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Liu K, Chen YJ, Su J, Fan XK, Yu H, Qin Y, Yang J, Zhu Z, Guan HY, Shen C, Pan EC, Lu Y, Zhou JY, Wu M. [Association of category of dietary intake and physical activity with the risk of mortality in patients with type 2 diabetes mellitus: a prospective cohort study]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1591-1598. [PMID: 37875446 DOI: 10.3760/cma.j.cn112338-20230328-00188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Objective: To investigate the association between dietary intake and physical activity category and their combined effects on all-cause and cause-specific mortality risk in patients with type 2 diabetes mellitus (T2DM). Methods: Between December 2013 and December 2021, a prospective cohort study was conducted on 19 863 T2DM patients in Changshu City, Qingjiangpu District (formerly Qinghe District), and Huai'an District, included in the national basic health service management. Information on deaths and underlying causes of death was obtained from the Jiangsu Provincial CDC and Prevention Death Surveillance System. Cox proportional hazards models were used to estimate the intensity of associations between dietary intake, physical activity, and their combined effects with all-cause and cause-specific mortality in patients with T2DM. Results: As of December 31, 2021, the research subjects had been followed up for 150 283 person-years, with a median follow-up time of 8.15 years. During the follow-up period, 3 293 people died, including 1 124 deaths from cardiovascular disease (CVD) and 875 deaths from cancer. Cox regression analysis showed that compared with the population of 0-1 recommended food group, those having more than five recommended food groups had a 19% lower risk of all-cause mortality [hazard ratio (HR)=0.81, 95%CI: 0.70-0.94] and a 33% lower risk of all-cause mortality (HR=0.67, 95%CI: 0.52-0.87). Compared with the T2DM population in the physical activity Q1 group, the risk of all-cause mortality, CVD mortality, and cancer mortality among the physical activity Q4 group reduced by 50% (HR=0.50, 95%CI: 0.45-0.56), 50% (HR=0.50, 95%CI: 0.41-0.61), and 27% (HR=0.73, 95%CI: 0.60-0.88), respectively. The combined effect showed that compared with the population in the intake of food categories 0-2 and low physical activity groups, the risk of all-cause, CVD mortality, and cancer mortality in the intake of food categories 4-9 and high physical activity groups reduced by 55% (HR=0.45, 95%CI: 0.38-0.53), 56% (HR=0.44, 95%CI: 0.32-0.59), and 40% (HR=0.60, 95%CI: 0.44-0.82), respectively. Conclusion: Type of dietary intake, physical activity, and their combined effects are associated with a reduced mortality risk in patients with T2DM.
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Affiliation(s)
- K Liu
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Y J Chen
- Department of Non-communicable Chronic Disease Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing 210003, China
| | - J Su
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X K Fan
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - H Yu
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Y Qin
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J Yang
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Z Zhu
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - H Y Guan
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - C Shen
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - E C Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an 223001, China
| | - Y Lu
- Department of Chronic Disease Prevention and Control, Suzhou City Center for Disease Control and Prevention, Suzhou 215004, China
| | - J Y Zhou
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - M Wu
- School of Public Health, Southeast University, Nanjing 210009, China Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
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Wang L, Hao Y, Chen L, Zhang YW, Deng HZ, Ke XY, Wang JH, Li F, Hou Y, Xie XH, Xu Q, Wang X, Guan HY, Wang WJ, Shen JN, Li F, Qian Y, Zhang LL, Shi XM, Tian Y, Jin CH, Liu XL, Li TY. [Psychological and behavioral functioning of children and adolescents during long-term home-schooling]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1059-1066. [PMID: 34619922 DOI: 10.3760/cma.j.cn112150-20210602-00533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the characteristics and risk factors of psychological and behavioral problems of children and adolescents of different ages and genders in long-term home-schooling during the coronavirus disease-2019 pandemic. Further, to provide scientific basis for more targeted psychological intervention and coping strategies in the future. Methods: A cross-sectional survey using an online questionnaire was conducted on students aged 6-16 years old in five representative cities of North (Beijing), East (Shanghai), West (Chongqing), South (Guangzhou) and Middle (Wuhan) in China. In this study, the social behavior and psychological abnormalities which was defined as the positive of any dimension were investigated in multiple dimensions during long-term home-schooling. The influencing factors of psycho-behavioral problems were analyzed by Logistic regression, and the confounding factors were corrected with graded multivariable adjustment. Results: A total of 6 906 valid questionnaires were collected including 3 592 boys and 3 314 girls, of whom 3 626 were children (6-11 years old) and 3 280 were adolescents (12-16 years old). The positive detection rate of psychosocial-behavioral problems were 13.0% (900/6 906) totally, 9.6% (344/3 592) in boys and 16.8% (556/3 314) in girls respectively, and 7.3%(142/1 946) in boys aged 6-11, 14.0%(235/1 680) in girls aged 6-11, 12.3%(202/1 646) in boys aged 12-16, 19.6%(321/1 634) in girls aged 12-16 respectively. There were significant differences between the psychological problems group and the non-psychological problems group in gender, parent-offspring conflict, number of close friends, family income change, sedentary time, homework time, screen exposure time, physical activity, dietary problems (χ²=78.851, 285.264, 52.839, 26.284, 22.778, 11.024, 10.688, 36.814, 70.982, all P<0.01). The most common symptoms in boys aged 6-11 years were compulsive activity, schizoid and depression, in girls aged 6-11 years were schizoid/compulsive activity, hyperactivity and social withdrawal, in boys aged 12-16 years were hyperactivity, compulsive activity and aggressive behavior, and in girls aged 12-16 years were schizoid, anxiety/compulsive activity and depression/withdrawal, respectively. After graded multivariable adjustment, besides the common risk factors, homework time and online study time were the risk factors of 6-11 years old groups [boys OR(95%CI): 1.750 (1.32-2.32), 1.214(1.00-1.47), girls: 1.579(1.25-1.99), 1.222(1.05-1.42), all P<0.05], videogames time were the risk factors of 12-16 years old groups [ boys: 2.237 (1.60-3.13), girls: 1.272 (1.00-1.61), all P<0.05]. Conclusions: Some children and adolescents may have psychological and behavioral problems during long-term home-schooling. The psychological and behavioral manifestations differed in age and gender subgroups, which deserve special attention in each subgroups. Schools, families and specialists should actively provide precise psychological support and comprehensive intervention strategies according to special features and risk factors.
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Affiliation(s)
- L Wang
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Hao
- Department of Child Health Care, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - L Chen
- National Clinical Research Center for Child Health and Disorder, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Y W Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Medical School of Shanghai Jiaotong University, Shanghai 200127, China
| | - H Z Deng
- Child Developmental & Behavioral Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - X Y Ke
- Child Mental Health Research Center, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
| | - J H Wang
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - F Li
- Department of Developmental-Behavioral Pediatrics,Xinhua Hospital Affiliated to Medical School of Shanghai Jiaotong University, Shanghai 200092, China
| | - Y Hou
- Department of Biostatistics, Peking University, Beijing 100871, China
| | - X H Xie
- Department of Surgery, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Q Xu
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X Wang
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Y Guan
- Department of Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - W J Wang
- Teacher Development Center, Shanghai Pudong Institute of Education Development, Shanghai 200127, China
| | - J N Shen
- Institute of Primary Education, Chongqing Educational Science Research Academy, Chongqing 400015, China
| | - F Li
- Department of Pediatrics, Jiangjin Centre Hospital, Chongqing 402260, China
| | - Y Qian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, National Health Commission Key Laboratory of Mental Health (Peking University), Beijing 100191, China
| | - L L Zhang
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X M Shi
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Tian
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - C H Jin
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X L Liu
- Department of Child Health Care, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - T Y Li
- National Clinical Research Center for Child Health and Disorder, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
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Guan HY, Xia HX, Chen XY, Wang L, Tang ZJ, Zhang W. Toll-Like Receptor 4 Inhibits Estradiol Secretion via NF-κB Signaling in Human Granulosa Cells. Front Endocrinol (Lausanne) 2021; 12:629554. [PMID: 33776924 PMCID: PMC7995891 DOI: 10.3389/fendo.2021.629554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/22/2021] [Indexed: 11/28/2022] Open
Abstract
Toll-like receptor 4 (TLR4) may play a critical role in regulating follicular development. Data are scarce on the role of TLR4 in the follicle. This study investigated the effects of TLR4 on steroidogenesis in human granulosa cells. Immunohistochemical analysis revealed stage-specific expression of TLR4 in the mouse ovarian cycle, and immunofluorescence showed TLR4 expression in the human granulosa-like tumor cell line (KGN). TLR4 agonist lipopolysaccharides (LPS) significantly inhibited follicular development and synthesis of estradiol (E2) in mice. In KGN cells, TLR4 activation significantly inhibited CYP19A1, FSHR and StAR, and TLR4 inhibition reversed these effects. TLR4 activation also inhibited forskolin-induced secretion of E2 by inhibiting CYP19A1, with no effect on progesterone. Further studies showed activation of p38, JNK and NF-κB signaling after TLR4 activation. Subsequent analyses showed that an NF-κB antagonist reversed the inhibitory effects on CYP19A1 expression and E2 secretion. Together, our results suggest that TLR4 activation may suppress CYP19A1 expression and E2 secretion via NF-κB signaling in human granulosa cells, with important implications for the regulation of ovarian pathophysiology.
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Affiliation(s)
- Hai-Yun Guan
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - He-Xia Xia
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiu-Ying Chen
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Lu Wang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Zhi-Jing Tang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Wei Zhang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
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Wang L, Guan HY, Xia HX, Chen XY, Zhang W. Dydrogesterone treatment for menstrual-cycle regularization in abnormal uterine bleeding – ovulation dysfunction patients. World J Clin Cases 2020; 8:3259-3266. [PMID: 32874980 PMCID: PMC7441273 DOI: 10.12998/wjcc.v8.i15.3259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dydrogesterone has shown significant efficacy in treatment of irregular menstrual cycle due to abnormal uterine bleeding - ovulation dysfunction (AUB-O), but there were few relevant studies. This observational study was designed to evaluate the effectiveness of dydrogesterone for the treatment of Chinese patients with AUB-O.
AIM To evaluate the effects of dydrogesterone on menstrual-cycle (MC) regularization and metabolism in the patients with AUB-O.
METHODS A prospective, non-interventional, single-arm, post-marketing observational study was conducted. Chinese women aged 16 years or above with AUB-O who had been prescribed dydrogesterone were enrolled. The patients were treated with dydrogesterone 10 mg from day 16 to day 25 of each cycle, consecutively for at least 3 cycles. The main outcome was defined as the percentage of patients whose MCs returned to normal (defined as 21 d < menstrual cycle ≤ 35 d) after three cycles of dydrogesterone treatment.
RESULTS One hundred and fourteen women with AUB-O were enrolled in the present study. Of 89 patients who completed treatment, 72 (80.9%) achieved a regular MC at the end of the 3rd circle. The level of androgen, including testosterone and dehydroepiandrosterone sulfate, declined significantly (P = 0.01 and 0.031, respectively), whereas other hormone levels remained steady. During the treatment, 44/80 (55.0%) subjects in the per-protocol set had reported biphasic basal body temperature.
CONCLUSION Dydrogesterone therapy was effective in achieving MC regularization for Chinese patients with AUB-O.
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Affiliation(s)
- Lu Wang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Hai-Yun Guan
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - He-Xia Xia
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Xiu-Ying Chen
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Wei Zhang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
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Wang L, Zhang W, Guan HY. Decay-accelerating factor promotes endometrial cells proliferation and motility under ovarian hormone stimulation. Reprod Biol 2018; 18:225-235. [PMID: 30001983 DOI: 10.1016/j.repbio.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 07/01/2018] [Accepted: 07/05/2018] [Indexed: 11/30/2022]
Abstract
The intent of the study was to explore the elevating expression of decay-accelerating factor(DAF) exerts influence on biological behaviors of endometrial stromal cells except in classical immunology on the basis of bioinformatic statistics and clinical miscarriages findings suggesting its potential role in the establishment of endometrial receptivity. We confirmed that DAF locates on the cellular surface of endometrial epithelium and stroma. By using plasmid transfection to down-regulate DAF expression in primary endometrial stromal cells(ESCs), we discovered that DAF expression in ESCs increases in response to estradiol and progesterone stimulation in dose- and time-dependent manners; moreover, tamoxifen and RU486 stimulations to block estrogen receptors(ERs) and progesterone receptors(PRs) respectively result in reduced DAF mRNA and protein, and it is more obvious to block PRs. Meanwhile, knocked-down DAF in ESCs weakens the proliferation, migration and invasion of endometrial cells. Cell cycle analysis showed knocked-down DAF accumulates cells in S phase and diminishes cells in G0/G1 phase, which substantiates DAF mediates endometrial cells proliferation. In conclusion, DAF is a potential molecule involving in endometrial cellular proliferation and motility to verify up-expressed DAF during the WOI may facilitate endometrial physiobiological behavior changes, which shed light on DAF function and potential role in the endometrial receptivity establishment.
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Affiliation(s)
- Lu Wang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, 413 Zhaozhou Road, Shanghai 200011, China
| | - Wei Zhang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, 413 Zhaozhou Road, Shanghai 200011, China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Disease, 413 Zhaozhou Road, Shanghai 200011, China.
| | - Hai-Yun Guan
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, 413 Zhaozhou Road, Shanghai 200011, China
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Zhang W, Guan J, Guan HY, Wang L. Mistaken oophorectomy in an adolescent with mccune–Albright syndrome: A case report and literature review. Reprod Dev Med 2018. [DOI: 10.4103/2096-2924.249887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhang W, Guan HY, Huang BQ. Induction of ovulation with clomiphene citrate combined with bromocriptine in polycystic ovary syndrome patients with infertility: A prospective, randomized, and controlled clinical trial. Reprod Dev Med 2017. [DOI: 10.4103/2096-2924.224917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chen XY, Xia HX, Guan HY, Li B, Zhang W. Follicle Loss and Apoptosis in Cyclophosphamide-Treated Mice: What's the Matter? Int J Mol Sci 2016; 17:E836. [PMID: 27248997 PMCID: PMC4926370 DOI: 10.3390/ijms17060836] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/14/2016] [Accepted: 05/24/2016] [Indexed: 12/21/2022] Open
Abstract
With increasing numbers of young female cancer survivors following chemotherapy, chemotherapy-induced fertility loss must be considered. Menstrual disorder and infertility are of particular concern in female cancer patients. We showed that treatment with the alkylating agent cyclophosphamide (CTX) could cause severe primordial follicle loss and growing follicle apoptosis, resulting in loss of ovarian reserve. SPF C57BL/6 female mice were treated with a single dose of 120 mg/kg of CTX or saline as a control, and both sides of ovaries were collected three or seven days after injection. Following CTX treatment, the ovaries were mostly composed of collapsed oocytes and presented marked cortical fibrosis and a reduced number of follicles, especially primordial follicles. The loss of primordial follicles was confirmed by primordial follicle counting, immunohistochemistry and Western blot detection of DDx4/MVH. Follicle apoptosis was tested by a TUNEL assay and the number of TUNEL-positive follicle cells increased, as expected, in CTX-treated mice. Furthermore, expression of APAF-1 and cleaved caspase-3 was also increased after CTX treatment. Analysis of the PI3K/Akt/mTOR signaling pathway showed that CTX increased phosphorylation of Akt, mTOR and downstream proteins without affecting total levels. These results demonstrated that the CTX treatment led to the hyperactivation of the PI3K/Akt/mTOR signaling pathway in ovaries which may be related to primordial follicle loss and growing follicle apoptosis.
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Affiliation(s)
- Xiu-Ying Chen
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
- Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China.
| | - He-Xia Xia
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
| | - Hai-Yun Guan
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
- Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China.
| | - Bin Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
| | - Wei Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
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