Relationship between Thyroid Function and Kidney Function in Patients with Type 2 Diabetes.

PURPOSE: To determine if the TSH is related to estimated glomerular filtration rate (eGFR) in T2D patients without overt thyroid dysfunction. METHODS: A cohort study of 5936 T2D patients was assessed for thyroid and kidney functions, in whom 248 with subclinical hyperthyroidism and 362 with subclinical hypothyroidism. Serum creatinine and 24-hour urine albumin excretion (UAE) were collected. Chronic kidney disease (CKD) was defined as eGFR < 60 ml/min/1.73 m2. RESULTS: Compared with euthyroid subjects, the patients with subclinical hypothyroidism had lower eGFR (82.7 ± 22.4 vs. 90.5 ± 22.4 ml/min/1.73 m2, p < 0.01), higher UAE (114 ± 278 vs. 88 ± 229 mg/24 h, p < 0.05), and high incidence of CKD (16.0% vs. 10.1%, p < 0.05). The participants with a TSH level between 0.55 and 3.0 µIU/ml had a higher eGFR (91.4 ± 22.2 ml/min/1.73 m2) and a lower prevalence of CKD (9.5%) than those with higher TSH (3.01-4.78 µIU/ml, 85.6 ± 22.7 ml/min/1.73 m2, p < 0.01 and 13.1%, p < 0.01). Linear logistic regression analysis showed that the eGFR was significantly negatively associated with TSH (OR: 0.519, 95% CI: 0.291-0.927, p < 0.05), after adjustment of confounders. CONCLUSION: High TSH was independently associated with decreased eGFR in type 2 diabetes patients without overt thyroid dysfunction. Our findings indicate that doctors who treat T2D patients should routinely measure the thyroid function.

Biatractylolide Modulates PI3K-Akt-GSK3ß-Dependent Pathways to Protect against Glutamate-Induced Cell Damage in PC12 and SH-SY5Y Cells.

Biatractylolide, isolated from the ethyl acetate extract of Atractylodes macrocephala, has shown various pharmacological activities such as antitumor and antioxidant activities. In this work, we aim to study the protective effect of biatractylolide on glutamate-induced rat adrenal pheochromocytoma cell (PC12) and human bone marrow neuroblastoma cell line (SH-SY5Y) injury and preliminarily explore its mechanism. The results showed that glutamate was cytotoxic with an inhibitory concentration 50% (IC50) of 8.5 mM in PC12 and 10 mM in SH-SY5Y cells. In this work, the preincubation with biatractylolide (10, 15, and 20 µM) observably improved cell viability, inhibited the apoptosis of cells induced by glutamate, and reduced the activity of LDH. AO staining revealed that apoptosis of cells was decreased. Additionally, the results of western blotting manifested that pretreatment with biatractylolide could downregulate GSK3ß protein expression and upregulate p-Akt protein expression, thereby protecting PC12 and SH-SY5Y cells from injury. All these findings indicate that biatractylolide has a neuroprotective effect on glutamate-induced injury in PC12 and SH-SY5Y cells through a mechanism of the PI3K-Akt-GSK3ß-dependent pathways.

Low Thyroid Stimulating Hormone Levels Are Associated with Low Bone Mineral Density in Femoral Neck in Elderly Women.

BACKGROUND AND AIMS: To determine the relationship between thyroid stimulating hormone (TSH) and bone mineral density (BMD) in elderly women. METHODS: This is a retrospective cross-sectional population cohort study of women aged ≥65 years. All 1097 subjects had no overt thyroid dysfunction, 47 had subclinical hyperthyroidism and 100 had subclinical hypothyroidism. Overall, 167 had normal BMD, 594 had osteopenia and 336 had osteoporosis. RESULTS: The femoral neck (FN) BMD was lower in women with lower TSH, with a high prevalance of osteoporosis and osteopenia (p = 0.036).The prevalence of osteoporosis and osteopenia was significantly low in the lowest quartile compared with the third quartile (p = 0.023) and the fourth quartile (p = 0.002), and the second low quartile, compared with the fourth quartile (p = 0.028). The differences were not significant among subclinical hyperthyroid, subclinical hypothyroid and euthyroid women. Low TSH was related to low BMDs at FN by multiple logistic regression analysis corrected for age and BMI. TSH in the lower two quartiles were independently related to osteoporosis (OR: 1.960, p = 0.023 and OR: 1.800, p = 0.037) and osteopenia (OR: 2.108, p = 0.005 and OR: 1.723, p = 0.030). Low TSH quartile (ß: 0.007, p = 0.013) predicting low BMDs at FN. CONCLUSION: Low TSH was independently related to decreased BMDs at FN in elderly women without overt thyroid dysfunction.

[Effect of montmorillonite on diffussion of urea between blood and intestine and on absorption of intestine in rats].

OBJECTIVE: To study the effect of montmorillonite on promoting diffussion of urea from blood vessel to intestine and preventing absorption of urea in intestine. METHODS: Rat intestine tract and blood vessel were perfusated circularly with intestinal tract perfusate and blood vessel perfusate with or without urea 1 g/L, respectively. The concentration of urea in perfusates was measured by urease and glutamic dehydrogenase coupling method. RESULTS: The blood vessel was circularly perfusated with vascular perfusate containing urea and intestinal tract was circularly perfusated with intestinal perfusate without urea. The concentration of urea in vascular perfusate decreased gradually, and the concentration of urea in intestine perfusate increased slowly. When montmorillonite was added into the intestinal tract, the urea concentration in both intestinal tract perfusate and the vascular perfusate in montmorillonite 0.5 g/kg and 1.0 g/kg groups were significantly lower than that of control group (P < 0.05). The blood vessel was circularly perfusated with vascular perfusate without urea and intestinal tract was circularly perfusated with perfusate containing urea, the concentration of urea in intestine perfusate decreased little by little, and the concentration of urea in vascular perfusate increased slowly. After montmorillonite was administrated into the intestinal tract, the urea concentrations in both the vascular perfusate and intestinal tract perfusate in montmorillonite 0.5 g/kg and 1.0 g/kg were obviously lower than that of control group (P < 0.05). CONCLUSION: Montmorillonite promotes the diffusion of urea from blood vessel to intestine, and inhibits the absorption of urea in intestine.

Independent anti-inflammatory effect of insulin in newly diagnosed type 2 diabetes.

BACKGROUND: Although insulin has been reported to have an anti-inflammatory effect, whether this effect is independent of its property to reduce blood glucose with insulin treatment in type 2 diabetes has not been investigated in detail. The purpose of this study was to evaluate the independent anti-inflammatory effect of insulin in patients with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS: An 8-week, randomized, parallel-group study that enrolled 90 patients with newly diagnosed type 2 diabetes, who were randomly assigned to receive either insulin or metformin, was carried out. The doses of insulin and metformin were titrated according to fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) during the 4 weeks; the target of FPG was 126 mg/dL and that of PPG was 160 mg/dL. The blood glucose levels were kept stabilized till the end of the study. The serum concentrations of high-sensitive C-reactive protein (hsCRP) and interleukin (IL)-6 were measured before starting the study and 4 and 8 weeks after initiation of insulin or metformin therapy. RESULTS: After 4 weeks of dose titration, the levels of FPG were reduced in the two groups compared to baseline (p < 0.001), but there was no significant difference between the two groups (p > 0.05). During the next 4 weeks' treatment, the levels of FPG were stable, but the serum concentration of hsCRP and IL-6 was markedly reduced in the insulin-treated group compared with that in the metformin-treated group (p < 0.001). CONCLUSIONS: Our data suggest that insulin has an anti-inflammatory effect that is independent of the reduction it causes in blood glucose.