PPP1R3基因多态性与中国汉族人群2型糖尿病的相关性研究

目的　旨在研究 1型蛋白磷酸酶骨骼肌特异的糖原靶向调节亚单位基因 (PPP1R3)Asp90 5Tyr以及 3′ -UTR5bpD/I多态性与安徽省汉人群的 2型糖尿病 (T2DM )相关性。方法　运用PCR -RFLP法对安徽省合肥地区 36 6例汉族受试者 (T2DM患者 2 6 2例 ,健康成人 10 4例 )进行基因型测定。结果　 (1)PPP1R3基因Asp90 5Tyr以及 3′ -UTR 5bpD/I多态性的基因型及等位基因频率在T2DM与健康对照组间分布均没有显著性差异 (P >0 .0 5 )。 (2 )PPP1R3基因Asp90 5Tyr以及3′ -UTR 5bpD/I多态性间呈连锁不平衡 ,其分布频率在不同人群中不尽相同。结论　PPP1R3基因Asp90 5Tyr以及 3′ -UTR 5bpD/I多态性可能在安徽省合肥地区 2型糖尿病发病中不起重要作用。两种多态性的分布表现明显的种族性。     

The search for type 2 diabetes genes

Type 2 diabetes (T2DM) is a serious disease with severe complications. Around one in 10 people alive today suffer from type 2 diabetes or are destined to develop it before they die. Inheritance plays an important role in the cause of type 2 diabetes. A considerable amount of research is devoted to defining the genes involved in the aetiology of this widespread disease. This information is crucial if we are to improve our methods of preventing and treating diabetes. Over the last 25 years there have been considerable advances in our understanding of the genetics of diabetes. Important discoveries have been made in dissecting the genes involved in rare monogenic forms of type 2 diabetes which has become a paradigm for genetic studies of type 2 diabetes. This review focuses on the main approaches currently adopted and our current understanding of the genes involved in susceptibility to type 2 diabetes.     

Genome-wide linkage analysis of type 2 diabetes mellitus reconfirms the susceptibility locus on 11p13-p12 in Japanese

Type 2 diabetes mellitus is a heterogeneous disorder, and the development of type 2 diabetes mellitus is associated with both insulin secretion defect and insulin resistance. The primary metabolic defect leading to type 2 diabetes mellitus has been thought to be varied among populations, especially in Japanese and Caucasians. Here, we have done the genome-wide scan for type 2 diabetes mellitus using 102 affected Japanese sib-pairs to identify the genetic factors predisposing to type 2 diabetes mellitus. Nonparametric linkage analysis showed one suggestive evidence for linkage to 11p13–p12 [D11S905: two-point maximum LOD score (MLS) of 2.89 and multipoint MLS of 2.32] and one nominally significant evidence for linkage to 6q15–q16 (D6S462: two-point MLS of 2.02). Interestingly, the 11p13–p12 region was reported to be a susceptibility locus for Japanese type 2 diabetes mellitus with suggestive evidence of linkage, and D11S905 was within 5 cM to D11S935 with the highest MLS in the previous linkage analysis reported. The only overlapped susceptibility region with suggestive evidence of linkage for Japanese type 2 diabetes mellitus was D11S935–D11S905 among the three reports including this study. These results taken together suggest that a susceptibility gene for type 2 diabetes mellitus in Japanese will reside in 11p13–p12.     

Anxiety proneness linked to epistatic loci in genome scan of human personality traits

A genome-wide scan between normal human personality traits and a set of genetic markers at an average interval of 13 centimorgans was carried out in 758 pairs of siblings in 177 nuclear families of alcoholics. Personality traits were measured by the Tridimensional Personality Questionnaire. We detected significant linkage between the trait Harm Avoidance, a measure of anxiety proneness, and a locus on chromosome 8p21–23 that explained 38% of the trait variance. There was significant evidence of epistasis between the locus on 8p and others on chromosomes 18p, 20p, and 21q. These oligogenic interactions explained most of the variance in Harm Avoidance. There was suggestive evidence of epistasis in other personality traits. These results confirm the important influence of epistasis on human personality suggested by twin and adoption studies. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 81:313–317, 1998. © 1998 Wiley-Liss, Inc.     

TLR2 signaling improves immunoregulation to prevent type 1 diabetes

Signaling through TLR2 promotes inflammation and modulates CD4⁺CD25⁺ Tregs. We assessed mechanistically how this molecule would alter immunoregulation in type 1 diabetes (T1D). We also asked whether TLR2 may be involved in our recent discovery that viral infection can protect from autoimmune diabetes by expanding and invigorating Tregs. Treatment of prediabetic mice with a synthetic TLR2 agonist diminished T1D and increased the number and function of CD4⁺CD25⁺ Tregs, also conferring DCs with tolerogenic properties. TLR2 ligation also promoted the expansion of Tregs upon culture with DCs and ameliorated their capacity to prevent the disease. Protection from T1D by lymphocytic choriomeningitis virus (LCMV) infection depended on TLR2. LCMV increased the frequency of CD4⁺CD25⁺ Tregs and their production of TGF‐β more significantly in WT than TLR2‐deficient mice. Furthermore, LCMV infection in vivo or LCMV‐infected DCs in vitro rendered, via TLR2, CD4⁺CD25⁺ Tregs capable of diminishing T1D. We identify novel mechanisms by which TLR2 promotes immunoregulation and controls autoimmune diabetes in naïve or infected hosts. This work should help understand T1D etiology and develop novel immune‐based therapeutic interventions.     

Family-based intervention by pharmacists for type 2 diabetes: A randomised controlled trial

Objectives

To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.

Cytokine profile and lymphocyte subsets in type 2 diabetes

Type 2 diabetes mellitus (T2D) is a metabolic disease with inflammation as an important pathogenic background. However, the pattern of immune cell subsets and the cytokine profile associated with development of T2D are unclear. The objective of this study was to evaluate different components of the immune system in T2D patients'' peripheral blood by quantifying the frequency of lymphocyte subsets and intracellular pro- and anti-inflammatory cytokine production by T cells. Clinical data and blood samples were collected from 22 men (51.6±6.3 years old) with T2D and 20 nonsmoking men (49.4±7.6 years old) who were matched for age and sex as control subjects. Glycated hemoglobin, high-sensitivity C-reactive protein concentrations, and the lipid profile were measured by a commercially available automated system. Frequencies of lymphocyte subsets in peripheral blood and intracellular production of interleukin (IL)-4, IL-10, IL-17, tumor necrosis factor-α, and interferon-γ cytokines by CD3⁺ T cells were assessed by flow cytometry. No differences were observed in the frequency of CD19⁺ B cells, CD3⁺CD8⁺ and CD3⁺CD4⁺ T cells, CD16⁺56⁺ NK cells, and CD4⁺CD25⁺Foxp3⁺ T regulatory cells in patients with T2D compared with controls. The numbers of IL-10- and IL-17-producing CD3⁺ T cells were significantly higher in patients with T2D than in controls (P<0.05). The frequency of interferon-γ-producing CD3⁺ T cells was positively correlated with body mass index (r=0.59; P=0.01). In conclusion, this study shows increased numbers of circulating IL-10- and IL-17-producing CD3⁺ T cells in patients with T2D, suggesting that these cytokines are involved in the immune pathology of this disease.     

NAT2基因多态性与2型糖尿病的关系

目的探讨NAT2基因多态性与2型糖尿病易感性的关系,为糖尿病的有效防治提供科学依据。方法采用PCR及测序技术对174例2型糖尿病患者和174例健康者的NAT2基因4个常见突变位点进行检测。结果糖尿病组中NAT2等位基因频率分别为：Wt（69.54%）,M2（16.37%）,M3（10.63%）,M1（3.44%）。与正常对照组比较差异无显著性。NAT2基因型（WT/WT,WT/Mx,Mx/Mx）在糖尿病组中分布频率分别为44.82%,49.42%,5.74%,两组间比较差异显著。糖尿病组中快乙酰化者164例（占94.25%）,慢乙酰化者10例（占5.75%）,两组间比较有差异。携带NAT2快乙酰化基因型者患2型糖尿病的风险是携带NAT2慢乙酰化基因型者的3.98倍。结论本研究提示快乙酰化代谢表型可能是糖尿病的一个遗传易感因素,而慢乙酰化代谢表型可能对糖尿病的发生具有一定保护作用。     

Declining structured diabetes education in those with type 2 diabetes: A plethora of individual and organisational reasons

Objective

to identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE).

血管紧张素原基因M235T分子变异与2型糖尿病肾病的关系

目的　探讨血管紧张素原（ａｎｇｉｏｔｅｎｓｉｎｏｇｅｎ , Ａ Ｇ Ｔ） 基因 Ｍ２３５ Ｔ 分子变异与中国人无肾病并发症的２ 型糖尿病（ｄｉａｂｅｔｅｓ ｍ ｅｌｌｉｔｕｓ , Ｄ Ｍ） 、２ 型糖尿病肾病（ｄｉａｂｅｔｉｃ ｎｅｐｈｒｏｐａｔｈｙ , Ｄ Ｎ） 的关系。方法　用 Ｐ Ｃ Ｒ及 Ｒ Ｆ Ｌ Ｐ 方法对８４ 例 Ｄ Ｍ、９６ 例 Ｄ Ｎ 及９８ 名正常对照进行了 Ａ Ｇ Ｔ 基因 Ｍ２３５ Ｔ 多态性的检测。结果　 Ｄ Ｎ 组 Ｔ 等位基因频率０８２ , Ｔ Ｔ 基因型频率０７０ ,与对照组（０６３ ,０４３） 比较有显著差异（ Ｐ＝ ０００３ , Ｐ＝００００４） ;校正了 Ｄ Ｎ 的几种危险因素后, Ｔ Ｔ 基因型对 Ｄ Ｎ 的 Ｏ Ｒ 为３４７（９５ ％ Ｃ Ｉ 为１５１ ～７９４ , Ｐ＝０００３３） 。 Ｄ Ｍ 组基因型频率分布与对照组比较无显著差异（ Ｐ＞ ００５） 。结论　 Ａ Ｇ Ｔ 基因 Ｔ Ｔ 型可能是中国人群２ 型糖尿病肾病的独立危险因素之一。     

延边汉族和朝鲜族人群脂联素基因与2型糖尿病的关联性研究

目的 本研究分析延边汉族和朝鲜族人群中脂联素基因启动子的单核苷酸多态性(SNPs)与2型精尿病的关联.方法 共有97个延边个体被纳入到本研究中,包括55个汉族(13个正常人和42个2型糖尿病患者)和42个朝鲜族(16个正常人和26个2型糖尿病患者).检测项目包括体重指数(BMI)、空腹血糖(FPG)、总胆同醇(TC)和甘油三酯(TC).PCR和测序用于SNP的筛选.ANOVA和χ~2检验用于数据分析.结果 在延边朝鲜族中TG在2型糖尿病组大于正常组(P=0.033).FPG、TC和TC在延边朝鲜族2型糖尿病组大于延边汉族2型糖尿病组(P=0.038;P=0.037;P=0.047).在延边朝鲜族中-11426A-11377C的单体型频率在2型糖尿病组小于正常组(P=0.043).在延边汉族中BMI与-11426位点的基因型有关,基因型-11426G的BMI小于基因型-11426A(P=0.039).-11426位点从基因型的BMI在延边汉族大于延边朝鲜族(P=0.006).结论 1.延边汉族和朝鲜族之间在2型糖尿病组中FPG、TC和TG存在民族差异.2.在延边朝鲜族中单体型-11426A-11377C可能在2型糖尿病发展过程中被认为是一种保护因素.3.在延边汉族中SNP-11426A>G可能与肥胖有关.     

胆胰转流术改善2型糖尿病的研究进展简

 胆胰转流术（BPD）将胆胰液转流至回肠,减少胆胰液与食物的混合时间,进而减弱消化吸收。临床观察上发现,BPD可以长期稳定地改善2型糖尿病并减少糖尿病各并发症,与胃旁路术有相似的效果,其确切机制不明,目前研究提示与胃肠激素、血脂、胰岛细胞功能的改变和胆胰液转流等有关。     

Management of type 2 diabetes mellitus in the elderly

Aim

To provide evidence based recommendations for optimal care diabetes care in the elderly.

Background

Diabetes affects approximately 25% of the population ≥65 years, and that percentage is increasing rapidly, particularly in minorities who represent an important fraction of the uninsured/underinsured. Diabetes is an important cause of hospital admissions and a co-morbidity in as high as 50% of hospital inpatients. It impacts mortality and quality of life. While tools have become available to improve glycemic control, enthusiasm for their application must be tempered with the sober realization of the risks involved in intensification of glycemic control, chiefly hypoglycemia.

Methods

Weighted review from PubMed and other literature search tools in descending order of randomized control trials, observational studies, pilot studies, published guidelines, the authors’ clinical experience, and expert opinion.

Results/conclusions

• • 

  HbA1c targets should be stratified according to the frailty of the elderly diabetic patient: <7.0% in the generally well elderly and < 8.0% in the frail elderly.

• • 

  Therapies are available that achieve glycemic goals, while minimizing the risk of hypoglycemia, taking into consideration such factors as cognitive function, renal and hepatic function, bone density, fall risk, and hypoglycemia unawareness.

• • 

  When insulin is used determir or glargine are safer choices than NPH.

• • 

  Ultra-short acting prandial insulins are safer than regular insulin.

• • 

  Pen devices for insulin delivery significantly reduce dosing errors and the risk of hypoglycemia.

• • 

  Sudden managed care formulary changes that disrupt patients’ diabetes treatment should be prevented through national policy initiatives.

• • 

  Up to date home medication lists help prevent dangerous medication errors.

• • 

  Widespread adoption of telehealth approaches can significantly improve glycemic control and render it safer.

     

Epigenetic mechanisms of macrophage activation in type 2 diabetes

The alarming rise of obesity and type 2 diabetes (T2D) has put a tremendous strain on global healthcare systems. Over the past decade extensive research has focused on the role of macrophages as key mediators of inflammation in T2D. The inflammatory environment in the obese adipose tissue and pancreatic β-cell islets creates and perpetuates imbalanced inflammatory macrophage activation. Consequences of this chronic low-grade inflammation include insulin resistance in the adipose tissue and pancreatic β-cell dysfunction. Recently, the emerging field of epigenetics has provided new insights into the pathogenesis of T2D, while also affording potential new opportunities for treatment. In macrophages, epigenetic mechanisms are increasingly being recognized as crucial controllers of their phenotype. Here, we first describe the role of macrophages in T2D. Then we elaborate on epigenetic mechanisms that regulate macrophage activation, thereby focusing on T2D. Next, we highlight how diabetic conditions such as hyperlipidemia and hyperglycemia could induce epigenetic changes that promote an inflammatory macrophage phenotype. In conclusion we discuss possible therapeutic interventions by targeting macrophage epigenetics and speculate on future research directions.     

一个中国汉族精神分裂症高发家系的全基因组连锁分析

目的 对一个汉族精神分裂症高发家系进行全基因组连锁分析,对易感基因进行定位.方法 抽取受试者外周血4 mL,用常规酚氯仿法提取基因组DNA,选择Illumina Infinium Linkage-24 BeadChips芯片对样本进行单核苷酸多态性检测及分型.用Illumina BeadStudio软件处理原始数据后,对分型结果应用Merlin软件进行两点非参数连锁分析和两点参数连锁分析.结果 用Merlin软件进行两点非参数连锁分析,共发现27个连锁值较高的位点(连锁值在0.63～0.75之间,P＜0.05),其中3个单核苷酸多态性(rs993694、rs992690、rs1861577)位于12p12.3区,剩余的位点均位于4p12-q22区.在显性模型下的两点参数连锁分析得到了几乎一致的结果.结论 染色体4p12-q22区以及12p12.3区可能包含精神分裂症的易感基因.     

川芎嗪通过抗炎作用减轻2型糖尿病大鼠心肌病变

目的:观察川芎嗪对抗糖尿病引起的大鼠心肌细胞损伤的作用。方法:雄性Wistar大鼠高糖高脂饲料喂养4周后空腹自尾静脉注射STZ制造2型糖尿病模型,观察不同给药剂量川芎嗪对糖尿病大鼠体重、血糖、心脏组织形态以及心肌组织中IL-1β、IL-6、TNF-α、IKKβ和NF-κB蛋白水平的影响。结果:高剂量川芎嗪可缓解糖尿病大鼠的体重减轻和血糖升高,并且可以减少促炎因子IL-1β、IL-6和TNF-α的表达,降低IKKβ和NF-κB的蛋白水平。结论:川芎嗪通过拮抗炎症通路能减轻糖尿病引起的大鼠心肌细胞损伤。     

AQP7和AQP9基因多态性与中国汉族人群2型糖尿病的相关性研究CSCD

目的探讨水通道蛋白7(aquaporin 7, AQP7)以及水通道蛋白9(aquaporin 9, AQP9)基因单核苷酸多态性(single nucleotide polymorphism, SNP)与中国汉族人群患2型糖尿病(type 2 diabetes mellitus, T2DM)的相关性。方法随机纳入1194例T2DM个体和1274例非糖尿病个体(non-diabetic, NDM)进行对照研究, 采用MassArray质谱基因分型方法对3个SNP位点(AQP7基因rs3758269、AQP9基因rs16939881和rs57139208)进行基因分型。评估以上3个SNP位点与T2DM的相关性;探讨NDM组SNP位点处不同基因型与糖脂代谢指标的关联。结果 AQP7基因rs3758269、AQP9基因rs16939881和rs57139208的等位基因频率及基因型频率在T2DM组和NDM组中的分布无统计学差异(P > 0.05);且分析结果显示不同遗传模式与T2DM无相关性(P > 0.05)。在NDM组中, AQP7基因rs3758269、AQP9基因rs16939881和rs57139208的不同基因型与糖脂代谢指标无相关性(P > 0.05)。结论 AQP7基因rs3758269和AQP9基因rs16939881和rs57139208与中国汉族人群T2DM遗传易感性无关。     

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

The objective of the present cross-sectional study was to assess the prevalence and the clinical and laboratory features of hepatitis C virus (HCV)-positive patients with type 2 diabetes mellitus (DM) attending either an outpatient clinic or hemodialysis units. Serologic-HCV testing was performed in 489 type 2 DM patients (303 outpatients and 186 on dialysis). A structured assessment of clinical, laboratory and DM-related complications was performed and the patients were then compared according to HCV infection status. Mean patient age was 60 years; HCV positivity (HCV+) was observed in 39 of 303 (12.9%) outpatients and in 34 of 186 (18.7%) dialysis patients. Among HCV+ patients, 32 were men (43.8%). HCV+ patients had higher serum levels of aspartate aminotransferase (0.90 ± 0.83 vs 0.35 ± 0.13 μKat/L), alanine aminotransferase (0.88 ± 0.93 vs 0.38 ± 0.19 μKat/L), gamma-glutamyl transferase (1.57 ± 2.52 vs 0.62 ± 0.87 μKat/L; P < 0.001), and serum iron (17.65 ± 6.68 vs 14.96 ± 4.72 μM; P = 0.011), and lower leukocyte and platelet counts (P = 0.010 and P < 0.001, respectively) than HCV-negative (HCV-) patients. HCV+ dialysis patients had higher diastolic blood pressure than HCV- patients (87.5 ± 6.7 vs 81.5 ± 6.0 mmHg; P = 0.005) and a lower prevalence of diabetic retinopathy (75 vs 92.7%; P = 0.007). In conclusion, our study showed that HCV is common among subjects with type 2 DM but is not associated with a higher prevalence of chronic diabetic complications.     

AQP7和AQP9基因多态性与中国汉族人群2型糖尿病的相关性研究

目的探讨水通道蛋白7(aquaporin 7, AQP7)以及水通道蛋白9(aquaporin 9, AQP9)基因单核苷酸多态性(single nucleotide polymorphism, SNP)与中国汉族人群患2型糖尿病(type 2 diabetes mellitus, T2DM)的相关性。方法随机纳入1194例T2DM个体和1274例非糖尿病个体(non-diabetic, NDM)进行对照研究, 采用MassArray质谱基因分型方法对3个SNP位点(AQP7基因rs3758269、AQP9基因rs16939881和rs57139208)进行基因分型。评估以上3个SNP位点与T2DM的相关性;探讨NDM组SNP位点处不同基因型与糖脂代谢指标的关联。结果 AQP7基因rs3758269、AQP9基因rs16939881和rs57139208的等位基因频率及基因型频率在T2DM组和NDM组中的分布无统计学差异(P > 0.05);且分析结果显示不同遗传模式与T2DM无相关性(P > 0.05)。在NDM组中, AQP7基因rs3758269、AQP9基因rs16939881和rs57139208的不同基因型与糖脂代谢指标无相关性(P > 0.05)。结论 AQP7基因rs3758269和AQP9基因rs16939881和rs57139208与中国汉族人群T2DM遗传易感性无关。     

Inflammation,diet, and type 2 diabetes: a mini-review

ABSTRACT

Inflammation is a common feature of type 2 diabetes (T2D). Inflammatory cytokines increase in patients with type 2 diabetes, metabolic syndrome, and heart disease. Various types of cells can produce inflammatory cytokines and then release them into the bloodstream, where their complex interactions with target tissues raise a tissue-specific immune response. This review focused on C-reactive protein (CRP), tumor necrosis factor (TNF)-α as an inflammatory cytokine, and adiponectin produced by adipose tissues. Despite the major role of cytokines in the development of T2D, further studies are required to investigate the possible effects of the macronutrient composition of diet on these cytokines.