青岛地区成人牛奶摄入与2型糖尿病关联研究

目的探讨居民牛奶摄入频率、摄入量与2型糖尿病(T2DM)患病风险之间的关联,为T2DM的防治提供科学依据。方法于2009年1月采用多阶段分层随机抽样的方法抽取青岛市6 000名35～74岁成年居民为研究对象,实际调查5 110名,排除牛奶摄入以及空腹血糖(FPG)、餐后2 h血糖(2 h PG)信息缺失者,最终4 955名研究对象纳入本研究。对其进行问卷调查、体格检查和实验室检测。采用SPSS 23.0统计软件进行t检验、χ~2检验、单因素和多因素非条件logistic回归分析。结果 4 955名研究对象中,T2DM患者占16.29%,T2DM组与非T2DM组牛奶摄入频率、牛奶摄入量差异均有统计学意义(P0.01)。多因素logistic回归分析显示,在调整年龄、性别、糖尿病家族史、体质指数(BMI)、婚姻、受教育程度、饮酒、职业体力活动、酸奶摄入等混杂因素后,牛奶摄入频率≥7次/周(OR=1.40,95%CI:1.10～1.79)、牛奶摄入量≥250g/d(OR=1.39,95%CI:1.09～1.77)均与T2DM患病呈正相关。结论牛奶摄入频率≥7次/周、摄入量≥250 g/d与T2DM患病风险呈正相关,后续还需要长期研究或干预试验进一步验证。     

血清一氧化氮水平与微量蛋白尿关系1∶2病例对照研究

目的 探讨血清一氧化氮水平与微量蛋白尿的关联性.方法 以苏州市金阊区的高血压现场调查为基础,采用1∶2配对研究方法,选择208例微量蛋白尿患者及与之在性别、年龄、血糖和腰围相匹配的居住同一小区、同等经济收入水平的非微量蛋白尿人群,测量血清一氧化氮水平,采用多因素条件logistic回归对血清一氧化氮水平与微量蛋白尿的关联性进行分析.结果 微量蛋白尿组的血清一氧化氮水平略低于非微量蛋白尿组(中位数,四分位间距:27.75,14.48～ 42.15μmol/L vs.28.25,17.40～ 43.45μmol/L),但两组间差异无统计学意义(P=0.316).多因素条件logistic回归分析显示,调整血压、血脂、尿酸、吸烟、饮酒后,血清一氧化氮水平与微量蛋白尿不存在显著关联性.进一步按是否患高血压分层,多因素条件logistic回归分析显示,与血清一氧化氮水平最高分位者相比,在多因素调整后,无论是在高血压还是非高血压的对子中,血清一氧化氮水平处于第1、2、3分位者患微量蛋白尿的危险性差异均无统计学意义.在有高血压的对子中,血清一氧化氮最低水平组患有微量蛋白尿的危险性是最高水平组的1.85倍(OR=1.85,95％CI:0.96～ 3.57);而在非高血压的对子中,血清一氧化氮最低水平组患有微量蛋白尿的危险性较最高水平组仅增加了40％(OR=1.40,95％CI:0.58 ～ 3.40).结论在一般人群中,血清一氧化氮水平与微量蛋白尿无显著相关性.     

短病程2型糖尿病大血管病变的相关因素分析

目的　探讨短病程 2型糖尿病 (T2DM)患者大血管病变的相关因素。方法　 2 6 8例短病程T2DM患者 (新诊断或病程在 1年以内 )通过超声波大动脉内中膜厚度 (IMT)检测 ,界定有无动脉粥样硬化 (AS)分为AS组 (10 1例 )和非AS组 (16 7例 ) ,对两组患者的多项临床指标进行比较及相关分析。结果　 (1)AS组的年龄、BMI、吸烟指数 (SI)、高血压病程、收缩压、舒张压、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL -Ch)、C -反应蛋白 (CRP)均高于非AS组(P <0 .0 5 ) ;有DM家族史的比率及胰岛素敏感性指数 (ISI)低于非AS组 (P <0 .0 5 )。 (2 )两组间性别、DM病程、空腹血糖 (FPG)、服糖后 2h血糖 (2hPG)、糖化血红蛋白 (HbA1 c)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -Ch)、空腹胰岛素 (FINS)的差异无显著性。 (3)Pearson相关分析 ,提示大动脉平均IMT与年龄 (r =0 .346 ,P <0 .0 0 1)、BMI(r=0 .2 2 9,P =0 .0 0 1)、SI(r =0 .349,P <0 .0 0 1)、收缩压 (r =0 .2 5 8,P <0 .0 0 1)、舒张压 (r =0 .2 0 7,P =0 .0 0 2 )、LDL -Ch(r=0 .178,P =0 .0 0 8)呈显著正相关。结论　短病程T2DM患者合并大血管病变主要与年龄、吸烟、超重或肥胖、高血压、高LDL -Ch血症、胰岛素抵抗 (IR)及CRP等因素相关     

2型糖尿病患者N末端前体B型尿钠肽水平变化及其影响因素分析

目的探讨2型糖尿病(T2DM)老年患者N末端前体B型尿钠肽(NT-pro BNP)的变化及其影响因素,为T2DM老年患者心血管疾病的预防提供可参考依据。方法选取2013年2月至2015年2月开滦总医院收治的T2DM老年患者150例为研究对象,依据是否患有高血压病及大量蛋白尿分为观察1组(单纯糖尿病)50例,观察2组(糖尿病合并高血压)75例,观察3组(糖尿病合并高血压及大量蛋白尿)25例;并选取同期健康查体人群50例为对照组。对各项实验室检测指标用SPSS 14.0软件进行χ~2检验及方差分析,各因素相关性用Pearson相关性分析,NT-pro BNP水平的影响因素用多因素logistic回归分析。结果观察2组和观察3组的血清NT-pro BNP水平[分别为(110.56±28.34)、(186.35±35.26)pg/L]明显高于对照组[(80.34±20.89)pg/L],差异均有统计学意义(P0.05);观察1组与对照组、观察2组和观察3组与观察1组之间的血清NT-pro BNP水平比较,差异均无统计学意义(P0.05)。Pearson相关性分析结果显示,年龄、糖尿病病程、高血压、收缩压(SBP)、大量蛋白尿、经皮冠状动脉介入治疗(PCI)史与NT-pro BNP水平呈正相关(r值分别为0.342、0.483、0.283、0.763、0.693和0.208,P0.05);多因素logistic回归分析结果示,年龄、SBP、大量蛋白尿是NT-pro BNP水平的独立影响因素(P0.05)。结论 T2DM合并高血压、大量蛋白尿老年患者的NT-pro BNP水平升高;应注意对高龄、高血压及大量蛋白尿T2DM患者心血管事件的预防。     

2型糖尿病合并高血压危险因素的病例对照研究

目的探讨糖尿病合并高血压的危险因素。方法采用以社区为基础的成组病例对照研究设计,对2型糖尿病患者中300例合并高血压的病例和300例未合并高血压的对照进行问卷调查、体格检查和实验室检测。利用单因素和多因素非条件logistic回归模型分析2型糖尿病合并高血压的相关危险因素。结果根据年龄调整经单因素非条件logistic回归分析,差异有统计学意义(P0.05)的变量有糖尿病家族史、高血压家族史、日常体育锻炼情况、生活工作压力、体质指数、腰臀比、空腹血糖、餐后2h血糖、收入水平、水果摄入量。进一步进行多因素logistic回归分析,这些因素差异也均有统计学意义(P0.05)。结论糖尿病合并高血压是遗传和环境多因素综合作用所致,在防治过程中,应采取综合防治的策略,预防疾病的发生。     

2型糖尿病一级亲属非糖尿病患者胰岛素抵抗与胰岛β-细胞功能状态的研究

目的　研究 2型糖尿病 (DM)一级亲属非糖尿病患者胰岛素抵抗与胰岛β-细胞功能 ,探讨其在糖尿病发生发展中的作用。方法　选取 2型 DM一级亲属非糖尿病患者 6 0例为实验组 ,6 0例无糖尿病家族史的正常人为对照组 ,计算并比较两组的稳态模型胰岛素抵抗指数 (HOMAIR)、β-细胞功能指数 (HOMAβ)及胰岛素敏感性指数 (ISI)。结果　在年龄、体质指数 (BMI)及性别构成比可比的情况下 ,实验组 HOMAIR(0 .80 2 7± 0 .4 6 74 )、HOMAβ(5 .12 39± 1.0 86 3)显著高于对照组 (分别为 0 .6 0 11± 0 .5 4 6 2 ,4 .735 6± 0 .5 6 77) (P<0 .0 5 ) ,而 ISI(- 3.92 31± 0 .5 0 11)显著低于对照组(- 3.6 5 4 4± 0 .4 0 981) (P<0 .0 1)。结论　 2型 DM非 DM一级亲属具有高β-细胞分泌功能 ,低胰岛素敏感性 ,提示非DM一级亲属存在胰岛素抵抗。     

2型糖尿病患者慢性肾脏病和蛋白尿的相关性分析

目的:探讨2型糖尿病(DM2)患者中1、2级慢性肾脏病(CKD1、CKD2)和蛋白尿的相关性。方法:对591例(男性:438例;女性:153例)DM2人群进行和断面调查。采用简化MDRD公式估算肾小球滤过率(eGFR)划分CKD1和CKD2。通过随机尿中白蛋白与肌酐比值(ACR,mg/g)确定蛋白尿。结果:CKD1组无蛋白尿、微量蛋白尿、大量蛋白尿的发生率分别为78.9%、18.1%和3.0%,CKD2组分别为63.4%、24.8%和11.8%。控制年龄、性别、糖尿病病程、体重指数、血压、血脂、空腹血糖和糖化血红蛋白,Logistic回归分析显示,微量蛋白尿较无蛋白尿的糖尿病患者发生CKD2危险性的OR(95%CI)值是3.06(1.19-7.84)倍;大量蛋白尿较无蛋白尿的糖尿病患者发生CKD2危险性的OR值是6.00(2.43-14.78)倍。结论:蛋白尿与CKD的发展联系紧密,是CKD1发展为CKD2的独立危险因素。     

妊娠期合并乙型肝炎危险因素的探讨

目的　探讨妊娠期合并乙型肝炎的相关危险因素 ,为妊娠期预防和控制危险因素提供依据。方法　采用病例对照研究方法对天津市塘沽地区 2 0 0 1年 7月～ 2 0 0 2年 12月期间接受产前健康检查的孕妇 ,其中病例组 2 3例 ,对照组 10 0例。用非条件logistic回归方法来分析探讨妊娠期合并乙型肝炎在本地区潜在的危险因素。所有数据采用SPSS 10 0处理。结果　①调查对象年龄分布病例组为 2 1～ 3 2岁 ,平均为 (2 6 17± 2 95 )岁 ;对照组为 2 0～ 3 9岁 ,平均为 (2 6 0 3± 3 3 8)岁。②非条件logistic回归单因素分析显示 ,与妊娠期合并乙型肝炎有显著性统计学意义的 9个变量 ,即危险因素如下 :文化程度(OR =2 5 91) ,文化程度高者危险性高 ;职业 (OR =2 .5 81) ,脑力劳动者危险性高 ;收入 (OR =3 .467) ,收入高者危险性高 ;经常接受注射史 (OR =8.981) ;父母患有乙肝史 (OR =3 .60 8) ;公共场所进餐方式 (OR =8.62 6) ,集体共餐危险性高 ;洗漱用具 (OR =7.3 49) ,共用危险性高 ;爱人患有乙肝史 (OR =2 0 83 7) ;血型 (OR =1.5 61) ,危险性由高到低依次为AB型、O型、B型、A型。结论　非条件logistic多因素回归分析得出 :职业、洗漱用具 2个变量是妊娠期合并乙型肝炎的独立危险因素。     

II型糖尿病血糖控制情况与合并肾病的关系

目的　探讨II型糖尿病 (NIDDM )病人的血糖控制情况对糖尿病肾病 (DN)发生的影响。方法　对合并有DN及未合并有DN的NIDDM患者进行配对病例对照研究 ,共 10 6对。采用硫柳酸法测定 2 4h尿中总蛋白含量 ,根据患DM以来 (对于已患DN的患者 ,至其发生DN前 ) ,平均空腹血糖值 (FBG)是否 >140mg/dl来评估血糖控制情况。对资料进行条件logistic回归分析。 结果　单因素结果显示 :血糖控制情况与DN有统计学联系 ,比值比 (OR)及其 95 %的可信区间 (CI)分别为 0 .43( 0 .2 5～ 0 .75 ) ,用可能起混杂作用的因素调整后 ,这种关系仍然存在。结论　良好的血糖控制可减少NIDDM患者合并DN的危险 ,其作用独立于其它危险因素 (包括DM病程 )。     

血清一氧化氮水平与微量蛋白尿关系1∶2病例对照研究

目的 探讨血清一氧化氮水平与微量蛋白尿的关联性.方法 以苏州市金阊区的高血压现场调查为基础,采用1∶2配对研究方法,选择208例微量蛋白尿患者及与之在性别、年龄、血糖和腰围相匹配的居住同一小区、同等经济收入水平的非微量蛋白尿人群,测量血清一氧化氮水平,采用多因素条件logistic回归对血清一氧化氮水平与微量蛋白尿的关联性进行分析.结果 微量蛋白尿组的血清一氧化氮水平略低于非微量蛋白尿组(中位数,四分位间距:27.75,14.48～ 42.15μmol/L vs.28.25,17.40～ 43.45μmol/L),但两组间差异无统计学意义(P=0.316).多因素条件logistic回归分析显示,调整血压、血脂、尿酸、吸烟、饮酒后,血清一氧化氮水平与微量蛋白尿不存在显著关联性.进一步按是否患高血压分层,多因素条件logistic回归分析显示,与血清一氧化氮水平最高分位者相比,在多因素调整后,无论是在高血压还是非高血压的对子中,血清一氧化氮水平处于第1、2、3分位者患微量蛋白尿的危险性差异均无统计学意义.在有高血压的对子中,血清一氧化氮最低水平组患有微量蛋白尿的危险性是最高水平组的1.85倍(OR=1.85,95％CI:0.96～ 3.57);而在非高血压的对子中,血清一氧化氮最低水平组患有微量蛋白尿的危险性较最高水平组仅增加了40％(OR=1.40,95％CI:0.58 ～ 3.40).结论在一般人群中,血清一氧化氮水平与微量蛋白尿无显著相关性.     

II型糖尿病血糖控制情况与合并肾病的关系

目的：探讨Ⅱ型糖尿病（ＮＩＤＤＭ）病人的血糖控制情况对糖尿病肾病（ＤＮ）发生的影响。方法：对合并有ＤＮ及未合并有ＤＮ的ＮＩＤＤＭ患者进行配对病例对照研究,共１０６对。有用硫柳酸法测定２４ｈ尿中总蛋白含量根据患儿ＤＭ以来（对于已患ＤＮ的患者,至其发生ＤＮ前）,平均空腹血糖值（ＦＢＧ）是否〉１４０ｍｇ／ｄｌ来评估血糖控制情况。对资料进行条件ｌｏｇｉｓｔｉｃ回归分析。结果：单因素结果显示：血糖控制情况与     

关于2型糖尿病并发末梢神经病变危险因素的病例对照研究

糖尿病末梢神经病变(Diabetic Peripheral Neuropathy,DPN)是糖尿病常见并发症之一,不仅本身严重危害健康,有很高的病死率,而且与其他慢性并发症的发生发展关系密切。目的探讨2型糖尿病病人并发DPN的危险因素。方法采用以医院为基础的1:1配对病例对照研究方法。运用条件Logistic回归分析,建立主效应方程分析讨论DPN的危险因素。结果单因素Logistic回归分析表明,DPN发生的保护性因素包括:文化程度高、治疗方法力度大、现患冠心病、饮茶;危险因素包括:糖尿病病程长、血糖控制(HbAlc%)不良、使用胰岛素、合并糖尿病肾病、合并糖尿病视网膜病变、主诉眩晕症状、皮肤干燥、现患高血压、既往酮症、患糖尿病前肉类食物的摄入较多、既往吸烟(调查时已戒烟)、创伤经历、腰臀比WHR超标、血胆固醇(Chol)水平高。多因素Logistic回归分析示DPN发生的危险因素有6个:糖尿病病程、使用胰岛素、主诉眩晕症状、糖尿病前肉类食物摄入较多、饮酒以及既往创伤经历(手术、冻伤等)。结论DPN与多种因素相关,在2型糖尿病患者中,糖尿病病程长、使用胰岛素、主诉眩晕症状、糖尿病前肉类食物摄入较多、饮酒、既往创伤史会增加糖尿病神经病变的发生危险,我们应在DPN的防治过程中特别予以注意。     

Prevalence of degenerative complications of diabetes in an outpatient population

The aim of this study was to evaluate the frequency of micro and macro vascular complications among a cohort of diabetic out-patients without proteinuria. PATIENTS AND METHODS: It is a cross sectional study of 249 diabetic patients (126 mean and 123 women) 166 with type 2 diabetes and 83 with type 1 diabetes. Patients were recruited according to sex, age and diabetic duration stratification. Mean age was 45.2 +/- 6.6 years and mean duration of diabetic was 8.9 +/- 7 years. Diabetic complications were investigated through a questionnaire, physical examination, ECG eyes fundoscopy and microalbuminuria measured in overnight urine collection. RESULTS: Prevalence of diabetic micro angiopathy in our population was one of the most frequent in the world. Diabetic peripheral neuropathy and retinopathy were the most frequent complications found in our patients. It was 63.5% for peripheral neuropathy, 43.8% for retinopathy and 25.3% for microalbuminuria. Macro angiopathy, as defined by hypertension, coronary heart diseases (CHD), lower limb arteritis (LLA) or stroke, was found in 24.5% of patients. CHD rate was equal to 14.5% and LLA in 12.4%. Prevalence rates of vascular complications of diabetes were correlated with age, duration and type of diabetes. CONCLUSION: Prevention of diabetes complications needs early screening of glucose tolerance abnormalities, better glycemic control, reduction of associated vascular risk factors and identification of genetic factors predisposing to a higher cardiovascular risk.     

Quality assessment of primary health care services provided for diabetes mellitus control in Alexandria

Diabetes is a growing health problem worldwide. It is recognized as a particular threat to public health of the third world communities, particularly those living in rapidly developing countries. Therefore, the present study was conducted aiming at: assessment of the quality of primary health care (PHC) services provided for the control of diabetes mellitus (DM) in Alexandria; and opportunistic screening of high risk individuals attending PHC facilities for DM. Accordingly, the availability of human and nonhuman resources for DM control in two rural and two urban PHC centers in Alexandria (one of them was serving a desert area) was assessed by a pre-designed checklist 920 adult PHC attendants were screened for risk factors of DM. Individuals having more than one of the following risk factors: age above 50 years, overweight (body mass index > or =27 kg/m2), family history of DM in first degree relatives, history of hypertension, hypertension (systolic blood pressure > or =140 mm Hg and /or diastolic blood pressure > or =90 mm Hg), history of hyperlipidemia and history of gestational diabetes or birth of a large sized baby in females- were subjected to random capillary blood glucose (RCBG) testing. Cases were considered likely diabetic if RCBG was >200 mg/dl The performance of all PHC physicians examining and managing 560 diabetic patients was observed over a period of two months. One fourth of the diabetic cases were checked for the level of glycaemic control by fasting capillary blood glucose testing. The results revealed that 61.7% of the studied PHC attendants were at risk of developing DM and 14% were likely diabetic, with an urban: desert ratio of 2:1 The following factors were found to be independently associated with an increasing risk of DM occurrence among males: overweight (about 14 folds), family history of DM (9 folds), age above 50 years and history of hypertension (4 folds each). Whereas, among females the following risk factors were found: family history of DM (8 folds), history of gestational diabetes (6 folds) and overweight (4 folds). The majority of diabetic patients were poorly examined, investigated and managed; and an optimal level of glycaemic control was achieved in only 12.9% of the cases, as the PHC physicians didn't follow a model treatment plan for DM and due to unavailability of some equipment, laboratory facilities and essential drugs.     

Factors Associated with Consumption of Diabetic Diet among Type 2 Diabetic Subjects from Ahmedabad,Western India

This cross-sectional study assessed the current situation of and factors associated with consumption of diabetic diet among 399 type 2 diabetes mellitus (T2DM) subjects from Ahmedabad, Western India. The study was performed with diagnosed (at least one year old) diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya Hospital), Ahmedabad during July 2010–November 2010. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, family history of diabetes, behavioural profile, risk profile (glycaemic status, hypertension, and obesity), and diet-related history (consumption of diabetic diet, consumption of low fat/skimmed milk, method of cooking, and sources for diet advice). Blood pressure, body mass index, glycosylated haemoglobin (HbA1c) level, and fasting lipid profile were measured. All analyses including multivariate logistic regression were conducted using SPSS, version 11.5. In total, 399 T2DM subjects (65% male, 35% female) with mean age of 53.16±7.95 years were studied. Although 73% of T2DM subjects were consuming diabetic diet, the good glycaemic control (HbA1c level <7%) was achieved only in 35% of the subjects. The majority (75%) of the subjects had a positive family history of diabetes, and 52% were obese. In 77%, the main source of dietary advice was doctor. In 36%, the main methods of cooking were: boiling and roasting. The final multivariate model showed that visit to dietician, level of education, intake of low fat, and family history of diabetes were independent predictors for diabetic diet consumption among T2DM subjects. However, longitudinal and cohort studies are required to establish the association between consumption of diabetic diet and glycaemic control.Key words: Cross-sectional study, Diet, Glycaemic control, Glycosylated haemoglobin, Obesity, Type 2 diabetes mellitus, India     

Random urine protein creatinine ratio as a preadmission test in hypertensive pregnancies with urinary protein creatinine ratio

To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Method: Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100). Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC) curve to detect significant proteinuria (≥300mg/day) using 24h. Urine protein as a gold standard. Forty six patients (46%) had significant proteinuria. The random protein creatinine ratio was correlated to 24h urine protein excretion (r(2)=0.777, P<0.001) Area under ROC curve to predict proteinuria was 0.926 (95% CI: 0.854-0.995, P<0.001). A cut off value of 0.22mg/mg for protein creatinine ratio best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values of 87%, 92.6%, 90.6% and 89.3% respectively. Random urinary protein creatinine ratio is a simple inexpensive and excellent alternative to 24h urine collection. It's helpful in diagnosis of preeclampsia and can be used as a pre admission test in PIH cases.     

Prevalence of proteinuria and its clinical implications in type 2 diabetic patients treated at a primary health care centre in Abha City

The aim of the present study is to describe the prevalence of proteinuria in a series of type 2 diabetic patients registered and followed up in the diabetes clinic of a primary health care center (PHCC) in Abha city, southern Saudi Arabia and to relate the proteinuria to some clinical manifestations. The study involved the files of 208 diabetic patients (118 females and 90 males). They were chosen from 475 files of diabetic patients receiving care in the PHC center of Shamasan in Abha City. The selection was based on the fulfillment of certain criteria: type 2 diabetic patients, registered for at least 12 months and visited the clinic for at least once during that period. For each patient the diabetes duration, the last readings of fasting blood sugar, total cholesterol level, were used. Proteinuria was considered whenever the last and any of the preceding 3 urine analysis revealed it by the dipstick test. Proteinuria is present in more than half the patients (54.3%). The fasting blood sugar shows a considerably high mean of 218.0 +/- 72.0 mg/dl. The total cholesterol level on the other hand showed a slight high average of 233.7 +/- 55.2 mg/dl. The results of the three different types of compliance as scored by the treating physician showed that the poor scores dominate with 74%, 82.7% and 78.4% of patients' diet, drug and appointment compliances. The outcome of the logistic regression model for proteinuria showed that the significant factors were the poor glycemic control with an odds ratio (OR) of 3.13, diabetes duration (OR = 1.08 for every year) and diastolic blood pressure (OR = 6.11). Diabetic patients treated in the PHC level should be regularly monitored for microalbuminuria and not gross proteinuria to prevent progression to overt nephropathy which will eventually lead to ESRD. The risk increases with poorly controlled and hypertensive patients.     

Effect of bis(maltolato)oxovanadium (IV) (BMOV) on selenium nutritional status in diabetic streptozotocin rats

The role of V as a micronutrient, and its hypoglycaemic and toxicological activity, have yet to be completely established. The present study focuses on changes in the bioavailability and tissue distribution of Se in diabetic streptozotocin rats following treatment with V. The following four study groups were examined: control; diabetic (DM); diabetic treated with 1?mg V/d (DMV); diabetic treated with 3?mg V/d (DMVH). V was supplied in the drinking water as bis(maltolato)oxovanadium (IV). The experiment had a duration of 5 weeks. Se was measured in food, faeces, urine, serum, muscle, kidney, liver and spleen. Glucose and insulin serum were studied, together with glutathione peroxidase (GSH-Px), glutathione reductase (GR), glutathione transferase (GST) activity and malondialdehyde (MDA) levels in the liver. In the DM group, we recorded higher levels of food intake, Se absorbed, Se retained, Se content in the kidney, liver and spleen, GSH-Px and GST activity, in comparison with the control rats. In the DMV group, there was a significant decrease in food intake, Se absorbed, Se retained and Se content in the liver and spleen, and in GSH-Px and GST activity, while fasting glycaemia and MDA remained unchanged, in comparison with the DM group. In the DMVH group, there was a significant decrease in food intake, glycaemia, Se absorbed, Se retained, Se content in the kidney, liver and spleen, and in GSH-Px and GST activity, and increased MDA, in comparison with the DM and DMV groups. We conclude that under the experimental conditions described, the treatment with 3?mg V/d caused a tissue depletion of Se that compromised Se nutritional status and antioxidant defences in the tissues.     

Cost-effectiveness of glycemic control and ophthalmological care in diabetic retinopathy

AIMS: Glycemic control and ophthalmological care are known to significantly diminish the risk of visual impairment and blindness by diabetic retinopathy (DRP). The (cost-)effectiveness of both strategies was studied to highlight their benefits for patients and care providers. METHODS: A computer analysis was developed, following the progression of DRP and the effectiveness of metabolic control and ophthalmological care continuously and individually in cohorts of type I and type II DM patients with divergent degrees of compliance. Costs relate to present medical charges in the Netherlands. RESULTS: Intensive glycemic control shortens the duration of blindness in a type I DM patient by 0.76 years, intensive ophthalmological care by 0.53 years. One year sight gain may cost 1126 euros by providing ophthalmological care and 50479 euros by glycemic control. The duration of blindness drops in a type II DM patient by 0.48 and 0.13 years, respectively, whereas the effectiveness decreases as the age of onset of DM rises. CONCLUSIONS: The vast majority of diabetic patients benefits from both intensive glycemic control and intensive ophthalmological care, but these cost-effective interventions which are not only complementary, but also substitute each other, require lasting, full compliance by all parties concerned.     

Inverse relationship between urinary markers of animal protein intake and blood pressure in Chinese: results from the WHO Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study

BACKGROUND: This issue of the relationship between animal protein intake and blood pressure (BP) is unsolved. We examined the associations between urinary 3-methylhistidine (3MH) excretion (a biological marker of animal protein intake) and BP in 11 Chinese population samples (Urumqi, Altai, Lhasa, Tulufan, Hetian, Guiyang, Guangzhou, Shanghai, Beijing, Shijiazhuang and Taipei). METHODS: This was a multi-centre cross-sectional study. In each centre, 100 men and 100 women aged 48-56 years were selected randomly from the general population. 3-methylhistidine in 24-hour (24-h) urine collections was measured by an Amino Acid Analyzer (Hitachi 835, Ibaragi, Japan). The total study sample included 966 men and 1025 women. Subjects who failed to collect complete 24-h urine samples were excluded in data analyses regarding associations between 3MH and BP. RESULTS: The results showed that: (1) for within-centre analyses of individuals, the 3MH and 3MH to creatinine ratios (3MH:cre) were significantly and negatively associated with BP and hypertension. These associations remained significant after adjustment for age, sex, sodium to potassium ratio, body mass index, calcium and magnesium. The pooled regression coefficients (SE) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on 3MH were -0.020 (0.01) and -0.018 (0.01), and of SBP and DBP on 3MH:cre were -0.022 (0.01) and -0.016 (0.01), respectively. Subjects with lower 3MH excretion had higher relative risks of hypertension than those who had higher 3MH excretion. (2) In cross-centre analyses, mean SBP and DBP were significantly and negatively associated with the mean 3MH:cre across the 11 population samples (R(2) = 0.56, P < 0.01). CONCLUSION: The results provide strong evidence that animal protein intake is associated inversely with BP in Chinese populations.