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Open access

Qiu-ming Yao, Bin Wang, Xiao-fei An, Jin-an Zhang and Liumei Ding


Type 2 diabetes is a risk factor for testosterone deficiency and impaired sex steroid status. Some studies also investigated the association of testosterone level with diabetes risk in men, but reported controversial findings. To clarify this issue, we conducted a systematic review and meta-analysis.


PubMed, EMBASE and Web of Science were searched for eligible cohort or nested case–control studies published up to August 15, 2017. Meta-analysis was used to calculate the pooled relative risk (RR) of type 2 diabetes associated with higher testosterone level.


Thirteen cohort or nested case–control studies with 16,709 participants were included. Meta-analysis showed that higher total testosterone level could significantly decrease the risk of type 2 diabetes in men (RR = 0.65; 95% CI 0.50–0.84; P = 0.001), and higher free testosterone level could also decrease the risk of type 2 diabetes in men (RR = 0.94; 95% CI 0.90–0.99; P = 0.014). After excluding two studies that did not calculate RRs by quartiles of testosterone levels, both higher total testosterone and free testosterone levels could decrease the risk of type 2 diabetes in men, and the pooled RRs were 0.62 (95% CI 0.51–0.76; P < 0.001) and 0.77 (95% CI 0.61–0.98; P = 0.03), respectively.


This meta-analysis suggests that higher testosterone level can significantly decrease the risk of type 2 diabetes in men. Therefore, combined with previous researches, the findings above suggest a reverse-causality scenario in the relation between testosterone deficiency and risk of type 2 diabetes in men.

Open access

Weiwei He, Bin Wang, Kaida Mu, Jing Zhang, Yanping Yang, Wei Yao, Sheli Li and Jin-An Zhang

Background: Accumulating data have shown that Interleukin-27 (IL-27) polymorphisms are linked to the susceptibility of some autoimmune diseases. We assessed whether there was an association between three single nucleotide polymorphisms (SNPs) of IL-27 gene and autoimmune thyroid diseases (AITDs).

Methods: Three SNPs (rs153109, rs17855750 and rs181206) of IL-27 gene were genotyped by Hi-SNP high-throughput genotyping in 843 patients with AITDs (516 GD and 327 HT) and 677 healthy controls in Chinese Han population.

Results: Compared with controls, rs153109 displayed significant associations with GD in allele and genotype frequencies (P=0.002 and P=0.008, respectively) and rs17855750 displayed significant associations with HT in allele frequencies (P=0.02), whereas no differences in genotype or allele frequencies were found between AITD patients and controls at rs181206.

Conclusion: Our study, for the first time, showed the significant association of the IL-27 gene SNPs with AITD.

Open access

Xu Han, Xuefeng Xu, Hongyun Ma, Yuan Ji, Dansong Wang, Tiantao Kuang, Wenchuan Wu, Bin Song, Gang Li, Gang Jin and Wenhui Lou


Emerging evidence suggests G3 pancreatic neuroendocrine neoplasms (pNENs) present heterogeneous morphology and biology. The 2017 WHO classification has introduced a new category of well-differentiated pancreatic neuroendocrine tumors (WD-pNETs) G3, compared with poorly differentiated pancreatic neuroendocrine carcinomas (PD-pNECs) G3. We aim to analysis the demographics and outcomes of patients with resectable 2017 WHO G3 pNENs to facilitate the distinction between two entities.


The multi-institutional retrospective cohort involving 57 surgically treated patients affected by 2017 WHO G3 pNENs were morphologically identified and clinically analyzed. Patients having WD-pNETs G3 and those having PD-pNECs G3 were compared.


Thirty patients had WD-pNETs and 27 patients had PD-pNECs. The distributions of Ki-67 and mitotic count in patients with PD-pNECs or WD-pNETs showed remarkable disparities. ROC indicated cut-off value of Ki-67 was 45. PD-pNECs were more common in patients with elevated Ki-67 and mitotic count, advanced AJCC TNM stage, vascular invasion, regional lymph-node metastases, elevated NSE and decreased CgA levels compared with WD-pNETs (P < 0.05). The association between 2017 WHO G3 grade and TTR was statistically significant (P < 0.05). Univariate analysis indicated OS rates were associated with morphologic differentiation (WD-pNETs vs PD-pNECs), Ki-67, TNM staging, synchronous distant metastases, initial treatments, vascular invasion, regional lymph nodes metastases, mitotic count and age (P < 0.05). Multivariate analyses illustrated Ki-67, differentiation, TNM staging and vascular invasion were independent predictors (P < 0.05).


PD-pNECs G3 presented malignant biological behavior and dismal outcome compared with WD-pNETs G3. These findings challenge 2010 WHO classification and suggest the categorization can be improved by refined tumor grading.