Search

Context In 2020, the terminology of metabolic dysfunction–associated fatty liver disease (MAFLD) was proposed to replace nonalcoholic fatty liver disease (NAFLD). Objectives This work aimed to investigate the prevalence and incidence of MAFLD and evaluate its effects on incident extrahepatic diseases. Methods A total of 6873 individuals, with a 4.6-year follow-up, were included in this study. Associations of MAFLD and NAFLD with diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD) were examined using logistic regression and Cox proportional hazards models. Results The prevalence of NAFLD and MAFLD was 40.3% (95% CI, 39.2%-41.5%) and 46.7% (95% CI, 45.6%-47.9%), respectively. Additionally, 321 (4.7%) and 156 (2.3%) participants had MAFLD with excessive alcohol consumption and hepatitis B virus (HBV) infection. During the follow-up period, the incidence of NAFLD and MAFLD was 22.7% (95% CI, 21.3%-24.0%) and 27.0% (95% CI, 25.5%-28.4%). MAFLD was associated with higher risks of incident diabetes (risk ratio [RR] 2.08; 95% CI, 1.72-2.52), CKD (RR 1.64; 95% CI, 1.39-1.94), and CVD (hazard ratio 1.44; 95% CI, 1.15-1.81). Similar associations for NAFLD were observed. Furthermore, the MAFLD subgroups with excessive alcohol consumption (RR 2.49; 95% CI, 1.64-3.78) and HBV infection (RR 1.98; 95% CI, 1.11-3.52) were associated with higher risks of incident diabetes. Conclusion The change from NAFLD to MAFLD did not greatly affect the associations with diabetes, CKD, and CVD. MAFLD further identified those patients of metabolically fatty liver combined with excessive alcohol consumption and HBV infection, who had increased risks of incident diabetes compared with those of non–fatty liver.

The first national cross-sectional survey of diabetic complications was conducted in Chinese adults with diabetes aged 18–74 years between 2018 and 2020 with a multistage sampling scheme. 50564 participants with gradable non-mydriatic fundus photographs were included in this study. The national prevalence of diabetic retinopathy (DR) and vision-threatening DR (VTDR) was 16.3% (95% confidence interval [CI] 15.3%-17.2%) and 3.2% (2.9%-3.5%), respectively. However, only a minority of participants with DR (non-VTDR: 9.4%, VTDR: 32.8%) reported being diagnosed with DR before this survey. The prevalence of DR and VTDR substantially varied across 31 provinces and was higher in the north than in the south. The differences in prevalence of any DR and VTDR between those who have attained a given metabolic goal and those who have not were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. Multiple factors were associated with the presence and severity of DR.

Inorganic-organic hybrid perovskite (ABX3, A = organic cation, B = metal ion, X = halogen anion) combines the advantages of inorganic and organic materials. However, the properties and performance of mixed-halide CH3NH3PbBr2.5Cl0.5 (MAPbBr2.5Cl0.5) are still poorly understood. In this study, we synthetized MAPbBr2.5Cl0.5 single crystal and studied its structure, optical, thermal stability properties and optoelectronics applications for photodetector device. Compared with those of MAPbCl3, the interplanar distance of (100) crystal plane for MAPbBr2.5Cl0.5 becomes larger and the absorption spectrum of MAPbBr2.5Cl0.5 is extended to the visible region. The band gap of the MAPbBr2.5Cl0.5 single crystal is 2.28 eV. We find the device based on MAPbBr2.5Cl0.5 has high selectivity from 369 to 564 nm. The maximum ▴J (Jon– Joff) under 3.0 V bias voltage is about 1.2 µAcmr-2 at 454 nm visible light with 1 W mr-2 light intensity (1/1000 of the standard sunlight intensity), which proves the device has a high sensitivity. The linear relationship is established between the value of ▴J and light intensity and bias voltage. The fast current intensity transients (Fit) shows that the disappearance period of photocurrent density is 0.3 ms, which indicates the device is rapidly responsive photodetector. The highest value (1.7%) of external quantum efficiency (EQE) and the highest value of detectivities (D) both appear at 480 nm visible light at 4.0 V bias voltage when the irradiation power is 30 W m-2. Therefore, this simple and low-cost photoresponsive device is promising for industrial production of photodetector and photocatalysts device in the future.

We assessed the impact of changes in body mass index (BMI), body fat percentage (BF%), and waist circumference (WC) on prediabetes among Chinese middle-aged and elderly adults.2.5-year changes in BMI, BF%, and WC were calculated by subtracting baseline levels from follow-up, based on a cohort of 3,632 participants with prediabetes, and outcomes were defined as remission to normal glucose regulation (NGR), persistence in prediabetes, and progression to newly diagnosed diabetes mellitus (NDM).Among participants with prediabetes, 16.9% returned to NGR and 24.6% progressed to NDM. Changes in BMI, BF%, but not WC were associated with remission and progression of prediabetes (risk ratio per standard deviation increase of BMI: 0.86 [0.79-0.93] and 1.15 [1.08-1.23]; BF%: 0.91 [0.84-0.98] and 1.11 [1.03-1.19]). Among participants with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), only BF% change was significantly associated with remission of prediabetes.Short-term management of BMI and BF% should be stressed to promote the remission and prevent the progression of prediabetes, regardless of whether someone is obese. Moreover, it is of particular clinical importance to monitor BF% among people with combined IFG and IGT.

OBJECTIVE We aimed to examine the relationship between osteocalcin (OC) and the risk of incident diabetes and the risk of incident diabetic kidney disease (DKD). RESEARCH DESIGN AND METHODS We followed 5,396 participants without diabetes (nondiabetes subcohort) and 1,174 participants with diabetes and normal kidney function (diabetes subcohort) at baseline. Logistic regression and modified Poisson regression models were used to estimate the relative risk (RR) of baseline OC levels with incident diabetes and DKD. RESULTS During a mean 4.6-year follow-up period, 296 cases of incident diabetes and 184 cases of incident DKD were identified. In the nondiabetes subcohort, higher OC levels were linearly associated with a decreased risk of diabetes (RR for 1-unit increase of loge-transformed OC 0.51 [95% CI 0.35–0.76]; RR for highest vs. lowest quartile 0.65 [95% CI 0.44–0.95]; P for trend < 0.05). In the diabetes subcohort, OC levels were linearly inversely associated with incident DKD (RR for 1-unit increase of loge-transformed OC 0.49 [95% CI 0.33–0.74]; RR for highest vs. lowest quartile 0.56 [95% CI 0.38–0.83]; P for trend < 0.05), even independent of baseline estimated glomerular filtration rate and urinary albumin-to-creatinine ratio. No significant interactions between OC and various subgroups on incident diabetes or DKD were observed. CONCLUSIONS Lower OC levels were associated with an increased risk of incident diabetes and DKD.

The performance of lead halogen perovskite is often closely related to its crystal structure. However, the chemical and optoelectronic properties of tetragonal phase single crystal MAPbCl3 (SC T-MAPbCl3) are rarely reported. In this study, we synthesized SC T-MAPbCl3 with the P4/mcc (124) space group by a modified inverse temperature crystallization (M-ITC) method. The twist angle of the Cl anion on the equatorial plane of the PbCl64- octahedron around the c-axis is 8.4°. The resistance (62 MΩ) of SC T-MAPbCl3 obviously decreased to 3 MΩ under 395 and 404 nm ultraviolet light. The photodetector based on SC T-MAPbCl3 under 3 V bias voltage exhibits high sensitivity (2.60 μA cm-2 under 1 W m-2 light intensity). The high selectivity of the device is in the ultraviolet region, rather than the visible region.

Metabolic syndrome (MTS) is a cluster of concurrent metabolic abnormal conditions. MTS and its component metabolic diseases are heterogeneous and closely related, making their relationships complicated, thus hindering precision treatment. Methods: We collected seven groups of samples (group a: healthy individuals; group b: obesity; group c: MTS; group d: hyperglycemia, group e: hypertension, group f: hyperlipidemia; group g: type II diabetes, n=7 for each group). We examined the molecular characteristics of each sample by metabolomic, proteomic and peptidomic profiling analysis. The differential molecules (including metabolites, proteins and peptides) between each disease group and the healthy group were recognized by statistical analyses. Furthermore, a two-step clustering workflow which combines multi-omics and clinical information was used to redefine molecularly and clinically differential groups. Meanwhile, molecular, clinical, network and pathway based analyses were used to identify the group-specific biological features. Results: Both shared and disease-specific molecular profiles among the six types of diseases were identified. Meanwhile, the patients were stratified into three distinct groups which were different from original disease definitions but presented significant differences in glucose and lipid metabolism (Group 1: relatively favorable metabolic conditions; Group 2: severe dyslipidemia; Group 3: dysregulated insulin and glucose). Group specific biological signatures were also systematically described. The dyslipidemia group showed higher levels in multiple lipid metabolites like phosphatidylserine and phosphatidylcholine, and showed significant up-regulations in lipid and amino acid metabolism pathways. The glucose dysregulated group showed higher levels in many polypeptides from proteins contributing to immune response. The another group, with better glucose/lipid metabolism ability, showed higher levels in lipid regulating enzymes like the lecithin cholesterol acyltransferase and proteins involved in complement and coagulation cascades. Conclusions: This multi-omics based study provides a general view of the complex relationships and an alternative classification for various metabolic diseases where the cross-talk or compensatory mechanism between the immune and metabolism systems plays a critical role.

Although obesity occurs in most of the patients with type 2 diabetes (T2D), a fraction of patients with T2D are underweight or have normal weight. Several studies have linked the gut microbiome to obesity and T2D, but the role of gut microbiota in lean individuals with T2D having unique clinical characteristics remains unclear. A metagenomic and targeted metabolomic analysis is conducted in 182 lean and abdominally obese individuals with and without newly diagnosed T2D. The abundance of Akkermansia muciniphila (A. muciniphila) significantly decreases in lean individuals with T2D than without T2D, but not in the comparison of obese individuals with and without T2D. Its abundance correlates inversely with serum 3β‐chenodeoxycholic acid (βCDCA) levels and positively with insulin secretion and fibroblast growth factor 15/19 (FGF15/19) concentrations. The supplementation with A. muciniphila is sufficient to protect mice against high sucrose‐induced impairment of glucose intolerance by decreasing βCDCA and increasing insulin secretion and FGF15/19. Furthermore, βCDCA inhibits insulin secretion and FGF15/19 expression. These findings suggest that decreased abundance of A. muciniphila is linked to the impairment of insulin secretion and glucose homeostasis in lean T2D, paving the way for new therapeutic options for the prevention or treatment of diabetes., Intestinal Akkermansia muciniphila is depleted in lean individuals with type 2 diabetes, who have increased 3β‐chenodeoxycholic acid (βCDCA), reduced insulin secretion and fibroblast growth factor 19 (FGF19) expression. A. muciniphila treatment in mice modulates βCDCA levels, stimulates insulin secretion and FGF19 expression, leading to improved glucose metabolism. The way is paved fornew therapeutic options for diabetes prevention or treatment.

The retinal vessel is one of the determining factors in an ophthalmic examination. Automatic extraction of retinal vessels from low-quality retinal images still remains a challenging problem. In this paper, we propose a robust and effective approach that qualitatively improves the detection of low-contrast and narrow vessels. Rather than using the pixel grid, we use a superpixel as the elementary unit of our vessel segmentation scheme. We regularize this scheme by combining the geometrical structure, texture, color, and space information in the superpixel graph. And the segmentation results are then refined by employing the efficient minimum spanning superpixel tree to detect and capture both global and local structure of the retinal images. Such an effective and structure-aware tree detector significantly improves the detection around the pathologic area. Experimental results have shown that the proposed technique achieves advantageous connectivity-area-length (CAL) scores of 80.92% and 69.06% on two public datasets, namely, DRIVE and STARE, thereby outperforming state-of-the-art segmentation methods. In addition, the tests on the challenging retinal image database have further demonstrated the effectiveness of our method. Our approach achieves satisfactory segmentation performance in comparison with state-of-the-art methods. Our technique provides an automated method for effectively extracting the vessel from fundus images.

The ileum-derived fibroblast growth factor 19 (FGF19) plays key roles in hepatic glucose homeostasis in animals in an insulin-independent manner. Here, we analyzed the association of FGF19 with glucose effectiveness (GE, the insulin-independent glucose regulation), as well as hepatic glucose production (HGP) in Chinese subjects. GE was measured by frequently sampled intravenous glucose tolerance test (FSIVGTT) in normal glucose tolerance (NGT), isolated-impaired glucose tolerance (I-IGT), and isolated-impaired fasting glucose (I-IFG) subjects. The oral glucose tolerance test-derived surrogate of GE (oGE) was determined in NGT, I-IFG, combined glucose intolerance (CGI), and type 2 diabetes (T2DM) subjects. HGP was assessed by labeled ([3-3H]-glucose) hyperinsulinemic–euglycemic clamp in NGT subjects. Insulin secretion and sensitivity were calculated by the hyperglycemic and hyperinsulinemic-euglycemic clamps in a subgroup of NGT, I-IGT, and I-IFG subjects. Serum FGF19 levels were determined by ELISA. FGF19 positively correlated with GE (r = 0.29, P = 0.004) as determined by FSIVGTT. The result was further confirmed by oGE (r = 0.261, P

Our study focused on the associations of metabolites with BMD and osteoporosis, finding that several metabolites are associated with BMD, and metabolites combined with bone turnover markers tend to be more sensitive in distinguishing osteoporosis in both males and postmenopausal females, which might be meaningful for the early diagnosis of osteoporosis. Our study aimed to evaluate the association of metabolites with bone, trying to find new metabolic markers that are distinguishing for low bone mineral density (BMD). Our study recruited 320 participants, including 138 males and 182 postmenopausal females from the Shanghai area. Bone turnover markers (BTMs), including osteocalcin, PINP and β-CTX, and other biochemical traits were tested. BMD values of the lumber spine (L1–4), femoral neck and total hip were determined using dual-energy X-ray absorptiometry and the serum metabolome profiles including 221 metabolites from five groups (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids and hexose) were assessed by mass spectrometry. No visual separation in the metabolic profiles between different BMD groups was observed in principal component analysis (PCA) or partial least squares discriminant analysis (PLS-DA) models. We compared metabolites in three groups with different BMD levels in males and postmenopausal females separately and further filtering these metabolites via random forest-based feature selection, a commonly applied machine learning algorithm which could select the features with the greatest impact on osteoporosis, then metabolites with the highest importance (≥ 5%) (5 in males and 9 in postmenopausal females) were selected to construct better models for osteoporosis classification. After adding these selected metabolites to the model, the area under the curve (AUC) of receiver operating characteristic (ROC) curves increased significantly (BTMs: AUC 0.729, 95% CI 0.647–0.802, p

Aims To compare the magnitude of associations of the obesity indicators with the risk of prediabetes and diabetes. Methods We performed an individually region-, sex-, and age-matched case and control analysis involving 42 918 Chinese adults aged 20–88 years (6876 matched prediabetes and normal glucose regulation [NGR] groups and 2873 matched newly diagnosed diabetes mellitus [NDM] and NGR groups). Results Compared with their respective NGR controls, the participants with prediabetes or NDM had significantly higher mean levels of obesity indices as follows: waist circumference (cm), 85.3 vs. 81.8 and 87.9 vs. 82.9; waist-to-height ratio (WHtR), 0.531 vs. 0.509 and 0.546 vs. 0.514; and body mass index (BMI) (kg/m2), 25.4 vs. 24.1 and 25.9 vs. 24.2 (all P Conclusions Mean differences in the three obesity indices were around 0.3 SD between matched prediabetes cases and NGR controls, and around 0.5 SD between matched NDM cases and NGR controls. Waist circumference and WHtR were more strongly associated with diabetes than BMI among Chinese adults.

Aim. To investigate the effects of alcohol on serum glycated albumin (GA) levels in Chinese men. Methods. A total of 2314 male subjects from the Jinuo ethnic group in China were enrolled. Of these, 986 subjects drank alcohol frequently and 404 subjects did not. Lifestyle information was gathered by using a questionnaire, and measurements of blood pressure, body mass index, blood glucose level, liver function, and kidney function were collected. GA was measured by using an enzymatic method. Frequent drinking was defined as a history of drinking ethanol > 80 g/d within the past two weeks. Nondrinking was defined as no alcohol consumption in the past three months. Subjects with an alcohol intake between 0 and 80 g/d in the past two weeks were included in the drinking-occasionally group. Analysis of variance (ANOVA), correlation analysis, and linear regression were used to evaluate the effects of drinking on serum GA levels. Decision tree regression (DTR) algorithm was used to evaluate the effect of features (variables) on GA levels. Results. We found that male subjects who drank frequently had significantly lower serum GA levels than subjects who did not drink (13.0 ± 1.7 vs. 14.1 ± 3.7, p < 0.05 ). Spearman’s correlation analysis calculated a coefficient of −0.152 between drinking and GA ( p < 0.005 ). Linear regression established that drinking was an independent predictor for GA levels with a standardized regression coefficient of −0.144 ( p < 0.05 ). Decision tree regression showed that the effect of drinking on GA levels (0.0283) is five times higher than that of smoking (0.0057). Conclusions. Frequent alcohol consumption could result in decreased GA levels in men of the Jinuo ethnic group in China.

Although significant progress has been made in generating images from the text by using generative adversarial networks (GANs), it is still challenging to deal with long text, which contains complex semantic information like recipes. This paper focuses on generating images with high visual realism and semantic consistency from the complex text of recipes. To achieve this, we propose a GANs based method termed ChefGAN. The critical concept of ChefGAN is that a joint image-recipe embedding model is used before the generation task to provide high-quality representations of recipes, and it acts as an extra regularization during the generation to improve semantic consistency. Two modules are designed for this image text embedding module (ITEM) and a cascaded image generation module (CIGM). The generation process is carried out in 3 steps: (1) Two encoders in ITEM are trained simultaneously to generate similar representations for each image-recipe pair. (2) CIGM generates images according to the representations from ITEM's text encoder. (3) The generated image is fed into ITEM's image encoder to calculate the similarity with the given recipe. This process can provide additional regularization effect other than the impact of a discriminator. To facilitate convergence, we applied a two-stage training strategy, which generates an image with low resolution and then one with high resolution in the CIGM module. Compared with other representative state-of-the-art methods, ChefGAN demonstrates better performance both in visual realism and semantic consistency.

The performance of lead halogen perovskite is often closely related to its crystal structure. However, the chemical and optoelectronic properties of tetragonal phase single crystal MAPbCl3 (SC T-MAPbCl3) are rarely reported. In this study, we synthesized SC T-MAPbCl3 with the P4/mcc (124) space group by a modified inverse temperature crystallization (M-ITC) method. The twist angle of the Cl anion on the equatorial plane of the PbCl64- octahedron around the c-axis is 8.4°. The resistance (62 MΩ) of SC T-MAPbCl3 obviously decreased to 3 MΩ under 395 and 404 nm ultraviolet light. The photodetector based on SC T-MAPbCl3 under 3 V bias voltage exhibits high sensitivity (2.60 μA cm-2 under 1 W m-2 light intensity). The high selectivity of the device is in the ultraviolet region, rather than the visible region.

Retinal screening contributes to early detection of diabetic retinopathy and timely treatment. To facilitate the screening process, we develop a deep learning system, named DeepDR, that can detect early-to-late stages of diabetic retinopathy. DeepDR is trained for real-time image quality assessment, lesion detection and grading using 466,247 fundus images from 121,342 patients with diabetes. Evaluation is performed on a local dataset with 200,136 fundus images from 52,004 patients and three external datasets with a total of 209,322 images. The area under the receiver operating characteristic curves for detecting microaneurysms, cotton-wool spots, hard exudates and hemorrhages are 0.901, 0.941, 0.954 and 0.967, respectively. The grading of diabetic retinopathy as mild, moderate, severe and proliferative achieves area under the curves of 0.943, 0.955, 0.960 and 0.972, respectively. In external validations, the area under the curves for grading range from 0.916 to 0.970, which further supports the system is efficient for diabetic retinopathy grading., As the leading cause of vision loss in working-age adults, diabetic retinopathy requires routinely retinal screening. Here the authors develop a deep learning system that can facilitate the screening by providing real-time image quality assessment, lesions detection, and grades across the disease spectrum.

Surface albedo is one of the most important properties of underlying surface. However, errors still exist in the calculation of the surface albedo because of complex influencing factors. Understanding the relationship between the surface albedos in different wavebands, and soil moisture will provide theory basis for the parameterization of surface albedos. In this paper, using the data on the spectral radiation and soil moisture observation in Dunhuang, China, from August to October 2016, the spectral radiation characteristics of the underlying surface in this arid Gobi area, the variation characteristics of the surface spectral albedo and its relationship with 2-cm soil moisture were analyzed. The results show that the decrease of the angle of the sun due to seasonal change is the reason of the decrease of NIR, GR, VIS, and UV. The surface albedos in different wavebands are affected by the surface soil moisture, and they exhibit obvious anti-correlations. During the observation period, the average surface albedo of NIR, GR, VIS, and UV is 0.263, 0.230, 0.204, and 0.096, respectively, while the correlation coefficient with 2-cm soil moisture is − 0.522, − 0.678, − 0.804, and − 0.812, respectively. When solar altitude is larger than 40°, the correlation coefficients between the NIR, GR, VIS, and UV surface albedos and 2-cm soil moisture are becoming larger. And the linear regression coefficients between the NIR, GR, VIS, and UV surface albedos and 2-cm soil moisture are becoming smaller. Shorter wavelengths correspond to stronger relationships between the surface albedo and soil moisture. At longer wavelengths, the decrease in the surface albedo due to the increase in soil moisture is sharper.

We aim to investigate the relationship between serum somatostatin (SST) levels and glucose-lipid metabolism at various stages of glucose tolerance in the Jino ethnic minority (n=111) and Han population (n=113) of Yunnan Province, southwest China. Anthropometric parameters and biochemical traits were measured. Serum SST and plasma glucagon levels were tested. Participants were divided into three subgroups: isolated fasting hyperglycemia (IFH), isolated post challenge hyperglycemia (IPH) and normal glucose tolerance (NGT). SST levels were found lower while glucagon levels were significantly higher in the Jino ethnic with IPH (P=0.0026 and P=0.0069, respectively). Fasting glucose and high density lipoprotein-cholesterol (HDL-C) levels were higher (P=0.0055 and P=0.0021, respectively) and fasting insulin levels and homeostasis model assessments β-cell function were lower (P=0.0479 and P=0.0007, respectively) in the Jino population. After adjusting for confounding factors, the serum SST level was associated with glucagon (P

To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.985 adults with diabetes in the Shanghai Taopu community health service center were enrolled at baseline and 907 subjects completed the follow-up. The follow-up levels of the metabolic profiles were assessed by their averages during the follow up period.After a mean 7-year follow-up period, heamoglobin A1c, systolic and diastolic blood pressure levels decreased by 0.6%, 5.7mmHg, and 1.5mmHg, respectively (all P0.001). There was a non-significant difference in low-density lipoprotein cholesterol, while high-density lipoprotein cholesterol increased 1.9mg/dL and triglycerides decreased 28.3mg/dL, respectively (all P0.001). The percentage of patients with diabetes who met any one of three Chinese Diabetes Society goals (heamoglobin A1c7.0%, blood pressure140/80mmHg, and low-density lipoprotein cholesterol100mg/dL) increased from 58.2% to 70.1%. The chronic diabetes complication screening rates (diabetic retinopathy, diabetic neuropathy, diabetic nephropathy) have significantly increased, from almost zero to 12-78%.This long-term program has increased the proportions of attaining major cardiovascular risk factors control goals and diabetic chronic complication screening rates among patients with diabetes.