Aims/hypothesis Current evidence suggests that type 2 diabetes may have a greater impact on those with earlier diagnosis (longer duration of disease), but data are limited. We examined the effect of age at diagnosis of type 2 diabetes on the risk of all-cause and cause-specific mortality over 15 years. Methods The data of 743,709 Australians with type 2 diabetes who were registered on the National Diabetes Services Scheme (NDSS) between 1997 and 2011 were examined. Mortality data were derived by linking the NDSS to the National Death Index. All-cause mortality and mortality due to cardiovascular disease (CVD), cancer and all other causes were identified. Poisson regression was used to model mortality rates by sex, current age, age at diagnosis, diabetes duration and calendar time.Results The median age at registration on the NDSS was 60.2 years (interquartile range [IQR] 50.9-69.5) and the median followup was 7.2 years (IQR 3.4-11.3). The median age at diagnosis was 58.6 years (IQR 49.4-67.9). A total of 115,363 deaths occurred during 7.20 million person-years of follow-up. During the first 1.8 years after diabetes diagnosis, rates of all-cause and cancer mortality declined and CVD mortality was constant. All mortality rates increased exponentially with age. An earlier diagnosis of type 2 diabetes (longer duration of disease) was associated with a higher risk of all-cause mortality, primarily driven by CVD mortality. A 10 year earlier diagnosis (equivalent to 10 years' longer duration of diabetes) was associated with a 1.2-1.3 times increased risk of all-cause mortality and about 1.6 times increased risk of CVD mortality. The effects were similar in men and women. For mortality due to cancer (all cancers and colorectal and lung cancers), we found that earlier diagnosis of type 2 diabetes was associated with lower mortality compared with diagnosis at an older age. Conclusions/interpretation Our findings suggest that younger-onset type 2 diabetes increases mortality risk, and that this is mainly through earlier CVD mortality. Efforts to delay the onset of type 2 diabetes might, therefore, reduce mortality. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00125-018-4544-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Data from 1997 to 2010 showed that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2 years compared with the general population.

Abstract.Increasing evidence has shown that cancer stem cells or tumor initiating cells are the 'root cause' of malignant cancers. However, the exact origin of cancer stem cells still remains obscure in thyroid research. EMT has been implicated in the initiation and conversion of early-stage tumors into invasive malignancies and is associated with the stemness of cancer cells. Based on these facts, a new hypothesis was suggested that EMT induces cancer stem cell generation and tumor progression in human thyroid cancer cells in vitro. In the present study, FTC133 cells identified as EMT-negative cells were used for EMT induction by HIF-1α transfection. Overexpression of HIF-1α induced FTC133 cells to undergo EMT, downregulated the epithelial markers E-cadherin, upregulated the mesenchymal marker vimentin, and associated with highly invasive and metastatic properties. Most importantly, the induction of EMT promoted the stem-like side population cell proportion in the FTC133 cells. These results indicate that EMT induction promotes CSC traits and cell proportions in the thyroid cancer cells, which implies that EMT could induce cancer stem cell generation and tumor progression in thyroid cancers. Further understanding of the role of EMT and cancer stem cells in cancer progression may reveal new targets for the prevention or therapy of thyroid cancers. IntroductionAnaplastic thyroid carcinoma is an aggressive malignancy characterized by an extensive local invasion, early systemic dissemination and marked resistance to chemo-and radiotherapy, and always has a poor prognosis with a mean survival of only few months (1). Current systemic therapy fails to eradicate this cancer or even to stop tumor progress. It has been hypothesized that this may be explained by the failure of current drugs to effectively target cancer stem-like cells (CSCs) (2,3). To date, CSCs have been reported in various solid tumors and in cancer cell lines (4-9). However, until recently, there are only very few studies on adult thyroid stem/progenitor cells and thyroid CSCs (10-12). We and others have recently described and characterized thyroid cancer stem cells as a side population (13-17) that may play a critical role in the progression and recurrence of cancer and its subsequent metastasis (18).Epithelial to mesenchymal transition (EMT) is a vital process for morphogenesis during embryonic development, but it has also been implicated in the conversion of early stage tumors into invasive malignancies (19). More recent studies have further demonstrated that EMT plays a critical role not only in tumor metastasis but also in tumor recurrence that is believed to be tightly linked with the biology of cancer stem-like cells or cancer-initiating cells (20-23). The relationship between EMT and CSCs has been observed, with the evidence suggesting that EMT cells acquire stem cell-like traits and that CSCs exhibit a mesenchymal-like appearance in immortalized non-tumorigenic mammary epithelial cells and breast cancers (22). In thyroid cancer, it was found i...

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Aims/hypothesis The aim of this work was to estimate the life expectancy (LE) and disability-free life expectancy (DFLE) for adults with and without diabetes. Methods The Chiang method and the adapted Sullivan method were used to estimate LE and DFLE by age and sex. Mortality data in 2011 were available from the National Diabetes Services Scheme for diabetes and from standard national mortality datasets for the general population. Data on prevalence of disability and severe or profound core activity limitation were derived from the 2012 Australian Survey of Disability, Ageing and Carers (SDAC). The definitions of disability used in the SDAC followed the International Classification of Functioning, Disability and Health. Data on diabetes prevalence were derived from the Australian Diabetes, Obesity and Lifestyle study. ResultsThe estimated LE and DFLE (with 95% uncertainty interval [UI]) at age 50 years were 30.2 (30.0, 30.4) and 12.7 (11.5, 13.7) years, respectively, for men with diabetes, and the estimates were 33.9 (33.6, 34.1) and 13.1 (12.3, 13.9) years, respectively, for women with diabetes. The estimated loss of LE associated with diabetes at age 50 years was 3.2 (3.0, 3.4) years for men and 3.1 (2.9, 3.4) years for women, as compared with their counterparts without diabetes. The corresponding estimated loss of DFLE was 8.2 (6.7, 9.7) years for men and 9.1 (7.9, 10.4) years for women. Women with diabetes spent a greater number of absolute years and a greater proportion of their life with disability as compared with men with diabetes and women without diabetes. The gains in LE and DFLE across the whole population at age 50 years after hypothetically eliminating diagnosed diabetes were 0.6 (0.5, 0.6) years and 1.8 (1.0, 2.8) years. Conclusions/interpretation In adults, diabetes results in a modest reduction in LE and a substantial reduction in DFLE. Efforts to identify the specific causes of disability and effective interventions are needed.

To build a risk prediction model of gestational diabetes mellitus using nomogram to provide a simple-to-use clinical basis for the early prediction of gestational diabetes mellitus (GDM). This study is a prospective cohort study including 1385 pregnant women. (1) It is showed that the risk of GDM in women aged ≥ 35 years was 5.5 times higher than that in women aged < 25 years (95% CI: 1.27–23.73, p < 0.05). In the first trimester, the risk of GDM in women with abnormal triglyceride who were in their first trimester was 2.1 times higher than that of lipid normal women (95% CI: 1.12–3.91, p < 0.05). The area under the ROC curve of the nomogram of was 0.728 (95% CI: 0.683–0.772), the sensitivity and specificity of the model were 0.716 and 0.652, respectively. This study provides a simple and economic nomogram for the early prediction of GDM risk in the first trimester, and it has certain accuracy.

Compared with the general population, people with Type 1 diabetes comprised more young and fewer elderly individuals. The prevalence of metabolic syndrome in the Type 1 diabetes population was 10.1%. Hypertension and dyslipidaemia were more prevalent in obese than non-obese individuals.

Content and density of soil organic carbon (SOC) and labile and stable SOC fractions in peat mire soil in wetland, soybean field and rice paddy field reclaimed from the wetland around Xingkai Lake in Northeast China were studied. Studies were designed to investigate the impact of reclamation of wetland for soybean and rice farming on stability of SOC. After reclamation, SOC content and density in the top 0-30 cm soil layer decreased, and SOC content and density in soybean field were higher than that in paddy field. Content and density of labile SOC fractions also decreased, and density of labile SOC fractions and their ratios with SOC in soybean field were lower than that observed in paddy field. In the 0-30 cm soil layer, densities of labile SOC fractions, namely, dissolved organic carbon (DOC), microbial biomass carbon (MBC), readily oxidized carbon (ROC) and readily mineralized carbon (RMC), in both soybean field and paddy field were all found to be lower than those in wetland by 34.00% and 13.83%, 51.74% and 35.13%, 62.24% and 59.00%, and 64.24% and 17.86%, respectively. After reclamation, SOC density of micro-aggregates (< 0.25 mm) as a stable SOC fraction and its ratio with SOC in 0-5, 5-10, 10-20 and 20-30 cm soil layers increased. SOC density of micro-aggregates in the 0-30 cm soil layer in soybean field was 50.83% higher than that in paddy field. Due to reclamation, SOC density and labile SOC fraction density decreased, but after reclamation, most SOC was stored in a more complex and stable form. Soybean farming is more friendly for sustainable SOC residence in the soils than rice farming.