training. Sports scientists/trainers should monitor caloric intake and training intensity to avoid RED-S, protect the health and improve the performance of all athletes.

Objective:To explore the predictive values of early pregnancy fasting plasma glucose (FPG), lipid profiles and blood pressure, and establish prediction models for gestational diabetes mellitus (GDM) of different pre-pregnancy body mass index (p-BMI) ranges.Methods:This is a prospective case-control study. From September 2017 to June 2018, 1 471 singleton pregnant women in our hospital were prospectively enrolled. We chose women with intact data of p-BMI, early pregnancy blood pressure, FPG and lipid profiles as objectives. According to the International Diabetes and Pregnancy Study Group (IADPSG) criteria, 222 women diagnosed with GDM, and 420 women diagnosed with normal glucose tolerance (NGT) were enrolled into case-control study. The relevant data were collected. Objectives were divided into normal weight group and overweight/obese group basing on p-BMI, then logistic regression was used to establish GDM prediction models, and ROC was used to analyze the predictive values.Results:(1) Compared with the NGT group, the GDM group were older at gestation, had higher proportions of diabetes mellitus (DM) family history, and GDM history. Pre-pregnancy weight, BMI, early pregnancy systolic and diastolic blood pressure (SBP and DBP), FPG, triglycerides (TG), total cholesterol (TCHO), and low-density lipoprotein cholesterol (LDL-C) of the GDM group were all significantly higher. Seventy five g OGTT FPG, 1 hour plasma glucose (1 hPG), 2 hour plasma glucose (2 hPG) during middle pregnancy were also significantly higher in the GDM group ( P<0.05). (2) The age at gestation higher than 31.2 years, early pregnancy FPG higher than 5.42 mmol/L, TG higher than 1.00 mmol/L, LDL-C higher than 2.49 mmol/L, DBP higher than 72.5 mmHg (1 mmHg=0.133 kPa) and DM family history were independent predictors of GDM. (3) For pre-pregnancy normal weight women, GDM can be predicted using age at gestation, early pregnancy FPG and DBP. For pre-pregnancy overweight/obese women, besides early pregnancy FPG and DBP, TG, times of pregnancy and DM family history were all independent predictors. The predictive value of TG was higher than that of FPG or DBP (area under curve were 0.718,0.640 and 0.648). The prediction model combining above independent predictors had improved predictive value (area under curve was 0.793). Conclusions:While GDM was diagnosed during middle or late pregnancy, higher levels of FPG, TG, LDL-C and DBP have emerged during early pregnancy. Women with different p-BMI have different predictive indicators in early pregnancy. Age at gestation, FPG and DBP were independent predictors for normal-weight women. For pre-pregnancy overweight/obese women, besides early pregnancy FPG and DBP, TG, times of pregnancy and DM family history were all independent predictors. The predictive value of TG was higher than that of FPG or DBP. The prediction model combining above independent predictors had improved predictive value.

目的:家族性高胆固醇血症(FH)现有的诊断标准复杂且不完全适用于中国人群,故本研究拟探索一种基于中国人群的新的家族性胆固醇血症简化诊断标准(Chinese Simplified Criteria for Familial Hypercholesterolemia,CSCFH)的可靠性.方法:连续纳入2011年11月至2018年5月就诊于阜外医院血脂中心的12901例住院患者,并收集临床特征、实验室检查和基因检测等数据.FH的诊断基于Simon Broome(SB)标准、荷兰脂质诊所网络(DLCN)标准和CSCFH,并分析CSCFH相对于上述两个标准的敏感度、特异度和一致性.结果:12901例受试者中,根据DLCN、SB和CSCFH标准,FH的患病率分别为1.73％(223/12901),1.57％(202/12901)和1.59％(205/12901).与DLCN和SB标准相比,CSCFH显示出高灵敏度(91.9％和100％)、高特异度(100％和99.9％)和良好的一致性(κ=0.957;κ=0.993).当根据不同地区对受试者进行分层分析时,CSCFH得到了相似的结果.结论:CSCFH与现有标准相比具有高敏感度和特异度,临床上更易于使用,未来需要进一步开展更大规模的前瞻性研究来评估该标准的可行性和可靠性.