Background At present, only a few studies have focused on the risk factors for depression in elderly diabetic patients, and there is little evidence for the effect of metformin in depressed elderly patients with diabetes than on its effect on blood glucose. The aim of the current work was to study the risk factors for depression in elderly diabetic patients and to ascertain the effects of metformin on the depressive state. Methods We initiated a 1:4 matched case–control study. The case group comprised 110 elderly diabetic patients with depression from nine communities in Shenyang in 2017. The control group comprised 440 non-depressed elderly diabetic patients from the same communities, which were matched by gender and age (± 2 years of age) with the case group. Depression was measured using the Geriatric Depression Scale-15, and we performed matched univariate and multivariate logistic regression analyses. Results In the multivariate analysis, overweight status, poor physical capabilities and low activity level, and the presence of more than two additional illnesses were risk factors for depression in elderly patients with diabetes. For these risk factors, the adjusted ORs (all P < 0.05) were as follows: an adjusted OR of 2.031 and 95% CI of 1.180–3.495; an adjusted OR of 2.342 and 95% CI of 1.465–3.743; and an adjusted OR of 5.350 and 95% CI of 2.222–12.883, respectively. Patients taking metformin had a lower risk of depression than those taking no medication, with an adjusted OR of 0.567 and 95% CI of 0.323–0.997 ( P < 0.05). Conclusions Overweight status, poor physical capabilities and low activity level, and the presence of more than two additional illnesses were risk factors for depression in elderly diabetic patients, and metformin was a protective factor against depression in elderly diabetic patients.
Aims. Sarcopenia is a common condition in older individuals, especially in the elderly with type 2 diabetes mellitus (T2DM). The aim of the present study was to examine the risk factors for sarcopenia in elderly individuals with T2DM and the effects of metformin. Methods. A total of 1732 elderly with T2DM were recruited to this cross-sectional observational study, and we analyzed the data using logistic regression analyses. Skeletal muscle mass, grip strength, and usual gait speed were measured to diagnose sarcopenia according to the criteria of the Asian Working Group for Sarcopenia, combined with expert consensus on sarcopenia in China. Results. The overall prevalence of sarcopenia was 10.37% of the participants. In the multivariate analysis, sex, age, educational level, and BMI were risk factors for sarcopenia, with women more likely to develop sarcopenia relative to men ( OR = 2.539 , 95% CI = 1.475 –4.371; P < 0.05 ). We observed that sarcopenia increased with age and decreased with increasing BMI and educational level ( P < 0.05 ). Participants who took metformin alone or combined with other drugs exhibited a lower risk for sarcopenia than those who took no medication ( OR = 0.510 , 95% CI = 0.288 –0.904 and OR = 0.398 , 95% CI = 0.225 –0.702, respectively; P < 0.05 ). Conclusions. We showed that being female and at an older age, lower educational level, and lower BMI were risk factors for sarcopenia in elderly T2DM and that metformin acted as a protective agent against sarcopenia in these patients.
Pharmacological stimulation of adipose tissue remodeling and thermogenesis to increase energy expenditure is expected to be a viable therapeutic strategy for obesity. Berberine has been reported to have pharmacological activity in adipose tissue to anti-obesity, while the mechanism remains unclear. Here, we observed that berberine significantly reduced the body weight and insulin resistance of high-fat diet mice by promoting the distribution of brown adipose tissue and thermogenesis. We have further demonstrated that berberine activated energy metabolic sensing pathway AMPK/SIRT1 axis to increase the level of PPARγ deacetylation, which leads to promoting adipose tissue remodeling and increasing the expression of the thermogenic protein UCP-1. These findings suggest that berberine that enhances the AMPK/SIRT1 pathway can act as a selective PPARγ activator to promote adipose tissue remodeling and thermogenesis. This study proposes a new mechanism for the regulation of berberine in adipose tissue and offers a great prospect for berberine in obesity treatment
Background and objective: Oxidative stress has been demonstrated to be a mechanism that leads to bone mass reduction, and according to many studies, serum uric acid (UA) is a strong endogenous antioxidant that can protect bone mineral density (BMD). To date, there have been no large-scale, cross-sectional studies based on the population in northeast China to assess the relationship between serum UA and BMD. Therefore, we examined the association between serum UA and BMD among a Chinese population older than 60 years old in northeast China. Methods: This research was a cross-sectional study of 3465 Chinese individuals over 60 years old in nine communities from the city of Shenyang, which is the capital of northeast China’s Liaoning Province. Participants were stratified into three groups by serum UA or BMD levels, and then Pearson’s correlation analysis and multiple regression analysis were used to study the relationship between serum UA and BMD. Results: We found that participants with higher serum UA levels had significantly greater BMD and T-values compared to those of participants with lower serum UA levels. After adjusting for confounding factors, Pearson’s correlation analysis and multiple regression analysis showed that higher serum UA levels remained associated with higher BMD levels ( P <0.05). In different models, the prevalence of osteoporosis (OP) among participants with higher serum UA levels was reduced by 23% to 26% ( P <0.05) compared to that in individuals with lower serum UA levels. In addition, serum UA levels were negatively correlated with estimated glomerular filtration rate (eGFR) and positively correlated with 25-hydroxy vitamin D 3 [25-(OH)D 3 ] ( P <0.05). Conclusion: We concluded that higher serum UA levels are associated with greater BMD, and serum UA might have a protective effect on bone metabolism due to its antioxidant properties.
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