Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease

AIM： To explore the association between hepatocellular carcinoma （HCC） and type 2 diabetes mellitus, describe the temporal relations between the onset of diabetes and the development of HCC and evaluate the possible effects of antidiabetic therapy on HCC risk,METHODS： We recruited 465 HCC patients, 618 with cirrhosis and 490 control subjects. We evaluated the odds ratio （OR） for HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic subjects treated with insulin or sulphanylureas and with metformin were calculated.RESULTS： The prevalence of diabetes mellitus was 31.2% in HCC, 233% in cirrhotic patients and 12.7% in the Control group. By univariate and multivariate analysis, the OR for HCC in diabetic patients were respectively 3.12 （CI 2.2-4.4, P 〈 0.001） and 2.2 （CI 1.2-4.4, P = 0.01）. In 84.9% of cases, type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we report an OR for HCC of 2.99 （CI 1.34-6.65, P = 0.007） in diabetic patients treated with insulin or sulphanylureas, and an OR of 0.33 （CI 0.1-0.7, P = 0.006） in diabetic patients treated with metformin.CONCLUSION： Our study confirms that type 2 diabetes mellitus is an independent risk factor for HCC and pre-exists in the majority of HCC patients. Moreover, in male patients with type 2 diabetes meUitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy.     

Classification tree model analysis on related factors of different stages of kidney in type 1 diabetic patients

正Objective To analyze the related factors of micro-albuminuria and macro-albuminuria in type 1 diabetes mellitus(DM)in the classification tree model,and to screen the high risk population of diabetic kidney disease.Methods 394 patients with type 1 diabetes were enrolled in the hospital from 2008 to 2015.According to glomerular filtration rates and urine albumin quantification,the     

新疆维吾尔自治区汉、维吾尔和哈萨克族人群正常血压和高血压前期状况分析

目的 探讨新疆维吾尔自治区汉、维吾尔和哈萨克族35岁及以上成年人正常血压和高血压前期分布状况,高血压前期的患病率及其危险因素.方法 采用整群随机抽样法,对新疆维吾尔自治区乌鲁木齐市、克拉玛依市、阜康市、吐鲁番地区、和田地区、阿勒泰地区、伊犁哈萨克自治州7个市及地区汉、维吾尔和哈萨克族35岁及以上成年人进行血压和危险因素情况的横断面调查.结果 共随机抽取新疆维吾尔自治区汉、维吾尔和哈萨克族35岁以上人群16 460名,实际完成调查的人数共14 618名.正常血压占24.90%;高血压前期患病率标准化后为34.24%,其中汉族为37.34%,维吾尔族为32.95%,哈萨克族为30.62%.男性高血压前期患病率高于女性(35.58%比31.53%,P<0.01).45岁及以上男性和女性汉族和维吾尔族人群高血压前期患病率均随年龄增长而呈降低趋势,35岁及以上男性和女性哈萨克族人群高血压前期患病率随年龄增长而呈降低趋势(P均<0.05).多因素非条件logistic回归分析显示,甘油三酯≥1.7 mmol/L、年龄≥45岁、空腹血糖≥7.0 mmol/L和体质指数≥24.0 kg/m2是高血压前期的危险因素,女性是高血压前期的保护因素.结论 新疆维吾尔自治区35岁及以上汉、维吾尔和哈萨克族人群中正常血压者较少,而高血压前期的患病率较高,并与多种危险因素相关.

Abstract：

Objective To investigate the situation of normal blood pressure and prevalence and risk factors of prehypertension in Han, Uygur and Hazakh population ≥35 years old of Xinjiang Uygur autonomous region.Methods Random samples were used to analyze the incidence of normal blood pressure and prehypertension in 3 nationalities based on data from Han, Uygur and Hazakh residents living in 7 areas (Urumqi,Ke lamayi, Fukang, the Turfan Basin locality, Hetian locality, Altay locality,and Yili Hazakh autonomous prefecture) in Xinjiang Uygur autonomous region.Results A total of 16 460 subjects were selected with cluster sampling, and eligible data of 14 618 subjects were actually analyzed in Han, Uygur and Hazakh population ≥35 years old of Xinjiang Uygur autonomous region.Incidence of normal blood pressure was 24.9% and the prevalence of prehypertension was 34.24% (35.6% fro male and 31.5% for female, P<0.01) in Han, Uygur and Hazakh population ≥35 years old in Xinjiang Uygur autonomous region.The prevalence of prehypertension was 37.34%, 32.95% and 30.62% in Han, Uygur and Hazakh population, respectively. The prevalence of prehypertension decreased with increasing age in Han and Uygur population ≥45 years old, and in Hazakh population≥35 years old (all P<0.05).Multiple logistic regression analysis revealed that hypertriglyceridemia≥1.7 mmol/L, age≥45 years old, fasting plasma glucose≥7.0 mmol/L and body mass index≥24.0 kg/m2 were risk factors while the female was a protective factor of prehypertension. Conclusion The people with normal blood pressure is few and the prevalence of prehypertension is high in Han, Uygur and Hazakh population ≥35 years old of Xinjiang Uygur autonomous region, and it is associated with many risk factors.     

A 3 year-cumulative incidence of diabetes mellitus in a community in Shanghai and analysis of its related influential factors

<正>Objective To investigate the 3 year-cumulative incidence of diabetes mellitus in a community in Shanghai and the analysis of related influential factors analysis.Methods The resident subjects were from a communitybased diabetes prospective cohort(35-74 years old)in Pudong New Area.Two surveys on diabetes risk factors,physical examination,and the measurements of biochem-     

2型糖尿病患者诊断前体重变化特征及影响因素分析

调查河南地区1 364例初诊2型糖尿病患者诊断前最大体重,分析其变化特征并探讨相关影响因素.2型糖尿病患者出现最大体重时的年龄与2型糖尿病初诊时的年龄间隔(3.3±5.6)年.男性、有糖尿病家族史、商人和公务员等,分别与女性、无糖尿病家族史、其他职业等相对应比较,前者出现最大体重的年龄及2型糖尿病初诊年龄均较小(P<0.01).

Abstract：

The weight change before type 2 diabetes mellitus was diagnosed in Henan Province was investigated in 1 364 cases and the related factors were analyzed.The time interval from the appearance of the maximum bedv weight to newly diagnosed type 2 diabetes mellitus was(3.3±5.6)years.The ages by the appearance of the maximum body weight and newly diagnosed type 2 diabetes mellitus were younger in males,individuals with familv history of diabetes mellitus,civil servants,and businessmen as compared with females,individuals without diabetes mellitus family history,and other occupations(P<0.01).     

天津地区内分泌科就诊的2型糖尿病患者视网膜病变及黄斑水肿的患病率调查

9 237例住院2型糖尿病患者的分析结果表明,糖尿病视网膜病变(DR)患病率为32.9%,其中轻度、中度、重度非增生性DR的患病率分别为10.1%、18.3%、3.2%,增生性DR患病率为1.3%;糖尿病黄斑水肿(DME)患病率为3.56%,占DR患者的10.8%;糖尿病病程和蛋白尿是DR和DME的共同危险因素.

Abstract：

According to the analysis of 9 237 hospitalized type 2 diabetic patients, the prevalence of diabetic retinopathy ( DR )was 32.9％ , with the prevalence of mild, moderate, and serious non-proliferative DR and proliferative DR being 10. 1％, 18. 3％, 3.2％, and 1.3％ respectively. The prevalence of diabetic macular edema ( DME ) was 3.56％ in type 2 diabetics and i 0. 8％ in patients with DR. Diabetes duration and proteinuria were the common risk factors of DR and DME.     

Clinical features and risk factors of patients with fatty liver in Guangzhou area

AIM:There is still no accepted conclusion regarding the clinical features and related risk factors of patients with fatty liver.The large-scale clinical studies have not carried out yet in Guangzhou area. The aim of the present study was to investigate the clinical features and related risk factors of patients with fatty liver in Guangzhou area.METHODS:A total of 413 cases with fatty liver were enrolled in the study from January 1998 to May 2002. Retrospective case-control study was used to evaluate the clinical features and related risk factors of fatty liver with logistic regression.RESULTS: Obesity (OR：21.204), alcohol abuse (OR：18.601),type 2 diabetes mellitus (OR：4.461), serum triglyceride (TG)(OR：3.916), serum low-density lipoprotein cholesterol (LDL-C) (OR：1.840) and fasting plasma glucose (FPG) (OR：1.535) were positively correlated to the formation of the fatty liver.The levels of serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) increased mildly in the patients with fatty liver and were often less than 2-fold of the normal limit.The higher abnormalities of aspartate aminotransferase (AST) levels (42.9%) with AST/ALT more than 2(17.9%) were found in patients with alcoholic fatty liver (AFL) than those with nonalcoholic fatty liver (NAFL) (16.9% and 5.0% respectively).The elevation of serum TG, cholesterol (CHOL), LDL-C was more common in patients with NAFL than with AFL.CONCLUSION:Obesity, alcohol abuse, type 2 diabetes mellitus and hyperlipidernia may be independent risk factors of fatty liver.The mildly abnormal hepatic functions can be found in patients with fatty liver.More obvious damages of liver function with AST/ALT usually more than 2 were noted in patients with AFL.     

Prevalence of type 2 diabetes in Algerian patients with hepatitis C virus infection

AIM:To investigate the prevalence of,and risk factors for,diabetes mellitus(DM) in Algerian patients with chronic hepatitis C virus(HCV) infection and in a control group.METHODS:A cross-sectional study was undertaken.A total of 416 consecutive patients with viral chronic hepatitis attending the Internal Medicine Department of the University Hospital Center Touhami Benflis in Batna [290 HCV-infected and 126 hepatitis B virus(HBV)-infected patients] were prospectively recruited.RESULTS:The prevalence of DM wa...     

Analysis of the prevalence and risk factors of thyroid nodule in elderly patients with type 2 diabetes mellitus

正Objective To investigate the prevalence of thyroid nodule(TN)and to explore the independent risk factors in elderly(age≥45 years)patients with type 2 diabetes mellitus(T2DM).Methods 173 T2DM were enrolled and 100 individuals without T2DM were selected as the control group.173 T2DM were divided into TN92 cases(T2DM-TN group)and non TN 81 cases(Non-TN     

新疆汉、维吾尔、哈萨克族成年人高尿酸血症及痛风的流行病学调查

应用四阶段整群随机抽样法,在新疆地区调查了13 559名汉、维吾尔、哈萨克族成年人的高尿酸血症及痛风患病率.汉、维吾尔、哈萨克族高尿酸血症标化患病率分别为11.00%、3.27%和3.94%;痛风患病率分别为1.32%、0.65%和0.70%,差异均有统计学意义(均P＜0.05).非条件logistic回归分析显示,维吾尔族及哈萨克族患高尿酸血症的风险较汉族低;体重指数、肾功能及血脂为高尿酸血症的危险因素;女性及体力活动为保护因素.食海鲜及动物内脏是汉族患高尿酸血症的独立危险因素,食动物内脏及饮酒是哈萨克族的独立危险因素.

Abstract：

Four-stage selected random samples were used to analyze the prevalence and distributing feature of hyperuricemia and gout in 13 559 Han,Uighur,and Hazakh adults in Xinjiang. The prevalence of hyperuricemia was 11.00%,3.27%,and 3.94% respectively in Han,Uighur,and Hazakh populations,and 1.32%, 0.65%,and 0.70% for gout,with statistically significant difference among three groups(all P＜0.05). No-conditional logistic regression analysis showed that nationality,body mass index,renal function,and serum lipid were risk factors of hyperuricemia,while female and physical activity were protective factors. Eating seafood and animal visceral organs were independent risk factors of hyperuricemia in Han population. Eating animal visceral organs and drinking alcohol were independent risk factors of hyperuricemia in Hazakh population.     

南京鼓楼医院体检人群超重率和肥胖率及其与心血管疾病风险因素的关联研究

目的:分析南京鼓楼医院体检人群超重率和肥胖率及其与心血管风险疾病之间的关联。方法:纳入384 061名20岁以上成人进行回顾性分析,采用2010年中国人口普查数据进行超重率和肥胖率的标化,采用多因素 logistic回归模型分析超重和肥胖与心血管疾病风险因素之间的关联。 结果:年龄标化的超重率和肥...     

The prevalence and identification of risk factors for type 2 diabetes mellitus and impaired glucose tolerance in Kayseri, central Anatolia, Turkey

Type 2 diabetes mellitus is a chronic disease which causes neurologic, cardiac, vascular, ocular and renal complications. The present study documented the prevalence of diabetes and associated risk factors in 1774 adults who were older than 30 years. An oral glucose tolerance test (OGTT) was conducted according to the World Health Organization (WHO) criteria. Of the 1452 subjects, 58 (4%) had diagnosed diabetes, 41 (2.9%) undiagnosed diabetes and 130 (9%) had impaired glucose tolerance. The total glucose intolerance was 15.9%. The prevalences of type 2 diabetes mellitus (9.7%–4.1%) were significantly different in low occupational and high occupational activity groups, respectively (P<0.0001). The prevalence of type 2 diabetes mellitus was 17.9% among the hypertensive group (P<0.0001). The prevalence of type 2 diabetes mellitus was higher in smokers (P<0.05). Patients with diagnosed diabetes, undiagnosed diabetes and IGT were older, more obese and have higher blood glucose values, triglyceride values, systolic and diastolic blood pressures than healthy subjects (P<0.001). We conclude that type 2 diabetes mellitus and IGT prevalences are quite high in the urban area of Kayseri, central Anatolia and multivariate analysis indicated that low occupational activity, low leisure acitivity, family history for diabetes, hypertension and obesity were significant independent risk factors for diabetes mellitus. Received: 23 January 1999 / Accepted in revised form: 19 May 1999     

上海市浦东新区社区人群糖尿病状况和相关危险因素分析

目的调查和了解上海市浦东新区社区人群糖代谢异常状况及其相关危险因素。方法采用抽样分层横断面现场调查方法对浦东新区4个社区18岁以上1869名成人进行问卷调查，并进行口服75g葡萄糖耐量试验。结果糖尿病(DM)患病率6．6％，糖耐量受损(IGT)患病率13．3％；DM和IGT患病率随增龄和肥胖度而增高，而随受教育程度的增高而下降；肥胖度随增龄有增高趋势，而受教育程度与增龄呈显著负相关；DM知识知晓率随受教育程度增高而增高；糖代谢异常与高血压密切相关，而与性别、职业和吸烟无显著相关。结论上海市浦东新区社区人群DM和IGT患病率较高，多种危险因素参与糖代谢异常的发生、发展。     

新疆维、汉族中老年人肥胖症的流行病学研究

随机抽取新疆年龄大于50岁的维、汉族中老年人8 284例,按照亚太地区肥胖诊断标准进行肥胖症的调查,了解新疆维、汉民族中老年人群肥胖症的现患状况及分布特点.维、汉两族肥胖标化率分别为20.12%和23.07%,汉族妇女患病率最高,饮酒、糖代谢异常、血清胆固醇是重要的危险凶素.     

Fibrinogen, other cardiovascular risk factors and diabetes mellitus in Hong Kong: a community with high prevalence of Type 2 diabetes mellitus and impaired glucose tolerance.

AIMS: To determine the prevalence of Type 2 diabetes mellitus and impaired glucose tolerance (IGT) and their relationships to fibrinogen and other cardiovascular risk factors in Hong Kong Chinese. METHODS: A probability sample of 1,316 men and 1,348 women aged 25-74 years were examined in a population-based cross-sectional study. RESULTS: A total of 3.0% (95% confidence interval 2.1-3.9) of men had previously diagnosed (known) and 6.4% (5.0-7.8) newly diagnosed (unknown) diabetes, 14.4% (12.4-16.5) had IGT and 79.2% were normal by 1985 WHO diagnostic criteria; corresponding prevalences in women were 3.7% (2.7-4.7), 5.9% (4.6-7.2), 17% (14.8-19.2) and 73.4%. The age-standardized prevalence of Type 2 diabetes for the 35-64 age group was 9.5% (7.5-11.6) in men and 10.2% (8.0-12.4) in women. Age-adjusted mean fibrinogen levels in these four groups (normal/IGT/unknown diabetes/known diabetes) with decreasing degrees of glucose tolerance (diabetes status) were 2.80, 2.57, 2.51 and 2.47 g/l (P = 0.003) in men, and 2.86, 2.72, 2.67, 2.61 g/l (P = 0.005) in women. Age, obesity, systolic blood pressure and triglycerides were significantly associated with diabetes status in both sexes, fibrinogen in men only and high density lipoprotein cholesterol negatively in women. CONCLUSIONS: The prevalence of Type 2 diabetes mellitus was very high especially in older subjects, and fibrinogen was associated with increasing glucose intolerance in men but not in women. The detection and better control of cardiovascular risk factors, particularly hypertension in this developed Chinese community with a high prevalence of diabetes and glucose intolerance, is particularly important.     

四种代谢综合征诊断标准在初发2型糖尿病人群中应用的比较

目的 比较WHO(1999年)、国际糖尿病联盟(IDF,2005年)、美国国家胆固醇教育计划成人治疗组(NCEP-ATPⅢ,2001年)的代谢综合征(MS)诊断标准和中华医学会糖尿病学分会(CDS,2004年)制定的MS诊断标准在我国初发老年2型糖尿病人群中应用的异同.方法 对初诊2型糖尿病患者1399例进行MS诊断相关指标测定,按年龄分为老年组259例和非老年组1140例,计算不同标准的MS诊断率,比较两组结果的异同.结果 (1)MS患病率以WHO诊断标准检出率最高(68.0%),NCEP-ATPⅢ标准次之(54.8%),CDS标准(47.9%)与IDF标准(46.7%)相近,NCEP-ATPUI标准、WHO诊断标准、IDF标准与CDS标准诊断率比较,差异均有统计学意义(P＜0.01);(2)NCEP-ATPⅢ标准与CDS标准诊断符合率较高,WHO、IDF标准稍差.结论 对初诊2型糖尿病患者,应用WHO标准诊断MS阳性率最高,NCEP标准与CDS标准一致性最高,WHO诊断标准可能更适合本组初发老年2型糖尿病患者.     

克拉玛依市区35岁以上汉族与维吾尔族人群鼾症流行病调查

目的 调查克拉玛依市区35岁以上汉族与维吾尔族人群打鼾的发病率,并分析其相关危险因素,为该病的防治提供依据.方法 采用整群抽样的方法对克拉玛依市区天山社区和永红社区35岁以上汉族及维吾尔族常住居民进行入户鼾症问卷调查.内容包括打鼾情况、白天嗜睡程度[爱波沃斯评分(ESS评分)],测量血压、身高、体质量、颈围、腹围、腰围及臀围.结果 2600人参加了鼾症问卷调查,实际调查人数为2 533人(应答率在95%以上).有效问卷2 357份(有效率为97.4%),其中汉族1021人,维吾尔族1 336人,打鼾者1 298人(51.2%),汉族打鼾发病率为61.9%,维族打鼾发病率为45.4%.汉族与维族鼾症高危组冠状动脉粥样硬化性心脏病及高血压发病率明显高于低危组(P值均<0.01).结论 克拉玛依市区35岁以上人群打鼾发病率为52.5%.打鼾随年龄、体质量指数、颈围、ESS评分的增加而增加,肥胖和ESS评分增高是汉族和维族打鼾的主要危险因素.打鼾是高血压、冠状动脉粥样硬化性心脏病的独立危险因素,是影响公众健康的重要问题,应当引起重视.     

Prevalence of macrovascular complications and cardiovascular risk factors in people treated for diabetes and living in France: the ENTRED study 2001

AIM: The aim of this study is to estimate the prevalence of macrovascular complications and cardiovascular risk factors among people with diabetes living in France and to compare these prevalences with other national estimates. METHODS: We randomly sampled 10,000 people who received one or more reimbursements for insulin or oral hypoglycaemic treatment from the major national medical insurance system during the period October-December 2001; 3646 of the 10,000 people completed a questionnaire; for a subgroup of 1718 people, their care providers completed a medical questionnaire. RESULTS: The prevalence of diagnosed macrovascular complications was of 17% according to patients (angina or myocardial infarction, 15%; coronary revascularization, 9%) and of 20% overall, according to physicians (angina or myocardial infarction, 16%; coronary revascularization, 6%; stroke, 5%). Macrovascular complications were more frequent in people with type 2 than type 1 diabetes, reflecting an age effect. The prevalences of cardiovascular risk factors in type 1 and type 2 diabetes were: current smoking, 35 and 14%; overweight, 28 and 42%; obesity, 9 and 36%; blood pressure superior to 130/80 mmHg, 29 and 59%; LDL cholesterol superior or equal to 3.4 mmol/l, 18 and 26%, respectively. CONCLUSIONS: Compared with other European countries, elevated blood pressure is more frequent in people with diabetes living in France; compared with US estimates, the prevalence of macrovascular complications is lower, glucose control better and blood pressure control poorer in France. These data, observed in a country with widespread access to care and at low cost to the patient, nevertheless demonstrate an urgent need for improving the cardiovascular risk profile of people with type 1 and type 2 diabetes, both with and without macrovascular complications.     

辽宁省农村地区高血压人群糖代谢异常的流行病学调查

目的了解辽宁省农村地区≥35岁高血压人群糖代谢异常患病率及相关危险因素。方法采用分层整群抽样方法对阜新农村≥35岁常住（≥5年）高血压人群进行流行病学调查。FPG按1997年ADA建议分类,使用SPSS11.5进行统计分析。结果空腹血糖受损（IFG）患病率为9.7%,男性高于女性;女性IFG患病率随年龄增长而增加。糖尿病（DM）患病率为10.0%,男性低于女性;DM患病率男、女均随年龄增长而增加。IFG及DM患病率随血压级别增高而增加。Logistic回归分析显示,糖代谢异常的相关危险因素为年龄、血压级别、超重或肥胖。结论辽宁省阜新农村地区高血压人群IFG及DM患病率较高,应给予关注,综合评估,全面治疗。