Elimination kinetics of Lipofundin MCT: bolus injection and infusion compared

Fifteen healthy young probands (nine males, six females) underwent an intravenous fat tolerance test (IVFTT) and, on the following day, a fat infusion lasting 6 hr. The emulsion tested was Lipofundin MCT 10%. One half of its triglyceride mass contains medium chain fatty acids. The IVFTT was started by injection of 0.1 g lipid per kg body weight into the fasting proband. Lipid elimination was estimated by measurement of light-scattering intensity of serum samples collected during a 60-min period. Individual fraction elimination rate constants covered a considerable range (K2 = 8.84 +/- 3.45%/min). The infusion test was performed at a rate of 0.1 g lipid per kg body weight and hr and lasted 6 hr. Serum triglyceride concentrations were determined enzymatically. They increased from 0.941 +/- 0.285 mmol/liter at the fasting state to a plateau level of 1.753 +/- 0.306 mmol/liter during infusion, and returned to initial levels 1 to 2 hr after the infusion was terminated. Individual triglyceride increments during infusion were significantly correlated with half-life periods of lipid elimination during IVFTT (r = 0.792, p less than 0.001). This relationship was derived using a model of the stationary state during infusion. We conclude that elimination kinetics of exogenous fat given either as bolus or infusion are ruled by the same fractional elimination rate constant K2. The IVFTT provides an estimate of the stationary triglyceride increment during a lipid infusion lasting several hr.     

Elimination and metabolism of a fat emulsion containing medium chain triglycerides (lipofundin MCT 10%)

Medium chain triglycerides (MCT) are supposed to be advantageous on account of rapid energy supply in parental nutrition. However, data on the elimination rate of MCT-containing emulsions during an intravenous fat-tolerance test (IVFTT) are scarce. We performed this test (0.1 g lipid/kg body weight) in 18 young healthy volunteers (nine females and nine males) using Lipofundin MCT 10% (50% MCT; egg phospholipids as emulsifier). Our results indicate that both elimination and metabolization of the emulsion are fast: a prompt decrease of light-scattering index and of triglyceride concentrations in serum, an immediate appearance of post-load fatty acids and of beta-hydroxybutyrate were observed. This was in good agreement with the findings obtained during 6-hr infusions in the same probands. Fractional elimination rates k2 obtained from light-scattering indices are 7.29 +/- 2.73%/min in males and 11.59 +/- 3.38%/min in females, indicating a higher removal capacity in women. In the same subjects, the corresponding k2 values for Lipofundin S 10% (containing only long chain triglycerides) were higher, reflecting an elimination rate that is faster due to the use of soya bean phospholipids as emulsifier. In comparison, k2 values based on the course of the triglyceride concentrations are generally lower.     

北京社区体检人群餐后与空腹血脂水平的比较分析及意义

目的:探讨非空腹血脂异常判定标准在北京社区人群中应用的可行性。方法:采用自身对照研究。中国中医科学院广安门医院检验科于2018年1至10月招募社区体检者839名（男性292名,女性547名）,年龄中位数（四分位间距）为60（54, 66）岁,同时检测空腹和标准餐后4 h血脂谱水平,采用配对 t检验或者配对非...     

Ethanol elimination in the anesthetized dog: intragastric versus intravenous administration

We computed by linear kinetics predicted equilibrated plasma concentrations, elimination parameters and availability of ethanol for fasting anesthetized dogs who received the same dose (11 mmol/kg) of ethanol twice, once intragastrically and once intravenously. Agreement between predicted (y) and observed (x) equilibrated plasma levels above 3 mmol/l was for intragastric ethanol y = 0.031 + 1.008x (r = 0.973) and for intravenous ethanol y = 0.2 + 0.99x (r = 0.992). Linear elimination (elimination rate, clearance, time of disappearance of half the dose) was significantly slower and Widmark's ratio r was significantly greater for intragastric than for intravenous ethanol. Apparent availability of intragastric ethanol, computed by dividing the intragastric by the intravenous plasma ethanol concentration at zero time (both values extrapolated from the linear portion of the blood alcohol curve), was 0.739 +/- 0.125. Considerable ethanol residuals were present in the stomach four hours after intragastric instillation. We conclude that retention of ethanol in the stomach, probably because of anesthesia, created the apparent differences in elimination of ethanol between intragastric and intravenous administration. Despite gastric retention, decrease of ethanol levels was linear above 3 mmol/l after intragastric instillation.     

三酰甘油与青年冠状动脉粥样硬化病变关系的研究

目的 探讨三酰甘油(TG)对青年冠心病患者冠状动脉狭窄严重程度及病变血管范围的影响.方法 对行经皮冠状动脉介入治疗(PCI)的93例青年冠心病患者(<45岁)的临床资料进行回顾性分析.按TG测定结果分为I组(TG<1.70 mmol/L,36例)、Ⅱ组(1.70 mmol/L≤TG≤2.25mmol/L,19例)、Ⅲ组(TG>2.25mmol/L,38例),对比各组冠状动脉狭窄严重程度及病变血管范围的差异.结果 93例患者中男性占94.62%(88/93)、吸烟者占83.87%(78/93).III组的总胆固醇、非高密度脂蛋白胆固醇明显高于I组(P=0.006、0.003),三组间低密度脂蛋白胆固醇、高密度脂蛋白胆同醇及空腹血糖比较差异无统计学意义(P=0.648、0.795、0.247).三组患者的冠状动脉病变血管范围、狭窄严重程度比较差异无统计学意义(P=0.241、0.879).结论 高TG血症对青年冠心病患者冠状动脉狭窄严重程度及病变血管范围无影响,不是冠心病患者病情严重程度的决定性因素.     

广州某百货公司员工血脂异常情况分析

目的 了解广州某百货公司员工血脂异常情况及其影响因素,为有针对性地进行健康教育提供依据。 方法 检测参与体检的该公司员工空腹血脂水平,收集性别、年龄、体质量指数(BMI)及吸烟、饮酒、饮食等生活行为方式信息,对相关资料进行统计学分析。 结果 611名体检者总体血脂水平:总胆固醇(5.04 ±0.87) mmol/L、甘油三酯(1.36 ±1.25) mmol/L、低密度脂蛋白胆固醇(2.86 ±0.67) mmol/L、高密度脂蛋白胆固醇(1.35 ±0.29) mmol/L。员工血脂异常率为53.4%,对血脂异常的知晓率为2.8%。相比于女性、年龄小(19~39岁)、BMI<24.0、不吸烟,男性、年龄大(≥ 40岁)、BMI ≥ 24.0、吸烟均为血脂异常的危险因素(OR=1.968、1.870、2.210、3.775,P均<0.05)。该公司保安甘油三酯水平高于行政人员和营业员,高密度脂蛋白胆固醇水平低于营业员和行政人员,差异均有统计学意义(P<0.05)。保安的血脂总体异常率高于营业员和行政人员,高胆固醇血症发生率低于营业员和行政人员,高甘油三酯血症、低高密度脂蛋白血症发生率高于营业员和行政人员,差异均有统计学意义(P<0.05/3)。 结论 该公司血脂异常患病率较高,知晓率低,提示社会人群血脂异常现象可能较为严重。应向患者及全社会人员加大健康宣传力度。     

Boys from populations with high-carbohydrate intake have higher fasting triglyceride levels than boys from populations with high-fat intake

Experimentally, high-carbohydrate diets have been shown to elevate triglycerides, but it has not been established whether this rise is permanent or transient. The authors approached this question by studying 719 boys from worldwide populations with marked differences in long-term carbohydrate intake. Fasting serum triglycerides, total cholesterol and high density lipoprotein (HDL) cholesterol concentrations were measured in boys aged 8 and 9 years from 12 countries--eight in Europe, three in Africa, and one in Asia. A standardized protocol was used for obtaining fasting blood and for the preparation, storage and transport of serum, and all measurements were made in one laboratory. Published values were used for the United States. Mean values for lipid levels per country were compared with the percentage of daily energy intake consumed as carbohydrate or fat, as determined by survey. Boys from populations with higher carbohydrate and lower fat intake had lower low density lipoprotein (LDL) cholesterol levels (univariate regression coefficient (+/- standard error, -0.028 +/- 0.009 mmol/liter for each percent of energy from carbohydrate; p less than 0.01, n = 13), but they also had higher fasting triglycerides (0.010 +/- 0.002 mmol/liter for each percent of energy from carbohydrate; p less than 0.01, n = 13) and lower HDL cholesterol levels (-0.022 +/- 0.003 mmol/liter for each percent of energy from carbohydrate; p less than 0.001, n = 13). These trends agree with results from epidemiologic studies within populations and from controlled dietary trials, and suggest that in normolipidemic healthy subjects, high-carbohydrate, low-fat diets cause higher triglyceride levels than diets that are higher in fats and oils.     

指尖毛细血管空腹血糖筛查糖尿病和糖尿病前期的切点及应用

目的 探讨指尖毛细血管空腹血糖(指尖FPG)筛检社区45岁以上人群糖尿病和糖尿病前期[空腹血糖受损(IFG)、糖耐量低减(IGT)]的切点,为人群普查提供依据.方法 随机整群抽取保定市3个社区,以社区内45岁以上居民3250人为筛查对象.对指尖FPG≥5.1 mmol/L者进行75 g口服葡萄糖耐量试验(OGTT),测空腹血糖及服糖2 h静脉血浆血糖(2hPG),诊断糖尿病和糖尿病前期.应用受试者工作(ROC)曲线确定糖尿病及IFG、IGT的切点,判断诊断价值.结果 检出糖尿病230例(7.3%),IFG 166例(5.2%),IGT 204例(6.7%);以指尖FPG为测试变量,以是否FPG≥7.0 mmol/L及或2hPG≥11.1 mmol/L为说明变量ROC曲线分析,曲线下面积为0.905,最佳切点为6.0 mmol/L,最大灵敏度和特异度分别是78.0%和89.3%;以是否FPG<5.6 mmol/L、是否FPG<7.0 mmol/L及7.8 mmol/L≤2hPG≤11.1 mmol/L为说明变量ROC曲线分析,曲线下面积分别为0.633、0.719,最佳切点均为5.7 mmol/L,灵敏度和特异度均较低(50.3%、28.0%;60.8%、28.0%).结论 用指尖FPG 6.0mmol/L为切点筛查45岁以上人群糖尿病,相对可靠;但指尖FPG筛查IFG、IGT不可靠.指尖FPG筛查社区人群简便、快捷,有一定的应用意义.     

Adult male all-cause, cardiovascular and cerebrovascular mortality in relation to ethnic group, systolic blood pressure and blood glucose concentration in Trinidad, West Indies

In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, age-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and mean of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks of all-cause, cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the associations were U-shaped. No ethnic differences were apparent in relative risks. For systolic pressure, mortality from all-causes and cardiovascular diseases respectively were about two and three times higher at 180 mmHg or more than at pressures below 130 mmHg. For blood glucose, all-cause and cardiovascular mortality were about four times higher at fasting concentrations greater than 7.7 mmol/l than in the lowest risk group (4.2-4.6 mmol/l). All-cause population attributable mortality rates for systolic pressures of 130 mmHg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus.     

广东省≥15岁居民血脂异常分布特征及影响因素

目的了解广东省≥15岁居民血清胆固醇、甘油三脂、高密度脂蛋白的水平、分布及相关影响因素。方法运用多阶段整群随机抽样方法,抽取广东省大城市、中小城市、2类农村各3个区(县),1类农村4个县,每个县(区)抽取3个街道(乡)、6个居委,共540户进行体格检查和血脂测定。用面对面询问调查获得15岁及以上居民个人基本情况,体检获取体重、身高数据;血脂采用酶法进行检测,使用Saturno 300生化分析仪和日立7060自动生化分析仪进行测定。结果共调查5 260人,甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)均值分别为1.13 mmol/L、4.27 mmol/L和1.31 mmol/L,年龄校正的均数分别为0.81 mmol/L、3.15 mmol/L和1.00 mmol/L。TG均值城市高于农村(P<0.05),随着年龄的增加而上升(P<0.05)。TC、HDL-C均值女性高于男性,城市高于农村(P<0.05)。血脂异常率为23.3%,其中高TG、高TC和低HDL-C的患病率分别为12.0%、8.1%和8.0%,年龄标化率分别为9.4%、5.9%和7.9%。高TG患病率男性高于女性,城市高于农村(P<0.05),随着年龄的增加有上升趋势(P<0.05)。高TC患病率城市高于农村(P<0.05),随着年龄的增加有上升趋势(P<0.05)。低HDL-C患病率女性低于男性(P<0.05)。年龄是高TG、TC的危险因素;超重肥胖是高TG、高TC和低HDL-C的危险因素;饮酒是高TG、高TC的危险因素,但是低HDL-C的保护因素;中等收入是高TG、高TC血症的危险因素,高收入对低HDL-C血症是保护因素。结论广东省居民血脂异常率较高,年龄、超重肥胖、饮酒和家庭经济收入是血脂异常的主要影响因素。     

Postprandial lipemia and chylomicron clearance in athletes and in sedentary men

To examine the effects of exercise on postprandial serum triglyceride (TG) metabolism, we measured oral and intravenous fat tolerance and chylomicron-TG half-life in highly trained endurance athletes and in a sedentary control group matched for body weight and fasting serum TG concentration. Postprandial lipemia was lower in athletes after meals containing 40 g fat (1.5 +/- 0.7 vs 2.6 +/- 1.5 mmol.L-1.8 h-1, p less than 0.001) or 140 g fat (2.5 +/- 1.2 vs 6.1 +/- 1.9 mmol.L-1.8 h-1, p less than 0.001). The disappearance of an intravenous bolus of Intralipid was faster in athletes (5.4 +/- 1.2%/min) than in sedentary men (4.3 +/- 0.8%/min, p less than 0.01). The half-life of chylomicron-TG was shorter in athletes (3.0 +/- 0.8 min) than in sedentary men (4.0 +/- 1.0 min, p less than 0.05). These findings indicate that chronic exercise decreases postprandial lipemia by reducing chylomicron-TG's half-life. This effect is due partly to reduced fasting serum TG pool size and partly to a direct effect of exercise on the serum TG removal system.     

二甲双胍联合利拉鲁肽对糖尿病患者心血管作用的研究

目的 探讨二甲双胍联合利拉鲁肽对2型糖尿病（T2DM）患者心血管的作用.方法 选取60例T2DM患者,按随机数字表法分为试验组和对照组,每组30例.对照组患者继续进行饮食以及运动控制,并且其原磺脲类药物治疗方案也继续进行.试验组在对照组治疗基础上应用二甲双胍联合利拉鲁肽治疗.治疗3个月,比较两组治疗前后甘露糖结合凝集素（MBL）、超敏C反应蛋白（hs-CRP）、空腹血糖、糖化血红蛋白（HbA1c）、体质量指数（BMI）、空腹胰岛素、三酰甘油（TG）、总胆固醇（T℃）、高密度脂蛋白胆固醇（HDL-C）以及低密度脂蛋白胆固醇（LDL-C）的变化.结果 两组患者治疗后MBL、hs-CRP、空腹血糖、空腹胰岛素、HbA1c、BMI、TC、TG、LDL-C水平均较治疗前有所降低,HDL-C水平有所升高,且试验组较对照组变化幅度更显著[（0.31±0.09） mg/L比（0.43±0.11）mg/L、（1.25±0.83） mg/L比（1.75±0.67） mg/L、（8.01±1.11） mmol/L比（8.76±1.54） mmol/L、（13.21±7.11） mU/L比（16.78±6.02） mU/L、（6.99±1.11）％比（10.03±1.01）％、（29.79±2.11） kg/m2比（31.66±2.01） kg/m2、（4.11±1.02） mmol/L比（5.61±1.01） mmol/L、（2.11±0.23） mmol/L比（2.45±0.21） mmol/L、（2.79±0.11） mmol/L比（2.98±0.10） mmol/L、（1.83±0.31） mmol/L比（1.43±0.40）mmol/L],差异有统计学意义（P＜0.05）.结论 二甲双胍与利拉鲁肽联合应用能够有效影响T2DM患者心血管病变的相关危险因素水平.     

中国18岁及以上人群血脂水平及分布特征

目的 研究我国城乡不同地区居民血浆总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）水平及分布特征。方法 对49252名18岁及以上调查对象空腹血浆血脂进行检测。结果 我国18岁及以上成人血浆TC、TG、HDL-C水平分别为3．81mmol／L、1．10mmol／L、1．30mmol／L;其中城市成人TC、TG、HDL-C水平分别为3．96mmol／L、1．16mmol／L、1．30mmol／L,农村成人TC、TG、HDL-C水平分别为3．75mmol／L、1．07mmol／L、1．30mmol／L。18～44岁、45～59岁和60岁以上人群血浆TC平均水平分别为3．70mmol／L、4．09mmol／L、4．21mmol／L;血浆TG平均水平分别为1．07mmol／L、1．21mmol／L、1．20mmol／L;血浆HDL-C平均水平分别为1．29mmol／L、1．33mmol／L、1．33mmol／L。结论 本次调查结果为全国人群血脂水平的代表性数据。城市成年人TC、TG水平高于农村;随着年龄的增长,血浆TC水平升高;45-59岁和60岁以上人群血浆TG水平差别无统计学意义,但均高于18-44岁组人群血浆TG水平。     

链脲佐菌素注射剂量对建立2型糖尿病大鼠模型的影响

目的探讨不同链脲佐菌素(STZ)注射剂量和方法对大鼠血糖值、血糖稳定性和胰岛损害的影响。方法75只SPF级6周龄雄性Wistar大鼠高脂高糖、饲养8周后,分别给予20、25、30mg/kg的STZ腹腔注射。造模后连续7周每周观察各组大鼠的体重、空腹血糖和餐后2h血糖。评价各组大鼠血糖变化和成模率。实验结束时测定血清胰岛素(INS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等。HE染色和胰岛素免疫组化观察胰岛细胞形态学特点。结果20mg/kg注射组成模率较低(30%);25mg/kg注射组成模率较高(73.3%),血糖中度升高并且稳定,胰岛结构完整,β细胞数量和细胞质内棕色颗粒有所减少;30mg/kg的STZ注射组血糖较高,死亡率较高,并且胰岛和β细胞数量极少,小胰岛多见,形状不规则,出现空泡样变性。结论高脂、高糖饲养8周后联合小剂量STZ25mg/kg能够造成更具有代表人类2型糖尿病病理生理特征的大鼠模型。     

2型糖尿病合并冠心病患者调脂治疗达标情况分析

目的了解2型糖尿病（T2DM）合并冠心病（CHD）患者调脂治疗的达标情况。方法对6个月内接受过调脂治疗的161例合并CHD的T2DM患者进行血脂检测,并以2007年《中国2型糖尿病防治指南》为标准分析其达标情况。结果 LDL-C、HDL-C和TG水平分别为（2.71±0.67）、（1.15±0.43）和（2.06±0.87）mmol/L,经t检验,HDL-C水平达标（P〉0.05）,LDL-C和TG水平未达标（P均〈0.05）。LDL-C、HDL-C和TG的达标率分别为33.5%、65.2%和46.6%。结论 T2DM合并CHD患者调脂治疗达标率较低,需进一步提高患者对调脂治疗的依从性和医生应用调脂药物的水平。     

甘油三酯、高密度脂蛋白变化与空腹血糖变化的 5年随访研究

摘要:目的　探讨甘油三酯（TG）、高密度脂蛋白（HDL）、甘油三酯/高密度脂蛋白（TG/ HDL）变化对2 型糖尿病发病的影响。方法　基线人群为石家庄市6个企事业单位职工,排除标准为糖尿病、冠心病、恶性肿瘤、肾衰及空腹血糖（FPG）≥5.6 mmol/L,进行连续5年随访,比较TG、HDL、TG/ HDL不同变化下FPG变化率,运用Logistic 回归模型分析研究三者变化与FPG变化的关系。结果　在随访过程中TG、HDL、TG/ HDL未控制组FPG变化高于三者保持正常或控制组,差异有统计学意义（P＜0.05）。Logistic 回归分析与各组在基线正常随访过程中仍保持正常相比,FPG变化TG组边缘升高转为TG升高RR值2.642（95% CI 1.572～4.379）、保持TG升高组RR值2.136（95% CI 1.455～3.135）、TG正常转为TG升高RR值1.969（95% CI 1.572～4.379）、TG升高转为TG边缘升高RR值1.954（95% CI 1.084～3.522）、保持TG边缘升高RR值1.717（95% CI 1.110～2.654）、TG正常转为TG边缘升高RR值1.64（95% CI 1.183～2.273）、TG边缘升高转为TG正常RR值1.495（95% CI 1.032～2.167）;HDL组RR值最高为HDL正常转为HDL减低1.857（95% CI 1.620～2.129）;TG/HDL组RR值由高至低为比值仍保持升高组（RR值7.506,95% CI 1.431～4.388）、比值正常转为升高组（RR值2.453,95% CI 1.365～4.408）。结论　TG、HDL 及 TG/HDL比值长期的变化与空腹血糖水平明显相关,血脂代谢异常在2型糖尿病的发生发展中可能扮演着重要角色。     

Administration of fat emulsions with nutritional mixtures from the 3-liter delivery system in total parenteral nutrition

A series of studies was performed to test the efficacy and safety of a parenteral lipid emulsion, Lipofundin S, when given as part of a complete nutritive mixture from the three-liter bag total parenteral nutrition (TPN) delivery system. In vitro stability studies with mixtures corresponding to high and low nutritional intakes showed the fat emulsion to be stable during refrigerated storage for at least 6 days. The clinical use of Lipofundin S in 3-liter TPN bags was studied in 39 consecutive patients requiring TPN, and there were no untoward side-effects. Nitrogen balance was maintained in patients with pancreatitis, those recovering postoperatively, and those with miscellaneous conditions. However, patients with multiple trauma remained in negative balance. The ability of sera, from patients on TPN to agglutinate Lipofundin S was compared to that from healthy controls, and acutely ill patients not on TPN. Patients on TPN showed a higher degree of in vitro creaming than acutely ill controls, and this may have been related to the severity of the underlying illness. These studies suggest that this parenteral lipid emulsion can be safely administered to patients requiring TPN when given from the 3-liter bag delivery system.     

北京地区1359名非糖尿病人群心血管病危险因素与胰岛素抵抗的关系研究

目的 采用横断面研究的方法 分析北京地区非糖尿病人群各心血管病危险因素与胰岛素抵抗的关系.方法 采用分层随机抽样方法 在年龄25～64岁的北京市自然人群中选取1475人,利用该人群中未患糖尿病的1359人资料对各心血管疾病危险因素与胰岛素抵抗关联的密切程度进行分析.分析中采用稳态模式评估法(HOMA)获得的HOMA指数作为胰岛素抵抗程度的评价指标.结果 将HOMA指数取自然对数后进行分析,心血管病危险因素与HOMA指数均存在不同程度的关联(P＜0.001).按关联密切程度由高到低依次为血糖、体重指数(BMI)、甘油三酯(TG)、腰围(WC)、高密度脂蛋白胆固醇(HDL-C)、血清尿酸、DBP、SBP和总胆固醇(TC).在调整了性别和年龄后,血糖(r=0.49)、BMI(r=0.44)、TG(r=0.44)、WC(r=0.41)、HDL-C(r=-0.32)、尿酸(r=0.33)、SBP(r=0.20)、DBP(r=0.18)和TC(r=0.16)依然和HOMA指数存在关联(P＜0.001).将HOMA指数位于人群上四分之一分位者定义为有胰岛素抵抗,多因素logistic回归分析显示性别(OR=1.75)、低HDL-C(OR=1.80)、高尿酸血症(OR=2.11)、高TG(OR=2.14)和腹部肥胖(OR=2.68)与胰岛素抵抗独立相关.结论 心血管病危险因素均与胰岛素抵抗存在不同程度的关联,其中低HDL-C、高TG、腹部肥胖和高尿酸血症与胰岛素抵抗独立相关.     

短期胰岛素强化治疗对初发2型糖尿病游离脂肪酸的影响

目的 探讨短期胰岛素强化治疗对初发2型糖尿病(T2DM)患者血清游离脂肪酸(FFA)的影响.方法 对64例初发T2DM患者进行短期胰岛素强化治疗,治疗前和治疗达标后检测空腹血糖(FPG)、餐后2h血糖(2hPG)、血脂、空腹胰岛素(FINS)、血清FFA.结果 短期胰岛素强化治疗达标后T2DM患者FPG、2hPG、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、FFA、稳态模型胰岛素抵抗指数(HOMA-IR)分别为(9.68±2.02)mmol/L、(12.77±1.35)mmol/L、(4.26±1.07) mmol/L、(1.52±0.58)mmol/L、(2.50±0 75)mmol/L、(435 84±190.94)μmol/L、0.51±0.62,均较治疗前的(14.66±3.50)mmol/L、(17.43±4.89)mmol/L、(5.03±0.94)mmol/L、(2.05±1.42)mmol/L、(2.91±0.78)mmol/L、(586.68±229.45)μmol/L、0.65±0.89显著下降(P＜0.05),稳态模型胰岛素分泌指数(HOMA-β)为2.70±0.83,较治疗前的1.74±1.04显著升高(P＜0.05),并且HOMA-β的升高、HOMA-IR的下降与FFA的下降呈正相关.结论 短期胰岛素强化治疗可以明显降低初发T2DM患者的血清FFA水平,有利于胰岛细胞功能及胰岛素抵抗的改善.

Abstract：

Objective To study the effect of transient intensive insulin treatment on the serum free fatty acid (FFA) in newly diagnosed type 2 diabetic patients.Methods Sixty-four newly diagnosed type 2 diabetic patients were treated with transient intensive insulin.The fasting plasma glucose (FPG),2 hours post-prandial glucose (2hPG),lipid,fastin insulin (FINS),and serum FFA was examined hefore and after treatment.Results The levels of FPG,2hPG,total cholesterol (TC),triglycerides (TG),low density lipoproteins cholesterol (LDL-C),FFA and HOMA-IR after treatment were (9.68 ± 2.02) mmol/L,(12.77 ± 1.35) mmol/L,(4.26 ± 1.07) mmol/L,(1.52 ± 0.58) mmol/L,(2.50 ±0.75) mmol/L,(435.84 ± 190.94) μmol/L,0.51 ± 0.62,and they decreased obviously compared with those before treatment [(14.66 ± 3.50) mmol/L,(17.43 ±4.89) mmol/L,(5.03 ±0.94) mmol/L,(2.05 ± 1.42) mmol/L,(2.91 ±0.78) mmol/L,(586.68 ±229.45)μmol/L,0.65 ± 0.89](P＜0.05).The level of HOMA-β increased obviously (2.70 ± 0.83 vs.1.74 ± 1.04)(P＜0.05).The increase of HOMA-β and the decrease of HOMA-IR was positively correlated with the decrease of FFA.Conclusion The transient intensive insulin treatment can evidently decrease the level of FFA that can improve beta-cell function and relieve insulin resistance in newly diagnosed type 2 diabetic patients.     

北京市成年人睡眠问题与血脂异常关系的研究

目的 探讨北京市成年人睡眠问题现状,及与血脂异常的关系,为血脂异常早期预防提供科学依据。方法 2017年8-12月采用多阶段分层整群随机抽样方法抽取北京市18～79岁常住居民13 188人作为调查对象,进行问卷调查、体格测量和实验室检查。采用调查问卷收集调查对象的人口学特征和睡眠情况等,测量身高体重,采集空腹静脉血,测定TC、HDL-C、LDL-C和TG。结果 北京市成年人睡眠问题的比例为52.1%,且血脂异常患者（55.1%）高于血脂正常者（50.7%）。打鼾、入睡困难、夜间觉醒、早醒和服用安眠药的比例分别为30.1%、18.8%、24.6%、20.1%和3.0%。打鼾者高TC血症、高TG血症、高LDL-C血症患病率分别为7.5%、23.5%和6.6%,均高于不打鼾者（分别为5.7%、15.5%和4.9%）。夜间觉醒者TC平均水平和高TC血症患病率分别为4.74 mmo/L和7.5%,均明显高于无夜间觉醒者（4.66 mmol/L和5.8%）。在控制年龄、性别、吸烟、超重肥胖等潜在混杂因素后,打鼾与TC、TG和LDL-C水平呈正相关（P<0.05）;打鼾是血脂异常的危险因素（OR=1.248,P<0.05）。结论 北京市成年人睡眠问题严重,主要睡眠问题是打鼾和夜间觉醒。打鼾与TC、TG和LDL-C水平呈正相关,是血脂异常的独立危险因素。