DOI: https://doi.org/10.1111/1753-0407.13221 EDITOR'S RECOMMENDATION 2. Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)2004 - 2014年中国1型糖尿病妇女妊娠结局:回顾性研究(CARNATION研究)作者：Sihui Luo, Xingwu Ran, Mei Zhang, Ji Hu, Daizhi Yang, Dalong Zhu, Jiajun Zhao, Xinhua Xiao, Xiaohui Guo, Tao Yang, Qin Huang, Fang Liu, Lu Jing, Jing Ma, Xinli Zhou, Fan Ping, Nan Gu, Wenwen Li, Yaling Yang, Chen Fang, Wei Bao, Xueying Zheng, Jinhua Yan, Zhiguang Zhou, Jianping Weng背景 本研究旨在报道中国1型糖尿病(T1D)患者的妊娠结局，该方面相关研究数据较少。方法 对全国8个城市的11家综合医疗中心进行回顾性研究。我们调查了2004年1月1日至2014年12月31日期间所有在这些中心就诊的单胎妊娠妇女的临床资料。确定妊娠期T1D的妇女妊娠情况，并与无T1D的妇女进行比较。结果 在11年的研究期间，从超过30万例妊娠中，我们鉴定了265例患有T1D的单胎妊娠妇女。265例T1D孕妇中有一例(0.37%)死亡，318486例无T1D孕妇中有83例(0.03%)死亡。与无T1D的女性相比，T1D的女性流产率更高(13.21% vs 2.92%，粗风险比[cRR] 5.08, 95%置信区间[CI] 3.56-7.26)、子痫前期(17.74% vs 4.20%， cRR 4.94, 95% CI 3.60-6.77)。与未患T1D的妇女相比，患有T1D妇女的婴儿新生儿死亡率(5.65% vs 0.16%， cRR 37.36, 95% CI 21.21-65.82)和先天性畸形率(8.26% vs 3.53%， cRR 2.46, 95% CI 1.54-3.93)较高。在2004-2014年间，T1D患者妊娠结局无明显改善。结论 2004-2014年中国T1D患者妊娠结局仍然较差。需要改善妊娠护理以减少中国T1D女性的不良妊娠结局。DOI: https://doi.org/10.1111/1753-0407.13229 ORIGINAL ARTICLE3. A study on the status of normoalbuminuric renal insufficiency among type 2 diabetes mellitus patients: A multicenter study based on a Chinese population
ORIGINAL ARTICLE4. The mediating role of gestational diabetes mellitus in the associations of maternal prepregnancy body mass index with neonatal birth weight
妊娠期糖尿病在孕妇孕前体重指数与新生儿出生体重关系中的作用
作者：Hao Hu, Pei Feng, Qian Yu, Wei Zhu, He Xu, Di Wu, Lei Wu, Jieyun Yin, Hongmei Li背景 妊娠前肥胖和妊娠糖尿病(GDM)都与新生儿出生体重不良有关。然而, GDM在孕前肥胖和新生儿出生体重之间的作用尚不清楚。方法 采用队列研究方法, 对17260名单胎孕妇及其新生儿进行调查。记录患者的人口学特征、病史、家族史及围产期结局。在校正协变量和GDM之前和之后, 采用logistic回归分析孕妇孕前BMI状态与小胎龄(SGA)和大胎龄(LGA)新生儿之间的关系。研究GDM在孕前BMI和不良出生体重之间的潜在作用。结果 多因素logistic回归显示, 孕前体重偏轻的孕妇比正常体重的孕妇更容易分娩SGA新生儿, 而孕前肥胖孕妇更容易分娩LGA新生儿。RMediation分析显示, GDM对孕产妇孕前BMI和SGA风险的调节作用不显著, 而孕前BMI与LGA之间的关联是由GDM介导的(a*b的95%CI: 0.009-0.051)。Iacobacci's(2012)方法表明, 孕产妇孕前超重(Zmediation= 2.418, p=0.015)和肥胖(Zmediation= 2.165, p=0.030)对LGA的影响部分由GDM介导, 间接影响分别为16.3%和13.1%。结论 孕前BMI与SGA、LGA相关。妊娠前超重和肥胖与LGA的关系部分由GDM介导。DOI: https://doi.org/10.1111/1753-0407.13233 ORIGINAL ARTICLE 5. Relationships between type 2 diabetes, cell dysfunction, and redox signaling: A meta-analysis of single-cell gene expression of human pancreatic α- and β-cells
2型糖尿病、细胞功能障碍和氧化还原信号的关系:人胰腺α-和β-细胞单细胞基因表达的meta分析
作者：Emily Sara Marques, Emily Formato, Wenle Liang, Emily Leonard, Alicia R. Timme-Laragy背景 2型糖尿病(T2D)是一种以胰岛素抵抗和β细胞无法满足胰岛素代谢需求为特征的慢性疾病。近年来在单细胞RNA测序(sc-RNA-Seq)方面的进展为进一步深入研究T2D的细胞机制奠定了基础。在β细胞中, 氧化还原信号对胰岛素的产生至关重要。本研究对人胰岛sc-RNA-Seq数据进行meta分析, 以评估T2D如何调控α-和β-细胞的转录组。方法 收集6项研究的sc-RNA-Seq数据, 这些数据来自代谢正常的人胰岛和T2D供者。根据关键标记基因的表达水平鉴定α-细胞和β-细胞、增殖中的α-细胞亚群、未成熟和衰老的β-细胞。在使用加权比较进行组合之前, 每个数据集都被单独分析。然后评估重要基因的通路和单个氧化还原相关基因的表达, 以进一步了解氧化还原信号在T2D诱导的β-细胞功能障碍中可能扮演的角色.结果来自T2D供者的α-和β-细胞修饰了与能量代谢、免疫反应、自噬和细胞应激相关的基因, 在T2D供者中α-和β-细胞NFE2L2介导的抗氧化反应增强。在T2D供者中, 未成熟和衰老的β-细胞比例增加, 并且在未成熟和衰老的β-细胞中, 受NFE2L2调控的基因进一步上调。结论这些发现提示NFE2L2在β-细胞成熟和功能障碍中起作用。氧化还原信号通路可能是β-细胞修复和T2D治疗的关键途径。DOI: https://doi.org/10.1111/1753-0407.13236 ORIGINAL ARTICLE 6. Relationships between fasting glucose levels, lifestyle factors, and metabolic parameters in Korean adults without diagnosis of diabetes mellitus
未诊断糖尿病的韩国成年人空腹血糖水平、生活方式因素和代谢参数之间的关系
作者：Seo Young Kang,Young Sik Kim背景 在未诊断为糖尿病的成年人中, 我们调查了空腹血糖水平范围与生活方式因素和代谢特征之间的关系方法 我们分析了2016-2018年韩国国家健康和营养检查调查(Korea National Health And Nutrition Examination Survey)中13,625名之前未诊断糖尿病的成年人。我们将空腹血糖水平(mg/dL)分类如下:<90、90-99、100-109、110-124和≥125。我们根据这些类别评估了肥胖、腹部肥胖、当前吸烟、酗酒和低体力活动的个体比例的趋势, 以及与空腹血糖水平<90 mg/dL相比, 每种空腹血糖水平不受控制的血压(BP)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和高密度脂蛋白胆固醇(LDL-C)的几率。结果 肥胖、腹型肥胖和大量饮酒的比例随着空腹血糖水平的升高而增加(p<0.05)。男性BP140/90 mmHg、TG≥150 mg/dL、HDL-C<40 mg/dL和女性HDL-C<50 mg/dL的发生几率随空腹血糖水平的升高而增加, 而LDL-C≥130 mg/dL的发生几率仅在女性中随空腹血糖水平的升高而增加。不受控制的血压和血脂的发生几率增加主要在空腹血糖水平≥90 mg/dL时观察到。结论 需要尽可能防止空腹血糖水平升高, 因为更高的水平, 即使在正常范围内, 也与较差的代谢谱相关。DOI: https://doi.org/10.1111/1753-0407.13238 ORIGINAL ARTICLE 7. Association of sedentary time and carotid atherosclerotic plaques in patients with type 2 diabetes
久坐时间与2型糖尿病患者颈动脉粥样硬化斑块的关系
作者：Jing Ke, Kun Li, Tingyu Ke, Xu Zhong, Qidong Zheng, Yufan Wang, Li Li, Yuancheng Dai, Qijuan Dong, Bangqun Ji, Fengmei Xu, Juan Shi, Ying Peng, Yifei Zhang, Dong Zhao, Weiqing Wang背景 动脉粥样硬化是2型糖尿病患者的常见并发症。动脉粥样硬化的发生发展涉及多种因素。我们评估了每周久坐时间(WST)与颈动脉斑块形成的关系。方法 数据清理后, 纳入2017年6月至2021年4月10个国家代谢管理中心(MMC)的26664例2型糖尿病患者。自报生活方式资料包括WST, 睡眠时间, 吸烟和饮酒情况, 颈动脉超声和生化指标。用多变量Logistic回归模型评估久坐与其他生活方式行为之间的独立关联, 并报告95%可信区间(CI)的优势比(OR)。此外, 还对混杂因素进行了分层分析, 论证了混杂因素的影响。结果 受试者的平均年龄为54.0(11.6)岁, WST的中位数(四分位数范围)为35.0(21.0, 42.0)小时。与WST前3分位数的受试者相比, WST第二或第三3分位数的受试者年龄更小, 糖尿病病程更短。调整后久坐时间与动脉斑块形成的OR值呈正相关, 调整后2, 3分位数的OR值分别为1.40(95%CI:1.31~1.50)和1.67(95%CI:1.56~1.79)。而WST对18~40岁患者斑块的影响无统计学意义, 第三3分位数P值为0.163。结论 高WST似乎与T2 DM患者颈动脉斑块的高患病率有关, 尤其是在老年人群中。DOI: https://doi.org/10.1111/1753-0407.13242 COMMENTARIES 8. Fatty kidney disease: The importance of ectopic fat deposition and the potential value of imaging
脂肪肾病：异位脂肪积贮的重要性和影像学检查的潜在价值
作者：Christian Mende, Daniel Einhorn
The prevalence of obesity, defined by the World Health Organization as a body mass index >30, is now over 42% in US adults. Visceral adiposity, a distinct subset of obesity often used interchangeably, is a well-recognized risk factor for metabolic syndrome, prediabetes, diabetes, hypertension, cardiovascular disease, and heart failure. Less well recognized is that obesity is associated with a 36% increase of chronic kidney disease (CKD), a 51% increased risk of new-onset albuminuria, and a 3-fold risk of developing end-stage kidney disease.
We comparefatty kidney disease (FKD) to fatty liver disease, beginning with non-alcoholic fatty liver disease (NAFLD) and progressing to non-alcoholic steatohepatitis (NASH). NAFLD has been recognized as a risk for albuminuria, CKD, and its progression, but a specific type of renal involvement or renal pathology has not been described as there are no renal biopsy reports in studies of both NAFLD and CKD combined. As delineated by Byrne it is the many risk factors that are shared by both diseases that would be the likely cause of their frequent co-existence.
DOI: https://doi.org/10.1111/1753-0407.13232 COMMENTARIES 9. Addressing type 1 diabetes health inequities in the United States: Approaches from the T1D Exchange QI Collaborative为解决美国的1型糖尿病健康的不公：来自T1D交流公平促进协作组织的方法作者：Osagie Ebekozien, Ann Mungmode, Oriyomi Odugbesan, Shideh Majidi, Priya Prahalad, Nudrat Noor, Nicole Rioles, Shivani Agarwal, Ruth S. Weinstock, Robert Rapaport, Manmohan Kamboj, T1DX-QI CollaborativeIn 2016, the T1D Exchange Quality Improvement Collaborative (T1DX-QI) was established.8 T1DX-QI is a learning health network9 with over 40 centers across the United States. Participating centers use continuous quality improvement (QI) methods10-12 and real-world electronic medical record (EMR) data4, 6 for T1D population health improvement.The T1DX-QI uses its unique EMR database with de-identified data on over 35 000 people with T1D to perform population health analysis. Recent analyses have revealed troubling and unnecessary inequities in diabetes device use and health outcomes.4, 6 Majidi et al,4 in an analysis of the T1DX-QI population health data of 18 000 patients with T1D (73% non-Hispanic White [NHW]; 8% NHB, 9% Hispanic, 10% other), found significant differences in glycosylated hemoglobin (HbA1c) in NHB and Hispanic patients with T1D compared to NHW patients (NHB 10.3%; Hispanic 9.2%; NHW 8.3%; P < .001). NHB patients also had the lowest rate of CGM use (NHB 17%; Hispanic 37%; NHW 40%; P < .001) and insulin pump use (NHB 41%; Hispanic 56%; NHW 60%; P < .001). Desalvo et al,6 using real-world pediatric data from the T1DX-QI, found that among youth with private insurance, NHB patients with T1D had less use of CGM than NHW patients with private as well as public insurance. DOI: https://doi.org/10.1111/1753-0407.13235 COMMENTARIES 10. T1D exchange quality improvement collaborative: Accelerating change through benchmarking and improvement science for people with type 1 diabetes
T1D交流公平促进协作组织：通过基准和改进科学来加速1型糖尿病患者的现状变革
作者：Priya Prahalad,Nicole Rioles, Nudrat Noor, Robert Rapaport, Ruth S. Weinstock, Osagie Ebekozien, for the T1DX-QI CollaborativeSince the discovery of insulin 100 years ago, there have been continual advances in medications and technologies for the management of type 1 diabetes (T1D). Despite these innovations, many people struggle to meet hemoglobin A1c (HbA1c) goals, and the gap is larger in individuals from minority groups or lower socioeconomic status. Quality improvement (QI) efforts have been shown to improve outcomes for patients with T1D. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) was established in 2016 with 10 pilot centers, primarily consisting of pediatric sites. The collaborative has now grown to 41 participating centers (28 pediatric and 13 adult centers) across the United States.
In this commentary, we describe the goals of the T1DX-QI and highlight QI and population health conference abstracts recently presented at the 2021 T1DX-QI conference.
The T1DX-QI has five core goals:
1. Collecting the right kind of data to drive real-world improvements.
2. Using data to make the best decisions for the population of people with T1D.
3. Designing and testing initiatives to improve clinical and T1D population health outcomes.
4. Quantifying factors that are contributing to driving positive outcomes for the T1D population.
5. Generating real-world insights.
DOI: https://doi.org/10.1111/1753-0407.13234 LETTER TO THE EDITOR 11. Euglycemic diabetic ketoacidosis and COVID-19: A combination to foresee in pregnancy
真血糖性糖尿病酮症酸中毒和COVID-19：妊娠期可预见的发病组合
作者：Inés Velasco, Berta Soldevila, Teresa Julián, Natalia García-Riaño, Manel Puig-DomingoDiabetic ketoacidosis (DKA) is a serious complication of diabetes, becoming a life-threatening event to both the mother and the fetus. Euglycemic diabetic ketoacidosis (eu-DKA) is defined by a biochemical triad: blood glucose levels below 200 mg/dL, increased anion gap metabolic acidosis, and ketonemia. Eu-DKA is extremely rare in obstetric practice and requires a high degree of suspicion for diagnosis.
COVID-19 infection may cause ketosis or ketoacidosis in the general population and can also induce DKA for those with diabetes. Diabetes does not seem to increase the risk of COVID-19 occurring but is more frequent in patients with severe COVID-19. Very few cases of eu-DKA have been reported in pregnant women with COVID-19.
DOI: https://doi.org/10.1111/1753-0407.13237 期刊简介
Journal of Diabetes (JDB) 是Wiley与上海交通大学医学院附属瑞金医院合作出版的刊物，致力于糖尿病的研究、治疗和教育，旨在针对糖尿病的流行病学、病因学、发病机理、并发症、管理及预防等方面，包括糖尿病的分子、生化、生理等各个层面开展东西方科研工作者和从业人员的交流合作。
本刊已于2022年转为金色开放获取（OA）出版，2020 影响因子为4.006。
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