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Development and validation of a novel non-invasive test for diagnosing nonalcoholic fatty liver disease in Chinese children

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World Journal of Pediatrics 2024年第4期20卷 413-421页

作者： Zhe-Wen Qin Qian-Nan Ren Hong-Xi Zhang Ya-Ru Liu Ke Huang Wei Wu Guan-Ping Dong Yan Ni Jun-Fen Fu Division of endocrinology National Clinical Research Center for Child HealthNational Children’s Regional Medical CenterThe Children’s HospitalDepartment of EndocrinologyNational Clinical Research Center for Child HealthNational Children’s Regional Medical CenterThe Children’s HospitalZhejiang University School of MedicineHangzhou310052China

With the exploding prevalence of obesity,many children are at risk of developing nonalcoholic fatty liver disease.Using anthropometric and laboratory parameters,our study aimed to develop a model to quantitatively evaluate liver fat content(LFC)in children with obesity.Methods A well-characterized cohort of 181 children between 5 and 16 years of age were recruited to the study in the endocrinology Department as the derivation cohort.The external validation cohort comprised 77 children.The assessment of liver fat content was performed using proton magnetic resonance spectroscopy.Anthropometry and laboratory metrics were measured in all subjects.B-ultrasound examination was carried out in the external validation cohort.The Kruskal-Wallis test,Spearman bivariate correlation analyses,univariable linear regressions and multivariable linear regression were used to build the optimal predictive model.Results The model was based on indicators including alanine aminotransferase,homeostasis model assessment of insulin resistance,triglycerides,waist circumference and Tanner stage.The adjusted R^(2)of the model was 0.589,which presented high sensitivity and specificity both in internal[sensitivity of 0.824,specificity of 0.900,area under curve(AUC)of 0.900 with a 95%confidence interval:0.783–1.000]and external validation(sensitivity of 0.918 and specificity of 0.821,AUC of 0.901 with a 95%confidence interval:0.818–0.984).Conclusions Our model based on five clinical indicators was simple,non-invasive,and inexpensive;it had high sensitivity and specificity in predicting LFC in children.Thus,it may be useful for identifying children with obesity who are at risk for developing nonalcoholic fatty liver disease.

关键词： Biochemical markers Children Magnetic resonance spectroscopy Nonalcoholic fatty liver disease Pediatric obesity

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Serum 25-hydroxyvitamin D, genetic susceptibility, and the risk of incident type 2 diabetes: A prospective cohort in East China

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中华医学杂志(英文版) 2024年第8期137卷 972-979页

作者： Sun Ying Zhang Haojie Wang Bin Wang Yuying Chen Chi Chen Yi Lu Yingli Wang Ningjian West China Hospital Sichuan University Chengdu Sichuan 610041 Department of endocrinology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai 201203 Institute and Department of endocrinology and Metabolism Shanghai Ninth People’s Hospital Shanghai JiaoTong University School of Medicine Shanghai 200011 China Department of endocrinology and Metabolism and Department of Guideline and Rapid Recommendation Cochrane China center MAGIC China center Chinese Evidence-Based Medicine center

Background: The serum vitamin D level varies widely by population, and studies have linked vitamin D levels with the risk of type 2 diabetes mellitus (T2DM). However, the relationship is inconsistent and the impact of vitamin D on T2DM among East Chinese adults is unclear. The study aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and the risk of T2DM and evaluated whether the association is modified by genetic predisposition.Methods: In the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cohort, 1862 participants free of T2DM at baseline were included. A weighted genetic risk score was calculated with 28 variants associated with T2DM. Hierarchical logistic models were used to examine the association of serum 25(OH)D and genetic risk with T2DM.Results: After a 5-year follow-up, 132 cases of T2DM were documented. We observed no significant association between quartiles of serum 25(OH)D and T2DM risk after multivariable adjustment (χ2 = 0.571,Pfor trend = 0.426). Compared to those in the lowest quartile of 25(OH)D, the odds ratios (ORs) (95% confidence interval [CI]) for participants with increased quartiles were 1.29 (0.74-2.25), 1.35 (0.77-2.36), and 1.27 (0.72-2.24), respectively. We observed a positive association of glycated hemoglobin (HbA1c) with 25(OH)D at baseline (β = 1.752,P = 0.001) and after follow-up (β = 1.385,P = 0.003), and a negative association of ln conversion homeostasis model assessment (HOMA)-β with 25(OH)D at baseline (β = -0.982,P = 0.021). There was no significant interaction between 25(OH)D and diabetes genetic predisposition on the risk of T2DM (χ2 = 2.710,Pfor interaction = 0.100). The lowest OR (95% CI) of T2DM was among participants with low genetic risk and the highest quartile of 25(OH)D (0.17 [0.05–0.62]).Conclusion: Serum 25(OH)D may be irrelevant to the risk of incident T2DM among East Chinese adults regardless of genetic predisposition.

关键词： Vitamin D Diabetes mellitus, Type 2 Genetic predisposition to disease Prospective cohort Glycated hemoglobin SPECT-China

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Pancreatic β-cell failure, clinical implications, and therapeutic strategies in type 2 diabetes

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中华医学杂志(英文版) 2024年第7期137卷 791-805页

作者： Cui Daxin Feng Xingrong Lei Siman Zhang Hongmei Hu Wanxin Yang Shanshan Yu Xiaoqian Su Zhiguang Molecular Medicine Research center and Department of endocrinology and Metabolism West China Hospital Sichuan University Chengdu Sichuan 610041 China State Key Laboratory of Biotherapy Clinical Translational Innovation center

Pancreatic β-cell failure due to a reduction in function and mass has been defined as a primary contributor to the progression of type 2 diabetes (T2D). Reserving insulin-producing β-cells and hence restoring insulin production are gaining attention in translational diabetes research, and β-cell replenishment has been the main focus for diabetes treatment. Significant findings in β-cell proliferation, transdifferentiation, pluripotent stem cell differentiation, and associated small molecules have served as promising strategies to regenerate β-cells. In this review, we summarize current knowledge on the mechanisms implicated in β-cell dynamic processes under physiological and diabetic conditions, in which genetic factors, age-related alterations, metabolic stresses, and compromised identity are critical factors contributing to β-cell failure in T2D. The article also focuses on recent advances in therapeutic strategies for diabetes treatment by promoting β-cell proliferation, inducing non-β-cell transdifferentiation, and reprograming stem cell differentiation. Although a significant challenge remains for each of these strategies, the recognition of the mechanisms responsible for β-cell development and mature endocrine cell plasticity and remarkable advances in the generation of exogenous β-cells from stem cells and single-cell studies pave the way for developing potential approaches to cure diabetes.

关键词： Pancreatic β-cell regeneration Diabetes Insulin Dedifferentiation Transdifferentiation Stem cell

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Correlation between rate-pressure product or pressure-rate quotient and urinary albumin-creatinine ratio in the Chinese older population:The REACTION study

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Chinese Medical Journal 2024年第2期137卷 238-240页

作者： Linghuan Wang Peixin Wu Kang Chen Binqi Li Jie Wang Yiming Mu Department of endocrinology The First Medical CenterChinese PLA General HospitalNational Key Laboratory of Kidney DiseasesBeijing 100853China Department of Medicine School Nankai UniversityTianjin 300071China Department of endocrinology Beijing Chao-Yang HospitalBeijing 100020China

To the Editor:Chronic kidney disease(CKD)is a critical health threat.An elevated urinary albumin-creatinine ratio(UACR)is a marker of impaired renal function and is a key risk factor for cardiovascular disease.The rate-pressure product(RPP)[1]and pressure rate quotient(PRQ)are widely used as methods to quantify cardiac load and hemodynamic response to exercise in clinical practice.Therefore,to better predict CKD,it is of great signicance to explore the relationships between RPP or PRQ and UACR.

关键词： urinary impaired creatinine

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Individualized intensive insulin therapy of diabetes: Not only thegoal, but also the time

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World Journal of Diabetes 2024年第1期15卷 11-14页

作者： Yun Hu Hong-Jing Chen Jian-Hua Ma Department of endocrinology The Affiliated Wuxi People's Hospital of Nanjing Medical UniversityWuxi People's HospitalWuxi Medical CenterNanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina Department of endocrinology Nanjing First HospitalNanjing 210000Jiangsu ProvinceChina

Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes.According to current guidelines,intensive glycemic control requires individu-alized glucose goals rather than as low as possible.During intensive therapy,rapid blood glucose reduction can aggravate microvascular and macrovascular complications,and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy,hypoglycemia,obesity,lipodystrophy,and insulin antibody syndrome.Therefore,we need to develop individualized hypoglycemic plans for patients with diabetes,including the time required for blood glucose normalization and the duration of intensive insulin therapy,which deserves further study.

关键词： Diabetes Intensive therapy Insulin Treatment-induced neuropathy

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Role of fullerenols derivative 3HFWC in the treatment of Alzheimer's disease

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Neural Regeneration Research 2024年第8期19卷 1641-1642页

作者： Sanja Ivkovic Djuro Koruga Department of Molecular Biology and endocrinology “VINCA”Institute of Nuclear Sciences-National Institute of Republic of SerbiaUniversity of BelgradeBeogradSrbija TFT Nano center BelgradeSerbia

Fullerenes:The extensive development of nanoscience that has marked this century continues to evolve,producing new materials,structures,and devices for the treatments of diverse pathologies.Fullerenes are a family of nanoparticles with great applicative promise due to their small size(approximately 1 nm in diameter),structure,and capacity to cross biological barriers.

关键词： treatment evolve size

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Direct detection of C9orf72 hexanucleotide repeat expansions by nanopore biosensor

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Chinese Chemical Letters 2024年第5期35卷 351-354页

作者： Xinqiong Li Guocheng Rao Xi Peng Chan Yang Yanjing Zhang Yan Tian Xianghui Fu Jia Geng State Key Laboratory of Biotherapy and Cancer center West China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengdu 610041China Division of endocrinology and Metabolism West China School of Medicine/West China HospitalSichuan UniversityChengdu 610041China Department of endocrinology and Metabolism Affiliated Hospital of North Sichuan Medical CollegeNorth Sichuan Medical CollegeNanchong 637000China Division of endocrinology and Metabolism National Clinical Research Center for GeriatricsState Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengdu 610041China Department of Laboratory Medicine State Key Laboratory of BiotherapyMed-X Center for ManufacturingWest China HospitalSichuan University and Collaborative Innovation CenterChengdu 610041China Tianfu Jincheng Laboratory City of Future MedicineChengdu 641400China

Diagnostic C9orf72 hexanucleotide repeat expansions(C9-HRE)is essential for the early and accurate diagnosis of amyotrophic lateral sclerosis(ALS)and will provide support for the prognosis and gene therapy of ALS.In the present study,by combining catalytic hairpin assembly(CHA)with Mycobacterium smegmatis porin A(MspA)nanopore,a new nanopore-based strategy for the detection of C9-HRE was reported.Less than 30 repeats of C9-HRE could be detected via this method,and the results have the potential to help distinguish between patients and healthy individuals.Moreover,the method demonstrated its great specificity for C9-HRE by identifying other repeat expansions.Given the high selectivity,this approach had been successfully used to detect C9-HRE in cell and blood samples with high accuracy.This detection strategy is user-friendly and has a strong anti-interference ability,thus providing a powerful tool for clinical diagnosis.

关键词： MspA nanopore C9orf72 HRE Detection Biosensor Catalytic hairpin assembly

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Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

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Frontiers of Medicine 2024年第2期18卷 303-314页

作者： Yi Ding Xiaoli Xu Zhuojun Xin Qiuyu Cao Jiaojiao Huang Xianglin Wu Yanan Huo Qin Wan Yingfen Qin Ruying Hu Lixin Shi Qing Su Xuefeng Yu Li Yan Guijun Qin Xulei Tang Gang Chen Min Xu Tiange Wang Zhiyun Zhao Zhengnan Gao Guixia Wang Feixia Shen Zuojie Luo Li Chen Qiang Li Zhen Ye Yinfei Zhang Chao Liu Youmin Wang Tao Yang Huacong Deng Lulu Chen Tianshu Zeng Jiajun Zhao Yiming Mu Shengli Wu Yuhong Chen Jieli Lu Weiqing Wang Guang Ning Yu Xu Yufang Bi Mian Li Department of Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic DiseasesRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Shanghai National Clinical Research center for Metabolic Diseases Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of ChinaShanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Jiangxi Provincial People’s Hospital Affiliated to Nanchang UniversityNanchang330000China Department of endocrinology The Affiliated Hospital of Southwest Medical UniversityLuzhou646000China Department of endocrinology The First Affiliated Hospital of Guangxi Medical UniversityNanning530000China Zhejiang Provincial center for Disease Control and Prevention Hangzhou310000China Department of endocrinology Affiliated Hospital of Guiyang Medical UniversityGuiyang550000China Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai200000China Tongji Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430000China Sun Yat-sen Memorial Hospital Sun Yat-sen UniversityGuangzhou510000China Department of endocrinology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou450000China Department of endocrinology The First Hospital of Lanzhou UniversityLanzhou730000China Fujian Provincial Hospital Fujian Medical UniversityFuzhou350000China Dalian Municipal Central Hospital Affiliated of Dalian Medical UniversityDalian116000China Department of endocrinology The First Hospital of Jilin UniversityChangchun130000China Department of endocrinology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou325000China Qilu Hospital of Shandong University Jinan250000China Department of endocrinology The Second Affiliated Hospital of Harbin Medical UniversityHarbin150000China Department of endocrinology Cen

Studies have found a U-shaped relationship between sleep duration and chronic kidney disease(CKD)risk,but limited research evaluated the association of reallocating excessive sleep to other behavior with CKD.We included 104538 participants from the nationwide cohort of the Risk Evaluation of Cancers in Chinese Diabetic Individuals:A Longitudinal Study,with self-reported time of daily-life behavior.Using isotemporal substitution models,we found that substituting 1 h of sleeping with sitting,walking,or moderate-to-vigorous physical activity was associated with a lower CKD prevalence.Leisure-time physical activity displacement was associated with a greater prevalence reduction than occupational physical activity in working population.In stratified analysis,a lower CKD prevalence related to substitution toward physical activity was found in long sleepers.More pronounced correlations were observed in long sleepers with diabetes than in those with prediabetes,and they benefited from other behavior substitutions toward a more active way.The U-shaped association between sleep duration and CKD prevalence implied the potential effects of insufficient and excessive sleep on the kidneys,in which the pernicious link with oversleep could be reversed by time reallocation to physical activity.The divergence in the predicted effect on CKD following time reallocation to behavior of different domains and intensities and in subpopulations with diverse metabolic statuses underlined the importance of optimizing sleeping patterns and adjusting integral behavioral composition.

关键词： sleep physical activity chronic kidney disease isotemporal substitution behavioral pattern

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Establishment and evaluation of a prognostic model for patients with unresectable gastric cancer liver metastases

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World Journal of Clinical Cases 2024年第13期12卷 2182-2193页

作者： Zheng-Yao Chang Wen-Xing Gao Yue Zhang Wen Zhao Di Wu Lin Chen Department of General Surgery The First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of endocrinology The First Medical Center of Chinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China

BACKGROUND Liver metastases(LM)is the primary factor contributing to unfavorable outcomes in patients diagnosed with gastric cancer(GC).The objective of this study is to analyze significant prognostic risk factors for patients with GCLM and develop a reliable nomogram model that can accurately predict individualized prognosis,thereby enhancing the ability to evaluate patient outcomes.AIM To analyze prognostic risk factors for GCLM and develop a reliable nomogram model to accurately predict individualized prognosis,thereby enhancing patient outcome assessment.METHODS Retrospective analysis was conducted on clinical data pertaining to GCLM(type III),admitted to the Department of General Surgery across multiple centers of the Chinese PLA General Hospital from January 2010 to January 2018.The dataset was divided into a development cohort and validation cohort in a ratio of 2:1.In the development cohort,we utilized univariate and multivariate Cox regression analyses to identify independent risk factors associated with overall survival in GCLM patients.Subsequently,we established a prediction model based on these findings and evaluated its performance using receiver operator characteristic curve analysis,calibration curves,and clinical decision curves.A nomogram was created to visually represent the prediction model,which was then externally validated using the validation cohort.RESULTS A total of 372 patients were included in this study,comprising 248 individuals in the development cohort and 124 individuals in the validation cohort.Based on Cox analysis results,our final prediction model incorporated five independent risk factors including albumin levels,primary tumor size,presence of extrahepatic metastases,surgical treatment status,and chemotherapy administration.The 1-,3-,and 5-years Area Under the Curve values in the development cohort are 0.753,0.859,and 0.909,respectively;whereas in the validation cohort,they are observed to be 0.772,0.848,and 0.923.Furthermore,the calibration curves demonstrated excellent cons

关键词： Gastric cancer Liver metastases Nomogram Prognostic model Survival analysis

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Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2269-2274页

作者： Arif Al Nooryani Wael Aboushokka Branko Beleslin Biljana Nedeljkovic-Beleslin Department of Cardiology Al Qassimi HospitalSharjah 1234United Arab Emirates Department of Cardiology Medical FacultyUniversity of BelgradeBelgrade 11000Serbia Institute of endocrinology Diabetes and Metabolic DisordersUniveristy Clinical Center of SerbiaBelgrade 11000Serbia Department of Internal Medicine/endocrinology Medical facultyUniversity of BelgradeBelgrade 11000Serbia

BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.

关键词： Fractional flow reserve Coronary flow reserve Index of microvascular resistance Optical coherence tomography Intermediate coronary stenosis Case report

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