Objective To explore the relationship between TCF7L2 genetic polymorphisms with intimal -medial thickness (IMT),carotid arterial stiffness in patients of type 2 diabetes mellitus(T2DM)with hypertension. Methods 872 patients of hypertension and T2DM were enrolled into this study,and they were divided into two groups according to IMT,carotid arterial stiffness and cPWV:the observation group(n =432,IMT >1.0mm,cPWV >12m/s),the control group(n =440,IMT≤1.0mm,cPWV≤12m/s).Meanwhile,400 healthy subjects(normal fasting gluose,blood pressure,without diabetes and hypertension family history)were selected as the healthy group.Typed gene polymorphisms of TCF7L2 by RT -PCR,the body mass index(BMI),waist -hip ratio,systolic blood pressure, diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL -Ch), low -density lipoprotein cholesterol(LDL -Ch),insulin sensitivity index(ISI),glycated hemoglobin A1C(HbA1c) between groups were compared.Calculated each allele and genotype frequencies and implemented Hardy -Weinberg equivalent test.The distributional differences of alleles frequencies between groups were analyzed by χ2 test and geno-type frequencies through dominant model.Results Distributional differences of rs290487 genotype frequencies had statistically significant differences in the observation group vs the control group(χ2 =33.296,P <0.05 )and the T2DMgroup vs the normal group(χ2 =100.801,P <0.05).Statistically significant differences existed in C and T alleles frequencies as well:the observation group vs the control group(χ2 =16.280,P <0.05),the T2DM group vs normal group(χ2 =27.190,P <0.05).However,the gene polymorphisms of rs11196205 and rs11196218 showed no statistically significant difference (P >0.05 ).Conclusion rs290487 involved in the development of T2DM with hypertension,C and T alleles might be the risk factors of increasing the IMT and carotid arterial stiffness levels in patients of T2DMwith hypertension.Logistic regression analysis revealed that the increase of SBP,DBP,TC,TG,LDL-Ch and decrease of HDL -Ch may be the risk factors of hypertension and diabetic patients.Meanwhile,it dedicated that the increase of those biochemical indexes might be the important elements which would lead to the gene variations of C and T alleles.

Objective:To investigate the efficacy and safety of dapagliflozin combined with liraglutide in the treatment of type 2 diabetes mellitus complicated by chronic heart failure.Methods:Ninety patients with type 2 diabetes mellitus complicated by chronic heart failure, who received treatment in the Siming Branch of the First Affiliated Hospital of Xiamen University from August 2018 to August 2020, were included in this study. They were randomly assigned to receive either routine treatment + liraglutide (control group, n = 45) or routine treatment + liraglutide + dapagliflozin (observation group, n = 45) for 16 weeks. Blood glucose control, glycosylated hemoglobin level, cardiac function grade, serum N-terminal B-type natriuretic peptide precursor level, left ventricular ejection fraction, total effective rate, and adverse reactions were compared between the control and observation groups before and after treatment. Results:There were no significant differences in blood glucose level, glycosylated hemoglobin, and cardiac function grade between the two groups (all P > 0.05) before treatment. After treatment, fasting blood glucose level, 2-hour postprandial glucose level, glycosylated hemoglobin level, cardiac function grade, N-terminal B-type natriuretic peptide precursor , and left ventricular ejection fraction were (7.21 ± 1.23) mmol/L, (9.14 ± 2.24) mmol/L, (7.03 ± 2.59)%, (1.25 ± 0.21), (548.9 ± 116.3) ng/L, and (46.7 ± 7.5)%, respectively, in the observation group and they were (9.45 ± 2.21) mmol/L, (11.24 ± 5.29) mmol/L, (8.23 ± 1.91)%, (2.23 ± 0.46), (510.3 ± 110.7) ng/L, and (48.1 ± 6.8)%, respectively in the control group. There were significant differences in these indexes between the two groups ( t = 24.03, 20.47, 51.09, 32.42, 10.19, 13.23, all P < 0.05). Total effective rate was significantly higher in the observation group than in the control group [97.78% (44/45) vs. 80.00% (36/45), χ2 = 7.20, P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dapagliflozin combined with liraglutide is highly effective in the treatment of type 2 diabetes mellitus complicated by chronic heart failure. The combined therapy has good effects on blood glucose level and cardiac function and is certainly safe.

Objective:To correlate serum 25-hydroxylvitamin D and parathyroid hormone levels with hypertension in patients with type 2 diabetes mellitus.Methods:A total of 100 patients with type 2 diabetes mellitus admitted to Siming Branch, the First Affiliated Hospital of Xiamen University, China from February 2018 to August 2020 were included in this study. These patients were stratified according to hypertension, and serum 25-hydroxyvitamin D level. The correlation between serum 25-hydroxyvitamin D and parathyroid hormone and hypertension was analyzed.Results:Among the 100 patients with type 2 diabetes meliitus, 25 patients had grade 1 hypertension, 30 patients had grade 2 hypertension, 45 patients had grade 3 hypertension, 5 patients (5%) had sufficient levels of 25-hydroxyvitamin D, 10 patients (10%) had insufficient levels of 25-hydroxyvitamin D, 85 patients (85%) had inadequate levels of 25-hydroxyvitamin D. Serum levels of 25-hydroxyvitamin D in patients with grade 1, grade 2, and grade 3 hypertension were (12.18 ± 2.52) μg/L, (12.45 ± 2.39) μg/L, (10.33 ± 1.26) μg/L, respectively, and parathyroid hormone levels were (36.48 ± 0.25) ng/L, (41.15 ± 0.39) ng/L, and (47.52 ± 1.44) ng/L, respectively. As blood pressure increased, the patient's serum levels of 25-hydroxyvitamin D increased first and then decreased, while parathyroid hormone levels gradually increased. However, there were no statistically significant differences in serum levels of 25-hydroxyvitamin D and parathyroid hormone between patients of different hypertension grades ( F = 0.96, 1.93, both P > 0.05). Logistic regression analysis showed that hypertension in type 2 diabetes patients was correlated with age, body mass index, serum 25 hydroxyvitamin D level, glycated hemoglobin and parathyroid hormone level ( OR = 1.076, 1.266, 0.937, 1.257, 1.000, all P < 0.05). Conclusion:The serum levels of 25-hydroxyvitamin D and parathyroid hormone in patients with type 2 diabetes mellitus are related to hypertension.

Objective:To investigate the clinical efficacy of liraglutide in the treatment of type 2 diabetes mellitus complicated by osteoporosis and its effects on serum chemokines and bone mineral density.Methods:This is a case-control study. The clinical data of 78 patients with type 2 diabetes mellitus complicated by osteoporosis who received treatment in the Siming Branch of The First Affiliated Hospital of Xiamen University from May 2019 to September 2021 were retrospectively analyzed. These patients were divided into an observation group and a control group ( n = 39 per group) according to different treatment methods. The control group was treated with adjuvant therapy with afacalcitol, while the observation group was given liraglutide in addition to adjuvant therapy with afacalcitol. Both groups were treated for 16 weeks. Clinical efficacy was compared between the two groups. Before and after treatment, serum chemokines and bone mineral density were determined in each group. Adverse reactions were evaluated in each group. Results:The total effective rate in the observation group was 92.3% (36/39), which was significantly higher than 71.8% (28/39) in the control group ( χ2 = 5.57, P < 0.05). After treatment, the serum chemokine level in the observation group was (60.11±10.25) μg/L, which was significantly lower than (63.15 ± 10.24) μg/L in the control group ( t = -2.01, P < 0.05). Bone mineral density in the observation group was (1.77 ± 1.05) g/cm 2, which was significantly higher than (1.01 ± 0.06) g/cm 2 in the control group ( t = 4.51, P < 0.05). The incidence of adverse reactions in the observation group was 7.7% (3/39), which was not significantly different from 12.8% (5/39) in the control group ( χ2 = 0.56, P > 0.05). Conclusion:Liraglutide is highly effective on type 2 diabetes mellitus complicated by osteoporosis. Liraglutide can effectively decrease serum chemokine levels, increase bone mineral density, and thereby is worthy of clinical application.