Omarigliptin for the treatment of type 2 diabetes mellitus

Introduction: The estimated global prevalence of diabetes mellitus for adults aged 20-70 in 2015 was 415 million with approximately 90% of diagnosed cases being Type 2 diabetes mellitus (T2DM). Improvements in lifestyle and effective therapies are key to management but due to the progressive nature of T2DM, pharmacotherapy is typically required. Whilst the initial therapy will usually be with metformin, thereafter treatment should be individualised, with consideration of several different second line options. These include the dipeptidyl peptidase-4 (DPP-4) inhibitors, of which omarigliptin is the second once weekly version.

Areas covered: The paper summarises key pharmoacodynamic and pharmacokinetic features and reviews the efficacy and safety trial data of omarigliptin, a once-weekly DPP-4 inhibitor.

Expert opinion: Omarigliptin results in a significant improvement in glycaemia with an effective once weekly pharmacokinetic profile and low risk of drug-drug interactions. It has equivalent efficacy to existing once daily DPP-4 inhibitors and shares a similar side effect profile. It is weight neutral with a significantly lower risk of hypoglycaemia compared with sulphonylureas. Adherence to prescribed medication is poor in patients with T2DM. Once weekly omarigliptin is a welcomed addition to the therapeutic armoury but whether it will improve compliance remains to be seen.     

H型高血压患者血压变异性与冠脉病变程度的关系

目的探讨H型高血压患者血压变异性与冠脉病变程度的关系。方法选择锦州市中心医院2017年1月-2018年12月收治的H型高血压患者349例,分为对照组(单纯H型高血压)186例和观察组(H型高血压+冠心病)163例。比较两组患者的日间收缩压(dSBP)、夜间收缩压(nSBP)及SCV;比较两组患者的日间舒张压(dSBP)、夜间舒张压(nSBP)及DCV,并对血压变异性与冠脉病变程度的关系进行探讨。结果两组dSBP.nSBP.SCV和dDBP.nDBP.DCV差异均有统计学意义(P<0.05).Gensini评分=2.231+3.414×SCV+2.917×SCV。结论H型高血压患者血压变异性与患者冠脉病变程度密切相关,SCV和DCV是其独立危险因素。     

Le transfert de microbiote fécal : quel potentiel thérapeutique dans le traitement des maladies métaboliques ?

An imbalance of the gut microbiota composition or functions is frequently observed during obesity and metabolic diseases. Studies on rodents showed that the modulation of microbiota dysbiosis by various methods is associated with an improvement in metabolic parameters. In humans, dietary interventions or bariatric surgery are accompanied by changes in the composition of the microbiota. Fecal microbiota transfer is a promising therapeutic approach to change the composition of the gut microbiota, however, it is currently only officially indicated in the treatment of recurrent Clostridioides difficile colitis. Literature documenting the effect of faecal microbiota transplantation in metabolic diseases is much less abundant. Nevertheless, FMT from healthy donors to obese patients with metabolic syndrome significantly improves the insulin sensitivity of the recipients despite the large response variability. This variability seems to be mainly related to the difference in richness between the donor's microbiota and the recipient's microbiota. To date, the impact of the donor's choice, the protocol of preparation, storage and administration of the inoculum, as well as the possible preparation of the recipient are to be explored.     

Orthorexia Nervosa in Turkish dietitians and dietetic students

ObjectivesOrthorexia Nervosa (ON) is characterized by a pathological obsession with healthy eating, and dietetic majors may have a potential risk of developing ON due to their occupation that necessitates consideration of optimal food choices. This study aimed to determine the prevalence of ON among a large sample of dietitians and dietetic students in Turkey and to investigate the association of ON with socio-demographic features and eating attitudes within the whole sample.MethodsParticipants (n = 1429) completed a self-administered online survey that featured socio-demographic characteristics, the Orthorexia Nervosa Questionnaire (ORTO-11), and the Eating Attitudes Test-26 (EAT-26). Scores on the ORTO-11 and EAT-26 determined the prevalence of ON and disordered eating behaviors, respectively.ResultsThe prevalence of ON among Turkish dietetic majors was 59.8% with a higher ratio in dietetic students (63.8%) than dietitians (52.9%) (P < 0.001). While graduation was associated with 33.1% lower odds of ON (P = 0.006), eating disorders could increase the ON risk approximately five times (P < 0.001). Furthermore, the greater total and subscale (dieting, bulimia, and oral control) scores of EAT-26 were associated with higher ON tendency (P < 0.001), even after adjustment for potential confounders.ConclusionsOur findings may shed light on the relevance of developing strategies to reduce the prevalence of ON in the dietetic population but need to be supported by further longitudinal and prospective studies.     

Ⅱ型排卵障碍女性使用克罗米芬或来曲唑诱导排卵的AID临床结局及妊娠结局比较

目的比较Ⅱ型排卵障碍女性使用克罗米芬(CC)方案或来曲唑(LE)方案诱导排卵后供精人工授精(AID)周期的临床结局和妊娠结局。方法回顾性分析2012年1月至2019年8月578名Ⅱ型排卵障碍妇女在我中心完成的1253个AID周期的超声监测数据及临床资料。比较单用CC或LE或联合促性腺激素(Gn)诱导排卵的AID周期的参数和临床结局。采用单因素和多因素Logistic回归分析,探讨诱导排卵方案与宫内妊娠和活产的关系。比较CC及LE方案的妊娠结局和新生儿出生状况。结果总体上4种方案的宫内妊娠率和活产率无显著差异(P>0.05);校正混杂因素后,与单用CC相比,CC联合Gn及LE联合Gn均显著促进宫内妊娠(分别为OR=1.641,P=0.024;OR=1.543,P=0.019)和活产(分别为OR=1.589,P=0.047;OR=1.508,P=0.034),而单用LE与单用CC相比均无显著差异(P>0.05);各种妊娠结局的发生率及新生儿出生状况在CC及LE方案之间均无显著差异(P>0.05)。结论在宫内妊娠和活产方面,无论单用还是与Gn联用,LE与CC疗效相当,且联用Gn优于单用;LE和CC方案的妊娠结局及新生儿出生状况基本可比。     

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults

Background and aimsSome amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults.Methods and resultsA cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk.ConclusionSerum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.     

2型糖尿病患者智谋水平与生活质量的相关性研究

目的 探讨2型糖尿病患者智谋水平现状,并分析其与生活质量的相关性。方法 采用一般资料问卷、智谋量表(resourcefulness scale,RS)、糖尿病生存质量特异性量表(diabetes specific quality of life scale,DSQL)对210例2型糖尿病患者进行问卷调查。结果 2型糖尿病患者的智谋得分为(75.20±22.17)分,单因素分析显示,不同文化程度、人均月收入的患者,智谋水平得分比较,差异有统计学意义。2型糖尿病患者生活质量得分为(59.17±12.16)分;Pearson相关分析显示,智谋水平各维度得分及总分与生活质量得分均呈负相关(P＜0.05)。结论 2型糖尿病患者智谋水平越高,其生活质量水平越高,临床工作者应关注糖尿病患者的智谋水平,采取针对性的护理干预,以提高患者的智谋水平,从而提高其生活质量水平。