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Akiyama T, Yamakawa T, Orime K, Ichikawa M, Harada M, Netsu T, Akamatsu R, Nakamura K, Shinoda S, Terauchi Y. Effects of hybrid closed-loop system on glycemic control and psychological aspects in persons with type 1 diabetes treated with sensor-augmented pump: A prospective single-center observational study. J Diabetes Investig 2024; 15:219-226. [PMID: 37934090 PMCID: PMC10804894 DOI: 10.1111/jdi.14103] [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: 06/30/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023] Open
Abstract
AIMS/INTRODUCTION This study evaluated the effects of the Medtronic MiniMed 770G hybrid closed-loop system on glycemic control and psychological aspects in persons with type 1 diabetes mellitus. MATERIALS AND METHODS This 3-month prospective observational study included 22 participants with type 1 diabetes mellitus who used the Medtronic MiniMed 640G predictive low-glucose suspend system and were switched to the 770G system. Time in the range of 70-180 mg/dL and glycated hemoglobin levels were evaluated; satisfaction, emotional distress and quality of life were assessed using self-reported questionnaires, including the Diabetes Treatment Satisfaction Questionnaire Status, Problem Area in Diabetes and Diabetes Therapy-Related Quality of Life. RESULTS Time in the range of 70-180 mg/dL increased (63.5 ± 13.4 to 73.0 ± 10.9% [mean ± standard deviation], P = 0.0010), and time above the range of 181-250 mg/dL decreased (26.9 ± 8.9 to 19.6 ± 7.1%, P < 0.0005). Glycated hemoglobin levels decreased (7.7 ± 1.0 to 7.2 ± 0.8%, P = 0.0021). The percentage of participants with time below the range of 54-69 mg/dL <4% of readings increased from 91% to 100% (P < 0.0005). No significant changes were detected in the satisfaction, emotional distress and quality of life levels, but increased sensor calibration might be related to worsened emotional distress and quality of life. CONCLUSIONS The hybrid closed-loop system decreased hyperglycemia and minimized hypoglycemia, but did not improve psychological aspects compared with the predictive low-glucose suspend system, probably because sensor calibration was increased.
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Affiliation(s)
- Tomoaki Akiyama
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Tadashi Yamakawa
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
- Kanazawa Medical ClinicYokohamaJapan
| | - Kazuki Orime
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Masahiro Ichikawa
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Marina Harada
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Takumi Netsu
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Ryoichi Akamatsu
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Keita Nakamura
- Department of Endocrinology and DiabetesYokohama City University Medical CenterYokohamaJapan
| | - Satoru Shinoda
- Department of BiostatisticsYokohama City University School of MedicineYokohamaJapan
| | - Yasuo Terauchi
- Department of Endocrinology and MetabolismYokohama City University School of MedicineYokohamaJapan
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Chatterjee T, Ravichandran N, Nair N, Gracia‐Ramos AE, Barman B, Sen P, Joshi M, Saha S, Nune A, Pande AKR, Velikova T, Parodis I, Tan AL, Shinjo SK, Boro H, Agarwal V, Aggarwal R, Gupta L. Type 1 diabetes, COVID-19 vaccines and short-term safety: Subgroup analysis from the global COVAD study. J Diabetes Investig 2024; 15:131-138. [PMID: 37697820 PMCID: PMC10759717 DOI: 10.1111/jdi.14079] [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: 04/15/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS/INTRODUCTION Coronavirus disease 2019 (COVID-19) vaccinations have been proven to be generally safe in healthy populations. However, the data on vaccine safety in patients with type 1 diabetes are scarce. This study aimed to evaluate the frequency and severity of short-term (<7-day) adverse vaccination events (AEs) and their risk factors among type 1 diabetes patients. MATERIALS AND METHODS This study analyzed data from the COVID-19 vaccination in Autoimmune Diseases (COVAD) survey database (May to December 2021; 110 collaborators, 94 countries), comparing <7-day COVID-19 vaccine AE among type 1 diabetes patients and healthy controls (HCs). Descriptive statistics; propensity score matching (1:4) using the variables age, sex and ethnicity; and multivariate analyses were carried out. RESULTS This study analyzed 5,480 completed survey responses. Of all responses, 5,408 were HCs, 72 were type 1 diabetes patients (43 females, 48.0% white European ancestry) and Pfizer was the most administered vaccine (39%). A total of 4,052 (73.9%) respondents had received two vaccine doses. Patients with type 1 diabetes had a comparable risk of injection site pain, minor and major vaccine AEs, as well as associated hospitalizations to HCs. However, type 1 diabetes patients had a higher risk of severe rashes (3% vs 0.4%, OR 8.0, 95% confidence interval 1.7-36), P = 0.007), although reassuringly, these were rare (n = 2 among type 1 diabetes patients). CONCLUSIONS COVID-19 vaccination was safe and well tolerated in patients with type 1 diabetes with similar AE profiles compared with HCs, although severe rashes were more common in type 1 diabetes patients.
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Affiliation(s)
- Tulika Chatterjee
- Department of Internal Medicine, Center for Outcomes ResearchUniversity of Illinois College of Medicine PeoriaPeoriaIllinoisUSA
| | - Naveen Ravichandran
- Department of Clinical Immunology and RheumatologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
| | - Narmadha Nair
- Department of EndocrinologyRoyal Wolverhampton Hospitals NHS TrustWolverhamptonUK
| | - Abraham Edgar Gracia‐Ramos
- Department of Internal Medicine, National Medical Center “La Raza”, Instituto Mexicano del Seguro SocialGeneral HospitalMexico CityMexico
| | - Bhupen Barman
- Department of MedicineAll India Institute of Medical Science (AIIMS)GuwahatiIndia
| | | | - Mrudula Joshi
- Byramjee Jeejeebhoy Government Medical College and Sassoon General HospitalsPuneIndia
| | | | - Arvind Nune
- Department of RheumatologySouthport and Ormskirk Hospital NHS TrustSouthportUK
| | | | | | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska InstitutetKarolinska University HospitalStockholmSweden
- Department of Rheumatology, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Ai Lyn Tan
- NIHR Leeds Biomedical Research CentreLeeds Teaching Hospitals TrustLeedsUK
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
| | - Samuel Katsuyuki Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Hiya Boro
- Department of Endocrinology and MetabolismAll India Institute of Medical SciencesNew DelhiIndia
| | - Vikas Agarwal
- Department of Clinical Immunology and RheumatologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical ImmunologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Latika Gupta
- Department of RheumatologyRoyal Wolverhampton Hospitals NHS TrustWolverhamptonUK
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine, and Health, Centre for Musculoskeletal Research, Manchester Academic Health Science CentreThe University of ManchesterManchesterUK
- Sandwell and West Birmingham Hospitals NHS TrustCity HospitalBirminghamUK
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Imafuku H, Tanimura K, Masuko N, Tomimoto M, Shi Y, Uchida A, Deguchi M, Fujioka K, Yamamoto A, Yoshino K, Hirota Y, Ogawa W, Terai Y. Advantages of sensor-augmented insulin pump therapy for pregnant women with type 1 diabetes mellitus. J Diabetes Investig 2023; 14:1383-1390. [PMID: 37706627 PMCID: PMC10690839 DOI: 10.1111/jdi.14075] [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: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS/INTRODUCTION To evaluate the efficacy of sensor-augmented pump (SAP) for improving obstetric and neonatal outcomes among pregnant women with type 1 diabetes mellitus by comparing it with continuous subcutaneous insulin infusion plus self-monitoring of blood glucose (continuous subcutaneous insulin infusion [CSII]/SMBG). MATERIALS AND METHODS This retrospective cohort study included 40 cases of pregnancy complicated by type 1 diabetes mellitus treated with SAP (SAP group), and 29 cases of pregnancy complicated by type 1 diabetes mellitus treated with CSII/SMBG (CSII/SMBG group). The obstetric and neonatal outcomes were compared between the two groups. RESULTS The median of the glycoalbumin levels in the first (18.8% vs 20.9%; P < 0.05) and second (15.4% vs 18.0%; P < 0.05) trimesters, the hemoglobin A1c levels in the peripartum period (6.1% vs 6.5%; P < 0.05) and the standard deviation score of birthweights (0.36 vs 1.52; P < 0.05) were significantly lower in the SAP group than in the CSII/SMBG group. The incidence rate of large for gestational age newborns was significantly lower in the SAP group than in the CSII/SMBG group (27.5% vs 65.5%; P < 0.05). No significant differences in the incidence rates of hypertensive disorders of pregnancy, small for gestational age, respiratory distress syndrome, neonatal hypoglycemia, hypervolemia and hyperbilirubinemia were observed between the groups. CONCLUSION The present study showed that SAP therapy is more effective in preventing large for gestational age newborns in pregnant women with type 1 diabetes mellitus than CSII/SMBG.
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Affiliation(s)
- Hitomi Imafuku
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Kenji Tanimura
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Naohisa Masuko
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Masako Tomimoto
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Yutoku Shi
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Akiko Uchida
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Masashi Deguchi
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
| | - Kazumichi Fujioka
- Department of PediatricsKobe University Graduate School of MedicineKobeJapan
| | - Akane Yamamoto
- Division of Diabetes and Endocrinology, Department of the Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Kei Yoshino
- Division of Diabetes and Endocrinology, Department of the Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of the Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of the Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yoshito Terai
- Department of Obstetrics and GynecologyKobe University Graduate School of MedicineKobeJapan
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Kodani N, Chujo D, Terakawa A, Ito K, Inagaki F, Takemura N, Matsumoto S, Tajima T, Ohmagari N, Ajima K, Takaki T, Yamashita Y, Shinohara K, Kajio H, Awata T, Shimoda M. Graft failure after allogeneic islet transplantation in a patient with type 1 diabetes and a high anti-glutamic acid decarboxylase antibody titer. J Diabetes Investig 2023; 14:725-729. [PMID: 36860136 PMCID: PMC10119917 DOI: 10.1111/jdi.13996] [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: 09/01/2022] [Revised: 01/09/2023] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
Pancreatic islet transplantation is a β-cell replacement therapy for people with insulin-deficient diabetes who have difficulty in glycemic control and suffer from frequent severe hypoglycemia. However, the number of islet transplantations carried out is still limited in Asia. We report a case of allogeneic islet transplantation in a 45-year-old Japanese man with type 1 diabetes. Although the islet transplantation was successfully carried out, graft loss was observed on the 18th day. Immunosuppressants were used in accordance with the protocol, and donor-specific anti-human leukocyte antigen antibodies were not detected. Autoimmunity relapse was also not observed. However, the patient had a high titer of anti-glutamic acid decarboxylase antibody from before the islet transplantation, and autoimmunity might thus have affected the β-cells in the transplanted islet. The evidence is still scarce to reach conclusions, and further data accumulation is required to enable proper patient selection before islet transplantation.
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Affiliation(s)
- Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Chujo
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan.,Center for Clinical Research, Toyama University Hospital, Toyama, Japan.,Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Aiko Terakawa
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kyoji Ito
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fuyuki Inagaki
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuyuki Takemura
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Matsumoto
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsuyoshi Tajima
- Department of Diagnostic Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumiko Ajima
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tadashi Takaki
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yzumi Yamashita
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koya Shinohara
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuya Awata
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Shimoda
- Department of Pancreatic Islet cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan
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Hashemipour M, Maracy M, Javanmard SH, Zamaneh F, Mostofizadeh N, Hovsepian S. Trends in incidence rates of childhood type 1 diabetes mellitus: A retrospective study in Isfahan province, Iran. J Diabetes Investig 2023; 14:376-386. [PMID: 36695001 PMCID: PMC9951581 DOI: 10.1111/jdi.13975] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023] Open
Abstract
AIMS/INTRODUCTION We aimed to determine the incidence trend of childhood type 1 diabetes mellitus in Isfahan province over a period of 12 years. MATERIALS AND METHODS In this retrospective study, children aged <20 years at the time of type 1 diabetes mellitus diagnosis, from March 2007 to March 2019, were included. The crude and adjusted incidence rate of type 1 diabetes mellitus is calculated as the number of cases per 100,000 person-years by the period. The cumulative, age- and sex-specific incidence rates were also calculated. Age-specific incidence rates were calculated for age and sex groups. RESULTS A total of 1,954 (983 boys and 971 girls) cases of type 1 diabetes mellitus were identified. The mean age at diagnosis in all studied populations was 9.89 (standard deviation 4.76). There were no significant differences between the proportion of boys and girls in different years (P = 0.12) and different age groups (P = 0.19). The average annual percent change of incidence rate for the total population, for girls and boys, was 6.9%, 6.7% and 6.3% respectively. The type 1 diabetes mellitus incidence rate had a significant trend to be increased from 2007 to 2019 (P < 0.001, t = 3.6). CONCLUSION Our findings showed that currently our region is considered a region with a high incidence rate of type 1 diabetes mellitus. Although we have had fluctuations in the incidence rate over the 12 years, the overall trend is increasing.
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Affiliation(s)
- Mahin Hashemipour
- Metabolic Liver Diseases Research Center, Isfahan Endocrine and Metabolism Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mohammadreza Maracy
- Department of Epidemiology and Biostatistics, School of HealthIsfahan University of Medical SciencesIsfahanIran
| | | | - Farzane Zamaneh
- Metabolic Liver Diseases Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Neda Mostofizadeh
- Department of Pediatric Endocrinology, Isfahan Endocrine and Metabolism Research Center, Imam Hossein Children's HospitalIsfahan University of Medical SciencesIsfahanIran
| | - Silva Hovsepian
- Metabolic Liver Diseases Research Center, Imam Hossein Children's HospitalIsfahan University of Medical SciencesIsfahanIran
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Zhang L, Xu Y, Jiang X, Wu J, Liu F, Fan L, Li X, Yin G, Yang L. Impact of flash glucose monitoring on glycemic control varies with the age and residual β-cell function of patients with type 1 diabetes mellitus. J Diabetes Investig 2021; 13:552-559. [PMID: 34637185 PMCID: PMC8902407 DOI: 10.1111/jdi.13693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/02/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022] Open
Abstract
Aims/Introduction We aimed to explore the clinical factors associated with glycemic variability (GV) assessed with flash glucose monitoring (FGM), and investigate the impact of FGM on glycemic control among Chinese type 1 diabetes mellitus patients in a real‐life clinical setting. Materials and Methods A total of 171 patients were included. GV was assessed from FGM data. A total of 110 patients wore FGM continuously for 6 months (longitudinal cohort). Hemoglobin A1c (HbA1c), fasting and 2‐h postprandial C‐peptide, and glucose profiles were collected. Changes in HbA1c and glycemic parameters were assessed during a 6‐month FGM period. Results Individuals with high residual C‐peptide (HRCP; 2‐h postprandial C‐peptide >200 pmol/L) had less GV than patients with low residual C‐peptide ( 2‐h postprandial C‐peptide ≤200 pmol/L; P < 0.001). In the longitudinal cohort (n = 110), HbA1c and mean glucose decreased, time in range (TIR) increased during the follow‐up period (P < 0.05). The 110 patients were further divided into age and residual C‐peptide subgroups: (i) HbA1c and mean glucose were reduced significantly only in the subgroup aged ≤14 years during the follow‐up period, whereas time below range also increased in this subgroup at 3 months (P = 0.047); and (ii) HbA1c improved in the HRCP subgroup at 3 and 6 months (P < 0.05). The mean glucose decreased and TIR improved significantly in the low residual C‐peptide subgroup; however, TIR was still lower and time below range was higher than those of the HRCP subgroup at all time points (P < 0.05). Conclusions HRCP was associated with less GV. FGM wearing significantly reduced HbA1c, especially in pediatric patients and those with HRCP. Additionally, the mean glucose and TIR were also found to improve.
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Affiliation(s)
- Liyin Zhang
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yaling Xu
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaofang Jiang
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jieru Wu
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fang Liu
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Fan
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xia Li
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Guangming Yin
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Lin Yang
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, China
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