ABSTRACT
Objective:To investigate the association between time in target range and risk of vertebral fracture in patients with type 2 diabetes.Methods:The clinical data of 1 032 patients with type 2 diabetes who were hospitalized in endocrine department of Henan Provincial People′s Hospital from June 2017 to July 2021 were collected. Among which 632 patients were included into final analysis. The diabetes-specific risk score for vertebral fracture was used to assess the risk of vertebral fracture. Multivariate linear regression analysis was used to test the association between time in target range and risk score of vertebral fracture. Risk score≥9 was defined as increased risk of vertebral fracture. Multivariate logistic regression was used to estimate the association between time in target range and risk of vertebral fracture. Results:Among the included patients, mean age was(55.0±12.4) years and the percent of male was 72.5%. The mean course of diabetes was(9.4±8.0) years, and mean score of risk of vertebral fracture was 5.6±4.3. Time in target range was negatively correlated with risk score of vertebral fracture( P for trend <0.001), which was independent of potential confounders and continuous glucose monitoring parameters. The included patients were divided into four groups based on quartiles of time in target range. Multivariate logistic regression indicated that the risk of vertebral fracture in the first quartile of time in target range was 4.6 times higherthanthatinthe4thquartile, and the significance remained adjusted for potential confounders, s, CV, or meanamplitudeofglycemicexcursions(MAGE), respectively. Conclusion:Timein target rangewasnegativelycorrelatedwithriskscoreofvertebralfracturein patient with type 2 diabetes. Low time in range level was an independent risk factor for increased risk of vertebral fracture.
ABSTRACT
Objective:To investigate the relationship between time in range(TIR) of glucose and sarcopenia in elderly patients with type 2 diabetes mellitus.Methods:A total of 673 patients with type 2 diabetes aged 65 years and above who were admitted to Henan Provincial People′s Hospital from March 2018 to July 2020 were selected. All patients completed questionnaire, physical and laboratory examination. Sensor-based flash continuous glucose monitoring(CGM) systems was used to monitor glucose levels, and the TIR was computed. Dual energy X-ray was used to assess total muscle mass and appendicular skeletal muscle mass index(ASMI) was calculated, the muscle strength was assessed with testing handgrip strength, and physical function was assessed by testing gait speed. Sarcopenia was diagnosed and graded according to the 2019 Asian Working Group on Sarcopenia(AWGSOP) standard. Patients with less than 3 days of CGM were excluded and a total of 658 subjects were included in the analysis.Results:The total prevalence of sarcopenia was 28.72%. Compared with non-sarcopenia group, TIR levels in the sarcopenia and severe sarcopenia groups were significantly decreased [55.0%(36.5%, 68.0%), 49.0%(31.0%, 70.5%) vs 66.0%(44.8%, 79.0%), both P<0.01]. The level of ASMI increased in line with TIR quartiles and topped in the fourth quartile group( P<0.05). Pearson correlation analysis showed that TIR was significantly positively correlated with ASMI, gait speed, and handgrip strength in male patients( P<0.05 or P<0.001), and TIR was significantly positively associated with ASMI and gait speed in female patients( P<0.05 or P<0.01). After logistic regression adjusted for gender, age, body mass index, blood pressure, disease duration, HbA 1C, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein-choresterol, high density lipoprotein-choresterol, estimated glomerular filtration rate, protein intake, exercise intensity, smoking and alcohol consumption, an increase in TIR levels was associated with a decrease in the prevalence of severe sarcopenia( OR=0.923, 95% CI 0.878-0.970, P=0.002). The lowest quartile TIR significantly increased the risk of sarcopenia compared with the highest quartile TIR( OR=3.733, 95% CI 1.129-12.342, P=0.031). Conclusion:Decline in TIR is significantly associated with an increased risk of sarcopenia in older patients with type 2 diabetes.
ABSTRACT
Objective:To explore the significance of next-generation sequencing to detect gene mutations for diagnosis of patients with unexplained pancytopenia.Methods:The next-generation sequencing was used to detect 32 common hematological tumor gene mutations in 113 patients with unexplained pancytopenia in Huazhong University of Science and Technology Union Shenzhen Hospital from February 2016 to February 2019.Results:The next-generation sequencing results showed that of the 32 genes tested in 113 patients, 69 mutations occurred in 25 genes. Among them, 105 patients (92.9%) carried at least 1 gene mutation, and the median number of mutations was 2 (1-5). Fifty-one patients were diagnosed with myelodysplastic syndrome (MDS), and the related mutant genes were detected; 62 patients were diagnosed with atypical aplastic anemia or cytopenia of unknown significance. The total effective rate of treatment for 113 patients was 65.5% (74/113).Conclusion:The next-generation sequencing helps to diagnose patients with unexplained pancytopenia, and provides targeted strategies for finding new treatments and prolonging the overall survival of patients.
ABSTRACT
Objective:To investigate the association of time in range(TIR) with the severity of coronary artery disease and acute coronary syndrome in patients with type 2 diabetes mellitus.Methods:A total of 216 patients with type 2 diabetes mellitus and coronary heart disease were recruited and undergone anthropometric and biochemical measurements, continuous glucose monitoring, and calculation of SYNTAX score. TIR was defined as the percentage of time within the glucose range of 3.9-10.0 mmol/L during 24 h. Spearman correlation analysis and multivariate linear regression analysis were used to evaluate the correlation factors of SYNTAX score. Multivariate logistic regression analysis was used to analyze the association of TIR with the severity of coronary artery disease and acute coronary syndrome. Results:Compared with patients with mild coronary artery disease, TIR in patients with moderate to severe coronary artery disease was lower[(69.4±17.3)% vs (60.8±17.8)%, t=3.0, P=0.003], and HbA 1C of patients with moderate to severe coronary artery disease was higher [(9.6±1.7)% vs (8.8±1.6)%, t=3.3, P=0.001]. SYNTAX score was negatively correlated with TIR ( r=-0.251, P<0.01) and positively correlated with HbA 1C ( r=0.249, P<0.01). Moreover, compared with HbA 1C (standardized coefficients=0.181, P=0.007), TIR (standardized coefficients=-0.192, P=0.004) had a greater influence on SYNTAX score. Multivariate linear regression analysis showed that TIR, HbA 1C, duration of diabetes and smoking were independently correlated with SYNTAX score. Multivariate logistic regression analysis revealed that compared with TIR Q1, Q3 and Q4 were independent protective factors for moderate to severe coronary artery disease (respectively, OR=0.61 and 0.59, 95% CI 0.39-0.96 and 0.38-0.94, P=0.014 and 0.009) and acute coronary syndrome (respectively, OR=0.51 and 0.39, 95% CI 0.32-0.95 and 0.26-0.75, P=0.022 and 0.008). Conclusion:TIR was significantly and independently correlated with the severity of coronary artery disease and acute coronary syndrome in type 2 diabetes mellitus after controlling confounding factors. When TIR level was decreased, the severity of coronary artery disease was aggravated, and SYNTAX score and the risk of acute coronary syndrome was increased.
ABSTRACT
Objective To investigate the relationship between serum 25-OH vitamin D3 (25-OHD3)levels and carpal tunnel syndrome(CTS)in type 2 diabetes.Methods Data from 102 patients with type 2 diabetes were collected,and patients were divided into a CTS group(n=29)and a non-CTS group(n=73)according to clinical symptoms,signs,and electrophysiological testing.Fasting venous blood was collected to assay serum 25-OHD3 levels that were compared between the two groups.The correlation between 25-OHD3 and clinical parameters for type 2 diabetes was analyzed.Results The incidence of vitamin D3 deficiency was 65.5％ (n=19)in the CTS group and 46.6％(n=34)in the non CTS group,and the difference was statistically significant(x2 =16.85,P＜0.01).Levels of 25-OHD3 were lower in the CTS group(14.13±4.91) μg/L than in the non-CTS group(17.08±3.35)μg/L(t =4.067,P ＜ 0.01).Levels of 25 OHD3 were negatively correlated with those of glycosylated hemoglobin(HbA1c)(r =-0.176,P =0.041)and the duration of diabetes(r=-0.29,P=0.01) Conclusions Low 25-OHD3 is a risk factor for carpal tunnel syndrome in type 2 diabetes and is negatively associated with the duration of diabetes and HbA1c in patients with type 2 diabetes.
ABSTRACT
Objeetive To investigate the changes of kidney cortex hemoperfusion before and after extracorporeal shock wave lithotripsy (ESWL) with contrast-enhanced ultrasonography (CEUS) and time-intensity curve.Methods Thirty patients of renal calculi were treated with ESWL and examined with CEUS before and after ESWL.Renal cortex blood perfusion parameters of the lithotriptic areas,including the contrast agent arrival time (AT) ,time to peak (TTP) .peak intensity (PI) and velocity parameters (β) were quantitatively measured with ACQ software.Results The value of AT,TTP and β were not significantly different before and after ESWL (P＞0.05) .PI value after ESWL was lower than that before ESWL (P＜0.05) . Conclusion CEUS can quantitatively evaluate the changes of kidney cortex hemoperfusion after ESWL,and reflect the minor renal damage resulted from ESWL.CEUS can be used as a new method of observing and evaluating the renal damage caused by ESWL.