2型糖尿病大血管病变与视黄醇结合蛋白4及高敏C反应蛋白关系的研究

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.     

2型糖尿病大血管病变与视黄醇结合蛋白4及高敏C反应蛋白关系的研究

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.     

低蛋白饮食对3/4期慢性肾脏病患者肾功能及营养状况的影响

Objective To assess the influences of low-protein diet on the renal function and nutritional status in patients with stage 3/4 chronic kidney diseases (CKD).Methods Totally 34 patients with stage 3/4 CKD were randomly divided into group A (protein intake:0.6 g·kg~(-1)·d~(-1);n=14) and B (protein intake:0.8 g·kg~(-1)·d~(-1);n=20).Anthropometric measurement and blood biochemical tests were performed,nutri-tional status was assessed,and 24-hour dietary recall survey was conducted before and after the treatment.Patients were followed up for 6 months.Results In group A,the creatinine level significantly decreased (P=0.010),while albumin level (P=0.042) and the intake of energy (P=0.018) and carbohydrate (P<0.001) signifi-cantly increased after the treatment In all the 34 patients,in group A and group B,the malnutrition rates were de-creased by 14.7%,7.2%,and 21.1% after nutritional intervention.Conclusion The low-protein diet (protein intake 0.6 g·kg~(-1)·d~(-1)),in which part of the staple food was replaced by wheat starch,can increase the in-takes of carbohydrate and energy and improve renal function and nutritional status in patients with stage 3/4 CKD.     

精氨酸刺激试验评估胰岛β细胞功能的临床价值

Objective To investigate the value of intravenous arginine stimulation test (AST) in evaluating function of pancreatic islet beta cell response in patients of diabetes mellitus. Methods Twentyone patients with type 1 diabetes mellitus (DM1, DM1 group) and 113 patients with type 2 diabetes mellitus (DM2, DM2 group) were recruited in this study. DM2 patients were divided into two sub-groups, DM2a group (duration of no more than 1 year, 58 patients) and DM2b group (more than 1 year, 55 patients). The serum levels of C-peptide (CP) were determined at fasting and 2,3,4,5 minutes after intravenous injection of 5 g arginine. Results In DM1 group, the level of CP after injection of arginine was. similar to the fasting level (P> 0.05 ). In DM2 group, the peak level of CP appeared at 3th minute (CP3) during AST, and was significantly higher than fasting CP level(P < 0.01 ). The level of fasting and arginine-stimulated CP in DM2a group was significantly higher than that in DM2b group, and the level of fasting and arginine-stimulated CP in DM2b group was significantly higher than that in DM1 group. The patients of DM1 group whose level of CP3 < 600 pmol/L all needed insulin injection to control hyperglycemia, and the coincident rate was 100.0%.In DM2 group, there were 91 patients whose CP3 ≥600 pmol/L, among which 85 patients could be well controlled with diet or oral hypoglycemic agents, and the coincidentrate was 93.4%; there were 22 patients whose CP3 < 600 pmol/L, among which 19 patients need insulin injection to control hyperglycemia, and the coincident rate was 86.4%. Conclusions AST is valuable in assessing the function of pancreatic islet beta cell in patients with diabetes mellitus. The level of CP3 ≥600 pmol/L can be considered as a reference in diagnosis and treatment of diabetes mellitus.     

精氨酸刺激试验评估胰岛β细胞功能的临床价值

Objective To investigate the value of intravenous arginine stimulation test (AST) in evaluating function of pancreatic islet beta cell response in patients of diabetes mellitus. Methods Twentyone patients with type 1 diabetes mellitus (DM1, DM1 group) and 113 patients with type 2 diabetes mellitus (DM2, DM2 group) were recruited in this study. DM2 patients were divided into two sub-groups, DM2a group (duration of no more than 1 year, 58 patients) and DM2b group (more than 1 year, 55 patients). The serum levels of C-peptide (CP) were determined at fasting and 2,3,4,5 minutes after intravenous injection of 5 g arginine. Results In DM1 group, the level of CP after injection of arginine was. similar to the fasting level (P> 0.05 ). In DM2 group, the peak level of CP appeared at 3th minute (CP3) during AST, and was significantly higher than fasting CP level(P < 0.01 ). The level of fasting and arginine-stimulated CP in DM2a group was significantly higher than that in DM2b group, and the level of fasting and arginine-stimulated CP in DM2b group was significantly higher than that in DM1 group. The patients of DM1 group whose level of CP3 < 600 pmol/L all needed insulin injection to control hyperglycemia, and the coincident rate was 100.0%.In DM2 group, there were 91 patients whose CP3 ≥600 pmol/L, among which 85 patients could be well controlled with diet or oral hypoglycemic agents, and the coincidentrate was 93.4%; there were 22 patients whose CP3 < 600 pmol/L, among which 19 patients need insulin injection to control hyperglycemia, and the coincident rate was 86.4%. Conclusions AST is valuable in assessing the function of pancreatic islet beta cell in patients with diabetes mellitus. The level of CP3 ≥600 pmol/L can be considered as a reference in diagnosis and treatment of diabetes mellitus.     

学龄期儿童膳食钙与骨密度的关系

Objective To investigate the prevalence of overweight and obesity and the nutritional status of dietary calcium intake in school-age children in Shanghai and to analyze the relationship between dietary calcium and bone mineral density (BMD).Methods A cross-sectional study was conducted in the second and third grade students of 10 primary schools in Yangpu District and Baoshan District in Shanghai. Food frequency questionnaire was used tu estimate the relative intake of dietary calcium of students in 6 primary schools in Baoshnn District. Quantitative ultrasound bone density examination was used to estimate the calcaneal BMD.The relation-ship between calcium intake and BMD was analyzed.Results The average calcium intake was 647 mg/d among ested students.BMD was not significantly different among different age groups (F=1.595,P=0.173),while Z-score was significantly different among different age groups (F=16.02,P=0.000).The total calcium intake was not correlated with BMD or Z-score.The percentage of dairy calcium intake was positively correlated with BMD (r=0.097,P=0.015)and Z-score (r=O.117,P=0.003),the percentage of non-dairy calcium intake and the non-dairy calcium intake were negatively correlated with BMD (r=-0.097,P=0.015) and Z-score(r=-0.110,P=0.006).When the total dietary calcium intake was ≥600 mg/d,BMD and Z-score significantly higherin students with high dairy calcium intake than those with low dairy calcium intake (P<0.05).When the total dietary calcium intake was <600mg/d,BMD and Z-score were higher in students with high dairy calcium in-take than in those with low dairy calcium intake,although no statistical significance was noted (P>0.05).Conclusions BMD and Z-score increase along with the increase of dairy calcium intake.Such effect becomes even more obvious when the total dietary calcium intake is ≥600 mg/d.     

慢性乙型肝炎肝组织损伤的相关因素研究

Objective To study the expression of adiponectin and α-smooth muscle actin (α-SMA) in liver from the patients of chronic hepatitis B(CHB) overlapped non-alcoholic fatty liver disease( NAFLD), and to explore the mechanism of CHB patients with NAFLD. Methods 94 patients of CHB overlapped NAFLD (case group)underwent liver biopsy, 119 cases of patients with CHB alone (control group) as control, the fasting venous blood sample was taken for liver biochemical and virological indicators. Liver biopsy specimens were immunohistochemically stained for histology, adiponectin and α-SMA, and integral absorbance. Results The serum ALT, total cholesterol, triglyceride, low density lipoprotein cholesterol and fasting glucose levels in case group were significantly higher than that in control group (Z = 3.425,4.488,4.858、2.265, P < 0.05) .There was no significant difference in HBV DNA viral load and HBeAg between the two groups( Z = 0.825, χ2 = 0.323, P > 0.05). In case group, adiponectin expression was no significant correlation with steatosis, inflammation and fibrosis(r = 0.032, -0.107, -0.133, P>0.05); however, in control group adiponectin was negatively related to inflammation and fibrosis(r= -0.223, -0.259,P<0.05). In case group,α-SMA expression was significant correlation with inflammation and fibrosis( r = 0.323,0.355, P < 0.05). In control group, its expression was no correlation with inflammation and fibrosis( r = 0.172,0.155, P > 0.05). Conclusions The occurrence of NAFLD is mainly related to metabolic factors and no relation with viral factors. Adiponectin is not directly related to liver injury of patients of CHB overlapped NAFLD. α-SMA may be important indicator of liver injury,and NAFLD may promote the progress of liver injury in patients with CHB.     

慢性阻塞性肺疾病的炎症反应与营养不良密切相关

Objective To study the relationship between inflammation and malnutrition in patients with stable chronic obstructive pulmonary disease (COPD).Methods A total of 85 patients with stable COPD and 30 healthy subjects were recruited .All patients were divided into the lower body mass index (BMI,BMI<18.5 kg/m~2) group and normal BMI (BMI=18.5-23.9 kg/m~2) group.Lung function,arterial blood gall,cell differenti-als in induced sputum,and the levels of serum C-reactive protein (CRP),interleukin-8(IL-8),interleukin-6 (IL-6),interleukin-10 (IL-10),and tumor necrosis factor-α(TNF-α) were determined.Results The levels of total cell count and neutrophils in induced sputum were significantly higher in lower BMI group than in normal BMI group and healthy subjects (P<0.05).The forced expiratory volume in 1 second percentage,forced expiratory volume in 1 second/forced vital capacity,and arterial oxygen tension were significantly lower in lower BMI group than in normal BMI group,and the arterial carbon dioxide tension was significantly higher in lower BMI group than in normal BMI group (P<0.05).The levels of serum CRP,IL-8,IL-6,and TNF-α were significantly higher in lower BMI group than those in normal BMI group and healthy subjects (P<0.05).In lower BMI group,BMI was negatively correlated with total cell count (r=-0.492,P=0.0038) and neutrophils (r=-0.501,P=0.0032) in induced sputum and the levels of serum CRP (r=-0.473,P=0.0083),IL-8(r=-0.382,P=0.0421),IL-6(r=-0.422,P=0.0147),and TNF-α(r=-0.416,P=0.0156),respectively.Conclu-sion Local and systemic inflammatory reaction is responsible for malnutrition associated with COPD.     

亚甲基四氢叶酸还原酶基因多态和叶酸摄取与乳腺癌的发病风险

Objective To evaluate the relationship between dietary folate intake and genetic polymorphisms of 5, 10-methylenetetrahydrofolate reductase (MTHFR) with reference to breast cancer risk. Methods A case-control study was conducted with 669 cases and 682 population-based controls in Jiangsu province of China. MTHFR C677T and AI298C genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Dietary folate intake was assessed by using an 83-item food frequency questionnaire. Odds ratios (OR) were estimated with an unconditional logistic model. Results The frequencies of MTHFR C677T C/C, C/T and T/T genotypes were 32. 37% (202/624), 48. 88% (3051624) and 18. 75% (117/624) in cases and 37. 66% (235/624), 48.24% (301/624) and 14. 10% (88/624) in controls,respectively. The difference in distribution was significant (X2=6. 616, P=0. 037), the T/T genotype being associated with an elevated OR for breast cancer (1.62, 95% CI: 1.14 -2. 30). The frequencies of MTHFR A1298C A/A,A/C and C/C were 71.47% (446/624), 27.08% (169/624) and 1.44% (9/624) in cases and 68. 11% (425/624) ,30. 13% (188/624) and 1.76% (11/624) in controls, with no significant differences found (X2=1.716, P=0. 424). Folate intake of cases [(263.00±137. 38)μg/d]was significantly lower than that of controls [(285. 12±149. 61)μg/d](t=-2. 830,P=0. 005). Compared with the lowest tertile (≤199. 08μg/d) of folate intake,the adjusted OR for breast cancer in the top tertile (≥315.μg/d) was 0. 70 (95% CI:0. 53 -0. 92). Among individuals with the MTHFR A1298C A/A genotype,adjusted OR for breast cancer were 0. 89 (95% CI: 0. 62 -1.27)and 1.69 (95% CI: 1.20 -2. 36) for the second to the third tertite of folato intake compared with thehighest folate intake group (Xtrend2=11. 372, P=0. 001). Conclusion The findings of the present study suggest that MTHFR genetic polymorphisms, and dietary intake of folate may modify susceptibility to breast cancer.     

亚甲基四氢叶酸还原酶基因多态和叶酸摄取与乳腺癌的发病风险

Objective To evaluate the relationship between dietary folate intake and genetic polymorphisms of 5, 10-methylenetetrahydrofolate reductase (MTHFR) with reference to breast cancer risk. Methods A case-control study was conducted with 669 cases and 682 population-based controls in Jiangsu province of China. MTHFR C677T and AI298C genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Dietary folate intake was assessed by using an 83-item food frequency questionnaire. Odds ratios (OR) were estimated with an unconditional logistic model. Results The frequencies of MTHFR C677T C/C, C/T and T/T genotypes were 32. 37% (202/624), 48. 88% (3051624) and 18. 75% (117/624) in cases and 37. 66% (235/624), 48.24% (301/624) and 14. 10% (88/624) in controls,respectively. The difference in distribution was significant (X2=6. 616, P=0. 037), the T/T genotype being associated with an elevated OR for breast cancer (1.62, 95% CI: 1.14 -2. 30). The frequencies of MTHFR A1298C A/A,A/C and C/C were 71.47% (446/624), 27.08% (169/624) and 1.44% (9/624) in cases and 68. 11% (425/624) ,30. 13% (188/624) and 1.76% (11/624) in controls, with no significant differences found (X2=1.716, P=0. 424). Folate intake of cases [(263.00±137. 38)μg/d]was significantly lower than that of controls [(285. 12±149. 61)μg/d](t=-2. 830,P=0. 005). Compared with the lowest tertile (≤199. 08μg/d) of folate intake,the adjusted OR for breast cancer in the top tertile (≥315.μg/d) was 0. 70 (95% CI:0. 53 -0. 92). Among individuals with the MTHFR A1298C A/A genotype,adjusted OR for breast cancer were 0. 89 (95% CI: 0. 62 -1.27)and 1.69 (95% CI: 1.20 -2. 36) for the second to the third tertite of folato intake compared with thehighest folate intake group (Xtrend2=11. 372, P=0. 001). Conclusion The findings of the present study suggest that MTHFR genetic polymorphisms, and dietary intake of folate may modify susceptibility to breast cancer.