7 Endocrinology and Metabolism

7 Endocrinology and Metabolism

2015160 Association and interaction between 10 SNP of peroxisome proliferator-activated receptor and non-HDL-C.LIU Mengmeng（刘萌萌），et al. Suzhou Dis Contr&Prev Center，Suzhou 215123.Chin J Prev 2015；49（3）：259-264.

Objective To examine the main effect of 10 Peroxisome proliferators-activated receptor（PPAR）SNP in contribution to non-HDL-C and study whether there is an interaction in the 10 SNPs.Methods Participants were recruited within the framework of the PMMJS（Prevention of Multiple Metabolic Disorders and Metabolic Syndrome in Jiangsu province）cohort-population-survey，which was initiated from April 1999 to June 2004，and 5-year follow-up data from total 4 582 subjects were obtained between March 2006 and October 2007.A total of 4 083 participants received follow-up examination.After excluding subjects who had experienced stroke or exhibited cardiovascular disease，type 2 diabetes or a BMI＜18.5 kg/m2，a total of 820 unrelated individual subjects were selected from 3 731 subjects on October of 2009.Blood samples which were collected at the baseline were subjected to PPARα，PPARδ and PPARγ 10 SNPs genotype analysis.Logistic regression model was used to examine the association between 10 SNPs in the PPARs and non-HDL-C.Interactions within the 10 SNP were explored by using the Generalized Multifactor Dimensionality Reduction（GMDR）.Results A total of 820 participants（mean age was 50.05±9.41）were included in the study and 270 were males and 550 were females.Single-locus analysis showed that after adjusting gender，age，smoking，alcohol consumption，physical activity，high-fat diet and low-fiber diet factors，rs1800206-V and rs3856806-T were significantly associated with higher non-HDL-C levels.V allele（LV+VV genotype）carriers of rs1800206 have an average non-HDL-C levels on（3.15±0.89）mg/L（F=15.01，P=0.002）；T allele（CT+TT genotype）carriers of rs3856806 have an average non-HDL-C levels on（3.03±1.01）mg/L（F=9.87，P=0.005）. GMDR model analysis showed that after adjusting the same factors，two-locus model，five-locus model，six-locus model and seven-order interaction models were all statistically significant（P＜0.05），and the seven-locus model（rs1800206，rs3856806，rs135539，rs4253778，rs2016520，rs1805192，rs709158）were the best model （P=0.001），the cross-validation consistency was 10/ 10andtestingaccuracywas 0.656.Conclusion Rs1800206 and rs3856806 were significantly associated with non-HDL-C.And there was a gene-gene inte ractionamong rs1800206，rs3856806，rs1800206，rs135539，rs4253778，rs2016520，rs1805192，rs3856806and rs709158 which could influence the non-HDL-C levels.

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2015161 The role of thrombelastogram in the evaluation of the hypercoagulability status in older type 2 diabetic patients with macrovascular disease.LU Bangchao（陆帮超），et al.Dept Geriatr，Nanjing Drum Tower Hosp，Nanjing 210008.Chin J Diabetes 2015；23 （3）：219-222.

Objective To explore the role of thrombelastogram （TEG）in the evaluation of the hypercoagulability status in older type 2 diabetic patients with macrovascular disease.Methods A total of 60 older diabetic patients were divided into two groups：according to their macrovascular complications：30 cases with macroangiopathy（T2DM+ MVC group）；30 cases without macroangiopathy（T2DM group）；and another 30 healthy persons were selected as control group（NC group）.TEG and regular coagulation function were tested.Results Compared with NC group，the levels of serum FIB were higher in T2DM group［（3.79±0.75）vs（3.36±0.91）g/L］and in T2DM+ MVC group［（4.27±1.06）vs（3.36±0.91）g/L］（P＜0.05），and it was much higher in T2DM+MVC group than in T2DM group（P＜0.05）.TEG test showed that compared with NC group，TEG reaction time （R value）［（6.31±0.94）vs（5.74±0.88）min］was significantly shorter in T2DM group（P＜0.05），R value［（6.31±0.94）vs（4.76±1.27）min］and K value［（2.31±0.24）vs（1.64±0.62）min］were also significantly shorter in T2DM+MVC group，but Angle α value［（60.61±4.75）vs（67.40±7.77）deg］was larger（P＜0.01）.Conclusion Blood coagulation function disorders exist in older diabetic patients with diabetic macroangiopathy.TEG indexes can reflect coagulation abnormalities in those patients.

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2015162 Efficacy and safety of different treatment strategy for mild versus severe hyperglycemia during continuous subcutaneous insulin infusion in type 2 diabetics.CHEN Feng（陈锋），et al.Dept Endocrinol，Huangshi TCM Hosp，Huangshi 435000.Chin J Diabetes 2015；23（3）：233-236.

Objective To compare the efficacy and safety of different strategy for mild versus severe hyperglycemia during continuous subcutaneous insulin infusion（CSII）in type 2 diabetics.Methods A total of 40 T2DM patients using CSII were divided into treatment group and control group（n=20，each）.The right insulin dose was used to treat hyperglycemia in control group，and additional basal dose was added to treat hyperglycemia in treatment group.Peripheral blood glucose at baseline versus at 4 h after processing hyperglycemia，insulin dose for the treatment of hyperglycemia，total daily insulin dose and incidence of hypoglycemia were observed and recorded.Results There were no statistical differences in baseline hyperglycemia level［（16.7±4.3）vs（16.4±4.8）mmol/L，P＞0.05］and in peripheral blood glucose at 4 h after processing hyperglycemia［（8.1±1.5）vs（8.3± 1.2）mmol/L，P＞0.05］in control group versus treatment group.There were statistical differences in insulin dose for the treatment of hyperglycemia［（6.4±2.1）vs （2.8±1.6）U，P＜0.05］，daily insulin dose［（34.25± 2.10）vs（29.10±3.40）U，P＜0.05］and incidence of hypoglycemia［3（15%）vs 0（0%），P＜0.05］between two groups.Conclusion Using additional basal dose to treat hyperglycemia could be effective，and more stable with lower risk of hypoglycemia and lower insulin dose.It's a better way to mimic the physiological insulin secretion.

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2015163 Role of Hcdc14A in the in vitro diabetes environment-induced human brain vascular endothelial cell injury.ZHOU Houguang（周厚广），et al. Dept Geriatr Neurol，Huashan Hosp，Fudan Univ，Shanghai 200030.Chin J Endocrinol Metab 2015；31 （1）：59-65.

Objective To investigate the effects of the in vitro diabetes environment such as high glucose，high free fatty acid（FFA），and hypoxia on human cell division cycle protein 14A（Hcdc14A）and related cyclins expressions，cell proliferation and apoptosis in human brain vascular endothelial cells（HBVEC），and to explore the new mechanism of HBVEC injury induced by diabetes. Methods HBVECs were stimulated respectively with high glucose，high FFA，and hypoxia under different conditions.The mRNA and protein levels of Hcdc14A were detected by RT-PCR and Western blot.At the same time，the protein levels of cyclin B，cyclin D，cyclin E，and p53 were detected by Western blot.The cell proliferation was tested by XTT.The cell apoptosis was detected by AnnexinV/PI.Results After HBVECs were incubated with various concentrations of glucose（10，15，and 25 mmol/L）and FFA（50，100，and 200 μmol/L）or with 25 mmol/L glucose and 200 μmol/L FFA for 24，48，and 72 h，respectively，the mRNA and protein expressions of Hcdc14A were dose-and time-dependently decreased，along with decreased cyclin B，cyclin D，and cyclin E protein expressions and increased p53 protein expression（all P＜0.05）.Treatment with hypoxia showed a similar result.Compared with control，high glucose，FFA，and hypoxia，the combined intervention of high glucose+FFA+hypoxia significantly down regulated the mRNA and protein（all P＜0.05）expressions of Hcdc14A，along with decreased cyclin B，cyclin D，and cyclin E protein expressions and increased p53 protein expression（all P＜0.05）.Compared with control，high glucose，FFA，and hypoxia，the combined intervention of above stimuli obviously reduced the proliferation of HBVECs（40.7% ±12.1%vs 100.0% ±10.2%，67.5% ±12.1%，55.3% ±11.2%，and 64.4% ± 11.3%，all P＜0.05）and increased the cell apoptosis （22.5% ±1.77%vs 5.7% ±0.83%，9.3% ± 0.95%，16.3% ±1.69%，and 16.3% ±1.15%，all P＜0.05）.Conclusion The findings suggest that Hcdc14A may play an important role in diabetes-induced injury of brain vascular endothelial cells，and seems to be one of the major signaling pathways involved in cell injury.

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2015164 Effects of 1，25-dihydroxyvitamin D3on the expression of transforming growth factor β1 and related factors in rats with diabetic nephropathy. YANG Ye（杨烨），et al.Dept Endocrinol，1st Hosp，Xinjiang Med Univ，Urumqi 830054.Chin J Endocrinol Metab 2015；31（1）：66-70.

Objective To explore the protective effect as well as its mechanism of 1，25-dihydroxyvitamin D3on the pathological change in rats with diabetic nephropathy and different levels of transforming growth factor β1（TGF-β1）in kidney.Methods SD rats（n=24）with diabetic nephropathy were respectively injected with three kinds of lentivirus vectors.Calcitriol（0.03 μg·kg-1·d-1）or peanut oil as control was administered to these rats by lavage for 37 days，and then the kidney was taken.The mRNA levels of TGF-β1，gene of phosphate and tension homology deleted on chromsome ten（PTEN），collagen-1 （COL-1），and connective tissue growth factor（CTGF）were measured by realtime PCR.The changes of ultrastructure in the kidneys were observed by electronic microscopy.Results（1）1，25-dihydroxyvitamin D3decreased the mRNA expressions of TGF-β1，COL-1，and CTGF in rat kidney with TGF-β1 overexpression，TGF-β1 downregulation，and vector groups（P＜0.05），while increased the mRNA expression of PTEN（all P＜0.05）. （2）The electronic microscopy showed more serious change of renal lesions when TGF-β1 was overexpressed. The pathological changes of rat kidney in various groups were improved by calcitriol.Conclusion 1，25-dihydroxyvitamin D3may have a protective effect on diabetic nephropathy via the pathway of TGF-β1.

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2015165 Relationship between neck circumference and insulin resistance in a community population. WANG Yu（王玉），et al.Dept Endocrinol，Centr Hosp，Xuzhou 221009.Chin J Endocrinol Metab 2015；31（1）：33-36.

Objective To investigate the relationship between neck circumference（NC）and insulin resistance in a large Chinese cohort of community population.Methods A total of 2 318 subjects in this study were from a community-based health examination survey in Xuzhou.Serum triglyceride（TG），total cholesterol（TC），high den-sity lipoprotein-cholesterol（HDL-C），low density lipoprotein-cholesterol（LDL-C），and glucose levels were determined.NC，height，waist circumference（WC），hip circumference，and body weight were measured.Insulin resistance was assessed by homeostasis model assessment-insulin resistance（HOMA-IR）index.Results NC was positively correlated with age，body mass index （BMI），WC，hip circumference，waist-to-hip ratio，systolic blood pressure，diastolic blood pressure，uric acid，TC，TG，LDL-C，while negatively correlated with HDL-C.NC was significantly associated with increasing trend of HOMA-IR in both men and women after adjusting for age and other cardiometabolic risk factors.The associations still existed after further adjustment for BMI and WC.Moreover，there were significant interactions between NC and BMI or WC on HOMA-IR（P＜0.01）. The associations between NC and HOMA-IR appeared stronger among those with higher BMI or WC.Conclusion In healthy Chinese adults，NC is independently related to HOMA-IR and other cardiometabolic risk factors，and interacts with other parameters of overall or central adiposity，such as BMI and WC.

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2015166 Meta-analysis of the relationship of NeuroD1 Ala45Thr polymorphism with type 2 diabetes. MUHADASI Tuerxunyiming（木哈达斯），et al.Occupat Health&Environment Health Dept，Sch Public Health，Xinjiang Med Univ，Urumqi 830011.Chin J Endocrinol Metab 2015；31（1）：37-42.

Objective To investigate the association of neural differentiation factor 1（NeurolD1）Ala45Thr polymorphism with type 2 diabetes by meta-analysis.Methods The electronic databases were retrieved from PubMed，EMBASE，CNKI，VIP fulltext database，and Wanfang fulltext database.Literatures about the association of NeuroD1 Ala45Thr polymorphism with type 2 diabetes from 2004 to 2012 were searched.The selected studies from 2004 to 2012 were included to analyze data based onthepublishedmeta-analysisoftheNeuroD1 （Ala45Thr）gene polymorphism and type 2 diabetes written by Kavvoura，et al.The odds ratio of NeuroD1（Ala45Thr）genotype distributions in type 2 diabetic patients compared with healthy control were analyzed.Rev-Man 5.0 software was applied for investigating hereogeneity among individual studies and summarizing effects with proper statistical methods.Thirteen case control studies were enrolled.Results A total of 3 896 patients and 3 186 control subjects were enrolled for the study. ThepooledORsofThr45Thr45/（Ala45Thr+ Ala45Ala45）genotype in type 2 diabetes mellitus and control groups were 3.16（95%CI 0.99-10.11）in the subgroup of yellow race and 1.09（95%CI 0.90-1.32）in the subgroup of white race，with no statistically significant difference（P＞0.05）.The pooled OR of G/A allele in type 2 diabetes mellitus and control groups was 0.85（95%CI 0.72-0.99）/1.18（95%CI 1.07-1.38），with statistically significant difference（Z= 2.02，P=0.04）.Conclusion The A allele of NeuroD1 （Ala45Thr）locus may be a risk factor for type 2 diabetes mellitus.

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2015167 Relationship of nodule size and thyroid cancer.YAN Huixian（闫慧娴），et al.Dept Endocrinol，Chin PLA General Hosp，Beijing 100853.Chin J Endocrinol Metab 2015；31（1）：10-13.

Objective To evaluate the association of nodule size with thyroid cancer risk.Methods This retrospective study included 5 440 patients undergoing thyroidectomy in Chinese PLA General Hospital from 2001 to 2011.Of these patients，6 907 nodules with histological results were analysed.The nodules were devided into five groups according to nodule size：＜1.0 cm，≥1.0 cm and＜2.0 cm，≥2.0 cm and＜3.0 cm，≥3.0 cm and＜4.0 cm，≥4.0 cm.Results（1）Of 6 907 evaluated thyroid nodules in 5 440 patients，28.94%（1 999/6 907）nodules were malignant.97.39%（1 947/1 999）malignant nodules were papillary thyroid cancer.（2）Of those＜1.0 cm，≥1.0 cm and＜2.0 cm，≥2.0 cm in diameter，51.6%，26.8%，and 11.2%were malignant respectively（P＜0.01）.However，nodules in diameter≥2.0 cm and＜3.0 cm，≥3.0 cm and＜4.0 cm，≥4.0 cm，12.1%，10%， and 9.5%of cases were malignant（P=0.313 2）.（3）Of all thyroid cancers，the proportion of papillary carcinoma was decreased as nodules enlarged（＜1.0 cm：99.4%，≥1.0 cm and＜2.0 cm：98.4%，≥2.0 cm and＜3.0 cm：90.3%，≥3.0 cm and＜4.0 cm：89.5%，≥4.0 cm：68.4%），while follicular cancer was increased（＜1.0 cm：0.5%，≥1.0 cm and＜2.0 cm：1.3%，≥2.0 cm and＜3.0 cm：6.3%，≥3.0 cm and＜4.0 cm：5.3%，≥4.0 cm：21.1%）.Conclusion The risk of papillary thyroid cancer was decreased and the risk of follicular cancer and other rare thyroid malignancies was increased as nodules enlarged.

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2015168 Relationship between serum thyroxin-stimulating hormone and papillary thyroid micrcarcinoma in nodular thyroid disease.JIAO Jie（矫杰），et al.Dept Endocrinol&Metab，Affil Beijing Anzhen Hosp，Capital Med Univ，Beijing 100029.Natl Med J China 2015；95（2）：908-912.

Objective To explore the relationship between serum level of thyroxin-stimulating hormone（TSH）and development and progression of papillary thyroid microcarcinoma（PTMC）in nodular thyroid disease.Methods A total of 365 eligible patients with thyroid nodules undergoing initial thyroidectomy were enrolled，including 113 patients with PTMC diagnosed by postoperative pathology （PTMC group）and 252 patients with benign thyroid nodules（BTN group）.Their clinical data were retrospectively reviewed.The serum levels of TSH in two groups and the proportion of PTMC in different serum TSH level groups in all patients were compared respectively.The relationship of preoperative serum TSH levels with tumor size and lymphatic metastasis in patients with PTMC were analyzed.Results No significant difference existed in serum TSH levels between PTMC and BTN groups（P＞0.05）.The median age was younger in PTMC group than that in BTN group（Z=-2.877，P=0.004）.And the TGAb levels were higher in PTMC group than those in BTN group（Z=-2.887，P=0.004）.They were divided into 6 groups according to the serum TSH levels，and there weren't significant difference in the proportion of PTMC among those group（P＞0.05）.Binary logistic regression analysis showed age was the only risk factor of PTMC（OR=0.971，95%CI：0.953-0.990，P= 0.003）.The serum TSH levels were positively correlated with tumor size in patients with PTMC（r=0.218，P= 0.025）.However，the proportions of lymphatic metastasis were comparable among different TSH levels groups in patients with PTMC（P＞0.05）.Conclusion Serum TSH is probably associated with the de novo oncogenesis of PTMC.However，serum TSH may be involved in the growth of preexisting PTMC.

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2015169 Clinical significance of HMGA1 and HMGA2expression in papillary thyroid carcinoma. WANG Yunsheng（汪运生），et al.Dept Endocrinol，2nd People's Hosp，Hefei 230011.Chin J Endocrinol Metab 2015；31（1）：18-22.

Objective To study the relationship of high mobility group A（HMGA）1 and HMGA2 expressions with the occurrence，development，and metastasis of papillary thyroid carcinoma.Methods Fresh and paraffin-embedded 35 cases of papillary thyroid carcinoma tissues（PTC）and corresponding paracancerous thyroid tissues（PT），and 10 cases of normal tissues（NT）from adjacent thyroid benign lesions were collected.The mRNA and protein expressions of HMGA1 and HMGA2 were detected by realtime PCR and immunohistochemistry respectively. Results The mRNA expressions of HMGA1 and HMGA2 showed nearly no expression in the NT group，no significant difference between PT group and NT group（P＞0.05），and significantly higher expression in PTC group compared with NT group（173.5 folds and 5.9 folds，both P＜0.01）.The protein expressions of HMGA1 and HMGA2 gradually increased in NT group，PT group，and PTC group，with significant difference between these groups（both P＜0.01）.The protein expressions of HMGA1 and HMGA2 in PTC group with various clinical stages or with and without lymph node metastasis showed statistically significant difference（P＜0.05 or P＜0.01），but it did not show any significant difference regarding patients'age，gender，and tumor size（P＞0.05）.The mRNA and protein expressions of HMGA1 were significantly higher than those of HMGA2 in PTC group（P＜0.05 or P＜0.01）.Conclusion The overexpressions of HMGA1 and HMGA2 were related to development and metastasis of papillary thyroid carcinoma. Compared with HMGA2，HMGA1 was a better molecular marker in identifying benignandmalignant thyroid tumors.

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2015170 Clinicalcharacteristics andassociated prognosis of methicillin resistant staphylococcus aureus infections in patients with diabetic foot ulcer. XU Lei（许蕾），et al.Dept Endocrinol Metab Dis，Jiaotong Univ Med Sch，Shanghai 200025.Chin J Endocrinol Metab 2015；31（1）：28-32.

Objective To investigate the positive rates of staphylococcus aureus culture and its antibiotic resistance in the patients with diabetic foot infection（DFI），and to analyse its related risk factors and prognosis.Methods Pretreatment specimens of foot secretion were obtained from 790 patients with DFI and sent for pathogen culture.The antibiotic susceptibility of methicillin resistant staphylococcus aureus（MRSA）infection，clinical characteristics，the healed rates of ulcer，amputation，and mortality were analyzed.Results Among the 624 positive cultures，127 cases turned out to be staphylococcus aureus，of which 51.2%was MRSA.MRSA accouted for 9.1%of all the cultures，and one strain was vancomycin-resistant.MRSA was primarily susceptible to vancomycin，rifampicin，linezolid，teleoplanin and so on. Within three months，47.7%of the patients infected with MRSA were cured，47.7%lost their toes or legs，and 9.2%died，worse prognosis as compared with non-MRSA group（P＜0.05）.History of antibiotic medication suggested higher probability of MRSA infection. Conclusion MRSA infection was mostly detected in refractory diabetic foot infection，and also indicated poor prognosis.

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2015171 Single-fiber conduction study of motor nerve in patients with diabetic peripheral neuropathy.TIAN Li（田丽），et al.Dept Neurol，3rd Centr Clin Coll，Tianjin Med Univ，Tianjin 300170.Chin J Neurol 2015；48（3）：188-191.

Objective To assess the function of motor nerve fiber inpatientswithdiabeticperipheralneuropathy （DPN）by single-fiber conduction studies.Methods According to the diagnostic standard of DPN issued in Toronto meeting in 2009，on the basis of the result of peroneal nerve conventional conduction study，a total of 65 patients with DPN in the Department of Endocrinology and the Department of Neurology of Tianjin Third Central Hospital from October 2012 to October 2013 were enrolled into the study，from whom 33 had abnormal sensory conduction（sensory-diabetic peripheral neuropathy group，S-DPN group），32 had abnormal sensory motor conduction（sensory motor-diabetic peripheral neuropathy group，SM-DPN group）.Single-fiber conduction velocity （SF-CV）and single-fiber distal motor latency（SF-DML）were detected in all subjects.The obtained results were compared with the data from 34 healthy volunteers（control group）.The relationship of SF-CV，SF-DML and the duration of diabetes mellitus，fasting glucose，HbA1c was also studied in DPN patients.Results The SF-CV［（43.1±3.6）m/s］was decreased in SDPN group compared with control group［（47.5±3.3）m/s，t= 5.077，P＜0.01］.There were no significant differences in SF-DML［（3.6±0.7）ms］，motor nerve conduction velocity［MCV（49.5±2.6）m/s］and DML［（3.4± 0.6）ms］in S-DPN group compared with that of control group［（3.4±0.5）ms，（50.9±3.5）m/s，（3.2± 0.5）ms，respectively］.SM-DPN group had lower SFCV［（35.2±3.6）m/s，t=9.119，14.219］，MCV［（40.9±3.2）m/s，t=11.131，13.025］and increased SF-DML［（4.5±0.7）ms，t=5.692，7.231］，DML［（4.2±0.7）ms，t=5.561，6.975］compared with the other two groups（P＜0.01）.SF-CV in DPN patients was negatively related to the diabetic duration（r=-0.340，P=0.006），while SF-DMI had no correlation with duration of DM，fasting blood glucose and HbA1c.Conclusion Detection of SF-CV is easy to find early motor nerve dysfunction in DPN pati ents.SF-SV is decreased with the increasing duration of diabetes.

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2015172 Expression of thyroid-stimulating hormone receptor in thyroid tissue of lactating rats.WAN Siyuan（万思源），et al.Dept Prev Med，Qiqihar Med Coll，Qiqihar 161006.Chin J Endemiol 2015；34（3）：164-167.

Objective To observe the expressions of thyroidstimulating hormone receptor（TSHR）protein and mRNA in thyroid gland of lactating rats.Methods Eighty adult Wistar rats（60 females and 20 males），weighing 210-250 g，were selected.The 60 female Wistar rats were divided into 6 groups according to their body weight by means of random number table：normal non-pregnant group，lactating for 5，10，15 and 20 days groups and weaning for 5 days group，10 rats in each group.All rats were fed with conventional fodder and tap water freely，and the rats of lactating groups except the normal nonpregnant group cohabited with male rats（3∶1）.Then all rats were killed on the 5th，10th，15th and 20th day after lactation and on the 5th day after weaning to get thyroid tissues.The expressions of TSHR protein and mRNA were determined by immunohistochemical staining and real-time quantitative PCR.Results TSHR protein was expressed in cytoplasm and membrane of rat thyroid follicular cells.The expression of TSHR protein in thyroid gland was significant different statistically between groups（χ2=11.227，P＜0.05）；the staining intensity of rat thyroid tissues in the normal non-pregnant group （weak，n=2；moderate，n=5；strong，n=3）was stronger than that of rats lactating for 5 days（weak，n= 7；moderate，n=3；χ2=5.895，P＜0.05）.But the expression of TSHR protein in thyroid tissues in the normal non-pregnant group was not significantly different statistically compared with the expression of TSHR protein in other groups（lactating for 10，15 and 20 days）and weaning for 5 days group（all P＞0.05）.The expression of TSHR mRNA in thyroid gland was significantly different statistically between groups（F=2.970，P＜0.05）；the expression of TSHR mRNA in lactating for 5 days group（0.74±0.13）was lower than that of the nonpregnant group（1.02±0.24，P＜0.05）；and the expression of TSHR mRNA in the normal non-pregnant group was not significantly different statistically compared with those of other groups（lactating for 10，15 and 20 days）and weaning for 5 days group（all P＞0.05）. Conclusion TSHR is widely expressed in thyroid gland of lactating rats，but relatively lower in early lactation period.

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2015173 Expressions of lysozyme C and lactoferrin in tears of thyroid-associated ophthalmopathy patients.JIANG Lihong（江利红），et al.Dept Ophthalmol，Shanghai Shidong Hosp，Shanghai 200438.Natl Med J China 2015；95（10）：749-752.

Objective To explore the differential expressions of lysozyme C and lactoferrin in tears of thyroid-associated ophthalmopathy（TAO）patients versus healthy subjects by proteomics.Methods Tear samples were obtained from patients with active period TAO and age and gendermatched healthy subjects without symptoms of ocular surface.Then they were divided into patient and control groups.Then tear samples of two groups were analyzed. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis （SDS-PAGE）of 15%gel was performed to determine the different protein bands in sample groups.And different labeled protein bands were collected for in-gel tryptic digestion.Mass spectrometry was employed to determine the protein components from different protein bands. Then Scaffold search engine was used for analyzing the results of mass spectrometry and identifying specific proteins.Results Based on mass spectrometric analysis of different protein bands，most proteins were down-regulated or became absent in TAO patients.Both lysozyme C and lactoferrin were up-regulated.Identification of protein relative quantitative ratio（patient/control）：lysozyme C：4.88，lactoferrin：1.61.Conclusion Lysozyme C and lactoferrin are two important effectors of tear function and metabolism.Both are up-regulated in TAO patients' tears.Thus both are probably involved in inflammatory process of TAO and play synergistic roles in the pathogenesis of disease.

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2015174 The impact of glycosylated hemoglobin target value in treatment guidelines on glycemic control of type 2 diabetic in Chinese cities.GU Weijun（谷伟军），et al.Dept Endocrinol，PLA General Hosp，Beijing 100853.Chin J Intern Med 2015；54（3）：193-196.

Objective To investigate the influence of glycosylated hemoglobin A1c（HbA1c）standard value（2007 and 2010 Chinese Diabetes Prevention Cuide）on glycemic control and treatment of type 2 diabetic patients in Chinese cities.Methods A cross-sectional study was carried out in type 2 diabetes mellitus from outpatients in selected hospitals all over China in 2009 and 2012.Patients treated with oral antidiabetic drugs（OADs），insulin or OAD combined with insulin were enrolled.A questionnaire including general characters，therapy，complications and blood glucose was completed by trained surveyors.Results A total of 30 853 patients were enrolled in 2009，and 48 232 patients in 2012.The distribution of HbA1c＜6.5%，6.5%-＜7.0%，7.0%-＜8.0%，8.0%-＜9.0%，9.0%-＜10.0%and≥10.0% was 20.35%，12.59%，35.50%，18.94%，6.46% and 6.16%in 2012；14.81%，27.72%，14.55%，6.55%and 8.36%in 2009，respectively.The top three OAD was biguanides，sulfonylureas and thiazolidine. The most common treatment options for combined therapy are metformin combined with sulfonylurea in both 2009 and 2012.Conclusion There is an increase in the proportion of patients with good and general blood glucose control in 2012.With the generalization of Chinese Diabetes Prevention Guide，a steady tendency is presented in blood glucose control.

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2015175 The relationship between serum 25-hydroxy vitamin D and the first-phase insulin secretion of β cell in newly diagnosed type 2 diabetic patients. YANG Yan（阳琰），et al.Dept Endocrinol，Affil Hosp，Zunyi Med Coll，Zunyi 563099.Chin J Diabetes 2015；23（4）：334-337.

Objective To evaluate the relationship between serum 25-hydroxy vitamin D［25（OH）D］and the firstphase insulin secretion of beta cell in newly diagnosed type 2 diabetic patients.Methods Clinical characteristics and laboratory data were collected in 188 newly diagnosed type 2 diabetic patients（T2DM group）and 190 normal glucose tolerance subjects（NGT group）.AIR3～5（3～5 minutes acute insulin response）was calculated as the average internal insulin concentration during 3 to 5 minutes after the glucose loading and the results were compared between two groups.Results The levels of serum 25（OH）D and AIR3～5were lower in T2DM group than in NGT group［25（OH）D：（14.7±9.4）vs（36.7± 11.3）ng/ml；AIR3～5：（7.58±2.25）vs（57.38± 9.34）mU/L，P＜0.05］.AIR3～5was positively associated with 25（OH）D and HDL-C（P＜0.05），and negatively correlated with TC，TG，LDL-C，BMI，WHR，FFA，2 hFA，FPG，2 hPG FIns（all P＜0.05）.The 25 （OH）D，TG and BMI were the independent relative factors for AIR3～5.Conclusion The levels of 25（OH）D and AIR3～5are decreased in newly diagnosed type 2 diabetes mellitus.AIR3～5is positively correlated with 25 （OH）D，and 25（OH）D may predict insulin secretion capability.

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2015176 The changes of serum ferritin and homocysteine and their associated factors in obese type 2 diabetes mellitus.WU Naijun（吴乃君），et al.Dept Metab&Endocrinol，Affil，Hebei United Univ，Tangshan 063000.Chin J Diabetes 2015；23（4）：317-319.

Objective To investigate the changes of serum ferritin（SF）and homocysteine（Hcy）and their associated factors in obese type 2 diabetes mellitus.Methods A total of 62 newly diagnosed type 2 diabetes and 38 controls were enrolled in this study.All the participants were divided into four groups：obese T2DM group（T2DM+Ob，n=26），T2DM without obesity group（T2DM，n=36），obese group（Ob，n=18）and control group（NC，n= 20）.Serum SF，Hcy，FPG，TC，TG，FFA，homeostatic model assessment for insulin resistance（HOMA-IR）and their association were tested in all the groups.Results Serum levels of SF and Hcy were gradually increased in NC group，Ob group， T2DM+Ob group andOb group［SF：（168.70±20.00）vs（202.11±23.48）vs（236.08±32.38）vs（286.19±34.92）ng/ml；Hcy：（6.99±1.37）vs（8.61±1.98）vs（9.97± 1.30）vs（13.64±1.92）μmol/L，P＜0.05］.SF was positively correlated with BMI，FFA in T2DM patients by the multi-stepwise regression analysis（P＜0.05）.Conclusion Serum levels of SF and Hcy were increased in T2DM patients.Serum SF and Hcy may be involved in the process of obesity and T2DM.

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2015177 Effect of glycemic control on islet alpha and β cell function in newly diagnosed type 2 diabetic patients with abdominal obesity.HU Guoping（胡国平），et al.Dept Endocrinol，3rd Affil Hosp，Anhui Med Univ，Hefei 230061.Chin J Diabetes 2015；23 （4）：313-316.

Objective To evaluate effects of glycemic control on islet α and β cell function in newly diagnosed type 2 diabetics with abdominal obesity.Methods A total of 148 newly diagnosed type 2 diabetics patients were divided into abdominal obese group（AO）and non-abdominal obese group（NAO）.Steamed bread meal test was performed in all the participants at baseline and a week after glycemic control.Blood glucose（BG），C-peptide（C-P）and glucagon（Glu）were measured at different time points（0，30，60，120 and 180 min）during steamed bread meal test.Results Areas under glucose curve （AUCg）had no significant differences between two groups at baseline or after treatment（P＞0.05）.But areas under C-peptide curve（AUCC-P）was higher in AO group than NAO in baseline and after treatment（P＜0.01）.Areas under glucagon curve（AUCGlu）were higher in AO group［（609.34±167.26）vs（555.76± 153.86）ng/L］than in NAO before treatment，but lower［（477.22±108.13）vs（518.12±129.48）ng/L］than in NAO after treatment（P＜0.05）.Compared with baseline，AUCC-Pincreased while AUCBGand AUCGludecreased in both groups（all P＜0.01）.Besides，the reduction of AUCGluwas larger in AO group than in NAO group.Conclusion The islet α and β cell dysfunction could be seen in newly diagnosed type 2 diabetes with abdominal obesity.The α and β islet cells function could be improved by glycemic control，especially in newly diagnosed type 2 diabetes with abdominal obesity.

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