Volume 01 · Issue 06 · 2009

polycystic ovary syndrome (PCOS) was first reported by Chereau and Rokitansky in 1844, and further described by Stein and Leventhal^[1]。 PCOS is the most common cause of female infertility and a common female endocrine disease. Among women of childbearing age, the prevalence rate is 7% ~8%, but the results of the study vary greatly due to different ethnicity and diagnostic criteria^[2]。 Patients with PCOS often present with reduced ovulation frequency, hyperandrogenicity, ovarian polycystization, elevated luteinizing hormone (LH), and insulin resistance, and have an increased risk of metabolic syndrome (type 2 diabetes, hypertension, dyslipidemia, and cardiovascular disease). Studies at home and abroad^[3,4]It indicates that patients with PCOS have different degrees of insulin resistance regardless of obesity or not, and that insulin resistance is the main risk factor of metabolic syndrome in these patients, and its role in PCOS will still be the focus of future research.

polycystic ovary syndrome (PCOS) is a common gynecological disease that causes thin menstruation and infertility in women. There are many similarities between PCOS and metabolic syndrome, all with insulin resistance, dyslipidemia, hypertension and central obesity. It is unclear what association exists between them, and insulin resistance may be an important factor linking the two diseases. Due to different diagnostic criteria, reports on the incidence of metabolic syndrome in PCOS patients are also inconsistent, roughly between 30% and 50%. According to the Rotterdam diagnostic criteria, PCOS can be classified into the following types: (1) complete type: thin menstruation, polycystic ovaries, and hyperandrogenism; (2) ovulatory type: hyperandrogenism and polycystic ovary; (3) NICHD (National Institute of Child Health and Human Development) Type: hyperandrogenism and menstrual rarity; (4) Non-hyperandrogenic type: thin menstruation and polycystic ovary. Studies have reported that the incidence of metabolic syndrome is related to the type of PCOS. The incidence of metabolic syndrome in complete, ovulatory and NICHD types is significantly higher than that in non-hyperandrogenic types, suggesting that too high androgen in PCOS may be involved in the occurrence of metabolic syndrome^[1]。 In addition, the incidence of metabolic syndrome in obese PCOS patients is also significantly higher than that in non-obese PCOS.

Non-alcoholic fatty liver disease (NAFLD) is an acquired metabolic stress liver injury closely related to insulin resistance and genetic susceptibility. The disease spectrum includes simple fatty liver, non-alcoholic steatohepatitis (NASH) and its associated cirrhosis. Hepatic histological changes of NAFLD were similar to those of alcoholic liver disease, but there was no history of excessive alcohol consumption and other definite liver damaging factors. With the change of lifestyle, NAFLD has become the leading cause of chronic liver disease in western developed countries and rich areas of China^[1], resulting in an increased incidence of decompensated cirrhosis, type 2 diabetes, atherosclerosis, and metabolic syndrome-related malignancies. The main risk factors of NAFLD are obesity, abdominal obesity and related disorders of glucose and lipid metabolism. Endocrine diseases such as hypothyroidism, hypopituitary function, Cushing syndrome and polycystic ovarian syndrome (PCOS) are also related to the occurrence and development of NAFLD. Among them, PCOS has a high prevalence (involving 6% ~10% of women of childbearing age) and is an important component of metabolic syndrome along with NAFLD. The relationship and interaction between PCOS and PCOS have attracted attention^[2,3,4]。

polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. Its prevalence is 5% ~10%, accounting for 50% ~70% of anovulatory infertility patients. The clinical manifestations of PCOS are highly heterogeneous and complex, which not only affect the reproductive endocrine function, but also are prone to long-term complications. At present, the pathogenesis of PCOS is still unclear, and there is no unified and standardized treatment plan. This article summarizes the treatment progress of PCOS in recent years.

Gestational diabetes refers to different degrees of abnormal glucose tolerance occurring or first discovered during pregnancy, accounting for 80% to 90% of pregnancy complicated diabetes, including gestational glucose tolerance abnormality and gestational diabetes. With the increasing number of obese people, the incidence of gestational diabetes mellitus is increasing year by year, and the academic awareness of gestational diabetes mellitus is gradually improved. This article will review the research progress of gestational diabetes in China in recent years.

To evaluate the characteristics and prevalence of abnormal glucose metabolism in polycystic ovary syndrome (PCOS) patients.

A retrospective case–control study was performed in 654 PCOS patients (101 were in adolescence, 553 were adults) and 120 healthy controls (40 were in adolescence, 80 were adults). Oral glucose tolerance test (OGTT), insulin releasing test (IRT), and other biochemical testing were underwent in all patients and controls. The characteristics and prevalence of abnormal glucose metabolism were analyzed and compared.

The prevalence of abnormal glucose metabolism, including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM), was 24.5% in PCOS patients, which was significantly higher than that in the controls(χ²=27.11, P<0.0001). The prevalence of abnormal glucose metabolism in adolescent PCOS patients was lower than that in adult PCOS patients (12.9% and 26.6%, respectively; χ²=8.688, P=0.003), but higher than that in age–matched adolescent controls (12.9% and 0%, respectively; χ ²=5.671, P=0.02). IGT was the most common manifestation of abnormal glucose metabolism in PCOS patients (62.5%), followed by IFG (43.8%) and DM (8.1%). In PCOS patients, 13 patients were diagnosed with DM, however, 9 of them (69.2%) were exposed by OGTT screening. In PCOS patients, the prevalence of abnormal glucose metabolism increased with body mass index(BMI) (χ²=53.71, P<0.0001).

PCOS patients are at a higher risk of abnormal glucose metabolism, and IGT may be the most common phenotype. It's recommended that all PCOS patients should be screened for abnormal glucose metabolism by using 2–h OGTT.

To investigate the effect of sex hormone binding globulin (SHBG) and total testosterone (TT) on predicting insulin resistance (IR), reproductive endocrine hormones, carbohydrate and lipid changes in polycystic ovary syndrome (PCOS) patients.

Three hundred forty–four cases of PCOS and 100 cases of normal women cellected from June 2004 to May 2006 in the Obstetrics and Gynecology Hospital of Fudan University were included in the study, the mean age was (23±5) years, the levels of SHBG and TT in serum were compared between PCOS and normal control, the correlation between SHBG/TT and basal body index, waist to hip ratio, endocrine hormone, lipids and glucose profile were analyzed by Spearman correlation. The impact of age, ovarian volume, leuteinizing hormone(LH), follicle stimulating hormone(FSH), LH/FSH ratio, TT, SHBG, dehydroepiandrosterone–sulphate, prolactin and cortisol on IR were analyzed by Logistic regression. A receiver operating characteristic(ROC) curve between SHBG and IR were taken and acquired a cut–off point, difference between groups with higher/lower SHBG were compared.

SHBG was lower in PCOS group than in normal control ((114±88) vs (201±106) mmol/L, t=–5.60, P<0.01) and TT was higher in PCOS than in normal control ((2.8±1.0) vs (1.7±0.6) nmol/L,t=7.73, P<0.01), the difference had significantly statistic mean. SHBG had an inverse correlation with fasting plasma insulin, insulin area under curve, glucose area under curve, homeostasis model assessment insulin resistance, triglycerides and waist–hipo ratio(r=–0.30, –0.26, –0.29, –0.19, –0.20, –0.29, –0.22, respectively, all P<0.01). Total testosterone had a positive correlation with fasting plasma insulin (r=0.14, P<0.01), all the point of insulin releasing test (1, 2, 3 hr=0.15, 0.12, 0.11, respectively, all P<0.05), the corresponding insulin area under curve(r=0.15, P<0.05)and homeostasis model assessment insulin resistance(r=0.11, P<0.05). Logistic regression demonstrated that SHBG was an independent predictor of IR(OR=3.741). A SHBG level of 88 mmol/L(95%CI: 0.668 to 0.774) was used as the cut–off point for predicting IR according to the ROC curve.Fasting plasma insulin, insulin area under curve, homeostasis model assessment insulin resistance, fasting plasma glucose, glucose area under curve were higher in patients with SHBG<88 mmol/L than those SHBG≥88 mmol/L(t=–6.45, –5.08, –6.19, –3.16, –3.66, respectively, all P<0.01), the same trend as triglycerides(t=–2.06, P<0.05).

TT in serum is higher in PCOS women while SHBG on the control. TT has a positive correlation and SHBG has a negative correlation with IR in PCOS. SHBG is perhaps the only independent risk factor to predict IR in PCOS women.

We hypothesize that cryptotanshinone may directly reduce both insulin resistance and AE of the direct contribution of insulin resistance on ovary induced by dexamethasone.

Ovaries from mature mice were isolated and cultured. Insulin resistance was induced in ovaries by dexamethasone (Dex) treatment for 48 h. Insulin–resistant ovaries were further intervened by cryptotanshinone or vericle DMSO in 48 h, and were analyzed with regards to medium glucose, testosterone, androstanedione, progesterone, 17–hydroxide progesterone and estradiol as well as the cellular expression of key signal molecules by RT–PCR.

Ovaries induced by Dex had a significantly decreased level of glucose utilization, but elevated levels of testosterone and androstanedione as compared with untreated ovaries in medium, indicating establishment of insulin resistance and enhanced androgenic potentials were explored in the induced ovarian. Cryptotanshinone improved glucose utilization in medium, reduced testosterone and androstanedione as compared with vehicle treatment in induced ovaries, suggesting improve significantly insulin resistance and steroidogenesis in induced ovaries. The RT–PCR results showed that dexamethasone decrease the expressions of protein kinase B (AKT2), glycogen synthase kinase–3β(GSK3β)and extracellular regulated protein (ERK), but increased the expressions of cytochrome 17–hydroxylase and minichromosome maitenance protein 2 (MCM2). Cryptotanshinone could improve expression of these signaling molecular mRNA. However, estrogens and its enzymes were reported to be unchanged. Thus, such a differential impacts on theca and granulose by dex will potentiate androgen production in IR ovary. And troglitazone plays similar results as cryptotanshinone except androstanedione, progesterone, 17–hydroxide progesterone.

Dex could directly induce insulin resistance and androgenic excess within ovaries and crytotanshinon intervene showed beneficial effect. The beneficial effect of cryptotanshinone could ameliorate remarkably molecular regulating proteins of glucose metabolism, cell proliferation and hormone production. This may be a mechanism of Chinese medicine cryptotanshinone improving insulin resistance and androgen synthesis.

To systemically review the efficacy of aspirin on the primary prevention of cardio–cerebrovascular events in diabetic patients.

Database search of MEDLINE, EMBASE, Cochrane Controlled Trials Register, VIP Database, CNKI, CBM disc (from the date of database establishment to July 2009) was carried out. The key words included diabetes, hyperglycemia, aspirin, acetylsalicylic acid hydrolase, non–steroidal anti–inflammatory drugs (NSAIDS), primary prevention, cardiovascular diseases, myocardial infarction, and stroke. No language restriction was applied. Additional studies were retrieved via references of the articles and directed conduct of authors to possess relevant data.Prospective randomized controlled trials without previous history of cardiovascular disease in diabetic patients were selected. Quality of all the studies was evaluated, and the data which met the inclusion criteria were extracted. Review Manager Software 5.0 was used for statistical analysis.

Four trials with a total of 5883 participants were included. The meta–analysis showed that aspirin was associated with 30% reduction in stroke (RR=0.71, 95% CI 0.55 to 0.93, P=0.01), but no significant effect on major cardiovascular events (RR=0.90, 95% CI 0.77 to 1.04, P=0.15) or myocardial infarctions (RR=1.02, 95% CI 0.78 to 1.32, P=0.90) was found, and no sex–specific difference was identified. Aspirin increased more than 4 odds of bleeding events compared with the control group (RR=4.03, 95% CI 2.09 to 7.78, P<0.0001). There was no significant difference between the aspirin group and the control group in cardiovascular mortality (RR=0.85, 95% CI 0.32 to 2.24, P=0.74) and major mortality (RR=0.87, 95% CI 0.47 to 1.61, P=0.67).

Findings from this meta–analysis suggest that low–dose aspirin therapy could significantly reduce the risk of stroke, although increasing the risk of bleeding in diabetic patients.

To investigate the morbidity rate of diabetic peripheral neuropathy (DPN) and analyze its related factors through the testing of the vibration perception threshold (VPT) in outpatients with type 2 diabetes mellitus (T2DM).

VPT on both feet in 1018 T2DM outpatients was examined by the quantitative examination equipment of vibration perception. The participants were then assigned to the low–risk group (<15 V,n=484), mediate–risk group (15 to 25 V, n=302), and high–risk group (>25 V,n=232). The clinical characteristics and biochemical parameters were compared.

The patients in the low–risk, mediate–risk, and high–risk group accounted for 47.54%, 29.67%, and 22.79%, respectively. The patients with neuropathy symptoms accounted for 39.26%, 61.26%, and 65.52% in the low–risk, mediate–risk, and high–risk group, respectively. There were significant differences in age, diabetic duration, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and glycated serum albumin (GA) among the three groups (all P< 0.05). VPT of male patients was worse than that of female patients (P<0.01). VPT was positively correlated with age, gender, diabetic duration, SBP, HbA1c, GA, and fasting plasma glucose (FPG) (allP<0.05). In multiple stepwise regression analysis, age (P=0.000), HbA1c (P=0.046), and GA (P=0.030) were independent influencing factors of VPT.

The prevalence of DPN was 22.79% screened by VPT examination in type 2 diabetic outpatients. Age, HbA1c and GA may be independent influencing factors of VPT.

To evaluate the effect of cinnamaldehyde (Cin) on glucose and lipids profiles in rats with type 2 diabetes mellitus (T2DM), subsequently to investigate its molecular mechanisms for reducing insulin resistance (IR).

Rat models of T2DM were established by combination of high–fat diet induction and intraperitoneal injection of low–dose streptozotocin. Rats were divided into the normal control group (NC), T2DM group, T2DM+ metformin (Met) group and T2DM + Cin group. After four weeks of treatment, blood was extracted for measurement of serum glucose, insulin and lipids. Western blot was used to detect the serum or tissue retinol–binding–protein 4(RBP4) and glucose transporter 4(GLUT4) protein levels. Immunohistochemistry was applied to detect the expression of insulin receptor substrate–1 (IRS–1) and phosphatidylinositol 3–kinase (PI3K) regulatory subunit p85 alpha (p85α) in gastrocnemius muscles.

Cin displayed promising hypolipidemic, anti–hyperglycemic, and insulin sensitizing functions (FPG: (7.5±1.5) vs (22.7±4.0) mmol/L; TG: (0.77±0.15) vs(1.53±0.13)mmol/L; HOMA–IR: 8.0±3.0 vs 61.2±12.1, P<0.01) compared with the T2DM group. Serum RBP4 levels in Cin treated rats were markedly lowered, and the protein contents of tissue GLUT4 were significantly up–regulated. Also, Cin increased the expression of IRS–1 in gastrocnemius muscles of T2DM rats (0.52±0.05 vs 0.63±0.06,P<0.05), whereas notably decreased the expression of p85α (0.51±0.05 vs 0.43±0.04,P<0.05).

Cinnamaldehyde can improve glucose and lipids metabolism in type 2 diabetic rats and its pharmacological mechanisms are at least partially related with reducing serum RBP4 concentration, increasing IRS–1 and decreasing of p85α in gastrocnemius muscles.

To investigate the effects of cannabinoind–1 receptor (CB1R) on pancreatic beta–cell function in obese rats.

A total of 30 male 8–week healthy SD rats were randomly assigned to the control group (n=6) or obesity group (n=24). After 8 weeks' intervention, 24 obese rats were randomly divided into the saline group (n=8), WIN55212–2 injection group (n=8) and AM251 injection group (n=8). The body weight, insulin, lipids, and proinsulin levels were measured in fasting status. Hyperglycemic clamp was performed to evaluate the insulin sensitivity and islet beta–cell function. LSD test was used for data analysis.

After 2–week peritoneal injection, compared with the control group, body weight, lipids, fasting glucose, C peptide, insulin, proinsulin, proinsulin/C peptide, proinsulin/insulin, 10 to 90 min insulin release and maximum insulin secretion were significantly higher in the saline or WIN55212–2 injection group (all P<0.05). These parameters in the WIN55212–2 injection group were higher than those in the saline group (allP<0.05). Above measurements in the AM251 injection group were lower than those in the saline or WIN55212–2 injection group (allP<0.05). Compared with the control group, 0 to 10 min insulin release and glucose infusion rate (GIR) were significantly lower in the saline or WIN55212–2 injection group (allP<0.05). GIR and 0 to 10 min insulin release in the WIN55212–2 injection group were lower than those in the saline group. GIR and 0 to 10 min insulin release in the AM251 injection group were higher than those in the saline or WIN55212–2 injection group.

Agitating CB1R could elevate body weight, lipid profile, insulin resistance and islet beta–cell function impairment in obese rats. Restraining CB1R could reverse those effectiveness.

Polycystic ovary syndrome (PCOS) is a special disease in which reproductive dysfunction and metabolic abnormalities coexist. Reproductive dysfunction, including ovarian ovulatory dysfunction and excessive androgen, is the core content of clinical manifestations of PCOS patients; Metabolic abnormalities are mainly manifested as insulin resistance and hyperinsulinemia. Recent studies have found that in addition to the insulin resistance of skeletal muscle, fat and liver, the classical target tissues of insulin action, there is also insulin resistance in the ovary in PCOS patients^[1]。 At the same time, there are symptoms of insulin resistance and peripheral hyperinsulinemia in patients with type 2 diabetes, but ovarian dysfunction is not common. Obviously, it is not accurate to explain the dysfunction of ovary itself by insulin resistance outside ovarian tissue and peripheral hyperinsulinemia. Therefore, the insulin resistance of the ovary itself has more important significance for the change of ovarian function in patients with PCOS.

Recent studies have shown that high-frequency polymorphic loci of pathogenic genes of monogenic diabetes may affect the genetic susceptibility of polygenic diabetes. These high-frequency polymorphisms themselves have weak or even insignificant effects on gene expression or activity, but they can increase the risk of diabetes in individuals.

With the increasing incidence of obesity, various diseases related to obesity seriously endanger human health, and also become a huge burden of social health management. Prevention and treatment of obesity has become an urgent problem to be solved. In recent years, the existence of brown adipose tissue (BAT) in adults has been confirmed continuously, which is an important revelation for the prevention and treatment of obesity.

Around the world, the prevalence of diabetes is increasing rapidly, which brings a heavy burden to the social and economic development of all countries. Diabetes-related organizations and institutions are working to prevent, treat and delay the occurrence and development of diabetes and its complications. However, the current treatment status of type 2 diabetes in China is not optimistic: on the one hand, the compliance rate of blood sugar control is low, and the risk of diabetes-related complications is increasing day by day; On the other hand, there is a lack of fundamental treatment for progressive hypofunction of islet beta cells in type 2 diabetes, and existing therapeutic measures often present risks such as hypoglycemia and weight gain, thus delaying the best time to initiate treatment. After years of research, it has been found that glucagon-like peptide-1 (GLP-1) analogs can safely and effectively control blood sugar, protect the function of pancreatic islet β cells, and reduce body weight, opening up a new course of treatment of type 2 diabetes.

The patient, a 53-year-old male, was admitted to the hospital mainly for "dry mouth, emaciation, fatigue for 12 years, and poor blood sugar control for 1 week". He was diagnosed with type 2 diabetes 12 years ago, and was given hypoglycemic drugs, insulin, etc. to control his blood sugar, and his blood sugar control was average. Admitted 1 week ago due to poor glycemic control. No previous history of smoking and alcoholism, no history of surgical trauma, no history of rheumatoid disease, no history of epilepsy, and no family history of palmar aponeurosis contracture. Physical examination: The aponeurosis of both hands was contracted, and the subcutaneous cord-like tightness and hardness changed without tenderness. Limited movement of the ring finger, unable to straighten and oppose the palm. There is no swelling and tightness in the skin of the fingers, and no Raynaud's phenomenon (Figure 1), no obvious abnormalities were found in the heart, lung and abdomen. Follow-up medical history: 7 years ago, small nodules appeared at the metacarpophalangeal joints of the ring fingers of both hands, which were closely attached to the skin, and gradually appeared skin and tendon contraction. The bilateral ring fingers could not be straightened, and there was no morning stiffness and no fever. Laboratory tests: rheumatoid factor (–); anti-streptococcal "O" (-); Immunization full item (–); thyroid function (–); There were no abnormalities in liver and kidney function; Glycosylated hemoglobin 8.2%; There was no abnormality in the bone quality of the hands in the anterior and lateral X-ray radiographs of both palms. Combined with the medical history and clinical manifestations, the clinical diagnosis was: type 2 diabetes mellitus and palmar aponeurosis contracture type II. On the basis of hypoglycemic (insulin combined with oral medicine) and lipid-lowering therapy, the treatment principle of type Ⅱ palmar aponeurosis contracture was referred to^[1]Pancreatic kininogenase, Xuesaitong and alprostadil were given to improve microcirculation therapy. After 2 weeks, the patient felt that the tightness of the palm contracture was slightly improved. After discharge, he continued to take pancreatic kininogenase and Xuesaitong orally. After 2 months, the tightness symptoms further improved, and the skin tension was reduced. At present, he is still maintaining treatment.

In order to strengthen the organizational construction of the Youth Committee of Diabetes Branch of Chinese Medical Association and promote the academic exchange among all members of the Youth Committee, entrusted by Professor Yang Wenying, the chairman of the fifth committee of the branch and the Youth Committee, Professor Hong Tianpei, the vice chairman of the Youth Committee, was responsible for planning and organizing the first Young Physicians Forum with the assistance of three other vice chairmen, Professor Bao Yuqian, Professor Li Yanbing and Professor Ran Xingwu. The youth committee members gave enthusiastic support and cooperation, and actively organized the young scholars of the unit to contribute enthusiastically. As an integral part of the 13th National Conference on Diabetes, the forum was held at Zhengzhou International Convention Center in Henan Province on November 4, 2009. Chairman Professor Yang Wenying and host Professor Zhao Zhigang attended the opening ceremony and delivered enthusiastic speeches, encouraging all young committee members to make greater contributions to the cause of diabetes in China. The selection principle of speeches at this forum conference is "emphasizing the basics, taking into account the clinical practice, paying attention to academics and equal participation". A total of 28 young scholars from the units of the youth committee members gave speeches at this forum. The main contents of this conference are briefly introduced below.

Epidemiological evidence suggests that type 2 diabetes is associated with tumorigenesis, and insulin itself is associated with tumorigenesis. To this end, Dejgaard et al. used meta-analysis to evaluate the carcinogenic risk of long-acting insulin analogue insulin detemir.

The 5th International Symposium on Gestational Diabetes recommended that the target of blood glucose control in patients with gestational diabetes be set as: fasting terminal blood glucose<5.3 mmoL, 1 h postprandial<7.8 mmol/L and/or 2 h postprandial<6.7 mmol/L. However, it is unclear whether this goal is the optimal glycemic control goal or the impact of different glycemic control conditions on patient prognosis.

Compared with fasting blood glucose, glycated hemoglobin detection does not require fasting state, the detection value is less affected by recent lifestyle changes, and the differences between individuals are not obvious. However, there are few studies on the correlation between glycosylated hemoglobin level and retinopathy. Therefore, the researchers studied glycosylated hemoglobin and fasting blood glucose levels associated with the development of diabetic retinopathy in the U.S. population, comparing the efficacy of these two blood glucose measurements in differentiating retinopathy.

At present, obesity has become a public health problem that seriously endangers human health. Studies have found that obesity can cause a variety of serious complications and diseases, and is related to the occurrence of malignant tumors such as breast cancer, rectal cancer and prostate cancer. There are many clinical treatments for obesity, but it is difficult to achieve satisfactory results in patients with severe and morbid obesity.

In recent years, the incidence of obesity has increased significantly, but there are few safe and effective treatments for obesity. Liraglutide is a human glucagon-like peptide-1 analog and is a new drug developed for the treatment of type 2 diabetes. Clinical studies have shown that the drug can not only effectively control blood sugar and blood pressure, improve the function of pancreatic islet β cells, but also significantly reduce body weight, so it has become the treatment choice for patients with type 2 diabetes or obesity. To this end, the researchers explored the effect of liraglutide on body mass and its tolerance in obese patients without diabetes.

At present, reliable markers that can identify vascular damage and its risk in diabetic patients are rare. Studies have investigated the correlation between serum adiponectin level and macrovascular disease, but the results are not consistent. Adiponectin is present in the form of trimers, hexamers and higher molecular polymers in the blood. Whether adiponectin in urine can serve as a more precise new marker to measure vascular damage in patients with type 2 diabetes compared to its metabolic effects in blood has been of interest to researchers.

Several previous studies from Europe have confirmed that serum 25 – OH vitamin D levels are low in patients with type 1 diabetes. To verify this assertion in sunny Florida, the researchers collected serum samples from 415 Florida residents, including 153 controls, 46 patients with new type 1 diabetes, and 110 patients with type 1 diabetes who had been diagnosed for at least 5 months. There were 106 first-degree immediate family members of diabetic patients. The results showed that the serum vitamin D levels were 20.1 μ g/L (13.0-37.4 μ g/L) in the control group, 21.2 μ g/L (12.2-30.2 μ g/L) in the new type 1 diabetes group, 23.2 μ g/L (13.8-33.9 μ g/L) in the type 1 diabetes group diagnosed for at least 5 months, and 22.2 μ g/L (12.7-33.1 μ g/L) in the first-degree immediate family group of diabetic patients. There was no statistically significant difference in serum vitamin D levels between the groups (P=0.87), mean 25-OH vitamin D levels were all lower than the optimal value recommended by the World Health Organization (30 μ g/L). Therefore, the researchers believe that the decrease in serum 25-OH vitamin D level may not be specifically related to type 1 diabetes, and living in a sunny area does not mean having sufficient vitamin D level. Appropriate increase in vitamin D intake may be necessary. – – Translated from Vitamin D levels in subjects with and without type 1 diabetes residing in a solar-rich environment. Diabetes Care, 2009, 32: 1977 – 1979.

Obese or overweight patients can obtain significant weight loss from surgical bariatric surgery, but postoperative complications and related psychosocial problems will have a long-term impact on the patient's quality of life. To this end, Batsis et al. conducted a follow-up study on obese patients undergoing Roux-en-Y gastric bypass surgery, aiming to evaluate whether the quality of life and functional status of patients have improved after surgery.

Although the main regulators of brown adipose tissue are unknown, adult brown adipose tissue may have important implications for the prevention of obesity. Mammalian studies have shown that brown adipose tissue shows seasonal changes with ambient temperature and light cycle, but whether there is seasonal change in human brown adipose tissue, the correlation between its change and light cycle or temperature change is not clear. To this end, the researchers performed PET and CT scans on 3614 patients from March 14, 2006 to October 30, 2008, and retrospectively reviewed the radiological examination records to understand their brown adipose tissue activity, and performed correlation analysis with light and ambient temperature changes. The researchers found that 167 patients (4.6%) had recorded radiographic brown adipose tissue activity. In winter, brown adipose tissue was found in 52 of 724 imaging scans (7.2%); In summer, brown adipose tissue was found in 27 out of 1067 imaging scans (2.5%) (P<0.00001)。 Correlation between monthly changes in brown adipose tissue and light cycle changes (r²=0.876) compared to its correlation with changes in ambient temperature (r²=0.696) more closely. Individuals subjected to serial scans also showed strong seasonal variations in brown adipose tissue activity (maximum standard uptake values of 9.4, 1.5 in January and June, respectively). In women, brown adipose tissue was more common (7.2% in women and 2.8% in men;P<0.00001)。 Accordingly, the researchers believe that brown adipose tissue has obvious seasonal change characteristics, and it is more closely related to the change of light cycle; A new mechanism for regulating the function of brown adipose tissue exists in human body, and its activation has potential value for preventing and reversing obesity. – – Translated from Brown adipose tissue and seasonal variation in humans. Diabetes, 2009, 58:2583 – 2587.