EDITORIAL article Front. Endocrinol., 25 January 2024Sec. Cancer Endocrinology Volume 15 - 2024 | https://doi.org/10.3389/fendo.2024.1368737

This report describes a case of maturity-onset diabetes of the young (MODY) type 3 (MODY3) complicated with type 5 (MODY5), including the patient's clinical features, diagnosis, and treatment, and reviews relevant literature. Using next-generation sequencing of MODY (types 1-14) gene exons and Sanger sequencing for verification, the patient and her mother were assessed. Based on the clinical phenotype and genetic test results, the patient was diagnosed as MODY3 combined with MODY5. Treatment included insulin and linagliptin, with monitoring of blood glucose changes. Clinicians should enhance their understanding of MODY clinical phenotypes. In adolescents with diabetes who have congenital pancreatic and renal developmental defects, elevated high-density lipoprotein cholesterol, no spontaneous ketosis, insulin secretion defects, negative pancreatic autoantibodies, no significant insulin resistance, and who are not obese, gene testing should be conducted to screen for MODY. Accurate diagnosis and personalized treatment can aid in achieving glycemic control, improving quality of life, and optimizing reproductive planning.

In this editorial, we commented on the article published in the recent issue of the World Journal of Diabetes. Diabetic cardiomyopathy (DCM) is characterized by myocardial fibrosis, ventricular hypertrophy and diastolic dysfunction in diabetic patients, which can cause heart failure and threaten the life of patients. The pathogenesis of DCM has not been fully clarified, and it may involve oxidative stress, inflammatory stimulation, apoptosis, and autophagy. There is lack of effective therapies for DCM in the clinical practice. Statins have been widely used in the clinical practice for years mainly to reduce cholesterol and stabilize arterial plaques, and exhibit definite cardiovascular protective effects. Studies have shown that statins also have anti-inflammatory and antioxidant effects. We were particularly concerned about the recent findings that atorvastatin alleviated myocardial fibrosis in db/db mice by regulating the antioxidant stress and anti-inflammatory effects of macrophage polarization on diabetic myocardium, and thereby improving DCM.

恶性肿瘤与糖尿病密切相关,随着医学的发展,恶性肿瘤的治疗取得了一定的进步,但仍不尽如人意.二甲双胍为一种常规降糖药物,近年来,因其抗癌作用受到广泛关注.然而,对合并2型糖尿病的恶性肿瘤二甲双胍的应用尚无明确指导.因此,在中国抗癌协会肿瘤内分泌专业委员会的支持下,国内多名内分泌学及肿瘤学专家共同制定了《二甲双胍辅助治疗合并2型糖尿病的恶性肿瘤患者的专家共识(2022年版)》,阐述了二甲双胍抗肿瘤机制,分析了二甲双胍对不同恶性肿瘤的影响及使用方法,并对二甲双胍在不同肿瘤中的推荐和临床疗效等问题进行了详细介绍.该文解读了该共识部分内容.

Objective:To investigate the effect of the problem-based learning (PBL)-case-based learning (CBL) integrated teaching model in the training of clinical professional postgraduates on rotation in endocrinology.Methods:A total of 80 clinical professional postgraduates on rotation in endocrinology were randomly divided into experimental group (using PBL-CBL integrated teaching) and control group (using traditional teaching), with 40 students in each group, and the rotation period was 3 months. Professional examination scores were recorded for the two groups at the time of enrollment and graduation, and a questionnaire survey was performed to investigate their self-confidence, learning initiative, and interpersonal skills. SPSS 20.0 was used to perform the t-test and the chi-square test. Results:The two groups had similar conditions at baseline. After three months of rotation, the experimental group showed significant improvements in department examination scores, self-confidence, learning initiative, and interpersonal skills ( P<0.001). Conclusion:The PBL-CBL integrated teaching model has a better effect than traditional teaching and can help to improve the learning ability and performance of clinical professional postgraduates on rotation in endocrinology, and therefore, it holds promise for further application.

家族性白蛋白异常性高甲状腺素血症(FDH)是临床上甲状腺功能正常的高甲状腺素血症的常见原因之一,易被误诊为甲状腺毒症.若进一步给予不必要的相关治疗,可能导致一系列的后续疾病出现.因此加强对FDH的认识十分必要.该文就其发病机制、检测手段、鉴别诊断等方面进行综述,为认识FDH提供临床参考.

目的 探讨教师标准化患者(TSP)-情景模拟教学法在研究生内分泌专业学习中的应用效果.方法 选取2017年9月1日至2021年7月1日在陆军军医大学第一附属医院、陆军军医大学第二附属医院、重庆医科大学附属第一医院、重庆医科大学附属第二医院、重庆大学附属中心医院、重庆大学附属肿瘤医院、武警重庆总队医院内分泌专业轮转的90名临床医学专业学位研究生作为研究对象,将其分为试验组和对照组,每组各45名,试验组采用TSP-情景模拟教学法,对照组采用传统教学法,教学时间为3个月.设计课程为内分泌科部分常见病、多发病和疑难病的基础知识、技能操作、结果分析及健康教育.记录两组学生教学前后的专业和技能考试成绩,通过问卷调查分析学生的自信心、学习主动性和人际交往能力.结果 两组基线情况一致,入科考试成绩差异无统计学意义(P=0.853).教学后,对照组出科成绩高于入科成绩(P＜0.05),但自信心评分、学习主动性评分、人际交往能力评分方面与教学前比较差异无统计学意义(P＞0.05).教学后,试验组出科成绩高于与入科成绩,自信心评分、学习主动性评分和人际交往能力评分均高于教学前,差异有统计学意义(P＜0.05).组间分析发现,试验组在出科成绩,教学后的自信心评分、学习主动性评分和人际交往能力评分均高于对照组,差异有统计学意义(P＜0.05).结论 TSP-情景模拟教学法优于传统教学法,有助于提高临床医学专业学位研究生内分泌专业的学习能力和成绩.

Background. Cartilage intermediate layer protein 2 (CILP2) is associated with a variety of plasma lipoproteins and lipid traits. However, the correlation between CILP2 and obesity remains unknown. The aim of this study was to investigate the relationship between circulating CILP2 levels and obesity based on body mass index (BMI). Methods. A total of 252 subjects were divided into three groups: normal weight (n=124), overweight (n=94), and obese (n=34). Metabolic parameters were measured in a fasting state. Serum CILP2 concentration was tested by enzyme-linked immunosorbent assay. Multivariate linear regression analysis was used to explore the relationship between CILP2 and obesity. We also conducted bioinformatics analysis to further explore the genes and signaling pathways related to CILP2. Results. The concentrations of serum CILP2 in the overweight and obese groups were significantly higher than that in the normal weight group. In multiple linear regression analysis, BMI was positively correlated with CILP2 concentration after controlling gender and age. Being overweight and obese were independently correlated with CILP2 concentration after adjusting for gender, age, SBP, DBP, FBG, 2-hour OGTT blood glucose (2h-BG), fasting blood insulin (FIns), TG, TC, HDL-C, LDL-C, and FFA. Bioinformatics analysis showed that the genes related to CILP2 are primarily associated with lipid metabolism and insulin resistance. Conclusion. We speculate that CILP2 may attribute to metabolic disorders in obesity.

BACKGROUND:This study investigated the effects of metformin on breast density in overweight/obese premenopausal women.METHODS:Overweight/obese premenopausal women (n=120) were randomly assigned to the metformin or placebo group, and all women received lifestyle interventions. The outcomes included weight, BMI, FPG, FIN, glucose, HOMA-IR, LDL-C, HDL-C, TG, TC, SBP, DBP, FSH, E, AD, and the BIRADS grade, and the incidence of breast cancer was assessed by pathological biopsy and BIRADS grade greater than 4.RESULTS:In total, 120 overweight/obese women completed the 1-year trial. Seven patients had a BIRADS grade greater than 4, including 5 patients who were biopsy positive, in the control group, and 2 patients had a BIRADS grade greater than 4, including 1 patient who was biopsy positive, in the metformin group. Compared with those in the control group, the body weight, BMI, FIN, FPG, HOMA-IR, TC, BIRADS grade and positive pathological biopsy rate in the metformin group were significantly decreased (P<0.05), while AD was significantly increased (P<0.05). The correlation analysis indicated that the BIRADS grade was significantly correlated with weight, BMI, FPG, FIN, HOMA-IR, SBP, AD and the positive pathological biopsy rate, and the positive pathological biopsy rate was significantly correlated with weight, BMI, HOMA-IR, SBP, AD and BIRADS grade. The logistic regression analysis revealed that the BIRADS grade was significantly correlated with the positive pathological biopsy rate and AD and that the positive pathological biopsy rate was significantly correlated with the BIRADS grade.CONCLUSION:As adjunctive therapy, the combination of lifestyle changes and metformin was found to be a safe strategy for improving related metabolic markers and increasing adiponectin. The BIRADS grade was significantly correlated with the positive pathological biopsy rate and AD, and the positive pathological biopsy rate was significantly correlated with the BIRADS grade.

Objective To explore the efficacy of the hospital glycemic management system with information integration in patients with malignant tumors and hyperglycemia. Methods Three hundred ninety-three patients diagnosed with malignant tumors with hyperglycemia and hospitalized in the non-endocrinology department of a specialized cancer hospital from March 2019 to November 2020 were recruited. All the patients were diagnosed and treated according to the clinical department and disease course. In total, 196 patients were divided into the control group, who received the conventional blood glucose management mode, and 197 patients were divided into the intervention group, who received the hospital glycemic management system with information integration. The average daily glucose levels were recorded before and after breakfast, lunch, and dinner, at bedtime and at night. The average glucose level, glucose compliance rate, hypoglycemia rate, hyperglycemia rate, glucose measurements per day, average number of hospitalization days and patient satisfaction were compared between the groups. Results In the intervention group, the average glucose level was significantly lower than that in the control group (P<0.05). The hyperglycemia and hypoglycemia rates in the intervention group were lower than those in the control group (P<0.05). The glucose compliance rate in the intervention group was higher than that in the control group (P<0.05). The highest blood glucose level in the intervention group was lower than that in the control group (P<0.05), and the lowest blood glucose level was higher than that in the control group (P<0.05). The glucose measurements per day in the intervention group were higher than those in the control group, and the average number of hospitalization days in the intervention group was lower than that in the control group (P<0.05). Patient satisfaction in the intervention group was higher than that in the control group (P<0.05). Conclusion The hospital glycemic management system with information integration significantly improved the glycemic management of patients with malignant non-endocrine tumors and hyperglycemia, including their glucose level and glucose compliance rate, as well as patient satisfaction, and reduced the average number of hospitalization days and risk of hyperglycemia/hypoglycemia.

Bone morphogenetic protein9 (BMP9) has been reported to have a role in vascular development. However, there is still a lack of information regarding the association between circulating BMP9 levels and cardiovascular disease in humans. The goal of this study is to measure circulating BMP9 concentrations in patients with essential hypertension (HTN), coronary heart disease (CHD) and HTN + CHD, and evaluates the relationship between circulating BMP9 and these cardiovascular diseases. A total of 417 individuals were recruited for this cross-sectional study from June 2015 to December 2017. These subjects were screened for HTN and CHD. Circulating BMP9 concentrations were measured by ELISA. Circulating BMP9 concentrations were significantly low in HTN, CHD and HTN + CHD individuals relative to those of the healthy individuals. Circulating BMP9 correlated negatively with SBP, FIns and HOMA-IR in HTN patients and correlated negatively with FBG and 2 h-BG in CHD patients. In both HTN and CHD patients, circulating BMP9 correlated negatively with BMI, WHR, FAT%, BP and TG. Multivariate logistic regression analysis showed that circulating BMP9 levels were associated with HTN, HTN + CHD and CHD. Individuals with low quartile of circulating BMP9 had a significantly high risk of HTN or/and CHD as compared with those in high quartile. BMP9 is likely to be a biomarker for cardiovascular disease in humans, and it may play a role in the progression of cardiovascular disease. ChiCTR-OPC-14005324 .

目的观察厄贝沙坦对2型糖尿病（type 2 diabetes mellitus，T2DM）合并高血压患者胰岛素抵抗（insulin resistance，IR）及胰岛B细胞功能的影响。方法将94例初发T2DM合并高血压患者随机分为两组（n=47）：厄贝沙坦组、苯磺酸氨氯地平组，分别给予厄贝沙坦和苯磺酸氨氯地平治疗12周。比较治疗前后两组患者体质量指数（body mass index，BMI）、腰围（waist circumference，WC）、血压（bloodpressure，BP）、空腹血糖（fasting blood glucose，FBG）、空腹胰岛素（fasting plasma insulin，FINS）、糖化血红蛋白（glycosylated hemoglobin，HbAlC）、甘油三酯（triglyeride，TG）、总胆固醇（totalcholesterol，TC）、低密度脂蛋白胆固醇（low—density lipoprotein cholesterol，LDL—C），并采用稳态模式评估法计算胰岛素抵抗指数（HOMA—HOMA-insulin resistance index，HOMA，IR）、胰岛素分泌指数（HOMA—pcellSecretionindex，HOMA—p）及治疗前后的变化。结果治疗12周后，两组患者治疗后的BP、FBG、HbAlC均较治疗前降低（均P〈0．05），两组患者治疗后的胰岛素分泌指数均较治疗前升高（均P〈0．05），两组治疗前后WC、BMI、TG、TC、LDL—C、HDL．C差异均无统计学意义（均P〉0．05）。厄贝沙坦组治疗后胰岛素抵抗指数较治疗前下降[3．79（2．51～4．99）掷4．58（3．38—5．94），P〈0．05]，氨氯地平组治疗前后胰岛素抵抗指数差异无统计学意义[3．90（2．52—5．26）1）83．90（2．52～5．26），P〉0．05]。结论厄贝沙坦在降低血压的同时，可能改善T2DM患者的胰岛素抵抗。