Rong Li

Chongqing Medical University, Ch’ung-ch’ing-shih, Chongqing Shi, China

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Publications (7)17.02 Total impact

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    ABSTRACT: To investigate combined effects of sex hormone-binding globulin (SHBG) and sex hormones on risk of type 2 diabetes (T2D). This was a nested case-control study among Chinese who participated in the Environment, Inflammation and Metabolic Diseases Study (2008-2013). Of the 3510 subjects who were free of diabetes, 145 men and 87 women developed diabetes during the five-year follow-up. One control subject was selected for each case and matched for age and gender. The distributions of SHBG, estradiol, testosterone and dehydroepiandrosterone-sulfate (DHEA-S) at baseline were split by tertile and subjects were stratified into those with low, intermediate and high levels accordingly. After multivariable adjustment, men with low SHBG levels compared to those with high SHBG levels exhibited a four-fold increased risk of T2D, whereas men with high estradiol levels exhibited a four-fold increased risk of T2D compared with those with low estradiol levels. Men with low SHBG and high estradiol exhibited a nineteen-fold increased risk of T2D compared to men with high SHBG and low estradiol (odds ratio [OR] 20.23 [95% CI 4.62-51.33]). These risk associations in men were not observed for testosterone or DHEA-S, alone or in combination with SHBG. Compared with low SHBG, the risk of T2D decreased with increasing SHBG tertile (OR 0.92[0.21-4.53], 0.14[0.10-0.74]; p for trend=0.043) after multivariable adjustment in women. Estradiol, testosterone and DHEA-S levels showed no association with T2D in women. Low SHBG in conjunction with high estradiol exerts an additive detrimental effect on risk of T2D in men. This article is protected by copyright. All rights reserved.
    No preview · Article · Jun 2015 · Journal of Diabetes
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    ABSTRACT: Background In newly diagnosed type 2 diabetic patients with severe hyperglycemia, insulin therapy should be strongly considered. However, after short-term intensive insulin therapy, should insulin be continued or transferred to an oral anti-diabetic drug (OAD) therapy is not clear.Methods After receiving intensive insulin therapy for 10-14 days, 47 patients were randomized into the glargine group (n=21) and the metformin-based OAD group (n=26) for a six-month intervention. After the six-month intervention, the glargine group was changed to metformin-based OAD therapy while medication of the OAD group remained unchanged. These patients were followed up for another six months.ResultsHbA1c was reduced by a similar amount in the two treatment groups at the end of the six-month intervention (glargine: 11.81±1.70 vs. 6.48±0.79%; P<0.001; OAD: 11.71±1.89 vs. 6.16±0.52%; P<0.001). At the end of the 12th month, HbA1c was still kept at a comparable and near optimal level in the metformin-based OAD group and the glargine group. Homeostasis model assessment of β-cell function increased similarly in the two groups after the six-month intervention. There was no significant difference between the two groups in insulin sensitivity improvement, hypoglycemia episodes, weight change, treatment satisfaction and quality of life after the six-month intervention.Conclusions The effects of metformin-based OAD therapy on glycemic control and β-cell function improvement are not inferior to glargine in newly diagnosed type 2 diabetic patients with severe hyperglycemia after short-term intensive insulin therapy. Considering the metformin's superiorities in safety, cost and convenience, metformin-based OAD therapy should be strongly recommended for these patients.
    No preview · Article · May 2014 · Journal of Diabetes
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    ABSTRACT: Objectives: The study aimed to analyze the relationship between metabolic variables and estimated glomerular filtration rate (eGFR) and explore the potential risk factors for a mildly reduced eGFR in a community-based population. Design and methods: Cross-sectional study in 643 adults without a history of kidney disease whose eGFR levels were greater than 60 mL/min/1.73 m(2) according to the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). Anthropometric measurements, blood pressure, fasting lipid profile and levels of fasting and post-load glucose, insulin, serum creatinine and uric acid (UA) were tested. The eGFR was calculated, and the correlations between eGFR and each variable were analyzed. Results: The subjects were divided into two groups by using 90 mL/min/1.73 m(2) as the cut-off value of the eGFR. In the lower eGFR group, the age, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), 2 h post-load plasma glucose (2 h-PG) levels and UA were significantly increased, and the incidences of hypertension, diabetes, obesity, hypertriglyceridemia and hypercholesterolemia were also higher (P<0.05). A multiple linear stepwise regression analysis showed that the WC, SBP, FPG and UA were independently correlated with the eGFR after adjusting for the other covariables. Conclusions: The WC, SBP, FPG and UA were closely related to the eGFR in the subjects whose eGFR levels were greater than 60 mL/min/1.73 m(2). The increased WC, SBP, FPG and UA may be the main risk factors for a mildly reduced eGFR.
    No preview · Article · Jan 2013 · Clinical biochemistry
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    ABSTRACT: Studies confirm that the lipid accumulation product (LAP), which is based on the waist circumference and fasting serum triglycerides, is highly related to cardiovascular and metabolic diseases. Nonalcoholic fatty liver disease is a hepatic manifestation of metabolic syndrome and closely correlated with the alanine aminotransferase (ALT) elevation. Abdominal obesity and dyslipidemia are the important risk factors for nonalcoholic fatty liver disease. Our aim was to examine the correlation between the LAP and ALT in apparently healthy adults. We conducted a cross-sectional study of 587 adults. The blood pressure, anthropometric measurements, fasting and postload glucose, insulin, fasting lipid profile, and liver enzymes were measured. The LAP was calculated. For each gender, the subjects were divided into 3 groups according to the ALT level. The correlation between the LAP and ALT was analyzed. The LAP increased progressively across the ALT tertiles. A Pearson correlation analysis demonstrated that the LAP positively associated with the ALT in men and women (both P < .05) but independently related to the ALT only in men. Furthermore, after adjusting for the other confounding factors, the subjects in the upper quartile of LAP was 3.61 times more likely to show ALT elevation compared with those in the lower quartiles in men. In addition, in men, the LAP was considered as the best marker to predict increased ALT. Our findings suggested that the LAP was independently correlated with the ALT but only in men. The LAP was the main risk marker and might be superior to other variables in recognizing increased ALT.
    No preview · Article · Aug 2012 · Nutrition research
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    ABSTRACT: Goiter is a very common clinical problem; however, Langerhans cell histiocytosis (LCH) with thyroid involvement that presents as a goiter is very rare. In this article, we report one case of thyroid LCH. An 18-year-old male patient presented with goiter, polyuria, polydipsia, and lymphadenectasis of the neck, and LCH was confirmed by a lymph node biopsy and pathological investigation. Without a thyroidectomy, the goiter shrank after nine cycles of chemotherapy. In addition, we summarize the reported thyroid LCH cases in the literature from the last 10 years. LCH usually involves other organs, such as the lungs, bones, skin, pituitary gland, and lymph nodes. Thyroid LCH is more common in adults than in children, and it may coexist with a thyroid carcinoma. Without any unique thyroid manifestations, either clinically or by imaging, it is difficult to distinguish thyroid LCH from other thyroid diseases. Pathology is the gold standard for the diagnosis of LCH. A fine needle aspiration biopsy (FNAB) may help to diagnosis LCH, although sometimes it leads to misdiagnosis. Chemotherapy is recommended for multi-system LCH. Younger patients with widespread disease or who are non-responsive to chemotherapy have poor outcomes.
    No preview · Article · Jan 2012 · Endocrine Journal
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    ABSTRACT: Inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is considered as a major predictor of cardiovascular events. Apolipoprotein B (ApoB) directly reflects the number of plasma atherogenic lipoproteins, and may play a major role in vascular inflammation. We aimed to assess whether an association between ApoB and hsCRP exists and, furthermore, to examine whether ApoB is more predictive of the inflammatory status than other cardiovascular risk factors. This was a cross-sectional study, with 511 apparently healthy adult subjects enrolled. Waist circumference (WC), body mass index (BMI), and blood pressure (BP) were measured. Plasma glucose levels, hsCRP, lipid profile, and insulin were collected after 10-14 h fasting. From the lowest to the highest quartile of hsCRP, the values for BMI, WC, BP, HOMA-IR, insulin, glucose level, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ApoB and the ApoB/apolipoprotein A1 (ApoA1) ratio were increased as the hsCRP level increased (P < 0.01), and high-density lipoprotein cholesterol (HDL-C) and ApoA1 levels declined as hsCRP level increased (P < 0.0001). Pearson's correlation analysis demonstrated that hsCRP correlated with all variables (P < 0.01), except for total cholesterol (TC) (P = 0.154) and LDL-C (P = 0.087). According to forward stepwise regression analysis with hsCRP as the dependent variable, WC was the only variable entered the regression model. ApoB level correlated with hsCRP level but was not the major determinant of hsCRP. WC was stronger than other cardiovascular risk factors in the associations with hsCRP. Abdominal obesity rather than atherogenic dyslipidemia was the primary cause of chronic inflammatory status.
    No preview · Article · Jan 2012 · Endocrine
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    ABSTRACT: To study the impact of genetic factor on pancreatic beta-cell function in the Chinese population. 233 first-degree relatives of patients with type 2 diabetes (T2D) with no history of blood glucose abnormalities and their 190 spouses, who did not have a family history of T2D, underwent a 75-g oral glucose tolerance test (OGTT). Based upon the OGTT, these two groups were further divided into three subgroups, including groups with normal glucose tolerance (NGT), impaired glucose regulation (IGR), and type 2 diabetes. Insulin resistance (IR) was evaluated using the homeostasis model assessment-IR (HOMA-IR), beta-cell function indices of basal and first-phase were measured by DI1 (HOMA-beta/HOMA-IR) and DI2 (DeltaI30/DeltaG30/HOMA-IR), respectively. Among the first-degree relatives and their spouses, the HOMA-IR was highest in the T2D group and lowest in the NGT group. However, the HOMA-beta, DI1 and DI2 declined significantly with progressive reductions in glucose tolerance (P<0.01 or 0.05). DI1 and DI2 of the NGT group of first-degree relatives (FNGT) were significantly lower than those of the spouse NGT (SNGT) group (P<0.05). DI1 and DI2 of the IGR of first-degree relatives (FIGR) group were significantly lower than those of the spouse IGR (SIGR) group. Defects in pancreatic beta-cell function exist in the first-degree relatives, who have different glucose tolerance statuses, of T2D patients. These defects are more profound in FNGT and FIGR when compared to their spouses in corresponding glucose tolerance subgroups. However, there is no difference in IR between the corresponding glucose tolerance subgroups of the first-degree relatives and their spouses. It suggests that the genetic factor possibly aggravates beta-cell lesion.
    No preview · Article · Sep 2009 · Diabetes research and clinical practice