糖代谢异常和糖尿病患者血循环中白细胞计数的观察

目的探讨血循环中白细胞计数（WBC）在糖代谢异常和糖尿病患者中的变化。方法对156例糖尿病、糖代谢异常和正常对照组患者血循环中WBC、空腹血糖、胆固醇、三酰甘油进行对比观察。结果糖尿病、糖代谢异常和正常对照组之间WBC和三酰甘油在各组之间比较差异有显著性（P〈0.01）;WBC的多因素Linear regression分析发现,空腹血糖是WBC的相关因子（P〈0.01）。结论糖尿病和糖代谢异常患者血循环中WBC升高,而且WBC与空腹血糖水平相关。因此,血循环中WBC升高可能参与糖尿病的发病和进展。     

高血压冠心病患者血循环中白细胞计数的临床初步观察

本实验观察了高血压、冠心病及高血压合并冠心病患者血循环中白细胞计数，以探讨白细胞在这些疾病形成中的作用机制。观察组81例，对照组33例。结果：高血压组、冠心病组和高血压合并冠心病组的白细胞计数与对照组均有显著性差异（P＜0．01）；高血压合并冠心病组的白细胞计数和单纯高血压病组有显著性差异（P＜0.01）；而和单纯冠心病组无显著性差异。白细胞计数的增高在高血压和冠心病的形成中具有重要作用。     

不同糖耐量个体外周血的白细胞计数与糖脂代谢指标的相关研究

选取糖耐量正常(NGT)者、糖耐量受损(IGT)者、糖尿病(DM)患者各40例,测量身高、体重、血压、血常规、血糖、血脂,比较各组白细胞计数的变化,并分析白细胞计数与糖脂代谢指标的相关性。结果IGT组的白细胞计数较NGT组的明显升高,差异有统计学差异(P<0.05),DM组的白细胞计数较IGT组的明显升高,差异有统计学差异(P<0.05);白细胞计数与餐后2小时血糖(2h PG)和糖化血红蛋白(HbA1c)呈正相关(r=,P<0.05)。结论白细胞计数与糖脂代谢状态密切相关。     

红细胞体积分布宽度与糖代谢异常/糖耐量异常和糖尿病相关

目的探讨红细胞体积分布宽度（RDW）与2型糖尿病（T2DM）、空腹血糖受损／葡萄糖耐量异常（IFG／IGT）的相互关系。方法对152例在我院定期进行健康体检或治疗的患者,依据血糖情况分为3组,其中T2DM组42例,IFG／IGT组38例,正常对照（NGT）组72例,采取空腹血,采用全自动血液分析仪测定RDW、血红蛋白,多功能血生化自动分析仪测定血总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血肌酐、血尿素氮和空腹血糖,同时统计高血压、冠心病的发病率并分析其关系。结果RDW在T2DM组、IFG／IGT组和NGT组之间比较具有统计学差异,其中T2DM组和NGT组、IFG／IGT组比较,差异均有统计学意义（P〈0．05或P〈0．01）,IFG／IGT组与NGT组比较差异无统计学意义（P〉0．05）。多因素直线回归分析显示空腹血糖（P〈0．01）和高密度脂蛋白胆固醇（P〈0．05）是RDW的独立危险因子。结论T2DM患者RDW升高,RDW的变化与空腹血糖水平相关。     

妊娠初期外周血白细胞计数与妊娠糖尿病发生的相关性研究

目的探讨妊娠初期外周血白细胞（WBC）计数与随后发生的妊娠糖尿病（GDM）的相关性。方法在妊娠初期检测孕妇的外周血WBC计数,将以后发生GDM的232例作为病例组,糖耐量正常的482名孕妇作为对照组,比较两组的wBC计数;再按WBC计数四分位,从而将研究对象分为四组,进行Logistic回归分析。结果病例组的妊娠初期外周血WBC计数明显高于对照组（8．56×10^9／L vs8．18×10^9／L,P〈0．01）。根据wBC计数四分位的结果,将研究对象分为四组,第一组WBC〈7．46×10^9／L,第二组wBC（7．46～8．33）×10^／L,第三组WBC（8．34～9．16）×10^9／L,第四组wBC≥9．17×10^9／L,相应的GDM的检出率分别为20．13％、34．61％、36．02％、39．61％。调整年龄、孕次、孕前BMI、SBP、DBP及糖尿病家族史等因素,行Logistic回归发现,相对于第一组而言,第二组、第三组及第四组发生GDM的危险分别是第一组的2．17倍（95％CI 1．25～3．77）、2．15倍（95％CI1．23～3．76）及2．59倍（95％CI1．49～4．50）。结论GDM患者妊娠初期WEC计数升高,慢性炎症可能参与了GDM的发生。     

辛伐他汀对糖尿病动脉硬化危险因素的影响

本应用辛伐了汀对３６例Ⅱ型糖尿病伴高脂血症患进行了为期１２周短期观察。结果显示：辛伐他汀明显降低血胆固醇、甘油三酯及低密度脂蛋白胆固醇（４．４２±１．３３ｍｏｌ／Ｌ比３．０１±０．９８ｍｍｏｌ／Ｌ）,明显升高高密度脂蛋白胆固醇（Ｐ均〈０．０５）;同时明显升高血浆纤溶酶原激活物活性和降低血浆纤溶酶原激活物抑制－１活性,Ｐ〈０．０５,上述指标的变化不依赖血糖控制的改变。提示辛伐他汀可明显改善糖尿病     

辛伐他汀对糖尿病动脉硬化危险因素的影响

本文应用辛伐他汀对36例Ⅱ型糖尿病伴高脂血症患者进行了为期12周短期观察.结果显示辛伐他汀明显降低血胆固醇、甘油三酯及低密度脂蛋白胆固醇(4.42±1.33mmol/L比3.01±0.98mmol/L),明显升高高密度脂蛋白胆固醇(P均＜0.05);同时明显升高血浆纤溶酶原激活物活性和降低血浆纤溶酶原激活物抑制-1活性,P＜0.05,上述指标的变化不依赖血糖控制的改变.提示辛伐他汀可明显改善糖尿病患者异常的脂质代谢和纤溶障碍,对糖尿病患者加速的动脉硬化性疾病的防治有较好的作用.     

高血压高脂血症患者外周血中白细胞计数的初步观察

动物实验已证明血循环中的白细胞参与高血压和冠状动脉粥样硬化性心脏病的病理生理过程[1] ,但在人体尚未普遍开展这方面的研究。本文观察了高血压、高脂血症以及高血压合并高脂血症患者外周血中白细胞计数 ,初步探讨白细胞与这些疾病的关系。对象与方法　　 1.对象　在健康体检中检出的高血压、高脂血症患者共 4 6 6例 ,男 358例 ,女 10 8例 ,其中高血压组收缩压≥ 2 1.3ｋＰａ(16 0ｍｍＨｇ)及 /或舒张压≥ 12 .7ｋＰａ(95ｍｍＨｇ) 154例 (男 132例 ,女 2 2例 ) ,年龄 6 3.5± 6 .7岁 ;高脂血症组 (血清总胆固醇 >5.7ｍｍｏｌ/Ｌ及 /或甘…     

老年女性2型糖尿病患者尿酸水平、白细胞计数与骨密度的关系

目的探讨老年女性2型糖尿病(T2DM)患者血尿酸(UA)、白细胞计数与骨密度的关系。方法采用双能X线吸收法测定老年女性T2DM患者及正常对照组患者腰椎及左股骨颈的BMD,检测其空腹及餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、血尿酸(UA)、血清钙(ALP)、血清磷、血清总碱性磷酸酶(ALP)水平、白细胞计数、淋巴细胞计数。结果 (1)老年女性T2DM患者腰椎、左股骨颈BMD值显著低于正常对照组,UA水平显著高于正常对照组(P<0.05)。(2)老年女性T2DM患者高UA组L1~L3 BMD值显著低于正常UA组(P<0.05)。(3)Logistic回归分析示,年龄、T2DM和血UA是老年女性骨质疏松或骨含量降低的危险因素,而外周白细胞计数则为保护因素(OR值分别为1.108、5.911、1.005、0.689,P<0.05)。结论老年女性T2DM患者BMD降低,定期检测血UA水平和外周白细胞计数,可预测老年女性T2DM患者的BMD。     

肺癌患者外周血白细胞计数升高的临床意义

肺癌患者外周血白细胞 (WBC)计数升高除并有细菌感染外 ,还可见于在治疗过程中使用糖皮质激素或抗癌药物 ,以及无其它原因的肺癌本身引起的WBC升高。严格区分在 WBC升高中感染和非感染因素的作用 ,对于防止滥用抗生素具有重要意义。1 996～ 2 0 0 1年 ,我院收治肺癌患者 847例 ,WBC升高 1 3 4例 ,现将其升高原因及临床特点报告如下。1　临床资料　　本文 WBC升高入选标准为感染、糖皮质激素和抗癌药物所致 WBC>1 0 .0× 1 0 9/L者 ;无其它原因WBC>2 0 .0× 1 0 9/L[1]肺癌者。细菌感染时 ,患者入院体温 >3 7.5℃ ,咳黄痰或痰培养…     

Association of circulating leukocyte count with coronary atherosclerosis regression after pravastatin treatment

Epidemiological studies have demonstrated that the peripheral blood leukocyte count could be used as a marker of the progression of atherosclerosis. Few data exist regarding the relationship between inhibition of the progression of coronary atherosclerosis and the anti-inflammatory effects of statins, especially the drugs' effects on the leukocyte count in patients with coronary artery disease. A 6-month prospective study was, therefore, conducted in 50 patients treated with pravastatin. The plaque volume, as assessed by volumetric analysis using intravascular ultrasound, reduced significantly by 14% (p<0.0001, vs. baseline) following the treatment, furthermore, a corresponding decrease of the leukocyte count (8.9%, p<0.01, vs. baseline) was also seen. No correlation was found between the change in the leukocyte count and any of the changes in the lipid levels; changes in either of these are known to be associated with the rate of progression of atherosclerosis. A multivariate regression analysis using other traditional risk factors and medications as covariates revealed that the decrease in the leukocyte count was an independent predictor of inhibition of the progression of coronary atherosclerosis. In conclusion, a reduction of the leukocyte count as one of the non-lipid-lowering effects of pravastatin may be a novel marker of regression of coronary atherosclerosis.     

Association of sleep time with diabetes mellitus and impaired glucose tolerance

BACKGROUND: Experimental sleep restriction causes impaired glucose tolerance (IGT); however, little is known about the metabolic effects of habitual sleep restriction. We assessed the cross-sectional relation of usual sleep time to diabetes mellitus (DM) and IGT among participants in the Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing. METHODS: Participants were 722 men and 764 women, aged 53 to 93 years. Usual sleep time was obtained by standardized questionnaire. Diabetes mellitus was defined as a serum glucose level of 126 mg/dL or more (> or =7.0 mmol/L) fasting or 200 mg/dL or more (> or =11.1 mmol/L) 2 hours following standard oral glucose challenge or medication use for DM. Impaired glucose tolerance was defined as a 2-hour postchallenge glucose level of 140 mg/dL or more (> or =7.8 mmol/L) and less than 200 mg/dL. The relation of sleep time to DM and IGT was examined using categorical logistic regression with adjustment for age, sex, race, body habitus, and apnea-hypopnea index. RESULTS: The median sleep time was 7 hours per night, with 27.1% of subjects sleeping 6 hours or less per night. Compared with those sleeping 7 to 8 hours per night, subjects sleeping 5 hours or less and 6 hours per night had adjusted odds ratios for DM of 2.51 (95% confidence interval, 1.57-4.02) and 1.66 (95% confidence interval, 1.15-2.39), respectively. Adjusted odds ratios for IGT were 1.33 (95% confidence interval, 0.83-2.15) and 1.58 (95% confidence interval, 1.15-2.18), respectively. Subjects sleeping 9 hours or more per night also had increased odds ratios for DM and IGT. These associations persisted when subjects with insomnia symptoms were excluded. CONCLUSIONS: A sleep duration of 6 hours or less or 9 hours or more is associated with increased prevalence of DM and IGT. Because this effect was present in subjects without insomnia, voluntary sleep restriction may contribute to the large public health burden of DM.     

Association of short sleep duration with impaired glucose tolerance or diabetes mellitus

Aims/Introduction: To examine the cross‐sectional relationship between sleep duration and impaired glucose tolerance (IGT), including diabetes mellitus (DM), we analyzed a large‐scale healthy workers database in Japan. Materials and Methods: We examined the baseline database of 4143 participants (3415 men and 728 women) aged 19–69 years. Sleep duration of participants was categorized into four groups: <6, 6 to <7, 7 to <8 and ≥8 h. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined IGT including DM (IGT/DM) in the present study according to previous studies as follows: fasting blood sugar level ≥110 mg/dL, or if <8 h after meals ≥140 mg/dL, or on medication for diabetes mellitus, or those diagnosed as having DM. Logistic regression was applied to estimate the odds ratio (OR) to examine the relationship between IGT/DM, sleep duration and other related factors. Results: The number of participants with IGT/DM was 402 (9.7%). The factors that significantly associated with IGT/DM were age (OR 1.08, 95% confidence interval [CI] 1.07–1.10, P < 0.001), high blood pressure (OR 1.94, CI 1.52–2.47, P < 0.001), and <6 h of sleep duration in comparison with 6 to <7 h sleep (OR 2.32, CI 1.18–4.55, P = 0.015). The associations of difficulty in sleep initiation, IPAQ classification, current smoking and alcohol intake with IGT/DM were not statistically significant. Conclusions: Our results showed that shorter sleep duration (<6 h of sleep duration per night) was associated with a risk of IGT/DM independent of other lifestyle habits and metabolic risk factors. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00114.x , 2011)     

Endothelial dysfunction in impaired fasting glycemia, impaired glucose tolerance, and type 2 diabetes mellitus

The aim of this study was to evaluate whether abnormal endothelial function is present in early stages of diabetes, such as impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Endothelial function was assessed by measuring flow-mediated dilatation and nitrate-induced dilatation of the brachial artery using high-resolution ultrasound. Fasting serum lipid levels were determined, and glucose and insulin values in response to a 75-g oral glucose load were also measured. The results showed the following new findings: (1) compared with subjects with normal glucose tolerance, those with IFG and IGT had impaired flow-mediated dilatation, more remarkable in subjects with type 2 diabetes mellitus than those with IFG and IGT, and (2) flow-mediated dilatation was inversely and strongly related to the extent of hyperglycemia. In conclusion, endothelial dysfunction is present in subjects with IGT and IFG, indicating endothelial damage in these stages.     

空腹血糖正常的住院高血压患者的糖耐量调查分析

目的 检测住院原发性高血压伴有糖代谢异常患者的数据,为全面干预危险因素提供科学依据.方法 选择既往无糖代谢异常病史,空腹血糖<5.6 mmol/L确诊为原发件高血压的586例住院患者行口服葡萄糖耐量试验(OGYT)后2 h的血糖测定.观察年龄、性别、体质指数、入院时血压、血尿酸、血脂、动脉硬化等参数与OGTT后2 h血糖的关系.结果 (1)586例患者中检出糖耐量减低患者159例(27.1%);2型糖尿病患者41例(7.0%).(2)糖代谢异常的患者动脉硬化的比例高达67.5%,高于血糖正常组的59.6%,年龄标化后比较差异无统计学意义.结论 原发性高血压患者合并糖耐量异常的比例高,对于合并代谢综合征的原发性高血压患者,应积极行OGTT测定,以早期发现和干预糖代谢紊乱,减少动脉硬化的发生.     

Serum high-molecular weight adiponectin decreases abruptly after an oral glucose load in subjects with normal glucose tolerance or impaired fasting glucose, but not those with impaired glucose tolerance or diabetes mellitus

Adiponectin exists in the blood as 3 forms, which are a trimer, a hexamer, and a high-molecular weight (HMW) form. We investigated whether circulating HMW adiponectin levels were altered by oral glucose or fat ingestion. Forty male subjects underwent a 75-g oral glucose loading test (OGTT), and 11 healthy subjects (5 women and 6 men) received a fat loading test. Serum levels of HMW and total adiponectin were measured during the OGTT and the fat loading test. The fat loading test was performed for at least 8 hours. Among the 40 male subjects, 11 had normal glucose tolerance (NGT), 9 had impaired fasting glucose (IFG), 11 had impaired glucose tolerance, and 9 had diabetes mellitus (DM). In all 40 subjects, the serum total adiponectin level did not change significantly, whereas serum HMW adiponectin decreased significantly after a glucose load and reached 92.2% of the basal level at 120 minutes after the OGTT (P < .01). The HMW to total adiponectin ratio decreased significantly from 0.47 ± 0.15 at baseline to 0.43 ± 0.13 at 120 minutes after a glucose load (P < .05). Serum HMW adiponectin measured at 120 minutes after the OGTT decreased significantly to 86.0% and 85.6% of the basal level in subjects with NGT or IFG, respectively (both P < .01). In subjects with impaired glucose tolerance or DM, however, serum HMW adiponectin did not change. The area under the curve for insulin at 30 minutes after a glucose load during the OGTT was significantly larger in subjects with NGT or IFG than in those with DM (P < .05). In addition, the insulinogenic index (ΔI_0-30/ΔG_0-30) was significantly higher in subjects with NGT or IFG than in those with DM (P < .001). Percentage changes in serum HMW adiponectin of the baseline at 120 minutes correlated negatively with those in serum insulin (r = −0.468, P = .0023), but not plasma glucose, of the baseline at 30 minutes in 40 subjects. On the other hand, serum triglycerides increased significantly after an oral fat load in 11 healthy subjects; but neither serum total nor HMW adiponectin changed. In conclusion, serum HMW adiponectin (but not total adiponectin) decreased rapidly after glucose loading in subjects with NGT or IFG; and the decrease of HMW adiponectin may be associated with an increase of serum insulin at 30 minutes.     

单一测定空腹血糖在诊断糖尿病和糖耐量减低中的局限性

分析了经７５ｇＯＧＴＴ确诊的７９７例糖尿病（ＤＭ）和８１８例糖耐量减低（ＩＧＴ）患者的空腹血糖（ＦＢＳ）水平，并与１２８９例正常人作了比较。结果显示：７９７例糖尿病患者中ＦＢＳ≥７．８ｍｍｏｌ／Ｌ者有５０９例（６３．８６％）。ＦＢＳ≥７．８ｍｍｏｌ／Ｌ诊断糖尿病的敏感性和特异性分别为６３．８６％和９９．３０％，ＦＢＳ≥６．１１ｍｍｏｌ／Ｌ则敏感性和特异性分别为９４．２３％和９１．５４％，假阳性率和假阴性率均不到１０％。８１８例ＩＧＴ患者的ＦＢＳ值正常者（＜６．１１ｍｍｏｌ／Ｌ）占７９．７１％，与正常人重叠较多。提示ＦＢＳ≥７．８ｍｍｏｌ／Ｌ对糖尿病的诊断不是一个敏感的指标，若ＦＢＳ≥６．１１ｍｍｏｌ／Ｌ者应作进一步检查。而用ＦＢＳ不能估价ＩＧＴ。     

Trace and toxic element patterns in nonsmoker patients with noninsulin-dependent diabetes mellitus, impaired glucose tolerance, and fasting glucose

PROJECT:

Noninsulin dependent diabetes mellitus is supposed to be associated with fluctuations in the plasma levels of several trace elements. There is accumulating evidence that the metabolism of several trace elements is altered in patients with noninsulin dependent diabetes mellitus and that these nutrients might have specific roles in the pathogenesis and progression of this disorder.

PROCEDURE:

The aim of the present study is to compare the levels of essential trace and toxic elements including lead (Pb), arsenic (As), cadmium (Cd), chromium (Cr), aluminium (Al), nickel (Ni), cobalt (Co), iron (Fe), copper (Cu), selenium (Se), zinc (Zn), vanadium (V), manganese (Mn), barium (Ba), silver (Ag), and mercury (Hg) in patients with noninsulin dependent diabetes mellitus (n = 31), impaired glucose tolerance (n = 20), impaired fasting glucose (n = 14), and healthy controls (n = 22). Plasma concentrations of the elements were measured by using inductively coupled plasma mass spectrometry.

RESULTS:

The results indicated that values of lead, nickel, aluminium, copper, and chromium were significantly higher, but not above toxic levels, in the plasma of nonsmoker patients with noninsulin dependent diabetes mellitus (P < 0.05). The values for these elements were found to be significantly higher (P < 0.05) in patients with impaired fasting glucose than in controls. Moreover, a statistically significant correlation was found between plasma levels of glycated hemoglobin and of some trace elements like lead, nickel, aluminium, copper, chromium, cadmium, and mercury.

CONCLUSIONS

Thus, it was concluded that chronic complications of glucose metabolism disorders might be associated with alterations in the levels of some trace elements. Nevertheless, some more timely and extensive studies are required to clarify the exact mechanisms of each of these changes.