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Impact of diabetes and its treatments on skeletal diseases

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《医学前沿(英文)》 2013年 第7卷 第1期   页码 81-90 doi: 10.1007/s11684-013-0243-9

摘要:

Diabetes mellitus is an enormous menace to public health globally. This chronic disease of metabolism will adversely affect the skeleton if not controlled. Both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are associated with an increased risk of osteoporosis and fragility fractures. Bone mineral density is reduced in T1DM, whereas patients with T2DM have normal or slightly higher bone density, suggesting impaired bone quality is involved. Detrimental effects of T1DM on the skeleton are more severe than T2DM, probably because of the lack of osteo-anabolic effects of insulin and other pancreatic hormones. In both T1DM and T2DM, low bone quality could be caused by various means, including but not limited to hyperglycemia, accumulation of advanced glycosylation end products (AGEs), decreased serum levels of osteocalcin and parathyroid hormone. Risk for osteoarthritis is also elevated in diabetic population. How diabetes accelerates the deterioration of cartilage remains largely unknown. Hyperglycemia and glucose derived AGEs could contribute to the development of osteoarthritis. Moreover, it is recognized that oral antidiabetic medicines affect bone metabolism and turnover as well. Insulin is shown to have anabolic effects on bone and hyperinsulinemia may help to explain the slightly higher bone density in patients with T2DM. Thiazolidinediones can promote bone loss and osteoporotic fractures by suppressing osteoblastogenesis and enhancing osteoclastogenesis. Metformin favors bone formation by stimulating osteoblast differentiation and protecting them against diabetic conditions such as hyperglycemia. Better knowledge of how diabetic conditions and its treatments influence skeletal tissues is in great need in view of the growing and aging population of patients with diabetes mellitus.

关键词: diabetes     bone     osteoporosis     osteoarthritis    

New practice in semaglutide on type-2 diabetes and obesity: clinical evidence and expectation

《医学前沿(英文)》 2022年 第16卷 第1期   页码 17-24 doi: 10.1007/s11684-021-0873-2

摘要: Obesity is an important risk factor of type 2 diabetes (T2D), which has become an important factor threatening human health. However, no perfect drug choice for obesity exists. Semaglutide is a kind of human glucagon-like peptide-1 (GLP-1) analog that promotes insulin secretion while inhibiting glucagon secretion through a glucose concentration-dependent mechanism. GLP-1 can also delay stomach emptying and suppress appetite to help lose weight. This review summarizes clinical evidence of the semaglutide effect on T2D and obesity and establishes expectations on future clinical trials for obesity treatment.

关键词: semaglutide     type 2 diabetes     obesity    

Early-onset diabetes: an epidemic in China

Jiemin Pan, Weiping Jia

《医学前沿(英文)》 2018年 第12卷 第6期   页码 624-633 doi: 10.1007/s11684-018-0669-1

摘要:

Although type 2 diabetes is a disease often associated with aging, the global prevalence of early-onset diabetes has been increasing due to man’s sedentary lifestyle, low-physical activity, obesity, and some non-modifiable risk factors. Many studies have found that individuals with early-onset type 2 diabetes were at higher risk of developing vascular complications than those with late-onset diabetes. Individuals with early-onset diabetes are usually unwilling to visit hospital and have more confidence in their health, which results in poor glycemic control and the delayed detection of diabetes-related complications. Few studies have focused on the treatment and prevention of complications in specific population of individuals with early-onset type 2 diabetes. Therefore, focusing on this particular population is critical for the government and academic societies. Screening for T2DM is imminent for young adults with a family history of diabetes, obesity, markers of insulin resistance, or alcohol consumption. More data are definitely required to establish a reasonable risk model to screen for early-onset diabetes.

关键词: diabetes     early-onset     diabetes complications    

Metabolomics in human type 2 diabetes research

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《医学前沿(英文)》 2013年 第7卷 第1期   页码 4-13 doi: 10.1007/s11684-013-0248-4

摘要:

The high prevalence of diabetes and diabetic complications has caused a huge burden on the modern society. Although scientific advances have led to effective strategies for preventing and treating diabetes over the past several decades, little progress has been made toward curing the disease or even getting it under control, from a public health and overall societal standpoint. There is still a lack of reliable biomarkers indicative of metabolic alterations associated with diabetes and different drug responses, highlighting the need for the development of early diagnostic and prognostic markers for diabetes and diabetic complications. The emergence of metabolomics has allowed researchers to systemically measure the small molecule metabolites, which are sensitive to the changes of both environmental and genetic factors and therefore, could be regarded as the link between genotypes and phenotypes. During the last decade, the progression made in metabolomics has provided insightful information on disease development and disease onset prediction. Recent studies using metabolomics approach coupled with statistical tools to predict incident diabetes revealed a number of metabolites that are significantly altered, including branched-chain and aromatic amino acids, such as isoleucine, leucine, valine, tyrosine and phenylalanine, as diagnostic or highly-significant predictors of future diabetes. This review summarizes the current findings of metabolomic studies in human investigations with the most common form of diabetes, type 2 diabetes.

关键词: metabolomics     type 2 diabetes     metabolic pathway     mass spectrometry     nuclear magnetic resonance (NMR)    

Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

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《医学前沿(英文)》 2017年 第11卷 第1期   页码 110-119 doi: 10.1007/s11684-016-0484-5

摘要:

This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA1c levels, retinopathy and nephropathy (P<0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm2, PPD 4--6 mm (%) and PPD≥7 mm (%) emerged as significant predictors for elevated HbA1c in regression model (P<0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.

关键词: type 2 diabetes mellitus     hemoglobin A     glycated     chronic periodontitis    

A case of thymic Langerhans cell histiocytosis with diabetes insipidus as the first presentation

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《医学前沿(英文)》 2013年 第7卷 第1期   页码 143-146 doi: 10.1007/s11684-013-0238-6

摘要:

Langerhans cell histiocytosis (LCH) is an idiopathic group of reactive proliferative diseases linked to aberrant immunity, pathologically characterized by clonal proliferation of Langerhans cells. LCH rarely involves the thymus. We report a case of thymic LCH with diabetes insipidus as the first presentation, without evidence of myasthenia gravis and without evidenced involvement of the skin, liver, spleen, bones, lungs and superficial lymph nodes. This present case may have important clinical implications. In screening for LCH lesions, attention should be attached to rarely involved sites in addition to commonly involved organs. Follow-up and imageological examination are very important to a final diagnosis.

关键词: diabetes insipidus     thymus     Langerhans cell histiocytosis    

Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai

《医学前沿(英文)》 2022年 第16卷 第1期   页码 126-138 doi: 10.1007/s11684-021-0897-7

摘要: This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43±8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95±5.53 (SD) years. The percentage of patients who achieved the target level for HbA1c (<7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP)<130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c)<2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (<140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.

关键词: type 2 diabetes     quality of care     macrovascular complication     microvascular complication     treatment pattern     epidemiology    

Oxidative stress and diabetes: antioxidative strategies

Pengju Zhang, Tao Li, Xingyun Wu, Edouard C. Nice, Canhua Huang, Yuanyuan Zhang

《医学前沿(英文)》 2020年 第14卷 第5期   页码 583-600 doi: 10.1007/s11684-019-0729-1

摘要: Diabetes mellitus is one of the major public health problems worldwide. Considerable recent evidence suggests that the cellular reduction–oxidation (redox) imbalance leads to oxidative stress and subsequent occurrence and development of diabetes and related complications by regulating certain signaling pathways involved in β-cell dysfunction and insulin resistance. Reactive oxide species (ROS) can also directly oxidize certain proteins (defined as redox modification) involved in the diabetes process. There are a number of potential problems in the clinical application of antioxidant therapies including poor solubility, storage instability and non-selectivity of antioxidants. Novel antioxidant delivery systems may overcome pharmacokinetic and stability problem and improve the selectivity of scavenging ROS. We have therefore focused on the role of oxidative stress and antioxidative therapies in the pathogenesis of diabetes mellitus. Precise therapeutic interventions against ROS and downstream targets are now possible and provide important new insights into the treatment of diabetes.

关键词: diabetes     oxidative stress     redox modification     antioxidative therapy     novel antioxidant delivery    

Transplantation of placenta-derived mesenchymal stem cells in type 2 diabetes: a pilot study

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《医学前沿(英文)》 2011年 第5卷 第1期   页码 94-100 doi: 10.1007/s11684-011-0116-z

摘要:

Mesenchymal stem cells (MSC) have been used in clinical trials for severe diabetes, a chronic disease with high morbidity and mortality. Bone marrow is the traditional source of human MSC, but human term placenta appears to be an alternative and more readily available source. Here, the therapeutic effect of human placenta-derived MSC (PD-MSC) was studied in type 2 diabetes patients with longer duration, islet cell dysfunction, high insulin doses as well as poor glycemic control in order to evaluate the safety, efficacy and feasibility of PD-MSC treatment in type 2 diabetes (T2D). Ten patients with T2D received three intravenous infusions of PDSC, with one month interval of infusion. The total number of PDSC for each patient was (1.22–1.51) × 106/kg, with an average of 1.35 × 106/kg. All of the patients were followed up after therapy for at least 3 months. A daily mean dose of insulin used in 10 patients was decreased from 63.7?±?18.7 to 34.7?±?13.4 IU (P<0.01), and the C-peptide level was increased from 4.1?±?3.7 ng/mL to 5.6?±?3.8 ng/mL (P<0.05) respectively after therapy. In 4 of 10 responders their insulin doses reduced more than 50% after infusion. The mean levels of insulin and C-peptide at each time point in a total of 10 patients was higher after treatment (P<0.05). No fever, chills, liver damage and other side effects were reported. The renal function and cardiac function were improved after infusion. The results obtained from this pilot clinical trial indicate that transplantation of PD-MSC represents a simple, safe and effective therapeutic approach for T2D patients with islet cell dysfunction. Further large-scale, randomized and well-controlled clinical studies will be required to substantiate these observations.

关键词: placenta stem cells     treatment of type 2 diabetes    

Diagnostic criteria of latent autoimmune diabetes in adults (LADA): a review and reflection

Yu Liao, Yufei Xiang, Zhiguang Zhou

《医学前沿(英文)》 2012年 第6卷 第3期   页码 243-247 doi: 10.1007/s11684-012-0201-y

摘要: Diabetes has become a major public health problem in China nowadays. There are almost 97 million diabetic patients nationwide. Latent autoimmune diabetes in adults (LADA) is a subtype of autoimmune diabetes. Although it has been reported for about 20 years, the diagnostic criteria of this disease remain controversial. The discussion mainly focused on serum autoantibodies, period of insulin need and age of diagnosis. Besides, β cell function, metabolic parameters, genetic factors and cell immunity may also contribute to the formulation of the criteria. Here, we aim to review and discuss the diagnostic criteria of latent autoimmune diabetes in adults.

关键词: LADA     diagnostic criteria     autoantibodies     insulin independence     age of diagnosis    

Hybrid deep learning model for risk prediction of fracture in patients with diabetes and osteoporosis

《医学前沿(英文)》 2022年 第16卷 第3期   页码 496-506 doi: 10.1007/s11684-021-0828-7

摘要: The fracture risk of patients with diabetes is higher than those of patients without diabetes due to hyperglycemia, usage of diabetes drugs, changes in insulin levels, and excretion, and this risk begins as early as adolescence. Many factors including demographic data (such as age, height, weight, and gender), medical history (such as smoking, drinking, and menopause), and examination (such as bone mineral density, blood routine, and urine routine) may be related to bone metabolism in patients with diabetes. However, most of the existing methods are qualitative assessments and do not consider the interactions of the physiological factors of humans. In addition, the fracture risk of patients with diabetes and osteoporosis has not been further studied previously. In this paper, a hybrid model combining XGBoost with deep neural network is used to predict the fracture risk of patients with diabetes and osteoporosis, and investigate the effect of patients’ physiological factors on fracture risk. A total of 147 raw input features are considered in our model. The presented model is compared with several benchmarks based on various metrics to prove its effectiveness. Moreover, the top 18 influencing factors of fracture risks of patients with diabetes are determined.

关键词: XGBoost     deep neural network     healthcare     risk prediction    

Modulatory effect on dyslipidemia and anti-atherosclerotic function of in newly diagnosed type 2 diabetes

SUN Mingxiao, WANG Yao, CHI Jiamin

《医学前沿(英文)》 2008年 第2卷 第2期   页码 174-177 doi: 10.1007/s11684-008-0032-z

摘要: The modulatory effect of on dyslipidemia and the preventive effect on atherosclerosis in newly diagnosed type 2 diabetic patients were studied. A prospective clinical trial was conducted to test the effectiveness of in selected 201 newly diagnosed type 2 diabetic patients. All patients were randomly divided into two groups: 108 with therapy and 93 without therapy. The mean follow-up period was 22 months. The blood glucose and blood pressure of all patients were under control. Serum levels of total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) were significantly lowered and their decreased percentages were significantly higher in therapy group ( < 0.05). The number of patients with arteria iliaca intima thickening was significantly lower in group of therapy ( = 0.024). With stepwise multivariate logistic regression analysis, the decreased percentage of TG was significantly and independently related with the decreased number of patients with arteria iliaca intima thickening ( = 0.005). The study demonstrates that therapy is effective on modulating dyslipidemia in newly diagnosed type 2 diabetes patients, and may be related with the improvement of early atherosclerosis.

From gut changes to type 2 diabetes remission after gastric bypass surgeries

null

《医学前沿(英文)》 2013年 第7卷 第2期   页码 191-200 doi: 10.1007/s11684-013-0258-2

摘要:

Increasing evidence suggests that the gut may influence the host’s metabolism and ultimately change the outcomes of type 2 diabetes mellitus (T2DM). We review the evidence on the relationship between the gut and T2DM remission after gastric bypass surgery, and discuss the potential mechanisms underlying the above relationship: gut anatomical rearrangement, microbial composition changes, altered gut cells, and gut hormone modulation. However, the exact changes and their relative importance in the metabolic improvements after gastric bypass surgery remain to be further clarified. Elucidating the precise metabolic mechanisms of T2DM resolution after bypass surgery will help to reveal the molecular mechanisms of pathogenesis, and facilitate the development of novel diagnoses and preventative interventions for this common disease.

关键词: gastric bypass     T2DM     gut    

Type 2 diabetes is causally associated with depression: a Mendelian randomization analysis

Liping Xuan, Zhiyun Zhao, Xu Jia, Yanan Hou, Tiange Wang, Mian Li, Jieli Lu, Yu Xu, Yuhong Chen, Lu Qi, Weiqing Wang, Yufang Bi, Min Xu

《医学前沿(英文)》 2018年 第12卷 第6期   页码 678-687 doi: 10.1007/s11684-018-0671-7

摘要:

Type 2 diabetes (T2D) has been associated with a high prevalence of depression. We aimed to determine the causal relation by performing a Mendelian randomization (MR) study using 34 T2D risk genetic variants validated in East Asians as the instrumental variable (IV). An MR analysis was performed involving 11 506 participants from a large longitudinal study. The T2D genetic risk score (GRS) was built using the 34 typical T2D common variants. We used T2D_GRS as the IV estimator and performed inverse-variance weighted (IVW) and Egger MR analysis. The T2D_GRS was found to be associated with depression with an OR of 1.21 (95% CI: 1.07–1.37) after adjustments for age, sex, body mass index, current smoking and drinking, physical activity, education, and marital status. Using T2D_GRS as the IV, we similarly found a causal relationship between genetically determined T2D and depression (OR: 1.84, 95% CI: 1.25–2.70). Though we found no association between the combined effect of the genetic IVs for T2D and depression with Egger MR (OR: 0.95, 95% CI: 0.42–2.14), we found an association for T2D and depression with IVW (OR: 1.75, 95% CI: 1.31–2.46) after excluding pleiotropic SNPs. Overall, the MR analyses provide evidence inferring a potential causal relationship between T2D and depression.

关键词: causal modeling     depression     Mendelian randomization     type 2 diabetes    

Hyperglycemic memory in diabetic cardiomyopathy

《医学前沿(英文)》 2022年 第16卷 第1期   页码 25-38 doi: 10.1007/s11684-021-0881-2

摘要: Cardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

关键词: diabetes     diabetic cardiomyopathy     hyperglycemic memory    

标题 作者 时间 类型 操作

Impact of diabetes and its treatments on skeletal diseases

null

期刊论文

New practice in semaglutide on type-2 diabetes and obesity: clinical evidence and expectation

期刊论文

Early-onset diabetes: an epidemic in China

Jiemin Pan, Weiping Jia

期刊论文

Metabolomics in human type 2 diabetes research

null

期刊论文

Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

null

期刊论文

A case of thymic Langerhans cell histiocytosis with diabetes insipidus as the first presentation

null

期刊论文

Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai

期刊论文

Oxidative stress and diabetes: antioxidative strategies

Pengju Zhang, Tao Li, Xingyun Wu, Edouard C. Nice, Canhua Huang, Yuanyuan Zhang

期刊论文

Transplantation of placenta-derived mesenchymal stem cells in type 2 diabetes: a pilot study

null

期刊论文

Diagnostic criteria of latent autoimmune diabetes in adults (LADA): a review and reflection

Yu Liao, Yufei Xiang, Zhiguang Zhou

期刊论文

Hybrid deep learning model for risk prediction of fracture in patients with diabetes and osteoporosis

期刊论文

Modulatory effect on dyslipidemia and anti-atherosclerotic function of in newly diagnosed type 2 diabetes

SUN Mingxiao, WANG Yao, CHI Jiamin

期刊论文

From gut changes to type 2 diabetes remission after gastric bypass surgeries

null

期刊论文

Type 2 diabetes is causally associated with depression: a Mendelian randomization analysis

Liping Xuan, Zhiyun Zhao, Xu Jia, Yanan Hou, Tiange Wang, Mian Li, Jieli Lu, Yu Xu, Yuhong Chen, Lu Qi, Weiqing Wang, Yufang Bi, Min Xu

期刊论文

Hyperglycemic memory in diabetic cardiomyopathy

期刊论文