This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

High glucose level, bacterial infection, and persistent inflammation within the microenvironment are key factors contributing to the delay of diabetic ulcers healing, while traditional therapeutic methods generally fail to address these issues simultaneously. Here, we present a spatiotemporally responsive cascade bilayer microneedle (MN) patch for accelerating diabetic wound healing via local glucose depletion and sustained nitric oxide (NO) release for long-term antibacterial and anti-inflammatory effects. The MN patch (G/AZ-MNs) possesses a degradable tip layer loading glucose oxidase (GOx), as well as a dissolvable base layer encapsulating l-arginine (Arg)-loaded nanoparticles (NPs). After wound administration, the base part rapidly dissolved, resulting in prompt separation of the MN tip within the wound tissue, which subsequently responded to the overexpressed matrix metalloproteinase-9 (MMP-9) in diabetic lesions, leading to the responsive release of GOx. The released enzyme catalyzed glucose into gluconic acid and hydrogen peroxide (H₂O₂), which not only reduced glucose level within the diabetic wound, but also initiated the cascade reaction between H₂O₂ with the Arg that was released from NPs, thereby achieving continuous production of NO for 7 days. Our findings demonstrate that a single administration of the MN patch could effectively heal non-infected or biofilm-infected diabetic wounds with the multifunctional properties.

Organoids are complex tiny organ-like model systems formed by three-dimensional culture in vitro, based on the self-renew and self-organization of stem cells. This article reviewed the recent progress in organoids construction from tissues involved in the regulation of glucose homeostasis and chronic diabetic microvascular complications, and their applications in diabetes mellitus. Organoid technology is expected to further promote the progress of diabetes research in disease modeling, personalized medicine, and regenerative medicine.

Bone marrow adipose tissue (MAT) is formed by the accumulation of adipocytes in the bone marrow cavity. Previously, the function of MAT is mainly considered to be filled with bone marrow cavity for the mechanical support. However,with the in-depth study of MAT,it has been gradually understood that MAT is not only a part of the bone marrow microenvironment,may also be a new endocrine "organ". The main component of bone marrow adipocytes(BMA) plays a regulatory role in bone marrow and systemic metabolism through the autocrine and paracrine secretion of adiponectin, leptin, interleukin-6, and a series of cytokines. Though its biological characteristics are somewhat similar with white fat adipose tissue(WAT) and brown adipose tissue(BAT),there are some significant differences,so MAT is thought to be a special adipose tissue. MAT is also involved in the development of hematological diseases,metabolic diseases,degenerative diseases,and may affect their outcomes. MAT may be the auxiliary diagnostic criteria and treatment targets of such diseases. This article will review the MAT's own biological characteristics,the differences and associations among three types of adipose tissue and the link between MAT and the diseases,which aims to explore the new research direction through the profound understanding of MAT.

Adult ; Body Weight ; Humans ; Liver ; enzymology

Objective To investigate the prevalence of dyslipidemia and the relationship between breakfast frequency and dyslipidemia in residents over 40 years old in Yiling area of Yichang City in Hubei Province. Methods A random sampling was conducted, and 10 420 inhabitants were investigated during 2011 to 2012. Results The morbidity of dyslipidemia was 64. 0%. It was significantly higher in female than in male (65. 9% vs 60. 6%). Compared with regular breakfast eaters, non-breakfast eaters had significantly higher morbidity of higher blood low density lipoprotein-cholesterol(LDL-C) and hypertriglyceridemia(P<0. 05). The risk of elevated serum LDL-C was higher in the non-breakfast eaters group(OR=2. 382, 95%CI 1. 300-4. 367, P=0. 019) after adjusted by age, sex, smoking, drinking, etc. Conclusions Compared with regular breakfast eaters, breakfast skippers had significantly higher morbidity of dyslipidemia. Eating breakfast on daily basis may have a significant protective effect on preventing dyslipidemia.

ObjectiveTo investigate the effects of adult catch-up growth on insulin sensitivity and stress in rats, as well as the probable mechanism of insulin resistance. MethodsMale Sprague-Dawley rats were divided into 6 groups:caloric restriction group ( R4, caloric restriction for 4 weeks) and normal controls for 4 weeks ( NC4 ) ; catchup growth group refed with normal chow( RN4, refeeding for 4 weeks after caloric restriction for 4 weeks), catch-up growth group refed with high-fat diet( RH4, refeeding for 4 weeks after caloric restriction for 4 weeks ), normal chow (NC8) or high-fat diet( HF8 ) controls for 8 weeks. The animal model of catch-up growth was devoloped by way of refeeding after caloric restriction as scheduled. The glucose infusion rate( GIR ), 2-deoxyglucose uptake and insulinsitmulated insulin signaling in skeletal muscle during hyperinsulinemic-euglycemic clamp, plasma corticosterone, and 11β-hydroxysteroid dehydrogenase type 1 ( 11β-HSD1 ) mRNA expression level in skeletal muscle were determined.ResultsAfter caloric restriction for 4 weeks, plasma corticosterone and 1 1 β-HSD1 mRNA expression in skeletal muscle were significantly higher in R4 group compared with NC4 group( both P＜0. 05 ), but there were no differences in 2-deoxyglucose uptake and Ser473 phosphorylation of Akt in skeletal muscle between two groups. The plasma corticosterone and 11β-HSD1 mRNA expression in skeletal muscle in RN4 group were significantly higher than those in NC8 group, and were higher in RH4 group than those in NC8 and HF8 groups; while the 2-deoxyglucose uptake and insulin-stimulated Ser473 phosphorylation of Akt in skeletal muscle during the clamp in RN4 were remarkably lower than those in NC8 group, and were lower in RH4 than those in NC8, HF8, and RN4 groups (all P ＜ 0. 05 ).ConctusionsCatch-up growth rats refed with normal chow or high-fat diet are characterized by significant insulin resistance and stress in the whole body and skeletal muscle. These changes are more evident in catch-up growth rats refed with high-fat diet. The interaction of increased stress and diet might be of utmost importance in the etiology of insulin resistance in catch-up growth animals.

Objective To investigate the effect of ovariectomy and estrogen on secretion function and number of pancreatic islet beta cell in low-dose streptozotocin-induced diabetic rats. Methods Thirty female SD rats were randomly divided into five groups: normal control(NC) group, streptozotocin(STZ) group, ovariectomized(OVX) group, OVX + STZ(OS) group and OVX+STZ+estradiol(OSE) group. OVX, OS and OSE groups underwent ovariectomy, while NC and STZ groups underwent just sham operation. After surgery, OSE group was treated subcutaneously with estradiol 0.2 mg/kg twice weekly. At the end of 3 weeks, STZ, OS and OSE groups were induced by a single intraperitoneal injection of 40 mg/kg STZ. Then eight days later, plasma glucose and insulin levels were tested. The insulin protein, the average beta cell area and the relative beta cell mass were tested by streptavidin peroxidase conjugation method (SP). The quantification of beta cell apoptosis was performed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). The expressions of proliferating cell nuclear antigen(PCNA) protein, Bax and Bcl-2 were tested. Results With the administration of low-dose STZ, the plasma glucose was significantly higher and the insulin secretion curve after glucose loading, △I30/△G30 and modified beta cell function index(MBCI) were lower in OVX group than in other groups(all P<0.05). At the same time, the insulin protein, the relative beta cell mass and the beta cell area were dramatically decreased(all P<0.05). The beta cell apoptotic index was increased (t = 2.957, P< 0.05), the expression ratio of Bcl-2/Bax was decreased (0.41±0.03 vs. 0.76±0.05, P<0.05). Estrogen replacement therapy could obviously inhibit these changes. Compared with OS group, glucose disturbances and insulin secretion were improved dramatically in OSE group(all P<0.05); the insulin content, the relative beta cell mass and the average beta cell area were all enhanced (all P<0.05); the beta cell apoptotic rate was decreased(t =2.482, P<0.05), and the expression tatio of Bcl-2/Bax was increased (0.71±0.05 vs. 0.41±0.03, P<0.05). Conclusions The ovx rats are significantly more susceptible to low-dose STZ toxicity than in control rats. Under the effect of STZ, the ability of insulin secretion of beta cell is obviously decreased, while apoptosis is increased, which induces a higher glucose level and a lower insulin secretion. Administration of estrogen may protect OVX rats from the metabolic disturbances.