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Diabetic kidney disease is a severe microvascular complication of diabetes characterized by complex etiology, diverse mechanisms, long course, and poor prognosis, posing a significant threat to patients′ quality of life. In recent years, research on gut microbiota has progressed deeper, and the concept of the gut-kidney axis emerges, introducing novel therapeutic concepts. This article provides an overview of the role of gut microbiota in the development of diabetic kidney disease and explores potential therapeutic strategies involving gut microbiota for the treatment of this condition.
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Objective:To investigate the gut microbiota composition in subclinical hypothyroidism and euthyroidism patients with Hashimoto′s thyroiditis, and its relationship with clinical indicators and inflammatory factors.Methods:A total of 48 patients diagnosed with Hashimoto′s thyroiditis and 28 healthy controls(HC group) were enrolled from Henan Provincial People′s Hospital from July 2019 to March 2022 in this cross-sectional study. According to thyroid function, 18 patients with Hashimoto′s thyroiditis were divided into subclinical hypothyroidism group(SH group) and 30 patients in euthyroidism function group(Eu group). Fecal microbial composition was detected by 16S rRNA sequencing technology, and peripheral blood was collected to test clinical indicators and inflammatory factors.Results:Compared with HC group, there were significant differences in α and β diversity of gut microbiota in SH and Eu group( P=0.045, P=0.037). At the phylum level, Firmicutes, Bacteroidota, and Proteobacteria were the dominant phylum in the three groups. At the genus level, the abundance of 4 bacterial genera increased gradually in HC group, Eu group, and SH group, including Streptococcus, Comamonas, Elizabethkingia, Achromobacter. However, the abundance of the other 9 genera decreased gradually, such as Subdoligranulum, Coprococcus, Oscillospirales_ UCG-010, Clostridia_ UCG-014, Oscillospiraceae_ UCG-002, Alistipes et al. In addition, the level of serum B-cell activating factor was positively correlated with several bacterial genera such as Achromobacter, Streptococcus, Intestinibacter et al. Conclusion:There are differences in the gut microbiota structure of patients with Hashimoto′s thyroiditis in different thyroid functional states, which is correlated with inflammatory factors.
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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.
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Objective:To investigate the correlation between serum calcium levels and severity of novel coronavirus pneumonia(COVID-19).Methods:The clinical data of 165 COVID-19 patients diagnosed from January to February 2020 were analyzed retrospectively. Combined with clinical classification, the differences of various indexes between the critically ill group and the control group were compared, and the influencing factors of disease severity were analyzed by multivariate logistic regression. According to the corrected serum total calcium levels, patients were divided into low calcium group and normal calcium group, and the related indexes of the 2 groups were compared for further analyzing the causes of hypocalcemia. Results:Compared with the control group, the age, diabetes, basic respiratory disease, and cardiovascular disease ratio, C-reactive protein(CRP), fasting blood glucose(FPG), interferon γ(IFN-γ), and interleukin 17(IL-17) levels increased while the lymphocyte percentage, serum albumin(ALB), corrected calcium levels, CD4 + T cells percentage, CD8 + T cell percentage decreased, the difference was statistically significant( P<0.05). There was no significant statistical difference in gender between the two groups, hypertension ratio, alanine aminotransferase(ALT), glomerular filtration rate(eGFR), CD4 +/CD8 + ratio and interleukin 4(IL-4) levels( P>0.05). The decrease of calcium level, age and eGFR were all risk factors for COVID-19 patients. Compared with the normal calcium group of COVID-19 patients, the level of ALB, CD4 + T cells percentage, CD8 + T cell percentage in low calcium group decreased and age, proportion of critically ill patients, diabetes, basic respiratory disease and cardiovascular disease ratio and CRP level all increased, the differences were statistically significant( P<0.05), and there was no statistical difference in the other biochemical indexes( P<0.05). Conclusion:There are obvious hypocalcemia and immune dysfunction in critically ill patients of COVID-19, and close monitoring of blood calcium levels may predict the severity of the disease more effectively
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Objective:To evaluate the feasibility and safety of strictureplasty in the surgical management of Crohn′s disease.Methods:A retrospective study on patients receiving strictureplasty from Jan 2015 to Jun 2019 was conducted.The clinical data and the surgical outcomes were evaluated.Results:35 patients undering 72 episodes of strictureplasty (H-M, 70; Finney, 2) were involved in the study. The most common site of strictureplasty was small bowel, followed by upper gastrointestinal tract and previous site of anastomosis. 7 patients developed postoperative complication, and all of them were cured with conservative management. The median postoperative hospital stay was 8 days.Conclusion:Stricturoplasty——a bowel-sparing option was feasible and safe for the management of Crohn′s disease obstruction related bowel and could reduce the risk of short bowel syndrome.
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3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.
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The association of non-HDL-cholesterol and non-HDL-C-to-HDL-cholesterol ratio (non-HDL-C-to-HDL-C ratio) with early diabetic nephropathy in patients with type 2 diabetes mellitus was investigated.Non-HDL-C and non-HDL-C-to-HDL-C ratio were positively related with microalbuminuria (P＜0.05 or P＜0.01).Non-HDL-C-to-HDL-C ratio is an independent risk factor of early diabetic nephropathy in patients with type 2 diabetes mellitus.