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Alcohol consumption is a proven risk factor of dyslipidemia. In the present analysis, we investigated the association of alcohol intake with dyslipidemia, an emerging epidemic in China, in male patients with hypertension and diabetes mellitus. Our study participants were from a nationwide registry (n = 1181). A questionnaire was administered to collect information on alcohol intake. Dyslipidemia was defined as an elevated concentration of serum triglycerides (≥2.3 mmol/L), total (≥6.2 mmol/L) or low‐density lipoprotein (LDL) cholesterol (≥4.1 mmol/L), or a reduced high‐density lipoprotein (HDL) cholesterol (< 1.0 mmol/L). Serum concentrations of triglycerides (1.60 mmol/L) and total (4.93 mmol/L) and LDL cholesterol (2.95 mmol/L) were highest with current usual drinking, with a significant P value for trend from never (n = 679) to ever (n = 107) and to rare (n = 187) and usual drinkers (n = 208, P ≤ .002). Serum HDL cholesterol (1.13 mmol/L) was lowest in ever drinkers, with a nonsignificant P value for trend (P = .22). The prevalence was highest in usual drinkers for hypertriglyceridemia (27.4%) and total (12.5%) and LDL hypercholesterolemia (8.7%), and in ever drinkers for low HDL cholesterol (34.6%). The P value for trend was significant for hypertriglyceridemia and total hypercholesterolemia (P ≤ .01), but not for LDL hypercholesterolemia or low HDL cholesterol (P ≥ .26). The between‐province ecological analysis showed that the proportion of usual drinking was significantly associated with the prevalence of any dyslipidemia across 10 China provinces (r = .42, P < .0001). In conclusion, alcohol drinkers showed a worse lipid profile in patients with hypertension and diabetes mellitus. Usual drinking ecologically explained the between‐province variation in the prevalence of dyslipidemia.

With the increasing use of immune checkpoint inhibitors (ICI) including anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) in cancers, ICI-induced type 1 diabetes has been reported throughout the world. In this review, we aim to summarize the characteristics of this disease and discuss the mechanism of it. As an immune-related adverse event, type 1 diabetes developed after the administration of anti-PD-1 or anti-PD-ligand 1 (PD-L1) in the combination with or without anti-CTLA-4. It usually presented with acute onset, and 62.1% of the reported cases had diabetic ketoacidosis. Only a third of them had positive autoantibodies associated with type 1 diabetes. Susceptible HLA genotypes might be associated. T-cell-stimulation by blocking of the interaction of PD-1 and PD-L1 in pancreatic β cells was the main mechanism involved in the pathology. Insulin was the only effective treatment of ICI-induced type 1 diabetes. In conclusions, ICI-induced type 1 diabetes is a potentially life-threating adverse event after the immunotherapy of cancers. Screening and early recognition is important. Further investigation of the mechanism may help to better understand the pathology of type 1 diabetes.

Dyslipidemia is an emerging disease in China, especially in the presence of hypertension and diabetes mellitus. We investigated the association of dyslipidemia with the use of antihypertensive and antidiabetic agents. The study participants (n = 2423) were hypertensive and diabetic patients enrolled in a China nationwide registry. Serum mean ± (SD, except for serum triglycerides, median [interquatile range]) concentrations were 1.38 (0.97‐2.02) mmol/L, 4.85 ± 1.12 mmol/L, 1.30 ± 0.36 mmol/L, and 2.89 ± 0.92 mmol/L for triglycerides and total, high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) cholesterol, respectively. The prevalence of dyslipidemia was 18.9%, 13.5%, 16.6%, and 37.7% for hypertriglyceridemia (serum triglycerides ≥2.3 mmol/L), hypercholesterolemia (total cholesterol ≥6.2 mmol/L or LDL cholesterol ≥4.1 mmol/L), low HDL cholesterol (HDL cholesterol <1.0 mmol/L), and any of the three lipid disorders, respectively. Treated (n = 1647), compared with untreated hypertensive patients (n = 303), had a significantly (P ≤ .0006) lower serum total, LDL, and HDL cholesterol, but similar serum triglycerides (P = .20). Treated (n = 1325), compared with untreated diabetic patients (n = 238), had a significantly (P ≤ .004) lower serum triglycerides, and total and LDL cholesterol, but similar serum HDL cholesterol (P = .81). After adjustment, the odds ratios (OR) were significant for hypercholesterolemia (OR 0.76, 95% confidence interval [CI] 0.58‐0.997, P = .048) and low HDL cholesterol (OR 1.56, CI 1.19‐2.03, P = .001) in treated versus untreated hypertension, and for low HDL cholesterol (OR 1.50, CI 1.18‐1.89, P = .0008) in treated versus untreated diabetes. In conclusion, the prevalence of dyslipidemia differed between treated and untreated hypertension and diabetes. The prevalence of dyslipidemia differed between treated and untreated hypertension and diabetes mellitus in favor of treatment, in spite of some compromise in HDL cholesterol with the use of some antihypertensive or antidiabetic medications.

Background： Previous studies suggested that zinc level was related to relationship between zinc level and all the microvascular complications in a certain diabetic microvascular complication. However, the type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level. Methods： We included the hospitalized patients with type 2 diabetes （T2D） at our department from May 30, 2013 to March 31,2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level. Results： The 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy （P 〈 0.001）, diabetic nephropathy （DN, P 〈 0.001 ）, or diabetic peripheral neuropathy （P = 0.002） compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN （odds ratio = 0.869, 95% confidence interval = 0.765-0.987, P 〈 0.05）. The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A I c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels. Conclusions： Lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.

Background Hypertension and diabetes mellitus are often jointly present, especially in early onset cases of either disease. We investigated clinical characteristics of hypertensive patients with newly diagnosed diabetes and diabetic patients with newly diagnosed hypertension. Methods Our study subjects were recruited in a China nationwide multicenter registry of hypertension and diabetes (n = 2510). We performed logistic regression to compare patients seen for hypertension in cardiology, with newly diagnosed diabetes (n = 137) and patients seen for diabetes mellitus in endocrinology, with newly diagnosed hypertension (n = 155). Albuminuria was defined as a urinary albumin-to-creatinine ratio of ≥ 30 mg/g, and left ventricular hypertrophy according to the Cornell product index. Results These two groups of patients with both hypertension and diabetes mellitus were similar in most of the characteristics ( P  ≥ 0.06). However, hypertensive patients with newly diagnosed diabetes, compared to diabetic patients with newly diagnosed hypertension, had a significantly greater body mass index (26.3 vs. 25.4 kg/m 2 , P  = 0.03) and slower heart rate (73.7 vs. 78.1 beats/min, P  = 0.01). In logistic regression analyses adjusted for sex (48.3% women) and age (mean 60.0 ± 11.5 years), the odds ratio for newly diagnosed diabetes mellitus versus newly diagnosed hypertension was 1.27 (95% CI 1.03–1.56) and 0.80 (95% CI 0.66–0.96) for body mass index (+ 3 kg/m 2 ) and heart rate (+ 10 beat/min), respectively. Hypertensive patients with newly diagnosed diabetes also had a lower prevalence of albuminuria (16.0% vs. 30.1%, P  = 0.02) and slightly and non-significantly higher prevalence of left ventricular hypertrophy (5.1% vs. 1.9%, P  = 0.14) than diabetic patients with newly diagnosed hypertension. Conclusions Earlier or later onset of hypertension than diabetes mellitus may have different risk factors and organ damage.

Individual differences in glycemic response to metformin in antidiabetic treatment exist widely. Although some associated genetic variations have been discovered, they still cannot accurately predict metformin response. In the current study, we set out to investigate novel genetic variants affecting metformin response in Chinese type 2 diabetes (T2D) patients. A two-stage study enrolled 500 T2D patients who received metformin, glibenclamide or a combination of both were recruited from 2009 to 2012 in China. Change of HbA , adjusted by clinical covariates, was used to evaluate glycemic response to metformin. Selected single nucleotide polymorphisms (SNPs) were genotyped using the Infinium iSelect and/or Illumina GoldenGate genotyping platform. A linear regression model was used to evaluate the association between SNPs and response. A total of 3739 SNPs were screened in Stage 1, of which 50 were associated with drug response. Except for one genetic variant preferred to affect glibenclamide, the remaining SNPs were subsequently verified in Stage 2, and two SNPs were successfully validated. These were rs2727528 (discovery group: β=-0.212, =0.046; validation group: β=-0.269, =0.028) and rs1105842 (discovery group: β=0.205, =0.048; validation group: β=0.273, =0.025). C allele carriers of rs2727528 and C allele carriers of rs1105842 would have a larger difference of HbA level when using metformin. Two variants rs2727528 and rs1105842 in , encoding γ2 subunit of AMP-activated protein kinase (AMPK), were found to be associated with metformin response in Chinese T2D patients. These findings may provide some novel information for personalized pharmacotherapy of metformin in China.

Primary pigmented nodular adrenocortical disease （PPNAD） causes adrenocorticotropic hormone （ACTH）-independent Cushing＇s syndrome （CS）,which is the most frequent endocrine manifestation of Carney complex （CNC）.[1] In the disease process of PPNAD,both presadrenal glands are involved and feature small brown-black nodules separated by the atrophic adrenal cortex.

Our aim was to search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy. A multicenter, prospective cohort of 499 diabetic subjects was enrolled in this study: patients with newly diagnosed diabetes (NDM group) or poor glycemic control with oral antidiabetic drugs (OADs) (PDM group). All subjects then started or intensified OADs therapy and followed up for 91 days. Glycemic control was determined according to HbA1c at day 91 with HbA1c <7% considered good. The proportions of patients with good glycemic control after follow up for 91 days were 66.9% and 34.8% in NDM group and PDM group respectively. Logistic regression analysis showed that the change in GA at 28 days was the only predictor of good glycemic control in NDM patients (OR = 1.630, 95% CI 1.300–2.044, P < 0.001). In PDM patients, changes in GA at 28 days, CPI, baseline HbA1c, diabetic duration, and BMI were all independent predictors of good glycemic control (All P < 0.05). GA decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside GA decline, other individualized clinical characteristics should also be considered. •Predictors of response to therapeutic adjustment differs between early stage and advanced stage of type 2 diabetes.•GA decline is a good predictor of future success in newly diagnosed patients.•In patients intensifying therapy, beside GA decline, other clinical characteristics should also be considered.