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Objective To investigate the relationship between FGF23 and Klotho in GD patients. Methods From March 2016 to November 2016, forty-three newly diagnosed and untreated Grave disease patients (GD group) and 27 healthy subjects were selected. Meanwhile,Peripheral venous serum was collected to detect serum calcium, phosphorus and thyroid function in GD group. The levels of FGF23, Klotho protein and 1 in each group were detected by enzyme-linked immunosorbent assay ( ELISA ) . The expression levels of FGF23,Klotho protein and 1,25-dihydroxyvitamin D3 were detected by enzyme-linked immunosorbent assay ( ELISA ) . The differences of FGF23, Klotho protein, 1, 25-dihydroxyvitamin D3, serum calcium and phosphorus between GD group and normal control group were compared,and the correlation between each index was analyzed. The relationship between FGF23 and Klotho protein and the pathogenesis of GD was explored. Results ( 1) Thyrotropin in thyroid function was significantly lower in GD group than that in normal group,and the difference was statistically significant ( 0. 003 ( 0. 002, 0. 004 ) mU/L vs. 1. 650 ( 0. 81, 2. 14 ) mU/L, Z=- 7. 587,P<0. 05] . Thyrotropin receptor antibodies,free triiodothyronine and free thyroxine in GD group were significantly higher than those in normal group. There were [ thyroid stimulating hormone receptor antibodies:9. 03(3. 89,21. 29)) U/L vs. 0. 60(0. 38,0. 97)) U/L,free triiodothyronine:23. 36(11. 61,38. 00)) pmol/L vs. 4. 63(4. 03,4. 92)) pmol/L,free thyroxine:4. 34(33. 94,100. 00) pmol/Lvs. 17. 69(15. 80,20. 35) pmol/L;Z=-6. 694,-6. 878,-6. 836,P<0. 05];( 2) The serum levels of FGF23,Klotho and phosphorus in patients with hyperthyroidism were significantly higher than those in the normal group,and the difference was statistically significant [FGF23:(524. 2±66. 7) ng/L vs. (467. 2±64. 5) ng/L,Klotho:8. 29(6. 89,11. 37) pg/ml vs. 6. 69 (6. 36,7. 53) pg/ml,phosphorus:1. 33(1. 03,1. 52) mmol/L vs. 1. 02(0. 84,1. 20) mmol/L; t=3. 517,Z=-3. 936,-3. 795,P<0. 05]. The Results of correlation analysis showed that: (1) There was no correlation among FGF23 and Klotho,thyroid stimulating hormone receptor antibody,free thyroxine,1,25-dihydroxyvitamin D3,phosphorus and calcium a ( P>0. 05);( 2) There was no correlation among Klotho and thyroid stimulating hormone receptor antibody, free thyroxin, 1, 25-dihydroxyvitamin D3, phosphorus and calcium ( P>0. 05 ) . Conclusion The elevated expression of FGF23 in GD may be involved in the pathogenesis of GD, and the elevated expression of Klotho in GD may be due to the abnormal immune status in GD patients,which may play a protective role.
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Objective To discuss the value of body adiposity index( BAI) in the prediction of the risk of dysglycemia,dyslipidemia and hyperuricemia.Methods Five thousand and thirty residents as the participants from Jinshan New Area and nearby of Jinshan,Shanghai were enrolled,including 2004 males and 3026 females. The receiver operating characteristic curve( ROC) was drew to predict dysglycemia,dyslipidemia and hyperurice?mia by body mass index( BMI) ,waist circumference( WC) ,waist?hip ratio( WHR) and BAI in different gender groups.Medcale soft was used to compare the area under the curve.Results According to the ROC analysis,in males the area under curve in the prediction of dysglycemia of BMI,WC,WHR and BAI was 0.553,0.556,0. 538,0.540(P<0.05),and 0.513,0.523,0.523,0.535 in females(P<0.05).The area under curve in the predic?tion of dyslipidemia of BMI,WC,WHR and BAI was 0.641,0.626,0.563,0.588(P<0.05) in males and 0.617, 0.613,0.597,0.587(P<0.05) in females.The area under curve in the prediction of hyperuricemia of BMI,WC, WHR and BAI was 0.685,0.665,0.609,0.577(P<0.05) in males and 0.730,0.708,0.656,0.649(P<0.05) in females,and BMI, WC of AUC were higher than BAI both in males and females(P<0.05).Conclusion BAI could be a predictor for the risk of metabolic disease,but less than BMI and WC.
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Objective To evaluate the risk factors for diabetic foot in patients with type 2 diabetic mellitus (T2DM).Methods One hundred and forty-three patients with T2DM including 63 cases with diabetic foot(DF) and 80 cases with non-diabetic foot (NDF) were recruited.All possible risk factors for diabetic foot were documented,including low density lipoprotein-cholesterol (LDL-C),homocysteine (Hcy),diabetic polyneuropathy(DPN),diabetic retinopathy(DR),peripheral vascular disease(PVD) and so on.Results (1) There were significant differences between DF group and NDF group in terms of general clinical data,including age(65.38±11.58) years old and (60.12±9.92) years old,precious history of foot ulcer(28.6％ (18/63) and 3.8％(3/80)),serum homocysteine(Hcy) ((23.24± 11.77) μmol/L and (18.62±7.74) μmol/L)),glycosylated hemoglobin(HbA1c) ((10.22±2.81) ％ and (8.67±2.30) ％),blood albumin (Alb) ((32.45±5.83) g/L and (38.58±4.71) g/L),LDL-C ((2.15±0.72) mmol/L and (2.60±0.78) mmol/L),diabetic nephropathy (DN) (77.8％ (49/63) and 45.0％ (36/80)),diabetic retinopathy (DR) ((73.0％ (46/63) and 33.8％ (27/80)),diabetic peripheral vascular disease (PVD) (93.7％ (59/63) and 65.0％ (52/80)) and diabetic peripheral neuropathy (DPN) (77.8％ (46/63) and 60.0％ (48/80)) (P ＜0.05).(2) Logistic regression analysis showed that the development of diabetic foot was significantly correlated with age(OR =1.09,95％ CI:1.02-1.16,P =0.01),Hcy (OR =1.12,95％ CI:1.03-1.22,P =0.01),DR(OR=8.47,95％CI:1.85-38.87,P=0.01),PVD(OR=8.73,95％CI:1.07-70.92,P =0.04) and precious history of foot ulcer (OR =12.28,95％ CI:1.57-96.28,P =0.02).Conclusion Complications due to multiple factors of Diabetic foot,and Hcy is another risk factor for that.
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Objective To investigate the clinical significant and the difference of predicting the risk of dysglycemia and dyslipidemia by body mass index (BMI),waist circumference (WC) and waist-to-hip ratio (WHR) in order to look for the best predicting index.Methods Five thousand and thirty residents were participated to this study who were from Jinshan New Area and nearby of Jinshan,Shanghai,including 2004 males and 3026 females.They were divided into obesity group and non-obesity group based on the index of BMI,WC and WHR respectively.The ROC was made based on the above indies in different gender groups.Results The ROC area of BMI was the biggest with 0.641 (P ＜0.05) for male and 0.617(P ＜0.05) for female.The cut off value was 24.67 or 23.88 based on the male or the female.The same trend was seen in terms of WC with 88.5 cm for the male and 84.5 cm for the female.The small cut off value was seen in terms of WHR and there was no significant between male and female.Among male people,the cut off values was 26.01 in terms of BMI and 88.5 cm in terms of WC,0.89 cm in terms of WHR.Among the female people,there was the less predicting significant in terms of WC or WHR.The area under the curve had no significant differences,and the BMI predicted abnormal blood glucose of no value,the area under the curve is only 0.513 (P ＞ 0.05).Conclusion BMI is proved the best predictor for the risk of dyslipidemia.There are significant among BMI,WC and WHR in terms of predicting dysglycemia in different gender.BMI is proved without significant regarding of predicting dysglycemia in females.
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Objective To investigate the relationship between serum 25-(OH) D3 and autoimmune thyroid diseases (AITD).Methods Serum levels of 25-(OH) D3, thyroid antibodies (thyroid stimulating hormone receptor antibody (TRAb), TGAb (thyroid globulin antibody), thyroid peroxidase antibody (TPOAb) and thyroid function of 32 cases patients with Graves' diseases (GD), 17 cases patients without remission of GD,10 cases patients with remission of GD,35 cases patients with Hashimoto's thyroiditis (HT),and 58 cases healthy subjects were measured,and the relationships between serum 25-(OH) D3 and the above clinical index were analyzed.Results The serum level of 25-(OH) D3 in patients with GD or HT were obviously lower than that in healthy subjects((50.75±17.60) μg/L, (36.40±21.65) μg/L, (43.05±19.53) μg/L,P＜0.05).No significant difference of the serum level of 25-(OH) D3 was found between patients refractory of GD and those with GD in remission((32.43±17.50) μg/L, (31.88±14.48) μg/L,P=0.866).However,compared with the normal control group,both diseased groups showed significantly decrease (P＜0.05).No correlation was found between serum 25-(OH) D3 and TRAb, FT3, Fr4 as well as TSH in GD group.No correlation was found between serum 25-(OH) D3 and TGAb, TPOAb (P＞ 0.05).Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-(OH) D3 in AITD.
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Objective To investigate the situation of subjective well-being feeling of type 2 diabetes patients and its influential factors.Methods One hundred and twenty-seven patients with type 2 diabetes were recruited as our subjects and all of them were performed the questionnaire investigation about well-being feeling.Influential factors were analyzed through several statistic methods.Results The index of subject wellbeing ranged from 3.70 to 13.70 and the average was 10.67 ± 2.10 of all type 2 diabetes patients.Of which The index of total affectation was 5.11 ± 0.92 and the range was from 2.63 to 6.63.The score of life satisfaction was 5.58 ± 1.22,and the range was from 1.10 to 7.70.Index of subjective well-being significantly associated with education,family income,therapy approach,HbA1 c level,complication,medicine burden.However there was no correlation with gender,age,diabetes duration.Conclusion The main types of subjective well-being feeling of patients with type 2 diabetes were positive effect and positive experience.Many factors could be the influence factor to well-being.Measures should be taken to improve Subjective well-being of type 2 diabetes patients.