人新饱食分子蛋白1在妊娠期代谢异常中的研究进展

人新饱食分子蛋白1(Nesfatin-1)是一种分泌性肽,与抑食功能有关,但其作用机制尚未完全阐明。国内外学者研究发现,Nesfatin-1不仅影响抑食功能,还参与能量代谢。目前,Nesfatin-1在2型糖尿病、代谢综合征、妊娠期糖尿病及摄食行为中的研究较多,而在妊娠期代谢异常等方面涉及甚少。该文就Nesfatin-1在妊娠期代谢异常的研究进展作一综述。     

妊娠期糖尿病孕妇血糖和体重控制情况研究

目的探讨系统化血糖及体重控制对妊娠期糖尿病孕妇妊娠结局的影响。方法选择2018年1月-2019年1月中山大学附属第三医院粤东医院收治的100例妊娠期糖尿病孕妇作为研究对象,按护理方式的不同分为观察组和对照组各50例。对照组接受常规治疗及饮食指导干预,观察组在对照组基础上进行系统化血糖和体重控制干预。比较两组孕妇餐前空腹血糖、体重控制情况及母婴并发症发生情况。结果观察组孕妇的血糖及体重控制情况优于对照组,且观察组孕妇及围生儿并发症的发生率低于对照组,差异均有统计学意义(P<0.05)。结论接受系统化血糖及体重控制的妊娠期糖尿病孕妇取得的效果较好,其血糖和体重指数控制较好,母婴并发症少,具有临床推广价值。     

Influence of sodium-glucose Co-transporter 2 inhibitors on clinical and biochemical markers of dehydration during the Holy Ramadan

Background and aimsAlteration of the hydration status with the use of sodium-glucose co-transporter- 2 inhibitors (SGLT2i) during the Holy Ramadan has not been studied in depth. Precisely, we aimed to detect the potential alteration of hydration status in adult Muslims with type 2 diabetes mellitus (T2D) who used SGLT2i during Ramadan.MethodsAn observational non-interventional study included 245 patients with type 2 diabetes mellitus of matched age and sex. The study included 3 groups: empagliflozin group; 87 patients, dapagliflozin group; 85 patients and control group; 73 patients without the use of SGLT2i. Participants in each group were well-settled on their medications for more than 3 months before the onset of Ramadan. Clinical and biochemical parameters of hydration status were evaluated during the last week of Ramadan.ResultsWe noticed a higher prevalence of orthostatic dizziness and postural hypotension among SGLT2i users than non-SGLT2i users (p < 0.001). The mean arterial blood pressure was significantly lowered among users of empagliflozin and dapagliflozin than non-SGLT2i users; 93.7 ± 5.1 and 93.1 ± 6.9 versus 106.2 ± 4.3, p < 0.001, respectively. Moreover, patients who used empagliflozin or dapagliflozin exhibited significantly higher values of urine specific gravity; 1029.6 ± 1.5 and 1029.1 ± 1.6 versus 1016.9 ± 4.4, p < 0.001, serum osmolality; 300.7 ± 10.2 and 297.8 ± 8.9 versus 290.9 ± 6.7, p < 0.001, and BUN/creatinine ratio; 24.1 ± 4.1 and 23.2 ± 4.6 versus 16.3 ± 4.2, p < 0.001 than non-SGLT2i users.ConclusionSignificant clinical and biochemical markers of dehydration were noticed among users of SGLT2i during the Holy Ramadan.     

Calorie restriction for enhanced longevity: The role of novel dietary strategies in the present obesogenic environment

Calorie restriction (CR) is a potent modulator of longevity in multiple species. A growing body of evidence shows that sustained periods of CR without malnutrition improves risk factors involved in the pathophysiology of type 2 diabetes, cardiovascular diseases, cancer, and neurological disorders in humans. Innovative dietary strategies such as intermittent fasting and protein restriction have recently emerged as alternative approaches that improve markers of aging. Some of these newer strategies might provide benefits for healthy aging with little to no CR and therefore, compared to traditional CR, may be easier to follow. Further to providing an update of CR studies in humans, the present narrative review appraises the influence of these contemporary dietary strategies on mechanisms posited to drive CR-induced longevity in humans, including those involving energy metabolism, oxidative damage, inflammation, glucose homeostasis, and functional changes in the neuroendocrine systems. The review also discusses the utilization of these diets for populations in the current obesogenic environment, and comments on whether current research can inform an optimal diet that attenuates aging, can be easily followed, and promises to improve longevity in humans.     

强化血糖控制对胰腺癌合并糖尿病患者术后血糖变异性的影响

目的 探讨强化血糖控制对胰腺癌合并糖尿病患者术后血糖变异性的影响。方法 选取2019年1月-2020年1月我院普通外科研究所收治的90例胰腺癌行胰十二指肠切除术后患者为研究对象，随机分为对照组和试验组各45例,对照组给予常规模式护理，试验组在对照组基础上给予强化血糖控制干预，比较两组患者初始血糖值、平均血糖值、血糖标准差及血糖变异系数。结果 两组初始血糖值相比较，差异无统计学意义（P＞0.05）。与对照组相比较，强化血糖控制后平均血糖值[(8.03±1.12)vs(8.80±1.58)]、血糖标准差[(1.730.93)vs(2.16±0.71)]、血糖变异系数[(20.72±10.04)vs(24.88±7.63)]均降低，试验组患者血糖控制水平明显优于对照组（P<0.05）。结论 强化血糖控制能有效改善胰腺癌合并糖尿病患者术后血糖水平，保障患者安全，改善预后，促进康复。     

Deficient glucose uptake is linked to impaired Glut1 expression upon CD3/CD28 stimulation in memory T cells from pleural effusions secondary to lung cancer

Glucose and nutrient uptake is essential in supporting T cell activation and is increased upon CD3/CD28 stimulation. As T cells from pleural effusions secondary to lung cancer show impaired function, we hypothesized that these cells might have altered expression of nutrient transporters. Here, we analysed by flow cytometry the expression of the transferrin receptor CD71, amino acid transporter CD98 and glucose transporter Glut1 and glucose uptake in pleural effusion‐derived T cells from lung cancer patients, after stimulation via CD3/CD28 under normoxia or hypoxia (2% O₂). We compared the response of T cells from pleural effusions secondary to lung cancer with that of T cells from nonmalignant effusions. In memory T cells from both groups, anti‐CD3/CD28‐stimulation under normoxia upregulated CD98 and CD71 expression (measured as median fluorescence intensity, MFI) in comparison with anti‐CD3‐stimulation. Costimulation under hypoxia tended to increase CD98 expression compared to CD3‐stimulation in memory T cells from both groups. Remarkably, in the cancer group, memory T cells stimulated via CD3/CD28 under hypoxia failed to increase CD71 and Glut1 expression levels compared to the cells receiving anti‐CD3 stimulation, a phenomenon that contrasted with the behaviour of memory T cells from nonmalignant effusions. Consequently, glucose uptake by memory T cells from the cancer group was not increased after CD3/CD28 stimulation under hypoxia, implying that their glycolytic metabolism is defective. As this process is required for inducing an antitumoural response, our study suggests that memory T cells are rendered dysfunctional and are unable to eliminate lung tumour cells.