Ming Liu

Background: To examine medication use and simultaneous achievement of glycemic, blood pressure and lipid targets across body mass index (BMI) categories in Chinese adults with Type 2 diabetes. Methods: This BMI‐focused secondary cross‐sectional analysis included 8590 adults with evaluable BMI recruited from 60 hospitals in the iCaReMe China Registry. The primary comparison was obesity versus normal weight for simultaneous achievement of HbA1c < 7.0%, blood pressure < 130/80 mmHg and LDL cholesterol < 2.6 mmol/L. Missing data were handled by multiple imputation (20 datasets; 20 iterations per chain), and associations were estimated with center‐clustered generalized estimating equations (GEE). Results: The cohort comprised 99 (1.2%) adults with underweight, 2725 (31.7%) normal weight, 3663 (42.6%) overweight, and 2103 (24.5%) obesity. Among 6683 with all three observed components, 332 (5.0%) achieved the composite. Compared with normal weight, the pooled adjusted OR for obesity was 0.55 (95% CI 0.39–0.78); each 1‐kg/m ² higher BMI was associated with an OR of 0.93 (0.90–0.96). For obesity, component‐specific ORs were 0.72 (0.61–0.85) for HbA1c, 0.47 (0.40–0.55) for blood pressure and 1.05 (0.91–1.22) for LDL‐C. Sensitivity analyses supported the composite finding, with no evidence of nonlinearity ( p = 0.904). Conclusions: Obesity was associated with lower odds of simultaneous target attainment, with component‐specific associations for glycemia and blood pressure but not LDL‐C. GLP‐1 receptor agonists and SGLT2 inhibitors were used more often at higher BMI; these prescribing patterns do not establish treatment effectiveness. Trial Registration: ChiCTR2300073764.

Aims: To estimate the prevalence and incidence of hypoglycaemia and the variations in Chinese type 2 diabetes (T2D) patients. Materials and Methods: A multi‐centre, non‐interventional study was conducted across 103 hospitals in 20 provinces in China between 18 March 2022 and 5 December 2023. The study adopted an integrated 12‐week prospective cohort study design, enrolling 15 437 adults with T2D. Hypoglycaemic events were captured through a structured questionnaire and patient diary, including laboratory‐confirmed, symptomatic, any, severe and nocturnal hypoglycaemia. Variations in hypoglycaemia burden were examined by socio‐demographic factors, health status, treatment regimens, geographic region and hospital level. The endpoints were the prevalence of patients experiencing at least one hypoglycaemic event and the corresponding incidence during the study period. Results: The 15 437 participants who completed the follow‐up at Week 12 were included in this study. During this period, 9.0% [95% CI: 8.6, 9.5] of the participants experienced at least one hypoglycaemic event, corresponding to an incidence rate of 79.8 [76.9, 82.8] events per 100 person‐years. Hypoglycaemia burden differed markedly according to treatment background. The 12‐week prevalence of any hypoglycaemia was 5.5%, 9.7% and 12.2% among participants receiving neither insulin nor secretagogues, secretagogues without insulin and insulin, respectively, with corresponding incidence rates of 48.6, 105.0 and 104.3 events per 100 person‐years. Similar treatment‐related patterns were observed for laboratory‐confirmed, symptomatic and nocturnal hypoglycaemia. Hypoglycaemia burden also varied substantially across age, diabetes duration, body mass index (BMI), HbA1c, geographic region and hospital level. Greater hypoglycaemia burden was generally observed among participants with longer diabetes duration and lower BMI. The prevalence of any hypoglycaemia was highest in the eastern region and tertiary hospitals, whereas its incidence rate was highest in western regions and primary hospitals. Conclusions: Although the prevalence and incidence of hypoglycaemia among Chinese T2D patients were lower than previous studies, hypoglycaemia still remains a significant clinical concern. These findings highlight the importance of individualized strategies for glycaemic management to minimize hypoglycaemia risk in routine diabetes care. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2100053847

Background: Reninoma is rare and very challenging to diagnose. It is characterized by excessive renin secretion that causes severe hypertension and occurs more frequently in young females. Here, we compare and analyze three cases, which were not initially considered reninoma, because there was no increase in plasma renin activity (PRA), patients had refractory hypertension, or were older. Results: In two cases, PRA is normal or decreased but the direct renin concentration (DRC) is elevated. The third is in an older man with ambiguous imaging assessments and no evident lateralization of renal vein renin levels. Conclusions: Our findings suggest that the diagnosis of reninoma should not be completely excluded in patients with no elevated renin activity or refractory hypertension. In addition, a combination of blood tests and imaging analysis is highly recommended, and lateralization of renin levels is more applicable in cases where tumors are relatively small.

Bofanglutide is a novel glucagon-like peptide-1 receptor agonist under development for type 2 diabetes mellitus (T2DM) and overweight and obesity. To evaluate the efficacy and safety of bofanglutide compared with semaglutide. Phase 2b, randomized, open-label, active-controlled trial. (ClinicalTrials.gov: NCT06256549). Multicenter (37 sites in China). Adults with T2DM who were drug-naive or receiving stable oral antidiabetic drugs (glycated hemoglobin A_1c [HbA_1c], 7.0% to 11.0%). Participants were randomly assigned 1:1:1:1:1 to 1 of 5 treatment groups: bofanglutide titrated to targets of 12, 18, or 24 mg (biweekly [once every 2 weeks; Q2W]); bofanglutide titrated to 24 mg (once weekly [QW]); or semaglutide titrated to 1 mg QW. Change in HbA_1c level from baseline to week 24 (primary end point), secondary efficacy end points, and safety. Overall, 272 participants were enrolled, with a mean age of 50.8 years, HbA_1c level of 8.35%, and body mass index of 27.9 kg/m². At week 24, HbA_1c level change from baseline was -1.87% (95% CI, -2.11% to -1.63%), -2.28% (CI, -2.54% to -2.03%), and -1.94% (CI, -2.19% to -1.69%) for bofanglutide 12, 18, 24 mg Q2W, respectively; -2.32% (CI, -2.57% to -2.06%) for bofanglutide 24 mg QW; and -1.60% (CI, -1.85% to -1.35%) for 1 mg of semaglutide QW. Corresponding treatment differences versus semaglutide were -0.27% (CI, -0.61% to -0.08%), -0.68% (CI, -1.04% to -0.33%), -0.34% (CI, -0.70% to 0.02%), and -0.72% (CI, -1.08% to -0.36%), respectively. Gastrointestinal adverse events (GIAEs) (mostly grade 1 or 2 in severity) occurred in 81.8% to 87.3% and 51.9% of participants in the bofanglutide and semaglutide groups, respectively. Hypoglycemia occurred in 0% to 3.8% versus 1.9%, with no severe hypoglycemia. Open-label, short duration, only Chinese participants. Meaningful reductions in HbA_1c levels were seen with bofanglutide in patients with T2DM; GIAEs were the most common and generally manageable. Gan & Lee Pharmaceuticals.

Background: Cushing syndrome (CS) is a severe endocrine disorder caused by prolonged exposure to glucocorticoid excess. Among its diverse complications, reproductive and sexual disorders arehighly prevalent, impacting patients’ quality of life. Despite this clinical significance, clinicalstudies specifically investigating the hypothalamic-pituitary-gonadal (HPG) axis status in femalepatients with CS remain insufficient, highlighting the urgent need for thorough evaluation. Method: This retrospective cross-sectional study evaluated the HPG axis status in 137 women diagnosed with CS between 2007 and May 2024, comprising adrenal CS, Cushing’s disease (CD) and ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS), with reproductive hormone profiles compared across the three subtypes. Linear regression analysis was employed to assess the association between reproductive hormone levels and the severity of hypercortisolism. In a subgroup of 45 women with available steroid profiles quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS), plasma androgens were evaluated through receiver operating characteristic (ROC) curve analysis to determine their diagnostic power. Additionally, the relative susceptibility of the thyroid axis and the gonadal axis to hypercortisolism was comparatively examined. Results: Among the three CS subtypes, female patients with EAS exhibited markedly elevated ACTH, serum cortisol, and 24-hour urinary free cortisol (24h-UFC), alongside markedly elevated testosterone and reduced luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. Linear regression analysis revealed significant positive associations between serum cortisol with testosterone, whereas inverse correlations were observed with LH and FSH, particularly in postmenopausal women. Furthermore, plasma androgens, including testosterone, androstenedione (A2), dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS), demonstrated superior diagnostic power in discriminating CD from adrenal CS. Additional comparative analyses between the thyroid axis and the gonadal axis indicated that the latter exhibited greater susceptibility to hypercortisolism. Conclusion: Our findings demonstrate that a severity-dependent glucocorticoid suppression of HPG axis function across CS subtypes, with the most pronounced effects observed in EAS, which may facilitate clinical identification.