2型糖尿病患者动脉内中膜厚度与磷酸烯醇式丙酮酸羧激酶基因变异的相关性

目的探讨与2型糖尿病患者动脉内中膜厚度(TMT)进展与磷酸烯醇式丙酮酸羧激酶(PEPCK)基因rs2071023位点的变异的相关性。方法新诊断2型糖尿病患者121例超声测量颈动脉、股动脉和髂动脉的IMT,多聚酶链反应一限制性内切酶片段长度多态性技术(PCR-RFLP)检测基因型,比较不同基因型IMT进展的情况,随访5年后复查IMT。结果基线状态下rs2071023位点不同基因型(CC,CG,GG)各组年龄、IMT、BM[、FPG、HbAlc、血脂比较差异无统计学意义。5年后随访患者中有16例失访或指标不全,共105例患者,与基线比较随访5年后颈动脉IMT增厚(0.84 mm比0.92 mm,P=0.004)。按rs2071023基因型分组,结果发现CC基因型组颈动脉IMT在随访5年后增厚(0.86 mm比0.97 mm),不同基因型对IMT增厚的贡献,差异具有统计学意义(P=0.012)。结论 PEPCK基因rs2071023位点的CC基因型可能与2型糖尿病患者颈动脉内中膜增厚有关     

糖尿病患者的口腔状况值得关注

糖尿病患者易患牙周疾病是在教科书上早有记载的糖尿病合并症之一,但由于糖尿病的血管并发症是患者致残致死的主要原因,内科或内分泌科医师更多关注的是糖尿病患者的血糖、血压、血脂是否得到控制,是否需要抗血小板治疗等,而对患者的口腔问题很少问津.     

针对华人糖尿病特点优化降糖方案

我国糖尿病患病率增长迅速，2001年上海社区调查显示糖尿病患病率达10．58％，但糖尿病控制达标率低。我国糖尿病患者以餐后血糖升高为主，老年患者多见，且并发症发生率高。因此应结合中国糖尿病患者的具体情况，合理选择用药，优化降糖方案，提高血糖达标率。     

以专题专护在住院病人中开展糖尿病教育的体会

随着我国逐渐进入老龄化社会，糖尿病的发病率越来越高。作为一种终身疾病，控制血糖及减少急慢性并发症的发生，是糖尿病治疗的关键。健康教育是糖尿病综合治疗的重要组成部分，是关键中的关键。如果每个糖尿病病人都能得到良好的教育，遵从医嘱控制饮食、合理运动、按时服药、定期复诊以监测血糖及并发症情况从而及时调整治疗方案，那么糖尿病病情就可以得到有效地控制，这将会大大地减轻个人和社会的负担。糖尿病的健康教育在我们北大医院内分泌病房已开展多年，许多病人从中受益匪浅。为了进一步提高健康教育的质量和水平，并将糖尿病教育引向深入，我们于2003年初在病房试行糖尿病健康教育的专题专护，效果显著，现将具体做法介绍如下。     

联合起来战胜糖尿病(Unite for Diabetes)

全球现有两亿多糖尿病病人,他们中许多人还没有得到应有的关心和治疗。为此,今年(2006)世界糖尿病日的主题是:关爱每一个糖尿病人(Diabetes for Everyone)。为了实现这一目标,在今年华盛顿召开的美国糖尿病学会年会上,国际糖尿病联盟(IDF)号召各会员国加入开展“联合起来战胜糖     

脂肪激素与脂肪因子在能量代谢及相关疾病发病中的作用将是本世纪研究的热点--2005年美国糖尿病学会学术年会侧记

继今年4月国际糖尿病联盟(IDF)专家组提出的代谢综合征新定义建议强调腹型肥胖对2型糖尿病(T2DM)等代谢病的重要性之后[1],在刚闭幕的第65届美国糖尿病学会(ADA)学术年会上,将2005年美国糖尿病学术研究的最高成就奖Banting奖章授予了美国哈佛大学的DrFlier,奖励他30年来在胰岛素抵抗和肥胖分子机制以及分子病理生理方面的研究,特别是他领导的研究小组对能量平衡综合性研究的成就;2005年优秀学术奖授予了纽约爱因斯坦医学院的DrScherer,奖励他1995年先后发现脂联素(adiponectin/Acrp30)和抵抗素(resis tin)。DrFlier向大会作了题为“…     

中国门诊2型糖尿病患者口服药降糖达标状况调查及格列齐特缓释片优化治疗效果分析

Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.     

二甲双胍对脂肪肝作用机制的实验研究

目的观察胰岛素抵抗大鼠肝脏脂肪聚积和胆固醇调节元件结合蛋白-1(SREBP-1)表达并研究二甲双胍对脂肪肝的作用。方法分3组:设LETO大鼠为对照组,OLETF大鼠随机分为模型组和治疗组(二甲双胍每天100mg·kg-1)。于治疗后9,22周,测定肝组织甘油三酯含量;用WesterBlot方法测定肝脏SREBP-1蛋白表达水平;用定量PCR方法测定SREBP-1及参与其裂解的蛋白。结果与对照组比较,模型组大鼠肝组织甘油三酯含量增高,肝脏SREBP-1mRNA和蛋白表达水平升高,其靶基因脂肪酸合成酶(FAS)的mRNA表达增加。治疗后,与模型组比较,治疗组甘油三酯含量下降;治疗9周后,S1P和S2P mRNA水平下降;治疗22周后,肝脏SREB-1的mRNA表达水平下调。结论OLETF大鼠肝脏SREBP-1高表达,促进脂肪肝形成;二甲双胍可通过下调SREBP-1的表达,改善肝脏脂肪沉积。     

中国门诊2型糖尿病患者口服药降糖达标状况调查及格列齐特缓释片优化治疗效果分析

Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.     

碳酸酐酶生理功能的研究进展

碳酸酐酶(carbonic anhydrase,CA)是一族含锌酶.在哺乳动物中,几乎所有的组织均可检测到CA.CA至少有14种同工酶[1], 其结构、动力学性质、对抑制剂的敏感性、组织内的分布及亚细胞的定位均有不同,参与机体气体运输、酸碱调节和组织的分泌等面功能[1],在维持内环境的稳定方面发挥重要作用.