2型糖尿病患者脂联素与炎症因子相关性研究

目的检测胰岛素抵抗2型糖尿病(T2DM)患者血清脂联素与炎症因子的水平并分析其相关性。方法选择胰岛素抵抗指数(HOMA-IR)高于2.69的T2DM患者(T2DM组)和HOMA-IR为1.00的健康人(CON组)作为研究对象,检测并比较两组研究对象间血清脂联素、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和白细胞介素-18(IL-18)的差异,分析T2DM患者血清脂联素与炎症因子的相关性。结果 T2DM患者hs-CRP、TNF-α、IL-1β、IL-6、IL-8和IL-18水平均显著高于CON组,而脂联素和IL-10水平显著低于CON组,差异均有统计学意义(P0.05)。将TDM组患者血清脂联素和hs-CRP、TNF-α、IL-1β、IL-6、IL-8、IL-10和IL-18进行相关性分析,表明血清脂联素和hs-CRP、TNF-α、IL-1β、IL-6、IL-8和IL-18均呈负相关(rs0,P0.05),与IL-10呈正相关(rs0,P0.05)。结论胰岛素抵抗T2DM患者处于炎症紊乱状态,血清脂联素显著低于健康人,其水平与炎症因子密切相关。     

中国人群2型糖尿病血清脂联素水平及胰岛素抵抗相关性的Meta分析

目的探讨中国人2型糖尿病血清中脂联素水平与胰岛素抵抗的相关性。方法对国内2000~2010年关于脂联素与2型糖尿病的前瞻性及横断面研究进行检索。数据分析采用Cochrane协作网提供的Rev-Man 5.0软件进行Meta分析。危险度分析采用比值比作为效应量表示结果,连续性变量采用加权均数差值分析。两者均以95%可信区间(CI)表示。应用固定效应模型分析结果。结果 (1)在血清脂联素水平中,2型糖尿病组与健康组(P<0.01)有明显差异,呈负相关性。(2)胰岛素抵抗性中,2型糖尿病组与健康组(P<0.01)有明显差异,呈正相关性。结论中国人2型糖尿病血清中脂联素水平及胰岛素抵抗具有明显关联性。     

血浆脂联素水平变化与2型糖尿病胰岛素抵抗相关性的探讨

目的：了解2型糖尿病（T2DM）患者血浆脂联素浓度的改变，并探讨与胰岛素抵抗的关系。方法：正常对照组50例。T2DM组94例按体重指数（BMI）又分为正常体重组、超重组及肥胖组，测定正常对照组和T2DM各患者的血浆脂联素（APN）、空腹血糖（FPG）、糖化血红蛋白（HbAlc）、空腹血浆胰岛素（FINS）、血脂、体重指数（BMI），计算胰岛素抵抗指数（Homa—IR）及β-细胞功能指数（HOMA—β）。比较各组中脂联素浓度的差异，以及与其它因素的相关性。结果：与正常对照组相比，T2DM各组APN显著降低（均p〈0.01）．肥胖组APN较超重组显著降低，超重组APN较正常体重组显著降低（均p〈0.05）；与正常对照组相比，T2DM各组Homa—IR显著升高（均p〈0.01）。所有研究个体APN与BMI（r=-0.564。p〈0.05）和Homa-IR（r=-0．494。p〈0.05）呈负相关。与HDL—C（r=0.42，p〈0.05）呈正相关。结论：T2DM患者血浆APN水平显著下降，并随着体重增加降低更显著；APN与BMI和Homa—IR呈负相关。     

血清脂联素与2型糖尿病及其大血管病变的相关性研究

目的 测定正常人群与2型糖尿病及其大血管病变患者的血清脂联素水平,探讨脂联素与2型糖尿病及其大血管病变的相关性.方法 正常对照组102例,2型糖尿病组116例、2型糖尿病并大血管病变组123例,比较各组的血清脂联素水平,分析其影响因素.结果 ①型糖尿病组及其大血管病变组的血清脂联素水平[分别为(8.62±2.97)、(6.17±2.55)mg/L]较正常对照组[(10.03±4.41)mg/L]降低,大血管病变组的血清脂联素水平较2型糖尿病组更低,差异均有统计学意义(P均<0.05);②相关分析显示,脂联素水平与体重指数、腰臀比、胰岛素抵抗指数、空腹胰岛素、糖化血红蛋白、甘油三酯负相关(r值分别为-0.492、-0.581、-0.813、-0.754、-0.619、-0.387,P均<0.05);③多元逐步回归分析显示脂联素与胰岛素抵抗指数、空腹胰岛素、糖化血红蛋白呈负相关(r值分别为-0.828、-0.769、-0.631,P均<0.01).结论 2型糖尿病及其大血管病变患者的血清脂联素水平降低,低脂联素血症可能与2型糖尿病及其大血管病变相关,在糖尿病动脉粥样硬化的发生、发展过程中有重要作用.     

脂联素基因多态性与妊娠期糖耐量受损相关性研究

目的探讨脂联素基因多态性与妊娠期糖耐量受损相关性。方法选取2013年2月-2014年2月我院收治的妊娠期糖尿病患者共60例,以及选取同期我院体检糖耐量正常的孕妇共60例,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术分析脂联素基因多态性位点(+276G/T、+45T/G、-3971A/G)。结果脂联素基因、276、+45位点的等位基因频率经过Hardy-Weinberg遗传平衡定律检验指出各基因频率已达遗传平衡(P0.05)。两组的脂联素基因+276G/T等位基因、基因型频率分布对比,均不存在显著性差异(P0.05)。受损组患者的G等位基因频率明显低于正常组(P0.05)。两组的脂联素基因+45T/G基因型频率分布对比,均不存在显著性差异(P0.05)。两组的脂联素基因-3971的G、A等位基因、基因型频率分布对比,均存在显著性差异(P0.05)。结论本文推测脂联素基因多态性+45T/G可能是妊娠糖尿病发病的易感位点之一,-3971位点A等位基因可能为妊娠糖尿病的一个危险原因,因此监测孕妇此位点能预测妊娠期糖尿病的发生,从而及早积极处理多种危险因素,从而有助于早期预防妊娠期糖尿病,降低远期并发症发生及对于胎儿不佳的影响。     

2型糖尿病患者血浆脂联素浓度改变及其与胰岛素抵抗的关系

目的　了解 2型糖尿病患者血浆脂联素浓度的改变 ,并探讨与胰岛素抵抗的关系。方法　测定 64例 2型糖尿病和 3 0例正常对照组的血浆脂联素、空腹血糖 (FPG)、糖化血红蛋白 (HbA1c)、空腹血浆胰岛素 (FINS)、血脂、体重指数(BMI) ,计算胰岛素抵抗指数 (HOMA IR)及 β 细胞功能指数 (HOMA β)。比较脂联素浓度的改变 ,以及与其它因素的相关性。结果　正常对照组、非肥胖糖尿病组及肥胖糖尿病组 ,脂联素浓度依次降低 ,且均有统计学意义。大中血管并发症糖尿病组血浆脂联素水平较无大中血管并发症糖尿病组明显降低。在糖尿病患者中血浆脂联素与BMI、HOMA IR呈负相关 (P <0 0 5 ) ,与高密度脂蛋白胆固醇 (HDL c)呈正相关 (P <0 0 5 )。与FBG、HbA1c、甘油三酯 (TG)、总胆固醇 (TC)及 β 细胞功能指数 (HOMA β)相关性不明显。结论　 2型糖尿病患者血浆脂联素水平明显下降 ,并且与胰岛素抵抗有一定的相关性     

新诊断2型糖尿病患者血清肌联素与胰岛素抵抗的相关性研究

目的 探讨新诊断2型糖尿病(nT2DM)患者血清肌联素与胰岛素抵抗的关系.方法 纳入维吾尔族健康人群89例(对照组)、糖耐量受损(IGT)128例(IGT组)和nT2DM患者111例(nT2DM组)为研究对象,采用酶联免疫法检测血清肌联素的水平.结果 IGT组和nT2DM组年龄、体质量指数(BMI)、全身脂肪百分比(FAT％)、腰臀比(WHR)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)、759葡萄糖负荷后2h血糖(2 hPG)、759葡萄糖负荷后2h血浆胰岛素(2 hINS)、稳态模型评估胰岛素抵抗指数(HOMA-IR)和肌联素均高于对照组,差异有统计学意义(P＜0.05或P＜0.01).IGT组和对照组患者高密度脂蛋白胆固醇(HDL-C)高于nT2 DM组患者,差异有统计学意义(P＜0.05或P＜0.01).IGT组与nT2 DM组在FAT％、总胆固醇(TC)、HbA1c、FBG、FINS、2 hPG、2 hINS、HOMA-IR和肌联素方面比较,差异有统计学意义(P ＜0.05或P＜0.01).肌联素与年龄、BMI、WHR、HbA1c、FBG、2 hPG、FINS、2 hINS、HOMA-IR呈显著正相关(P＜0.05或P＜0.01),与HDL-C呈显著负相关(P＜0.01).多元逐步回归分析提示,2 hPG、2 hINS及HOMA-IR是影响肌联素水平的独立相关因素(β=0.34、0.42、0.90,P＜0.01、0.01、0.05).受试者工作特征(R0C)曲线显示,血清肌联素预测IGT和T2DM的曲线下面积分别为0.72和0.92.结论 T2DM和超重/肥胖人群血清肌联素水平明显升高,肌联素与胰岛素抵抗密切相关,在T2DM、胰岛素抵抗的发生发展中发挥着重要的作用.     

广州地区2型糖尿病人群脂联素SNP+45基因型与胰岛素抵抗水平的研究

目的:探讨广州地区2型糖尿病人群与健康对照组人群脂联素+45(SNP+45)住点不同基因型组之间胰岛素抵抗水平的变化及意义.方法:分别测定广州地区已知SNP+45位点基因型的2型糖尿病人群和健康对照组人群的腰臀比(WHR)、体质指数(BMI)、体脂分布(BF)、空腹血糖(FBG)、空腹胰岛素(FIN),并计算胰岛素抵抗指数(IRI).结果:(1)2型糖尿病人群和健康对照人群各个组内SNP+45位点的TT基因型组与GG+TG基因型组之间的WHR、BMI、BF、FBG和IRI比较,差异没有统计学意义.(2)2型糖尿病人群SNP+45位点TT、GG+TG基因型组与健康对照人群SNP+45位点TT、GG+TG基因型组之间的WHR、BMI、BF、FBG和IRI有统计学意义上的差异.结论:脂联素SNP+45位点与2型糖尿病的发生有关;在2型糖尿病的发生发展过程中,胰岛素抵抗起到重要的作用.     

血清脂联素与2型糖尿病及其大血管病变的相关性研究

Objective To understand the serum adiponectin levels in normal subjects and type 2 diabetes patients with macrovascular complications, to investigate the correlation between adipnectin and macrovascular complications in type 2 diabetes patients. Methods One hundred and two normal subjects, 116 type 2 diabetes patients and 123 type 2 diabetic patients with macrovascular complications were recruited in the current study. The serum adiponectin levels among three groups were compared, and the factors affecting the serum adiponectin were investigated. Results ①The serum adiponectin level was significantly lower in type 2 diabetic patients (8. 62 ± 2. 97) mg/L than that in normal subjects (10. 03 ± 4.41) mg/L, and was the lowest in type 2 diabetic patients with macrovascular complications(6. 17 ± 2. 55) mg/L(P < 0.05). ②Serum adiponetin level was negatively correlated with BMI,WHR,HOMA-IR,fasting insulin level, HbAlC and TG(r = -0.492, -0. 581, -0. 813, -0. 754, -0.619, -0.387, P<0.05). ③In a general multivariate regression, HOMA-IR fasting insulin and HbAlc.were negatively correlated with serum adipnectin level (r = - 0. 828, - 0. 769, - 0. 631, P < 0. 01). Conclusions The serum adiponectin level in type 2 diabetic patients is significantly decreased and even more in type 2 diabetic patients with macrovascular complications. These results suggest that lower serum adiponectin level is related to macrovascular complications in type 2 diabetic patients and maybe plays an important role in atherosclerosis in type 2 diabetic patients.     

血清脂联素与2型糖尿病及其大血管病变的相关性研究

Objective To understand the serum adiponectin levels in normal subjects and type 2 diabetes patients with macrovascular complications, to investigate the correlation between adipnectin and macrovascular complications in type 2 diabetes patients. Methods One hundred and two normal subjects, 116 type 2 diabetes patients and 123 type 2 diabetic patients with macrovascular complications were recruited in the current study. The serum adiponectin levels among three groups were compared, and the factors affecting the serum adiponectin were investigated. Results ①The serum adiponectin level was significantly lower in type 2 diabetic patients (8. 62 ± 2. 97) mg/L than that in normal subjects (10. 03 ± 4.41) mg/L, and was the lowest in type 2 diabetic patients with macrovascular complications(6. 17 ± 2. 55) mg/L(P < 0.05). ②Serum adiponetin level was negatively correlated with BMI,WHR,HOMA-IR,fasting insulin level, HbAlC and TG(r = -0.492, -0. 581, -0. 813, -0. 754, -0.619, -0.387, P<0.05). ③In a general multivariate regression, HOMA-IR fasting insulin and HbAlc.were negatively correlated with serum adipnectin level (r = - 0. 828, - 0. 769, - 0. 631, P < 0. 01). Conclusions The serum adiponectin level in type 2 diabetic patients is significantly decreased and even more in type 2 diabetic patients with macrovascular complications. These results suggest that lower serum adiponectin level is related to macrovascular complications in type 2 diabetic patients and maybe plays an important role in atherosclerosis in type 2 diabetic patients.     

Assessing progression to impaired glucose tolerance and type 2 diabetes mellitus

BACKGROUND: A prospective evaluation of the relationship between insulin secretion and insulin sensitivity, derived from the fasting state, is needed in clinical practice in order to identify the worsening of glucose metabolism. In this study the authors examine whether the product of insulin sensitivity and insulin secretion, assessed from the fasting state, predicts progression from normal glucose tolerance (NGT) to impaired fasting glucose (IFG) and from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A cohort of 300 subjects with NGT and 75 subjects with IGT were followed up over a 5-year period. Insulin sensitivity was calculated using the Belfiore index (B) and insulin secretion by the homeostasis model analysis beta-cell (HOMA-beta cell) index: the product of B-beta is expressed as: (40 x Ins(0) pmol L(-1))/Glu(0) mmol L(-1){[(Glu(0) mmol L(-1)x Ins(0) pmol L(-1)) + 1] - 3.5[(Glu(0) mmol L(-1) x Ins(0) pmol L(-1)) - 1]}, where Glu(0) is fasting glucose and Ins(0) is fasting insulin. RESULTS: From baseline at the end of the follow-up period, the product B-beta decreased 10.7% and 52.2% in progressors to IGT and T2DM, respectively. The product B-beta predicts the progression from NGT to IGT [relative risk (RR) 2.7, CI(95%) 1.2-9.1] and from IGT to T2DM (RR 5.3, CI(95%) 1.3-8.55). The cut-off point for the product B-beta that better predicts progression from NGT to IGT is 0.25 (sensitivity 88%, specificity 92%) and from IGT to T2DM 0.15 (sensitivity 92%, specificity 95%). CONCLUSIONS: Adaptation of insulin secretion to compensate for decreased insulin sensitivity during transition to IGT and T2DM can be successfully assessed with simple measures derived from the fasting state. The product B-beta predicts the development to IGT and T2DM.     

Relationship between impaired glucose tolerance, non-insulin-dependent diabetes mellitus and obesity

Plasma glucose concentration is the best predictor for the development of non-insulin-dependent diabetes mellitus (NIDDM). However, obesity is also a recognized risk factor for development of the disease, and is easier to track over time. Thus obesity could be of considerable clinical importance as a predictor of diabetes. Studies have shown that the degree of overweight, the change in weight and the duration of overweight are all separate predictors of diabetes. The British Regional Heart Study showed that an increasing body mass index (BMI) was associated with increased risk of developing diabetes, even at BMI values not considered obese. A separate study showed that weight gain increased the risk of diabetes independently of BMI, while weight loss decreased the risk. The duration of obesity was also an important factor in developing NIDDM. A long duration increased the risk of diabetes, irrespective of the final BMI value. The effects of obesity on insulin action have also been investigated. Studies have shown that insulin sensitivity is inversely related to insulin secretion, with a disproportionate increase in insulin secretion seen with decreasing sensitivity. A recent European study showed that the prevalence of both insulin hypersecretion and insulin resistance increased with increasing BMI. Thus, in obesity, higher insulin levels are necessary to maintain glucose tolerance, leading to increased stress on the β-cells. In obese individuals, weight loss improved insulin sensitivity in proportion to the degree of weight loss, leading to decreased insulin secretion. Weight loss can therefore, at least in the short term, act to decrease the risk of developing diabetes by reducing insulin resistance, and thus relieving β-cell stress, the factor ultimately responsible for hyperglycaemia in predisposed individuals.     

Levels of serum sialic acid and thiobarbituric acid reactive substances in subjects with impaired glucose tolerance and type 2 diabetes mellitus

Cardiovascular disease is a common cause of death for diabetic patients. High sialic acid levels (SA) and increased oxidative stress are important factors for cardiovascular diseases. We aimed to research whether SA and thiobarbituric acid reactive substances (TBARS) levels are associated with the degree of the diabetic regulation and investigate if SA and TBARS levels can be controlled with the regulation of the blood glucose levels. A total of 179 subjects were included in the study. Three groups, which were comprised of subjects with type 2 diabetes mellitus (DM) (DM group [DMG], n=149), impaired glucose tolerance (IGT) (IGT group [IGTG], n=15), and normal oral glucose tolerance (NGT) (NGTgroup [NGTG], n=15) were constituted. Glucose, cholesterol, high-density lipoprotein (HDL) and glycated hemoglobin (HbA1C), SA, and TBARS were measured in the sera of the patients. SA and TBARS levels were significantly increased in subjects with type 2 DM (P<0.001 for both). SA concentrations showed significant correlation with triglycerides (r=0.229; P<0.05), fasting glucose (r=0.508; P<0.01), 2-hr postprandial glucose (r=0.455; P<0.01), and HbA1C (r=0.467; P<0.01), and there was a positive correlation between TBARS and HbA1C (r=0.251; P<0.01). Diabetic patients were found to have higher risk for inflammation and oxidative stress. The regulation of blood glucose levels may contribute to the decline of both SA and TBARS levels.     

食药材降糖方治疗糖耐量异常及2型糖尿病气阴两虚证的临床效果

目的 探讨食药材降糖方治疗糖耐量异常及2型糖尿病气阴两虚证的临床效果.方法 选取2019年1月至2019年6月在陕西省中医医院就诊的糖耐量异常(5例)及2型糖尿病气阴两虚证(55例)共计60例患者作为研究对象,给予食药材降糖方治疗.观察临床疗效,比较患者治疗前、后的中医证候积分、血糖指标、血脂指标及胰岛素功能指标,同时...     

毛细血管恢复率评估糖耐量异常者和2型糖尿病患者微循环功能

目的测定甲襞微循环毛细血管恢复率评价2型糖尿病和糖耐量异常患者的微血管舒张功能。方法2型糖尿病患者、糖耐量异常和糖耐量正常者各48例,微循环显微镜测定甲襞微循环毛细血管恢复率,比较微血管舒张功能差异。结果口服葡萄糖耐量试验正常者48例平均年龄（60.4±6.7）岁,平均毛细血管恢复率为（35.4±8.7）%;糖耐量异常者48例平均年龄（62.4±7.7）岁,平均毛细血管回复率（30.1±7.7）%比糖耐量正常者下降（P〈0.05）。2型糖尿病者48例平均年龄（64.3±8.1）岁,平均毛细血管恢复率（27.5±9.3）%,明显低于正常人和糖耐量异常者（P〈0.05）。在糖尿病患者,随病程延长,毛细血管恢复率呈递减趋势（P〈0.05）。结论糖耐量异常者已存在明显的微血管舒张功能降低,在糖尿病患者中这种微循环障碍进一步加重,提示糖代谢受损早期即出现微血管舒张功能障碍。     

中青年2型糖尿病患者颗粒蛋白前体、脂联素水平及其比值与胰岛素抵抗的相关性分析

目的 研究中青年2型糖尿病(T2DM)患者脂联素(ADP)、颗粒蛋白前体(PGRN)水平的变化情况,分析PGRN与ADP比值(PGRN/ADP)与胰岛素抵抗的相关性.方法 选取2019年1月至2020年5月来该院内分泌科就诊的20～60岁新近诊断(半年内)的55例T2DM患者作为T2DM组,收集同期在该院体检中心体检糖...     

Prevalence of diabetes mellitus and impaired glucose tolerance in a middle-aged Finnish population

Objective - To describe the prevalence of previously diagnosed and undiagnosed diabetes and impaired glucose tolerance (IGT) by sex, marital status, employment, exercise behaviour, and body mass index (BMI), and to compare previously diagnosed and undiagnosed diabetic patients.

Design - A survey of the total 55-year-old population living in a Finnish city on 1 October 1990. All the participants who were not on antidiabetic medication were invited for an oral glucose tolerance test (OGTT).

Setting - Oulu, a city in northern Finland.

Subjects - 1008 eligible subjects (456 men and 552 women), of whom 345 men (76%) and 435 women (79%) participated.

Main results - the prevalence of previously diagnosed diabetes was 6.1% in the men and 3.0% in the women and that of previously undiagnosed diabetes 4.5% of the men and 3.7% of the women. the prevalence of IGT was 28.6% in the men and 26.7% in the women. Diabetes was related to BMI, and previously undiagnosed diabetes was related to the amount of physical exercise in both sexes. One third of the undiagnosed diabetic men and half of the undiagnosed diabetic women were identified among the persons with marked obesity (BMI 30 kg/m² or more). the group of previously diagnosed diabetic patients included a significantly greater proportion of retired people and people on sick leave than the group of undiagnosed diabetic persons.

Conclusions - Diabetes is common in middle-aged Finns. Undiagnosed diabetes was detected especially in persons with marked obesity who were not physically active.