抑郁症患者的血糖、血脂水平及其与症状关系的对照研究

目的了解抑郁症患者糖脂代谢的情况及其与精神症状的关系。方法以HAMD17和HAMA评定92例近期未服用精神药物的抑郁症患者的精神症状,了解他们简易体质参数、测定其空腹血糖和血脂,并与60例健康者组成的对照组进行比较。结果抑郁症组的甘油三酯(TG)、空腹血糖(FBS)值显著高于对照组(P＜0．001),而高密度脂蛋白胆固醇(LDL—ch)、载脂蛋白A1(ApoA1)值显著低于对照组(P＜0．01)；血浆总胆固醇(TC)、高密度脂蛋白胆固醇(HDL—ch)和载脂蛋白B(ApoB)两组之间无显著性差异(P＞0．05)；相关分析发现,抑郁症患者的HAMA总分、精神性焦虑因子分以及躯体性焦虑因子分与TG水平呈正相关(P＜0．01或P＜0．05)。结论抑郁症患者存在一定的糖脂代谢异常,临床医师应该对抑郁症患者的血糖、血脂进行监测,以便早期发现,早期治疗。     

社区人群空腹血糖受损对估算肾小球滤过率的影响研究

背景 估算肾小球滤过率(eGFR)是反映慢性肾脏病严重程度的量化指标之一。研究表明糖尿病前期血糖升高可增加慢性肾脏病风险,但对eGFR直接影响报道较少。目的 探讨社区人群中空腹血糖(FPG)受损患者血糖水平对eGFR的影响。方法 选择2020年1—12月于南昌大学第二附属医院体检中心体检的人群,收集一般资料与临床资料(包括既往史、性别、年龄、体质指数、血压、尿酸、血脂、FPG、尿常规、血肌酐),经相应纳入标准与排除标准筛选,最终纳入28 601例受试者。根据FPG水平将受试者分为FPG升高组(5.6 mmol/L≤FPG<7.0mmol/L)、FPG正常组(3.9 mmol/L≤FPG<5.6 mmol/L),比较两组一般资料与临床资料。为明确FPG对e GFR影响,采用个案匹配控制对两组受试者进行多因素(性别、年龄、平均动脉压、尿酸、总胆固醇、体质指数)匹配,采用Mann-Whitney U秩和检验比较匹配后两组一般资料。采用Spearman秩相关检验分析FPG与eGFR在FPG升高组、FPG正常组及匹配后FPG升高组、FPG正常组间的相关性。结果 共获得FPG正常组患者...     

Dietary restriction: effects of short-term fasting on protein uptake and cell death/proliferation in the rat liver

Dietary restriction (DR) is known to prolong life in laboratory animals. Intermittent (alternate-day) fasting or short-term repeated fasting has also been reported to increase the life span of animals. In the present study, we investigated the changes or induction of abnormalities of protein metabolism in rats during fasting, and measured asialoglycoprotein uptake and cell death/proliferation in the liver of rats receiving fasting and refeeding. In the results, liver weight decreased significantly after 48 h of fasting and increased during the refeeding period, returning to the pre-fasting level by 12 h of refeeding. Cell death, determined by single stranded DNA (ssDNA) staining method, increased during the fasting period, and returned to the pre-fasting level during the refeeding period. Cell proliferation, determined using antibodies (Ab) against proliferating cell nuclear antigen, decreased during the fasting period, and increased during the refeeding period. Changes in cell death and cell proliferation were inversely related. However, there was no significant difference in asialoglycoprotein uptake by the whole liver between the ad libitum (AL)-fed rats and 48 h fasted rats. Thus, neither the changes in liver weight nor cell death/proliferation affected asialoglycoprotein uptake on a living body. These results suggest that episodes of 48 h fasting do not induce protein metabolism abnormalities in the liver.     

Fast-induced changes in plasma glucose, insulin and free fatty acid concentration compared in rats during the night and day

Changes in PG, PI and PFFA were examined and compared in fed rats or after 0 to 12 hours of fasting, during the night or during the day. At night, a progressive decrease in PG and PI and an increase in PFFA were induced by 0 to 12 hours of food deprivation. During the light period a decrease in PG occurred only from the 6th hour of fasting. A slight, progressive increase in PFFA levels was induced from 0 to 12 hours of fasting, while no significant variation of PI levels was observed. The results are discussed in terms of relationships between blood glucose, PFFA levels, and food intake in control rats over the circadian cycle.     

急性胰腺炎患者空腹高血糖发生率及其危险因素分析

目的:回顾性分析急性胰腺炎(AP)患者空腹高血糖发生率及其危险因素。方法:收集2018-01—2018-12武汉大学人民医院胰腺外科133例AP且无糖尿病(DM)病史的住院患者病历资料,按照不同性别、年龄、AP临床分型、病因、CT指数评分(CISI)等分组,χ2检验分析各组临床因素与空腹高血糖(FPG≥6.1mmol/L)发生率的关系,多因素二元logistic回归分析空腹高血糖独立危险因素。结果:AP临床分型(χ2=5.494,P=0.019)和CTSI(χ2=6.236,P=0.013)与AP患者空腹高血糖相关(P<0.05)。CTSI≥6分(P=0.015,OR=2.920,95%Cl=1.234—6.905)为AP患者空腹高血糖的独立危险因素(P<0.05)。结论:临床分型中重症+重症及CTSI≥6分的AP患者易发生空腹高血糖,尤其CTSI≥6分是AP后空腹高血糖的独立危险因素,临床应高度关注。     

The metabolic response to prolonged walking in fed and fasted men

Summary Six healthy men walked 37 km (23 miles) per day over a 3-lap course for each of 4 consecutive days. Subjects were allowed breakfast and an unrestricted diet was consumed after completion of the walk, but no food was consumed during or between laps. At a later date the same subjects walked over the same course after an overnight fast and without breakfast. Completion time for each lap was 139±1 min (mean ±SE) and exercise intensity was equivalent to 17±1% . Mean 24h energy intake was 14.5±0.8 MJ during the fed walk. Estimated daily energy expenditure was 12.0 MJ. Blood glucose concentration fell significantly on the first, third and fourth days of the fed walk, but no subject became hypoglycaemic. Glucose concentration did not fall during the fasted walk and was significantly higher pre-exercise and at the end of laps one and three when compared to the first day of the fed walk. Blood alanine concentration fell significantly after the end of the first lap of each day of the fed walk but not during the fasted walk. Blood lactate levels did not change during the course of either walk. Plasma free fatty acid, glycerol and blood 3-hydroxybutyrate concentrations were unchanged during the passage of the first lap on each day of the fed walk, but all three had increased significantly by the end of the first lap of the fasted walk. The elevations from rest to the end of each day's walking for these three metabolites were of similar magnitude when comparing each day of the fed walk and the fed and fasted walks. The present experiment indicates that feeding a mixed diet can affect the pattern of substrate mobilization in a similar manner to that seen during more strenuous exercise. It also appears that the pattern of fuel substrate mobilization is very similar from one day to the next providing dietary intake is similar.     

糖化血红蛋白、空腹及服糖后2小时胰岛素水平与高血压发病风险的前瞻性研究

目的 探讨糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、空腹胰岛素(Fasting insulin,INS)及服糖后2小时胰岛素(Insulin 2 hours after oral glucose tolerance test,INS-2H)与高血压发病的风险。方法 本研究采用全人群多阶段整群随机抽样方法,抽取了贵州省12个区(县)的48个乡镇共9 280人进行调查,排除基线HbA1c、INS及INS-2H缺失及有高血压病史者,最终纳入1 684例进入分析。中位随访6.23年。采用Cox生存回归分析HbA1c、INS及INS-2H与高血压发病的相关性。PAF及Survival计算人群归因危险百分比。结果 HbA1c和INS-2H每升高一个单位,高血压发病风险分别增加31.5%和1.1%。HbA1c高水平组发病风险是低水平组的2.87倍。相比第一分位组,INS-2H第四分位组发病风险增加73.6%。HbA1c水平控制在6.3 mmol/L及以下可降低人群8.6%的发病。INS-2H水平分别控制在8.81 mIU/L、15.60 mIU/L、24.30 mIU/L以下,可降低人群22.6%、11.9%和6.8%的发病。年龄>42岁组的人群中,HbA1c高水平组发病风险是低水平组的2.84倍; INS-2H第二、三、四分位组发病风险分别是第一分位组的2.001倍、2.145倍和2.145倍。男性人群中,HbA1c高水平组发病风险是低水平组的2.760倍; INS-2H第三、四分位组发病风险是第一分位组的1.828倍和2.116倍。结论 HbA1c及INS-2H是高血压发病的危险因素,在年龄>42岁和男性人群更为敏感。控制HbA1c及INS-2H能有效降低人群高血压发病。     

老年糖尿病患者运动状况及血糖控制情况研究

目的 研究老年糖尿病患者运动状况及血糖控制情况。方法 以2020年1月至2021年12月商丘市某医院诊治的老年糖尿病患者为研究对象,自制调查问卷获取患者的基本资料（包括性别、年龄、文化程度、居住地、病程、糖尿病并发症和其他基础疾病）,采用老年糖尿病患者运动锻炼评估量表评估运动状况,采用血生化指标检测评估血糖控制达标情况,分析老年糖尿病患者运动状况、血糖控制达标情况及其影响因素。结果 共纳入有效研究对象1 173例,其中男645例（54.99%）,年龄60~84岁,以60~69岁为主（45.69%）,文化程度以初中及以下为主（51.66%）,居住地以农村为主（56.61%）,病程以<5年为主（65.47%）,无糖尿病并发症者占90.88%,无其他基础疾病者占79.71%。血糖控制达标389例,达标率33.16%。运动状况总分（114.39±; 20.53）分,血糖未达标患者的运动状况总分及运动知识、运动行为、专业支持维度评分均显著低于血糖达标患者（均P<0.01）。多因素Logistic回归分析结果显示,病程（OR=0.689）、糖尿病并发症（OR=0.498）、其他基础疾病（OR=0.842）是老年糖尿病患者血糖达标的影响因素。结论 老年糖尿病患者运动状况有待改善,应针对不同情况的老年糖尿病患者进行个体干预,通过宣传教育提高运动知识认知及运动意愿,改善运动行为,增强运动锻炼的社会支持和专业支持,以促进血糖达标。     

甘油三酯、空腹血糖及甘油三酯葡萄糖乘积指数与高血压发病风险的前瞻性队列研究

目的探讨TG、FPG及TG葡萄糖乘积指数(TyG)与高血压发病间的关系,为人群高血压的防治提供基础数据。方法以金昌队列中符合研究标准的23581人作为研究对象,运用Cox比例风险模型研究TG、FPG及TyG与高血压发病风险间的关系,并按性别进行分层分析。结果在调整混杂因素后,与正常TG组相比,总人群中TG边缘升高组和升高组的HR值(95%CI)分别为1.16(1.01~1.34)和1.49(1.30~1.70),男性中分别为1.13(1.01~1.27)和1.17(1.06~1.30),女性中分别为1.05(0.88~1.26)和1.06(0.88~1.28);与正常FPG组相比,总人群中空腹血糖受损组的HR值(95%CI)为1.29(1.13~1.48),男性中为1.26(1.08~1.48),女性中为1.59(1.14~2.21);以最低四分位数组为参照,总人群中TyG的最高四分位数组的HR值(95%CI)为1.73(1.45~2.07),男性中为1.32(1.14~1.53),女性中为1.87(1.37~2.54)。TG、FPG与高血压发病风险间呈非线性的剂量反应关系,TyG与高血压发病风险线性相关。结论较高的TG、FPG、TyG是高血压发病的独立危险因素,TG、FPG及TyG较高的人群为高血压的高危人群,在高血压防治中应予以重视。