Abstract：
BACKGROUND: Clinical endocrinology has observed emerging endocrine complications following COVID-19 vaccination, amidst successful reductions in COVID-19 hospitalizations and deaths. The Pfizer-BioNTech and Moderna mRNA vaccines have demonstrated efficacy. Reports indicate a potential association between SARS-CoV-2 vaccination and diabetes, exploring interactions with ACE-2 receptors and molecular mimicry. Additionally, altered liver and kidney function tests post-vaccination prompt investigation into their role in predicting type 2 diabetes. This study aims to explore these biochemical abnormalities in a case-control, single-centre prospective study.
METHODS: This prospective study aimed to evaluate a total of five hundred healthy donors, out of which 203 qualified for final analysis. Participants were selected based on their vaccination status with a COVID-19 vaccine and prior exposure to the SARS-CoV-2 virus. Donors without prior SARS-CoV-2 infection were excluded from the study. Included participants were adults who had received three doses of the COVID-19 vaccine.
RESULTS: A total of 203 individuals were included in the study, comprising 104 with type 2 diabetes mellitus (T2DM) and 99 without. Demographic characteristics including age, sex, nationality, Rh factors, ABO blood groups, liver function tests (LFT), kidney function tests (KFT), lactate dehydrogenase (LDH), and mineral ion levels were analysed. Among the participants, the distribution based on HbA1c levels showed 47.8% with HbA1c <7% classified as normal, 38.48% with HbA1c 8-10% classified as high, and 16.64% with HbA1c <10% classified as uncontrolled diabetes. Significant findings included a decrease in magnesium levels to 0.77±0.82 mmol/L (p<0.04*), an increase in LDH levels to 420.70±356.26 µL (p<0.01*), and elevated levels of alkaline phosphatase (143.22 ± 142.62 µL, p<0.001), gamma-glutamyl transferase (GGT) (55.70 ± 32.20 µL, p<0.001), and serum bilirubin (9.23 ± 4.87 µmol/L, p<0.001). Creatinine levels were significantly lower at 116.75 ± 101.94 µmol/L (p#60;0.001), while uric acid levels were significantly elevated at 305.92 ± 145.04 µmol/L (p<0.001) in individuals with uncontrolled HbA1c <10%. A majority of these individuals belonged to the O+ blood group.
CONCLUSIONS: This study underscores significant shifts in serum biomarkers and their complex interplay with mRNA-based SARS-CoV-2 vaccination and diabetes, particularly in uncontrolled cases. The findings suggest potential autoimmune reactions triggered by the self-adjuvant properties of mRNA and polyethylene glycol lipid conjugates. Variations observed among different blood groups may correspond to racial disparities influencing molecular mimicry mechanisms. Despite these insights, the underlying pathophysiological mechanisms remain unclear, highlighting the critical need for further research to validate and expand upon these findings.
METHODS: This prospective study aimed to evaluate a total of five hundred healthy donors, out of which 203 qualified for final analysis. Participants were selected based on their vaccination status with a COVID-19 vaccine and prior exposure to the SARS-CoV-2 virus. Donors without prior SARS-CoV-2 infection were excluded from the study. Included participants were adults who had received three doses of the COVID-19 vaccine.
RESULTS: A total of 203 individuals were included in the study, comprising 104 with type 2 diabetes mellitus (T2DM) and 99 without. Demographic characteristics including age, sex, nationality, Rh factors, ABO blood groups, liver function tests (LFT), kidney function tests (KFT), lactate dehydrogenase (LDH), and mineral ion levels were analysed. Among the participants, the distribution based on HbA1c levels showed 47.8% with HbA1c <7% classified as normal, 38.48% with HbA1c 8-10% classified as high, and 16.64% with HbA1c <10% classified as uncontrolled diabetes. Significant findings included a decrease in magnesium levels to 0.77±0.82 mmol/L (p<0.04*), an increase in LDH levels to 420.70±356.26 µL (p<0.01*), and elevated levels of alkaline phosphatase (143.22 ± 142.62 µL, p<0.001), gamma-glutamyl transferase (GGT) (55.70 ± 32.20 µL, p<0.001), and serum bilirubin (9.23 ± 4.87 µmol/L, p<0.001). Creatinine levels were significantly lower at 116.75 ± 101.94 µmol/L (p#60;0.001), while uric acid levels were significantly elevated at 305.92 ± 145.04 µmol/L (p<0.001) in individuals with uncontrolled HbA1c <10%. A majority of these individuals belonged to the O+ blood group.
CONCLUSIONS: This study underscores significant shifts in serum biomarkers and their complex interplay with mRNA-based SARS-CoV-2 vaccination and diabetes, particularly in uncontrolled cases. The findings suggest potential autoimmune reactions triggered by the self-adjuvant properties of mRNA and polyethylene glycol lipid conjugates. Variations observed among different blood groups may correspond to racial disparities influencing molecular mimicry mechanisms. Despite these insights, the underlying pathophysiological mechanisms remain unclear, highlighting the critical need for further research to validate and expand upon these findings.
摘要：
背景：临床内分泌学观察到COVID-19疫苗接种后出现内分泌并发症，在成功减少COVID-19住院和死亡的同时。Pfizer-BioNTech和ModernamRNA疫苗已证明有效。报告表明SARS-CoV-2疫苗接种与糖尿病之间存在潜在关联，探索与ACE-2受体和分子模拟的相互作用。此外,疫苗接种后改变的肝和肾功能检测提示研究其在预测2型糖尿病中的作用.本研究旨在探索这些生化异常在病例对照，单中心前瞻性研究。
方法：这项前瞻性研究旨在评估总共500名健康捐献者，其中203人符合最终分析条件。参与者是根据他们使用COVID-19疫苗的疫苗接种状态和之前接触过SARS-CoV-2病毒而选择的。先前没有SARS-CoV-2感染的供体被排除在研究之外。参与者包括接受过三剂COVID-19疫苗的成年人。
结果：共有203人被纳入研究，包括104例2型糖尿病（T2DM）和99例无。人口统计学特征，包括年龄，性别,国籍,Rh因子,ABO血型,肝功能测试（LFT），肾功能试验（KFT），乳酸脱氢酶（LDH），并分析了矿物离子水平。在参与者中，基于HbA1c水平的分布显示47.8%，HbA1c<7%被归类为正常，38.48%与HbA1c8-10%分类为高，16.64%的HbA1c<10%被归类为不受控制的糖尿病。重要的发现包括镁水平降低至0.77±0.82mmol/L（p＆＃60;0.04*），LDH水平增加至420.70±356.26µL（p＆＃60;0.01*），碱性磷酸酶水平升高(143.22±142.62微升，p＆＃60;0.001），γ-谷氨酰转移酶（GGT）（55.70±32.20µL，p＆＃60;0.001），和血清胆红素（9.23±4.87µmol/L，p<0.001)。肌酐水平显着降低，为116.75±101.94µmol/L（p＃60;0.001），而尿酸水平显著升高，为305.92±145.04µmol/L（p<0.001）。这些个体中的大多数属于O+血型。
结论：这项研究强调了血清生物标志物的显著变化及其与基于mRNA的SARS-CoV-2疫苗接种和糖尿病的复杂相互作用，特别是在不受控制的情况下。研究结果表明，由mRNA和聚乙二醇脂质缀合物的自佐剂特性引发的潜在自身免疫反应。在不同血型之间观察到的差异可能对应于影响分子模仿机制的种族差异。尽管有这些见解,潜在的病理生理机制尚不清楚，强调了进一步研究以验证和扩展这些发现的迫切需要。
方法：这项前瞻性研究旨在评估总共500名健康捐献者，其中203人符合最终分析条件。参与者是根据他们使用COVID-19疫苗的疫苗接种状态和之前接触过SARS-CoV-2病毒而选择的。先前没有SARS-CoV-2感染的供体被排除在研究之外。参与者包括接受过三剂COVID-19疫苗的成年人。
结果：共有203人被纳入研究，包括104例2型糖尿病（T2DM）和99例无。人口统计学特征，包括年龄，性别,国籍,Rh因子,ABO血型,肝功能测试（LFT），肾功能试验（KFT），乳酸脱氢酶（LDH），并分析了矿物离子水平。在参与者中，基于HbA1c水平的分布显示47.8%，HbA1c<7%被归类为正常，38.48%与HbA1c8-10%分类为高，16.64%的HbA1c<10%被归类为不受控制的糖尿病。重要的发现包括镁水平降低至0.77±0.82mmol/L（p＆＃60;0.04*），LDH水平增加至420.70±356.26µL（p＆＃60;0.01*），碱性磷酸酶水平升高(143.22±142.62微升，p＆＃60;0.001），γ-谷氨酰转移酶（GGT）（55.70±32.20µL，p＆＃60;0.001），和血清胆红素（9.23±4.87µmol/L，p<0.001)。肌酐水平显着降低，为116.75±101.94µmol/L（p＃60;0.001），而尿酸水平显著升高，为305.92±145.04µmol/L（p<0.001）。这些个体中的大多数属于O+血型。
结论：这项研究强调了血清生物标志物的显著变化及其与基于mRNA的SARS-CoV-2疫苗接种和糖尿病的复杂相互作用，特别是在不受控制的情况下。研究结果表明，由mRNA和聚乙二醇脂质缀合物的自佐剂特性引发的潜在自身免疫反应。在不同血型之间观察到的差异可能对应于影响分子模仿机制的种族差异。尽管有这些见解,潜在的病理生理机制尚不清楚，强调了进一步研究以验证和扩展这些发现的迫切需要。
