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Role of Vaspin in Roux-en-Y Gastric Bypass on Type 2 Diabetes Mellitus Rats

Objective　To study the therapeutic effect of Roux-en-Y gastric bypass （RYGB） on type 2 diabetes mellitus （T2DM） rats and explore the possible mechanism of vaspin in RYGB on T2DM. Methods　Twenty SD rats with T2DM and 20 age- and sex-matched normal SD rats were randomly divided into 4 groups according to the random digits table：T2DM-RYGB group， T2DM-sham operation （SO） group，RYGB group，and SO group，10 rats in each group. Fasting plasma glucose （FPG） level，serum insulin （INS） level，vaspin level，and homeostasis model of insulin resistance （HOMA-IR） were determined before operation and on week 4，8 after operation，respectively．At the same time，the correlation between vaspin and the indicators （FPG，INS，or HOMA-IR） was analyzed．Results　Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not significantly different between the T2DM-RYGB group and T2DM-SO group （P＞0.05） or between the RYGB group and SO group （P＞0.05），but the FPG level，INS level，vaspin level，and HOMA-IR in the T2DM-RYGB group and T2DM-SO group were significantly higher than those in the RYGB group （P＜0.05） and SO group （P＜0.05），respectively. On week 4 after operation，the FPG level，INS level，vaspin level，and HOMA-IR decreased in the T2DM-RYGB group，except for the FPG level，the other indexes had no significant differences as compared with the values before operation. On week 8 after operation，the FPG level，INS level，vaspin level，and HOMA-IR further decreased in the T2DM-RYGB group，there were significant differences of these indicators between before operation and on week 8 after operation. Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not statistically significant （P＞0.05） in the T2DM-SO group，RYGB group，or SO group. The changes in serum vaspin level correlated positively with those in INS and HOMA-IR before operaion and on week 4，8 after operaion in the T2DM-RYGB group and T2DM SO group rats （P＜0.05），respectively. Conclusions　RYGB surgery has a therapeutic effect on T2DM rats，and serum vaspin level decreases and insulin resistance is improved after RYGB surgery，which may be one of the mechanisms of the treatment for T2DM.

Turn Bariatric Surgery into the Conventional Treatment of Type 2 Diabetes： What Kind of Clinical System We Need?

Key Points of Surgical Treatment of Type 2 Diabetes Mellitus

Clinical Analysis of the Co-Administrated Rosiglitazone and Insulin in the Treatment of 40 Patients Type 2 Diabetes Mellitus

目的:比较罗格列酮钠片与二甲双胍片分别联合胰岛素治疗2型糖尿病的疗效和安全性。方法:40例单用胰岛素控制血糖不理想的2型糖尿病患者,随机分为A组,太罗组(罗格列酮钠片)(21例);B组,二甲双胍组(19例),进行为期16周的对照观察。结果:两组治疗后空腹及餐后2小时血糖及糖化血红蛋白(HbA1c)均呈有意义的下降(Plt;0.05),从下降幅度的百分率统计,太罗组下降幅度明显高于二甲双胍组。结论:太罗联合胰岛素治疗对于血糖的控制明显优于二甲双胍联合胰岛素治疗。

Analysis of the Related Factors of Peripheral Arterial Disease in Lower Limbs of Type 2 Diabetes Patients

目的:通过踝肱指数 (ABI)检查,探讨2型糖尿病患者下肢动脉病变 (PAD)的患病率及其影响因素。方法:采用血管多普勒诊断仪对120名 2型糖尿病患者进行 ABI测定,ABIlt;0. 9为 PAD组,ABI≥0. 9为非PAD组,分析比较2组患者的代谢参数。结果:检出ABIlt;0.9者31例,占总例数的25. 8%。与非 PAD组比较, PAD组患者年龄大、病程长,餐后2h血糖、SBP 、DBP、TG、LDL  C、HbA1c均明显升高,有显著性差异 (Plt;0.05)。结论:ABI在诊断2型糖尿病下肢动脉病变中具有重要意义;年龄、病程、高 LDLC、高TG、高血糖、高血压为下肢动脉病变的主要危险因素。

The Effect of Rosiglitazone on Insulin Sensitivity and Inflammatory Factors in Type 2 Diabetic Patients

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。

Relationship between Retinal Vessel Caliber and Diabetic Retinopathy of Type 2 Diabetes Mellitus

目的 探讨视网膜微血管直径与2型糖尿病(DM2)并发症糖尿病视网膜病变(DR)的关系。 方法 选取2009年1月-11月住院确诊DM2患者200例，根据眼底彩色照相结果将患者分为DR组和NDR组，测量视网膜血管直径、测定生化指标及血压，用非条件Logistic回归分析糖尿病视网膜病变发生的危险因素。 结果 V1扩张10 μm时，DM2患者并发DR危险性增加(OR 1.75，95% CI 1.14～3.04，Plt;0.05)；空腹血糖水平增加1 mmol/L，DM2患者并发DR的危险性增加(OR 1.87，95% CI 1.43～2.81，Plt;0.05)； 糖化血红蛋白增加1个单位，DM2患者并发DR的危险性增加(OR 1.08，95% CI 1.02～1.13，Plt;0.05)；DM病程增加1年，DM2患者并发DR的危险性增加(OR 1.41，95% CI 1.18～1.70，Plt;0.05)。 结论 在DM2患者中，视网膜静脉直径大小、空腹血糖水平、糖化血红蛋白水平、糖尿病病程是DR发生的危险因素。

The delayed diagnosis time of chronic obstructive pulmonary disease is associated with elevated type 2 inflammation markers.

Objective To investigate the relationship between delayed diagnosis time (time from symptom onset to diagnosis) in patients with chronic obstructive pulmonary disease (COPD) and the burden of type 2 inflammation (defined as the persistent inflammatory status assessed by blood EOS counts, EOS%, and Fractional exhaled nitric oxide(FeNO) among other biomarkers).MethodsThis study was a single-center, observational study that included patients with COPD first diagnosis at the respiratory outpatient department of our hospital from June 2023 to December 2024. Asthma-COPD overlap (ACO) were identified according to the 2017 Spanish COPD guidelines. Clinical data were collected, including gender, age, delayed diagnosis time, acute exacerbations in the past year, pulmonary function tests, exhaled nitric oxide (FeNO), and type 2 inflammatory markers such as blood eosinophil counts (EOS). The correlation between the delayed diagnosis time and type 2 inflammation burden, as well as its influencing factors, were analyzed. Results A total of 195 patients were included, with 98 cases of COPD and 97 cases of ACO. The mean delayed diagnosis time was 18.0 (2.8, 37.5) months for the overall patients, 24.0 (1.0, 60.0) months for COPD, and 16.5 (3.0, 36.0) months for ACO, with no significant difference between the COPD and ACO groups (P>0.05). The median blood EOS counts, EOS%, andFeNO levels were 180 cells/μL, 1.9%, and 18 ppb in the COPD group, respectively, compared to 350 cells/μL, 4.7%, and 28 ppb in the ACO group, indicating higher type 2 inflammation levels in the ACO group (all P<0.001). A significant correlations were found between the disease course and the blood EOS counts and EOS% of the patients (respectively r=0.159, 0.152, all P<0.05).FeNO levels showed no significant correlation with delayed diagnosis time of COPD (P>0.05). Patients with a history of asthma and acute exacerbations in the past year had longer delayed diagnosis time and higher peripheral blood eosinophil counts (all P<0.05). Binary logistic regression analysis revealed that BMI and delayed diagnosis time were independent influencing factors for blood EOS counts (all P<0.05). ConclusionDelayed diagnosis of COPD was associated with aggravated type 2 inflammatory burden. Clinical practice should emphasize early recognition of COPD symptoms and implement prompt therapeutic interventions.

Relation between Diabetes and Pedopathy of Type II Diabetes and Insulin Resistance

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(HOMAIR)=FPG×FIns/22.5。结果:糖尿病足患者的HOMAIR显著高于无糖尿病的患者(Plt;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 (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;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.

Effect of Multifactorial Intervention on Quality of Life and Cost-Effectiveness in Newly Diagnosed Type 2 Diabetic Patients

Objective　To explore the effects on quality of life (QOL), the targeted rates of metabolic parameters and cost-effectiveness in newly diagnosed type 2 diabetic patients who underwent multifactorial intensive intervention. Methods　One hundred and twenty seven cases in an intensive intervention and 125 cases in a conventional intervention group were investigated by using the SF-36 questionnaire. The comparison of QOL and the targeted rates of metabolic parameters between the two groups were made. We assessed the influence factors of QOL by stepwise regression analysis and evaluated the efficiency by pharmacoeconomic cost-effectiveness analysis. Results　The targeted rates of blood glucose, blood lipid and blood pressure with intensive policies were significantly higher than those with conventional policy (P＜0.05). The intensive group’s role limitations due to physical problems (RP), general health (GH), vitality (VT), role limitation due to emotional problems (RE) and total scores after 6 months intervention were significantly higher than those of baseline (P＜0.05). The vitality scores and health transition (HT) of the intensive group were better than those of the conventional group after 6 months intervention. But the QOL scores of the conventional group were not improved after intervention. The difference of QOL’s total scores after intervention was related to that of HbA1c. The total cost-effectiveness rate of blood glucose, blood lipid, blood pressure control and the total cost-effectiveness rate of QOL with intensive policy were higher than those with the conventional policy. Conclusions　Quality of life and the targeted rates of blood glucose, blood lipid and blood pressure in newly diagnosed type 2 diabetic patients with multifactorial intensive intervention policy are better and more economic than those with conventional policy.