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REVIEWrespiratory and muscle involvement). The symptoms are primarily manifested as symmetrical limb weakness, and a single limb is involved [4], with the manifestation of progressive muscle weakness, wasting, and even atrophy, without muscle paralysis and sensory disturbance. Muscle weakness first involves the proximal muscle group; the distal muscle group and bilateral symmetry are subsequently involved in the sequence [5]. According to the proximal muscle group, the scapular girdle muscle is more involved than the pelvic girdle muscle, and extension is involved more than flexion. Overall, patients often complain about difficulties in climbing stairs, standing up from a squatting position, as well as combing their hair. In most patients, serum potassium, creatine kinase (CK), and myoglobin levels are normal.For the pathogenesis of CTM, excessive thyroid hormone can reduce CK activity and the contents of creatine and phosphate in skeletal muscle [6]. Also, thyroid hormone exerts an impact on mitochondria in muscle cells, which causes swelling and degeneration, thereby causing energy metabolism disorder in muscle cells [7,8]. As a result, muscle weakness and muscle atrophy are induced. On the whole, the proximal muscle group of the human body covers muscle red fibres that are abundant in mitochondria [7,9]. For this reason, myopathy usually involves the proximal muscle group first. Pathological variations are largely characterized Endokrynologia Polska

Objective: Adiponectin is an adipocyte-derived hormone with an important role in glucose metabolism. The present study explored the effect of adiponectin in diverse population groups on pre-diabetes and newly diagnosed diabetes. Methods: A total of 3300 individuals were enrolled and their data were collected in the analyses dataset from December 2018 to October 2019. Cluster analysis was conducted based on age, body mass index, waistline, body-fat, systolic blood pressure, triglycerides and glycosylated hemoglobin 1c. Cluster analysis divided the participants into four groups: a young-healthy group, an elderly-hypertension group, a high glucose-lipid group, and an obese group. Odds ratio and 95% confidence intervals were calculated using multivariate logistic regression analysis. Results: Compared with the first quartile of adiponectin, the risk of pre-diabetes of fourth quartile was decreased 61% (aOR=0.39, 95%CI [0.20-0.73]) in the young-healthy group; and the risk of diabetes of fourth quartile was decreased 85% (aOR=0.15, 95%CI [0.02-0.67]) in the obese group. There were no significant correlations between the adiponectin level and diabetes/pre-diabetes in the other two groups. Additionally, receiver operating characteristic curve analysis indicated that adiponectin could significantly improve the diagnosis based on models in the young-healthy group (from 0.640 to 0.675) and the obese group (from 0.714 to 0.761). Conclusions: Increased adiponectin levels were associated with decreased risk of pre-diabetes in the young-healthy population, and with a decreased the risk of diabetes in the obese population. An increased adiponectin level is an independent protective factor for pre-diabetes and diabetes in specific population in south China.

Background The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index has been recommended as an ideal indicator of body fat and exhibited significant correlation with cardiometabolic risk factors. However, whether the CUN-BAE index correlates with incident diabetes in Asian populations is unknown. Therefore, this longitudinal study was designed to evaluate the association between baseline CUN-BAE index and type 2 diabetes mellitus (T2DM). Methods This retrospective longitudinal study involved 15,464 participants of 18–79 years of age in the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study over the period of 2004–2015. Cox proportional hazards regression was performed to test the relationship between the baseline CUN-BAE index and diabetes incidence. Further stratification analysis was conducted to ensure that the results were robust. The diagnostic utility of the CUN-BAE index was tested by the receiver operating characteristic (ROC) curve. Results Over the course of an average follow-up of 5.4 years, 373 (2.41%) participants developed diabetes. A higher diabetes incidence was associated with higher CUN-BAE quartiles (P for trend< 0.001). Each 1 unit increase in CUN-BAE index was associated with a 1.08-fold and 1.14-fold increased risk of diabetes after adjustment for confounders in males and females, respectively (both P < 0.001). Stratification analysis demonstrated a consistent positive correlation between baseline CUN-BAE and diabetes incidence. Moreover, based on ROC analysis, CUN-BAE exhibited a better capacity for diabetes prediction than both body mass index (BMI) and waist circumference (WC) in both sexes. Conclusions The baseline CUN-BAE level was independently related to the incidence of diabetes. Increased adiposity determined by CUN-BAE could be used as a strong nonlaboratory predictor of incident diabetes in clinical practice.