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Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
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Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
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Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.
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The relationship between Sulfonylureas(SUs) and cardiovascular (CV) risks has attracted great attention.Previous studies have illustrated that some SUs increase CV risk in type 2 diabetes (T2DM) patients;while others do not.Clinical studies have found that the CV risks of different SUs may be different.Compared with other SUs;glimepiride and gliclazide may have lower CV risks.Here we reviewed evidence-based CV safety of SUs and the recent research progress.
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In 2015, American College of Endocrinology ( ACE), American Association of Clinical Endocrinologists ( AACE ) , European Association for the Study of Diabetes ( EASD ) , Chinese Society of Endocrinology, American Diabetes Association ( ADA ) , American Association of Diabetes Educators ( AADE ) , Academy of Nutrition and Dietetics(AND), etc. published several guidelines and statements on diabetes and its complications. The selection of hypoglycemic drugs, diabetes self-management education and support, the characteristics of blood pressure and blood lipid, the efficacy and adverse reaction of hypoglycemic drugs were also suggested and recommended. These guidelines and statements will play key roles in the clinical diagnosis and treatment of diabetes mellitus, which is reviewed in this article.
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[Summary] Thyroid nodules are the most common endocrine and metabolic diseases,and most of them are accidental nodules.How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment.In addition to detailed history collecting and physical examination,highresolution ultrasound,serum thyrotrophin levels,and fine needle aspiration biopsy (FNAB) form the basis for the diagnosis of thyroid nodules.Endocrinologists should grasp the indications of FNAB.When the pathological finding is unable to distinguish between benign and malignant nodules,molecular or genetic diagnosis should be adopted for further diagnosis.Appropriate treatment is selected according to the definitive results.In this article,we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery,so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment.
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In the past 2013,American Diabetes Association (ADA),American Association of Clinical Endocrinologists(AACE),Chinese Society of Endocrinology,etc.published some guidelines and consensuses on topics such as clinical diagnnsis,treatment,integrated management,and the relationship between reducing body weight and complications.Characters of blood pressure control in diabetic patients were also announced by the Eighth Joint National Committee (JNC 8).Meanwhile,Food and Drug Administration (FDA) declared the statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles in standardizing clinical diagnosis,treatment,and medication.
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During the past year of 2011,International Diabetes Federation ( IDF),American Association of Clinical Endocrinologists ( AACE),Chinese Diabetes Society,and Chinese Society of Endocrinology,etc had published some guidelines and consensuses on clinical diagnosis,treatment,laboratory test,and complication therapy of diabetes.Characters of diabetic angiopathy in Chinese and death cause of diabetes were also announced by several new studies.Meanwhile,Food and Drug Administration ( FDA ) and The European Agency for the Evaluation of Medicinal Products(EMEA) declared their statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles on standard clinical diagnosis,treatment,and medication.
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To investigate the association of HLA-A0205 and HLA-A30 with latent autoimmune diabetes mellius in adults (LADA) in Chengdu Hans, 121 subjects (41 cases of LADA, 40 cases of T2DM, and 40 normal controls) were enrolled in the study. The frequencies of HLA-A0205 and HLA-A30 were determined by nested PCR-SSP and direct sequencing, respectively. The allele frequencies of patient groups and of normal controls were compared by chi-square test using SPSS 11.0 (alpha = 0.05). Hardy-Weinberg equilibrium was tested with use of software HWE (alpha = 0.05). Data from the subjects showed: HLA-A0205 was present in 1 patient with LADA and in 1 normal control (2.44% and 2.5%, respectively), HLA-A30 was present in 2 patients with LADA, in 2 patients with T2DM and in 1 normal control (4.87%, 5.0% and 2.5%, respectively). There was no statistically significant difference between the allele frequencies of the three groups. These results suggest that HLA-A0205, HLA-A30 may not be related to LADA in Chengdu Hans. Yet, further studies with larger sample size may be needed to warrant this conclusion.
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Adult , Female , Humans , Male , Age of Onset , Autoimmune Diseases , Genetics , Case-Control Studies , China , Diabetes Mellitus , Genetics , Genotype , HLA-A Antigens , Genetics , Polymerase Chain Reaction , Methods , Polymorphism, Single-Stranded ConformationalABSTRACT
The alterations in atherogenic index of plasma (AlP) in type 2 diabetic patients and their normoglycemic first-degree relatives (NFDR) were investigated, and the effects of Acarbose or Glimepiride on AIP in 99 type 2 diabetic patients were evaluated. Triglycerride (TG), total cholesterol, high density lipoprotein-cholesterol (HDL-C) levels were analyzed, and Log (TG/HDL-C) was calculated as AIP in 62 type 2 diabetic patients and their 67 NFDR from 29 type 2 diabetic pedigrees and in 45 healthy controls without family histories of diabetes. Also analyzed were the same parameters in 99 type 2 diabetic patients before and after therapy with Acarbose or Glimepiride. The results revealed that diabetic patients and their NFDR had significantly higher AIP than did the controls, whereas no significant differences were seen between diabetic patients and their NFDR. Positive correlation of AIP between type 2 diabetic patients and their offspring were observed (r = 0.241, P < 0.05). After 8 weeks therapy with Acarbose, the AIP of type 2 diabetic patients was decreased significantly, and no differences were observed for AIP levels in Glimepiride group although the AIP was lower when compared with the untreated level. As a significant inverse correlation of small dense low density lipoprotein (sdLDL) with AIP was confirmed, our data suggest that diabetic patients and their NFDR from type 2 diabetic pedigrees had significantly higher AIP than did controls; AIP could be decreased by therapy with Acarbose in type 2 diabetic patients; Glimepiride may bring potential benefit to type 2 diabetic patients by influencing sdLDL.
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Humans , Acarbose , Therapeutic Uses , Atherosclerosis , Blood , Body Mass Index , Case-Control Studies , Cholesterol, HDL , Blood , Diabetes Mellitus, Type 2 , Blood , Drug Therapy , Hypoglycemic Agents , Therapeutic Uses , Pedigree , Sulfonylurea Compounds , Therapeutic Uses , Triglycerides , BloodABSTRACT
This animal experiment was aimed at the questions whether high glucose concentration inhibits insulin secretion (glucose toxicity, GT) of beta-cell of islets from SHR and Wistar-Kyoto (WKY) rat and whether adrenomedullin (AM) enhances GT. Ten 6-week-old SHRs (test group) and ten 10-week-old Wistar-Kyoto rats (WKY) (control group) were selected. RAMI-1640 medium containing 5.6 mM glucose (normal glucose group) and 20 mM glucose (high glucose group) were applied. Various concentrations of AM (0, 10(-8), 10(-7), 10(-6) M) and RPMI-1640 medium containing high glucose were mixed, respectively. The isolated islets from rats were put into 12-well plates (90 islets/well). The islets were incubated in RAMI-1640 medium containing normal or high glucose for one hour. Then the supernatants from both incubations were determined by RIA for insulin. In SHR group, the insulin concentration in supernatants gained from high glucose group without AM was lower than that from normal glucose group (19.9+/-6.6 vs 60.9+/-33.6 mU/L, P<0.05). With the increment of the concentration of AM, insulin concentration in supernatants from islets incubated in high glucose and various concentrations of AM tended to be low further (19.9+/-6.6 vs 22.2+/-8.0 vs 21.5+/-5.6 vs 17.9+/-3.6 mU/L). The changing tendency in control group was the same as in SHR group. When the islets were incubated in normal glucose and high glucose medium, the insulin concentration in supernatant significantly decreased in SHR group compared with that in control group (P<0.01). The insulin secretion was inhibited by high glucose in beta-cell of islets from SHR and WKY. The results suggest GT to beta-cell of islets from SHR and WKY. AM tended to inhibit insulin secretion in a dose-dependent manner in beta-cell of islets from SHR and WKY. The inhibition of insulin secretion caused by high glucose in beta-cell of islets from SHR was more remarkable than from WKY. This may be related to secretion dysfunction in beta-cell of islets from SHR.
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Animals , Female , Male , Rats , Adrenomedullin , Blood Glucose , Metabolism , Cells, Cultured , Glucose , Pharmacology , Hyperglycemia , Blood , Hypertension , Metabolism , Pathology , Insulin , Bodily Secretions , Insulin Resistance , Islets of Langerhans , Pathology , Bodily Secretions , Peptides , Pharmacology , Rats, Inbred SHR , Rats, Inbred WKYABSTRACT
Recently some studies have showed that bone strength may avoid the misdiagnosis and missed diagnosis of osteoporosis(OP) by bone mineral density (BMD) alone. It was found that corrected bone mineral content (cBMC) was well correlated with bone strength. In this study bone strength was replaced by cBMC to compare it with BMD, and evaluate whether BMD has limitations in the diagnosis of OP in obese individuals. one hundred and two healthy subjects in the community with the body mass index (BMI) between 25 and 39 kg/m2 were enrolled. There were 31 males and 71 females with a mean age of 37.2 +/- 9.4 years. Their BMD and BMC of lower limbs, trunk and the whole body were measured with dual energy X-ray absorptiometry (DEXA). cBMC was expressed by BMC divided by weight. Intra abdominal fat area (IAFA) was measured by CT scan at the level between 4th-5th lumbar vertebra. Linear correlation analysis with SPSS 10.0 soft pack was used for statistics. The results showed that there was a positive correlation and tendency between body weight, BMI and BMD values of lower limbs, trunk and the whole body. However, negative correlation and tendency were demonstrated between body weight, BMI and cBMC, between IAFA and BMD of lower limbs, trunk and the whole body and between IAFA and cBMC as well. We found that the tendency of changes of cBMC and bone strength was similar. So we suggest in certain extent that cBMC could replace bone strength in the diagnosis of OP in obese individuals.
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Adult , Female , Humans , Male , Middle Aged , Abdomen , Adipose Tissue , Bone Density , Bone and Bones , Physiology , Obesity , Osteoporosis , DiagnosisABSTRACT
Objective To explore the effects of adrenomedullin(AM) on human umbilical vein endothelial cells (HUVECs) and possible mechanisms involved. Methods The HUVECs were selected to be a model and the following aspects were studied: (1) Effects of high glucose (30 mmol/L) on the endothelial dysfunction induced. (2) The role of protein kinase C (PKC)? and PKC? in the endothelial dysfunction induced by high glucose and the effects of AM. The translocation of PKC? or PKC? in a single HUVEC was observed by laser-scanning confocal microscope and the expressions analysis was conducted quantificationally by Western blotting. HUVECs were cultured and divided into 3 groups: (1) Matched control group; (2) High glucose group (30 mmol/L glucose); (3) AM (10~(-9), 10~(-8), 10~(-7) mol/L) + highglucosegroupHUVECswereincubated with AM for 48 h. Results (1) High glucose could induce HUVECs dysfunction: increased apoptosis, decreased NO concentration and increased sICAM level of HUVECs. AM reversed the above changes of HUVECs induced by high glucose. (2) It was observed that AM inhibited the translocation of PKC? from plasma to nucleus in HUVECs induced by high glucose and the translocation of PKC? from nucleus to plasma and membrane in HUVECs. (3) AM inhibited the increasing expressions of PKC? in HUVECs induced by high glucose. The expressions of PKC? in high glucose group were not different from that of the control. Conclusion AM appears to correct the endothelial cell dysfunctions induced by high glucose. The inhibition of PKC? and PKC? seems to play some roles during the process.
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The effect of adrenomedullin (AM) on insulin sensitivity in normal Wistar rats was investigated by hyperinsulinemic-euglycemic clamp in combination with isotope dilution technique. The infusion rates of AM during the clamp were 0, 0.05, 0.2, 1 ?g?kg~(-1)?min~(-1), rspectively. The glucose disposal rate (GDR) and hepatic glucose output (HGO) were calculated by the plasma 3-~(3)H-glucose specific activity. After AM infusion, the insulin-mediated glucose disposal was reduced in a dose-dependant manner. It indicated that high dose of AM could induce a marked state of insulin resistance, which was mainly characterized by inhibition of the effect of insulin to stimulate peripheral glucose metabolism.
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Diabetes is characterized by glycemic disorders which play a key role in the risk for complications of diabetes.Glucose variability is an important parameter of glycometabolism.The study of none evidence-based medicine(EBM) has investigated the relationship among glycemic variability and vascular injury and the subsequent development of diabetes complications.Due to deficiency of large clinical interventional tests,this relationship lack the evidence of EBM.In conclusion,particular attention should be paid to glucose variability in our clinical work and meanwhile the EBM studies should also be conducted.
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This article reviews a recently d is covered new peptide-growth hormone-releasing peptide: ghrelin. Ghrelin is secr eted by various tissues of body, mainly by gastric tissue. Ghrelin regulates GH release from pituitary, participates in the regulation of energy metabolism, inh ibits the proliferation of tumor cells and influences the cardiovascular functio n and the release of other hormones. The study of ghrelin in many fields is prel iminary and needs further investigation.
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For different individuals with diabetes,blood glucose control varies.In the blood glucose controlling,blood glucose levels are sometimes higher than the target,sometimes the diabetic patients may develop hypoglycemia.In insulin therapy for blood glucose fluctuations,the most important thing is to avoid hypoglycemia.Finding out regular patterns of blood glucose fluctuations,then according to that,we need to choose the right insulin preparations to treat the condition.For the patients with irregular fluctuations of blood glucose,insulin pump therapy should be a proper choice.
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In type 2 diabetes mellitus,the levels of leptin were higher in female and obese subjects compared with male and non-obese subjects.There was negative relationship in female between leptin and HbA_1c,and negative relationship between leptin and HDL-C in male.Gender and obesity had no effect on TNF-? and NP Y.