2型糖尿病并发甲状腺癌与血清HbA1c水平升高的可能机制分析

目的探讨2型糖尿病并发甲状腺癌与血清糖化血红蛋白(HbA1c)水平升高的相关机制。方法选取2019年3月—2021年2月该院收治的2型糖尿病并发甲状腺癌患者86例,设为研究组同时取单纯2型糖尿病患者220例,设为对照组采集两组患者的晨起空腹静脉血,离心取上层血清,采用全自动生化分析仪对血清HbA1c、空腹糖(FPG)及血脂水平进行测量,并分析2型糖尿病患者血清HbA1c水平与血糖、血脂的相关性及影响2型糖尿病患者并发甲状腺癌的危险因素。结果研究组患者的HbA1c、FPG、三酰甘油(TG)、总胆固醇(TC)水平均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异有统计学意义(P0.05);2型糖尿病患者血清HbA1c水平和FPG、TG、TC水平呈正相关,和HDL-C水平呈负相关(P0.05);血清HbA1c、TG、TC水平为2型糖尿病并发甲状腺的危险因素,HDL-C为保护因素(P0.05)。结论 2型糖尿病并发甲状腺癌可能受到血清HbA1c水平的影响,HbA1c水平可能对机体血脂水平进行调控,由此使2型糖尿病患者发生甲状腺癌的风险加大。     

肥胖及脂代谢紊乱对老年糖尿病患者心血管疾病发生情况的影响

选取2015年12月至2016年9月40例老年糖尿病患者及40例年龄及体重指数均匹配的健康对照者。根据BMI分为两组:超重/肥胖糖尿病组(对照组)40例,非肥胖糖尿病组(观察组)40例。测定血清25(OH)D_3、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA_(1c))。结果对照组预后心血管疾病发生率为10.00%(4/40)明显高于观察组2.50%(1/40);观察组临床疗效97.50(39/40)显著高于对照组80.00%(32/40)(P0.05);对照组血清25(OH)D_3、FPG、TC、TG、LDL-C和HDL-C、HbA_(1c)高于观察组(P0.05)。结论老年糖尿病患者心血管疾病发生水平减低与肥胖和脂代谢紊乱密切相关。     

糖化血红蛋白及血脂在糖尿病合并冠心病中的检测分析

目的探讨糖化血红蛋白及血脂在糖尿病合并冠心病中的价值。方法选取2017年9月—2018年9月该院收治的133例糖尿病合并冠心病患者为观察组,将同期在该院进行体检的133名健康者为对照组,进行HbA1c和血脂检测并比较。结果观察组HbA1c、TC、TG、LDL-C水平显著高于对照组,HDL-C水平显著低于对照组(P0.05);观察组Hb A1c及血脂检测阳性率显著高于对照组(P0.05);HbA1c检测阳性率90.2%显著高于血脂检测(P0.05)。结论对糖尿病合并冠心病患者进行Hb A1c与血脂检测,有助于了解病情进展,为预防和治疗提供重要依据。     

冠心病合并2型糖尿病患者冠状动脉的CT特点

目的 用64排双源CT评估合并2型糖尿病的冠心病患者冠状动脉病变特点,同时分析其临床特征.方法 临床已经确诊的冠心病患者152例;其中冠心病合并2型糖尿病组(DM-CHD)95例、单纯冠心病组(non DM-CHD)57例,进行包括血压、血糖、糖化血红蛋白(HbA1c)、血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇( HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)水平测定,并行无创性64排128层冠脉CT扫描检查,分析糖尿病及血糖、血脂代谢因素与冠状动脉病变的关系.结果 DM-CHD组多支病变明显高于nonDM-CHD组(P＜0.05).冠状动脉病变的支数与年龄(r=0.165,P=0.042)、HbA1c(r =0.230,P=0.006)、空腹血糖(r=0.211,P=0.010)呈正相关.DM-CHD组的TC、TG、LDL-C、apoB均显著高于non DM-CHD组(P＜0.001,P＜0.05).结论 冠心病合并糖尿病患者冠状动脉病变严重,糖代谢异常和血脂紊乱共同促进动脉粥样硬化的发生和发展.     

酮症酸中毒对1型糖尿病患者血脂水平影响的临床分析

目的分析60例1型糖尿病患者血脂和脂蛋白代谢的改变与血糖水平和酸中毒代谢的关系。方法 60例1型糖尿病患者根据有无糖尿病酮症酸中毒分成DKA组(n=16)和非DKA组(n=44),比较两组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1和脂蛋白a有无差异;根据血脂水平分为异常组(n=30)和正常组(n=30),比较两组DKA发生、病程、FBG、甲状腺激素水平和HbA1c差异;分析FBG与血脂代谢的相关性。结果 DKA组和非DKA组的FBG、HbA1c、TG、TC和HDL-C差异有统计学意义(P0.05);LDL-C、载脂蛋白A1和脂蛋白a差异无统计学意义(P0.05)。血脂异常组和血脂正常组发生DKA的百分比分别是30%和13.33%,差异有统计学意义(P0.05),两组间病程、FBG、甲状腺激素水平和HbA1c差异无统计学意义(P0.05)。TG随着FBG水平升高而升高,呈正相关;HDL-C和载脂蛋白A1随FBG水平的增加而下降,呈负相关;TC、LDL-C及脂蛋白a与FBG无相关性。结论以DKA起病的1型糖尿病患者存在明显的脂质代谢异常,且以TG水平升高为主,高血脂会加重DKA的病情进展,同时血糖控制不佳会加重血脂代谢紊乱,形成恶性循环。因此,1型糖尿病患者在积极控制血糖的同时,也需要加强血脂管理。     

老年糖尿病肾病与下肢血管病变的相关性

目的 研究老年糖尿病肾病与下肢血管病变的相关性.方法 选取2型糖尿病(T2DM)患者274例,回顾性分析所有患者性别、年龄、糖尿病(DM)病程、DM家族史、冠心病史、高血压史、周围神经病变、视网膜病史、收缩压(SBP)、舒张压(DBP)及体重质数(BMI)等一般临床资料及空腹血糖(FPG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1 c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)和尿微量白蛋白等临床辅助检查资料.结果 DM下肢血管病变与DM病程、DM家族史、冠心病史、高血压史、FPG、2 h PG、HbA1c及尿微量白蛋白正相关(r≥0.286,P＜0.05),与HDL-C负相关(r=-0.153,P＜0.05);与T2 DM组比较,糖尿病肾病(DN)组患者年龄、DM病程、DM及冠心病家族史比例、视网膜病史比例、SBP、BMI、FPG、2hPG、HbA1c、TC、TG、Cr及微量白蛋白均有相关性(P＜0.05),其发生下肢血管病变的危险性是DN患者的3.15倍.结论 DM病程、DM家族史、冠心病史、高血压史、FPG、2hPG、HbA1c、HDL-C及尿微量白蛋白是DN患者发生下肢血管病变的独立危险因子.     

2型糖尿病合并急性心肌梗死患者血清内脂素水平及阿托伐他汀钙的干预作用

目的观察2型糖尿病(T2DM)合并急性心肌梗死(AMI)患者血清内脂素含量及生化、糖化血红蛋白(HbA1c)等指标变化及阿托伐他汀钙(立普妥)干预作用。方法单纯T2DM组64例和T2DM合并AMI组72例均给予立普妥;另选择72名健康人为对照组给予安慰剂,测定给药前后血清内脂素含量及生化、HbA1c等指标。结果单纯T2DM组和T2DM合并AMI组血清内脂素、高密度脂蛋白胆固醇(HDL-C)、HbA1c、空腹胰岛素(FINS)、空腹血糖(FPG)、甘油三酯(TG)、胰岛素抵抗指数(HOMA-IR)均明显高于对照组(均P<0.05),其中T2DM合并AMI组血清内脂素、TG、FPG、HOMA-IR值明显高于单纯T2DM组,HDL-C低于单纯T2DM组(均P<0.05);血清内脂素和HOMA-IR是合并AMI的危险因素。治疗6个月后单纯T2DM组与T2DM合并AMI组HOMA-IR与内脂素水平均较干预前降低(P<0.01)。结论血清内脂素是T2DM合并AMI的高危因素,他汀类药物可降低血清中内脂素含量,进而降低HOMA-IR的含量,延缓疾病发展。     

二甲双胍对2型糖尿病患者血清瘦素水平的影响

DM2患者40例及正常对照者(NC)25人,行标准餐实验,测定Leptin及空腹、餐后0.5小时、餐后2小时血糖(Plasma glucose,PG)及胰岛素(insulin,Ins),同时测定甘油三酯(TG)、胆固醇(CH)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及糖化血红蛋白(HbA1c)。初诊DM2患者30例给予二甲双胍0.5bid治疗12周,复查上述指标,观察其变化。结果与NC组相比,DM2组Leptin水平明显升高(P<0.05),且女性患者高于男性(P<0.05),肥胖患者高于非肥胖者。二甲双胍治疗12周后DM2组FPG、0.5hPG、2hPG、HbA1c、TG、CH、HOMA-IR、Leptin均显著降低(P均<0.05),HDL-C升高(P<0.05)。结论二甲双胍治疗12周后,DM2患者FPG、0.5hPG、2hPG、HbA1c、TG、CH、HOMA-IR、Leptin均显著降低,HDL-C升高。     

2型糖尿病脂代谢与大血管并发症关系

选择大血管并发症的T2DM患者各45例,同期伴与不伴进行分析.结果空腹血糖(FPG)、餐后2小时血糖(2HPG),糖化血红蛋白(HbA1c)、甘油三脂(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)均明显高于无血管并发症组(P＜0.05)而HDL-C低于无血管并发症组(P＞0.05),提示在降糖同时,对血脂异常的治疗,对防止大血管病变也有重要的意义.     

非糖尿病冠心病患者糖化血红蛋白与血脂相关性分析

目的研究非糖尿病冠心病患者糖化血红蛋白(HbA1c)水平与血脂水平的相关性。方法入选排除糖尿病并经冠状动脉造影证实为冠心病的患者,空腹抽血收集HbA1c及血脂[包括胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、脂蛋白a(Lp(a))]信息。按照三分位法将HbA1c分为高水平组(HbA1c6.0%)、中水平组(5.7%HbA1c6.0%)、低水平组(HbA1c5.7%),分析比较不同级别HbA1c患者的血脂水平。校正年龄、性别、体重指数(BMI)、入院收缩压(SP)、舒张压(DP)、入院前用药史(β受体阻滞剂和利尿剂)、肿瘤病史、高血压史、吸烟史、饮酒史、ALT、AST、血Cr等已知的影响血糖和血脂因素后,采用偏相关分析,评价HbA1c与血脂各项指标的相关性。结果研究共入选328例患者,HbA1c高水平组127例,中水平组99例,低水平组102例。随着HbA1c的增高,Lp(a)增高并有显著统计学差异(P=0.004)。TG随HbA1c的增高而增高,HDL-C在HbA1c高水平组低于中等水平及低水平组,但均未达统计学差异(P=0.871,P=0.550)。TC及LDL-C在各水平HbA1c组无明显差异。偏相关分析显示HbA1c与Lp(a)呈正相关(偏相关系数=0.167,P=0.004),而与TG、TC、HDL-C、LDL-C无相关性。结论非糖尿病冠心病患者HbA1c与Lp(a)呈正相关,而与TG、TC、HDL-C、LDL-C无显著相关性。     

Utility of serum fructosamine as a measure of glycemia in young and old diabetic and non-diabetic subjects

PURPOSE: Currently used methods to determine glycemia have certain disadvantages, including cost, heavy labor involvement, and storage problems. Determination of serum fructosamine levels, on the other hand, offers several potential advantages over these current measures. Our goal was to evaluate the utility of serum fructosamine as a measure of glycemia. SUBJECTS AND METHODS: Fructosamine levels were measured in 145 normal and diabetic subjects aged 20 to 86 years. The measured levels were then related to standard measures of glycemia, including glycosylated hemoglobin, glycosylated albumin, and fasting glucose. The effects of chronic illness and medications known to alter glucose tolerance were also investigated. RESULTS: Fructosamine levels were well correlated with other measures: r = 0.73 with glucose, 0.76 with hemoglobin A1C (HbA1C), and 0.80 with glycosylated albumin. Levels of fructosamine were significantly higher (p less than 0.001) in diabetic subjects compared with those in non-diabetic subjects, but were not affected by age and were only minimally affected by chronic illness. Values for diabetic subjects with well-controlled and poorly controlled disease were also significantly different. CONCLUSION: Assay of serum fructosamine appears to be comparable to that of HbA1C for determination of glycemic control. The automaticity, reproducibility, and lower cost for the fructosamine assay argue strongly in favor of this assay in comparison to those for other glycosylated proteins.     

No significant effect of vitamin E deficiency or supplementation on collagen-linked fluorescence in skin of diabetic rats.

It is speculated that oxidative stress in vivo may have some influence on advanced, nonenzymatic, glycosylation end products. However, this has not been demonstrated yet. We assessed changes in collagen-linked fluorescence in the skin of nondiabetic and streptozotocin-induced diabetic rats fed three different diets for 4 weeks that could modify oxidative stress: vitamin E-deficient (D), vitamin E-supplemented (S), and control (C). The serum lipid peroxide level expressed as thiobarbituric acid (TBA) activity in diabetic rats on the S diet (9.6 +/- 1.0 [SE] nmol/L/mL) was significantly (P less than .01) lower than that in rats on the D diet (111.4 +/- 22.4), and similar to that in nondiabetic rats on the C diet (12.4 +/- 2.2). The collagen-linked fluorescence level was significantly (P less than .01) higher in diabetic rats than in nondiabetic rats, which corresponded to the serum glucose and glycosylated hemoglobin levels. However, there were no significant differences in the fluorescence levels among three groups classified by three different diets in both nondiabetic and diabetic rats (21.7 +/- 1.7 arbitrary U/mg collagen for D, 22.3 +/- 2.0 for C, and 22.8 +/- 2.5 for S in nondiabetic rats v 41.2 +/- 4.1 for D, 40.1 +/- 4.7 for C, and 39.3 +/- 3.5 for S in diabetic rats), despite significant changes in serum lipid peroxide levels. Consequently, there were no significant changes found in collagen-linked fluorescence levels in diabetic rats wherein oxidative stress was modified by vitamin E deficiency and supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)     

糖化血红蛋白联合血清C肽检验在糖尿病诊断中的应用价值分析

目的探究糖尿病患者经糖化血红蛋白联合血清C肽检验的临床诊断价值。方法该文将该院在2016年1月—2020年10月收治的50例糖尿病患者与50名健康体检者分别设为观察组与对照组,两组患者均接受糖化血红蛋白联合血清C肽检验,对比患者空腹血糖、餐后2 h血糖、糖化血红蛋白及血清C肽指标差异。结果患者经检测,观察组空腹血糖(10.21±0.29)mmol/L、餐后2 h血糖(16.04±1.26)mmol/L、糖化血红蛋白(9.67±1.12)%,均高于对照组,差异有统计学意义(t=81.384、38.981、21.489,P<0.05)。观察组血清C肽(0.76±0.15)μg/L,低于对照组的(1.39±0.18)μg/L,差异有统计学意义(t=19.013,P<0.05)。结论糖尿病经糖化血红蛋白联合血清C肽检测,不仅给患者提供了准确的诊断,还可根据检测结果,为患者制定良好的诊治方案。     

Detection of liver membrane antibodies in patients with non-insulin-dependent diabetes mellitus

Circulating liver membrane antibodies (LMAb) were examined in 71 patients with non-insulin-dependent diabetes mellitus (NIDDM) without liver dysfunction and 16 cases of KK mouse as a model of obese diabetic animals. LMAb were detected in 10 NIDDM patients (14.1%). Fasting blood glucose, glycosylated serum albumin (G-Alb), and glycosylated hemoglobin A1 (HbA1) levels were compared with LMAb-positive and negative groups. The G-Alb levels and HbA1 levels of the LMAb-positive group were significantly higher (p less than 0.05 and p less than 0.01, respectively) than those of the LMAb-negative group. In addition, there were no differences in histological findings in KK mouse liver between the LMAb-positive and negative cases. These results revealed that the state of continued high blood glucose directly or indirectly influence the autoimmunity and clinical features of NIDDM patients.     

Serum lipid profile in diabetic macular edema

PurposeTo evaluate the correlation of lipid profile and clinical presentation of macular edema in Type 2 diabetes mellitus (DM) patients.Materials and MethodsThe study included 20 patients with chronic diabetic macular edema and plaque-like hard exudates (Group 1), 20 patients with diabetic macular edema (Group 2), and 20 DM patients but without retinopathy (Group 3). Diabetic retinopathy was classified according to the Early Treatment Diabetic Retinopathy Study grading system. Sample t test was used to evaluate the association between the fasting serum lipid [total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL)], glycosylated hemoglobin (HbA1c), fasting blood glucose, creatinine levels, and the clinical findings. P values <.05 were considered statistically significant.ResultsThere was no difference between fasting serum lipids and HbA1c levels. Duration of diabetes was shorter in Group 3 than in Groups 1 and 2. Patients in Group 1 had longer duration of diabetes than others (P<.05). Creatinine levels in Group 1 were higher than in other groups (P<.05). Although there was no correlation between fasting blood glucose and HbA1c levels, HbA1c was higher in all three groups from the baseline-normal limits (P<.05).ConclusionNo correlation was found between serum lipid levels and macular edema severity, but the duration of diabetes was demonstrated as a significant factor in the progression of macular edema. High HbA1c levels in all patients highlight the importance of intense glycemic control in diabetic patients.     

糖化血红蛋白测定在糖尿病诊断中的临床意义分析

目的分析探究糖化血红蛋白测定在糖尿病诊断的临床意义。方法将2018年4月—2019年4月进入该院进行体检的136名健康人群划分为对照组,将同期该院收治的136例糖尿病患者划分为观察组,两组均实行免疫抑制投射比浊法测定糖化血红蛋白(HbA1c)指标水平,利用葡萄糖氧化酶法测定其空腹血糖(FPG)水平,进一步比较两组诊断结果。结果①观察组FPG、HbA1c均明显高于对照组,两组数据差异有统计学意义(P<0.05)。②根据FPG水平将观察组划分为3个等级,即:6~8 mmol/L、8 mmol/L相似文献   

老年糖尿病周围神经病变的相关危险因素研究

目的探讨老年糖尿病周围神经病变(diabetic peripheral neuropathy,DNP)的相关危险因素。方法将89例老年糖尿病患者按是否合并周围神经病变分为病变组与对照组,观察2组体质量指数(BMI)、腰臀比(WHR)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及末梢神经功能、下肢血管超声等指标并进行比较分析。结果病变组WHR、LDL-C、下肢血管损伤程度均较对照组升高(P<0.05),神经传导速度、HDL-C较对照组降低(P<0.05),多元回归分析提示DNP与HbA1c、LDL-C、TG、血管病变负相关,与HDL-C正相关。结论DNP的发生与血糖、血脂及血管病变有关。     

血清C肽与糖化血红蛋白检验诊断糖尿病的临床效果分析

目的分析血清C肽与糖化血红蛋白检验在糖尿病诊断中的临床应用效果。方法将2018年6月—2020年11月该院收治的55例糖尿病患者纳入观察组,同时间段取健康体检人员55名纳入对照组,均接受血清C肽与糖化血红蛋白联合检验,对两组患者的血清C肽、糖化血红蛋白、空腹血糖与餐后2 h血糖水平进行详细记录,并对比分析临床诊断效果。结果观察组患者的血清C肽水平(5.02±0.09)μg/L较对照组(1.32±0.72)μg/L明显更高,且糖化血红蛋白水平(11.73±0.34)%较对照组(4.88±0.11)%明显更高,差异有统计学意义(t=6.112、136.684,P<0.05);观察组患者空腹血糖与餐后2 h血糖水平分别是(9.58±2.19)、(12.58±2.50)mmol/L,与对照组数据(4.35±0.71)、(4.69±1.46)mmol/L相比明显更高,差异有统计学意义(t=18.848、20.211,P<0.05)。结论血清C肽与糖化血红蛋白联合检验在糖尿病中的诊断价值高,是糖尿病诊断的重要诊断指标,在临床中应当推广和应用。     

Glycated hemoglobin, dyslipidemia and risk of atherosclerosis in type 1 diabetic patients

The aim of this study was to determine whether the dyslipidemia was associated with glycated hemoglobin (HbA1c) and to study the relationship of dyslipidemia and glycated hemoglobin with atherosclerosis as well as the gender difference in dyslipidemia. Twenty five clinically diagnosed type 1 diabetic children and adolescents in the age group of 7-18 years and 25 age and sex matched healthy children and adolescents constituted the study population. HbA1c was positively associated with total triglycerides, LDL, VLDL and HDL in diabetic cases as compared with controls. The gender differences were studied using chi-square test which showed that females were more prone to changes in lipid profiles as related to HbA1c levels. It was concluded that type 1 diabetes mellitus patients were at increased risk of premature atherosclerosis due to associated dyslipidemia that could be due to higher levels of glycated hemoglobin. Lower HDL levels, a possible risk of atherosclerosis showed inverse association with HbA1c levels, implying that elevated glycated hemoglobin was associated with multi-fold risk of atherosclerosis. Females were at increased risk of atherosclerosis than males because of higher prevalence of dyslipidemia among them.     

基于社区管理模式探讨家庭医生签约服务模式对空巢老年糖尿病的影响

目的基于社区管理模式探讨家庭医生签约服务模式对空巢老年糖尿病的影响。方法选取2018年3月-2019年7月广西医科大学第二附属医院社区卫生服务中心签约家庭医生服务模式及未签约家庭医生服务模式的空巢老年糖尿病患者各92例,签约家庭医生的患者设为观察组,未签约家庭医生的患者设为对照组。观察并比较2组患者干预前和干预1个月后、干预3个月后、干预6个月后、干预1年后的空腹血糖、糖化血红蛋白及自我管理水平;评估并比较2组血糖达标率、血压达标率、血脂达标率及联合达标率。结果干预后2组糖化血红蛋白和空腹血糖明显降低(P<0.05),且观察组干预3个月后、干预6个月后、干预1年后的糖化血红蛋白和空腹血糖明显低于对照组(P<0.05),重复测量结果显示,观察组糖化血红蛋白和空腹血糖数值下降趋势明显大于对照组(P<0.05);观察组干预后血糖达标率、血压达标率、血脂达标率及联合达标率均明显升高(P<0.05),且明显高于对照组(P<0.05);干预后2组自我管理水平明显升高(P<0.05),观察组干预1个月后、干预3个月后、干预6个月后、干预1年后自我管理水平明显高于对照组(P<0.05);观察组的干预满意度(98.91%)明显高于对照组(90.22%)(P<0.05)。结论家庭医生签约服务模式能够提高社区管理模式中糖尿病空巢老人血糖、血脂、血压的自我管理能力,降低患者糖化血红蛋白及血糖水平,提高患者满意度,有利于糖尿病病情控制。