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Gestational diabetes mellitus combined with fulminant type 1 diabetes mellitus, four cases of double diabetes: A case report

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World Journal of Clinical Cases 2024年第4期12卷 787-794页

作者： Hui Li Yun Chai Wei-Hong Guo Yu-Meng Huang Xiao-Na Zhang Wen-Li Feng Qing He Jin Cui Ming Liu Department of endocrinology and metabolism Tianjin Medical University General HospitalTianjin 300052China

BACKGROUND Fulminant type 1 diabetes mellitus(FT1DM)that occurs during pregnancy or the perinatal period is known as pregnancy-related FT1DM(PF),always without history of abnormal glucose metabolism.Here,we present four patients who developed FT1DM during treatment but were first diagnosed with gestational diabetes mellitus(GDM).CASE SUMMARY The clinical data of four patients with GDM combined with FT1DM admitted to our hospital between July 2018 and April 2021 were collected,and the patients and their infants were followed up.All patients were diagnosed with GDM during the second trimester and were treated.The blood glucose level elevated suddenly during the third trimester and then were diagnosed with FT1DM.Two patients had an insulin allergy,and two had symptoms of upper respiratory tract infection before onset.One patient developed ketoacidosis,and three developed ketosis.Two patients had cesarean section deliveries,and two had vaginal deliveries.The growth and development of the infants were normal.C-peptide levels were lower than those at onset,suggesting progressive impairment of islet function.The frequencies of the DRB109:01,DQB103:03,DQA103:02,DPA101:03,DPA102:02,DPB105:01,DRB401:03,G 01:01,and G 01:04 human leukocyte antigen(HLA)-G alleles were high in the present study.CONCLUSION In comparison with pregnancy-associated FT1DM(PF),patients with GDM combined with FT1DM had an older age of onset,higher body mass index,slower onset,fewer prodromal symptoms,and less acidosis.The pathogenesis may be due to various factors affecting the already fragileβ-cells of GDM patients with genetically susceptible class II HLA genotypes.We speculate that GDM combined with FT1DM during pregnancy,referred to as“double diabetes,”is a subtype of PF with its own unique characteristics that should be investigated further.

关键词： Fulminant type 1 diabetes mellitus Gestational diabetes mellitus Pregnancy-related fulminant type 1 diabetes mellitus Double diabetes Case report

Mediating role of social support in dysphoria,despondency,and quality of life in patients undergoing maintenance hemodialysis

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World Journal of Psychiatry 2024年第3期14卷 409-420页

作者： Xiang Zhou Hong Jiang Yi-Peng Zhou Xiao-Yu Wang Hai-Yan Ren Xue-Fei Tian Qing-Qing Zhang Department of Nephrology People’s Hospital of Xinjiang Uygur Autonomous RegionXinjiang Clinical Research Center for Kidney DiseaseUrumqi 832000Xinjiang Uygur Autonomous RegionChina Department of endocrinology and metabolism People’s Hospital of Xinjiang Uygur Autonomous RegionUrumqi 832000Xinjiang Uygur Autonomous RegionChina section of Nephrology Department of Internal MedicineYale University School of MedicineNew HavenCT 06510United States

BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a signifi

关键词： Maintenance hemodialysis Social support Dysphoria Despondency Quality of life Mediating effect

Validity of self-reported male sexual function scalesin a young Chinese population:a comparative studywith clinician-assisted evaluation

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Asian Journal of Andrology 2024年第3期26卷 321-327页

作者： Hui Zhang Elena Colonnello Erika Limoncin Tommaso B Jannini Xu-Chong Tu Andrea Sansone Emmanuele A Jannini Yan Zhang Department of Infertility and Sexual Medicine Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510000China Chair of endocrinology and MedicalSexology(ENDOSEX) Department of Experimental MedicineUniversity of Rome Tor VergataRome 00133Italy Department of Urology First Affiliated Hospital ofGuangzhou University of Chinese MedicineGuangzhou 510000China section of Medical Pathophysiology Food Science and EndocrinologySapienza University ofRomeRome 00133Italy School of Psychiatry Department of Systems MedicineUniversity of Rome Tor VergataRome 00133Italy

Psychometric scales,commonly used to gauge sexual function,can sometimes be influenced by response biases.In our researchfrom June 2020 to April 2021,we examined the accuracy of self-reported sexual function scales.We invited patients from theDepartment of Infertility and Sexual Medicine at the Third Affiliated Hospital of Sun Yat-sen University(Guangzhou,China),whohave male sexual dysfunction,to participate by filling out a self-reported version of a specific questionnaire.In addition,they wentthrough a clinician-assisted version of this questionnaire,encompassing tools such as the Premature Ejaculation Diagnostic Tool(PEDT),the 6-item International Index of Erectile Function(IIEF-6),the Erection Hardness Scale(EHS),and the MasturbationErection Index(MEI).Using the clinician-assisted version as a reference,we categorized patients and applied various statisticalmethods,such as the Chi-square test,intraclass correlation coefficient(ICC),logistic regression,and the Bland–Altman plot,to gauge reliability.In our study with 322 participants,we found that while there were no notable discrepancies in error ratesbased on our categorization,certain scales showed significant differences in terms of overestimation and underestimation,withthe exception of the PEDT.The positive diagnosis rate consistency between the self-reported and clinician-assisted versions wasobserved.High ICC values between the two versions across the scales were indicative of remarkable reliability.Our findings showthat the self-reported versions of tools such as EHS,IIEF-6,MEI,and PEDT are credible and hold clinical reliability.However,employing a dual-diagnosis approach might be more prudent to circumvent potential misdiagnoses.

关键词： psychometry scale sexual function sexual health

Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics:The Study of Muscle,Mobility and Aging(SOMMA)

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Journal of Sport and Health Science 2024年第5期13卷 621-630页

作者： Yujia(Susanna)Qiao Terri L.Blackwell Peggy M.Cawthon Paul M.Coen Steven R.Cummings Giovanna Distefano Samaneh Farsijani Daniel E.Forman Bret H.Goodpaster Stephen B.Kritchevsky Theresa Mau Frederico G.S.Toledo Anne B.Newman Nancy W.Glynn Department of Epidemiology School of Public HealthUniversity of PittsburghPittsburghPA 15261USA San Francisco Coordinating Center California Pacific Medical Center Research InstituteSan FranciscoCA 94143USA Department of Epidemiology and Biostatistics University of CaliforniaSan FranciscoCA 94143USA Translational Research Institute AdventHealthOrlandoFL 32804USA Department of Medicine(Geriatrics and Cardiology) University of Pittsburghand GeriatricsResearchEducationand Clinical Center(GRECC)VA Pittsburgh Healthcare SystemPittsburghPA 15261USA Department of Internal Medicine Section on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston-SalemNC 27109USA Division of endocrinology and metabolism Department of MedicineUniversity of PittsburghPittsburghPA 15261USA

Background:Skeletal muscle energetics decline with age,and physical activity(PA)has been shown to offset these declines in older adults.Yet,many studies reporting these effects were based on self-reported PA or structured exercise interventions.Therefore,we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior(SB)with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle energetics.Methods:As part of the Study of Muscle,Mobility and Aging,enrolled older adults(n=879),810(age=76.4±5.0 years old,mean±SD;58%women)had maximal muscle oxidative capacity measured ex vivo via high-resolution re spirometry of permeabilized myofibers(maximal oxidative phosphorylation(maxOXPHOS))and in vivo by ^(31)phosphorus magnetic resonance spectroscopy(maximal adenosine triphosphate(ATP_(max))).Accelerometry-measured sedentary behavior,light activity,and moderate-to-vigorous PA(MVPA)were assessed using a wrist-worn ActiGraph GT9X over 7 days.Self-reported sedentary behavior,MVPA,and all PA were assessed with the Community Healthy Activities Model Program for Seniors(CHAMPS)questionnaire.Linear regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics,as well as the attenuation of the age/muscle energetics association by MVP A and sedentary behavior.As a sensitivity analysis,we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle energetics.Results:Every 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s×mg)higher maxOXPHOS and 0.012 mM/s higher ATP_(max)after adjusting for age,site/technician,and sex(p<0.05).Light activity was not associated with maxOXPHOS or ATP_(max).Meanwhile,every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s×mg lower maxOXPHOS and0.006 mM/s lower ATP_(max)(p<0.05).Only associatio

关键词： Aging Exercise Mitochondria

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Long-term outcomes in patients with non-alcoholic fatty liver disease: further evidence that a multidisciplinary and patient-centred approach to treatment is needed

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 143-146页

作者： Giovanni Targher section of endocrinology Diabetes and MetabolismDepartment of MedicineUniversity and Azienda Ospedaliera Universitaria Integrata of VeronaVeronaItaly

The prevalence of non-alcoholic fatty liver disease(NAFLD)is thought to be on the rise globally(1).An updated meta-analysis reported that in 2019 the pooled global prevalence of NAFLD was 29.8%[95%confidence interval(CI):28.6-31.1%]with the highest NAFLD prevalence observed in South America and North America(2).From 1991-2019,trend analysis also showed that NAFLD prevalence increased from~22%to 37%(with yearly increase of 0.7%),with South America showing the most rapid change of 2.7%per year followed by the Europe at 1.1%(2).

关键词： prevalence NAFLD centre

Clinical and molecular characterization of 10 Chinese children with congenital adrenal hyperplasia due to 11beta‑hydroxylase deficiency

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World Journal of Pediatrics 2024年第4期20卷 422-433页

作者： Wen‑Li Lu Xiao‑Yu Ma Jiao Zhang Jun‑Qi Wang Ting‑Ting Zhang Lei Ye Yuan Xiao Zhi‑Ya Dong Wei Wang Shou‑Yue Sun Chuan‑Yin Li Rong‑Gui Hu Guang Ning Li‑Dan Zhang Department of Pediatrics Ruijin HospitalShanghai Jiao Tong University School of MedicineNo.197Ruijin 2nd RdHuangpu DistrictShanghai 200025China Department of Pediatric Genetic and Metabolic endocrinology West China Second University HospitalSichuan UniversityNo.20Section 3Renmin South RoadSichuan 610041China Department of Endocrine and Metabolic Diseases Shanghai Clinical Center for Endocrine and Metabolic DiseasesRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Cancer Center School of MedicineShanghai Tenth People’s HospitalTongji UniversityYanchang Zhong Lu 301St RdJing’an DistrictShanghai 200031China

Background The clinical manifestations of nonclassical 11beta-hydroxylase deficiency are very similar to those of nonclassical 21-hydroxylase deficiency.For this study,we investigated the relationship between the clinical and molecular features of congenital adrenal hyperplasia caused by 11beta-hydroxylase deficiency and reviewed the related literature,which are expected to provide assistance for the clinical diagnosis and analysis of congenital adrenal hyperplasia.Methods Clinical data for 10 Chinese patients diagnosed with congenital adrenal hyperplasia in our hospital from 2018 to 2022 were retrospectively analyzed.We examined the effects of gene mutations on protease activity and constructed threedimensional structure prediction models of proteins.Results We describe 10 patients with 11beta-hydroxylase gene mutations(n=5,46,XY;n=5,46,XX),with 10 novel mutations were reported.Female patients received treatment at an early stage,with an average age of 2.08±1.66 years,whereas male patients received treatment significantly later,at an average age of 9.77±3.62 years.The most common CYP11B1 pathogenic variant in the Chinese population was found to be c.1360C>T.All mutations lead to spatial conformational changes that affect protein stability.Conclusions Our study found that there was no significant correlation between each specific mutation and the severity of clinical manifestations.Different patients with the same gene pathogenic variant may have mild or severe clinical manifestations.The correlation between genotype and phenotype needs further study.Three-dimensional protein simulations may provide additional support for the physiopathological mechanism of genetic mutations.

关键词： 11β-hydroxylase deficiency CYP11B1 Enzymatic activity Phenotype-genotype correlation Threedimensional protein simulations

Toll-like receptor 9 defciency induces osteoclastic bone loss via gut microbiota-associated systemic chronic inflammation

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Bone Research 2022年第3期10卷 594-614页

作者： Peng Ding Qiyuan Tan Zhanying Wei Qiyu Chen Chun Wang Luyue Qi Li Wen Changqing Zhang Chen Yao Department of Orthopedic Surgery Shanghai Jiaotong University affiliated Sixth People’s HospitalShanghaiChina Department of endocrinology and metabolism Shanghai Jiaotong University affiliated Sixth People’s HospitalShanghaiChina Department of Osteoporosis and Skeletal Disorders Shanghai Jiaotong University affiliated Sixth People’s HospitalShanghaiChina Department of endocrinology and metabolism Second Affiliated Hospital of Soochow UniversitySuzhouChina section of endocrinology Department of Internal MedicineYale University School of MedicineNew HavenUSA

Toll-like receptors(TLRs)play pivotal roles in inflammation and provide important links between the immune and skeletal systems.Although the activation of TLRs may affect osteoclast differentiation and bone metabolism,whether and how TLRs are required for normal bone remodeling remains to be fully explored.In the current study,we show for the first time that TLR9^(-/-)mice exhibit a low bone mass and low-grade systemic chronic inflammation,which is characterized by the expansion of CD4^(+)T cells and increased levels of inflammatory cytokines,including TNFα,RANKL,and IL1β.The increased levels of these cytokines significantly promote osteoclastogenesis and induce bone loss.Importantly,TLR9 deletion alters the gut microbiota,and this dysbiosis is the basis of the systemic inflammation and bone loss observed in TLR9^(-/-)mice.Furthermore,through single-cell RNA sequencing,we identified myeloid-biased hematopoiesis in the bone marrow of TLR9^(-/-)mice and determined that the increase in myelopoiesis,likely caused by the adaptation of hematopoietic stem cells to systemic inflammation,also contributes to inflammation-induced osteoclastogenesis and subsequent bone loss in TLR9^(-/-)mice.Thus,our study provides novel evidence that TLR9 signaling connects the gut microbiota,immune system,and bone and is critical in maintaining the homeostasis of inflammation,hematopoiesis,and bone metabolism under normal conditions.

关键词： inflammation metabolism osteoclast

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Parathyroid carcinoma located in the thyroid gland:A case report

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World Journal of Clinical Cases 2024年第18期12卷 3609-3614页

作者： Shu-Yan Gui Chang-Ning Zhang Li Ling Ruo-Xi Tang Jing Yang Department of endocrinology Huazhong University of Science and Technology Union Shenzhen HospitalThe 6th Affiliated Hospital of Shenzhen University Health Science CenterShenzhen 518052Guangdong ProvinceChina

BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMARY This study reported the clinical diagnosis and treatment of a rare patient with PC located in the thyroid gland and provided a case reference for the diagnosis and treatment of PC.A case of a 64-year-old male patient who presented to our hospital with systemic muscle and joint pain and palpitations is outlined.Subsequently,the patient was admitted to the Department of Nephrology for the treatment of“multiple myeloma nephropathy pending investigation”.The patient was diagnosed with“primary hyperparathyroidism and hypercalcemic crisis”using thyroid color ultrasound.CONCLUSION The intraoperative frozen section report considered the parathyroid tumor.Surgical tumor resection was promptly performed,and the diagnosis of PC was confirmed.

关键词： Parathyroid carcinoma Surgical resection Fine needle aspiration Intraoperative frozen section Case report

Identification of monocyte-related transcriptomic signature of peripheral blood mononuclear cells in type 1 diabetes

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Chinese Medical Journal 2022年第21期135卷 2608-2610页

作者： Min Yin Yan Zhang Juan Huang Xinyu Li Haibo Yu Xia Li National Clinical Research Center for Metabolic Diseases Key Laboratory of Diabetes ImmunologyMinistry of Educationand Department of Metabolism and EndocrinologyThe Second Xiangya HospitalCentral South UniversityChangshaHunan 410011China Department of Internal Medicine Section of EndocrinologySchool of MedicineYale UniversityNew HavenCTUSA Hunan Engineering Research Center of Cell Therapy for Diabetes ChangshaHunan 410011China

To the Editor:Type 1 diabetes(T1D)is caused by autoimmunity-mediated destruction of pancreatic islet beta cells,with islet autoimmunity being the essential component in the pathogenesis of T1D.[1]However,studies on human islets are limited due to sampling difficulties.Therefore,immunological changes in peripheral blood mononuclear cells(PBMCs)should be emphasized.In one way,islet-infiltrating immune cells are presumably in equilibrium with circulating pools and changes in PBMCs might partly reflect islet inflammation.On the other,PBMCs represent a useful tool to detect biomarkers for disease.[2]Traditionally,studies on PBMCs in T1D are characterized by the use of limited numbers of cell-surface markers and secreted cytokines measured using flow detection and other antibody-based assays.

关键词： islet diabetes blood

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