Graves’ disease (GD) is an autoimmune form of hyperthyroidism characterized by loss of immune tolerance to the thyrotropin receptor and sustained thyroid hormone excess. Interest in the gut–thyroid axis has expanded rapidly, placing the gut microbiota within current models of GD pathophysiology. This review summarizes current evidence on gut microbial alterations in GD and discusses how these changes may intersect with thyroid autoimmunity. Available studies broadly support disruption of the intestinal microbial ecosystem in GD, although findings for individual taxa and diversity indices vary across cohorts. Proposed links between dysbiosis and disease include altered short-chain fatty acid and bile acid metabolism, impairment of epithelial barrier integrity with translocation of microbial products, shifts in Th17/Treg balance and related immune activation, molecular mimicry, and disturbed handling of micronutrients involved in thyroid hormone synthesis and metabolism. The oral–gut microbial connection has also emerged as a potentially relevant dimension of disease-associated dysbiosis. In parallel, microbiota-directed approaches, including probiotics, prebiotics, synbiotics, dietary modulation, and fecal microbiota transplantation, are being explored as possible adjuncts in GD management. Overall, gut microbial disturbance offers a biologically plausible link between environmental exposure, immune disequilibrium, and thyroid dysfunction in GD; however, stronger mechanistic, longitudinal, and interventional evidence is still required before these findings can be translated into precision clinical practice.

While Pan-Immune-Inflammation Value (PIV) has been associated with chronic kidney disease of various etiologies, there is a lack of studies specifically analyzing the relationship between PIV and diabetic kidney disease (DKD) in individuals with type 2 diabetes mellitus (T2DM). This study aimed to explore the association between PIV and DKD. The data were obtained from Guang’anmen Hospital and 38 community health service centers, spanning the period from 2014 to 2022. This study conducted a cross-sectional study including 7,610 T2DM patients and a cohort study comprising 1,494 T2DM patients without baseline kidney disease. In both studies, multivariable-adjusted logistic regression models and restricted cubic spline (RCS) analyses were used to assess the relationship between PIV and DKD. In the cross-sectional study, after adjusting for potential confounders, PIV was significantly and positively associated with DKD prevalence in T2DM patients, with those in the highest quartile exhibiting a 76.3

OBJECTIVE:Conflicting evidence exists on the association of obesity, depression and mortality risk. This study evaluates a cohort of subjects with depression from the USA NHANES and all-cause and cardiovascular mortality risks based on baseline BMI and ABSI. METHODS:A nationally representative cohort study was conducted using NHANES data (2005-2018), including 2854 adults with depression. Weighted Cox regression and restricted cubic spline (RCS) models were applied to assess anthropometric associations with mortality. Weighted receiver operating characteristic (ROC) curves evaluated the diagnostic value of BMI and ABSI. RESULTS:Each 1-SD BMI increase was predictive of reduced all-cause (HR = 0.81, 95 % CI:0.67-0.98) and cardiovascular mortality (HR = 0.62, 95 % CI:0.43-0.89). Each 1-SD ABSI increase was predictive of elevated all-cause (HR = 1.27, 95 % CI:1.06-1.51) and cardiovascular mortality (HR = 1.60, 95 % CI:1.20-2.15). In these depressed individuals, BMI showed the U-shaped and ABSI the expected curvi-linear relationships with mortality as established from the studies of the NHANES cohorts. In ROC analyses, ABSI showed the best predictive performance for all-cause mortality (AUC = 0.678) and for cardiovascular mortality (AUC = 0.706). BMI Tertile 1 & ABSI Tertile 3 had the highest mortality risks (all-cause HR = 3.09, 95 % CI:1.38-6.93; cardiovascular HR = 5.45, 95 % CI:1.36-21.85). Due to the approximate statistical independence of BMI and ABSI, combining them further improved AUC values (all-cause: 0.691; cardiovascular: 0.722). CONCLUSION:Among individuals with depression ABSI predicts mortality similar to the general population, while obesity as defined by BMI was "paradoxically" associated with lower mortality. Personalized mortality risk for an individual can be derived by combining the independent risks based on BMI and ABSI.

Arteriosclerosis plays a significant role as one of the key pathological mechanisms underlying Diabetic Kidney Disease (DKD). The estimated Pulse Wave Velocity (ePWV) is used to assess arteriosclerosis, and is considered a potential clinical surrogate for pulse wave velocity. There are no studies on ePWV in relation to DKD. Our research represents the first embark to explore the relationship between ePWV and DKD. In this cross-sectional analysis, we collected ePWV data from a cohort of 4,296 hospitalized Chinese patients. Multivariable-adjusted logistic regression models and restricted cubic spline (RCS) analysis were employed to examine the relationship between eGDR and the prevalence of DKD, UACR ≥ 30 mg/g, and eGFR < 60 mL/min per 1.73 m². After adjusting for confounding factors, each unit increase in ePWV was associated with a 23

Background Pancreatic cancer (PC) is one of the most lethal cancers around the world. A high body mass index (BMI) is recognized as a significant and modifiable risk factor for this disease. Methods Data were obtained from the Global Burden of Disease (GBD) 2021 study. We used joinpoint regression and age-period-cohort (APC) models for trend analysis, and the Autoregressive Integrated Moving Average (ARIMA) model to forecast the burden of high BMI-related PC in 2022-2041. In addition, we used decomposition and health inequality analyses to examine causes and regional inequalities in the burden of high BMI-related PC. Results From 1990 to 2021, the total number of deaths from high BMI-related PC increased nearly tenfold. In the last 30 years, females consistently bore a greater burden of BMI-related PC, whereas the increase among males was more substantial. Deaths from high BMI-related PC escalated by 7 to 12 times in the 20-49 age group and by over sevenfold in low social development index (SDI) regions, reflecting increasing risk in younger populations and worsening global health inequalities. Furthermore, we predict that the global age-standardized mortality rate (ASMR) will continue to increase over the next 20 years. Conclusion Our findings generally revealed a sharply increased trend for the global burden of PC associated with high BMI during the past 30 years, as well as pronounced disparities by sex, age, and region. Hence, countries and nations should urgently advocate targeted public health initiatives in the future, especially in high-burden regions and populations.

Background: Hyperuricemia is the underlying condition of gout. Previous studies have indicated that specific strategies may be effective in preventing the progression of hyperuricemia to gout. However, there is a lack of widely applicable methods for identifying high-risk populations for gout. Gout is linked to inflammation, especially in the hyperuricemic population. Systemic inflammation response index (SIRI) is a novel method for evaluating an individual's systemic inflammatory activity. However, the association between SIRI and gout in the hyperuricemic population has not been studied. Methods: The study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018.SIRI was log2-transformed before analysis. Multivariable logistic regression, subgroup analysis, and smooth curve fitting were employed to comprehensively evaluate the correlation between SIRI and gout prevalence in the hyperuricemic population. Additionally, we compared SIRI with other inflammatory markers. Result: A total of 6,732 hyperuricemic patients were included, of which 3,764 were men. After adjusting for all covariates, SIRI was found to be significantly positively correlated with gout prevalence in the female group ([OR = 1.385, 95% CI (1.187, 1.615), p < 0.001]), and its diagnostic performance was superior to other inflammatory markers. In the male group, the correlation between log2-SIRI and gout prevalence was not significant ([OR = 0.994, 95% CI (0.892, 1.108), p = 0.916]). But there were significant positive correlations in the 20-45 age group ([OR = 1.362, 95% CI (1.021, 1.818), p = 0.036]). Subgroup analyses revealed that the results were largely consistent when the individuals were divided into different subgroups (FDR adjusted p for interaction >0.05 for all). Conclusion: Our study suggests that the Systemic Inflammation Response Index (SIRI) has potential as a predictive marker for gout risk in hyperuricemic women. However, given the higher gout prevalence in men, the potential of SIRI as a predictive marker for gout risk in this population may be limited. Subgroup analyses, however, indicated that the relationship between SIRI and gout prevalence, as well as its statistical significance, varied across different age groups. Future research could further explore this association by investigating the relationship between SIRI and gout prevalence in different age cohorts.

Previous studies have emphasized the independent effects of anthropometric indices—including body mass index (BMI), A Body Shape Index (ABSI), waist-to-height ratio (WHtR), body roundness index (BRI), and Conicity Index—on mortality. However, their combined impact, especially in diabetic populations with distinct obesity patterns, has been less frequently explored. This study investigates both the independent and combined effects of these anthropometric indices on mortality in diabetic Americans and compares their individual and combined diagnostic value. A nationally representative cohort study was conducted using NHANES data (2005–2018), including 6,572 diabetic adults. Weighted Cox proportional hazards models and restricted cubic splines were applied to evaluate the independent and combined associations of anthropometric indices (BMI, ABSI, WHtR, BRI, and Conicity Index) with all-cause mortality. The weighted receiver operating characteristic (ROC) curve was used to assess the diagnostic value of individual anthropometric indices and their combinations in predicting mortality. Among all the anthropometric indices, ABSI exhibited the strongest independent association with all-cause mortality, outperforming other measures such as BMI, WHtR, BRI, and Conicity Index. A clear linear relationship was identified, with higher ABSI tertiles consistently linked to an increased risk of mortality. Notably, within each BMI tertile, ABSI effectively differentiated mortality risk, particularly in the highest tertile. Furthermore, ABSI demonstrated the highest predictive performance among individual metrics (weighted AUC = 0.653) and showed further improvement when combined with BMI (weighted AUC = 0.669). BMI and ABSI collectively provide a comprehensive evaluation of mortality risk in diabetic populations, capturing the synergistic effects of general and central obesity. These findings highlight the importance of integrating BMI and ABSI into risk assessments to identify high-risk individuals and guide targeted interventions for reducing mortality.

The prevalence of type 2 diabetes mellitus (T2DM) and bone metabolism disorders increase with age. Diabetic kidney disease (DKD) is one of the most serious microvascular complications of T2DM, and bone metabolism disorders are closely linked to the occurrence of DKD. The relationship between bone turnover markers(BTMs) and the kidney disease in elderly patients with T2DM remains unclear. Therefore, this study aims to investigate the association between common BTMs and DKD in a large sample of elderly patients. The goal is to provide a basis for early identification of high-risk individuals for DKD among elderly T2DM patients from a bone metabolism perspective. In this cross-sectional study, BTMs were collected from a cohort of 2,051 hospitalized Chinese patients. The relationships between 25-hydroxyvitamin D (25-OH-D), β-CrossLaps (β-CTX), osteocalcin (OSTEOC), intact parathyroid hormone (iPTH), and total type I collagen N-terminal propeptide (TP1NP), and DKD, as well as urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were analyzed using regression analysis and restrictive cubic spline (RCS) curves. Higher 25-OH-D levels were independently linked to a lower incidence of DKD and decreased UACR. The RCS curves showed a linear association of 25-OH-D and DKD, approaching the L-shape. β-CTX was independently and positively correlated with UACR. There is an independent positive correlation between OSTEOC and UACR and a negative correlation with eGFR. iPTH is independently and positively correlated with DKD incidence and UACR, and negatively correlated with eGFR. Additionally, the RCS curves showed a non-linear association of OSTEOC and iPTH and DKD, approaching the J-shape, and the point of inflection is 10.875 ng/L and 34.15 pg/mL respectively. There is an independent positive correlation between TP1NP and UACR incidence, and a negative correlation with eGFR. Risk estimates significantly increase with higher TP1NP levels in the RCS model. BTMs are closely associated with kidney disease in elderly patients with T2DM. These discoveries potentially assist clinicians in establishing more preventive measures and targeted treatment strategies for elderly patients with T2DM.

Abstract Objective This meta-analysis aims to analyze the relationship between serum vitamin D (VD) levels and Graves’ disease (GD). Methods We conducted a search for publications on VD and GD in the English language. Our search encompassed databases such as PubMed, Embase, Web of Science, and the Cochrane Library, covering publications available through August 2023. A meta-analysis was performed using Cochrane RevMan 5.4 software. The standardized mean difference (SMD) and 95% confidence interval (CI) were used for outcome calculation. We used R software to test for publication bias. Results Twelve studies were selected, comprising 937 (22.4%) cases with GD and 3254 (77.6%) controls. The overall meta-analysis revealed that patients with GD are significantly more likely to have low VD levels (SMD = − 0.66; 95% CI: −1.05, − 0.27; p = 0.001) than those in the control group. Egger’s test results indicated no publication bias (p = 0.0791). These studies exhibited a high degree of heterogeneity (chi-square = 205.86, p < 0.00001; I2 = 95%). Subgroup analysis was conducted based on assay method, geographic location, and mean age of the case group to explore the heterogeneity sources. Assay methods and geographic locations were identified as potential heterogeneity sources. Based on the mean age, there were no statistically significant differences found in the subgroup analysis of the included studies. Conclusion There is promising evidence that low serum VD levels may increase the risk of GD. Further rigorous and long-term trials are needed to explore the role of VD in the onset and treatment of GD.

Background: To investigate the association between the NLR and the risk of all-cause and cardiovascular mortality in US adults with diabetic kidney disease (DKD). Methods: The data utilized for this analysis were sourced from ten National Health and Nutrition Examination Survey cycles (1999- 2018) with mortality data (up to 31 December 2019) via linkage to the National Death Index. The optimum NLR threshold for predicting survival outcomes was determined through the maximally selected rank statistics. Restricted cubic spline (RCS), weighted Cox proportional hazard regression, stratified analyses, and time-dependent receiver-operating characteristic curve (ROC) were employed to delineate the prospective correlations of the NLR with both all-cause and cardiovascular mortality. Results: In this investigation, a cohort comprising 2581 patients diagnosed with DKD was examined, encompassing 624 individuals with a higher NLR (>= 3.07) and 1957 subjects with a lower NLR (< 3.07). Over a median follow-up of 79 months (interquartile range, 44- 128 months), 1103 deaths occurred, including 397 from cardiovascular causes and 706 from non-cardiovascular causes. The RCS analysis elucidated the positive linear correlation (both nonlinear P > 0.05). In the multivariable analyses, each one-unit increase in the NLR value was correlated with a 51% increased risk of all-cause mortality (1.51(1.28, 1.77)) and a 71% increased risk of cardiovascular mortality (1.71(1.32, 2.21)). The results were largely consistent across stratified analyses encompassing variables such as age, sex, race/ethnicity, marital status, family income, education levels, BMI, drinking status, smoking status, hypertension, CVD, and anti-infective drugs (P for interaction > 0.05 for all). Time-dependent ROC analyses underscored the NLR's credible predictive efficacy for both short-term and extended durations in forecasting both all-cause and cardiovascular mortality. Conclusion: The findings emphasize the promising use of the NLR in stratifying and prognosticating the risk of mortality in DKD in clinical practice.

Objective: Few studies have explored the correlation between cardiovascular health (CVH) and depression. We aimed to investigate the relationship between CVH using Life's Essential 8 (LE8) and depression among US adults. Methods: 16,362 individuals from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included. The patient Health Questionnaire (PHQ-9) was utilized to recognized depression (PHQ-9 >= 10). LE8 was scored by four health behaviors (sleep, tobacco/nicotine exposure, physical activity and diet) and four health factors (body mass index, non -high -density lipoprotein cholesterol, blood glucose and blood pressure) and classified into low, moderate and high CVH groups. Weighted logistic regressions, restricted cubic splines and sensitivity analyses were utilized to investigate the correlation between LE8 and depression. Results: 1306 subjects had depression (7.98% of the participants), of which 860 (7.42%), 305 (17.24%) and 141 (3.01%) had low, moderate and high CVH, separately. In the fully adjusted model, LE8 was negatively correlated with depression (OR: 5.50, 95% CI 3.92-7.71, P < 0.001). Furthermore, there were inversely dose -response relationships between LE8 and depression (overall P < 0.001). Conclusions: Adhering to a high CVH, estimated by the LE8 score, was correlated with lower odds of depression.

Objective: A considerable percentage of individuals with chronic kidney disease (CKD) are reported to be frail. Lower physical activity and higher sedentary time are most consistently associated with frailty among the potentially alterable risk factors. Although the single effect of physical activity or sedentary time on suppressing frailty have been widely studied, whether physical activity can mitigate or counteract the detrimental consequences of higher sedentary time on frailty among CKD population has never been explored. This study aims to explore whether and to what extent the correlation between sedentary time and frailty was diminished by physical activity among CKD population. Study design and setting: Data were acquired from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018 cycles. Frailty index was assessed using 49-item deficit model. Physical activity and sedentary time were measured using the Global Activity Questionnaire. Weighted binary logistic regression models, restricted cubic spline models and sensitivity analyses were performed to investigate the aforementioned relationship. Results: The final sample included 2551 adults aged >= 20 years with CKD, which is represented a weighted number of 4.98 million noninstitutionalized US population. In the fully adjusted model, the group with low physical activity was 1.56 (95 % CI:1.19, 2.03) times more likely to develop frailty than the group with high physical activity and each unit of increase of sedentary time was associated with an 41 % increased risk of frailty (OR = 1.41, 95 % CI = 1.04-1.89). Our findings also indicated that engaging in 1240-6200 MET-min/week of high physical activity was associated with a decreased risk of frailty related to moderate-to-high sedentary time among CKD population (OR = 0.69, 95 % CI = 0.49-0.99, P = 0.044). In subgroup analyses, high physical activity was associated with a 0.43-fold (95%CI: 0.24, 0.77) decreased risk of moderate-to-high sedentary time associated with frailty in female groups and a significant modification effect of gender was uncovered (P interaction = 0.024). Conclusion: High physical activity was associated with a decreased risk of frailty related to moderate-to-high sedentary time in adults with CKD, especially in females subgroups.

ObjectiveThe activation of platelets in individuals with type 2 diabetes mellitus (T2DM) triggers inflammation and hemodynamic abnormalities, contributing to the development of diabetic kidney disease (DKD). Despite this, research into the relationship between plateletcrit (PCT) levels and DKD is sparse, with inconsistent conclusions drawn regarding the connection between various platelet parameters and DKD. This highlights the necessity for comprehensive, large-scale population studies. Therefore, our objective is to explore the association between PCT levels and various platelet parameters in relation to DKD.MethodsIn this cross-sectional study, hematological parameter data were collected from a cohort of 4,302 hospitalized Chinese patients. We analyzed the relationships between PCT, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and DKD, along with the urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic potential of these parameters.ResultsDKD patients exhibited significantly higher PCT levels compared to those without DKD. Multivariate regression analysis identified elevated PCT and PLT levels as potential independent risk factors for both DKD and UACR, while lower MPV levels might serve as independent protective factors for eGFR. The areas under the ROC curve for PCT in relation to DKD and UACR (≥30 mg/g) were 0.523 and 0.526, respectively. The area under the ROC curve for PLT in relation to UACR (≥30 mg/g) was 0.523.ConclusionPCT demonstrates a weak diagnostic value for T2DM patients at risk of developing DKD and experiencing proteinuria, and PLT shows a similarly modest diagnostic utility for detecting proteinuria. These insights contribute to a deeper understanding of the complex dynamics involved in DKD. Additionally, incorporating these markers into routine clinical assessments could enhance risk stratification, facilitating early interventions and personalized management strategies.

BACKGROUND Obesity in children and adolescents is a serious problem, and the efficacy of exercise therapy for these patients is controversial. AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers. METHODS The PubMed, Web of Science, and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023. The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children. RESULTS In total, 1010 patients from 28 studies were included. Exercise therapy reduced the levels of fasting blood glucose (FBG) [standardized mean difference (SMD): -0.78; 95% confidence interval (CI): -1.24 to -0.32, P = 0.0008], fasting insulin (FINS) (SMD: -1.55; 95%CI: -2.12 to -0.98, P < 0.00001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD: -1.58; 95%CI: -2.20 to -0.97, P < 0.00001), interleukin-6 (IL-6) (SMD: -1.31; 95%CI: -2.07 to -0.55, P = 0.0007), C-reactive protein (CRP) (SMD: -0.64; 95%CI: -1.21 to -0.08, P = 0.03), and leptin (SMD: -3.43; 95%CI: -5.82 to -1.05, P = 0.005) in overweight and obese children. Exercise training increased adiponectin levels (SMD: 1.24; 95%CI: 0.30 to 2.18, P = 0.01) but did not improve tumor necrosis factor-alpha (TNF-α) levels (SMD: -0.80; 95%CI: -1.77 to 0.18, P = 0.11). CONCLUSION In summary, exercise therapy improves glucose metabolism by reducing levels of FBG, FINS, HOMA-IR, as well as improves inflammatory status by reducing levels of IL-6, CRP, leptin, and increasing levels of adiponectin in overweight and obese children. There was no statistically significant effect between exercise training and levels of TNF-α. Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.

Osteoporosis is a major public health problem. Dietary inflammatory preference and body mass index (BMI) are emerging factors that tends to affect bone health. There is limited evidence regarding the joint influence of BMI and dietary status on the bone health. This study aimed to investigate the relationship between dietary inflammatory index (DII) and bone health among adults under different levels of BMI utilizing the National Health and Nutrition Examination Survey (NHANES). Data were collected from 2005–2010, 2013–2014 to 2017–2018 in NHANES. In total, 10,521 participants who aged ≥ 20 years and had complete data for dietary intake interview, bone mineral density (BMD) and bone mineral content (BMC) were included. DII was performed to evaluate the dietary inflammatory potential based on dietary intake interview. We evaluated bone health by femoral neck BMD and BMC measured by dual energy X-ray absorptiometry. Weighted multivariable linear regression and BMI-stratified subgroup analysis were performed. The average DII score for 10,521 participants was 1.24 ± 0.04, mean femoral neck BMD was 0.82 ± 0.00 g/cm2 and mean BMC was 4.37 ± 0.01 g. In the fully adjusted model, there was a negative correlation between DII with BMD (β = − 0.016, P < 0.001) and BMC (β = − 0.011, P < 0.001) in the most anti-inflammatory diet. Using BMI-stratified subgroup analysis, this correlation became more evident in both the overweight (BMD: β = − 0.024, P < 0.001; BMC: β = − 0.058, P = 0.042) and obese groups (BMD: β = − 0.015, P = 0.049; BMC: β = − 0.009, P = 0.042), while this correlation was opposite in DII tertile 2 (middle DII score) in the underweight group (BMD: β = 0.047, P = 0.038; BMC: β = 0.274, P = 0.010). Relationship between higher consumption of pro-inflammatory and increased risk of lower BMD and BMC was only existed in overweight and obese participants.

甲状腺结节是临床最常见的甲状腺疾病.笔者基于"木郁达之"理论探讨甲状腺结节的发病机制及风药在甲状腺结节中的应用,并提出"木郁"是对五行属木之脏腑结构及功能运行失衡、阻滞的概括,"达之"则是通过"宣吐""升降""疏泄"使肝脏等相关脏腑结构及功能相适的方法总称.据此笔者提出"木郁"是甲状腺结节发生发展的病机总括,肝脏的功能之郁及结构之郁是甲状腺结节发生发展的重要因素.风药可开透微观结构、调复功能状态,在甲状腺结节的治疗中可发挥重要作用,临证治疗时可适当配伍.

Diabetic nephropathy (DN), a prevalent microvascular complication of diabetes mellitus, is the primary contributor to end-stage renal disease in developed countries. Existing clinical interventions for DN encompass lifestyle modifications, blood glucose regulation, blood pressure reduction, lipid management, and avoidance of nephrotoxic medications. Despite these measures, a significant number of patients progress to end-stage renal disease, underscoring the need for additional therapeutic strategies. The endoplasmic reticulum (ER) stress response, a cellular defense mechanism in eukaryotic cells, has been implicated in DN pathogenesis. Moderate ER stress can enhance cell survival, whereas severe or prolonged ER stress may trigger apoptosis. As such, the role of ER stress in DN presents a potential avenue for therapeutic modulation. Chinese herbal medicine, a staple in Chinese healthcare, has emerged as a promising intervention for DN. Existing research suggests that some herbal remedies may confer renoprotective benefits through the modulation of ER stress. This review explores the involvement of ER stress in the pathogenesis of DN and the advancements in Chinese herbal medicine for ER stress regulation, aiming to inspire new clinical strategies for the prevention and management of DN.

目的:分析糖尿病肾病(DN)内质网应激的研究现状、热点和发展趋势.方法:检索Web of Science核心合集数据库2011—2020年DN内质网应激研究文献,运用CiteSpace 5.7 R1软件绘制可视化图谱并进行分析.结果:共纳入文献316篇,研究显示,中国、美国、日本是本领域研究的主要国家;复旦大学、上海交通大学、首都医科大学等为主要研究机构;Hengjiang GUO、Aimin WANG、Aili CAO、Wen PENG为最高产的作者,INAGI R为共被引频次最高的作者;AM J PHYSIOL-RENAL为刊文量最多的期刊,J AM SOC NEPHROL为共被引频次最高的期刊;主要研究热点为凋亡、自噬、炎症、氧化应激等;研究前沿涉及肾纤维化和线粒体功能障碍.结论:DN内质网应激的研究逐渐成熟,对其进行深入探讨,有望为DN的诊治提供一个新策略.

Chronic low-grade inflammation affects health and is associated with aging and age-related diseases. Dysregulation of the gut flora is an important trigger for chronic low-grade inflammation. Changes in the composition of the gut flora and exposure to related metabolites have an effect on the inflammatory system of the host. This results in the development of crosstalk between the gut barrier and immune system, contributing to chronic low-grade inflammation and impairment of health. Probiotics can increase the diversity of gut microbiota, protect the gut barrier, and regulate gut immunity, thereby reducing inflammation. Therefore, the use of probiotics is a promising strategy for the beneficial immunomodulation and protection of the gut barrier through gut microbiota. These processes might positively influence inflammatory diseases, which are common in the elderly.