Objective To investigate the association between glycated albumin/hemoglobin A1c(GA/HbA1c)and type 2 diabetes mellitus(T2DM)complicated with metabolic associated fatty liver disease(MAFLD).Methods A total of 502 hospitalized T2DM patients were enrolled between January 2022 and December 2023 and divided into T2DM group(n=301)and combined with MAFLD(MAFLD,n=201)group.Clinical data were collected,and Logistic regression analyses were performed to evaluate the relationship between GA/HbA1c and MAFLD.Mediation analysis was conducted to assess the role of blood lipids.Results The MAFLD group had higher levels of drinking,waist-to-hip ratio,body mass index,fasting insulin,fasting C-peptide,insulin resistance index,alanine aminotransferase,aspartate aminotransferase,triglycerides(TG),small dense low-density lipoprotein(sdLDL),and blood uric acid compared to the T2DM group(P<0.05).The age,DM duration,GA,GA/HbA1c,and high-density lipoprotein cholesterol(HDL-C)were lower in the MAFLD group than in the T2DM group(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,GA/HbA1c was an influencing factor for the occurrence of MAFLD in T2DM patients.Mediation analysis revealed that TG,sdLDL,and HDL-C had significant mediating effects,accounting for 19.3%,12.4%,and 8.5%of the risk association,respectively.Conclusions GA/HbA1c is influencing factor of MAFLD in T2DM patients,with blood lipids showing significant mediating effects,suggesting that GA/HbA1c may serve as a novel indicator for assessing MAFLD risk.

Objective To explore the correlation between thyroid hormone(TH)sensitivity and diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods A total of 776 patients with T2DM and normal thyroid function who were hospitalized in the Department of Endocrinology and Metabolism in Heze Mudan People's Hospital between July 2023 and January 2025 were enrolled in this study.They were divided into the simple T2DM group(n=456)and the DR group(n=320)based on the presence or absence of DR.The general data,biochemical indicators,thyroid feedback quartile index(TFQI),parameterized TFQI(PTFQI),thyroid stimulating hormone index(TSHI),thyroid resistance index(TT4RI),free triiodothyronine/free thyroxine(FT3/FT4),etc.were compared between the two groups.Logistic regression analysis was used to explore the influencing factors of DR.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of thyroid function-related parameters for DR.Results The DR group had higher age,the proportion of hypertension,the proportion of coronary heart disease,DM duration,the proportion of smoking,hemoglobin A1c(HbA1c),triglycerides,thyroid stimulating hormone(TSH),TFQI,PTFQI,TSHI,and TT4RI(P<0.05),while the proportion of male,fasting C-peptide,and FT4 were lower compared with the T2DM group(P<0.05).Logistic regression analysis revealed that age,DM duration,the proportion of smoking,TFQI,PTFQI,TT4RI,TSHI,and HbA1c were the influencing factors for the occurrence of DR in patients with T2DM.After adjusting for confounding factors,the risk of DR increased for each indicator in the Q4 groups compared with the Q1 quartile groups of TFQI,PTFQI,TT4RI,and TSHI respectively(OR 1.954,1.080,1.853,2.028,95%CI 1.039～3.676,1.035～1.127,1.003～3.426,1.090～3.775).The ROC curve analysis showed that the areas under the curve in predicting the occurrence of DR in patients with T2DM were 0.648,0.609,0.590,and 0.580 for TFQI,PTFQI,TT4RI,and TSHI respectively,and the sensitivities were 0.385,0.647,0.465,and 0.601 respectively,while the specificities were 0.615,0.578,0.258,and 0.541 respectively.Conclusions Central resistance to TH is associated with an elevated risk of DR in euthyroid patients with T2DM.

Objective To explore the correlation between body fat estimation formula of Navarra University(CUN-BAE)and bone mineral density(BMD)in patients with type 2 diabetes mellitus(T2DM)and its predictive value for osteoporosis(OP).Methods A total of 428 patients with T2DM who were hospitalized in the Department of Endocrinology and Metabolism,Affiliated Hospital of Jiangsu University were enrolled in this study between October 2017 and October 2023.All the patients were divided into simple T2DM group(n=226),osteopenia(OT,n=126)group and OP group(n=76)according to BMD.The general data and biochemical indexes were compared between the two groups.The value of CUN-BAE was calculated,and the BMD value was testedby dual-energy X-ray method.The correlation between CUN-BAE and other indexes was evaluated by Spearman correlation,and the influencing factors for OP was evaluated by Logistic regression in T2DM patients.The diagnostic efficacy of CUN-BAE was explored by receiver operating characteristic(ROC)curve in T2DM patients complicated with OP.Results CUN-BAE was higher in OP group than in T2DM and OT group(P<0.05).Spearman correlation analysis showed that CUN-BAE was negatively correlated with the values of L1,L2,L3,L4,L1～L4,L2～L4,femoral neck BMD,wards triangle BMD,greater trochanter BMD,total hip BMD and L1～L4 BMD T value(P<0.05).Logistic regression analysis showed that CUN-BAE was a influencing factor for OP in T2DM patients.ROC curve analysis showed that the area under the curve predicted by CUN-BAE for T2DM patients complicated with OP was 0.672.Conclusions CUN-BAE value were significantly elevated in T2DM patients with OP.CUN-BAE was valuable for predicting OP in T2DM patients.

Objective To analyze the significance of serum glucagon-like peptide-1(GLP-1)expression in patients with type 2 diabetes mellitus(T2DM)and its predictive value for diabetic retinopathy(DR).Methods A total of 160 T2DM patients admitted to our hospital from January 2020 to January 2022 were enrolled in this study and divided into DR group(n=68)and T2DM group(n=92)according to whether they had DR.Another 80 healthy physical examination subjects were selected as normal control(NC)group from our physical examination center during the same period.Serum GLP-1 levels were detected and compared among all the groups.Serum GLP-1 levels were compared among patients with different stages of DR.The correlation between serum GLP-1 and other indexes was evaluated by Pearson analysis.The influencing factors for DR were analyzed by Logistic regression analysis.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was generated,and the predictive efficacy of serum GLP-1 on DR was analyzed.Results Serum GLP-1 in NC,T2DM and DR groups decreased in turn(P<0.05).Serum GLP-1 in subgroups Ⅱ,Ⅲ,Ⅳ and Ⅴ decreased in turn(P<0.05).Pearson analysis showed that serum GLP-1 was negatively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP),2 h postprandial blood glucose(2 hPG),low density lipoprotein cholesterol(LDL-C),tumor necrosis factor-α(TNF-α)(r=-0.359,-0.314,-0.361,-0.308,-0.429,P<0.05),positively correlated with fasting C-peptide(FC-P)(r=0.382,P<0.05).Logistic regression analusis showed that DM duration,SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P were the influencing factors for DR.The AUC of GLP-1 was 0.091 in predicting DR,and the sensitivity and specificity were 93.76%and 90.23%when the optimal cut-off value was 1.95 pmol/L.Conclusions Serum GLP-1 expression is low in T2DM patients,and serum GLP-1 is correlated with SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P to a certain extent,which has high sensitivity and specificity in predicting the occurrence of DR.Abnormal low expression of serum GLP-1,metabolic disorders of blood glucose and lipids,hypertension,inflammation and other factors are involved in the progression of the disease,all of which are influencing factors for inducing DR,and should attract clinical attention.

Objective To investigate the relationship between the stages of diabetic retinopathy(DR)and the risk of arterial disease in lower limbs(LEAD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 70 patients with T2DM admitted to The First Affiliated Hospital of Nanyang Medical College from March 2021 to October 2023 were selected as the research object.According to whether or not there was LEAD,they are divided into combined LEAD(LEAD,n=69)group and simple DR group(n=201).The clinical data and DR staging between two groups were compared.The correlation between intima-media thickness of lower limb arteries and other indicators in T2DM patients was evaluated by Spearman analysis.The risk factors of T2DM patients complicated with LEAD were analysis by Logistic regression.The receiver operator characteristic(ROC)curve was drawn,and the prediction efficiency was evaluated by the area under the curve.Results The incidence of LEAD in 270 DR patients was 25.56%.The age,DM duration,homeostasis model assessment-insulin resistance(HOMA-IR),hemoglobin A1c(HbA1c),total cholesterol(TC),C-reactive protein(C-RP),interleukin-6(IL-6),fibrinogen(FIB),cystatin C(CysC)and DR stage in the LEAD group were higher than in the DR group(P<0.05).Spearman correlation analysis showed that the intima-media thickness of lower extremity arteries was positively correlated with age,DM duration,HOMA-IR,HbA1c,TC,C-RP,IL-6,FIB,CysC and DR stages(P<0.05).Logistic regression analysis showed that age(OR 3.271,95%CI 1.694～6.314),DM duration(OR 3.340,95%CI 1.730～6.448),HbA1c(OR 3.466,95%CI 1.795～6.691),C-RP(OR 3.408,95%CI 1.765～6.578)and DR staging(OR 3.607,95%CI 1.869～6.964)were all influencing factors for T2DM patients with LEAD.The ROC curve analysis results showed that the area under the curve of HbA1c,C-RP,DR staging,and their combination for predicting LEAD in T2DM patients were 0.780,0.783,0.761,and 0.925,respectively.Conclusions There is a close relationship between DR staging and the occurrence of LEAD in T2DM patients,and the combination of HbA1c,C-RP,and DR staging has a higher predictive power for LEAD in T2DM patients.

Objective To investigate the correlation between thyroid hormone(TH)sensitivity and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 949 T2DM patients with normal thyroid function were selected from the National Standardized Metabolic Disease Management Center database of our hospital between May 2020 and October 2024.All the patients were divided into DKD group(n=466)with urinary albumin/creatinine ratio(UACR)≥30 mg/g and simple T2DM group(n=483)with UACR<30 mg/g.Free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroid feedback quantification index(TFQI),thyroid stimulating hormone resistance index(TT4RI),thyroid stimulating hormone index(TSHI),FT3/FT4 were compared between the two groups.Results Body mass index(BMI),DM duration,subcutaneous fat area(SFA),blood urea nitrogen(BUN),serum creatinine(Scr),UACR,TSHI and FT4 were higher(P<0.05 or P<0.01),while FT3,TFQI was lower in DKD group than in T2DM group(P<0.05).Spearman correlation analysis showed that TT4RI was positively correlated with Scr(P<0.05),and FT3/FT4 was negatively correlated with UACR(P<0.05)in DKD group.TT4RI was positively correlated with UACR in T2DM group(P<0.05).Logistic regression analysis showed that FT3,BUN and BMI were influencing factors for DKD.The model formula was established as follows:DKD=0.711+0.102×BMI-0.002×SFA+0.138×BUN+0.007×Scr-0.578×FT3-0.089×FT4+0.750×TFQI-0.277×TSHI,which can forecasted the risk of DKD occurrence by 10%.The receiver operator characteristic curve evaluated the area under the curre of the above model formula as 0.705,the sensitivity was 49.1%,the specificity was 80.3%,and the cut-off value was 0.464.Conclusions With normal thyroid function,impaired central and peripheral TH sensitivity is correlated with T2DM combined with DKD,and elevated FT3 is a protective factor for T2DM combined with DKD.

Objective To investigate the correlation between blood glucose(BG)control and barrier dysfunction in diabetes mellitus(DM)patients with ulcerative colitis(UC).Methods A total of 120 patients with DM and UC admitted to the Department of Gastroenterology of our hospital between January 2021 and January 2024 were selected and divided into injury group(n=68)and non-injury group(n=52)according to the injury of intestinal barrier function.Pearson correlation analysis was used to analyze the correlation between hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2 hPG and D-lactic acid(D-LA),diamine oxidase(DAO),lipopolysaccharide(LPS),and Galectin-3.Logistic regression analysis was used to analyze the influencing factors for intestinal barrier dysfunction.Receiver operator characteristic(ROC)curve was drawn to analyze the diagnostic value of BG level for intestinal barrier dysfunction.Results The levels of HbA1c,FPG,2 hPG,D-LA,DAO,and LPS were higher in the injury group than in the non-injury group(P<0.05),and the level of Galectin-3 was lower in the injury group than in the non-injury group(P<0.05).Pearson correlation analysis showed that HbA1c,FPG,and 2 hPG levels were positively correlated with D-LA,DAO,and LPS(P<0.05),and negatively correlated with Galectin-3(P<0.05).Logistic regression analysis showed that HbA1c,FPG and 2 hPG were the influencing factors for intestinal barrier dysfunction.ROC curve analysis showed that the area under the curve of HbA1c,FPG and 2 hPG was 0.968,0.942 and 0.910 for predicting intestinal barrier dysfunction.Conclusions BG level affects the damage of intestinal barrier function,and the risk of intestinal barrier function damage can be reduced by strengthening BG control in clinical practice.

Objective To investigate the mechanism of long non-coding RNA(LncRNA)FUT8-AS1 on diabetic ischemia-reperfusion injury by regulating growth differentiation factor 15(GDF15).Methods Male SD rats were randomly divided into Sham group,cerebral ischemia-reperfusion injury(MCAO/R)group,diabetic cerebral ischemia-reperfusion injury(DM-MCAO/R)group,DM-MCAO/R+sh NC group,and DM-MCAO/R+sh FUT8-AS1 group.TTC staining was used to assess the size of cerebral infarction.Tunel staining was selected to evaluate the apoptosis of neurons in brain tissue.Nissl staining was used to assess the number of neurons in brain tissue.The expression of LncRNA FUT8-AS1,GDF15 mRNA in Willis arterial loop and internal carotid artery tissues were detected by qRT-PCR.The expression of α-SMA,eNOS,p-eNOS,GDF15 protein in Willis arterial loop and internal carotid artery was detected by Western blot.The rat brain microvascular endothelial cells were divided into control(Con)group,OGD/R group,HG-OGD/R group,HG-OGD/R+sh NC group,HG-OGD/R+sh FUT8-AS1 group,HG-OGD/R+sh FUT8-AS1+oe NC group,and HG-OGD/R+sh FUT8-AS1+oe GDF15 group.MTT assay was used to detect cell viability.Lactate dehydrogenase(LDH)assay was used to detect cell damage.The expression ofα-smooth muscle actin(α-SMA),endothelial nitric oxide synthase(eNOS),p-eNOS protein was detected by Western blot.Results Compared with the Sham group,the percentage of cerebral infarction,the number of Tunel-positive cells,the FUT8-AS1 and mRNA expression of GDF15 and the expression of GDF-15 protein increased(P<0.05),and the expression of α-SMA,eNOS,p-eNOS proteins decreased in the MCAO/R group(P<0.05),and the number of neurons in the hippocampus decreased,the morphology was shrunk,and the color was dark in the MCAO/R group.Compared with the MCAO/R group,the percentage of cerebral infarction,the number of Tunel-positive cells,the FUT8-AS1 and mRNA expression of GDF15 and the expression of GDF-15 protein increased(P<0.05),and the expression of α-SMA,eNOS,p-eNOS proteins decreased in the DM-MCAO/R group(P<0.05),and the number of neurons in the hippocampus decreased in the DM-MCAO/R group.Compared with the DM-MCAO/R+sh NC group,the percentage of cerebral infarction,the number of Tunel-positive cells,the FUT8-AS1 and mRNA expression of GDF15 and the expression of GDF-15 protein decreased(P<0.05),and the expression of α-SMA,eNOS,p-eNOS proteins increased in the DM-MCAO/R+sh FUT8-AS1 group(P<0.05),and the number of neurons in the hippocampus increased in the DM-MCAO/R+sh FUT8-AS1 group.Compared with the Con group,the LDH release,FUT8-AS1 expression,GDF15 mRNA and protein expression increased(P<0.05),and the cell activity,α-SMA,eNOS,and p-eNOS protein expressions decreased in the OGD/R group(P<0.05).Compared with the OGD/R group,the LDH release,FUT8-AS1 expression,GDF15 mRNA and protein expression increased(P<0.05),and the cell activity,α-SMA,eNOS,and p-eNOS protein expressions decreased in the HG-OGD/R group(P<0.05).Compared with the HG-OGD/R+sh NC group,the LDH release,FUT8-AS1 expression,GDF15 mRNA and protein expression decreased(P<0.05),and the cell activity,α-SMA,eNOS,and p-eNOS protein expressions increased in the HG-OGD/R+sh FUT8-AS1 group(P<0.05).Compared with the HG-OGD/R+sh NC group,the LDH release,GDF15 mRNA and protein expression increased(P<0.05),and the cell activity decreased in the HG-OGD/R+oe GDF15 group(P<0.05).Compared with the HG-OGD/R+sh FUT8-AS1+oe NC group,the expression of α-SMA,eNOS,p-eNOS proteins decreased in the HG-OGD/R+sh FUT8-AS1+oe GDF15 group(P<0.05).Conclusions LncRNA FUT8-AS1 may exacerbate diabetic cerebral ischemia-reperfusion injury by regulating GDF15.

Evolocumab is a lipid-lowering agent used to reduce low-density lipoprotein cholesterol levels and decrease the all-cause mortality rate of cardiovascular diseases.There are few ocular adverse reactions when the drug is used clinically.This article reports a case of primary angle-closure glaucoma.After three sessions of lipid-lowering treatment with the proprotein convertase subtilisin type 9(PCSK9)inhibitor Evolocumab,the patient developed swelling and pain in the left eye and blurred vision.Ophthalmic examination revealed a significant increase in intraocular pressure in the left eye,suggesting an acute attack of angle-closure glaucoma.After treatment,the intraocular pressure dropped to the normal level.This article discusses this case and reviews relevant literature,suggesting that when using PCSK9 inhibitors in clinical practice,the ocular conditions of patients should be closely monitored,especially for those with risk factors for glaucoma.

Objective To explore the effects of long non-coding RNA(LncRNA)metastasis associated in lung denocarcinoma transcript 1(MALAT1)on high glucose-induced cardiomyocyte injury by regulating miR-320-3p-protein kinase B3(Akt3)axis.Methods H9c2 cells were divided into normal control(NC)group and high glucose(HG)group.After transfection,the cells were cultured in HG group were further divdided into subgroups as follows:HG+MALAT1 knock-down(HG+sh-MALAT1)group,HG+sh-NC group,HG+miR-320-3p mimic group,HG+mimic-NC group,HG+sh-MALAT1+miR-320-3p inhibitor group and HG+sh-MALAT1+pcDNA3.1-Akt3 group.Cell activity,apoptosis rate,B-cell lymphoma 2-related protein X(Bax),B-cell lymphoma factor 2(Bcl-2),cleaved caspase-3,Akt3 protein,MALAT1,miR-320-3p,Akt3 mRNA expression,interleukin(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)were compared among the groups.Results The apoptosis rate of cardiomyocytes,the expressions of IL-1β,IL-6,TNF-α,Bax,cleaved caspase-3/caspase-3 protein,MALAT1 and Akt3 mRNA increased(P<0.05),while the expression of Bcl-2 protein and miR-320-3p decreased in HG group(P<0.05).After knocking down LncRNA MALAT1,apoptosis rate of HG-induced cardiomyocytes and levels of inflammatory factors were decreased(P<0.05).MALAT1 could negatively regulate expression of miR-320-3p,and miR-320-3p could negatively regulate expression of Akt3 protein.The overexpression of miR-320-3p could decrease apoptosis rate and inflammation level,while overexpression of Akt3 or inhibition of miR-320-3p expression could increase apoptosis rate of cardiomyocytes and inflammation level(P<0.05).Conclusions LncRNA MALAT1 can promote the expression of Akt3 protein by inhibiting miR-320-3p expression,thereby reduce activity of HG-induced cardiomyocytes and aggravate cardiomyocytes injury.