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Objective To investigate the influencing factors and bilirubin levels of diabetic retinopathy (DR) in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods T2DM patients who were hospitalized in the Department of Endocrinology from January to December 2021 in Xuanwu Hospital of Capital Medical University were retrospectively enrolled. All included patients underwent non-mydriatic fundus photography. The data of duration of diabetes, body mass index (BMI), creatinine, total bilirubin, direct bilirubin, indirect bilirubin, glycated hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP) and urinary albumin to creatinine ratio (UACR) were collected. The patients were divided into non-diabetic retinopathy (NDR) group and DR group according to the diagnostic and staging criteria of DR. The t-test, Mann-Whitney U test and χ2 test were used to compare the general clinical data between the two groups; multivariate logistic regression analysis was used to analyze the risk factors of DR. Results A total of 1 027 patients were enrolled, including 245 patients with DR and 782 patients with NDR. The prevalence of DR in hospitalized T2DM patients was approximately 23.9% (245/1 027). Compared with the NDR group, the DR group had a longer duration of diabetes, higher HbA1c, creatinine, UACR, hs-CRP levels, and lower total bilirubin, direct bilirubin and indirect bilirubin concentrations. The differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for gender, age and BMI, HbA1c (OR=1.199, 95%CI 1.112-1.293), duration of diabetes (OR=1.063, 95%CI 1.034-1.093), creatinine (OR=1.007, 95%CI 1.002-1.013), UACR (OR=1.389, 95%CI 1.280-1.507) and hs-CRP (OR=1.260, 95%CI 1.108-1.432) were the main risk factors for DR, total bilirubin (OR=0.927, 95%CI 0.873-0.983), direct bilirubin (OR=0.831, 95%CI 0.701-0.985) and indirect bilirubin (OR=0.898, 95%CI 0.825-0.976) were protective factors for DR; after further adjustment for HbA1c, diabetes duration (OR=1.063, 95%CI 1.033-1.093), creatinine (OR=1.008, 95%CI 1.002-1.013), UACR (OR=1.382, 95%CI 1.272-1.502) and hs-CRP (OR=1.214, 95%CI 1.065-1.384) were still independent risk factors for DR, total bilirubin (OR=0.922, 95%CI 0.867-0.980), direct bilirubin (OR=0.827, 95%CI 0.694-0.984) and indirect bilirubin (OR=0.889, 95%CI 0.815-0.969) were still protective factors for DR. Conclusion HbA1c, duration of diabetes, creatinine, UACR and hs-CRP are risk factors for DR, and bilirubin may be a protective factor for DR. [ABSTRACT FROM AUTHOR]

Objective. The objective of this study was to examine the correlation between blood glucose and serum insulin with acute cerebrovascular disease. Methods. A total of 1548 patients with acute cerebrovascular illness and 364 patients with a normal physical examination who were admitted to our hospital (endocrinology department) between January 2017 and July 2020 were recruited. Patients with acute cerebrovascular illness were included in the experimental group, while healthy individuals after physical examinations were included in the control group. All patients' blood glucose and serum insulin levels were measured, and the association of blood glucose and serum insulin with acute cerebrovascular illness was investigated. Results. Acute cerebrovascular disease is associated with significantly higher blood glucose and serum insulin levels versus healthy status (P < 0.05). Blood glucose and serum insulin levels were observed to be significantly higher in the hemorrhagic stroke group than in the ischemic stroke or mild hemorrhagic group (P < 0.05). Severe ischemic strokes were associated with significantly higher blood glucose levels versus mild ischemic strokes (P < 0.05). There were no significant differences in serum insulin levels between the severe ischemic stroke group and the mild ischemic stroke group (P > 0.05). Conclusion. A rise in blood glucose and serum insulin levels is associated with the incidence and prognosis of acute cerebrovascular disease, and it is positively correlated with the severity of the acute cerebrovascular disease. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between thyroid function and sarcopenia in Chinese geriatric patients with type 2 diabetes mellitus (T2DM). Methods Patients with T2DM aged over 60 years old were recruited from department of endocrinology, Xuanwu Hospital, Capital Medical University, from April 2017 to April 2019. Appendicular skeletal muscle mass, grip strength, and walking speed were measured, appendicular skeletal muscle mass index (ASMI) was calculated. Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined, FT3/FT4 ratio was calculated. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia. The included patients were divided into sarcopenia group and non-sarcopenia group. The t test or χ² test was used to compare general characteristics between the two groups; correlation analysis and multivariate logistic regression analysis were used to explore the relationship between thyroid function and sarcopenia. Results A total of 535 patients with T2DM aged over 60 years old were enrolled. There were 490 patients in sarcopenia group and 45 patients in non-sarcopenia group, respectively. Compared with non-sarcopenia patients, patients with sarcopenia demonstrated lower levels of FT3 and FT3/FT4 ratio (all P<0.05). In geriatric patients with T2DM, FT3/FT4 ratio was significant positively correlated with ASMI, grip strength and walking speed (r=0.240, 0.242 and 0.227, respectively, all P<0.01), the same with FT3 levels (r=0.300, 0.366 and 0.296, respectively, all P< 0.01). Multivariate logistic regression analysis showed that FT3/FT4 ratio (OR=0.396, 95%CI 0.158-0.992, P=0.048) was independent risk factor for sarcopenia. Conclusions In geriatric patients with T2DM, the concentrations of FT3 and FT3/FT4 ratio are significant positively correlated with the components of sarcopenia, and FT3/FT4 ratio is an independent predictor of sarcopenia. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate whether elderly people with impaired fasting glucose (IFG) or diabetes mellitus (DM) share the common risk factors for cognitive impairment as compared to normal blood glucose population. Methods: This cross-sectional study assessed 10,039 community-dwelling participants aged ≥ 55 years in Beijing, China. According to the glycemic status, subjects were classified into three groups: normal fasting plasma glucose (NG, n=6399), impaired fasting glucose (IFG, n=873) and DM (n=2626). The Mini-Mental State Examination (MMSE) was applied to evaluate the cognitive function status of the study population. Potential demographic, clinical, and genetic risk factors for cognitive impairment were collected and compared across the three groups. Multivariate logistic regression model was performed to explore the risk factors associated with cognitive impairment. Results: Education-modified MMSE scores in the participants with NG, IFG, and DM were 26.91±3.94, 26.67±4.00, and 26.58±4.11, respectively (P=0.0008). In the age- and sex-adjusted comparisons, the MMSE scores in subjects with DM and IFG were significantly lower than that in subjects with normal glucose (P=0.01 and P=0.02, respectively). The logistic regression analysis showed that risk factors only in the NG population were older age, female, apoEε4 carrier, normal or lower uric acid (UA) levels. Hypertension was an independent risk factor only in IFG group, and the history of stroke and depression were the risk factors associated with cognitive impairment only in the DM group. Conclusion:Subjects with DM or IFG had a lower performance on the MMSE test compared with subjects who had normal blood glucose. The elderly with diabetes and IFG have some different risk factors for cognitive impairment as compared to those with normal blood glucose. [ABSTRACT FROM AUTHOR]

The relationship between serum uric acid (sUA) and cognitive function is contradictory. This study assessed the association between sUA and cognitive impairment in 10,039 community–dwelling subjects aged ≥55 years living in Beijing, China. Participants underwent determination of sUA and an evaluation of cognitive function using the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ≤17 for illiterates; MMSE ≤ 20 for primary school graduates (≥6 years of education); and MMSE ≤ 24 for junior school graduates or above (≥9 years of education). Among the 10016 persons with valid MMSE scores, the prevalence of cognitive impairment was 9.14%. A multivariate logistic regression model including demographic, clinical and genetic parameters was performed to assess the relationship between sUA and cognitive impairment. Persons with cognitive impairment had lower sUA levels than those with normal cognitive function: (302.30 ± 82.80 vs. 312.20 ± 84.01 μmol/L, p = 0.001). After adjusting for age, sex, lifestyle, relevant diseases and the apolipoprotein E (APOE) ε4 allele, stepwise logistic regression showed that participants with higher levels of sUA had a lower risk of cognitive impairment (hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.62–0.96; p = 0.022). In this baseline cross-sectional population-based sample, high levels of sUA were associated with a decreased risk of cognitive impairment. [ABSTRACT FROM AUTHOR]

With aging populations around the world, frailty is becoming more prevalent increasing the need to early identify those at risk of frailty. The association between thyroid hormone levels and frailty in subjects with type 2 diabetes mellitus (T2DM) remains unclear. The objective of the study was to evaluate the relationship between thyroid hormone concentrations and frailty in older adults with T2DM. A total of 240 older adults with T2DM were divided into three groups according to the frailty phenotype criteria: robust group (n = 94), pre-frail (n = 110) and frail group (n = 36). Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D 3 [25(OH) D 3 , highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined. Handgrip strength was measured using a Jamar hand dynamometer. Physical function was assessed by gait speed and the timed go and up (TUG) test. Logistic regression analysis was performed to evaluate the association between FT3 and frailty. The FT3 level was the lowest among frail people (2.56 ± 0.42 pg/mL), followed by pre-frail participants (2.73 ± 0.38 pg/mL), with the highest among the robust subjects (2.83 ± 0.43 pg/mL). FT3 level was positively correlated with handgrip strength and gait speed (R = 0.313, P < 0.001; R = 0.250, P < 0.001, respectively), while negatively correlated with TUG time (R = −0.276, P < 0.001). After adjusting for age, sex, TSH, 25(OH) D 3 and estimate glomerular filtration rate (eGFR), logistic regression showed that low FT3 was significantly associated with an increased risk of frailty (odds ratio (OR): 4.53; 95% confidence interval (CI): 1.89–10.83; P = 0.001). Low levels of FT3 were associated with an increased risk of frailty in older adults with T2DM. Measuring FT3 might be useful for identifying those at high risk of frailty. • The association between thyroid hormone concentrations and frailty in older adults with T2DM was investigated. • The free triiodothyronine (FT3) FT3 level was the lowest among frail people • Low levels of FT3 were associated with an increased risk of frailty [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between body fat (BF%) and sarcopenia in older adults with type 2 diabetes mellitus (T2DM) and potential link with increased levels of inflammatory indicators and insulin resistance., Methods: A total of 543 older adults with T2DM were included in this cross-sectional study. Appendicular skeletal muscle (ASM), handgrip strength and gait speed were measured to diagnose sarcopenia according to the updated Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Body composition data were tested using dual-energy X-ray absorptiometry (DEXA). Levels of serum high-sensitive C-reactive protein (hs-CRP), interleukin-6, fasting blood insulin (FINS), hemoglobin A1c (HbA1c), 25-hydroxyvitamin D 3 [25(OH) D 3 ] were also determined., Results: The prevalence of sarcopenia in all participants was 8.84%, of which 11.90% were male and 5.84% females. The Pearson's correlation analysis revealed that BF% was negatively correlated with gait speed in men and women (R =-0.195, P =0.001; R = -0.136, P =0.025, respectively). After adjusting for all potential confounders, sarcopenia was positive associated with BF% (male, OR: 1.38, 95% CI: 1.15-1.65, P < 0.001; female, OR: 1.30, 95% CI: 1.07-1.56, P =0.007), and negatively associated with body mass index (BMI) (male, OR: 0.57, 95% CI: 0.44-0.73, P <0.001; female, OR: 0.48, 95% CI: 0.33-0.70, P <0.001). No significant differences were found in hs-CRP, interleukin-6, and insulin resistance between older T2DM adults with and without sarcopenia., Conclusion: Higher BF% was linked to an increased risk of sarcopenia in older adults with T2DM, suggesting the importance of assessing BF% rather than BMI alone to manage sarcopenia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sun, Fu, Mu, Duan, Chan and Xiu.)

Aim: The aim of this study was to investigate the risk factors for cognitive impairment in older people with diabetes., Methods: This cross-sectional study included 2626 community-dwelling participants with diabetes aged ⩾55 years, living in Beijing, China. The participants were screened for risk factors, including smoking, obesity, hypertension, stroke, coronary heart disease, dyslipidemia, depression, apolipoprotein E (APOE) genotype, and low physical activity. Cognitive function was assessed with the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ⩽17 for iliterate participants; MMSE ⩽20 for primary school graduates (⩾6 years of education); and MMSE ⩽24 for junior school graduates or above (⩾9 years of education)., Results: The prevalence of cognitive impairment in older people with diabetes was 9.90%. Multiple logistic regression analysis demonstrated that stroke [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.20-2.43], less than 0.5 h exercise per day (OR = 1.89, 95% CI = 1.37-2.61), and depression (OR = 1.64, 95% CI = 1.06-2.54), but not smoking, obesity, hypertension, dyslipidemia, and coronary heart disease, were independent risks for cognitive impairment in older people with diabetes. In addition, being married (OR = 0.66, 95% CI = 0.47-0.93) and urban living (OR = 0.33, 95% CI = 0.22-0.48) could decrease the risk of cognitive impairment., Conclusions: Stroke, depression, and less than 0.5 h exercise per day were independent risks for cognitive impairment in older people with diabetes, whereas being married and urban living were protective., Competing Interests: Conflict of interest statement: The authors declare that there is no conflict of interest.