The Risk Evaluation of cAncers in Chinese diabeTic Individuals:A lONgitudinal(REACTION) Study is the largest prospective study of diabetes in China to date.It aims to investigate associations between type 2 diabetes and risks of cancer as well as cardiovascular diseases.The Study also examined the association between insulin resistance and β-cell function in diabetic patients and individuals with impaired glucose tolerance.It has provided data on the current prevalences and related risk factors of osteoporosis,chronic kidney diseases,and thyroid nodules in Chinese adults with abnormal glucose metabolism.This large cohort constitutes an important platform and a rich resource for investigators from different fields to answer important research questions concerning risk factors,mechanisms,early detection,and management of metabolic diseases.

Diabetes has been an epidemic in China. Developing economic levels, changes in diet, increasing of obesity, aging, and other factors are thought to be the main contributors. In the new situation for preventing and managing diabetes, several key issues should be seriously considered. We need to carry out high quality multi-center clinical researches based on a well-established nationwide collaborative research network; to identify and validate novel, sensitive and reliable diabetes risk factors and predictors using the new data collection system, and the omics technology based on the large-scale prospective cohorts with a long-term follow up; to reclassify diabetes based on the molecular and functional annotation, and finally to in-depth understand and update the pathogenesis of the disease. Furthermore, using the artificial intelligence and other advanced technologies combined with big medical and research data, etc., we should build new types of diabetes prediction models and systems, as well as machine-assisted diagnosis and treatment systems. Finally, we should carry out translational researches, as well as to develop early detection technologies and clinical pathways suitable for all levels of medical institutions.

Non-classical 21-hydroxylase deficiency(21OHD)is one of the most frequent autosomal recessive hereditary disease.Non-classical 21OHD is often underdiagnosed or misdiagnosed in patients with hyperandrogenemic symptoms(such as hirsutism,acne),menstrual disorder and infertility because of its moderate symptoms and hormonal abnormalities.However,the long-term healthy risks of non-classical 21OHD,such-as insulin resistance,dyslipidemia and cardiovascular diseases are clearly elevated.Basal and ACTH-stimulated 17- hydroxyprogesterone levels are quite helpful as a screening approach in diagnosis of non-classical 21OHD. Furthermore,non-classical 21OHD can be effectively treated with low-cost,therefore we should pay great attention to the diagnosis and treatment of non-classical 21OHD.

HbA1C has been used clinically since 1980s as the index of glycemic control in individuals with diabetes mellitus.Several significant clinical trials demonstrated that the intensive blood glucose control reduced the chronic complications in diabetes.In recent years,HbA1C has been recommended as one of the diagnostic criteria for diabetes mellitus.However,the standardization of HbA1C measurement still remains to be an important and arduous task in China.

Incretins are glucose-dependent insulinotropic hormones that are secreted from intestinal endocrine cells stimulated by meal nutrients after eating. Incretins can maintain glucose homeostasis through promoting insulin secretion from β cell and suppressing inappropriately glucagon secretion from α cell, as well as many other physiological effects. Furthermore, incretins can delay and even reverse the deterioration of type 2 diabetes by enhancing islet β cell function. Incretin-based therapies, including glucagon-like peptide-1 mimetics and dipeptidyl peptidase-Ⅳ inhibitors, will bring us new insights into the treatment of type 2 diabetes.

The definition of pheochromacytoma is the tumor derived from the adrenal chromaffin cell excessive producing catecholamines.Until now,the urine and plasma metanephrines(MNs) determined by HPLC-ED is considered as the first choice for the biochemical diagnosis of pheochromacytoma.According to the clinical pathway,the location of pheochromocytoma is determined by imaging methods including CT,MRI and PET,however,123I-MIBG is a more specific method for location of the tumor.The candidate genes screening including RET,VHL,SDHD,SDHB and NF1 have been recommended.The surgery to remove the tumor is the first choice for curing of pheochromacytoma.

Recently,with the improvement in recognition and diagnosis technology for primary hyperaldosteronism(PA),the incidence of PA has risen markedly.As a cause of hypertension,PA should be diagnosed based on correct clinical practice.This article discusses the screening test,confirmation tests and subtype classification of PA.

Liraglutide is a long-acting human GLP-1 analogue,which provides pharmacological level of GLP-1 and combines with GLP-1 receptor widely distributing in the body.Liraglutide demonstrates multiple antidiabetic and other effects,including glucose-dependent glucose-lowering action,pancreatic islet cells protection,gastric emptying inhibition,appetite reduction/feelings of satiety and fullness increasing,weight loss,cardioprotection and blood pressure lowering action.Meanwhile,clinical practice also shows that some gastrointestinal adverse events occur accompanying with good glucose control and weight loss.This review will explain the potential mechanisms of GLP-1 and gastrointestinal reaction,clinical evidence of liraglutide and effective management rules,aim to help readers better understand this issue,as well as to advise clinicians of proper use of liraglutide while reducing or avoiding those adverse events.

[Summary] A dozens of variants in intron 1 of FTO gene have been found to be significantly associated with obesity by a serious genome-wide association studies (GWAS) in past eight years.Very recently,The New England Journal of Medicine published an important genetic study of obesity,which challenged the point of FTO causing obesity directly.The researchers find one of the variants changes the binding ability of upstream regulator to IRX3/IRX5 and thus promotes IRX3/IRX5 expression instead of FTO.Which one is the real causal gene of common obesity,FTO,IRX3/5,both,or neither? All these questions need to be answered.

Recently, genome-wide association study (GWAS)has achieved great success in illuminating genetic basis of complex diseases. GWAS of type 2 diabetes is regarded as a paradigm of genetic dissection of complex human diseases, which are caused by both genetic and environmental factors. Some basic facts of GWAS,as well as implementation of GWAS in type 2 diabetes, are reviewed in this article.