2型糖尿病患者内脏脂肪与代谢指标及胰岛素抵抗的关系

目的 探讨2型糖尿病(T2DM)患者内脏脂肪与代谢指标及胰岛素抵抗的关系.方法 选取T2DM患者236例,测量内脏脂肪面积(VFA)和皮下脂肪面积(SFA),检测TG、TC、HDL-C、LDL-C、尿酸(UA)、空腹胰岛素(FIns)、HbA1c、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β).根...     

银屑病患者脂肪因子水平及其与代谢性疾病的相关性研究

目的 检测江西省皮肤病专科医院住院的银屑病患者外周血中脂肪因子水平,同时探索其与代谢性疾病的相关性.方法 本研究纳入30例银屑病患者及30例其它皮肤病患者.ELISA法检测银屑病患者的外周血中脂肪因子(瘦素、脂联素、抵抗素、内脏脂肪组织源性丝氨酸蛋白酶抑制剂vaspin、白介素-6)的分泌水平;分析脂肪因子水平与BMI、PASI评分及代谢相关性指标(空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、糖化血红蛋白、尿酸等)的相关性.结果 银屑病患者组较对照组外周血中瘦素、抵抗素、IL-6水平高,脂联素、vaspin水平低.瘦素、抵抗素、IL-6水平与BMI值、PASI评分呈正相关,脂联素、vaspin水平与BMI值、PASI评分呈负相关.瘦素与糖化血红蛋白、甘油三酯水平呈正相关,与HDL水平呈负相关,IL-6与糖化血红蛋白、甘油三酯水平呈正相关,脂联素与糖化血红蛋白呈负相关,vaspin表达水平与甘油三酯水平呈负相关,但控制BMI、PASI评分后仅脂联素水平与LDL水平呈轻微负相关.高尿酸血症者的瘦素、抵抗素、IL-6水平较尿酸水平正常者高,vaspin水平较低,而低HDL血症者的脂联素、vaspin水平较HDL正常者低.结论 上述脂肪因子水平可能用于评估银屑病患者的疾病严重程度及其合并症如肥胖、高血糖、高尿酸血症、高脂血症等代谢性疾病甚至代谢综合征的发生.     

2型糖尿病患者瘦素水平测定及临床意义的研究

目的探讨2型糖尿病患者的血清瘦素水平、瘦素与胰岛素抵抗的关系及临床意义。方法糖尿病组100例,分为糖尿病非肥胖组[体重指数(BMI)<25kg/m2)]与肥胖组(BMI≥25kg/m2),计算BMI、腰臀围比值(WHR),用酶联免疫吸附试验(ELISA)测定人血清瘦素,同时测定空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素原(PI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(FFA)、睾酮。胰岛素敏感性以HOMA模型中胰岛素抵抗指数(HOMA-R)评价。对照组:健康人60名与糖尿病组相匹配,分组和观察指标也相同。结果山西地区人血清瘦素正常值女性为(7.6±3.6)μg/L,男性为(2.1±1.0)μg/L;糖尿病组与对照组肥胖者瘦素水平均明显高于非肥胖者,瘦素水平与性别、体重、BMI、FINS、PI、HOMA-R、FFA显著相关,男性瘦素水平与男性睾酮呈显著负相关。肥胖者多数存在高胰岛素血症,胰岛素不敏感者较胰岛素敏感者瘦素水平增高。多元回归结果显示,糖尿病组性别、BMI、FINS、HOMA-R是瘦素水平的影响因素。结论2型糖尿病患者瘦素水平与非糖尿病无明显差异,瘦素水平与肥胖和胰岛素抵抗关系密切,并对糖尿病患者的防治有一定的临床意义。     

成年男性内脏脂肪面积与腰椎骨密度相关性研究

目的探讨成年男性内脏脂肪面积(VFA)与腰椎骨密度(BMD)的相关性。方法收集 2017年 5月至 2017年 8月入华北石油总医院体检男性共 1368例，年龄(50.91±0.30)岁，年龄范围为 25～65岁。所有研究对象均测定身高、体质量、腰围，计算体质指数(BMI)；利用定量 CT(QCT)测量 L1、2椎体的平均骨密度值及 L2层面的腹部皮下脂肪面积(SFA)与 VFA。根据研究对象的骨密度分为骨量正常骨量组、低骨量组及骨质疏松组，比较各组年龄、 BMI、VFA、SFA的差异，并分析其与腰椎骨密度的相关性。结果正常骨量组 805例、低骨量组 449例及骨质疏松组 114例。正常骨量组、低骨量组和骨质疏松组年龄分别为(39.25±9.33)、(56.17±7.61)、(67.28±8.19)岁， BMI分别为(24.31±4.62)、(22.65±2.81)和(19.84±3.11)kg/m2；低骨量组和骨质疏松组年龄均高于正常骨量组，骨质疏松组年龄高于低骨量组；低骨量组和骨质疏松组 BMI均低于正常骨量组；骨质疏松组 BMI低于低骨量组；低骨量组和骨质疏松组内脏脂肪量(VAT)［(25.59±2.11)g和(39.68±5.05)g］和 VFA值均高于正常骨量组(24.20±2.09)g，同时骨质疏松组 VAT、VFA值明显高于低骨量组，均差异有统计学意义(P＜0.05)；男性腰椎骨密度与 VFA呈负相关，且控制年龄及 BMI因素后，男性腰椎骨密度与 VFA仍呈负相关。结论男性腰椎骨密度与内脏脂肪组织呈负相关关系。     

二甲双胍对2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的影响

【】 目的 研究二甲双胍对2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的影响。方法 120例2型糖尿病患者随机分为二甲双胍组(n=60)和单纯胰岛素组(n=60),单纯胰岛素组只进行胰岛素治疗,二甲双胍组在胰岛素治疗基础上加用二甲双胍,测定两组患者治疗前后胰岛素功能 (FINS、PINS、HOMA-IR)、糖脂代谢指标(FBG、PBG、HbAlc、TG、TC、LDL-C、HDL-C、FFA)、脂肪因子(瘦素、内脂素、抵抗素、脂联素、网膜素、Vaspin)。结果 治疗后,两组患者的FINS、HOMA-IR、FBG、PBG、HbAlc、TG、FFA、瘦素和抵抗素水平均明显降低,与治疗前比较差异均具有统计学意义(P<0.05)。且二甲双胍组治疗后FINS、HOMA-IR、FBG、PBG、HbAlc、TG、FFA、瘦素和抵抗素水平均低于单纯胰岛素治疗后的水平(P<0.05)。而两组患者的PINS 、TC和HDL-C均无明显变化。治疗后二甲双胍组的内脂素和Vaspin水平均明显降低,网膜素水平明显上升,差异均具有统计学意义,而二甲双胍组的脂联素水平无明显变化。治疗后单纯胰岛素组内脂素、Vaspin、网膜素和脂联素的水平均无明显变化。结论 二甲双胍可明显改善2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的水平,特别是对内脂素、Vaspin、网膜素等脂肪因子的影响,提示二甲双胍治疗2型糖尿病的机制不仅是通过改善糖脂代谢,还可能与改善内脂素、Vaspin、网膜素等脂肪因子有关。     

腹腔内脏脂肪面积与2型糖尿病及血清胰岛素的相关研究

目的观察腹腔内脏脂肪面积(VA)与2型糖尿病及血清胰岛素的关系。方法 2型糖尿病患者273例,非糖尿病者122例,分为高脂肪组198例和低脂肪组197例。检测空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1C)、尿酸(UA)、游离脂肪酸(FFA)、血脂系列等相关指标,采用CT测定VA,计算胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)。结果糖尿病组的VA显著高于非糖尿病组(P<0.05),高脂肪组的腰围、BMI、UA、FINS、TG、IR、FFA、舒张压、收缩压明显高于低脂肪组(P<0.05),HDL明显低于低脂肪组(P<0.05)。腰围、BMI、FINS、UA、IR、TG、舒张压、收缩压、FFA与腹腔内脏脂肪面积呈正相关(r=0.697、0.625、0.374、0.371、0.332、0.317、0.181、0.136、0.110,均P<0.05),HDL与VA呈负相关(r=-0.230,P<0.05)。腰围、FINS、UA为VA的独立危险因素(b=6.657、2.819、2.405,均P<0.05)。结论内脏脂肪增加伴有胰岛素水平增高,胰岛素抵抗加重,糖尿病风险增加,并出现血压、尿酸、脂肪酸、胰岛素等多项代谢指标的异常。     

低碳水化合物饮食结合利拉鲁肽治疗2型糖尿病合并肥胖症的临床疗效

目的 探讨低碳水化合物饮食结合利拉鲁肽治疗2型糖尿病合并肥胖症的临床疗效.方法 将入组的60例2型糖尿病合并肥胖症患者随机分为2组,A组给予低碳水化合物饮食+利拉鲁肽干预治疗;B组给予低碳水化合物饮食,比较治疗后两组患者的体重、体重指数(BMI)、腰围、血脂(TC、TG、LDL、HDL)、脂肪率、内脏脂肪、空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)等指标的变化情况.结果 A组治疗后体重降至(79.00±11.95) kg,腰围降至(97.48±10.78) cm,BMI降至(27.72±3.10) kg/m2,TC、TG、LDL分别降至[(4.42±0.86)、(1.57±0.54)、(3.12±0.61)mmol/L],FBG、2hPBG分别为[(5.42±0.86)、(7.26±0.84)mmol/L],HbA1c降至(5.93±0.63)％,FINS为(13.72±4.20)μIU/nl;B组治疗后体重降至(81.04±8.78)kg,腰围降至(99.32±8.08) cm,BMI降至(28.84±2.35) kg/m2,TC、TG、LDL分别降至[(4.74±0.72)、(1.72±1.09)、(3.25±0.84) mmol/L],FBG、2hPBG分别为[(5.84±0.79)、(7.99±1.04) mmol/L],HbAIc降至(6.11±0.87)％,FINS为(15.71±3.27)μIU/ml,A、B组两组治疗后比较,体重、BMI、腰围、TC、TG、LDL、脂肪率、内脏脂肪FBC、2hPBG、HbA1c、FINS、HOMA-IR比较差异有统计学意义(P＜0.05),但HDL干预后改善不显著(P＞0.05).结论 低碳水化合物饮食结合利拉鲁肽可明显降低患者体重,改善肥胖相关指标、降低血糖、改善胰岛素抵抗,且效果优于单纯低碳水化合物饮食.     

新诊断2型糖尿病患者血浆内脏脂肪素水平与胰岛素抵抗的关系研究

目的探讨新诊断2型糖尿病患者血浆内脏脂肪素(visfatin)水平与胰岛素抵抗及相关因素的关系。方法选取我院收治的30例初次诊断2型糖尿病患者为观察组,选取同期30例健康查体者作为对照组,测定两组患者血浆visfatin水平,观察不同visfatin水平与胰岛素抵抗及相关因素的关系。结果观察组和对照组比较体质指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)、胰岛素敏感指数(ISI)、visfatin比较,差异均有统计学意义(P<0.05);两组年龄、男性、UA比较差异均无统计学意义(P>0.05)。多元逐步回归分析显示,visfatin表达量与性别、年龄、UA无相关性,与FPG、HbA1c、WHR、BMI、HOMA-IR、TC、TG、LDL-C呈正相关,与ISI呈负相关。结论新诊断2型糖尿病患者血浆visfatin水平与胰岛素敏感性作用有关,与人内脏脂肪的数量有很强的相关性,与糖脂代谢有密切关系。     

2型糖尿病、冠状动脉硬化性心脏病与血清脂联素、网膜素、内脏脂肪素的相关性探索

目的探讨血清脂联素、网膜素、内脏脂肪素在2型糖尿病(T2DM)患者及冠状动脉硬化性心脏病(CHD)患者中的变化。方法健康体检者30例为对照组,2型糖尿病患者34例为T2DM组,冠状动脉硬化性心脏病患者41例为CHD组。采用双抗体夹心法酶联免疫吸附试验(ELISA)检测各组患者血清脂联素、网膜素和内脏脂肪素含量;采用全自动血生化分析仪分别检测各组患者空腹血清葡萄糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)含量,采用化学发光法检测各组患者空腹血清胰岛素(FINS)含量,采用稳态模型评估法(HOMA-IR)计算胰岛素抵抗指数。结果 T2DM组、CHD组血清脂联素、网膜素水平均明显低于对照组(F=34.99,100.65,q=7.60~21.68,P<0.01);T2DM组、CHD组血清内脏脂肪素水平明显高于对照组(F=21.28,q=9.25,8.30,P<0.01),T2DM组与CHD组以上指标比较差异无统计学意义(P>0.05)。各组血清脂联素、网膜素、内脏脂肪素与HOMA-IR均有相关性(P<0.01)。结论血清脂联素、网膜素、内脏脂肪素与2型糖尿病、冠状动脉硬化性心脏病的发生发展密切相关。     

脂肪细胞因子与肥胖和糖尿病的关系

目的 探讨腹脂素等脂肪细胞因子与肥胖和糖尿病的关系.方法 分别测定单纯性肥胖组(30例)、糖尿病组(30例)和正常对照组(20例)的体重指数(BMI)、腰围、臀围、空腹胰岛素(FINS)、空腹血糖(FBS)、血脂、腹脂素、瘦素和脂联素的水平,计算胰岛素抵抗指数(HOMA-IR).结果 (1)单纯性肥胖组和糖尿病组血清腹脂素及瘦素水平高于正常对照组,而脂联素水平明显降低 (P＜0.05);(2)糖尿病组血清腹脂素、瘦素及脂联素水平与单纯肥胖组比较差异无显著性(P=0.450);(3)腹脂素与BMI、腰围、腰臀比、瘦素呈正相关,与脂联素呈负相关;(4)腰围可较好地预测腹脂素水平.结论 腹脂素及瘦素在单纯性肥胖和糖尿病患者中明显升高,而脂联素降低,其表达水平与肥胖程度及肥胖类型(中心性肥胖)密切相关.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.