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Jie Xiang,1 Liyan Qin,2 Jinling Zhong,3 Ning Xia,2 Yuzhen Liang3 1Department of Clinical Nutrition, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Geriatric Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 3Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaCorrespondence: Yuzhen Liang, Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China, Email liangyuzhen26@163.com Ning Xia, Department of Geriatric Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China, Email xianing12@sina.comBackground: Obesity is related to the loss of skeletal muscle mass and function (sarcopenia). The co-existence of obesity and sarcopenia is called sarcopenic obesity (SO). Glucagon like peptide-1 receptor agonists (GLP-1RA) are widely used in the treatment of diabetes and obesity. However, the protective effects of GLP-1RA on skeletal muscle in obesity and SO are not clear. This study investigated the effects of GLP-1RA liraglutide and semaglutide on obesity-induced muscle atrophy and explored the underlying mechanisms.Methods: Thirty-six male C57BL/6J mice were randomly divided into two groups and fed a regular diet and a high-fat diet for 18 weeks, respectively. After establishing an obesity model, mice were further divided into six groups: control group, liraglutide (LIRA) group, semaglutide (SEMA) group, high-fat diet (HFD) group, HFD + LIRA group, HFD + SEMA group, and subcutaneous injection for 4 weeks. The body weight, muscle mass, muscle strength, glycolipid metabolism, muscle atrophy markers, myogenic differentiation markers, GLUT4 and SIRT1 were analyzed. C2C12 myotube cells treated with palmitic acid (PA) were divided into four groups: control group, PA group, PA + LIRA group, PA + SEMA group. The changes in glucose uptake, myotube diameter, lipid droplet infiltration, markers of muscle atrophy, myogenic differentiation markers, GLUT4 and SIRT1 were analyzed, and the changes in related indicators were observed after the addition of SIRT1 inhibitor EX527.Results: Liraglutide and semaglutide reduced HFD-induced body weight gain, excessive lipid accumulation and improved muscle atrophy. Liraglutide and semaglutide eliminated the increase of muscle atrophy markers in skeletal muscle and C2C12 myotubes. Liraglutide and semaglutide restored impaired glucose tolerance and insulin resistance. However, these beneficial effects were attenuated by inhibiting SIRT1 expression.Conclusion: Liraglutide and semaglutide protects skeletal muscle against obesity-induced muscle atrophy via the SIRT1 pathway.Keywords: liraglutide, semaglutide, muscle atrophy, obesity, insulin resistance, SIRT1

Ning Xia,1 Hao Wang,2 Yu Chen,1 Xiao-Jun Fan,1 Xiu-Hong Nie1 1Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Xiu-Hong Nie, Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China, Tel +86-18611876008, Email xiuhongnie@outlook.comObjective: We aimed to explore the relationship of sleep efficiency (SE) with the prevalence of hypertension in Chinese obstructive sleep apnea (OSA) patients based on polysomnography (PSG) records.Methods: We studied 2360 patients with OSA and 764 primary snorers who underwent PSG in our hospital. SE was divided into three grades, including ≥ 85%, 80%~84.9%, and < 80%. Hypertension was defined based either on direct blood pressure measurements, under anti-hypertensive treatments or on physician diagnosis. Multivariate logistic regression models were conducted to investigate the association between SE and hypertension.Results: After adjusting for potential confounding factors, OSA patients with < 80% SE and those with 80% to 84.9% SE were significantly associated with the prevalence of hypertension (OR = 1.248, 95% CI 1.018~1.531, P=0.033; OR = 1.380, 95% CI 1.040~1.832, P=0.026). Compared to primary snorers, OSA combined with < 85% SE increased the odds of hypertension. In stratified analysis by SE, risk of hypertension only in those with < 80% SE was significantly different between OSA and primary snorers. Furthermore, this relationship between reduced SE and hypertension was evident especially in female, younger ages, obese, moderate and severe OSA patients. No significant relationship between reduced SE and hypertension was found in primary snores group.Conclusion: We found that poor SE was correlated with the prevalence of hypertension in Chinese OSA patients, but not in those with primary snoring. Moreover, this relationship was evident especially in female, younger ages, obese, moderate and severe OSA patients.Keywords: sleep efficiency, hypertension, obstructive sleep apnea, polysomnography

Li Ping Wong,1,2 Sun Tee Tay,3 Kek Heng Chua,4 Xiang Ting Goh,4 Haridah Alias,1 Zizheng Zheng,5 Qinjian Zhao,6 Ting Wu,5 Ningshao Xia,5,7 Zhijian Hu,2 Yulan Lin2 1Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; 2Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, People’s Republic of China; 3Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; 4Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia; 5State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, 361102, People’s Republic of China; 6College of Pharmacy, Chongqing Medical University, Chongqing, People’s Republic of China; 7The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, 361102, People’s Republic of ChinaCorrespondence: Yulan Lin, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, People’s Republic of China, Email yulanlin@fjmu.edu.cn Li Ping Wong, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia, Email wonglp@ummc.edu.myBackground: As scant data are available about Hepatitis E virus (HEV) infection in Malaysia, this study aimed to determine the seroprevalence of HEV amongst ruminant farmworkers in Malaysia.Methods: A total of 87 farmworkers provided serum samples, which were collected from eight farms. All serum samples were tested for anti-HEV IgG and anti-HEV IgM by an enzyme-linked immunosorbent assay (ELISA) using the Wantai HEV-IgG and HEV-IgM ELISA kits from Beijing Wantai Biological Pharmacy Enterprise Co., Ltd, Beijing, China.Results: Farmworkers from six cattle farms, one sheep farm and one goat farm were investigated in this study. Only one farm practices zero-grazing, with the rest using rotational grazing. Of the 87 farmworkers, males comprised 83.9%, and almost half (47.1%) were aged 20– 35 years old. By ethnic group, the vast majority were Malay. Most of the farmworkers have good hygiene practices; washing or changing their clothes and showering after dealing with farm animals were common. None of the farmworker serum samples had anti-HEV IgM and IgG detected (95% confidence interval (CI): 0, 0.0415).Conclusion: The finding suggests that the farmworkers had no previous exposure to Hepatitis E, and were not at risk of occupational exposure to HEV infection. Our findings suggest that a zero seroprevalence of HEV infection among ruminant farmworkers in the Muslim majority country. Good farm management, hygiene practices and the absence of contact with swine-related contamination might have contributed to the no or minimal zoonotic risks of HEV amongst farmworkers surveyed in this study.Keywords: HEV, farmworkers, seroprevalence, antibody

Manqiu Mo,1 Zichun Huang,2 Dongmei Huo,3 Ling Pan,3 Ning Xia,1 Yunhua Liao,3,&ast; Zhenhua Yang3,&ast; 1Geriatric Department of Endocrinology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China; 2Department of Cardiovascular Thoracic Surgery, the Third Affiliated Hospital of Guangxi Medical University: Nanning Second People’s Hospital, Nanning, 530031, People’s Republic of China; 3Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhenhua Yang; Yunhua Liao, Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning, 530021, Guangxi, People’s Republic of China, Email 593456108@qq.com; yunhualiao1962@163.comObjective: To explore the relationship between red blood cell distribution width (RDW) and all-cause death in critical diabetic patients with acute kidney injury (AKI).Methods: The clinical data of critical diabetic patients with AKI in MIMIC-III database were analyzed retrospectively. According to the survival status of 28-day after AKI and levels of RDW, patients were divided into survival and death groups, high RDW (RDW > 15.3%) and low RDW groups (RDW ≤ 15.3%). Kaplan–Meier curves were used to compare the survival rates of diabetic patients with AKI in different RDW and AKI stages, and Cox regression analysis was used to evaluate the risk factors of 28-day all-cause death in critical diabetic patients with AKI.Results: A total of 5200 patients with critical diabetic patients with AKI were included in this study with the male to female ratio of 1.53:1. The mean follow-up time was 24.97 ± 7.14 days, and the 28-day all-cause mortality was 17.9% (931/5200). Age, RDW, blood urea nitrogen, serum creatinine, lactic acid, proportion of AKI stage, sepsis and respiratory failure in the death group were higher than those in the survival group, while mean arterial pressure (MAP) and red blood cell count were lower than those in the survival group. Kaplan–Meier analysis showed that the 28-day survival rate of the high RDW group was significantly lower than that of the low RDW group (log-rank χ2 = 9.970, P = 0.002). Multivariate Cox regression analysis showed that advanced age (HR = 1.042, 95% CI = 1.021– 1.063), decreased MAP (HR = 0.984, 95% CI = 0.969– 0.998), stage 3 AKI (HR = 3.318, 95% CI = 1.598– 6.890) and increased RDW (HR = 1.255, 95% CI = 1.123– 1.403) were independent risk factors of 28-day all-cause death in critical diabetic patients with AKI (P < 0.05).Conclusion: High level of RDW is an important risk factor of all-cause death in critical diabetic patients with AKI, and it may be used as a valuable index to classify the mortality.Keywords: diabetes, acute kidney injury, all-cause death, red cell distribution width, critical

Zhigang Zhou, Na Xia Department of Gynecological Oncology, Maternal and Child Health Hospital of Hubei Province, Wuhan City, Hubei Province, People’s Republic of ChinaCorrespondence: Na Xia Tel +86 15902772665Email naxia301@aliyun.comIntroduction: LncRNAs have been reported to play critical roles in liver cancer, while its role in other cancers remains unclear. The aim of this study was to investigate the role of DCST1-AS1 in cervical squamous cell carcinoma (CSCC).Methods: Expression of DCST1-AS1 in CSCC tissues and non-tumor tissues from 68 CSCC patients was determined by RT-qPCR. A 5-year follow-up study was carried out to explore the prognostic value of DCST1-AS1 for CSCC. Overexpression of DCST1-AS1 and miR-107 was achieved in CSCC tissues to explore the interaction between them. The roles of DCST1-AS1, miR-107 and CDK6 in regulating the proliferation and viability of CSCC cells were assessed by cell proliferation and viability assays, respectively.Results: We found that DCST1-AS1 was upregulated in CSCC and predicted poor survival. RNA interaction prediction showed potential interaction between DCST1-AS1 and miR-107. However, overexpression experiments revealed no significant interaction between them. Moreover, overexpression of DCST1-AS1 led to upregulate CDK6 and increase cell proliferation rate, while overexpression of miR-107 played an opposite role and attenuate the effects of overexpression of DCST1-AS1.Conclusion: DCST1-AS1 may sponge miR-107 to upregulate CDK6 in CSCC.Keywords: DCST1-AS1, miR-107, cervical squamous cell carcinoma, CSCC, CDK6, proliferation

Qiong Yang,1,* Yu-Mei Wen,1,* Jing Shen,1 Mei-Mei Chen,1 Jiang-Hua Wen,2 Zheng-Ming Li,3 Yu-Zhen Liang,3,* Ning Xia1,* 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 2Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong 529070, People’s Republic of China; 3Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ning XiaDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of ChinaTel +86 77 1280 2380Email xianinggxmu@163.comBackground and Objective: Insulin resistance is well known to exhibit essential effects on the progression of diabetes mellitus (DM). Guava leaf was also reported to exhibit anti-diabetic effects including decreasing blood glucose. Therefore, this present study aims to explore the role guava leaf extract (GLE) plays in insulin resistance and its mechanism of action via the PI3K/Akt signaling pathway.Methods: KK-Ay mice is a spontaneous genetic type 2 diabetes mouse model induced by feeding a high fat and high sugar diet. Mice were randomly assigned into three groups: diabetic mice (DM), DM + MET (diabetic mice treated with metformin) and DM + GLE (diabetic mice treated with GLE) groups. After 8 weeks of treatment, body weight and levels of fasting plasma glucose (FPG), fasting insulin and lipids in plasma were measured. Mice were sacrificed and mRNA and protein expression of insulin receptor substrate1 (IRS1), phosphatidylinositol 3-kinase (PI3K) and serine/threonine kinase protein B (Akt) in livers were measured.Results: GLE markedly reduced body weight, FPG, fasting insulin and insulin resistance index but increased the insulin sensitivity index of diabetic KK-Ay mice. Moreover, GLE upregulated the expression of IRS-1, PI3K and Akt mRNAs in livers of diabetic KK-Ay mice. In addition, GLE also elevated IRS-1, PI3K, Akt, p-PI3K and p-Akt protein expression in their livers. The results of the DM + MET group were similar to those of the DM + GLE group.Conclusion: GLE plays anti-diabetic roles by ameliorating insulin resistance in KK-Ay diabetic mice and this is related to the activation of PI3K/Akt signaling pathway.Keywords: diabetes, guava leaf extract, insulin resistance, PI3K/Akt signaling pathway

Ying Luo,1,* Pijian Yang,1,* Zhengming Li,2 Yunchen Luo,2 Jing Shen,1 Ruwen Li,1 Hua Zheng,3 Yuzhen Liang,2 Ning Xia1 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 2Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 3Life Sciences Institute, Guangxi Medical University, Nanning 530021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuzhen Liang; Ning Xia Email liangyuzhen26@163.com; xianinggxmu@163.comBackground: Many chronic metabolic diseases, such as obesity and type 2 diabetes (T2DM), are closely related to a chronic low-grade inflammatory state in tissues. The high prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with T2DM is related to the role of inflammation in the disease. In this study, we investigated the role of liraglutide in improving lipid metabolism disorders and preventing their progression to NAFLD by modulating inflammatory signaling pathways, thereby providing new treatment options for NAFLD.Methods: We designed a 2×2 factorial analysis experiment. A mouse model of NAFLD with T2DM was established by feeding the animals a high-fat diet (HFD). The NAFLD mice with HFD-induced diabetes were treated with liraglutide for 10 weeks. Hematoxylin and eosin staining, Oil Red O staining and electron microscopy were used to observe the accumulation of triglycerides in the liver. RT-PCR and Western blotting were used to analyze the expression of α-SMA, IL-1β, TNF-α, NF-κB and the NF-κB inhibitory protein IκB in the liver at the gene and protein levels, respectively.Results: Liraglutide reduced the body weight and fasting blood glucose levels of HFD-fed mice. The expression of α-SMA, IL-1β, TNF-α, and NF-κB in the liver of HFD-fed mice was increased at the mRNA and protein levels, but liraglutide treatment decreased the expression of these molecules. The expression of IκB in the liver decreased at the mRNA and protein levels but was upregulated after liraglutide treatment.Conclusion: Based on the current findings, liraglutide can significantly improve hepatic steatosis, primarily by downregulating the expression of inflammatory signaling mediators in the TNF-α pathway.Keywords: liraglutide, nonalcoholic fatty liver disease, inflammatory signaling pathway

Zhengming Li1,*, Pijian Yang2,*, Yuzhen Liang1,*, Ning Xia2,*, Yingrong Li1, Hongye Su1, Hailin Pan1 1Department of Endocrinology and Metabolism, Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuzhen LiangDepartment of Endocrinology and Metabolism, Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, People’s Republic of ChinaEmail liangyuzhen26@163.comNing XiaDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning 530021, People’s Republic of ChinaEmail xianinggxmu@163.comBackground: Liraglutide reduces blood glucose, body weight and blood lipid levels. Hormone-sensitive lipase (HSL) is a key enzyme in lipolysis. Evidence from our and other studies have demonstrated that adenylate cyclase 3 (AC3) is associated with obesity and can be upregulated by liraglutide in obese mice. In the present study, we investigated whether hepatic HSL activity is regulated by liraglutide and characterized the effect of liraglutide in the AC3/protein kinase A (PKA)/HSL signalling pathway.Methods: Obese mice or their lean littermates were treated with liraglutide or saline for 8 weeks. Serum was collected for the measurement of insulin and lipids. We investigated hepatic AC3, HSL and phosphorylated HSL Ser-660 (p-HSL(S660)) protein expression levels andAC3 and HSL mRNA expression levels and cyclic adenosine monophosphate (cAMP), PKA activity in liver tissue.Results: Liraglutide treatment decreased triglycerides (TGs) and free fatty acids (FFAs), increased glycerol, and upregulated hepatic AC3 and p-HSL(s660) levels and cAMP and PKA activities.Conclusion: The results suggest that liraglutide can upregulates AC3/PKA/HSL pathway and may promotes lipolysis.Keywords: liraglutide, obesity, lipolysis, adenylate cyclase 3, hormone-sensitive lipase

Zhenhua Yang,1 Luhuai Feng,2 Yu Huang,3 Ning Xia41Department of Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of General Internal Medicine, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 3Department of Nephrology, The People’s Hospital of Wuzhou, Wuzhou, People’s Republic of China; 4Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaCorrespondence: Ning XiaDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People’s Republic of ChinaTel +8613707714058Fax +860771-5356707Email xianing5356707@126.comPurpose: Differentiating between diabetic nephropathy (DN) and non-diabetic renal disease (NDRD) is difficult and inefficient. The aim of the present study was to create a model for the differential diagnosis of DN and NDRD in patients with type 2 diabetes mellitus (T2DM).Patients and methods: We consecutively screened 213 patients with T2DM complicated with chronic kidney disease, who underwent renal biopsy at The First Affiliated Hospital of Guangxi Medical University (Nanning, China) between 2011 and 2017. According to the pathological results derived from the renal biopsy, the patients were divided into three groups (74, 130, and nine in the DN, NDRD, and NDRD superimposed with DN group, respectively). Clinical and laboratory data were compared and a diagnostic model was developed based on the following logistic regression model: logit(P)=β0+β1X1+β2X2+ … +βmXm.Results: We observed a high incidence of NDRD (61.0% of all patients), including various pathological types; the most common type was idiopathic membranous nephropathy. By comparing clinical variables, we identified a number of differences between DN and NDRD. Logistic regression analyses showed that the following variables were statistically significant: the absence of diabetic retinopathy (DR), proteinuria within the non-nephrotic range, the absence of anemia and an estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2. We subsequently constructed a diagnostic model for predicting NDRD, as follows: PNDRD=1/[1+exp(−17.382–.339×DR−1.274×Proteinuria−2.217×Anemia-1.853×eGFR−0.993×DM+20.892Bp)]. PNDRD refers to the probability of a diagnosis of NDRD (a PNDRD≥0.5 predicts NDRD while a PNDRD

Pijian Yang1,*, Yuzhen Liang2,*, Yunchen Luo,2 Zhengming Li,2 Yumei Wen,1 Jing Shen,1 Ruwen Li,1 Hua Zheng,3 Harvest F Gu4,*, Ning Xia1,*1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 2Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 3Life Sciences Institute, Guangxi Medical University, Nanning 530021, People’s Republic of China; 4Center for Pathophysiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009 People’s Republic of China*These authors contributed equally to this workPurpose: High prevalence of nonalcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes has implicated the role of hepatic insulin resistance (IR) in the diseases. To better understand the underlying mechanism, we have evaluated the pathophysiological effects of Liraglutide on NAFLD via the insulin signaling pathway.Patients and methods: A 2×2 factorial experiment was designed. High-fat diet (HFD)-induced NAFLD mice with diabetes were treated with Liraglutide for 10 weeks, while the control mice were saline-treated. Hepatic expressions of InsR, IGF-1R, IRS2, PI3K and Akt at mRNA and protein levels were analyzed with RT-PCR and Western blotting. Hematoxylin and eosin staining, Oil Red O staining and electron microscopy were used to visualize triglyceride accumulation in liver.Results: Liraglutide significantly decreased body weight, fasting blood glucose levels and HOMA-IR scores in HFD mice. Compared with the control mice fed with chow diet, hepatic expressions of InsR, IRS2, PI3K and Akt at both mRNA and protein levels in HFD mice were significantly reduced, but upregulated after Liraglutide treatment. Furthermore, Liraglutide treatment was found to improve hepatic steatosis.Conclusion: The current study thereby provides evidence that Liraglutide ameliorates NAFLD and improves hepatic steatosis mainly by upregulation of the IRS2/PI3K/Akt signaling mediators.Keywords: glucagon like peptide 1, Liraglutide, nonalcoholic fatty liver disease, insulin resistance, insulin signaling

Yue Sun,1 Weiran Dai,2 Yuzhen Liang,3 Pijian Yang,1 Qiong Yang,1 Min Liang,4 Ning Xia1,5 1Geriatric Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 2Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 5Department of Science and Technology Education, Guangxi Zhuang Autonomous Region Health Committee, Nanning, Guangxi, People’s Republic of China Purpose: Many studies have reported the relationship between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) among adults. However, fewer studies on this topic have been reported in adolescents. We thus conducted a meta-analysis to show the association between NAFLD and BMD in adolescents with obesity.Materials and methods: Computer retrieval was carried out via PubMed, Embase, Cochrane Library and the Cochrane Central Register of Controlled Trials from inception to September 2018. Six published case–control studies that assessed the relationship between NAFLD and BMD were included.Results: The six studies included 217 obese adolescents with NAFLD and 236 controls. The meta-analysis indicated that obese children with NAFLD had a lower BMD and Z-score than the control group (weighted mean difference [WMD]–0.03, 95% CI [−0.05, –0.02], P=0.000; [WMD] –0.26, 95% CI [−0.37, –0.14], P=0.000). However, we analyzed the factor of bone mineral content, and there was no correlation between the two groups ([WMD]–55.99, 95% CI [−132.16, 20.18], P=0.150).Conclusion: Obese children with NAFLD are more susceptible to osteoporosis than children with only obesity. Because of the limitations related to the quantity and quality of the included literature, further studies are still needed. Keywords: nonalcoholic fatty liver disease, NAFLD, bone mineral density, BMD, meta-analysis, obesity, adolescent

Ning Xia,1 Dehua Deng,1,2 Yiru Wang,1 Chao Fang,3 Su-Juan Li1 1Henan Province of Key Laboratory of New Optoelectronic Functional Materials, College of Chemistry and Chemical Engineering, Anyang Normal University, Anyang, Henan, People’s Republic of China; 2College of Chemistry and Chemical Engineering, Henan University, Kaifeng, Henan, People’s Republic of China; 3School of Chemical Engineering, Xiamen University Malaysia, Sepang, Selangor, Malaysia Background: Prostate-specific antigen (PSA), a serine protease, is a biomarker for preoperative diagnosis and screening of prostate cancer and monitoring of its posttreatment. Methods: In this work, we reported a colorimetric method for clinical detection of PSA using gold nanoparticles (AuNPs) as the reporters. The method is based on ascorbic acid (AA)-induced in situ formation of AuNPs and Cu2+-catalyzed oxidation of AA. Specifically, HAuCl4 can be reduced into AuNPs by AA; Cu2+ ion can catalyze the oxidation of AA by O2 to inhibit the formation of AuNPs. In the presence of the PSA-specific peptide (DAHSSKLQLAPP)-modified gold-coated magnetic microbeads (MMBs; denoted as DAHSSKLQLAPP-MMBs), complexation of Cu2+ by the MMBs through the DAH–Cu2+ interaction depressed the catalyzed oxidation of AA and thus allowed for the formation of red AuNPs. However, once the peptide immobilized on the MMB surface was cleaved by PSA, the DAHSSKLQ segment would be released. The resultant LAPP fragment remaining on the MMB surface could not sequestrate Cu2+ to depress its catalytic activity toward AA oxidation. Consequently, no or less AuNPs were generated. Results: The linear range for PSA detection was found to be 0~0.8 ng/mL with a detection limit of 0.02 ng/mL. Because of the separation of cleavage step and measurement step, the interference of matrix components in biological samples was avoided. Conclusion: The high extinction coefficient of AuNPs facilitates the colorimetric analysis of PSA in serum samples. This work is helpful for designing of other protease biosensors by matching specific peptide substrates. Keywords: colorimetric assay, gold nanoparticles, prostate-specific antigen, ascorbic acid, Cu2+ ion

Li Gao,1 Qin Li,1 Zebin Deng,1 Brendan Brady,2 Ni Xia,1 Yang Zhou,1 Haixia Shi3 1Institute of Life Sciences, Jiangsu University, Zhenjiang, 2Department of Physics, University of Victoria, Victoria, BC, Canada, 3Department of Physical Education, Dalian Jiaotong University, Dalian, People’s Republic of China Abstract: Molybdenum disulfide (MoS2) has shown highly attractive superiority as a platform for sensing. However, DNA physisorption on the surface of MoS2 was susceptible to nonspecific probe displacement and false-positive signals. To solve these problems, we have developed a novel MoS2–aptamer nanosheet biosensor for detecting thrombin using a covalently linked aptamer to the MoS2 nanosheet. Ten percent Tween 80 was used to prevent thrombin from nonspecific binding and to rapidly form thiol-DNA/gold nanoparticle (AuNP) conjugates. Furthermore, an MoS2 and exonuclease coassisted signal amplification strategy was developed to improve the detection limit for thrombin. We used the hybridization of the aptamer molecules and the matched strand with a 5' terminal thiol to immobilize the aptamer molecules on the surface of AuNPs in AuNPs@MoS2 nanocomposites. Exonuclease digested the single-strand aptamer and released the thrombin, which was then detected in the next recycle. With the coassisted amplification strategy, a 6 fM detection limit was achieved, showing that this method has higher sensitivity than most reported methods for thrombin detection. The results presented in this work show that this method of covalently attaching the aptamer and using the coassisted amplification is a promising technique for the detection of protein in medical diagnostics. Keywords: Molybdenum disulfide, aptamer, thrombin, protein detection, high sensitivity

Ning Xia,1,2 Ke Liu,1 Yingying Zhou,1 Yuanyuan Li,1 Xinyao Yi2 1Key Laboratory of New Optoelectronic Functional Materials, College of Chemistry and Chemical Engineering, Anyang Normal University, Anyang, 2College of Chemistry and Chemical Engineering, Central South University, Changsha, China Abstract: miRNAs have emerged as new biomarkers for the detection of a wide variety of cancers. By employing duplex-specific nuclease for signal amplification and gold nanoparticles (AuNPs) as the carriers of detection probes, a novel electrochemical assay of miRNAs was performed. The method is based on conversion of the well-known colorimetric assay into electrochemical analysis with enhanced sensitivity. DNA capture probes immobilized on the electrode surface and ferrocene (Fc)-labeled DNA detection probes (denoted “Fc-DNA-Fc”) presented in the solution induced the assembly of positively charged AuNPs on the electrode surface through the electrostatic interaction. As a result, a large number of Fc-DNA-Fc molecules were attached on the electrode surface, thus amplifying the electrochemical signal. When duplex-specific nuclease was added to recycle the process of miRNA-initiated digestion of the immobilized DNA probes, Fc-DNA-Fc-induced assembly of AuNPs on the electrode surface could not occur. This resulted in a significant fall in the oxidation current of Fc. The current was found to be inversely proportional to the concentration of miRNAs in the range of 0–25 fM, and a detection limit of 0.1 fM was achieved. Moreover, this work presents a new method for converting colorimetric assays into sensitive electrochemical analyses, and thus would be valuable for design of novel chemical/biosensors. Keywords: microRNA, duplex-specific nuclease, gold nanoparticle, signal amplification, electrochemical biosensor, colorimetric assay

Qingyun Chen,1 Yanhua Yi,2 Ning Xia,1 Chunling Li,3 Zuojie Luo,1 Gaoming Huang,3 Ying Chen,1 Shumin Li,4 Luhua Lai,1 Mingdeng Wang,5 Jing Tan,6 Jie Zhang,1 Hanlei Shen,1 Bixun Li,7 Feiqun Su,8 Hua Wei,5 Xia Dai,1 Fengji Lu,9 Shuilian Li8 1Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, 2School for International Education, Guangxi Medical University, Nanning, 3Department of Public Health, Guangxi Medical University, Nanning, 4The Second People’s Hospital of Qinzhou, Qinzhou, 5Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 6Nandan County People’s Hospital, Nandan, 7Tumor Hospital of Guangxi Zhuang Autonomous Region, Nanning, 8Hezhou City People’s Hospital, Hezhou, 9Long’an County People’s Hospital, Nanning, Guangxi, People’s Republic of China Background: This study aimed to examine the prevalence of diabetes mellitus and other categories of glucose intolerance (impaired glucose tolerance and impaired fasting glucose) and explore the risk factors in an ethnic minority region, Guangxi Zhuang Autonomous Region, People’s Republic of China. Methods: A population-based study enrolled 53,270 residents older than 5 years in Guangxi, People’s Republic of China. The prevalence of diabetes was calculated using the 1999 World Health Organization (WHO) oral glucose tolerance test diagnostic criteria. Results: Among 53,270 individuals, the prevalence of diabetes, impaired glucose tolerance, and impaired fasting glucose was 5.96%, 7.36%, and 2.62%, respectively. Of the 3,173 individuals with diabetes mellitus, 696 (21.94%) were found to have a history of diabetes and 2,477 (78.06%) were newly diagnosed. A lower prevalence was found in Zhuang ethnic minority people compared with the majority of Han people. The prevalence was significantly associated with age, body mass index, waist-to-hip ratio, dyslipidemia, medical history of hypertension, and family history of diabetes. Conclusion: Guangxi shows a rapidly rising prevalence of diabetes. Weight control and blood lipid control are important to decrease the rapidly increasing prevalence of diabetes in Guangxi, an ethnic minority region. Keywords: diabetes mellitus, ethnic minority, OGTT, diagnosis, factors, prevalence

Lin Liu,1,2 Yun Xing,1 Hui Zhang,1 Ruili Liu,1 Huijing Liu,1 Ning Xia1,21College of Chemistry and Chemical Engineering, Anyang Normal University, Anyang, Henan, People’s Republic of China; 2College of Chemistry and Chemical Engineering, Central South University, Changsha, Hunan, People’s Republic of ChinaAbstract: Ultrasensitive detection of protein biomarkers is essential for early diagnosis and therapy of many diseases. Glycoproteins, differing from other types of proteins, contain carbohydrate moieties in the oligosaccharide chains. Boronic acid can form boronate ester covalent bonds with diol-containing species. Herein, we present a sensitive and cost-effective electrochemical method for glycoprotein detection using 4-mercaptophenylboronic acid (MBA)/biotin-modified gold nanoparticles (AuNPs) (MBA-biotin-AuNPs) as labels. To demonstrate the feasibility and sensitivity of this method, recombinant human erythropoietin (rHuEPO) was tested as a model analyte. Specifically, rHuEPO was captured by the anti-rHuEPO aptamer-covered electrode and then derivatized with MBA-biotin-AuNPs through the boronic acid–carbohydrate interaction. The MBA-biotin-AuNPs facilitated the attachment of streptavidin-conjugated alkaline phosphatase for the production of electroactive p-aminophenol from p-aminophenyl phosphate substrate. A detection limit of 8 fmol L-1 for rHuEPO detection was achieved. Other glycosylated and non-glycosylated proteins, such as horseradish peroxidase, prostate specific antigen, metallothionein, streptavidin, and thrombin showed no interference in the detection assay.Keywords: electrochemical biosensor, boronic acid, signal amplification, alkaline phosphatase

PAHs represent a prevalent form of environmental contamination. Efficiently managing PAHinduced pollution is a pivotal focus in contemporary environmental research and management. Globally distributed, Suaeda heteroptera exhibits robust bioaccumulation traits and also it can be grown sustainably, therefore, it is suggested to be used for its soil and water pollutant removal efficiency, particularly in the case of heavy metals. This study selected phenanthrene (PHE) and benzo[a]pyrene (BaP), as representative PAH mixtures with predefined concentrations. The research investigated Suaeda heteroptera's capability to mitigate PAHs under hydroponic conditions. Findings indicated concentration-dependent variations in Suaeda heteroptera's absorption capacity for PAHs. At a concentration of 100 µg/L, Suaeda heteroptera demonstrated the highest efficacy in reducing total PAHs, achieving a removal efficiency of 82.351 µg/kg/d. At concentrations of 10 µg/L, Suaeda heteroptera exhibited optimal reduction in PHE concentration, achieving a removal efficiency of 2.874 µg/kg/d. Regarding BaP, the most effective concentration reduction by Suaeda heteroptera occurred at a concentration of 100 µg/L, with a removal efficiency of 68.542 µg/kg/d. Over time, Suaeda heteroptera exhibited an increasingly significant removal effect on PAHs, notably at concentrations of 10 µg/L and 100 µg/L. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate the clinical effectiveness of semaglutide on weight loss, body composition and muscle strength in the Chinese population with obesity. PATIENTS AND METHODS: Data were retrospectively analyzed for participants prescribed semaglutide in 2021 and 2022 from a Chinese weight management clinic. Changes in weight, body composition, biochemical indicators, calf circumference and handgrip strength were collected. Body fat and skeletal muscle were also measured using the bioelectrical impedance analysis. Paired t-test was used to compare the values after 6 months of treatment with the baseline values. RESULTS: A total of 53 obese patients received 24 weeks of lifestyle intervention plus semaglutide treatment. 10 patients who failed to adhere to the follow-up were excluded, and 43 patients were studied. The average baseline body mass index (BMI) was 33.0 kg/m2, and the average body weight was 90.0 kg. After 6 months of treatment, the patient's weight was significantly reduced by 9.9 ± 3.9 kg (p < 0.001), and the weight loss percentage was 11.2 ± 4.5% (p< 0.001). The proportion of patients with weight loss = 5% and = 10% was 93% and 54%, respectively. Fasting blood glucose, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, blood uric acid and blood lipid levels also decreased after treatment. Body composition analysis showed that the loss of skeletal muscle mass was 1.4 ± 1.3 kg (p < 0.001), which was significantly less than the loss of fat mass of 5.6 ± 3.7 kg (p < 0.001). By percentage, the fat mass loss was 15.6 ± 10.1%, and the muscle mass loss was 4.8 ± 4.4% (p < 0.001). The visceral fat area was significantly reduced by 24.4 ± 17.7 cm (p < 0.001). There was no significant change in skeletal muscle index (8.1 ± 1.0 kg/m2 at baseline and 7.9 ± 1.0 kg/m2 at 24 weeks). The calf circumference (42.6 ± 3.6 cm at baseline, 41.2 ± 3.8 cm at 24 weeks) and grip strength (33.3 ± 9.5 kg at baseline, 32.3 ± 9.0 kg at 24 weeks) did not decrease significantly. The main adverse reactions were mild gastrointestinal dysfunction (nausea, diarrhea and vomiting), without ketoacidosis. CONCLUSIONS: In a real-world setting, semaglutide can reduce the weight and fat of obese patients while effectively maintaining muscle mass and muscle strength. [ABSTRACT FROM AUTHOR]