Objectives Role of Vitamin D Receptor (VDR), Calcium Sensing Receptor (CaSR) and their associated long non-coding RNAs (lncRNAs) in Parathyroid Cancer (PC) development and PC diagnosis need to be explored. LncRNA SLC2A1-DT and SLC22A5-AS1 were dysregulated in previous microarray study. LncRNA SLC2A1-DT may target on VDR in prediction. Meanwhile, lncRNA SLC22A5-AS1was associated with CaSR. Methods 12 patients with PC and 43 patients with Parathyroid Adenoma (PA) were enrolled in this study. Fresh tissue samples were collected. Quantitative Real-Time Polymerase Chain Reaction (RT-qPCR) were used to assess the mRNA expression level of VDR and CaSR. In addition, protein level of VDR and CaSR were evaluated by Immunofluorescence (IF) detecting. Furthermore, expression level of lncRNA SLC2A1-DT, which may target on VDR in prediction, was validated by RT-qPCR in this study. Meanwhile, expression level of lncRNA SLC22A5-AS1, which was associated with CaSR in previous microarray study, was also detected by RT-qPCR. Results Down-regulated mRNA expression levels of VDR (p = 0.003) and CaSR (p = 0.000) were detected in patients with PC. Consistent with the mRNA profile, protein expression levels for these two genes were also decreased in PC group in IF detection. In addition, association between VDR and CaSR were also confirmed in patients with hyperparathyroidism (p = 0.000). However, there was no significant difference in Area Under Curve (AUC) among VDR, CaSR and PTH in parathyroid cancer diagnosis. Meanwhile, there was no difference in lncRNA SLC2A1-DT and SLC22A5-AS1 expression levels in RT-qPCR validation. However, expression levels of lncRNA SLC2A1-DT (p = 0.004) and SLC22A5-AS1 (p = 0.002) were increased in PC patients with normal serum phosphorus. In patients with normal serum phosphorus, the AUC of SLC2A1-DT was 0.896 (p < 0.001). Similarly, the AUC of SLC22A5-AS1 was 0.920 (p < 0.001). Conclusion Decreased VDR and CaSR may play a role in parathyroid cancer. VDR and CaSR may have interaction in hyperparathyroidism. LncRNA SLC2A1-DT and SLC22A5-AS1 were dysregulated in PC patients with normal phosphorate. These lncRNAs could serve as potential biomarkers for PC patients with normal phosphorus. Level of evidence This diagnostic or monitoring test accurate? (Diagnosis). Level 4 Case-control studies.

Primary intestinal lymphangiectasia (PIL) is a rare disease characterized by the loss of lymphatic fluid in the intestinal lumen and is a known cause of protein-losing enteropathy (PLE). Although uncommon, few cases of secondary hyperparathyroidism (SHPT) have been reported in patients with PIL. This study summarizes the characteristics of four cases diagnosed with PIL. Notably, all cases were confirmed to have hyperparathyroidism secondary to vitamin D deficiency and hypocalcemia. Recurrent diarrhea and limb convulsions were also observed in all patients, with one patient diagnosed with osteoporosis. Simultaneously, hypomagnesemia was detected in three cases. Treatment with vitamin D and calcium supplements relieved symptoms, elevated serum calcium levels, and decreased parathyroid hormone (PTH) levels. In patients with PIL, evaluation of 25-hydroxyvitamin D, calcium, and PTH levels is crucial. Bone diseases should be considered in patients with SHPT, and appropriate vitamin D3 and calcium supplementation is highly recommended.

Periodontitis is a periodontal inflammatory disease closely related to hypertension. However, the role of age and systemic inflammation is unclear. This study examined the effect of age and systemic inflammation on the association between severity of periodontitis and blood pressure in periodontitis patients. This cross-sectional clinical study included periodontitis patients treated at Beijing Chaoyang Hospital, Capital Medical University from January 2020 to July 2023. Patients with periodontitis were included using inclusion and exclusion criteria, and data on basic information, blood pressure, periodontal examination indicators, and biochemical examination indicators were collected. Patients were grouped by blood pressure, and differences in basic information, blood indexes, and periodontal examination indexes between the two groups were compared by independent sample T-test. With PBOP as independent variables, systolic blood pressure (SBP) and diastolic blood pressure as dependent variables, and several indexes as covariables, the relationship between them was studied by linear regression. The interaction was used to explore the relationship between age and systemic inflammation in periodontitis and hypertension. A total of 144 patients with periodontitis were enrolled. In fully adjusted analyses, the percentage of site with bleeding on probing (PBOP) was significantly associated with SBP (B = 10.08, p = 0.027) in the overall group. In patients 50 years or older, but not in those younger than 50, PBOP remained significantly associated with SBP (p = 0.018 for interaction). The strength of association between PBOP and SBP was greater in patients with higher systemic immune-inflammation index. The regression coefficients of PBOP in the systemic immune-inflammation index ≥ 400 and < 400 groups were 16.61 (95

INTRODUCTION:Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized primarily by insulin resistance and hyperglycemia, often leading to multiple complications. Sleep disturbances, including insomnia and sleep apnea, are prevalent in patients with T2DM and are associated with poorer glucose metabolism. Despite research examining the relationship between glucose metabolism, body composition, and sleep quality, the underlying mechanisms remain unclear, particularly within patients with T2DM. METHODS:This study involved 269 newly diagnosed patients with T2DM from January to June 2024. Data collected included demographic information, clinical variables, glycemic markers, and body composition analyses. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), categorizing participants into poor (PSQI-H) and good sleep quality (PSQI-L) groups. Univariate and multivariate regression analyses, along with mediation analysis, were performed using SPSS 26.0 and R software to explore associations between sleep quality, glycemic markers, and body composition. RESULTS:Significant correlations were found between PSQI scores and glycemic markers such as HbA1c, HOMA-IR, and postprandial blood glucose levels, showing that poorer glucose control was correlated with worse sleep quality. Mediation analysis suggested that body composition, particularly the trunk-to-limb fat mass ratio, may act as a statistical mediator in the relationship between glucose metabolism and sleep quality. CONCLUSIONS:Our findings highlight the complex relationship between glucose metabolism, body composition, and sleep quality in patients with T2DM. Targeting glucose regulation and body composition may be explored in future studies as potential approaches to improve sleep quality in individuals with T2DM. TRIAL REGISTRATION:Clinical ChiCTR1900022768.

What is already known on this topic?:Norovirus is the leading cause of global acute gastroenteritis outbreaks. Norovirus outbreaks mainly occur in schools and kindergartens in China, always causing public health issues. What is added by this report?:Conditional logistic regression method was used to analyze the risk factors for norovirus outbreaks in schools and kindergartens, and found that students vomiting at school or kindergarten, case activity in public areas, and the first case's classroom less than 5 meters from toilets were risk factors. What are the implications for public health practice?:Effective measures to address these factors can help reduce the risk of norovirus outbreaks in schools and kindergartens.

Ectopic parathyroid carcinoma (EPC) is a rare clinical entity with multiple diagnostic pitfalls, making surgical cures challenging. We assessed the clinicopathological spectrum and outcome of EPCs. In this retrospective cohort study, 24 EPCs were identified from 133 PC patients treated at a tertiary referral center. The relationship between clinicopathological findings and locations was analyzed. The locations of EPCs were predominantly intrathyroidal (62.5

AbstractBackgroundAsthma is widely recognized as an inflammatory disorder. In the context of this inflammatory microenvironment, the involvement of hypoxia and its impact on related pathways have drawn considerable attention. However, the exact role of hypoxia, a prevalent environmental factor, in the development and progression of asthma remains poorly understood.MethodsMice were treated with house dust mite (HDM) extracts for 23 days to induce asthma. Mice were divided into room air (RA) group and intermittent hypoxic (IH) group by exposing to different conditions and IH preconditioning (IHP) were underwent to the above groups before the hypoxic regimen. Airway inflammation in mice was evaluated by airway hyperresponsiveness, excessive mucus secretion, and recruitment of inflammatory cells. Immunohistochemistry was employed to quantify the expression levels of NF‐κB. Subsequently, the dose of allergen was modified to investigate whether the impact of hypoxia on asthma is affected by different doses of allergens.ResultCompared to the RA and IH groups, HDM‐treated mice in the IHP group exhibited aggravated inflammatory cell infiltration and airway hyperresponsiveness (p＜.05). Moreover, there was an increased release of inflammatory mediators and higher expression levels of NF‐κB (p＜.05). Importantly, the impact ia on asthma was found to be influenced by high dose of allergen (p＜.05).ConclusionIHP treatment potentially exacerbates HDM‐induced airway inflammation in asthma, with the involvement of NF‐κB, particularly under high‐dose allergen stimulation.

Abstract Objective To evaluate the association between systemic factors and periodontal status in patients with type 2 diabetes mellitus (T2DM). Methods A total of 169 patients with T2DM and periodontitis were included in this study. Patients were divided into three groups: mild periodontitis, moderate periodontitis and severe periodontitis. Periodontal parameters (PD, CAL and BI) were evaluated. FPG, HbA1c and Hs-CRP levels were measured in fasting venous blood. The association between insulin use and severity of periodontitis was investigated in ordered logistic and binomial logistic regression models. Results Ordered logistic regression analysis showed insulin use had a statistically significant influence on severity of periodontitis: OR 2.36 [95%CI: 1.23-4.55, P=0.010] after adjusting for age and gender; OR 2.10 [95%CI: 1.05-4.18, P=0.035] after adjusting for age, gender, smoking status, daily toothbrushing frequency and HbA1c level; OR 2.04 [95%CI: 1.01-4.14, P=0.048] after adjusting for age, gender, smoking status, daily toothbrushing frequency BMI, HbA1c level, FPG, statin and biguanide use. Binomial logistic regression models showed an association between insulin use and moderate to severe periodontitis: OR 2.44 [95% CI: 1.24-4.94, P=0.011] after adjusting for age and gender; OR 2.17 [95% CI: 1.07-4.53, P=0.035] after adjusting for age, gender, smoking status, daily toothbrushing frequency and HbA1c level; OR 2.13 [95% CI: 1.03-4.56, P=0.046] after adjusting for age, gender, smoking status, daily toothbrushing frequency BMI, HbA1c level, FPG, statin and biguanide use. Conclusion Patients with T2DM who require insulin injections have a high risk for moderate to severe periodontitis and should be provided oral health education.

Objective: To investigate the association of bedtime with the risk of early-onset diabetes mellitus (DM) and islet beta cell function. Methods: 138 participants with treat-naive DM were included in this study. All participants underwent a 75g oral glucose tolerance test. Sleep habit was obtained through a standardized questionnaire. Bedtime was categorized as < 22:00, 22:00-24:00, and & GE; 24:00 in this study. Multivariate logistic regression and multiple linear regression were used to estimate the association between bedtime and risk of early-onset DM and islet beta cell function, respectively. Results: Patients with early-onset DM had a later bedtime than those with late-onset DM. Individuals with bedtime & GE; 24:00 had a higher prevalence of early-onset DM than those with bedtime at 22:00-24:00 and < 22:00 (51.2% vs 29.3% vs 14.3%, respectively, p = 0.028). The multivariate logistic regression showed that per hour later in bedtime was associated with a 52% increased risk of early-onset DM (p = 0.023). Patients with bedtime after 24:00 had a 146% increased risk of early-onset DM compared to those went to bed between 22:00 to 24:00 (OR = 2.46, 95% CI 1.05 to 5.77, p = 0.039). The multiple linear regression showed that bedtime was independently negatively correlated with late-phase insulin secretion (assessed by disposition index, DI120). Conclusion: Later bedtime was associated with worse late-phase insulin secretion and may be a risk factor for early-onset DM. Proper bedtime to lower risk of early-onset DM deserves further investigation.

Objective: To assess the correlation between body components with insulin resistance (IR) and islet beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM) or pre-diabetes mellitus (pre-DM) and to explore whether this correlation differs in males and females.Methods: 111 newly diagnosed diabetic or pre-diabetic patients were recruited in this cross-sectional study. 75g oral glucose tolerance test was used to determine the diagnosis of DM or pre-DM. Homeostasis model assessment of insulin resistance (HOMA-IR) and glucose disposition index (DI30) was calculated to assess IR and islet beta cell function, respectively. Whole-body and regional lean mass (LM) and fat mass (FM) were obtained by dual-energy X-ray absorptiometry (DEXA). Partial correlation and multiple linear regression analyses were used to determine the associations between body composition, IR, and islet beta cell function.Results: More body fat and appendicular fat was observed in female patients than in male, though with similar BMI. Legs fat % was negatively correlated with HOMA-IR, whereas legs lean % was positively associated with HOMA-IR in females (r = -0.673, p = 0.017; r =0.664, p = 0.018, respectively). The regression analysis showed that legs LM was positively correlated with HOMA-IR in females. However, in male patients, android FM was positively correlated with HOMA-IR (r = 0.462, p = 0.007), and trunk LM was negatively associated with DI30 (r = -0.458, p = 0.007). Nevertheless, no significant correlation was observed between body composition and islet beta cell function in female patients.Conclusion: Android FM was positively correlated with IR only in male patients but not in females. Besides, relative legs fat and LM were independently associated with IR in female patients but not in males. Further studies are needed to explore the underlying mechanism.

Objective:To analyze the influencing factors of dentition defect in people with type 2 diabetes mellitus (T2DM) and periodontitis and to provide evidence-based support for improving the oral health and quality of life of T2DM patients.Methods:A total of 169 patients with T2DM and periodontitis were selected by convenience sampling. According to the number of remaining teeth, the subjects were divided into two groups, group A (number of remaining teeth in the mouth≥20, n=115) and group B (the number of remaining teeth in the mouth<20, n=54). Questionnaire surveys, systemic and oral examinations, and laboratory blood tests were performed. Systematic influencing factors of dentition defect in people with T2DM and periodontitis were analyzed with logistic regression.Results:Compared with patients in group A, patients in group B had higher findings in age, systolic blood pressure (SBP), prevalence of coronary heart disease and hyperlipidemia, glycosylated hemoglobin (HbA1c), periodontal probing depth (PD), and clinical attachment loss (CAL). Furthermore, their behaviors and awareness of oral health were not as good as those of patients in group A. Logistic regression showed that age, HbA1c, and SBP were independent risk factors for the number of remaining teeth in the mouth <20 among T2DM patients with periodontitis ( P<0.05).Conclusion:Increasing age, lower HbA1c, and increased SBP are the most important influencing factors for the number of remaining teeth in the mouth <20 in T2DM patients with periodontitis. Clinical practitioners should give more attention to the general health status of the patients and strengthen health education, thereby improving patients' quality.

Background To investigate the difference in the structural composition of salivary flora between chronic periodontitis patients with and without diabetic nephropathy (DN). Methods Thirty salivary samples of 15 chronic periodontitis patients with DN (DN group) and 15 chronic periodontitis patients with diabetes but without DN (DM group) were subjected to pyrosequencing of polymerase chain reaction-amplified 16 s ribosomal RNA genes. After diversity testing, the differential flora were analyzed. The sequencing results were compared with GenBank database to determine the type of differential flora using species composition analysis, hierarchical cluster analysis, principal co-ordinate analysis, and species difference analysis. Results There were significant between-group differences with respect to Gemella , Selenomonas spp , Lactobacillales_unclassified, Bacteria-unclassified and Abiotrophia ( p < 0.05). Compared with DM group, the relative abundance of Selenomonas spp. in DN group was significantly higher; the area under the receiver operating characteristic curve of Selenomonas spp. was 0.713 ( P < 0.05). Multi-level biological identification and feature maps indicated that Selenomonas spp. might be used as a potential biomarker for DN patients. On binary logistic regression analysis, increase of Selenomonas spp. was related with DN. Conclusions We found significant between-group differences in the structural composition of oral flora. The increase in the relative abundance of Selenomonas spp. may be associated with DN in patients with chronic periodontitis.

OBJECTIVE The aim of this study was to investigate the association between periodontitis and total serum cholesterol level in patients with type 2 diabetic nephropathy (T2DN). BACKGROUND Periodontitis is now recognized as the sixth complication of diabetes and can also affect other complications of diabetes, including nephropathy and coronary artery diseases. Studies have considered dyslipidemia as a risk factor for exacerbation of periodontitis. METHODS A total of 119 T2DN patients with chronic periodontitis were included in this observational study. Participants were stratified into the Normal (serum total cholesterol <5.17 mmol/L, n = 89) and the Dyslipidemia groups (serum total cholesterol ≥5.17 mmol/L, n = 30). Participants completed a validated questionnaire that collected information on oral hygiene behaviors and knowledge of oral health and underwent a clinical oral examination. The number of remaining teeth, probing depth (PD), clinical attachment level (CAL), and bleeding index (BI) was recorded. Physical examination and laboratory tests (fasting plasma glucose, serum glycosylated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride, and high-sensitivity C-reactive protein levels) were performed. RESULTS Means of CAL and BI were significantly higher in the Dyslipidemia group compared with the Normal group. In the Dyslipidemia group, PD and percent of sites with PD ≥4 mm were positively correlated with urinary albumin/creatinine ratios; PD and percent of sites with PD ≥4 and PD ≥5 mm were positively correlated with HbA1c level; a number of remaining teeth were negatively correlated with serum LDL-C level. After adjusting for age, gender, body mass index, smoking, FPG, and serum HbA1c and triglyceride levels, BI was found to be positively associated with dyslipidemia in T2DN patients with periodontitis. CONCLUSION T2DN patients with chronic periodontitis had a 2.355-fold higher risk of developing dyslipidemia, implying an important relationship between periodontitis and blood lipid control among T2DN patients.

目的 探讨股骨颈动力交叉钉系统(femoral neck system,FNS)治疗中青年PauwelsⅡ型股骨颈骨折的临床价值.方法 回顾性分析2018年11月至2020年11月我科诊治且符合选择标准的79例中青年PauwelsⅡ型股骨颈骨折患者的临床资料,分为A组(35例,空心螺钉内固定治疗)和B组(44例,FNS内固定治疗).对比A、B组患者手术操作时间、术中出血量、C型臂X线机透视次数以及骨折痊愈时间;分析骨折复位质量并测量患侧股骨颈短缩;评估髋关节Harris评分.结果 术后A组2例骨折复位指数为(Ⅲ+Ⅳ),B组3例骨折复位指数为(Ⅲ+Ⅳ).余患者术中复位指数为Ⅰ或Ⅱ.A、B组之间骨折复位指数差异无统计学意义(P>0.05);两组手术时间差异无统计学意义(P>0.05).A组的术中出血量略少于B组,差异无统计学意义(P>0.05);B组术中的透视次数明显少于A组,差异有统计学意义(P<0.05).A组4例术后3个月内空心螺钉倒出(断端无骨痂生长)、头钉切出,B组4例术后3个月头钉切出,余两组患者骨折均临床痊愈.两组患者的骨折痊愈时间差异无统计学意义(P>0.05).A组3例股骨头坏死(8.57％),B组4例股骨头坏死(9.09％),差异无统计学意义(P>0.05).于末次临床病例随访时,X线片检查结果显示A组中5例术后发生颈短缩,B组中2例术后发生颈短缩,A、B组内固定术后股骨颈短缩患者的骨折均为临床愈合,差异无统计学意义(P>0.05).于末次随访时记录、分析髋关节功能评分,Harris评分差异无统计学意义(P>0.05).结论 与空心螺钉内固定治疗中青年PauwelsⅡ型股骨颈骨折相比,FNS在获得良好临床效果同时,可显著减少术中透视次数.

目的 观察经皮拉力螺钉内固定治疗三踝骨折中Haraguchi Ⅰ型后踝骨折的临床疗效.方法 回顾性分析自2018-01-2019-05采用手术治疗的32例三踝骨折合并Haraguchi Ⅰ型后踝骨折,外踝骨折经外侧切口钛板螺钉内固定,内踝骨折经内侧切口空心钉内固定,后踝骨折采用闭合复位经皮拉力螺钉内固定.结果 本组手术时间1.5～2.5h,平均1.8 h;住院时间5～11 d,平均7.5 do 32例均获得随访,随访时间平均15.5(14～18)个月.术后骨折复位质量根据Burwell-Charnley放射学评分标准评定:解剖复位24例,复位可6例,复位差2例.术后至开始完全负重时间11～14周,平均13.4周.骨折愈合时间11～13周,平均12.5周.未出现骨折不愈合及内固定失败.术后6个月踝与后足功能AO-FAS评分为79～83分,平均81.5分;术后12个月踝与后足功能AOFAS评分为86～94分,平均90.2分.2例螺钉置入下胫腓关节内,于术后1年取出内固定.结论 采用经皮拉力螺钉内固定治疗三踝骨折中Haraguchi Ⅰ型后踝骨折术中对踝关节周围软组织损伤小,骨折固定牢靠,后踝骨折复位维持良好,术后患者踝关节功能恢复满意.

Objective: To explore potential effects of pancreatic fat content measured by computed tomography (CT) on carotid plaque in patients with type 2 diabetes mellitus (T2DM). Methods: T2DM patients who underwent an un-enhanced CT scan of the upper abdomen and ultrasound of the carotid artery were enrolled. The patients were divided into a non-plaque group and a plaque group (including hypoechoic plaque subgroup and non-hypoechoic plaque subgroup). The CT attenuation of pancreas and spleen were measured. Pancreas-to-spleen attenuation ratio (P/S) and the difference between pancreatic and splenic attenuation (P-S) were calculated. The cutoff values of P/S and P-S were obtained using receiver operating characteristic curves. Logistic regression models were used to evaluate association of P/S or P-S with carotid plaque or hypoechoic plaque. Results: 337 patients were enrolled, including 101 cases in the non-plaque group, 146 cases in the hypoechoic plaque subgroup, and 90 cases in the non-hypoechoic plaque subgroup. P/S and P-S in hypoechoic plaque group were lower than those in non-plaque group, with a cut off value of P/S and P-S as 0.72 and -13.33, respectively. After adjusting for risk factors, P/S and P-S correlated with carotid plaque [for low P/S: OR (95% CI): 3.15 (1.47-6.73), P = 0.0031; for low P-S: OR (95% CI): 2.84 (1.42-5.66), P = 0.0031] as well as carotid hypoechoic plaque [for low P/S: OR (95% CI): 1.82 (1.07-3.08), P = 0.0259; for low P-S: OR (95% CI): 1.82 (1.09-3.02), P = 0.021]. Conclusion: T2DM patients with hypoechoic carotid plaque have higher pancreatic fat content than those without. Pancreatic steatosis correlates with carotid plaque and hypoechoic plaque in T2DM patients.

目的 研究不同血糖控制水平的糖尿病肾病(diabetic nephropathy,DN)患者的牙周状况及特点,探讨牙周炎症程度对糖尿病肾病患者血糖控制的作用.方法 纳入119例糖尿病肾病患者,分为两组,糖化血红蛋白(glycosylated hemoglobin,HbA1c)良好(HbA1c<7％)组27例和糖化血红蛋白不良(HbA1c≥7％)组92例.牙周检查内容包括探诊深度(probing depth,PD)、出血指数(blood index,BI)、临床附着丧失(clinical attachment loss,CAL)以及口内余留牙数,口腔健康问卷包括口腔健康行为等.血清检测指标包括HbA1c、空腹血糖、总胆固醇等.结果 与HbA1c<7％组的患者相比,HbA1c≥7％组患者的PD(3.99±1.05 vs 3.49±0.93,P=0.031)、BI(3.45±0.58 vs 3.10±0.67,P=0.001)、CAL(6.40±2.18 vs 5.37±1.99,P=0.003)、PD≥4 mm百分率(中位数:54.17％vs 38.15％,P=0.001),PD≥5mm百分率(中位数:24.13％vs 12.85％,P=0.028)增加,差异具有统计学意义.多因素Logistic回归分析结果表明,除空腹血糖增加与HbA1c控制不良高度相关外,牙周检查指标CAL增加与DN患者HbA1c控制不良亦高度相关(OR=1.36,95％CI:1.01-1.83,P=0.043).结论 糖尿病肾病患者的HbA1c控制情况与牙周炎症程度有关,CAL增加与糖尿病肾病患者HbA1c控制不良高度相关.

Background Dysregulated lncRNA score and PVT1 expression may be involved in cancer. However, relationships of lncRNAs with hyperparathyroidism and parathyroid cancer (PC) diagnosis remain mysterious. Methods Using quantitative real-time polymerase chain reaction (RT-qPCR), expression profile of PVT1 was evaluated in 57 patients with primary hyperparathyroidism, including 11 with parathyroid cancer (PC) and 46 with parathyroid adenoma (PA). Results Higher levels of lncRNA score and PVT1 expression were associated with increased serum calcium level after water ingestion and PC risk ( P < 0.05). Accordingly, lncRNA score and PVT1 expression were increased with varying degrees of hypercalcemia in PC. A higher level of lncRNA score (but not PVT1) was an independent risk factor of PC, with an AUC up to 0.872 (95% CI: 0.756–0.945, P < 0.001). Moreover, lncRNA score was more valuable (with AUC 0.974, sensitivity of 85.71% and specificity of 100%, respectively) than intact parathyroid hormone (iPTH) in predicting risk of PC among patients with hypercalcemia (especially based on greater AUC, P = 0.010). Conclusion Increased lncRNA score is correlated with an elevated level of serum calcium, which may serve as a potential biomarker for PC diagnosis, especially with hypercalcemia. Graphical Abstract

Background Pancreatic steatosis correlates with the thickness of arterial intima. However, the correlation between pancreatic steatosis and carotid atherosclerosis plaque, which better predict the prognosis of cardiovascular disease, is unclear. We aimed to explore potential effects of pancreatic fat content measured by computer tomography (CT) on carotid plaque in patients with type 2 diabetes mellitus (T2DM). Methods Patients with T2DM who underwent CT scan of the upper abdomen and ultrasound of the carotid artery were consecutively enrolled. Based on ultrasound results, the patients were divided into non-plaque group and plaque group, and the latter was categorized into hypoechoic plaque subgroup and non-hypoechoic plaque subgroup. The CT attenuation of pancreas and spleen were measured. Pancreas-to-spleen attenuation ratio (P/S) and difference between pancreatic and splenic attenuation (P-S) were calculated. The cut-off values of P/S and P-S were obtained using receiver operating characteristic (ROC) curves. Logistic regression models were used to evaluate association of P/S or P-S with carotid plaque or hypoechoic plaque. Results A total of 337 patients with T2DM were enrolled, including 101 cases (30.0%) in the non-plaque group, 146 cases (43.3%) in the hypoechoic plaque subgroup, and 90 cases (26.7%) in the non-hypoechoic plaque subgroup. P/S and P-S in plaque group were lower than those in non-plaque group, with a cut-off value of P/S and P-S as 0.72 and -13.33, respectively. After adjusting for risk factors, P/S and P-S correlated with carotid plaque [for low P/S: OR (95% CI): 3.15 (1.47-6.73), P=0.0031; for low P-S: OR (95% CI): 2.84 (1.42-5.66), P=0.0031] as well as carotid hypoechoic plaque [for low P/S: OR (95% CI): 1.82 (1.07-3.08), P=0.0259; for low P-S: OR (95% CI): 1.82 (1.09-3.02), P=0.021]. Conclusions T2DM patients with carotid plaque have higher pancreatic fat content than those without. Pancreatic steatosis correlates with carotid plaque and hypoechoic plaque in T2DM patients.