Diabetes tipo 1 y Miastenia Gravis / Type-1 Diabetes and Myasthenia Gravis

Introducción: El desarrollo de la tolerancia inmunológica frente a los autoantígenos se denomina autotolerancia. La Diabetes Mellitus tipo 1A (1ADM) es un trastorno metabólico secundario a la destrucción autoinmune de las células beta pancreáticas e insulitis. La miastenia grave (MG) es una enfermedad autoinmune causada por el bloqueo postsináptico de la placa mioneural por AAcs contra los receptores de acetilcolina (ACRA) o contra moléculas de la membrana postsináptica. La asociación entre DM1A y MG se puede observar en el síndrome poliglandular tipo III, caracterizado por enfermedad autoinmune de la glándula tiroides asociada con otras entidades autoinmunes. Método: Reporte de Casos, cuatro pacientes entre 7-19 años, con asociación de MG y DM1A atendidos en el Hospital Garrahan. Conclusión: La Tiroiditis de Hashimoto y la Enfermedad Celíaca son las enfermedades autoinmunes relacionadas más frecuentemente con DM1A en nuestra población. La bibliografía describe la asociación de MG y Tiroiditis de Hashimoto y su coexistencia con DM1A se describe en el Síndrome Poliglandular III. En este trabajo presentamos 4 casos de DM1A asociado con MG fuera de dicho síndrome (AU)

Introduction: The development of immune tolerance to autoantibodies (AAbs) is referred to as self-tolerance. Type 1A Diabetes Mellitus (1ADM) is a metabolic disorder secondary to autoimmune destruction of pancreatic beta cells and insulitis. Myasthenia gravis (MG) is an autoimmune disease caused by postsynaptic blockade of the myoneural plate by AAbs against acetylcholine receptors (Acra) or against postsynaptic membrane molecules. The association between 1ADM and MG may be observed in polyglandular syndrome type III, characterized by autoimmune disease of the thyroid associated with other autoimmune conditions. Methods: Case report; four patients between 7-19 years old, with an association of MG and 1ADM seen at the Garrahan Hospital. Conclusion: Hashimoto's thyroiditis and celiac disease are autoimmune diseases most frequently related to 1ADM in our population. In the literature, the association of MG and Hashimoto's thyroiditis has been described and its coexistence with 1ADM is reported in polyglandular syndrome III. In this study we present 4 cases of 1ADM associated with MG unrelated to this syndrome. (AU)

The function and drug development progress of free fatty acid receptor 1 in chronic inflammatory diseases / 药学学报

As a member of G protein coupled-receptors superfamily, free fatty acid receptor 1 (FFAR1), is also known as GPR40, has been shown to regulate numerous pathophysiological processes in a variety of tissues and organs. The activated FFAR1 has a variety of biological functions. For instance, it can not only regulate metabolism of fatty acids and glucose, but also play an important role in immune inflammatory response, it may be a potential drug target for the treatment of various chronic inflammatory diseases. In this review, we focus on the recent researches of FFAR1's action in the regulation of pathophysiological processes, its molecular mechanism and new agonists development. At the same time, this review will take the discovery of series FFAR1 agonists as examples, and display the applied prospects of FFAR1.

Association between early-life factors and pubertal timing in girls / 中国当代儿科杂志

OBJECTIVES@#To study the association between early-life factors (including birth weight, method of birth, gestational age, and history of gestational metabolic disorders) and pubertal timing in girls.@*METHODS@#The stratified cluster sampling method was used to select the girls in grades 2-3 and 7-8 from three primary schools and three middle schools in Guangzhou, China from March to December, 2019, and breast development was examined for all girls. A questionnaire survey was performed to collect the information on early-life factors. The multivariate logistic regression model was used to evaluate the association of gestational metabolic disorders, birth weight, method of birth, and gestational age with pubertal timing in girls. The Bootstrap method was used to assess the mediation effect of body mass index (BMI) (Z score) between high birth weight (≥4 000 g) and pubertal timing.@*RESULTS@#A total of 1 665 girls were enrolled, among whom 280 (16.82%) were judged to have early pubertal timing. The multivariate logistic regression analysis showed that high birth weight was associated with the increased risk of early pubertal timing (OR=2.12, 95%CI: 1.19-3.66, P=0.008). Nevertheless, no significant association was observed between other early-life factors and pubertal timing (P>0.05). The OR for the mediation effect of BMI (Z score) between high birth weight and early pubertal timing was 1.25 (95%CI: 1.09-1.47), accounting for 29.33% of the total effect of high birth weight on early pubertal timing.@*CONCLUSIONS@#High birth weight is associated with the increased risk of early pubertal timing in girls, and overweight/obesity may play a partial mediating role in the association between high birth weight and early pubertal timing in girls.

Effects of Different Dietary Approaches on Type 2 Diabetes Mellitus: A Review

Type 2 diabetes (T2D) is a metabolic disorder that occurs due to various etiologies including lifestyle. One of the significant contributors in causing Type-2 diabetes is diet. For high-risk individuals, diet is way more significant in causing Type-2 diabetes. This present study discussed several published papers comprising of various food categories and their effects on type-2 diabetes or its role in causing the disorder. The study revealed the advantages of functional foods and their role in the prevention of T2D. The study has elaborated the outcome of T2D due to consumption of fats, carbohydrates, protein, dietary fibres, red meat, fried food, common beverages like carbonated drinks, and a few other foods. The authors also reviewed T2D from the aspect of religion, region, specific lifestyles, smoking and drinking habit and body weight. Overall, the study has successfully drawn a map of the spectrum of dietary role in T2D including its prevention, increasing the risk of T2D, its causation and affecting the outcome of the disorder.

Hemoglobina glucosilada en el diagnóstico de diabetes gestacional en mujeres mexicanas durante el tercer trimestre / Glycosylated hemoglobin in the diagnosis of gestational diabetes in Mexican women during the third trimester

Resumen El objetivo del trabajo fue analizar los valores de hemoglobina glucosilada en el tercer trimestre de embarazo como predictores alternativos de la diabetes gestacional en pacientes del Noreste de México. Se trata de un estudio retrospectivo de casos y controles a partir de 121 expedientes de pacientes embarazadas, divididos en dos grupos, pacientes con diabetes gestacional (casos) y gestantes con valores glucémicos normales (controles). Se analizaron los factores de riesgo asociados a la diabetes gestacional y se obtuvo un punto de corte para la hemoglobina glucosilada. Se encontró que la obesidad materna, la edad y el antecedente del padecimiento fueron asociados significativamente con la diabetes gestacional. Valores de hemoglobina glucosilada ≥5% incrementaron el riesgo de padecer diabetes mellitus gestacional 4 veces y, aunado a un factor de riesgo, la probabilidad se incrementó 7 veces. Se concluye que los valores de hemoglobina glucosilada en el tercer trimestre de embarazo podrían emplearse como prueba diagnóstica de la diabetes gestacional en pacientes del Noreste de México. Sin embargo, aunque las diferencias encontradas fueron estadísticamente significativas, los resultados se deben interpretar con cautela y requieren su confirmación con estudios que incluyan una muestra mayor.

Abstract The objective of this study was to analise glycosylated hemoglobin values in the third trimester of pregnancy as an alternative predictor of gestational diabetes in North East Mexican cohort patients. This is a retrospective case-control study based on 121 records of pregnant patients, divided into two groups, patients with gestational diabetes (cases) and pregnant women with normal glycemic values (control). The risk factors associated with gestational diabetes were analised and a cut-off point for glycosylated hemogestaglobin was obtained. It was found that maternal obesity, age and a history of the condition were significantly associated with gestational diabetes. Values of glycosylated hemoglobin ≥5% increased the risk of suffering from gestational diabetes 4 times, and coupled with a risk factor, the risk increased 7 times. It is concluded that glycosylated hemoglobin values in the third trimester of pregnancy could be used as a diagnostic test for gestational diabetes in patients from the North East of Mexico. Although the differences found were statistically significant, our results must be interpreted with caution and require confirmation by studies with a larger sample.

Resumo O objetivo deste estudo foi analisar os valores da hemoglobina glicada no terceiro trimestre de gestação como preditores alternativos do diabetes gestacional em pacientes na região nordeste do México. Trata-se de um estudo retrospectivo de casos e controles utilizando 121 prontuários de gestantes divididas em dois grupos; pacientes com diabetes gestacional (casos) e gestantes com valores de glicemia normais (controles). Foram analisados os fatores de risco associados a diabetes gestacional obtendo-se um ponto de corte para a hemoglobina glicada. Descobriu-se que a obesidade materna, idade e antecedentes da doença foram associados significativamente ao diabetes gestacional. Valores da hemoglobina glicada ≥ 5% aumentaram o risco de padecer diabetes mellitus gestacional 4 vezes, e juntamente a um fator de risco, a probabilidade aumentou 7 vezes. Conclui-se que os valores da hemoglobina glicada no terceiro trimestre de gestação poderiam ser usados como teste diagnóstico do diabetes gestacional em pacientes da região nordeste do México. Embora as diferenças encontradas tenham sido estatisticamente significativas, os resultados devem ser interpretados com cautela e requerem confirmação através de estudos que incluam uma amostra maior.

Trastornos metabólicos urinarios en pacientes urolitiásicos con enfermedad renal poliquística y sin ella / Urinary metabolic disorders in urolithiasis patients with and without polycystic kidney disease

Introducción: La urolitiasis se ha incrementado en las últimas décadas. La enfermedad renal poliquística autosómica dominante (ERPAD), enfermedad renal hereditaria más frecuente, ocupa un lugar preponderante. Objetivos: Identificar la frecuencia de presentación de los trastornos metabólicos urinarios en pacientes litiásicos cubanos con ERPAD y sin ella Métodos: Estudio descriptivo, transversal. Fueron estudiados 579 pacientes adultos sin ERPAD, seleccionados por muestreo simple aleatorio y los 21 pacientes con ERPAD, del total de pacientes con litiasis urinaria que se realizó estudio metabólico renal en el Laboratorio de Fisiopatología Renal del Instituto de Nefrología, en el periodo 2010-2015. Los datos fueron tomados de la historia clínica y del informe de estudio metabólico renal. La información se procesó de forma automatizada (SPSS 22.0). Se utilizó el promedio, desviación estándar, análisis de distribución de frecuencias y el test de homogeneidad. Resultados: En los pacientes con ERPAD predominó el sexo femenino (57,1 por ciento), mientras que en los pacientes sin ERPAD, el masculino (63,4 por ciento). Los trastornos más frecuentes en la población no poliquística fueron hipercalciuria (45,3 por ciento) e hipofosfatemia (17,1 por ciento). En los poliquísticos, aclaramiento aumentado de ácido úrico (38,1 por ciento) e hipercalciuria (23,8 por ciento). Se encontraron diferencias estadísticamente significativas para aumento del aclaramiento de ácido úrico (p = 0,01) e hiperfosfatemia (p = 0,04). Conclusiones: Los principales trastornos metabólicos de los pacientes litiásicos, tanto poliquísticos como no poliquísticos, son el aclaramiento de ácido úrico aumentado, hipercalciuria, hiperuricosuria e hipofosfatemia, aunque el orden de presentación es diferente. El aclaramiento de ácido úrico aumentado y la hiperfosfatemia se presentan con mayor frecuencia en los pacientes litiásicos poliquísticos(AU)

Introduction: Urolithiasis has increased in recent decades. Autosomal dominant polycystic kidney disease (ADPKD), the most common of all hereditary kidney diseases, occupies a predominant position in terms of incidence. Objectives: Identify the frequency of occurrence of urinary metabolic disorders in Cuban urolithiasis patients with and without ADPKD. Methods: A descriptive cross-sectional study was conducted of 579 adult patients without ADPKD selected by simple random sampling, and 21 patients with ADPKD, from the total urolithiasis patients undergoing renal metabolic evaluation at the Renal Physiopathology Laboratory of the Institute of Nephrology in the period 2010-2015. Data were obtained from medical records and reports of renal metabolic studies. Information was processed with the statistical software SPSS version 22.0. Average and standard deviation were estimated and use was made of frequency distribution analysis and homogeneity testing. Results: A predominance was found of female sex among patients with ADPKD (57.1 percent) and male sex among patients without ADPKD (63.4 percent). The most common disorders were hypercalciuria (45.3 percent) and hypophosphatemia (17.1 percent) in the non-polycystic population, and increased uric acid clearance (38.1 percent) and hypercalciuria (23.8 percent) in polycystic patients. Statistically significant differences were found in uric acid clearance increase (p = 0.01) and hyperphosphatemia (p = 0.04). Conclusions: The main metabolic disorders of lithiasis patients, polycystic as well as non-polycystic, are increased uric acid clearance, hypercalciuria, hyperuricosuria and hypophosphatemia, with a varying order of presentation. Increased uric acid clearance and hyperphosphatemia are more common in polycystic lithiasis patients(AU)

Factores de riesgo asociados a diabetes mellitus tipo 2. Policlínico Docente José Jacinto Milanés. Matanzas, 2019 / Risk factors associated with type 2 diabetes mellitus. Teaching Polyclinic José Jacinto Milanés. Matanzas, 2019

RESUMEN Introducción: la diabetes es un trastorno endocrino-metabólico crónico que afecta a diversos órganos y tejidos. Más del 90 % de los que la padecen sufren diabetes tipo 2. Esta se acompaña de complicaciones crónicas, que pueden prevenirse mediante un control adecuado de la hiperglucemia y de los factores de riesgo cardiovascular. Objetivo: caracterizar los factores de riesgo asociados a la diabetes mellitus tipo 2, en pacientes del Consultorio del Médico de la Familia no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas. Materiales y métodos: se realizó un estudio descriptivo de corte transversal, durante el período de enero a diciembre de 2019. El universo estuvo constituido por 50 pacientes pertenecientes al consultorio no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas, dispensarizados con diabetes mellitus tipo 2. Resultados: el sexo femenino fue el predominante, y el 24 % de los pacientes se encontraban entre 55 y 59 años. En cuanto al estado nutricional, resultó la obesidad el de mayor frecuencia. En el 52 % existían antecedentes familiares de diabetes tipo 2. Conclusiones: la obesidad, los malos hábitos dietéticos, el sedentarismo y la hipertensión arterial constituyeron los factores de riesgo más frecuentes en estos pacientes (AU).

ABSTRACT Introduction: diabetes is a chronic endocrine-metabolic disorder that affects numerous organs and tissues. More than 90 % of those with it suffer from type 2 diabetes. This is accompanied by chronic complications, which can be prevented by adequate control of hyperglycemia and cardiovascular risk factors. Objective: to characterize the risk factors associated with type 2 diabetes mellitus in patients from the Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas. Materials and methods: a cross-sectional, descriptive study was carried out during the period from January to December 2019. The universe were 50 patients belonging to Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas, diagnosed with type 2 diabetes mellitus. Results: female sex predominated, and 24 % of patients were aged 55-59 years. According to the nutritional status, obesity was the more frequent. There was a family history of type 2 diabetes mellitus in 52 %. Conclusion: obesity, poor dietary habits, sedentary way of life, and arterial hypertension were the most frequent risk factors found in these patients (AU).

Association of single nucleotide polymorphism of TNF-α gene G308A with obesity and metabolic disorder in children / 中华内分泌代谢杂志

Objective:To investigate the association of tumor necrosis factor-α(TNF-α)gene G308A single nucleotide polymorphism(SNP)with childhood obesity and metabolic disorders.Methods:A total of 620 obese children admitted to our pediatric department from January 2015 to December 2019 were selected as research subjects, who were divided into metabolic non-healthy group( n=267)and metabolic healthy group( n=353), and 260 healthy children were selected as the control group. Single nucleotide polymorphism of TNF-α gene G308A was detected, serum TNF-α level, obesity indicators, glucose and lipid metabolism indicators were compared among the children in various groups. Results:No significant differences in body mass index(BMI), waist circumference, hip circumference, and serum TNF-α level were found between metabolic non-healthy group and metabolic healthy group( P>0.05), but higher than those in control group( P<0.05). There were no significant differences in fasting plasma glucose(FPG)and total cholesterol(TC) levels among the three groups( P>0.05). The levels of fasting insulin(FINS), fasting glucagon(FGC), HbA 1C, triglyceride(TG), and low density lipoprotein-cholesterol(LDL-C)in metabolic non-health group and metabolic health group were significantly higher than those in control group, higher in metabolic non-health group compared with metabolic healthy group( P<0.05). HDL-C level in two obese groups was significantly lower than that in control group, lower in metabolic non-health group compared with metabolic healthy group( P<0.05). The frequencies of GG genotype and allele G in metabolic non-healthy group and metabolic healthy group were significantly lower than those in control group, lower in metabolic non-health group compared with metabolic healthy group. The frequencies of AA, GA genotypes and allele A were significantly higher in metabolic non-health group than those in metabolic healthy group( P<0.05). There were no significant differences in TNF-α, FPG, and TC among AA, GA and GG groups( P>0.05). BMI, waist circumference, hip circumference, FINS, FGC, HbA 1C, TG, HDL-C and LDL-C were comparable between AA type and GA type( P>0.05), but revealed a significant difference compared with GG type( P<0.05). Pearson correlation analysis showed that the level of TNF-α was positively correlated with BMI, waist circumference, hip circumference, FPG, FINS, FGC, HbA 1C, TC, TG, and LDL-C( P<0.05), but negatively correlated with HDL-C( P<0.05). Conclusion:TNF-α gene G308A single nucleotide polymorphism is associated with obesity and metabolic disorders in children.

Application prospects of trigonelline in regulating metabolic disorders after renal transplantation / 器官移植

Metabolic disorders, such as glucose and lipid, are likely to occur after renal transplantation, leading to graft dysfunction and reduced long-term survival. Trigonelline is a type of natural alkaloid with various biological activities, which can alleviate the metabolic disorders of glucose, lipid and other types, and relieve inflammatory reaction, oxidative stress and cell apoptosis of the kidney, thereby protecting the renal function. Therefore, trigonelline may be a potential drug to regulate metabolic disorders after renal transplantation. In this article, the role of trigonelline in metabolic disorders of glucose, lipid and other types, and its application prospect in renal transplantation were reviewed, aiming to provide reference for alleviating metabolic disorders after renal transplantation and improving the long-term survival of renal transplant recipients and transplanted kidneys.

Incidencia y determinantes del Pie Diabético Úlceras en la ciudad de Amara / Incidence and determinants of Diabetic Foot Ulcers in Amara city

Diabetic foot infections are frequent clinical problem. Properly managed, most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches. The aim of this study is to evaluate patients with diabetic foot ulcer and their incidences. 320 cases were taken for our study of deferent gender and age group, date of study was from January 2019 to the end of December 2019, study was done in Maysan Endocrine and Diabtology Center. Most cases were males about (59%) of young age group, most of the cases occurred in extreme weathers. Diabetic foot ulcers are preventable lesions, males at active age group more prone to develop diabetic foot lesions because they are more liable to expose to minor trauma during work. Health education for protection of diabetic patients from serious DFU complications

Berberine ameliorates dexamethasone-induced metabolic disorder in C57 mice / 药学学报

The aim of this study was to evaluate the effects and mechanisms of berberine (BBR) against dexamethasone (Dex)-induced metabolic disorders. 3T3-L1 cells were differentiated by Dex treatment and then treated with BBR (2.5, 5, 10 μmol·L-1). Lipid accumulation was detected using oil-red O staining. After review and approval of the ethics committee of the Institute of Materia Medica, Peking Union Medical College, Chinese Academy of Medical Sciences, C57BL/6N mice were randomly divided into three groups. In the BBR treatment group, mice were subcutaneously implanted with an osmotic pump containing Dex and gavaged with BBR (100 mg·kg-1·day-1) for 4 weeks. The model control group was implanted with a Dex osmotic pump with no other treatment. Mice given a saline-filled osmotic pump were used as a negative control. During the study, food intake and body weight were measured weekly. Subcutaneous fat and visceral fat was detected by MRI. At the end of the experiment the plasma levels of total cholesterol (CHO), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), glucose (Glu), and muscle mass were measured. The expression of peroxisome proliferator-activated receptor γ (PPARγ) and AMP-activated protein kinase α (AMPKα) in 3T3-L1 cells and epididymal fat of C57BL/6N mice was evaluated through RT-PCR and Western blot analysis. The results showed that BBR inhibited Dex-induced adipocyte differentiation in 3T3-L1 preadipocytes by up to 23% in a dose-dependent manner. In C57BL/6N mice, berberine alleviated hyperlipidemia and hyperglycemia and reduced visceral fat accumulation induced by Dex. The results from RT-PCR and Western blot analysis showed that BBR reduced PPARγ expression and increased the phosphorylation of AMPKα in 3T3-L1 cells as well as in adipose tissue. Berberine might alleviate Dex-induced metabolic disorder and visceral fat accumulation by modulating PPARγ and AMPK expression.

Caulerpa okamurae extract attenuates inflammatory interaction, regulates glucose metabolism and increases insulin sensitivity in 3T3-L1 adipocytes and RAW 264.7 macrophages / 中西医结合学报

OBJECTIVE@#To examine whether Caulerpa okamurae ethanolic extract (COE) could inhibit obesity-mediated inflammation, improve glucose metabolism and increase insulin sensitivity, using in vitro cell models of RAW 264.7 macrophages and 3T3-L1 adipocytes.@*METHODS@#We cocultured 3T3-L1 adipocytes in direct contact with lipopolysaccharide-stimulated RAW 264.7 macrophages and induced insulin resistance in 3T3-L1 adipocytes with tumor necrosis factor-α (TNF-α) in the presence or absence of 250 µg/mL of COE. We investigated various markers of inflammation, glucose regulation and insulin sensitivity in these models using Griess reagent to measure nitric oxide (NO) production, 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxyglucose to measure glucose uptake, Western blot analysis to quantify protein expression and reverse transcriptase-polymerase chain reaction to evaluate mRNA expression.@*RESULTS@#We found that COE (250 µg/mL) significantly inhibited the lipopolysaccharide-induced inflammatory response in RAW 264.7 macrophages by downregulating NO production, nitric oxide synthase 2 expression and nuclear translocation of nuclear factor-κB. COE also showed similar anti-inflammatory activity in coculture, along with decreased TNF-α, interleukin-6 and monocyte chemoattractant protein mRNA expression. In addition, COE also improved glucose uptake in coculture by upregulating glucose transporter-4 (GLUT-4) and adiponectin and reducing serine phosphorylation of insulin receptor substrate-1 (IRS1). In the TNF-α-induced insulin resistance model of 3T3-L1 adipocytes, COE significantly improved both basal and insulin-stimulated glucose uptake, accompanied by phosphorylation of IRS1 at tyrosine 632, phospho-5' adenosine monophosphate-activated protein kinase α and glycogen synthase kinase-3β (Ser9) as well as upregulation of GLUT-4.@*CONCLUSION@#Together, these findings suggest that COE has potential to treat or prevent obesity-induced metabolic disorders.

Epigenetic role of N 6-methyladenosine (m6A) RNA methylation in the cardiovascular system / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

As the most prevalent and abundant transcriptional modification in the eukaryotic genome, the continuous and dynamic regulation of N6-methyladenosine (m6A) has been shown to play a vital role in physiological and pathological processes of cardiovascular diseases (CVDs), such as ischemic heart failure (HF), myocardial hypertrophy, myocardial infarction (MI), and cardiomyogenesis. Regulation is achieved by modulating the expression of m6A enzymes and their downstream cardiac genes. In addition, this process has a major impact on different aspects of internal biological metabolism and several other external environmental effects associated with the development of CVDs. However, the exact molecular mechanism of m6A epigenetic regulation has not been fully elucidated. In this review, we outline recent advances and discuss potential therapeutic strategies for managing m6A in relation to several common CVD-related metabolic disorders and external environmental factors. Note that an appropriate understanding of the biological function of m6A in the cardiovascular system will pave the way towards exploring the mechanisms responsible for the development of other CVDs and their associated symptoms. Finally, it can provide new insights for the development of novel therapeutic agents for use in clinical practice.

Pathogenesis of Metabolic Syndrome from "Qi of five Internal Organs" / 中国实验方剂学杂志

Metabolic syndrome (MS) is a group of syndromes caused by the disorder of metabolism of various substances in the body. The main clinical manifestations are dyslipidemia, central obesity, hypertension, abnormal glucose tolerance and insulin resistance. With the changes of diet structure and habits, the incidence rate of MS is increasing, and the patients are younger. It is an important factor in many diseases, such as diabetes, atherosclerosis, coronary heart disease, hyperlipidemia, cirrhosis and some cancers. MS has seriously affected people's lives and health. Central obesity and insulin resistance are recognized as important pathogenic factors. At present, the pathogenesis of MS and its components has not been fully understood. The clinical manifestations of metabolic syndrome are complex and diverse. Traditional Chinese medicine (TCM) believes that the occurrence of metabolic syndrome is related to such factors as proper diet, emotional disorders, excessive escape and little movement, old age and physical deficiency. TCM scholars have studied the pathogenesis of MS in such pathological factors as phlegm and blood stasis, such visceral functions as liver, spleen and kidney, roles of Qi and blood, and emotional factors. As the basic substance of organism, Qi is closely related to the process of metabolism. The occurrence of MS is closely related to the rise and fall of Qi moving to and from the body as well as the abnormal gasification function of the transformation of Qi. Qi is derived from the five internal organs, which are respectively called Heart Qi, liver Qi, spleen Qi, lung Qi and kidney Qi. The "Qi of the five internal organs" is involved in the whole process of the generation, transportation and excretion of the essence of the body. Based on the "Qi of five internal organs", this paper discusses the pathogenesis of MS with phlegm, blood stasis and water drink as pathological factors.

Epigenetic role of N6-methyladenosine (m6A) RNA methylation in the cardiovascular system / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

As the most prevalent and abundant transcriptional modification in the eukaryotic genome, the continuous and dynamic regulation of N6-methyladenosine (m6A) has been shown to play a vital role in physiological and pathological processes of cardiovascular diseases (CVDs), such as ischemic heart failure (HF), myocardial hypertrophy, myocardial infarction (MI), and cardiomyogenesis. Regulation is achieved by modulating the expression of m6A enzymes and their downstream cardiac genes. In addition, this process has a major impact on different aspects of internal biological metabolism and several other external environmental effects associated with the development of CVDs. However, the exact molecular mechanism of m6A epigenetic regulation has not been fully elucidated. In this review, we outline recent advances and discuss potential therapeutic strategies for managing m6A in relation to several common CVD-related metabolic disorders and external environmental factors. Note that an appropriate understanding of the biological function of m6A in the cardiovascular system will pave the way towards exploring the mechanisms responsible for the development of other CVDs and their associated symptoms. Finally, it can provide new insights for the development of novel therapeutic agents for use in clinical practice.

Waist hip ratio: an anatomical predictive marker of risk of PCOS

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders seen in infertility clinic of Gynae OPD. It is basically is disease of metabolic disorder and requires ultrasound and hormonal assay for its diagnosis.Methods: The study was carried out in the GOPD of MGM medical College and M.Y. Hospital Indore (M.P.) India. It included 200 women in the age group 18-40 years diagnosed as PCOS and who were compared with 200 women of same age group without PCOS. The height, weight BMI and waist hip ratio were measured and analyzed statistically.Results: The present study shows that women with PCOS had higher incidence of acne hirsutism and irregular menses (p<0.0001), women with PCOS had higher mean ovarian volume measurement (11±1.4cc) compared to female controls who had lower volume of ovary with a range of (7.94±2.34cc. (p<0.0001) as calculated by USG by sonologist.Conclusions: The presence of central obesity, (waist hip ratio >0.87) is an indication for presence of PCOS. Thus, these patients may undergo further hormone evaluation and this simple measurement can help to screen out PCOS from general population. This prevents financial burden on low resource settings.

Updated therapeutic approach in the management of Polycystic Ovary Syndrome (PCOS): A Review

Polycystic ovary syndrome (PCOS) is a heterogeneous clinical entity that is defined as the association of hyperandrogenism with chronic an ovulation in women without specific underlying diseases of the adrenal or pituitary glands. PCOS is also associated with a metabolic disturbance with complex inter relation of obesity, insulin resistance and endocrine abnormalities remains unresolved. However, several studies link obesity, body fat distribution and nutritional habits with the hormonal and metabolic profiles of PCOS. Moreover, intervention studies have suggested that reducing weight and hyper insulinaemia either by diet alone or by a combination of diet with drugs improves hirsutism, fertility, hormonal and metabolic profiles of PCOS. In fact, the evaluation of nutritional factors in PCOS is helpful for the screening of metabolic abnormalities and the management of women with PCOS. A point of particular interest in the management of PCOS is that the choice of contraception remains difficult in these high cardiovascular risk women. The lack of prospective studies to evaluate long-term metabolic and cardiovascular tolerance necessitates care and the assessment of other hormonal possibilities

A Prospective Study on Prevalence and Percentage of Undiagnosed Type 2 Diabetics Patients Undergoing Elective Surgery

xIntroduction: The major form of diabetes mellitus is Type 2diabetes. It accounts for 90 percent of the diabetic population.Patients with diabetes mellitus (DM) are prone to adverseoutcomes. It is observed that one fifth of the patientsundergoing surgery are diabetic.Methodology: This study was conducted in the Department ofSurgery in the Department of General Surgery, Ananta Instituteof Medical Sciences and Research Centre, Rajsamand. 289total numbers of cases were included in this study. Each casehas Type 2 DM.Results: In our study, 289 total numbers of cases wereincluded. Among the 289 cases 53.9% were male & 46.1%were female. Incidence of Diabetic Mellitus in undiagnosed &diagnosed cases was found 41.5% & 58.5% respectively.Conclusion: This study concludes that there is a strong needof awareness about diabetes and early diagnosis of diabetes toreduce its various complications.

Cytokines and inflammation in adipogenesis: an updated review / 医学前沿

The biological relevance of cytokines is known for more than 20 years. Evidence suggests that adipogenesis is one of the biological events involved in the regulation of cytokines, and pro-inflammatory cytokines (e.g., TNFα and IL-1β) inhibit adipogenesis through various pathways. This inhibitory effect can constrain the hyperplastic expandability of adipose tissues. Meanwhile, chronic low-grade inflammation is commonly observed in obese populations. In some individuals, the impaired ability of adipose tissues to recruit new adipocytes to adipose depots during overnutrition results in adipocyte hypertrophy, ectopic lipid accumulation, and insulin resistance. Intervention studies showed that pro-inflammatory cytokine antagonists improve metabolism in patients with metabolic syndrome. This review focuses on the cytokines currently known to regulate adipogenesis under physiological and pathophysiological circumstances. Recent studies on how inhibited adipogenesis leads to metabolic disorders were summarized. Although the interplay of cytokines and lipid metabolism is yet incompletely understood, cytokines represent a class of potential therapeutic targets in the treatment of metabolic disorders.

Protective Effect of Linggui Zhugan Tang on Bone Injury in ob/ob Mice Based on Gut Microbiota / 中国实验方剂学杂志

Objective:To observe the effect of Linggui Zhugan Tang on gut microbiota in ob/ob mice, in order to explore whether its bone protective effect is related to its regulatory effect of gut microbiota. Method:The ob/ob mice were divided into control group, model group, Linggui Zhugan Tang group, and Atorvastatin group. After administration for 4 weeks, morphological changes in intestine and bone were observed by htoxylin eosin(HE) staining. The protein expression of alkaline phosphatase(ALP) was detected by Western blot in bone. The expression of farniol X receptor(FXR) was detected by in immunofluorescence staining. And the content of interleukin-6(IL-6) in serum was analyzed by the enzyme-linked immunosorbent assay(ELISA) method. Gut microbiota was analyzed by 16S rRNA. Result:Compared with control group, the trabecular bone of the femur became thinner, the bone marrow cavity was infiltrated with fat, and the epithelium of the small intestine was damaged in the model group. The protein expressions of ALP and FXR decreased, while the content of IL-6 in serum was increased in the model group. Compared with model group, the protein expressions of ALP and FXR increased, while the content of IL-6 in serum was decreased in the Linggui Zhugan Tang group. At the genus level, compared with control group, the abundance of Lachnospiraceae_UCG-001 increased (PBacteroidales_S24-7_group decreased in model group (PLachnospiraceae_UCG-001 was positively correlated with the weight of body (r=0.661), while norank_f__Bacteroidales_S24-7_group was negatively correlated with the weight of body (r=-0.622). Conclusion:Linggui Zhugan Tang has a protective effect on bone injury in ob/ob mice, and its mechanism may be related to its regulation of gut microbiota.