No abstract

Intravenous (i.v.) glucocorticoid is recommended for active moderate-to-severe thyroid-associated ophthalmopathy (TAO). However, the details of the treatment schedule are still debatable. The present prospective randomized trial was performed to compare clinical outcomes and serum cytokines between the two regimens. A cohort of 90 patients with active moderate-to-severe TAO was randomized to receive i.v. methyl prednisolone on a weekly protocol or daily scheme. The response rate was evaluated at the 12-week follow-up visit. Serum interleukin (IL)-2, IL-6 and IL-17 levels were measured in 160 patients with TAO, 60 patients with isolated Graves' disease (GD) and 60 normal control (NC) at baseline, as well as patients with active moderate-to-severe TAO at the 12th week after treatment. The daily scheme had a higher response rate than the weekly protocol without a significant difference (77.8 vs. 63.6%, P>0.05). No major adverse events were recorded under either regimen. Overall, minor events were more common on the daily scheme (11.36 vs. 4.35%, P<0.05)than on the weekly protocol, whereas the deterioration of eye symptoms (two patients) was only reported on the weekly protocol. At baseline, the IL-17 level in the TAO group was higher than that in the isolated GD and NC groups (P<0.05). In addition, the IL-17 level in the active TAO group was higher than that in the inactive TAO group (P<0.05). Furthermore, the IL-17 level had significantly decreased under the two regimens at the 12-week visit (P<0.05). In conclusion, for patients with active moderate-to-severe TAO, daily i.v. glucocorticoid therapy has a relative higher response rate than the weekly protocol with a few more minor adverse events. These two regimens have their own merits with regard to adverse effects. IL-17 has the potential to be a biomarker for evaluating TAO activity and treatment effects.

Aims: To investigate if the gender is a risk factor of the prevalence of diabetic retinopathy (DR) among type 2 diabetic patients, we designed and performed a cross-sectional study in twelve provinces in the mainland of China. Methods: Patients with type 2 diabetes, age of 18 years or older, were recruited from 76 cities/counties of 12 provinces in the mainland of China, during January 2015 to December 2018. All participants received a standard interview, eye examinations and digital fundus photography. The presence and severity of DR were diagnosed and graded by retinal specialists according to the DR domestic typing method. Results: A total of 12,766 eligible participants (5963 males and 6803 females) were included in this study. The overall prevalence of DR was 30.1%. Females exhibited a significantly higher prevalence of DR than males (31.1%% vs. 29.0%, P=0.011). A multivariate logistic regression analysis confirmed that the female sex was an independent predictor for higher prevalence of DR after adjusting for age, duration of diabetes, economic status and presence of hypertension (OR: 1.096, 95% CI: 1.013-1.186, P=0.023). Even after stratification by diabetic duration, age and economic status, the female sex was still independently associated with the presence of DR in patients whose T2DM history was more than 10 years (OR 1.150, 95% CI:1.012-1.306, P=0.032), whose ages were over 60 years (OR 1.141,95% CI:1.031-1.262, P=0.010) or who were in a relatively intermediate economic area (OR 1.123, 95% CI: 1.001-1.259, P=0.048). Conclusion: Chinese T2DM females had a higher prevalence of DR than T2DM males. In addition, the female sex remains as an independent predictor for DR in patients with diabetes for more than 10 years, ages over 60 years or a relatively intermediate economic status. Disclosure M. Li: None. P. Mu: None. Y. Tan: None. Y. Chen: None. Funding Research and Development Plans in Key Areas of Guangdong Province (2019B020227003); National Natural Science Foundation of China (81770826); National Key Research and Development Program of China (2017YFA0105803)