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Yu L, Wang J, Gong Q, An Y, Chen F, Chen Y, Chen X, He S, Qian X, Chen B, Dong F, Li H, Zhao F, Zhang B, Li G. Influence of a diet and/or exercise intervention on long-term mortality and vascular complications in people with impaired glucose tolerance: Da Qing Diabetes Prevention Outcome study. Diabetes Obes Metab 2024; 26:1188-1196. [PMID: 38168886 DOI: 10.1111/dom.15413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
AIM We aimed to investigate the long-term influence of a diet and/or exercise intervention on long-term mortality and cardiovascular disease (CVD) events. METHODS The Da Qing Diabetes Prevention Study had 576 participants with impaired glucose tolerance (IGT) randomized to diet-only, exercise-only and diet-plus-exercise intervention group and control group. The participants underwent lifestyle interventions for 6 years. The subsequent Da Qing Diabetes Prevention Outcome Study was a prospective cohort study to follow-up the participants for up to 24 years after the end of 6-year intervention. In total, 540 participants completed the follow-up, while 36 subjects lost in follow-up. Cox proportional hazards analysis was applied to assess the influence of lifestyle interventions on targeted outcomes. RESULTS Compared with controls, the diet-only intervention in people with IGT was significantly associated with a reduced risk of all-cause death [hazard ratio (HR) 0.77, 95% confidence interval (CI) (0.61-0.97)], CVD death [HR 0.67, 95% CI (0.46-0.97)] and CVD events [HR 0.72, 95% CI (0.54-0.96)]. The diet-plus-exercise intervention was significantly associated with a decreased risk of all-cause death [HR 0.64, 95% CI (0.48-0.84)], CVD death [HR 0.54, 95% CI (0.30-0.97)] and CVD events [HR 0.68, 95% CI (0.52-0.90)]. Unexpectedly, the exercise-only intervention was not significantly associated with the reduction of any of these outcomes, although there was a consistent trend towards reduction. CONCLUSIONS A diet-only intervention and a diet-plus-exercise intervention in people with IGT were significantly associated with a reduced risk of all-cause death, CVD death and CVD events, while an exercise-only intervention was not. It suggests that diet-related interventions may have a potentially more reliable influence on long-term vascular complications and mortality.
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Affiliation(s)
- Liping Yu
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Qiuhong Gong
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - XiaoPing Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Siyao He
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Qian
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fen Dong
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Fang Zhao
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Qu J, Zhang T, Zhang X, Zhang W, Li Y, Gong Q, Yao L, Lui S. MRI radiomics for predicting intracranial progression in non-small-cell lung cancer patients with brain metastases treated with epidermal growth factor receptor tyrosine kinase inhibitors. Clin Radiol 2024; 79:e582-e591. [PMID: 38310058 DOI: 10.1016/j.crad.2024.01.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 02/05/2024]
Abstract
AIM To identify clinical and magnetic resonance imaging (MRI) radiomics predictors specialised for intracranial progression (IP) after first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment in non-small-cell lung cancer (NSCLC) patients with brain metastases (BMs). MATERIALS AND METHODS Seventy EGFR-mutated NSCLC patients with a total of 212 BMs who received first-line EGFR-TKI therapy were enrolled. Radiomics features were extracted from the BM regions on the pretreatment contrast-enhanced T1-weighted images, and the radiomics score (rad-score) of each BM was established based on the selected features. Furthermore, the mean rad-score derived from the average rad-score of all included BMs in each patient was calculated. Univariate and multivariate logistic regression analyses were performed to identify potential predictors of IP. Prediction models based on different predictors and their combinations were constructed, and nomogram based on the optimal prediction model was evaluated. RESULTS Thirty-three (47.1 %) patients developed IP, and the remaining 37 (52.9 %) patients were IP-free. EGFR-19del mutation (OR 0.19, 95 % CI 0.05-0.69), third-generation TKI treatment (OR 0.33, 95 % CI 0.16-0.67) and mean rad-score (OR 5.71, 95 % CI 1.65-19.68) were found to be independent predictive factors. Models based on these three predictors alone and in combination (combined model) achieved AUCs of 0.64, 0.64, 0.74, and 0.86 and 0.64, 0.64, 0.75, and 0.84 in the training and validation sets, respectively, and the combined model demonstrated optimal performance for predicting IP. CONCLUSIONS The model integrating EGFR-19del mutation, third-generation TKI treatment and mean rad-score had good predictive value for IP after EGFR-TKI treatment in NSCLC patients with BM.
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Affiliation(s)
- J Qu
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - T Zhang
- Department of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - X Zhang
- Pharmaceutical Diagnostic Team, GE Healthcare, Life Sciences, Beijing, China
| | - W Zhang
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Y Li
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Q Gong
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - L Yao
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| | - S Lui
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
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Wang H, He S, Wang J, An Y, Wang X, Li G, Sun N, Gong Q. Does high-normal blood pressure lead to excess cardiovascular disease events and deaths in Chinese people? A post-hoc analysis of the 30-year follow-up of the Da Qing IGT and Diabetes Study. Diabetes Obes Metab 2024; 26:871-877. [PMID: 38012837 DOI: 10.1111/dom.15379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/29/2023]
Abstract
AIM Whether systolic/diastolic blood pressure (SBP/DBP) values of 130-139/80-89 mmHg should be defined as hypertension has been debated for decades. We aimed to characterize the effect of high-normal BP on cardiovascular disease (CVD) events and deaths. METHODS In total, 1726 individuals from the original Da Qing IGT and Diabetes Study were enrolled, and divided into the normal BP group (SBP <130 mmHg and DBP <80 mmHg), high-normal BP group (SBP 130-139 mmHg and/or DBP 80-89 mmHg) and hypertension group (SBP ≥140 mmHg and/or DBP ≥90 mmHg). CVD events and their components were assessed from 1986 to 2016. RESULTS During the 30-year follow-up, the high-normal BP group was not at higher risk for CVD events [hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.84-1.30, p = .68], coronary heart disease (HR 1.12, 95% CI 0.77-1.63, p = .57), stroke (HR 1.05, 95% CI 0.82-1.34, p = .71), or CVD deaths (HR 1.15, 95% CI 0.82-1.60, p = .41) compared with the normal BP group, after adjusting for covariates. However, the hypertension group exhibited significantly increased cardiovascular risk (CVD events, HR 1.91, 95% CI 1.48-2.46, p < .0001; coronary heart disease, HR 1.73, 95% CI 1.12-2.67, p = .01; stroke, HR 1.90, 95% CI 1.43-2.52, p < .0001; CVD deaths, HR 2.07, 95% CI 1.43-3.01, p = .0001) than the normal BP group. Subgroup analyses showed that, regardless of the presence of diabetes, high-normal BP did not increase CVD events compared with normal BP. CONCLUSIONS This post-hoc study provided no evidence that the high-normal BP increased cardiovascular risk in the Da Qing study population, suggesting that it was reasonable to continue to define hypertension at 140/90 mmHg in China.
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Affiliation(s)
- Haixu Wang
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyao He
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Daqing, China
| | - Yali An
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuan Wang
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- China-Japan Friendship Hospital, Beijing, China
| | - Ningling Sun
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Qiuhong Gong
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Qian X, Jia H, Wang J, He S, Yu M, Feng X, Gong Q, An Y, Wang X, Shi N, Li H, Zou Z, Li G, Chen Y. Circulating palmitoyl sphingomyelin levels predict the 10-year increased risk of cardiovascular disease death in Chinese adults: findings from the Da Qing Diabetes Study. Cardiovasc Diabetol 2024; 23:37. [PMID: 38245731 PMCID: PMC10800040 DOI: 10.1186/s12933-023-02116-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/30/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Higher levels of palmitoyl sphingomyelin (PSM, synonymous with sphingomyelin 16:0) are associated with an increased risk of cardiovascular disease (CVD) in people with diabetes. Whether circulating PSM levels can practically predict the long-term risk of CVD and all-cause death remains unclear. This study aimed to investigate whether circulating PSM is a real predictor of CVD death in Chinese adults with or without diabetes. METHODS A total of 286 and 219 individuals with and without diabetes, respectively, from the original Da Qing Diabetes Study were enrolled. Blood samples collected in 2009 were used as a baseline to assess circulating PSM levels. The outcomes of CVD and all-cause death were followed up from 2009 to 2020, and 178 participants died, including 87 deaths due to CVD. Cox proportional hazards regression was used to estimate HRs and their 95% CIs for the outcomes. RESULTS Fractional polynomial regression analysis showed a linear association between baseline circulating PSM concentration (log-2 transformed) and the risk of all-cause and CVD death (p < 0.001), but not non-CVD death (p > 0.05), in all participants after adjustment for confounders. When the participants were stratified by PSM-tertile, the highest tertile, regardless of diabetes, had a higher incidence of CVD death (41.5 vs. 14.7 and 22.2 vs. 2.9 per 1000 person-years in patients with and without diabetes, respectively, all log-rank p < 0.01). Individuals with diabetes in the highest tertile group had a higher risk of CVD death than those in the lowest tertile (HR = 2.73; 95%CI, 1.20-6.22). CONCLUSIONS Elevated PSM levels are significantly associated with a higher 10-year risk of CVD death, but not non-CVD death, in Chinese adults with diabetes. These findings suggest that PSM is a potentially useful long-term predictor of CVD death in individuals with diabetes.
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Affiliation(s)
- Xin Qian
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Jia
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Siyao He
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Yu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxing Feng
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuan Wang
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Shi
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Zhongmei Zou
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Guangwei Li
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, 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K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, 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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, 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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Gao PY, Chen QY, Gong Q, Liu CH. [Pathogenesis of DOCK family protein gene variations in immunodeficiency diseases]. Zhonghua Er Ke Za Zhi 2023; 61:1139-1143. [PMID: 38018054 DOI: 10.3760/cma.j.cn112140-20230828-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- P Y Gao
- Department of Immunology, Yangtze University Health Science Center, Yangtze University, Jingzhou 434023, China
| | - Q Y Chen
- Department of Medical Laboratory Technology, Hubei College of Chinese Medicine, Jingzhou 434020, China
| | - Q Gong
- Department of Immunology, Yangtze University Health Science Center, Yangtze University, Jingzhou 434023, China
| | - C H Liu
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Zhang L, Gong Q, Sun N, Ji L, Li G. Explaining the high rate of progression from prediabetes to type 2 diabetes in China - Authors' reply. Lancet Diabetes Endocrinol 2023; 11:794-795. [PMID: 37884323 DOI: 10.1016/s2213-8587(23)00283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Affiliation(s)
- Lihui Zhang
- The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qiuhong Gong
- Department of Endocrinology, Fuwai Hospital and Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Ningling Sun
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, Fuwai Hospital and Chinese Academy of Medical Sciences, Beijing 100037, China.
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Wang JJ, Xu LM, Yu WJ, Ke Q, Gong Q. [Current situation and trend of medical laboratory results homogeneity management]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1504-1509. [PMID: 37743315 DOI: 10.3760/cma.j.cn112150-20230418-00299] [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: 09/26/2023]
Abstract
Medical test results are indispensable and important tools in diagnosis and treatment services. It is necessary to promote the homogenization of test results first, because homogenization is the basis for mutual recognition of test results. Mutual recognition of medical test results can help share resources among medical institutions, provide more reliable test results for early prevention, screening and treatment of diseases, and reduce repeated tests, thus improving people's medical experience. In recent years, with the deepening of medical system reform and the promotion of graded diagnosis and treatment, governments have continuously introduced policies of mutual recognition of test results around country. However, homogenization is a prerequisite for mutual recognition of test results, with the emergence of intelligent medicine in the era of internet big data, opportunities and challenges coexist in the development of homogeneity management. In the future, the homogeneity of medical test results will present a trend of digitalization, automation, informatization and intelligence.
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Affiliation(s)
- J J Wang
- Department of Laboratory Medicine, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700,China
| | - L M Xu
- Department of Laboratory Medicine, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700,China
| | - W J Yu
- Department of Laboratory Medicine, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700,China
| | - Q Ke
- Department of Laboratory Medicine, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700,China
| | - Q Gong
- Department of Laboratory Medicine, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700,China
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Zhang L, Zhang Y, Shen S, Wang X, Dong L, Li Q, Ren W, Li Y, Bai J, Gong Q, Kuang H, Qi L, Lu Q, Cheng W, Liu Y, Yan S, Wu D, Fang H, Hou F, Wang Y, Yang Z, Lian X, Du J, Sun N, Ji L, Li G. Safety and effectiveness of metformin plus lifestyle intervention compared with lifestyle intervention alone in preventing progression to diabetes in a Chinese population with impaired glucose regulation: a multicentre, open-label, randomised controlled trial. Lancet Diabetes Endocrinol 2023; 11:567-577. [PMID: 37414069 DOI: 10.1016/s2213-8587(23)00132-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/05/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Impaired glucose regulation (defined as either impaired glucose tolerance or impaired fasting glucose) is an important risk factor for the development of diabetes. We aimed to evaluate the safety and effectiveness of metformin plus lifestyle intervention compared with lifestyle intervention alone in preventing diabetes in Chinese participants with impaired glucose regulation. METHODS We did a multicentre, open-label, randomised controlled trial at 43 endocrinology departments in general hospitals across China. Eligible participants were individuals with impaired glucose regulation (ie, impaired glucose tolerance or impaired fasting glucose, or both), men or women aged 18-70 years with a BMI of 21-32 kg/m2. Eligible participants were randomly assigned (1:1) via a computer-generated randomisation to receive either standard lifestyle intervention alone or metformin (850 mg orally once per day for the first 2 weeks and titrated to 1700 mg orally per day [850 mg twice per day]) plus lifestyle intervention. Block randomisation was used with a block size of four, stratified by glucose status (impaired fasting glucose or impaired glucose tolerance), hypertension, and use of any anti-hypertensive medication. Lifestyle intervention advice was given by investigators at all participating sites. The primary endpoint was the incidence of newly diagnosed diabetes at the end of the 2-year follow-up. Analysis was done using the full analysis set and per-protocol set. This study is registered with ClinicalTrials.gov, number NCT03441750, and is completed. FINDINGS Between April, 2017, and June, 2019, 3881 individuals were assessed for eligibility, of which 1678 (43·2%) participants were randomly assigned to either the metformin plus lifestyle intervention group (n=831) or the lifestyle intervention alone group (n=847) and received the allocated intervention at least once. During a median follow-up of 2·03 years, the incidence rate of diabetes was 17·27 (95% CI 15·19-19·56) per 100 person-years in the metformin plus lifestyle intervention group and 19·83 (17·67-22·18) per 100 person-years in the lifestyle intervention alone group. The metformin plus lifestyle intervention group showed a 17% lower risk of developing diabetes than the lifestyle intervention alone group (HR 0·83 [95% CI 0·70-0·99]; log-rank p=0·043). A higher proportion of participants in the metformin plus lifestyle intervention group reported adverse events than in the lifestyle intervention alone group, primarily due to more gastrointestinal adverse events. The percentage of participants reporting a serious adverse event was similar in both groups. INTERPRETATION Metformin plus lifestyle intervention further reduced the risk of developing diabetes than lifestyle intervention alone in Chinese people with impaired glucose regulation, showing additional benefits of combined intervention in preventing progression to diabetes without new safety concerns. FUNDING Merck Serono China, an affiliate of Merck KGaA, Darmstadt, Germany. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Lihui Zhang
- Department of Endocrinology and Metabolism, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yunliang Zhang
- Department of Endocrinology and Metabolism, Baoding First Central Hospital, Baoding, Hebei, China
| | - Sheng'ai Shen
- Department of Endocrinology and Metabolism, Yanji Hospital, Yanji, Yanbian Korean Autonomous Prefecture, Jilin, China
| | - Xueying Wang
- Department of Endocrinology and Metabolism, Jinzhou Central Hospital, Jinzhou, Liaoning, China
| | - Luling Dong
- Department of Endocrinology and Metabolism, Zhangjiakou First Hospital, Zhangjiakou, Hebei, China
| | - Qiuyun Li
- Department of Endocrinology and Metabolism, Kailuan General Hospital, Tangshan, Hebei, China
| | - Weidong Ren
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Yufeng Li
- Department of Endocrinology and Metabolism, Beijing Pinggu Hospital, Beijing, China
| | - Jianling Bai
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiuhong Gong
- Department of Endocrinology, Fuwai Hospital and Chinese Academy of Medical Sciences, Beijing, China
| | - Hongyu Kuang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lin Qi
- Department of Endocrinology and Metabolism, Beijing Yanhua Hospital, Beijing, China
| | - Qiang Lu
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Wenli Cheng
- Department of Hypertension, Beijing Anzhen Hospital, Beijing, China
| | - Yanjie Liu
- Department of Endocrinology and Hematology, Affiliated Hospital of Jilin Medical University, Jilin city, Jilin, China
| | - Shuang Yan
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Donghong Wu
- Department of Endocrinology, Harbin The First Hospital, Harbin, Heilongjiang, China
| | - Hui Fang
- Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei, China
| | - Fang Hou
- Community Health Service Center, Jiefang Road, Tanggu Street, Binhai New Area, Tianjin, China
| | - Yingju Wang
- Department of Endocrinology, Beijing Miyun District Hospital, Beijing, China
| | - Zhixia Yang
- Department of Endocrinology, The People's Hospital of Langfang, Langfang, Hebei, China
| | - Xu Lian
- Department of Endocrinology and Metabolism, Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Jianling Du
- Department of Endocrinology, The First affiliated hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ningling Sun
- Department of Hypertension, Peking University People's Hospital, Beijing, China.
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
| | - Guangwei Li
- Department of Endocrinology, Fuwai Hospital and Chinese Academy of Medical Sciences, Beijing, China.
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Chen F, Wang J, Chen X, Yu L, An Y, Gong Q, Chen B, Xie S, Zhang L, Shuai Y, Zhao F, Chen Y, Li G, Zhang B. Correction to: Development of models to predict 10-30-year cardiovascular disease risk using the Da Qing IGT and diabetes study. Diabetol Metab Syndr 2023; 15:88. [PMID: 37127792 PMCID: PMC10152581 DOI: 10.1186/s13098-023-01066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Affiliation(s)
- Fei Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Xiaoping Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Liping Yu
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuo Xie
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lihong Zhang
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Shuai
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Fang Zhao
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
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Shen X, He S, Wang J, Qian X, Wang H, Zhang B, Chen Y, Li H, An Y, Gong Q, Li G. Modifiable predictors of type 2 diabetes mellitus and roles of insulin resistance and β-cell function over a 6-year study and 30-year follow-up. J Endocrinol Invest 2023; 46:883-891. [PMID: 36219314 DOI: 10.1007/s40618-022-01932-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/29/2022] [Indexed: 04/17/2023]
Abstract
PURPOSE This study aimed to examine the modifiable predictors of T2DM and the roles of insulin resistance (IR) and β-cell function over a 6-year study and 30-year follow-up. METHODS A total of 462 non-diabetic participants, 282 with impaired glucose tolerance (IGT), and 180 with normal glucose tolerance (NGT) were enrolled in this analysis. The Matsuda IR index and area under the curve of insulin-to-glucose ratio (AUCI/G-R) were used as IR and β-cell function indices in the analysis. RESULTS In all participants, multivariable analysis showed that BMI, glucose status, Matsuda IR index and systolic blood pressure (SBP) at baseline were independently associated with an increased risk of T2DM over 30 years, whereas lifestyle intervention and AUCI/G-R were inversely associated with this risk. The predictive effect of the Matsuda IR index and AUCI/G-R in participants with IGT was consistent with the results of all participants, whereas in those with NGT, only the Matsuda IR index, not the AUCI/G-R, predicted the development of T2DM (HR = 1.42, 95% CI 1.07-1.89 vs HR = 1.09, 95% CI 0.76-1.56). The predictive effect of the Matsuda IR index on T2DM existed even in participants with BMI < 25 (p = 0.049). CONCLUSION The modifiable predictors of T2DM in Chinese adults were high BMI, hypertension, mild hyperglycaemia, IR, and β-cell dysfunction. Both IR and β-cell function contributed to the development of T2DM in the long term; however, IR remains the initial and long-standing key risk factor for T2DM.
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Affiliation(s)
- X Shen
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - S He
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - J Wang
- Department of Cardiology, Da Qing First Hospital, No. 9 Zhongkang Street, Saltu District, Da Qing, 163411, Heilongjiang, China
| | - X Qian
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - H Wang
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - B Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Y Chen
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - H Li
- Department of Cardiology, Da Qing First Hospital, No. 9 Zhongkang Street, Saltu District, Da Qing, 163411, Heilongjiang, China
| | - Y An
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China
| | - Q Gong
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China.
| | - G Li
- Center of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China.
- Department of Endocrinology, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.
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Chen F, Wang J, Chen X, Yu L, An Y, Gong Q, Chen B, Xie S, Zhang L, Shuai Y, Zhao F, Chen Y, Li G, Zhang B. Development of models to predict 10-30-year cardiovascular disease risk using the Da Qing IGT and diabetes study. Diabetol Metab Syndr 2023; 15:62. [PMID: 36998090 PMCID: PMC10061839 DOI: 10.1186/s13098-023-01039-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND This study aimed to develop cardiovascular disease (CVD) risk equations for Chinese patients with newly diagnosed type 2 diabetes (T2D) to predict 10-, 20-, and 30-year of risk. METHODS Risk equations for forecasting the occurrence of CVD were developed using data from 601 patients with newly diagnosed T2D from the Da Qing IGT and Diabetes Study with a 30-year follow-up. The data were randomly assigned to a training and test data set. In the training data set, Cox proportional hazard regression was used to develop risk equations to predict CVD. Calibration was assessed by the slope and intercept of the line between predicted and observed probabilities of outcomes by quintile of risk, and discrimination was examined using Harrell's C statistic in the test data set. Using the Sankey flow diagram to describe the change of CVD risk over time. RESULTS Over the 30-year follow-up, corresponding to a 10,395 person-year follow-up time, 355 of 601 (59%) patients developed incident CVD; the incidence of CVD in the participants was 34.2 per 1,000 person-years. Age, sex, smoking status, 2-h plasma glucose level of oral glucose tolerance test, and systolic blood pressure were independent predictors. The C statistics of discrimination for the risk equations were 0.748 (95%CI, 0.710-0.782), 0.696 (95%CI, 0.655-0.704), and 0.687 (95%CI, 0.651-0.694) for 10-, 20-, and 30- year CVDs, respectively. The calibration statistics for the CVD risk equations of slope were 0.88 (P = 0.002), 0.89 (P = 0.027), and 0.94 (P = 0.039) for 10-, 20-, and 30-year CVDs, respectively. CONCLUSIONS The risk equations forecast the long-term risk of CVD in patients with newly diagnosed T2D using variables readily available in routine clinical practice. By identifying patients at high risk for long-term CVD, clinicians were able to take the required primary prevention measures.
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Affiliation(s)
- Fei Chen
- Department of Endocrinology, Friendship Hospital, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Xiaoping Chen
- Department of Endocrinology, Friendship Hospital, Beijing, China
| | - Liping Yu
- Department of Endocrinology, Friendship Hospital, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuo Xie
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lihong Zhang
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Shuai
- Department of Endocrinology, Friendship Hospital, Beijing, China
| | - Fang Zhao
- Department of Endocrinology, Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, Friendship Hospital, Beijing, China
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, Friendship Hospital, Beijing, China.
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Wang H, He S, Wang J, An Y, Wang X, Li G, Gong Q. Hyperinsulinemia and plasma glucose level independently associated with all-cause and cardiovascular mortality in Chinese people without diabetes-A post-hoc analysis of the 30-year follow-up of Da Qing diabetes and IGT study. Diabetes Res Clin Pract 2023; 195:110199. [PMID: 36481224 DOI: 10.1016/j.diabres.2022.110199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
AIMS We aimed to characterize the effect of insulin resistance and plasma glucose on all-cause and cardiovascular disease (CVD) death. METHODS A total of 462 individuals without diabetes in the original Da Qing Diabetes and IGT Study were enrolled in the present analysis, and further divided into G1 (low insulin low glucose), G2 (high insulin low glucose), G3 (low insulin high glucose) and G4 (high insulin high glucose) groups according to medians of glucose and insulin level at baseline. The all-cause and CVD death were assessed from 1986 to 2016. RESULTS During the 30-year follow-up, compared with G1, G2, G3, and G4 groups were all at increased death risk after adjusting covariates. G2 and G3 were associated with similar risks in both all-cause (G2: HR 1.65, 95%CI 1.02-2.67; G3: HR 1.76, 95%CI 1.11-2.81) and CVD death (G2: HR 2.03, 95%CI 1.01-4.05; G3: HR 1.85, 95%CI 0.93-3.68). The highest risk was observed in G4 (all-cause death: HR 2.32, 95%CI 1.45-3.69; CVD death: HR 2.68, 95%CI 1.35-5.29). CONCLUSIONS In this post-hoc study, participants with either high glucose or high insulin were related to increased risk of mortality, implying that strategies targeting eliminating both hyperglycemia and hyperinsulinemia may favor the long-term outcomes.
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Affiliation(s)
- Haixu Wang
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyao He
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Yali An
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuan Wang
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; China-Japan Friendship Hospital, Beijing, China
| | - Qiuhong Gong
- Center of Endocrinology, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Qian X, He S, Shen X, Shi N, Gong Q, An Y, Chen Y, Wang J, Li G. Circulating levels of GDF-15 for predicting cardiovascular and cancer morbidity and mortality in type 2 diabetes: Findings from Da Qing IGT and Diabetes Study. Diabetes Metab 2022; 48:101380. [PMID: 35918035 DOI: 10.1016/j.diabet.2022.101380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
AIM To investigate the relationship between circulating growth differentiation factor (GDF-15) levels and the risk of cardiovascular disease and cancer in people with diabetes. METHODS Totally, 510 participants with type 2 diabetes were enrolled from the long-term follow-up of the Da Qing Impaired Glucose Tolerance (IGT) and Diabetes Study (2006-2009). Plasma GDF-15 levels were assessed. Outcomes of cardiovascular events, cancer, and related death were followed up until 2016. RESULTS Over a 7.5-year follow-up period, 143 (28.0%) of the participants died, and 155 and 56 experienced cardiovascular events and cancer respectively. Multivariable Cox analysis showed that higher circulating GDF-15 levels were significantly associated with the increased risk of cardiovascular and cancer death. The HRs after adjustment of traditional confounders were 1.90 (95%CI 1.31-2.74) and 2.50 (95%CI 1.34-4.67) respectively for an increase in one unit of loge transformed GDF-15 (pg/ml). The cause-specific hazard model analysis further confirmed the results after adjusting the same confounders. In addition, the higher GDF-15 levels were also significantly associated with the increased risk of cardiovascular events (HR=1.35, 95%CI: 1.04-1.76) and cancer (HR=1.62, 95%CI 1.06-2.47). CONCLUSIONS Elevated circulating levels of GDF-15 predicted a significant increase in the dual risk of cancer and cardiovascular diseases in Chinese people with type 2 diabetes. Thus, it may be a potential predictor of these outcomes in people with diabetes.
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Affiliation(s)
- Xin Qian
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyao He
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoxia Shen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Shi
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Daqing, China.
| | - Guangwei Li
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
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He S, Wang J, Zhang X, Qian X, Yan S, Wang W, Zhang B, Chen X, An Y, Gong Q, Zhang L, Zhu X, Li H, Chen Y, Li G. Long-term influence of type 2 diabetes and metabolic syndrome on all-cause and cardiovascular death, and microvascular and macrovascular complications in Chinese adults - A 30-year follow-up of the Da Qing diabetes study. Diabetes Res Clin Pract 2022; 191:110048. [PMID: 36029887 DOI: 10.1016/j.diabres.2022.110048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/03/2022] [Accepted: 08/19/2022] [Indexed: 11/27/2022]
Abstract
AIMS To examine the long-term influence of metabolic syndrome (MetS) on death and vascular complications. METHODS Altogether, 1419 individuals with different levels of glycemia and MetS were recruited for this study. The participants were followed up for 30 years to assess outcomes. RESULTS Compared with the non_MetS, individuals with impaired glucose tolerance (IGT) plus MetS had a higher incidence (per 1000 person-years) of all-cause death (20.98 vs 11.70, hazard ratio [HR] = 1.84), macrovascular events (29.25 vs 15.94, HR = 1.36), and microvascular complications (10.66 vs 3.57, HR = 1.96). The incidence of these outcomes was even higher in participants with type 2 diabetes mellitus (T2DM) plus MetS. The T2DM without MetS shared a comparable risk profile of the outcomes with the T2DM plus MetS group (HRs were 3.45 vs 3.15, 2.21 vs 2.65, and 6.91 vs 7.41, respectively). CONCLUSIONS The degree of hyperglycemia in MetS is associated with the severity of death and both micro- and macrovascular complications. T2DM was associated with a comparable risk for all outcomes as T2DM plus MetS. The findings highlight the need of early prevention of diabetes in individuals with IGT plus MetS, while the justification to redefine a subgroup of patients with T2DM as having MetS remains to be clarified.
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Affiliation(s)
- Siyao He
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Xiaoxing Zhang
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Xin Qian
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Shuang Yan
- Department of Endocrinology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenjuan Wang
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bo Zhang
- China-Japan Friendship Hospital, Beijing, China
| | | | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Lihong Zhang
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Xiaolin Zhu
- University of Alabama at Birmingham, Diabetes Research and Training Center, Birmingham, AL 35233, USA
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China
| | - Guangwei Li
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing China; China-Japan Friendship Hospital, Beijing, China.
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Chen Y, Jia H, Qian X, Wang J, Yu M, Gong Q, An Y, Li H, Li S, Shi N, Zou Z, Li G. Erratum. Circulating Palmitoyl Sphingomyelin Is Associated With Cardiovascular Disease in Individuals With Type 2 Diabetes: Findings From the China Da Qing Diabetes Study. Diabetes Care 2022;45:666-673. Diabetes Care 2022; 45:1699. [PMID: 35363277 PMCID: PMC9274221 DOI: 10.2337/dc22-er07a] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Aletaha D, Westhovens R, Atsumi T, Tan Y, Pechonkina A, Gong Q, Rajendran V, Strengholt S, Burmester GR. POS0678 CLINICAL OUTCOMES OF METHOTREXATE (MTX)-NAIVE RHEUMATOID ARTHRITIS (RA) PATIENTS (pts) ON FILGOTINIB (FIL) LONG-TERM EXTENSION (LTE) TRIAL INITIALLY ON FIL OR MTX DURING THE PHASE 3 PARENT STUDY (PS). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe preferential Janus kinase-1 inhibitor FIL is approved for treatment of moderate to severe active RA in Europe and Japan.ObjectivesIn this post hoc, exploratory analysis, efficacy and safety of long-term treatment with FIL (± MTX) were assessed in MTX-naïve pts treated with FIL or MTX in the Phase 3 PS (NCT02886728).1MethodsPts received FIL 200 mg (FIL200)+MTX, FIL 100 mg (FIL100)+MTX, FIL200 alone, or MTX alone up to 52 W in PS.1 Those completing PS on study drug could enter LTE (NCT03025308; data cutoff: June 1, 2020). MTX completers were rerandomized, blinded, to FIL200 or FIL100; pts on FIL in PS remained on the same dose in LTE. MTX was washed out for 4 W at LTE baseline (BL); pts could (re)start MTX and/or other conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) ≥4 W after LTE first dosing.1 Efficacy data to LTE W48 and safety data are reported.ResultsAs of June 1, 2020, 439/492 (89%) and 144/169 (85%) pts who entered LTE from PS FIL200 and PS FIL100 groups, respectively, remained on LTE study treatment; of those rerandomized from MTX, 131/148 (89%) FIL200 and 133/151 (88%) FIL100 pts remained on study treatment. LTE BL characteristics were similar between FIL200 and FIL100 groups. After MTX washout, 17% of FIL200 and 23% of FIL100 pts (re)started MTX (at clinical judgment). ACR20/50/70 response rates among pts from PS FIL arms decreased modestly from LTE BL to W12 then stabilized. Among pts who switched from PS MTX to LTE FIL, response rates remained stable or improved to approach those of PS FIL pts by W48 (Figure 1). Similar trends were seen in DAS28(CRP) and CDAI. Treatment-emergent adverse events (TEAEs), Grade ≥3 AEs, serious AEs, and infections were largely comparable across groups and did not increase after MTX to FIL switch. There were 6 deaths, all among PS FIL200 pts (Table 1).Table 1.EAIRs of TEAEs through June 2020EAIR (95% CI)FIL200+MTX →FIL200 →FIL100+MTX →MTX →MTX →FIL200 LTEFIL200 LTEFIL100 LTEFIL200 LTEFIL100 LTEn=325n=167n=169n=148n=151PYE=474.4PYE=232.5PYE=236.4PYE=213.4PYE=215.4TEAE49.7 (43.8, 56.5)46.9 (38.9, 56.6)49.9 (41.7, 59.8)50.6 (41.9, 61.1)46.4 (38.2, 56.5)TEAE Grade ≥37.2 (5.1, 10.0)6.5 (3.9, 10.7)10.2 (6.8, 15.1)7.0 (4.2, 11.7)7.0 (4.2, 11.6)TE serious AE5.9 (4.1, 8.5)6.0 (3.6, 10.2)8.9 (5.8, 13.6)6.6 (3.9, 11.1)6.5 (3.9, 11.0)Death1.1 (0.3, 2.5)0.4 (0.1, 3.1)0 (0, 1.6)0 (0, 1.7)0 (0, 1.7)Infections28.5 (24.0, 33.7)29.7 (23.4, 37.6)27.5 (21.6, 35.1)28.6 (22.2, 36.7)27.4 (21.2, 35.4)Serious infections1.1 (0.4, 2.5)3.0 (1.4, 6.3)2.5 (1.1, 5.7)1.9 (0.7, 5.0)1.9 (0.7, 4.9)Opportunistic infections0.2 (0, 1.5)0 (0, 1.6)0.8 (0.2, 3.4)0 (0, 1.7)0 (0, 1.7)Herpes zoster0.8 (0.3, 2.2)1.7 (0.6, 4.6)0.8 (0.2, 3.4)1.9 (0.7, 5.0)0.9 (0.2, 3.7)MACE (adjudicated)0.6 (0.1, 1.8)0.9 (0.2, 3.4)0 (0, 1.6)0 (0, 1.7)0 (0, 1.7)VTE (adjudicated for DVT/PE)0.2 (0, 1.2)0.4 (0.1, 3.1)0 (0, 1.6)0 (0, 1.7)0 (0, 1.7)Malignancies (excluding NMSC)0.6 (0.2, 2.0)0 (0, 1.6)1.7 (0.6, 4.5)0.5 (0, 2.6)0 (0, 1.7)NMSC0.6 (0.2, 2.0)0.4 (0.1, 3.1)0.8 (0.2, 3.4)0.5 (0, 2.6)0 (0, 1.7)DVT, deep vein thrombosis; EAIRs, exposure-adjusted incidence rates (per 100 patient-years of exposure); MACE, major adverse cardiovascular event; NMSC, nonmelanoma skin cancer; PE, pulmonary embolism; VTE, venous thromboembolismFigure 1.ConclusionOverall, response rates improved from LTE BL to W48 for pts switched from PS MTX to FIL and decreased modestly for PS FIL pts. Rates of AEs of special interest were generally low and tended to be higher in pts maintained on FIL from PS. Safety findings in this subpopulation were comparable with the PS through W521 and with a 7-trial integrated safety analysis.2 Limitations: the LTE was not formally randomized at BL, the groups were of unequal size, and the switch from MTX to FIL for LTE was by design rather than based on disease activity.References[1]Westhovens R et al. Ann Rheum Dis 2021;80:727–38.[2]Winthrop K et al. Arthritis Rheumatol 2020;72(suppl 10): abstract 0229.AcknowledgementsFunding for the trials was provided by Galapagos NV and Gilead Sciences, Inc. The sponsors participated in the planning, execution, and interpretation of the research. This study was funded by Gilead Sciences, Inc., Foster City, CA. Medical writing support was provided by Gregory Bezkorovainy, MA, of AlphaScientia, LLC, San Francisco, CA; and funded by Gilead Sciences, Inc., Foster City, CA. Funding for this analysis was provided by Gilead Sciences, Inc.Disclosure of InterestsDaniel Aletaha Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Medac, Merck, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sandoz, Sanofi/Genzyme, and UCB, Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, and Sanofi/Genzyme, Grant/research support from: AbbVie, Merck Sharp & Dohme, Novartis, and Roche, Rene Westhovens Consultant of: Celltrion, Galapagos, and Gilead Sciences, Inc., Grant/research support from: Celltrion, Galapagos, and Gilead Sciences, Inc., Tatsuya Atsumi Speakers bureau: AbbVie Inc., Astellas Pharma Inc., Bristol Myers Squibb Co., Chugai Pharmaceutical Co., Ltd, Daiichi Sankyo Co., Ltd, Eisai Co. Ltd, Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co., Ltd, Pfizer Inc., Takeda Pharmaceutical Co., Ltd, UCB Japan Co. Ltd, Consultant of: AbbVie Inc., Chugai Pharmaceutical Co., Ltd, Daiichi Sankyo Co., Ltd, Eli Lilly Japan K.K., Gilead Sciences, Inc., Pfizer Inc., UCB Japan Co. Ltd, Grant/research support from: AbbVie Inc., Alexion Pharmaceuticals, Inc., Astellas Pharma Inc., Bristol Myers Squibb Co., Chugai Pharmaceutical Co., Ltd, Daiichi Sankyo Co., Ltd, Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Pfizer Inc., YingMeei Tan Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Qi Gong Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Vijay Rajendran Shareholder of: Galapagos NV, Employee of: Galapagos NV, Sander Strengholt Shareholder of: Galapagos BV, Employee of: Galapagos BV, Gerd Rüdiger Burmester Speakers bureau: AbbVie, Eli Lilly, Gilead Sciences, Inc. and Pfizer, Consultant of: AbbVie, Eli Lilly, Gilead Sciences, Inc. and Pfizer
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Buch MH, Takeuchi T, Rajendran V, Gottenberg JE, Pechonkina A, Tan Y, Gong Q, Van Beneden K, Caporali R. AB0394 CLINICAL OUTCOMES UP TO WEEK 48 OF ONGOING FILGOTINIB (FIL) RHEUMATOID ARTHRITIS (RA) LONG-TERM EXTENSION (LTE) TRIAL OF BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUG (bDMARD) INADEQUATE RESPONDERS (IR) INITIALLY ON FIL OR PLACEBO IN A PHASE 3 PARENT STUDY (PS). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe preferential Janus kinase-1 inhibitor FIL is approved for treatment of moderate to severe active RA in Europe and Japan.ObjectivesEfficacy and safety of FIL were assessed in patients (pts) with IR to bDMARDs in a LTE trial (NCT03025308) enrolled from a Phase 3 PS (NCT02873936).1MethodsbDMARD-IR pts received FIL 200 mg (FIL200), FIL 100 mg (FIL100), or placebo (PBO), all with stable conventional synthetic (cs)DMARDs up to 24 weeks (W). At W14 of the PS, pts with IR to FIL or PBO (<20% improvement in swollen [66] and tender [68] joint counts) switched to standard of care (SOC; investigator’s choice of treatment). Pts completing the PS on FIL, PBO, or SOC could enter the LTE. PS FIL pts were maintained, blinded, on their FIL dose; PS PBO and PS SOC pts were rerandomized, blinded, to FIL200 or FIL100. Efficacy data to LTE W48 and safety data to data cutoff (June 1, 2020) are reported.ResultsThe PS included 147, 153, and 148 pts on FIL200, FIL100, and PBO. Pts continuing on LTE FIL200 and FIL100 at data cutoff: 80/121 (66%) and 76/110 (69%) from PS FIL200 and FIL100; 35/47 (75%) and 32/46 (70%) from PS PBO, and 13/23 (57%) and 13/22 (59%) from PS SOC. LTE baseline (BL) characteristics were similar in FIL200 and FIL100 pts. During LTE, PS FIL ACR20/50/70 response rates decreased modestly by W48 (Figure 1). Among PS PBO pts, response rates were lower at LTE BL, reaching similar levels to PS FIL pts by W48; rates increased to W48 in PS SOC pts on either FIL dose but not to levels of other groups. Percentages of pts attaining DAS28(CRP) ≤3.2, DAS28(CRP) <2.6, CDAI ≤10, and CDAI ≤2.8 were maintained up to W48 for FIL/FIL pts. PBO/FIL and SOC/FIL pts showed similar patterns to ACR responses (Figure 1). Exposure-adjusted incidence rates (EAIRs)/100 pt-years of exposure for treatment-emergent adverse events (TEAE), serious AEs, and serious infection were higher in SOC/FIL pts vs FIL/FIL or PBO/FIL pts, but samples were small and confidence intervals overlapped. There were 5 deaths (Table 1).Table 1.EAIRs of TEAEs in LTE, as of June 1, 2020EAIR (95% CI)FIL200+csD → FIL200+csD n=121PYE 228.4PBO+csD → FIL200+csD n=47PYE 98.1SOC+csD → FIL200+csD n=23PYE 42.1FIL100+csD → FIL100+csD n=110PYE 223.3PBO+csD → FIL100+csD n=46PYE 91.1SOC+csD → FIL100+csD n=22PYE 38.2TEAE46.9 (38.8, 56.6)38.7 (28.2, 53.2)52.2 (34.4, 79.3)40.3 (32.8, 49.5)40.6 (29.4, 56.1)49.8 (31.8, 78.0)TEAE Grade ≥310.5 (7.0, 15.7)10.2 (5.5, 18.9)19.0 (9.5, 38.0)10.3 (6.8, 15.5)13.2 (7.5, 23.2)18.3 (8.7, 38.5)TE serious AE12.3 (8.5, 17.8)12.2 (6.9, 21.5)21.4 (11.1, 41.1)8.1 (5.1, 12.8)13.2 (7.5, 23.2)21.0 (10.5, 41.9)Death1.3 (0.4, 4.1)1.0 (0, 5.7)0 (0, 8.8)0.4 (0.1, 3.2)0 (0, 4.0)0 (0, 9.7)TE infections34.2 (27.4, 42.6)22.4 (14.8, 34.1)35.6 (21.5, 59.1)22.4 (17.0, 29.5)26.3 (17.7, 39.3)39.3 (23.7, 65.2)TE serious infections3.5 (1.8, 7.0)2.0 (0.5, 8.2)7.1 (2.3, 22.1)0.9 (0.2, 3.6)2.2 (0.5, 8.8)7.9 (2.5, 24.4)Opportunistic infections0 (0, 1.6)0 (0, 3.8)0 (0, 8.8)0 (0, 1.7)0 (0, 4.0)0 (0, 9.7)TE herpes zoster2.2 (0.7, 5.1)1.0 (0.1, 7.2)0 (0, 8.8)0 (0, 1.7)2.2 (0.5, 8.8)2.6 (0.1, 14.6)TE MACE (adjudicated)1.3 (0.4, 4.1)1.0 (0.1, 7.2)0 (0, 8.8)0.9 (0.2, 3.6)1.1 (0.2, 7.8)0 (0, 9.7)TE DVT/PE (adjudicated)0.9 (0.2, 3.5)0 (0, 3.8)2.4 (0.1, 13.2)0.4 (0.1, 3.2)0 (0, 4.0)0 (0, 9.7)Malignancies (excluding NMSC)1.3 (0.4, 4.1)3.1 (1.0, 9.5)4.7 (0.6, 17.2)1.8 (0.7, 4.8)3.3 (1.1, 10.2)0 (0, 9.7)NMSC0 (0, 1.6)0 (0, 3.8)4.7 (0.6, 17.2)0 (0, 1.7)0 (0, 4.0)0 (0, 9.7)DVT, deep vein thrombosis; MACE, major adverse cardiovascular event; NMSC, nonmelanoma skin cancer; PE, pulmonary embolism; TE, treatment-emergentConclusionEfficacy was mostly maintained in PS FIL pts up to W48. Response among PS PBO and SOC pts increased from BL to W48, but response in PS SOC pts continued to be lower than in other groups; these pts may represent a refractory population. FIL safety was largely consistent between PS and LTE.References[1]Genovese MC et al. JAMA 2019;322:315–25.AcknowledgementsThis study was funded by Gilead Sciences, Inc., Foster City, CA. Medical writing support was provided by Claudine Bitel, PhD, of AlphaScientia, LLC, San Francisco, CA; and funded by Gilead Sciences, Inc., Foster City, CA.Disclosure of InterestsMaya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Galapagos, Gilead, and Pfizer, Grant/research support from: Gilead and Pfizer, Tsutomu Takeuchi Speakers bureau: AbbVie, AYUMI, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Dainippon Sumitomo, Eisai, Eli Lilly Japan, Gilead Sciences, Mitsubishi-Tanabe, Novartis, Pfizer Japan, and Sanofi, Consultant of: Astellas, Chugai, and Eli Lilly Japan, Grant/research support from: AbbVie, Asahi Kasei, Astellas, Chugai, Daiichi Sankyo, Eisai, Mitsubishi-Tanabe, Shionogi, Takeda, and UCB Japan, Vijay Rajendran Shareholder of: Galapagos, Employee of: Galapagos, Jacques-Eric Gottenberg Speakers bureau: AbbVie, Eli Lilly and Co., Galapagos, Gilead Sciences, Inc., Roche, Sanofi Genzyme, and UCB, Consultant of: Bristol Myers Squibb, Sanofi Genzyme, and UCB, Grant/research support from: Bristol Myers Squibb and Pfizer, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., YingMeei Tan Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Qi Gong Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Katrien Van Beneden Shareholder of: Galapagos, Employee of: Galapagos, Roberto Caporali Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, and UCB, Consultant of: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, Fresenius-Kabi, MSD, Novartis, Pfizer, Roche, Sandoz, and UCB
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Combe B, Tanaka Y, Emery P, Pechonkina A, Kuo A, Gong Q, Van Beneden K, Rajendran V, Schulze-Koops H. POS0679 CLINICAL OUTCOMES UP TO WEEK (W) 48 IN THE ONGOING FILGOTINIB (FIL) LONG-TERM EXTENSION (LTE) TRIAL OF RHEUMATOID ARTHRITIS (RA) PATIENTS (pts) WITH INADEQUATE RESPONSE (IR) TO METHOTREXATE (MTX) INITIALLY TREATED WITH FIL OR ADALIMUMAB (ADA) DURING THE PHASE 3 PARENT STUDY (PS). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe preferential Janus kinase-1 inhibitor FIL is approved for treatment of moderate to severe active RA in Europe and Japan.ObjectivesEfficacy and safety of FIL were assessed in pts with IR to MTX who completed a Phase 3 trial (NCT02889796)1 and enrolled in an LTE (NCT03025308).MethodsPts completing the PS1 on study drug were eligible to enter the LTE (data cutoff: June 1, 2020). Median exposure: 2.2 years (y). Efficacy data to W48 are reported for 4 treatment groups (all with background MTX): pts receiving FIL 200 mg (FIL200) or FIL 100 mg (FIL100) in the PS and continuing their dose in LTE (FIL200/FIL200, FIL100/FIL100) and ADA pts rerandomized, double blind, to FIL200 or FIL100 for LTE (ADA/FIL200, ADA/FIL100); safety data are reported.ResultsAs of June 1, 2020, 522/571 (91%) FIL200/FIL200, 502/570 (88%) FIL100/FIL100, 118/128 (92%) ADA/FIL200, and 115/130 (89%) ADA/FIL100 pts remained on study drug. LTE baseline disease characteristics were similar between groups: mean duration of RA approximately 8.7 y; DAS28(CRP) 2.55, and mean concurrent MTX dosage was 15.0 mg/week. Proportions of pts achieving ACR20/50/70, DAS28(CRP) ≤3.2, <2.6, and CDAI ≤10, ≤2.8 were generally maintained in all LTE groups through W48 (Figure 1). Numerically greater proportions of pts met response criteria at W48 in the FIL200 groups vs FIL100, regardless of PS treatment. Treatment-emergent AEs (TEAE), serious AEs, and AEs Grade ≥3 were largely comparable between groups and lowest in ADA/FIL100. There were 10 deaths (Table 1). Exposure-adjusted incidence rates (EAIRs)/100 pt-y of exposure for deaths were lower for FIL/FIL vs ADA/FIL.Table 1.EAIRs of TEAEs in LTE, as of June 1, 20201TEAE, n (%)3FIL200+MTX → FIL200+MTX6ADA+MTX → FIL200+MTX9FIL100+MTX → FIL100+MTX12ADA+MTX → FIL100+MTX2EAIR (95% CI)4n=5717n=12810n=57013n=1305PYE=859.48PYE=197.811PYE=852.314PYE=192.6TEAE429 (75.1)91 (71.1)443 (77.7)88 (67.7)49.9 (45.4, 54.9)46.0 (37.5, 56.5)52.0 (47.4, 57.0)45.7 (37.1, 56.3)TEAE Grade ≥364 (11.2)15 (11.7)72 (12.6)7 (5.4)7.4 (5.8, 9.5)7.6 (4.6, 12.6)8.4 (6.7, 10.6)3.6 (1.7, 7.6)TE serious AE52 (9.1)13 (10.2)60 (10.5)9 (6.9)6.1 (4.6, 7.9)6.6 (3.8, 11.3)7.0 (5.5, 9.1)4.7 (2.4, 9.0)Death3 (0.5)2 (1.6)3 (0.5)2 (1.5)0.3 (0.1, 1.1)1.0 (0.3, 4.0)0.4 (0.1, 1.1)1.0 (0.3, 4.2)TE infections243 (42.6)52 (40.6)249 (43.7)43 (33.1)28.3 (24.9, 32.1)26.3 (20.0, 34.5)29.2 (25.8, 33.1)22.3 (16.6, 30.1)TE serious infections7 (1.2)2 (1.6)13 (2.3)1 (0.8)0.8 (0.4, 1.7)1.0 (0.3, 4.0)1.5 (0.9, 2.6)0.5 (0.1, 3.7)Opportunistic infections2 (0.4)02 (0.4)00.2 (0, 0.8)0 (0, 1.9)0.2 (0, 0.8)0 (0, 1.9)TE herpes zoster16 (2.8)5 (3.9)13 (2.3)1 (0.8)1.9 (1.1, 3.0)2.5 (1.1,6.1)1.5 (0.9, 2.6)0.5 (0.1, 3.7)TE MACE (adjudicated)1 (0.2)03 (0.5)3 (2.3)01 (0, 0.6)0 (0, 1.9)0.4 (0.1, 1.1)1.6 (0.5, 4.8)TE DVT/PE (adjudicated)3 (0.5)03 (0.5)00.3 (0.1, 1.0)0 (0, 1.9)0.4 (0.1, 1.0)0 (0, 1.9)Malignancies (excluding NMSC)5 (0.9)3 (2.3)4 (0.7)00.6 (0.2, 1.4)1.5 (0.5, 4.7)0.5 (0.1, 1.2)0 (0, 1.9)NMSC3 (0.5)02 (0.4)00.3 (0.1, 1.0)0 (0, 1.9)0.2 (0, 0.8)0 (0, 1.9)DVT, deep vein thrombosis; MACE, major adverse cardiovascular event; NMSC, nonmelanoma skin cancer; PE, pulmonary embolism; TE, treatment-emergentFigure 1.ConclusionDuring the LTE through W48, response rates generally were maintained for FIL/FIL and ADA/FIL pts. Though there were differences between LTE groups, safety was largely comparable and consistent with PS observations1 and previously reported results from 7 trials2: rates of AEs of special interest were low; all confidence intervals were overlapping. Limitation: the LTE was not formally randomized for comparison between FIL/FIL and ADA/FIL treatment groups, the groups were of unequal size, and the switch from ADA to FIL for LTE was by design, rather than based on disease activity.References[1]Combe B et al. Ann Rheum Dis 2021;80:848–58.[2]Winthrop K et al. Arthritis Rheumatol 2020;72(suppl 10); abstract 0229.AcknowledgementsThis study was funded by Gilead Sciences, Inc., Foster City, CA. Medical writing support was provided by Claudine Bitel, PhD, of AlphaScientia, LLC, San Francisco, CA; and funded by Gilead Sciences, Inc., Foster City, CA.Disclosure of InterestsBernard Combe Speakers bureau: BMS, Eli Lilly & Co., Gilead Sciences, Inc., MSD, Pfizer, Roche-Chugai, and UCB, Consultant of: AbbVie, Eli Lilly & Co., Gilead Sciences, Inc., Janssen, Pfizer, Roche-Chugai, and Sanofi, Grant/research support from: Novartis, Pfizer, and Roche-Chugai, Yoshiya Tanaka Speakers bureau: AbbVie, Asahi-Kasei, Astellas, Bristol-Myers, Chugai, Daiichi- Sankyo, Eli Lilly, Eisai, Gilead, GSK, Janssen, Mitsubishi-Tanabe, Novartis, Pfizer, Sanofi, and YL Biologics, Consultant of: AbbVie, Ayumi, Daiichi- Sankyo, Eli Lilly, GSK, Sanofi, and Taisho, Grant/research support from: AbbVie, Asahi-Kasei, Chugai, Daiichi-Sankyo, Eisai, Mitsubishi-Tanabe, and Takeda, Paul Emery Consultant of: AbbVie, BMS, Celltrion, Gilead, Lilly, Novartis, Roche, Samsung, and Sandoz, Grant/research support from: AbbVie, BMS, Lilly, and Samsung, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Albert Kuo Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Qi Gong Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Katrien Van Beneden Shareholder of: Galapagos NV, Employee of: Galapagos NV, Vijay Rajendran Shareholder of: Galapagos NV, Employee of: Galapagos NV, Hendrik Schulze-Koops Speakers bureau: AbbVie, Amgen, BMS, Celgene, Celltrion, Chugai, Gilead, Janssen, Eli Lilly and Company, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, Roche, and Sanofi, Consultant of: AbbVie, Amgen, BMS, Celgene, Celltrion, Chugai, Gilead, Janssen, Eli Lilly and Company, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, Roche, and Sanofi, Grant/research support from: AbbVie and Novartis
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You W, Luo L, Li Q, Wang Y, Wang Y, Gong Q, Li F. Altered dynamic functional topology in first-episode untreated patients with schizophrenia can aid in early diagnosis. Eur Psychiatry 2022. [PMCID: PMC9564955 DOI: 10.1192/j.eurpsy.2022.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction There is a growing consensus on brain networks that it is not immutable but rather a dynamic complex system for adapting environment. The neuroimaging research studying how brain regions work collaboratively with dynamic methods had demonstrated its effectiveness in revealing the neural mechanisms of schizophrenia. Objectives To investigate altered dynamic brain functional topology in first-episode untreated schizophrenia patients (SZs) and establish classification models to find objective brain imaging biomarkers. Methods Resting-state-functional magnetic resonance data for SZs and matched healthy controls were obtained(Table1). ![]()
Power-264-template was used to extract nodes and sliding-window approach was carried out to establish functional connectivity matrices. Functional topology was assessed by eigenvector centrality(EC) and node efficiency and its time-fluctuating was evaluated with coefficient of variation(CV). Group differences of dynamic topology and correlation analysis between Positive and Negative Syndrome Scale(PANSS) scores and topology indices showing group differences, which also were used in establishing classification models, was examed. Results The CV of node efficiency in angular and paracingulate gyrus was larger in SZs. There are 13 nodes assigned into several brain networks displaying altered CV of EC between groups(Figure1.A). Fluctuation of EC of the node in DMN, which was lower in SZs, showed negative correlation with PANSS total scores(Figure1.B). Dynamic functional topology of above nodes was used to train classification models and demonstrated 80% and 71% accuracy for support vector classification(SVC) and random forest(RF), respectively(Figure2). ![]()
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Conclusions Dynamic functional topology illustrated a capability in identifying SZs. Aberrated dynamics of DMN relevant to severity of patient’s symptoms could reveal the reason why it contributed to classification. Disclosure No significant relationships.
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Li Q, Luo L, You W, Wang Y, Wang Y, Gong Q, Li F. Brain controllability and clinical relevance in schizophrenia. Eur Psychiatry 2022. [PMCID: PMC9566872 DOI: 10.1192/j.eurpsy.2022.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Apart from the psychiatric symptoms, cognitive deficits are also the core symptoms of schizophrenia. Brain network control theory provided information on the role of a specific brain region in the cognitive control process, helping understand the neural mechanism of cognitive impairment in schizophrenia.
Objectives
To characterize the control properties of functional brain network in first-episode untreated patients with schizophrenia and the relationships between controllability and psychiatric symptoms, as well as exploring the predictive value of controllability in differentiating patients from healthy controls (HCs).
Methods
Average and modal controllability of brain networks were calculated and compared between 133 first-episode untreated patients with schizophrenia and 135 HCs. The associations between controllability and clinical symptoms were evaluated using sparse canonical correlation analysis. Support vector machine (SVM) and SVM-recursive feature elimination combined with the controllability were performed to establish the individual prediction model.
Results
Compared to HCs, the patients with schizophrenia showed increased average controllability and decreased modal controllability in dorsal anterior cingulate cortex (dACC). Brain controllability predominantly in somatomotor, default mode, and visual networks was associated with the positive symptomatology of schizophrenia. The established model could identify patients with an accuracy of 0.68. Furthermore, the most discriminative features were located in dACC, medial prefrontal lobe, precuneus and superior temporal gyrus.
Conclusions
Altered controllability in dACC may play a critical role in the neuropathological mechanisms of cognitive deficit in schizophrenia, which could drive the brain function to different states to cope with varied cognitive tasks. As symptom-related biomarkers, controllability could be also beneficial to individual prediction in schizophrenia.
Disclosure
No significant relationships.
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Zhang X, Wang S, Gong Q. Gray Matter Deficits of Cortical-striatal-limbic Circuit in Social Anxiety Disorder. Eur Psychiatry 2022. [PMCID: PMC9567801 DOI: 10.1192/j.eurpsy.2022.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The extant findings have been of great heterogeneity due to partial volume effects in the investigation of cortical gray matter volume (GMV), high comorbidity with other psychiatric disorders, and concomitant therapy in the neuroimaging studies of social anxiety disorder (SAD). Objectives
To identity gray matter deficits in cortical and subcortical structures in non-comorbid never-treated patients, so as to explore the “pure” SAD-specific pathophysiology and neurobiology. Methods
Thirty-two non-comorbid free-of-treatment patients with SAD and 32 demography-matched healthy controls were recruited to undergo high-resolution 3.0-Tesla T1-weighted MRI. Cortical thickness (CT) and subcortical GMV were estimated using FreeSurfer; then the whole-brain vertex-wise analysis was performed to compare group differences in CT. Besides, differences in subcortical GMV of priori selected regions-of-interest: amygdala, hippocampus, putamen, and pallidum were compared by an analysis of covariance with age, gender, and total subcortical GMV as covariates. Results The SAD patients demonstrated significantly decreased CT near-symmetrically in the bilateral prefrontal cortex (Monte Carlo simulations of P < 0.05). Besides, smaller GMV in the left hippocampus and pallidum were also observed in the SAD cohort (two-sample t-test of P < 0.05). Conclusions For the first time, the current study investigated the structural alterations of CT and subcortical GMV in non-comorbid never-treated patients with SAD. Our findings provide preliminary evidences that structural deficits in cortical-striatal-limbic circuit may contribute to the psychopathological basis of SAD, and offer more detailed structural substrates for the involvement of such aberrant circuit in the imbalance between defective bottom-up response and top-down control to external stimuli in SAD. Disclosure No significant relationships.
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Chen Y, Jia H, Qian X, Wang J, Yu M, Gong Q, An Y, Li H, Li S, Shi N, Zou Z, Li G. Circulating Palmitoyl Sphingomyelin Is Associated With Cardiovascular Disease in Individuals With Type 2 Diabetes: Findings From the China Da Qing Diabetes Study. Diabetes Care 2022; 45:666-673. [PMID: 35165706 PMCID: PMC8918230 DOI: 10.2337/dc21-1520] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/05/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association of potential cardiovascular disease (CVD) biomarkers in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We enrolled 120 participants (aged 61.5-69.5 years) with type 2 diabetes and 60 (aged 62.5-73.5 years) with normal glucose tolerance in the discovery group from the original Da Qing Diabetes Study. Their diabetes status was confirmed in 1986; then, the participants were followed over 23 years to collect CVD outcome data. Untargeted and targeted metabolomics analyses based on ultra-high-performance liquid chromatography-tandem mass spectrometry were used to identify potential markers. Multivariable regression analysis was used to evaluate the association between metabolites and CVD outcomes. An independent group of 335 patients (aged 67.0-77.0 years) with diabetes was used for biomarker validation. RESULTS In the discovery group, untargeted metabolomics analysis found 16 lipids and fatty acids metabolites associated with CVD risk in patients with diabetes, with palmitoyl sphingomyelin (PSM) having the strongest association. Plasma PSM concentrations were significantly higher in cases of diabetes with CVD than without (41.68 ± 10.47 vs. 9.69 ± 1.47 μg/mL; P < 0.0001). The odds ratio (OR) of CVD for 1 µg/mL PSM change was 1.19 (95% CI 1.13-1.25) after adjustment of clinical confounders. The validation study confirmed that PSM was significantly associated with increased CVD risk in diabetes (OR 1.22 [95% CI 1.16-1.30]). CONCLUSIONS Changes in lipid and fatty acid content were significantly associated with CVD risk in the Chinese population with diabetes. PSM is a potential biomarker of increased CVD risk in diabetes.
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Affiliation(s)
- Yanyan Chen
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, Guangdong, China
| | - Hongmei Jia
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Qian
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Meng Yu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuhong Gong
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Sidong Li
- Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Na Shi
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhongmei Zou
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Endocrinology Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Endocrinology, China-Japan Friendship Hospital, Beijing
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Gong Q, Zhang P, Wang J, Gregg EW, Cheng YJ, Li G, Bennett PH. Efficacy of lifestyle intervention in adults with impaired glucose tolerance with and without impaired fasting plasma glucose: A post hoc analysis of Da Qing Diabetes Prevention Outcome Study. Diabetes Obes Metab 2021; 23:2385-2394. [PMID: 34212465 PMCID: PMC8429240 DOI: 10.1111/dom.14481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/04/2021] [Accepted: 06/27/2021] [Indexed: 12/28/2022]
Abstract
AIMS The extent that pre-diabetic fasting plasma glucose (FPG) levels influence the effectiveness of lifestyle interventions in preventing type 2 diabetes (T2DM) is uncertain. We aimed to determine if the outcome of lifestyle intervention in people with impaired glucose tolerance (IGT) differs in those with normal or impaired FPG levels. MATERIALS AND METHODS Data were used from the Da Qing Diabetes Prevention Outcome Study, which was a 30-year follow-up of a 6-year randomized trial of lifestyle intervention in 576 people with IGT. We then conducted a post-hoc analysis to compare the efficacy of intervention to reduce the incidence of T2DM and its complications in those with baseline FPG <100 mg/dL and FPG ≥100 mg/dL. RESULTS Lifestyle intervention reduced the cumulative incidence of T2DM by 37%-46% in those with baseline FPG <100 mg/dL and by 47%-51% in those with FPG ≥100 mg/dL. The FPG <100 mg/dL group had a lower cumulative incidence of diabetes and 6.41 years median delay in its onset compared with 2.21 years delay in the FPG ≥100 mg/dL group. In those with FPG <100 mg/dL intervention was associated with at least as great a reduction in cardiovascular disease and all-cause mortality as in the FPG ≥100 mg/dL group. CONCLUSIONS Lifestyle intervention reduced the incidence of T2DM in people with IGT regardless of baseline FPG levels, and in those with FPG <100 mg/dL led to a substantial delay in its onset. All persons with IGT, with normal or impaired FPG levels, may benefit from lifestyle intervention to delay its onset and mitigate the incidence of T2DM.
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Affiliation(s)
- Qiuhong Gong
- Endocrinology and Cardiovascular Disease Center, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Edward W. Gregg
- Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Yiling J. Cheng
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Guangwei Li
- Endocrinology and Cardiovascular Disease Center, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- China–Japan Friendship Hospital, Beijing, China
| | - Peter H. Bennett
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
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Wang Y, Liao MQ, Wang YH, Gong Q, Xu W, Wang M, Zhang YN, Wang JF. Application of Sarcosaprophagous Insects to Estimate the Postmortem Interval in 11 Cases. Fa Yi Xue Za Zhi 2021; 37:332-337. [PMID: 34379901 DOI: 10.12116/j.issn.1004-5619.2021.410201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Indexed: 11/30/2022]
Abstract
Abstract Objective To test the feasibility and accuracy of with sarcosaprophagous insects postmortem interval (PMI) estimation with sarcosaprophagous insects and provide references for estimation practice. Methods Eleven cases confirmed by the detection results, with complete entomological evidence were selected. The insect species, estimation results and true results involved in the cases were statistically analyzed and compared. Results Thirteen species of insects were found at the criminal scene, including Chrysomya megacephala (Fabricius), Chrysomya rufifacies (Macquart), Chrysomya nigripes (Aubertin), Lucilia sericata (Meigen), Hydrotaea spinigera Stein, Muscina stabulans (Fallén), Sarcophagid (species were not identified), Megaselia scalaris (Loew), Hermetia illucens (Linnaeus), Saprinus splendens (Paykull), Creophilus maxillosus (Linnaeus), Dermestes maculatus (De Geer) and Necrobia ruficollis (Fabricius). The PMI of all eleven cases was within the range of estimated PMI. The estimated results of 72.73% cases were on the same day of the true results. Conclusion Sarcosaprophagous insects can estimate the PMI simply and conveniently. In cases where the PMI is within the time range of one generation of flies or beetles, the estimation results are relatively accurate. However, the estimation is less accurate when the PMI is beyond the time range.
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Affiliation(s)
- Y Wang
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
| | - M Q Liao
- Zhongshan Public Security Bureau, Zhongshan 510080, Guangdong Province, China
| | - Y H Wang
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Q Gong
- Criminal Investigation Brigade of Chongqing Public Security Bureau, Chongqing 400070, China
| | - W Xu
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
| | - M Wang
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Y N Zhang
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
| | - J F Wang
- Department of Forensic Medicine, Soochow University, Suzhou 215000, Jiangsu Province, China
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Yang CH, Qi WL, Zhao CW, Cai WJ, Gong Q, Niu JY, Zhao WH, Xu L. Parecoxib prevents nucleus pulposus cells apoptosis by suppressing endoplasmic reticulum stress. Eur Rev Med Pharmacol Sci 2021; 24:11295-11304. [PMID: 33215449 DOI: 10.26355/eurrev_202011_23619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Intervertebral disc degeneration (IVDD) is the main cause of spine diseases, and apoptosis of nucleus pulposus (NP) cells is an important risk factor for the degeneration of intervertebral discs. Endoplasmic reticulum (ER) stress is involved in multiple apoptosis processes. This study investigated whether the specific COX-2 inhibitor parecoxib can inhibit NP cell apoptosis induced by ER stress. PATIENTS AND METHODS Human NP cells were isolated from the disc tissue collected from IVDD patients. We used IL-1β to establish an NP cell degenerated model. Degenerated levels were detected by the analysis of cell viability, collagen II, collagen X, aggrecan, TNF-α, IL-6, and MMP-13 expression. ER stress status was examined by GRP78 and CHOP expression. Apoptosis level was mainly indicated by the positive apoptotic cells and caspase-12 expression. CHOP-plasmid transfection was performed to overexpress the CHOP protein level. RESULTS IL-1β could induce the decrease of viability, collagen Ⅱ, aggrecan, but an increase of collagen X, TNF-α, IL-6, and MMP-13 in NP cells, as well as the upregulation of GRP78/PERK/caspase-12 and apoptosis level, which could be inhibited by parecoxib. Parecoxib could also suppress CHOP caused by COX-2 upregulation and apoptosis in NP cells. CONCLUSIONS Parecoxib is a safe and efficient COX-2 inhibitor to NP cells, which could prevent NP cells apoptosis by suppressing ER stress.
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Affiliation(s)
- C-H Yang
- Department of Orthopedics, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China.
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Anderson K, Nelson C, Gong Q, Alani M, Tarnowski T, Othman AA. AB0259 EVALUATION OF THE EFFECT OF FILGOTINIB ON THE PHARMACOKINETICS OF ROSUVASTATIN, ATORVASTATIN, AND PRAVASTATIN. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Filgotinib is an orally administered small molecule that preferentially inhibits Janus kinase 1 and is approved for use in Europe and Japan in adult patients with rheumatoid arthritis (RA) who have had an inadequate response to conventional therapies. Patients with RA are at a higher risk of cardiovascular morbidity and mortality relative to the general population1. Thus, it is important to understand potential drug-drug interactions of filgotinib with lipid-lowering agents such as statins. Based on in vitro studies, filgotinib is not expected to significantly increase exposure of statins via inhibition of the organic anion transporting peptide (OATP) at clinically relevant exposures. Hence, in Phase 2 and Phase 3 clinical studies, statins were allowed for use with filgotinib. A post-hoc analysis showed no increase in statin-induced AEs such as muscle or liver toxicities when statins were coadministered with filgotinib (“Concomitant Use of Statins in Filgotinib-Treated Patients with Rheumatoid Arthritis: A Post Hoc Analysis”, submitted to EULAR 2021).Objectives:The objectives of this study (NCT04608344) were to evaluate the effect of filgotinib on the pharmacokinetics of atorvastatin, pravastatin, and rosuvastatin, which are sensitive substrates for the OATP-1B1/1B3, and the short-term safety of administering filgotinib with or without statins.Methods:This was an open-label, randomized, two-way, crossover study in healthy adult volunteers (n = 27). Study participants received a single dose of atorvastatin (ATV 40 mg) and a single dose of a cocktail of pravastatin (PRA 40 mg)/rosuvastatin (ROS 10 mg), on two different occasions with washout in between, alone or in combination with filgotinib (200 mg QD for 11 days). Serial pharmacokinetic sampling was performed and pharmacokinetic parameters for each statin were calculated. Safety was assessed throughout the study. An analysis of variance using a mixed-effects model was applied to the natural logarithmic transformation of pharmacokinetic parameters (Cmax and AUCinf) for ATV, 2-OH-ATV (active metabolite of ATV), PRA, and ROS. Geometric-least squares means (GLSM) ratios and 90% confidence intervals (90% CI) of pharmacokinetic parameters were estimated for each analyte and were compared against pre-specified lack of pharmacokinetic alteration boundaries of 70 to 143%.Results:Of the 27 enrolled participants, 25 participants completed all study treatments. Most AEs and laboratory abnormalities were Grade 1 or 2 in severity; 1 participant discontinued due to a Grade 3 increase in creatine kinase and 1 participant discontinued due to difficulty in blood draws. Following coadministration of filgotinib with ATV, relative to ATV alone, ATV AUCinf was unaffected (GLSM ratio (90% CI): 0.91 (0.84, 0.99)), but ATV Cmax was slightly reduced (GLSM ratio (90% CI): 0.82 (0.69, 0.98)). 2-OH-ATV exposure (Cmax and AUCinf) were unaffected (GLSM ratio (90% CI): 0.98 (0.81, 1.18) for Cmax and 1.12 (1.02, 1.22) for AUCinf), and were within the pre-specified lack-of-effect bounds. Following coadministration with filgotinib, PRA AUCinf was unaffected (GLSM ratio (90% CI): 1.22 (1.06, 1.42)), but PRA Cmax was slightly higher (1.25 (1.01, 1.54)). ROS exposure (Cmax and AUCinf) were moderately higher upon coadministration with filgotinib (GLSM ratio (90% CI): 1.68 (1.43, 1.97) for Cmax and 1.42 (1.30, 1.56) for AUCinf), and these changes in rosuvastatin exposure are not considered to be clinically relevant.Conclusion:All study treatments were generally well tolerated. Co-administration with filgotinib did not have a clinically meaningful impact on the exposure of ATV, PRA, and ROS. These data support concomitant use of filgotinib with OATP substrates such as statins.References:[1]Piepoli MF, Hoes AW, Agewall S, et al. Eur Heart J. 2016;37(29): 2315-2381.Disclosure of Interests:Kacey Anderson Shareholder of: Gilead Sciences, Employee of: Gilead Sciences, Cara Nelson Shareholder of: Gilead Sciences, Employee of: Gilead Sciences, Qi Gong Shareholder of: Gilead Sciences, Employee of: Gilead Sciences, Muhsen Alani Shareholder of: Gilead Sciences, Employee of: Gilead Sciences, Thomas Tarnowski Shareholder of: Gilead Sciences, Employee of: Gilead Sciences, Ahmed A. Othman Shareholder of: Gilead Sciences, Employee of: Gilead Sciences
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Chen Y, Zhang P, Wang J, Gong Q, An Y, Qian X, Zhang B, Li H, Gregg EW, Bennett PH, Li G. Associations of progression to diabetes and regression to normal glucose tolerance with development of cardiovascular and microvascular disease among people with impaired glucose tolerance: a secondary analysis of the 30 year Da Qing Diabetes Prevention Outcome Study. Diabetologia 2021; 64:1279-1287. [PMID: 33608769 DOI: 10.1007/s00125-021-05401-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/04/2020] [Indexed: 02/04/2023]
Abstract
AIMS/HYPOTHESIS We aimed to determine associations of regression to normal glucose tolerance (NGT), maintaining impaired glucose tolerance (IGT) or progression to diabetes with subsequent risks of CVD and microvascular disease among Chinese adults with IGT. METHODS We conducted an observational study among 540 participants in the Da Qing Diabetes Prevention Study, a 6 year lifestyle intervention trial in people with IGT, defined by 1985 WHO criteria as fasting plasma glucose <7.8 mmol/l and 2 h post-load plasma glucose ≥7.8 and <11.1 mmol/l. At the end of the trial, the groups that had regressed to NGT, remained with IGT or progressed to diabetes were identified. Participants were then followed for 24 years after completion of the trial, during which we compared the incidence and hazard ratios for CVD and microvascular disease in each group and estimated the differences in their median time to onset from parametric Weibull distribution models. RESULTS At the end of the 6 year trial, 252 (46.7%) participants had developed diabetes, 114 (21.1%) had remained with IGT and 174 (32.2%) had regressed to NGT. Compared with those who developed diabetes during the trial, the median time to onset of diabetes was delayed by 14.86 years (95% CI 12.49, 17.25) in the NGT and 9.87 years (95% CI 8.12, 11.68) in the IGT groups. After completion of the trial, among those with diabetes, IGT and NGT, the 24 year cumulative incidence of CVD was 64.5%, 48.5% and 45.1%, respectively, and 36.8%, 21.7% and 16.5% for microvascular diseases. Compared with participants who had progressed to diabetes during the trial, those who regressed to NGT had a 37% (HR 0.63; 95% CI 0.47, 0.85) reduction in CVD incidence and a median delay of 7.45 years (95% CI 1.91, 12.99) in onset, and those who remained with IGT had a 34% (HR 0.66; 95% CI 0.47, 0.91) lower CVD incidence with a median delay in onset of 5.69 years (95% CI 1.0, 10.38). Participants with NGT had a 66% (HR 0.34; 95% CI 0.20, 0.56) lower incidence of microvascular diseases and a median delay in the onset of 18.66 years (95% CI 6.08, 31.24), and those remaining with IGT had a 52% (HR 0.48; 95% CI 0.29, 0.81) lower incidence with a median delay of 12.56 years (95% CI 2.49, 22.63). CONCLUSIONS/INTERPRETATION People with IGT who reverted to NGT or remained with IGT at the end of the 6 year trial subsequently had significantly lower incidences of CVD and microvascular disease than those who had developed diabetes.
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Affiliation(s)
- Yanyan Chen
- Center of Endocrinology and Cardiovascular Metabolism, Fuwai Hospital, Beijing, China
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Qiuhong Gong
- Center of Endocrinology and Cardiovascular Metabolism, Fuwai Hospital, Beijing, China
| | - Yali An
- Center of Endocrinology and Cardiovascular Metabolism, Fuwai Hospital, Beijing, China
| | - Xin Qian
- Center of Endocrinology and Cardiovascular Metabolism, Fuwai Hospital, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Edward W Gregg
- School of Public Health, Imperial College London, London, UK
| | - Peter H Bennett
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Guangwei Li
- Center of Endocrinology and Cardiovascular Metabolism, Fuwai Hospital, Beijing, China.
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
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Winthrop K, Buch MH, Curtis J, Burmester GR, Aletaha D, Amano K, Pechonkina A, Tiamiyu I, Leatherwood C, Ye L, Gong Q, Besuyen R, Galloway J. POS0092 HERPES ZOSTER IN THE FILGOTINIB RHEUMATOID ARTHRITIS PROGRAM. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The once daily, oral Janus kinase (JAK)-1 preferential inhibitor filgotinib (FIL) improved signs and symptoms of rheumatoid arthritis (RA) in phase (P)3 trials.1-3 Patients (pts) with RA have increased herpes zoster (HZ) reactivation risk vs the general population. JAK inhibition is associated with increased infection incidence, including HZ.4Objectives:To assess long-term safety of FIL across the global clinical program with respect to HZ.Methods:Pts meeting 2010 ACR/EULAR RA criteria in a pooled analysis of P2 DARWIN 1–2 (D1–2), P3 FINCH 1–3 (F1–3), and long-term extension studies (D3, F4) were included. Placebo (PBO)-controlled as-randomised analysis included pts receiving FIL 100 mg (FIL100), FIL 200 mg (FIL200), or PBO up to week (W)12 (D1–2, F1–2); active-controlled as-randomised analysis included pts receiving FIL100, FIL200, adalimumab (ADA), or methotrexate (MTX) up to W52 (F1, F3). Long-term as-treated analysis included pts in all 7 studies receiving FIL100, FIL200, ADA, MTX, or PBO; data after re-randomisation were included and contributed to treatment received. Exposure-adjusted incidence rates (EAIR)/100 patient-years, calculated up to the last follow-up time or day, and differences with 95% confidence intervals (CIs) were calculated from the Poisson model. Logistic regression model was used for treatment-emergent (TE) HZ risk factor analysis and odds ratio (95% CI) and P value were provided.Results:Table 1 shows TE HZ EAIRs in a pooled analysis. Rates of HZ were lower for FIL200 vs PBO during the 12W PBO-controlled period. At 52W, HZ rates were higher for FIL200/100 vs active control. Long-term HZ rates increased for FIL200 vs FIL100.Table 1.EAIR of treatment-emergent herpes zosterNPatient-years exposureEAIR(95% CI)EAIR diff(95% CI vs PBO/active control)12W PBO-controlled FIL200777179.80.6 (0.1, 3.9)−0.56 (−2.5, 1.3) FIL100788181.61.1 (0.3, 4.4)−0.02 (−2.2, 2.2) PBO781178.41.1 (0.3, 4.5)Active-controlled, as-randomiseda FIL200475439.71.4 (0.6, 3.0)0.69 (−0.7, 2.1) FIL100480443.40.9 (0.3, 2.4)0.23 (−1.1, 1.5) ADA325297.60.7 (0.2, 2.7)Active-controlled, as-randomiseda FIL200626578.01.7 (0.9, 3.2)0.65 (−0.8, 2.2) FIL100207195.01.5 (0.5, 4.8)0.46 (−1.6, 2.5) MTX416372.21.1 (0.4, 2.9)Long-term as-treatedb FIL20022674047.71.8 (1.4, 2.3)NC FIL10016472032.91.1 (0.8, 1.7)NCaup to W52. bdata cut for LTE FINCH 4, Sept 19, 2019; DARWIN 3, April 26 2019.ADA, adalimumab; CI, confidence interval; EAIR, exposure-adjusted incidence rate; FIL, filgotinib; MTX, methotrexate; NC, not calculated; PBO, placebo; W week.Figure 1 shows multivariate logistic regression model of TE risk factors.Of 104 pts with TE HZ in long-term as-treated analysis set, 5 receiving FIL200 had history of HZ; EAIR (95% CI) was 8.7 (3.6–21.0). Of 8 pts with multiple events, 3 had events of differing severity for the same HZ episode.EAIRs (95% CI) of TE HZ in Asia were: 3.7 (1.7–8.1) FIL200, n=197; 2.8 (1.3–6.3) FIL100, n=158; 0 ADA, n=40; 2.8 (0.4–19.6) MTX, n=43; and 3.4 (0.5–23.8) PBO, n=77 in long-term as-treated population. EAIRs (95% CI) in rest of the world were: 1.6 (1.2–2.1) FIL200, n=2070; 0.9 (0.6–1.5) FIL100, n=1489; 0.8 (0.2–3.1) ADA, n=285; 0.9 (0.3–2.9) MTX, n=373; and 0.7 (0.2–2.9) PBO, n=704 for all pts as-treated.Most TE HZ infections were mild to moderate and non-serious; 6 were serious; 2 were recurrences. No visceral TE HZ occurred across the FIL RA program; there was 1 case each of genital, disseminated, and ophthalmic HZ. The disseminated HZ occurred in a pt with prior HZ history. Lymphopenia was not associated with HZ during the PBO-controlled W12 period.Conclusion:HZ was more common in both FIL groups vs ADA or MTX up to 52 weeks but comparable vs PBO during the 12-week placebo-controlled period. In multivariate analyses, prior history of HZ, Asian region, and age ≥50 years were associated with increased HZ risk.References:[1]Genovese et al. JAMA. 2019;322:315–25.[2]Westhovens et al. Ann Rheum Dis. 2021; online first.[3]Combe et al. Ann Rheum Dis. 2021; online first.[4]Higarashi and Honda. Drugs. 2020;80:1183–201.Disclosure of Interests:Kevin Winthrop Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly and Co., Galapagos NV, Gilead Sciences, GlaxoSmithKline, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, Bristol-Myers Squibb, and Pfizer, Maya H Buch Speakers bureau: AbbVie; Eli Lilly and Company; Gilead Sciences, Inc.; Merck-Serono; Pfizer; Roche; Sandoz; Sanofi; and UCB, Consultant of: AbbVie; Eli Lilly and Company; Gilead Sciences, Inc.; Merck-Serono; Pfizer; Roche; Sandoz; Sanofi; and UCB, Grant/research support from: AbbVie; Eli Lilly and Company; Gilead Sciences, Inc.; Merck-Serono; Pfizer; Roche; Sandoz; Sanofi; and UCB, Jeffrey Curtis Grant/research support from: AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Regeneron, Roche, and UCB, Gerd Rüdiger Burmester Speakers bureau: AbbVie; Eli Lilly; Pfizer; and Gilead Sciences, Inc., Consultant of: AbbVie; Eli Lilly; Pfizer; and Gilead Sciences, Inc., Daniel Aletaha Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Medac, Merck, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sandoz, Sanofi/Genzyme, and UCB, Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, and Sanofi/Genzyme, Grant/research support from: AbbVie, Merck Sharp & Dohme, Novartis, and Roche, Koichi Amano Speakers bureau: AbbVie GK, Astellas, Chugai Pharmaceutical Co. Ltd., Eli Lilly, GlaxoSmithKline KK, Pfizer Japan, Mitsubishi-Tanabe Pharma, Grant/research support from: Asahi Kasei Pharma, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Iyabode Tiamiyu Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Cianna Leatherwood Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Lei Ye Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Qi Gong Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Robin Besuyen Shareholder of: Galapagos, BV, Employee of: Galapagos, BV, James Galloway Speakers bureau: Pfizer, Bristol-Myers Squibb, UCB and Celgene
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Luo L, Yang Y, Gong Q, Li F. Distinct alternations of brain functional network dynamics in obsessive-compulsive disorder and schizophrenia. Eur Psychiatry 2021. [PMCID: PMC9471499 DOI: 10.1192/j.eurpsy.2021.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Obsessive-compulsive disorder (OCD) and schizophrenia (SZ) are both severe psychiatric disorders. Though these two disorders have distinct typical symptoms, there are partial polygenic overlap and comorbidity between the two disorders. However, few studies have explored the shared and disorder-specific brain function underlying the neural pathophysiology of the two disorders, especially in the aspect of dynamics. Objectives To explore the abnormal characteristics of the dynamic functional connectivity (dFC) in OCD and SZ as well as the association between dFC metrics and symptom severity. Methods The resting state functional magnetic resonance imaging data of 31 patients with OCD, 49 patients with SZ, and 45 healthy controls were analyzed using independent component analysis to obtain independent components (ICs) and assigned them into eight brain networks (Figure 1), then used the sliding-window approach to generate dFC matrices. Using k-means clustering, we obtained three reoccurring dFC states (Figure 2), and state transition metrics were obtained![]() Results In a sparsely connected state (state 1), SZ showed both increased fractional time and mean dwell time than controls (P=0.047 and P=0.033) and OCD (P=0.001 and P=0.003). In a state characterized by negative FC between networks (state 2), OCD showed both increased fractional time and mean dwell time than controls (P=0.032 and P=0.013) and SZ (P=0.005 and P=0.003). Moreover, the fractional time of state 2 was positively correlated with anxiety scores in OCD (r=0.535, P=0.021, FDR corrected) (Figure 3).![]() ![]() Conclusions OCD and SZ patients showed distinct alternations of brain functional dynamics. Disclosure No significant relationships.
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You W, Luo L, Li F, Gong Q. Altered brain functional dynamics in auditory and visual networks in schizophrenia. Eur Psychiatry 2021. [PMCID: PMC9471729 DOI: 10.1192/j.eurpsy.2021.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction One of the most perplexing and characteristic symptoms of the schizophrenia (SZ) patients is hallucination. The occurrence of hallucinations to be associated with altered activity in the auditory and visual cortex but is not well understood from the brain functional network dynamics in SZ. Objectives To explore the brain abnormal basis of hallucinations in SZ with the dynamic functional connectivity (dFC). Methods Using magnetic resonance imaging for 83 SZ patients and 83 matched healthy controls and independent component analysis, 52 independent components (ICs) were identified as nodes and assigned into eight intrinsic connectivity networks (Figure 1A). Subsequently, we established dFC matrices and clustered them into four discrete states (Figure 1B) and three state transition metrics were obtained. To further explore the changes in the centrality of each component, eigenvector centrality (EC) was calculated and its time-varying was evaluated.![]() Results Compared to controls with FDR correction, we found that patients had more mean dwell times and fractional time in state 1 (P=0.0081 and P=0.0018), mainly with hypoconnectivity between auditory and visual network and other networks and hyperconnectivity between language and default-mode network (DMN). While, patients had less dwell times and fractional time in state 3 (P=0.0018 and P=0.0009), and decreased FC between visual network and executive control network (ECN) and increased FC between ECN and DMN than controls (Figure 2).![]() EC statistics showed that SZs displayed increased temporal dynamics in visual-related regions (Figure 3).![]() Conclusions SZ was mainly manifested as altered dFC and temporal variability of nodal centrality in auditory and visual networks. Disclosure No significant relationships.
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Luo L, Yang Y, Gong Q, Li F. Different alternations of static and dynamic brain regional topological metrics in schizophrenia and obsessive-compulsive disorder. Eur Psychiatry 2021. [PMCID: PMC9475567 DOI: 10.1192/j.eurpsy.2021.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Though schizophrenia (SZ) and obsessive-compulsive disorder (OCD) are conceptualized as distinct clinical entities, they do have notable symptom overlap and a tight association. Graph-theoretical analysis of the brain connectome provides more indicators to describe the functional organization of the brain, which may help us understand the shared and disorder-specific neural basis of the two disorders. Objectives To explore the static and dynamic topological organization of OCD and SZ as well as the relationship between topological metrics and clinical variables. Methods Resting state functional magnetic resonance imaging data of 31 OCD patients, 49 SZ patients, and 45 healthy controls (HC) were involved in this study (Table 1). Using independent component analysis to obtain independent components (ICs) (Figure 1), which were defined as nodes for static and dynamic topological analysis.![]() ![]() Results Static analysis showed the global efficiency of SZ was higher than HC. For nodal degree centrality, OCD exhibited decreased degree centrality in IC59 (located in visiual network) (P = 0.03) and increased degree centrality in IC38 (located in salience network) (P = 0.002) compared with HC. Dynamic analysis showed OCD exhibited decreased dynamics of degree centrality in IC38 (P = 0.003) compared with HC, which showed a negative correlation with clinical scores in OCD. While SZ showed decreased dynamics of degree centrality in IC76 (located in sensory motor network) compared with OCD (P=0.009), which showed a positive correlation with clinical scores in SZ (Figure 2).![]() Conclusions These changes are suggestive of disorder-specific alternation of static and dynamic brain topological organization in OCD and SZ.
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Qian X, He S, Wang J, Gong Q, An Y, Li H, Chen Y, Li G. Prediction of 10-year mortality using hs-CRP in Chinese people with hyperglycemia: Findings from the Da Qing diabetes prevention outcomes study. Diabetes Res Clin Pract 2021; 173:108668. [PMID: 33453295 DOI: 10.1016/j.diabres.2021.108668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/24/2020] [Accepted: 01/07/2021] [Indexed: 12/29/2022]
Abstract
AIMS To examine whether high-sensitivity C-reactive protein (hs-CRP) can predict all-cause death in Chinese adults with hyperglycemia. METHODS All the 237 diabetes and 49 prediabetes recruited in the study were evolved from the participants with impaired glucose tolerance in the original Da Qing Diabetes Study. Blood hs-CRP level was measured at 2006. Ten-year outcome of death was traced from 2006 to 2016. Cox model was used to analyse the association between hs-CRP level and the risk of all-cause death occurred over the subsequent 10 years. RESULTS During the follow-up, death occurred in 36 (37.9%) subjects in the highest hs-CRP tertile group (hs-CRP > 2.16 mg/L) and 19 (20.0%) in the lowest hs-CRP tertile group (hs-CRP < 0.82 mg/L, p < 0.05). The corresponding incidence of all-cause death (per 1,000 person-years) was 44.7 (95% CI 30.1-59.3) and 21.6 (95% CI 11.9-31.3) in the two groups respectively (p < 0.0001). The highest hs-CRP tertile was associated with the increased risk of all-cause death significantly (hazard ratio 1.88, 95% CI 1.07-3.32) after controlling for traditional risk factors. CONCLUSIONS Serum hs-CRP was predictive of 10-year all-cause death in Chinese adults with hyperglycemia, suggesting the impact of low-grade inflammation on mortality deserves more attention.
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Affiliation(s)
- Xin Qian
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyao He
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Daqing, China
| | - Qiuhong Gong
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Daqing, China
| | - Yanyan Chen
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangwei Li
- Endocrinology and Cardiovascular Metabolism Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Gong Q, Chen C, Yan L, Zhan H, Chen Y, Chen W. PCN15 Disease Burden of Myelodysplastic Syndrome UNDER the Current Treatment Pattern in China. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.065] [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: 10/23/2022]
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Gong Q, Chen C, Yan L, Zhan H, Chen Y, Chen W. PCN14 Disease Burden of Waldenstrom's Macroglobulinemia UNDER the Current Treatment Pattern in China. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.064] [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: 10/23/2022]
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Gong Q, Chen C, Yan L, Zhan H, Chen Y, Chen W. PCN21 Disease Burden of Multiple Myeloma UNDER the Current Treatment Pattern in China. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.071] [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: 10/23/2022]
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Gong Q, Peng YG, Niu MF, Qin CL. Research Note: The immune enhancement ability of inulin on ptfA gene DNA vaccine of avian Pasteurella multocida. Poult Sci 2020; 99:3015-3019. [PMID: 32475437 PMCID: PMC7597738 DOI: 10.1016/j.psj.2020.03.006] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 02/27/2020] [Indexed: 11/24/2022] Open
Abstract
To evaluate the ability of inulin to enhance the immune response of a ptfA gene DNA vaccine for avian Pasteurella multocida, inulin was added as an adjuvant to the ptfA-DNA vaccine, obtaining an inulin-adjuvant DNA vaccine. The DNA vaccine was administered to chickens; a fimbria protein vaccine and an attenuated live vaccine were used as positive controls. The levels of the serum antibody and concentrations of interferon-γ (IFN-γ), interleukin-2 (IL-2), and interleukin-4 (IL-4) were determined, and a lymphocyte proliferation assay was performed. After being challenged with virulent P. multocida, the protective efficacy was evaluated. The results showed that the serum antibodies induced by the ptfA-DNA vaccine were not enhanced by inulin. The stimulation index values and the concentrations of IL-2 and IFN-γ in chickens vaccinated with inulin-adjuvant DNA vaccine were significantly higher than those in chickens vaccinated with the DNA vaccine, those with the fimbria protein vaccine, and the chickens gavaged with inulin. The concentrations of IL-4 in the inulin-adjuvant DNA vaccine group and the fimbria protein vaccine group were higher than those in the DNA vaccine group and the inulin-gavage group. The protective efficacy rates of the attenuated live vaccine group, the fimbria protein vaccine group, the DNA vaccine group, the inulin-adjuvant DNA vaccine group, and the inulin-gavage group were 90, 70, 55, 65, and 55%, respectively.
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Affiliation(s)
- Q Gong
- Henan University of Science and Technology, Luoyang 471023, P.R. China.
| | - Y G Peng
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research, Institute Chinese Academy of Agricultural Sciences, Harbin 150069, P.R. China
| | - M F Niu
- Henan University of Science and Technology, Luoyang 471023, P.R. China
| | - C L Qin
- Henan University of Science and Technology, Luoyang 471023, P.R. China
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Zhu H, Yuan M, Qiu C, Ren Z, Li Y, Wang J, Huang X, Lui S, Gong Q, Zhang W, Zhang Y. Multivariate classification of earthquake survivors with post-traumatic stress disorder based on large-scale brain networks. Acta Psychiatr Scand 2020; 141:285-298. [PMID: 31997301 DOI: 10.1111/acps.13150] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The identification of post-traumatic stress disorder (PTSD) among natural disaster survivors is remarkably challenging, and there are no reliable objective signatures that can be used to assist clinical diagnosis and optimize treatment. The current study aimed to establish a neurobiological signature of PTSD from the connectivity of large-scale brain networks and clarify the brain network mechanisms of PTSD. METHODS We examined fifty-seven unmedicated survivors with chronic PTSD and 59 matched trauma-exposed healthy controls (TEHCs) using resting-state functional magnetic resonance imaging (rs-fMRI). We extracted the node-to-network connectivity and obtained a feature vector with a dimensionality of 864 (108 nodes × 8 networks) to represent each subject's functional connectivity (FC) profile. Multivariate pattern analysis with a relevance vector machine was then used to distinguish PTSD patients from TEHCs. RESULTS We achieved a promising diagnostic accuracy of 89.2% in distinguishing PTSD patients from TEHCs. The most heavily weighted connections for PTSD classification were among the default mode network (DMN), visual network (VIS), somatomotor network, limbic network, and dorsal attention network (DAN). The strength of the anticorrelation of FC between the ventral medial prefrontal cortex (vMPFC) in DMN and the VIS and DAN was associated with the severity of PTSD. CONCLUSIONS This study achieved relatively high accuracy in classifying PTSD patients vs. TEHCs at the individual level. This performance demonstrates that rs-fMRI-derived multivariate classification based on large-scale brain networks can provide potential signatures both to facilitate clinical diagnosis and to clarify the underlying brain network mechanisms of PTSD caused by natural disasters.
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Affiliation(s)
- H Zhu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - M Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - C Qiu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Z Ren
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Y Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - J Wang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - X Huang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - S Lui
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Q Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - W Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Y Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Wang J, Shen X, He S, An Y, Gong Q, Li H, Zhang B, Shuai Y, Chen Y, Hu Y, Li G. Hypertriglyceridaemia predicts subsequent long-term risk of cardiovascular events in Chinese adults: 23-year follow-up of the Daqing Diabetes Study. Diabetes Metab Res Rev 2019; 35:e3163. [PMID: 30939629 DOI: 10.1002/dmrr.3163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/02/2019] [Accepted: 03/26/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Limited information is available on the long-term risk of cardiovascular disease (CVD) associated with hypertriglyceridaemia (HTG) in the Chinese population. We estimated this risk over a 23-year period in participants recruited from among those included in the Da Qing Diabetes Study. METHODS A total of 833 Chinese adults including 379 with normal glucose levels and 454 with hyperglycaemia were identified by their oral glucose tolerance in 1986 in Da Qing, China. CVD outcomes were monitored until 2009. Thirty-four percent (280/833) of the participants had HTG, which was defined as a fasting plasma triglyceride (TG) level ≥ 1.7 mmol/L, at the baseline time point. RESULTS Over the 23-yearfollow-up period, 149 subjects in the HTG group and 190 subjects in the non-HTG group (NTG group) experienced their first CVD event, including fatal or nonfatal myocardial infarction (MI) and stroke. The age and sex-adjusted annual incidence of the first CVD event per 1000 person-years was 30.23 for the HTG group vs 18.68 for the NTG group. The corresponding rates for MI and stroke were 7.71 vs 3.89 and 19.55 vs 13.98, respectively. After adjusting for confounders, the HTG group had a 28% higher risk of the first CVD event than the NTG group. This association was significant among only the subjects with a serum cholesterol level > 5.7 mmol/L and those with diabetes or impaired glucose tolerance (IGT). CONCLUSION HGT predicted a substantially higher subsequent long-term risk of the first CVD event in Chinese adults, especially in those with hypercholesterolaemia and hyperglycaemia.
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Affiliation(s)
- Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Daqing City, China
| | - Xiaoxia Shen
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Siyao He
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yali An
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiuhong Gong
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Daqing City, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Ying Shuai
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yinghua Hu
- Department of Cardiology, Da Qing First Hospital, Daqing City, China
| | - Guangwei Li
- Center of Endocrinology and Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
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Huo X, Krumholz HM, Bai X, Spatz ES, Ding Q, Horak P, Zhao W, Gong Q, Zhang H, Yan X, Sun Y, Liu J, Wu X, Guan W, Wang X, Li J, Li X, Spertus JA, Masoudi FA, Zheng X. Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus. Circ Cardiovasc Qual Outcomes 2019; 12:e005805. [DOI: 10.1161/circoutcomes.119.005805] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background:
Mobile health interventions may support risk factor management and are readily scalable in healthcare systems. We aim to evaluate the efficacy of a text messaging–based intervention to improve glycemic control in patients with coronary heart disease and diabetes mellitus in China.
Methods and Results:
The CHAT-DM study (Cardiovascular Health and Texting-Diabetes Mellitus) was a parallel-group, single-blind, randomized clinical trial that included 502 patients with both coronary heart disease and diabetes mellitus from 34 hospitals in China. The intervention group (n=251) received 6 text messages per week for 6 months in addition to usual care. Messages were theory driven and culturally tailored to provide educational and motivational information on glucose monitoring, blood pressure control, medication adherence, physical activity, and lifestyle. The control group (n=251) received usual care and 2 thank you messages per month. The primary outcome was change in glycated hemoglobin (HbA
1C
[hemoglobin A
1C
]) from baseline to 6 months. Secondary outcomes were change in proportion of patients achieving HbA
1C
<7%, fasting blood glucose, systolic blood pressure, LDL (low-density lipoprotein) cholesterol, body mass index, and physical activity from baseline to 6 months. The end points were assessed using analyses of covariance. The follow-up rate was 99%. When compared with control group at 6 months, the intervention group had a greater reduction in HbA
1C
(−0.2% versus 0.1%;
P
=0.003) and a greater proportion of participants who achieved HbA
1C
<7% (69.3% versus 52.6%;
P
=0.004). Change in fasting blood glucose was larger in the intervention group (between-group difference: −0.6 mmol/L; 95% CI, −1.1 to −0.2;
P
=0.011), but no other outcome differences were observed. Nearly all participants reported that messages were easy to understand (97.1%) and useful (94.1%).
Conclusions:
A text message intervention resulted in better glycemic control in patients with diabetes mellitus and coronary heart disease. While the mechanism of this benefit remains to be determined, the results suggest that a simple, culturally sensitive mobile text messaging program may provide an effective and feasible way to improve disease self-management.
Clinical Trial Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02883842.
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Affiliation(s)
- Xiqian Huo
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (H.M.K., E.S.S., Q.D.)
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (H.M.K., E.S.S.)
- Department of Health Policy and Management, Yale University School of Public Health, New Haven, CT (H.M.K.)
| | - Xueke Bai
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Erica S. Spatz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (H.M.K., E.S.S., Q.D.)
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (H.M.K., E.S.S.)
| | - Qinglan Ding
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (H.M.K., E.S.S., Q.D.)
| | - Paul Horak
- Stanford University School of Medicine, CA (P.H.)
| | - Weigang Zhao
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Beijing, China (W.Z.)
| | - Qiuhong Gong
- Endocrinology and Cardiovascular Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China (Q.G.)
| | - Haibo Zhang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Xiaofang Yan
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Ying Sun
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Jiamin Liu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Xuekun Wu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Wenchi Guan
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Xiuling Wang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Jing Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
| | - John A. Spertus
- Health Outcomes Research, Saint Luke’s Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.)
| | - Frederick A. Masoudi
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.)
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.H., X.B., H.Z., X.Y., Y.S., J. Liu, X.W., W.G., X.W., J.Li, X.L., X.Z.)
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Li X, Wang J, Shen X, An Y, Gong Q, Li H, Zhang B, Shuai Y, Chen Y, Hu Y, Li G. Higher blood pressure predicts diabetes and enhances long-term risk of cardiovascular disease events in individuals with impaired glucose tolerance: Twenty-three-year follow-up of the Daqing diabetes prevention study. J Diabetes 2019; 11:593-598. [PMID: 30556339 PMCID: PMC6618010 DOI: 10.1111/1753-0407.12887] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/08/2018] [Revised: 11/15/2018] [Accepted: 12/04/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Hypertension is more prevalent in subjects with impaired glucose tolerance (IGT), but whether higher blood pressure per se or the mild hyperglycemia in combination with the hypertension enhanced the risk of cardiovascular disease (CVD) remains unclear. METHODS Five hundred and sixty-eight participants with IGT in the original Daqing diabetes prevention study, 297 with hypertension (HBP) and 271 without hypertension (NBP), were enrolled in 1986 and the intervention phase lasted for 6 years. In 2009, they were followed up to assess the outcomes of cardiovascular events (including stroke and myocardial infarction) and incidence of diabetes. RESULTS Over 23 years, the incidence of diabetes was 93.9/1000 person-years in HBP and 72.2/1000 person-years in the NBP group, with an age- and sex-adjusted hazard ratio of 1.26 (95% confidence interval [CI], 1.04-1.54, P = 0.02). The yearly incidence of CVD events was 27.7/1000 person-years and 16.6/1000 person-years, indicating a 35% higher risk in HBP than in the NBP group (95% CI, 1.01-1.81; P = 0.04). Cox proportional hazard analysis showed that a 10-mm Hg increase of the baseline systolic blood pressure was associated with 9% increased risk of the development of diabetes (P = 0.02), together with a 7% higher risk of the CVD events (P = 0.02). CONCLUSIONS Hypertension predicted diabetes and enhances long-term risk of CVD events in patients with IGT. An individualized strategy that targets hypertension as well as hyperglycemia is needed for diabetes and its cardiovascular complications.
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Affiliation(s)
- Xiaojue Li
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
| | - Jinping Wang
- Department of CardiologyDaQing First HospitalDa QingChina
| | - Xiaoxia Shen
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
| | - Yali An
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
| | - Qiuhong Gong
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
| | - Hui Li
- Department of CardiologyDaQing First HospitalDa QingChina
| | - Bo Zhang
- Department of EndocrinologyChina‐Japan Friendship HospitalBeijingChina
| | - Ying Shuai
- Department of EndocrinologyChina‐Japan Friendship HospitalBeijingChina
| | - Yanyan Chen
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
| | - Yinghua Hu
- Department of CardiologyDaQing First HospitalDa QingChina
| | - Guangwei Li
- Center of Endocrinology and Cardiology, Fuwai HospitalChinese Academy of Medical SciencesBeijingChina
- Department of EndocrinologyChina‐Japan Friendship HospitalBeijingChina
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Hui Y, Wang J, An Y, Gong Q, Li H, Zhang B, Shuai Y, Chen Y, Hu Y, Li G. Premature death and risk of cardiovascular disease in young-onset diabetes: a 23-year follow-up of the Da Qing Diabetes Study. Endocrine 2019; 65:46-52. [PMID: 31001730 DOI: 10.1007/s12020-019-01928-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/08/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to investigate premature mortality and the risk of cardiovascular disease (CVD) in Chinese adults with diabetes diagnosed before the age of 45 years. METHODS A total of 519 participants with normal glucose tolerance (NGT) and 630 with newly diagnosed diabetes mellitus (DM) were recruited in 1986 in the Da Qing Diabetes Study. In 2009, the participants were followed up to assess mortality and CVD events. The subjects were stratified into four subgroups according to age and diabetes status: age <45 years with NGT (NGT<45y), age <45 years with DM (DM<45y), age ≥45 years with NGT (NGT≥45y), and age ≥45 years with DM (DM≥45y). The risk of death and CVD events in patients with young-onset DM and elder subjects with NGT were compared to show the extent of premature death and CVD in the DM participants. RESULTS During the 23-year follow-up, 26 (10.40%) participants in NGT<45y, 72 (34.12%) in DM<45y, 74 (30.58%) in NGT≥45y, and 266 (68.73%) in DM≥45y died, including 13 (5.20%), 36 (17.06%), 24 (9.92%), and 128 (33.07%) death attributed to CVD. The corresponding rates of CVD events were 56 (22.40%), 90 (42.65%), 89 (36.78), and 213 (55.04%). It also showed that the risk of all-cause death (HR 1.23, 95% CI 0.88-1.71) or CVD events (HR 1.25, 95% CI 0.93-1.69) did not differ significantly between the DM<45y and NGT≥45y groups after adjusting for sex, smoking, body mass index, systolic blood pressure, total cholesterol and previous history of CVD. Of note, participants in the DM<45y group had an higher risk of CVD mortality compared with that in the NGT≥45y group (HR 1.76, 95% CI 1.04-2.98), although the mean age in the former group was 12 years lesser than that in the latter group (39.01 ± 5.00 vs 51.45 ± 5.14). CONCLUSIONS Young-onset diabetes is a risk factor for the premature death and cardiovascular disease. Early prevention and intensive treatment are warrented in patients with young-onset diabetes.
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Affiliation(s)
- Yuanchi Hui
- Center of of Endocrinology and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Yali An
- Center of of Endocrinology and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiuhong Gong
- Center of of Endocrinology and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Ying Shuai
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Center of of Endocrinology and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yinghua Hu
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Guangwei Li
- Center of of Endocrinology and Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
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Yang S, Fu HM, Xiao Q, Liu Q, Wang Y, Yan TM, Zhou J, Liu Y, Gong Q, Zhao L. The Structure of the Skin, Types and Distribution of Mucous Cell of Yangtze Sturgeon ( Acipenser dabryanus ). INT J MORPHOL 2019. [DOI: 10.4067/s0717-95022019000200541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gong Q, Zhang P, Wang J, Ma J, An Y, Chen Y, Zhang B, Feng X, Li H, Chen X, Cheng YJ, Gregg EW, Hu Y, Bennett PH, Li G. Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. Lancet Diabetes Endocrinol 2019; 7:452-461. [PMID: 31036503 PMCID: PMC8172050 DOI: 10.1016/s2213-8587(19)30093-2] [Citation(s) in RCA: 284] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lifestyle interventions can delay the onset of type 2 diabetes in people with impaired glucose tolerance, but whether this leads subsequently to fewer complications or to increased longevity is uncertain. We aimed to assess the long-term effects of lifestyle interventions in people with impaired glucose tolerance on the incidence of diabetes, its complications, and mortality. METHODS The original study was a cluster randomised trial, started in 1986, in which 33 clinics in Da Qing, China, were randomly assigned to either be a control clinic or provide one of three interventions (diet, exercise, or diet plus exercise) for 6 years for 577 adults with impaired glucose tolerance who usually receive their medical care from the clinics. Subsequently, participants were followed for up to 30 years to assess the effects of intervention on the incidence of diabetes, cardiovascular disease events, composite microvascular complications, cardiovascular disease death, all-cause mortality, and life expectancy. FINDINGS Of the 577 participants, 438 were assigned to an intervention group and 138 to the control group (one refused baseline examination). After 30 years of follow-up, 540 (94%) of 576 participants were assessed for outcomes (135 in the control group, 405 in the intervention group). During the 30-year follow-up, compared with control, the combined intervention group had a median delay in diabetes onset of 3·96 years (95% CI 1·25 to 6·67; p=0·0042), fewer cardiovascular disease events (hazard ratio 0·74, 95% CI 0·59-0·92; p=0·0060), a lower incidence of microvascular complications (0·65, 0·45-0·95; p=0·025), fewer cardiovascular disease deaths (0·67, 0·48-0·94; p=0·022), fewer all-cause deaths (0·74, 0·61-0·89; p=0·0015), and an average increase in life expectancy of 1·44 years (95% CI 0·20-2·68; p=0·023). INTERPRETATION Lifestyle intervention in people with impaired glucose tolerance delayed the onset of type 2 diabetes and reduced the incidence of cardiovascular events, microvascular complications, and cardiovascular and all-cause mortality, and increased life expectancy. These findings provide strong justification to continue to implement and expand the use of such interventions to curb the global epidemic of type 2 diabetes and its consequences. FUNDING US Centers for Disease Control and Prevention, WHO, Chinese Center for Disease Control and Prevention, World Bank, Ministry of Public Health of the People's Republic of China, Da Qing First Hospital, China-Japan Friendship Hospital, and National Center for Cardiovascular Diseases & Fuwai Hospital.
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Affiliation(s)
- Qiuhong Gong
- Endocrinology and Cardiovascular Disease Centre, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ping Zhang
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Jixiang Ma
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yali An
- Endocrinology and Cardiovascular Disease Centre, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanyan Chen
- Endocrinology and Cardiovascular Disease Centre, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Zhang
- China-Japan Friendship Hospital, Beijing, China
| | - Xinxing Feng
- Endocrinology and Cardiovascular Disease Centre, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | | | - Yiling J Cheng
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yinghua Hu
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Peter H Bennett
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Guangwei Li
- Endocrinology and Cardiovascular Disease Centre, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China; China-Japan Friendship Hospital, Beijing, China.
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Gong Q, Ruan M, Niu M, Qin C, Hou Y, Guo J. Immune efficacy of DNA vaccines based on oprL and oprF genes of Pseudomonas aeruginosa in chickens. Poult Sci 2018; 97:4219-4227. [DOI: 10.3382/ps/pey307] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/23/2018] [Indexed: 01/18/2023] Open
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Tang Y, An D, Xiao Y, Niu R, Tong X, Liu W, Zhao L, Gong Q, Zhou D. Cortical thinning in epilepsy patients with postictal generalized electroencephalography suppression. Eur J Neurol 2018; 26:191-197. [PMID: 30153362 DOI: 10.1111/ene.13794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 04/08/2018] [Accepted: 08/17/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE The aim was to investigate the brain microstructural abnormalities in epilepsy patients with postictal generalized electroencephalographic suppression (PGES) using a cortical surface-based analysis. METHODS According to the video-electroencephalography records of epilepsy patients with generalized convulsive seizures, 30 patients with PGES (PGES+) and 21 patients without PGES (PGES-) were recruited. High-resolution T1-weighted images were acquired from each patient and 30 matched healthy control subjects. Cortical thickness was compared amongst the three groups using FreeSurfer software. RESULTS Patients with PGES showed reduced cortical thickness in the right paracentral lobule, inferior parietal lobule, supramarginal gyrus and middle temporal lobe compared with patients without PGES. In relation to healthy control subjects, the PGES+ group presented reduced cortical thickness in the right superior parietal lobule and supramarginal gyrus, whilst the PGES- group presented reduced cortical thickness in the left precuneus, precentral gyrus, lateral occipital gyrus, parahippocampal gyrus, superior parietal lobule and right caudal middle frontal gyrus. CONCLUSIONS Patients with PGES exhibited characteristic brain microstructural abnormalities, corroborating the PGES mechanisms at the brain level. The right-sided predominance of the detected PGES-related cortical thinning was the same as that of sudden unexpected death in epilepsy (SUDEP) cases and patients at high risk for SUDEP, implying that PGES and SUDEP may share a common abnormal brain substrate that is involved in the pathophysiology of these conditions.
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Affiliation(s)
- Y Tang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Y Xiao
- Department of Radiology, Huaxi MR Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - R Niu
- Department of Radiology, Huaxi MR Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - X Tong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - W Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - L Zhao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Q Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Shen X, Zhang P, Wang J, An Y, Gregg EW, Zhang B, Li H, Gong Q, Chen Y, Shuai Y, Engelgau MM, Hu Y, Bennett PH, Li G. Influence of improvement or worsening of glucose tolerance on risk of stroke in persons with impaired glucose tolerance. Int J Stroke 2018; 13:941-948. [PMID: 29956594 DOI: 10.1177/1747493018784432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM We sought to determine the effect of regression to normal glucose tolerance (NGT) or progression to diabetes in early years of impaired glucose tolerance (IGT) on subsequent risk of stroke. METHODS In 1986, 576 adults aged 25 years and older with impaired glucose tolerance in Da Qing, China, were randomly assigned by clinic to control, diet, exercise, or diet plus exercise intervention groups for a six-year period. Subsequently participants received medical care in their local clinics. We tracked participants for additional 17 years to ascertain stroke events and other outcomes. RESULTS At the end of 6-year intervention trial follow-up, 272 (50.2%) had progressed to diabetes, 169 (31.2%) regressed to normal glucose tolerance, and 101 (18.6%) remained impaired glucose tolerance. During the subsequent 17-year follow-up, 173 (31.9%) developed a stroke, 26.7% of normal glucose tolerances, 30.7% of impaired glucose tolerances, and 36.1% of those with diabetes. After controlling for age, sex, baseline blood pressure, smoking, total cholesterol, previous cardiovascular disease and intervention group, those who developed diabetes in the first six years had a higher incidence of stroke than those who reverted to normal glucose tolerance (HR = 1.49, 95% CI 1.01-2.19, p = 0.04), whereas for those who remained impaired glucose tolerance compared to those who regressed to normal glucose tolerance the HR was 1.25 (95% CI 0.80-1.93; p = 0.30). A 1-mmol/L increase in both fasting and 2-h post-load plasma glucose from entry to end of the six-year trial was significantly associated with a higher risk of development of stroke in the subsequent 17 years, respectively (HR = 1.07, 95% CI 1.03-1.11, p < 0.0001 for fasting glucose, HR = 1.05, 95% CI 1.02-1.09, p = 0.007 for 2-h post-load plasma glucose). CONCLUSIONS Among Chinese adults with impaired glucose tolerance, early progression to diabetes predicted a higher risk of stroke, compared those who regressed to normal glucose tolerance.
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Affiliation(s)
- Xiaoxia Shen
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ping Zhang
- 2 Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinping Wang
- 3 Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Yali An
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Edward W Gregg
- 2 Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bo Zhang
- 4 Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Hui Li
- 3 Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Qiuhong Gong
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanyan Chen
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Shuai
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Michael M Engelgau
- 5 Center for Translation Research and Implementation Science, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | - Yinghua Hu
- 3 Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Peter H Bennett
- 6 Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Guangwei Li
- 1 Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.,4 Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
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Wang ZY, Wang YB, Hao GZ, Jiang YF, Gu XS, Fan WZ, Gong Q, Wang Q, Fu XH. [Relationship between coronary tortuosity and coronary microvascular disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2018; 46:359-363. [PMID: 29804437 DOI: 10.3760/cma.j.issn.0253-3758.2018.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To explore the relationship between coronary tortuosity and coronary microvascular disease (CMVD). Methods: Patients with typical angina symptoms and without serious coronary artery stenosis by coronary angiography were enrolled from June 2014 to December 2016, and CMVD was diagnosed by single photon emission tomography (SPECT). According to the SPECT results, patients were divided to the CMVD group and non-CMVD group. The baseline clinical characteristics, results of coronary angiography were compared between the two groups. The logistic analysis was used to analyze the relationship between coronary tortuosity and CMVD. Result: A total of 117 cases were enrolled, with 69 cases in the CMVD group and 48 cases in the non-CMVD group. No differences were found in gender distribution, age, hypertension, lipid abnormality, hyperuricemia and uses of statins between the two groups (all P>0.05). Incidence of diabetes (78.26%(54/69) vs. 35.42% (17/48) , P<0.05), hs-CRP ((4.29±2.15)mmol/L vs. (2.63±1.20)mmol/L, P<0.001), LDL-C ((2.98±0.96)mmol/L vs. (2.52±0.83)mmol/L, P=0.008) and homocysteine ((13.7±5.61)mmol/L vs. (11.5±4.38)mmol/L, P=0.025) levels were higher in the CMVD group than in the non-CMVD group. The data derived from echocardiographic examination were similar between the two groups. The Corrected TIMI frame counts were higher in the CMVD group than in non-CMVD group (LAD: 31.56±4.92 vs. 27.31±3.75, LCX: 29.47±4.18 vs. 26.62±3.19, RCA: 29.09±5.05 vs. 26.24±3.28, all P<0.001). The incidences of coronary atherosclerosis (76.81% (53/69) vs. 27.08% (13/48) , P<0.001) and coronary tortuosity ( (60.87% (42/69) vs. 33.33% (16/48) , P=0.035) were also higher in the CMVD group than in non-CMVD group. Logistic analysis found that coronary tortuosity (OR=6.111, 95%CI 2.707-13.794, P<0.001), diabetes (OR=6.565, 95%CI 2.883-14.948, P<0.001) and coronary atherosclerosis (OR=8.918, 95%CI 3.822-20.808, P<0.001) were independent risk factors of CMVD. Conclusion: Coronary tortuosity, diabetes and coronary atherosclerosis are related to CMVD in this patient cohort.
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Affiliation(s)
- Z Y Wang
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
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