Diabetes,a leading global chronic disease,poses a significant health threat,with physical inactivity being a major risk factor for its development and progression.This guideline,developed by the Chinese Society of End...Diabetes,a leading global chronic disease,poses a significant health threat,with physical inactivity being a major risk factor for its development and progression.This guideline,developed by the Chinese Society of Endocrinology,synthesizes the latest evidence and expert insights to provide evidence-based recommendations for physical activity and exercise therapy in adults with type 2 diabetes(T2D).It is generally recommended that all adult patients with T2D engage in at least 150—300 min of moderate-intensity aerobic exercise per week,or a minimum of75—150 min of vigorous-intensity exercise,or an equivalent combination of moderate-and vigorous-intensity exercise(with a total exercise volume of at least 450 metabolic equivalent-min per week).For patients with T2D who are capable,moderate over-exercise and a combination of different forms of exercise(aerobic,resistance,flexibility,and/or balance training)are encouraged.The guideline also underscores the necessity of targeting specific subgroups of patients with T2D,including the elderly,individuals with obesity or pre-obesity,cardiovascular disease,hypertension,chronic kidney disease,metabolic dysfunction-associated steatotic liver disease,and/or diabetic foot and its high-risk populations.The guideline provides a scientific basis for clinicians to develop personalized exercise guidance and recommendations,with the goal of improving the disease prognosis of the relevant population.展开更多
The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pre...The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.展开更多
To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the Europ...To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the European Thyroid Association,the Chinese Society of Endocrinology(CSE),and the American College of Obstetricians and Gynecologists(ACOG)issued several guidelines for the management of thyroid disorders during gestation.Over 13 years ago,SCH during pregnancy was defined as a serum thyroid stimulating hormone(TSH)level between 2.5 mIU/L and 10.0 mIU/L with a normal free thyroxine(FT4)concentration.[1]Six years later,the upper limit of the pregnancy-specific TSH reference was raised to 4.0 mIU/L.[2]Levothyroxine(LT4)is the most recommended drug for thyroid hormone supplementation in pregnant women.However,according to diverse guidelines,the conditions triggering the initiation of LT4 supplementation differ among pregnant women.展开更多
Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic sy...Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic syndrome(MS),and we named it metabolic dysfunction syndrome(MDS).The pathogenesis of T2D is not fully understood,with IR andβcell dysfunction playing central roles in its pathophysiology.Dyslipidemia,hyperglycemia,along with other metabolic disorders,results in IR and/or isletβcell dysfunction via some shared pathways,such as inflammation,endoplasmic reticulum stress(ERS),oxidative stress,and ectopic lipid deposition.There is currently no cure for T2D,but it can be prevented or in remission by lifestyle intervention and/or some medication.If prevention fails,holistic and personalized management should be taken as soon as possible through timely detection and diagnosis,considering target organ protection,comorbidities,treatment goals,and other factors in reality.T2D is often accompanied by other components of MDS,such as preobesity/obesity,metabolic dysfunction associated steatotic liver disease,dyslipidemia,which usually occurs before it,and they are considered as the upstream diseases of T2D.It is more appropriate to call“diabetic complications”as“MDS-related target organ damage(TOD)”,since their development involves not only hyperglycemia but also other metabolic disorders of MDS,promoting an up-to-date management philosophy.In this review,we aim to summarize the underlying mechanism,screening,diagnosis,prevention,and treatment of T2D,especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of“MDS-related TOD”.展开更多
To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-...To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.展开更多
To the Editor:Non-alcoholic fatty liver disease(NAFLD)includes a spectrum of diseases:simple steatosis,nonalcoholic steatohepatitis(NASH),and the related fibrosis and cirrhosis.[1]The treatment of NAFLD should aim to ...To the Editor:Non-alcoholic fatty liver disease(NAFLD)includes a spectrum of diseases:simple steatosis,nonalcoholic steatohepatitis(NASH),and the related fibrosis and cirrhosis.[1]The treatment of NAFLD should aim to reverse or prevent liver fibrosis,which is associated with liver-specific morbidity or mortality,rather than just to reduce circulating liver enzyme activities and improve NASH.展开更多
To the Editor:The post-acute sequelae of coronavirus disease 2019(COVID-19)(PASC)manifest broadly and persist over time.Cardiovascular autonomic dysfunction(CVAD)is implicated in some characteristic PASC symptoms,alth...To the Editor:The post-acute sequelae of coronavirus disease 2019(COVID-19)(PASC)manifest broadly and persist over time.Cardiovascular autonomic dysfunction(CVAD)is implicated in some characteristic PASC symptoms,although the underlying mechanisms are not fully elucidated.[1]While certain studies suggest that targeted exercise training ameliorates PASC symptoms,advocating its adoption in rehabilitation strategies,others indicate potential exacerbation or relapse of symptoms post-exercise,highlighting a poorly understood interaction between exercise training and the autonomic nervous system during the post-acute phase of COVID-19.[2]This study,therefore,aimed to investigate the effects of exercise training postacute COVID-19 on cardiovascular autonomic function.展开更多
摘要Diabetes,a leading global chronic disease,poses a significant health threat,with physical inactivity being a major risk factor for its development and progression.This guideline,developed by the Chinese Society of Endocrinology,synthesizes the latest evidence and expert insights to provide evidence-based recommendations for physical activity and exercise therapy in adults with type 2 diabetes(T2D).It is generally recommended that all adult patients with T2D engage in at least 150—300 min of moderate-intensity aerobic exercise per week,or a minimum of75—150 min of vigorous-intensity exercise,or an equivalent combination of moderate-and vigorous-intensity exercise(with a total exercise volume of at least 450 metabolic equivalent-min per week).For patients with T2D who are capable,moderate over-exercise and a combination of different forms of exercise(aerobic,resistance,flexibility,and/or balance training)are encouraged.The guideline also underscores the necessity of targeting specific subgroups of patients with T2D,including the elderly,individuals with obesity or pre-obesity,cardiovascular disease,hypertension,chronic kidney disease,metabolic dysfunction-associated steatotic liver disease,and/or diabetic foot and its high-risk populations.The guideline provides a scientific basis for clinicians to develop personalized exercise guidance and recommendations,with the goal of improving the disease prognosis of the relevant population.
基金supported by the National Key Research and Development Program of China(2017YFC1309800)the“Outstanding University Driven by Talents”Program and Academic Promotion Program of Shandong First Medical University(2019LJ007)the Key Research and Development Program of Shandong Province(2017CXGC1214).
摘要The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.
基金This work was supported by the National Natural Science Foundation of China(No.82100851)the Natural Science Foundation of Sichuan Province,China(No.2024NSFSC0583).
摘要To the Editor:Maternal overt hypothyroidism(OH),subclinical hypothyroidism(SCH),or thyroid autoimmunity(TAI)can lead to adverse pregnancy outcomes.During the last decade,the American Thyroid Association(ATA),the European Thyroid Association,the Chinese Society of Endocrinology(CSE),and the American College of Obstetricians and Gynecologists(ACOG)issued several guidelines for the management of thyroid disorders during gestation.Over 13 years ago,SCH during pregnancy was defined as a serum thyroid stimulating hormone(TSH)level between 2.5 mIU/L and 10.0 mIU/L with a normal free thyroxine(FT4)concentration.[1]Six years later,the upper limit of the pregnancy-specific TSH reference was raised to 4.0 mIU/L.[2]Levothyroxine(LT4)is the most recommended drug for thyroid hormone supplementation in pregnant women.However,according to diverse guidelines,the conditions triggering the initiation of LT4 supplementation differ among pregnant women.
基金supported by the National Nature Science Foundation of China(82170830)grants from the 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYGD 18017)grants from Nature Science Foundation of Department of Science and Technology of Sichuan Province(China)(2023YFS0078).
摘要Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic syndrome(MS),and we named it metabolic dysfunction syndrome(MDS).The pathogenesis of T2D is not fully understood,with IR andβcell dysfunction playing central roles in its pathophysiology.Dyslipidemia,hyperglycemia,along with other metabolic disorders,results in IR and/or isletβcell dysfunction via some shared pathways,such as inflammation,endoplasmic reticulum stress(ERS),oxidative stress,and ectopic lipid deposition.There is currently no cure for T2D,but it can be prevented or in remission by lifestyle intervention and/or some medication.If prevention fails,holistic and personalized management should be taken as soon as possible through timely detection and diagnosis,considering target organ protection,comorbidities,treatment goals,and other factors in reality.T2D is often accompanied by other components of MDS,such as preobesity/obesity,metabolic dysfunction associated steatotic liver disease,dyslipidemia,which usually occurs before it,and they are considered as the upstream diseases of T2D.It is more appropriate to call“diabetic complications”as“MDS-related target organ damage(TOD)”,since their development involves not only hyperglycemia but also other metabolic disorders of MDS,promoting an up-to-date management philosophy.In this review,we aim to summarize the underlying mechanism,screening,diagnosis,prevention,and treatment of T2D,especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of“MDS-related TOD”.
基金1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University(No. ZYGD18017)
摘要To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.
基金supported by a grant from the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.ZYGD 18017)
摘要To the Editor:Non-alcoholic fatty liver disease(NAFLD)includes a spectrum of diseases:simple steatosis,nonalcoholic steatohepatitis(NASH),and the related fibrosis and cirrhosis.[1]The treatment of NAFLD should aim to reverse or prevent liver fibrosis,which is associated with liver-specific morbidity or mortality,rather than just to reduce circulating liver enzyme activities and improve NASH.
基金supported by National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University(No.Z2023LC004)Sichuan Science and Technology Bureau-Key Research&Develop Support Program(No.22GJHZ0044)。
摘要To the Editor:The post-acute sequelae of coronavirus disease 2019(COVID-19)(PASC)manifest broadly and persist over time.Cardiovascular autonomic dysfunction(CVAD)is implicated in some characteristic PASC symptoms,although the underlying mechanisms are not fully elucidated.[1]While certain studies suggest that targeted exercise training ameliorates PASC symptoms,advocating its adoption in rehabilitation strategies,others indicate potential exacerbation or relapse of symptoms post-exercise,highlighting a poorly understood interaction between exercise training and the autonomic nervous system during the post-acute phase of COVID-19.[2]This study,therefore,aimed to investigate the effects of exercise training postacute COVID-19 on cardiovascular autonomic function.