糖尿病人发铬含量测定

本文测定了27名糖尿病人及63名健康人发铬含量。样品处理采用湿消化法。铬的测定采用无火焰原子吸收法。平均回收率为103％,变异系数为4.3％。 结果表明,糖尿病人平均发铬含量(104.22±61.99ng/g)明显低于健康人(173.19±79.96ng/g)(P<0.001),用胰岛素治疗的糖尿病人(158.67±102.83ng/g)明显高于未用胰岛素治疗者(88.67±34.76ng/g),提示糖尿病可能与缺铬有关,注入胰岛素可能刺激体库释放铬并表现在发铬含量上。     

富铬酵母对糖尿病病人糖耐量的影响

随机将63名非胰岛素依赖型糖尿病病人分为A、B、C三组,用双盲法进行观察。A组以高铬酵母形式每天补铬100μg;C组以普通啤酒酵母形式每天补铬15μg;B组给安慰剂作对照组。两个月后,A组糖尿病病人的空腹血糖水平由191±78mg/dl降至167±72mg/dl(p<0.01),馒头餐负荷后糖耐量曲线明显降低,血糖面积由938±351mg·h/dl降至809±272mg·h/dl(p<0.01)。其它两组实验前后无变化。本结果提示糖尿病病人有缺铬倾向,补给一定量的高铬酵母具有辅助治疗作用。     

糖尿病患者尿液中微量元素铬(Ⅲ)的测定及临床意义

应用离子交换PAR分光光度法进行尿铬(Ⅲ)测定,该法可直接测定尿液中铬(Ⅲ)含量。以尿铬(Ⅲ)/尿肌酐比值作为尿铬(Ⅲ)检测指标消除了年令及昼夜因素对尿铬(Ⅲ)含量的影渠。25例Ⅱ型非胰岛素依赖型糖尿病组和60例正常对照组尿铬(Ⅲ)含量(/±SD)分别为:5.45±0.85ng/mg)酐和7.56±0.94ng/mg肌酐、统计学处理表明:正常对照组含量与有关文献报道值相符,糖尿病组尿铬(Ⅲ)含量显著低于正常对照组(P<0.01)。提示:尿铬(Ⅲ)含量的测定可作为糖尿病患者诊断。治疗及预后的一项重要辅观察指标。     

德州市居民膳食铬摄入量对糖尿病发生的影响分析

目的:通过对德州市常见食品铬含量的测定,了解德州市居民膳食铬摄入情况,发现膳食铬水平对糖尿病发生的影响,指导德州市居民科学膳食,预防缺铬性糖尿病的发生和发展。方法:对德州市居民日常膳食中铬摄入量进行调查;对100名30岁以上健康成人和50名II型糖尿病患者血清铬含量进行检测。结果:德州市居民日常膳食中铬摄入量为45.7μg/d,低于中国营养学会建议的铬的适宜安全摄入量;健康成人血清铬为0.040~0.73μmol/L,与相邻地区相比略偏低;糖尿病患者血清铬的含量为0.019~0.63μmol/L,低于推荐的血清铬正常范围,显著低于健康成人血清铬含量。结论:德州市居民由于膳食结构不合理而致人体铬营养缺乏。通过国内外大量资料对铬与糖尿病密切关系的深入分析,提示由于铬营养缺乏而引起缺铬性糖尿病发生发展的危险性。     

心脏病患者血清铜、锌、锰、铬、硒含量测定的临床意义

作者应用原子吸收光谱法和原子荧光光谱法测定了人血清铜、锌、锰、铬、及全血硒。测定对象分正常对照(40例),冠心病(36例),风湿性心脏瓣膜病(27例),扩张型心肌病(34例)4组。结果表明,正常人平均血铜值1.227±0.213μg/ml,锌1.0±0.149μg/ml,铬8.945±5.464ng/ml,锰12.163±4.21ng/ml,硒0.0625±0.03μg/ml,与文献报道值接近。其余三组心脏病人血铜值(1.448μg/ml,1.740μg/ml、1.746μg/ml)均显著升高(P<<0.001),血锌在冠心病、风心病组降低(P<0.01),铬三组无变化,锰仅在风心病组降低(P<0.01),硒在冠心病组增高(P<0.05),在扩张型心肌病组则显著降低(P<0.0001)。急性心肌梗塞(13例),血铜升高,而锌降低;心衰时血铜显著升高。以上变化对三种心脏病及急性心肌梗塞的诊断与鉴別、判断心脏的功能可能有一定意义。特别是扩张型心肌病呈现出特异性血硒降低,可能是该病的致病因素之一。     

妊娠糖尿病孕妇血清铬的测定及临床意义

目的:测定妊娠糖尿病(GDM)孕妇血铬含量及其临床意义。方法:61例GDM孕妇为研究对象,糖耐量正常孕妇37例为对照组,测定两组血清铬含量、空腹血糖(FBG)和空腹胰岛素(FINS)。结果:GDM孕妇血铬含量明显低于正常孕妇(P<0.05),FBG、FINS和胰岛素敏感指数(ISI)均高于正常孕妇(P<0.05),GDM组血清铬与ISI、FBG、FINS均呈负相关,其中血清铬与ISI相关性最强。结论:GDM孕妇存在着明显的铬缺乏,补充适量的铬有助于改善胰岛素抵抗。     

人体铅的胎盘转运和乳汁传递

采用原子吸收光谱法对上海市区165名无职业铅接触史产妇的血铅、脐血铅、乳汁铅(119份)、胎盘组织铅(153份)样品进行测定,其均值分别为0.68±0.33μmol/L(14.13±16.79μg/dl)、0.40±0.23μmol/L(8.27±4.87μg/dl)、5.63±4.39ppb、1.14±1.10μmol/kg(23.73±22.85μg/100g)[中位数为0.63(13.2)、0.33(6.90)、4.74、0.86(17.85)]。产妇年龄对母血铅、脐血铅、乳汁铅和胎盘组织铅无显著影响。脐血铅、乳汁铅随母血铅增高而上升,其相关系数分别为0.714(P<0.0001)和0.353(P<0.01)。12名铅作业产妇平均年龄24岁,工龄1.9年,其乳汁铅几何均值为52.68ppb,显著高于非职业接触人群的4.43ppb(P<0.01),两者相差约12倍,提示对乳儿健康可能构成威胁。本文在国内首次报告了正常产妇的血铅、乳汁铅、脐血铅以及胎盘组织铅的参考值。     

工业区居民铬暴露解析及影响因素分析

目的对工业区居民铬暴露情况进行解析并对其影响因素进行分析。方法于2017年采用美国环保署推荐模型评估工业区环境铬暴露健康风险;随机整群分层抽取常住居民135人进行问卷调查、尿铬和血铬含量检测;两组间差异分析采用Mann-Whitney U检验;多组间差异分析采用Kruskal-Wallis H检验;相关性采用Spearman等级相关分析。结果工业区环境中铬的总非致癌风险(HI)为7.45×10~(-2),低于非致癌风险可接受水平1。铬的总致癌风险(Risk)T为1.24×10~(-2),超过致癌风险可接受水平10~(-4);其中,饮用水经皮肤摄入途径的致癌风险(Risk)占(Risk)T的59.61%。尿铬、血铬几何均数分别为0.22μg/L、0.49μg/L,尿铬、血铬水平,成人均显著高于儿童,吸烟者均显著高于非吸烟者(P0.05)。尿铬、血铬水平与不同暴露途径健康风险值均无相关性。结论工业区环境中的铬存在显著的致癌健康风险,应加强居民涉水活动的皮肤防护工作,年龄和吸烟对人体内铬负荷有影响。铬的内暴露水平与外暴露健康风险无显著相关。     

铬化物生产工人的铬吸收排泄关系及鼻损伤

本文对30名制造铬化物工人收集了所在工段的空气铬(CrO_3)浓度资料,并检测了代表皮肤接触铬的两手污染量以及尿铬排出量,用二元回归方程计算显示空气与手染铬量和尿中排铬量呈直线回归,F 值有非常显著意义,且中气变量x_2系数明显大于手染铬变量x_1系数数百倍,表明呼吸道对六价铬的吸收远比皮肤要多,但手污染严重时吸收量也相应增多。鼻损伤与手污染量明显相关,如能保持空气中六价铬的最高容许浓度,手染铬量少于2/μg/dl 时可能防止鼻拙伤的发生。     

铬负荷与铬中毒性肾损害关系的实验研究

在亚慢性铬中毒性肾损害动物模型研究发现：当血铬在６．６ｍｇ／ｍｌ以下时血铬与尿铬排泄率和肾铬水平呈明显正相关；当血铬超过６．６ｍｇ／ｍｌ时，尿铬排泄率开始下降，肾铬水平无明显增加。尿Ｌｙｓ、尿蛋白和ＧＦＲ出现异常的尿铬临界浓度分别为５．９０、７．５７和９．３６ｕｇ／ｍｇ肌酐。尿Ｌｙｓ和尿蛋白出现异常的肾皮质铬临界浓度分别是３６．７ｐｐｍ和４１．８ｐｐｍ。     

Effect of chromium supplementation on hair chromium concentration and diabetic status

Thirty-nine diabetic and 39 non-diabetic subjects matched for age and sex were given torula yeast (placebo) or brewer's yeast (68 μg chromium/day) in a double blind experiment. Hair chromium concentration was determined on all subjects before and after the 90 day yeast supplementation period. An overnight fasting blood sample was drawn from all diabetic subjects before and after yeast supplementation. The blood was analyzed for glycosylated hemoglobin and for serum glucose, insulin, total cholesterol, HDL cholesterol, and triglycerides. Mean initial hair chromium concentration of the non-diabetic subjects was 383±75 ppb, which was greater than that of the diabetic subjects (317±74 ppb) (p<0.001). Hair chromium concentration increased 111±78 ppb in subjects who received high chromium yeast compared with 17±80 ppb in those who received the placebo (p<0.001). The amount of increase in hair chromium concentration was similar between non-diabetic and diabetic subjects who received the high chromium yeast (p<0.05). No significant effect of chromium supplementation occurred in diabetic subjects as measured by any of the blood parameters (p>0.05).     

有机铬对2型糖尿病患者红细胞胰岛素受体的影响

目的 探讨有机铬改善糖代谢的作用机制。方法 将61例血铬正常的健康者作为对照组，63例血铬降低的2型糖尿病（T2DM）患者作为病例组。病例组患者随机分为酵母治疗组（n=32）和安慰剂对照组（n=31），停用原降糖药，仅饮食控制，并每日口服10g啤酒酵母或安慰剂。分别于服药前及服药两周后采用放射性配体结合分析法，以^125I标记的胰岛素（INS）为配体，与红细胞进行受体结合分析。同时测定空腹血铬、空腹血糖及空腹INS水平。结果 与对照组比较，病例组血铬水平显著降低（P〈0．01），^125I-INS与受体的最大特异性结合率降低（P〈0．01），高亲合力受体的结合位点数和低亲合力受体的结合位点数均降低（P〈0．001），空腹INS水平与受体的结合位点数之间呈显著的负相关（r=-0．91，P〈0．05）。与治疗前比较，酵母治疗组的血铬水平增高（P〈0．01），低亲合力受体的结合位点数显著增加（P〈0．01）。结论 有机铬可能通过增加受体的敏感性增加INS与受体的结合率，从而改善胰岛素抵抗，调节糖代谢。     

大连市糖尿病患者血硒水平的研究

用新极谱法测定大连市 型 (非胰岛素依赖型 )糖尿病患者血样 43 8例 (男性 2 3 3例 ,女性 2 0 5例 ) ,全血硒含量为 1 2 4 .9± 41 .0 μg/L(男性 1 2 7.0± 42 .0 μg/L,女性 1 2 2 .5± 3 9.3 μg/L) ,呈正态分布。糖尿病患者的血硒水平低于健康人 ,有显著差异 (P<0 .0 1 )。     

糖耐量减低者胰岛素分泌功能及胰岛素抵抗状态初探

[目的 ]　探讨糖耐量减低者的胰岛素分泌及胰岛素抵抗状态。　 [方法 ]　选择 162例研究对象进行口服葡萄糖耐量试验 (OGTT)后 ,分为 3组 :正常糖耐量 (NGT)组 49例 ,糖耐量减低 (IGT)组 5 8例 ,糖尿病 (DM )组 5 5例。查空腹和餐后 2h胰岛素 ,应用稳态模式胰岛素抵抗指数 (HOMA -IR )作为胰岛素抵抗指标 ,稳态模式胰岛 β细胞功能指数(HBCI)及胰岛素分泌指数 (IS)作为胰岛素分泌指标 ,对 3组患者的这些指标及临床特征进行分析。　 [结果 ]　与NGT组比较 ,IGT组HOMA -IR( 1.4± 0 .6)、FINS( 2 1± 15 )mU/L、2hINS( 61± 3 8)mU /L、HBCI( 5 .7± 0 .9)、IS ( 1.3± 0 .6)均增高 ,P值均 <0 .0 0 1。　 [结论 ]　IGT人群可能以外围组织的胰岛素抵抗为主及胰岛素持续的高分泌状态 ,IGT者胰岛素的分泌功能已有明显受损接近DM。     

Evaluation of Self-Care Practices and Emotional Distress Among People with Type 2 Diabetes Mellitus in Dar Es Salaam,Tanzania

This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, height, waist, hip, mid-upper arm circumference, blood pressure and fasting blood glucose were measured. Self-care practices and diabetic related emotion distress were evaluated by using validated instruments. Results revealed that, the average fasting plasma glucose was 11.2 ± 5.5 mmol/l, blood pressure was 134.7/86.1 mm/Hg and the mean BMI for males and females were 25.0 ± 4.3 and 27.0 ± 5.1 kg/m², respectively. Subject's self-care score for general diet, specific diet, physical exercise, foot-care and medication were 4.6 ± 2.4, 3.7 ± 1.5, 3.4 ± 1.8, 3.6 ± 2.8 and 5.5 ± 2.8 days per week, respectively. Self-monitoring of blood glucose was irregular and only 46.3% of the subjects tested their levels of blood glucose at least once in between the appointments (90 days). Low income was the major limitation for complying with the self-care practices related to diet, blood glucose testing and medication. It is recommended that, the Government of Tanzania should in the short run subsidize the prices of diabetes drugs, remove all taxes on the glucose test kits and establish a national diabetes program that would coordinate and oversee provision of the basic services such as screening, glucose testing, medication, counseling and management of the condition. In the long run, the government should establish a preventive public health program in order to curtail the escalation of diabetes. Further research should be conducted to determine how factors such as socio-cultural and demographic, self-care, and psychosocial distress interact to determine biomedical outcomes such as blood pressure, blood glucose and body mass index.     

Potential Antioxidant Effects of Zinc and Chromium Supplementation in People with Type 2 Diabetes Mellitus

Objective: To determine the effects of combined zinc (Zn) and chromium (Cr) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes.

Design: Tunisian adult subjects with HbA1C >7.5% were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo. The effects of supplementation on plasma zinc (Zn), copper (Cu), selenium (Se), urinary Zn, Cr, plasma thiobarbituric acid reactive substances (TBARS), Cu-Zn superoxide dismutase (SOD) and Se glutathione peroxidase (GPx) in red blood cells, blood lipids and lipoproteins, HbA1C and fasting glucose were measured at the beginning of the study and after six months.

Results: At the beginning of the study, more than 30% of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L, whereas levels of plasma Cu, Se and antioxidant RBC enzyme activities were in the normal ranges. Following supplementation, there were significant decreases of plasma TBARS in the Cr (13.6%), Zn (13.6%) and Zn/Cr (18.2%) groups with no significant changes in the placebo group. The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36% to 50% in the three supplemented groups. Supplementation did not modify significantly HbA1C nor glucose homeostasis. No adverse effects of Zn supplementation were observed on Cu status, HDL cholesterol nor interactions in Zn or Cr.

Conclusions: These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM. These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes.     

Retinol, alpha-tocopherol and carotenoids in diabetes.

OBJECTIVE: A case-control study was conducted to evaluate the effects of diabetes mellitus on serum levels of vitamin A, alpha-carotene, beta-carotene, alpha-tocopherol, serum and urine RBP. SUBJECTS: One hundred and seven patients with Type 2 diabetes mellitus (28-74 y) were recruited from those attending a primary health care clinic in King Khalid University Hospital in Riyadh City (Saudi Arabia). They were matched for age and sex with 143 healthy individuals. METHODS: Fasting blood samples and 10h urine collections were obtained from all subjects. Levels of vitamins and carotenoids in serum measured by high performance liquid chromatography (HPLC), and of retinol binding protein (RBP) in serum and urine by an enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean serum concentrations of retinol, alpha-carotene, and alpha-tocopherol were similar in both groups after correction of lipid soluble vitamins for serum lipids levels. However, serum beta-carotene concentration was significantly higher in control subjects than diabetics (P = 0.002). Serum and urine RBP concentrations were significantly higher in diabetics than in controls (P = 0.0001). In normal subjects (but not diabetics) serum concentrations of retinol and RBP were higher in men than in women (P = 0.02, P = 0.0001 respectively). In both normal and diabetic subjects, serum levels of alpha-tocopherol (P = 0.007) and urine RBP (P = 0.005), were higher in men than women. Urinary excretion of RBP was significantly higher in diabetic patients with renal impairment than other diabetics or controls (P = 0.0001). There was a negative correlation between fasting blood glucose (FBG) concentration and serum beta-carotene (P = 0.008) in the total combined group and a positive correlation between FBG and urinary RBP/creatinine (P = 0.009) in diabetic patients. CONCLUSION: Serum beta-carotene concentration was significantly lower in diabetic patients than controls. Serum retinol concentration in patients with diabetes was normal, yet serum and urine RBP concentrations were significantly higher in diabetics than in controls.     

Prevalence of hypothyroidism and diabetes mellitus in elderly kibbutz members

The aim of this study was to determine the prevalence of hypothyroidism and diabetes mellitus (DM) in elderly (aged 65–92 years) kibbutz members in Northern Israel. Method: The medical records of 1096 elderly (642 females and 454 males) residing in 11 kibbutzim were reviewed for data regarding thyroid function tests (TSH and FT4) and fasting blood glucose. Fasting blood glucose levels above 7.8 mmol/l was considered diagnostic for diabetes mellitus. Results: The prevalence of hypothyroidism was 14% (9.7% in males and 18.2% in females) and that of DM was 11.5% (12.1% in males and 11.1% in females). In 74% of the diabetics the diagnosis was made after the age of 60 years. Distribution of treatment modalities in diabetics was as follows: diet only 42%, oral hypoglycemic agents 52% and Insulin 6%. Subclinical hypothyroidism (serum TSH levels above 4.5 mU/L with normal FT4 levels) was detected in 38% of all the hypothyroid subjects. Conclusion: The data suggest that diabetes mellitus and primary hypothyroidism are common disorders in elderly subjects. DM in the elderly can usually be handled with diet and oral hypoglycemic drugs. Since the clinical features of hypothyroidism in the elderly are often atypical, we suggest that elderly subjects should be screened for hypothyroidism.