福建沿海地区1型和2型糖尿病人群血脂水平以及腰臀比值的相关调查研究

目的 探讨福建沿海地区1型（T1DM）和2型糖尿病（T2DM）人群的血脂各项指标和腰臀比值的差异.方法 研究对象包括对照组882名,T2DM组936例,T1DM组96例,血脂水平（包括甘油三酯、总胆固醇、高低密度脂蛋白和载脂蛋白）和腰臀比值（WHR）测定,稳态模型（HOMA）计算胰岛素抵抗（IR）指数,SPSS13.0软件统计.结果 （1）腰臀比值在T1DM组、T2DM组和对照组中不存在显著性差异,甘油三酯和低密度脂蛋白测定值T1DM组明显高于T2DM组和对照组（P〈0.05） 而甘油三酯与总胆固醇的比值在各组中差异无统计学意义（P〉0.05）.（2）载脂蛋白B在T1DM组与T2DM组内的分布差异无统计学意义（P〉0.05）,但高于对照组,高密度脂蛋白在各组间的分布差异有统计学意义（x2=3.549,x2=3.412,P≤0.05）即T1DM组〈T2DM组〈对照组.在DM组内,T2DM组的CHOL和LDL-C测定值均明显低于T1DM组（F1=6.406,P1=0.007 F2=9.183,P2=0.005）.结论 福建地区糖尿病人群血脂水平在T1DM组、T2DM组和对照组中存在显著差异,但腰臀比糖尿病组内无差别,T1DM比T2DM明显提高了DM合并血脂代谢紊乱的风险性.     

2型糖尿病合并高血压患者心脏功能和胰岛素抵抗的关系研究

目的：研究2型糖尿病（T2DM ）合并高血压患者心脏功能和胰岛素抵抗（IR）的关系,并分析影响其变化的危险因素,为临床治疗提供理论依据。方法选取2010年6月至2013年6月张家港市广和中西医结合医院300例T2DM 患者作为研究对象,根据 E/A比值进行分组。E/A比值小于或等于1为舒张功能降低,设为 A组;＞1为舒张功能正常,设为B组。A组160例患者,B组140例患者。检测并比较两组患者一般指标,胰岛素情况,心脏结构和功能指标。结果 A 组患者血浆胰岛素、胰岛素抵抗指数（HOMA2-IR）分别为（28．68±7．61） IU/mL、（4．89±0．96）,明显高于B组的（16．12±1．35）IU/mL、（2．80±0．29）,差异有统计学意义（P＜0．05）。Lo-gistic回归分析显示,心脏舒张功能降低与年龄和HOM A2-IR有关,年龄越大、HOM A2-IR越高发生心脏舒张功能降低的风险越大;心脏舒张功能降低与病程、年龄、体质量指数、三酰甘油、高密度脂蛋白、低密度脂蛋白之间未见显著相关性（ P＞0．05）。结论 IR可导致心脏损害的发生,与左心室肥厚、心力衰竭之间存在着互相促进、恶性循环的关系。     

1型糖尿病患者体脂含量与糖尿病血管并发症相关性分析

目的探讨1型糖尿病患者体脂含量与糖尿病血管并发症的相关性。方法选取2017年3月至2019年7月收入我院的1型糖尿病患者200例作为研究对象,其中发生血管并发症患者78例,未发生并发症122例,通过进行单因素以及多因素logistic回归分析,明确体脂含量与血管并发症相关性。结果结果显示,体脂含量水平及TG,TC,HDL-C,LDL-C是糖尿病相关血管并发症的发生的影响因素。logsitic回归分析结果显示,体脂含量水平和TG,TC,LDL-C与糖尿病相关血管并发症的发生存在正相关,HDL-C与糖尿病相关血管并发症的发生存在负相关。结论体脂含量水平和TG,TC,LDL-C是糖尿病相关血管并发症的危险因素,HDL-C是糖尿病血管并发症的保护因素。对于1型糖尿病患者应控制患者体脂含量水平,可采用饮食指导、运动干预等护理措施达到降低糖尿病血管并发症发生风险的目的。     

2型糖尿病各并发症及影响因素的临床分析

目的探讨2型糖尿病各并发症间的相互关系及影响因素,以期为2型糖尿病病人并发症的早期诊治和预防提供依据。方法收集330例临床被诊断为2型糖尿病的病人信息及其血标本。对这330例病人的年龄、性别、体重指数及各项临床、生化指标进行统计学分析,观察出各并发症之间及并发症与其常规指标有无相关性。结果 330例2型糖尿病各并发症与性别、体重指数及血糖无关,年龄与个并发症密切相关,并且在所统计的5种并发症中,患病率都随年龄的增高而增加,且各年龄组的患病率差异存在统计学意义。60岁以上组的各并发症中,高血压为最高(47.5%),其次是周围血管病变(43.33%),第三是周围神经病变(40.83%)。脂代谢异常是周围血管病变风险因子。高血压与糖尿病肾病、周围神经病变、周围血管病变及眼病相关联。患周围血管病变的人群中高发周围神经病变(50.94%)。结论高龄是2型糖尿病并发症的风险因子。2型糖尿病高血压患者更易进一步导致其它糖尿病并发症,而患周围血管病变的人群中更易伴发周围神经病变。     

Polymorphism of glutathione S-transferases as genetic risk factors for the development of complications in type 2 diabetes mellitus

Background

Diabetes is characterized by chronic hyperglycemia that produces dysregulation of cellular metabolism and result in excess free radical production and oxidative stress. Glutathione S-transferases (GSTs) are a family of multifunctional enzymes that work as antioxidants. Therefore, diminished expression of GSTs may result in a reduced body defense against oxidative stress, followed by development of diabetic complications.

Objectives

To investigate the possible association between GSTM1 and GSTT1 polymorphism and the occurrence of complications in type 2 DM and to study the other risk factors for complications in DM.

Methods

Twenty noncomplicated type 2 diabetic patients and 40 complicated type 2 diabetic patients were enrolled in the study. The GSTM1 and GSTT1 genotypes were identified by polymerase chain reaction of peripheral blood DNA samples. Analysis of data was done by using SPSS (SPSS, Chicago, Ill).

Results

The frequencies of null GSTM1 and GSTT1 genotypes were 55% (11/20) and 40% (8/20), respectively, in noncomplicated DM group. The frequencies of null GSTM1 and GSTT1 genotype in complicated DM group were 57.5% (23/40) and 60% (24/40), respectively. The null GSTT1 genotype was more prevalent in the group of complicated DM with odds ratio (odds ratio, 2.3; 95% confidence interval, 0.75-6.7) when compared with noncomplicated DM.

Conclusion

Our data provide evidence that diabetics with null GSTT1 genotypes are substantially at higher risk for developing complications.     

T1DM患者直系亲属ZnT-8A、IA-2A、IAA、GADA、ICA检测及3年发病风险分析

目的探讨1型糖尿病(T1DM)患者直系亲属Zn T-8A、IA-2A、IAA、GADA、ICA检测及3年发病风险的临床价值。方法采用放射免疫沉淀法检测T1DM患者(n=80)及其直系亲属(n=100)与正常受试者(n=100)血清中锌转运蛋白8抗体(Zn T-8A)阳性率,同时采用免疫印迹试剂法检测胰岛细胞抗体(ICA)、谷氨酸脱羧酶抗体(GADA)、蛋白酪氨酸磷酸酶自身抗体(IA-2A)、胰岛素自身抗体(IAA),对不同组合抗体联合检测效果用ROC曲线评价,同时分析直系亲属中3年发病情况。结果 T1DM组患者Zn T-8A、IA-2A、IAA、GADA、ICA血清抗体检出率均显著高于直系亲属组和健康组(P0.05),且直系亲属组上述血清抗体检出率显著高于健康组(P0.05)。5种抗体联合检测总阳性率最高为91.25%,其中2种、3种和4种抗体联合总阳性率最高,分别为83.75%、87.5%和90.0%。5种抗体联合检测法的ROC曲线下面积(AUC)最大,各种抗体联合检测法AUC无显著差异,但均显著高于Zn T-8A抗体单独检测(P0.05)。3年随访调查中2例Zn T-8A和GADA抗体阳性直系亲属被诊断为T1DM,其余个体在随访期间无发病症状。结论 5种抗体联合检测能够提高T1DM临床诊断率,其中Zn T-8A和GADA抗体组合检测,对糖尿病及时、准确分型具有重要价值,还可作为T1DM直系亲属流行病学的筛选指标。     

Methylenetetrahydrofolate reductase C677T gene polymorphism and the association with dyslipidemia in type 2 diabetic Palestinian patients

BackgroundDyslipidemia in diabetes is common and characterized by hypertriglyceridemia with decreased levels of high‐density lipoprotein. The objective of this study was to assess the prevalence of MTHFR C677T polymorphism in Palestinian T2DM patients and to investigate the association between this polymorphism and lipid profile in diabetic patients with and without dyslipidemia.MethodsA total of 208 T2DM patients including 98 with dyslipidemia and 110 without dyslipidemia were enrolled in this study. The MTHFR C677T genotyping was conducted by PCR‐RFLP followed by agarose gel electrophoresis.ResultsThere were no significant differences in either the genotype distribution or allele frequency in T2DM patients with or without dyslipidemia (37.8% CC, 54% CT, 8.2% TT vs. 48.2% CC, 41.8% CT, 11% TT; p = 0.209). However, among the dyslipidemic group, the TT carriers have a higher HDL level (46.8 ± 17.8) compared to (CC+CT) carriers (34.68 + 11.9) (p = 0.01). In the group without dyslipidemia, there was a significant elevation in diastolic blood pressure (DBP) among the CC carriers (83.6 ± 10.6) compared to those who carried at least one mutant allele (CT+TT) (78.1 ± 11.1) (p = 0.009).ConclusionsThe study shows that in our Palestinian population the MTHFR 677TT genotype lowers DBP significantly in patients without dyslipidemia and is related to increased level of HDL in diabetic dyslipidemia patients.     

2型糖尿病病人疾病感知、用药信念与血糖控制的相关性研究

[目的]了解2型糖尿病病人疾病感知、用药信念及血糖控制情况,探讨疾病感知、用药信念与血糖控制的关系。[方法]2016年10月-2018年10月通过方便抽样选取254例住院的2型糖尿病病人,采用一般资料调查表、改良版疾病感知问卷和用药信念量表调查2型糖尿病病人的一般资料、疾病感知及用药信念情况。[结果]2型糖尿病病人糖化血红蛋白水平为(8.72±2.44)%,病人对疾病病情的看法均分为2.29~3.68分,用药信念的均分为2.67~3.80分。相关分析显示,疾病感知的病程、治疗控制以及疾病周期性维度,用药信念的药物过度使用维度与2型糖尿病病人血糖控制水平具有显著相关性。[结论]2型糖尿病病人的血糖控制水平欠佳,疾病感知、用药信念可直接影响病人的血糖控制水平。     

新疆地区老年2型糖尿病患者甲状腺结节的危险因素分析

目的探讨新疆地区老年2型糖尿病(年龄≥60岁)患者甲状腺结节的患病情况及其相关危险因素。方法选取老年2型糖尿病患者202例,其中,甲状腺结节患者91例(甲状腺结节组),非甲状腺结节组111例(对照),收集患者病史、体质量指数(BMI)、空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等资料进行统计学分析。结果年龄、性别、BMI、TC、HbA1c、BMI在两组间比较,差异有统计学意义(P0.05);病程、脉压、收缩压、腹围、吸烟史、HDL、TG、FBG、2hPBG在甲状腺结节组与非甲状腺结节组之间比较,差异均无统计学意义(P0.05)。多因素Logistic回归进行分析显示:性别、年龄、TC、HbA1c、BMI是甲状腺结节发生的危险因素。结论对老年女性、肥胖、胆固醇升高的糖尿病患者进行甲状腺结节相关影像学检查具有重要临床意义。     

血尿酸与2型糖尿病患者心血管并发症相关性的临床研究

目的 探讨血尿酸与2型糖尿病(T2DM)患者心血管并发症的关系,为预防和治疗糖尿病并发症提供理论依据.方法 将268例T2DM患者分为T2DM心血管并发症组和T2DM非心血管并发症组,并选择体检的健康人做对照,比较各组血尿酸、胆固醇、甘油三酯、高密度脂蛋白、空腹血糖、体重指数、病程和血压的差异,并对心血管并发症组和非心血管并发症组差异有统计学意义的指标进行Logistic回归分析,探讨糖尿病心血管并发症的危险因素.结果 T2DM心血管并发症组、T2DM非心血管并发症组体重指数、收缩压、舒张压、空腹血糖、甘油三酯和血尿酸均显著高于正常对照组,差异有统计学意义(P<0.05);T2DM心血管并发症组较非心血管并发症组血尿酸高、收缩压高、病程长,差异有统计学意义(P<0.05);多元回归分析显示,病程、收缩压和血尿酸与T2DM心血管并发症呈正相关.结论 与病程和高血压一样,血尿酸是T2DM心血管并发症的独立危险因素.     

2型糖尿病合并冠心病患者miR-26a与心电图校正QT间期的关系及临床意义

目的 研究2型糖尿病(T2DM)合并冠心病(CHD)患者外周血miR-26a表达水平与心电图校正QT(QTc)间期的关系及临床意义.方法 将2018年1月至2020年12月河南省直第三人民医院收治的135例T2DM患者,根据冠状动脉CT血管成像检查分为合并CHD的T2DM+CHD组(80例),不合并CHD的T2DM组(...     

The association of diabetes specialist care with health care practices and glycemic control in patients with type 1 diabetes: a cross-sectional analysis from the Pittsburgh epidemiology of diabetes complications study

OBJECTIVE: To determine whether diabetes care characteristics and glycemic control differ by use of specialist care in a representative cohort of patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Health care, sociodemographic characteristics, and glycemic control were compared between participants in the Pittsburgh Epidemiology of Diabetes Complications Study who reported receiving specialist care (n = 212) and those who did not (n = 217). Specialist care was defined as having received care from an endocrinologist or diabetologist or diabetes clinic attendance during the last year. RESULTS: Patients who reported receiving specialist care were more likely to be female, to have an education level beyond high school, to have an annual household income >$20,000, and to have health insurance. Additionally, patients receiving specialist care were more likely to have received diabetes education during the previous 3 years, to have knowledge of HbAlc testing and to have received that test during the previous 6 months, to have knowledge of the Diabetes Control and Complications Trial results, to self-monitor blood glucose, and to inject insulin more than twice daily. A lower HbA1 level was associated with specialist care versus generalist care (9.7 vs. 10.3%; P = 0.0006) as were higher education and income levels. Multivariate analyses suggest that the lower HbA1 levels observed in patients receiving specialist care were restricted to patients with an annual income >$20,000. CONCLUSIONS: Specialist care was associated with higher levels of participation in diabetes self-care practices and a lower HbA1 level. Future efforts should research and address the failure of patients with low incomes to benefit from specialist care.     

The impact of cinnamon on anthropometric indices and glycemic status in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials

Background and aimsThere is some evidence regarding the positive effects of cinnamon on metabolic status in patients with type 2 diabetes (T2DM). However, they are conflicting. In the present study, we aimed to systematically review the effects of cinnamon on glycemic status and anthropometric indices in patients with T2DM.MethodsFive electronic databases including PubMed/Medline, SCOPUS, Web of Sciences, EMBASE, and the Cochrane library were searched until 31 February 2018 with no language limitation. Randomized clinical trials that examined the effects of cinnamon on at least fasting blood sugar (FBS) were included. Other glycemic parameters and anthropometric indices were also extracted. A random effects model with DerSimonian and Laird method was used for pooling the effect sizes.ResultsFinally, 18 studies were included in the meta-analysis. Supplementation with cinnamon reduced FBS by −19.26 mg/dL (95% CI: −28.08, −10.45; I²:96.5%; p = 0.0001) compared to placebo. However, the effects of cinnamon on HbA1C (−0.24%; 95% CI: −0.48, −0.01; I²: 76.8%, p = 0.0001), body weight (−0.46, 95%CI: −1.87, 2.30; I²:0%; p = 0.79), body mass index (WMD: −0.05 kg/m2; 95% CI: −0.52, 0.42; I²: 0%; p = 0.91), and waist circumference (WMD: −0.53 cm; 95% CI: −3.96, 2.81; I²: 0%; p = 0.66) were not significant. Additionally, cinnamon did not change the serum levels of insulin and insulin resistance significantly.ConclusionSupplementation with cinnamon can reduce serum levels of glucose with no changes in other glycemic parameters and anthropometric indices. However, due to high heterogeneity findings should be interpreted with great caution.     

超声弹性成像技术评价2型糖尿病患者颈动脉和足背动脉血管壁弹性

目的：利用超声弹性成像技术评价2型糖尿病（T2DM）患者颈动脉、足背动脉血管壁弹性的变化及与年龄的关系。方法研究对象分为T2DM组和对照组,各78人,使用高频线阵探头分别测量二组颈动脉、足背动脉内径（D）,并用超声弹性成像技术对血管壁弹性进行评估,计算血管内血液与血管壁的应变率比值（B/A）。然后将二组的血管内径、B/A值进行比较分析。同时把T2DM组、对照组按年龄分为青年亚组,中年亚组及老年亚组,比较不同年龄段B/A值与年龄的关系。结果两组间颈动脉、足背动脉血管内径相似,差异无统计学意义（P＞0．05）;T2DM组B/A值明显高于对照组,差异具有统计学意义（P＜0．05）;对照组不同年龄段B/A值随年龄增加而增加,差异具有统计学意义（P＜0．05）;T2DM组不同年龄段B/A值随年龄增加无明显变化,差异无统计学意义（P＞0．05）。结论T2DM组较对照组颈动脉、足背动脉血管壁弹性明显下降;对照组血管弹性随年龄增长而减低;T2DM组血管弹性随年龄增长无明显变化。超声弹性成像技术能在血管形态学改变之前对管壁弹性进行评价,具有方便、快捷、无创特点,对糖尿病的早期治疗有指导意义。     

2型糖尿病患者Hcy、HbAlc、MAU与肾脏微血管病变的关系探讨

目的 探讨2型糖尿病(T2DM)患者同型半胱氨酸(Hcy)、糖化血红蛋白(HbAlc)、尿微量白蛋白(MAU)与肾脏微血管病变的关系.方法 216例T2DM患者分为合并微血管病变组95例,无微血管病变组121例,治疗后按糖化血红蛋白(HbAlc)控制水平又分别分为HbAlc＜7.0%组、HbAlc＞7.0%组,以46例...     

初诊2型糖尿病患者糖化血红蛋白与并发症的关系

目的 探讨初诊2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)与糖尿病并发血管病变和肾功能损害的关系.方法 对221例初诊T2DM患者行颈动脉彩色多普勒超声波检查[颈动脉内膜至中膜厚度(IMT)＞1.3 mm诊断为血管病变,纳入血管病变组,反之纳入血管正常组],并检测尿微量清蛋白(mAlb)>22.5 mg/L诊断为肾功能损害,为RI组;mAlb 0~2.25 mg/L为肾功能正常,纳入NR组.利用ROC曲线分析不同切点HbA1c值,判断糖尿病并发血管病变和肾功能损害的敏感性和特异性.结果 HbA1c在不同切点HbA1c≥6.75%、HbA1c≥6.85%、HbA1c≥7.35%,诊断初诊T2DM 患者并发血管或肾功能损害、血管病变、肾功能损害的敏感度和特异性分别是93.4%和77.4%(ROC=0.929),91.7%和76.8%(ROC=0.918),85.7%和91.4%(ROC=0.943).结论 HbA1c用于早期预测诊断DM并发血管病变和肾功能损害具有较高的敏感度和特异性,对防治糖尿病并发血管病变和肾功能损害有重要意义.     

2型糖尿病患者血浆中PAI-1及sVCAM-1水平与耳鸣的相关性研究

目的探讨2型糖尿病(T2DM)患者血浆相关指标预测耳鸣发生情况的意义。方法对64例T2DM并发耳鸣患者及148例单纯T2DM患者临床资料进行回顾性分析,分别将其纳入观察组与对照组。比较两组患者血浆相关指标纤维酶原激活物抑制物-1(PAI-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、3-硝基酪氨酸(3-NT)、神经生长因子(NGF)水平,以受试者工作特征曲线(ROC曲线)分析上述指标单独或联合预测T2DM并发耳鸣的诊断效能,借助Pearson相关系数模型,探索观察组患者上述指标与耳鸣严重程度[耳鸣残疾度量化表(THI)]的相关性。结果观察组血浆PAI-1、sVCAM-1、3-NT、NGF水平均明显高于对照组,差异有统计学意义(P<0.05)。血浆PAI-1、sVCAM-1、3-NT、NGF单独预测T2DM患者并发耳鸣ROC曲线下面积(AUC)均大于0.5,Youden指数对应cut-off值分别为8.06 mmol/L、58.50 ng/mL、269.79 pg/mL、4.16 ng/mL;4个指标联合预测的ROC曲线AUC为0.796,均明显大于单独预测指标(P<0.05)。观察组患者血浆PAI-1、sVCAM-1、3-NT、NGF水平与THI评分均表现出显著正相关(r>0,P<0.05)。结论血浆PAI-1、sVCAM-1水平与T2DM患者并发耳鸣存在密切关系,可通过联合3-NT、NGF等指标开展较为准确的早期预测诊断,以期提高临床干预的目的性。     

Associations between single-nucleotide polymorphisms of the adiponectin gene,serum adiponectin levels and increased risk of type 2 diabetes mellitus in Iranian obese individuals

Abstract

Introduction: Adiponectin is an adipose tissue-secreted hormone with important metabolic effects. There have been inconsistent reports about SNPs of the adiponectin gene and risk of type 2 diabetes (T2DM). The aim of this study was to investigate any association between SNPs (+45 T/G and +276 G/T) of the adiponectin gene with serum adiponectin levels, metabolic factors and risk of T2DM in obese individuals. Design and methods: Genotyping for two common SNPs of adiponectin gene was performed in 50 unrelated obese type 2 diabetic patients and 52 obese non-diabetic control subjects by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Lipid profile was measured by enzymatic methods. Serum adiponectin, insulin, leptin and glucose levels were measured by immunoassay, and glucose oxidase methods, respectively. Results and conclusion: It was observed that obesity and T2DM are associated with low serum adiponectin levels. The G allele and TG/GG genotype of SNP 45 occurred more frequently than the T allele and TT genotype in T2DM patients compare to the controls (p<0.05). Subjects with the G/G + TG genotype of SNP 45 were at increased risk for T2DM [Odds Ratio (OR) 2.574; 95% Confidence Interval (CI) 1.051–6.302; p=0.036] compared with those T/T genotype. There was no statistically significant difference in allele and genotype frequencies of SNP 276 comparing control group with T2DM group. Thus, our results demonstrated that, adiponectin SNP 45T/G, rather than SNP 276G/T, is more associated with risk of T2DM in obese individuals.