BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes...BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes have an increased risk of hip and vertebral fractures.AIM To assess lumbar spine trabecular volumetric BMD(vBMD)across different BMI categories in individuals with and without diabetes.METHODS This cross-sectional study included 966 men over 50 years old and 1001 postmenopausal women from the Pinggu Metabolic Disease Study.The vBMD of lumbar vertebrae 2 through 4 was measured using quantitative computed tomography.Total adipose tissue,subcutaneous adipose tissue(SAT),visceral adipose tissue(VAT),and lumbar skeletal muscle area were also quantified.RESULTS In men with obesity(P=0.038)and overweight(P=0.032),vBMD was significantly higher in the diabetes group compared to non-diabetic men.After adjusting for age and sex,no significant saturation effect between BMI and BMD was found in participants with diabetes or in women without diabetes.However,a BMI threshold of 22.33 kg/m²indicated a saturation point for vBMD in nondiabetic men.Independent predictors of vBMD in men included age(r=-0.387,P<0.001),BMI(r=0.130,P=0.004),and VAT(r=-0.145,P=0.001).For women,significant predictors were age(r=-0.594,P<0.001),BMI(r=0.157,P=0.004),VAT(r=-0.112,P=0.001),and SAT(r=-0.068,P=0.035).CONCLUSION The relationship between BMI and trabecular vBMD differs in individuals with and without diabetes.Overweight and obese men with diabetes exhibit higher vBMD.展开更多
The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-loweri...The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic treatments.Recent studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 diabetes.However,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary intervention.It highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with CHD.The consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty fields.Additionally,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.展开更多
Background： Previous studies suggested that zinc level was related to relationship between zinc level and all the microvascular complications in a certain diabetic microvascular complication. However, the type 2 diab...Background： Previous studies suggested that zinc level was related to relationship between zinc level and all the microvascular complications in a certain diabetic microvascular complication. However, the type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level. Methods： We included the hospitalized patients with type 2 diabetes （T2D） at our department from May 30, 2013 to March 31,2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level. Results： The 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy （P 〈 0.001）, diabetic nephropathy （DN, P 〈 0.001 ）, or diabetic peripheral neuropathy （P = 0.002） compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN （odds ratio = 0.869, 95% confidence interval = 0.765-0.987, P 〈 0.05）. The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A I c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels. Conclusions： Lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.展开更多
To the Editor：Diabetes caused by mitochondrial tRNALeu（UUR） A3243G mutation is one of the most common types ofmitochondrial diabetes mellitus （MDM）.Seventeen years ago,we reported that the prevalence of MDM was ...To the Editor：Diabetes caused by mitochondrial tRNALeu（UUR） A3243G mutation is one of the most common types ofmitochondrial diabetes mellitus （MDM）.Seventeen years ago,we reported that the prevalence of MDM was 0.4％ in clinically diagnosed type 2 diabetes mellitus （T2DM） patients （n =716）.[1] Recently,we reviewed all the studies reporting MDM cases from grade three and first-class hospitals in China （unpublished） and found that the prevalence of MDM in a pooled randomly selected T2DM population was 0.64％.MDM patients are usually characterized by early age at diagnosis,low beta-cell function,and lack of obesity,insulin resistance,and autoantibodies associated with type 1 diabetes mellitus （T1DM）.展开更多
基金National Natural Science Foundation of China,No.81970698 and No.81900805Peking University People's Hospital Research and Development Funds,No.Project RS2022-03。
文摘BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes have an increased risk of hip and vertebral fractures.AIM To assess lumbar spine trabecular volumetric BMD(vBMD)across different BMI categories in individuals with and without diabetes.METHODS This cross-sectional study included 966 men over 50 years old and 1001 postmenopausal women from the Pinggu Metabolic Disease Study.The vBMD of lumbar vertebrae 2 through 4 was measured using quantitative computed tomography.Total adipose tissue,subcutaneous adipose tissue(SAT),visceral adipose tissue(VAT),and lumbar skeletal muscle area were also quantified.RESULTS In men with obesity(P=0.038)and overweight(P=0.032),vBMD was significantly higher in the diabetes group compared to non-diabetic men.After adjusting for age and sex,no significant saturation effect between BMI and BMD was found in participants with diabetes or in women without diabetes.However,a BMI threshold of 22.33 kg/m²indicated a saturation point for vBMD in nondiabetic men.Independent predictors of vBMD in men included age(r=-0.387,P<0.001),BMI(r=0.130,P=0.004),and VAT(r=-0.145,P=0.001).For women,significant predictors were age(r=-0.594,P<0.001),BMI(r=0.157,P=0.004),VAT(r=-0.112,P=0.001),and SAT(r=-0.068,P=0.035).CONCLUSION The relationship between BMI and trabecular vBMD differs in individuals with and without diabetes.Overweight and obese men with diabetes exhibit higher vBMD.
文摘The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic treatments.Recent studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 diabetes.However,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary intervention.It highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with CHD.The consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty fields.Additionally,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.
文摘Background： Previous studies suggested that zinc level was related to relationship between zinc level and all the microvascular complications in a certain diabetic microvascular complication. However, the type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level. Methods： We included the hospitalized patients with type 2 diabetes （T2D） at our department from May 30, 2013 to March 31,2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level. Results： The 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy （P 〈 0.001）, diabetic nephropathy （DN, P 〈 0.001 ）, or diabetic peripheral neuropathy （P = 0.002） compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN （odds ratio = 0.869, 95% confidence interval = 0.765-0.987, P 〈 0.05）. The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A I c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels. Conclusions： Lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.
文摘To the Editor：Diabetes caused by mitochondrial tRNALeu（UUR） A3243G mutation is one of the most common types ofmitochondrial diabetes mellitus （MDM）.Seventeen years ago,we reported that the prevalence of MDM was 0.4％ in clinically diagnosed type 2 diabetes mellitus （T2DM） patients （n =716）.[1] Recently,we reviewed all the studies reporting MDM cases from grade three and first-class hospitals in China （unpublished） and found that the prevalence of MDM in a pooled randomly selected T2DM population was 0.64％.MDM patients are usually characterized by early age at diagnosis,low beta-cell function,and lack of obesity,insulin resistance,and autoantibodies associated with type 1 diabetes mellitus （T1DM）.
