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1.
目的 研究2型糖尿病(T2DM)家系人群的胰岛素抵抗与心血管疾病危险因素聚集的关系。方法 选取2型糖尿病家系115个。共计570人,其中268例糖尿病患者为病例组,非糖尿病一级血缘亲属302人为内对照组,健康者161人为外对照组,应用x^2检验以及二项分类Logistic回归方法。结果 3组的心血管危险因素聚集程度与胰岛素抵抗程度有关(均P〈0.05)。随着胰岛素抵抗指数(HOMA-IR)的增高,3组人群的心血管疾病危险因素聚集的风险均增加。内对照组的胰岛初期分泌功能指数的平均水平高于T2DM人群和外对照人群(P=0.018,0.000)。结论 健康人群在未发生糖尿病之前均有胰岛素抵抗,因胰岛β细胞代偿性分泌增加,故不发病;当其失代偿时.则导致糖尿病发生。胰岛素抵抗为心血管疾病危险因素聚集的基础,心血管疾病危险因素聚集则是导致家系2型糖尿病高发的原因之一。  相似文献   

2.
目的对齐齐哈尔地区达斡尔族人群胰岛素抵抗、胰岛素分泌功能与糖尿病发病关系进行探讨,以研究胰岛素抵抗和胰岛素分泌功能是否存在民族差异,同时对该人群糖尿病早期诊断、早期治疗以及预防提供参考。方法采用1∶3配比的病例对照研究方法(每组各61例),计算稳态模型(HOMA)比较各人群的胰岛素抵抗指数、胰岛素分泌指数、胰岛β细胞功能指数。结果4组人群一般情况均衡性较好,年龄、体质指数以及腰臀比差异无统计学意义(P〉0.05),空腹血糖各人群差异有统计学意义(F=17.0427,P=0.0000)。胰岛素抵抗和胰岛素分泌功能指标HOMA-IR和FβCI在各人群中的水平比较差异有统计学意义(F=57.8686,P=0.0000;F=10.5674,P=0.0000)。结论达斡尔族和汉族糖尿病患者的胰岛素抵抗和胰岛素分泌功能存在差异,胰岛素抵抗影响胰岛素分泌功能,进而影响血糖水平。  相似文献   

3.
[目的]通过高葡萄糖钳夹技术精确评价正常、肥胖和2型糖尿病者胰岛β细胞功能和胰岛素抵抗差异,探讨肥胖和2型糖尿病发病机制. [方法]选择正常者10人(正常对照组)、肥胖和2型糖尿病者备15人(肥胖组和糖尿病组),应用高葡萄糖钳夹技术进行研究,观测钳夹过程中胰岛素分泌情况,评价胰岛β细胞功能状态,计算胰岛素敏感指数,了解胰岛素抵抗情况. [结果]①3组均4~8min达到目标高糖平台并维持钳夹结束,平均葡萄糖输注速度正常对照组和肥胖组均高于2型糖尿病组(F=1128.17,v=2,P=0.0000),正常对照组和肥胖组比较无统计学差异(t=1.990,P=0.059);②3组胰岛素双相分泌曲线形态相似,肥胖组曲线微高于正常组;糖尿病组胰岛素1相和2相分泌曲线均显著低于正常组,各项指标差异均有统计学意义(P<0.01或P<0.05);③正常组和肥胖组平均葡萄糖代谢率无统计学差异,但显著高于糖尿病组(P<0.01或P<0.05);④正常、肥胖和2型糖尿病胰岛素敏感指数分别是(15.56±2.47)、 (14.26±2.36)和(10.34±3.68)mg·kg-1min-1/mU/L(F=13.71 v=2,P=0.000). [结论]①高葡萄糖钳夹成功建立,评价了不同人群的胰岛β细胞功能和机体胰岛素抵抗的差异;②代偿性胰岛素分泌增多与肥胖相关;③2型糖尿病者胰岛β细胞受损,普遍存在胰岛素分泌缺陷和(或)胰岛素抵抗. 1或P<0.05);③正常组和肥胖组平均葡萄糖代谢率无统计学差异,但显著高于糖尿病组(P<0.01或P<0.05);④正常、肥胖和2型糖尿病胰岛素敏感指数分别是(15.56±2.47)、 (14.26±2.36)和(10.34±3.68)mg·kg-1min-1/mU/L(F=13.71 v=2,P=0. 00). [结论]①高葡萄糖钳夹成功建立,评价了不同人群的胰岛β细胞功能和机体胰岛素抵抗的差异;②代偿性胰岛素分泌增多与肥胖相关;③2型糖尿病者胰岛β细胞受损,普遍存在胰岛素分泌缺陷和(或)胰岛素抵抗. 1或P<0.05);③正常组和肥胖组平均葡萄糖代谢率无统计学差异,但显著高于糖尿病组(P<0.01或P<0.05);④正常、肥胖和2型糖尿病胰岛素敏感指数分别是(15.56±2.47)、 (14.26±2.36)和(10.34±3.68)mg·kg-1min-1/mU/L(F=13.71 v=2,P=0. 00)  相似文献   

4.
陈小龙 《现代保健》2009,(13):85-86
目的观察阿托伐他汀强化调脂治疗对初诊2型糖尿病患者胰岛素抵抗和胰岛B细胞功能的影响。方法30例2型糖尿病患者口服阿托伐他汀20mg,每天1次。按HOMA模型计算胰岛素抵抗指数(HOMA—IR)和胰岛素分泌指数(HOMA—IS)。结果阿托伐他汀强化调脂治疗12周后,空腹血糖(FPG)、餐后两小时血糖(PG2h)、糖化血红蛋白(HbA),C、HOMA—IR均明显下降,HOMA—IS明显增加(P〈0.01或P〈0.05)。结论阿托伐他汀治疗初诊的2型糖尿病.可明显改善胰岛素抵抗和胰岛B细胞分泌功能。  相似文献   

5.
目的 比较新疆地区汉族和维吾尔(维)族人群空腹血糖受损(IFG)、糖耐量减低(IGT)及混合性糖调节受损(CGI,IFG/IGT)阶段胰岛素分泌及其功能.方法 2007-2008年在新疆部分地区采用多中心横断面调查(中国第三次糖尿病流行病学调查),共计2203名研究对象(汉族111 8人,维族1085人)行口服75 g葡萄糖耐量试验(OGTT),用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,胰岛β细胞功能指数(HOMA-β评估基础胰岛素分泌,OGTT中空腹和30 min胰岛素、血糖差值的比值(ΔI30/ΔG30)评价胰岛素早相分泌,ΔI30/ΔG30/HOMA-IR评估葡萄糖处置指数(DI).结果 腰围、体重指数、血脂水平、0及120 min胰岛素值在汉维两民族不同糖代谢组的差异有统计学意义.在糖调节正常(NGT)、IFG、CGI组,维族人群的腰围要显著高于汉族(P<0.01).在NGT、IFG、IGT组,汉族人群的120 min血清胰岛素水平则显著高于维族(P<0.01).汉族人群的HOMA-IR、HOMA-β在不同糖代谢组均显著高于维族(P<0 01).ΔI30/ΔG30、DI在两民族不同糖代谢组间的差异无统计学意义.结论 汉族人群较维族在糖调节受损阶段有显著的胰岛素抵抗,同时存在胰岛β细胞代偿性分泌以维持血糖水平.  相似文献   

6.
目的 观察初诊 2型糖尿病患者胰岛β细胞功能。方法 根据有无典型糖尿病症状分为A、B两组 ,A组和B组患者均进行口服葡萄糖耐量试验 (OGTT)、胰岛素释放试验 (IRT) ,并计算胰岛素敏感指数 (IAI)、Homaβ功能指数和修正的 β细胞胰岛素分泌指数 (MBCI)。结果 B组OGTT各点的血糖值均明显低于A组 (P <0 .0 1) ;B组IRT各点的胰岛素值均明显高于A组 (P <0 .0 1) ;两组IRT显示均有胰岛素释放高峰延迟 ;根据IAI示B组患者胰岛素抵抗较A组患者轻 (P <0 .0 5 ) ,Homaβ指数和MBCI均示B组胰岛 β细胞功能好于A组 (P <0 .0 5 )。结论 初诊 2型糖尿病患者 ,胰岛 β细胞功能均一定程度受损 ,但无典型糖尿病症状者胰岛 β细胞功能好于有典型糖尿病症状者 ,且胰岛素抵抗程度比后者轻。  相似文献   

7.
目的探讨胰岛B细胞的功能障碍在2型糖尿病(DM)发病过程中的作用。方法对49例正常人及125例2型DM一级亲属进行研究,测定了空腹血糖(FBG)、空腹血浆胰岛素,并计算HOMA模型胰岛素抵抗指数(HOMAIR)、胰岛B细胞功能指数(HOMAB)、胰岛素敏感性指数(ISI)、胰岛初期分泌功能指数(△I30/△G30),差异显著性用t′检验。结果一级亲属正常组HOMAB和△I30/△G30均高于正常对照组(P<0.05);一级亲属糖耐量减低(IGT)组HOMAB和△I30/△G30分别高于和低于正常对照组(P<0.05);新诊断DM组HOMAB和△I30/△G30均低于正常对照组(P<0.05)。结论2型DM一级亲属胰岛B细胞分泌功能增强,但在IGT病人B细胞初期分泌功能下降,在2型DM分泌功能明显下降。  相似文献   

8.
目的探讨脑硫脂与2型糖尿病的关系及可能的作用机制。方法测定54例2型糖尿病患者身高、体重、腰围及血压,检测血糖、血脂、真胰岛素及脑硫脂;另设健康对照组48例。结果糖尿病组空腹血糖、胰岛素抵抗指数(HOMA—IR)水平高于对照组(t=9.216,4.609;P〈0.05),脑硫脂水平低于对照组(t=12.116,P〈0.05);HOMA—IR与体重指数、腰围、收缩压、空腹血糖、高密度脂蛋白胆固醇(HDL—C)和真胰岛素存在单变量相关(r值分别为0.348,0.419,0.368,0.539,-0.533,0.757);脑硫脂与体重指数、腰围、收缩压、舒张压、空腹血糖、HDL-C和HOMA—IR存在单变量相关(r值分别为-0.326,-0.363,-0.414,-0.342,-0.676,0.430,-0.566);行多元线性回归显示,脑硫脂(β=-48.651,P=0.000),性别(β=-0.933,P=0.002),腰围(β=0.033,P=0.042)为HOMA—IR的独立危险因素。结论2型糖尿病患者血清脑硫脂降低,血清脑硫脂与糖尿病、胰岛素抵抗之间有密切的相关性,在糖尿病的发生、发展中可能起重要作用。  相似文献   

9.
目的分析2型糖尿病药物干预治疗后的胰岛素抵抗变化。方法46例2型糖尿病患者作为观察对象,观察期间口服二甲双胍250mg与格列吡嗪2.5mg,测量干预前后空腹胰岛素、血糖、血脂、BMI、腰围等,并计算胰岛素抵抗指数IR。结果FBG、IR.在药物治疗干预前后存在显著性统计学差异(P=0.000),TG、LDL-C在干预前后均明显降低(P〈0.05);多元逐步回归分析结果表明,腰围与TG、LDL—C进入回归方程。结论二甲双胍联合格列吡嗪干预治疗2型糖尿病能够明显改善胰岛素抵抗.TG与LDL—C水平也显著下降,且TG下降可能是胰岛素抵抗指数IR改善的主要原因。  相似文献   

10.
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。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

16.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

17.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

18.
19.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

20.
Occupational health hazards in mining: an overview   总被引:1,自引:0,他引:1  
This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.  相似文献   

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