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Cai SS, Zheng TY, Wang KY, Zhu HP. Clinical study of different prediction models in predicting diabetic nephropathy in patients with type 2 diabetes mellitus. World J Diabetes 2024; 15:43-52. [PMID: 38313855 PMCID: PMC10835501 DOI: 10.4239/wjd.v15.i1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/25/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Among older adults, type 2 diabetes mellitus (T2DM) is widely recognized as one of the most prevalent diseases. Diabetic nephropathy (DN) is a frequent complication of DM, mainly characterized by renal microvascular damage. Early detection, aggressive prevention, and cure of DN are key to improving prognosis. Establishing a diagnostic and predictive model for DN is crucial in auxiliary diagnosis. AIM To investigate the factors that impact T2DM complicated with DN and utilize this information to develop a predictive model. METHODS The clinical data of 210 patients diagnosed with T2DM and admitted to the First People's Hospital of Wenling between August 2019 and August 2022 were retrospectively analyzed. According to whether the patients had DN, they were divided into the DN group (complicated with DN) and the non-DN group (without DN). Multivariate logistic regression analysis was used to explore factors affecting DN in patients with T2DM. The data were randomly split into a training set (n = 147) and a test set (n = 63) in a 7:3 ratio using a random function. The training set was used to construct the nomogram, decision tree, and random forest models, and the test set was used to evaluate the prediction performance of the model by comparing the sensitivity, specificity, accuracy, recall, precision, and area under the receiver operating characteristic curve. RESULTS Among the 210 patients with T2DM, 74 (35.34%) had DN. The validation dataset showed that the accuracies of the nomogram, decision tree, and random forest models in predicting DN in patients with T2DM were 0.746, 0.714, and 0.730, respectively. The sensitivities were 0.710, 0.710, and 0.806, respectively; the specificities were 0.844, 0.875, and 0.844, respectively; the area under the receiver operating characteristic curve (AUC) of the patients were 0.811, 0.735, and 0.850, respectively. The Delong test results revealed that the AUC values of the decision tree model were lower than those of the random forest and nomogram models (P < 0.05), whereas the difference in AUC values of the random forest and column-line graph models was not statistically significant (P > 0.05). CONCLUSION Among the three prediction models, random forest performs best and can help identify patients with T2DM at high risk of DN.
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Affiliation(s)
- Sha-Sha Cai
- Department of Nephrology, The First People’s Hospital of Wenling, Wenling 317500, Zhejiang Province, China
| | - Teng-Ye Zheng
- Department of Nephrology, The First People’s Hospital of Wenling, Wenling 317500, Zhejiang Province, China
| | - Kang-Yao Wang
- Department of Nephrology, The First People’s Hospital of Wenling, Wenling 317500, Zhejiang Province, China
| | - Hui-Ping Zhu
- Department of Nephrology, The First People’s Hospital of Wenling, Wenling 317500, Zhejiang Province, China
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Chen N, Zeng R, Xu C, Lai F, Chen L, Wang C, Pei L, Li Z, Li Y, Xiao H, Cao X. Low Serum Creatinine Levels in Early Pregnancy Are Associated with a Higher Incidence of Postpartum Abnormal Glucose Metabolism among Women with Gestational Diabetes Mellitus: A Retrospective Cohort Study. Nutrients 2023; 15:2193. [PMID: 37432359 DOI: 10.3390/nu15092193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 07/12/2023] Open
Abstract
The predictive factors for the progression from gestational diabetes mellitus (GDM) to type 2 diabetes remain incompletely elucidated. Our objective was to investigate the link between serum creatinine, a proxy for skeletal muscle mass, and the development of postpartum abnormal glucose metabolism (AGM). METHODS A retrospective review of the medical records of 501 women with GDM was conducted, all of whom underwent a 75 g oral glucose tolerance test (OGTT) between 4 and 12 weeks postpartum. Women were grouped based on quartiles of serum creatinine at the first antenatal visit to estimate the association between serum creatinine and postpartum AGM incidence. RESULTS Compared with the highest quartile of creatinine, lower quartiles were substantially linked to an increased incidence of postpartum AGM (adjusted odds ratios 3.37 [95% CI 1.77-6.42], 2.42 [95% CI 1.29-4.51] and 2.27 [95% CI 1.23-4.18], respectively). The generalized additive model suggested a linear relationship between serum creatinine levels and the risk of postpartum AGM below 68 µmol/L of serum creatinine levels. A decrease of 2 μmol/L in serum creatinine levels was found to be associated with a 10% increase in the odds of developing postpartum AGM. Linear regression revealed that a low serum creatinine level was linked to a higher postpartum 2-h glucose level and a decreased insulinogenic index (p = 0.007 and p = 0.027, respectively). CONCLUSIONS An association was observed between lower serum creatinine levels in early pregnancy and an increased risk of postpartum AGM and poorer β-cell function in women with a recent history of GDM. Further research is needed to understand the mechanisms underlying our findings, as well as the role of skeletal muscle mass or nutritional status in early pregnancy on later glucose metabolism.
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Affiliation(s)
- Nan Chen
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Rui Zeng
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Changliu Xu
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Li Chen
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Chenxue Wang
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Ling Pei
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Zhuyu Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
| | - Xiaopei Cao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
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3
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Li R, He M, Yang Q, Liang Z, Li Y, Huang L, Wu R, Huang J. Association between serum creatinine and type 2 diabetes in the Chinese population: a retrospective cohort study. Sci Rep 2023; 13:6806. [PMID: 37100791 PMCID: PMC10133309 DOI: 10.1038/s41598-023-33878-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/20/2023] [Indexed: 04/28/2023] Open
Abstract
The relationship between serum creatinine and type 2 diabetes is limited. We aimed to investigate the association of baseline serum creatinine and new-onset type 2 diabetes in Chinese population. This retrospective cohort study was conducted using data from the health screening program in China. The population were divided into four groups based on serum creatinine levels, and the outcome of interest was the occurrence of a diabetic event. Cox proportional risk model was used to assess the independent effect of baseline serum creatinine level on future diabetes risk. Sensitivity and subgroup analysis were used to verify the reliability of the results. After an average follow-up of 3.12 years, among 201,298 individuals aged ≥ 20 years, 3389 patients developed diabetes. Compared with participants in quartile 2-4 (> 51.6umol/L for female, > 71.8umol/L for male,), a significantly higher risk of new-onset Type 2 Diabetes (OR, 1.15; 95%CI: 1.07-1.23) was found in those in quartile 1 (< 51.6umol/L for female, < 71.8umol/L for male). Moreover, Similar results were found in various subgroups stratified by age, BMI, TG, TC, FPG and family history group. Low serum creatinine is independently associated with increased risk of type 2 diabetes in Chinese adults. It was also stable in various subgroups stratified.
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Affiliation(s)
- Rugang Li
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China
| | - Min He
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China
| | - Qilin Yang
- Department of Critical Care, the Second Affiliated Hospital of Guangzhou Medical University, No. 250 Changgang East Road, Haizhu District, Guangzhou, Guangdong, China
| | - Zezhi Liang
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China
| | - Ying Li
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China
| | - Ling Huang
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China
| | - Rong Wu
- Department of Cardiology, Chenzhou Third People's Hospital, Chenzhou, 423000, Hunan, China
| | - Jieping Huang
- Department of Nephrology, Yuebei People's Hospital, No. 133 South Huimin Road, Shaoguan, 512026, Guangdong, China.
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Wu Q, Yan R, Yang H, Wang Y, Zhang C, Zhang J, Cui Z, Wang Y, Sun W. Qing-Re-Xiao-Zheng-Yi-Qi formula relieves kidney damage and activates mitophagy in diabetic kidney disease. Front Pharmacol 2022; 13:992597. [PMID: 36605399 PMCID: PMC9807870 DOI: 10.3389/fphar.2022.992597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction: Qing-Re-Xiao-Zheng-Yi-Qi Formula is an effective prescription in diabetic kidney disease treatment, we have confirmed the efficacy of Qing-Re-Xiao-Zheng therapy in diabetic kidney disease through clinical trials. In this study, we investigated the mechanisms of Qing-Re-Xiao-Zheng-Yi-Qi Formula in the treatment of diabetic kidney disease. Methods: We used Vanquish UHPLCTM to analyze the chemical profiling of Qing-Re-Xiao-Zheng-Yi-Qi Formula freeze-dried powder. We constructed diabetic kidney disease rat models induced by unilateral nephrectomy and high-dose streptozocin injection. We examined blood urea nitrogen, serum creatinine, serum glucose, total cholesterol, triglyceride, serum total protein, albumin, alanine aminotransferase, aspartate aminotransferase and 24 h urinary total protein in diabetic kidney disease rats. The renal pathological changes were observed by HE, Masson, PAS stanning and transmission electron microscopy. The levels of fibrosis-related proteins and mitophagy-related proteins were detected by western blot analysis. We also conducted an immunofluorescence co-localization analysis on podocytes to further investigate the effect of Qing-Re-Xiao-Zheng-Yi-Qi Formula treatment on mitophagy. Results: A total of 27 constituents in Qing-Re-Xiao-Zheng-Yi-Qi Formula were tentatively identified. We found PINK1/Parkin-mediated mitophagy was inhibited in diabetic kidney disease. Qing-Re-Xiao-Zheng-Yi-Qi Formula treatment could raise body weight and reduce renal index, reduce proteinuria, improve glycolipid metabolic disorders, ameliorate renal fibrosis, and reduce the expression of Col Ⅳ and TGF-β1 in diabetic kidney disease rats. Qing-Re-Xiao-Zheng-Yi-Qi Formula treatment could also increase the expression of nephrin, activate mitophagy and protect podocytes in diabetic kidney disease rats and high glucose cultured podocytes. Conclusion: PINK1/Parkin-mediated mitophagy was inhibited in diabetic kidney disease, and Qing-Re-Xiao-Zheng-Yi-Qi Formula treatment could not only ameliorate pathological damage, but also promote mitophagy to protect podocytes in diabetic kidney disease.
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Affiliation(s)
- Qiaoru Wu
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Runze Yan
- Department of Nephrology, Beijing Dongcheng First People’s Hospital, Beijing, BJ, China
| | - Hanwen Yang
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Yixuan Wang
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Chao Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Jiale Zhang
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Zhaoli Cui
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China
| | - Yaoxian Wang
- Beijing University of Chinese Medicine, Beijing, BJ, China,*Correspondence: Yaoxian Wang, ; Weiwei Sun,
| | - Weiwei Sun
- Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, BJ, China,*Correspondence: Yaoxian Wang, ; Weiwei Sun,
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Mojsak P, Maliszewska K, Klimaszewska P, Miniewska K, Godzien J, Sieminska J, Kretowski A, Ciborowski M. Optimization of a GC-MS method for the profiling of microbiota-dependent metabolites in blood samples: An application to type 2 diabetes and prediabetes. Front Mol Biosci 2022; 9:982672. [PMID: 36213115 PMCID: PMC9538375 DOI: 10.3389/fmolb.2022.982672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Changes in serum or plasma metabolome may reflect gut microbiota dysbiosis, which is also known to occur in patients with prediabetes and type 2 diabetes (T2DM). Thus, developing a robust method for the analysis of microbiota-dependent metabolites (MDMs) is an important issue. Gas chromatography with mass spectrometry (GC–MS) is a powerful approach enabling detection of a wide range of MDMs in biofluid samples with good repeatability and reproducibility, but requires selection of a suitable solvents and conditions. For this reason, we conducted for the first time the study in which, we demonstrated an optimisation of samples preparation steps for the measurement of 75 MDMs in two matrices. Different solvents or mixtures of solvents for MDMs extraction, various concentrations and volumes of derivatizing reagents as well as temperature programs at methoxymation and silylation step, were tested. The stability, repeatability and reproducibility of the 75 MDMs measurement were assessed by determining the relative standard deviation (RSD). Finally, we used the developed method to analyse serum samples from 18 prediabetic (PreDiab group) and 24 T2DM patients (T2DM group) from our 1000PLUS cohort. The study groups were homogeneous and did not differ in age and body mass index. To select statistically significant metabolites, T2DM vs. PreDiab comparison was performed using multivariate statistics. Our experiment revealed changes in 18 MDMs belonging to different classes of compounds, and seven of them, based on the SVM classification model, were selected as a panel of potential biomarkers, able to distinguish between patients with T2DM and prediabetes.
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Affiliation(s)
- Patrycja Mojsak
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Katarzyna Maliszewska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | | | - Katarzyna Miniewska
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Godzien
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Julia Sieminska
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Adam Kretowski
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Michal Ciborowski
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
- *Correspondence: Michal Ciborowski,
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Tangjittipokin W, Srisawat L, Teerawattanapong N, Narkdontri T, Homsanit M, Plengvidhya N. Prevalence and Characteristics of Prediabetes and Metabolic Syndrome in Seemingly Healthy Persons at a Health Check-Up Clinic. J Multidiscip Healthc 2022; 15:1585-1594. [PMID: 35909422 PMCID: PMC9331204 DOI: 10.2147/jmdh.s374164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study investigated the prevalence and characteristics of prediabetes (PreDM) and metabolic syndrome (MetS) in seemingly healthy persons attending a health check-up clinic at a tertiary care hospital. Patients and Methods This was a cross-sectional study that enrolled 1213 subjects (339 male, 874 female) who underwent an annual health check-up at Siriraj Hospital, Bangkok, Thailand from 2009 to 2019. Factors that independently related to PreDM were analyzed using unconditional logistic regression analysis with adjustments for age, BMI, and gender. Results The prevalence of PreDM and MetS was 54.3% and 19.7% respectively. Participants with impaired fasting glucose (IFG) and glycated hemoglobin (HbA1c) 38.8–46.4 mmol/mol had significantly higher waist circumference (WC) and blood pressure (BP) compared to those with IFG or HbA1c 38.8–46.4 mmol/mol alone (P < 0.05). Among three PreDM subgroups, the average age was lowest in the HbA1c 38.8–46.4 mmol/mol subgroup (P < 0.001). PreDM participants with MetS were older (p = 0.03), had higher WC, BP, fasting plasma glucose and serum triglyceride level (all P < 0.001) but had lower serum high-density lipoprotein (HDL) cholesterol level (P < 0.001). Multivariate analysis revealed high MetS score, obesity, and low serum HDL cholesterol level to be independently associated with PreDM with odds ratios of 9.02 (95% confidence interval [CI]: 4.03–20.18), 1.8 (95% CI: 1.07–3.04), and 1.42 (95% CI: 1.02–1.96), respectively. Conclusion The prevalence of PreDM and MetS was relatively high in seemingly healthy persons. Distinct PreDM subgroups with or without MetS exhibited diverse clinical and biochemical features suggesting dissimilar pathogenesis.
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Affiliation(s)
- Watip Tangjittipokin
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand
| | - Lanraphat Srisawat
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand.,Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nipaporn Teerawattanapong
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand.,Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tassanee Narkdontri
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand.,Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Mayuree Homsanit
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nattachet Plengvidhya
- Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand.,Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Song DK, Hong YS, Sung YA, Lee H. Association of serum creatinine levels and risk of type 2 diabetes mellitus in Korea: a case control study. BMC Endocr Disord 2022; 22:4. [PMID: 34983489 PMCID: PMC8725385 DOI: 10.1186/s12902-021-00915-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/30/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Reduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. METHODS We analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated. RESULTS In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. CONCLUSIONS Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.
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Affiliation(s)
- Do Kyeong Song
- Department of Internal Medicine, Ewha Womans University School of Medicine, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, South Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University School of Medicine, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, South Korea
| | - Yeon-Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, South Korea
| | - Hyejin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, South Korea.
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Sun Y, Wang Z, Huang Z, Hu H, Han Y. The Association Between the Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio and the Risk of Progression to Diabetes From Prediabetes: A 5-year Cohort Study in Chinese Adults. Front Endocrinol (Lausanne) 2022; 13:947157. [PMID: 35923622 PMCID: PMC9340202 DOI: 10.3389/fendo.2022.947157] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Evidence regarding the relationship between the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-c) ratio and the risk of progression from prediabetes to diabetes remains limited. The purpose of our study was to investigate the relationship between the TG/HDL-C ratio and incident diabetes in prediabetic patients. METHODS This retrospective cohort study covered 32 regions and 11 cities in China and consecutively and non-selectively collected data from 15,017 patients with prediabetes who had received a health check from 2010 to 2016. Data were obtained from the DATADRYAD database (www.datadryad.org). The Cox proportional-hazards regression model with cubic spline functions and smooth curve fitting (cubic spline smoothing) was used to explore the non-linear relationship between the baseline TG/HDL-c ratio and the risk of diabetes in patients with prediabetes. In addition, we performed a series of sensitivity and subgroup analyses. RESULTS The mean age of the included individuals was 50.95 ± 13.48 years, and 9,745 (64.51%) were men. The median (interquartile range) TG/HDL-c ratio was 1.09 (0.69-1.72). During a median follow-up time of 3.05 years, 1,731 (11.46%) patients had a final diagnosis of diabetes. The analysis after adjusting for covariates showed that the TG/HDL-c ratio was positively related to incident diabetes in patients with prediabetes (HR = 1.111, 95% CI 1.061-1.164). Participants with the highest TG/HDL-c ratio (Q4) had higher diabetes incidence rates than those with the lowest TG/HDL-c ratio (Q1) (P < 0.001 for the trend). There was a non-linear relationship between the TG/HDL-c ratio and the risk of diabetes, and the inflection point of the TG/HDL-c ratio was 1.415. The effect sizes (HR) on the left and right sides of the inflection point were 1.336 (95% CI: 1.134-1.573) and 1.055 (95% CI: 0.988-1.126), respectively. The sensitivity analysis demonstrated the robustness of these results. CONCLUSION This study demonstrates a positive, non-linear relationship between the TG/HDL-c ratio and the risk of diabetes in Chinese patients with prediabetes. Aggressive intervention from a treatment perspective is required to lower the TG/HDL-c ratio below the inflection point (1.415) by lowering TG or increasing HDL-c levels.
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Affiliation(s)
- Yanfei Sun
- Department of Trauma Center/Burns, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhibin Wang
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Zhiqiang Huang
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, China
- *Correspondence: Haofei Hu, ; Yong Han,
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
- *Correspondence: Haofei Hu, ; Yong Han,
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9
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Osaki Y, Kuwahara K, Hu H, Nakagawa T, Yamamoto S, Honda T, Mizoue T. Shift work and the onset of type 2 diabetes: results from a large-scale cohort among Japanese workers. Acta Diabetol 2021; 58:1659-1664. [PMID: 34263404 DOI: 10.1007/s00592-021-01770-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/25/2021] [Indexed: 01/21/2023]
Abstract
AIMS Data are limited regarding how shift work is linked to the development of type 2 diabetes, especially among workers at high risk of diabetes. We examined the risk of diabetes according to shift-work conditions over several years among Japanese adults. METHODS This prospective study enrolled 17,515 workers (age 40-78 years). Shift work was self-reported at annual health examinations over time from 2004 to 2017 and categorized as shift workers or non-shift workers. Diabetes was defined as fasting plasma glucose, random glucose, HbA1c, and self-reported use of antidiabetic medications. The association of shift work and diabetes was quantified using Cox regression. RESULTS During a follow-up of 8.1 years in median, 2071 incident cases of diabetes were documented. Compared with non-shift work, shift work showed a significantly elevated hazard ratios of developing diabetes. Shift work showed a 19% (95% confidence intervals: 3-37%) higher hazard ratios for diabetes, after adjustment for demographic-, cardiometabolic-, and work-related factors. Further adjustment for lifestyle factors and body mass index did not materially change this association (a 16% increase; 95% confidence intervals, 1-34%). This relationship was replicated among workers with prediabetes. CONCLUSIONS Engaging in shift work may increase the risk of developing diabetes independently of lifestyle factors and body mass index, even among prediabetic workers.
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Affiliation(s)
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
| | - Huan Hu
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
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10
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Sarker MK, Tony SR, Siddique AE, Karim MR, Haque N, Islam Z, Islam MS, Khatun M, Islam J, Hossain S, Alam Saud Z, Miyataka H, Sumi D, Barchowsky A, Himeno S, Hossain K. Arsenic Secondary Methylation Capacity Is Inversely Associated with Arsenic Exposure-Related Muscle Mass Reduction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9730. [PMID: 34574656 PMCID: PMC8472591 DOI: 10.3390/ijerph18189730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/25/2022]
Abstract
Skeletal muscle mass reduction has been implicated in insulin resistance (IR) that promotes cardiometabolic diseases. We have previously reported that arsenic exposure increases IR concomitantly with the reduction of skeletal muscle mass among individuals exposed to arsenic. The arsenic methylation capacity is linked to the susceptibility to some arsenic exposure-related diseases. However, it remains unknown whether the arsenic methylation capacity affects the arsenic-induced reduction of muscle mass and elevation of IR. Therefore, this study examined the associations between the arsenic methylation status and skeletal muscle mass measures with regard to IR by recruiting 437 participants from low- and high-arsenic exposure areas in Bangladesh. The subjects' skeletal muscle mass was estimated by their lean body mass (LBM) and serum creatinine levels. Subjects' drinking water arsenic concentrations were positively associated with total urinary arsenic concentrations and the percentages of MMA, as well as inversely associated with the percentages of DMA and the secondary methylation index (SMI). Subjects' LBM and serum creatinine levels were positively associated with the percentage of DMA and SMI, as well as inversely associated with the percentage of MMA. HOMA-IR showed an inverse association with SMI, with a confounding effect of sex. Our results suggest that reduced secondary methylation capacity is involved in the arsenic-induced skeletal muscle loss that may be implicated in arsenic-induced IR and cardiometabolic diseases.
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Affiliation(s)
| | - Selim Reza Tony
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Abu Eabrahim Siddique
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Md. Rezaul Karim
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh; (M.R.K.); (M.S.I.)
| | - Nazmul Haque
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Zohurul Islam
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Md. Shofikul Islam
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh; (M.R.K.); (M.S.I.)
| | - Moriom Khatun
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Jahidul Islam
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Shakhawoat Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
| | - Hideki Miyataka
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan; (H.M.); (D.S.); (S.H.)
| | - Daigo Sumi
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan; (H.M.); (D.S.); (S.H.)
| | - Aaron Barchowsky
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Seiichiro Himeno
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan; (H.M.); (D.S.); (S.H.)
- Division of Health Chemistry, School of Pharmacy, Showa University, Tokyo 142-8555, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; (S.R.T.); (A.E.S.); (N.H.); (Z.I.); (M.K.); (J.I.); (S.H.); (Z.A.S.)
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11
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Ghazali FMM, W Ahmad WMA, Srivastava KC, Shrivastava D, Noor NFM, Akbar NAN, Aleng NA, Alam MK. A Study of Creatinine Level among Patients with Dyslipidemia and Type 2 Diabetes Mellitus using Multilayer Perceptron and Multiple Linear Regression. J Pharm Bioallied Sci 2021; 13:S795-S800. [PMID: 34447203 PMCID: PMC8375798 DOI: 10.4103/jpbs.jpbs_778_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022] Open
Abstract
Background and Objective: Dyslipidemia is one of the most important risk factors for coronary heart disease with diabetes mellitus. Diabetic dyslipidemia is correlated with reduced concentrations of high-density lipoprotein cholesterol, elevated concentrations of plasma triglycerides, and increased concentrations of dense small particles of low-density lipoprotein cholesterol. Furthermore, dyslipidemia is one of the factors that accelerate renal failure in patients with nephropathy that is observed to be higher in these patients. This paper aims to propose the variable selection using the multilayer perceptron (MLP) neural network methodology before performing the multiple linear regression (MLR) modeling. Dataset consists of patient with Dyslipidemia, and Type 2 Diabetes Mellitus was selected to illustrate the design-build methodology. According to clinical expert's opinion and based on their assessment, these variables were chosen, which comprises the level of creatinine, urea, total cholesterol, uric acid, sodium, and HbA1c. Materials and Methods: At the first stage, all the selected variables will be a screen for their clinical important point of view, and it was found that creatinine has a significant relationship to the level of urea reading, a total of cholesterol reading, and the level of uric acid reading. By considering the level of significance, α = 0.05, these three variables are being selected and used for the input of the MLP model. Then, the MLR is being applied according to the best variable obtained through MLP process. Results: Through the testing/out-sample mean squared error (MSE), the performance of MLP was assessed. MSE is an indication of the distance from the actual findings from our estimates. The smallest MSE of the MLP shows the best variable selection combination in the model. Conclusion: In this research paper, we also provide the R syntax for MLP better illustration. The key factors associated with creatinine were urea, total cholesterol, and uric acid in patients with dyslipidemia and type 2 diabetes mellitus.
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Affiliation(s)
| | | | - Kumar Chandan Srivastava
- Departments of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Saudi Arabia
| | - Deepti Shrivastava
- Preventive Dentistry, College of Dentistry, Jouf University, Saudi Arabia
| | - Nor Farid Mohd Noor
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nurul Asyikin Nizam Akbar
- Department of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nor Azlida Aleng
- Faculty of Ocean Engineering Technology and Informatics, Universiti MalaysiaTerengganu, Terengganu, Malaysia
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12
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Determinants of Longitudinal Change of Glycated Hemoglobin in a Large Non-Diabetic Population. J Pers Med 2021; 11:jpm11070648. [PMID: 34357115 PMCID: PMC8307008 DOI: 10.3390/jpm11070648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Although many cross-section studies have assessed the determinants of glycated hemoglobin (HbA1c), there have been limited studies designed to evaluate the temporal correlates of HbA1c in non-diabetic patients. This study aimed to identify the major determinants of longitudinal change of HbA1c in non-diabetic patients. This study included subjects from the 104,451 participants enrolled between 2012 and 2018 in the Taiwan Biobank. We only included participants with complete data at baseline and follow-up (n = 27,209). Patients with diabetes at baseline or follow-up (n = 3983) were excluded. Finally, 23,226 participants without diabetes at baseline and follow-up were selected in this study. △Parameters was defined as the difference between the measurement baseline and follow-up. Multivariable linear regression analysis was used to identify the major determinants of HbA1c longitudinal change (△HbA1c). During a mean 3.8 year follow-up, after multivariable analysis, new-onset hypertension (coefficient β: 0.014, p < 0.001), high △heart rate (coefficient β: 0.020, p = 0.002), high △BMI (coefficient β: 0.171, p = 0.028), high △fasting glucose (coefficient β: 0.107, p < 0.001), low △creatinine (coefficient β: −0.042, p < 0.001), high △total cholesterol (coefficient β: 0.040, p < 0.001), high △hemoglobin (coefficient β: 0.062, p < 0.001), high △GPT (coefficient β: 0.041, p = 0.001), and low △albumin (coefficient β: −0.070, p < 0.001) were significantly associated with high △HbA1c. In non-diabetic population, strategies to decrease the development of new-onset hypertension, resting heart rate, body mass index, fasting glucose, total cholesterol, and GPT and increase serum albumin level might be helpful in slowing the longitudinal change of HbA1c. In addition, increased hemoglobin and decreased serum creatinine over time also had an impact on the HbA1c elevation over time in non-diabetic population.
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13
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Wu Y, Hu H, Cai J, Chen R, Zuo X, Cheng H, Yan D. Applying latent class analysis to risk stratification of incident diabetes among Chinese adults. Diabetes Res Clin Pract 2021; 174:108742. [PMID: 33722702 DOI: 10.1016/j.diabres.2021.108742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To use latent class analysis to identify unobservable subpopulations amongst the heterogeneous population and explore the relationship between subpopulations and incident diabetes among Chinese adults. METHODS The retrospective study included 32,312 Chinese adults without diabetes at baseline. Latent class indicators included demographic and clinical variables. The outcome was incident diabetes. The relationship between latent class and outcome was evaluated with Cox proportional hazard regression analysis. RESULTS After screening, the two-class latent class model best fits the population. Participants in class 2 are characterized by higher age, body mass index, systolic and diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, serum creatinine, serum urea nitrogen, alanine aminotransferase, and a higher proportion of males, ever/current smokers and drinkers, but lower high-density lipoprotein cholesterol and a lower proportion of family history of diabetes. The risk of diabetes in class 2 was 5.451 times (HR: 6.451, 95%CI: 4.179-9.960, P < 0.00001) and 5.264 times (HR: 6.264, 95%CI: 4.680-8.385, P < 0.00001) higher than that in class 1 during 3-year and 5-year follow-up, respectively. CONCLUSIONS We used latent class analysis to identify two distinct subpopulations with differential risk of diabetes during 3-year and 5-year follow-up.
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Affiliation(s)
- Yang Wu
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China; Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong Province, China; Shenzhen University Health Science Center, Shenzhen 518071, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China; Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong Province, China; Shenzhen University Health Science Center, Shenzhen 518071, Guangdong Province, China
| | - Jinlin Cai
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China; Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong Province, China; Shantou University Medical College, Shantou 515000, Guangdong Province, China
| | - Runtian Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China; Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong Province, China; Shenzhen University Health Science Center, Shenzhen 518071, Guangdong Province, China
| | - Xin Zuo
- Department of Endocrinology, The Third People's Hospital of Shenzhen, Shenzhen 518116, Guangdong Province, China
| | - Heng Cheng
- Department of Endocrinology, The Third People's Hospital of Shenzhen, Shenzhen 518116, Guangdong Province, China
| | - Dewen Yan
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China; Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong Province, China; Shenzhen University Health Science Center, Shenzhen 518071, Guangdong Province, China.
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14
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Chao G, Zhu Y, Chen L. Role and Risk Factors of Glycosylated Hemoglobin Levels in Early Disease Screening. J Diabetes Res 2021; 2021:6626587. [PMID: 33880380 PMCID: PMC8049785 DOI: 10.1155/2021/6626587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To clarify the correlation among glycosylated hemoglobin (HbA1c), gender, age, fatty liver, and biochemical indicators through the analysis of big database, and to further investigate the risk factors affecting HbA1c, so as to lay a foundation for the study of HbA1c-related diseases and disease management. METHODS People who have been examined in Health Promotion Center from July 2018 to June 2019 were selected as the research objects. All data were analyzed using the Windows R software (version 3.5.1). Detailed medical history inquiry, laboratory examination, and B-ultrasound examination were carried out for the selected sample population. We determined the sample population according to the inclusion and exclusion criteria and, then, further grouped and analyzed the data. T-test or Mann-Whitney U test was used for continuous variable comparison, and chi-square test was used to compare categorical variables. Logistic regression analysis was used to analyze the risk factors of HbA1c. RESULTS A total of 23,933 subjects were included in this study. The HbA1c level of men was significantly higher than that of women, the HbA1c level of the group with diabetes was higher than that of the group with no diabetes, and the HbA1c level of the group with fatty liver was higher than that of the group with no fatty liver. In the group with no diabetes, the HbA1c level increased with weight gain. Age, gender (male), fatty liver, waist circumference, systolic blood pressure (SBP), triglyceride (TG), blood urea nitrogen (BUN), free thyroxine (FT4), and red blood cell (RBC) were the risk factors for elevated HbA1c level, while high-density lipoprotein cholesterol (HDL-C), uric acid (UA), creatinine (Cr), free triiodothyronine (FT3), and hemoglobin were protective factors. CONCLUSION Blood glucose, age, weight, gender, fatty liver, blood lipids, and UA are related to the increase of HbA1c level. HbA1c is related to many metabolic indexes and may be used as a marker for early detection of chronic diseases.
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Affiliation(s)
- Guanqun Chao
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
| | - Yue Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
| | - Liying Chen
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
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15
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Diabetes, prediabetes, and suicide deaths in a Japanese working population. J Psychosom Res 2020; 138:110246. [PMID: 33010680 DOI: 10.1016/j.jpsychores.2020.110246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/16/2020] [Accepted: 09/04/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the association of diabetes and prediabetes with suicide deaths in a Japanese working population. METHODS A nested case-control study was conducted using data from the Japan Epidemiology Collaboration on Occupational Health Study. During 8 years of follow-up, we identified 56 registered cases of suicide death that had information on fasting plasma glucose or glycated hemoglobin A1c at any health check-up during the past 3 years prior to suicide. For each case, we randomly selected five controls matched for age, sex, and worksite. We used the latest health check-up data for analysis. We defined diabetes status based on the American Diabetes Association criteria and used a conditional logistic regression model to investigate the association. RESULTS Adjusted odds ratios and 95% confidence intervals for suicide death were 0.67 (0.32-1.41) and 3.53 (1.05-11.91) for prediabetes and diabetes, respectively, compared to normoglycemia. Similar results were obtained when diabetes status was exclusively defined by the fasting plasma glucose or glycated hemoglobin A1c level. CONCLUSION Diabetes, but not prediabetes, was associated with a higher risk of suicide death, compared with normoglycemia, among a Japanese working population.
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16
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Mondal V, Hosen Z, Hossen F, Siddique AE, Tony SR, Islam Z, Islam MS, Hossain S, Islam K, Sarker MK, Hasibuzzaman MM, Liu LZ, Jiang BH, Hoque MM, Saud ZA, Xin L, Himeno S, Hossain K. Arsenic exposure-related hyperglycemia is linked to insulin resistance with concomitant reduction of skeletal muscle mass. ENVIRONMENT INTERNATIONAL 2020; 143:105890. [PMID: 32619914 DOI: 10.1016/j.envint.2020.105890] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Alargebodyof evidence has shown a link between arsenic exposure and diabetes, but the underlying mechanisms have not yet been clarified. OBJECTIVE We explored the association between arsenic exposure and the reduction of skeletal muscle mass as a potential mechanism of insulin resistance for developing arsenic-related hyperglycemia. METHODS A total of 581 subjects were recruited from arsenic-endemic and non-endemic areas in Bangladesh and their fasting blood glucose (FBG), serum insulin, and serum creatinine levels were determined. Subjects' arsenic exposure levels were assessed by arsenic concentrations in water, hair, and nails. HOMA-IR and HOMA-β were used to calculate insulin resistance and β-cell dysfunction, respectively. Serum creatinine levels and lean body mass (LBM) were used as muscle mass indicators. RESULTS Water, hair and nail arsenic concentrations showed significant positive associations with FBG, serum insulin and HOMA-IR and inverse associations with serum creatinine and LBM in a dose-dependent manner both in males and females. Water, hair and nail arsenic showed significant inverse associations with HOMA-β in females but not in males. FBG and HOMA-IR were increased with the decreasing levels of serum creatinine and LBM. Odds ratios (ORs)of hyperglycemia were significantly increased with the increasing concentrations of arsenic in water, hair and nails and with the decreasing levels of serum creatinine and LBM. Females' HOMA-IR showed greater susceptibility to the reduction of serum creatinine and LBM, possibly causing the greater risk of hyperglycemia in females than males. Path analysis revealed the mediating effect of serum creatinine level on the relationship of arsenic exposure with HOMA-IR and hyperglycemia. CONCLUSION Arsenic exposure elevates FBG levels and the risk of hyperglycemia through increasing insulin resistance with greater susceptibility in females than males. Additionally, arsenic exposure-related reduction of skeletal muscle mass may be a mechanism underlying the development of insulin resistance and hyperglycemia.
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Affiliation(s)
- Victor Mondal
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Zubaer Hosen
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh
| | - Faruk Hossen
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Abu Eabrahim Siddique
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Selim Reza Tony
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Zohurul Islam
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Shofikul Islam
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh
| | - Shakhawoat Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Khairul Islam
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science & Technology University, Tangail 1902, Bangladesh
| | | | - M M Hasibuzzaman
- Interdisciplinary Graduate Program in Human Toxicology, The University of Iowa, Iowa City, IA 52242, United States
| | - Ling-Zhi Liu
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States
| | - Bing-Hua Jiang
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States
| | - Md Mominul Hoque
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Lian Xin
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Seiichiro Himeno
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan; Division of Health Chemistry, School of Pharmacy, Showa University, Tokyo 142- 8555, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh.
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17
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Qin P, Lou Y, Cao L, Shi J, Tian G, Liu D, Zhou Q, Guo C, Li Q, Zhao Y, Liu F, Wu X, Qie R, Han M, Huang S, Zhao P, Wang C, Ma J, Peng X, Xu S, Chen H, Zhao D, Zhang M, Hu D, Hu F. Dose-response associations between serum creatinine and type 2 diabetes mellitus risk: A Chinese cohort study and meta-analysis of cohort studies. J Diabetes 2020; 12:594-604. [PMID: 32185882 DOI: 10.1111/1753-0407.13038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study aims to investigate the association between serum creatinine and risk of type 2 diabetes mellitus (T2DM) based on a cohort analysis and meta-analysis of cohort studies. METHODS We enrolled 41 439 participants aged ≥18 years without T2DM at baseline, who had ≥2 health examinations based on an ongoing prospective cohort in Beijing. Cox proportional hazards regression model was used to estimate hazard ratios (HRs) and 95% CIs. For the meta-analysis, cohort studies reporting risk estimates for the serum creatinine-T2DM association were included. A random-effects model was used to calculate summary relative risks (RRs) and restricted cubic splines to model the dose-response association. RESULTS During a mean follow-up of 3.54 years, 1867 developed T2DM. Low serum creatinine was associated with increased risk of T2DM; adjusted HRs (95% CIs) across sex-specific quartiles were 1.45 (1.24, 1.71), 1.19 (1.02, 1.39), 1.07 (0.92, 1.24), and 1.00 (reference). The association was significant for both sexes and individuals with overweight or obesity. In the meta-analysis of six cohort studies (including the current study) involving 115 767 participants and 5370 T2DM events, the pooled RR was 1.61 (95% CI 1.35, 1.92), comparing the lowest with the highest category of serum creatinine. We found a linear association between serum creatinine and T2DM risk (Pnonlinearity = .082) and an increased risk of T2DM with each 0.1-mg/dL decrease in serum creatinine (RR = 1.07; 95% CI 1.04, 1.09). CONCLUSIONS The cohort study and meta-analysis provide further evidence supporting the negative association between serum creatinine and T2DM risk in a linear dose-response pattern.
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Affiliation(s)
- Pei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Liming Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Jing Shi
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Qionggui Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Chunmei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Quanman Li
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Feiyan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Xiaoyan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Ranran Qie
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, People's Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, People's Republic of China
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Should we pay more attention to low creatinine levels? ENDOCRINOLOGIA, DIABETES Y NUTRICION 2020; 67:486-492. [PMID: 32331974 DOI: 10.1016/j.endinu.2019.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 12/25/2022]
Abstract
A review is made of the basic aspects of creatine/creatinine metabolism and the close relationship between creatinine and muscle mass, which makes the former a biochemical marker of the latter. Emphasis is placed on the current prognostic value of both the low urinary excretion of creatinine and low serum creatinine levels in different clinical settings in which sarcopenia probably plays a significant role in morbidity and mortality.
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Hashimoto Y, Okamura T, Hamaguchi M, Obora A, Kojima T, Fukui M. Creatinine to Body Weight Ratio Is Associated with Incident Diabetes: Population-Based Cohort Study. J Clin Med 2020; 9:jcm9010227. [PMID: 31952309 PMCID: PMC7020036 DOI: 10.3390/jcm9010227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/29/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
We investigated the association between creatinine to body weight (Cre/BW) ratio and incident diabetes. In this cohort study, 9659 men and 7417 women were follow up mean (SD) 5.6 (3.5) years and 5.4 (3.4) years, respectively. For men, tertile 1 (T1; n = 3176), Cre/BW < 0.01275; tertile 2 (T2; n = 3258), 0.01275 ≤ Cre/BW < 0.0148; and tertile 3 (T3; n = 3225), Cre/BW ≥ 0.0148; and for women, T1 (n = 2437), Cre/BMI < 0.0118; T2 (n = 2516), 0.0118 ≤ Cre/BMI < 0.014; and T3 (n = 2477), Cre/BMI ≥ 0.014. Among them, 362 men and 102 women developed diabetes. The hazard ratios (HRs) of incident diabetes in the T2 group was 0.56 (95% CI 0.44–0.71, p < 0.001) in men and 0.61 (0.38–0.99, p = 0.045) in women and in the T3 group was 0.42 (0.32–0.54, p < 0.001) in men and 0.55 (0.34–0.89, p = 0.014) in women after adjusting for covariates, compared with the T1 group. Moreover, Δ0.001 incremental of Cre/BW is negatively associated with incident diabetes (adjusted HR 0.84, 95% CI 0.80–0.88, p < 0.001 for men and 0.88, 0.81–0.96, p = 0.003 for women). In conclusion, Cre/BW ratio is inversely related to incident diabetes. Checking Cre/BW ratios may predict future diabetes risks.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.H.); (T.O.); (M.F.)
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.H.); (T.O.); (M.F.)
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.H.); (T.O.); (M.F.)
- Correspondence: ; Tel.: +81-75-251-5505
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, Gifu 501-0223, Japan; (A.O.); (T.K.)
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, Gifu 501-0223, Japan; (A.O.); (T.K.)
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.H.); (T.O.); (M.F.)
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Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Creatinine-to-bodyweight ratio is a predictor of incident non-alcoholic fatty liver disease: A population-based longitudinal study. Hepatol Res 2020; 50:57-66. [PMID: 31692179 DOI: 10.1111/hepr.13429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/27/2019] [Accepted: 09/17/2019] [Indexed: 02/06/2023]
Abstract
AIM Serum creatinine (Cre) is used as a surrogate marker of muscle mass. We investigated the impact of the Cre-to-bodyweight (BW) ratio (Cre/BW) on incident non-alcoholic fatty liver disease (NAFLD). METHODS Fatty liver disease was diagnosed by abdominal ultrasonography. In this historical cohort study of 13 728 participants (6397 men and 7331 women), we divided the participants into two groups by sex and into quartiles according to Cre (mg/dL)/BW (kg; Q1-4). We carried out Cox proportional hazard models, adjusting for age, alanine aminotransferase, fasting plasma glucose, systolic blood pressure, alcohol consumption, smoking status, and exercise. RESULTS During the 5.1-year follow up for men and 6.0-year follow up for women, 2497 participants (1696 men, 801 women) developed NAFLD. The 4000-days cumulative incidence rates of FLD for men and women were 29.6% and 16.6% in Q1, 28.2% and 10.6% in Q2, 25.5% and 8.8% in Q3, and 22.7% and 7.7% in Q4, respectively. The hazard ratios of incident NAFLD in Q1 (Cre/BW [×100]: men <1.28; women <1.17) were 1.89 (95% confidence interval 1.64-2.17, P < 0.001) in men and 2.96 (2.42-3.62, P < 0.001) in women, compared with Q4 (Cre/BW [×100]: men ≥1.61; women ≥1.51). CONCLUSIONS A low Cre/BW is associated with an increased risk of NAFLD. Screening Cre/BW can be used to identify individuals who are at high risk of NAFLD.
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Affiliation(s)
- Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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