Objective To explore the relationship between serum CXC chemokine ligand 12(CXCL12),an-giotensin Ⅱ receptor-like 1 endogenous ligand 13(Apelin-13)and carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods From October 2022 to September 2024,a total of 105 T2DM patients in Rugao People's Hospital(the hospital)were included as the T2DM group,and healthy volunteers who experienced physical check ups in the hospital were regarded as the control group.According to whether T2DM patients developed CAS,they were assigned into non CAS group(n=61)and CAS group(n=44).Fully automatic biochemical analyzer was applied to detect the levels of blood lipid indicators total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein choles-terol(LDL-C).Fully automatic glycated hemoglobin analyzer was used to detect glycated hemoglobin(HbA1c)level.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of CXCL12 and Apelin-13.Multivariate Logistic regression was applied to analyze the influencing factors of concurrent CAS in T2DM.Pearson correlation was used to analyze the correlation between CXCL12,Apelin-13 and the course of diabetes,blood glucose and lipid indicators.Receiver operating characteristic(ROC)curve was applied to ana-lyze the predictive value of CXCL12 and Apelin-13 for T2DM complicated with CAS,and the Z-test was ap-plied to compare the differences in the area under the curve(AUC).Results The level of CXCL12 in the T2DM group was higher than that in the control group(P＜0.05),and Apelin-13 level was lower than that in the control group(P＜0.05).The course of T2DM,HbA1c,TC,TG,LDL-C,and CXCL12 levels in the CAS group were higher than those in the non CAS group(P＜0.05),while HDLC and Apelin-13 levels were lower than those in the non CAS group(P＜0.05).The level of CXCL12 in the CAS group was positively correlated with the course of T2DM,HbA1c,TC,TG,and LDL-C levels(P＜0.05),and negatively correlated with HDL-C levels(P＜0.05),while the correlation of Apelin-13 was opposite(P＜0.05).CXCL12 and Apelin-13 were independent influencing factors for concurrent CAS in T2DM patients(P＜0.05).The AUC predicted by CX-CL12 and Apelin-13 in T2DM patients complicated with CAS was 0.916,which was better than 0.783 and 0.788 predicted separately(P＜0.05).Conclusion The high levels of CXCL12 and low levels of Apelin-13 in the serum of T2DM patients are independent influencing factors for concurrent CAS in T2DM.The combined detection of CXCL12 and Apelin-13 to predict CAS in T2DM patients has certain clinical significance and pro-vides a basis for disease assessment and treatment.

Objective To explore the association between R611H(G/A,rs734312)variation of WFS1 gene and early-onset type 2 diabetes mellitus(T2DM).Methods A total of 181 Chinese patients with early-onset T2DM(T2DM group)and 196 non-diabetic controls(NC group)were enrolled in this study.The rs734312 variation was detected by PCR-direct sequencing.Genotypic and allelic frequencies of rs734312 and clinical variables were compared and analyzed between the two groups.Results Compared with the NC group,the frequencies of AA genotype and A allele in R611H(G→A)variation were significantly elevated in the early-onset T2DM group,AA vs GA+GG(OR 1.720,95%CI 1.100～2.680,P<0.05).A vs G(OR 1.500,95%CI 1.020～2.220,P<0.05).The remarkable differences of frequencies of genotype and allele in rs734312(G/A)were observed between Asians(China,Japan and Korea)and Caucasians(Denmark,Britain,Spain,France and Russia,P<0.01 for each).Compared with AA genotype,fasting and 2 hours postprandial insulin(FIns and 2 hIns)as well as HOMA-β were significantly rise in GG+GA genotype carriers of early-onset T2DM group(P<0.05).Conclusions The a allele of rs734312 in WFS1 may be a risk factor for early-onset T2DM in Chinese population,and the variation might be a potential genetic marker for predicting the islet β-cell dysfunction in early-onset T2DM in Chinese population.

Hypercalcemia is an abnormal calcium metabolism, which can be caused by many diseases. Hypercalcemia caused by sarcoidosis is unusual. Sarcoidosis is a systemic granulomatous disease, it is lack of specificity in initial manifestations and easy to be misdiagnosed. In this paper, we report a patient with hypercalcemia and mediastinal lymphadenectasis, which the first diagnosis was misdiagnosed as tumour. Finally, sarcoidosis was diagnosed by mediastinal lymph node biopsy, and the patient was subsequently treated with glucocorticoid. Prednisone treatment improved symptoms of sarcoidosis, normalised serum calcium and mediastinal lymph nodes were diminished. This case suggests that clinicians need to raise awareness of sarcoidosis to identify and diagnose it correctly.