The prevalence and impact on physical function of osteosarcopenia in the Chinese population remain unclear. The purpose of this study was to assess the prevalence of osteosarcopenia and its association with physical function in the elderly population of China. A total of 519 participants (327 males, 192 females; mean age: 67.2 years) elderly people were recruited. Physical performance was evaluated using the Timed Up and Go test and the Short Physical Performance Battery (SPPB). Osteoporosis was diagnosed based on the 1994 WHO criteria, while sarcopenia was defined according to the AWGS guidelines. Osteosarcopenia was diagnosed when both sarcopenia and osteoporosis were present. Among the participants, osteosarcopenia was identified in 27 (5.20

This network meta-analysis aimed to compare the efficacy of three forms of intermittent energy restriction (IER), including alternate-day fasting (ADF), the 5:2 diet, and time-restricted feeding (TRF), in overweight or obese adults. A literature search was conducted in PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) to find relevant randomized controlled trials (RCTs) until August 10, 2022. The modified Cochrane risk of bias assessment tool was applied to assess the methodological quality of eligible studies. Random network meta-analysis was conducted using STATA 14.0. Sixteen RCTs were included, with 1228 patients. Overall, the methodological quality ranged from low to moderate. ADF was superior to CER and 5:2 diet in reducing waist circumference, whereas 5:2 diet was superior to CER in reducing BMI. Regarding fat mass and drop-out, all forms of IER were comparable. Sensitivity analyses indicated that the type of individuals had no influence on the pooled results; nevertheless, ADF significantly reduced weight compared to CER and achieved significant waist circumference reduction compared to CER, 5:2 diet, and TRF. ADF may be preferentially prescribed for overweight or obese adults. More large-scale and high-quality studies are required, however, to investigate the effect of TRF on overweight and obesity.

Type 2 diabetes mellitus (T2DM) is a major risk factor of a number of neurodegenerative diseases (NDDs). Ketogenic diet (KD) has significant beneficial effects on glycemic control and may act effectively against NDDs, but the mechanism remains unclear. In this study, we aimed to investigate the potential effects of KD on gene expressions in the brains of T2DM model mice. Male db/db mice at the age of 9 weeks were fed with KD or normal diet to the age of 6 months, and the whole brains were subjected to mRNA-seq analysis for differentially expressed genes. KD significantly lowered fasting glucose and body weights in db/db mice (P<0.05), and the expression of 189 genes in the brain were significantly changed (P<0.05, |log2|>1). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed that the differentially expressed genes upon KD are involved in inflammatory responses and the functions of biosynthesis. In inflammatory responses, NF-κB signaling pathway, viral protein interaction with cytokine and cytokine receptor, and cytokine-cytokine receptor interaction pathways were enriched, and in biosynthesis pathways, genes functioning in lipid and amino acid metabolism, protein synthesis, and energy metabolism were enriched. Moreover, consistent with the gene set enrichment analysis results, proteasomal activity measured biochemically were enhanced in KD-fed T2DM mice. These data may facilitate the understanding of how KD can be protective to the brain in T2DM background. KD could be a new strategy for the prevention of NDDs in T2DM patients.

BACKGROUND Dyslipidemia and type 2 diabetes mellitus (T2DM) are chronic conditions with substantial public health implications. Effective management of lipid metabolism in patients with T2DM is critical. However, there has been insufficient attention given to the relationship between thyroid hormone sensitivity and dyslipidemia in the T2DM population, particularly concerning non-high-density lipoprotein cholesterol (non-HDL-C). AIM To clarify the association between thyroid hormone sensitivity and dyslipidemia in patients with T2DM. METHODS In this cross-sectional study, thyroid hormone sensitivity indices, the thyroid feedback quantile-based index (TFQI), the thyroid-stimulating hormone index (TSHI), the thyrotrophic T4 resistance index (TT4RI), and the free triiodothyronine (FT3)/free thyroxine (FT4) ratio were calculated. Logistic regression analysis was performed to determine the associations between those composite indices and non-HDL-C levels. Random forest variable importance and Shapley Additive Explanations (SHAP) summary plots were used to identify the strength and direction of the association between hyper-non-HDL-C and its major predictor. RESULTS Among the 994 participants, 389 (39.13%) had high non-HDL-C levels. Logistic regression analysis revealed that the risk of hyper-non-HDL-C was positively correlated with the TFQI (OR: 1.584; 95%CI: 1.088-2.304; P = 0.016), TSHI (OR: 1.238; 95%CI: 1.034-1.482; P = 0.02), and TT4RI (OR: 1.075; 95%CI: 1.006-1.149; P = 0.032) but was not significantly correlated with the FT3/FT4 ratio. The relationships between composite indices of the thyroid system and non-HDL-C levels differed according to sex. An increased risk of hyper-non-HDL-C was associated with elevated TSHI levels in men (OR: 1.331; 95%CI: 1.003-1.766; P = 0.048) but elevated TFQI levels in women (OR: 2.337; 95%CI: 1.4-3.901; P = 0.001). Among the analyzed variables, the average SHAP values were highest for TSHI, followed by TT4RI. CONCLUSION Impaired sensitivity to thyroid hormones was associated with high non-HDL-C levels in patients with T2DM.

Objective The objective of this probe is to determine the effects of High-Protein Diets (HPD) on weight loss programs. Methodology From January 2021 to May 2022, 133 patients, who were enrolled in a Chinese-based weight loss program, participated in a clinical trial aimed at investigating the impact of High-Protein Diets (HPD) on weight loss programs. The effects of the diet plan on the patients’ insulin, hemoglobin, and Vitamin D levels were assessed and the findings examined to evaluate the impact of HPD on muscle and skeletal mass. Results and Findings HPD was useful in catalyzing the effectiveness of weight loss programs. It led to reductions in skeletal and muscle mass during the trial period based on its impact on insulin, hemoglobin, and Vitamin D levels among the trial population..

The association between the geriatric nutritional risk index (GNRI) and osteosarcopenia in older adults with type 2 diabetes mellitus (T2DM) is not clear. A total of 573 individuals with T2DM were included in this cross-sectional study. Osteosarcopenia was defined as the presence of both osteoporosis and sarcopenia. Appendicular skeletal muscle mass and bone mineral density (BMD) was measured by dual energy X-ray absorptiometry to diagnose sarcopenia and osteoporosis. Multivariate analyses were used to assess the association between Geriatric Nutritional Risk Index (GNRI) and osteosarcopenia. The patients were divided into four groups: robust (n = 367), osteoporosis alone (n = 154), sarcopenia alone (n = 29), and osteosarcopenia (n = 23). The GNRI was the lowest in osteosarcopenia group and was positively correlated with skeletal muscle index (SMI) (r = 0.122, p = 0.004), grip strength (r = 0.154, p < 0.001), gait speed (r = 0.123, p = 0.004), and BMD of lumbar spine 2–4, femoral neck, and total hip (r = 0.137, p = 0.002; r = 0.096, p = 0.028; r = 0.086, p = 0.049, respectively). In the logistic regression model low GNRI was significantly associated with an increased risk of osteosarcopenia (adjusted OR, 4.164; 95

ObjectivesTo investigate the association between body fat (BF%) and sarcopenia in older adults with type 2 diabetes mellitus (T2DM) and potential link with increased levels of inflammatory indicators and insulin resistance.MethodsA total of 543 older adults with T2DM were included in this cross-sectional study. Appendicular skeletal muscle (ASM), handgrip strength and gait speed were measured to diagnose sarcopenia according to the updated Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Body composition data were tested using dual-energy X-ray absorptiometry (DEXA). Levels of serum high-sensitive C-reactive protein (hs-CRP), interleukin-6, fasting blood insulin (FINS), hemoglobin A1c (HbA1c), 25-hydroxyvitamin D3 [25(OH) D3] were also determined.ResultsThe prevalence of sarcopenia in all participants was 8.84%, of which 11.90% were male and 5.84% females. The Pearson’s correlation analysis revealed that BF% was negatively correlated with gait speed in men and women (R =-0.195, P=0.001; R = -0.136, P =0.025, respectively). After adjusting for all potential confounders, sarcopenia was positive associated with BF% (male, OR: 1.38, 95% CI: 1.15–1.65, P< 0.001; female, OR: 1.30, 95% CI: 1.07–1.56, P=0.007), and negatively associated with body mass index (BMI) (male, OR: 0.57, 95% CI: 0.44–0.73, P<0.001; female, OR: 0.48, 95% CI: 0.33–0.70, P<0.001). No significant differences were found in hs-CRP, interleukin-6, and insulin resistance between older T2DM adults with and without sarcopenia.ConclusionHigher BF% was linked to an increased risk of sarcopenia in older adults with T2DM, suggesting the importance of assessing BF% rather than BMI alone to manage sarcopenia.

Objective:Our aim was to explore the effects of the energy-limiting balance intervention on serum uric acid (SUA) and high sensitivity C-reactive protein (hs-CRP) and analyze the correlation between the two. Methods:Retrospectively chosen study patients were 98 obese individuals who received diagnoses and care in Xuanwu Hospital Capital Medical University between January 2021 and September 2022. The patients were divided into the intervention group and the control group via random number table, with 49 patients in each group. The control group received standard food interventions, while the intervention group received minimal energy balance interventions. The clinical outcomes in both groups were compared. We also compared patients' pre- and post-intervention levels of SUA, hs-CRP, and markers of glucose and lipid metabolism were assessed. Analysis was done on the relationship between markers of glucose and lipid metabolism and SUA and hs-CRP levels. Results:Patients in the intervention and control groups had respective ineffective rates of 6.12% and 20.41%, effective rates of 51.02% and 57.14%, substantial effective rates of 42.86% and 22.45% and overall effective rates of 93.88% and 79.59%. The intervention group's overall effective rate was substantially greater than the control group's rate (P < .05). After the intervention, patients in the intervention group had markedly decreased SUA and hs-CRP levels than patients in the control group (P < .05). Prior to the intervention, there was no clinically meaningful discrepancy between the two groups in terms of fasting blood glucose, insulin, glycated hemoglobin (HbA1c) or 2 hours postprandial blood glucose (P > .05). Following the intervention there was a statistically significant discrepancy between the intervention group and the control group in terms of fasting blood glucose, insulin, HbA1c and 2 hours postprandial blood glucose (P < .05). According to a Pearson correlation study, high-density lipoprotein (HDL) was negatively correlated with the SUA levels and positively correlated with fasting blood sugar, insulin, triglycerides, total cholesterol and low-density lipoprotein (LDL). Before the intervention, there was no clinically meaningful variation in the intervention or control groups in triglycerides, total cholesterol, LDL or HDL (P > .05). Following the intervention, patients in the intervention group had markedly decreased triglycerides, total cholesterol and LDL levels than patients in the control group, while their HDL levels had substantially increased compared with the control group (P < .05). Fasting blood sugar, insulin, triglycerides and LDL all had a positive correlation with their SUA levels (P < .05). The amount hs-CRP was inversely correlated with HDL (P < .05) and positively correlated with fasting blood glucose, insulin, 2h postprandial blood glucose, HbA1c, triglycerides and LDL. Conclusion:An energy-limiting balance intervention can effectively reduce SUA and hs-CRP, regulate the metabolism of glucose and lipid and were closely related.

To investigate the effects of different weight loss interventions on body mass index (BMI) and glucose and lipid metabolism in obese patients. Obese patients (n = 135) admitted to our hospital between December 2020 and August 2022 were divided into 3 groups, according to their diet patterns: calorie-restricted diet (CRD) group (n = 39), high-protein diet (HPD) group (n = 28), and 5 + 2 intermittent fasting (IF) group (n = 68). Body weight, body fat rate, BMI, hip circumference, and waist circumference were measured before and 60 days after implementation of the respective diet plan. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), triglyceride (TG), total cholesterol, low-density lipoprotein, high-density lipoprotein, and adverse events were evaluated. Following the dietary intervention, the weight (P = .005 for CRD, P < .001 for HPD, and P = .001 for IF), body fat rate (P = .027 for CRD, P = .002 for HPD, and P = .011 for IF group), BMI (P = .017 for CRD, P < .001 for HPD, and P = .002 for IF group), hip circumference (P < .001 for CRD, P = .013 for HPD, and P = .032 for IF group), waist circumference (P = .005 for CRD, P < .001 for HPD, and P = .028 for IF group), HbA1c (P = .014 for CRD, P = .002 for HPD, and P = .029 for IF group), FBG (P = .017 for CRD, P < .001 for HPD, and P = .033 for IF group), and 2hPG (P = .009 for CRD, P = .001 for HPD, and P = .012 for IF group), were significantly decreased. TG (P = .007 for CRD, P < .001 for HPD, and P = .018 for IF group), TC (P = .029 for CRD, P = .013 for HPD, and P = .041 for IF group), LDL-C (P = .033 for CRD, P = .021 for HPD, and P = .042 for IF group), and LDL-C (P = .011 for CRD, P < .001 for HPD, and P = .027 for IF group) improved significantly in the 3 groups, when compared to that before treatment. The HPD had the best effect on reducing blood lipids, followed by the CRD; the effect of IF was slightly lesser. Short-term HPD, CRD, and IF can reduce the weight and body fat of overweight/obese individuals and improve blood lipid and blood sugar levels. The effect of HPD on weight loss, body fat, and blood lipid levels was greater than that of CRD or IF.

目的 回顾性分析阻塞性睡眠呼吸暂停患者睡眠效率与糖尿病发病率的相关性.方法 回顾性分析2002年10月1日-2021年9月30日某院呼吸科睡眠医学中心接受睡眠监测,并符合OSA诊断及纳入标准的2360名患者.所有患者根据睡眠效率比例不同分为≥85％,80％～84.9％和＜80％3个组别,以多因素Logistic模型分析睡眠效率与DM之间的相关性.结果 在所有OSA患者中,校正相关因素后,与睡眠效率≥85％相比,睡眠效率＜80％组其发生DM的概率明显升高(OR 1.476,95％CI 1.073～2.030,P=0.017).年龄＜60岁、男性以及BMI≥25kg/m2患者中,校正相关因素后,睡眠效率＜80％与DM的发生存在独立相关性(OR 1.619,95％CI 1.094～2.398,P=0.016;OR 1.712,95％CI 1.161～2.524,P=0.007;OR 1.500,95％CI 1.043～2.158,P=0.029).结论 在OSA患者中,睡眠效率差与DM的发生存在显著的相关性,尤其在年轻男性及肥胖的人群中尤为显著.

Objective:To investigate the correlation between fasting blood glucose (FPG) and neurological function in patients with acute ischemic stroke.Methods:A retrospective analysis was performed on 3 338 stroke patients admitted to Xuanwu Hospital of Capital Medical University within 24 hours of onset from November 2013 to October 2016. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. FPG, 2 hours postprandial-based blood glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), glycated hemoglobin A 1c (HbA 1c), serum creatinine (Scr), urea, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), homocysteine (Hcy), plasma fibrinogen (Fg) were detected. National institutes of health stroke scale (NIHSS), Glasgow coma index (GCS) and modified Rankin scale (MRS) were used to evaluate neurological function. Patients were divided into three groups according to different FPG levels on admission: normal blood glucose group (FPG<6.1 mmol/L, no history of diabetes, 1 507 cases), FPG impaired group (6.1 mmol/L≤FPG<7.0 mmol/L, 1 002 cases), diabetes group (FPG≥7.0 mmol/L or previous history of diabetes, 829 cases). According to NIHSS score, all patients were divided into neurological impairment group (NIHSS score>1 point, 1 906 cases) and normal neurological function group (NIHSS score≤1 point, 1 432 cases). The analysis of variance, t test, and χ2 test were used for comparison between groups. Pearson correlation analysis was used to analyze the correlation between FPG and neural function score. Multivariate logistic regression analysis was used to analyze the influencing factors of neurological function in acute ischemic stroke patients. Results:Compared with the normal blood glucose group and the impaired FPG group, SBP, DBP, FPG, ALT and AST were increased and the indexes of Scr, urea and TG were decreased in the diabetic group, the differences were statistically significant (all P<0.05). Compared with the normal blood glucose group, the SBP, DBP, FPG and ALT in the FPG impaired group were increased, while the AST, Scr, urea and TG were decreased, and the differences were statistically significant (all P<0.05). There were statistically significant differences in NIHSS, MRS and GCS scores among the three groups (all P<0.001). NIHSS and MRS scores in the diabetic group were significantly higher than those in the FPG impaired group, and GCS scores were significantly lower than those in the FPG impaired group (all P<0.001). NIHSS and MRS scores in the FPG impaired group were significantly higher than those in the normal blood glucose group, and GCS scores were significantly lower than those in the FPG impaired group (all P<0.05). FPG was positively correlated with NIHSS and MRS scores ( r=0.80, P<0.05; r=0.84, P<0.05), was negatively correlated with GCS scores ( r=-0.83, P<0.05). Multivariate logistic regression analysis showed that age, 2 hours postprandial-based blood glucose, hypoglycemic agents and FPG were all related to neurological function in stroke patients ( P<0.05). Conclusions:There is a significant correlation between FPG and neurological function score in patients with acute ischemic stroke. Patients with high FPG have more severe neurological function injury, poorer neurological function recovery state and worse consciousness state.

目的 探讨老年2型糖尿病患者跌倒的相关因素,找出跌倒风险的相关因素.方法 纳入2016年5月10日-2019年11月20日北京某三甲医院内分泌科住院的60岁以上的2型糖尿病患者共530例,根据过去1年是否有跌倒情况分为跌倒组和无跌倒组.测定空腹血糖、糖化血红蛋白、血脂、骨骼肌肌肉质量、握力、步速等.计算体质量指数与四肢骨骼肌肌肉质量指数.分析跌倒的影响因素.结果 跌倒组的ASMI、握力、步速、前白蛋白、血色素水平显著低于非跌倒组(P＜0.05).跌倒组女性比例、糖尿病视网膜病变患病率显著高于非跌倒组(分别为P＜0.001).多元Logistic回归分析显示糖尿病视网膜病变OR(95％CI):2.517(1.553-4.078)、低步速 OR(95％CI):2.894(1.692-4.948)、前白蛋白OR(95％CI):0.996(0.992-0.999)为跌倒的独立影响因素.结论 糖尿病视网膜病变、低步速为老年T2DM患者跌倒的危险因素,前白蛋白为跌倒的保护因素.

Purpose: Muscle dysfunction is considered as a sign of poor prognosis in patients with type 2 diabetes (T2D). Thus, early detection of muscle disorders is particularly important in T2D population. For free fatty acid (FFA) is known as a clinical indicator of metabolic diseases and muscle function, hence, we aimed to investigate whether FFA could serve as a biomarker for muscle function. Methods: There are totally 160 adult subjects with T2D were characterized and analyzed in this study. Muscle mass and function were measured by walking speed, grip strength and height-adjusted appendicular skeletal muscle mass (SMI). Logistic regression was applied to explore the correlation of FFA with muscle indicators. Receiver operating characteristic (ROC) curves were utilized to conduct the diagnostic value of FFA. Results: FFA was negatively correlated with SMI (r = -0.347, P = 1.0E-05), grip strength (r = -0.313, P = 7.1E-05) and walking speed (r = -0.167, P = 0.039). Notably, the relationships between FFA and SMI and walking speed remained significant even after adjusting for age, sex, body mass index (BMI) and hemoglobin A1C (HbA1c). The combination of conventional indicators including age, BMI and HbA1c provided discrimination effect of low grip strength with an AUC of 0.648, low walking speed with an AUC of 0.714. Importantly, when FFA was added to the model, the value of ROC curve was further improved, with an AUC of 0.785 for low grip strength, 0.755 for low walking speed. Conclusions: The current study demonstrated a negative correlation of FFA with muscle indicators in adult T2D patients after adjusting for HbA1c. FFA may play an important role in the pathological process of muscle dysfunction in adults with T2D.

Abstract Objectives Several studies demonstrated a positive relationship between hemoglobin level and bone mineral density (BMD). Thus, the association between hemoglobin concentration and osteoporosis in elders with type 2 diabetes mellitus (T2DM) was explored in this study. Methods Totally, 573 elders with T2DM were included in the study. BMD was measured by dual-energy X-ray absorptiometry. Hemoglobin levels were tested. The association between the hemoglobin level and osteoporosis was subjected to logistic regression analysis. Results For men, the hemoglobin levels were significantly lower in osteoporosis group than that in non-osteoporosis group (135.98 ± 16.20 vs. 142.84 ± 13.78 g/L, P = 0.002). Hemoglobin levels were positively related with BMD of total hip and femoral neck in men (r = 0.170, P = 0.004; r = 0.148, P = 0.012, respectively). After adjusting for age, body mass index (BMI), hemoglobin A1c (HbA1c), estimated glomerular filtration rate (eGFR) and 25-hydroxyvitamin D3 [25(OH) D3], the hemoglobin level was related with a 0.97-fold lower risk of osteoporosis (odds ratio (OR): 0.97; 95% confidence interval (CI): 0.95–0.99; P = 0.004) in men, but no such association was found in women. Conclusion Higher levels of hemoglobin play a protective role against osteoporosis in older men with T2DM.

目的 探索不同方法校正的肌肉质量与老年2型糖尿病(type 2 diabetes mellitus,T2DM)躯体功能的相关性.方法 纳入首都医科大学宣武医院内分泌科≥60岁的T2DM患者248例,测定血红蛋白(hemoglobin,Hb),糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、空腹血糖(fasting plasma glucose,FPG),维生素D、握力、步速、起立行走计时(timed go and up,TUG)测试时间,计算体质量指数(body mass index,BMI).并用双能X线吸收检测仪测定四肢骨骼肌肌肉质量(appendicular skeletal muscle mass,ASM),分别用身高(height,ht)的平方(ASM/ht2)和BMI(ASM/BMI)两种方法对肌肉质量校正,分析躯体功能的影响因素.结果 偏相关分析结果显示,ASM/BMI均与握力、步速、TUG时间显著相关(分别为r=0.636,P<0.001;r=0.191,P=0.003;r=-0.143,P=0.026),而ASM/ht2仅与握力相关(r=0.513,P<0.001).多元Logistic回归分析结果显示,低ASM/BMI显著影响患者的步速和TUG时间(分别为OR=4.73,95％CI:1.54～14.60,P=0.007;OR=2.92,95％CI:1.12～7.63,P=0.029),而ASM/ht2对患者躯体功能无显著影响.结论 低ASM/BMI而不是低ASM/ht2与老年T2DM患者差的躯体功能相关,ASM/BMI可能是更适合于T2DM患者的肌肉质量校正方法.

目的 探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)体脂率与肌力及躯体功能的相关性.方法 纳入127例于首都医科大学宣武医院内分泌科住院的≥60岁的T2DM患者,测定糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、25羟维生素D3[25-hydroxyvitamin D3,25(OH)D3],空腹胰岛素(fasting insulin,FINS),C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)浓度.双能X线吸收仪测定受试者体脂率及四肢骨骼肌肌肉质量(appendicular skeletal muscle mass,ASM).用握力和椅子起坐试验来评价肌肉力量.步速和简易体能状况量表(Short Physical Performance Battery,SPPB)来评价躯体功能.多元线性回归分析体脂率对肌力和躯体功能的影响.结果 女性患者体脂率显著高于男性(35.18％ ±6.32％vs 28.75％ ±4.48％,P<0.001).体脂率与ASM、骨骼肌肌肉质量指数(appendicular skeletal muscle massindex,ASMI)、握力、步速、SPPB评分显著负相关,与CRP、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、椅子起坐时间正相关(P<0.01).调整年龄、性别、ASM、HbA1c和高腰围后,体脂率与握力、步速降低相关(分别为β=-33.68,P=0.003;β=-1.316,P=0.002),亦与5次起坐时间增加相关(β=31.60,P=0.011).结论 体脂率与老年2型糖尿病患者的肌力下降及不良的躯体功能显著相关.

Objective:The objective of this study was to examine the correlation between blood glucose and serum insulin with acute cerebrovascular disease. Methods:A total of 1548 patients with acute cerebrovascular illness and 364 patients with a normal physical examination who were admitted to our hospital (endocrinology department) between January 2017 and July 2020 were recruited. Patients with acute cerebrovascular illness were included in the experimental group, while healthy individuals after physical examinations were included in the control group. All patients' blood glucose and serum insulin levels were measured, and the association of blood glucose and serum insulin with acute cerebrovascular illness was investigated. Results:Acute cerebrovascular disease is associated with significantly higher blood glucose and serum insulin levels versus healthy status (P < 0.05). Blood glucose and serum insulin levels were observed to be significantly higher in the hemorrhagic stroke group than in the ischemic stroke or mild hemorrhagic group (P < 0.05). Severe ischemic strokes were associated with significantly higher blood glucose levels versus mild ischemic strokes (P < 0.05). There were no significant differences in serum insulin levels between the severe ischemic stroke group and the mild ischemic stroke group (P > 0.05). Conclusion:A rise in blood glucose and serum insulin levels is associated with the incidence and prognosis of acute cerebrovascular disease, and it is positively correlated with the severity of the acute cerebrovascular disease.

Objective:To investigate the influencing factors and bilirubin levels of diabetic retinopathy (DR) in hospitalized patients with type 2 diabetes mellitus (T2DM).Methods:T2DM patients who were hospitalized in the Department of Endocrinology from January to December 2021 in Xuanwu Hospital of Capital Medical University were retrospectively enrolled. All included patients underwent non-mydriatic fundus photography. The data of duration of diabetes, body mass index (BMI), creatinine, total bilirubin, direct bilirubin, indirect bilirubin, glycated hemoglobin A 1c (HbA 1c), high-sensitivity C-reactive protein (hs-CRP) and urinary albumin to creatinine ratio (UACR) were collected. The patients were divided into non-diabetic retinopathy (NDR) group and DR group according to the diagnostic and staging criteria of DR. The t-test, Mann-Whitney U test and χ 2 test were used to compare the general clinical data between the two groups; multivariate logistic regression analysis was used to analyze the risk factors of DR. Results:A total of 1 027 patients were enrolled, including 245 patients with DR and 782 patients with NDR. The prevalence of DR in hospitalized T2DM patients was approximately 23.9% (245/1 027). Compared with the NDR group, the DR group had a longer duration of diabetes, higher HbA 1c, creatinine, UACR, hs-CRP levels, and lower total bilirubin, direct bilirubin and indirect bilirubin concentrations. The differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for gender, age and BMI, HbA 1c (OR =1.199, 95 %CI 1.112-1.293), duration of diabetes (OR=1.063, 95%CI 1.034-1.093), creatinine (OR=1.007, 95%CI 1.002-1.013), UACR (OR=1.389, 95%CI 1.280-1.507) and hs-CRP (OR=1.260, 95%CI 1.108-1.432) were the main risk factors for DR, total bilirubin (OR=0.927, 95%CI 0.873-0.983), direct bilirubin (OR=0.831, 95%CI 0.701-0.985) and indirect bilirubin (OR=0.898, 95%CI 0.825-0.976) were protective factors for DR; after further adjustment for HbA 1c, diabetes duration (OR=1.063, 95%CI 1.033-1.093), creatinine (OR=1.008, 95%CI 1.002-1.013), UACR (OR=1.382, 95%CI 1.272-1.502) and hs-CRP (OR=1.214, 95%CI 1.065-1.384) were still independent risk factors for DR, total bilirubin (OR=0.922, 95%CI 0.867-0.980), direct bilirubin (OR=0.827, 95%CI 0.694-0.984) and indirect bilirubin (OR=0.889, 95%CI 0.815-0.969) were still protective factors for DR. Conclusion:HbA 1c, duration of diabetes, creatinine, UACR and hs-CRP are risk factors for DR, and bilirubin may be a protective factor for DR.

目的 探讨老年2型糖尿病(T2DM)患者骨质疏松与肌少症的相关性.方法 选择2017年5月至2019年7月于首都医科大学宣武医院内分泌科住院的579例年龄≥60岁的T2DM患者为研究对象,测量患者腰椎、左股骨颈及左全髋骨密度(BMD);测量糖化血红蛋白(HbA1c)、握力与步速、四肢骨骼肌质量( ASM),计算四肢骨骼肌质量指数( ASMI).按照患者是否发生骨质疏松和肌少症分别将患者分为骨质疏松组(180例)和非骨质疏松组(399例),肌少症组(52例)和非肌少症组(527例),分析骨质疏松与肌少症的相关性.采用SPSS 24. 0统计软件进行数据分析.根据数据类型,分别采用t检验、Mann-Whitney U检验或χ2 检验进行组间比较.采用多元logistic回归分析肌少症与骨质疏松的相互影响.结果 肌少症组体质量指数(BMI)、左股骨颈与左全髋的BMD和T值均显著低于非肌少症组(P<0. 05);骨质疏松组BMI、ASMI、握力、步速均显著低于非骨质疏松组(P<0. 05).多元logistic回归分析显示,老年T2DM患者肌少症为骨质疏松的危险因素( OR=2. 16,95% CI 1. 131～4. 125,P=0. 02),骨质疏松为肌少症的危险因素(OR=2. 27,95%CI 1. 121～4. 596,P=0. 023).结论 老年T2DM患者骨质疏松与肌少症有相互促进作用.

Objective:To investigate the relationship between thyroid function and sarcopenia in Chinese geriatric patients with type 2 diabetes mellitus (T2DM).Methods:Patients with T2DM aged over 60 years old were recruited from department of endocrinology, Xuanwu Hospital, Capital Medical University, from April 2017 to April 2019. Appendicular skeletal muscle mass, grip strength, and walking speed were measured, appendicular skeletal muscle mass index (ASMI) was calculated. Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined, FT3/FT4 ratio was calculated. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia. The included patients were divided into sarcopenia group and non-sarcopenia group. The t test or χ2 test was used to compare general characteristics between the two groups; correlation analysis and multivariate logistic regression analysis were used to explore the relationship between thyroid function and sarcopenia. Results:A total of 535 patients with T2DM aged over 60 years old were enrolled. There were 490 patients in sarcopenia group and 45 patients in non-sarcopenia group, respectively. Compared with non-sarcopenia patients, patients with sarcopenia demonstrated lower levels of FT3 and FT3/FT4 ratio (all P<0.05). In geriatric patients with T2DM, FT3/FT4 ratio was significant positively correlated with ASMI, grip strength and walking speed ( r=0.240, 0.242 and 0.227, respectively, all P<0.01), the same with FT3 levels ( r=0.300, 0.366 and 0.296, respectively, all P<0.01). Multivariate logistic regression analysis showed that FT3/FT4 ratio (OR=0.396,95%CI 0.158-0.992, P=0.048) was independent risk factor for sarcopenia. Conclusions:In geriatric patients with T2DM, the concentrations of FT3 and FT3/FT4 ratio are significant positively correlated with the components of sarcopenia, and FT3/FT4 ratio is an independent predictor of sarcopenia.