Oxidative stress and nitric oxide related parameters in type II diabetes mellitus: effects of glycemic control

OBJECTIVES: The aim of this study is to investigate the status of oxidative stress and nitric oxide related parameters in type II diabetes mellitus (DM) patients in which heart disease, atherosclerosis, retinopathy, and nephropathy commonly occur, and also to determine the effect of glycemic control on these parameters. DESIGN AND METHODS: Erythrocyte copper zinc-superoxide dismutase (CuZn-SOD), erythrocyte and plasma selenium dependent glutathione peroxidase (Se-GPx), erythrocyte catalase (CAT) activities, erythrocyte and plasma thiobarbituric acid reactive substances (TBARS) levels; nitrite/nitrate (NO(2)(-)/NO(3)(-)), cyclic guanosine monophosphate (cGMP) and nitrotyrosine levels in plasma of type II DM patients were measured. RESULTS: Erythrocyte CuZn-SOD activities in type II DM were significantly higher than those of the control subjects (p < 0.05). TBARS levels in type II DM were significantly higher than the control subjects (p < 0.001). Plasma NO(2)(-)/NO(3)(-) levels in type II DM patients both during poor glycemic control and after three months of oral antidiabetic treatment were significantly higher than those of the control subjects (p < 0.001). Plasma cGMP levels in type II DM patients during poor glycemic control were significantly lower than those of control subjects (p < 0.001). CONCLUSION: These results indicate that oxidative status and nitric oxide metabolism are affected in type II DM patients. We found high CuZn-SOD activity in type II DM patients. This increased activity could not protect the patients against the reactive oxygen species (ROS), since lipid peroxidation (defined by erythrocyte and plasma TBARS levels) still occurs in DM patients. After the therapy with oral antidiabetic agents for three months, erythrocyte SE-GPx and CAT activities were found to be decreased below the control values. Our results suggested that the low cGMP levels in the study may be a good marker of endothelium dysfunction in DM.     

内皮型一氧化氮合酶基因多态性与糖尿病肾病早期干预的关系

目的遗传因素对糖尿病肾病发病(DN)有重要影响,探讨一氧化氮合酶(ecNOS)第4个内含子一个27bp的插入/缺失(a/b)多态性与DN患者体内NO水平的关系。方法应用PCR方法检测了37例健康对照者(NC)与84例2型糖尿病(DM)患者的eNOS基因a/b基因型,并测定上述人群空腹血清一氧化氮代谢物(NOx)水平。DM组患者根据清蛋白排泄率又分为3组,即正常清蛋白尿组(DM1组)、微量清蛋白尿组(DM2组)、大量清蛋白尿组(DM3组)。结果(1)DM各组a等位基因和aa+ab基因型频率明显高于对照组(χ2=3.91to4.28,P<0.05;χ2=17.16to36.05,P<0.01)。DM1组a等位基因及aa+ab基因型频率显著低于DM2及DM3组(χ2=4.17to4.64,P<0.05;χ2=8.23to9.21,P<0.01)。(2)NC组aa+ab基因型空腹血清NOx明显低于bb基因型(t=2.30,P<0.05)。(3)血清NOx在DM1组较NC组有明显的升高(u=2.35,P<0.05),但在DM2,DM3组却较NC组有显著的降低(u=1.68,P>0.05)。结论eNOS基因a/b多态性与DN患者体内NO水平有关,eNOS基因可能通过减少NO的释放而引起DN的发病。因此可以通过对携带a等位基因的DM患者进行早期干预而减缓DN的发生,提高患者生活质量。     

Effects of propylthiouracil, propranolol, and vitamin E on lipid peroxidation and antioxidant status in hyperthyroid patients.

OBJECTIVE: The purpose of this study was to examine lipid peroxidation and antioxidant states during hyperthyroidism states and after given different treatments. DESIGN AND METHODS: We examined 44 hyperthyroid patients and 19 euthyroid healthy controls. Patients were divided into three groups according to the treatment: Propylthiouracil (PTU) group, PTU + propranolol (PRP) group, PTU + PRP + vitamin E (vitE) group. RESULTS: In the hyperthyroid patients plasma malondialdehyde (MDA) levels were significantly high as compared to the control group (p < 0,001).There was a significant decrease in the MDA levels post-treatment (p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group, p < 0.01 in the PTU group). In the hyperthyroidism, blood reduced glutathione (GSH) levels were lower, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities were higher than in the control group, but these changes were not significant. Post-treatment in each of the three groups the GSH levels were increased significantly as compared to the pretreatment levels (p < 0.001). There was significant decrease in the SOD activity post treatment (p < 0.01 in all three groups). Post-treatment CAT activity was decreased (p < 0.05 in the PTU group, p < 0.001 in the other two groups). The erythrocyte glutathione peroxidase (Gpx) activity was lower significantly in the hyperthyroidism as compared to the control group (p < 0.001). Post-treatment, in the three groups Gpx activity increased significantly as compared to the pretreatment levels (p < 0.05 in the PTU group, p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group). CONCLUSION: We considered that giving all three treatments would be useful to the prevention of oxidative stress in the hyperthyroidism states.     

炎症因子、脂质水平与2型糖尿病并发冠心病发病风险分析

目的研究炎症因子、脂质水平与2型糖尿病合并冠心病的相关性。方法分析我院2014年1月-2015年1月我院收治的糖尿病患者和同期来我院门诊体检者的体检结果,健康(N)对照组为同期门诊体检者58例,2型糖尿病患者(T2DM)组56例,2型糖尿病合并冠心病患者(T2DM+CHD)组64例,比较三组血清中的炎症因子和脂质水平。结果 T2DM组中血清炎症因子指标(IL-6、HS-CRP)及脂质水平指标(TG、Apo B)水平显著高于健康对照组(P0.05),且T2DM合并冠心病组与T2DM组比较水平明显升高(P0.05)。T2DM患者组和T2DM合并冠心病患者组血清中Apo A1、HDL-C较正常体检者偏低(P0.05),两组比较也具有显著差异(P0.05);T2DM组和T2DM合并冠心病组患者的WBC、TC和LDL-C比正常健康组明显升高,差异均有统计学意义(P0.05);但在T2DM组和T2DM合并冠心病组差异均无统计学意义(P0.05)。结论T2DM合并冠心病的发展中TC、LDL-C、TG、ApoB、ApoA1、HDL-C、IL-6、HS-CRP可作为较为敏感的指标,为临床早期诊断和治疗提供依据。     

Simultaneous triple organ specific autoantibody profiling in adult patients with type 1 diabetes mellitus and their first-degree relatives

AIMS: We aimed to document prevalence and clinical presentations of seropositivities for glutamate decarboxylase (GAD)-antibody, celiac's disease (CD) and autoimmune thyroiditis (AIT) in adult patients with type 1 diabetes mellitus (T1DM), and their first-degree relatives. METHODS: Sixty-five patients with T1DM, 124 first-degree relatives and 65 healthy controls were screened for GAD-antibody, anti-thyroid peroxidase (ATPO), anti-thyroid stimulating hormone receptor (TSHR), anti-tissue transglutaminase and anti-gliadin antibodies in a matched case-control study. RESULTS: Prevalence of more than one seropositivity for CD-associated antibodies in T1DM-group is 6.0 times increased, compared with controls (p < 0.05). ATPO seropositivity is 5.3 times increased in T1DM group (p < 0.05), but TSHR antibody is comparable with controls (p > 0.05). Seropositivities for T1DM, AIT and CD are 4.3, 1.9 and 2.4 times more prevalent among first-degree relatives respectively, compared with controls (p < 0.05). Pathologically confirmed cases with CD among first-degree relatives were all identified at screening. In contrast, all of pathologically confirmed cases with CD in T1DM group, were either previously diagnosed or symptomatic at time of screening. In the group of patients with T1DM, 31% of seropositive cases for anti-ATPO were clinically latent for AIT, and 74% of ATPO (+) cases were identified at current screening study. Sixty-four per cent of ATPO (+) first-degree relatives were clinically latent for AIT, and 54% were identified at screening. CONCLUSION: Type 1 diabetes mellitus, CD and AIT represent a significant overlap in an adult population with already-diagnosed T1DM and their first-degree relatives. With regard to clinical presentations, CD was less likely to be clinically silent than AIT among patients with T1DM.     

2型糖尿病肾病患者外周血IL-17和IL-22 mRNA水平

目的 研究2型糖尿病(T2DM)患者肾脏不同病变时期外周血IL-17和IL-22 mRNA水平,探索糖尿病肾病(DN)患者IL-17和IL-22基因表达水平与肾脏病变的关系。方法 实验包括60名2型T2DM患者和20名正常对照者(NC),其中糖尿病患者包括:无蛋白尿组(NA,n=22)、微量清蛋白尿组(MA,n=18)和糖尿病肾病组(DN,n=20)。采用实时荧光定量PCR方法检测IL-17和IL-22 mRNA水平,分析各组外周血IL-17和IL-22 mRNA水平差异。结果 DN组IL-17和IL-22 mRNA水平显著高于MA组,NA组和NC组差异有统计学意义(P<0.01); MA,NA和NC三组之间IL-17和IL-22 mRNA差异无统计学意义(P>0.05)。结论 在2型糖尿病肾病外周血中IL-17和IL-22 mRNA水平升高,IL-17和IL-22可能在DN病变中发挥作用。     

三个指标联合检测在糖尿病早期肾损害中的临床意义

目的 探讨联合检测糖化血红蛋白(HbA1c),随机尿微量清蛋白(mALB)及尿β2-微球蛋白(β2-MG)3个指标在糖尿病(DM)患者早期肾损害中的临床意义.方法 糖尿病肾病组、单纯糖尿病组、健康对照组均采用酶法测定糖化血红蛋白,采用散色比浊法检测β2-MG及尿微量清蛋白.结果 单纯糖尿病组与健康对照组相比,上述3项指标差异有统计学意义(P<0.05),在糖尿病肾病组中,HbA1c、尿中mALB及β2-MG的含量均明显高于健康对照组和单纯糖尿病组,差异有统计学意义(P<0.01).结论 HbA1c、mALB、β2-MG三者联合检测可作为诊断DM早期肾损害可靠而敏感的指标,为监测DM 肾病发生及监护治疗的良好实验室指标.     

联合检测尿KIM-1、mALB、β2-MG在2型糖尿病早期肾损伤诊断中的价值

目的 探讨尿肾损伤因子-1(KIM-1)、尿微量清蛋白(mALB)、β2微球蛋白(β2-MG)联合检测对2型糖尿病(T2DM)早期肾损伤的诊断价值.方法 81例T2DM 患者分为糖尿病肾病(DN)组38例,不伴DN组43例,以45例健康体检者为健康对照组.尿KIM-1用酶联免疫吸附法(ELISA)测定,尿mALB 和β2-MG用全自动生化分析仪测定.结果 T2DM患者尿KIM-1、mALB、β2-MG水平明显高于健康对照组(P<0.01) ;T2DM患者DN组尿KIM-1、mALB、β2-MG水平明显高于不伴DN组(P<0.05);联合检测阳性率达93.8%,明显高于单项检测.结论 联合检测尿KIM-1、mALB和β2-MG对T2DM早期肾损伤的诊断更为敏感.     

Quantitative ultrasound measurements in diabetic and nondiabetic patients with end-stage renal disease

The aim of the study was to assess skeletal status in diabetic and nondiabetic subjects with end-stage renal disease (ESRD). One hundred twenty-three patients with ESRD (57 patients with diabetes: 9 type 1 and 48 type 2) and 66 nondiabetic patients were evaluated. Control group comprised 1541 subjects (614 males and 927 females). Diabetes and/or renal insufficiency was the only reason of bone disease and, in control group, no factors known to influence bone metabolism (chronic diseases or prolonged medications) were noted. Skeletal status was evaluated by quantitative ultrasound measurements at the hand phalanges using DBM 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). Because of some differences in mean age in subgroups of patients and controls, comparisons were performed using values of Z-score. In all diabetic patients, Z-score was significantly higher compared with nondiabetics (p < 0.05). In all type 1 diabetes patients, Z-score was significantly lower than in all nondiabetic patients (p < 0.05) and in patients with type 2 diabetes (p < 0.001). Z-score was also significantly lower in type 2 diabetics than in nondiabetic females (p < 0.00001) but did not differ in males. Comparisons between Z-scores in controls and patients showed that Z-score in nondiabetic females was significantly lower than in female controls (p < 0.000001), and in nondiabetic males--diabetic type 2 males as well as females--Z-score did not differ vs. results in adequate control group. Z-score was significantly lower in patients with diabetes type 1 vs. all controls (p < 0.001). Correlation analysis showed in all nondiabetic patients that Z-score was negatively affected by duration time of dialysis (r = -0.37, p < 0.01) and parathyroid hormone (PTH) serum level (r = -0.35, p < 0.01). In patients with type 1 diabetes, only PTH influenced significantly Z-score (r = -0.76, p < 0.05) and, in patients with type 2 diabetes, no significant correlations were obtained. Subjects with type 1 diabetes seemed to be sensitive for skeletal disturbances in a course of renal insufficiency, whereas subjects with type 2 diabetes did not show such skeletal pathology as shown by ultrasound measurements at hand phalanges.     

糖尿病微血管病变与血清同型半胱氨酸、氧化应激反应的相关性

目的 探讨糖尿病微血管病变患者血清同型半胱氨酸与氧化应激反应的相关性.方法 测定80名健康人(对照组),100例无微血管病变2型糖尿病患者(DM组)、100例合并糖尿病肾病2型糖尿病患者(DN组)及100例合并DR2型糖尿病患者(DR组)血清同型半胱氨酸(Hcy)、丙二醛(MDA)、超氧化物歧化酶(SOD)及还原型谷胱甘肽(GSH)浓度.结果 DM组、DN组、DR组Hcy浓度分别为(98.86±21.46)、(198.95±19.35)、(138.65±15.25)ng/L,MDA浓度分别为(17.49±1.64)、(28.89±2.14)、(22.47±1.86)nmol/L,均明显高于对照组(62.48±15.36)ng/L,(11.86±0.48)nmol/L)(F值分别为7.95、6.89,P均＜0.01);DN组及DR组均较DM组明显升高(P均＜0.01),DM组、DN组、DR组血清SOD浓度分别为(107.80±15.62)、(79.86±14.63)、(89.34±12.75)mg/L,GSH浓度分别为(179.26±25.81)、(143.36±21.75)、(156.96±19.35)mg/L,均低于正常对照组(128.32±19.21)mg/L,(237.38±27.31)mg/L(F值分别为7.89、8.76,P均＜0.01);DN组及DR组均较DM组低(P均＜0.01);同时DN组又低于DR组(P＜0.01);血清Hcy与MDA浓度呈正相关(r=0.79,P＜0.05),与SOD、GSH浓度均呈负相关(r值分别为-0.71、-0.78,P均＜0.05).结论 糖尿病微血管病变患者血清同型半胱氨酸浓度升高,氧化应激反应增强,氧化应激与血清同型半胱氨酸浓度升高有关,血清同型半胱氨酸浓度升高,氧化应激促进糖尿病微血管病变发生发展.     

Oxidative stress parameters and keap 1 variants in T2DM: Association with T2DM,diabetic neuropathy,diabetic retinopathy,and obesity

IntroductionChronic hyperglycemia activates the inflammatory pathways and oxidative stress mechanisms with consequent damage to nerve tissue and retina. The Keap1‐Nrf2 pathway acts as one of the most important antioxidant pathways of the organism. Variants of Keap1 could affect susceptibility to diabetes and its complications.MethodsIn a case‐control study, 400 individuals included type 2 diabetes mellitus (T2DM) patients without complication, with neuropathy, with retinopathy, and healthy individuals were investigated. The levels of glutathione (GSH), glutathione peroxidase (GPx), malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured using chemical methods. Using the PCR‐RFLP method, the Keap1 (rs11085735) variants were identified.ResultsNeuropathic patients had significantly lower levels of GSH, GPx, and TAC and higher levels of total oxidative status (TOS), MDA, and oxidative stress index (OSI) compared to T2DM patients without complication and controls. Lower levels of GSH and GPx and a higher level of MDA were observed in patients with retinopathy compared with controls. Obesity was associated with significantly lower GPx activity and higher TOS. A significantly higher Keap1 AA genotype was found in patients with neuropathy than T2DM without complication and controls. The presence of Keap1 AA genotype correlated with lower GPx activity compared to CC genotype.ConclusionsOur study suggests the role of reduced antioxidant system and Keap1 variants in the pathogenesis of T2DM and its complications of neuropathy and retinopathy and also obesity in enhanced oxidative stress. Monitoring oxidative stress parameters in diabetic patients, especially those with complication and their treatment with antioxidants is suggested.     

2型糖尿病肾病患者检测血清基质金属蛋白酶-10的意义

目的 探讨血清基质金属蛋白酶-10(MMP-10)水平与2型糖尿病肾病发病的关系。方法 将100例2型糖尿病肾病患者按糖尿病肾病(DN)诊断标准分为糖尿病无肾病(DM)组(42例)与DN组(58例)。按照Mogenson分期将DN组分为DN早期(DN1)30例,DN晚期(DN2)28例。另择60例健康体检者作为正常对照(NC)组。同时检测糖化血红蛋白(HbA1c)、肌酐(Scr)、尿素氮(BUN)、24 h尿微量清蛋白排泄率(UAER)、β₂微球蛋白(β₂-MG)和MMP-10,进行相关的统计学分析。结果 DM,DN和NC组HbA1c,Scr,UAER,BUN,β₂-MG和MMP-10指标差异有统计学意义(F=6.478～10.892,均P<0.05)。DM组和NC组间除HbA1c外其它检测指标差异均无统计学意义(t=1.421～2.637,均P>0.05),而DN组与NC组比较差异均有统计学意义(t=8.451～26.678,均P<0.05)。DN组和DM组间除HbA1c外其它检测指标差异均有统计学意义(t=6.371～21.673,均P<0.05)。DN1组和DN2组间HbA1c,Scr,UAER,BUN和β₂-MG差异无统计学意义(t=0.891～1.385,均P>0.05)。而DN2组MMP-10水平明显比DN1组高,两组差异有统计学意义(t=86.371,P<0.01)。结论 血清MMP-10水平可能是2型糖尿病肾病患者肾脏损伤程度的靶标。     

NGAL、炎症细胞因子在2型糖尿病肾脏疾病患者体内的变化

目的 探讨中性粒细胞明胶酶相关载脂蛋白（NGAL）以及炎症细胞因子在2型糖尿病肾脏疾病（T2DM DKD）患者体内的变化情况。方法 2型糖尿病患者180例,根据尿微量白蛋白排泄量分为单纯糖尿病组、早期肾病组和临床肾病组,每组60例;同时选取健康志愿者60例作为对照组,检测各组NGAL、白细胞介素6（IL 6）和肿瘤坏死因子α（TNF α）的表达水平。 结果 治疗前,糖尿病患者的IL 6、TNF α水平表达明显高于对照组患者,同时糖尿病肾脏疾病越严重,其血清中的IL 6、TNF α水平越高（P＜0.05）。对各组患者空腹血糖、肾功能指标进行检测,发现糖尿病患者的空腹血糖（FPC）、血肌酐（SCr）、尿素氮（BUN）水平表达明显高于对照组患者,同时糖尿病肾病越严重,其血清中的FPC、SCr、BUN水平越高（P＜0.05）。结论 2型糖尿病肝肾疾病患者患病程度越严重,其体内NGAL、炎症细胞因子的表达就越高。     

2型糖尿病患者血清网膜素-1水平与肾损伤程度关系的研究

目的 探讨血清网膜素-1(serum omentin-1)水平与2型糖尿病(T2DM)肾病发病的关系。方法 将100例2型糖尿病肾病患者按糖尿病肾病(diabetic nephropathy,DN)诊断标准分为DM组(44例)与DN组(56例)。按照Mogenson分期将DN组分为DN早期(DN1)30例,DN晚期(DN2)26例。另择80例健康体检者作为正常对照组(NC)。同时检测糖化血红蛋白(HbA1c)、肌酐(Scr)、尿素氮(BUN)、β2微球蛋白(β2-MG)、胰岛素抵抗指数(HOMA-IR)和血清网膜素-1,进行相关的统计学分析。结果DM,DN和NC组HbA1c,Scr,BUN,β2-MG,HOMA-IR和血清网膜素-1指标差异均有统计学意义(F=6.078～16.231,均P<0.05)。其中DM组和NC组间除了HbA1c和HOMA-IR以外,其它检测指标相比差异均无统计学意义(t=1.421～2.637,均P>0.05),而DN组与NC组上述六项指标相比差异均有统计学意义(t=8.981～26.785,均P<0.05)。DN组和DM组间检测指标差异均有统计学意义(t=6.371～21.673,均P<0.05)。DN1组和DN2组间HbA1c,Scr,BUN和β2-MG差异均无统计学意义(t=0.981～1.389,均P>0.05)。而DN2组HOMA-IR水平明显比DN1组高,而血清网膜素-1水平明显比DN1组低,两组差异均有统计学意义(t=68.451～76.814,均P<0.01)。DN组HOMA-IR水平与血清网膜素-1指标呈显著负相关(r=-0.405,P<0.05)。结论 血清网膜素-1与胰岛素抵抗关系密切,血清网膜素-1可能是2型糖尿病患者肾脏损伤程度的靶标。     

Oxidative stress and male IGF-1, gonadotropin and related hormones in diabetic patients.

Elevation of glucose concentration in diabetes may induce generation of oxygen free radicals such as superoxide (O2*-) and hydroxyl (*OH). The aim of the present study was to investigate the effect of the oxidative stress on the activities of blood superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GSSG-R) and aldose reductase, the levels of reduced glutathione (GSH), lipid peroxidation (thiobarbituric acid reactive substances; TBARS) and plasma levels of insulin-like growth factor-1 (IGF-1), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone in type 2 (non-insulin-dependent diabetes) patients and in healthy controls. Blood SOD, CAT, GSH-Px and GSSG-R were lower in type 2 diabetic patients compared with the the control group. Blood aldose reductase activity was elevated in patients with type 2 diabetes compared with the control group. GSH was decreased while TBARS concentration was increased in red blood cells (RBC) and leukocytes from the patients with type 2 diabetes mellitus in comparison to the control group. The mean values of plasma LH, FSH and testosterone were decreased, whereas the mean plasma IGF-1 concentration was increased in type 2 diabetes compared with controls. These findings support the hypothesis that hyperglycemia enhances the activity of the polyol pathway and impairs the antioxidant status, particularly glutathione redox cycle, resulting in poorer defense against oxidative stress. In addition, decreased circulating testosterone and gonadotropin levels may reflect the oxidative stress exerted by diabetes.     

Hey、脂蛋白a、L-FABP水平变化与DN患者早期肾损伤的关系

【目的】探讨同型半胱氨酸(Hey)、脂蛋白a、肝型脂肪酸结合蛋白(L-FABP)在糖尿病肾病(DN)早期肾损伤中的变化及其临床意义。【方法】本院收治的60例2型糖尿病患者(T2DM组)、60例2型糖尿病伴微量白蛋白尿患者(MA组)、60例2型糖尿病肾损伤达到临床期患者(CN组)及60例健康体检者(对照组)为研究对象;比较四组研究对象的Hey、脂蛋白a、L-FABP水平及肾功能指标;并采用线性相关法探讨Hey、脂蛋白a、L-FABP水平与患者肾功能指标变化的关系。【结果】T2DM组、MA组及CN组的Hey、脂蛋白a、L-FABP水平均显著高于对照组(P<0.05),MA组及CN组的Hey、脂蛋白a、L-FABP水平显著高于T2DM组(P<0.05),CN组的Hey、脂蛋白a、L-FABP水平显著高于MA组(P<0.05);CN组的血尿素氮(BUN)、血肌酐(SCr)水平显著高于T2DM组、MA组及对照组(P<0.05),MA组、CN组的尿微量白蛋白排泄率(UAER)值高于T2DM组(P<0.05),CN组的UAER值高于MA组(P<0.05);UAER范围>20畔/min的T2DM患者的Hey、脂蛋白a、L-FABP水平与SCr、UAER呈显著的正相关关系(P<0.05)。【结论】DN患者Hey、脂蛋白a、L-FABP水平显著地升高,并且与患者肾功能损害和病情程度具有相关性。     

Altered diurnal variation of nitric oxide production in patients with panic disorder

The aim of this prospective study was to investigate the diurnal change in serum nitric oxide (NO) levels in active and remission phases of patients with panic disorder. This study included 15 patients fulfilling the criteria for panic disorder of Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition and 15 healthy controls matched for age and sex. All patients were receiving a selective serotonin reuptake inhibitor at therapeutic doses. The serum nitrite and nitrate levels of subjects were determined at 10:00 a.m. after overnight fasting and at 3:00 p.m. 2 hours after lunch. NO levels of all patients measured in the morning were significantly higher than those of controls. The patients were also divided into active and remission groups according to clinical status and Panic Agoraphobia Scale's cut-off point. There were no statistically significant differences in serum nitrite and nitrate levels of the active group between the 10:00 a.m. and 3:00 p.m. measurements. In contrast, statistically significant differences were found in the serum levels of nitrite (p<0.05) and nitrate (p<0.05) in the remission group. Notably, the afternoon nitrite and nitrate levels of the remission group were higher than those of the morning levels as seen in control subjects. Thus, diurnal variation of NO production is altered in patients with panic disorder but is resumed in the remission phase. The present study suggests that serum NO levels are a good marker for evaluation of panic disorder.     

2型糖尿病视网膜病变患者血清脂联素水平的研究

目的 为观察血清脂联素水平的变化与2型糖尿病合并视网膜病变(DR)各期的关系.方法 采用ELISA法对113例2型糖尿病患者血清脂联素水平进行检测,其中2型糖尿病无DR患者30例(DM组)、2型糖尿病合并DR背景型患者45例(BDR组)、2型糖尿病合并DR增殖型患者38例(PDR组)和健康对照30例(NC组).结果 (1)DM组血清脂联素水平与NC组比较差异有统计学意义(P＜0.05);BDR组血清脂联素水平与DM组、NC组比较差异均有统计学意义(P＜0.05或P＜0.01);PDR组血清脂联素水平与BDR组、DM组、NC组比较差异均有统计学意义(P＜0.05或P＜0.01).(2)相关分析发现,2型糖尿病患者血清脂联素水平与收缩压、糖化血红蛋白、TG、TC、LDL-C成显著负相关,而与HDL-C成显著正相关.结论 2型糖尿病患者血清脂联素水平明显降低, 2型糖尿病合并DR后血清脂联素水平更低.脂联素可作为判断2型糖尿病合并DR损害程度的指标.     

绝经后女性2型糖尿病患者骨密度的变化及相关因素分析

目的　探讨绝经后女性 2型糖尿病 (T2DM)患者骨密度 (BMD)改变及其相关因素。方法　用X线骨密度仪测定 112例绝经后T2DM患者和 74例非糖尿病对照者正位腰椎 (L2 ～L4)及股骨近端 [Neck区、Ward区、GT(大转子 ) ]BMD ,血钙 (Ca)、磷 (P)、碱性磷酸酶 (ALP) ,病例组加测糖化血红蛋白 (HbA1c)、血脂浓度。结果　绝经后T2DM患者L2 、L3 、L4、Neck、Ward区、GT的BMD值高于对照组 (P <0 .0 1) ;L2 ～L4BMD高于对照组 ,差异无统计学意义 (P >0 .0 5 )。除L2 外 ,糖尿病 5年以上组 (DM B)上述各部位BMD低于 5年及以下组 (DM A组 )。多元逐步回归分析后显示 :年龄与Neck、Ward区、GTBMD显著负相关 (P <0 .0 1) ,绝经年限与L2 、L2 ～L4BMD明显负相关 (P<0 .0 5 ) ,HbA1c同L2 、L3 、L2 ～L4BMD明显负相关 (P <0 .0 5 ) ,体重指数 (BMI)与L2 、GTBMD明显正相关 (P <0 .0 5 ) ,病程、血脂与骨密度无显著相关。T2DM患者血钙、血磷、ALP与对照组者比较差异无统计学意义 (P >0 .0 5 )。结论　绝经后T2DM患者各部位BMD明显高于对照组 ;年龄、绝经年限、血糖控制不良是BMD危险因素 ;BMI可能是T2DM患者BMD保护性因素之一     

超声评价糖尿病合并微量蛋白尿患者下肢动脉硬化

目的 探讨超声评价2型糖尿病(T2DM)合并微量白蛋白尿(MA)患者的下肢动脉硬化的临床价值。方法 收集58例T2DM患者及40名正常对照,根据尿白蛋白排泄率(UAER)将T2DM患者分为T2DM合并MA组(T2DM1组)30例和T2DM未合并MA组(T2DM2组)28例,利用高频超声检测两组下肢股动脉内-中膜厚度(IMT)和粥样硬化斑块形成情况。结果 T2DM组IMT明显高于正常对照组,T2DM1组IMT高于T2DM2组(P均<0.05)。Pearson相关分析显示T2DM组IMT与UAER及病程呈正相关(r=0.311、0.441,P均<0.05);多元线性回归分析显示,病程、UAER是IMT的独立影响因素。T2DM组股动脉IMT>腘动脉IMT>末梢动脉IMT;股动脉及腘动脉以不均质回声斑块为主;股浅动脉远端、下肢末梢动脉以点状强回声斑块为主,当腘动脉IMT增厚明显时,末梢动脉点状强回声更加密集。结论 T2DM患者下肢动脉IMT与硬化斑块形成情况与UAER密切相关。超声能够快捷、准确地检测T2DM合并MA患者下肢动脉硬化。