Publications by authors named "Changqin Liu"

58 Publications

AMH was independently associated with central obesity but not with general obesity in women with PCOS.

Endocr Connect 2021 Nov 1. Epub 2021 Nov 1.

C Liu, Fujian Medical University, Fuzhou, China.

Objective: Anti-Müllerian hormone (AMH) is recognized as the most important biomarker for ovarian reserve. In this cross-sectional study, we aimed to explore the potential association of AMH with central obesity or general obesity in women with polycystic ovary syndrome (PCOS).

Methods: In this cross-sectional study, 179 patients with PCOS were enrolled and underwent anthropometric measurements (BMI and waist circumference (WC)) and serum AMH level detection. Pearson's correlation and multivariable logistic regression analyses were performed to determine associations of AMH with central obesity and general obesity.

Results: Subjects with the increasing of body mass index (BMI) showed significantly lower values of AMH (median (IQR) 8.95 (6.03-13.60) ng/mL in normal weight group, 6.57 (4.18-8.77) ng/mL in overweight group, and 6.03 (4.34-9.44) ng/mL in obesity group, respectively, p=0.001), but higher levels of systolic blood pressure, fasting insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and obesity indices (WC, hip circumferences, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and Chinese visceral adiposity index (CVAI)) respectively. Compared with the group of PCOS women without central obesity, the group with central obesity had significantly lower value of AMH (median (IQR) 8.56(5.29-12.96) vs. 6.22(4.33-8.82) ng/mL; p=0.003). Pearson's correlation analysis showed that AMH were significantly and negatively correlated with BMI (r=-0.280; p<0.001), WC (r=-0.263; p<0.001), WHtR (r=-0.273; p<0.001), and CVAI (r=-0.211; p=0.006) respectively. Multivariate logistic regression analysis with adjustment for potential confounding factors showed that AMH was independently and negatively associated with central obesity, but was not significantly associated with general obesity.

Conclusions: AMH was independently and negatively associated with central obesity. Closely monitoring WC and AMH should be addressed in terms of assessing ovarian reserve in women with PCOS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1530/EC-21-0243DOI Listing
November 2021

Independent associations of thyroid-related hormones with hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults.

BMC Gastroenterol 2021 Nov 18;21(1):431. Epub 2021 Nov 18.

Epidemiology Research Unit, Translational Medical Research Center, The First Affiliated Hospital, Xiamen University, Xiamen, China.

Purpose: The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance.

Methods: A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China.

Results: Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1-3, respectively, p = 0.007) and fatty liver index (FLI) score (47.7 (33.9-60.8), 61.5 (45.1-88.9) and 90.5 (84.5-94.8), respectively, p < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (β (95%CI): 0.024 (0.004-0.043), p = 0.020), HOMA-IR (β (95%CI): 0.091 (0.007-0.174), p = 0.034), CAP (β (95%CI): 25.45 (2.59-48.31), p = 0.030) and FLI (β (95%CI): 0.121 (0.049-0.194), p = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis.

Conclusions: Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults. Trial registration Registration is not applicable for our study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12876-021-02011-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603528PMC
November 2021

Dysmyelination by Oligodendrocyte-Specific Ablation of Ninj2 Contributes to Depressive-Like Behaviors.

Adv Sci (Weinh) 2021 Nov 17:e2103065. Epub 2021 Nov 17.

State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, Fujian, 361005, China.

Depression is a mental disorder affecting more than 300 million people in the world. Abnormalities in white matter are associated with the development of depression. Here, the authors show that mice with oligodendrocyte-specific deletion of Nerve injury-induced protein 2 (Ninj2) exhibit depressive-like behaviors. Loss of Ninj2 in oligodendrocytes inhibits oligodendrocyte development and myelination, and impairs neuronal structure and activities. Ninj2 competitively inhibits TNFα/TNFR1 signaling pathway by directly binding to TNFR1 in oligodendrocytes. Loss of Ninj2 activates TNFα-induced necroptosis, and increases C-C Motif Chemokine Ligand 2 (Ccl2) production, which might mediate the signal transduction from oligodendrocyte to neurons. Inhibition of necroptosis by Nec-1s administration synchronously restores oligodendrocyte development, improves neuronal excitability, and alleviates depressive-like behaviors. This study thus illustrates the role of Ninj2 in the development of depression and myelination, reveals the relationship between oligodendrocytes and neurons, and provides a potential therapeutic target for depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/advs.202103065DOI Listing
November 2021

Joint associations of metabolically healthy abdominal obesity and non-alcoholic fatty liver disease with prediabetes and diabetes in Chinese adults.

BMJ Open Diabetes Res Care 2021 08;9(1)

Epidemiology Research Unit, Translational Medicine Research Center, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China

Introduction: We aimed to evaluate the joint associations of metabolically healthy abdominal obesity (MHAO) with non-alcoholic fatty liver disease (NAFLD) on risks of diabetes and prediabetes.

Research Design And Methods: Baseline information of 1318 adults with abdominal obesity (waist circumference ≥90 cm for men and 80 cm for women) from an ongoing cohort study in Xiamen, China were analyzed. Metabolic health was identified as none of the criteria of metabolism syndrome, except for obesity, was met.

Results: MHAO and metabolically unhealthy abdominal obesity (MUAO) were identified on 173 (13.1%) and 1145 (86.9%) subjects. NAFLD was further diagnosed on 60 (34.7%) in MHAO and 721 (63.0%) in MUAO groups (p<0.001). Both MUAO (vs MHAO) and NAFLD (vs non-NAFLD) were independently associated with increased risks of diabetes as well as prediabetes plus diabetes, with the adjusted ORs (95% CIs) of 9.40 (3.38 to 26.14) and 2.02 (1.47 to 2.77), respectively. Compared with MHAO and non-NAFLD, MHAO and NAFLD showed significantly increased risks of prediabetes plus diabetes with the adjusted ORs (95% CIs) of 2.87 (1.32 to 6.27, p=0.008). And there were significantly positive trends between increasing categories jointly by MHAO and NAFLD (from MHAO and non-NAFLD, MHAO and NAFLD, MUAO and non-NAFLD to MUAO and NAFLD) with risks of diabetes and prediabetes plus diabetes (both trend tests: p<0.001).

Conclusions: About 35% of subjects with MHAO accompanied by NAFLD showed excessive risk of prediabetes plus diabetes compared with MHAO and non-NAFLD. Thus, NAFLD should be screened and intervened even for those subjects with metabolically healthy obesity (MHO) and should be considered as one additional criterion when defining and diagnosing MHO.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjdrc-2021-002362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388268PMC
August 2021

Success of Cyclosporin and Tofacitinib Combination Therapy in a Patient With Severe Steroid-refractory Ulcerative Colitis.

Inflamm Bowel Dis 2021 11;27(12):e157-e158

Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

At present, the conventional therapies for acute severe ulcerative colitis (ASUC) mainly include corticosteroids, cyclosporin, and biological agents. However, the treatment of patients with severe steroid-refractory ulcerative colitis remains a serious challenge to clinicians. This study reports a case of steroid-refractory ASUC treated with cyclosporin combined with tofacitinib after treatment failure with infliximab.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ibd/izab181DOI Listing
November 2021

Twist1 contributes to developing and sustaining corticosteroid resistance in ulcerative colitis.

Theranostics 2021 26;11(16):7797-7812. Epub 2021 Jun 26.

Department of Gastroenterology, The Shanghai Tenth People's Hospital of Tongji University, Shanghai, China.

Corticosteroid resistance (CR) is a serious drawback to steroid therapy in patients with ulcerative colitis (UC); the underlying mechanism is incompletely understood. Twist1 protein (TW1) is an apoptosis inhibitor and has immune regulatory functions. This study aims to elucidate the roles of TW1 in inducing and sustaining the CR status in UC. Surgically removed colon tissues of patients with ulcerative colitis (UC) were collected, from which neutrophils were isolated by flow cytometry. The inflammation-related gene activities in neutrophils were analyzed by RNA sequencing. A CR colitis mouse model was developed with the dextran sulfate sodium approach in a hypoxia environment. Higher TW1 gene expression was detected in neutrophils isolated from the colon tissues of UC patients with CR and the CR mouse colon tissues. TW1 physically interacted with glucocorticoid receptor (GR)α in CR neutrophils that prevented GRα from interacting with steroids; which consequently abrogated the effects of steroids on regulating the cellular activities of neutrophils. STAT3 (Signal Transducer and Activator of Transcription-3) interacted with Ras protein activator like 1 to sustain the high TW1 expression in colon mucosal neutrophils of CR patients and CR mice. Inhibition of TW1 restored the sensitivity to corticosteroid of neutrophils in the colon tissues of a CR murine model. UC patients at CR status showed high TW1 expression in neutrophils. TW1 prevented steroids from regulating neutrophil activities. Inhibition of TW1 restored the sensitivity to corticosteroids in the colon tissues at the CR status.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7150/thno.62256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315068PMC
August 2021

Comparative effectiveness of team-based care with a clinical decision support system versus team-based care alone on cardiovascular risk reduction among patients with diabetes: Rationale and design of the D4C trial.

Am Heart J 2021 08 4;238:45-58. Epub 2021 May 4.

Department of Endocrinology and Diabetes, Xiamen Diabetes Institute, and Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, the First Affiliated Hospital of Xiamen University, Xiamen, China; Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China.. Electronic address:

Background: Diabetes has become a major public health challenge worldwide, especially in low- and middle-income countries (LMICs). Uncontrolled hyperglycemia, hypertension, and dyslipidemia major risk factors for all-cause mortality and cardiovascular disease (CVD) are common in patients with diabetes in China. We propose to compare the effectiveness of team-based care plus a clinical decision support system (CDSS) with team-based care alone on glycemic, blood pressure (BP), and lipid control, and clinical CVD reduction among patients with type-2 diabetes and at high risk for CVD.

Methods: The Diabetes Complication Control in Community Clinics (D4C) study is a cluster-randomized trial conducted among 38 community health centers in Xiamen City, China. Nineteen clinics have been randomly assigned to team-based care plus CDSS and 19 to team-based care alone. Team-based care includes primary care providers, health coaches, and diabetes specialists working collaboratively with patients to achieve shared treatment goals for CVD risk factor reduction. The CDSS integrates guideline-based treatment algorithms for glycemic, BP, and lipid control, along with a patient's medical history and insurance policy, to recommend treatment and follow-up plans. In phase 1, the co-primary outcomes are mean reduction in glycated hemoglobin (HbA1c), systolic BP (SBP), and low-density lipoprotein (LDL)-cholesterol over 18 months, and the proportion of patients with controlled HbA1c, SBP, and LDL-cholesterol at 18 months' between the 2 comparison groups. In phase 2, the primary outcome is the difference in major CVD incidence (non-fatal stroke, non-fatal myocardial infarction, hospitalized heart failure, and CVD mortality) between the 2 comparison groups. Mean reduction in HbA1c, SBP, and LDL-cholesterol levels will be simultaneously modeled for a single overall treatment effect.

Conclusion: The D4C trial will generate evidence on whether a CDSS will further reduce the CVD burden among patients with diabetes beyond team-based care at community clinics. If proven effective, this implementation strategy could be scaled up within primary care settings in China and other LMICs to reduce CVD incidence and mortality among patients with diabetes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ahj.2021.04.009DOI Listing
August 2021

Benefits and harms of hemithyroidectomy, total or near-total thyroidectomy in 1-4 cm differentiated thyroid cancer.

Clin Endocrinol (Oxf) 2021 10 30;95(4):668-676. Epub 2021 May 30.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China.

Objective: For 1-4 cm differentiated thyroid cancer (DTC), current ATA guideline recommended hemithyroidectomy (HT) as an acceptable alternative initial procedure to total or near-total thyroidectomy (TT). The aim of this study was to evaluate benefits and harms of HT, TT in 1-4 cm DTC.

Design: Retrospective cohort study.

Patients: DTC patients aged 18 years or older who underwent initial thyroidectomy in a tertiary medical centre were included from January 2008 to July 2018.

Measurements: The structural persistent/recurrent disease, reoperation rates and surgical complications were compared using Cox proportional regression and logistic regression. Propensity score matching was performed to adjust for related clinicopathological variables.

Results: Among 1824 DTC patients, 795 patients sized 1-4 cm were included. A total of 286 patients underwent HT and 509 patients underwent TT. In the matched analysis, no significant difference in disease-free survival (DFS) between HT and TT was observed during the median follow-up period of 56.5 months (hazard ratio [HR] 0.86; 95% CI, 0.37-2.00; p = .733). The difference in DFS between two groups was consistent regardless of age, sex, tumour size, follow-up duration. Meanwhile, HT was associated with a decreased risk of surgical complications (odds ratio [OR] 0.47, 95% CI 0.31-0.71, p < .001), as well as lower proportion of levothyroxine replacement (p = .007). Two cases in HT group received reoperation. Further multivariate analysis showed surgical procedure was not associated with structural persistence/recurrence (HR 0.68; 95%CI, 0.29-1.58, p = .367).

Conclusions: For patients with 1-4 cm DTC without clinical evidence of lymph node metastasis or extrathyroidal extension, HT was associated with lower risk of surgical complications than TT while provided similar benefits as TT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/cen.14495DOI Listing
October 2021

Polyglycoside Ameliorated TNBS-Induced Colitis in Rats via Regulating Th17/Treg Balance in Intestinal Mucosa.

J Inflamm Res 2021 1;14:1243-1255. Epub 2021 Apr 1.

Gastroenterology Department, The Shanghai Tenth People's Hospital, Tongji University, Shanghai, People's Republic of China.

Purpose: To investigate the therapeutic effect of polyglycoside (TWP), a derivative from a Chinese traditional herb, on 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis, in a model for inflammatory bowel disease (IBD) in rats.

Methods: TWP was administrated to Wistar rats during TNBS-induced colitis to determine its therapeutic effect on active inflammation using the Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR), flow cytometry, and Western blotting. Peripheral blood CD4 T-cells were isolated from patients with ulcerative colitis (UC) and incubated with TWP to verify its immune regulation mechanism by qRT-PCR and flow cytometry.

Results: Intragastric administration of TWP attenuated the severity of intestinal inflammation in TNBS-induced rat colitis, characterized by decreased DAI, histopathological scores, and expression of IL-6, TNFα, IFNγ, and IL-17A in intestinal mucosa. Furthermore, TWP reduced IL-17ACD4 T-cells, while enhanced Foxp3CD25CD4 T-cells in peripheral blood, mesenteric lymph nodes (MLN), and spleen in rat colitis. Downstream signaling including ROR-γt, STAT3, and HIF1α expression in intestinal mucosa were suppressed by TWP. In addition, incubation with TWP suppressed IL-17ACD4 T-cell differentiation, while it promoted Foxp3CD25CD4 T-cell differentiation in CD4 T-cells isolated from UC patients.

Conclusion: TWP successfully ameliorated experimental rat colitis via regulating innate immune responses as well as Th17/Treg balance in intestinal mucosa, peripheral blood, MLN, and spleen. Moreover, the differentiation of peripheral blood CD4 T-cell isolated from patients with UC was modulated by TWP. TWP may act as an optional complementary and alternative medicine for IBD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/JIR.S293961DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021269PMC
April 2021

Resistance to thyroid hormone caused by heterozygous mutation of thyroid hormone receptor B gene c.G1378A: Report of one Chinese pedigree and literature review.

Clin Case Rep 2021 Mar 8;9(3):1055-1059. Epub 2021 Feb 8.

Department of Endocrinology and Diabetes The First Affiliated Hospital of Xiamen University Xiamen China.

The same thyroid hormone receptor B gene (THRB) mutation led to thyroid hormone resistance with different clinical manifestations in the kindreds.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.3497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981654PMC
March 2021

Higher Apnea-Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) Were Independently Associated with Increased Risks of Hypertension in Patients with T2DM: A Cross-Sectional Study.

Int J Hypertens 2021 21;2021:8887944. Epub 2021 Jan 21.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China.

Objective: The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2DM).

Methods: This study recruited 316 T2DM patients. Multivariable logistic regression analyses were performed to determine the independent association of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) with hypertension with adjustment for potential confounders.

Results: Among 316 patients, 130 (41.1%) and 204 (64.6%) had hypertension and OSAS, respectively. T2DM patients with hypertension showed significantly increased levels of AHI ((median (interquartile range)): 17.2 (5.7-34.9) vs. 5.7 (2.1-17.3) events/hour,  < 0.001), nonrapid eye movement AHI (NREM-AHI) (17.6 (5.5-36.5) vs. 5.2 (2.2-16.6) events/hour,  < 0.001), ODI (48.4 (21.9-78.0) vs. 22.6 (10.8-48.1) events/hour,  < 0.001), and severities of OSAS and decreased levels of lowest SaO ((mean ± standard deviation): 74.0 ± 10.4 vs. 77.3 ± 9.8,  = 0.004). Multivariable logistic regression analysis showed that higher levels of AHI, NREM-AHI, and ODI were significantly associated with increased risks of hypertension, and the adjusted odds ratios (ORs) with 95% CI were 1.026 (1.008-1.044,  = 0.004), 1.026 (1.009-1.044,  = 0.003), and 1.005 (1.001-1.010,  = 0.040), respectively. Compared with non-OSAS, severe OSAS was significantly associated with the risk of hypertension with the adjusted OR (95% CI) of 3.626 (1.609-8.172,  = 0.002), but associations of rapid eye movement AHI (REM-AHI) and lowest SaO with hypertension were not statistically significant.

Conclusion: Increased AHI, NREM-AHI, ODI, and severities of OSAS were significantly associated with higher risks of hypertension in T2DM patients. Detection and treatment of OSAS are needed to prevent hypertension in T2DM patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2021/8887944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846401PMC
January 2021

Correlation Between Daily Energy Intake from Fat with Insulin Resistance in Patients with Polycystic Ovary Syndrome.

Diabetes Metab Syndr Obes 2021 22;14:295-303. Epub 2021 Jan 22.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China.

Objective: The aim of the present study was to investigate the possible correlation between the percentage of daily energy intake from fat (PEF) with insulin resistance (IR) in women with polycystic ovary syndrome (PCOS).

Methods: In this cross-sectional study, a total of 186 females with PCOS were screened. Daily dietary intake data were collected by a trained nutritionist using the 24-h dietary recall method over three consecutive days. A total of 111 subjects who had complete data were divided into two groups based on the percentage of daily energy intake from fat (PEF): the normal PEF (NPEF) group (PEF < 30%) and the high PEF (HPEF) group (PEF ≥ 30%). Pearson's correlation analysis and stepwise multivariate linear regression analysis were used to analyze the correlation of PEF with homeostasis model assessment of insulin resistance (HOMA-IR).

Results: The total prevalence rate of overweight/obesity was 80.2%. There were significant differences in waist circumference (WC), body mass index (BMI), fasting insulin, and HOMA-IR (P < 0.001) among the normal weight, the overweight, and the obese groups, but no significant differences were observed in total energy and dietary macronutrients intake in the three groups. The daily intake of fat and protein, fasting insulin, and HOMA-IR in the NPEF group were significantly higher than those in the HPEF group. Pearson's correlation analysis showed PEF in PCOS women was negatively correlated with BMI (r= -0.189, p=0.047) and HOMA-IR (log-transformed) (r= -0.217, p=0.022). Further, stepwise multivariate linear regression analysis showed PEF was negatively correlated with HOMA-IR (p<0.05).

Conclusion: The percentage of daily energy intake from fat is negatively correlated with IR in women with PCOS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/DMSO.S287936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837551PMC
January 2021

Lipid accumulation product (LAP) was independently associatedwith obstructive sleep apnea in patients with type 2 diabetes mellitus.

BMC Endocr Disord 2020 Dec 9;20(1):179. Epub 2020 Dec 9.

The School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China.

Background: Lipid accumulation product (LAP) is a new index based on a combination of waist circumference (WC) and serum triglycerides (TG) reflecting lipid accumulation. In this cross-sectional study, we aimed to explore whether LAP was independently associated with obstructive sleep apnea (OSA) in Type 2 diabetes mellitus (T2DM) patients.

Methods: A cross-sectional study of 317 T2DM patients who underwent overnight polysomnography (PSG) tests was conducted. The clinical data between non-OSA group and OSA group were compared. Multivariable linear regression and multivariable logistic regression analyses were performed to determine associations of LAP, with apnea-hypopnea index (AHI) and OSA.

Results: Among 317 patients, 219 (69.1%) were men, and the mean ages (±SD) were 51.4 (±13.5) years for men and 54.6 (±15.1) years for women (p = 0.067). The prevalence rates of OSA were 63.0% for men and 68.4% for women (p = 0.357). LAP (log-transformed) was significantly correlated with AHI (log-transformed), with the Pearson's correlation coefficient of 0.170 (p = 0.002). With adjustment for potential confounding factors, multivariate linear regression analyses showed the association of LAP with AHI was not statistically significant, with the adjusted linear regression coefficients (95% CI) of per SD increase of LAP for AHI (log-transformed) was 0.092 (- 0.011-0.194, p = 0.080). Multivariate logistic regression analyses showed LAP was significantly associated with increased risk of OSA, with the adjusted OR (95%CI) of per SD increase of LAP of 1.639 (1.032-2.604, p = 0.036). However, as constituents of LAP, neither TG nor WC was significantly associated with AHI and OSA.

Conclusion: LAP was independently associated with OSA and might be used as a potential OSA risk marker in T2DM patients, beyond the general index of obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12902-020-00661-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727244PMC
December 2020

Crohn's disease exacerbated by IL-17 inhibitors in patients with psoriasis: a case report.

BMC Gastroenterol 2020 Oct 15;20(1):340. Epub 2020 Oct 15.

Department of Gastroenterology, Shanghai Tenth People's Hospital of Tongji University, No. 301 Yanchang Road, Shanghai, 200072, China.

Background: Previous studied revealed that psoriasis and Inflammatory bowel disease (IBD) have highly overlapping epidemiological characteristics, genetic susceptibility loci, disease risk factors, immune mechanisms, and comorbidities. More and more biologics have been used to treat psoriasis and IBD. Interleukin (IL)-17 inhibitors played an important role in the treatment of psoriasis, but induced and aggravated inflammatory bowel disease in some patients. IL-23 inhibitors have shown to be effective to both psoriasis and CD.

Case Presentation: Forty-one year old Chinese male patient who came to the hospital for psoriasis, developed severe gastrointestinal symptoms after using an IL-17 inhibitor, and was diagnosed with Crohn's disease (CD). The patient eventually used an IL-23 inhibitor to relieve both psoriasis and CD.

Conclusion: IBD patients and psoriasis patients have increased probability of suffering from the other disease. The case that patients had suffered from psoriasis and CD before the use of IL-17 inhibitor is quite rare. This case suggests that physicians need to be careful when treating patients with psoriasis and CD with biologics, and it is necessary to evaluate the gastrointestinal tract.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12876-020-01474-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560304PMC
October 2020

Neck circumference is a good predictor for insulin resistance in women with polycystic ovary syndrome.

Fertil Steril 2021 03 9;115(3):753-760. Epub 2020 Sep 9.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; The School of Clinical Medicine, Fujian Medical University, Fujian, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China. Electronic address:

Objective: To assess the role of neck circumference (NC) in assessing insulin resistance (IR) in polycystic ovary syndrome (PCOS).

Design: A cross-sectional study.

Setting: University-affiliated hospital.

Patient(s): One hundred forty-three women with PCOS were recruited from November 2018 to February 2020.

Intervention(s): None.

Main Outcome Measure(s): The associations of NC with IR and the cutoff points of NC for IR.

Result(s): The prevalence rates of IR were 64.3%. The patients with PCOS with IR had significantly greater values of systolic blood pressure, NC, body mass index, waist-to-hip ratio, waist circumference, fasting blood glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR). Pearson correlation analysis showed body mass index (log-transformed), waist circumference, waist-to-hip ratio, and HOMA-IR (log-transformed) were positively correlated with NC. Multivariable linear regression showed that NC was significantly associated with HOMA-IR (log-transformed), with the standardized regression coefficient of 0.330 with adjustment for potential confounding factors. Furthermore, multivariate logistic regression analyses showed NC was associated significantly with increased risk of IR, with the adjusted odds ratio of 1.423. Additionally, NC was able to identify IR in women with PCOS; the optimal cut-off points was 34.3 cm (Youden index = 0.586).

Conclusion(s): Neck circumference is positively associated with IR in women with PCOS. We suggest NC as a novel, simple, practical, and reliable anthropometric measure to be used to predict the risk of IR in patients with PCOS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.fertnstert.2020.07.027DOI Listing
March 2021

Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma: A Rare Case of Diffuse Ulcers in the Intestine.

Clin Gastroenterol Hepatol 2021 Dec 12;19(12):e121-e122. Epub 2020 Jul 12.

Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China; Department of Gastroenterology, Shanghai Tenth People's Hospital Chongming Branch, Chongming, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cgh.2020.07.011DOI Listing
December 2021

The Relationship of Serum 25-Hydroxyvitamin-D Level with Severity of Obstructive Sleep Apnea in Patients with Type 2 Diabetes Mellitus.

Diabetes Metab Syndr Obes 2020 28;13:1391-1398. Epub 2020 Apr 28.

The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.

Objective: To explore the association of serum vitamin-D levels with the severity of obstructive sleep apnea (OSA) in patients with type 2 diabetes mellitus (T2DM).

Methods: A cross-sectional study of 136 patients with T2DM who underwent overnight polysomnography (PSG) tests and serum 25-hydroxyvitamin-D3 (25(OH)D3) level detections was conducted. Multivariable linear regression and logistic regression analyses were performed to determine the associations of serum 25(OH)D3 levels with apnea-hypopnea index (AHI) and obstructive sleep apnea (OSA).

Results: The prevalence rates of OSA were 84.4% for male and 65.2% for female patients, respectively (p = 0.011). With increasing severities of OSA categories (none, mild, moderate and severe), patients were more likely to be male and obese, but there was no significant difference in serum 25(OH)D3 level ((mean ± standard deviation) 21.8 ± 8.8, 27.7 ± 14.6, 24.2 ± 9.8 and 26.8 ± 6.2 ng/mL, respectively, p=0.086). Serum 25(OH)D3 level was not significantly correlated with AHI (log-transformed), with the correlation coefficient of 0.133 (p=0.124). With adjustment for potential confounding factors, multivariable linear regression and logistic regression analyses showed that serum 25(OH)D3 level was not significantly associated with either AHI (log-transformed) or the risk of OSA, with the standardized regression coefficient (95% confidence interval (CI)) of 0.098 (-0.004-0.014, p=0.252) and the adjusted odds ratio (95% CI) of 1.055 (0.991-1.124, p=0.095), respectively.

Conclusion: Serum 25(OH)D3 level was not significantly associated with either AHI or the risk of OSA in patients with T2DM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/DMSO.S250694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211054PMC
April 2020

Maternal postload 1-hour glucose level during pregnancy and offspring's overweight/obesity status in preschool age.

BMJ Open Diabetes Res Care 2020 02;8(1)

Xiamen Diabetes Institute, Xiamen, China

Background: Childhood obesity is associated with adverse outcomes such as metabolic syndrome, diabetes, and cardiovascular diseases in adulthood. Identifying risk factors related to excessive adiposity in early childhood is of great importance for obesity intervention. The results of studies for associations between maternal with gestational diabetes and offspring obesity are conflicting. Nonetheless, the association of maternal glucose across a spectrum of glucose values with childhood adiposity outcomes is less clear.

Aim: To assess the association of maternal glucose across a spectrum of glucose values with childhood adiposity at age 5 years.

Methods: A population-based cohort study was conducted between 2011 and 2018. Using the healthcare records data were from the Medical Birth Registry in Xiamen, China. The primary outcome was offspring obese/obesity. Primary predictors were maternal oral glucose tolerance test values during pregnancy.

Results: 6090 mother-child pairs were analyzed. The mean age of the children at follow-up was 5.2 years. At multiple logistic regression, after adjustment for variables, including maternal pre-pregnancy body mass index (BMI), birth weight of offspring, and insulin therapy, ORs for offspring overweight/obesity were 1.13 (95% CI 0.90 to 1.42) for maternal fasting glucose levels, 1.12 (95% CI 1.04 to 1.22) for 1-hour glucose, and 1.04 (95% CI 0.95 to 1.14) for 2-hour glucose. The adjusted association of offspring BMI Z-score with maternal 1-hour glucose level remained significant. There were no significant associations between BMI Z-score and maternal fasting glucose and 2-hour glucose level. Exploratory sex-specific analyses indicated generally consistent associations for boys and girls.

Conclusion: Maternal postload 1-hour glucose across a spectrum of glucose values during pregnancy was an independent risk for offspring weight gain at age 5 years, indicating the importance of screen and management of maternal 1-hour glucose level, except for fasting glucose and 2-hour glucose level during pregnancy in order to prevent offspring weight gain in early childhood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjdrc-2019-000738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039585PMC
February 2020

Associations of apnea hypopnea index and educational attainments with microvascular complications in patients with T2DM.

Endocrine 2020 02 11;67(2):363-373. Epub 2020 Jan 11.

The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.

Purpose: The relationship between obstructive sleep apnea (OSA) and diabetic microvascular complications (DMC) are controversial. Whether low education is associated with increased risk of DMC independently of poor lifestyles are currently unknown. The aim of this study is to explore the independent associations of different PSG index and educational attainment with risks of DR, DKD, and DPN.

Methods: A cross-sectional study of 330 patients with T2DM who underwent overnight polysomnography (PSG) tests. Multivariable logistic regression analysis was performed to determine the associations of PSG index and educational attainments with DR, DKD, and DPN.

Results: The prevalence rates of DMC were 30.6% for DR, 24.9% for DKD, and 64.6% for DPN. All PSG index (AHI, REM-AHI, NREM-AHI, the severity of OSAS, ODI, MAI, and lowest SaO) were not significantly associated with risks of DR, DKD, or DPN with adjustment for potential confounding factors. Subjects with increasing educational attainments showed significantly decreased prevalence rates of DR (42.6, 27.3, and 21.3%, p = 0.005), DKD (31.7, 25.3, and 14.7%, p = 0.035) and DPN (74.3, 63.6, and 53.3%, p = 0.015), respectively. Logistic regression analyses showed that educational attainment of primary or below showed significantly increased risks of DR (OR (95% CIs): 3.596 (1.453-8.899, p = 0.006)) and DKD (OR (95% CIs): 3.201 (1.244-8.242, p = 0.016)) as compared with that of college or above. There were significant trends of lower educational attainment with increased risks of DR and DKD (p values < 0.05).

Conclusion: PSG index were not significantly associated with DMC. But lower education was significantly associated with increased risks of DR and DKD, and strategies to prevent DMC for those with low education should be strengthened.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12020-020-02192-wDOI Listing
February 2020

Lipid accumulation product independently correlate with hepatic steatosis quantified by controlled attenuation parameter in women with polycystic ovary syndrome.

Endocr Connect 2020 Feb;9(2):154-162

Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China.

Objective: To explore the independent associations of the new adiposity indices lipid accumulation product (LAP) index, visceral adiposity index (VAI), and product of triglycerides and glucose (TyG) with the risks of hepatic steatosis (HS) in women with polycystic ovary syndrome (PCOS).

Design: This is a cross-sectional study with 101 women with PCOS undergoing controlled attenuation parameter (CAP) measurement who were recruited from November 2018 to August 2019. Multivariable logistic regression analysis was performed to determine the associations of adiposity indices with HS.

Result(s): Among the 101 PCOS patients, the prevalence rate of HS was 70.3%. The PCOS patients with HS have higher percentage of overweight/obesity status, higher level of aminotransferase (AST and ALT), homeostasis model assessment of insulin resistance (HOMA-IR), LAP, VAI, TyG, waist circumference (WC), and BMI (P < 0.05). Partial correlation analysis showed LAP, WC and BMI were significantly positively associated with CAP (P < 0.05) after controlling for confounding factors. Besides, BMI, WC, and CAP were gradually elevated with the increase of LAP level. Further, multivariable logistic regression analysis showed adjusted odd ratio (OR) with associated 95% CI (OR (95% CI)) were respectively 1.09 (1.03-1.16) for LAP, 1.14 (1.05-1.23) for WC, 1.28 (1.08-1.51) for BMI, respectively.

Conclusions: The present study demonstrates that in women with PCOS, except for the traditional adiposity indices (WC and BMI), LAP is independently correlated with the risk of HS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1530/EC-19-0559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993272PMC
February 2020

Association of Fetuin-B with Subclinical Atherosclerosis in Obese Chinese Adults.

J Atheroscler Thromb 2020 May 13;27(5):418-428. Epub 2019 Sep 13.

Department of Cardiology, The First Affiliated Hospital of Xiamen University.

Aim: We aimed to explore the independent associations of serum Fetuin-B and common genetic variants in FETUB locus with subclinical atherosclerosis.

Methods: A cross-sectional study of 1,140 obese adults, who underwent serum Fetuin-B testing, hepatic ultrasonography scanning, genotyping on four tagging single nucleotide polymorphisms (SNPs) in FETUB locus and atherosclerosis detection, was conducted in Xiamen, China.

Results: Increasing tertiles of brachial ankle pulse wave velocity (ba-PWV) were significantly associated with higher prevalence of nonalcoholic fatty liver disease (NAFLD) (48.8%, 61.5%, and 70.5% for tertiles of 1-3, respectively, p<0.001) and serum Fetuin-B (3.85±1.39, 4.09±1.40, and 4.27±1.46 µg/ml, p=0.047). Multivariable linear regression analyses with adjustment for potential confounding factors, even NAFLD per se, showed that serum Fetuin-B were significantly and positively associated with ba-PWV, with standardized regression coefficients (β) ranging from 0.055 to 0.075 (all p-values <0.05) in different models. However, the significant relationship between serum Fetuin-B and ba-PWV disappeared with further adjustment for insulin resistance. Serum Fetuin-B was not significantly associated with ankle-brachial index (ABI). All genotypes of the four tested FETUB tagging SNPs were not significantly associated with either ba-PWV or ABI with adjustment for potential confounding factors.

Conclusion: Serum Fetuin-B was positively associated with ba-PWV and may link liver fat accumulation to subclinical atherosclerosis via insulin resistance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5551/jat.49619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242228PMC
May 2020

Serum Uric Acid Is Independently Associated with Risk of Obstructive Sleep Apnea-Hypopnea Syndrome in Chinese Patients with Type 2 Diabetes.

Dis Markers 2019 3;2019:4578327. Epub 2019 Apr 3.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China.

Purpose: We aimed to investigate the association between serum uric acid (SUA) levels and obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with type 2 diabetes.

Methods: A cross-sectional study of 212 type 2 diabetes mellitus (T2DM) patients was conducted in Xiamen, China. All patients underwent polysomnography (PSG) recordings for OSAHS diagnosis. Patients were grouped according to the apnea-hypopnea index (AHI) as mild (5-14.9), moderate (15-29.9), and severe (≧30) OSAHS. Patients with AHI ≤ 4.9 served as the control group. Weight, body mass index (BMI), SUA, liver function, renal function, blood pressure, lipid profiles, and glycemic parameters were measured.

Results: A total of 158 patients (101 men and 57 women) with complete data were analyzed in this study. 127 patients were identified as OSAHS. Among the 127 patients with OSAHS, 56 (44.1%), 37 (29.1%), and 34 (26.8%) had mild, moderate, and severe OSAHS, respectively. Correlation analyses showed that the SUA level was significantly related to the apnea-hypopnea index (AHI) ( = 0.194, = 0.016). The level of SUA was significantly higher among OSAHS patients compared to the control group (control group: 333.14 ± 80.52 mol/L, mild group: 345.50 ± 90.27 mol/L, moderate group: 363.59 ± 134.26 mol/L, and severe group: 428.37 ± 123.58 mol/L and = 0.029). Multivariable logistic regression analyses showed that SUA was the independent risk factor for OSAHS (OR: 1.006, 95% CI: 1.001-1.011, = 0.020).

Conclusions: The SUA level is significantly associated with the severity of OSAHS and should be controlled when managing OSAHS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2019/4578327DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590532PMC
December 2019

Fetuin-B Links Nonalcoholic Fatty Liver Disease to Chronic Kidney Disease in Obese Chinese Adults: A Cross-Sectional Study.

Ann Nutr Metab 2019 9;74(4):287-295. Epub 2019 Apr 9.

Xiamen Diabetes Institute, The First Affiliated Hospital, Xiamen University, Xiamen, China,

Background: There is no evidence available on the association of Fetuin-B with chronic kidney disease (CKD), and mechanisms linking nonalcoholic fatty liver disease (NAFLD) to CKD are not fully understood. We aimed to explore the independent associations and potential mechanisms of Fetuin-B and NAFLD with CKD.

Methods: A cross-sectional study of 1,072 Chinese adults who underwent serum Fetuin-B test and hepatic ultrasonography scanning was conducted in Xiamen, China. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or the presence of albuminuria.

Results: Subjects with CKD showed significantly higher prevalence of NAFLD (69.5 vs. 57.2%, p < 0.001) and serum Fetuin-B levels (4.32 ± 1.45 vs. 4.05 ± 1.36 µg/mL, p = 0.007) than their controls. Increased serum Fetuin-B was also significantly associated with increased levels of fasting insulin and homeostasis model assessment - insulin resistance (both p values < 0.05). NAFLD and higher serum Fetuin-B were significantly associated with increased risk of CKD, and the unadjusted ORs (95% CIs) were 1.701 (1.256-2.303, p = 0.001) and 1.213 (1.053-1.399, p = 0.008, per SD increase of Fetuin-B), respectively. With adjustment for potential confounding factors, including metabolic/insulin resistance syndrome, NAFLD but not serum Fetuin-B was still significantly associated with increased risk of CKD, and the adjusted ORs (95% CIs) were 1.820 (1.327-2.496, p < 0.001) and 1.116 (0.959-1.298, p = 0.153, per SD increase of Fetuin-B), respectively.

Conclusions: Fetuin-B might link NAFLD to CKD via inducing insulin resistance, and NAFLD contributes independently to the pathogenesis of CKD via multiple mechanisms besides of metabolic/insulin resistance syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000499843DOI Listing
May 2020

Risk factors for delayed hemorrhage after colonoscopic postpolypectomy: Polyp size and operative modality.

JGH Open 2019 Feb 9;3(1):61-64. Epub 2018 Nov 9.

Department of Gastroenterology and Hepatology Shanghai Tenth People's Hospital of TongJi University Shanghai China.

Background And Aim: Delayed postpolypectomy hemorrhage is relatively common, with occasional extensive blood loss, endangering life. This study aimed to determine the factors associated with postoperative hemorrhage.

Methods: The study was a retrospective cohort study of patients hospitalized for colonoscopic polypectomy at the Department of Gastroenterology and Hepatology, Tenth People's Hospital of Tongji University, China, between January and December 2015. Data on gender, age, bowel preparation, location, size, number of polyps, operative modality, pathology, and operation practitioner were collected. Patients were divided into two groups based on the presence or absence of postoperative hemorrhage.

Results: A total of 1962 polyps were detected in patients and they underwent polypectomy; hemorrhage occurred in 41 cases. A correlation was demonstrated between postpolypectomy hemorrhage and each of the following factors: polyp size and operative modality. The odds ratio (OR) was 4.535 (95% confidence interval [CI], 2.331-8.823) for 1-2-cm polyps, 4.008 (95% CI, 0.904-17.776) for 2-3-cm polyps, and 22.407 (95% CI, 5.783-86.812) for ≥3-cm polyps. Compared with argon plasma coagulation, OR was 9.128 (95% CI, 3.548-23.486) for endoscopic mucosal resection and 31.257 (95% CI, 7.009-139.395) for endoscopic submucosal dissection.

Conclusions: The independent risk factors for delayed postpolypectomy hemorrhage include polyp size and operative modality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jgh3.12106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386734PMC
February 2019

Independent Association of Serum Fibroblast Growth Factor 21 Levels With Impaired Liver Enzymes in Hyperthyroid Patients.

Front Endocrinol (Lausanne) 2018 14;9:800. Epub 2019 Jan 14.

Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

Fibroblast growth factor 21 (FGF21) is identified as a potential biomarker for liver diseases. However, information is limited regarding serum FGF21 and impaired liver function in hyperthyroidism. We aim to determine the potential association of serum FGF21 levels with impaired liver enzymes in hyperthyroid patients. In this case-control study, 105 normal subjects and 122 overt hyperthyroid patients were included. Among them, 41 hyperthyroid patients who obtained euthyroid status after thionamide treatment received second visit. Serum FGF21 levels were determined using the ELISA method. Compared to the normal subjects, patients with hyperthyroidism had significantly elevated serum liver enzymes, including alanine transaminase (ALT) ( < 0.001), aspartate aminotransferase (AST) ( < 0.001) levels, as well as FGF21 levels ( < 0.001). Further analysis showed serum FGF21 ( < 0.05), as well as thyroid hormone (TH) free T3 ( < 0.05), free T4 ( < 0.05) levels were higher in hyperthyroid patients with impaired liver enzymes than in those with normal liver enzymes. After reversal of hyperthyroid state, elevated serum FGF21 levels in hyperthyroid patients declined significantly ( < 0.001), with a concomitant decrease in serum ALT ( < 0.001), AST ( < 0.001) levels. Correlation analysis showed close correlation between FGF21 and ALT ( < 0.002), AST ( < 0.012), free T3 ( < 0.001), free T4 ( < 0.001). Further logistic regression analysis revealed FGF21 is significantly associated with elevated ALT [Odds Ratio, OR 1.79, (95% confidence interval, CI), (1.30-2.47), < 0.001], AST [1.59 (1.07-2.34), < 0.020]. After adjustment of potential confounders, the association between FGF21 and elevated ALT remained significant [1.42 (1.01-1.99), < 0.043]. In conclusion, serum FGF21 is independently associated with impaired liver enzymes in hyperthyroid patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fendo.2018.00800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339876PMC
January 2019

The rs4686434 variant in the fetuin B (FETUB) locus is associated with intrahepatic triglyceride content in obese Chinese adults.

J Diabetes 2018 Dec 22;10(12):916-925. Epub 2018 May 22.

Xiamen Diabetes Institute, The First Affiliated Hospital, Xiamen University, Xiamen, China.

Background: This study explored associations of genetic variants in the fetuin B (FETUB) locus with intrahepatic triglyceride (IHTG) content.

Methods: Four tagging single-nucleotide polymorphisms (SNPs) of the FETUB locus and patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 and transmembrane 6 super family member 2 (TM6SF2) rs58542926 were genotyped in 418 obese Chinese adults in whom serum FETUB and IHTG were measured.

Results: Subjects carrying the minor G allele for FETUB rs4686434 (AG/GG) had lower serum FETUB levels (mean [±SD] 3.89 ± 1.36 vs 4.22 ± 1.46 μg/mL; P = 0.021) and IHTG content (12.7 ± 9.4% vs 14.6 ± 9.8%; P = 0.045) than their controls (AA), whereas IHTG content was higher in those carrying the minor G allele for PNPLA3 rs738409 (CG/GG) than in their controls (CC; 14.5 ± 10.1% vs 12.0 ± 8.6%; P = 0.012). After adjusting for potential confounders, IHTG content was lower in carriers of the minor G allele for FETUB rs4686434 (AG/GG vs AA, β -2.27 ± 0.91, P = 0.012), but was higher in carriers of the minor G allele for PNPLA3 rs738409 (CG/GG vs CC, β 2.65 ± 0.97, P = 0.006). There was a significant joint effect between FETUB rs4686434 and PNPLA3 rs738409 on IHTG content, with increasing genetic risk score (counting the risk allele of A in rs4686434 and G in rs738409) being associated with higher IHTG content (β 1.85 ± 0.48, P <0.001).

Conclusions: Carrying the minor G allele for FETUB rs4686434 was significantly associated with decreased IHTG content and may affect hepatic triglyceride accumulation in individuals at high risk of non-alcoholic fatty liver disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1753-0407.12774DOI Listing
December 2018

Fetuin-B links nonalcoholic fatty liver disease to type 2 diabetes via inducing insulin resistance: Association and path analyses.

Cytokine 2018 08 30;108:145-150. Epub 2018 Mar 30.

Xiamen Diabetes Institute, The First Affiliated Hospital, Xiamen University, Xiamen, China; Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China. Electronic address:

Objective: Laboratory models suggested that Fetuin-B impaired insulin action in myotubes and hepatocytes and caused glucose intolerance in mice. We aimed to explore the independent associations and pathways among serum Fetuin-B, nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D).

Methods: A cross-sectional study of 1318 obese adults who underwent serum Fetuin-B test and hepatic ultrasonography scanning was conducted in Xiamen, China. Multivariable logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence intervals (CI) of serum Fetuin-B level and NAFLD for T2D in different models with adjustment for potential confounders. Structural equation modeling (SEM) was used to examine the paths among NAFLD, serum Fetuin-B, metabolic/insulin resistance syndrome and T2D.

Results: Subjects with T2D or NAFLD showed significantly increased serum Fetuin-B levels compared to their controls (4.25 ± 1.35 vs. 4.08 ± 1.38 µg/ml for diabetes; and 4.26 ± 1.41 vs. 4.07 ± 1.33 µg/ml for NAFLD; both p-values < 0.05). NAFLD and higher serum Fetuin-B were significantly associated with higher risk of T2D with adjustment for sociodemographic and lifestyle habits; and the adjusted ORs (95%CIs) were 2.90 (2.17-3.87, p < 0.001) and 1.16 (1.01-1.32, p = 0.032), respectively. With further adjustment for metabolic/insulin resistance syndrome (BMI, systolic and diastolic BP, triglyceride, total cholesterol, HDL- and LDL-cholesterol, HOMA-IR and serum uric acid), NAFLD but not serum Fetuin-B was significantly associated with increased risk of T2D (ORs (95%CIs): 1.58 (1.12-2.21, p = 0.009) and 1.07 (0.92-1.23, p = 0.384), respectively). A one pathway model by using SEM fitted well (χ = 497.92, p < 0.001; CFI = 0.965; TLI = 0.926; and RMSEA = 0.097) and showed that NAFLD increased serum Fetuin-B and elevated Fetuin-B increased fasting insulin level, which in turn induced insulin resistance and T2D. Besides, NAFLD increased the risk of T2D directly in addition to its indirect effects of inducing metabolic/insulin resistance syndrome which in turn increased the risk of T2D.

Conclusions: Fetuin-B links NAFLD to T2D via inducing insulin resistance, and NAFLD contributes to the pathogenesis of T2D via multiple mechanisms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cyto.2018.03.023DOI Listing
August 2018

Common genetic variants in the FETUB locus, genetically predicted fetuin-B levels, and risk of insulin resistance in obese Chinese adults.

Medicine (Baltimore) 2017 Dec;96(50):e9234

Xiamen Diabetes Institute Epidemiology Research Unit, the First Affiliated Hospital School of Public Health Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University Department of Endocrinology and Diabetes, the Teaching Hospital of Fujian Medical University, Xiamen, China.

Elevated serum fetuin-B is suggested to be associated with insulin resistance, but it is unknown if this association is causal. The aim of this study was to explore the potential causal relationship between fetuin-B and insulin resistance.We used Mendelian randomization analysis by incorporating information of genetic variants in FETUB and serum fetuin-B concentrations with insulin resistance in 1148 obese Chinese adults.Common genetic variants (FETUB rs4686434, rs6785067, and rs3733159) were significantly associated with serum fetuin-B concentrations but not with insulin resistance. Higher serum fetuin-B levels were significantly associated with increased homeostasis model assessment of insulin resistance (HOMA-IR) (0.17 [95%CI: 0.01 to 0.32, P = .037] 10 mol IU L higher per SD). However, Mendelian randomization analysis using 3 single-nucleotide polymorphisms as instrumental variables did not support a significant association between genetically predicted fetuin-B levels and HOMA-IR (-0.09 [95%CI: -0.62 to 0.44, P = .738] 10 mol IU L lower per SD). The regression coefficients for measured and genetically predicted fetuin-B concentrations on HOMA-IR were significantly different (P <.001).This study suggests the association between fetuin-B and insulin resistance may not be causal. Future studies on the nongenetic determinants of serum fetuin-B concentration to assess if such unmeasured factors may confound the association between fetuin-B and insulin resistance as well as more pathway analysis for this association are warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000009234DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815766PMC
December 2017

Serum fetuin-B is positively associated with intrahepatic triglyceride content and increases the risk of insulin resistance in obese Chinese adults: A cross-sectional study.

J Diabetes 2018 Jul 5;10(7):581-588. Epub 2018 Jan 5.

Xiamen Diabetes Institute, Xiamen, China.

Background: Fetuin-B impairs insulin action in myotubes and hepatocytes and causes glucose intolerance in mice. This study explored the correlation between serum fetuin-B and intrahepatic triglyceride (IHTG) content, and the association between fetuin-B and the risk of insulin resistance in the general adult population.

Methods: A cross-sectional study of 1318 obese adults who underwent serum fetuin-B testing and hepatic ultrasonography was conducted in Xiamen, China. The IHTG content was determined in 428 subjects by magnetic resonance spectroscopy.

Results: Non-alcoholic fatty liver disease prevalence was significantly higher in those with the highest serum fetuin-B concentrations and the highest IHTC content (Tertile 3) than in subjects in Tertiles 1 and 2 (62.6% vs 60.7% and 54.3%, respectively [P = 0.032], and 15.3% vs 12.8% and 12.7%, respectively [P = 0.049]). There was a significant association between increasing serum fetuin-B tertiles and both increasing fasting insulin concentrations (mean [± SD] 11.9 ± 6.8, 12.7 ± 7.6, and 13.3 ± 6.4 mIU/L in Tertiles 1, 2 and 3, respectively; P = 0.006) and prevalence of insulin resistance (54.4%, 58.9%, and 64.5% in Tertiles 1, 2 and 3, respectively; P = 0.010). In linear regression analysis, IHTG content was independently and positively correlated with serum fetuin-B (regression coefficient 0.015; P = 0.045). With adjustment for potential confounders, serum fetuin-B was independently associated with increased risk of insulin resistance, with an adjusted odds ratio per standard deviation increase in fetuin-B of 1.14 (95% confidence interval 1.01-1.30; P = 0.031).

Conclusions: The results demonstrate the role of fetuin-B linking liver fat accumulation to insulin resistance in humans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1753-0407.12632DOI Listing
July 2018

Evaluation of the three-in-one team-based care model on hierarchical diagnosis and treatment patterns among patients with diabetes: a retrospective cohort study using Xiamen's regional electronic health records.

BMC Health Serv Res 2017 Nov 28;17(1):779. Epub 2017 Nov 28.

Xiamen Diabetes Institute, No.55 Zhenhai Road, Xaimen, 361003, China.

Background: Xiamen is a pilot city in China for hierarchical diagnosis and treatment reform of non-communicable diseases, especially diabetes. Since 2012, Xiamen has implemented a program called the "three-in-one", a team-based care model for the treatment of diabetes, which involves collaboration between diabetes specialists, general practitioners, and health managers. In addition, the program provides financial incentives to improve care, as greater accessibility to medications through community health care centers (CHCs). The aim of this study was to evaluate the effectiveness of these policies in shifting visits from general hospitals to CHCs for the treatment of type 2 diabetes mellitus (T2DM).

Method And Materials: A retrospective observational cohort study was conducted using Xiamen's regional electronic health record (EHR) database, which included 90% of all patients registered since 2012. Logistic regression was used to derive the adjusted odds ratio (OR) for patients shifting from general hospitals to CHCs. Among patients treated at hospitals, Kaplan-Meier(KM) curves were constructed to evaluate the time from each policy introduction until the switch to CHCs. A k-means clustering analysis was conducted to identify patterns of patient care-seeking behavior.

Results: In total, 89,558 patients and 2,373,524 visits were included. In contrast to increased outpatient visits to general hospitals in China overall, the percentage of visits to CHCs in Xiamen increased from 29.7% in 2012 to 66.5% in 2016. The most significant and rapid shift occurred in later periods after full policy implementation. Three clusters of patients were identified with different levels of complications and health care-seeking frequency. All had similar responses to the policies.

Conclusions: The "three-in-one" team-based care model showed promising results for building a hierarchical health care system in China. These policy reforms effectively increased CHCs utilization among diabetic patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12913-017-2705-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704596PMC
November 2017
-->