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Effect of Glucagon-like peptide 1 on Lipid Metabolism

Chinese Journal of Endocrinology and Metabolism.2015;(6):558-560. doi:10.3760/cma.j.issn.1000-6699.2015.06.022

[Summary] Glucagon-like peptide-1 ( GLP-1 ) as a new treatment of type 2 diabetes, not only has hypoglycemic effect, but also plays an important role in the regulation of lipid metabolism. GLP-1 plays a unique role in regulating lipid metabolism via lipid absorption and transport, fat formation and decomposition, hepatic lipid metabolism, and cholesterol transport.

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Effect of thyrotropin on bone metabolism

Guofang CHEN ; Chao LIU

Chinese Journal of Endocrinology and Metabolism.2015;(6):555-557. doi:10.3760/cma.j.issn.1000-6699.2015.06.021

[Summary] Epidemiologic evidence favors strong correlations between low thyrotropin(TSH) and high bone turnover, low bone mineral density ( BMD), and high fracture risk in hyperthyroid patients. Even subclinical hyperthyroidism, in which TSH is low and thyroid hormones are normal, is associated with osteopenia and osteoporosis. These evidences indicate that action of TSH on bone metabolism is independent of thyroid hormones and thus support the theory of the pituitary-bone axis. TSH plays its osteoprotective effect by binding TSH receptor on osteoclasts and inhibiting TNF-α expression. Physicians should screen the BMD in patients with overt and subclinical hyperthyroidism, especially the elderly, and make early diagnosis and better management for the underlying osteopenia and osteoporosis.

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Effects of antidiabetic agents on bone metalbolism in diabetic patients

Xia LI ; Tao LEI

Chinese Journal of Endocrinology and Metabolism.2015;(6):552-554. doi:10.3760/cma.j.issn.1000-6699.2015.06.020

[Summary] The prevalence of diabetes mellitus and osteoporosis is rapidly growing and pose a serious threat to human health,. Accumulating evidence indicates that diabetes mellitus is a risk factor for osteoporosis and they could be linked by similar pathophysiological mechanisms. Antidiabetic agents may not only help to control the chronic hyperglycemia state but can also effect bone, This article reviewed the correlation between diabetes mellitus and bone metabolism and summarized the available data on skeletal effects of clinically approved antidiabetic therapies, aimed to provide the basis for clinical medicine use.

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Recent progress in studying type 2 diabetes mellitus and tumor risk

Yuehong CHEN ; Liang DU ; Chunlin ZHANG ; Xingyuan GENG ; Guanjian LIU

Chinese Journal of Endocrinology and Metabolism.2015;(6):544-547. doi:10.3760/cma.j.issn.1000-6699.2015.06.018

[Summary] During recent years, increasing evidences have indicated that type 2 diabetes mellitus(T2DM) might increase the risk of certain tumors; the process might be not only related with the chronic pathologic status of T2DM such as hyperglycemia, hyperinsulinemia, insulin resistance, dyslipidemia, status of chronic inflammation but also associated with the long-term use of anti-diabetic drugs (i. e. sulfonylureas, biguanides, glitazones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptitide-1 receptor agonists), as well as the use of insulin and insulin analogues. Herewith a system review was made about the recent progress in studying T2DM and tumor risk.

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Effect and mechanism of liraglutide on proliferation and apoptosis of human pancreatic cancer cells

Rui WEI ; Jin YANG ; Tianpei HONG ; Hejun ZHAO ; Jing KE ; Wenfang HOU ; Ye LIU

Chinese Journal of Endocrinology and Metabolism.2015;(6):530-534. doi:10.3760/cma.j.issn.1000-6699.2015.06.014

Objective To investigate the effects and mechanism of glucagon-like peptide-1 ( GLP-1 ) receptor agonist liraglutide on the proliferation and apoptosis of human pancreatic cancer cells. Methods The human pancreatic cancer cell line MIA PaCa-2 was incubated for 24 h with liraglutide at various concentrations (10-1 000 nmol/ L), or with 100 nmol/ L liraglutide for various durations (0-72 h). Cell proliferation was determined by Cell Counting Kit-8 (CCK-8) analysis. RT-PCR and Western blot were used to detect the mRNA and protein expression levels of related genes. Results GLP-1 receptor was expressed in the MIA PaCa-2 cells. Liraglutide suppressed cell proliferation, up-regulated the expression levels of pro-apoptotic protein Bax and down-regulated the expression levels of anti-apoptotic protein Bcl2 in human pancreatic cancer cells in a dose- and time-dependent manner. Meanwhile, liraglutide down-regulated the expression levels of insulin receptor (INSR) and insulin-like growth factor-1 receptor (IGF-1R), and the phosphorylation levels of their downstream signaling proteins Erk1 / 2 and Akt, in a dose- and time-dependent way. Conclusion Liraglutide inhibits proliferation and promotes apoptosis of human pancreatic cancer cells; the process may be mediated via suppressing the expression of INSR and IGF-1R and inhibiting activation of the downstream MEK/ Erk1 / 2 and PI3k/ Akt pathways.

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Management of infertility in patients with non-obese polycystic ovary syndrome by micro-pulse infusion of GnRH

Huiying JIA ; Shouyue SUN ; Weiqing WANG ; Guang NING

Chinese Journal of Endocrinology and Metabolism.2015;(6):528-529. doi:10.3760/cma.j.issn.1000-6699.2015.06.013

[Summary] Patients with infertility and non-obese polycystic ovary syndrome ( PCOS) were treated with continuous subcutaneous pulse infusion of GnRH. After the treatment, a 32-year old female had regular menstrual cramps. Dominant follicle occurred after 2 months of treatment. The patient was pregnant and now has a healthy baby boy. It shows that the pulse infusion of GnRH could induce spontaneous ovulation and natural fertilization of the patients with non-obese PCOS.

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The main effect and interaction between haplotypes of CIDEB and CIDEC to obesity

Zhiguang PING ; Li LIU ; Fangfang ZHAN ; Minjie QI ; Xiaoping LE

Chinese Journal of Endocrinology and Metabolism.2015;(6):518-521. doi:10.3760/cma.j.issn.1000-6699.2015.06.010

[Summary] A selection of 528 unrelated subjects were enrolled(198 males, 330 females) with the mean age of(52. 23 ± 13. 41) years old. According to body mass index, 253 persons belonged to the normal weight group and 275 persons overweight/ obesity group. A total of 10 SNPs in CIDEB and CIDEC genes were detected. SHEsis online were used to get the haplotypes of these two genes. The relationship between above SNPs and obesity were analyzed under additive inheritance pattern. The main effects and interaction on obesity induced by two genes’ haplotypes were analyzed by logistic regression. rs2144493 in CIDEB gene was associated with obesity, C was a protective alleles, OR (95% CI) equals 0. 722(0. 525-0. 992). CCTT haplotype of CIDEB gene carriers and GCG haplotype of CIDEC gene carriers were more prone to obesity or overweight, there was an interaction between the haplotypes of 2 genes. CIDEB, CIDEC haplotypes may play independent and interactive roles in causing obesity.

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Triple combination therapy using saxagliptin/metformin/rosiglitazone versus intensive insulin therapy in the treatment of newly-diagnosed type 2 diabetes:Effects on glycaemic control andα/β-cell function

Huijin LUO ; Rongping CHEN ; Rui YANG ; Zhen ZHANG ; Min YI ; Hong CHEN

Chinese Journal of Endocrinology and Metabolism.2015;(6):515-517. doi:10.3760/cma.j.issn.1000-6699.2015.06.009

[Summary] Drug naive, newly diagnosed type 2 diabetic subjects were randomized to Saxagliptin/Metformin / Rosiglitazone(Triple Therapy, n=23) or insulin 70 30 mix group(Intensive Insulin Therapy) (n=21) for 24 weeks. How did the 2 therapies influence fasting blood glucose, fasting insulin, C-peptide, and glucagon levels and the change of body weight were compared. This study was aimed to explore the comparative glycemic efficacy and impact on α/ β-cell function of two different antidiabetic therapies, triple combination therapy using saxagliptin/metformin/ rosiglitazone and intensive insulin therapy, for newly diagnosed type 2 diabetes mellitus. The results indicated that fasting blood glucose, HbA1C , insulin resistance index 2(HOMA 2-IR), glucagon and body mass index level were significantly decreased, and insulin secretion index 2 ( HOMA 2-% β) was increased significantly( P <0. 05) in triple therapy group, and the decreasing extent of HOMA 2-IR, glucagon, and body mass index were significantly greater than that in the intensive insulin group(P<0. 05). Triple therapy group has a stronger effect of reducing insulin resistance, as well as on inhibiting glucagon and promoting weight loss.

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A retrospective study:analyzing the risk factors of liver dysfunction in Graves’ disease

Chengxia LI ; Jian TAN ; Guizhi ZHANG ; Zhaowei MENG ; Renfei WANG ; Wei LI ; Wei ZHENG

Chinese Journal of Endocrinology and Metabolism.2015;(6):501-505. doi:10.3760/cma.j.issn.1000-6699.2015.06.006

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.

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Analysis of liver dysfunction parameters and its associated factors in 1 221 untreated adult patients with Graves’ disease

Ran LIU ; Qianlin YANG ; Li ZHAO ; Jinjing WANG ; Dan ZHENG ; Jing ZENG ; Yi FANG

Chinese Journal of Endocrinology and Metabolism.2015;(6):497-500. doi:10.3760/cma.j.issn.1000-6699.2015.06.005

Objective To investigate the trend of liver function changes in untreated adult patients with Graves’ disease in China, and to analyze the associated factors. Methods Patients with newly diagnosed as well as recurrent Graves’ disease from January 2006 to August 2014 were enrolled. They were over 18 years old and did not receive any treatments, Examination of liver function, thyroid function, and thyroid related antibodies as well as tests regarding virus hepatitis were performed. Results A total of 1 254 patients were enrolled. 33 patients with virus hepatitis were ruled out. Ultimately, 1 221 patients matched the criteria of our trial, with 347 males and 874 females [(39. 3 ± 9. 5) year old]. After inclusion, they were assigned to 2 groups according to their liver function results(605 in normal group and 616 in abnormal group). Compared to normal group, patients in the abnormal group were older [(40. 1 ± 9. 2 vs 38. 5 ± 8. 7) year old, P<0. 05] and with higher proportion of females(81. 8% vs 61. 2% , P<0. 05). Regarding the thyroid function and related antibody tests, some patients yielded results that were extremely high so as to exceed the upper limit of the normal range. These patients were more frequently seen in the group with abnormal liver function. The patients whose thyroid function parameters exceeded the upper limit had higher level of alanine aminotransferase[ALT,(37. 69 ± 7. 51 vs 31. 90 ± 5. 95) U/ L, P<0. 05], aspartate aminotransferase[AST, (31. 97 ± 5. 09 vs 27. 88 ± 3. 82) U/ L, P<0. 05], direct bilirubin[DBiL, (5. 58 ± 0. 77 vs 4. 54 ± 0. 71) μmol/ L, P<0. 05]than the group whose thyroid function on the detected range. In the patients with all results detected, patients in abnormal liver function group had higher level of triiodthyronine[T3 , (5. 42 ± 0. 29 vs 4. 94 ± 0. 33) nmol/ L, P<0. 05], thyroxin[T4 ,(217. 53 ±14. 32 vs 204. 22 ±13. 54) nmol/ L, P<0. 05], free triiodthyronine[FT3 ,(15. 88 ± 2. 86 vs 14. 48 ±4. 83) pmol/ L, P<0. 05], free thyroxin[FT4 ,(48. 91 ±8. 45 vs 42. 95 ±6. 14) pmol/ L, P<0. 05], thyroid peroxidase antibody[ TPOAb, (402. 75 ± 89. 99 vs 210. 70 ± 44. 63) IU/ ml, P < 0. 05] and thyrotrophin receptor antibody[TRAb,(14. 08 ± 5. 24 vs 9. 04 ± 2. 58) IU/ L, P<0. 05]. Multivariate logistic regression analysis revealed that patients’ age(OR=0. 98, 95% CI 0. 97-0. 99), gender(OR=0. 94, 95% CI 0. 91-0. 97), level of FT4 (OR=3. 08, 95% CI 2. 19-4. 32), TPOAb(OR = 0. 98, 95% CI 0. 97-0. 99), and TRAb(OR = 1. 07, 95% CI 1. 01-1. 12) were independent risk factors of their liver dysfunction. Conclusion Graves’ disease may lead to liver dysfunction, which is much more common and severe in elder and female patients, as well as patients who are suffering from hyperthyroidism and raised level of thyroid related antibodies.

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