Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T...Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.展开更多
Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and n...Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.展开更多
Background:Non-communicable chronic diseases have become the leading causes of disease burden worldwide.The trends and burden of“metabolic associated fatty liver disease”(MAFLD)are unknown.We aimed to investigate th...Background:Non-communicable chronic diseases have become the leading causes of disease burden worldwide.The trends and burden of“metabolic associated fatty liver disease”(MAFLD)are unknown.We aimed to investigate the cardiovascular and renal burdens in adults with MAFLD and non-alcoholic fatty liver disease(NAFLD).Methods:Nationally representative data were analyzed including data from 19,617 non-pregnant adults aged≥20years from the cross-sectional US National Health and Nutrition Examination Survey periods,1999 to 2002,2003 to 2006,2007 to 2010,and 2011 to 2016.MAFLD was defined by the presence of hepatic steatosis plus general overweight/obesity,type 2 diabetes mellitus,or evidence of metabolic dysregulation.Results:The prevalence of MAFLD increased from 28.4%(95% confidence interval 26.3–30.6)in 1999 to 2002 to 35.8%(33.8–37.9)in 2011 to 2016.In 2011 to 2016,among adults with MAFLD,49.0%(45.8–52.2)had hypertension,57.8%(55.2–60.4)had dyslipidemia,26.4%(23.9–28.9)had diabetes mellitus,88.7%(87.0–80.1)had central obesity,and 18.5%(16.3–20.8)were current smokers.The 10-year cardiovascular risk ranged from 10.5%to 13.1%;19.7%(17.6–21.9)had chronic kidney diseases(CKDs).Throughthe fourperiods,adults withMAFLD showedanincrease in obesity;increase intreatment to lower bloodpressure(BP),lipids,and hemoglobin A1c;and increase in goal achievements for BP and lipids but not in goal achievement for glycemic control in diabetes mellitus.Patients showed a decreasing 10-year cardiovascular risk over time but no change in the prevalence of CKDs,myocardial infarction,or stroke.Generally,although participants with NAFLD and those with MAFLD had a comparable prevalence of cardiovascular disease and CKD,the prevalence of MAFLD was significantly higher than that of NAFLD.Conclusions:From 1999 to 2016,cardiovascular and renal risks and diseases have become highly prevalent in adults with MAFLD.The absolute cardiorenal burden may be greater for MAFLD than for NAFLD.These data call for early identification and risk stratification of MAFLD and close collaboration between endocrinologists and hepatologists.展开更多
Background:China has experienced rapid urbanization in the past 30 years.We aimed to report blood cadmium level(BCL)in the rapidly urbanized Yangtze Plain of China,and explore the association between BCL and 25-hydrox...Background:China has experienced rapid urbanization in the past 30 years.We aimed to report blood cadmium level(BCL)in the rapidly urbanized Yangtze Plain of China,and explore the association between BCL and 25-hydroxyvitamin D(25(OH)D).Methods:Our data source was the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors(SPECT-China)cross-sectional study(ChiCTR-ECS-14005052,www.chictr.org).We enrolled 3234 subjects from 12 villages in the Yangtze Plain.BCLs were measured by atomic absorption spectrometry.25(OH)D was measured with a chemiluminescence assay.Results:A total of 2560(79.2%)subjects were diagnosed with vitamin D deficiency.The median(interquartile range)BCL was 1.80μg/L(0.60-3.42)for men and 1.40μg/L(0.52-3.10)for women.In women,mean 25(OH)D concentrations were inversely associated with BCL(0.401,95%confidence interval:-0.697 to-0.105 nmol/L lower with each doubling of the BCL)after adjustment for age,educational status,current smoking,body mass index,diabetes,and season.However,there was no significant difference in 25(OH)D across the BCL tertiles for men.Conclusions:BCL in Chinese residents in the Yangtze Plain were much higher than that in developed countries.An inverse association between BCL and 25(OH)D was found in general Chinese women after multivariable adjustment.Future prospective cohort and animal studies are warranted to resolve the direction and temporality of these relationships,and to elucidate the exact mechanisms involved.展开更多
Background::Insulin resistance is the central abnormality and mechanism underlying the progression of cardiometabolic-based chronic diseases.This study aimed to evaluate the trends in insulin resistance andβ-cell dys...Background::Insulin resistance is the central abnormality and mechanism underlying the progression of cardiometabolic-based chronic diseases.This study aimed to evaluate the trends in insulin resistance andβ-cell dysfunction from 2001 to 2016 among US adults with undiagnosed diabetes,prediabetes,and normal glucose regulation and to provide sex-specific information using data from National Health and Nutrition Examination Surveys(NHANES)2001-2016.Methods::Data from 14,481 participants aged over 20 years from 8 consecutive 2-year cross-sectional cycles of the NHANES from 2001 to 2016 were used.Updated homoeostasis model assessment 2(HOMA2:HOMA2%B forβ-cell function and HOMA2IR for insulin resistance)was used as a surrogate measure.We defined the upper sex-specific tertile of HOMA2IR as insulin resistance and the lower corresponding tertile of HOMA2%B as lowβ-cell function.Results::In both sexes with undiagnosed diabetes,HOMA2%B(men,Ptrend=0.118;women,Ptrend=0.184)and HOMA2IR(men,Ptrend=0.710;women,Ptrend=0.855)remained stable over time.In the prediabetes group,both sexes exhibited significant increasing trends in HOMA2%B(men,Ptrend<0.010;women,Ptrend<0.010)and HOMA2IR(men,Ptrend<0.010;women,Ptrend<0.050).Adjusting for waist circumference mildly attenuated the trend in HOMA2IR and insulin resistance in men(Ptrend<0.010),but it resulted in no significance in women(Ptrend=0.196).In regard to normal glucose regulation,both sexes presented significant decreasing trends in lowβ-cell function(men,Ptrend<0.050;women<0.010)and attenuated trends in insulin resistance(men,Ptrend=0.196;women,Ptrend=0.121).Conclusions::Over 16 years,insulin resistance demonstrated an increasing trend in adult US population with prediabetes,whileβ-cell function showed a compensatory increasing trend.Identifying people with prediabetes early and focusing on reducing insulin resistance as the intervention core,especially controlling central obesity,might increase the opportunity for cardiovascular and diabetes risk reduction.展开更多
基金supported by the National Natural Science Foundation of China(No.82120108008,No.91857117)the Project of Biobank(No.YBKA201909)from Shanghai Ninth People’s Hospital,Shanghai Jiaotong University School of Medicinea grant from Shanghai Jiaotong University School of Medicine(No.19XJ11007).
文摘Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.
基金grants from the National Natural Science Foundation of China(No.81270885,No.81570726 and No.81600609)Shanghai Jiao Tong University School of Medicine(2014)+4 种基金the Ministry of Science and Technology in China(No.2012CB524906)the Science and Technology Commission of Shanghai Municipality(No.14495810700 and No.16410723200)Three-year Action Plan for Public Health System Construction in Shanghai by Shanghai Municipal Commission of Health and Family Planning(2015-2017)Clinical Potential Subject Construction of Shanghai Jiao Tong University School of Medicine(2014),Shanghai Municipal Health Bureau of China(No.20124262)Seed Founding of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine(No.JYZZ032).
文摘Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.
基金supported by the National Natural Science Foundation of China(No.91857117)the Science and Technology Commission of Shanghai Municipality(Nos.19140902400,18410722300).
文摘Background:Non-communicable chronic diseases have become the leading causes of disease burden worldwide.The trends and burden of“metabolic associated fatty liver disease”(MAFLD)are unknown.We aimed to investigate the cardiovascular and renal burdens in adults with MAFLD and non-alcoholic fatty liver disease(NAFLD).Methods:Nationally representative data were analyzed including data from 19,617 non-pregnant adults aged≥20years from the cross-sectional US National Health and Nutrition Examination Survey periods,1999 to 2002,2003 to 2006,2007 to 2010,and 2011 to 2016.MAFLD was defined by the presence of hepatic steatosis plus general overweight/obesity,type 2 diabetes mellitus,or evidence of metabolic dysregulation.Results:The prevalence of MAFLD increased from 28.4%(95% confidence interval 26.3–30.6)in 1999 to 2002 to 35.8%(33.8–37.9)in 2011 to 2016.In 2011 to 2016,among adults with MAFLD,49.0%(45.8–52.2)had hypertension,57.8%(55.2–60.4)had dyslipidemia,26.4%(23.9–28.9)had diabetes mellitus,88.7%(87.0–80.1)had central obesity,and 18.5%(16.3–20.8)were current smokers.The 10-year cardiovascular risk ranged from 10.5%to 13.1%;19.7%(17.6–21.9)had chronic kidney diseases(CKDs).Throughthe fourperiods,adults withMAFLD showedanincrease in obesity;increase intreatment to lower bloodpressure(BP),lipids,and hemoglobin A1c;and increase in goal achievements for BP and lipids but not in goal achievement for glycemic control in diabetes mellitus.Patients showed a decreasing 10-year cardiovascular risk over time but no change in the prevalence of CKDs,myocardial infarction,or stroke.Generally,although participants with NAFLD and those with MAFLD had a comparable prevalence of cardiovascular disease and CKD,the prevalence of MAFLD was significantly higher than that of NAFLD.Conclusions:From 1999 to 2016,cardiovascular and renal risks and diseases have become highly prevalent in adults with MAFLD.The absolute cardiorenal burden may be greater for MAFLD than for NAFLD.These data call for early identification and risk stratification of MAFLD and close collaboration between endocrinologists and hepatologists.
基金supported by grants from the National Natural Science Foundation of China(No.81600609)Science and Technology Commission of Shanghai Municipality(No.18410722300)+2 种基金Municipal Human Resources Development Program for Outstanding Young Talents in Medical and Health Sciences in Shanghai(No.2017YQ053)Fundamental Research Program Funding of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine(No.JYZZ099)Shanghai Sailing Program(No.20YF1423500)。
文摘Background:China has experienced rapid urbanization in the past 30 years.We aimed to report blood cadmium level(BCL)in the rapidly urbanized Yangtze Plain of China,and explore the association between BCL and 25-hydroxyvitamin D(25(OH)D).Methods:Our data source was the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors(SPECT-China)cross-sectional study(ChiCTR-ECS-14005052,www.chictr.org).We enrolled 3234 subjects from 12 villages in the Yangtze Plain.BCLs were measured by atomic absorption spectrometry.25(OH)D was measured with a chemiluminescence assay.Results:A total of 2560(79.2%)subjects were diagnosed with vitamin D deficiency.The median(interquartile range)BCL was 1.80μg/L(0.60-3.42)for men and 1.40μg/L(0.52-3.10)for women.In women,mean 25(OH)D concentrations were inversely associated with BCL(0.401,95%confidence interval:-0.697 to-0.105 nmol/L lower with each doubling of the BCL)after adjustment for age,educational status,current smoking,body mass index,diabetes,and season.However,there was no significant difference in 25(OH)D across the BCL tertiles for men.Conclusions:BCL in Chinese residents in the Yangtze Plain were much higher than that in developed countries.An inverse association between BCL and 25(OH)D was found in general Chinese women after multivariable adjustment.Future prospective cohort and animal studies are warranted to resolve the direction and temporality of these relationships,and to elucidate the exact mechanisms involved.
基金the Science and Technology Commission of Shanghai Municipality(No.19140902400 and No.20ZR 1432500).
文摘Background::Insulin resistance is the central abnormality and mechanism underlying the progression of cardiometabolic-based chronic diseases.This study aimed to evaluate the trends in insulin resistance andβ-cell dysfunction from 2001 to 2016 among US adults with undiagnosed diabetes,prediabetes,and normal glucose regulation and to provide sex-specific information using data from National Health and Nutrition Examination Surveys(NHANES)2001-2016.Methods::Data from 14,481 participants aged over 20 years from 8 consecutive 2-year cross-sectional cycles of the NHANES from 2001 to 2016 were used.Updated homoeostasis model assessment 2(HOMA2:HOMA2%B forβ-cell function and HOMA2IR for insulin resistance)was used as a surrogate measure.We defined the upper sex-specific tertile of HOMA2IR as insulin resistance and the lower corresponding tertile of HOMA2%B as lowβ-cell function.Results::In both sexes with undiagnosed diabetes,HOMA2%B(men,Ptrend=0.118;women,Ptrend=0.184)and HOMA2IR(men,Ptrend=0.710;women,Ptrend=0.855)remained stable over time.In the prediabetes group,both sexes exhibited significant increasing trends in HOMA2%B(men,Ptrend<0.010;women,Ptrend<0.010)and HOMA2IR(men,Ptrend<0.010;women,Ptrend<0.050).Adjusting for waist circumference mildly attenuated the trend in HOMA2IR and insulin resistance in men(Ptrend<0.010),but it resulted in no significance in women(Ptrend=0.196).In regard to normal glucose regulation,both sexes presented significant decreasing trends in lowβ-cell function(men,Ptrend<0.050;women<0.010)and attenuated trends in insulin resistance(men,Ptrend=0.196;women,Ptrend=0.121).Conclusions::Over 16 years,insulin resistance demonstrated an increasing trend in adult US population with prediabetes,whileβ-cell function showed a compensatory increasing trend.Identifying people with prediabetes early and focusing on reducing insulin resistance as the intervention core,especially controlling central obesity,might increase the opportunity for cardiovascular and diabetes risk reduction.
