Insulin resistance (IR) contributes to the development of the no-reflow phenomenon in acute myocardial infarction patients following coronary revascularization. However, the impact of IR on futile recanalization for anterior circulation large vessel occlusion (LVO) patients following endovascular treatment (EVT) remains unclear. This study was based on a multicenter cohort. Acute ischemic stroke patients with LVO who underwent successful EVT within 24 h of symptom onset were enrolled. IR was assessed by the triglyceride-glucose (TyG) index, obtained as ln [fasting TG (mg/dl) × FBG (mg/dl)/2]. The primary outcome was futile recanalization (90-day modified Rankin Scale [mRS] score 3–6 despite successful recanalization). Symptomatic intracranial hemorrhage was assessed as an independent short-term outcome and evaluated as a potential mediator between TyG and futile recanalization. Of 860 patients screened for eligibility, 608 patients who achieved recanalization were included. Enrolled patients were divided into three groups based on the TyG index levels (tertile [T] 1: 5.45–8.41; T2: 8.41–8.95; T3: 8.95–10.97). After adjustment for confounders, the T3 group had a higher proportion of futile recanalization than the T1 and T2 groups (T3 vs. T1: adjusted OR: 2.08, 95% CI 1.30–3.33, P = 0.002; T3 vs. T2: adjusted OR: 1.89, 95% CI 1.18–3.02, P = 0.008). The restricted cubic splines regression model revealed that the risk of futile recanalization and symptomatic intracranial hemorrhage (sICH) increased linearly with elevated TyG index. Mediation analysis showed that sICH partially mediated an estimated 17.4% (95% CI 1.3–58.0%) of the association between a higher TyG index and futile recanalization. The TyG index is a robust risk factor for symptomatic intracranial hemorrhage and futile recanalization in acute LVO patients who achieved successful recanalization.

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

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.

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

Background Maturity-onset diabetes of the young type 2 (MODY2) is a rare genetic disorder characterized as mild fasting hyperglycemia with low risk of vascular complications caused by glucokinase gene mutation. This study aims to investigate metabolites alteration associated with MODY2, exploring possible mechanism underlying characteristic clinical manifestations and low cardiovascular risks of MODY2 and providing serum metabolite biomarkers to facilitating MODY2 diagnosis. Methods Fasting serum samples from MODY2, type 1 diabetes (T1DM) and healthy individuals were collected. By using targeted metabolomics via liquid chromatography–tandem mass spectrometry platform, we quantified the metabolites involved in tricarboxylic acid (TCA) cycle and one-carbon metabolism. Results Metabolomic profiling revealed significant difference of intermediates from central metabolism cycle, methionine cycle and several amino acids between MODY2 and T1DM groups. Among these, serum citrate, α-ketoglutaric acid, serine, glycine, glutamine and homocysteine were significantly elevated in MODY2 patients compared with T1DM patients; and compared with healthy subjects, malate and methionine levels were significantly increased in the two groups of diabetic patients. The correlation analysis with clinical indexes showed that α- ketoglutarate, serine, glycine, and glutamine were negatively correlated with blood glucose indicators including fasting blood glucose, HbA1c, and GA, while citrate was positively correlated with C-peptide. And homocysteine displayed positive correlation with HDL and negative with C-reactive protein, which shed light on the mechanism of mild symptoms and low risk of cardiovascular complications in MODY2 patients. A panel of 4 metabolites differentiated MODY2 from T1DM with AUC of 0.924, and a combination of clinical indices and metabolite also gained good diagnostic value with AUC 0.948. Conclusion In this research, we characterized the metabolite profiles of TCA cycle and one-carbon metabolism in MODY2 and T1DM and identified promising diagnostic biomarkers for MODY2. This study may provide novel insights into the pathogenesis and clinical manifestations of MODY2.

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: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.

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.

Aims Glucokinase–maturity-onset diabetes of the young (GCK-MODY) is the most common monogenic diabetes in China. We have previously reported on the low levels of high-sensitivity C-reactive protein (hsCRP) in patients with GCK-MODY. In this study, we further explored the correlation between the serum lipid profiles and hsCRP levels of patients with different types of diabetes. We also proposed to determine the possible mechanism of macrovascular protection in GCK genetic variants. Methods The serum lipid profiles of the GCK-MODY group (n = 50) were compared with those of the hepatocyte nuclear factor-1 alpha (HNF1A)-MODY group (n = 19), the type 1 diabetes (T1D) group (n = 50), and the type 2 diabetes (T2D) group (n = 54). The associations between the lipid compositions and the hsCRP levels in each group were also explored. Results Elevated levels of high-density lipoprotein cholesterol (HDL-C) were found in the GCK-MODY group (1.5 ± 0.27) compared with the T1D (1.2 ± 0.47, p < 0.01) and T2D (1.3 ± 0.3, p < 0.01) groups. On the other hand, a significantly lower LDL-C level (2.4 ± 0.69) in the GCK-MODY group compared with the T1D (2.7 ± 0.72, p < 0.01) and T2D (2.9 ± 0.68, p < 0.01) groups was also noted. A lower ratio of triglyceride to HDL-C (TG/HDL) and a lower hsCRP level were also found in the GCK-MODY group [TG/HDL = 0.38 (0.25–0.52), hsCRP = 0.2 mg/L (0.16–0.37)] compared with the T1D group [(TG/HDL = 0.56 (0.39–1.29), hsCRP = 0.56 mg/L (0.39–1.29), p < 0.01] and the T2D group [(TG/HDL = 1.6 (1.1–2.68), hsCRP = 1.11 mg/L (0.66–2.34), p < 0.01]. Although patients with HNF1A-MODY showed similar hsCRP levels [0.17 (0.08–0.52), p > 0.05] compared with the patients in the GCK-MODY group, they had higher TG levels [1.01 (0.66–1.76), p < 0.05] and TG/HDL ratios [0.84 (0.56–1.31), p < 0.05]. Analysis of the correlations between the hsCRP levels and lipid profiles of each group confirmed that the LnhsCRP (natural logarithm-transformed hsCRP level) was positively correlated with the LnTG (natural logarithm-transformed TG) (r = 0.352, p = 0.011) and the Ln(TG/HDL) ratio (r = 0.283, p = 0.047) only in individuals with GCK-MODY. Conclusions Individuals harboring GCK variants have the characteristics of protective lipid profiles manifested as a higher level of HDL-C and a lower level of LDL-C compared with type 1 and 2 diabetes milletus (T1DM and T2DM, respectively) patients. In addition, lower ratios of TG/HDL were found to be associated with the inhibition of secretion of hsCRP, even when adjusted for the HbA1c levels in patients with GCK-MODY. It is suggested that the protective effect of macrovascular complications in GCK-MODY patients might partly be due to their unique lipid profiles associated with the suppression of inflammation.

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.

Background: Maturity-onset diabetes of the young (MODY) patients have unique clinical manifestations and need individualized treatments. We identified novel serum metabolic biomarkers to distinguish MODY and explore the possible mechanism of the clinical manifestation and complications of MODY.Methods: Fasting serum samples were collected from MODY3 (n = 17), MODY2 (n = 33), type 1 diabetes (T1DM) (n = 34) and healthy individuals (n = 30), and were analyzed using the ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) metabolomic platform.Results: 4 metabolites were found significantly fluctuated between groups, including glycerophosphocholine, LysoPC(18:2(9Z,12Z)), sphinganine and L-Phenylalanine. Glycerophosphocholine was selected as a diagnostic biomarker. The the area under the ROC curve (AUC) for distinguishing MODYs from healthy controls and differentiating MODY3 from T1DM reached 1.0. The combination of metabolites also gained good diagnostic value. The AUC of the combination of LysoPC(18:2(9Z,12Z)), sphinganine and L-Phenylalanine for discriminating MODY3 from T1DM was 0.983. Besides, the combination of clinical indices and metabolites helped to better differentiate the 2 MODY subtypes.Conclusions: We identified the metabolic profiles of MODY2 and MODY3 and found promising biomarkers for distinguishing MODY from T1DM, which provides evidence for the pathogenesis and characteristic clinical manifestations of patients with MODY2 and MODY3.

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.

Objectives The link between excess adiposity and left ventricular hypertrophy is multifaceted with sparse data among youths. Given that adipokines/hepatokines may influence lipid metabolism in myocardium, we aimed to investigate the relation of the novel hepatokine angiopoietin-like protein 8 (ANGPTL8) and other adipokines with cardiac structure in a cohort of youths and explore to what extent these adipokines/hepatokines affect cardiac structure through lipids. Methods A total of 551 participants (aged 15-28 years) from the Beijing Child and Adolescent Metabolic Syndrome Study (BCAMS) cohort underwent echocardiographic measurements plus a blood draw assayed for five adipokines/hepatokines including adiponectin, leptin, retinol binding protein 4, fibroblast growth protein 21 and ANGPTL8. Results Both ANGPTL8 (β = -0.68 g/m 2.7 per z-score, P = 0.015) and leptin (β = -1.04 g/m 2.7 per z-score, P = 0.036) were significantly inversely associated with left ventricular mass index (LVMI) independent of classical risk factors. Total cholesterol and low-density lipoprotein cholesterol significantly mediated the ANGPTL8–LVMI association (proportion: 19.0% and 17.1%, respectively), while the mediation effect of triglyceride on the ANGPTL8–LVMI relationship was strongly moderated by leptin levels, significantly accounting for 20% of the total effect among participants with higher leptin levels. Other adipokines/hepatokines showed no significant association with LVMI after adjustment for body mass index. Conclusions Our findings suggest ANGPTL8, particularly interacting with leptin, might have a protective role in cardiac remodeling among youths with risk for metabolic syndrome. Our results offer insights into the pathogenesis of the cardiomyopathy and the potential importance of tissue-tissue crosstalk in these effects.

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.

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.

Objective: Genetic detection for the diagnosis of maturity-onset diabetes of the young (MODY) in China has low sensitivity and specificity. Better gene detection is urgently needed to distinguish testing subjects. We proposed to use numerous and weighted clinical traits as key indicators for reasonable genetic testing to predict the probability of MODY in the Chinese population. Methods: We created a prediction model based on data from 306 patients, including 140 patients with MODY, 84 patients with type 1 diabetes (T1D), and 82 patients with type 2 diabetes (T2D). This model was evaluated using receiver operating characteristic curves. Results: Compared with patients with T1D, patients with MODY had higher C-peptide levels and negative antibodies, and most patients with MODY had a family history of diabetes. Different from T2D, MODY was characterized by lower body mass index and younger diagnostic age. A clinical prediction model was established to define the comprehensive probability of MODY by a weighted consolidation of the most distinguishing features, and the model showed excellent discrimination (areas under the curve of 0.916 in MODY vs T1D and 0.942 in MODY vs T2D). Further, high-sensitivity C-reactive protein, glycated hemoglobin A1c, 2-h postprandial glucose, and triglyceride were used as indicators for glucokinase-MODY, while triglyceride, high-sensitivity C-reactive protein, and hepatocellular adenoma were used as indicators for hepatocyte nuclear factor 1-alpha MODY. Conclusion: We developed a practical prediction model that could predict the probability of MODY and provide information to identify glucokinase-MODY and hepatocyte nuclear factor 1-alpha MODY. These results provide an advanced and more reasonable process to identify the most appropriate patients for genetic testing. (C) 2021 AACE. Published by Elsevier Inc. All rights reserved.

Objectives: The aim of this study was to evaluate the association between the serum levels of prealbumin and sarcopenia in older adults with type 2 diabetes mellitus. Methods: This cross-sectional study included 582 older adults with type 2 diabetes mellitus. Sarcopenia was defined based on the recently updated Asian Working Group for Sarcopenia 2019 criteria. Appendicular skeletal muscle was measured by dual energy x-ray absorptiometry. Serum levels of prealbumin, hemoglobin, hemoglobin A1c, and 25-hydroxyvitamin D-3 were also tested. Multivariate analyses were used to assess the association between prealbumin levels and sarcopenia, adjusted for potential confounders. Results: The overall prevalence of sarcopenia was 9%, of which 12% for men and 6% for women. Male participants with sarcopenia had lower prealbumin levels than those without sarcopenia (213 + 72 versus 260 + 56 mg/L, P < 0.001). The proportion of men with low prealbumin level (<170 mg/L) was significantly higher in individuals with sarcopenia than in those without (31% versus 6%, respectively). In a logistic regression model, after adjusting for all potential covariates, low prealbumin (odds ratio, 4.15; 95% confidence interval, 1.13-15.25; P = 0.03) was significantly associated with sarcopenia in men, but the relationship between prealbumin and sarcopenia was not found in women. Conclusion: Low prealbumin levels were associated with an increased risk for sarcopenia in older men with T2DM. (C) 2021 Elsevier Inc. All rights reserved.