This article discusses the design, key findings and implications of a recent paper published in Diabetes, Obesity and Metabolism titled "The efficacy and safety of iGlarLixi versus IDegAsp in Chinese people with type 2 diabetes suboptimally controlled with oral antidiabetic drugs: The Soli-D randomized controlled trial" . This study is the first randomized, active-controlled, phase Ⅲ study comparing the efficacy and safety of iGlarLixi versus IDegAsp in Chinese patients with type 2 diabetes. It offers new evidence for initiating injection therapy in Chinese patients with type 2 diabetes who are inadequately controlled with oral antidiabetic drugs.

Objective:To investigate the association between cardiovascular health(CVH) metrics and microvascular complications in patients with type 2 diabetes mellitus(T2DM).Methods:A cross-sectional study was conducted with 4 614 T2DM patients who received standardized metabolic disease management at the First Affiliated Hospital of Ningbo University from March 1st, 2018, to February 29th, 2024. Ideal CVH metrics were defined as non-smoking, non-drinking or moderate drinking, a healthy diet, regular physical activity, a healthy waist circumference, and adequate sleep duration. Microvascular complications included diabetic kidney disease(DKD), diabetic retinopathy(DR), and diabetic peripheral neuropathy(DPN). Logistic regression analysis was used to assess the relationship between CVH metrics and microvascular complications. Results:Patients with≤1, 2, 3, 4, or≥5 ideal CVH metrics were 378(8.2%), 933(20.2%), 1 480(32.1%), 1 218(26.4%), and 605(13.1%), respectively. A total of 2 736(59.3%) patients had at least one microvascular complication. Multivariate logistic regression analysis showed that compared to those with≤1 ideal CVH metric, patients with≥5 ideal CVH metric had an odds ratio( OR) of 0.55(95% CI 0.41-0.74, Ptrend<0.001) for microvascular complications, an OR of 0.51(95% CI 0.36-0.72, Ptrend<0.001) for DKD, and an OR of 0.54(95% CI 0.40-0.73, Ptrend<0.001) for DPN. No significant association was found for DR, with an OR of 1.31(95% CI 0.87-1.98, Ptrend=0.615). Conclusion:A great number of ideal CVH metrics was associated with a reduction in microvascular complications in T2DM patients, with variations across different types of microvascular complications.

Objective:To examine the clinical features and genetic profiles of patients with thyroid peroxidase(TPO) gene mutations and provide diagnostic guidance for clinicians.Methods:A retrospective review of four patients with TPO mutations treated at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from January 2014 to December 2023. Data on demographics, clinical manifestation, genotypes, treatment, and prognosis of these patients were analyzed.Results:Two males and two females, aged 13 to 27 years at diagnosis, presented with goiter as the initial symptom, with three cases menifesting during puberty. Laboratory findings showed mildly elevated or upper-limit-normal serum thyroid-stimulating hormone(TSH) levels, significantly increased free triiodothyronine/free thyroxine(FT 3/FT 4) ratios, and elevated thyroglobulin(TG) levels. Genetic testing revealed compound heterozygous pathogenic or likely pathogenic TPO mutations. Despite regular levothyroxine(L-T 4) therapy, goiter persisted. Three patients required thyroidectomy due to cosmetic or compressive symptoms, with pathology showing follicular hyperplasia. Conclusion:TPO mutations are characterized by adolescent-onset goiter, elevated FT 3/FT 4 ratios, and normal to high TSH. Genetic testing confirms the diagnosis. L-T 4 offers limited improvement, and surgery is often needed.

Objective:To investigate the effect and mechanism of Jianpi Qinghua granule in improving skeletal muscle insulin resistance induced by long-term low-dose cadmium exposure in rats.Methods:A total of 24 SPF-grade healthy 2-month-old Sprague-Dawley rats were assigned to normal control(NC) group, cadmium exposure(Cd) group, and Jianpi Qinghua granule protection(Cd+ JPQHG) group. After 24 weeks, fasting blood glucose and insulin levels were measured, and HOMA-IR was calculated. The intraperitoneal glucose tolerance test and insulin tolerance test were conducted to assess insulin sensitivity. Skeletal muscle tissues were extracted for Western blot analysis to detect levels of insulin signaling pathway-related proteins. Immunofluorescence was used to assess the translocation of glucose transporter 4(GLUT4), and oxidative stress markers were measured.Results:Compared to the NC group, the Cd group showed significant increases in fasting plasma glucose, fasting insulin levels, and HOMA-IR after 24-week exposure. Abnormal glucose and insulin tolerance were also observed in the Cd group. The 12-week intervention with Jianpi Qinghua granule significantly improved glucose metabolism and alleviated the abnormalities in glucose and insulin tolerance. Western blot results indicated that the phosphorylation levels of PI3K and Akt in the skeletal muscle of the Cd group were significantly reduced compared to the NC group, while these levels were significantly elevated in the Cd+ JPQHG group, along with increased translocation of GLUT4 to the cell membrane. Additionally, cadmium exposure significantly increased H 2O 2 and malondialdehyde levels while decreased antioxidant enzyme activity. These oxidative stress indicators improved significantly after Jianpi Qinghua granule intervention( P<0.05). Conclusion:Jianpi Qinghua granule may improve skeletal muscle insulin resistance and glucose metabolism disorders due to long-term low-dose cadmium exposure by reducing oxidative stress, regulating the phosphorylation levels of key proteins in the insulin signaling pathway, and promoting GLUT4 translocation to the cell membrane.

The 60th annual meeting of the European Association for the Study of Diabetes(EASD), held in Madrid, Spain, in September 2024, convened leading physicians and researchers from more than 130 countries. This premier event shared and discussed advances in diagnosis and treatment, as well as future trends in diabetes and metabolic disease research. Key topics included the presentation of the Claude Bernard Prize, advancements in diabetes management strategies, the interplay between obesity and diabetes, novel therapeutic developments, and emerging diagnostic and treatment approaches for metabolic dysfunction-associated steatotic liver disease.

Basal insulin plays a crucial role in the treatment of patients with type 2 diabetes mellitus(T2DM). Previous clinical trials have demonstrated that insulin glargine 300 U/mL(Gla-300) is effective in improving glycaemic control with a relatively low risk of hypoglycaemia. However, there is limited real-world data on its effectiveness and safety in China. This article reviews the INITIATION study, which evaluated the use of Gla-300 in clinical practice in China, demonstrating that Gla-300 is an effective treatment option for Chinese adults with suboptimally controlled T2DM, whether insulin-na?ve or switching from other basal insulins.

Brown adipose tissue(BAT), a metabolically active organ, not only plays a pivotal role in thermogenesis, but also exerts endocrine effects that regulate both its own metabolic processes and the function of various other organ systems. These effects are primarily mediated by brown adipose tissue-derived factors, or batokines. Recent advances in the understanding of batokine types, target organs, and underlying mechanisms have highlighted their significant role in the crosstalk between BAT and other organs. This review focuses on the various batokines secreted by BAT and their involvement in regulating interactions with key target organs such as the liver, cardiovascular system, skeletal muscle, and nervous system. By examining the specific functions and molecular mechanisms of these factors, this review aims to offer novel insights and suggest potential research directions for the prevention and treatment of related metabolic diseases.

Objective:To investigate the inpact of thyroid cancer-derived cancer-associated fibroblasts(CAF) autophagy on papillary thyroid cancer(PTC).Methods:CAF and normal fibroblasts were isolated from cancerous and adjacent normal thyroid tissues from four PTC patients. Expressions of fibroblast activation protein(FAP) and α-smooth muscle actin in cells were assessed. Conditioned medium of CAF and normal fibroblasts were prepared and used to culture PTC cells. The effects of CAF and normal fibroblasts on survival, proliferation, migration, invasion and iodine uptake of PTC cells were evaluated through cell proliferation assay, cell scratch assay, cell invasion assay, and cell iodine uptake assay. The autophagy level of CAF was also evaluated. Autophagy inhibition and activation were used to regulate the autophagy of CAF, and then their effects on PTC cell proliferation, migration and invasion were further evaluated. The in vivo effect of CAF autophagy on PTC xenograft tumor growth was evaluated.Results:CAF exhibited higher FAP expression and basal autophagy levels. PTC cells co-cultured with CAF-conditioned media showed enhanced proliferation, migration, invasion, and reduced iodine uptake. Autophagy inhibition reduced these effects, while autophagy activation further promoted them. In vivo, inhibiting CAF autophagy suppressed tumor growth.Conclusions:CAF promotes PTC cell malignancy through autophagy activation, enhancing proliferation, migration, and invasion while reducing iodine uptake.

Objective:To explore the effect and mechanism of Chlorfortunone A(ChlA) in the treatment of diabetic nephropathy(DN) in mice.Methods:The DN model mice were assigned to DN, low-dose ChlA(ChlAL) and high-dose ChlA(ChlAH), and the normal control groups(Ctrl). Kidney tissue was analyzed via HE and Masson staining, and urine albumin, fasting blood glucose and kidney weight were measured. Collagen1 and α-SMA proteins were detected in renal tissues. The level of GSH-px, SOD, CAT, and TGF-β were detected. The TGF-β/Smad2 pathway in kidney tissue was detected. The mechanism was verified by setting the high glucose+ ChlA+ TGF-β group in MPC-5 cells. The proliferation of the cells and DCFDA staining were detected.Results:Compared to the Ctrl group, the DN group had significantly higher UACR and kidney weight( P<0.001). High-dose ChlA reduced UACR and kidney weight( P<0.05), with no effect on blood glucose( P>0.05). Masson staining showed reduced fibrosis with ChlA treatment. Collagen I and α-SMA expressions were significantly higher in DN( P<0.001) and decreased with ChlA treatment( P<0.05). GSH-px, SOD, and CAT levels were lower in DN( P<0.001), while TGF-β was elevated( P<0.001); ChlA increased antioxidant enzymes and decreased TGF-β( P<0.05). The TGF-β/Smad2 pathway was upregulated in DN( P<0.001) and inhibited by ChlA( P<0.001). In vitro, ChlA reduced cell proliferation( P<0.05) and increased ROS levels( P<0.001). Conclusions:ChlA alleviates kidney injury and fibrosis in DN mice, reduces oxidative stress, which may be related to the inhibition of the TGF-β/Smad2 pathway.

Pituitary stalk interrupt syndrome is characterized by pituitary stalk thinning or disappearance, anterior pituitary hypoplasia and posterior pituitary ectopic, this article reviewed and analyzed a case of PSIS presenting with bilateral lower limb edema, abnormal liver and kidney function, and significantly above-normal height. We explore the clinical manifestations, laboratory tests, diagnosis, and treatment of this case, as well as the potential underlying mechanisms of non-alcoholic fatty liver disease(NAFLD) and its related complications. The findings suggest that PSIS should be considered in patients with abnormal liver and kidney function. Early identification and timely intervention may improve patient prognosis.