Objective To investigate the effect of liraglutide and metformin hydrochioride on overweight diabetic patients because of poor glycemic control.Methods Forty-four overweight patients with poor glycemic control were randomly divided to the control group,the liraglutide group and the metformin hydrochioride group.Patients in control group were given diet and exercise control,in liraglutide group and the metformin hydrochioride group were given subcutaneous injection liraglutide,metformin hydrochioride oral treatment respectively for 12 weeks.Body mass index(BMI),fasting blood glucose (FBG),2-hour postprandial blood glucose (2 hPBG) and glycosylated hemoglobin (HbA1c) were measured.Results Compared with pretreatment,FBG,2 hPBG and HbA1c of patients in liraglutide group and metformin hydrochioride group were lower after treatment,and there was significant difference between the two group and the control group after treatment(P ＜ 0.05).BMI of patients in liraglutide group was (24.61 ± 3.47) kg/m2,lower than of the control group((25.37 ± 4.70) kg/m2,P ＜ 0.05).2 hPBG of patients in the liraglutide group was (7.13 ± 3.85)mtmol/L,lower than that of the metformin hydrochioride group ((8.03 ± 4.33) mtmol/L,P ＜ 0.05).FBG level in metformin hydrochioride group ((6.31 ± 3.45) mmol/L) was lower than that of the liraglutide group ((6.98±2.97) mmol/L),but the difference was not statistically significant(P ＞ 0.05).Conclusion Liraglutide and metformin hydrochioride treatment can effectively reduce weight and blood sugar of the overweight diabetics.The effect of liraglutide to reduce postprandial blood glucose and weight of the patient is more significant than of metformin hydrochioride.

Objective To compare the blood glucose level and associated hypoglycemia risks between group of insulin glargine combined with repaglinide and group of mixed insulin in the treatment of type 2 diabetes in the elderly. Methods Sixty four type 2 diabetes patients (age≥60 years) with inadequate glyeaemic control by drugs were divided into 2 groups randomly: glargine group (32 cases) and mixed insulin group (32 cases). In glargine group, 32 patients were given repaglinide before breakfast, lunch, supper respectively and injection of glargine hypodermically once at 22 o'clock every night, while the 32 patients in mixed insulin group were injected with the mixed insulin (Novolin 30R) hypodermically before breakfast and supper respectively for 16 weeks. The dose of repaglinide and insulin were adjusted every 3 days according to the level of fasting glucose (FPG)and postprandial glucose (PPG), reaching the aim of FPG less than 7.2 mmol/L and PPG less than 10mmol/L. The blood glucose level and the incidence of hypoglycemia were observed. Results The daily glucose profile and the level of HbAlc of the 2 groups dropped obviously after 16 weeks treatments (all P<0. 05). At the end of the experiment, the PPG of lunch and supper, and the level of HbAlc were markedly lower in glargine group than in mixed insulin group (all P<0. 05), and the body mass index (BMI) increased markedly in mixed insulin group compared with pre-experiment (P<0. 05), but no significant change was found in glargine group (P>0. 05). The incidence of hypoglycemia in glargine group was lower than that in mixed insulin group (2 patients in glargine group, 12 patients in mixed insulin group, P<0.05). Conclusions Both of the mixed insulin and glargine combined with repaglinide have visible effects on controlling the blood glucose, but the latter has better efficacy, lower risk of hypoglycemia and lower increase of BMI than the former.

Objective To observe the effect of febuxostat on epithelial-to-mesenchymal transition (EMT) of kidney tubules and the levels of serum IL-6 nad transforming growth factor (TGF) β1 in hyperuricemic rats.Methods Forty male SD rats were divided into 4 groups:normal control group (NC group),oteracil potassium group (OP group),oteracil potassium with febuxostat group (OF group) and oteracil potassium with benzbromarone group (OB group).Each group had 10 rats and balanced in body weights.To induce hyperuricemia,rats were given oteracil potassium by gastric garage once a day for eight weeks.Rats in OF group and OB group were given either febuxostat or benbromarone starting with oteracil potassium,and rats in NC group was given saline only.Blood samples were taken before,and at the end of 4 and 8 weeks of the treatments and serum uric acid,creatinine,blood usea nitrogen (BUN),IL-6 and TGFβ1 contents were measured at each time point.Renal pathological changes were observed via HE and Masson staining,and the expression of α-SMA and E-cadherin were detected by immunohistochemistry.Results Compared with those in NC group,the levels of serum uric acid,creatinine,BUN,IL-6 and TGFβ1 in the another three groups were increased significantly (all P ＜ 0.01).However,the IL-6 and TGFβ1 contents in OF group were much lower than those in OP group (P ＜0.01).HE and Masson staining showed that OF group had less damage and tubulointerstitial fibrosis than OP group and OB group (P ＜0.01).Moreover,the expression of α-SMA was significantly down-regulated (P ＜ 0.01) and that of E-cadherin was significantly up-regulated in OF group compared with those in OP group.Conclusion Febuxostat treatment significantly inhibited EMT and reduced the levels of IL-6 and TGFβ1 in hyperuricemia rats.

Objective To evaluate the relationship between the trend of glutamyl transpeptidase(GGT)change and newly developed metabolic syndrome(MS),and to explore the relationship between GGT and MS.Methods The study was a prospective cohort study,with baseline data sourced from the Beijing subcenter population of the"REACTION"study.A total of 6482 non-MS subjects was enrolled as the study subjects,and divided into four groups using the quartile method based on GGT level:G1(GGT<14.2 U/L,n=1613),G2(14.2≤GGT<18.6 U/L,n=1602),G3(18.6≤GGT<26.1 U/L,n=1639)and G4(GGT≥26.1 U/L,n=1628)group.Follow up was conducted 3.2 years later to analyze the correlation between baseline GGT and the trend of GGT changes with the risk of new MS.Results Baseline GGT was a risk factor for newly diagnosed MS.Compared with G1 group,the relative risk(RR)(95%CI)of newly diagnosed MS at follow-up in G2,G3,G4 group were 1.480(1.220～1.780,P<0.01),2.090(1.750～2.490,P<0.01),and 2.800(2.360～3.320,P<0.01),respectively.The increase in GGT is a risk factor for newly diagnosed MS during follow-up in this population.Compared with the group with decreased GGT,the RR(95%CI)of newly diagnosed MS during follow-up was 1.410(1.320～1.510)(P<0.01)in the group with increased GGT.In stratified subgroup analysis,the incidence of new-onset MS was[1.650(1.410～1.940)vs 1.510(1.310～1.750),P<0.01]respectively in female and middle-aged people in the GGT increase group compared with the GGT decrease group.There was no statistically significant difference in the risk of developing new MS in both male and elderly populations between the GGT increasing group and the decreasing group(P>0.05).Conclusions The increase in GGT is a risk factor for newly diagnosed MS,especially in female and middle-aged populations.

Objective To analyze the association between fatty liver index(FLI)and the risk of newly diagnosed diabetes mellitus(DM)in people with different glucose metabolism.Methods A retrospective cohort study was conducted,with baseline data sourced from the Beijing sub center population of the REACTION study.The follow-up was conducted 3.2 years later.A total of 6425 non DM subjects were included in this study,and divided into four groups using the quartile method based on FLI level:Q1(FLI＜11.68,n=1608),Q2(11.68≤FLI＜24.33,n=1607),Q3(24.33≤FLI＜44.73,n=1604)and Q4(FLI≥44.73,n=1606).Results During follow-up,a total of 556 new DM patients were found,with a cumulative incidence rate of 8.7%.Logistic regression analysis showed that FLI level was an independent risk factor for new DM patients,whether in non-DM people,NGT subgroups or IGR subgroups.In non DM population,the risk of developing new DM in the Q1,Q2,Q3 is 1.650 times(95%CI 1.200～2.290,P=0.002),2.040 times(95%CI 1.420～2.940,P＜0.001),and 2.950 times(95%CI 1.860～4.670,P＜0.001)higher than that in the Q1,respectively.In the NGT population,the risk of newly diagnosed DM in the Q3,Q4 is 1.670 times higher(95%CI 1.010～2.750,P=0.045)and 2.320 times higher(95%CI 1.410～3.800,P=0.001)than that in the first quartile,respectively.FLI level is an independent risk factor for newly diagnosed DM in the IGR population(P=0.012).The risk of newly diagnosed DM in the Q2,Q3,Q4 is 1.480 times(95%CI 1.080～2.020,P=0.015),1.620 times(95%CI 1.190～2.220,P=0.002),and 1.630 times(95%CI 1.180～2.250,P=0.003)higher than that in the Q1 respectively.Conclusions FLI is significantly associated with the risk of new onset DM in both NGT and IGR populations,and is an independent risk factor for newly diagnosed DM.

Objective:To analyze the correlation between fatty liver index (FLI) and myocardial remodeling.Methods:For cross-sectional study, cluster sampling was used to conduct a follow-up study of “Risk evaluation of cancers in Chinese diabetic individuals: A longitudinal (REACTION) study” among communities of Gucheng and Pingguoyuan of Beijing from April 2015 to September 2015. According to the inclusion and exclusion criteria, 8 848 participants were selected. Biochemical indicators such as body mass index, waist circumference, triglycerides, and γ-glutamyl transpeptidase were detected to calculate the FLI. The correlation between FLI and myocardial remodeling was analyzed. Interventricular septal thickness (IVS), left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), and the presence of diastolic dysfunction were measured by color doppler ultrasound. The participants were divided into Q1 group (FLI<30, 4 529 cases), Q2 group (30≤FLI<60, 2 762 cases), and Q3 group (FLI≥60, 1 557 cases) based on FLI levels. Single factor analysis of variance was used for inter-group comparison, logistic regression analysis was used to analyze the correlation between FLI and myocardial remodeling.Results:A total of 8 848 subjects were selected for the study (3 110 male and 5 738 female, mean age: 59.96 years). The IVS of Q1, Q2, and Q3 groups were (9.35±1.08), (9.73±1.22), and (10.07±1.31) mm, respectively. The LAD were (30.94±3.90), (33.37±4.12), and (34.98±4.47) mm, respectively. The LVEDD were (42.51±5.05), (44.43±5.10), and (46.06±5.52) mm, respectively. All increased with the increase of FLI (all P<0.001). FLI was an independent risk factor for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease. The respective risks for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease in a population with intermediate and higher FLI levels was 1.62 times (95% CI 1.39-1.89) and 2.53 times (95% CI 2.13-3.00); 2.71 times (95% CI 2.39-3.06) and 5.00 times (95% CI 4.12-6.08); 2.36 times (95% CI 1.85-3.00) and 4.33 times (95% CI 3.33-5.62); and 1.90 times (95% CI 1.63-2.19) and 1.95 times (95% CI 1.60-2.37) than those with lower FLI levels. Conclusion:There is a certain relevance between FLI and myocardial remodeling.

Objective:To analyze the correlation between fatty liver index (FLI) and the outcomes of individuals with high normal blood pressure.Methods:In this retrospective cohort study, data from the follow-up population of the Beijing branch of the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal (REACTION) study conducted from December 2011 to August 2012 were selected. Obtain indicators such as height, weight, waist circumference, fasting blood glucose, 2-h postprandial blood glucose, triglycerides, high-density lipoprotein cholesterol, and glutamyl transpeptidase were measured, and the FLI was calculated. The population with high normal blood pressure was divided into the FLI<30 group (1 822 cases); 30≤FLI<60 group (1 026 cases); and FLI≥60 group (473 cases) based on FLI levels. The blood pressure outcome data from the follow-up survey of this population from April 2015 to September 2015 were collected. Single factor analysis of variance was used for intergroup comparison, and logistic regression was used to analyze the correlation between FLI and the outcome of high normal blood pressure in the population.Results:The FLI was an independent influencing factor for their conversion to normal blood pressure (all P<0.01). Among all observed populations, the likelihood of conversion to normal blood pressure in the 30≤FLI<60 group and FLI≥60 group was 0.63 (95% CI 0.51-0.78) and 0.61 (95% CI 0.45-0.82) of the FLI<30 group, respectively. In the population of 40≤age<60 years, this likelihood was 0.60 (95% CI 0.47-0.76) and 0.57 (95% CI 0.41-0.79), respectively. FLI is not an independent influencing factor for the conversion to normal blood pressure in individuals aged over 60 years ( P=0.161). FLI is an independent risk factor for hypertension (all P<0.05). Among all observed populations and population of 40≤age<60 years and age>60 years, the risk of hypertension in the 30≤FLI<60 group and FLI≥60 group was 1.49 times (95% CI 1.23-1.80) and 1.54 times (95% CI 1.19-1.98); 1.41 times (95% CI 1.13-1.75) and 1.38 times (95% CI 1.04-1.83); and 1.75 times (95% CI 1.22-2.53) and 2.10 times (95% CI 1.24-3.58) of the FLI<30 group, respectively. Conclusions:There is a correlation between FLI levels and future outcomes of individuals with normal high blood pressure. Although people with higher FLI are more likely to develop hypertension, those with higher FLI are also less likely to develop normal blood pressure in the 40≤age<60-year group.