实验性Ⅱ型糖尿病大鼠主动脉早期超微结构改变及影响因素

本实验测定了实验性Ⅱ型糖尿病大鼠血脂、血浆过氧化脂质及超氧化物歧化酶，观察了１０周时大鼠主动脉超微结构的改变。结果表明：糖尿病组及单纯肥胖组大鼠均有主动脉内膜病变，前者较明显。与对照组大鼠比较，前二者过氧化脂质、甘油三脂及低密度脂蛋白胆固醇均增高，而高、低密度脂蛋白胆固醇比值下降，差异非常显著（Ｐ＜０．０１），糖尿病组大鼠超氧化物歧化酶下降而单纯肥胖组大鼠则升高。以上结果提示，实验性Ⅱ型糖尿病大鼠主动脉内膜有早期超微病理改变，这种病变与过氧化脂质升高及超氧化物歧化酶活性下降有关。与脂代谢紊乱也有一定的关系。     

实验性糖尿病大鼠体内LPO水平,SOD和GSH—Px活性的变化

实验性糖尿病大鼠体内ＬＰＯ水平、ＳＯＤ和ＧＳＨ－Ｐｘ活性的变化段有金王晓颖董瑶由胜志冯兰飞王灏关于糖尿病的发病与氧自由基的关系，许多人已经证实：四氧嘧啶对胰岛细胞伤害可能与Ｈ２Ｏ２、超氧阴离子及羟自由基升高有密切关系［１，２］；四氧嘧啶使胰岛的活性氧...     

Ⅱ型糖尿病患者红细胞变形能力改变及其影响因素

作者探讨了Ⅱ型糖尿病患者的红细胞变形能力(RCD)改变及其影响因素。结果表明患者的RCD显著降低,且与糖化血红蛋白、空腹血糖、血浆纤维蛋白原和血浆总胆固醇、甘油三酯有密切关系。提示糖尿病病情控制好坏或代谢紊乱程度对RCD有明显影响。     

实验性糖尿病大鼠早期视网膜超微结构的改变

糖尿病视网膜病变(DR)的基本病理改变为视网膜微血管异常；本实验通过建立DM太鼠模型，观察了DM早期的视网膜超微结构改变及神经组织的病变情况。     

Ⅱ型糖尿病脂质代谢紊乱与动脉粥样硬化

Ⅱ型糖尿病是动脉粥样硬化的主要危险因素，本文综述了Ⅱ型糖尿病时血脂、脂蛋白、载脂蛋白的改变和高血糖、高胰岛素血症对脂质代谢的影响，及其和动脉粥样硬化的关系。     

实验性糖尿病大鼠心肌血管病变的早期超微结构改变

糖尿病心肌病变是糖尿病常见并发症之一，其发生与心肌内微血管损害有关。本实验对链脲佐菌素（STZ）诱发的糖尿病大鼠心肌超微结构改变进行观察，以探讨糖尿病心肌病变的早期病理改变及发病机理，现报告如下。材料与方法1．材料：SD大白鼠3O只，体重140～180召。随机分成正常对照组（C组）和糖尿病组（DM组）。动物按60mg／kg腹腔注射STZ一次或等体积缓冲液，将空腹血糖＞11．lmmol／L者纳入DM组。2．方法：5周后宰杀动物，迅速取出心脏，在房室瓣环水平下约Zmm处，切取约smm厚之左右两心室相连的横截面心肌组织一块，立即置卡罗固…     

实验性糖尿病大鼠心肌ATⅡ和心肌超微结构的研究

观察了链脲佐菌素实验性糖尿病大鼠心房、心室肌血管紧张素Ⅱ（ＡＴⅡ）和心房、心室肌超微结构的改变，结果表明，病程１４天的糖尿病大鼠心房、心室肌ＡＴⅡ显著高于正常对照组（Ｐ〈０．０５，Ｐ〈０．０１），心房、心室肌心肌纤维细胞核及肌原纤维大量糖原沉着，肌丝溶解，可见髓样小体形成，线粒体变性、胶原纤维增多等超微结构改变。     

桑叶提取液对实验性糖尿病大鼠血糖、LPO含量及SOD水平的影响

目的　观察桑叶提取液对实验性糖尿病大鼠血糖、LPO含量及 SOD活性的影响。方法　以 2 0 0 mg/ kg四氧嘧啶皮下注射造成糖尿病大鼠模型 ,以拜糖平为阳性药物对照 ,用桑叶提取液 (0 .4g/ ml)灌胃 4w,测定各组血糖、L PO、SOD水平。结果　与对照组比较 ,桑叶提取液、拜糖平均有明显降血糖作用 (P<0 .0 5)。桑叶提取液组血糖由 1 8.95± 4.2 8降至 1 0 .82± 3.2 2 (mmol/ L,P<0 .0 1 ) ,L PO含量由 1 0 .2 0± 2 .50降至 5.56± 2 .38(nmol/ L,P<0 .0 5) ,SOD水平由 5.61± 2 .0 3升至 7.45± 2 .1 4 (u/ ml,P>0 .0 5)。拜糖平组血糖由 1 8.90± 2 .42降至 1 1 .85± 3.82 (mmol/ L,P<0 .0 5) ,LPO含量由 9.57± 2 .41降至 4.82± 2 .32 (nmol/ L,P<0 .0 5) ,SOD水平由 6.57± 2 .45升至 7.1 4± 3.1 6(u/ ml,P>0 .0 5)。结论　蚕桑叶水提取液能降低四氧嘧啶糖尿病大鼠血糖及 LPO含量 ,同时能升高 SOD水平。     

Ⅱ型糖尿病肾病危险因素探讨

本文以尿白蛋白排泄率作为糖尿病肾病早期检测指标，用临床流行病学方法对１３０例单纯糖尿病及６８例早期及临床期ＤＮ进行病例对照试验，以探讨Ⅱ型糖尿病肾病发生的危险因素。结果表明：血压、血糖、糖化血红蛋白及胆固醇升高与ＤＮ发生有关；而肥胖及甘油三酯升高与ＤＮ发生无关。由此证明，Ⅱ型糖尿病肾病系多因素作用结果。     

Autonomic Dysfunction in Non-insulin-dependent Diabetes Mellitus and Fibrocalculous Pancreatic Diabetes in South India

The prevalence of cardiovascular autonomic dysfunction in non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) and fibrocalculous pancreatic diabetes (FCPD) was assessed by a standard battery of autonomic dysfunction tests involving heart rate responses and blood pressure responses. Three hundred and thirty-six patients with NIDDM and 40 patients with FCPD were studied. Logistic regression analysis was done to look for risk factors associated with autonomic dysfunction. Abnormalities of autonomic function tests were detected in 120 NIDDM patients (35.7 %) and 9 FCPD patients (22.5 %). There was no significant difference in severity of autonomic dysfunction between NIDDM and FCPD groups. There was an increase in prevalence of autonomic dysfunction with age and duration of diabetes both in NIDDM and FCPD. In the 0–5 years duration group, 28.2 % of NIDDM and 16.6 % of FCPD had evidence of disordered autonomic function and these figures increased to 56.2 % and 60 % respectively, after 16–20 years duration of diabetes. Logistic regression analysis showed that only peripheral dysfunction was associated with autonomic dysfunction in NIDDM patients (r = 0.66, p = 0.02).     

Diastolic Dysfunction in Patients with Non-insulin-dependent Diabetes Mellitus of Short Duration

To determine whether abnormal left ventricular diastolic function is present at an early stage of non-insulin-dependent diabetes mellitus (NIDDM), left ventricular diastolic filling was evaluated by pulsed doppler echocardiography in 16 normotensive patients with NIDDM of short duration (1.8 ± 1 years, mean ± SD) and no evidence of microangiopathy, and in 16 healthy volunteers comparable for age, body mass index, and sex distribution. All patients showed normal systolic function. The interventricular septum thickness, left atrial diameter, and left ventricular mass index were increased in the diabetic as compared with the control group (p < 0.01, p < 0.01, and p < 0.02, respectively). Isovolumic relaxation time and atrial peak filling velocity were greater in diabetic patients (p < 0.001, and p < 0.01, respectively), whereas early to atrial peak filling velocity ratio was significantly reduced (p < 0.05). This study demonstrates that an impairment of left ventricular diastolic function occurs early in the natural history of NIDDM, and that this abnormality is unlikely to be related to clinical evidence of microangiopathic complications.     

Lipid Composition of Platelets in Patients with Non-insulin-dependent Diabetes Mellitus: Studies Before and After Treatment of Diabetes

The study was designed to investigate whether impaired composition of platelet lipids in untreated diabetic patients improved after diabetic treatment. Fourteen untreated patients with non-insulin-dependent diabetes mellitus (NIDDM) and 15 healthy control subjects were studied. In the diabetic patients, the ratio of free cholesterol to phospholipid (FC/PL) in platelets of 0.33 ± 0.02 (mean ± SEM) at pre-treatment, which was statistically (p < 0.05) higher than that of 0.26 ± 0.02 in control subjects, was significantly decreased to the value of 0.29 ± 0.02 (p < 0.01) after insulin therapy. Platelet FC level of 9.77 ± 0.77 μg 10^?8 cells pre-treatment was significantly (p < 0.01) reduced to the value of 7.72 ± 0.38 μg 10^?8 cells post-treatment. Platelet PL level showed no significant changes after the treatment. There was a significantly (p < 0.01) positive correlation between the decrease in FC/PL of platelets and that in haemoglobin A_1c (HbA_1c) after treatment for diabetes (rs = ?0.729). These results indicate that the impaired lipid composition in platelets can be improved after an adequate glycaemic control in patients with NIDDM.     

Non-insulin-dependent Diabetes Mellitus and Islet B-cell Mitochondrial Glycerophosphate Dehydrogenase Deficiency

A deficient activity of the mitochondrial FAD-linked glycerophosphate dehydrogenase (m-GDH) in the pancreatic islet B-cell may represent a contributing factor in the pathogenesis of non-insulin-dependent (Type 2) diabetes. This enzyme controls circulation in the glycerol phosphate shuttle and, hence, plays a key role in the B-cell glucose-sensing device. An impaired activity of this enzyme in pancreatic islets was documented in several, but not all, animal models of inherited or acquired non-insulin-dependent diabetes. Enzymatic studies conducted in lymphocytes or islets from diabetic patients, as well as a search for possible mutations of the m-GDH gene, were recently undertaken to extend these observations to human subjects.     

The Potential for Lifestyle Change to Influence the Progression of Impaired Glucose Tolerance to Non-insulin-dependent Diabetes Mellitus

Impaired glucose tolerance (IGT) is well recognized as a risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM). Detecting IGT offers a unique opportunity for targeting intervention to reduce the incidence of NIDDM. This article reviews current evidence for the efficacy of lifestyle intervention programmes involving people with IGT.     

糖尿病患者的胃电改变

观察具有及无上消化道症状的非胰岛素依赖型糖尿病（NIDDM）患者餐前及餐后2小时体表胃电图的变化。结果显示:①有症状组餐前、餐后胃电主频（Fp）均低于正常（P<0.01）,餐前、餐后Fp值无差异（P>0.05）。平均峰值幅值（Ap）正常。②无症状组餐前Fp值低于正常,餐后恢复至正常,餐前、餐后相比差异显著（P<0.05）,Ap值正常。③有症状组与无症状组间十二指肠球部的餐前及餐后即值异常率均存在差异（P<0.005）。④有症状组病程明显长于无症状组（P<0.05）。结论:NIDDM患者普遍存在胃电异常,主要表现为胃动过缓及胃一十二指肠球部运动不协调。及早发现无症状患者的胃动力异常,具有重要的临床意义。     

内皮素-1致大鼠急性肺损伤中脂质过氧化物含量的变化

目的 :旨在研究ET 1对大鼠肺和全身脂质过氧化损伤作用 ,以明确ET 1致大鼠ALI的作用机制。方法 :2 8只健康雄性Wistar大鼠 ,随机分为两组 :内皮素组经股静脉持续滴注ET 1,对照组用生理盐水代替。检测两组动物实验前后呼吸频率、血气分析、支气管肺泡灌洗液 (BALF)中蛋白含量、白细胞及分类计数、肺系数、肺组织学检查以及肺实质、BALF、全血中脂质过氧化物 (LPO)、超氧化物歧化酶 (SOD)、谷胱甘肽 (GSH)的含量。结果 :ET 1诱导出大鼠ALI ,内皮素组较对照组肺实质、BALF中LPO含量升高 ,SOD含量下降 (P <0 .0 1) ,全血LPO含量升高 ,SOD含量下降 (P<0 .0 5 ) ,BALF中GSH含量下降 (P <0 .0 1)。结论 :ET 1能够引起大鼠肺部脂质过氧化损伤效应。ET 1可能是机体内源性的致肺损伤因子之一。     

Non-insulin-dependent Diabetes and 11-Year Mortality in Asian Indian and Melanesian Fijians

This study reports 11-year all-cause and cause-specific mortality rates according to baseline glucose tolerance for a population-based sample of adult Melanesian and Indian Fijians (n = 2638), first surveyed in 1980. Risk factors for all-cause and cardiovascular disease (CVD) mortality in subjects with non-insulin-dependent diabetes (NIDDM) are also described. The baseline survey included 75 g oral glucose tolerance tests, measurements of blood pressure, body mass index, and triceps skinfold, assays of plasma cholesterol and triglycerides, electrocardiograms, and details of smoking habits and physical activity. Mortality status was ascertained for 2546 subjects through surveillance of death certificates, medical records and interview of subjects (or relatives). Mortality rates were increased in diabetic men and women of both ethnic groups: relative risks compared to subjects without diabetes at baseline were 1.7 (CI:0.9–3.1) and 2.0 (1.1–3.7) in Melanesian and 4.2 (2.7–6.5), 3.2 (1.9–5.7) in Indian men and women, respectively. A large proportion of mortality among diabetic subjects was attributed to CVD (62 %, 66 % in Melanesian and 54 %, 58 % in Indian men and women, respectively). Mortality rates tended to be higher in Melanesians than Indians, except for diabetic men where Indians had higher total and cardiovascular disease rates. In contrast to non-diabetic Fijians, diabetic women of both ethnic groups lost their relative protection from coronary heart disease (CHD). Cox regressions for diabetic subjects showed age and fasting plasma glucose to be independent predictors of all-cause mortality in men, and age, body mass index (inversely) and systolic blood pressure in women, but lipid concentrations, and cigarette smoking were not related. After accounting for conventional CVD risk factors, diabetes conferred significantly increased risk of total, CVD, and CHD mortality. The mortality experience of Melanesian and Indian Fijians with NIDDM is similar to that documented in developed populations, with excess mortality due to cardiovascular causes.     

Outcome of Unstable Angina in Patients with Diabetes Mellitus

This prospective hospital-based, case–control study compares the outcome of unstable angina in non-insulin dependent diabetic patients and non-diabetic control subjects. One hundred and sixty-two diabetic patients and 162 non-diabetic control patients with unstable angina were entered into the study. The 3-month mortality was 8.6 % (95 % confidence interval, CI = 4.4–12.9 %) in diabetic patients and 2.5 % (CI = 0.1–4.9 %) in control patients (p = 0.014). The 1-year mortality was 16.7 % (CI = 10.9 %–22.4 %) in diabetic patients and 8.6 % (CI = 4.4 %–12.9 %) in non-diabetic patients (p = 0.029). Diabetic patients received beta-blockade and underwent coronary angiography and angioplasty less frequently than controls; the frequency of unstable angina, of acute myocardial infarction, and of coronary artery bypass grafting was similar in both groups at 1 year of follow-up. It is concluded that diabetic patients with unstable angina have a higher mortality than non-diabetic patients and that this difference is largely accounted for by early (first 3 months) mortality. © 1997 by John Wiley & Sons, Ltd.