精神分裂症患者治疗过程中Hcy水平与血糖、血脂水平的关系

目的探讨精神分裂症患者治疗过程中同型半胱氨酸水平与糖脂代谢变化的关系。方法选择2018年1～12月在我院诊断治疗的精神分裂症患者35例为研究对象,根据Hcy水平分为Hcy正常组(19例)与Hcy升高组(16例)。比较两组入组时与治疗4周后FBG、2hPBG、TG、TC水平,分析治疗后Hcy水平与FBG、2hPBG、TG、TC的相关性。结果入组时,Hcy升高组FBG、2hPBG、TG、TC水平高于Hcy正常组,差异有统计学意义(P0.05);Hcy升高组治疗4周后FBG、2hPBG、TG、TC水平高于入组时及对照组,差异有统计学意义(P0.05);治疗4周后Hcy正常组FBG、2hPBG、TG、TC水平与入组时比较差异无统计学意义(P0.05)。Hcy水平与FBG呈正相关(r=0.835)。Hcy水平与2hPBG呈正相关(r=0.857)。Hcy水平与TG呈正相关(r=0.883)。Hcy水平与TC相关(r=0.899)。结论精神分离症患者合并Hcy升高在治疗过程中对糖脂代谢影响大,在临床工作中,对精神分裂症患者治疗过程中应积极监测Hcy水平,以指导治疗,评估预后。     

Impact of Food Intake on Liver Stiffness Determined by 2-D Shear Wave Elastography: Prospective Interventional Study in 100 Healthy Patients

The aim was to evaluate the influence of food intake on liver stiffness measurement (LSM), performed with 2-D shear wave elastography (Logiq E9, GE Medical Systems, Wauwatosa, WI, USA). One hundred healthy volunteers were prospectively enrolled. Mean age was 25.8 (19–55) y, and mean body mass index was 22.43 (17.3–30.8) kg/m². Patients fasted for at least 3 h and subsequently ingested a liquid meal of 800 kcal. Liver stiffness and portal vein velocity were measured before and after food intake. Food intake resulted in significantly higher LSM values compared with baseline LSM (5.74 ± 0.94 kPa vs. 4.80 ± 0.94 kPa, p < 0.001). On multiple linear regression analysis, body mass index was significantly positively correlated with the LSM increase after food intake (p?=?0.01). No correlation between the increase in LSM and the increase in post-prandial portal vein velocity was observed (r?=?0.09). In summary, food intake has a significant influence on LSM. There is an 11% risk of misclassifying non-fasting, healthy patients as having significant fibrosis.     

妊娠期糖尿病患者血糖控制与妊娠结局的关系

目的探究妊娠期糖尿病(GDM)患者血糖控制与妊娠结局的关系。方法2017年12月—2019年12月间对该院65例GDM患者的病历资料做回顾性分析,并随机选取30名正常妊娠的孕妇作为健康对照组,GDM患者均给予常规治疗,依据血糖控制情况分为达标组及未达标组,血糖达标以美国糖尿病协会制定的血糖控制目标为标准,分别比较3组对象及围产儿并发症发生情况。结果3组对象分娩前FBG、2 hPG、HbAlc水平比较差异有统计学意义(F=36.100、37.634、48.209,P<0.05);达标组羊水过多、胎膜早破、妊娠期高血压、酮症酸中毒发生率分别为(5.45%、7.27%、5.45%、9.09%)均较未达标组的(60.00%、50.00%、60.00%、70.00%)更低,差异有统计学意义(χ²=21.104、12.950、19.059、20.854,P<0.05),与健康对照组比较差异无统计学意义(P>0.05),3组产后感染、产后出血、剖宫产发生率比较差异无统计学意义(P>0.05);达标组巨大儿、新生儿窒息、新生儿低血糖、胎儿窘迫发生率分别为(7.27%、5.45%、3.64%、1.82%)均较未达标组的(60.00%、50.00%、40.00%、40.00%)更低,差异有统计学意义(χ²=18.071、15.557、9.366、12.412,P<0.05),与健康对照组比较差异无统计学意义(P>0.05),3组早产儿发生率比较差异无统计学意义(P>0.05)。结论GDM患者血糖水平控制情况与其妊娠结局及围产儿并发症具有密切关系。     

Fasting glucose and its association with 20-year all-cause and cause-specific mortality in Chinese general population

ObjectiveThe aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population.MethodsThe role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up. Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality.ResultsThere were 1471 deaths after a median follow-up of 20.2 years (a total of 187,374 person-years), including 310 cardiovascular deaths, 581 cancer deaths, and 580 other-cause deaths. After adjustment for age, sex, urban or rural, northern or southern of China, types of work, education level, physical exercise, smoking status, drinking status, body mass index, systolic blood pressure, and serum total cholesterol at baseline, the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in the fasting blood glucose categories of <60, 60–69, 70–79, 90–99, 100–109, 110–125, and ≥126 mg/dl were 1.38 (1.04–1.84), 1.20 (1.01–1.43), 1.18 (1.03–1.36), 1.18 (0.99–1.41), 1.48 (1.16–1.88), 1.17 (0.84–1.62), and 2.23 (1.72–2.90), respectively, in contrast to the reference group (80–89 mg/dl). The HRs and 95% CIs for cardiovascular disease mortality in these groups were 2.58 (1.44–4.61), 1.41 (0.95–2.10), 1.56 (1.15–2.11), 1.29 (0.88–1.89), 1.36 (0.78–2.37), 1.05 (0.52–2.11), and 2.73 (1.64–4.56), respectively.ConclusionsBoth low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.     

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults

Background and aimsSome amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults.Methods and resultsA cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk.ConclusionSerum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.     

The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis

BackgroundFasting and energy restricting diets have a potential means of delaying or preventing the onset of a range of age-related metabolic and neoplastic diseases. Consistently at the centre of this effect appears to be a significant reduction in circulating IGF-1 levels. The aim of the current systematic review and meta-analysis was to determine the influence of fasting and energy restriction on IGF-1 levels in human subjects.MethodsA comprehensive systematic search was conducted from onset of the database to February 2019 in Embase, MEDLINE/PubMed, and SCOPUS to identify randomized clinical trials that investigating the impact of fasting or energy restriction circulating IGF-1 levels. Effect size was reported as weighted mean difference (WMD) and 95% confidence intervals (CI) using a random-effects models. Subgroup analysis was performed to identify the probable source of heterogeneity among trials.ResultsTotal pooling of fasting and energy restriction randomised controlled trials in WMD analysis revealed no significant effect on circulating IGF-1 levels (WMD: −16.41 ng/ml, 95% CI: −35.88, 3.07). Sub grouped analysis fasting regimens appeared to substantially reduce IGF-1 (WMD: -28.87 ng/ml, 95% CI: −43.69, −14.05, I² = 00%), energy restricting regimens failed to do the same (WMD: -10.98 ng/ml, 95% CI: −33.08, 11.11, I² = 90%). Within this final subgrouping, it was observed that only energy restriction regimens of 50% or greater of normal daily energy intake were capable of significantly reducing IGF-1 levels (WMD: -36.57 ng/ml, 95% CI: −59.19, −13.95, I² = 00%). Finally, a meta regression were noted in which the percentage restriction of daily energy intake inversely correlated with plasma IGF-1 levels (p = 0.04).ConclusionThis study uncovered that fasting significantly reduced levels of IGF-1, while energy restriction diets were successful only when intake was reduced by 50% or more.     

影响脑梗死功能结局的危险因素

目的 探索影响脑梗死功能结局的危险因素。 方法 回顾性分析594例脑梗死患者的临床资料,并与年龄、性别相匹配的351例健康者相对照。比较两组人口统计学、既往史和临床实验室指标,并采用非条件 logistic 回归进行多因素分析,了解影响脑梗死功能结局的危险因素。 结果 同型半胱氨酸、脂蛋白a、空腹血糖、入院时的收缩压和高血压史是影响脑梗死功能结局的独立危险因素。 结论 临床应及早控制引起脑梗死预后不良的危险因素,以减轻、防止不良的功能结局和预防脑梗死的再发。     

Contributions of A1c,fasting plasma glucose,and 2-hour plasma glucose to prediabetes prevalence: NHANES 2011–2014

Purpose

Our goal was to characterize the contributions of A1c, fasting plasma glucose, and 2-hour plasma glucose to prediabetes prevalence and to characterize how those contributions differ among U.S. population subgroups.