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| 1 | Oxidative stress,insulin resistance,dyslipidemia and type 2 diabetes mellitus显示文摘Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus(T2DM) and this appears to underlie the development of cardiovascular disease,T2 DM and diabetic complications.Increased oxidative stress appears to be a deleterious factor leading toinsulin resistance,dyslipidemia,β-cell dysfunction,impaired glucose tolerance and ultimately leading to T2 DM.Chronic oxidative stress,hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant,have high oxidative energy requirements,decrease the gene expression of key β-cell genes and induce cell death.If β-cell functioning is impaired,it results in an under production of insulin,impairs glucose stimulated insulin secretion,fasting hyperglycemia and eventually the development of T2 DM. | Surapon Tangvarasittichai | 2015 | World Journal of Diabetes2015，6，3： | 95 |
| 2 | Literature review on the management of diabetic foot ulcer显示文摘Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications. | Leila Yazdanpanah Morteza Nasiri Sara Adarvishi | 2015 | World Journal of Diabetes2015，6，1： | 55 |
| 3 | Cardiac autonomic neuropathy in patients with diabetes mellitus显示文摘Cardiac autonomic neuropathy(CAN)is an often overlooked and common complication of diabetes mellitus.CAN is associated with increased cardiovascular morbidity and mortality.The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death.In addition,autoimmune and genetic factors are involved in the development of CAN.CAN might be subclinical for several years until the patient develops resting tachycardia,exercise intolerance,postural hypotension,cardiac dysfunction and diabetic cardiomyopathy.During its sub-clinical phase,heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic.Newer imaging techniques(such as scintigraphy)have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system.One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN;however,the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN,and also proposed screening for CAN in patients with diabetes mellitus.A major challenge,however,is the lack of specific treatment to slow the progression or prevent the development of CAN.Lifestyle changes,improved metabolic control might prevent or slow the progression of CAN.Reversal will require combination of these treatments with new targeted therapeutic approaches.The aim of this article is to review the latest evidence regarding the epidemiology,pathogenesis,manifestations,diagnosis and treatment for CAN. | Gerasimos Dimitropoulos Abd A Tahrani Martin J Stevens | 2014 | World Journal of Diabetes2014，5，1： | 48 |
| 4 | Metabolic syndrome and non-alcoholic fatty liver disease:Asian definitions and Asian studies显示文摘BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), as conventionally recognized, is a metabolic disorder largely confined to residents of affluent industrialized Western countries. However, obesity and insulin resistance are not restricted to the West, as witnessed by their increasingly universal distribution. In particular, there has been an upsurge in metabolic syndrome in the Asia-Pacific region, although there are critical differences in the extent of adiposity between Eastern and Western populations. DATA SOURCES: An English-language literature search using PubMed (1999-2007) on obesity, metabolic syndrome and NAFLD, focusing on Asian definitions and Asian studies. RESULTS: NAFLD appears to be of long-standing insulin resistance and likely represents the hepatic manifestation of the metabolic syndrome. With insulin resistance as a common factor, the disease is associated with atherosclerosis and cardiovascular risk. All features of the metabolic syndrome and related events are assessed for practical management of NAFLD, although the criteria for the diagnosis of obesity and central obesity differ across racial groups. CONCLUSIONS: The increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension and ultimately metabolic syndrome, puts a very large population at risk of developing NAFLD in the coming decades. The simultaneous identification and appropriate treatment of the components of metabolic syndrome are crucial to reduce hepatic as well as cardiovascular morbidity and mortality. | Fan, Jian-Gao Peng, Yong-De | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，6： | 42 |
| 5 | Ocular complications of diabetes mellitus显示文摘Diabetes mellitus(DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and isbecoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. | Nihat Sayin Necip Kara G?khan Pekel | 2015 | World Journal of Diabetes2015，6，1： | 38 |
| 6 | Type 2 diabetes mellitus:From a metabolic disorder to an inflammatory condition显示文摘Diabetes mellitus is increasing at an alarming rate and has become a global challenge.Insulin resistance intarget tissues and a relative deficiency of insulin secretion from pancreatic β-cells are the major features of type 2 diabetes(T2D).Chronic low-grade inflammation in T2 D has given an impetus to the field of immuno-metabolism linking inflammation to insulin resistance and β-cell dysfunction.Many factors advocate a causal link between metabolic stress and inflammation.Numerous cellular factors trigger inflammatory signalling cascades,and as a result T2 D is at the moment considered an inflammatory disorder triggered by disordered metabolism.Cellular mechanisms like activation of Tolllike receptors,Endoplasmic Reticulum stress,and inflammasome activation are related to the nutrient excess linking pathogenesis and progression of T2 D with inflammation.This paper aims to systematically review the metabolic profile and role of various inflammatory pathways in T2 D by capturing relevant evidence from various sources.The perspectives include suggestions for the development of therapies involving the shift from metabolic stress to homeostasis that would favour insulin sensitivity and survival of pancreatic β-cells in T2 D. | Iqra Hameed Shariq R Masoodi Shahnaz A Mir Mudasar Nabi Khalid Ghazanfar Bashir A Ganai | 2015 | World Journal of Diabetes2015，6，4： | 36 |
| 7 | Update on the treatment of type 2 diabetes mellitus显示文摘To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade. | Juan Jose Marin-Penalver Iciar Martin-Timon Cristina Sevillano-Collantes Francisco Javier del Canizo-Gomez | 2016 | World Journal of Diabetes2016，7，17： | 37 |
| 8 | Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research显示文摘The incidence of diabetes mellitus(DM) continues to rise and has quickly become one of the most prevalent and costly chronic diseases worldwide. A close link exists between DM and cardiovascular disease(CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. Cardiovascular(CV) risk factors such as obesity, hypertension and dyslipidemia are common in patients with DM, placing them at increased risk for cardiac events. In addition, many studies have found biological mechanisms associated with DM that independently increase the risk of CVD in diabetic patients. Therefore, targeting CV risk factors in patients with DM is critical to minimize the long-term CV complications of the disease. This paper summarizes the relationship between diabetes and CVD, examines possible mechanisms of disease progression, discusses current treatment recommendations, and outlines future research directions. | Benjamin M Leon Thomas M Maddox | 2015 | World Journal of Diabetes2015，6，13： | 39 |
| 9 | WJD 5^(th) Anniversary Special Issues(2): Type 2 diabetes Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?显示文摘Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular disease.Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these patients.However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors.Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus.Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events.Many of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from'common soil'.The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients. | Iciar Martín-Timón Cristina Sevillano-Collantes Amparo Segura-Galindo Francisco Javier del Caizo-Gómez | 2014 | World Journal of Diabetes2014，5，4： | 32 |
| 10 | 住院2型糖尿病患者合并慢性肾脏病的患病率及其危险因素分析显示文摘回顾性分析l 466例住院2型糖尿病(T2DM)患者的临床和实验室资料,统计慢性肾脏病(chronic kidney disease,CKD)患病率,应用logistic回归分析CKD的危险因素,根据危险因素进一步分层分析;住院T2DM患者合并CKD的患病率为52.25%,其中93.47%患者合并蛋白尿,27.93%患者肾小球滤过率(eGFR)<60 ml·min-1·1.73 m-2,24.28%患者肾小管功能受损,14.88%患者肾脏形态学异常;非条件logistic回归分析表明,年龄、体重指数、糖尿病病程、收缩压、血尿酸、低密度脂蛋白胆固醇(LDL-C)、吸烟与住院T2DM合并CKD独立相关;住院T2DM患者合并CKD的患病率随年龄、糖尿病病程、体重指数及低密度脂蛋白胆固醇增加而增加.CKD是住院T2DM的常见慢性并发症,尤其对病程较长的高龄、肥胖T2DM患者,更应注意CKD的早期筛查,筛查项目除尿蛋白、eGFR外,还应包括肾小管功能及肾脏形态学检查. | 许杰 杨菊红 单春艳 郑妙艳 王颖 任惠珠 常宝成 | 2014 | 中华内分泌代谢杂志2014，30，7： | 32 |
| 11 | Changing trends in management of gestational diabetes mellitus显示文摘Gestational diabetes mellitus(GDM)is on the rise globally.In view of the increasing prevalence of GDM and fetal and neonatal complications associated with it,there is a splurge of research in this field and management of GDM is undergoing a sea change.Trends are changing in prevention,screening,diagnosis,treatment and future follow up.There is emerging evidence regarding use of moderate exercise,probiotics and vitamin D in the prevention of GDM.Regarding treatment,newer insulin analogs like aspart,lispro and detemir are associated with better glycemic control than older insulins.Continuous glucose monitoring systems and continuous subcutaneous insulin systems may play a role in those who require higher doses of insulin for sugar control.Evidence exists that favors metformin as a safer alternative to insulin in view of good glycemic control and better perinatal outcomes.As the risk of developing GDM in subsequent pregnancies and also the risk of overt diabetes in later life is high,regular assessment of these women is required in future.Lifestyle interventions or metformin should be offered to women with a history of GDM who develop pre-diabetes.Further studies are required in the field of prevention of GDM for optimizing obstetric outcome. | Gunasekaran Kala Poomalar | 2015 | World Journal of Diabetes2015，6，2： | 32 |
| 12 | Gestational diabetes mellitus: Challenges for different ethnic groups显示文摘Ethnicity is defined as'belonging to a social groupthat has a common national or cultural tradition'.Membership of certain ethnic groups has long been associated with increased risk of gestational diabetes mellitus(GDM).Studies that examined ethnic differences amongst women with GDM were often conducted in western countries where women from various ethnic backgrounds were represented.The prevalence of GDM appears to be particularly high among women from South Asia and South East Asia,compared to Caucasian,African-American and Hispanic communities.For some,but not all ethnic groups,the body mass index is a risk factor for the development of GDM.Even within a particular ethnic group,those who were born in their native countries have a different risk profile for GDM compared to those born in western countries.In terms of treatment,medical nutrition therapy(MNT)plays a key role in the management of GDM and the prescription of MNT should be culturally sensitive.Limited studies have shown that women who live in an English-speaking country but predominantly speak a language other than English,have lower rates of dietary understanding compared with their English speaking counterparts,and this may affect compliance to therapy.Insulin therapy also plays an important role and there appears to be variation as to the progression of women who progress to requiring insulin among different ethnicities.As for peri-natal outcomes,women from Pacific Islander countries have higher rates of macrosomia,while women from Chinese backgrounds had lower adverse pregnancy outcomes.From a maternal outcome point of view,pregnant women from Asia with GDM have a higher incidence of abnormal glucose tolerance test results post-partum and hence a higher risk of future development of type2 diabetes mellitus.On the other hand,women from Hispanic or African-American backgrounds with GDM are more likely to develop hypertension post-partum.This review highlights the fact that management needs to be individualised and the clinician should be mindful of the impact that differences in ethnicity may have on the clinical characteristics and pregnancy outcomes inwomen affected by GDM,particularly those living in Western countries.Understanding these differences is critical in the delivery of optimal antenatal care for women from diverse ethnic backgrounds. | Lili Yuen Vincent W Wong | 2015 | World Journal of Diabetes2015，6，8： | 29 |
| 13 | Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke显示文摘Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. | Adrià Arboix | 2015 | World Journal of Clinical Cases2015，3，5： | 29 |
| 14 | Parental transmission of type 2 diabetes mellitus in a highly endogamous population显示文摘AIM: To determine the parental transmission of diabetes mellitus (DM) and evaluate its influence on the clinical characteristics. METHODS: This was a cross sectional study. The survey was carried out in urban and semi-urban primary health care centers. Of the 2400 registered with diagnosed diabetes, 1980 agreed and gave their consent to take part in this study, thus giving a response rate of 82.5%. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. DM was defined according to the World Health Organization expert group. A trained nurse performedphysical examinations and measurements. RESULTS: Of the study population, 72.9% reported a family history of DM. Family history of DM was significantly higher in females (54.2%; P = 0.04) and in the age group below 30 years (24%; P < 0.001). The prevalence of diabetes was higher among patients with a diabetic mother (25.4% vs 22.1%) and maternal aunts/uncles (31.2% vs 22.2%) compared to patients with a diabetic father and paternal aunts/ uncles. Family history of DM was higher in patients of consanguineous parents (38.5%) than those of non-consanguineous parents (30.2%). The development of type 2 diabetes mellitus (T2DM) complications was higher in patients with either a paternal or maternal history of DM than in those without. No significant difference was observed in the metabolic characteristics of patients with/without family history of DM except for hypertension. Complications were higher in diabetic patients with a family history of DM. CONCLUSION: The present study found a significant maternal effect in transmission of T2DM. Family history is associated with the increased incidence of diabetes. | Abdulbari Bener Mohammad T Yousafzai Abdulla OAA Al-Hamaq Abdul-Ghani Mohammad Ralph A DeFronzo | 2013 | World Journal of Diabetes2013，4，2： | 28 |
| 15 | Risk factors associated with the development of ischemic colitis显示文摘AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003.IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible his-tology.Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of colitis.Cases were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was performed.RESULTS:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%women.The principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(P<0.001);diabetes mellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(P<0.001).Finally,the following variables were independently associated with the development of IC:diabetes mellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associated with diabetes,dyslipid-emia,presence of heart failure,peripheral arterial dis-ease and treatment with digoxin or ASA. | Joaquín Cubiella Fernández Luisa Núez Calvo Elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel Martínez Silva Javier Fernández Seara | 2010 | World Journal of Gastroenterology2010，16，36： | 27 |
| 16 | Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes显示文摘Background:Weight gain during pregnancy reflects the mother's nutritional status.However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM).This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM.Methods:A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016.Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records.Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression.Results:In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG.Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50-3.52, P<0.001), large for gestational age (aOR 2.06, 95% CI 1.44-2.93, P<0.001), small for gestational age (aOR 0.49, 95% CI 0.25-0.97, P=0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20-12.00, P=0.023), preterm birth (aOR 0.45, 95% CI 0.21-0.96, P=0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13-1.87, P=0.004).Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96-6.37, P<0.001).Conclusions:Both excessive and insufficient weight gain require attention in women with GDM.Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes. | Bao-Hua Gou Hui-Min Guan Yan-Xia Bi Bing-Jie Ding | 2019 | Chinese Medical Journal2019，，2： | 28 |
| 17 | Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes显示文摘AIM:To evaluate the correlation between nonalcoholic fatty liver disease(NAFLD) and microvascular complications in type 2 diabetes mellitus(T2DM).METHODS:Data were obtained from 1217 inpatients with T2DM(757 females,460 males;aged 63.39 ± 12.28 years).NAFLD was diagnosed by hepatic ultrasonography.Diabetic nephropathy(DN),diabetic peripheral neuropathy(DPN),and diabetic retinopathy(DR) were diagnosed according to their respective criteria.The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression,respectively.RESULTS:Approximately 61% of inpatients with T2DM in Qingdao,China had NAFLD,which decreased significantly with increase in age and prolonged course of diabetes.The prevalence of NAFLD in patients presenting with DN,DPN and DR was 49.4%,57.2% and 54.9%,respectively.These rates were significantly lower than those of patients without DN,DPN and DR(65.9%,65.6% and 66.1%,respectively,P < 0.05).Participants with NAFLD had greater body weight,waist circumference(WC),body mass index(BMI),fasting blood glucose(FBG),hemoglobin A1c,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,blood pressure,as well as triglyceride(TG) levels and lower high-density lipoprotein(HDL) concentration than those without NAFLD(P < 0.05).NAFLD was positively correlated with BMI,WC,TG,FBG,diastolic blood pressure,and systolic blood pressure but negatively correlated with the duration of diabetes,DR,DPN,DN,and HDL.CONCLUSION:Despite the benign nature of NAFLD,efforts should be directed toward early diagnosis,intensive blood glucose and blood pressure control,and effective dyslipidemia correction. | Wen-Shan Lv Rui-Xia Sun Yan-Yan Gao Jun-Ping Wen Rong-Fang Pan Li Li Jing Wang Yu-Xin Xian Cai-Xia Cao Ming Zheng | 2013 | World Journal of Gastroenterology2013，19，20： | 26 |
| 18 | Association of type 2 diabetes mellitus and the risk ofcolorectal cancer: A meta-analysis and systematic review显示文摘AIM To provide a quantitative assessment of theassociation between type 2 diabetes mellitus (T2DM)and the risk of colorectal cancer (CRC).METHODS: Systematic review was conductedthorough MEDLINE, EMBASE, Cochrane Library, and ISI Web of knowledge databases till 31st January 2014.This meta-analysis included the cohort studies thatillustrated relative risk (RR) or odds ratio estimateswith 95%CI for the predictive risk of CRC by T2DM.Summary relative risks with 95%CI were analyzed byusing an effects summary ratio model. Heterogeneityamong studies was assessed by the Cochran's Q and I 2statistics.RESULTS: The meta analysis of 8 finally selectedstudies showed a positive correlation of T2DM withthe risk of CRC as depicted by effects summary RRof 1.21 (95%CI: 1.02-1.42). Diabetic women showedgreater risk of developing CRC as their effect summaryRR of 1.22 (95%CI: 1.01-49) with significant overallZ test at 5% level of significance was higher than theeffect summary RR of 1.17 (95%CI: 1.00-1.37) of menshowing insignificant Z test. The effect summary RRof 1.19 with 95%CI of 1.07-1.33 indicate a positiverelationship between DM and increased risk of CRCwith significant heterogeneity (I 2 = 92% and P -value 〈0.05).CONCLUSION: Results from this systematic reviewand meta-analysis report that diabetic people have anincreased risk of CRC as compared to non-diabetics. | | 2015 | World Journal of Gastroenterology2015，21，19： | 26 |
| 19 | Update on type 2 diabetes-related osteoporosis显示文摘It was previously understood that body weight gain and obesity observed in type 2 diabetes mellitus(T2DM) could be beneficial since body weight increase elevated bone mineral density and thus helped maintain the skeletal framework.However,a number of recent findings in humans and rodents have revealed that T2 DM is not only associated with trabecular defects but also increases cortical porosity,and compromised bone cell function and bone mechanical properties.Hyperglycemia and insulin resistance in T2 DM may further induce osteoblast apoptosis and uncoupling bone turnover.Prolonged accumulation of advanced glycation end products and diminished activity of lysyl oxidase,an essential enzyme for collagen cross-link,can lead to structural abnormalities of bone collagen fibrils,brittle matrix,and fragility fractures.Our studies in T2 DM rats showed that dyslipidemia,which often occurs in T2 DM,could obscure the T2DM-associated changes in bone microstructure and osteopenia.Longitudinal bone growth regulated by the growth plate chondrocytes is also impaired by T2 DM since differentiation of growth plate chondrocytes is arrested and retained in the resting state while only a small number of cells undergo hypertrophic differentiation.Such a delayed chondrocyte differentiation may have also resulted from premature apoptosis of the growth plate chondrocytes.Nevertheless,the underlying cellular and molecular mechanisms of insulin resistance in osteoblasts,osteoclasts,osteocytes,and growth plate chondrocytes remain to be investigated. | Kannikar Wongdee Narattaphol Charoenphandhu | 2015 | World Journal of Diabetes2015，6，5： | 26 |
| 20 | Molecular mechanisms of insulin resistance in type 2 diabetes mellitus显示文摘Free fatty acids are known to play a key role in promoting loss of insulin sensitivity in type 2 diabetes mellitus but the underlying mechanism is still unclear.It has been postulated that an increase in the intracellular concentration of fatty acid metabolites activates a serine kinase cascade,which leads to defects in insu-lin signaling downstream to the insulin receptor.In addition,the complex network of adipokines released from adipose tissue modulates the response of tissues to insulin.Among the many molecules involved in the intracellular processing of the signal provided by insulin,the insulin receptor substrate-2,the protein kinase B and the forkhead transcription factor Foxo 1a are of particular interest,as recent data has provided strong evidence that dysfunction of these proteins results in insulin resistance in vivo.Recently,studies have revealed that phosphoinositidedependent kinase 1-independent phosphorylation of protein kinase Cε causes a reduction in insulin receptor gene expression.Additionally,it has been suggested that mitochondrial dysfunction triggers activation of several serine kinases,and weakens insulin signal transduction.Thus,in this review,the current developments in understanding the pathophysiological processes of insulin resistance in type 2 diabetes have been summarized.In addition,this study provides potential new targets for the treatment and prevention of type 2 diabetes. | Vandana Saini | 2010 | World Journal of Diabetes2010，1，3： | 23 |
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