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Nikolaos Kyriakakis Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Marilena Giannoudi Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Satish S Kumar Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Khyatisha Seejore Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Georgios K Dimitriadis Department of Endocrinology, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Harpal Randeva Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

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Adam Glaser Pediatric Oncology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute of Medical Research, University of Leeds, UK

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Michelle Kwok-Williams Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Georgina Gerrard Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Carmel Loughrey Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Ahmed Al-Qaissi Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Ramzi Ajjan Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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Julie Lynch Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

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Robert D Murray Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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undertaken after 15 min of recumbent rest. A 24-h blood pressure (BP) monitor (Welch Allyn, London, UK) was fitted to the patient’s arm at the end of the study visit. Metabolic and endocrine investigations A morning blood sample following an at least

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Sarah Ying Tse Tan Department of Endocrinology, Singapore General Hospital, Singapore

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Hong Chang Tan Department of Endocrinology, Singapore General Hospital, Singapore

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Ling Zhu Department of Endocrinology, Singapore General Hospital, Singapore

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Lih Ming Loh Department of Endocrinology, Singapore General Hospital, Singapore

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Dawn Shao Ting Lim Department of Endocrinology, Singapore General Hospital, Singapore

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Du Soon Swee Department of Endocrinology, Singapore General Hospital, Singapore

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Yoke Ling Chan Department of Speciality Nursing, Singapore General Hospital, Singapore

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Huee Boon Lim Department of Speciality Nursing, Singapore General Hospital, Singapore

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Shiau Lee Ling Department of Speciality Nursing, Singapore General Hospital, Singapore

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En Jun Ou Department of Speciality Nursing, Singapore General Hospital, Singapore

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Wynn Ee Teo Department of Speciality Nursing, Singapore General Hospital, Singapore

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Xiao Ping Zhang Department of Speciality Nursing, Singapore General Hospital, Singapore

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Hui Fen Goh Department of Speciality Nursing, Singapore General Hospital, Singapore

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Peng Chin Kek Department of Endocrinology, Singapore General Hospital, Singapore

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.6 years old; no AI = 51.1 ± 16.4 years old), there was no significant difference between the two groups. The average body mass index, blood pressure, sodium, and albumin normal were normal. Table 1 Baseline characteristics and laboratory results

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Aliyu Tijani Jibril Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

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Ahmad Jayedi Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

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Sakineh Shab-Bidar Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

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activity, and behavioral support, against a control group; (3) considered change in body weight (weight and BMI), HbA1c, fasting plasma glucose (FPG), systolic (SBP) and diastolic blood pressure (DBP), LDL cholesterol, HDL cholesterol, TC, TG, and C

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Xun Gong Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Lili You Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Feng Li Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Qingyu Chen Department of Medical Examination Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China

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Chaogang Chen Department of Clinical Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China

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Xiaoyun Zhang Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Xiuwei Zhang Department of Endocrinology, Dongguan People’s Hospital, Dongguan, People’s Republic of China

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Wenting Xuan Department of Endocrinology, Dongguan People’s Hospital, Dongguan, People’s Republic of China

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Kan Sun Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Guojuan Lao Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Chuan Wang Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Yan Li Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Mingtong Xu Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Meng Ren Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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Li Yan Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

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(FBG), n  = 2; BMI, n  = 43; systolic blood pressure (SBP), n  = 105; triglycerides (TG), n  = 14; waistline, n  = 195, or body fat, n  = 218) were excluded from this analysis dataset. A total of 3300 subjects were included in the final data

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Eliana Piantanida Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Daniela Gallo Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Giovanni Veronesi Department of Medicine and Surgery, University of Insubria, Varese, Italy
Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy

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Eugenia Dozio Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Eugenia Trotti Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Adriana Lai Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Silvia Ippolito Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Jessica Sabatino Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Maria Laura Tanda Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Antonio Toniolo Department of Biotechnology and Life Science, University of Insubria, Varese, Italy

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Marco Ferrario Department of Medicine and Surgery, University of Insubria, Varese, Italy
Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy

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Luigi Bartalena Department of Medicine and Surgery, University of Insubria, Varese, Italy

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 cm; female ≥80 cm) ( 31 , 32 ). Blood pressure (BP), approximated at 5 mmHg, was measured using calibrated sphygmomanometer with appropriate-size cuff. Heart rate was measured. Definition of MetS According to the 2009 harmonized definition

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Wioletta Pijacka
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Morag G Hunter
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Fiona Broughton Pipkin School of Biosciences, New Maternity Unit, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire LE12 5RD, UK

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Martin R Luck
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Introduction The renin–angiotensin system (RAS) is mainly associated with the regulation of blood pressure and ion homeostasis. The classically described circulating RAS comprises angiotensinogen (AGT) produced in the liver, renin (REN) produced by

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Dandan Hu D Hu, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

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Xiangguo Cong X Cong, Department of Endocrinology, The Affiliated Suzhou Hospital of Nanjing Medical University, suzhou, China

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Beibei Gao B Gao, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

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Ying Wu Y Wu, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

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Qiong Shen Q Shen, Department of Endocrinology, Suzhou Municipal Hospital, Suzhou, China

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Lei Chen L Chen, The Affiliated Suzhou Hospital of Nanjing Medical University, 苏州, 2100000, China

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Background:

Evidence has demonstrated that visceral fat area (VFA) and subcutaneous fat area (SFA) had different influences on cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between the visceral fat area (VFA) to subcutaneous fat area (SFA) ratio (V/S) and carotid atherosclerosis (CAS) in patients with T2DM.

Methods:

From January 2018 to May 2023, 1,838 patients with T2DM admitted to the National Metabolic Management Centre in our hospital were assigned to two groups based on comorbid CAS. Dual bioelectrical impedance analysis was used to measure the VAF and SFA, and the V/S was calculated. Patient characteristics and serum biochemical indices were compared between groups. Factors influencing comorbid CAS were determined, and correlations between V/S and other clinical indices were analyzed.

Results:

The group with comorbid CAS included 858 individuals and 980 without comorbid CAS. Those with comorbid CAS were older and had a longer disease duration, more significant systolic blood pressure, and greater V/S. The proportions of patients with comorbid hypertension increased significantly with the V/S ratio. The V/S ratio positively correlated with triglyceride (TG), low-density lipoprotein cholesterol levels, and waist circumference. According to binary logistic regression analysis, V/S was an independent risk factor for CAS.

Conclusion:

Elevated V/S is an independent risk factor for CAS in patients with T2DM.

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A Daniel Bird Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Victoria, Australia

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Spencer Greatorex Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Victoria, Australia

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David Reser Department of Physiology, Monash University, Melbourne, Victoria, Australia

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Gareth G Lavery Institute of Metabolism and Systems Research, 2nd Floor IBR Tower, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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Timothy J Cole Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Victoria, Australia

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Steroid hormones play clinically important and specific regulatory roles in the development, growth, metabolism, reproduction and brain function in human. The type 1 and 2 11-beta hydroxysteroid dehydrogenase enzymes (11β-HSD1 and 2) have key roles in the pre-receptor modification of glucocorticoids allowing aldosterone regulation of blood pressure, control of systemic fluid and electrolyte homeostasis and modulation of integrated metabolism and brain function. Although the activity and function of 11β-HSDs is thought to be understood, there exists an open reading frame for a distinct 11βHSD-like gene; HSD11B1L, which is present in human, non-human primate, sheep, pig and many other higher organisms, whereas an orthologue is absent in the genomes of mouse, rat and rabbit. We have now characterised this novel HSD11B1L gene as encoded by 9 exons and analysis of EST library transcripts indicated the use of two alternate ATG start sites in exons 2 and 3, and alternate splicing in exon 9. Relatively strong HSD11B1L gene expression was detected in human, non-human primate and sheep tissue samples from the brain, ovary and testis. Analysis in non-human primates and sheep by immunohistochemistry localised HSD11B1L protein to the cytoplasm of ovarian granulosa cells, testis Leydig cells, and gonadatroph cells in the anterior pituitary. Intracellular localisation analysis in transfected human HEK293 cells showed HSD1L protein within the endoplasmic reticulum and sequence analysis suggests that similar to 11βHSD1 it is membrane bound. The endogenous substrate of this third HSD enzyme remains elusive with localisation and expression data suggesting a reproductive hormone as a likely substrate.

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Gunjan Garg Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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Garima Kachhawa Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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Rekha Ramot Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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Rajesh Khadgawat Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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Nikhil Tandon Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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V Sreenivas Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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Alka Kriplani Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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N Gupta Departments of Endocrinology, Obstetrics and Gynecology, Biostatics

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To assess the effect of vitamin D supplementation on parameters of insulin sensitivity/resistance (IS/IR) and insulin secretion in subjects with polycystic ovarian syndrome (PCOS). A prospective double-blind randomized control trial was conducted to assess the effect of vitamin D on insulin kinetics in women with PCOS. The trial was conducted in a tertiary care research hospital. A total of 36 subjects with PCOS, aged 18–35 years, were included in this study. Vitamin D3 4000 IU/day versus placebo was given once a month for 6 months and both groups received metformin. IS (by whole-body IS index or Matsuda index), IR (by homeostasis model assessment IR (HOMA-IR)), and insulin secretion (by insulinogenic index; II30) were the main outcome measures. Secondary outcome included blood pressure (BP), lipid profile, disposition index (DI), and vascular stiffness. Out of 36 subjects who consented, 32 completed the study. Subjects were randomized into two groups: group A (n=15; metformin and vitamin D 4000 IU/day) or group B (n=17; metformin and placebo). Oral glucose tolerance tests with 75 g glucose were carried out at baseline and 6 months after supplementation. Hypovitaminosis D was observed in 93.8% of all subjects with mean serum 25 hydroxy vitamin D level of 7.30±4.45 ng/ml. After 6 months of vitamin D supplementation, there was no significant difference in any of the parameters of IS/IR (area under curve (AUC)–glucose, AUC–insulin, insulin:glucose ratio, HOMA-IR, Matsuda index, insulinogenic index, and DI), II30, and cardiovascular risk factors between the two groups. Supplementation of vitamin D, at a dose of 4000 IU/day for 6 months, did not have any significant effect on parameters of IS/IR and insulin secretion in subjects with PCOS.

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Marenao Tanaka M Tanaka, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo, Japan

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Tomohito Gohda T Gohda, Department of Nephrology, Juntendo University, Bunkyo-ku, Japan

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Nozomu Kamei N Kamei, Department of Endocrinology and Metabolism, Hiroshima Red Cross Hospital and Atomic Bomb Survivors' Hospital, Hiroshima, Japan

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Maki Murakoshi M Murakoshi, Department of Nephrology, Juntendo University, Bunkyo-ku, Japan

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Tatsuya Sato T Sato, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

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Mitsunobu Kubota M Kubota, National Hospital Organization Kure Medical Center Attached Kure School of Nursing, Kure, Japan

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Michiyoshi Sanuki M Sanuki, National Hospital Organization Kure Medical Center Attached Kure School of Nursing, Kure, Japan

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Erika Ishiwata E Ishiwata, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

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Keisuke Endo K Endo, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

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Yusuke Suzuki Y Suzuki, Juntendo University, Bunkyo-ku, Japan

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Masato Furuhashi M Furuhashi, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

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Background: Fatty acid-binding protein 4 (FABP4) is an adipokine that plays significant roles in the development of insulin resistance and atherosclerosis. High levels of soluble tumor necrosis factor receptors (TNFRs) including TNFR1 and TNFR2 are associated with renal dysfunction and increased mortality in patients with diabetes mellitus (DM). However, the association between circulating levels of FABP4 and TNFRs remains unclear.

Methods: We investigated the associations of FABP4 with TNFRs and metabolic markers in Japanese patients with type 1 DM (T1DM, n=76, men/women: 31/45) and type 2 DM (T2DM, n=575, men/women: 312/263).

Results: FABP4 concentration was positively correlated with levels of TNFR1 and TNFR2 in both patients with T1DM and those with T2DM. Multivariable regression analyses showed that there were independent associations of FABP4 concentration with body mass index (BMI) and estimated glomerular filtration rate (eGFR) after adjustment of age and sex in both patients with T1DM and those with T2DM. FABP4 concentration was independently associated with circulating levels of TNFR1 and TNFR2 after adjustment of the confounders in patients with T2DM but not in those with T1DM. Similarly, levels of TNFR1 and TNFR2 were independently associated with FABP4 concentration after adjustment of age, sex, systolic blood pressure, duration of DM and levels of eGFR, high-density lipoprotein cholesterol and C-reactive protein in patients with T2DM but not in those with T1DM.

Conclusion: FABP4 concentration is independently associated with levels of TNFRs in patients with DM, but the association is more evident in patients with T2DM than in those with T1DM.

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