Annemarie Wentzel1,2,3*, Arielle C. Patterson1 , M. Grace Duhuze Karera1,4,5, Zoe C. Waldman1 , Blayne R. Schenk1 , Christopher W. DuBose1 , Anne E. Sumner1,4 and Margrethe F. Horlyck-Romanovsky1,6*
1 Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States,
2 Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa, 3South African Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa, 4National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States, 5 Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda, 6Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, New York, NY, United States
Background: Emerging data suggests that in sub-Saharan Africa β-cell-failure in the absence of obesity is a frequent cause of type 2 diabetes (diabetes). Traditional diabetes risk scores assume that obesity-linked insulin resistance is the primary cause of diabetes. Hence, it is unknown whether diabetes risk scores detect undiagnosed diabetes when the cause is β-cell-failure.
Aims: In 528 African-born Blacks living in the United States [age 38 ± 10 (Mean ± SE); 64% male; BMI 28 ± 5 kg/m2 ] we determined the: (1) prevalence of previously undiagnosed diabetes, (2) prevalence of diabetes due to β-cell-failure vs. insulin resistance; and (3) the ability of six diabetes risk scores [Cambridge, Finnish Diabetes Risk Score (FINDRISC), Kuwaiti, Omani, Rotterdam, and SUNSET] to detect previously undiagnosed diabetes due to either β-cell-failure or insulin resistance.
Methods: Diabetes was diagnosed by glucose criteria of the OGTT and/or HbA1c ≥ 6.5%. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤2.04). Diabetes due to β-cell-failure required diagnosis of diabetes in the absence of insulin resistance. Demographics, body mass index (BMI), waist circumference, visceral adipose tissue (VAT), family medical history, smoking status, blood pressure, antihypertensive medication, and blood lipid profiles were obtained. Area under the Receiver Operator Characteristics Curve (AROC) estimated sensitivity and specificity of each continuous score. AROC criteria were: Outstanding: >0.90; Excellent: 0.80–0.89; Acceptable: 0.70–0.79; Poor: 0.50–0.69; and No Discrimination: 0.50.
Results: Prevalence of diabetes was 9% (46/528). Of the diabetes cases, β-cell-failure occurred in 43% (20/46) and insulin resistance in 57% (26/46). The β-cell-failure group had lower BMI (27 ± 4 vs. 31 ± 5 kg/m2 P < 0.001), lower waist circumference (91 ± 10 vs. 101 ± 10cm P < 0.001) and lower VAT (119 ± 65 vs. 183 ± 63 cm3 , P < 0.001). Scores had indiscriminate or poor detection of diabetes due to β-cell-failure (FINDRISC AROC = 0.49 to Cambridge AROC = 0.62). Scores showed poor to excellent detection of diabetes due to insulin resistance, (Cambridge AROC = 0.69, to Kuwaiti AROC = 0.81).
Conclusions: At a prevalence of 43%, β-cell-failure accounted for nearly half of the cases of diabetes. All six diabetes risk scores failed to detect previously undiagnosed diabetes due to β-cell-failure while effectively identifyingdiabetes when the etiology was insulin resistance. Diabetes risk scores whichcorrectly classify diabetes due to B-cell-failure are urgently needed.
KEYWORDS
type 2 diabetes, risk score, African (Black) diaspora, β-cell failure, insulin resistance, diabetes screening
Wang Shuaishuai 1† , Zhu Tongtong1† , Wang Dapeng2 ,
Zhang Mingran1 , Wang Xukai 1 , Yu Yue1 , Dong Hengliang1 ,
Wu Guangzhi 1 * and Zhang Minglei 1 *
1 Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China,
2 Department of Orthopedics, Siping Central Hospital, Siping, China
EDITED BY
Xiaoyuan Li,
Northeast Normal University, China
REVIEWED BY
Fuzeng Ren,
Southern University of Science and
Technology, China
Gong Cheng,
Harvard University, United States
Ruogu Qi,
Nanjing University of Chinese Medicine,
China
*CORRESPONDENCE
Wu Guangzhi,
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Zhang Minglei,
†
These authors have contributed equally to this work
SPECIALTY SECTION
This article was submitted to Biomaterials, a section of the journal
Frontiers in Bioengineering and Biotechnology
RECEIVED 27 October 2022
ACCEPTED 18 January 2023
PUBLISHED 30 January 2023
CITATION
Shuaishuai W, Tongtong Z, Dapeng W, Mingran Z, Xukai W, Yue Y, Hengliang D, Guangzhi W and Minglei Z (2023), Implantable biomedical materials for treatment of bone infection.
Front. Bioeng. Biotechnol. 11:1081446.
doi: 10.3389/fbioe.2023.1081446
COPYRIGHT
© 2023 Shuaishuai, Tongtong, Dapeng, Mingran, Xukai, Yue, Hengliang, Guangzhi and Minglei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
The treatment of bone infections has always been difficult. The emergence of drugresistant bacteria has led to a steady decline in the effectiveness of antibiotics. It is also especially important to fight bacterial infections while repairing bone deffects and cleaning up dead bacteria to prevent biofilm formation. The development of biomedical materials has provided us with a research direction to address this issue.
We aimed to review the current literature, and have summarized multifunctional antimicrobial materials that have long-lasting antimicrobial capabilities that promote angiogenesis, bone production, or “killing and releasing.” This review provides a comprehensive summary of the use of biomedical materials in the treatment of bone infections and a reference thereof, as well as encouragement to perform further research in this field.
biological materials, bone infection, multifunctional material, implantable material, treatment of bone infection, progress of infection treatment, multifunctionalization of materials
原创：DF 中山二院糖尿病足中心
清创是从伤口或周围组织除去坏死的或无活性的组织及外来的异物，直到健康组织暴露出来为止。
糖尿病足负压引流：（Vacuum Assisted Closure, VAC）负压辅助创面愈合治疗技术是利用生物半透膜使开放创面封闭，使用专用负压机产生一定的负压，通过引流管和敷料作用于清创后的创面，是一种促进急慢性创面愈合的治疗方法。
下肢血管介入手术：糖尿病患者常伴有周围血管病变，尤其下肢动脉血管病变较为突出，是导致糖尿病足溃疡难以愈合的重要因素。
伤口新型敷料的应用，因费用低、效果好、操作方便而被广大患者所接受。
擅长断肢（指、趾、鼻、耳、阴茎）再植和再造手术、各种组织修复和皮瓣移植、严重复杂性创伤伴多发骨折、血管神经损伤的急救与早期处理和二期功能重建、先天性畸形及烧伤瘢痕挛缩畸形矫正、美容整形等
擅长疾病：糖尿病足；慢性、难愈合性伤口治疗。执业经历：
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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