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Real-world effectiveness of early insulin therapy on the incidence of cardiovascular events in newly diagnosed type 2 diabetes

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Signal Transduction and Targeted Therapy 2024年第7期9卷 2953-2959页

作者： Sihui Luo Xueying Zheng Wei Bao Sheng Nie Yu Ding Tong Yue Yilun Zhou Ying Hu Hua Li Qiongqiong Yang Qijun Wan Bicheng Liu Hong Xu Guisen Li Gang Xu Chunbo Chen Huafeng Liu Yongjun Shi Yan Zha Yaozhong Kong Guobin Su Ying Tang Mengchun Gong Linong Ji Fan Fan Hou jianping weng Department of Endocrinology First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHeifeiChina Institute of Public Health Sciences Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina Division of Nephrology National Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchNanfang HospitalSouthern Medical UniversityGuangzhouChina Department of Nephrology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina The Second Affiliated Hospital of Zhejiang University School of Medicine HangzhouChina Sir Run Run Shaw Hospital Zhejiang University School of MedicineHangzhouChina Department of Nephrology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouChina The Second People’s Hospital of Shenzhen Shenzhen UniversityShenzhenChina Institute of Nephrology Zhongda HospitalSoutheast University School of MedicineNanjingChina Children’s Hospital of Fudan University ShanghaiChina Renal Department and Institute of Nephrology Sichuan Provincial People’s HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaSichuan Clinical Research Center for Kidney DiseasesChengduChina Division of Nephrology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Critical Care Medicine Maoming People’s HospitalMaomingChina Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City Institute of NephrologyAffiliated Hospital of Guangdong Medical UniversityZhanjiangChina Huizhou Central People’s Hospital Sun Yat-Sen UniversityHuizhouChina Guizhou Provincial People’s Hospital Guizhou UniversityGuiyangChina Department of Nephrology the First People’s Hospital of FoshanFoshanChina Department of Nephrology Guangdong Provincial Hospital of Chinese Medicinethe Second Affiliated Hospitalthe Second Clinical CollegeGuangzhou University of Chinese Medicin

Early insulin therapy is capable to achieve glycemic control and restoreβ-cell function in newly diagnosed type 2 diabetes(T2D),but its effect on cardiovascular outcomes in these patients remains *** this nationwide real-world study,we analyzed electronic health record data from 19 medical centers across China between 1 January 2000,and 26 May *** included 5424 eligible patients(mean age 56 years,2176 women/3248 men)who were diagnosed T2D within six months and did not have prior cardiovascular *** Cox regression models were used to estimate the associations of early insulin therapy(defined as the first-line therapy for at least two weeks in newly diagnosed T2D patients)with the incidence of major cardiovascular events including coronary heart disease(CHD),stroke,and hospitalization for heart failure(HF).During 17,158 persons years of observation,we documented 834 incident CHD cases,719 stroke cases,and 230 hospitalized cases for *** diagnosed T2D patients who received early insulin therapy,compared with those who did not receive such treatment,had 31%lower risk of incident stroke,and 28%lower risk of hospitalization for *** significant difference in the risk of CHD was *** found similar results when repeating the aforesaid analysis in a propensity-score matched population of 4578 patients and with inverse probability of treatment weighting *** findings suggest that early insulin therapy in newly diagnosed T2D may have cardiovascular benefits by reducing the risk of incident stroke and hospitalization for HF.

关键词： cardiovascular treatment nationwide

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糖尿病临床表型：从临床到基因的路径探索

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中华糖尿病杂志 2024年第10期16卷 1141-1146页

作者：涂芷馨王沁郑雪瑛翁建平骆斯慧中国科学技术大学附属第一医院(安徽省立医院)内分泌科先导医学与前沿技术研究所内分泌代谢病研究所合肥

糖尿病的发病机制和并发症呈现多样性, 涉及基因遗传、环境因素和生活方式等多个方面。研究指出糖尿病患者表现出不同的临床亚型, 这促使人们尝试对疾病进行重新分类。通过临床数据和遗传数据的聚类分析, 已经识别出不同的2型糖尿病亚... 详细信息

糖尿病的发病机制和并发症呈现多样性, 涉及基因遗传、环境因素和生活方式等多个方面。研究指出糖尿病患者表现出不同的临床亚型, 这促使人们尝试对疾病进行重新分类。通过临床数据和遗传数据的聚类分析, 已经识别出不同的2型糖尿病亚型, 这些亚型在疾病进展和并发症风险上存在差异。另外, 根据多组学数据, 特别是遗传结构的不同, 确定了与糖尿病风险相关的基因, 进一步揭示了疾病发病机制的临床异质性。总体而言, 糖尿病的精准分型将有助于更有效地预防、治疗和管理这一慢性代谢性疾病。

关键词：糖尿病表型精准医学遗传学

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ASGR1:an emerging therapeutic target in hypercholesterolemia

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Signal Transduction and Targeted Therapy 2023年第2期8卷 335-337页

作者： Wenqi Zhao Suowen Xu jianping weng Department of Endocrinology Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineClinical Research Hospital of Chinese Academy of Sciences(Hefei)University of Science and Technology of ChinaHefei230027China

In a recent study published in Nature,Wang et al.1 discovered that inhibition of asialoglycoprotein receptor 1(ASGR1)increased cholesterol efflux and thus lowered blood cholesterol and reduced *** study offers an emerging new therapeutic target in hypercholesterolemia and its comorbidities and complications(such as fatty liver and atherosclerosis),which are major threats to public health.

关键词： therapeutic cholesterol al.

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A thorough analysis of diabetes research in China from 1995 to 2015: current scenario and future scope

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Science China(Life Sciences) 2019年第1期62卷 46-62页

作者： Zekai Wu Tianru Jin jianping weng Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of Diabetology The Third Affiliated Hospital of Sun Yat-Sen University Department of Physiology University of Toronto

The prevalence of diabetes has increased dramatically over the past three decades, and currently, China has the largest number of diabetics worldwide; this number continues to grow and puts ongoing strains on the medical resources. In this review, we reviewed the diabetes research conducted in China from 1995 to 2015 with the aim of providing new insights regarding the current status and future perspectives for researchers, diabetes health providers, and respective policy-makers. Remarkable progress has been made in diabetes research in China during the past two decades in terms of both the quantity and publication influence. The progress, however, struggles to adequately manage diabetes in China. Here we addressed opportunities to strengthen researches, including new drug development, high quality studies on health economics, and healthcare quality improvement studies. As the expected wave of diabetic complications is upcoming and overwhelming, we therefore recommend that immediate improvements are required to implement the researches regarding their prevention and treatment.

关键词： diabetes publication number publication influence clinical research basic research traditional Chinese medicine

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Targeting protein modifications in metabolic diseases:molecular mechanisms and targeted therapies

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Signal Transduction and Targeted Therapy 2023年第6期8卷 2968-3012页

作者： Xiumei Wu Mengyun Xu Mengya Geng Shuo Chen Peter JLittle Suowen Xu jianping weng Department of Endocrinology Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineClinical Research Hospital of Chinese Academy of Sciences(Hefei)University of Science and Technology of ChinaHefeiAnhui230001China Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of DiabetologyThe Third Affiliated Hospital of Sun Yat-sen University510000GuangzhouChina School of Pharmacy University of QueenslandPharmacy Australia Centre of ExcellenceWoolloongabbaQLD4102Australia Sunshine Coast Health Institute and School of Health and Behavioural Sciences University of the Sunshine CoastBirtinyaQLD4575Australia Bengbu Medical College Bengbu233000China

The ever-increasing prevalence of noncommunicable diseases(NCDs)represents a major public health burden *** most common form of NCD is metabolic diseases,which affect people of all ages and usually manifest their pathobiology through life-threatening cardiovascular complications.A comprehensive understanding of the pathobiology of metabolic diseases will generate novel targets for improved therapies across the common metabolic *** posttranslational modification(PTM)is an important term that refers to biochemical modification of specific amino acid residues in target proteins,which immensely increases the functional diversity of the *** range of PTMs includes phosphorylation,acetylation,methylation,ubiquitination,SUMOylation,neddylation,glycosylation,palmitoylation,myristoylation,prenylation,cholesterylation,glutathionylation,S-nitrosylation,sulfhydration,citrullination,ADPribosylation,and several novel ***,we offer a comprehensive review of PTMs and their roles in common metabolic diseases and pathological consequences,including diabetes,obesity,fatty liver diseases,hyperlipidemia,and *** upon this framework,we afford a through description of proteins and pathways involved in metabolic diseases by focusing on PTM-based protein modifications,showcase the pharmaceutical intervention of PTMs in preclinical studies and clinical trials,and offer future *** research defining the mechanisms whereby PTMs of proteins regulate metabolic diseases will open new avenues for therapeutic intervention.

关键词： diseases mechanisms consequences

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Decreased b-Cell Function is Associated with Cardiovascular Autonomic Neuropathy in Chinese Patients Newly Diagnosed with Type 2 Diabetes

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Neuroscience Bulletin 2019年第1期35卷 25-33页

作者： Xubin Yang Wen Xu Yanhua Zhu Hongrong Deng Ying Tan Longyi Zeng jianping weng Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of DiabetologyThird Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630China

The influence of b-cell function on cardiovascular autonomic neuropathy(CAN), an important diabetesrelated complication, is still unclear. In this study, we aimed to investigate the association between residual b-cell function and CAN in patients newly diagnosed with type 2 diabetes. We enrolled 90 newly-diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as controls. The patients were divided into a CAN? group(diabetic patients with CAN, n = 20) and a CAN-group(diabetic patients without CAN, n = 70) according to the standard Ewing battery of tests. Fasting and postprandial plasma glucose, insulin, and C-peptide were *** model assessment-beta cells(HOMA-B) and HOMA-insulin resistance(IR) were calculated. The prevalence of CAN in this population was 22.2%. Compared with the CAN-group, the CAN? group had significantly lower fasting plasma insulin(6.60 ± 4.39 vs 10.45 ± 7.82 l/L, P = 0.029), fasting C-peptide(0.51 ± 0.20 vs0.82 ± 0.51 nmol/L, P = 0.004), and HOMA-B(21.44 ± 17.06 vs 44.17 ± 38.49, P = 0.002). Fasting C-peptide was correlated with the Valsalva ratio(r = 0.24, P = 0.043) and the 30:15 test(r = 0.26,P = 0.023). Further analysis showed that fasting C-peptide(OR: 0.041, 95% CI 0.003–0.501, P = 0.012) and HOMAB(OR: 0.965, 95% CI 0.934–0.996, P = 0.028) were independently associated with cardiovascular autonomic nerve function in this population. The patients with fasting C-peptide values \ 0.67 nmol/L were more likely to have CAN than those with C-peptide levels C0.67 nmol/L(OR:6.00, 95% CI 1.815–19.830, P = 0.003). A high prevalence of CAN was found in patients with newly-diagnosed type 2 diabetes. Decreased b-cell function was closely associated with CAN in this population.

关键词： Cardiovascular autonomic neuropathy b-cell function Type 2 diabetes mellitus

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Insulin requirement profiles and related factors of insulin pump therapy in patients with type 2 diabetes

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Science China(Life Sciences) 2019年第11期62卷 1506-1513页

作者： Xubin Yang Hongrong Deng Xiuzhen Zhang Daizhi Yang Jinhua Yan Bin Yao jianping weng Wen Xu Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of Diabetologythe Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630China Department of Endocrinology and Metabolism Shenzhen People s HospitalShenzhen 518020China Department of Endocrinology of the First Affiliated Hospital Division of Life Sciences and Medicine of the University of Science and Technology of China(USTC)Hefei 230026China

Continuous subcutaneous insulin infusion(CSII)is an effective therapy to control hyperglycemia in both patients with type 1 diabetes and type 2 ***,there is little data investigating the insulin dose setting during CSII therapy in type 2 diabetes to achieve optimal glycemic control and avoid the risk of ***,this study is aimed to assess the dose characteristics of insulin requirement and explore the related clinical factors in patients with type 2 diabetes who were treated with CSII.A total of 327 patients(195 males)aged 52.9±12.5 years old were included in this *** were treated with CSII to achieve the target fasting capillary blood glucose(4.4-7.0 mmol L^(-1))and 2-h postprandial capillary blood glucose(4.4-10.0 mmol L^(-1))by adjusting insulin infusion according to the seven-point capillary blood glucose *** daily insulin dose(TDD),total daily insulin dose per kilogram(TDD kg-1)and the ratio of total basal insulin dose(TBD)to TDD(%TBa)were calculated after patients achieved the glucose targets for at least 3 days via 1-2 weeks of CSII *** insulin dose,insulin dosing patterns and the relevant clinical factors were *** mean ratio of basal/bolus insulin distribution of all patients was 40%:60%.Patients with central obesity needed more TDD(51.3±17.1 U versus 43.5±14.0 U,P<0.05)and TDD kg^(-1)(0.8±0.3 U kg^(-1)versus 0.7±0.2 U kg^(-1),P<0.05)than those without central ***'s correlation analysis demonstrated that TDD was positively correlated with body mass index(BMI),waist circumference(WC),baseline fasting plasma glucose(FPG),fasting C-peptide level,2 h-postprandial C-peptide level and time to achieve glycemic target(all P<0.05);TDD kg^(-1)was positively correlated with waist-to-hip ratio(WHR),baseline FPG,glycosylated hemoglobin Ale(HbAlc),fasting C-peptide level and time to achieve glycemic target,and negatively correlated with BMI(all P<0.05).Multiple linear regression analyses reveale

关键词： continuous subcutaneous insulin infusion insulin requirement profiles type 2 diabetes

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Association between population migration and epidemic control of coronavirus disease 2019

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Science China(Life Sciences) 2020年第6期63卷 936-939页

作者： Yu Ding Sihui Luo Xueying Zheng Ping Ling Tong Yue Zhirong Liu jianping weng The First Affiliated Hospital of USTC Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Institute of Public Health University of Science and Technology of ChinaHefei 230026China Joint Laboratory of Public Health USTC and Anhui NHCHefei 230001China Anhui Provincial Center for Disease Control and Prevention Hefei 230601China Division of Life Sciences and Medicine University of Science and Technology of ChinaHefei 230026China

Dear Editor,In January 2020,a widespread outbreak of coronavirus disease 2019(COVID-19)occurred after the beginning of the largest annual migration in China,which is known as the Spring Festival *** in January 20,2020,the Chinese government took a series of unprecedented measures to contain the spread of *** of the role of Wuhan as a central transportation hub.

关键词： Association between population migration and epidemic control of coronavirus disease 2019

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胰高糖素样肽-1受体激动剂类药物结合生活方式干预减重专家共识(2024版)

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中华糖尿病杂志 2024年第9期16卷 945-958页

作者：中国民族卫生协会中国健康管理协会健康体检分会翁建平曾强包巍苏枫张惠杰郑雪瑛不详安徽医科大学第一附属医院中国科学技术大学附属第一医院合肥230001 解放军总医院第二医学中心健康管理研究院北京100853 中国科学技术大学公共卫生研究院浙江中医药大学南方医科大学南方医院中国科学技术大学附属第一医院

肥胖是由遗传因素和不良生活方式共同引发的代谢性疾病,是多种慢性病的高危因素。超重和肥胖问题已成为我国重大公共卫生问题。体重管理的手段包括生活方式干预、药物治疗及代谢手术。目前,多款胰高糖素样肽-1受体激动剂(GLP-1RA)类药... 详细信息

肥胖是由遗传因素和不良生活方式共同引发的代谢性疾病,是多种慢性病的高危因素。超重和肥胖问题已成为我国重大公共卫生问题。体重管理的手段包括生活方式干预、药物治疗及代谢手术。目前,多款胰高糖素样肽-1受体激动剂(GLP-1RA)类药物被批准用于体重管理。生活方式干预是所有体重管理手段的基础措施,其应贯穿于GLP-1RA类药物治疗等其他管理手段的始终,药物与生活方式干预如何科学有效地结合成为一个重要临床问题。内分泌、营养、公共卫生等领域专家,依据国内外临床研究提供的循证医学证据并结合临床实践,撰写了《胰高糖素样肽-1受体激动剂类药物结合生活方式干预减重专家共识(2024版)》,内容涵盖超重和肥胖的定义、诊断、流行病学、相关并发症,超重和肥胖的体重管理目标、减重策略以及患者使用GLP-1RA类药物减重的管理流程,并提出推荐意见,以期为从事体重管理工作的临床医师提供指导。

关键词：减重胰高糖素样肽-1受体激动剂生活方式干预体重管理流程

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When Glanzmann thrombasthenia encounters antithrombin defi ciency: how do we balance the risk and benefi t of antithrombotic therapy?

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World Journal of Emergency Medicine 2024年第1期15卷 67-69页

作者： Yu Wang Zhihao Liu Haoyu weng jianping Li Department of Endocrinology Peking University First HospitalBeijing 100034China Department of Cardiology Peking University First HospitalBeijing 100034China Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education Health Science CenterPeking UniversityBeijing 100034China

Glanzmann’s thrombasthenia(GT)is an inherited autosomal recessive bleeding disorder,resulting from mutations in the ITGA2B and ITGB3 genes,that lead to a defect in the platelet membrane integrinαIIbβ3.[1]As integrinαIIbβ3 plays an important role in thrombus formation,the clinical manifestation of GT includes bleeding(mostly mucocutaneous)and *** this reason,patients with GT are typically thought to be unlikely to suffer from thromboembolic *** is an anticoagulant that inhibits thrombin and is activated factor X and other serine proteases in the coagulation cascade.[2]Antithrombin deficiency is an autosomal dominant hereditary disease with an approximate prevalence of 1/500 in the overall population.[3]In contrast to the hemorrhagic tendency of GT,patients with antithrombin deficiency are at increased risk of thromboembolism,especially in the venous ***,we describe a rare case of GT and antithrombin deficiency coexisting in a single *** was used for the treatment of pulmonary embolism(PE)and deep vein thrombosis(DVT).

关键词： thrombin throm bleeding

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