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Liu S, Wan H, Nie S, Cao H, Liu L, Liang H, Xu H, Liu B, Chen C, Liu H, Yang Q, Li H, Kong Y, Li G, Wan Q, Zha Y, Hu Y, Xu G, Shi Y, Zhou Y, Su G, Tang Y, Gong M, Guo A, Weng J, Wu H, Hou FF, Shen J. Dipeptidyl peptidase 4 inhibitors vs. metformin for new-onset dementia: a propensity score-matched cohort study. J Clin Endocrinol Metab 2024:dgae281. [PMID: 38652239 DOI: 10.1210/clinem/dgae281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/13/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Hypoglycemic pharmacotherapy interventions for alleviating the risk of dementia remains controversial, particularly about dipeptidyl peptidase 4 (DPP4) inhibitors versus metformin. Our objective was to investigate whether the initiation of DPP4 inhibitors, as opposed to metformin, was linked to a reduced risk of dementia. METHODS We included individuals with type 2 diabetes over 40 years old who were new users of DPP4 inhibitors or metformin in the Chinese Renal Disease Data System (CRDS) database between 2009 and 2020. The study employed Kaplan-Meier and Cox regression for survival analysis and the Fine and Gray model for the competing risk of death. RESULTS Following a 1:1 propensity score matching, the analysis included 3626 DPP4 inhibitor new users and an equal number of metformin new users. After adjusting for potential confounders, the utilization of DPP4 inhibitors was associated with a decreased risk of all-cause dementia compared to metformin (hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.45-0.89). Subgroup analysis revealed that the utilization of DPP4 inhibitors was associated with a reduced incidence of dementia in individuals who initiated drug therapy at the age of 60 years or older (HR 0.69, 95% CI 0.48-0.98), those without baseline macrovascular complications (HR 0.62, 95% CI 0.41-0.96), and those without baseline microvascular complications (HR 0.67, 95% CI 0.47-0.98). CONCLUSION In this real-world study, we found that DPP4 inhibitors presented an association with a lower risk of dementia in individuals with type 2 diabetes than metformin, particularly in older people and those without diabetes-related comorbidities.
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Affiliation(s)
- Siyang Liu
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Sheng Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Huanyi Cao
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Lan Liu
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Hua Liang
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Hong Xu
- Children's Hospital of Fudan University, Shanghai, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaozhong Kong
- Department of Nephrology, the First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Guisen Li
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Sun Yat-Sen University, Huizhou, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, Guangzhou, China
- DHC Technologies, Beijing, China
| | | | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Jie Shen
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
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Weng J, Bhupathiraju SHV, Samant T, Dresner A, Wu J, Samant SS. Convolutional LSTM model for cine image prediction of abdominal motion. Phys Med Biol 2024; 69:085024. [PMID: 38518378 DOI: 10.1088/1361-6560/ad3722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/22/2024] [Indexed: 03/24/2024]
Abstract
Objective.In this study, we tackle the challenge of latency in magnetic resonance linear accelerator (MR-Linac) systems, which compromises target coverage accuracy in gated real-time radiotherapy. Our focus is on enhancing motion prediction precision in abdominal organs to address this issue. We developed a convolutional long short-term memory (convLSTM) model, utilizing 2D cine magnetic resonance (cine-MR) imaging for this purpose.Approach.Our model, featuring a sequence-to-one architecture with six input frames and one output frame, employs structural similarity index measure (SSIM) as loss function. Data was gathered from 17 cine-MRI datasets using the Philips Ingenia MR-sim system and an Elekta Unity MR-Linac equivalent sequence, focusing on regions of interest (ROIs) like the stomach, liver, pancreas, and kidney. The datasets varied in duration from 1 to 10 min.Main results.The study comprised three main phases: hyperparameter optimization, individual training, and transfer learning with or without fine-tuning. Hyperparameters were initially optimized to construct the most effective model. Then, the model was individually applied to each dataset to predict images four frames ahead (1.24-3.28 s). We evaluated the model's performance using metrics such as SSIM, normalized mean square error, normalized correlation coefficient, and peak signal-to-noise ratio, specifically for ROIs with target motion. The average SSIM values achieved were 0.54, 0.64, 0.77, and 0.66 for the stomach, liver, kidney, and pancreas, respectively. In the transfer learning phase with fine-tuning, the model showed improved SSIM values of 0.69 for the liver and 0.78 for the kidney, compared to 0.64 and 0.37 without fine-tuning.Significance. The study's significant contribution is demonstrating the convLSTM model's ability to accurately predict motion for multiple abdominal organs using a Unity-equivalent MR sequence. This advancement is key in mitigating latency issues in MR-Linac radiotherapy, potentially improving the precision and effectiveness of real-time treatment for abdominal cancers.
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Affiliation(s)
- J Weng
- Department of Radiation Oncology, University of Florida, Gainesville, FL, United States of America
| | - S H V Bhupathiraju
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, FL, United States of America
| | - T Samant
- Tera Insights, Gainesville, FL, United States of America
| | - A Dresner
- Philips Healthcare MR Oncology, Cleveland, OH, United States of America
| | - J Wu
- Department of Radiation Oncology, University of Florida, Gainesville, FL, United States of America
| | - S S Samant
- Department of Radiation Oncology, University of Florida, Gainesville, FL, United States of America
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Liu Z, Yue T, Zheng X, Luo S, Xu W, Yan J, Weng J, Yang D, Wang C. Microbial and metabolomic profiles of type 1 diabetes with depression: A case-control study. J Diabetes 2024; 16:e13542. [PMID: 38599848 PMCID: PMC11006619 DOI: 10.1111/1753-0407.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 12/17/2023] [Accepted: 01/31/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Depression is the most common psychological disorder in patients with type 1 diabetes (T1D). However, the characteristics of microbiota and metabolites in these patients remain unclear. This study aimed to investigate microbial and metabolomic profiles and identify novel biomarkers for T1D with depression. METHODS A case-control study was conducted in a total of 37 T1D patients with depression (TD+), 35 T1D patients without depression (TD-), and 29 healthy controls (HCs). 16S rRNA gene sequencing and liquid chromatography-mass spectrometry (LC-MS) metabolomics analysis were conducted to investigate the characteristics of microbiota and metabolites. The association between altered microbiota and metabolites was explored by Spearman's rank correlation and visualized by a heatmap. The microbial signatures to discriminate TD+ from TD- were identified by a random forest (RF) classifying model. RESULTS In microbiota, 15 genera enriched in TD- and 2 genera enriched in TD+, and in metabolites, 14 differential metabolites (11 upregulated and 3 downregulated) in TD+ versus TD- were identified. Additionally, 5 genera (including Phascolarctobacterium, Butyricimonas, and Alistipes from altered microbiota) demonstrated good diagnostic power (area under the curve [AUC] = 0.73; 95% CI, 0.58-0.87). In the correlation analysis, Butyricimonas was negatively correlated with glutaric acid (r = -0.28, p = 0.015) and malondialdehyde (r = -0.30, p = 0.012). Both Phascolarctobacterium (r = 0.27, p = 0.022) and Alistipes (r = 0.31, p = 0.009) were positively correlated with allopregnanolone. CONCLUSIONS T1D patients with depression were characterized by unique profiles of gut microbiota and serum metabolites. Phascolarctobacterium, Butyricimonas, and Alistipes could predict the risk of T1D with depression. These findings provide further evidence that the microbiota-gut-brain axis is involved in T1D with depression.
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Affiliation(s)
- Ziyu Liu
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
- Department of EndocrinologyThe Sixth Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Tong Yue
- Department of Endocrinology, Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of ChinaHefeiChina
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of ChinaHefeiChina
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of ChinaHefeiChina
| | - Wen Xu
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Jinhua Yan
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Jianping Weng
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
- Department of Endocrinology, Institute of Endocrine and Metabolic DiseasesThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of ChinaHefeiChina
| | - Daizhi Yang
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Chaofan Wang
- Department of Endocrinology and MetabolismThe Third Affiliated Hospital of Sun Yat‐sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
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Gong Y, Luo S, Shi J, Wei T, Wang J, Liu Y, Yan J, Yang D, Li L, Sun Z, Zheng X, Weng J. Preconception episodes of severe hypoglycemia and risk of adverse pregnancy outcomes in pregnant women with type 1 diabetes mellitus. Diabetes Metab Res Rev 2024; 40:e3741. [PMID: 37876145 DOI: 10.1002/dmrr.3741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
AIMS To explore the relationship between preconception severe hypoglycemia (PSH) and pregnancy outcomes in pregnancies complicated with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS In this multicenter prospective cohort study, women with pregestational T1DM were stratified by episodes of severe hypoglycemia within 1 year before conception: No PSH, sporadic PSH (1-6 times/year), and recurrent PSH (>6 times/year). We analysed the predictive ability of PSH for maternal and neonatal outcomes using log-binomial regression models and receiver operating characteristic (ROC) curve. RESULTS Of the 124 women studied, 37.1% experienced at least one episode of severe hypoglycemia preconception. In the multiple adjusted regression models, recurrent PSH was significantly associated with increased incidence of preeclampsia (RR 17.59, 95% CI: 2.89-150.62, p for trend = 0.007), preterm birth (RR 6.34, 95% CI: 1.22-40.63, p for trend = 0.027), neonatal hypoglycemia (RR 4.52, 95% CI: 1.14-17.16, p for trend = 0.017), neonatal hyperbilirubinemia (RR 4.12, 95% CI: 1.11-15.56, p for trend = 0.004), and composite neonatal outcome (RR 3.85, 95% CI: 1.01-19.61, p for trend = 0.003). In the ROC analysis, PSH predicted preeclampsia, preterm birth, neonatal hypoglycemia, neonatal hyperbilirubinemia, and composite neonatal outcome with areas under the ROC curve all ≥0.6. CONCLUSIONS Recurrent preconception severe hypoglycemia is associated with increased risks of adverse outcomes in pregnant women with T1DM.
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Affiliation(s)
- Yixin Gong
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jie Shi
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Tian Wei
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Jing Wang
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yujie Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ling Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Zhou Y, Sardana D, Kuroko S, Haszard JJ, de Block MI, Weng J, Jefferies C, Wheeler BJ. Comparing the glycaemic outcomes between real-time continuous glucose monitoring (rt-CGM) and intermittently scanned continuous glucose monitoring (isCGM) among adults and children with type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials. Diabet Med 2024; 41:e15280. [PMID: 38197238 DOI: 10.1111/dme.15280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024]
Abstract
AIM To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the effectiveness of real-time continuous glucose monitoring (rtCGM) versus intermittently scanned continuous glucose monitoring (isCGM) on key glycaemic metrics (co-primary outcomes HbA1c and time-in-range [TIR] 70-180 mg/dL, 3.9-10.0 mmol/L) among people with type 1 diabetes (T1D). METHODS Medline, PubMed, Scopus, Web of Science and Cochrane Central Register of clinical trials were searched. Inclusion criteria were RCTs; T1D populations of any age and insulin regimen; comparing any type of rtCGM with isCGM (only the first generation had been compared to date); and reporting the glycaemic outcomes. Glycaemic outcomes were extracted post-intervention and expressed as mean differences and 95% CIs between the two comparators. Results were pooled using a random-effect meta-analysis. The risk of bias was assessed using the Cochrane RoB2 tool. The quality of evidence was assessed by the GRADE approach. RESULTS Five RCTs met the inclusion criteria (4 parallel and 1 crossover design; 4 with CGM use <8 weeks), involving 446 participants (354 adults; 92 children and adolescents). Overall, meta-analysis showed rtCGM compared to isCGM improved absolute TIR by +7.0% (95% CI: 5.8%-8.3%, I2 = 0%, p < 0.01) accompanied by a favorable effect on time-below-range <70 mg/dL (3.9 mmol/L) - 1.7% (95%CI: -3.0% to -0.4%; p = 0.03). No differences were seen regarding HbA1c. CONCLUSIONS This meta-analysis highlights that for people with T1D, rtCGM confers benefits over isCGM primarily related to increased TIR, with improvements in hypo- and hyperglycaemia.
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Affiliation(s)
- Yongwen Zhou
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, China
| | - Divesh Sardana
- Division of Pediatric Dentistry, Department of Developmental Sciences, Oklahoma University Health Sciences Center, Oklahoma, USA
| | - Sarahmarie Kuroko
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Martin I de Block
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
- Department of Paediatrics, Te Whatu Ora -Waitaha, New Zealand
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, China
| | - Craig Jefferies
- Starship Child Health, Te Whatu Ora - Health New Zealand, Te Toka Tumai Auckland
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Benjamin John Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Paediatric Endocrinology, Te Whatu Ora/Health New Zealand - Southern, Dunedin, New Zealand
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Cheng Y, Nie S, Zhao X, Xu X, Xu H, Liu B, Weng J, Chen C, Liu H, Yang Q, Li H, Kong Y, Li G, Wan Q, Zha Y, Hu Y, Shi Y, Zhou Y, Su G, Tang Y, Gong M, Hou FF, Ge S, Xu G. Incidence, Risk Factors and Outcome of Postoperative Acute Kidney Injury in China. Nephrol Dial Transplant 2024:gfad260. [PMID: 38262746 DOI: 10.1093/ndt/gfad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND HYPOTHESIS Postoperative acute kidney injury (AKI) is a common condition after surgery, however, the available data about nationwide epidemiology of postoperative AKI in China from the large and high-quality studies is limited. This study was aimed to determine the incidence, risk factors, and outcomes of postoperative AKI among patients undergoing surgery in China. METHODS This was a large, multicenter, retrospective study performed in 16 tertiary medical centers in China. Adult (at least 18 years old) patients who undergoing surgical procedures from January 1, 2013 to December 31, 2019 were included. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes creatinine criteria. The associations of AKI and in-hospital outcomes were investigated using logistic regression models adjusted for potential confounders. RESULTS Among 520 707 patients included in our study, 25 830 (5.0%) patients developed postoperative AKI. The incidence of postoperative AKI varied by surgery type, which was highest in cardiac (34.6%) surgery, followed by urologic (8.7%), and general (4.2%) surgeries. 89.2% postoperative AKI cases were detected in the first 2 postoperative days. However, only 584 (2.3%) patients with postoperative AKI were diagnosed with AKI on discharge. Risk factors for postoperative AKI included advanced age, male sex, lower baseline kidney function, pre-surgery hospital stay ≤ 3 days or > 7 days, hypertension, diabetes mellitus, and use of PPIs or diuretics. The risk of in-hospital death increased with the stage of AKI. In addition, patients with postoperative AKI had longer length of hospital stay (12 vs 19 days), were more likely to require intensive unit care (13.1% vs 45.0%) and renal replacement therapy (0.4% vs 7.7%). CONCLUSIONS Postoperative AKI was common across surgery type in China, particularly for patients undergoing cardiac surgery. Implementation and evaluation of an alarm system is important for the battle against postoperative AKI.
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Affiliation(s)
- Yichun Cheng
- Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology
| | - Sheng Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research
| | - Xingyang Zhao
- Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology
| | - Xin Xu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research
| | - Hong Xu
- Children's Hospital of Fudan University
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Maoming
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
| | - Yaozhong Kong
- Department of Nephrology, the First People's Hospital of Foshan
| | - Guisen Li
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Sun Yat-Sen University
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, DHC Technologies
- DHC Technologies, Beijing, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research
| | - Shuwang Ge
- Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology
| | - Gang Xu
- Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology
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Yang X, Deng H, Lv J, Chen X, Zeng L, Weng J, Liang H, Xu W. Comparison of changes in adipokine and inflammatory cytokine levels in patients with newly diagnosed type 2 diabetes treated with exenatide, insulin, or pioglitazone: A post-hoc study of the CONFIDENCE trial. Heliyon 2024; 10:e23309. [PMID: 38169889 PMCID: PMC10758788 DOI: 10.1016/j.heliyon.2023.e23309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Background Adipokines and inflammatory cytokines (ADICs) play important roles in type 2 diabetes mellitus (T2DM). This study aimed to compare the changes of ADIC levels (ΔADICs) in patients with newly diagnosed T2DM treated with different antihyperglycemic agents, and further investigate the impact of these changes on metabolic indices, β-cell function and insulin resistance (IR). Methods Four hundred and sixteen patients with newly diagnosed T2DM from 25 centers in China randomly received 48-week intervention with exenatide, insulin or pioglitazone. Anthropometric and laboratory data, indices of β-cell function and IR, and levels of AIDCs, including interleukin-1 beta (IL-1β), interferon-gamma (IFN-γ), leptin, and fibroblast growth factor 21 (FGF21) were detected at baseline and the end of the study. Results In total, 281 participants (68 % male, age: 50.3 ± 9.4 years) completed the study. After 48- week treatment, IL-1β and IFN-γ were significantly decreased with exenatide treatment (P < 0.001 and P = 0.001, respectively), but increased with insulin (P = 0.009 and P = 0.026, respectively). However, pioglitazone treatment had no impact on ADICs. No significant change in leptin or FGF21 was detected with any of the treatments. After adjustment for baseline values and changes of body weight, waist and HbA1c, the between-group differences were found in ΔIL-1β (exenatide vs. insulin: P = 0.048; and exenatide vs. pioglitazone: P = 0.003, respectively) and ΔIFN-γ (exenatide vs. insulin: P = 0.049; and exenatide vs. pioglitazone: P < 0.001, respectively). Multiple linear regression analysis indicated that Δweight was associated with ΔIL-1β (β = 0.753; 95 % CI, 0.137-1.369; P = 0.017). After adjusting for treatment effects, Δweight was also be correlated with ΔFGF21 (β = 1.097; 95%CI, 0.250-1.944; P = 0.012); furthermore, ΔHOMA-IR was correlated with Δleptin (β = 0.078; 95%CI, 0.008-0.147; P = 0.029) as well. However, ΔHOMA-IR was not significantly associated with ΔIL-1β after adjusting for treatment effects (P = 0.513). Conclusion Exenatide treatment led to significant changes of inflammatory cytokines levels (IL-1β and IFN-γ), but not adipokines (leptin and FGF21), in newly diagnosed T2DM patients. The exenatide-mediated improvement in weight and IR may be associated with a decrease in inflammatory cytokine levels.
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Affiliation(s)
- Xubin Yang
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
| | - Jing Lv
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
| | - Xueyan Chen
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
| | - Longyi Zeng
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Hua Liang
- Department of Endocrinology and Metabolism, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Foshan, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, the 3rd Affiliated Hospital of Sun Yat-sen University. NO.600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China
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8
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Xu S, Wu X, Wang S, Xu M, Fang T, Ma X, Chen M, Fu J, Guo J, Tian S, Tian T, Cheng X, Yang H, Zhou J, Wang Z, Yin Y, Xu W, Xu F, Yan J, Wang Z, Luo S, Zhang XJ, Ji YX, Weng J. TRIM56 protects against nonalcoholic fatty liver disease by promoting the degradation of fatty acid synthase. J Clin Invest 2024; 134:e166149. [PMID: 38206764 PMCID: PMC10904058 DOI: 10.1172/jci166149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/05/2024] [Indexed: 01/13/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) encompasses a disease continuum from simple steatosis to nonalcoholic steatohepatitis (NASH). However, there are currently no approved pharmacotherapies for NAFLD, although several drugs are in advanced stages of clinical development. Because of the complex pathophysiology and heterogeneity of NAFLD, the identification of potential therapeutic targets is clinically important. Here, we demonstrated that tripartite motif 56 (TRIM56) protein abundance was markedly downregulated in the livers of individuals with NAFLD and of mice fed a high-fat diet. Hepatocyte-specific ablation of TRIM56 exacerbated the progression of NAFLD, while hepatic TRIM56 overexpression suppressed it. Integrative analyses of interactome and transcriptome profiling revealed a pivotal role of TRIM56 in lipid metabolism and identified the lipogenesis factor fatty acid synthase (FASN) as a direct binding partner of TRIM56. TRIM56 directly interacted with FASN and triggered its K48-linked ubiquitination-dependent degradation. Finally, using artificial intelligence-based virtual screening, we discovered an orally bioavailable small-molecule inhibitor of FASN (named FASstatin) that potentiates TRIM56-mediated FASN ubiquitination. Therapeutic administration of FASstatin improved NAFLD and NASH pathologies in mice with an optimal safety, tolerability, and pharmacokinetics profile. Our findings provide proof of concept that targeting the TRIM56/FASN axis in hepatocytes may offer potential therapeutic avenues to treat NAFLD.
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Affiliation(s)
- Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Xiumei Wu
- Department of Endocrinology, Guangdong Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sichen Wang
- School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Mengyun Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Tingyu Fang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Xiaoxuan Ma
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Meijie Chen
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jiajun Fu
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute and
- School of Medical Information Engineering, Gannan Medical University, Gannan Medical University, Ganzhou, China
| | - Juan Guo
- College of Life Sciences, Wuhan University, Wuhan, China
| | - Song Tian
- School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Tian Tian
- School of Medical Information Engineering, Gannan Medical University, Gannan Medical University, Ganzhou, China
| | - Xu Cheng
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute and
| | - Hailong Yang
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute and
| | - Junjie Zhou
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute and
| | - Zhenya Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yanjun Yin
- School of Pharmacy, Bengbu Medical College, Bengbu, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Fen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhihua Wang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Xiao-Jing Zhang
- School of Basic Medical Sciences, Wuhan University, Wuhan, China
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute and
| | - Yan-Xiao Ji
- School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of the Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Jiang H, Zhao Y, Su M, Sun L, Chen M, Zhang Z, Ilyas I, Wang Z, Little PJ, Wang L, Weng J, Ge J, Xu S. A proteome-wide screen identifies the calcium binding proteins, S100A8/S100A9, as clinically relevant therapeutic targets in aortic dissection. Pharmacol Res 2024; 199:107029. [PMID: 38056513 DOI: 10.1016/j.phrs.2023.107029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/03/2023] [Indexed: 12/08/2023]
Abstract
Aortic dissection (AD) is a fatal cardiovascular disease with limited pharmacotherapies. To discover novel therapeutic targets for AD, the present study was conducted on ascending aorta samples from AD patients versus those from control subjects using proteomic analysis. Integrated proteomic data analysis identified S100 calcium-binding proteins A8 and A9 (S100A8/A9) as new therapeutic targets for AD. As assessed by ELISA, the circulating levels of S100A8/A9 were elevated in AD patients. In addition, we validated the upregulation of S100A8/A9 in a mouse model of AD. In vitro and in vivo studies substantiated that S100A8/A9, as danger-associated molecular pattern molecules, promotes the smooth muscle cells phenotypic switch by inhibiting serum response factor (SRF) activity but elevating NF-κB dependent inflammatory response. Depletion of S100A8/A9 attenuates the occurrence and development of AD. As a proof of concept, we tested the safety and efficacy of pharmacological inhibition of S100A8/A9 by ABR-25757 (paquinimod) in a mouse model of AD. We observed that ABR-25757 ameliorated the incidence of rupture and improved elastin morphology associated with AD. Further single-cell RNA sequencing disclosed that the phenotypic switch of vascular smooth muscle cells (VSMCs) and inflammatory response pathways were responsible for ABR-25757-mediated protection against AD. Thus, this study reveals the regulatory mechanism of S100A8/A9 in AD and offers a potential therapeutic avenue to treat AD by targeting S100A8/A9.
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Affiliation(s)
- Hui Jiang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yaping Zhao
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Meiming Su
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Lu Sun
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Meijie Chen
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Zhidan Zhang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Iqra Ilyas
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Zhihua Wang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Peter J Little
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Li Wang
- Department of Biomedical Sciences, City University of Hong Kong, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jianjun Ge
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China.
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10
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Zhou Y, Yue T, Ding Y, Tan H, Weng J, Luo S, Zheng X. Nanotechnology translation in vascular diseases: From design to the bench. Wiley Interdiscip Rev Nanomed Nanobiotechnol 2024; 16:e1919. [PMID: 37548140 DOI: 10.1002/wnan.1919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023]
Abstract
Atherosclerosis is a systemic pathophysiological condition contributing to the development of majority of polyvascular diseases. Nanomedicine is a novel and rapidly developing science. Due to their small size, nanoparticles are freely transported in vasculature, and have been widely employed as tools in analytical imaging techniques. Furthermore, the application of nanoparticles also allows target intervention, such as drug delivery and tissue engineering regenerative methods, in the management of major vascular diseases. Therefore, by summarizing the physical and chemical characteristics of common nanoparticles used in diagnosis and treatment of vascular diseases, we discuss the details of these applications from cellular, molecular, and in vivo perspectives in this review. Furthermore, we also summarize the status and challenges of the application of nanoparticles in clinical translation. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Emerging Technologies.
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Affiliation(s)
- Yongwen Zhou
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Tong Yue
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yu Ding
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Huiling Tan
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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11
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Li X, Chen G, Wu K, Zheng H, Tian Z, Xu Z, Zhao W, Weng J, Min Y. Imaging and monitoring of granzyme B in the immune response. Wiley Interdiscip Rev Nanomed Nanobiotechnol 2024; 16:e1928. [PMID: 37715320 DOI: 10.1002/wnan.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/17/2023]
Abstract
Significant progress has been made in tumor immunotherapy that uses the human immune response to kill and remove tumor cells. However, overreactive immune response could lead to various autoimmune diseases and acute rejection. Accurate and specific monitoring of immune responses in these processes could help select appropriate therapies and regimens for the patient and could reduce the risk of side effects. Granzyme B (GzmB) is an ideal biomarker for immune response, and its peptide substrate could be coupled with fluorescent dyes or contrast agents for the synthesis of imaging probes activated by GzmB. These small molecules and nanoprobes based on PET, bioluminescence imaging, or fluorescence imaging have proved to be highly GzmB specific and accuracy. This review summarizes the design of different GzmB-responsive imaging probes and their applications in monitoring of tumor immunotherapy and overreactive immune response. This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.
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Affiliation(s)
- Xiangxia Li
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
| | - Guiyuan Chen
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
| | - Kecheng Wu
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
| | - Haocheng Zheng
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
| | - Zuotong Tian
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
| | - Ze Xu
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Weidong Zhao
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jianping Weng
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yuanzeng Min
- Department of Chemistry, University of Science and Technology of China, Hefei, Anhui, China
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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12
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Tan H, Shi Y, Yue T, Zheng D, Luo S, Weng J, Zheng X. Machine learning approach reveals microbiome, metabolome, and lipidome profiles in type 1 diabetes. J Adv Res 2023:S2090-1232(23)00363-6. [PMID: 38042287 DOI: 10.1016/j.jare.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023] Open
Abstract
INTRODUCTION Type 1 diabetes (T1D) is a complex disorder influenced by genetic and environmental factors. The gut microbiome, the serum metabolome, and the serum lipidome have been identified as key environmental factors contributing to the pathophysiological mechanisms of T1D. OBJECTIVES We aimed to explore the gut microbiota, serum metabolite, and serum lipid signatures in T1D patients by machine learning. METHODS We evaluated 137 individuals in a cross-sectional cohort involving 38 T1D patients, 38 healthy controls, and 61 T1D patients for validation. We characterized gut microbiome, serum metabolite, and serum lipid profiles with machine learning approaches (logistic regression, support vector machine, Gaussian naive Bayes, and random forest). RESULTS The machine learning approaches using the microbiota composition did not accurately diagnose T1D (model accuracy = 0.7555), while the accuracy of the model using the metabolite composition was 0.9333. Based on the metabolite composition, 3-hydroxybutyric acid and 9-oxo-ode (area under curve = 0.70 and 0.67, respectively, both increased in T1D) were meaningful overlap metabolites screened by multiple bioinformatics methods. We confirmed the biological relevance of the microbiome, metabolome, and lipidome features in the validation group. CONCLUSION By using machine learning algorithms and multi-omics, we demonstrated that T1D patients are associated with altered microbiota, metabolite, and lipidomic signatures or functions.
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Affiliation(s)
- Huiling Tan
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Yu Shi
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Tong Yue
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Dongxue Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China.
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui 230001, China.
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13
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Xia J, Kong M, Yang Z, Sun L, Peng Y, Mao Y, Wei H, Ying W, Gao Y, Friml J, Weng J, Liu X, Sun L, Tan S. Chemical inhibition of Arabidopsis PIN-FORMED auxin transporters by the anti-inflammatory drug naproxen. Plant Commun 2023; 4:100632. [PMID: 37254481 PMCID: PMC10721474 DOI: 10.1016/j.xplc.2023.100632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/12/2023] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
The phytohormone auxin plays central roles in many growth and developmental processes in plants. Development of chemical tools targeting the auxin pathway is useful for both plant biology and agriculture. Here we reveal that naproxen, a synthetic compound with anti-inflammatory activity in humans, acts as an auxin transport inhibitor targeting PIN-FORMED (PIN) transporters in plants. Physiological experiments indicate that exogenous naproxen treatment affects pleiotropic auxin-regulated developmental processes. Additional cellular and biochemical evidence indicates that naproxen suppresses auxin transport, specifically PIN-mediated auxin efflux. Moreover, biochemical and structural analyses confirm that naproxen binds directly to PIN1 protein via the same binding cavity as the indole-3-acetic acid substrate. Thus, by combining cellular, biochemical, and structural approaches, this study clearly establishes that naproxen is a PIN inhibitor and elucidates the underlying mechanisms. Further use of this compound may advance our understanding of the molecular mechanisms of PIN-mediated auxin transport and expand our toolkit in auxin biology and agriculture.
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Affiliation(s)
- Jing Xia
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Mengjuan Kong
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Zhisen Yang
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Lianghanxiao Sun
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Yakun Peng
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Yanbo Mao
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Hong Wei
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Wei Ying
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Yongxiang Gao
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China
| | - Jiří Friml
- Institute of Science and Technology Austria (ISTA), Am Campus 1, 3400 Klosterneuburg, Austria
| | - Jianping Weng
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China.
| | - Xin Liu
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China.
| | - Linfeng Sun
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China.
| | - Shutang Tan
- MOE Key Laboratory for Cellular Dynamics, Hefei National Laboratory for Physical Sciences at the Microscale, The First Affiliated Hospital of USTC, Biomedical Sciences and Health Laboratory of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China; Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, China.
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14
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Su L, Li Y, Chen R, Zhang X, Cao Y, Luo F, Pi M, Xu R, Gao Q, Zhou S, Hu Y, Li H, Yang Q, Wan Q, Liu B, Xu H, Li G, Weng J, Xu G, Chen C, Liu H, Shi Y, Zha Y, Kong Y, Su G, Tang Y, Zhou Y, Gong M, Xu X, Nie S. Epidemiology and outcomes of post-AKI proteinuria. Clin Kidney J 2023; 16:2262-2270. [PMID: 37915920 PMCID: PMC10616502 DOI: 10.1093/ckj/sfad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Indexed: 11/03/2023] Open
Abstract
Background Acute kidney injury (AKI) has been associated with increased risks of new-onset and worsening proteinuria. However, epidemiologic data for post-AKI proteinuria was still lacking. This study aimed to determine the incidence, risk factors and clinical correlations of post-AKI proteinuria among hospitalized patients. Methods This study was conducted in a multicenter cohort including patients aged 18-100 years with hospital-acquired AKI (HA-AKI) hospitalized at 19 medical centers throughout China. The primary outcome was the incidence of post-AKI proteinuria. Secondary outcomes included AKI recovery and kidney disease progression. The results of both quantitative and qualitative urinary protein tests were used to define post-AKI proteinuria. Cox proportional hazard model with stepwise regression was used to determine the risk factors for post-AKI proteinuria. Results Of 6206 HA-AKI patients without proteinuria at baseline, 2102 (33.9%) had new-onset proteinuria, whereas of 5137 HA-AKI with baseline proteinuria, 894 (17.4%) had worsening proteinuria after AKI. Higher AKI stage and preexisting CKD diagnosis were risk factors for new-onset proteinuria and worsening proteinuria, whereas treatment with renin-angiotensin system inhibitors was associated with an 11% lower risk of incident proteinuria. About 60% and 75% of patients with post-AKI new-onset and worsening proteinuria, respectively, recovered within 3 months. Worsening proteinuria was associated with a lower incidence of AKI recovery and a higher risk of kidney disease progression. Conclusions Post-AKI proteinuria is common and usually transient among hospitalized patients. The risk profiles for new-onset and worsening post-AKI proteinuria differed markedly. Worsening proteinuria after AKI was associated with adverse kidney outcomes, which emphasized the need for close monitoring of proteinuria after AKI.
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Affiliation(s)
- Licong Su
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanqin Li
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruixuan Chen
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaodong Zhang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Cao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fan Luo
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mingjing Pi
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China
| | - Ruqi Xu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Gao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shiyu Zhou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Hong Xu
- Children's Hospital of Fudan University, Shanghai, China
| | - Guisen Li
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Sun Yat-Sen University, Huizhou, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China
| | - Yaozhong Kong
- Department of Nephrology, the First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, Guangzhou, China
- Digital China Health Technologies Corporation Limited, Beijing, China
| | - Xin Xu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sheng Nie
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
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15
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Weng J, Ryckman J, Katz MS, Saeed H, Estes C, Naqa IE, Moreno AC, Yom SS. Dose Constraints and Planning Considerations for Thoracic Radiation Therapy: Delphi Consensus from a National Survey of Experts. Int J Radiat Oncol Biol Phys 2023; 117:e73. [PMID: 37786123 DOI: 10.1016/j.ijrobp.2023.06.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Many physicians refer to trial protocols or published guidelines (NCCN, QUANTEC, HyTEC) for dose-volume histogram (DVH) metrics. However, there may be variation in implementing these metrics during plan optimization. Some studies have suggested better outcomes for patients treated at high-volume, high-expertise centers. These differences may in part be due to greater standardization or center-specific treatment planning processes. We surveyed radiation oncologists with stated thoracic-specific expertise using the Delphi method to formulate consensus DVH metrics that would be considered ideal for high-quality radiation treatment plans. MATERIALS/METHODS Thoracic radiation oncology experts were identified using departmental websites of ACGME-accredited radiation oncology programs. After confirming their expertise, panelists were invited to submit their institutional templates and complete three rounds of questions related to normal organ dose constraints, target coverage metrics, prescribing practices, and other planning considerations. Queried radiation schemes included conventional fractionation, twice-daily fractionation, and stereotactic body radiation therapy (3 and 5 fractions). Preliminary consensus statements were generated using median values for DVH metrics and were iteratively refined in subsequent surveys. Consensus was pre-defined as ≥75% agreement among panelists. RESULTS A total of 194 experts were invited, and 100 agreed to participate. The panel was 28% female and included experts from 29 states with a median of 11 years of clinical experience (IQR 6-19). 89% specialized in 1-2 disease sites. Response rates for the Demographics, round 1, 2, and 3 surveys were 83%, 78%, 57%, and 55%, respectively. 93% of panelists believed that DVH metrics should provide thresholds for both optimal and acceptable criteria for treatment planning. 49 of the 96 proposed normal tissue dose constraint statements were iterated to consensus (Table 1), and 5 of 7 proposed target coverage metric statements achieved consensus. CONCLUSION This study highlights the heterogeneity in metrics used by thoracic radiation oncologists and provides levels of consensus on ideal and acceptable dose constraints as guidance for treatment planning. Future directions include using these statements to develop prescription templates and acceptance criteria for treatment planning systems for widespread use as well as extending this Delphi approach to additional disease sites.
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Affiliation(s)
- J Weng
- MD Anderson Cancer Center, Houston, TX
| | - J Ryckman
- Department of Radiation Oncology, West Virginia University Medicine, Camden Clark Medical Center, Parkersburg, WV
| | - M S Katz
- Radiation Oncology Associates, Lowell, MA
| | - H Saeed
- Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida, Boca Raton, FL
| | - C Estes
- University of Kansas Medical Center, Kansas City, KS, United States
| | - I El Naqa
- H. Lee Moffitt Cancer Center and Research Institute, Department of Machine Learning, Tampa, FL
| | - A C Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S S Yom
- UCSF Medical Center-Mount Zion, San Francisco, CA
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16
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Ling P, Yang D, Wang C, Zheng X, Luo S, Yang X, Deng H, Xu W, Yan J, Weng J. A pregnancy-specific Glucose management indicator derived from continuous glucose monitoring in pregnant women with type 1 diabetes. Diabetes Metab Res Rev 2023; 39:e3689. [PMID: 37435769 DOI: 10.1002/dmrr.3689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/23/2023] [Accepted: 06/22/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE Glucose management indicator (GMI) is a core metric derived from continuous glucose monitoring (CGM) and is widely used to evaluate glucose control in patients with diabetes. No study has explored the pregnancy-specific GMI. This study aimed to derive a best-fitting model to calculate GMI from mean blood glucose (MBG) obtained from CGM among pregnant women with type 1 diabetes mellitus (T1DM). METHODS A total of 272 CGM data and corresponding laboratory HbA1c from 98 pregnant women with T1DM in the CARNATION study were analysed in this study. Continuous glucose monitoring data were collected to calculate MBG, time-in-range (TIR), and glycaemic variability parameters. The relationships between the MBG and HbA1c during pregnancy and postpartum were explored. Mix-effect regression analysis with polynomial terms and cross-validation method was conducted to investigate the best-fitting model to calculate GMI from MBG obtained by CGM. RESULTS The pregnant women had a mean age of 28.9 ± 3.8 years, with a diabetes duration of 8.8 ± 6.2 years and a mean body mass index (BMI) of 21.1 ± 2.5 kg/m2 . The HbA1c levels were 6.1 ± 1.0% and 6.4 ± 1.0% during pregnancy and at postpartum (p = 0.024). The MBG levels were lower during pregnancy than those at postpartum (6.5 ± 1.1 mmol/L vs. 7.1 ± 1.5 mmol/L, p = 0.008). After adjusting the confounders of haemoglobin (Hb), BMI, trimesters, disease duration, mean amplitude of glycaemic excursions and CV%, we developed a pregnancy-specific GMI-MBG equation: GMI for pregnancy (%) = 0.84-0.28* [Trimester] + 0.08 * [ BMI in kg/m2 ] + 0.01 * [Hb in g/mL] + 0.50 * [MBG in mmol/L]. CONCLUSIONS We derived a pregnancy-specific GMI equation, which should be recommended for antenatal clinical care. CLINICAL TRIAL REGISTRY NUMBER ChiCTR1900025955.
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Affiliation(s)
- Ping Ling
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Chaofan Wang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Disease, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Disease, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Xubin Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Disease, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
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17
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Zhang J, Zou Y, Chen L, Sun F, Xu Q, Zhou Q, Wang Y, Luo X, Wang N, Li Y, Zhang S, Xiong F, Yang P, Liu S, Yang T, Weng J, Eizirik DL, Yan J, Zhou Z, Wang CY. Myo9b mutations are associated with altered dendritic cell functions and increased susceptibility to autoimmune diabetes onset. Nat Commun 2023; 14:5977. [PMID: 37749140 PMCID: PMC10519942 DOI: 10.1038/s41467-023-41534-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/08/2023] [Indexed: 09/27/2023] Open
Abstract
The regulation of autoimmunity against pancreatic islet β cells for type 1 diabetes (T1D) onset is still unclear. NOD/ShiLtJ (NOD) mice are prone to the onset of autoimmune diabetes, but its congenic strain, ALR/Lt (ALR), is not. Here we show that dendritic cells (DC) in ALR mice have impaired migratory and T-cell priming capability. Genomic comparative analysis maps a 33-bp deletion in the ALR Myosin IXb (Myo9b) gene when compared with NOD genome; meanwhile, data from knock-in models show that this ALR Myo9b allele impairs phenotypic and functional maturation of DCs, and prevents the development and progression of spontaneous autoimmune diabetes in NOD mice. In parallel, while the ALR 33-bp deletion of Myo9b is not conserved in human, we find a MYO9B R133Q polymorphism associating with increased risk of T1D and enhanced DC function in patients with T1D. Our results thus hint that alterations in Myo9b may contribute to altered DC function and autoimmune diabetes onset.
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Affiliation(s)
- Jing Zhang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Zou
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longmin Chen
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Rheumatology and Immunology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Sun
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianqian Xu
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Zhou
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Luo
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Na Wang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Li
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shu Zhang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Xiong
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiwei Liu
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Tao Yang
- Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Décio L Eizirik
- ULB Center for Diabetes Research, Université Libre de Bruxelles, Brussels, Belgium
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Zhiguang Zhou
- Diabetes Center, the Second Xiangya Hospital, Institute of Metabolism and Endocrinology, Central South University, Changsha, China.
| | - Cong-Yi Wang
- Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Wang W, Jia T, Liu Y, Deng H, Chen Z, Wang J, Geng Z, Wei R, Qiao J, Ma Y, Jiang X, Xu W, Shao J, Zhou K, Li Y, Pan Q, Yang W, Weng J, Guo L. Data-driven subgroups of newly diagnosed type 2 diabetes and the relationship with cardiovascular diseases at genetic and clinical levels in Chinese adults. Diabetes Metab Syndr 2023; 17:102850. [PMID: 37683311 DOI: 10.1016/j.dsx.2023.102850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND To subgroup Chinese patients with newly diagnosed type 2 diabetes (T2D) by K-means cluster analysis on clinical indicators, and to explore whether these subgroups represent different genetic features and calculated cardiovascular risks. METHODS The K-means clustering analysis was performed on two cohorts (n = 590 and 392), both consisting of Chinese participants with newly diagnosed T2D. To assess genetic risks, multiple polygenic risk scores (PRSs) and mitochondrial DNA copy numbers (mtDNA-CN) were calculated for all participants. Furthermore, Framingham risk scores (FRS) of cardiovascular diseases in two cohorts were also calculated to verify the genetic risks. RESULTS Four clusters were identified including the mild age-related diabetes (MARD)(35.08%), mild obesity-related diabetes (MOD) (34.41%), severe autoimmune diabetes (SAID) 19.15%, and severe insulin-resistant diabetes (SIRD) 11.36% subgroups in the MARCH (metformin, and acarbose in Chinese patients as the initial hypoglycemic treatment) cohort. There was a significant difference in PRS for cardiovascular diseases (CVD) across four subgroups in the MARCH cohort (p < 0.05). Compared with the SIDD and SIRD subgroups, patients in the MOD subgroup had a relatively lower PRS for CVD (p < 0.05) in the MARCH cohort. Females had a higher PRS compared to males, with no significant difference in FRS across the four clusters. The MOD subgroup had a significantly lower FRS which was consistent with the results of PRS. Similar results of PRS and FRS were also replicated in the CONFIDENCE (comparison of glycemic control and b-cell function among newly diagnosed patients with type 2 diabetes treated with exenatide, insulin or pioglitazone) cohort. CONCLUSION There are different CVD risks in diabetic subgroups based on clinical and genetic evidence which may promote precision medicine.
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Affiliation(s)
- Weihao Wang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Tong Jia
- Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Yiying Liu
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China; College of Life Sciences, University of Chinese Academy of Sciences, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zihao Chen
- School of Software and Microelectronics, Peking University, Beijing, China
| | - Jing Wang
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Zhaoxu Geng
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Ran Wei
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Jingtao Qiao
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Yanhua Ma
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Xun Jiang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Wen Xu
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shao
- No. 9 XingDaoHuanBei Road, Guangzhou International Bio Island, Guangzhou, 510005, Guangdong Province, China
| | - Kaixin Zhou
- The Fifth People's Hospital of Chongqing, Chongqing, China
| | - Ying Li
- School of Software and Microelectronics, Peking University, Beijing, China
| | - Qi Pan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.
| | - Wenying Yang
- China-Japan Friendship Hospital, Beijing, China.
| | - Jianping Weng
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.
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19
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Jiang J, Zhou X, Lan L, Weng J, Ren W. The correlation between serum uric acid and diabetic kidney disease in adult-onset type 1 diabetes patients in China. Acta Diabetol 2023; 60:1231-1239. [PMID: 37264251 PMCID: PMC10359385 DOI: 10.1007/s00592-023-02119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/10/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND/AIM To assess the correlation between serum uric acid (UA) level and diabetic kidney disease among adult-onset Type 1 diabetes mellitus (T1DM) patients in China. METHODS A total of 184 patients with adult-onset T1DM between January 2014 and December 2016 were recruited, with demographics and medical data collected. Comparisons were performed between according to different serum UA gender-specific quartiles. Relationship between serum UA level with urinary ACR and eGFR was also assessed. RESULTS Median urinary ACR and eGFR were 21.55 [10.79, 45.02] mg/g and 113.86 [88.43, 143.61] ml/min/1.73 m2, respectively. The median UA was 257.4 (208.2-334.8) μmol/L. Participants with higher serum UA levels had higher urinary ACR and lower eGFR than those with lower UA (P < 0.05). Higher serum UA level was significantly associated with higher urinary ACR in Spearman's correlational analysis (P = 0.006) and multiple stepwise regression analysis (P = 0.013). The association between serum UA and urinary ACR was not linear, but showed a curve correlation, which also showed in the sensitivity analysis. Serum UA in the upper gender-specific quartile, was associated with lower eGFR (P < 0.001) and showed an independent negative correlation with eGFR in multiple stepwise regression analysis (P < 0.001). CONCLUSIONS The serum UA level was negatively correlated with eGFR and had a curve correlation with urinary ACR in adult-onset T1DM patients of China.
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Affiliation(s)
- Jun Jiang
- Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China
- The Department of Nephrology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xiaowan Zhou
- The Department of Nephrology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Lei Lan
- The Department of Nephrology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Jianping Weng
- Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.
- The Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Wei Ren
- Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.
- The Department of Nephrology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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20
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Zhao H, Li Y, Sun J, Xu G, Wang C, Zhou S, Nie S, Li Y, Su L, Chen R, Cao Y, Gao Q, Hu Y, Li H, Yang Q, Wan Q, Liu B, Xu H, Li G, Weng J, Chen C, Liu H, Shi Y, Zha Y, Kong Y, Su G, Tang Y, Zhou Y, Guo A, Gong M, Xu X, Hou FF. Immunosuppression versus Supportive Care on Kidney Outcomes in IgA Nephropathy in the Real-World Setting. Clin J Am Soc Nephrol 2023; 18:1186-1194. [PMID: 37314777 PMCID: PMC10564371 DOI: 10.2215/cjn.0000000000000215] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The efficacy of immunosuppression in the management of immunoglobulin A (IgA) nephropathy remains highly controversial. The study was conducted to assess the effect of immunosuppression, compared with supportive care, in the real-world setting of IgA nephropathy. METHODS A cohort of 3946 patients with IgA nephropathy, including 1973 new users of immunosuppressive agents and 1973 propensity score-matched recipients of supportive care, in a nationwide register data from January 2019 to May 2022 in China was analyzed. The primary outcome was a composite of 40% eGFR decrease of the baseline, kidney failure, and all-cause mortality. A Cox proportional hazard model was used to estimate the effects of immunosuppression on the composite outcomes and its components in the propensity score-matched cohort. RESULTS Among 3946 individuals (mean [SD] age 36 [10] years, mean [SD] eGFR 85 [28] ml/min per 1.73 m 2 , and mean [SD] proteinuria 1.4 [1.7] g/24 hours), 396 primary composite outcome events were observed, of which 156 (8%) were in the immunosuppression group and 240 (12%) in the supportive care group. Compared with supportive care, immunosuppression treatment was associated with 40% lower risk of the primary outcome events (adjusted hazard ratio, 0.60; 95% confidence interval, 0.48 to 0.75). Comparable effect size was observed for glucocorticoid monotherapy and mycophenolate mofetil alone. In the prespecified subgroup analysis, the treatment effects of immunosuppression were consistent across ages, sexes, levels of proteinuria, and values of eGFR at baseline. Serious adverse events were more frequent in the immunosuppression group compared with the supportive care group. CONCLUSIONS Immunosuppressive therapy, compared with supportive care, was associated with a 40% lower risk of clinically important kidney outcomes in patients with IgA nephropathy.
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Affiliation(s)
- Hao Zhao
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yang Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jingdi Sun
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cheng Wang
- Division of Nephrology, Department of Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shiyu Zhou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sheng Nie
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanqin Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Licong Su
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruixuan Chen
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Cao
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Gao
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Hong Xu
- Children's Hospital of Fudan University, Shanghai, China
| | - Guisen Li
- Sichuan Clinical Research Center for Kidney Diseases, Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jianping Weng
- Division of Life Sciences and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Sun Yat-sen University, Huizhou, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China
| | - Yaozhong Kong
- Department of Nephrology, The First People's Hospital of Foshan, Foshan, China
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | | | - Xin Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fan Fan Hou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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21
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Hou X, Wang L, Zhu D, Guo L, Weng J, Zhang M, Zhou Z, Zou D, Ji Q, Guo X, Wu Q, Chen S, Yu R, Chen H, Huang Z, Zhang X, Wu J, Wu J, Jia W. Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China. Nat Commun 2023; 14:4296. [PMID: 37463878 DOI: 10.1038/s41467-023-39864-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. 50,564 participants with gradable non-mydriatic fundus photographs were enrolled. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%-17.2%) and 3.2% (2.9%-3.5%), significantly higher in the northern than in the southern regions. The differences in prevalence between those who had not attained a given metabolic goal and those who had were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. The participants with vision-threatening diabetic retinopathy had significantly higher proportions of visual impairment and blindness than those with non-vision-threatening diabetic retinopathy. The likelihoods of diabetic retinopathy and vision-threatening diabetic retinopathy were also associated with education levels, household income, and multiple dietary intakes. Here, we show multi-level factors associated with the presence and the severity of diabetic retinopathy.
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Affiliation(s)
- Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, Beijing, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, the Second Xiangya Hospital and the Diabetes Center, Central South University, Changsha, Hunan Province, China
| | - Dajin Zou
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Xi'an, Shaanxi Province, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu Province, China
| | - Rong Yu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Hongli Chen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiarui Wu
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
- Center for Excellence in Molecular Science, Chinese Academy of Sciences, Shanghai, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
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22
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Qin W, Weng J. Hepatocyte NLRP3 interacts with PKCε to drive hepatic insulin resistance and steatosis. Sci Bull (Beijing) 2023; 68:1413-1429. [PMID: 37336688 DOI: 10.1016/j.scib.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/17/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
Hepatic insulin resistance (IR), as a downstream sequela of nonalcoholic fatty liver disease (NAFLD), is strongly associated with liver steatosis. Despite numerous mechanism advancements, the molecular underpinnings and pathogenesis of hepatic IR, especially regarding the pattern recognition receptors in hepatocytes, remain elusive. Here, we identified hepatocyte NLRP3 as a direct and previously-unresolved driver of hepatic IR to promote steatosis response. Under the model of NAFLD, we identified hepatocyte NLRP3 as a crucial inducer of hepatic IR by undertaking multilayer transcriptomic searches and further confirmed that its expression was increased in the liver tissues from NAFLD patients and mouse models (high-fat diet (HFD), leptin-receptor-deficient (db/db) mice), and in palmitic acid (PA)-induced hepatocytes. Loss- or gain-of-function of hepatocyte-specific NLRP3 in HFD-induced mice ameliorated or exacerbated hepatic IR and steatosis, respectively. Mechanistically, NLRP3 directly bound to and promoted protein kinase C epsilon (PKCε) activation to impair insulin signaling and increase liver steatosis, while inhibition of PKCε activation dampened the beneficial effects seen in HFD-induced NLRP3-deficient mice. Moreover, we performed screening and discovered that the transcription factor Yin Yang 1 (YY1) positively controlled NLRP3 expression. In translational potential, adeno-associated virus serotype 8 (AAV8)-mediated NLRP3 knockdown in the liver alleviated hepatic IR and steatosis in db/db mice, and pharmacological inhibition of NLRP3 markedly alleviated diet-induced metabolic disorders. This finding reveals a previously-unexpected regulatory axis from YY1 to PKCε via NLRP3 induction for metabolic diseases and establishes the YY1-NLRP3-PKCε axis as a potential therapeutic target for NAFLD.
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Affiliation(s)
- Weiwei Qin
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei 230027, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei 230027, China.
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23
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Gao Y, Shang Z, Nie S, Feng S, Wang B, Li Z, Wu M, Wen Y, Xu H, Weng J, Chen C, Liu H, Yang Q, Li H, Kong Y, Li G, Wan Q, Zha Y, Hu Y, Xu G, Shi Y, Zhou Y, Su G, Tang Y, Gong M, Fan HF, Liu B. Clinical predictive factors and prediction models for end-stage renal disease in Chinese patients with type 2 diabetes mellitus. Clin Transl Med 2023; 13:e1323. [PMID: 37386765 PMCID: PMC10310973 DOI: 10.1002/ctm2.1323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- Yueming Gao
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
- Department of NephrologyPeking University Third HospitalBeijingChina
| | - Zhi Shang
- Department of Cardiology and Institute of Vascular MedicinePeking University Third HospitalBeijingChina
| | - Sheng Nie
- Division of Nephrology, Nanfang HospitalSouthern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure ResearchGuangzhouChina
| | - Songtao Feng
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
| | - Bin Wang
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
| | - Zuolin Li
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
| | - Min Wu
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
| | - Yi Wen
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
| | - Hong Xu
- Children's Hospital of Fudan UniversityShanghaiChina
| | - Jianping Weng
- Department of EndocrinologyThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefeiChina
| | - Chunbo Chen
- Department of Critical Care MedicineMaoming People's HospitalMaomingChina
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang CityInstitute of Nephrology, Affiliated Hospital of Guangdong Medical UniversityZhanjiangChina
| | - Qiongqiong Yang
- Department of NephrologySun Yat‐Sen Memorial Hospital, Sun Yat‐Sen UniversityGuangzhouChina
| | - Hua Li
- Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
| | - Yaozhong Kong
- Department of NephrologyThe First People's Hospital of FoshanFoshanChina
| | - Guisen Li
- Renal Department and Institute of NephrologySichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney DiseasesChengduChina
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen UniversityShenzhenChina
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou UniversityGuiyangChina
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Gang Xu
- Division of NephrologyTongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Yongjun Shi
- Huizhou Municipal Central HospitalSun Yat‐Sen UniversityHuizhouChina
| | - Yilun Zhou
- Department of NephrologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Guobin Su
- Department of NephrologyGuangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical UniversityGuangzhouChina
| | - Mengchun Gong
- Institute of Health ManagementSouthern Medical UniversityGuangzhouChina
- Digital Health China Technologies Co., LTDBeijingChina
| | - Hou Fan Fan
- Division of Nephrology, Nanfang HospitalSouthern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure ResearchGuangzhouChina
| | - Bicheng Liu
- Institute of NephrologyZhongda Hospital, Southeast University School of MedicineNanjingChina
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24
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Xu X, Nie S, Xu H, Liu B, Weng J, Chen C, Liu H, Yang Q, Li H, Kong Y, Li G, Wan Q, Zha Y, Hu Y, Xu G, Shi Y, Zhou Y, Su G, Tang Y, Li Y, Su L, Chen R, Cao Y, Gao P, Zhou S, Zhang X, Luo F, Xu R, Gao Q, Hou FF. Detecting Neonatal AKI by Serum Cystatin C. J Am Soc Nephrol 2023; 34:1253-1263. [PMID: 36977125 PMCID: PMC10356146 DOI: 10.1681/asn.0000000000000125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/26/2023] [Indexed: 03/30/2023] Open
Abstract
SIGNIFICANCE STATEMENT Serum creatinine is not a sensitive biomarker for neonatal AKI because it is confounded by maternal creatinine level, gestational age, and neonatal muscle mass. In this multicenter cohort study of 52,333 hospitalized Chinese neonates, the authors proposed serum cystatin C-related criteria (CyNA) for neonatal AKI. They found that cystatin C (Cys-C) is a robust and sensitive biomarker for identifying AKI in neonates who are at an elevated risk of in-hospital mortality and that CyNA detects 6.5 times as many cases as the modified Kidney Disease Improving Global Outcomes creatinine criteria. They also show that AKI can be detected using a single test of Cys-C. These findings suggest that CyNA shows promise as a powerful and easily applicable tool for detecting AKI in neonates. BACKGROUND Serum creatinine is not a sensitive biomarker for AKI in neonates. A better biomarker-based criterion for neonatal AKI is needed. METHODS In this large multicenter cohort study, we estimated the upper normal limit (UNL) and reference change value (RCV) of serum cystatin C (Cys-C) in neonates and proposed cystatin C-based criteria (CyNA) for detecting neonatal AKI using these values as the cutoffs. We assessed the association of CyNA-detected AKI with the risk of in-hospital death and compared CyNA performance versus performance of modified Kidney Disease Improving Global Outcomes (KDIGO) creatinine criteria. RESULTS In this study of 52,333 hospitalized neonates in China, Cys-C level did not vary with gestational age and birth weight and remained relatively stable during the neonatal period. CyNA criteria define AKI by a serum Cys-C of ≥2.2 mg/L (UNL) or an increase in Cys-C of ≥25% (RCV) during the neonatal period. Among 45,839 neonates with measurements of both Cys-C and creatinine, 4513 (9.8%) had AKI detected by CyNA only, 373 (0.8%) by KDIGO only, and 381 (0.8%) by both criteria. Compared with neonates without AKI by both criteria, neonates with AKI detected by CyNA alone had an increased risk of in-hospital mortality (hazard ratio [HR], 2.86; 95% confidence interval [95% CI], 2.02 to 4.04). Neonates with AKI detected by both criteria had an even higher risk of in-hospital mortality (HR, 4.86; 95% CI, 2.84 to 8.29). CONCLUSIONS Serum Cys-C is a robust and sensitive biomarker for detecting neonatal AKI. Compared with modified KDIGO creatinine criteria, CyNA is 6.5 times more sensitive in identifying neonates at elevated risk of in-hospital mortality.
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Affiliation(s)
- Xin Xu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sheng Nie
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Xu
- Children's Hospital of Fudan University, Shanghai, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Jianping Weng
- Division of Life Sciences and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaozhong Kong
- Department of Nephrology, First People's Hospital of Foshan, Foshan, China
| | - Guisen Li
- Sichuan Clinical Research Center for Kidney Diseases, Renal Department and Institute of Nephrology, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Xu
- Division of Nephrology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Huizhou, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guobin Su
- Department of Nephrology, The Second Clinical College, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yanqin Li
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Licong Su
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruixuan Chen
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Cao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Peiyan Gao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shiyu Zhou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaodong Zhang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fan Luo
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruqi Xu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Gao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fan Fan Hou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Wu Z, Jin T, Weng J. Erratum to: A thorough analysis of diabetes research in China from 1995 to 2015: current scenario and future scope. Sci China Life Sci 2023:10.1007/s11427-023-2356-0. [PMID: 37410206 DOI: 10.1007/s11427-023-2356-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Zekai Wu
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Tianru Jin
- Department of Physiology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Jianping Weng
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
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Wu C, Zhang Y, Nie S, Hong D, Zhu J, Chen Z, Liu B, Liu H, Yang Q, Li H, Xu G, Weng J, Kong Y, Wan Q, Zha Y, Chen C, Xu H, Hu Y, Shi Y, Zhou Y, Su G, Tang Y, Gong M, Wang L, Hou F, Liu Y, Li G. Predicting in-hospital outcomes of patients with acute kidney injury. Nat Commun 2023; 14:3739. [PMID: 37349292 PMCID: PMC10287760 DOI: 10.1038/s41467-023-39474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
Acute kidney injury (AKI) is prevalent and a leading cause of in-hospital death worldwide. Early prediction of AKI-related clinical events and timely intervention for high-risk patients could improve outcomes. We develop a deep learning model based on a nationwide multicenter cooperative network across China that includes 7,084,339 hospitalized patients, to dynamically predict the risk of in-hospital death (primary outcome) and dialysis (secondary outcome) for patients who developed AKI during hospitalization. A total of 137,084 eligible patients with AKI constitute the analysis set. In the derivation cohort, the area under the receiver operator curve (AUROC) for 24-h, 48-h, 72-h, and 7-day death are 95·05%, 94·23%, 93·53%, and 93·09%, respectively. For dialysis outcome, the AUROC of each time span are 88·32%, 83·31%, 83·20%, and 77·99%, respectively. The predictive performance is consistent in both internal and external validation cohorts. The model can predict important outcomes of patients with AKI, which could be helpful for the early management of AKI.
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Affiliation(s)
- Changwei Wu
- Department of Nephrology and Nephrology Institute, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 610072, Chengdu, China
| | - Yun Zhang
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, 610054, Chengdu, China
| | - Sheng Nie
- National Clinical Research Center for Kidney Disease, State Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - Daqing Hong
- Department of Nephrology and Nephrology Institute, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 610072, Chengdu, China
| | - Jiajing Zhu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, 610054, Chengdu, China
| | - Zhi Chen
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, 610054, Chengdu, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, 210000, Nanjing, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, 524000, Zhanjiang, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 510515, Guangzhou, China
| | - Hua Li
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230000, Hefei, China
| | - Yaozhong Kong
- Department of Nephrology, the First People's Hospital of Foshan, 528000, Foshan, China
| | - Qijun Wan
- The Second People's Hospital of Shenzhen, Shenzhen University, 518000, Shenzhen, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guizhou University, 550000, Guiyang, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, 525000, Maoming, China
| | - Hong Xu
- Children's Hospital of Fudan University, 200000, Shanghai, China
| | - Ying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Sun Yat-Sen University, 516000, Huizhou, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, 100000, Beijing, China
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, 510000, Guangzhou, China
| | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, 510000, Guangzhou, China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, 510000, Guangzhou, China
- DHC Technologies, 100000, Beijing, China
| | - Li Wang
- Department of Nephrology and Nephrology Institute, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 610072, Chengdu, China
| | - Fanfan Hou
- National Clinical Research Center for Kidney Disease, State Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China.
| | - Yongguo Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, 610054, Chengdu, China.
| | - Guisen Li
- Department of Nephrology and Nephrology Institute, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 610072, Chengdu, China.
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27
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Zhou S, Su L, Xu R, Li Y, Chen R, Cao Y, Gao P, Zhang X, Luo F, Gao Q, An S, Cai W, Lin L, Xu H, Liu B, Weng J, Chunbo C, Liu H, Yang Q, Li H, Kong Y, Li G, Wan Q, Zha Y, Hu Y, Xu G, Shi Y, Zhou Y, Su G, Tang Y, Gong M, Xu X, Nie S. Statin initiation and risk of incident kidney disease in patients with diabetes. CMAJ 2023; 195:E729-E738. [PMID: 37247880 DOI: 10.1503/cmaj.230093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND The role of statin therapy in the development of kidney disease in patients with type 2 diabetes mellitus (DM) remains uncertain. We aimed to determine the relationships between statin initiation and kidney outcomes in patients with type 2 DM. METHODS Through a new-user design, we conducted a multicentre retrospective cohort study using the China Renal Data System database (which includes inpatient and outpatient data from 19 urban academic centres across China). We included patients with type 2 DM who were aged 40 years or older and admitted to hospital between Jan. 1, 2000, and May 26, 2021, and excluded those with pre-existing chronic kidney disease and those who were already on statins or without follow-up at an affiliated outpatient clinic within 90 days after discharge. The primary exposure was initiation of a statin. The primary outcome was the development of diabetic kidney disease (DKD), defined as a composite of the occurrence of kidney dysfunction (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2 and > 25% decline from baseline) and proteinuria (a urinary albumin-to-creatinine ratio ≥ 30 mg/g and > 50% increase from baseline), sustained for at least 90 days; secondary outcomes included development of kidney function decline (a sustained > 40% decline in eGFR). We used Cox proportional hazards regression to evaluate the relationships between statin initiation and kidney outcomes, as well as to conduct subgroup analyses according to patient characteristics, presence or absence of dyslipidemia, and pattern of dyslipidemia. For statin initiators, we explored the association between different levels of lipid control and outcomes. We conducted analyses using propensity overlap weighting to balance the participant characteristics. RESULTS Among 7272 statin initiators and 12 586 noninitiators in the weighted cohort, statin initiation was associated with lower risks of incident DKD (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.62-0.83) and kidney function decline (HR 0.60, 95% CI 0.44-0.81). We obtained similar results to the primary analyses for participants with differing patterns of dyslipidemia, those prescribed different statins, and after stratification according to participant characteristics. Among statin initiators, those with intensive control of high-density lipoprotein cholesterol (LDL-C) (< 1.8 mmol/L) had a lower risk of incident DKD (HR 0.51, 95% CI 0.32-0.81) than those with inadequate lipid control (LDL-C ≥ 3.4 mmol/L). INTERPRETATION For patients with type 2 DM admitted to and followed up in academic centres, statin initiation was associated with a lower risk of kidney disease development, particularly in those with intensive control of LDL-C. These findings suggest that statin initiation may be an effective and reasonable approach for preventing kidney disease in patients with type 2 DM.
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Affiliation(s)
- Shiyu Zhou
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Licong Su
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Ruqi Xu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yanqin Li
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Ruixuan Chen
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yue Cao
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Peiyan Gao
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Xiaodong Zhang
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Fan Luo
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Qi Gao
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Shengli An
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Wenyi Cai
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Lilong Lin
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Hong Xu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Bicheng Liu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Jianping Weng
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Chen Chunbo
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Huafeng Liu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Qiongqiong Yang
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Hua Li
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yaozhong Kong
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Guisen Li
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Qijun Wan
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yan Zha
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Ying Hu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Gang Xu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yongjun Shi
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Yilun Zhou
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Guobin Su
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Ying Tang
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Mengchun Gong
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Xin Xu
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
| | - Sheng Nie
- Division of Nephrology (S. Zhou, L. Su, R. Xu, Y. Li, Chen, Cao, P. Gao, Zhang, Luo, Q. Gao, X. Xu, Nie), National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Biostatistics (An), School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China; Huiqiao Medical Center (Cai), Standardized General Practice Training Site, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Cardiology (Lin), State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Children's Hospital of Fudan University (H. Xu), Shanghai, China; Institute of Nephrology (B. Liu), Zhongda Hospital, Southeast University School of Medicine, Nanjing, China; Department of Endocrinology (Weng), The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Critical Care Medicine (Chunbo), Maoming People's Hospital, Maoming, China; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City (H. Liu), Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China; Department of Nephrology (Yang), Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Sir Run Run Shaw Hospital (H. Li), Zhejiang University School of Medicine, Hangzhou, China; Department of Nephrology (Kong), the First People's Hospital of Foshan, Foshan, Guangdong, China; Renal Department and Institute of Nephrology (G. Li), Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China; The Second People's Hospital of Shenzhen (Wan), Shenzhen University, Shenzhen, China; Guizhou Provincial People's Hospital (Zha), Guizhou University, Guiyang, China; The Second Affiliated Hospital of Zhejiang University School of Medicine (Ying Hu), Hangzhou, China; Division of Nephrology (G. Xu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Huizhou Municipal Central Hospital (Shi), Sun Yat-Sen University, Huizhou, China; Department of Nephrology (Y. Zhou), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Nephrology (G. Su), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China; The Third Affiliated Hospital of Southern Medical University (Tang), Guangzhou, China; Institute of Health Management (Gong), Southern Medical University, Guangzhou, China; DHC Technologies (Gong), Beijing, China
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Wu X, Xu M, Geng M, Chen S, Little PJ, Xu S, Weng J. Targeting protein modifications in metabolic diseases: molecular mechanisms and targeted therapies. Signal Transduct Target Ther 2023; 8:220. [PMID: 37244925 DOI: 10.1038/s41392-023-01439-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/01/2023] [Accepted: 04/06/2023] [Indexed: 05/29/2023] Open
Abstract
The ever-increasing prevalence of noncommunicable diseases (NCDs) represents a major public health burden worldwide. The most common form of NCD is metabolic diseases, which affect people of all ages and usually manifest their pathobiology through life-threatening cardiovascular complications. A comprehensive understanding of the pathobiology of metabolic diseases will generate novel targets for improved therapies across the common metabolic spectrum. Protein posttranslational modification (PTM) is an important term that refers to biochemical modification of specific amino acid residues in target proteins, which immensely increases the functional diversity of the proteome. The range of PTMs includes phosphorylation, acetylation, methylation, ubiquitination, SUMOylation, neddylation, glycosylation, palmitoylation, myristoylation, prenylation, cholesterylation, glutathionylation, S-nitrosylation, sulfhydration, citrullination, ADP ribosylation, and several novel PTMs. Here, we offer a comprehensive review of PTMs and their roles in common metabolic diseases and pathological consequences, including diabetes, obesity, fatty liver diseases, hyperlipidemia, and atherosclerosis. Building upon this framework, we afford a through description of proteins and pathways involved in metabolic diseases by focusing on PTM-based protein modifications, showcase the pharmaceutical intervention of PTMs in preclinical studies and clinical trials, and offer future perspectives. Fundamental research defining the mechanisms whereby PTMs of proteins regulate metabolic diseases will open new avenues for therapeutic intervention.
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Affiliation(s)
- Xiumei Wu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, 510000, Guangzhou, China
| | - Mengyun Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Mengya Geng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Shuo Chen
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, 4102, Australia
- Sunshine Coast Health Institute and School of Health and Behavioural Sciences, University of the Sunshine Coast, Birtinya, QLD, 4575, Australia
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China.
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, 510000, Guangzhou, China.
- Bengbu Medical College, Bengbu, 233000, China.
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Zhou Y, Zheng M, Deng H, Zheng X, Luo S, Yang D, Mai X, Xu W, Yan J, Weng J. Relative contributions of fasting and postprandial glucose increments, glycemic variability, and non-glycemic factors to HbA1c in individuals with type 1 diabetes. J Diabetes 2023. [PMID: 37143431 DOI: 10.1111/1753-0407.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/07/2023] [Accepted: 04/01/2023] [Indexed: 05/06/2023] Open
Abstract
AIM Evidence for contribution of basal and postprandial glucose increment, and glycemic variability to glycated hemoglobin (HbA1c) among adults with type 1 diabetes (T1D) is limited. This study aimed to capture glycemic fluctuation patterns and quantify contributions of these factors to HbA1c levels among adults with T1D. METHODS HbA1c, continuous glucose monitoring (CGM), and diet diaries were collected and pooled from two clinical trials. Available data sets were divided into HbA1c quartiles: group 1 (≤6.7%), group 2 (6.7%-7.3%), group 3 (7.3%-7.8%), and group 4 (≥7.8%). Area under curve above 110 mg/dL (AUC>110mg/dL ) in 24-h profile was defined as overall hyperglycemia and stratified with postprandial hyperglycemia (PHG, AUC>110mg/dL in 3-h period after meals) and basal hyperglycemia (BHG, AUC>110mg/dL in remaining period). Linear regression analysis was used to estimate the proportion of variance in HbA1c explained by BHG, preprandial glucose, PHG, glycemic variability, and non-glycemic factors (age, body mass index, hemoglobin, and duration). RESULTS A total of 169 550 glucose data in 2409 meals recorded from 102 patients (male/female, 34/68) were included. Age and duration were 35.2 ± 12.6 and 8.9 (2.9, 13.0) years, with 51.0% using pumps. Overall, BHG was four times higher than PHG (p all <.05) and between-group comparisons showed BHG exhibited a progressive increase (group 1 vs. 2, 3, 4, p = .053, .086, .006) with fasting contribution of 76.1%, 82.6%, 81.5%, and 84.3% from group 1 to 4. The increment was not significant among groups 2, 3, and 4 (p > .05). Factors included in analysis explained a total of 74% of the variance in HbA1c, in which BHG accounted for 32.1% of variance whereas PHG accounted for 24.4%. In group with HbA1c >7.3%, BHG accounted for a higher percentage with 33.8% of the variance in HbA1c. CONCLUSIONS In our study, basal hyperglycemia better predicts overall glycemic control than postprandial hyperglycemia among adults with T1D. The relative contribution of basal hyperglycemia increased gradually with HbA1c increasing and predominant strategy for insulin titration among T1D is different among different levels of glycemic control.
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Affiliation(s)
- Yongwen Zhou
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), Hefei, Anhui, China
| | - Mao Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), Hefei, Anhui, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), Hefei, Anhui, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), Hefei, Anhui, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Xiaodong Mai
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), Hefei, Anhui, China
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30
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Lu B, Sun J, Chen L, Song X, Deng Y, Dong Y, Dong J, Du P, Ge J, Guo Y, Han P, Ji L, Li Q, Li Y, Liu C, Liu J, Liu J, Lu J, Shen X, Wan L, Wang Z, Wang Q, Wu S, Xu M, Xu Y, Xue Y, Yuan C, Yang Y, Zheng F, Zhuo G, Zhang L, Zhang Q, Zhu S, Zhao Z, Weng J, Zhu D, Hu R. Consensus of Chinese experts on strengthening personalized prevention and treatment of type 2 diabetes. Prim Care Diabetes 2023; 17:137-140. [PMID: 36709085 DOI: 10.1016/j.pcd.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/08/2023] [Indexed: 01/28/2023]
Abstract
Up to now, there has not yet been guidance or consensus from Chinese experts in the field of personalized prevention and treatment of type 2 diabetes. In view of the above, the endocrinology diabetes Professional Committee of Chinese Non-government Medical Institutions Association, the integrated endocrinology diabetes Professional Committee of the integrated medicine branch of Chinese Medical Doctor Association, and the diabetes education and microvascular complications group of the diabetes branch of the Chinese Medical Association organized relevant experts to discuss and reach the "Chinese expert consensus on strengthening personalized prevention and treatment of type 2 diabetes" for reference in clinical practice.
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Affiliation(s)
- Bin Lu
- Department of Endocrinology, Huashan Hospital Fudan University, China; Institute of Endocrinology and Diabetology, Fudan University, China
| | - Jianqin Sun
- Department of Clinical Nutrition, Huadong Hospital Fudan University, China
| | - Lili Chen
- Department of Endocrinology, Huashan Hospital Fudan University, China; Institute of Endocrinology and Diabetology, Fudan University, China
| | - Xiaoyan Song
- Cadre Diagnosis and Treatment Department, Eighth Medical Center of PLA General Hospital, China
| | - Yanbei Deng
- Department of Endocrinology, Suzhou Jiulong Hospital, School of Medicine, Shanghai Jiaotong University, China
| | - Yanhu Dong
- Qingdao Endocrine and Diabetes Hospital, China
| | - Jixiang Dong
- Department of Endocrinology, Suzhou Benq Medical Center, China
| | - Peiyi Du
- Department of Endocrinology, Yangzhou Dongfang Hospital, China
| | - Jiapu Ge
- Department of Endocrinology, Xinjiang Uygur Municipal People's Hospital, China
| | | | | | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, China
| | - Qiang Li
- Department of Endocrinology, Shenzhen University General Hospital, China
| | - Yuzhong Li
- Department of Endocrinology, Dongguan Kanghua Hospital, China
| | - Chao Liu
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, China
| | - Jing Liu
- Department of Endocrinology, Gansu Provincial Hospital, China
| | - Jie Liu
- Department of Endocrinology, Shanxi Provincial People's Hospital, China
| | - Juming Lu
- Beijing Ruijing Diabetes Hospital, China
| | | | - Limei Wan
- Anshan Wanliang Diabetes Hospital, China
| | - Zhili Wang
- Beijing Chaoyang Diabetes Hospital, China
| | - Quansheng Wang
- Department of Endocrinology, Nanjing Benq Medical Center, China
| | - Sen Wu
- Nanning Wutang Hospital, China
| | - Mingzhi Xu
- Department of Endocrinology, Hangzhou Shulan Hospital, China
| | - Yancheng Xu
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, China
| | - Yaoming Xue
- Department of Endocrinology, Nanfang Hospital, Southern Medical University, China
| | | | - Yuzhi Yang
- Department of Endocrinology, Heilongjiang Provincial Hospital, China
| | - Feng Zheng
- Shanghai Changying Industrial Development Group, China
| | - Guojin Zhuo
- Beijing Ruijing Hospital Management Limited, China
| | - Lei Zhang
- Qingdao Endocrine and Diabetes Hospital, China
| | - Qiu Zhang
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, China
| | - Shuiwang Zhu
- Hangzhou Tangyoubaobao Health Food Co., Ltd, China
| | - Zhigang Zhao
- Department of Endocrinology, Zhengzhou Yihe Hospital, China
| | - Jianping Weng
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), China.
| | - Dalong Zhu
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, China.
| | - Renming Hu
- Department of Endocrinology, Huashan Hospital Fudan University, China; Institute of Endocrinology and Diabetology, Fudan University, China.
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31
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Jiang P, Liu Z, Fang T, Zhang Z, Zhang Y, Wang D, Little PJ, Xu S, Weng J. Growth differentiation factor 15 is dispensable for acetaminophen-induced liver injury in mice. Basic Clin Pharmacol Toxicol 2023; 132:343-353. [PMID: 36602134 DOI: 10.1111/bcpt.13834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
Acetaminophen (APAP)-induced liver injury (AILI) has been recognized as a pivotal contributor to drug-induced liver failure in Western countries, but its molecular mechanism remains poorly understood. Growth differentiation factor 15 (GDF15) is a pleiotropic factor that alleviates non-alcoholic liver steatohepatitis, liver fibrosis and liver injury. The aim of the present study was to examine the possibility whether GDF15 confers protection against AILI. We found that the gene expression of Gdf15 was increased significantly after APAP overdose in mice. Next, the role of Gdf15 in AILI was evaluated by hepatic Gdf15 overexpression (using adeno-associated virus serotype 8), injection with recombinant human GDF15 (rhGDF15) and Gdf15 knockout mice after challenge with APAP. A marked elevation of Gdf15 was observed after AILI. However, there were no significant differences in AILI-related liver injury and JNK phosphorylation after Gdf15 overexpression, rhGDF15 injection or Gdf15 deficiency. Together, we conclude that, despite a noticeable elevation of Gdf15 level after AILI, Gdf15 is dispensable for APAP-induced AILI. Our study further suggests that genomic analysis of mRNA expression after APAP overdose is of limited relevance unless followed up by a functional analysis of candidate genes in vivo.
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Affiliation(s)
- Peng Jiang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China.,Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhenghong Liu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Tingyu Fang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Zhidan Zhang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Yu Zhang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Dongdong Wang
- Centre for Metabolism, Obesity and Diabetes Research and the Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, Queensland, Australia.,Sunshine Coast Health Institute and School of Health and Behavioural Sciences, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
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32
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Wang J, Liang H, Wang Y, Zheng X, Chen F, Shao J, Geng Z, Zheng L, Yang W, Weng J, Xu T, Zhou K. Mitochondrial DNA Copy Number Is a Potential Biomarker for Treatment Choice Between Metformin and Acarbose. Clin Pharmacol Ther 2023; 113:1268-1273. [PMID: 36841964 DOI: 10.1002/cpt.2877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/08/2023] [Indexed: 02/27/2023]
Abstract
Metformin is the first-line drug for type 2 diabetes (T2D) while acarbose is suggested as a viable alternative in Chinese patients with newly diagnosed T2D. However, few biomarkers have been established to guide the choice between these two agents. Mitochondrial DNA (mtDNA) copy number (mtDNA-CN) is a biomarker of mitochondrial function, which is associated with various metabolic outcomes. Using data from the trial of Metformin and Acarbose in Chinese as the Initial Hypoglycaemic Treatment (MARCH) (metformin n = 214; acarbose n = 198), we examined whether mtDNA-CN was associated with response to the drugs in terms of glycemic response and β-cell function protection response. The glycemic response is defined as the maximum glucose reduction of glycated hemoglobin A1c , fasting plasma glucose, or postprandial blood glucose during 48 weeks. β-cell function protection response is defined as the maximum increment of insulinogenic index (IGI) or disposition index (DI). For all three glycemic responses, mtDNA-CN was not significantly associated with either metformin or acarbose. Importantly, for β-cell function protection response, we found the increased mtDNA-CN was significantly associated with more IGI increment (beta: 0.84; 95% confidence interval (CI), 0.02 to 1.66) in the metformin group, but less IGI increment (beta: -1.38; 95% CI, -2.52 to -0.23) in the acarbose group. A significant interaction (P = 0.008) between mtDNA-CN and the treatment group was observed. Consistent results were also obtained when DI increment was used as a measure of β-cell function response. This study demonstrated the potential application of mtDNA-CN in guiding the treatment choice between metformin and acarbose based on β-cell protection.
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Affiliation(s)
- Jing Wang
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Hua Liang
- Department of Endocrinology and Metabolism, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Foshan, China
| | - You Wang
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- Department of Endocrinology of the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, Hefei, China
| | - Fei Chen
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Jian Shao
- Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, China
| | - Zhaoxu Geng
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Li Zheng
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Wenying Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Jianping Weng
- Department of Endocrinology of the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, Hefei, China
| | - Tao Xu
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, China
| | - Kaixin Zhou
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
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33
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Wang J, Liang H, Huang R, Weng X, Zheng L, Wang Y, Zheng X, Gu Z, Chen F, Shao J, Geng Z, Pearson ER, Weng J, Yang W, Xu T, Zhou K. Higher mitochondrial DNA copy number is associated with metformin-induced weight loss. Commun Med (Lond) 2023; 3:29. [PMID: 36806755 PMCID: PMC9938854 DOI: 10.1038/s43856-023-00258-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/09/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Considerable variability exists in response to metformin with few effective biomarkers to guide the treatment. Here we evaluated whether whole blood derived mitochondrial DNA copy number (mtDNA-CN) is a biomarker of metformin response as measured by glucose reduction or weight loss. METHODS Using data from the trial of Metformin (n = 304) and AcaRbose (n = 300) in Chinese as the initial Hypoglycaemic treatment (MARCH), we examined the association between mtDNA-CN and two metformin response outcomes of HbA1c reduction and weight loss. The acarbose arm was used as a comparator group. Whole blood mtDNA-CN was estimated by deep whole genome sequencing with adjustments for confounders. Multiple linear regression and repeated measurement analyses were used to evaluate the association between mtDNA-CN and drug response outcomes. RESULTS Here we show that glucose reduction is not significantly associated with mtDNA-CN and in either treatment arm. In the metformin arm, each increase of 1 SD in mtDNA-CN is significantly (P = 0.006) associated with a 0.43 kg more weight loss. Repeated measurement analysis shows that after 16 weeks of metformin monotherapy, patients in the top tertile of mtDNA-CN consistently lost 1.21 kg more weight than those in the bottom tertile (P < 0.001). In comparison, mtDNA-CN is not significantly associated with acarbose-induced weight loss. CONCLUSIONS Patients with higher mtDNA-CN are likely to lose more weight upon metformin treatment, suggesting mtDNA-CN as a potential novel biomarker for more effective weight management in type 2 diabetes.
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Affiliation(s)
- Jing Wang
- grid.410726.60000 0004 1797 8419College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Hua Liang
- grid.12981.330000 0001 2360 039XDepartment of Endocrinology and Metabolism, The Third Affiliated Hospital, Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, 510630 Guangdong, China ,grid.284723.80000 0000 8877 7471Department of Endocrinology and Metabolism, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), No. 1 Jiazi Road, Lunjiao Street, Foshan, 528300 P. R. China
| | - Rong Huang
- grid.452222.10000 0004 4902 7837Medical Science and Technology Innovation Center, Jinan Central Hospital, Shandong First Medical University, Jinan, 250013 Shandong China
| | - Xiong Weng
- grid.8241.f0000 0004 0397 2876Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Li Zheng
- grid.418856.60000 0004 1792 5640Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - You Wang
- grid.418856.60000 0004 1792 5640Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- grid.59053.3a0000000121679639Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001 China
| | - Zhenglong Gu
- Center for Mitochondrial Genetics and Health, Greater Bay Area Institute of Precision Medicine, Guangzhou, China ,grid.8547.e0000 0001 0125 2443School of Life Sciences, Fudan University, Shanghai, China
| | - Fei Chen
- grid.410726.60000 0004 1797 8419College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Jian Shao
- grid.410726.60000 0004 1797 8419College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaoxu Geng
- grid.418856.60000 0004 1792 5640Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Ewan R. Pearson
- grid.8241.f0000 0004 0397 2876Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Jianping Weng
- grid.59053.3a0000000121679639Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001 China
| | - Wenying Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Tao Xu
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China. .,Guangzhou Laboratory, Guangzhou, China.
| | - Kaixin Zhou
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China.
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34
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Zhao W, Xu S, Weng J. ASGR1: an emerging therapeutic target in hypercholesterolemia. Signal Transduct Target Ther 2023; 8:43. [PMID: 36690631 PMCID: PMC9869305 DOI: 10.1038/s41392-023-01319-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/16/2022] [Accepted: 12/26/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Wenqi Zhao
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230027, China
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230027, China.
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230027, China.
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35
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Yan J, Zhou Y, Zheng X, Zheng M, Lu J, Luo S, Yang D, Deng H, Xu W, Bi Y, Bao W, Weng J. Effects of intermittently scanned continuous glucose monitoring in adult type 1 diabetes patients with suboptimal glycaemic control: A multi-centre randomized controlled trial. Diabetes Metab Res Rev 2023; 39:e3614. [PMID: 36670050 DOI: 10.1002/dmrr.3614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 01/22/2023]
Abstract
AIMS To investigate whether intermittently scanned continuous glucose monitoring without alarms (intermittently scanned CGM (isCGM)) improves glycaemic control over capillary blood glucose monitoring (BGM) among adult type 1 diabetes mellitus (T1DM) patients with suboptimal control. MATERIALS AND METHODS Adults with T1DM and HbA1c between 7% and 10% were 1:1 randomized to use isCGM or BGM for 24 weeks. The primary outcome was the change in HbA1c levels after intervention. The secondary outcomes were the changes in sensor-derived metrics. RESULTS A total of 104 adults with T1DM (34.2 ± 12.2 years; M/F, 38/66) were randomized to the isCGM group (n = 54) and the BGM group (n = 50). After 24 weeks, HbA1c significantly decreased in the isCGM group (8.1 ± 0.7% to 7.5 ± 1.0%) and the BGM group (8.0 ± 0.8% to 7.7 ± 1.0%) with between-group differences of 0.3% (95% coefficient intervals, 0.0%-0.6%; P = 0.04). The percentage of HbA1c reduction over 1.0% and 1.5% was significantly higher in the isCGM group with adjusted odds ratios of 2.5 (95% CI: 1.1-5.5; P = 0.03) and 3.2 (95% CI: 1.1-9.0; P = 0.03). Mean time-in-range 70-180 mg/dl (TIR) in the isCGM group significantly increased (from 58.5 ± 13.0% to 63.0 ± 12.6%), whereas mean TIR was similar in the BGM group (from 58.0 ± 14.6% to 57.5 ± 14.5%). Time spent in hyperglycemia reduced more in the isCGM group and time spent in hypoglycemia did not change significantly in both groups. CONCLUSIONS Among adult T1DM patients with suboptimal glycaemic control, compared with BGM, isCGM use resulted in a statistically significant improvement in glycaemic control after 24-week intervention. TRIAL REGISTRATION Clinicaltrials.gov Identifier (NCT03522870).
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Affiliation(s)
- Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Yongwen Zhou
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Mao Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jing Lu
- Department of Endocrinology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
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36
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Su G, Xiao C, Cao Y, Gao P, Xie D, Cai Q, Nie S, Liu X, Lu F, Zhou Y, Hu Y, Li H, Yang Q, Wan Q, Liu B, Xu H, Li G, Weng J, Xu G, Chen C, Liu H, Shi Y, Zha Y, Kong Y, Tang Y, Shen J, Johnson DW, Xu X, Hou FF. Piperacillin/tazobactam and risk of acute kidney injury in adults hospitalized with infection without vancomycin: a multi-centre real-world data analysis. Int J Antimicrob Agents 2023; 61:106691. [PMID: 36372344 DOI: 10.1016/j.ijantimicag.2022.106691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/08/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is uncertainty about whether piperacillin/tazobactam (PT) increases the risk of acute kidney injury (AKI) in patients without concomitant use of vancomycin. This study compared the risk of hospital-acquired AKI (HA-AKI) among adults treated with PT or antipseudomonal β-lactams (meropenem, ceftazidime) without concomitant use of vancomycin. METHODS This real-world study analysed the data from China Renal Data System and assessed the risk of HA-AKI in adults hospitalized with infection after exposure to PT, meropenem or ceftazidime in the absence of concomitant vancomycin. The primary outcome was any stage of HA-AKI according to the Kidney Disease Improving Global Outcomes guidelines. A multi-variable Cox regression model and different propensity score (PS) matching models were used. RESULTS Among the 29,441 adults [mean (standard deviation) age 62.44 (16.84) years; 17,980 females (61.1%)] included in this study, 14,721 (50%) used PT, 9081 (31%) used meropenem and 5639 (19%) used ceftazidime. During a median follow-up period of 8 days, 2601 (8.8%) develped HA-AKI. The use of PT was not associated with significantly higher risk of HA-AKI compared with meropenem [adjusted hazard ratio (aHR) 1.07, 95% confidence interval (CI) 0.97-1.19], ceftazidime (aHR 1.09, 95% CI 0.92-1.30) or both agents (aHR 1.07, 95% CI 0.97-1.17) after adjusting for confounders. Results were consistent in stratified analyses, PS matching using logistic regression or random forest methods to generate a PS, and in an analysis restricting outcomes to AKI stage 2-3. CONCLUSIONS Without concomitant use of vancomycin, the risk of AKI following PT therapy is comparable with that of meropenem or ceftazidime among adults hospitalized with infection.
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Affiliation(s)
- Guobin Su
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China; Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China; Department of Global Public Health, Health Systems and Policy, Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cuixia Xiao
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Yue Cao
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Peiyan Gao
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Di Xie
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Qingqing Cai
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Sheng Nie
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Xusheng Liu
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Fuhua Lu
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Yilun Zhou
- Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Hu
- Department of Nephrology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hua Li
- Department of Nephrology, Sir Run Shaw Hospital affiliated to Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, China
| | - Qijun Wan
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
| | - Bicheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Hong Xu
- Children's Hospital of Fudan University, China
| | - Guisen Li
- Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, China
| | - Jianping Weng
- Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Chunbo Chen
- Department of Critical Care Medicine, Maoming People's Hospital, Guangdong Province, China
| | - Huafeng Liu
- Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Guangdong, China
| | - Yongjun Shi
- Huizhou Municipal Central Hospital, Guangdong, China
| | - Yan Zha
- Guizhou Provincial People's Hospital, Guiyang, China
| | | | - Ying Tang
- The Third Affiliated Hospital of Southern Medical University, China
| | - Jie Shen
- Shunde Hospital, Southern Medical University, The First People's Hospital of Shunde, Guangdong, China
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia
| | - Xin Xu
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Fan Fan Hou
- National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Centre for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China.
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Jiao Y, Zhang J, Yang X, Zhan T, Wu Z, Li Y, Zhao S, Li H, Weng J, Huo R, Wang J, Xu H, Sun Y, Wang S, Cao Y. Artificial Intelligence-Assisted Evaluation of the Spatial Relationship between Brain Arteriovenous Malformations and the Corticospinal Tract to Predict Postsurgical Motor Defects. AJNR Am J Neuroradiol 2023; 44:17-25. [PMID: 36549849 PMCID: PMC9835926 DOI: 10.3174/ajnr.a7735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Preoperative evaluation of brain AVMs is crucial for the selection of surgical candidates. Our goal was to use artificial intelligence to predict postsurgical motor defects in patients with brain AVMs involving motor-related areas. MATERIALS AND METHODS Eighty-three patients who underwent microsurgical resection of brain AVMs involving motor-related areas were retrospectively reviewed. Four artificial intelligence-based indicators were calculated with artificial intelligence on TOF-MRA and DTI, including FN5mm/50mm (the proportion of fiber numbers within 5-50mm from the lesion border), FN10mm/50mm (the same but within 10-50mm), FP5mm/50mm (the proportion of fiber voxel points within 5-50mm from the lesion border), and FP10mm/50mm (the same but within 10-50mm). The association between the variables and long-term postsurgical motor defects was analyzed using univariate and multivariate analyses. Least absolute shrinkage and selection operator regression with the Pearson correlation coefficient was used to select the optimal features to develop the machine learning model to predict postsurgical motor defects. The area under the curve was calculated to evaluate the predictive performance. RESULTS In patients with and without postsurgical motor defects, the mean FN5mm/50mm, FN10mm/50mm, FP5mm/50mm, and FP10mm/50mm were 0.24 (SD, 0.24) and 0.03 (SD, 0.06), 0.37 (SD, 0.27) and 0.06 (SD, 0.08), 0.06 (SD, 0.10) and 0.01 (SD, 0.02), and 0.10 (SD, 0.12) and 0.02 (SD, 0.05), respectively. Univariate and multivariate logistic analyses identified FN10mm/50mm as an independent risk factor for long-term postsurgical motor defects (P = .002). FN10mm/50mm achieved a mean area under the curve of 0.86 (SD, 0.08). The mean area under the curve of the machine learning model consisting of FN10mm/50mm, diffuseness, and the Spetzler-Martin score was 0.88 (SD, 0.07). CONCLUSIONS The artificial intelligence-based indicator, FN10mm/50mm, can reflect the lesion-fiber spatial relationship and act as a dominant predictor for postsurgical motor defects in patients with brain AVMs involving motor-related areas.
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Affiliation(s)
- Y Jiao
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - J Zhang
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - X Yang
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - T Zhan
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - Z Wu
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - Y Li
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - S Zhao
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - H Li
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - J Weng
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - R Huo
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - J Wang
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - H Xu
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - Y Sun
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - S Wang
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
| | - Y Cao
- From the Department of Neurosurgery (Y.J., J.Z., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.J., J.Z., X.Y., T.Z., Z.W., Y.L., S.Z., H.L., J. Weng, R.H., J. Wang, H.X., Y.S., S.W., Y.C.), Beijing, China
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Tan H, Yue T, Chen Z, Wu W, Xu S, Weng J. Targeting FGF21 in cardiovascular and metabolic diseases: from mechanism to medicine. Int J Biol Sci 2023; 19:66-88. [PMID: 36594101 PMCID: PMC9760446 DOI: 10.7150/ijbs.73936] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
Cardiovascular and metabolic disease (CVMD) is becoming increasingly prevalent in developed and developing countries with high morbidity and mortality. In recent years, fibroblast growth factor 21 (FGF21) has attracted intensive research interest due to its purported role as a potential biomarker and critical player in CVMDs, including atherosclerosis, coronary artery disease, myocardial infarction, hypoxia/reoxygenation injury, heart failure, type 2 diabetes, obesity, and nonalcoholic steatohepatitis. This review summarizes the recent developments in investigating the role of FGF21 in CVMDs and explores the mechanism whereby FGF21 regulates the development of CVMDs. Novel molecular targets and related pathways of FGF21 (adenosine 5'-monophosphate-activated protein kinase, silent information regulator 1, autophagy-related molecules, and gut microbiota-related molecules) are highlighted in this review. Considering the poor pharmacokinetics and biophysical properties of native FGF21, the development of new generations of FGF21-based drugs has tremendous therapeutic potential. Related preclinical and clinical studies are also summarized in this review to foster clinical translation. Thus, our review provides a timely and insightful overview of the physiology, biomarker potential, molecular targets, and therapeutic potential of FGF21 in CVMDs.
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Affiliation(s)
- Huiling Tan
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Tong Yue
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Zhengfang Chen
- Changshu Hospital Affiliated to Soochow University, Changshu No.1 People's Hospital, Changshu 215500, Jiangsu Province, China
| | - Weiming Wu
- Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China.,✉ Corresponding authors: E-mail: ;
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, 230001, China.,✉ Corresponding authors: E-mail: ;
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Liu R, Zheng X, Wang Z, Zhou M, Weng J, Li YM, Chen X. COVID-19 symptoms and compliance: The mediating role of fundamental social motives. Front Psychol 2023; 14:1093875. [PMID: 37020914 PMCID: PMC10067610 DOI: 10.3389/fpsyg.2023.1093875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
Background Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance. Methods An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis. Results The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained. Conclusion Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.
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Affiliation(s)
- Ruoting Liu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Ziyu Wang
- Department of Linguistics and Cognitive Science, College of Arts and Sciences, University of Delaware, Newark, DE, United States
| | - Mingjie Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yan-mei Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Yan-mei Li,
| | - Xuefeng Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Xuefeng Chen,
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Yue T, Shi Y, Luo S, Weng J, Wu Y, Zheng X. The role of inflammation in immune system of diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications. Front Immunol 2022; 13:1055087. [PMID: 36582230 PMCID: PMC9792618 DOI: 10.3389/fimmu.2022.1055087] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetic retinopathy is one of the most common complications of diabetes mellitus and the leading cause of low vision and blindness worldwide. Mounting evidence demonstrates that inflammation is a key mechanism driving diabetes-associated retinal disturbance, yet the pathophysiological process and molecular mechanisms of inflammation underlying diabetic retinopathy are not fully understood. Cytokines, chemokines, and adhesion molecules interact with each other to form a complex molecular network that propagates the inflammatory and pathological cascade of diabetic retinopathy. Therefore, it is important to understand and elucidate inflammation-related mechanisms behind diabetic retinopathy progression. Here, we review the current understanding of the pathology and pathogenesis of inflammation in diabetic retinopathy. In addition, we also summarize the relevant clinical trials to further suggest inflammation-targeted therapeutics for prevention and management of diabetic retinopathy.
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Affiliation(s)
- Tong Yue
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yu Shi
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Sihui Luo
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yali Wu
- Department of Ophthalmology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Yali Wu, ; Xueying Zheng,
| | - Xueying Zheng
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Yali Wu, ; Xueying Zheng,
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Yue T, Tan H, Wang C, Liu Z, Yang D, Ding Y, Xu W, Yan J, Zheng X, Weng J, Luo S. High-risk genotypes for type 1 diabetes are associated with the imbalance of gut microbiome and serum metabolites. Front Immunol 2022; 13:1033393. [PMID: 36582242 PMCID: PMC9794034 DOI: 10.3389/fimmu.2022.1033393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Background The profile of gut microbiota, serum metabolites, and lipids of type 1 diabetes (T1D) patients with different human leukocyte antigen (HLA) genotypes remains unknown. We aimed to explore gut microbiota, serum metabolites, and lipids signatures in individuals with T1D typed by HLA genotypes. Methods We did a cross-sectional study that included 73 T1D adult patients. Patients were categorized into two groups according to the HLA haplotypes they carried: those with any two of three susceptibility haplotypes (DR3, DR4, DR9) and without any of the protective haplotypes (DR8, DR11, DR12, DR15, DR16) were defined as high-risk HLA genotypes group (HR, n=30); those with just one or without susceptibility haplotypes as the non-high-risk HLA genotypes group (NHR, n=43). We characterized the gut microbiome profile with 16S rRNA gene amplicon sequencing and analyzed serum metabolites with liquid chromatography-mass spectrometry. Results Study individuals were 32.5 (8.18) years old, and 60.3% were female. Compared to NHR, the gut microbiota of HR patients were characterized by elevated abundances of Prevotella copri and lowered abundances of Parabacteroides distasonis. Differential serum metabolites (hypoxanthine, inosine, and guanine) which increased in HR were involved in purine metabolism. Different lipids, phosphatidylcholines and phosphatidylethanolamines, decreased in HR group. Notably, Parabacteroides distasonis was negatively associated (p ≤ 0.01) with hypoxanthine involved in purine metabolic pathways. Conclusions The present findings enabled a better understanding of the changes in gut microbiome and serum metabolome in T1D patients with HLA risk genotypes. Alterations of the gut microbiota and serum metabolites may provide some information for distinguishing T1D patients with different HLA risk genotypes.
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Affiliation(s)
- Tong Yue
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Huiling Tan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Chaofan Wang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ziyu Liu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Ding
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xueying Zheng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jianping Weng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Jianping Weng, ; Sihui Luo,
| | - Sihui Luo
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Jianping Weng, ; Sihui Luo,
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Su L, Hao Y, Li R, Pan W, Ma X, Weng J, Min Y. Red blood cell-based vaccines for ameliorating cancer chemoimmunotherapy. Acta Biomater 2022; 154:401-411. [PMID: 36241013 DOI: 10.1016/j.actbio.2022.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 12/14/2022]
Abstract
Immune checkpoint blockade (ICB) therapy has shown promising antitumor effects, but its immune response rate remains unsatisfactory. In recent years, chemotherapy has been proven to have synergistic effects with ICB therapy because some chemotherapeutic agents can enhance the immunogenicity of tumor cells by inducing immunogenic cell death (ICD). However, it cannot be ignored that chemotherapy often shows limited therapeutic efficacy due to high cytotoxicity, drug resistance, and some other side effects. Herein, we report a strategy to improve cancer immunotherapy by utilizing red blood cell-based vaccines (RBC-vaccines) where chemotherapy-induced tumor antigens (cAgs) are anchored onto red blood cells (RBCs) via the EDC/NHS-mediated amine coupling reaction. In this work, RBC-vaccines administered subcutaneously are primarily devoured by dendritic cells (DCs) and significantly improve the efficacy of αPD-1 (anti-programmed cell death 1) treatment by increasing the infiltration of intratumoral CD8+ and CD4+ T cells and elevating the intratumoral ratio of CD8+ T cells to regulatory T cells in the CT-26 colon cancer model. Finally, based on the rejection of tumor rechallenge in cured mice, the combination therapy of RBC-vaccines and αPD-1 can induce the expansion of memory T cells and thereby establish a long-term antitumor immune response. Taken together, the proposed RBC-vaccines have great potential to improve chemoimmunotherapy. STATEMENT OF SIGNIFICANCE: Immunotherapy, especially immune checkpoint blockade therapy, has made great contributions to the treatment of some advanced cancers. Unfortunately, the great majority of patients with cancer do not benefit from immunotherapy. To enhance the response rate of immunotherapy, we developed red blood cell-based vaccines (RBC-vaccines) against cancers where antigens were harvested from chemotherapy-treated cancer cells and then attached to erythrocytes via covalent surface modification. Such RBC-vaccines could provide a wide variety of tumor antigens and damage-associated molecular patterns without the use of any extra ingredients to trigger a stronger antitumor immune response. More importantly, the combination of RBC-vaccines with PD-1 blockade could significantly improve the efficacy of cancer immunotherapy and induce durable antitumor immunity.
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Affiliation(s)
- Lanhong Su
- Department of Chemistry, University of Science and Technology of China, Hefei, China
| | - Yuhao Hao
- Department of Chemistry, University of Science and Technology of China, Hefei, China
| | - Rui Li
- Department of Chemistry, University of Science and Technology of China, Hefei, China
| | - Wen Pan
- Department of Chemistry, University of Science and Technology of China, Hefei, China
| | - Xiaopeng Ma
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Jianping Weng
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yuanzeng Min
- Department of Chemistry, University of Science and Technology of China, Hefei, China; The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei, China; CAS Key Lab of Soft Matter Chemistry, University of Science and Technology of China, Hefei, China.
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Luo S, Yan J, Yang D, Xiong S, Wang C, Guo Y, Yao B, Weng J, Zheng X. Current practice, attitude and views of providing pregnancy care for women with type 1 diabetes in China: a qualitative study. BMJ Open 2022; 12:e061657. [PMID: 36343990 PMCID: PMC9644323 DOI: 10.1136/bmjopen-2022-061657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Data are sparse on healthcare needs related to pregnancy among Chinese women with type 1 diabetes (T1D) or the gap between the needs and healthcare provision in China. We aimed to identify their needs and the gaps in pregnancy care provision. DESIGN This is a qualitative, face-to-face, one-to-one in-depth interview study. We recruited our participants using a purposive sampling strategy. Semistructural outlines were used to guide the interviews. The interviews were digitally recorded, transcribed and analysed using a thematic framework method with NVivo V.10.0. SETTING Guangdong Province in China. PARTICIPANTS This study involved three key stakeholders of pregnancy care for women with T1D: 29 women with T1D of childbearing age (aged 18-50 years), 16 family members (husbands, parents and parents-in-law of women with T1D) and 35 relevant healthcare providers (HCPs). RESULTS We found that women with T1D and the family members had a more pessimistic attitude towards pregnancy outcomes, which was different from the more positive view of HCPs. However, all three stakeholders shared the following perspectives regarding pregnancy-related care for women with T1D: (1) lack of knowledge and access to education, (2) lack of multidisciplinary cooperation, (3) education should be started earlier in adulthood, (3) positive role of peer support, and (4) hope for future training of HCPs for relevant knowledge and skills specified for T1D and pregnancy with T1D. CONCLUSIONS An immense gap was identified between the needs of women with T1D regarding pregnancy-related care and current care provision in China. These findings suggest that education be provided to patients and HCPs, and the role of professional and multidisciplinary support should be enhanced to optimise pregnancy care for women with T1D in China.
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Affiliation(s)
- Sihui Luo
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
| | - Jinhua Yan
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Daizhi Yang
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Shanshan Xiong
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Chaofan Wang
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Yan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bin Yao
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
- Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China
| | - Xueying Zheng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China
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Ding Y, Zheng X, Liu Y, Wei T, Yue T, Wang S, Chen S, Weng J, Luo S. Intrapartum and early postpartum glycemic profiles in women with gestational diabetes mellitus: an observational study. Chin Med J (Engl) 2022; 135:2547-2553. [PMID: 36583918 PMCID: PMC9945305 DOI: 10.1097/cm9.0000000000002423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Data on the glycemic profile of pregnant women with gestational diabetes mellitus (GDM) during the perinatal period are sparse. This study described the intrapartum and early postpartum glucose profiles among pregnant women with GDM, and analyzed factors potentially affecting glycemic parameters during the period. METHODS This was a prospective observational study conducted from March 2020 to November 2021. Pregnant women with GDM receiving lifestyle interventions alone during pregnancy and matched women with non-diabetic pregnancies (NDPs) were enrolled from among patients admitted to the obstetrics department for childbirth. Glucose monitoring was performed via a flash glucose monitoring (FGM) system on admission, and glucose readings during labor and early postpartum were analyzed. The clinical characteristics and FGM-based parameters of participants in the two groups were compared. RESULTS A total of 124 participants (mean age: 29.5 ± 3.5 years, 92 [74.2%] primipara) were included in the final analysis. A total of 17,571 glucose readings were retrieved. There were no significant differences in clinical characteristics between the GDM (n = 60) and NDP (n = 64) groups. The average glucose level was 92.2 mg/dL, and the level was higher in the GDM group (95.5 ± 12.1 mg/dL vs. 89.1 ± 13.4 mg/dL, P = 0.008) during the intrapartum and early postpartum periods. The data were split into the intrapartum period (from the start of labor to delivery of the placenta) and the early postpartum period (within 24 h after placental delivery) for analysis. During intrapartum, women with GDM exhibited glycemic profiles and fluctuations similar to those in the NDP group. However, women with GDM had higher postpartum glucose levels (97.7 ± 13.4 mg/dL vs. 90.8 ± 15.3 mg/dL, P = 0.009), a longer time spent >140 mg/dL (8.7 ± 9.3% vs. 5.9 ± 10.3%, P = 0.011), and greater glycemic fluctuations than those with NDP. Postpartum hyperglycemia in GDM might be associated with high parity and postprandial glucose abnormalities in GDM screening tests. CONCLUSION Compared to those with normoglycemia, pregnant women with GDM receiving lifestyle interventions alone had similar intrapartum glucose profiles but higher early postpartum glucose levels and greater glucose variability, providing evidence for modification of the current perinatal glucose monitoring strategy for GDM. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR2000030972.
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Affiliation(s)
- Yu Ding
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Yujie Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Tian Wei
- Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Tong Yue
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Siqi Wang
- Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Suyu Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
- Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
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Weng J, Dabaja B, Das P, Gunn G, Chronowski G, Bloom E, Lee P, Koong A, Ning M, Semien K, Sanders C, Ritchey R, Nguyen K, Hoffman K, Robinson I, Kerr A, Brokaw J, Liao Z, Nguyen Q. Radiation Therapy Decision Making Process and Operations for COVID-19 Positive Patients. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595469 DOI: 10.1016/j.ijrobp.2022.07.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose/Objective(s) A challenging clinical dilemma during the COVID-19 pandemic is management of cancer patients who test positive for COVID. Given the need to balance the risk of disease progression with the risk of transmission to other patients and staff, radiation therapy for these patients requires careful consideration and modification of standard workflows. It is also critical to develop processes to mitigate radiation treatment interruption, which can affect patient outcomes. The objective of this study was to report the clinical operations and outcomes for COVID positive patients receiving radiation therapy during the pandemic at a tertiary cancer center including 2 network locations. Materials/Methods During March 2020 to March 2022, the Radiation Oncology COVID committee (RO COVID) developed an integrated process to triage patients, provide treatment recommendations, and implement infection control procedures to safely deliver radiation therapy to COVID positive patients. Policies were created for each center with multidisciplinary input from infectious disease, radiation oncology, radiation therapy, and nursing. All COVID positive patients were presented to the RO COVID group and evaluated for clinical urgency, benefit with radiation, and life expectancy. If deemed necessary, a limited planned break or hypofractionated regimen was recommended to minimize staff exposure. We conducted a retrospective review of COVID positive patients with different primary malignancies treated through the COVID positive pathway. Results A total of 68 COVID positive patients were treated with the COVID positive pathway (HN 15, Breast 9, CNS 8, GU 8, GYN, 7, Thoracic 6, GI 5, HEME 5, PED 3, SARC 2). The median age was 57.1 years (IQR 45.8-63.4) and 47% were female. There were 39 patients (57%) who were asymptomatic and were tested for routine pre-radiation screening or due to concerns of COVID exposure. Twenty-three (34%) patients were treated with palliative intent and 8 (12%) were treated for an emergent indication (i.e., spinal cord compression, bleeding). Thirteen (19%) patients were receiving radiation treatment, had a treatment break (7-21 days), and then resumed their radiation course. All treatments were successfully completed without known nosocomial spread of COVID to staff or other patients. Among this heterogenous group of patients, 58 (85%) were alive with a median follow up of 2 months (IQR 0.5-7.5). COVID infection may have contributed to 3 out of 10 deaths (4% of total cohort). The remaining deaths were due to progression of disease or other non-COVID causes. Conclusion In this study, COVID positive patients were safely treated with radiation therapy through a comprehensive decision making and clinical operations pathway taking into account evolving COVID guidelines for three different variant surges. Although limited in follow up, patient outcomes are promising with few COVID-related deaths and low overall mortality rates, even with hypofractionated regimens.
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Affiliation(s)
- J. Weng
- MD Anderson Cancer Center, Houston, TX,Corresponding author:
| | - B. Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P. Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G.B. Gunn
- MD Anderson Cancer Center, Houston, TX
| | - G.M. Chronowski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - P. Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A.C. Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M.S. Ning
- MD Anderson Cancer Center, Houston, TX
| | - K. Semien
- MD Anderson Cancer Center, Houston, TX
| | | | | | - K. Nguyen
- MD Anderson Cancer Center, Houston, TX
| | - K.E. Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I. Robinson
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A. Kerr
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Brokaw
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z. Liao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q.N. Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Andring L, Kelsey C, Weng J, Manzar G, Bailard N, Fellman B, Domingo M, Varkey J, Foster-Mills T, Kazantsev T, Lin L, Jhingran A, Colbert L, Eifel P, Klopp A, Joyner M. Baseline Characteristics of Patients Undergoing Brachytherapy for Gynecologic Cancer (GYN-BT) and the Role for an Enhanced Recovery Pathway (ERP). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Yue T, Tan H, Shi Y, Xu M, Luo S, Weng J, Xu S. Serum Metabolomic Profiling in Aging Mice Using Liquid Chromatography-Mass Spectrometry. Biomolecules 2022; 12:1594. [PMID: 36358944 PMCID: PMC9687663 DOI: 10.3390/biom12111594] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The process of aging and metabolism are intricately linked, thus rendering the identification of reliable biomarkers related to metabolism crucial for delaying the aging process. However, research of reliable markers that reflect aging profiles based on machine learning is scarce. METHODS Serum samples were obtained from aged mice (18-month-old) and young mice (3-month-old). LC-MS was used to perform a comprehensive analysis of the serum metabolome and machine learning was used to screen potential aging-related biomarkers. RESULTS In total, aging mice were characterized by 54 different metabolites when compared to control mice with criteria: VIP ≥ 1, q-value < 0.05, and Fold-Change ≥ 1.2 or ≤0.83. These metabolites were mostly involved in fatty acid biosynthesis, cysteine and methionine metabolism, D-glutamine and D-glutamate metabolism, and the citrate cycle (TCA cycle). We merged the comprehensive analysis and four algorithms (LR, GNB, SVM, and RF) to screen aging-related biomarkers, leading to the recognition of oleic acid. In addition, five metabolites were identified as novel aging-related indicators, including oleic acid, citric acid, D-glutamine, trypophol, and L-methionine. CONCLUSIONS Changes in the metabolism of fatty acids and conjugates, organic acids, and amino acids were identified as metabolic dysregulation related to aging. This study revealed the metabolic profile of aging and provided insights into novel potential therapeutic targets for delaying the effects of aging.
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Affiliation(s)
| | | | | | | | | | - Jianping Weng
- Correspondence: (J.W.); (S.X.); Tel.: +86-0551-63602683 (J.W.)
| | - Suowen Xu
- Correspondence: (J.W.); (S.X.); Tel.: +86-0551-63602683 (J.W.)
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Abstract
Natural products possess pleiotropic cardiovascular protective effects owing to their anti-oxidation, anti-inflammation and anti-thrombotic properties. Kaempferol, (3,5,7-trihydroxy-2-(4-hydroxyphenyl)-4H-1-benzopyran-4-one), is a kind of naturally occurring flavonoid existing in many common fruits and vegetables (e.g., onions, broccoli, strawberries and grapes) and particularly in traditional Chinese medicine as exemplified by Ginkgo biloba. Epidemiological, preclinical and clinical studies have revealed an inverse association between the consumption of kaempferol-containing foods and medicines and the risk of developing cardiovascular diseases. Numerous translational studies in experimental animal models and cultured cells have demonstrated a wide range of pharmacological activities of kaempferol. In this article, we reviewed the antioxidant, anti-inflammatory and cardio-protective activities of kaempferol and elucidated the potential molecular basis of the therapeutic capacity of kaempferol by focusing on its anti-atherosclerotic effects. Overall, the review presents the health benefits of kaempferol-containing plants and medicines and reflects on the potential of kaempferol as a possible drug candidate to prevent and treat atherosclerosis, the underlying pathology of most cardiovascular diseases.
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Affiliation(s)
- Meijie Chen
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, China
| | - Jianbo Xiao
- Department of Analytical Chemistry and Food Science, University of Vigo, Vigo, Spain
| | - Hesham R El-Seedi
- Pharmacognosy Group, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China
| | | | - Maria Daglia
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China
- Department of Pharmacy, University of Napoli Federico II, Naples, Italy
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, Australia
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, China
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, Anhui, China
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Xu S, Lyu QR, Ilyas I, Tian XY, Weng J. Vascular homeostasis in atherosclerosis: A holistic overview. Front Immunol 2022; 13:976722. [PMID: 36172381 PMCID: PMC9512393 DOI: 10.3389/fimmu.2022.976722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Atherosclerosis refers to the deposition of lipids and the co-existence of inflammation and impaired inflammation resolution in pan-vasculature, which causes lumen narrowing, hardening, plaque formation, and the manifestation of acute cardiovascular events. Emerging evidence has suggested that vascular circulation can be viewed as a complex homeostatic system analogous to a mini-ecosystem which consists of the vascular microenvironment (niche) and the crosstalk among phenotypically and functionally diverse vascular cell types. Here, we elucidate how cell components in the vascular wall affect vascular homeostasis, structure, function, and atherosclerosis in a holistic perspective. Finally, we discuss the potential role of vascular-stabilizing strategies including pharmacotherapies, natural substances and lifestyle modifications, in preventing cardiovascular diseases by preserving vascular integrity and homeostasis.
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Affiliation(s)
- Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China (USTC), Hefei, China
- *Correspondence: Suowen Xu, ; Jianping Weng,
| | - Qing Rex Lyu
- Medical Research Institute, Chongqing General Hospital, Chongqing, China
| | - Iqra Ilyas
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China (USTC), Hefei, China
| | - Xiao-Yu Tian
- School of Biomedical Sciences, Chinese University of Hong Kong, NT, Hong Kong SAR, China
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China (USTC), Hefei, China
- *Correspondence: Suowen Xu, ; Jianping Weng,
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Fang T, Wang H, Pan X, Little PJ, Xu S, Weng J. Mouse models of nonalcoholic fatty liver disease (NAFLD): pathomechanisms and pharmacotherapies. Int J Biol Sci 2022; 18:5681-5697. [PMID: 36263163 PMCID: PMC9576517 DOI: 10.7150/ijbs.65044] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 06/29/2022] [Indexed: 01/12/2023] Open
Abstract
The prevalence of non-alcoholic fatty liver disease (NAFLD) increases year by year, and as a consequence, NAFLD has become one of the most prevalent liver diseases worldwide. Unfortunately, no pharmacotherapies for NAFLD have been approved by the United States Food and Drug Administration despite promising pre-clinical benefits; this situation highlights the urgent need to explore new therapeutic targets for NAFLD and for the discovery of effective therapeutic drugs. The mouse is one of the most commonly used models to study human disease and develop novel pharmacotherapies due to its small size, low-cost and ease in genetic engineering. Different mouse models are used to simulate various stages of NAFLD induced by dietary and/or genetic intervention. In this review, we summarize the newly described patho-mechanisms of NAFLD and review the preclinical mouse models of NAFLD (based on the method of induction) and appraises the use of these models in anti-NAFLD drug discovery. This article will provide a useful resource for researchers to select the appropriate model for research based on the research question being addressed.
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Affiliation(s)
- Tingyu Fang
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei 230001, China
| | - Hua Wang
- Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Xiaoyue Pan
- Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, New York, NY 11501, USA
| | - Peter J. Little
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, 4102 Australia
| | - Suowen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei 230001, China.,✉ Corresponding authors: Jianping Weng, (ORCID ID: 0000-0002-7889-1697); Suowen Xu, (ORCID ID: 0000-0002-5488-5217)
| | - Jianping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei 230001, China.,✉ Corresponding authors: Jianping Weng, (ORCID ID: 0000-0002-7889-1697); Suowen Xu, (ORCID ID: 0000-0002-5488-5217)
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