Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Objective To analyze the clinical situation and related factors of subclinical hypothyroidism in patients with abnormal glucose metabolism, and to provide theoretical basis for the prevention and treatment of subclinical hypothyroidism in patients with abnormal glucose metabolism. Methods A total of 428 patients with abnormal glucose metabolism who were treated in the Department of Endocrinology of Tianmen First People's Hospital from March 2018 to March 2020 were selected, and serum FT3, FT4 and TSH levels were determined by automatic immune analysis system. Automatic analyzer was used to measure the levels of FBG, HbA1c, TC, TG, LDL-C and UA. A self-made questionnaire was used to investigate the basic information of all subjects, including gender, age, abnormal course of glucose metabolism, BMI and blood pressure. The survey method was combined with telephone inquiry and field investigation. Logistic regression was used to analyze the independent risk factors for subhypothyroidism in patients with abnormal glucose metabolism. Results Among 428 patients with abnormal glucose metabolism, 89 patients were accompanied by subclinical hypothyroidism, including 39 males and 43 females, with an average age of (45.12±8.13) years. The prevalence of subhypothyroidism in females was higher than that in males, and the difference was statistically significant (χ²=4.353 , P<0.05). There was no significant difference in serum FT3 and FT4 levels between the two groups (P>0.05). The serum TSH level in experimental group was significantly higher than that in control group (P<0.05). Univariate analysis showed statistically significant differences in age, gender, abnormal course of glucose metabolism, BMI, BMI, FBG, HbA1c, UA, TC, LDL-C and SBP between the two groups (P<0.05). Logistic regression analysis showed that old age, high levels of FBG, TC, SBP and UA were independent risk factors for subclinical hypothyroidism in patients with abnormal glucose metabolism (P<0.05). Conclusion The incidence rate of patients with abnormal glucose metabolism complicated with subclinical hypothyroidism is high. The biochemical indexes such as blood glucose, blood lipid, blood pressure and uric acid should be monitored regularly. The early regulation of glucose metabolism disorder is an effective way to prevent and treat subclinical hypothyroidism.

Objective:To explore correlation among serum vitamin D, folic acid and homocysteine (Hcy) levels in patients with type 2 diabetes mellitus (T2DM).Methods: A total of 87 T2DM patients treated in our hospital were selected as DM group, another 90 healthy subjects undergoing physical examination were enrolled as healthy control group.Serum levels of vitamin D, folic acid and Hcy were measured and compared between two groups, and their correlation was analyzed.Results: Compared with healthy control group, there were significant reductions in levels of vitamin D [(32.85±5.31) ng/ml vs.(24.75±6.13) ng/ml] and folic acid [(13.31±2.10) nmol/ml vs.(8.47±2.59) nmol/ml], and significant rise in Hcy level [(14.36±4.28) μmol/ml vs.(22.43±5.32) μmol/ml] in DM group, P=0.001 all.Pearson correlation analysis indicated that in healthy control group and DM group, vitamin D level was significant positively correlated with folic acid level (r=0.617, 0.684, P<0.05 both) and significant inversely correlated with Hcy level (r=-0.554,-0.604, P<0.05 both), folic acid level was significant inversely correlated with Hcy level (r=-0.631,-0.779, P<0.01 both).Conclusion: Serum vitamin D level significant reduces, and is significantly correlated with levels of folic acid and homocysteine in patients with type 2 diabetes mellitus.Vitamin D level possesses important significance in monitoring cardiovascular and cerebrovascular complications in these patients.