Objective To explore the expression of and its clinical significance of plasma omentin-1 in coronary heart disease in central obesity. Methods Plasma omentin-1 levels were measured by enzyme linked immunosorbent assay( ELISA)in 49 central obesity participants without coronary heart disease and 67 central obesity participants with coronary heart disease,as well as 56 normal healthy individuals as control group. In addition,glucose and lipid metabolism parameter and morphological characters were assessed. Finally multivariate logistic regression analysis was used to explore the risk fact for coronary heart disease in central obesity. Results The serum plasma omentin-1 level of central obesity participants without coronary heart disease group was (45. 63 ± 9. 66)μg/L,much higher than those of people in and central obesity participants with coronary group ((30. 67 ± 6. 78 )μg/L,P ﹤0. 01 ),while lower than control group(( 53. 12 ± 7. 97 )μg/L,P ﹤ 0. 01 ) . Multivariate logistic regression analysis revealed that,age was independent risk factor of coronary heart disease in central obesity(OR=1. 176,95%CI:1. 012-1. 330,P=0. 041),while plasma omentin-1 and high density lipoprotein cholesterol were independent protective factors(OR=0. 576,95%CI:0. 254-0. 898,P=0. 000;OR=0. 466,95%CI:0. 242 -0. 690,P =000). Conclusion Detection of plasma omentin-1 level may play an important role in early diagnosis and prevention of coronary heart disease in central obesity.

Objective To observe and evaluate the effects of metformin and pioglitazone on blood glucose,insulin,glucagon,β-cell function and insulin resistance among patients with diabetes and metabolic syndrome,so as to discuss the role of pancreatic α cells in pathogenesis of type 2 diabetes mainly caused by insulin resistance and the change of α-cell function after treatment.Methods A total of 60 patients diagnosed with diabetes and metabolic syndrome were selected in Beijing Chaoyang District Diabetes Center from April 2012 to April 2013 and divided with random number table into metformin group (treated with metformin 0.5 g orally thrice a day for 1 year,n =30) and pioglitazone group (treated with pioglitazone 15 mg orally once a day for 1 year,n =30).30 normal healthy people who had physical examination at the Center during the same period were enrolled into the control group,matched in age and gender with the intervention groups.The general condition of the 3 groups,and blood levels of glucose,insulin,and glucagon,insulin sensitivity index (ISI)-Matsuda,homeostasis model assessment of insulin resistance (HOMA-IR),β-cell function index (HOMA-β),1-phase index,2-phase index,and insulin secretion sensitivity index (ISSI) at baseline in the 3 groups and after treatment in the metformin group and the pioglitazone group were measured and calculated.Results Compared with the control group before treatment,the intervention groups as a whole had significantly higher fasting glucagon level [(146.22 ±25.41) pmol/L vs.(21.31 ±7.85) pmol/L,P =0.002] and area under curve (AUC) of glucagon [(469.84 ±13.12) pmol/(L · h) vs.(100.94 ± 7.73) pmol/(L · h),P =0.006].Compared with the results before treatment,the metformin group exhibited significantly reduced fasting glucose [(6.46 ± 1.38) mmol/L vs.(7.54 ± 0.43) mmol/L,P=0.031],fasting insulin [(119.22 ± 69.01) pmol/L vs.(139.38 ±71.13) pmol/L,P =0.042],fasting glucagon [(91.69 ±22.11) pmol/L vs.(142.81 ±24.56) pmol/L,P=0.029],AUC of glucose [(25.19 ± 1.31) mmol/ (L · h) vs.(32.68 ± 1.12) mmol/ (L · h),P =0.043],AUC of insulin [(468.65 ±20.10) pmol/ (L· h) vs.(786.32±21.37) pmol/ (L· h),P=0.017],and AUC of glucagon [(280.60±8.26) pmol/ (L · h) vs.(487.14±14.31) pmol/ (L · h),P=0.032];while the pioglitazone group after treatment also showed significantly decreased fasting glucose [(6.58 ±2.21) mmol/L vs.(7.68±0.59) mmol/L,P=0.028],fastinginsulin [(107.92±17.81) pmol/L vs.(144.66±74.43) pmol/L,P =0.033],fasting glucagon [(76.07 ±20.57) pmol/L vs.(148.34 ±28.94) pmol/L,P=0.025],AUC of glucose [(25.58 ±1.22) mmol/(L·h) vs.(35.07 ±1.38) mmol/(L· h),P=0.038],AUC of insulin [(435.54±19.30) pmol/ (L· h) vs.(854.75 ±20.61) pmol/(L·h),P=0.013],andAUCofglucagon [(223.43 ±5.83) pmol/ (L·h) vs.(458.55 ±12.96) pmol/ (L·h),P =0.026].The before-after-treatment differences were significantly smaller in the metformin group than in the pioglitazone group in terms of fasting insulin [(20.16 ± 2.98) mmol/L vs.(36.74 ± 2.88) mmol/L,P =0.011],fasting glucagon [(51.12 ± 3.67) pmol/L vs.(72.27 ± 4.58) pmol/L,P =0.016],AUC of insulin [(317.67 ±13.45) pmol/(L · h) vs.(419.21 ±15.44) pmol/(L · h),P=0.031] and AUC of glucagon [(206.54±9.66) pmol/(L· h) vs.(235.12±10.29) pmol/(L· h),P=0.046].Conclusions Glucagon in patients with diabetes and metabolic syndrome is higher than that in normal individuals.Metformin and pioglitazone can decrease the level of glucagon in patients with metabolic syndrome and diabetes as well as improve the glucose control,β-cell function and insulin resistance,suggesting improving effect of these two drugs on α-cell function.Pioglitazone manifests a stronger effect than metformin does.

Objective To evaluate clinical features,insulin sensitivity,and serum adipocytokines levels in pregnant women with different glucose tolerance status and to investigate the possible serum predictive biomarkers of gestational diabetes mellitus (GDM).Methods We included 74 pregnant women with positive results of 50 g glucose challenge test (GCT),who received regular obstetrical follow-up in Peking Union Medical College Hospital from January 2009 to June 2012.A further 100 g oral glucose tolerance test was performed in 24-28 gestational weeks,based on which the 74 pregnant women were divided into GDM group (n =25),impaired glucose tolerance (IGT) group (n =25) and normal glucose tolerance (NGT) group (n =24).The clinical data were recorded in detail.Serum fibroblast growth factor (FGF)-19,FGF-21,visceral adiposespecific serine protease inhibitor (vaspin),leptin,insulin-like growth factor binding protein-1 (IGFBP-1),and adiponectin levels of the 3 groups were measured by enzyme-linked immunosorbent assay (ELISA) and compared.The associations of these adipocytokines with the patients' baseline data and metabolic indexes were analyzed.Results The blood glucose after GCT and glycosylated hemoglobin A1c in the GDM group were significantly higher than those in the NGT group [(9.21 ±0.75) mmol/L vs.(8.52 ±0.50) mmol/L,P ＜0.05;(5.39 ± 0.34) ％ vs.(5.18 ± 0.20) ％,P ＜ 0.05],but not significantly different from those in the IGT group [(9.14 ± 0.64) mmol/L,P ＞ 0.05;(5.28 ± 0.28) ％,P ＞ 0.05].Age,systolic blood pressure and diastolic blood pressure in the first trimester,pre-gestational body mass index (BMI),increment of BMI during pregnancy,serum total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and C-reactive protein levels in the three groups showed no significant differences (all P ＞0.05).From the NGT group to the IGT group to the GDM group,the area under curve of blood glucose (AUCBG) [(19.84±1.95),(23.20±1.51),(26.58±2.02) mmol/(L · h)] and AUC of insulin (AUCINS) [(1.84± 0.91) ×103,(1.85 ±1.15) ×103,(2.49 ±1.36) ×103 pmol/(L · h)] both gradually increased.Compared with the NGT group,the GDM group had significantly higher HOMA-IR [3.0 (1.5,5.2) vs.2.5 (1.5,3.4),P ＜0.05] significantly lower HOMA-β [230.5 (144.6,311.6) vs.235.6 (168.1,350.0),P ＜ 0.05].Among the GDM,the IGT,and the NGT groups,there were no significant differences in serum FGF-19 [(284.42±78.16),(268.17 ±72.97),(283.86 ±79.74) ng/L],FGF-21 [(798.16±273.57),(882.43 ±322.17),(842.75 ±343.01) ng/L],vaspin [(22.36 ±7.27),(23.53 ±7.90),(22.63±9.11) μag/L],leptin [(5.51 ± 1.44),(5.58 ± 1.58),(5.48 ± 1.47) μg/L],adiponectin [(798.85 ± 255.14),(863.44 ± 252.18),(828.36 ± 249.32) μg/L] and IGFBP-1 [(40.44 ± 16.41),(49.57±12.60),(43.80±16.58) μg/L] levels (all P＞0.05).Conclusions There are no significant differences of a variety of adipocytokines in pregnant women with different glucose tolerance status,and no effective serum predictors of GDM are found.The effect of adipocytokines in the pathogenesis of GDM remains to be further investigated.

Objective To explore the relationship between glycated albumin ( GA ) in 2 consecutive months and hemoglobin A1c ( HbA1c) in diabetes patients.Methods Totally 100 consecutive patients with main diagnosis of diabetes mellitus were enrolled retrospectively from April 2015 to January 2016 in outpatient clinic of endocrinology of Peking Union Medical College Hospital, who had undertaken GA tests every 4 weeks for 2 successive months and had HbA1c test in the second month.GA was measured with liquid enzymatic method. HbA1c was measured by ion-exchange high performance liquid chromatography.The relationship between HbA1c and GA for the 2 successive months was determined.Results A total of 85 patients were enrolled.The regres-sion equation between HbA1c (y) and average GA (j) for successive 2 months was y=3.187+0.218j (adjusted R2 =0.520, P=0.000), which showed a similar effect as the regression equation for HbA1c and the levels of GA tested for the 2 successive months (adjusted R2 =0.514, P=0.000), and both had more significant regressive effect than the regression equation for HbA1c and single measurement of GA (adjusted R2 =0.392, P=0.000). Conclusions The regressive effect between HbA1c and GA (or the average of GA) in successive 2 months is bet-ter than that with single measurement of GA, hence could better predict HbA1c in clinical practice.

Objective: : This study aimed to investigate the changes and significance of microRNA155 levels in serum of patients with cerebral small vessel disease (CSVD). Methods: : Thirty patients with CSVD who met the inclusion criteria were selected and divided into eight patients with lacunar infarction (LI) group and 22 patients with multiple lacunar infarction (MLI) combined with white matter lesions (WML) group according to the results of head magnetic resonance imaging (MRI). Thirty samples from healthy volunteers without abnormalities after head MRI examination were selected as the control group. The levels of serum microRNA155 in each group were determined by real-time polymerase chain reaction, and the correlation between microRNA155 in the serum of patients with CSVD and the increase of imaging lesions was analyzed by Spearman correlation analysis. Results: : Compared with the control group, the serum microRNA155 level in the LI group, MLI combined with WML group increased, the difference was statistically significant (p<0.05); serum microRNA155 level was positively correlated with the increase of imaging lesions (p<0.05). Conclusion : The change of serum microRNA155 level in patients with CSVD may be one of its self-protection mechanisms, and the intensity of this self-protection mechanism is positively correlated with the number of CSVD lesions.

Objective:To examine the social isolation(SI)status among the elderly population in China and its effect on cardiovascular and cerebrovascular diseases(CCVD).Methods:Utilizing data from the Fourth China Urban and Rural Elderly Living Conditions Sample Survey, the social isolation(SI)score was determined based on four components: marital status, living arrangements, frequency of contact with relatives and friends, and social participation.The χ2 test was employed to examine variations among socially isolated individuals, regional disparities within each province, and subgroups within each covariate.Additionally, Logistic regression was conducted to evaluate the impact of SI and its associated factors on CCVD. Results:The final analysis included 218 329 elderly individuals, revealing that the incidence and number of SI in Shandong Province are the highest in China at 18.95%(3 360 out of 17 735).The incidence of SI in the Eastern coastal provinces is notably higher than in the Western region.Factors contributing to a higher prevalence of SI include living in rural areas, being female, older age, belonging to ethnic minorities, having low educational attainment, facing economic disadvantages, smoking, drinking alcohol, lack of exercise, loneliness, poor sleep quality, and dissatisfaction with housing conditions.The study found that SI increased the risk of developing cardiovascular disease even after adjusting for negative emotional experiences or poor lifestyle choices( OR=1.190, 95% CI: 1.016-1.296, P=0.016, OR=1.208, 95% CI: 1.131-1.291, P<0.001), and the risk further increased when both factors were simultaneously adjusted for( OR=1.237, 95% CI: 1.160-1.319, P<0.001). Conclusions:Combining SI with poor lifestyle and negative emotions significantly raises the risk of cardiovascular disease, highlighting the importance of addressing these factors in the elderly population.

Objective To summarize and evaluate the characteristics of current recurrent spontaneous abortion(RSA)animal models at home and abroad,and to provide reference and guidance for the standardized preparation of RSA models.Methods"Recurrent spontaneous abortion"and"animal model"were used as co-keywords in CNKI,Wanfang,VIP,PubMed and Web of Science databases to search the RSA animal experimental literature,covering the period up to January 20,2024,and a total of 1 411 articles were collected.The analysis focused on construction methods and essential elements of RSA animal models,the modeling process and result evaluation,as well as the application of these models in pharmacological and pharmacodynamic research.An Excel table was established for systematic analysis and discussion.Results A total of 138 experimental studies were obtained after screening.In constructing RSA animal models,immunological models were the most widely used in Western medicine(96.92％),with the Clark model being the main one(92.31％).In traditional Chinese medicine(TCM)models,70.00％were kidney deficiency-luteal inhibition-syndrome combination models,20.00％were kidney deficiency and blood stasis models,and 10.00％were deficiency-heat syndrome models.Most animals were selected at 6-8 weeks(33.86％)and 8 weeks(32.28％)of age.The majority of animals were paired for mating at 18:00 on the day of cage pairing.In 81.03％of literatures,vaginal plugs were checked once the following morning,with 8:00 being the most common time(17.02％).The most commonly used drug administration cycle was 14 days of continuous gavage after pregnancy.Among the tested drugs,Western drugs were mainly protein-based(29.17％),while TCM drugs were mainly TCM decoction(81.11％).The most frequently used methods for detecting indicators included visual observation of embryos(22.54％),western blot(15.96％),PCR(13.58％),ELISA(12.91％),HE staining(10.80％)and immunohistochemistry(9.39％).Conclusion The etiology of RSA is complex,and corresponding animal models should be established based on different etiologies.Clark model is commonly used in the construction of Western medicine model,while the kidney deficiency-luteal inhibition-syndrome combination model is predominant in TCM.RSA animal model is widely used in related research,but systematic evaluation needs to be strengthened.

Objective To explore the long-term outcome of postpartum glucose metabolism among patients with gestational hyperglycemia and its risk factors.Methods Patients with gestational hyperglycemia,diagnosed by 100 g oral glucose tolerance test (OGTT) during 24th to 28th gestation week between 2010 and 2012 and giving the childbirth in Peking Union Medical College Hospital,were included.The glucose metabolism outcomes were evaluated by 75 g OGTT.The risk factors influencing the glucose metabolism outcome and the glucose metabolism parameter changes between the pregnancy term and now were also analyzed.Results Forty patients with gestational hyperglycemia were included.The follow-up time was postpartum 5-8 years and (6.83±0.74) years on average.Among them,3 patients were diagnosed with type 2 diabetes and 9 patients were diagnosed with impaired glucose intolerance.The overall rate of abnormal glucose metabolism was 30 percent.The third-hour glucose of OGTT larger than 7.45 mmol/L and the area under the glucose curve (Glu AUC) during OGTT larger than 24.875 mmol×h/L were the risk factors for the abnormal glucose metabolism outcome,with the odds ratio of 5.769 (95％ confidence interval 1.064-31.270,P=0.042) and 12.5 (95％ confidence interval 2.226-70.187,P=0.004).Using the 2-hour glucose larger than 8.25 mmol/L and 3-hour glucose larger than 7.45 mmol/L in the OGTT of midtrimester to judge the glucose state in the follow-up visit can achieve the diagnostic efficacy with the sensitivity of 75％,specificity of 82％,positive prediction value of 64％ and negative prediction value of 88％.Comparing with now,the fasting glucose in the midtrimester was lower ([5.49±0.43] vs.[4.55±0.47] mmol/L,P＜0.001),the fasting insulin in the midtrimester was high-er (12.30 [6.35,16.55] vs.8.31 [6.79,12.00] μIU/ml,P=0.048),HOMA-β in the midtrimester was higher (202.67 [145.71,335.71] vs.85.41 [78.63,112.13],P＜0.001).Conclusion The third-hour glucose larger than 7.45 mmol/L and the glucose area under the curve larger than 24.88 mmol×h/L in the OGTT of midtrimester are the risk factors for the abnormal glucose state in the postpartum long-term follow-up.The combination of the second-hour and the third-hour glucoses in the 100 g OGTT of midtrimester can help to predict the postpartum long-term glucose state.

Objective To explore the relationship of MTNR1B DNA methylation with gestational diabetes and gestational glucose and lipid metabolism features.Methods 50 patients with gestational hyperglycemia,diagnosed by 100 g oral glucose tolerance test (OGTT) during mid-trimester were selected between 2009 and 2012.50 pregnant women with normal glucose tolkerance of matched age and body mass index were included in the control group.The blood samples during mid-trimester and the clinical parameters were collected.MTNR1B DNA methylation levels were measured.Results After adjusting age and body mass index,the CpG locus located at +64 bp away from the translation initiation site of MTNR1B was related with gestational diabetes (OR=0.859,95％ CI:0.772-0.955,P=0.005).DNA methylation level of several MTNR1B loci was also related with gestational glucose and lipid metabolism features.Conclusion MTNR1B DNA methylation is related with gestational diabetes and gestational glucose and lipid metabolism.

Glucocorticoids are widely used in clinical practice,and abnormal glucose metabolism due to the use of glucocorticoids is prevalent.There has been progress in studies evaluating post-glucocorticoid changes in blood glucose levels using continuous glucose monitoring.This paper reviews glycemic patterns and protocols for insulin treatment of abnormal glucose metabolism following the use of glucocorticoids as shown by continuous glucose monitoring.