Objective To analyze the diagnostic value of serum fibroblast growth factor 21(FGF21) and irisin in sarcopenia among elderly patients with diabetes.Methods From December 2021 to December 2024, 106 elderly patients with type 2 diabetes mellitus and sarcopenia admitted to the Department of Geriatrics of Suqian Hospital, Jiangsu Provincial People's Hospital were selected as the observation group, while 100 elderly patients with type 2 diabetes mellitus without sarcopenia during the same period served as the control group. Serum FGF21 and irisin levels were measured by ELISA, and muscle markers were assessed using a TMG-S1 muscle status test analyzer. Pearson correlation analysis was used to examine the relationship between serum FGF21 and irisin levels in elderly diabetic patients with sarcopenia. Logistic regression analysis was performed to identify factors associated with sarcopenia, and ROC analysis was used to evaluate the diagnostic value of serum FGF21 and irisin levels.Results Relative appendicular skeletal muscle mass(RASM), grip strength, gait speed, anterior ulnar muscle thickness, ulnar anterior muscle mass, lateral bone muscle thickness, and lateral bone muscle mass in the observation group were significantly lower than those in the control group(t/P=9.713/<0.001, 9.648/<0.001, 17.948/<0.001, 3.400/0.001, 3.530/0.001, 4.470/<0.001, 6.944/<0.001). Serum FGF21 levels in the observation group were higher than those in the control group, while serum irisin levels were lower(t/P=7.363/<0.001, 7.651/<0.001). A negative correlation was observed between serum FGF21 and irisin levels in elderly diabetic patients with sarcopenia(r=-0.420, P<0.001). High FGF21 levels were identified as an independent risk factor for sarcopenia [OR(95%CI)=3.142(1.404-7.032)], while high irisin levels, RASM, grip strength, gait speed, anterior ulnar muscle thickness, ulnar anterior muscle mass, lateral bone muscle thickness, and lateral bone muscle mass were independent protective factors[OR(95%CI)=0.714(0.583-0.874), 0.685(0.548-0.857), 0.691(0.558-0.856), 0.635(0.478-0.844), 0.714(0.565-0.902), 0.722(0.554-0.941), 0.675(0.511-0.892), 0.702(0.532-0.925)]. The AUC values of serum FGF21, irisin, and their combination for diagnosing sarcopenia in elderly diabetic patients were 0.783, 0.816, and 0.888, respectively. The combined diagnostic value was significantly higher than that of either biomarker alone(Z=2.655, 2.164; P=0.008, 0.030).Conclusion Serum FGF21 levels are elevated, while irisin levels are reduced, in elderly patients with type 2 diabetes and sarcopenia compared to those with diabetes alone. Serum FGF21 and irisin may serve as useful biomarkers for auxiliary diagnosis of sarcopenia in elderly diabetic patients.

Objective To observe the relationship between diabetic retinopathy(DR), glucose and lipid metabolism and serum uric acid(SUA) level in patients with type 2 diabetes(T2DM). Methods Ninety-seven patients with type 2 diabetes who were admitted to the ophthalmology department of Changsha Third Hospital from September 2021 to September 2022 were selected and divided into non DR group(n=42) and DR group(n=55) according to the presence or absence of DR. Clinical data and serum glucose metabolism indicators [fasting blood glucose(FPG), glycosylated hemoglobin(HbA1c), fasting insulin(FINS)], lipid metabolism indicators [total cholesterol(TC), triacylglycerol(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C)], and serum uric acid(SUA) levels were compared between the two groups. Logistic regression was used to analyze the risk factors for DR in T2DM patients, The predictive value of biochemical indicators on the occurrence of DR in T2DM patients was analyzed by subject performance characteristic curve(ROC). Results The course of DM and serum levels of FPG, HbA1c, TC, TG, LDL-C, and SUA in DR group were higher than those in NDR group(t/P=3.784/<0.001,3.830/<0.001,4.790/<0.001,2.912/0.005,3.544/<0.001,2.168 and="" .="" there="" was="" no="" significant="" difference="" in="" serum="" sua="" levels="" between="" the="" two="" p="">0.05). Logistic regression analysis showed that long duration of DM, high HbA1c, high TG, and high SUA were risk factors for DR in T2DM patients [OR(95%CI)=1.111(1.021-1.208), 2.722(1.182-6.272), 1.034(1.019-1.048), 3.014(1.278-7.11),P<0.05].The ROC curve analysis showed that the course of DM and the area under the curve for predicting DR by serum HbA1c, TG, and SUA were 0.740, 0.767, 0.721, and 0.693, respectively. The predictive value of serum HbA1c was higher than other indicators(Z=1.372, 1.075, 1.499, and 1.268, all P<0.001). Conclusion DR lesions in T2DM patients are closely related to the course of DM, HbA1c, TG, and SUA levels, and have good predictive value for the occurrence of DR.

Objective To analyze the influencing factors of ureteral stricture(US) after holmium laser lithotripsy(HLL) in patients with impacted ureteral calculus(IUC), and to construct a nomogram for predicting the risk of US.Methods From July 2015 to November 2024, 679 IUC patients who underwent HLL in our hospital were recruited and assigned into a modeling set(n=475) and a validation set(n=204) in a 7:3 ratio. All patients completed a 6-month follow-up after surgery. The modeling set was divided into a US group and a non-US group based on the presence or absence of US. Data from the two subgroups were collected for univariate analysis, and logistic regression was used to screen for factors influencing US occurrence after HLL. A prediction model was constructed based on the identified factors, and the area under the ROC curve(AUC) and calibration curves were used to evaluate the model's predictive performance. External validation was performed using the validation set.Results The incidence of US after HLL in the modeling set was 11.37%. Ureteral impaction time >3 months[OR(95%CI)=2.779(1.271-6.077)], stone diameter >1 cm [OR(95%CI)=4.056(2.069-7.952)], moderate to severe hydronephrosis [OR(95%CI)=4.483(2.156-9.321)], concomitant polyps [OR(95%CI)=4.409(2.145-9.063)], and mucosal injury [OR(95%CI)=3.533(1.843-6.775)]were identified as risk factors for US after HLL in IUC patients. Based on these five factors, a nomogram model was constructed to predict the risk of US after HLL. Both internal and external validations showed that the AUC values were 0.821(95%CI: 0.771-0.872) for the modeling set and 0.803(95%CI: 0.753-0.854) for the validation set, and the calibration curves demonstrated good fit.Conclusion The nomogram model constructed based on factors including impaction time, calculus diameter, degree of hydronephrosis, presence of polyps, and mucosal injury can effectively predict the risk of US in IUC patients after HLL.

Objective To investigate the correlation between peripheral blood omentin-1(Omentin-1), ephrinB2(EphB2) levels and major adverse limb events in patients with peripheral arterial disease( PAD) after interventional therapy. Methods From June 2021 to June 2023, 150 patients with PAD of lower extremity who were admitted to the Interventional Department of Harbin Medical University Affiliated Second Hospital for Interventional Therapy were selected as the case group, and 60 healthy subjects in the hospital during the same period were selected as the healthy control group. The case group was divided into MALE subgroup(n=35) and non-MALE subgroup(n=115) according to whether major adverse limb events(MALE) occurred within 12 months. The levels of Omentin-1 and EphB2 in peripheral blood were compared between the case group and the healthy control group. Pearson correlation analysis was used to analyze the correlation between the levels of Omentin-1 and EphB2 in peripheral blood and CRP, TNF-α and ABI in PAD patients; Multivariate Logistic regression analysis was used to analyze the influencing factors of MALE in PAD patients after interventional therapy; The receiver operating characteristic curve(ROC) was used to analyze the predictive value of peripheral blood omentin-1 and EphB2 levels for MALE. Results The serum Omentin-1 level in the case group was lower than that in the healthy control group, and the plasma EphB2 level was higher than that in the healthy control group(t=-16.083,24.454, all P<0.001);The level of Omentin-1 was negatively correlated with CRP and TNF-α, but positively correlated with ABI value; EphB2 level was positively correlated with CRP and TNF-α, but negatively correlated with ABI(r=-0.564,-0.493,0.602,0.397,0.560,-0.558,all P<0.05). High ABI and high Omentin-1 were independent protective factors for MALE after PAD interventional therapy, while high EphB2 was an independent risk factor[OR(95%CI)=0.802(0.655-0.981),0.613(0.444-0.845),2.335(1.200-4.561)].The AUC of Omentin-1, EphB2 and their combination in predicting the occurrence of MALE after PAD interventional therapy were 0.789, 0.715 and 0.889, respectively. The combination of the two was superior to their respective predictive values(Z=2.065, 3.177,P=0.039, 0.001). Conclusion The levels of Omentin-1 and EphB2 in peripheral blood are abnormally expressed in PAD patients, which are related to the inflammatory response and severity of PAD patients. The combination of the two is helpful to improve the predictive value of MALE after PAD interventional therapy.

Objective To establish a risk warning model for adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM) based on placental growth factor(PLGF), blood lipids, and glycosylated hemoglobin(HbA1c) and evaluate its efficacy. Methods A total of 100 GDM patients admitted to the Department of Obstetrics and Gynecology of Langfang People's Hospital from August 2022 to August 2024 were selected as the study subjects. Based on the presence or absence of adverse pregnancy outcomes, they were divided into an occurrence group(41 cases) and a non-occurrence group(59 cases). Differences in clinical data between the two groups were analyzed, and significant variables were included in a multivariate Logistic regression model to identify influencing factors for adverse pregnancy outcomes in GDM patients. A nomogram model was constructed based on these factors, and the ROC curve was used to analyze the predictive efficacy of the model. Results Among 100 GDM patients, 41(41.00%) experienced adverse pregnancy outcomes. The occurrence group was older and had a higher proportion of alcohol consumption history. Serum PLGF levels, white blood cell count(WBC), total cholesterol(TC), triglyceride(TG), and HbA 1c were higher in the occurrence group than in the non-occurrence group(t=2.135, 3.988, 6.281, 2.128, 5.138, 3.080, 5.849, all P<0.05). Multivariate Logistic regression analysis showed that older age, higher PLGF, TC, TG, and HbA1c were independent risk factors for adverse pregnancy outcomes in GDM patients [OR(95%CI)=1.250(1.037-1.570),1.057(1.019-1.096),4.967(1.916-12.881),4.241(1.431-12.571),1.905(1.085-3.344)], while high PLGF was a protective factor[OR(95%CI)=0.946(0.912-0.982),P<0.05].ROC analysis showed that the AUC values for age, PLGF, TC, TG, HbA1c, and the nomogram model were 0.631, 0.804, 0.778, 0.703, 0.803, and 0.941, respectively, indicating that age, PLGF, TC, TG, and HbA1c have certain predictive value for adverse pregnancy outcomes in GDM patients, and the nomogram model has high predictive value. At the cutoff value, the sensitivity of age, PLGF, TC, TG, HbA1c, and the nomogram model were 0.390, 0.746, 0.610, 0.634, 0.634, and 0.966, respectively, and the specificity were 0.814, 0.732, 0.864, 0.746, 0.932, and 0.805, respectively. Internal validation using the Bootstrap method(B=1000) showed that the prediction curve of the nomogram model closely aligned with the ideal curve, indicating good predictive ability. The decision curve analysis showed that the net benefit rate of the model was >0 within the threshold probability range of 0.04 to 1. Conclusions Increased age, TC, TG, and HbA1c are independent risk factors for adverse pregnancy outcomes in GDM patients, while increased PLGF is a protective factor. The risk warning model for adverse pregnancy outcomes in GDM patients based on PLGF, blood lipids, and HbA1c demonstrates good predictive efficacy and can assist in clinical intervention and treatment.