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Background Normoalbuminuric diabetic kidney disease (NADKD) is a newly defined DKD, the clinical features and pathogenesis for which are still being understood. This study aimed to investigate the features and risk factors for NADKD in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective cross-sectional study was conducted. The related clinical and laboratory data of patients with T2DM hospitalized between August 2012 and January 2020 were collected for statistical analysis. We classified the patients with T2DM into four groups on the basis of the presence or absence of albuminuria and reduced estimated glomerular filtration rate (eGFR). Analysis of variance, the Kruskal–Wallis test, and the chi-square test were used to compare the groups. Binary logistic regression analyses with a forward stepwise method were performed to explore the risk factors for renal dysfunction in hospitalized patients with normoalbuminuric T2DM. Results Among the 1620 patients evaluated, 500 (30.9%) had DKD, of which 9% had NADKD. The prevalence of stroke, cardiovascular events, carotid plaque, and peripheral arterial disease in NADKD was significantly higher than in a non-DKD control group (normoalbuminuric T2DM patients with eGFR of ≥60 ml/min/1.73 m2). Regression analyses revealed that three significant independent factors were associated with NADKD: age (OR = 1.089, confidence interval [CI] 95% [1.055–1.123], p p = 0.011), and glycated hemoglobin (HbA1c; OR = 0.839, CI 95% [0.716–0.983], p = 0.03). Conclusions NADKD is mainly associated with macrovascular rather than microvascular complications. NADKD is more common in patients with normoalbuminuric T2DM with older age, previous use of RASIs, and good glycemic control.

Through statistical analysis, we have found that inflammation and low femoral and lumbar spine BMD were strongly correlated with a high SIJ CT grade, and inflammation, low vitamin D levels, and a longer disease course within a certain time range influenced bone loss in axSpA. We investigated the relationship between bone mineral density (BMD), vitamin D, and computed tomography (CT)–based progression of disease grades of the sacroiliac joint (SIJ), and sought to identify parameters predicting low BMD in patients with axial spondyloarthropathy (axSpA). We collected the ankylosis spondylitis disease activity score (ASDAS), the course of the disease, HLA-B27 status, and vitamin D and C-reactive protein (CRP) levels of 98 axSpA patients. Lumbar spine and femoral BMD were assessed by dual-energy X-ray (DXA), and SIJ grade was determined by CT. The axSpA patients (71 men, 27 women) with a mean age of 31.9 years (range 18–57 years) and body mass index 21.8 kg/m2 (range 15.6–30.6 kg/m2), with disease duration 4.5 years (range 0.3–30 years) were included. A longer disease course, higher CRP level, and lower femoral and lumbar spine BMD were independently related to a higher CT grade. Older age, longer disease course, elevated CRP, and high SIJ CT grade were independently related to lower BMD (femur and/or lumbar spine L1–L4 T scores ≤ −1). Older age, elevated CRP, low vitamin D levels, and high CT grade were independently associated with low femur and lumbar spine BMD. However, a longer disease course was independently related to low femur BMD, but not low lumbar spine BMD. Thus, inflammation and low femoral and lumbar spine BMD were strongly correlated with a high SIJ CT grade, and inflammation, low vitamin D levels, and a longer disease course within a certain time range influenced bone loss in axSpA.

Background To determine whether apparent diffusion coefficient (ADC) values obtained using a b-value of 3000 s/mm2 can be used to differentiate high-grade glioma (HGG) from solitary metastases (SM). Methods Forty patients underwent conventional magnetic resonance imaging (MRI) and standard and high b-value diffusion-weighted imaging (DWI). Minimum, maximum, and mean ADC values (ADCMIN, ADCMAX, and ADCMEAN, respectively) were measured from ADC maps obtained for the two b-values for each subject. ADC ratios were also measured. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGG and SM. Results All ADC values for the peritumoral region of the HGGs examined were lower than those for the SM. Furthermore, a larger statistical difference was observed for ADCMIN, ADCMAX, and ADCMEAN values at a b-value of 3000 s/mm2 versus 1000 s/mm2 (P

Obesity is closely related to non-alcoholic fatty liver disease (NAFLD), which has become an important public health problem because of its high prevalence and association with metabolic syndromes. Irisin was recently identified as a novel peptide to improve obesity and glucose homeostasis, and considered to be therapeutic for human metabolic diseases. The aim of this study was to examine the association of serum irisin concentration and liver triglyceride contents in obese Chinese adults.Serum irisin levels were measured and liver fat contents determined by (1)H MRS in 296 obese adults. Anthropometric parameters and blood biochemical indexes including liver enzymes, glucose, and lipid profiles were detected. The liver triglyceride contents of subjects were measured by (1)H MRS. The protein levels of irisin were determined by quantitative ELISA.We found that serum irisin levels were reduced in obese adults with NAFLD. By dividing the distribution of intrahepatic triglyceride (IHTG) contents into quartiles, serum irisin levels were reduced gradually with the increase of IHTG contents (p0.01). Higher serum irisin levels were associated with preferable TG levels. Serum ALT and AST concentrations were inversely correlated with serum irisin levels. Multivariate linear regression analysis demonstrated that serum irisin levels were independently associated with liver fat (p0.01). By logistic regression analysis, the odds ratio for higher IHTG contents was reduced by 12.4% per 1 SD increase in serum irisin concentrations after adjustment for multivariate metabolic factors [OR (95% CI); 0.876 (0.777-0.987)].These results demonstrated that serum irisin concentrations were inversely associated with the triglyceride contents in the liver and liver enzymes in obese Chinese adults.

Corresponding authors: Shu-yu Yang, Xiamen Diabetes Institute, Department of Endocrinology and Metabolism, The First Hospital of Xiamen, Xiamen University, 55 Zhenhai Road, Xiamen 361003, China ( xmyangshuyu@126.com). Jiang He, MD, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Ste 2000, New Orleans, LA 70112 ( jhe@tulane.edu ). Xiao-Ying Li, MD, PhD, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025 (lixy@sibs.ac.cn). Introduction: Nonalcoholic fatty liver disease (NAFLD) and its cardiovascular complications are common public health problems. Hypothesis: Although the benefit of exercise on NAFLD and cardiometabolic risk factors is documented, the effects of intensive and moderate exercise on these outcomes have not been thoroughly investigated.. Methods: We conducted a randomized controlled trial among 220 individuals aged 40-65 years with a waist circumference of ≥90 cm in men and ≥85 cm in women. NAFLD was defined by proton magnetic resonance spectroscopy (1H-MRS). Participants were randomly assigned to the intensive exercise group (vigorous exercise at 65-80% maximum oxygen consumption by running on a treadmill 30 min/day and 5 days/week for 6 months, followed by moderate exercise by brisk walking 150 min/week for another 6 months), the moderate exercise group (brisk walking 150 min/week for the entire 12 months), or the usual care control (lifestyle counseling for 12 months). The primary outcome was the change of intra-hepatic triglyceride content as determined by 1 H-MRS. Secondary outcomes were metabolic risk factors. Results: At 12 months, the mean change of intra-hepatic triglyceride content from baseline was -6.10% in the intensive exercise, -5.91% in the moderate exercise, and -2.73% in the control groups (P Conclusions: Moderate intensity and vigorous intensity exercise were equally effective in improving NAFLD and blood pressure while vigorous exercise produced greater reductions of body fat.

Liver enzymes including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) are well recognized as surrogate makers reflecting non-alcoholic fatty liver disease (NAFLD). However, the associations of serum ALT, AST and GGT with hepatic lipid contents are not well established. The aim of this study was to investigate the relationship between liver enzymes and intrahepatic triglyceride (IHTG) contents, and explore the feasibility in using liver enzymes to reflect accumulation of IHTG in obese subjects. A cross-sectional analysis was conducted in 475 obese adults aged 40–65 years. Anthropometric parameters and blood biochemical indexes including liver enzymes, glucose and lipid profiles were measured. The liver triglyceride contents of subjects were determined by 1H-MRS. Serum ALT, AST and GGT were positively correlated with IHTG contents (p

Aim To investigate the utility of diffusion-weighted (DW) magnetic resonance imaging (MRI) with a high b-value (b = 3000 s/mm 2 ) compared with standard b-value (b = 1000 s/mm 2 ) DW imaging in patients with primary central nervous system lymphoma (PCNSL). Materials and methods High and standard b-value (b = 3000 and 1000 s/mm 2 , respectively) DW images were acquired in 15 patients with PCNSL. The number and location of the lesions were assessed. MRI signal intensities (SIs), signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), contrast ratios (CRs), and apparent diffusion coefficients (ADCs) of the lesions and normal parenchyma were measured. Results Thirty-two lesions in 15 patients were revealed. Twenty-seven of the lesions were hyperintense at DW MRI with high and standard b-values; high b-value images revealed five additional lesions. Lesions were also more conspicuous at high b-value (b = 3000 s/mm 2 ) DW MRI compared to standard b-value images (b = 1000 s/mm 2 ). SNR, CNR, and ADC values in lesions and normal parenchyma were lower in the b = 3000 s/mm 2 images compared to the b = 1000 s/mm 2 images (SNR: 250.7 ± 124.7 versus 112.3 ± 68.7; CNR: 83.4 ± 74.7 versus 59.6 ± 60.4, b = 1000 and 3000 s/mm 2 , respectively). The CR was significantly greater in the b = 3000 s/mm 2 images compared to the b = 1000 s/mm 2 images (CR: 0.28 ± 0.13 versus 0.18 ± 0.10). Conclusions Although quantitative analyses revealed higher SI, SNR, and CNR values in standard b-value (b = 1000 s/mm 2 ) DW images, higher b-value imaging could be beneficial for detecting additional lesions and improving the contrast between lesions and normal tissue in patients with PCNSL.