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Consensus on glycemic management for patients with coronary heart disease and type 2 diabetes

Journal of Geriatric Cardiology 2024年第7期21卷 689-702页

作者： li-nong ji Yun-Dai CHEN jing liU Xiang-Hai ZHOU Cardiovascular Subcommittee of Chinese International Exchange and Promotion Association for Medical and Healthcare Peking University People's Hospital Chinese PLA General Hospital

The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic *** studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 ***,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary *** highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with *** consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty ***,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.

关键词： coronary patients routine

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Treatment response between Asian and non-Asian patients with type 2diabetes:is there any similarity or difference?

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Chinese Medical Journal 2019年第1期132卷 1-3页

作者： Xiao-ling Cai li-nong ji Department of Endocrinology and Metabolism Peking University People's HospitalBeijing 100044China

Introduction According to the latest edition of Diabetes Atlas,the prevalence of diabetes is increasing globally,but the situation is particularly alarming in Asia and in China.[1,2,3] It was estimated that,for the same body mass index (BMI),Asian population had a higher prevalence of diabetes than the non-Asian counterparts,[4] because of the lower BMIs reported in Asian diabetes population.

关键词： Type 2 diabetes Asia body mass index (BMI)

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Indirect comparison of efficacy and safety of chiglitazar and thiazolidinedione in patients with type 2 diabetes:A meta-analysis

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World Journal of Diabetes 2023年第10期14卷 1573-1584页

作者： Chu lin Zong-lin li Xiao-ling Cai Sui-Yuan Hu Fang Lv Wen-jia Yang li-nong ji Department of Endocrinology and Metabolism Peking University People's HospitalBeijing 100044China

BACKGROUND Chiglitazar is an emerging pan-agonist of all peroxisome proliferator activated receptors(PPAR)-α,δandγ,and has therapeutic potential for type 2 diabetes(T2D).However,to date,no clinical studies or meta-analyses have compared the efficacy and safety of chiglitazar and traditional PPAR-γagonist thiazolidinediones(TZDs).A meta-analysis concerning this topic is therefore *** To compare the efficacy and safety of chiglitazar and TZD in patients with *** PubMed,Medline,Embase,the Cochrane Central Register of Controlled Trials,Reference Citation Analysis and *** websites were searched from August 1994 to March *** controlled trials(RCTs)of chiglitazar or TZD vs placebo in patients with T2D were *** comparisons and sensitivity analyses were implemented to evaluate multiple efficacy and safety endpoints of *** We included 93 RCTs that compared TZD with placebo and one that compared chiglitazar with *** efficacy endpoints,the augmented dose of chiglitazar resulted in greater reductions in hemoglobin(Hb)A1c[weighted mean difference(WMD)=-0.15%,95%confidence interval(CI):-0.27 to-0.04%],triglycerides(WMD=-0.17 mmol/L,95%CI:-0.24 to-0.11 mmol/L)and alanine aminotransferase(WMD=-5.25 U/L,95%CI:-8.50 to-1.99 U/L),and a greater increase in homeostasis model assessment-β(HOMA-β)(WMD=17.75,95%CI:10.73-24.77)when compared with TZD *** safety endpoints,the risks of hypoglycemia,edema,bone fractures,upper respiratory tract infection,urinary tract infection,and weight gain were all comparable between the augmented dose of chiglitazar and *** patients with baseline HbA1c≥8.5%,body mass index≥30 kg/m^(2)or diabetes durationlitazar compared with *** Augmented dose of chiglitazar,a pan-activator of PPARs,may serve as an antidiabetic agent with preferable glycemic and lipid control

关键词： Chiglitazar Thiazolidinedione Glycemic control β-cell function Drug safety

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Clinical evidence and treatment requirements related to heart failure in type 2 diabetes mellitus

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Chinese Medical Journal 2020年第10期133卷 1135-1137页

作者： Xiao-ling Cai Xiang-Qing Wang li-nong ji Department of Endocrinology&Metabolism Peking University People's HospitalBeijing 100044China.

Heart failure(HF),which is a common and serious complication of diabetes,has received more attention in recent *** reason for this focus on HF is that,with a large reduction in atherothrombotic events after acute myocardial infarction,HF is a relatively more frequently encountered cardiac outcome in patients with type 2 diabetes(T2DM).Another reason is the unexpected reduction in hospitalization for HF observed in cardiovascular outcome trials with sodium-glucose co-transporter-2 inhibitors(SGLT2is).[1-3]These findings led to speculation by clinicians and researchers on whether more effort should be made to differentiate patients with diabetes at a high risk of developing HF.

关键词： diabetes acute cardiovascular

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Type 1 diabetes induced by immune checkpoint inhibitors

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Chinese Medical Journal 2020年第21期133卷 2595-2598页

作者： Rui Zhang Xiao-ling Cai liu liu Xue-Yao Han li-nong ji Department of Endocrinology and Metabolism Peking University People's HospitalBeijing 100044China department of Endocrinology and Metabolism Guiyang Hospital of Guizhou Aviation Industry GroupGuiyangGuizhou 550009China

With the increasing use of immune checkpoint inhibitors(ICI)including anti-cytotoxic T lymphocyte associated antigen-4(CTLA-4)and anti-programmed cell death-1(PD-1)in cancers,ICI-induced type 1 diabetes has been reported throughout the *** this review,we aim to summarize the characteristics of this disease and discuss the mechanism of *** an immune-related adverse event,type 1 diabetes developed after the administration of anti-PD-1 or anti-PD-ligand 1(PD-L1)in the combination with or without *** usually presented with acute onset,and 62.1%of the reported cases had diabetic *** a third of them had positive autoantibodies associated with type 1 *** HLA genotypes might be associated.T-cell-stimulation by blocking of the interaction of PD-1 and PD-L1 in pancreatic β cells was the main mechanism involved in the *** was the only effective treatment of ICI-induced type 1 *** conclusions,ICI-induced type 1 diabetes is a potentially life-threating adverse event after the immunotherapy of *** and early recognition is *** investigation of the mechanism may help to better understand the pathology of type 1 diabetes.

关键词： Programmed cell death-1 Type 1 diabetes Immune checkpoint inhibitors

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Relationship Between Serum Zinc Level and Microvascular Complications in Patients with Type 2 Diabetes

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Chinese Medical Journal 2015年第24期128卷 3276-3282页

作者： Ying-Ying Luo jie Zhao Xue-Yao Han Xiang-Hai Zhou jing Wu li-nong ji Department of Endocrinology Peking University People's Hospital Beijing 100044 China Department of ICU Peking University International Hospital Beijing 102206 China

Background： Previous studies suggested that zinc level was related to relationship between zinc level and all the microvascular complications in a certain diabetic microvascular complication. However, the type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level. Methods： We included the hospitalized patients with type 2 diabetes （T2D） at our department from May 30, 2013 to March 31,2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level. Results： The 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy （P 〈 0.001）, diabetic nephropathy （DN, P 〈 0.001 ）, or diabetic peripheral neuropathy （P = 0.002） compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN （odds ratio = 0.869, 95% confidence interval = 0.765-0.987, P 〈 0.05）. The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A I c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels. Conclusions： Lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.

关键词： Diabetic Nephropathy Diabetic Peripheral Neuropathy Diabetic Retinopathy Type 2 Diabetes Zinc

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Characteristics,treatment patterns,and glycemic control of older type 2 diabetes mellitus patients in China

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Chinese Medical Journal 2021年第23期134卷 2893-2895页

作者： Xiao-ling Cai jie Shen Bin-Qi Ye Qiang li Douglas ASClark li-nong ji Department of Endocrinology and Metabolism Peking University People’s HospitalBeijing 100044China Department of Medical Affairs Boehringer Ingelheim(China)Investment Co.Ltd.Shanghai 200040China Department of Biostatistics&Data Sciences Asia Boehringer Ingelheim(China)Investment Co.Ltd.Shanghai 200040China Department of Global Epidemiology Boehringer Ingelheim(China)Investment Co.Ltd.Beijing 100027China Boehringer Ingelheim International GmbH Binger Strasse 17355216 Ingelheim am RheinGermany.

To the Editor:The prevalence of type 2 diabetes mellitus(T2DM)in older Chinese adults(≥60 years)is over 20%.[1]In comparison to younger patients,older diabetes patients tend to have lower rate of adequate glycemic control(limited data on the clinical characteristics and treatment patterns of older T2DM patients in *** conducted a nation-wide cross-sectional study to examine the clinical characteristics,anti-diabetic treatment patterns,and glycemic control in older(≥60 years)Chinese *** associated with poor glycemic control were identified with multivariate regression analysis.

关键词： patients T2DM diabetes

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A Novel Mutation of PRKAR1A Caused Carney Complex in a Chinese Patient

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Chinese Medical Journal 2017年第24期130卷 3009-3010页

作者： Xiao-ling Cai jing Wu Ying-Ying Luo ling Chen Xue-Yao Han li-nong ji Department of Endocrinology and Metabolism Peking University People's Hospital Beijing 100044 China

Primary pigmented nodular adrenocortical disease （PPNAD） causes adrenocorticotropic hormone （ACTH）-independent Cushing＇s syndrome （CS）,which is the most frequent endocrine manifestation of Carney complex （CNC）.[1] In the disease process of PPNAD,both presadrenal glands are involved and feature small brown-black nodules separated by the atrophic adrenal cortex.

关键词： Carney Complex Chinese Mutation PRKAR1A Gene

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Comparison of Placebo Effect between Asian and Caucasian Type 2 Diabetic Patients： A Meta-Analysis

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Chinese Medical Journal 2018年第13期131卷 1605-1612页

作者： Wei Guo lin Nie Xi-Rui Wang Mei-ling Xu Wen-jia Yang Xue-Ying Gao Xiao-ling Cai li-nong ji Department of Emergency Peking University People's Hospital Beijing 100044 China Department of Endocrinology and Metabolism Beijing Airport Hospital Beijing 101318 China Department of Endocrinology and Metabolism Peking University People's Hospital Beijing 100044 China

Background： Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes （T2DM）. The aim of this study was to evaluate the placebo effects ofantidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities. Methods： A search using the MEDliNE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea （SU）; alpha glucosidase inhibitors （AGI）; metfornlin （MET）; thiazolidinediones （TZD）; dipeptidyl peptidase-4 inhibitors （DPP-4i）; sodium-glucose cotransporter 2 inhibitors （SGLT2i）; glucagon-like peptide- 1 receptor agonist （GLP- 1RA）; type 2 diabetes （T2DM）; placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding. Results： This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant redtlctions of glycosylated hemoglobin （HbAlc）, -0.683% （P - 0.008） in SU monotherapy treatment, -0.193% （P = 0.001） in DPP-4i treatment, and -0.230% （P 〈 0.001） in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases ofHbA1c, 0.162% （P= 0.012） in DPP-4i treatment and -0.269% （P =0.028） in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg （P = 0.006） weight loss by SU treatment and 0.953 kg （P = 0.006） weight loss by GLP-I RA treatme

关键词： Asian Caucasiam Placebo Type 2 Diabetes Mellitus

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Comparing the incidence of major cardiovascular events and severe microvascular complications in patients with type 2 diabetes mellitus:A systematic review and meta-analysis

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World Journal of Meta-Analysis 2020年第5期8卷 400-410页

作者： Ying-Ying Zhu Zu-Yao Yang Ping li Xin-Ying Huang Xue-Hong Zhang li-nong ji jin-ling Tang Division of Epidemiology The Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong KongChina Channing Division of Network Medicine Department of MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMA 02115United States Department of Endocrinology and Metabolism Peking University People's HospitalPeking University Diabetes CentreBeijing 100044China

BACKGROUND Type 2 diabetes mellitus(T2DM)causes both macrovascular and microvascular ***,currently,selection of glycemic measures and their thresholds to diagnose T2DM,and efficacy outcomes in evaluation of anti-diabetic drugs is predominantly informed by the relation of T2DM to microvascular *** can be severely mistaken on T2DM by neglecting macrovascular complications which are generally more severe,if they also occur more commonly than microvascular *** To compare the incidence of major cardiovascular events(MACEs)and severe microvascular complications(SMICs)in T2DM *** MEDliNE,EMBASE,and Cochrane Central Register of Controlled Trials were searched from inception to September *** studies or trials of T2DM patients aged 18 years or older that reported incidence of both MACEs and SMICs were *** were defined as nonfatal myocardial infarction and stroke,and cardiovascular death,while SMICs included serious retinopathy,nephropathy and diabetic *** relative risk(RR)was estimated as the incidence of MACEs divided by that of SMICs in same patients and combined with meta-analysis in a random-effect *** Twelve studies with a total of 16 cohorts and 387376 patients were included,and the combined RR was 2.02(95%CI:1.46–2.79).The higher incidence of MACEs remained in various subgroup and sensitivity *** Patients with T2DM are much more likely to develop MACEs than *** taking more serious consequences and relatively higher incidence into consideration,macrovascular complications deserve more emphasis in developing the diagnostic criteria of T2DM and in evaluating the efficacy of antidiabetic drugs.

关键词： Diabetes mellitus Diabetic complications Cardiovascular disease Diabetic retinopathy Diagnostic criteria Anti-diabetic drugs

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