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27 December 2021, Volume 16 Issue 06 Previous Issue    Next Issue

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Clinical study on characteristics of endocrine metabolism in the patients of polycystic ovary syndrome with different body mass index CAO Wei, CHEN Rourou, XIE Yuan, ZOU Jing, HE Rongbo, QIAN Li, LIU Yu 2021, 16 (06):  381-386.  DOI: 10.16138/j.1673-6087.2021.06.003 Abstract ( 165 )   HTML ( 2 )   PDF (596KB) ( 62 )   Objective To investigate clinical characteristics of endocrine hormones and metabolic indicators in the patients of polycystic ovarian syndrome (PCOS) with different body mass index (BMI). Methods A total of 76 patients with PCOS were enrolled. Their age, height, and weight were recorded, and their BMI were calculated. The sex hormone levels, thyroid function, fasting plasma glucose (FPG), fasting serum insulin (FINS), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) and free androgen index (FAI) were calculated. According to different BMI, the patients were divided into obese, overweight, and normal weight groups, and the differences of endocrine and metabolism indexes among three groups were compared. As HOMA-IR≥2.69 was diagnostic cut-off point of insulin resistance, the proportion of patients with insulin resistance in different BMI groups was calculated respectively. As FAI≥6.1 was the diagnostic cut-off point of hyperandrogenism, the proportion of patients with hyperandrogenism in different BMI groups were also calculated. The chi-square test was used to analyze the difference of the incidence of insulin resistance or hyperandrogenemia in PCOS patients among three groups. Results The levels of sex hormone binding globulin (SHBG) all increased gradually while the levels of FINS and HOMA-IR decreased gradually in the PCOS patients in the obesity, overweight and normal weight groups. The differences had statistical significance among the three groups (P<0.05). Luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) were significantly lower while thyroid stimulating hormone (TSH) was significantly higher in the obese group than those in both overweight and normal weight groups (P<0.05). FAI, TC, TG, LDL-C in both obese and overweight groups were significantly higher than those in normal weight group (P<0.05). Free thyroxine (FT4), anti-Müllerian hormone (AMH) and HDL-C in obesity group were significantly lower than those in normal weight group(P<0.05). Spearman correlation analysis showed that BMI was positively correlated with FAI, thyroid-stimulating hormone (TSH), FPG, INS, HOMA-IR, TG, LDL-C (r=0.401, 0.315, 0.362, 0.644, 0.656, 0.582, 0.315 respectively, P<0.05), and negatively correlated with LH, LH/FSH, SHBG, FT4, AMH, HDL-C (r=-0.364, -0.236, -0.624, -0.304, -0.369, -0.542, P<0.05). The results of the chi-square test indicated that the incidence of insulin resistance and hyperandrogenemia increased gradually in the patients in normal, overweight, and obese groups, and the insulin resistance in the obese and overweight groups was significantly higher than normal weight group (P<0.05), while there was no significant difference between the overweight group and the obese group. In addition, there were statistical difference in hyperandrogenism among three groups (P<0.05). Conclusions The PCOS patients with obesity or overweight have more significant insulin resistance, hyperandrogenemia and abnormal blood lipid metabolism, while the level of pituitary gonadotropin increased more in the PCOS patients with normal weight. Figures and Tables | References | Related Articles | Metrics

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Effect of canagliflozin on urinary albumin / creatinine ratio and urinary podocyte-associated protein nephrin in patients with early diabetic kidney disease SUN Yan, DAI Danjiao, CHEN Zhiwei, ZHANG Huaqing 2021, 16 (06):  387-391.  DOI: 10.16138/j.1673-6087.2021.06.004 Abstract ( 262 )   HTML ( 2 )   PDF (523KB) ( 50 )   Objective To investigate the effect of canagliflozin (sodium-glucose cotransporter 2 inhibitor, SGLT-2i) on the ratio of urine albumin-to-creatinine ratio(UACR) and urine podocyte-related protein nephrin in early diabetic nephropathy. Methods From January 2018 to July 2019, 116 patients with early diabetic nephropathy who were hospitalized in the Department of Endocrinology, Southern University of Science and Technology Hospital were enrolled. They were divided into canagliflozin group and control group with 1∶1 random number method. One hundred and five(90.5%) patients completed all studies, 51 were in the canagliflozin group and 54 were in the control group. The canagliflozin group was routinely given canagliflozin 100-300 mg/d, the control group received basal insulin and losartan potassium tablets 100 mg/d, and the patients in both groups were treated 24 weeks. The biochemical indicators of the patients were tested before treatment, 12-weeks and 24-weeks treatment. The UACR and the urine podocyte-associated protein nephrin before and after treatment were compared between groups and within groups. Results Compared with before treatment, both UACR and nephrin in the canagliflozin and the control groups improved after 12 weeks and 24 weeks treatment (P<0.05). Before treatment and after 12-weeks treatment, the UACR and nephrin indexes in canagliflozin and control groups didn’t show significant difference (P>0.05); while after 24-weeks treatment, these indexes in the canagliflozin group were significantly better than the control group(P<0.05). Conclusions Canagliflozin can continuously reduce the content of podocyte-associated protein nephrin in urine of early diabetic nephropathy. It is speculated that the renal protection of SGLT-2i drugs is independent of the effect of lowering the blood sugar. Figures and Tables | References | Related Articles | Metrics

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Effect of selenium yeast combined with vitamin D on thyroid-associated antibody levels in patients with Hashimoto thyroiditis at different ages GU Wei, HOU Liping, LI Xiaolong, GENG Jianlin 2021, 16 (06):  392-396.  DOI: 10.16138/j.1673-6087.2021.06.005 Abstract ( 345 )   HTML ( 6 )   PDF (487KB) ( 125 )   Objective To investigate the effect of selenium yeast combined with vitamin D on thyroid related antibody levels in Hashimoto thyroiditis (HT) patients at different ages. Method In this study, 148 patients with HT (96 adults and 52 minors) were selected from December 2017 to December 2019. The patients were divided into control group and observation group. The patients in the control group were treated with routine methods and the observation group of patients used selenium yeast and vitamin D besides routine treatment. After 6 months, the levels of thyroid peroxidase autoantibody (TPOAb) and thyroglobulin antibody (TgAb) before and after treatment were compared between two groups. Results Serum 25-hydroxyvitamin D3 [25(OH) D3] levels were detected in both adults and minors before combined treatment. The average 25(OH) D3 level in 2 groups before treatment was lower than normal, while the 25(OH) D3 level in minors was higher than that in adults (P<0.05). There was no significant difference in TPOAb and TgAb in control group and the observation group before treatment(P>0.05). The levels of TPOAb and TgAb in the observation group were significantly lower than those in the control group(P<0.05), in addition, the treatment effect of the observation group was significantly higher than that of the control group(P<0.05). Conclusions The treatment of HT with selenium yeast combined with vitamin D on the basis of routine treatment can effectively reduce the TPOAb and TgAb level in adult and minor patients. The therapeutic effect is remarkable and has application value in the clinic. Figures and Tables | References | Related Articles | Metrics

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Effect of high-dose glucocorticoid on glucose metabolism in rats ZHAO Qingqing, ZHOU Jinxin, PAN Yu, JU Huijun, ZHU Liying, LIU Yang, ZHANG Yifan 2021, 16 (06):  397-403.  DOI: 10.16138/j.1673-6087.2021.06.006 Abstract ( 196 )   HTML ( 6 )   PDF (813KB) ( 88 )   Objective To explore the effect of high-dose glucocorticoid(GC) on glucose metabolism in rats. Methods Choose appropriate dose in dexamethasone treatment through using different doses. By administering high-dose dexamethasone to Wistar rats, the effects of high-dose GC on rat body weight, fasting blood glucose, fasting insulin, glucose tolerance test, and insulin resistance test were observed. 18F-fluorodeoxyglucose(FDG) positron emission tomography (PET)/CT imaging was used to detect the effect of high-dose GC on glucose metabolism in skeletal muscle and liver of rats. Results Different doses of dexamethasone can cause changes in glucose metabolism, of which a dose of 10 mg/kg was suitable for this study. After high-dose dexamethasone treatment, the body weight of rats decreased[days 0,3,7,11,15 were (261±8)(226±8)(192±10)(172±10)(156±10) g, all P<0.000 1], fasting blood glucose [days 0,3,7,11,15 were(4.3±0.8)(14.4±5.2)(8.3±2.6)(9.8±4.4)(9.8±4.9) mmol/L, all P<0.05] and insulin levels increased[days 0,3,7,11,15 were (0.8±0.2)(11.6±1.1)(9.2±1.0)(9.2±2.4)(13.5±2.1) μg/L, all P<0.05], the area under the curve of glucose increased(days 0,3,7,11,15 were 858±26,2 350±345,1 680±331,1 352±166,1 553±217, all P<0.05), and insulin sensitivity decreased(days 0,3,7,11,15 were 1.26±0.18,0.51±0.09,0.91±0.18,0.77±0.16,0.50±0.16, all P<0.05). FDG uptake in skeletal muscle increased (days 0,3,7,11,15 were 0.10±0.01,0.15±0.03,0.20±0.02,0.28±0.02,0.27±0.03, all P<0.05), FDG uptake in liver didn’t change significantly, glycogen content in skeletal muscle and liver increased. Conclusions High-dose GC could cause significant hyperglycemia and hyperinsulinemia. Hyperinsulinemia compensated the insulin resistance of skeletal muscle caused by GC, however it could not completely compensate the deficiency of glucose metabolism in the liver. Figures and Tables | References | Related Articles | Metrics

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Evaluating value of interleukin-6 combined with CD4+ T cell percentage on prognosis in patients with sepsis WANG Hu, ZHANG Jiaojiao, SUN Junnan, WANG Hairong 2021, 16 (06):  404-408.  DOI: 10.16138/j.1673-6087.2021.06.007 Abstract ( 165 )   HTML ( 2 )   PDF (541KB) ( 65 )   Objective To evaluate the value of interleukin （IL）-6 combined with CD4+ T lymphocyte percentage on prognosis in the patients with sepsis. Methods The data of 158 patients with sepsis in the emergency medical department of our hospital from June 2016 to June 2019 were collected, which included IL-6 level, CD4+ T lymphocyte percentage, CD4+ T lymphocyte, C-reactive protein (CRP), procalcitonin (PCT）, human leukocyte DR antigen (HLA-DR), and calculation of patients’ sepsis-related organ failure assessment(SOFA) score and acute physiology and chronic health evaluation-Ⅱ (APACHE Ⅱ) score within 24 h after admission. The patients were divided into survival group and death group according to the prognosis after 28 d, and the difference of the SOFA score, APACHE Ⅱ score, IL-6, CD4+ T lymphocyte percentage, the correlation between IL-6, CD4+ T lymphocyte percentage and SOFA score was analyzed, the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of IL-6, CD4+ T lymphocyte percentage and their combination on the patients with sepsis was evaluated. Results APACHE Ⅱ score (t=4.514, P<0.001), SOFA score (t=4.711, P<0.001), IL-6 (Z=2.114, P=0.035), PCT (t=2.192, P=0.021),CRP (Z=2.208, P=0.033) and D-dimmer (Z=1.963, P=0.043) in the death group were significantly higher than those in the survival group, while the percentage of CD4+ T lymphocytes (Z=2.398, P=0.016) and HLA-DR(t=2.004,P=0.040) in the death group were significantly lower than that in the survival group. Spearman correlation analysis of IL-6, CD4+ T lymphocyte percentage and SOFA showed that IL-6 was positively correlated with SOFA score (r=0.478, P<0.001) and APACHEⅡscore(r=0.351, P=0.024). CD4+ T lymphocyte percentage was negatively correlated with SOFA score(r=-0.305, P=0.043) and APACHEⅡscore(r=-0.347, P=0.031). ROC curve showed that IL-6 combined with CD4+ T lymphocyte percentage [area under the curve(AUC)=0.793] had better prognostic value for the patients with sepsis than both APACHE Ⅱ score(AUC=0.732) and SOFA score(AUC=0.750), with sensitivity of 86.7% and specificity of 63.0%. The predictive effect of the combination of two factors was better than that of single index. Conclusions IL-6 combined with CD4+T lymphocyte percentage can evaluate the prognosis of the patients with sepsis, and the combination of two indexed is better than using single index. Figures and Tables | References | Related Articles | Metrics

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Impact of preadmission anticoagulation adherent to guidelines on prognosis of the patients with atrial fibrillation BAI Ying, LIU Xinyao, ZHANG Xilin, GAO Zhaofang, SHI Xubo, DENG Kewu 2021, 16 (06):  409-412.  DOI: 10.16138/j.1673-6087.2021.06.008 Abstract ( 148 )   HTML ( 2 )   PDF (351KB) ( 40 )   Objective To explore the risk of all-cause death, stroke, and bleeding in the atrial fibrillation(AF) patients with or without recommended anticoagulation preadmitting to hospital. Methods A total of 5 526 hospitalized AF patients in our hospital from September 2008 to December 2018 were enrolled and their information were analyzed retrospectively. The outcomes were confirmed according to hospitalization records, course records and discharge diagnosis, including all bleeding events, major bleeding, minor bleeding, gastric bleeding, stroke and death. Univariate and multivariate Logistic regression analysis was performed to explore the risk of end events during hospitalization. Results The patients with recommended anticoagulation（1 480, 22.78%） had lower risk of stroke [odds ratio (OR)=0.68, 95% confidence interval (CI): 0.50-0.92, P=0.01]. They had similar risk in all bleeding events, major bleeding, minor bleeding, gastric bleeding and all-cause death compared to those without recommended anticoagulation. Conclusions Recommended anticoagulation reduced the risk of all-cause death and stroke, but did not increase the risk of all bleeding events, major bleeding, minor bleeding, gastric bleeding and all-cause death. Figures and Tables | References | Related Articles | Metrics