【摘要】 目的 探讨成都市成华区中老年人群血脂水平、分布特点及其与胰岛素抵抗指数（HOMA-IR）的关系。 方法 2007年5月在此区中老年（50~79岁）人群中随机抽取672人进行心血管危险因素研究调查，对其血脂水平及HOMA-IR进行统计分析。 结果 人群当中①女性各血脂项目的水平均比男性高，其中总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）的差异有统计学意义（Plt;0.05）；②三酰甘油（TG）升高的比例较高，其中男性为30.0%，女性为27.6%；大部分人群HDL-C、低密度脂蛋白胆固醇（LDL-C）水平处于合适范围，HDL-C降低的比例为6.0%，LDL-C升高的比例为7.3%；③随着TG水平的升高、HDL-C 水平的降低，HOMA-IR呈升高趋势；LDL-C水平的升高，HOMA-IR呈升高趋势，仅在女性人群中差异有统计学意义（Plt;0.05），在男性人群中差异无统计学意义；④TG与HOMA-IR呈正相关，相关系数为0.185（P=0.000）；HDL-C与HOMA-IR呈负相关，相关系数为-0.145（P=0.000）。LDL-C与HOMA-IR呈正相关，相关系数为0.099（P=0.010）。 结论 TG增高是成都市成华区中老年人群的显著特点，女性HDL-C比男性高；血脂紊乱与胰岛素抵抗相关。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.
目的:研究罗格列酮(ROS)治疗2型糖尿病,对患者组织胰岛素敏感性与血清炎症介质改变的关系。方法:选取符合1999年WHO标准确诊的2型糖尿病患者30例。试验采用前后自身配对方法。口服ROS 4mg每天一次,总疗程8周。测定指标包括常规临床检查项目、血糖,同时检测血浆胰岛素水平,糖化血红蛋白(HbA1c)水平、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,以 HOMA模型和胰岛素钳夹试验评价组织胰岛素敏感性。结果:应用ROS治疗的2型糖尿病患者组织胰岛素敏感性显著改善(Plt;0.05),并降低血浆CRP、IL-6、TNF-α水平,这些炎症介质的改变与组织胰岛素敏感性的改变相关。结论:应用ROS治疗2型糖尿病能降低患者血浆炎症介质水平,减轻胰岛素抵抗,延缓或减轻糖尿病大血管并发症的发生发展。
摘要:目的:探讨2型糖尿病合并糖尿病足患者与胰岛素抵抗的关系。方法:205例2型糖尿病患伴糖尿病足患者作为观察组,无足部病变的糖尿病患者作为对照组,观察其体重指数、空腹血糖、胰岛素、血脂等指标,两组间进行比较并相关性分析、多元回归分析。胰岛素抵抗指数(HOMAIR)=FPG×FIns/22.5。结果:糖尿病足患者的HOMAIR显著高于无糖尿病的患者(Plt;0.05)。多元回归分析显示糖尿病病程、LDL及BMI是影响2型糖尿病足患者胰岛素抵抗的主要危险因素。结论:糖尿病足患者存在着更严重的胰岛素抵抗。Abstract: Objective: To discuss the relationship between diabetes and pedopathy of type II diabetes and insulin resistance. Methods:The diabetes type II patients were divided into group A (combined with pedopathy) and group B (without pedopathy). The blood glucose and insulin of empty stomach, BMI,Alc and lipid were detected. The insulin resistance index (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;0.05).The duration of disease,LDL and BMI was positive related with diabetes pedopathy. Conclusion:The insulin resistance was more worse in pedopathy of Type II diabetes.
摘要:目的: 观察格列美脲对2型糖尿病患者心血管的保护作用并探讨其可能的机制。 方法 :112例T2DM患者随机分为格列美脲组(格列美脲+二甲双胍)和对照组(格列本脲+二甲双胍),观察治疗前后两者空腹及餐后两小时血糖(FBG,2hPBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、HOMA模型胰岛素抵抗指数(HOMAIR)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、同型半胱氨酸(HCY)、血浆脂联素的变化。 结果 :两组患者的TC、LDLC、TG、FBG、2hPBG都较治疗前降低,连续服用6个月以上格列美脲的T2DM患者其血浆HCY、HOMAIR、血糖水平明显下降,血浆脂联素水平明显升高,与对照组相比差异有统计学意义(〖WTBX〗P lt;005)。 结论 :格列美脲能降低多项心血管危险因子水平,对血脂、HCY和动脉粥样硬化都有良性调节作用,其作用基础可能与改善胰岛素抵抗,增加血浆脂联素相关。Abstract: Objective: To observe the protective effects and to explore mechanisms of glimepiride on cardiovascular system of Type 2 Diabetes Mellitus. Methods : 112 patients with type 2 diabetes mellitus were randomly divided into treatment group (glimepiride combined with metformin) and control group (glibenclamide combined with metformin). The fasting blood glucose (FBG), 2hPBG, hemoglobin A1c (HbA1c), FINS, HOMAIR, blood lipid (TC, TG, LDLC and HDLC), HCY (homocysteine) and adiponectin were detected before and after treatment. Results : In all cases, the level of TC、LDLC、TG、FBG、2hPBG were decreased after treated with glimepiride or glibenclamide combined with metformin for 6 monthes. Moreover, the level of HCY, HOMAIR and blood glucose were decreased and the level of adiponectin was increased significantly than that of in control group (Plt;005). Conclusion : Glimepiride showed the effective on decreasing the risk factor of cardiovascular system disease with regulation of blood lipid, HCY, and improve the atherosclerosis. The effective of glimepiride on cardiovascular system was relation to improved the insulin resistance and increase the adiponectin.
ObjectiveTo observe expressions of E3 ubiquitin ligase—mitsugmin53 (MG53) protein, MG53 mRNA, and insulin receptor substrate 1 (IRS-1) mRNA in skeletal muscle of non-obese type 2 diabetic mellitus (T2DM) rats after gastric bypass operation (GBP), and to investigate possible mechanism of GBP in improving insulin resistance.MethodsTwenty-four healthy male GK rats were randomly divided into diabetic operation group, diabetic sham operation group, and diabetic control group, 8 rats in each group; besides, 8 male Wistar rats were served as normal control group. The expressions of MG53 protein in skeletal muscle tissue were detected by using Western blot method on week8 after operation. The mRNA levels of IRS-1 and MG53 in skeletal muscles tissue were measured by RT-PCR methods on week 8 after operation.Results① The expressions of MG53 protein and MG53 mRNA in the diabetic sham operation group and diabetic control group were significantly higher than those in the diabetic operation group and the normal control group on week 8 after operation (P<0.05), respectively, which had no significant differences between the diabetic operation group and the normal control group (P>0.05), and between the diabetic sham operation group and the diabetic control group (P>0.05) on week 8 after surgery. ② Compared with the normal control group, the expression of IRS-1 mRNA was significantly decreased in the diabetic operation group, the diabetic sham operation group, and the diabetic control group (P<0.05), while there were no significant differences between the diabetic operation group, diabetic sham operation group, and the diabetic control group on week 8 after operation (P>0.05).ConclusionExpression of E3 ubiquitin ligase—MG53 protein in skeletal muscle tissue in T2DM rats following GBP is decreased, thus reduces the IRS-1 ubiquitin-degradation, increase the expression of IRS-1 protein in insulin signaling pathway of skeletal muscle tissue, and improve insulin resistance of skeletal muscle.
【摘要】 目的 观察罗格列酮加二甲双胍联合治疗对2型糖尿病患者的降糖作用和安全性以及对胰岛素抵抗的影响。 方法 对2007年8月-2008年5月收治的2型糖尿病患者53例采用自身前后对照研究，48例符合入选条件的患者，接受罗格列酮加二甲双胍为期12周治疗。试验开始和结束日测定患者空腹血糖（fast plasma glucose，FPG）、血清胰岛素（serum insulin，FINS）、总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）和糖化血红蛋白（glycosylated hemoblobin，HbA1c）以及标准餐后2 h血糖（postprandial 2 hours blood glucose，2hPPG）和胰岛素（postprandial 2 hours insulin，2hPINS）。胰岛素敏感性采用HOMA2模型公式评价。 结果 12周时FPG、FINS、2hPINS、 HbA1c均较治疗前基线时下降，分别为（8.16±2.37） mmol/L与（6.57±1.90） mmol/L，（8.84±8.07） mU/L与（7.28±6.84） mU/L，（26.87±3.13） mU/L与（20.18±13.25） mU/L，7.60%±1.71%与6.79%±1.82%，差异有统计学意义（Plt;0.05）。胰岛素抵抗指数显著低于治疗前（2.77±0.90与3.74±1.61，Plt;0.05）。其余代谢参数变化差异无统计学意义（Pgt;0.05）。 结论 罗格列酮加双胍类药物联合治疗2型糖尿病能有效降2型糖尿病患者的血糖水平，提高胰岛素敏感性，不增加体重，无低血糖发生，是一种安全有效的治疗方案。【Abstract】 Objective To observe the effect and security of rosiglitazone plus metformin in patients with type 2 diabetes mellitus, and the effect on insulin resistance. Methods Forty-eight cases suitable for this study were accepted and compared from August 2007 to May 2008. Patients accepted rosiglitazone plus metformin for 12 weeks. Fasting plasma glucose (FPG), serum insulin (FINS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), postprandial 2 hours blood glucose and postprandial 2 hours insulin were determined at the first and last day of this study. HOMA 2 model formula evaluation was used in testing insulin sensitivity. Results After a 12-weeks’ treatment, FPG, FINS, 2hPINS, and HbA1c of patients were lower than those before treatment [(8.16±2.37) mmol/L vs (6.57±1.90) mmol/L; (8.84±8.07) mU/L vs (7.28±6.84) mU/L; (26.87±19.31) mU/L vs (20.18±13.25) mU/L; 7.60%±1.71% vs 6.79%±1.82%; Plt;0.05)]. Insulin resistance index was lower than that after treatment (2.77±0.90 vs 3.74±1.61, Plt;0.05). Other metabolic related parameter had no statistical difference (Pgt;0.05). Conclusion Rosiglitazone plus metformin treatment of type 2 diabetes mellitus is effective both in reducing in blood glucose levels and improving insulin sensitivity, and without gain weight, incidence of hypoglycemia. It is a safe and effective option.
【摘要】 目的 探讨血浆内脏脂肪素(visfatin)与2型糖尿病的关系。方法 2007年7月—9月选取2型糖尿病患者和正常对照组各40例。根据体重指数再分为超重肥胖组和非超重肥胖组。检测visfatin水平、空腹血糖、空腹胰岛素、血脂、血压等,计算腰臀比、体重指数、稳态模型胰岛素抵抗指数homeostasis model assessment of insulin resistance,HOMAIR)及胰岛素分泌功能(HOMAβ)。结果 2型糖尿病组血浆visfatin水平显著低于正常对照组(Plt;0.05)。多元逐步相关分析表明,在肥胖的2型糖尿病个体中visfatin与高密度脂蛋白胆固醇、空腹血糖、体重指数呈负相关。二分类Logstic回归分析显示血浆visfatin及胰岛素抵抗指数与2型糖尿病的发生显著相关,回归方程式为Y=7.681+2.417 ln HOMAIR-2.549 visfatin。结论 visfatin的变化可能对2型糖尿病的发生、发展具有一定作用。
ObjectiveTo explore the clinical curative effect of high flux hemodialysis on diabetic nephropathy (DN) and impact on patients' insulin resistance (IR). MethodsA total of 96 patients with DN meeting the inclusion criteria treated between January 2013 and January 2014 were selected. The patients were randomly divided in to the observation group and control group with 48 in each. The control group received low flux hemodialysis, while the observation group underwent high flux hemodialysis. Before the treatment and in the first half of the year after the treatment, the clinical renal function and inflammatory indexes, lipid metabolism, and glucose metabolism related markers were recorded, and IR index (HOMA-IR) were calculated and compared. ResultsBefore and after the treatment, the Kt/V showed no significant change in the two groups (P > 0.05). Serum creatinine levels was lower after the treatment compared with that before the treatment in both of the two groups; in the observation group, C-reactive protein, interleukin-6 and tumor necrosis factorαwere significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). HOMA-IR and fasting insulin levels in the observation group after the treatment were significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). No significant changes of fasting plasma glucose and glycosylated hemoglobin levels in the two groups before and after the treatment in patients were found (P > 0.05). ConclusionHigh flux hemodialysis therapy is effective on DN, which can effectively remove the body and large molecular type of inflammatory mediators, alleviate the micro inflammatory state, improve the IR status and correct the lipid metabolic abnormalities.
ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
Objective We investigated the effect of supplementation with alanyl-glutamine dipeptide on insulin resistance and outcome in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods A prospective, randomized, open and controlled trial was conducted. Patients with COPD and respiratory failure were recruited between Jan 2005 to Feb 2006 and randomly assigned to a trial group (n=14) with glutamine dipeptide supplmented parenteral nutrition and a control group (n=16) with isocaloric, isonitrogenic parenteral nutrition. On the third day and fifth day of nutrition treatment, blood glucose was clamped at level of 4.4 to 6.1 mmol/L by intravenously bumped insulin. Blood gas, blood glucose level, insulin dosage were recorded everyday. The outcomes were mortality, length of stay (LOS) in hospital and in ICU, mechanical ventilation times and the costs of ICU and hospital.Results Thirty patients successfully completed the trial. There was no difference in blood gas between two groups, but PaO2 increased gradually. Compared with control group, blood glucose level had trend to decrease in trial group. The average insul in consumption decreased significantly in trial group on the fifth day. There was no statistical difference between two groups in mortality, length of stay in hospital and the costs of hospital. But compared with control group, length of stay in ICU and mechanical ventilation days had trend to decrease in trial group. Conclusion Alanyl-glutamine dipeptide do not improve pulmonary function of patients with COPD and respiratory failure. However, alanyl-glutamine dipeptide attenuated insul in resistance and stabilized blood glucose. This trial does not confirm alanyl-glutamine di peptide can improve outcome in critically ill patients with COPD and respiratory failure between two groups in mortality at the end of 30 days, length of stay in hospital and the costs of hospital. But the length of stay in ICU and the duration of mechanical ventilation does decrease, but not significantly, in the trial group.