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Summary [ABSTRACT FROM AUTHOR]

Middle‐aged and elderly women are at a higher risk of subclinical hypothyroidism (SHypo). Menopause is an important period of metabolic change in women and thyroid hormones are closely related to metabolic status. Neck circumference (NC) is a simple anthropometric index that reflects upper body fat accumulation. Therefore, this study aimed to explore the relationship between NC and thyroid hormones in postmenopausal women. A total of 1050 postmenopausal women were enrolled from Shanghai Zhabei communities (888 euthyroid subjects and 162 SHypo patients). Anthropometric parameters, including NC, were measured. The measurements of serum thyroid hormones were performed by electrochemical luminescence immunoassay. The results showed NC was positively correlated with thyroid‐stimulating hormone (TSH) (r =.064, P =.039). TSH and the proportion of SHypo patients increased significantly in those with elevated NC (both P <.05). In logistic regression analysis, the risk of SHypo increased by 46.4% in those with elevated NC (OR = 1.464 [1.035–2.071], P =.031). After adjusting for metabolic confounding factors, the positive association disappeared (P =.112). Multiple linear regression analysis showed there were no significant correlations between NC and TSH in either univariate or multivariate model in the total population (both P >.05). And in the subgroup analysis of euthyroid and SHypo individuals, NC was also not related to TSH (all P >.05). In conclusion, there was no independent association between NC, a simple anthropometric index for upper body fat accumulation, and serum TSH levels in Chinese euthyroid and SHypo postmenopausal women. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to investigate the clinical characteristics of fulminant type 1 diabetes mellitus (FT1DM) in Chinese patients and to further determine their glycaemic profiles through continuous glucose monitoring (CGM). Thirty subjects who were diagnosed with FT1DM according to the 2012 JDS criteria were enrolled. Clinical characteristics were compared to those reported in Japanese FT1DM. All subjects received retrospective CGM for 3 days after being converted to subcutaneous insulin injection therapy. Chinese FT1DM patients presented with a shorter duration of symptoms (2.84 ± 2.42 days vs 4.4 ± 3.1 days, P < 0.01), worse islet function (fasting C‐peptide, 0.09 ± 0.11 ng/mL vs 0.30 ± 0.21 ng/mL; 2‐hour C‐peptide, 0.13 ± 0.14 ng/mL vs 0.30 ± 0.30 ng/mL, both P < 0.01), lower prevalence of flu‐like symptoms (46.7% vs 71.4%, P < 0.05), and a significantly higher GADA positive rate (23.3% vs 5.1%, P < 0.01) when compared with Japanese patients. The CGM results showed that the mean time in range (TIR) of FT1DM patients was 49.8 ± 22.1%, while mean amplitude of glycaemic excursion (MAGE) and standard deviations of sensor glucose (SDSG) were 7.58 ± 3.59 mmol/L and 3.19 ± 1.22 mmol/L, respectively, with nearly 1/3 participants coefficient of variation (CV) > 36% (all are male), suggesting a large glucose fluctuation. The female patients were further divided into pregnancy‐related FT1DM (PF) and non‐PF (NPF) subgroups (both n = 5), and we found that PF patients had a significantly higher TIR than NPF patients (77.0 ± 16.1% vs 41.0 ± 22.4%, P < 0.05). There were heterogeneities in the clinical characteristics of FT1DM patients, and the CGM results indicated a very low TIR and large glucose fluctuation which needs careful attention. [ABSTRACT FROM AUTHOR]

Summary: Recent studies have shown that circulating fibroblast growth factor (FGF) 23 and vitamin D levels are closely correlated with insulin resistance. The aim of this study was to investigate the relationship among serum FGF 23 levels, serum 25‐hydroxyvitamin D [25(OH)D] levels, and non‐alcoholic fatty liver disease (NAFLD) in Chinese patients with type 2 diabetes mellitus (T2DM). This study enrolled 331 hospitalized T2DM patients (209 patients with NAFLD and 122 patients without NAFLD). Serum FGF23 levels were measured using a sandwich enzyme‐linked immunosorbent assay. Serum 25(OH)D levels were determined by an electrochemiluminescence immunoassay. NAFLD was diagnosed by hepatic ultrasound, and the fatty liver index (FLI) was calculated to quantify hepatic steatosis. Results showed that T2DM patients with NAFLD had significantly higher serum FGF23 levels (44.17 [37.92‐51.30] pg/mL vs 40.21 [34.07‐48.33] pg/mL, P = .002), but lower serum 25(OH)D levels (16.43 [12.70‐21.37] ng/mL vs 19.59 [13.78‐26.26] ng/mL, P = .002) than those without NAFLD. Moreover, the incidence rate of NAFLD increased with increasing serum FGF23 levels and decreased with increasing 25(OH)D levels (both P < .05). Logistic regression analysis showed that both serum FGF23 and 25(OH)D levels were independent factors for NAFLD (both P < .05). Furthermore, a multiple stepwise regression analysis also revealed that both serum FGF23 and 25(OH)D levels were independently correlated with FLI (both P < .01). In conclusion, both high FGF23 and low vitamin D levels showed an independent relationship with NAFLD in Chinese T2DM patients, indicating that FGF23 and vitamin D function via different regulatory pathways in the liver. [ABSTRACT FROM AUTHOR]

We investigated whether the serum osteocalcin levels at baseline were associated with the incidence of major adverse cardiovascular events (MACE) in a population-based retrospective cohort study of Chinese subjects. Coronary angiography was used to diagnose coronary artery disease (CAD). Survival curves were analyzed by performing log-rank tests with Kaplan-Meier figures. Multivariable Cox proportional hazards regression was performed to identify the association of serum osteocalcin levels with the incidence of MACE. A total of 247 subjects with a mean age of 65.50 ± 10.38 years were enrolled in the analysis. After a mean follow-up time of 4.4 ± 2.6 years, MACE occurred in 175 cases. For men patients, those with serum osteocalcin levels higher than 17.22 ng/mL had significantly lower fasting plasma glucose (FPG) than those with serum osteocalcin levels lower than 17.22 ng/mL ( P < .05). According to the multivariate Cox proportional hazards regression, the lower serum osteocalcin levels and the higher risk of future MACE occurred in men with CAD at baseline (hazard ratio = 0.970; 95% confidence interval 0.943-0.999, P = .04). However, this difference was not significant either in men without CAD or in women. In conclusion, relatively lower serum osteocalcin levels were associated with a higher risk of MACE in Chinese men with CAD. [ABSTRACT FROM AUTHOR]

Fibroblast growth factor 23 (FGF23) has been reported to be involved in cardiovascular disease. The aim of this study was to investigate the association between FGF23 and the presence of coronary artery disease (CAD), as well as the number of stenotic vessels. A total of 254 eligible participants (167 men and 87 postmenopausal women) were enrolled in this study. Coronary angiography was used for diagnosis of CAD. Serum intact FGF23 levels were determined by a twosided sandwich enzyme-linked immunosorbent assay. The median serum FGF23 levels of the entire study population were 39.9 (33.1–47.5) pg/mL. Serum FGF23 levels were higher in subjects with one-vessel disease than those without CAD (P < 0.05), which further increased significantly in the subjects with multi-vessel disease (P < 0.05). Serum FGF23 levels increased with cumulative number of stenotic vessels (P for trend < 0.001). Multiple stepwise regression analysis revealed estimated glomerular filtration rate (standardized β = 0.298; P < 0.001) and body mass index (standardized β = 0.132; P = 0.049) were independent factors correlated with FGF23. Multivariate logistic regression analysis showed that FGF23 was positively and independently associated with the presence of CAD (odds ratio = 1.058, 95% confidence interval = 1.025–1.092; P = 0.001). Additionally, FGF23 was also correlated with multi-vessel disease significantly (odds ratio = 1.034, 95% confidence interval = 1.007–1.062; P = 0.013). In conclusion, serum FGF23 levels exhibit positive and independent association with the presence of CAD and increase with the cumulative number of stenotic vessels. [ABSTRACT FROM AUTHOR]

Irisin is a novel hormone secreted by skeletal muscle after exercise, which may ameliorate insulin resistance. In this study, we aimed to explore the relationship between circulating irisin levels and type 2 diabetes mellitus (T2DM) as well as related metabolic traits in a Chinese population. A total of 203 subjects were recruited. Of these, 68 subjects with normal glucose tolerance (NGT), 63 subjects with impaired glucose regulation (IGR) and 72 subjects with new-onset T2DM. Circulating irisin levels were measured by enzyme-linked immunosorbent assay (ELISA). Detailed clinical investigations and biochemistry measurements were carried out in all of the subjects. Multivariate linear regression analysis was performed to assess the association between irisin levels and related metabolic characteristics. All subjects were classified into normal weight and overweight/obese subgroups according to body mass index (BMI). No significant differences in circulating irisin levels were identified among the three groups ( P = 0.9741). After adjusting for covariates, multiple linear regression analysis revealed that serum irisin level was independently and significantly associated with total cholesterol ( P = 0.0005), low-density lipoprotein cholesterol ( P = 0.0014), fasting fatty acids ( P = 0.0402) and uric acid ( P = 0.0062). By dividing the serum irisin levels into three tertile groups, the values of total cholesterol, low-density lipoprotein cholesterol, fasting fatty acids and uric acid were all increased significantly with the increase of irisin ( P < 0.05). Moreover, serum irisin levels remain closely related to total cholesterol in both normal weight and overweight/obese subgroups. Our study suggests that circulating irisin concentrations are significantly associated with lipid and uric acid metabolism in a Chinese population. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the correlations of glycated haemoglobin A1c (HbA1c) and glycated albumin ( GA) with subclinical atherosclerosis in middle-aged and elderly Chinese populations with impaired glucose regulation ( IGR). In total, 640 subjects with IGR and no history of cardiovascular disease or carotid artery plaque were recruited for this study (256 men, 384 women; age range, 40-70 years). The carotid intima-media thickness (C- IMT) measured by carotid ultrasonography was used as an indicator of subclinical atherosclerosis. Increased C- IMT was defined as ≥ 0.70 mm (upper quartile). HbA1c and GA were measured with high-performance liquid chromatography and enzymatic method, respectively. The average HbA1c and GA among all 640 subjects were 5.7 ± 0.3% and 14.0 ± 1.1%, respectively. HbA1c and GA were higher in subjects with increased C- IMT than in subjects with normal C- IMT (5.8 ± 0.3% vs 5.7 ± 0.3% and 14.2 ± 1.0% vs 13.9 ± 1.1%, respectively; both P < 0.01). Correlation analysis showed that both HbA1c and GA were positively correlated with C- IMT ( r = 0.135 and 0.112, respectively; both P < 0.01). Logistic regression analysis revealed that both HbA1c (odds ratio ( OR), 2.630; 95% confidence interval (95% CI), 1.401-4.935; P = 0.003) and GA OR, 1.215; 95% CI, 1.008-1.466; P = 0.041) were independent risk factors for increased C- IMT. Both HbA1c and GA reflect the risk of subclinical atherosclerosis in middle-aged and elderly Chinese populations with IGR. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the association between serum vitamin D levels and both visceral adipose and with non-alcoholic fatty liver disease ( NAFLD) in Chinese postmenopausal women. Four hundred and fifty-one postmenopausal women between 45 and 74 years of age (mean (± SD) age 57.3 ± 4.6 years) were enrolled in the study. All subjects participated in the Shanghai Obesity Study between June and August 2011 and underwent abdominal magnetic resonance imaging and an abdominal ultrasonography. Patients with a visceral fat area ( VFA) ≥ 80 cm2 were classified as abdominally obese. Serum 25-hydroxyvitamin D3 (25( OH)D3) levels were measured with an electrochemiluminescence immunoassay. The prevalence of NAFLD in the study population was 34.8% ( n = 157). Women with abdominal obesity had significantly lower serum 25( OH)D3 levels than those without abdominal obesity (median (interquartile range) 11.23 (8.64-14.12) vs 12.56 (9.41-15.98) ng/mL, respectively; P < 0.01). Regardless of abdominal obesity status, serum 25( OH)D3 levels in patients with NAFLD were lower than those without non- NAFLD (11.14 (8.63-13.81) vs 12.92 (9.48-16.37) ng/mL ( P < 0.05) for those without abdominal obesity; 10.86 (8.61-13.56) vs 11.55 (8.82-16.38) ng/mL ( P < 0.05) for those with abdominal obesity). Partial correlation analyses demonstrated a negative correlation between serum 25( OH)D3 levels and VFA ( P < 0.05). Logistic regression analysis revealed that high serum 25( OH)D3 levels were a protective factor against NAFLD after adjusting for risk factors such as VFA. In conclusion, independent of visceral obesity, vitamin D is inversely correlated with NAFLD in Chinese postmenopausal women. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effect of the E23K variant of the potassium inwardly rectifying channel, subfamily J, member 11 ( KCNJ11) gene on gliclazide modified release ( MR) treatment in newly diagnosed patients with type 2 diabetes mellitus (T2 DM). A total of 108 diabetic patients with no history of antidiabetic medication was treated with gliclazide MR for 16 weeks and underwent follow up at Weeks 2, 4, 8, 12 and 16. All patients were genotyped for KCNJ11 E23K (rs5219). At baseline, patients with the KK genotype had higher blood glucose and lower serum insulin levels after oral glucose administration than patients with the EE and EK genotypes ( P < 0.05 for all). During treatment, individuals with the KK genotype had lower fasting glucose levels and were more likely to attain the target fasting glucose level ( Plog rank = 0.028) than E allele carriers. Patients with the KK genotype had larger augmentations in changes (Δ) in acute insulin response ( P = 0.049) and Δ body mass index ( P = 0.003). Moreover, patients with the EK genotype had a lower variance in changes in fasting insulin levels ( P = 0.049) and homeostasis model assessment of β-cell function (P = 0.021) than those with the KK genotype. The findings of the present study suggest that the KCNJ11 E23K variant is associated with a greater effect of sulphonylurea treatment in newly diagnosed Chinese patients with T2 DM. [ABSTRACT FROM AUTHOR]

Perturbed serum vitamin D levels have been shown to be associated with increased risk of cardiovascular disease. The aim of the present study was to investigate the association of serum 25-hydroxyvitamin D3 (25(OH)D3) levels and B ultrasonography-detected carotid plaque and carotid intima-media thickness (C-IMT) in Chinese middle-aged and elderly men., In all, 1001 men, aged 45-78 years, were enrolled in the study. Increased C-IMT was defined as any C-IMT value in the highest quartile of the study subjects (≥ 0.75 mm)., The study population had a median serum 25(OH)D3 level of 14.51 ng/mL (interquartile range (IQR) 10.84-18.67 ng/mL). Subjects with carotid plaques had lower serum 25(OH)D3 levels than those without (13.80 (IQR 10.82-17.68) vs 14.74 (IQR 10.87-19.08) ng/mL, respectively; P = 0.029), and decreasing serum 25(OH)D3 levels were accompanied by increased C-IMT in both groups (13.24 (IQR 9.91-16.81) vs 14.45 (IQR 11.40-18.51) ng/mL, respectively ( P < 0.05) in those with plaque; 13.80 (IQR 9.99-17.09) vs 14.99 (IQR 11.17-19.43) ng/mL, respectively ( P < 0.01) in those without plaque). Multivariate logistic regression analysis showed that serum 25(OH)D3 levels were independently associated with carotid plaque (odds ratio (OR) 0.972; 95% confidence interval (CI) 0.946-0.998; P = 0.032). In addition, serum 25(OH)D3 levels were identified as an independent protective factor for increased C-IMT among subjects with plaque (OR 0.900; 95% CI 0.849-0.955; P = 0.001) and those without plaque (OR 0.944; 95% CI 0.908-0.981; P = 0.004)., Collectively, these findings suggest that serum 25(OH)D3 levels are inversely associated with atherosclerosis in Chinese middle-aged and elderly men. [ABSTRACT FROM AUTHOR]

The present study was designed to investigate the relationship between serum osteocalcin levels and non-alcoholic fatty liver disease ( NAFLD) in Chinese men., In all, 1558 men (21-78 years old) were recruited to the study. Serum osteocalcin, glucose and lipid profiles were determined. Demographic and clinical characteristics were recorded. All participants underwent hepatic ultrasonographic examination., Serum osteocalcin levels were significantly lower in subjects with NAFLD than those without ( P < 0.01). All study subjects were divided into four subgroups according to quartiles of serum osteocalcin levels. The frequency of NAFLD increased progressively with declining serum osteocalcin levels ( Ptrend < 0.01). Serum osteocalcin levels were inversely correlated with NAFLD ( P < 0.01). However, the significant association between serum osteocalcin levels and NAFLD disappeared in logistic regression analyses. Furthermore, multiple stepwise regression analysis showed that serum osteocalcin levels were independently associated with serum alanine aminotransferase levels in Chinese men ( P < 0.01)., The findings of the present study suggest that serum osteocalcin levels are not directly correlated with NAFLD. [ABSTRACT FROM AUTHOR]

The article discusses a study which analyzed whether genetic variants of FNDC5 were associated with diabetic microvascular complications in Chinese population. Topics include other factors that contribute to the progression of diabetic complications, the approval of the study by the institution review board of the Shanghai Jiao Tong University Affiliated Sixth People's Hospital in accordance with Helsinki Declaration II principles, and the association between irisin and diabetic retinopathy.