2010～2011年开滦社区人群血脂水平及调脂药物治疗

目的 调查开滦社区人群总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇的水平及血脂分层、危险评估、治疗建议、应用调脂药物的流行病学特征,为血脂异常的防治以及进一步预防控制心脑血管疾病的发生提供科学依据。方法 2010年至2011年对开滦社区92967例进行了普查,检测总胆固醇、甘油三酯、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇水平,分析不同性别、年龄段的血脂分层、危险评估、处理建议以及应用调脂药物情况。结果 最终对69488例男性和19228例女性血脂进行统计分析,开滦社区人群血脂水平：总胆固醇男4.93 mmol/L,女5.00 mmol/L;甘油三酯男1.32 mmol/L,女1.17 mmol/L;低密度脂蛋白胆固醇水平男2.58 mmol/L,女2.55 mmol/L;高密度脂蛋白胆固醇男1.51 mmol/L,女1.64 mmol/L;非高密度脂蛋白胆固醇男3.42 mmol/L,女3.36 mmol/L。50～59岁后女性血脂水平高于男性。经年龄、性别标化后,开滦社区人群高总胆固醇、甘油三酯、低密度脂蛋白胆固醇的患病率男性分别为7.48%、20.67%、2.59%,女性分别为9.04%、9.97%、2.88%,低高密度脂蛋白胆固醇的患病率男性11.52%,女性5.80%。11.56%的男性及11.98%的女性建议调脂药物治疗,55～59岁后女性推荐药物治疗的比例超过男性。仅2.28%的男性和2.60%的女性根据指南推荐服用降脂药物。结论 当前开滦社区人群血脂水平较高;根据指南推荐服用调脂药物的比例低;50～59岁后的女性是人群血脂防治的重点。     

沈阳市区部分公务员与专业技术人员的血脂水平

目的研究沈阳职业人群血脂水平及分类特征。方法采用近年3919例血脂调查资料(男2134例,女1785例,年龄40~89岁)按我国“血脂异常防治建议”并参考美国“NCEP-ATPⅢ指南”作血脂水平及分类研究。结果研究人群中50岁以上者只有40%左右总胆固醇及甘油三酯都在合适水平(老年女性28.6%)。总胆固醇大于5.2mmol/L中年男性46.7%,女性34.2%;老年前期男性45.1%,女性53.1%;老年男性51.1%,女性63.0%。总胆固醇大于6.2mmol/L者男性多于10%,老年前期及老年女性分别为18.2%及25.8%。高胆固醇血症比高甘油三酯血症约多2倍(除中年组男性外)。高密度脂蛋白胆固醇降低者男性约15%,女性仅5%左右;高密度脂蛋白胆固醇高水平者女性为31.9%~47.3%,男性只有16.5%~21.9%。结论沈阳中老年人血脂异常已超过半数,提示患动脉粥样硬化性心血管病的风险增高,防治血脂异常势在必行。     

辽宁农村地区高血压病人群的血脂水平

目的调查辽宁省农村地区高血压人群血脂水平的流行病学特征,为农村高血压人群血脂异常的防治提供科学依据。方法采用分层整群抽样方法于2004～2006年对辽宁省阜新县农村地区6412名(男性2805名,女性3607名)年龄≥35岁患原发性高血压病的常住人群(≥5年)进行流行病学调查和实验室检查,根据2006中国成人血脂异常防治指南标准,对血脂异常情况进行统计分析。结果(1)在辽宁省阜新农村高血压人群中,女性血脂平均水平高于男性,差异具有显著性(P<0.01)。(2)总胆固醇升高(≥6.21mmol/L),高密度脂蛋白胆固醇减低(<1.03mmol/L),低密度脂蛋白胆固醇升高(≥4.16mmol/L),甘油三酯升高≥(2.26mmol/L)的异常率分别为16.9%,8.8%,4.4%和19.8%。(3)随着血压分级的升高,总胆固醇和高密度脂蛋白胆固醇的异常率增高,差异具有统计学意义(P<0.05),但低密度脂蛋白胆固醇和甘油三酯未表现出这一趋势。结论辽宁省阜新县农村地区高血压病人群中血脂异常更为明显,对这一人群进行积极的干预尤为重要。     

南京部队1560例中老年干部生化结果的规律

目的 调查南京军区中老年干部生化指标随年龄增加变化的规律及异常检出率.方法 研究对象为南京军区中老年干部,共计1 556例(男1 417例,女139例),全自动生化仪检测生化指标.结果 球蛋白(Glo)、葡萄糖(Glu)水平随年龄增长而增高；总蛋白(TP)、白蛋白(Alb)、丙氨酸氨基转移酶(ALT)水平随年龄增长而减低.每10年血Glu增高0.14mmol/L,其中从49-69岁,每10年血Glu增高0.34 mtol/L;男性尿素(Urea)、肌酐(Cr)随年龄增长而增高,Urea每10年上升0.244 mmol/L,Cr每10年上升2.78 μmol/L,总胆固醇(T℃)、甘油三酯(TG)随年龄增长而减低；女性50岁以后TC、TG、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(Non-HDL-C)水平明显升高.Cr异常增高率最低,另有3.4％的人为低血糖.本人群所有指标均呈偏态分布,除Cr外所有指标的95％百分区间均大于目前国内参考范围.结论 由于不同人群生化参考值存在年龄和地区性等差异,因此在临床应用时,实验室针对不同年龄和地区人群设立不同参考值更为适用.     

1981～2001年北京市职业人群血清总胆固醇水平的变动

分析1981年至2001年20年间北京市部分职业人群血清总胆固醇水平的变化。在力求做到血脂测定标准化的基础上，回顾性分析20年来北京市部分机关和企事业单位工作人员47434人次总胆固醇水平的变化，按年度、性别、年龄分组统计，结果发现，总胆固醇水平从1981年至1988年间上升幅度较大，年龄调整均值男性上升0．73mmol／L(28m/dL)，女性上升0．62mmol／L(24mg/dL)。至1990年已达最高值，2001年低于1991年，男、女年龄调整均值分别回落0．21mmol/L(8mg/dL)及0．23mmol/L(9mg/dL)。男女总胆固醇水平随年龄上升，从青年至老年，男性上升约20％，而女性升高达35％，上升趋势基本一致。不同年龄组间上升幅度有明显的男女差异，青年期男性大于女性，中年以后女性上升幅度增大，从40～49岁至50～59岁组男性平均上升3％．而女性上升达14％．60岁以后上升很少。所以总胆固醇水平在50岁以前男性高于女性，50岁以后女性高于男性。以1985年、1991年和2001年为例，无论男女，年龄标化的高胆固醇检出率[总胆固醇≥5．17mmol／L(200mg/dL)、≥5．69mmol/L(220mg/dL)及≥6．02mmol／L(240mg/dL)]1991年比1985年明显增高，而2001年与1991年相差不多且有所回落。目前北京市职业人群的总胆固醇年龄调整均值男性4．86mmol/L(188mg/dL)，女性4．78mmol/L(185mg/dL)，年龄标化高胆固醇检出率≥5．7mmol／L者约20％，≥6．2mmol/L者约10％。结果提示，北京市职业人群血清总胆固醇水平及年龄标化的高胆固醇检出率在80年代升幅较大．90年代不再升高且有所回落。     

郑州市10636名公务员血脂现况

目的　研究10636名郑州市公务员血脂水平及血脂异常分布情况,为血脂异常防治提供依据。方法　按照2007年《中国成人血脂异常防治指南》标准,对10636名郑州市公务员血脂水平进行各年龄段分组观察。结果　10636名郑州市公务员血清总胆固醇水平为4.85　±　0.93　mmol/L,低密度脂蛋白胆固醇为2.92　±　0.73　mmol/L,高密度脂蛋白胆固醇为1.34　±　0.28　mmol/L,甘油三酯中位数为1.3（0.94～1.89）　mmol/L。血脂异常总检出率为29.7%,其中高胆固醇血症、高低密度脂蛋白血症、低高密度脂蛋白血症、高甘油三酯血症的检出率分别为7.6%、5.0%、10.6%、16.4%。男性总胆固醇、低密度脂蛋白胆固醇平均水平及高低密度脂蛋白血症检出率在30～39岁组、40～49岁组高于同年龄段女性（P<0.001）,但在50岁以后女性在各年龄组总胆固醇、低密度脂蛋白胆固醇水平显著升高,且高于男性,且50岁之后女性高胆固醇血症检出率高于男性（P<0.001）。结论　血脂异常防治应以中年男性和绝经后女性为重点,同时加强青年人对血脂异常的认识。     

老年冠心病患者血浆非高密度脂蛋白胆固醇水平的差异

目的探讨在老年冠心病患者的血清非高密度脂蛋白胆固醇的差异。方法选择120例行冠状动脉造影检查的老年患者,冠状动脉造影前空腹采静脉血,分析冠状动脉造影阳性组和对照组之间非高密度脂蛋白胆固醇与其它血脂数据(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白)差异的显著性及非高密度脂蛋白胆固醇对冠状动脉病变程度的相关性。结果冠状动脉造影阳性组非高密度脂蛋白胆固醇水平显著高于阴性组2.99±1.08mmol/L,一支病变组为3.41±0.59mmol/L,两支病变组为3.70±1.30mmol/L,三支病变组为3.77±1.10mmol/L,(P<0.001)并且非高密度脂蛋白的水平随冠状动脉病变支数逐渐增高,与冠状动脉狭窄分数相关(r=0.36,P<0.001);而两组间甘油三酯,高密度脂蛋白水平无统计学差异(P>0.05)。结论血清非高密度脂蛋白胆固醇对于老年人是一项简便实用的冠心病风险评估指标。     

杭州地区高血脂及其相关疾病的分布特征

目的了解高血脂及相关疾病在杭州地区成年人体检人群中的分布特征。方法 3019例体检者按性别、年龄分组,分析甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平,并对血脂检测结果及体检诊断结果进行统计分析。结果总胆固醇随年龄增加而增加;甘油三酯男性先增后降,女性一直增高;低密度脂蛋白胆固醇40岁以前男性高于女性(P<0.05),以后无明显差异(P>0.05);高密度脂蛋白胆固醇女性呈下降趋势,男性无变化趋势;男性高血脂检出率(59.0%)大于女性(33.5%),女性高甘油三酯、总胆固醇、低密度脂蛋白胆固醇检出率的高峰均出现在≥61岁组,男性高总胆固醇和低密度脂蛋白胆固醇检出率的高峰在≥61岁组,但高甘油三酯检出率高峰出现在41～50岁组;男性脂肪肝、高血压、糖尿病、肝内脂质沉着发生率(分别为29%、19%、8%、19%)高于女性(分别为16%、18%、6%、12%),动脉粥样硬化发生率则女性(18%)高于男性(12%);高血脂与脂肪肝、高血压、糖尿病、肝内脂质沉着的检出率呈正相关(P<0.05)。结论高血脂及其相关疾病在不同性别和年龄间的分布存在差异,只有了解高血脂及相关疾病在人群中的分布特征,才能有...     

吸烟与贵州老年男性人群血脂水平的关系研究

目的 探讨吸烟对贵州老年男性人群血脂水平的影响,为临床干预和健康教育提供资料.方法 选取2004年1月～2006年12月在我科常规体检的贵州老年男性人群2 160人,对其进行问卷调查、体格检查和血脂检查,包括年龄、吸烟史、饮酒史、体重指数(BMI)、血压等情况.对吸烟与总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)和脂蛋白a[Lp(a)]的关系进行分析.结果 当前吸烟者的TG水平 [(2.97±1.28) mmol/L]明显高于不吸烟者[(1.30±0.46) mmol/L]和已戒烟者[(1.32±0.78) mmol/L](P＜0.001),而HDL-C水平[(0.95±0.30) mmol/L]却明显低于不吸烟者[(1.24±0.40) mmol/L]和已戒烟者[(1.26±0.26) mmol/L](P＜0.001).当前吸烟者和已戒烟者的TG、TC及HDL-C 水平异常与不吸烟者相比更常见.在将吸烟与其他影响血脂的因素(如饮酒、BMI、年龄)进行比较后发现,吸烟对血脂紊乱的影响最大(β=0.219),当对这些影响因素进行校正分析后发现吸烟是血脂紊乱的一个独立危险因素(P=0.032).结论 吸烟对贵州老年男性人群血脂水平具有重要的影响,从而引发动脉粥样硬化(AS)、心血管疾病和脑血管疾病.     

中国初发急性心肌梗死患者血脂异常的年龄和性别分布特点分析

目的:分析中国初发急性心肌梗死(AMI)大队列人群中血脂异常的年龄和性别分布特点。方法:从中国AMI(CAMI)注册登记研究中筛选未接受降脂治疗的初发AMI患者26 298例,其中男性19 967例,女性6 331例,ST段抬高型心肌梗死(STEMI)患者19 821例(75.4%),非ST段抬高型心肌梗死(NSTEMI)患者6 477例(24.6%)。又将患者分为6个年龄段及年轻(男性45岁,女性55岁)和年长(男性≥45岁,女性≥55岁)两类,将低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)根据2016年中国成人血脂异常防治指南分为不同水平段。测量入院基线时血脂谱水平,分析血脂异常的年龄、性别分布特点。结果:全部患者的LDL-C、HDL-C和TG的平均水平分别为(2.83±0.91)mmol/L、(1.13±0.35)mmol/L及(1.77±1.24)mmol/L。女性患者LDL-C水平随年龄增长呈上升趋势(P=0.01),男性患者则呈下降趋势(P0.01)。全部患者LDL-C≥3.4 mmol/L和1.8 mmol/L的比例分别为25.1%和11.8%;在LDL-C≥4.1 mmoL/L患者中,年轻男性的比例高于年长男性患者(10.7%vs. 6.8%,P0.01)。年轻男性HDL-C1.04 mmol/L患者比例(53.0%vs. 46.9%,P0.01)和TG≥2.3 mmol/L患者比例(35.9%vs. 19.0%,P0.01)均高于年长男性患者。结论:中国初发AMI患者血脂谱随年龄和性别变化明显,年轻男性血脂异常发生比例高。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.