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Li P.,Liaoning Medical University | Jiang R.,Liaoyang Diabetes Hospital | Li L.,Liaoning Medical University | Li L.,Liaoning Provincial Key Laboratory of Endocrine Diseases | And 3 more authors.
Journal of Pediatric Endocrinology and Metabolism | Year: 2014

Background: Identifying adolescents with metabolic syndrome (MetS) is important in China, where diabetes and MetS is highly prevalent among adults. We aimed to estimate MetS prevalence and to determine risk factors for MetS in adolescents of northeast China. Methods: This cross-sectional study was conducted from December 2010 to March 2011. We recruited 1312 healthy students from 30 high school classes and 910 who met the inclusion criteria (13.80 ± 1.44 years, 53.3% boys) were enrolled. All subjects underwent anthropometric and biochemical examinations. MetS was defined using the definition specific for children and adolescents proposed by the International Diabetes Federation in 2007. Results: Total prevalence of MetS was 7.6% and was higher in boys than in girls (10.9% vs. 3.8%, p < 0.0001). The most frequent component of MetS was low high-density lipoprotein-cholesterol (46.8%), followed by central obesity (22.5%). More than one third of adolescents were overweight or obese. Insulin resistance, hyperuricemia, abnormal lipid profiles, increased aminotransferase, overweight, and obesity were all associated with MetS. Only overweight [odds ratio (OR) = 9.29, 95% confidence interval (CI) 5.36-16.00] and obesity (OR = 61.85, 95% CI 32.73-116.86) evaluated with body mass index (BMI) were independent predictors for MetS. Receiver operating characteristic curve analysis revealed that BMI had high diagnostic accuracy (area under curve value 0.914, 95% CI 0.882-0.947) and the cutoff point of 23.8 kg/m2 had maximum accuracy for determining the presence of MetS (sensitivity 92.8%, specificity 80.1%). Conclusions: MetS is highly prevalent among adolescents in northeast China and obesity is the major indicator for this disorder. Early identification and lifestyle modifications are strongly recommended. Source


Sun L.,China Medical University at Heping | Jin Z.,China Medical University at Heping | Teng W.,Liaoning Provincial Key Laboratory of Endocrine Diseases | Chi X.,China Medical University at Heping | And 3 more authors.
Journal of Perinatal Medicine | Year: 2012

Objective: To compare the expression of sex hormone binding globulin (SHBG) in normal placental tissues with placental tissues from patients with gestational diabetes mellitus (GDM) and to deduce the mechanism affecting placental SHBG in GDM. Methods: We detected SHBG localization and measured SHBG mRNA and protein using immunohistochemistry, reverse-transcription polymerase chain reaction, and Western blotting, respectively, in normal and GDM placental tissues. The distribution of SHBG in placental cells was examined using immune electron microscopy. Results : Compared to controls, placental tissues from patients in the GDM group displayed disordered cell surface microvilli that were decreased in quantity, swollen, and had narrowed and broken gap junctions. Intracellular abnormalities included expanded rough endoplasmic reticula, swollen mitochondria, and irregular nuclear morphologies with nonuniform chromatin. SHBG localized primarily to trophoblast cell membranes and cytoplasm. SHBG was strongly expressed on the microvilli side and weakly expressed on the basement membrane with uneven staining. SHBG also was expressed in villous stromal cells and vascular endothelial cells. Compared to the controls, placental tissues from the GDM group displayed significantly decreased immunostaining rates for SHBG, as well as significantly lower levels of SHBG mRNA and protein expression (P < 0.05). Conclusion: SHBG was detected in placental trophoblast cells from patients with GDM, and the synthesis and secretion of SHBG were reduced when trophoblast cells were irregular. A decrease in SHBG could affect placental function or aggravate GDM. Our results suggest that placental SHBG plays an important role in the pathogenesis of GDM. Copyright © by Walter de Gruyter · Berlin · Boston. Source


Li P.,Liaoning Medical University | Zhang J.-F.,Liaoning Medical University | Li L.,Liaoning Medical University | Li L.,Liaoning Provincial Key Laboratory of Endocrine Diseases | And 5 more authors.
American Journal of the Medical Sciences | Year: 2013

INTRODUCTION:: This study was performed to investigate the impact of a family history of type 2 diabetes (T2DM) on insulin resistance and beta-cell dysfunction in populations with varying glucose tolerance. METHODS:: Among the total of 142 participants, 73 subjects with no family history of T2DM (FH-) included 42 with normal glucose tolerance (NGT/FH-) and 31 with impaired glucose tolerance (IGT/FH-); and 69 first-degree relatives of patients with T2DM (FH+) included 36 with NGT (NGT/FH+) and 33 with IGT (IGT/FH+). Insulin resistance was evaluated by Insulin Sensitivity Index (ISI) based on the euglycemic hyperinsulinemic clamp. Islet beta-cell function was assessed by disposition index (DI) for the acute insulin response to glucose (AIRg) using intravenous glucose tolerance test. Metabolic data were compared between groups after adjustment for age, sex, body mass index and waist-to-hip ratio. RESULTS:: The NGT/FH+ group showed lower level of ISI (P = 0.023) than the NGT/FH- group, whereas no difference was found in AIRg or DI between these 2 subgroups. In the FH- individuals, both ISI and DI of the IGT/FH- group decreased compared with the NGT/FH- group (both P < 0.05). In the FH+ individuals, no difference was found in ISI between the IGT/FH+ and NGT/FH+ groups, whereas the IGT/FH+ group had a lower level of AIRg and DI than the NGT/FH+ group (both P < 0.0001). CONCLUSIONS:: This study showed that the pathophysiological changes were different between individuals with and without a family history of T2DM during the glucose tolerance aggravation. Copyright © by the Southern Society for Clinical Investigation. Source


Li P.,Liaoning Medical University | Jiang R.,Liaoyang Diabetes Hospital | Li L.,Liaoning Medical University | Li L.,Liaoning Provincial Key Laboratory of Endocrine Diseases | And 4 more authors.
Journal of Investigative Medicine | Year: 2013

Aims: To examine whether hemoglobin A1c (HbA1c) can be used instead of fasting plasma glucose (FPG) to identify nondiabetic Chinese adolescents with metabolic syndrome (MS). Methods: This was a cross-sectional study involving 910 adolescents (11-16 years; 46.8% girls) with an Hb A1c less than or equal to 6.4% and an FPG less than or equal to 6.9 mmol/L. All participants underwent anthropometric and biochemical examinations. Metabolic syndrome was defined using the definition proposed by the International Diabetes Federation (IDF) and the American Heart Association (AHA). Replacement of an FPG greater than or equal to 5.6 mmol/L with an Hb A1c greater than or equal to 5.7% yielded 2 HbA1c definitions (IDF-HbA1c and AHA-HbA1c). The use of an HbA1c greater than or equal to 5.7% or an FPG greater than or equal to 5.6 mmol/L in the definition of the glycemic component of the MS was compared. Results: The HbA1c definition resulted in an increase in the population prevalence of MS by 2.4% (IDF-HbA1c) and 2.5% (AHA-HbA1c), respectively (P ≥ 0.05). The degree of concordance (κ index) was as high as 0.900 for the concordance between the IDF and IDF-HbA1c definition, and 0.811 between the AHA and AHA-Hb A1c definition. Subjects who were diagnosed as normal based on the FPG definition and met the HbA1c definition for MS had more cardiometabolic risk factors (waist circumference, blood pressure, lipid profiles, uric acid, and homeostasis assessment model of insulin resistance; all P < 0.05), indicating that the HbA1c definition identified more subjects with cardiovascular diseaseY related risk factors. HbA1c greater than or equal to 5.7% was significantly associated with the presence of MS [adjusted odds ratio, 2.61 (1.13-6.01)]. Conclusions: An HbA1c greater than or equal to 5.7% was associated with the presence of MS and can be considered a surrogate for FPG in the diagnosis of MS in nondiabetic Chinese adolescents. Copyright © 2013 by The American Federation for Medical Research. Source


Sun L.,China Medical University at Heping | Jin Z.,China Medical University at Heping | Teng W.,Liaoning Provincial Key Laboratory of Endocrine Diseases | Chi X.,China Medical University at Heping | And 3 more authors.
Diabetes Research and Clinical Practice | Year: 2013

Aims: To compare the expression of sex hormone binding globulin (SHBG) in normal placental tissues and serum with placental tissues from patients with gestational diabetes mellitus (GDM) and to deduce the mechanism affecting placental SHBG in GDM. Methods: Enzyme-linked immunosorbent assay (ELISA) method were used to detect SHBG levels changes in normal and GDM maternal serum, umbilical cord serum and placental. We measured SHBG mRNA and protein using reverse-transcription polymerase chain reaction, and Western blotting, respectively, in normal and GDM placental tissues. Results: In maternal serum, compared with the control group, GDM group: glucose, insulin increased, SHBG decreased. In the placenta, compared with the control group, GDM group: SHBG, SHBG mRNA and SHBG protein decreased. There is no correlation between placenta SHBG and maternal serum SHBG respectively in control and GDM group, but in GDM group maternal serum insulin and placenta SHBG are linear correlation. Conclusions: GDM serum and placental SHBG levels are reduced, hyperinsulinemia may lead to a reduction of SHBG in circulating blood, but also damage the placenta cells which led to placental synthesis and secretion of SHBG decrease. © 2012 Elsevier Ireland Ltd. Source

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