ABSTRACT
Objective To observe the serum levels of calcium, phosphorus, alkaline phosphatase (ALP), parathy-roid hormone (PTH) and 25-hydroxyvitamin D, and the influence of biochemical markers of bone turnover in Graves’dis-ease. Methods Sixty-two patients with Graves’disease were enrolled into the Graves’disease group and 91 healthy indi-viduals as a control group. Electrochemical luminescence was used to evaluate the plasma levels of PTH and 25-hydroxyvita-min D in two groups. The serum levels of calcium, phosphorus and ALP were measured with biochemistry methods in two groups. Results The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in the Graves’disease group compared with those in control group (P<0.01). The serum levels of calcium, phosphorus, ALP and 25-hydroxyvitamin D were significantly higher in female patients than those of control group, and the level of PTH was lower than that of control group. For male patients, the levels of ALP and 25-hydroxyvitamin D were higher than those of control group, and the level of PTH was lower than that of control group. In Graves’disease group, patients with vitamin D deficien-cy were 17 cases (27.4%), insufficiency 20 cases (32.3%) and sufficiency 25 cases (40.3%), respectively. In control group, there were 54 cases with vitamin D deficiency (59.3%), 31 cases with insufficiency vitamin D (34.1%) and 6 cases with suffi-ciency vitamin D (6.6%), respectively. There was no correlation in plasma levels of PTH, 25-hydroxyvitamin D, serum calci-um and serum phosphorus in Graves’disease group. Conclusion The bone turnover is accelerated in Graves’disease. The increased plasma level of 25-hydroxyvitamin D is related with increased calcium level and decreased PTH level in Graves’ disease. The increased serum phosphorus reduces 1-α-hydroxylase activity. Vitamin D deficiency plays a minor role in bone metabolism of Graves’disease.
ABSTRACT
Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C ＜ 7.0％ at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21％ ± 1.65％ to 6.69％±0.83％,P＜0.001),69.7％ of the patients achieved HbA1C ＜7.0％ at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P＜0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2％,and the incidence of confirmed hypoglycemia was 3.8％.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.