Objective To explore the relationship between diabetic retinopathy (DR) and intima-media thickness in newly diagnosed type 2 diabetic patients. Methods A total of 1236 diabetic subjects who were diagnosed within 1 year, including 218 older patients, were enrolled in the study. Intima-media thickness of the right common carotid artery and femoral artery were determined using B mode ultrasonography. All subjects were ophthalmologically examined. Results The intima-media thickness values of the carotid artery and femoral artery[(0.83 ± 0.11)mm, (0. 80 ±0.11)mm] in elderly DR group were higher than those [(0. 78±0.12)mm, (0.75±0.13)mm] in elderly non-DR group(P＜0.05). The prevalences of DR in IMT≥0.8 mm group[20.6%: carotid artery, 18.6%: femoral artery] were higher than those in IMT＜ 0.8mm group [13.0%: carotid artery, 13.6%: femoral artery] (P＜0. 05). Logistic regression analysis also showed DR was associated with IMT. Conclusions DR is associated with IMT in newly diagnosed type 2 diabetic patients, and early changes of retinopathy are associated with increased IMT.

Objective To examine the sensitivity and specificity of glycated haemoglobin A1c (HbA1c) in predicting metabolic syndrome (MS) and its association with cardiovascular risk factors.MethodsIn 6292 adults (median age 45 years) who participated in a medical check-up program,analysis of distribution of HbA1c and its association with various cardiovascular risk factors was performed. The ability of HbA1 c to predict MS was evaluated.Anthropometric measurements were made and fasting plasma glucose,lipid profiles and HbA1c were tested. ResultsThe prevalence of MS was 11.24％.Cardiovascular risk factors were significantly increased as the serum level of HbA1c increased. HbA1c of 5.8％ predicted the presence of MS.Females showed the same cut-off of HbA1c for the prediction of MS with males ( the area under the curve of the females was higher than that of the males ). Conclusion HbA1c was increased as cardiovascular risk factors increased and HbA1c of 5.8％ may predict the presence of MS.HbA1c might be a predictive measure of MS and cardiovascular diseases in adults.

Objective To investigate the necessity and tolerance of operation for hip fracture in patients aged 75 years and over. Methods The general tolerance including the self-care ability, comorbidities and postoperative complications was retrospectively analyzed in 70 elderly patients with hip fracture. Then the relationship between operation and survival status was estimated. Results The average tolerance score was significantly higher in 46 patients who accepted the operation than in 24 patients who didn't C(76. 1±12. 2) vs. (65. 5±13. 9), P<0. 01]. The median survival period was significantly higher in operation group than in non-operation group ( 97 mouths vs. 48 mouths, P< 0. 05). Kaplan Meier analysis showed that the survival status was better in operation group than in non-operation group. Conclusions For elderly patients over 75 years old with hip fracture, comprehensive evaluations of surgical tolerance before operation are very important for assessing the perioperative risk and feasibility of surgery. The operative treatment is a reasonable choice, as long as the operation is well tolerated by the patients.

Objective To compare the prevalences of metabolic syndrome(MS)diagnosed with 4 diagnostic criteria by the World Health Organization(WHO,1999),the Inrernational Diabetes Federation(IDF,2005),the Third Report of the National Cholesterol Education Program Expert Panel on Detection,Evaluation and Treatment of High Blood Cholesterol in Adults(NCEP ATPⅢ,2001)and the Chinese Medical Association Diabetes Branch(CDS)respectively. Methods The interrelated parameters were measured in 1399 patients with newly-diagnosed type 2 diabetes mellitus.All the patients were divided into 2 groups:elderly group(259 cases)and non-elderly group(1140 cases),and the different prevalences diagnosed by 4 diagnostic criteria in 2 groups were compared. Results The MS prevalence was 68.0%,47.9%,46.7%and 54.8%in elderly group by WH0,CDS,IDF and NCEP ATPⅢ respectively.The consistent rate was 76.1% between WHO and CDS,and 70.3%between IDF and CDS,and 81.9% between NCEP ATPⅢ and CDS. Conclusions The WHO definition may be more suitable for MS diagnosis in elderly patients with newly-diagnosed type 2diabetes mellitus.

Objective To analyze the dietary habits, energy intake and expenditure, anthropometrics, and body composition of the outpatients visiting the weight loss clinic of Beijing Hospital.Methods We pro-spectively enrolled 89 consecutive patients with body mass index ( BMI) ≥24 kg/m2 from November 2014 to August 2015 in the weight loss clinic of Beijing Hospital.There were 35 male and 54 female, with the mean age of (45.8 ±16.4) years.We divided them into two groups:the diabetes group (n=35) and the non-diabetes group (n=54), and compared the dietary habits, energy intake and expenditure, anthropometrics and body composition between the two groups.Results Regardless of diabetes, the overweight and obese patients all ate fast, mostly finishing a meal in about 10 minutes.They preferred Chinese food and meat, and disliked hot food.The frequency of dinning out in the non-diabetes group (3-5 times per week) was higher than that in the diabetes group (1-2 times per week) .Compared with the diabetes group, the non-diabetes group had higher fat-to-energy ratio [(34.9 ±7.6)%vs.(30.8 ±5.9)%], but lower carbohydrate intake [(232.2 ±59.7) g vs.(283.6 ±89.5) g], carbohydrate-to-energy ratio [ (47.9 ±8.3)%vs.(53.4 ±7.1)%], and the ratio of resting metabolic rate to body weight [ (66.9 ±9.6) kJ/(d? kg) vs.(71.1 ±7.9) kJ/(d? kg)] (all P<0.05).There were no statistically significant differences between the two groups in total energy intake, pro-tein intake, high quality protein intake, fat intake, protein-to-energy ratio, and resting metabolic rate (all P>0.05).Anthropometrics showed that the mean BMI of the patients was (32.8 ±4.4) kg/m2, with the maxi-mum being 53.5 kg/m2.The hip circumference [ (117.15 ±9.9) cm vs.(111.1 ±8.2) cm], upper arm circumference [ (36.4 ±3.8) cm vs.(34.0 ±3.3) cm], and triceps skinfold thickness [ (36.1 ±8.9) mm vs.(31.6 ±8.8) mm] were larger in the non-diabetes group than in the diabetes group (all P<0.05), but the mean age was lower in the non-diabetes group [ (41.7 ±16.9) years vs.(52.9 ±13.1) years) (P=0.01).There were no statistically significant differences between the two groups in body weight, BMI, waist circumference, neck circumference, and bilateral hand grip strength (all P>0.05).According to body compo-sition analysis, the body weight [ (94.8 ±18.3) kg vs.(86.9 ±17.2) kg], body fat mass [ (39.7 ± 11.3) kg vs.(33.5 ±8.9) kg], body fat percentage [ (41.7 ±6.5)%vs.(38.5 ±6.7)%], and visceral fat area [ (145.3 ±24.8) cm2 vs.(130.7 ±27.5) cm2 ] were larger in the non-diabetes group than in the di-abetes group ( all P<0.05) .There were no statistically significant differences between the two groups in BMI and skeletal muscle mass (both P>0.05).Conclusion Compared with diabetes patients, overweight and obese non-diabetes patients may be younger, having worse dietary habits, and having larger body fat mass, body fat percentage, and visceral fat area.

Objective To investigate the effects of metformin on blood glucose control and body weight management in over-weight patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods A retrospective study was performed in T2DM patients who were treated with metaformin (male 38,female 23,mean age (50.8 ± 7.9) years old).Based on body mass index (BMI),all the participants were assigned to obese,over-weight and normal weight group.Analysis of variance and multivariate analysis were used to confirm the effects of metformin on blood glucose and body weight.Results Fasting blood glucose (FBG),HbA1 c and BMI were significantly reduced over 2 years.In comparison with baseline,BMI of the obesity and overweight group was significantly decreased during follow up (P ＜ 0.05),while BMI of the normal weight group increased by 0.7 kg/m2.At baseline,FBS and HbAlc of the obese group were lower than those of the normal weight group (FBS (7.3 ± 0.8) vs.(11.8 ± 4.8) mmol/L,P ＜ 0.05 ; HbA1 c (6.8 ± 1.2) ％ vs.(8.5 ±3.1)％,P ＜0.05),whereas insulin level was higher than that of the normal weight group ((2.20 ± 0.36) vs.(1.87 ± 0.29) U,P ＜ 0.05).At 2 years,HbA1 c was reduced on average by 2.5％,1.4％ and 1.9％ in the obesity,over-weight and normal weight group,respectively.Conclusions The present study demonstrates the beneficial effect of metformin on newly diagnosed diabetics,especially obese patients.

Objective To investigate the prevalence and characteristics of thyroid nodule and its relationship with thyroid function in a group of middle-aged to elderly individuals.Methods A cross-sectional,stratified,and cluster random sampling study was performed in 1 721 subjects (average age 71.4 years,from 40 to 108 years).All subjects underwent ultrasound thyroid scan,and the prevalence of thyroid nodule and its size,quantity,property,and distribution were age-stratified and analyzed.The relationship between nodule existence and thyroid function was assessed in subjects who randomly accepted TSH,FT4,and FT3 tests.Results The prevalence of thyroid nodule reached to 76.6％.The incidence of nodule increased with age (x2 =92.08,P＜0.01),and was more common in female (87.4％ vs 75.5％,P =0.001).In patients with thyroid nodule,the prevalence of solitary nodule was 25％,compared with 75％ of multiple nodules,which increased with age (x2 =78.55,P＜0.01).The prevalence of small nodule reached to 68.2％,compared with 31.8％ of large nodules,which also increased with age (x2 =36.82,P＜0.01).As to the property of nodule,solid nodule was the most common form (72.3 ％),cyst-solid nodule accounted for 26.6％,and detection rate of cyst nodule was only 2.1％,and there was no significant difference among the different age groups (x2 =14.22,P=0.076).884 among the total subjects underwent thyroid function test,multiple logistic regression analysis demonstrated that the reduction of TSH was the only independent predicting factor of thyroid nodule (P =0.005).Conclusions The prevalence of thyroid nodules was considerably high according to the examing of ultrasonographic image,especially in the elderly.The incidence of thyroid nodule,especially multiple nodules or larger nodule,increased with age and solid nodule was the most common finding.

Objective To study the effects of high glucose and the leucocyte of diabetic patients on endothelial cells. Methods The leucocyte adhesion percentage to endothelial cells and the (MMP-9) expression of co-culturing endothelial cells and leucocytes were determined under different levels of glucose and at different time. Results (1) The level of MMP-9 was much higher under high glucose culture, and it increased as culture time prolonged. (2) The percentage of leucocyte adhesion to endothelial cells under high level of glucose was increased, and it was further enhanced when (co-culture) with leucocytes of diabetic patients . (3) The level of MMP-9 in supernatant of endothelial cells and leucocytes was increased significantly after culture with leucocytes of diabetic patients. It showed leucocytes were toxic to endothelial cells. Conclusions High glucose increases the level of MMP-9 of endothelial cells and percentage of the leucocyte adhesion to endothelial cells.Leucocytes of diabetic patients are toxic for endothelial cells.

Objective To investigate the relationship between serum levels of adiponectin (APN) and retinol binding protein 4 (RBP4) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. Methods 95 newly diagnosed T2DM patients and 55 non-diabetic volunteers from health examination population were studied. The serum concentrations of APN and RBP4 were determined by ELISA. The levels of plasma glucose, lipid profiles and insulin were also measured in fasting samples. Insulin sensitivity was assessed by insulin resistance index (HOMA-IR). The control group and diabetic group were divided into ≥60 years subgroup and <60 years subgroup respectively. According to the guideline designed by Chinese Diabetes Society(CDS)in 2004, the control group and diabetic group were divided into different kinds of abnormal metabolism groups. Results (1)The level of APN was significantly decreased in diabetic group compared with the control group[(7.26±4.69)mg/L vs. (11.93±4.89)mg/L], while the serum level of RBP4 in diabetic group was obviously higher than that in control group[(16.48±7.82) mg/L vs. (10.91±5.26) rag/L]. (2) The prevalence of metabolic syndrome in diabetic group was higher than that in control group (46.3% vs. 7.3%). (3)APN level was decreased with the increasing number of components of MS, and RBP4 level was increased with the increasing number of components of MS. (4) In DM group, APN level was correlated negatively with MS, waist circumference and BMI, and RBP4 level was correlated positively with waist circumference, HOMA-IR, BMI and TG. Conclusions APN and RBP4 levels are significantly associated with metabolic syndrome. Hypoadiponectinemia and higher retinal binding protein 4 may play an important role in the pathogenesis of MS.

Objective To explore different features and influencing factors of 75 g oral glucose tolerance test (OGTT) and glycated hemoglobin Ale (HbAlc) levels in subjects with newly diagnosed diabetes and prediabetes of natural history of type 2 diabetes. Methods All subjects were classified by OGTT into four groups: (1) normal glucose test (NGT), 31 subjects at age of (48. 4±15. 3) yrs (29-75 years old); (2) impaired fasting glucose (IFG), 33 subjects at age of (50. 8±9. 8) yrs (38-72years old) ; (3) impaired glucose tolerance test (IGT), 34 subjects at age of (54. 5±11.4) yrs (33-74years old), (4) T2DM, 117 subjects at age of (54.3 ± 14.1) yrs (29-75 years old). Glucose metabolism was evaluated by results of OGTT and HbAlc levels. The insulin secretion function and insulin resistance (IR) were evaluated by HOMA-β, △I30/△G330, area under curve of insulin (AUCINS)and HOMA-IR respectively. Results (1) Significant changes of HbAlc values among groups were as following order: T2DM(7. 41%)>IGT(5. 85%)>NGT(5.21%) (P<0. 01). HOMA-β value in T2DM, IGT and IFG decreased by 53. 1% (P<0. 01), 29.3% (P<0. 01) and 23.4% (P<0. 05)respectively as compared with NGT group. HOMA-IR value in diabetes group was 1.66-fold of NGT (P<0.01), 1. 29-fold of IFG (P<0.001) and 1.44-fold of IGT (P<0.05). (2) Only 3 h blood glucose concentration (BG) in 75 g OGTT was independently and positively correlated with HbAlc level (r=0. 71, P<0. 01). △I30/△G330 ratio was independently and negatively correlated with both 1 h and 2 h BG of OGTT (P<0.01). AUCins was positively correlated with only 3 h BG of OGTT (P<0.01). HOMA-β was independently and negatively correlated with all OGTT results except 2 h BG(P<0.01). HOMA-IR was an independently and negatively correlative factor of all OGTT results (P<0. 01 or P<0. 05). TG level was independently and positively correlated to only fasting BG (P<0. 05), and waist circumference value had an independent and positive relationship with only 1/2h BG (P<0. 01). Independently correlative factors of OGTT changes included △I30/△G330, AUCINS,HOMA-β, HOMA-IR and circumference values. Only 3 h BG was probably an independent contributor to HbAlc variation. Conclusions There are obvious HbAlc differences among T2DM,IGT and NGT patients. When HbAlc values are over 8%, no significant changes of glucose and insulin levels at 75 g glucose load test are found among subjects.