中孕晚期孕妇胰岛素抵抗指数与骨代谢标志物水平的相关性

目的 调查中孕晚期孕妇胰岛素抵抗指数分布及其与总1型前胶原氨基端前肽等骨代谢标志物水平的相关性.方法 纳入孕周为24～26周孕妇共154例,检测空腹血糖、空腹胰岛素、空腹C肽、总Ⅰ型胶原氨基端延长肽、N端-骨钙素、β-胶原特殊序列水平.比较胰岛素抵抗指数与各骨代谢标志物水平的相关性,同时根据有无妊娠糖尿病进行分组比较.结果 胰岛素抵抗指数与总1型前胶原氨基端前肽、N端-骨钙素和β-胶原特殊序列的相关系数分别为0.469（P＜0.001）,0.201（P=0.012）和0.337（P ＜0.001）,均为正相关.妊娠糖尿病组孕妇胰岛素抵抗指数与总1型前胶原氨基端前肽、N端-骨钙素和β-胶原特殊序列的相关系数分别为0.623（P ＜0.001）,0.535（P ＜0.001）和0.718（P ＜0.001）,均为强正相关.结论 中孕晚期孕妇的胰岛素抵抗指数与骨合成代谢、骨转换率和骨分解代谢的相关标志物存在正相关,此相关性在妊娠糖尿病患者群体中表现得更为明显.     

绝经后2型糖尿病并发骨质疏松患者骨转换标志物的变化及探讨

目的探究绝经后2型糖尿病并发骨质疏松患者骨转换标志物的变化及检测意义。方法选取我院在2016年2月~2017年2月收治的100例绝经后女性患者进行研究,经诊断确诊后的50例绝经后骨质疏松患者作为对照组,50例绝经后2型糖尿病并发骨质疏松患者作为研究组,观察对比研究组患者骨转换标志物的相关因素分析、两组患者生化指标以及两组患者骨密度。结果研究组患者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、碱性磷酸酶(ALP)以及抗酒石酸酸性磷酸酶(TRAP-5b)、甲状旁腺素(PTH)、血肌酐(Scr)、显著高于对照组患者(P0.05),血清25羟维生素D(250HD)明显低于对照组患者(P0.05);研究组患者与对照组患者骨密度之间无明显差异(P0.05);N端中段骨钙素(N-MID)与糖尿病病程呈负相关以及抗酒石酸酸性磷酸酶(TRAP-5b)、I型胶原羧基端交联肽(CTX)与骨密度呈负相关。结论经检测发现2型糖尿病主要通过影响破骨细胞的活性进而影响骨代谢,绝经后2型糖尿病并发骨质疏松患者骨转换标志物可能是抗酒石酸酸性磷酸酶,对指标的检测有助于疾病的早期诊断。     

腹腔镜下胃转流术治疗2型糖尿病临床疗效评价

目的评价全腹腔镜下胃转流手术治疗2型糖尿病的临床疗效。方法对42例实施全腹腔镜下胃转流手术治疗的2型糖尿病患者,进行术前与术后的空腹及餐后2 h血糖、糖化血红蛋白、C肽、胰岛素和体重指数（BMI）等指标的比较分析。结果术后6个月空腹血糖、餐后2 h血糖、糖化血红蛋白较术前均有不同程度下降,与手术前比较相差显著（P〈0.05）,但是餐后血糖比空腹血糖下降得更快且显著;而空腹胰岛素、空腹C肽水平变化不明显;术前胰岛素、C肽水平高者效果更明显;手术治疗有效率100%,其中临床完全缓解率79.9%、临床部分缓解率20.1%。结论全腹腔镜下胃转流手术治疗2型糖尿病,近期临床疗效满意,是一种微创、安全、有效的外科治疗2型糖尿病的方法。     

胰岛素联合二甲双胍治疗初发Ⅱ型糖尿病42例报告

目的 评价胰岛素联合二甲胍治疗初发Ⅱ型糖尿病的临床疗效.方法 对42例新诊断Ⅱ型糖尿病患者进行为期4周的胰岛素联合二甲双胍强化治疗.观察治疗前后的空腹血糖(FPG)、餐后2h血糖(hPG)、糖化血红蛋白(HbAlc)、空腹胰岛素(Fins)、C肽(C-P)水平和胰岛素抵抗指数(Honla IR).结果 治疗后,患者的FPG、2 hPG、HbAlc均较治疗前明显下降(P＜0.01),胰岛素抵抗指数较治疗前明显下降(P＜0.01),Fim、C肽明显上升(P＜0.05).结论 对初诊的Ⅱ型糖尿病患者采用胰岛素联合二甲双胍能够全面控制血糖,改善胰岛B细胞功能.减轻胰岛素抵抗.     

临产孕妇胰岛素抵抗指数与骨代谢标志物水平的相关性

目的调查临产孕妇胰岛素抵抗指数分布情况及其与总1型前胶原氨基端前肽等骨代谢标志物水平的相关性。方法纳入孕周为38~41周的临产孕妇共190例,检测空腹血糖、糖化血红蛋白、胰岛素、C肽、总1型前胶原氨基端前肽、N端-骨钙素、β-胶原特殊序列水平。分析糖化血红蛋白、胰岛素抵抗指数等糖代谢标志物与各骨代谢标志物水平的相关性,同时根据糖化血红蛋白水平分为糖代谢异常组和糖代谢正常组进行分组比较。结果胰岛素抵抗指数与总1型前胶原氨基端前肽、N端-骨钙素和β-胶原特殊序列的相关系数分别为0.558（P〈0.001）,0.448（P〈0.001）和0.488（P〈0.001）,均为正相关。糖代谢异常组孕妇胰岛素抵抗指数与总1型前胶原氨基端前肽、N端-骨钙素和β-胶原特殊序列的相关系数分别为0.664（P〈0.001）,0.641（P〈0.001）和0.593（P〈0.001）,均为中度正相关。结论临产孕妇的胰岛素抵抗指数与骨合成代谢、骨转换率和骨分解代谢的相关标志物存在正相关,此相关性在糖代谢异常孕妇中表现得更为明显。     

血清Leptin在2型糖尿病、肥胖发病机制中的临床价值

目的：研究2型糖尿病血清Leptin与胰岛素,体脂分布和睾酮的关系。方法：对65例2型糖尿病患者及42例正常对照者用放免法测定血清Leptin及胰岛素。34例糖尿病患者进行75克葡萄糖耐量试验,32例行螺旋CT SSD技术测定体脂分布。30例男性糖尿病患者测定血清睾酮。结果：在调整了BMI（体重指数）,性别后,糖尿病组与对照组血清Leptin无差异。女性血清Leptin为男性的2．3倍,餐后2小时血清Leptin较空腹下降为19．19％,代谢控制不良者（空腹血糖＞14mmol)Leptin水平较低。性别,BMI,ASF（腹部皮下脂肪）是影响血清Leptin的重要因素,Leptin浓度与体重指数,胰岛素,腹部皮下脂肪显著正相关,与睾酮负相关,结论：2型糖尿病患者无异常血清Leptin,提示Leptin并非致2型糖尿病的主要因素,代谢控制不良者有Leptin缺乏,男性较低的Leptin可能与睾酮有关,性别,体重指数,腹部皮下脂肪是影响Leptin的主要因素。     

罗格列酮治疗糖尿病肾病的临床疗效观察

目的探讨胰岛素增敏剂罗格列酮对糖尿病患者肾脏的保护作用。方法选取早期糖尿病肾病患者42例,在原控制血糖方案基础上加用罗格列酮4mg／d,观察3个月,治疗前后分别检测患者空腹血糖（FBG）、早餐后2h血糖（2h PBG）、糖化血红蛋白（HbA1c）、收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、尿微量白蛋白排泄率（UAER）、C-反应蛋白（CRP）、C肽。结果患者FBG、2h PBG、HbA1c、SBP、DBP、TG、UAER、CRP、C肽下降及HDL-C上升,具有统计学意义。结论罗格列酮在降糖的同时亦可减少尿蛋白排泄,有一定的。肾脏保护作用。     

利拉鲁肽对首诊2型糖尿病患者血糖、血脂及T细胞亚群的影响

目的 探讨利拉鲁肽治疗首诊超重或肥胖2型糖尿病患者的效果及其对T细胞亚群的影响。方法 选取2018年2月~2019年6月我院收治的72例确诊为2型糖尿病超重或肥胖患者,采用随机数字表法分为对照组和研究组,每组36例。对照组予以常规治疗,研究组在对照组基础上加用利拉鲁肽治疗,比较两组治疗前后血糖水平（FPG、BPG、HbA1c）、空腹胰岛素+C肽、餐后2h胰岛素+C肽水平、BMI、血脂（HDL-C、LDL-C、VLDL-C、TC、TG）以及CD4+、CD4+/CD8+水平。结果 治疗后,研究组FPG、BPG、HBA1c水平低于对照组（P＜0.05）,空腹胰岛素、餐后2h胰岛素和空腹C肽、餐后2h C肽水平高于对照组（P＜0.05）;研究组BMI水平低于对照组（P＜0.05）;研究组TG、TC、LDL-C、VLDL-C水平低于对照组,HDL-C水平高于对照组（P＜0.05）;研究组CD4+、CD4+/CD8+高于对照组（P＜0.05）。结论 利拉鲁肽可调节CD4+T细胞亚群平衡,改善胰岛素β细胞功能并降低胰岛素抵抗,可更好控制2型糖尿病患者血糖水平,改善血脂水平,降低体质量。     

血清同型半胱氨酸水平检测在2型糖尿病诊治中的价值

目的探讨动态检测血清同型半胱氨酸（homocysteic acid,HCA）水平在2型糖尿病患者中的诊治价值。方法前瞻性地调查102例2型糖尿病患者血清HCA、空腹血糖（fasting blood glucose,FBG）、空腹胰岛素（fasting insulin,FINS）以及C肽水平,计算了胰岛素抵抗指数HOMA-IR以及胰岛β细胞分泌指数HOMA-β,并分析了HCA和FBG、FINS、C肽、HOMA-IR以及HOMA-β的相关性。结果2型糖尿病患者血清HCA水平明显高于正常对照组（P〈0.05）,血清HCA水平与FINS、HOMA-IR以及HOMA-β呈明显负相关,与FBG以及空腹C肽无明显相关。结论胰岛素缺乏和胰岛素抵抗可能是2型糖尿病患者血清HCA水平升高的重要相关因素,检测血清HCA水平对评估疾病程度、了解病情进展和转归以及指导临床治疗均有一定的临床价值。     

瘦素、脂联素与妊娠期糖尿病胰岛素抵抗关系的研究

目的探讨瘦素、脂联素与妊娠期糖尿病胰岛素抵抗的关系。方法采用稳态模型评估法评估正常糖耐量孕妇（NGT）糖耐量减低孕妇（GIGT）和妊娠期糖尿病孕妇（GDM）的胰岛素抵抗指数,采用放射免疫分析方法检测其血浆瘦素、脂联素、血糖及胰岛素水平。结果 GDM组和GIGT组HOMA-IR显著高于NGT组,GDM组HOMA-IR显著高于GIGT组。血清瘦素水平由NGT组到GIGT组和GDM组呈显著增高,瘦素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著正相关;血清脂联素由NGT组到GIGT组和GDM组呈显著下降,脂联素与空腹胰岛素、孕晚期体重指数、HOMA-IR呈显著负相关。结论瘦素、脂联素水平与GDM患者IR程度密切相关,其水平可作为预测妊娠期糖尿病胰岛素敏感性的指标,将来可能是治疗妊娠期糖尿病的新靶点。     

葡萄籽原花青素通过Nrf2调节糖尿病大鼠肾组织GSTM的表达

目的: 研究葡萄籽原花青素(GSP)对糖尿病大鼠肾保护作用的分子生物学机制,为GSP治疗糖尿病肾病提供实验依据。方法: 雄性Wistar大鼠尾静脉注射0.1%链脲佐菌素(STZ)建立糖尿病大鼠模型,成模后随机分为糖尿病组(DM组)和糖尿病GSP治疗组(GSP组,GSP 250 mg·kg^-1·d^-1),另设正常对照组(C组)。观察24周后测量大鼠体重、收缩压、肾重/体重和24 h尿蛋白定量;采血测定空腹血糖(FPG)、尿素氮(BUN)、肌酐(SCr)和糖基化血红蛋白(HbA1c);观察糖尿病大鼠肾脏病理改变,并应用Western blotting和免疫组化法测定肾组织谷胱甘肽S-转移酶μ亚型(GSTM)和核因子E2相关因子2(Nrf2)的表达。结果: 实验开始时3组大鼠体重无明显差异(P>0.05),24周时DM组大鼠较C组大鼠体重显著下降(P<0.01),治疗后GSP组大鼠体重较DM组增加,但无显著差异(P>0.05)。第24周时DM组大鼠与C组相比较,收缩压、FPG、HbA1c、肾重/体重、24 h尿蛋白定量、BUN和SCr水平显著升高(P<0.01)。治疗后GSP组大鼠与DM组比较FPG和HbA1c水平降低,但无显著差异(P>0.05),收缩压、24 h尿蛋白定量和肾重/体重显著降低,(P<0.01),BUN和SCr水平显著降低(P<0.05)。GSP组肾组织病理改变较DM组改善。GSTM和Nrf2表达在DM组表达较C组上调,在GSP组治疗后回调(P<0.05)。结论: GSP可能通过Nrf2下调GSTM表达而起肾保护作用。     

Serum testosterone in Nigerian men with type 2 diabetes mellitus and its relationship with insulin sensitivity and glycemic control

BackgroundThere is increasing evidence that testosterone deficiency has key associations with insulin sensitivity and glycemic control. Its presence may therefore contribute to and/or exacerbate clinical disease in men with type 2 diabetes mellitus (T2DM). This study sought to determine the frequency of low free testosterone and explore its relationship with, insulin sensitivity and glycemic control among Nigerian men with T2DM.MethodsOne hundred and four men with type 2 DM and one hundred and one apparently healthy non-diabetic men matched for age, were recruited into the study Socio-demographic data, anthropometric measurements and blood samples were obtained for measurement of serum total testosterone (TT), sex hormone binding globulin (SHBG), fasting plasma insulin, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c) and fasting lipid profile in all the subjects. Insulin sensitivity (%IS) and free testosterone (CFT) were then calculated.ResultsThe median CFT for men with T2DM was significantly lower than that of non-diabetic controls (0.17 nmol/L vs 0.58 nmol/L respectively; P < 0.001). 52.9% of men with T2DM had low CFT, as compared with 21.4% amongst the non-diabetic controls; P < 0.001.Among men with T2DM, those with lower CFT had significantly lower median % S and higher mean HbA1c than those with normal CFT (37.0% versus 63.0%; P = 0.021 and 7.79 (2.03) % versus 7.02 (1.94) %; P = 0.038 respectively]. HbA1c had significant negative correlations with both CFT (correlation coefficient: ?0.239 (P < 0.05) and TT (correlation coefficient: 0.354; P < 0.01.There was no significant difference in serum lipids when T2DM men with low serum CFT were compared with T2DM men with normal serum CFT levels.ConclusionWe conclude that low serum testosterone is common among men with T2DM and has a significant association with glycemic control (HbA1c) and insulin sensitivity.     

不同浓度糖化血红蛋白及空腹血糖的2型糖尿病患者β-羟丁酸水平变化分析

目的:观察2型糖尿病(T2DM)患者不同糖化血红蛋白(HbA1c)及空腹血糖(FBG)水平时β-羟丁酸(β-HBA)血清水平的变化。方法:随机选择T2DM患者100例,男65例,女35例,年龄25～83岁,平均57±13岁。测定各患者血清β-HBA浓度,根据HbA1c水平将T2DM患者分为轻度组(HbA1c<7%)、中度组(7%≤HbA1c≤9%)、重度组(HbA1c>9%)。又根据FBG水平将T2DM患者分为轻度组(FBG<7mmol/L)、中度组(7mmol/L≤FBG≤mmol/L)、重度组(FBG>9mmol/L)。分析比较不同水平HbA1c和FBG组间β-HBA水平差异。结果:随着HbA1c水平的逐渐升高,β-HBA水平亦有逐渐升高的趋势,HbA1c重度组与轻度组和中度组比较差异有统计学意义(P<0.05)。不同FBG水平组间β-HBA没有统计学差异(P>0.05)。结论:在血浆HbA1c>9%的T2DM患者中,β-HBA显著升高,提示临床加强血糖控制,降低HbA1c,防止糖尿病酮症及酮症酸中毒。     

Retinol binding protein 4 correlates with and is an early predictor of carotid atherosclerosis in type 2 diabetes mellitus patients

The association of retinol binding protein 4 (RBP4) with atherosclerosis of the carotid artery in type 2 diabetes mellitus (T2DM) remains undefined. We aimed to investigate the correlation of RBP4 expression with atherosclerosis of the carotid artery in T2DM. A total of 1,076 subjects were investigated for intima-media thickness of the bilateral common carotid arteries, and they were divided into three groups: in group I, patients had normal neck vascular ultrasound, in group II, intimal carotid artery media thickness was equal to or more than 1 mm, and in group III, carotid artery plaque was present. Height, weight, blood pressure (BP), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (apoA-1), apolipoprotein B (apoB) and lipoprotein (a) [Lp(a)] were determined by routine laboratory methods. RBP4 and high sensitivity C reactive protein (HsCRP) were measured by an enzyme-linked immuno-sorbent assay, and insulin concentration was measured by an electrochemiluminescence sandwich immunoassay. Duration of diabetes, waist and BP, FPG, HbA1c, TG, TC, LDL-C, APOB, Lp(a), HsCRP, RBP4 and homeostasis model assessment insulin resistance index (HOMA-IR) were significantly lower in group I than in the other two groups (P<0.01, P<0.01). Plasma levels of HbA1c, RBP4, LDL-C, TC, HOMA-IR, HsCRP and Lp(a), waist and BP were significantly increased in group III than in group II (P<0.01). Multivariate logistic regression analysis showed that there were seven factors associated with the occurrence of carotid artery atherosclerosis and its risks in descending order were: high LDL-C, high waist, high HsCRP, duration of diabetes, high HOMA-IR, HbA1c and high RBP4. Our finding supported that RBP4 was positively correlated with carotid atherosclerosis in patients with T2DM and could be used as an early predictor of cardiovascular disease.     

Effects of raltegravir combined with tenofovir/emtricitabine on body shape,bone density,and lipids in African-Americans initiating HIV therapy

Background:

Raltegravir (RAL) plus tenofovir/emtricitabine (TDF/FTC) is a recommended initial antiretroviral regimen. A substantial proportion of persons diagnosed with HIV infection and starting antiretrovirals in the U.S. are African-American (AA); however, the effects of this regimen on metabolic parameters have largely been studied in white patients.

Methods:

Single-arm, open-label study of untreated AA HIV-infected patients administered RAL with TDF/FTC for 104?weeks. Changes in fasting lipids, insulin resistance, visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (SAT), limb and trunk fat, and bone mineral density (BMD) were assessed at weeks 56 and 104.

Results:

Thirty (85% men) participants were included. Median entry characteristics included age of 38?years, CD4 323?cells/mm³, HIV RNA level 29?245 copies/ml, and body mass index 28.1?kg/m². At 56 and 104?weeks, significant increases in VAT, trunk fat, limb fat, and overall fat were observed. Bone mineral density decreased by 1.5% by week 104.There were no significant changes in non-HDL-cholesterol, fasting triglycerides, or insulin resistance. A median CD4 cell count increase of 318?cells/mm³ (IQR 179, 403; full range 40, 749) (P?Conclusions:

In this cohort of AAs, initiation of RAL with TDF/FTC was associated with significant general increases in fat. Significant changes in lipids or insulin resistance were not observed and there was a small decline in BMD. Therapy was well tolerated and effective. These results are consistent with findings of studies of initial antiretroviral therapy in racially diverse cohorts and inform treatment selection for AA patients starting therapy for HIV infection.     

新诊断2型糖尿病患者平均血糖的相关因素分析

目的:通过研究新诊断的2型糖尿病患者平均血糖(MBG)与糖化血红蛋白A1c(Hb A1c)及其它代谢、血糖波动指标的关系,分析影响该人群MBG的相关因素。方法:90例来自广东省4家医院的新诊断2型糖尿病患者,检测空腹血糖、血脂、胰岛素及OGTT 2 h血糖、胰岛素,并进行72 h的连续动态血糖监测,计算MBG以及血糖波动参数。结果:血糖波动参数[血糖标准差、平均血糖波动幅度、日间血糖平均绝对差(MODD)及血糖波动最大幅度(DMMG)]、Hb A1c、空腹血糖以及服糖后2 h血糖均与MBG相关(P0.01);逐步线性回归提示Hb A1c、MODD、DMMG及空腹血糖与MBG有最强关联性(P0.05)。纳入以上4个指标的线性拟合方程较仅纳入Hb A1c的线性拟合方程更精确。结论:影响我国新诊断2型糖尿病患者MBG的因素包括Hb A1c、空腹血糖、DMMG以及MODD。在临床上单纯依靠Hb A1c推算新诊断2型糖尿病患者的MBG可能存在误差。     

Age and microvascular responses to knee extensor exercise in women

This study investigated the effect of intense physical activities that generate high mechanical constraints on bone metabolism and serum leptin concentrations and the potential relationships among bone mineral density (BMD), bone biochemical markers and leptin variation. Thirteen male decathletes (mean age 22.4 ± 2.9 years), nationally or internationally ranked (15.5 h/week of training), were compared with 13 healthy sedentary subjects (mean age 25.9 ± 3.3 years). BMD was measured by DEXA and bone turnover was evaluated by specific markers. Leptin and calciotropic hormones levels were analysed in parallel. BMDs were higher in athletes than in controls at total body (13.9%), lumbar spine (17%), femoral neck (25%) and radius (9%), but not at the head. Athletes presented higher concentrations of osteocalcin (59.8%), cross-linked C-telopeptide of type-I collagen (41.1%) and 1,25-dihydroxyvitamin-D (37.1%). Basal leptin concentration was lower in athletes (0.94 ± 0.54 vs. 5.07 ± 1.1 ng ml⁻¹), and this difference persisted when leptin levels were adjusted for whole body fat mass (WBFM). No difference was observed for bone-specific alkaline phosphatase or intact parathyroid hormone. Serum leptin levels were negatively correlated with various BMD values only when both the groups were pooled (n = 26). This relationship did not persist when leptin levels were adjusted for WBFM. Male athletes, who practise sports generating high mechanical constraints on the body, present a specific bone metabolism that includes high BMD, as well as high bone turnover. The blunted leptin secretion did not seem to have deleterious effect on the process of bone adaptation to high mechanical constraints.     

糖维胶囊辅助治疗2型糖尿病的疗效及安全性研究

目的 探讨糖维胶囊治疗2型糖尿病(T2DM)患者的疗效及安全性.方法 选择2013年2月至2016年4月我院收治的200例T2DM患者,按随机数字表法分为对照组与观察组各100例,对照组采用糖尿病常规治疗,观察组加用糖维胶囊治疗,均治疗12周,比较两组治疗前后空腹血糖(FPG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbAlc)、C肽(CP)、胰岛素水平(FINS)、餐后2h胰岛素(2hINS)、胰岛素敏感指数(HOMA-IS)、胰岛β细胞功能指数(HOMA-β)等血糖及胰岛素功能指标的改善情况,比较两组治疗效果,监测两组治疗不良反应发生率.结果 ①治疗前,两组FPG、2hPBG、HbA1c、CP、FINS、2hINS、HOMA-IS 、HOMA-β比较差异无统计学意义(P＞0.05),治疗后,两组FPG、2hPBG、HbA1c均降低,CP、FINS、2hINS、HOMA-IS、HOMA-β均上升,与同组治疗前比较差异有统计学意义(P＜0.05),观察组FPG、2hPBG、HbA1c下降幅度及CP、FINS、2hINS、HOMA-IS、HOMA-β上升幅度均高于对照组(P＜0.05);②观察组治疗总有效率高于对照组(P＜0.05),但两组不良反应发生率比较差异无统计学意义(P＞0.05).结论 糖维胶囊可降低T2DM患者血糖水平,提高患者胰岛β细胞功能,优化T2DM治疗效果,且安全性肯定.     

去卵巢大鼠不同时期骨量、骨转换指标、雌激素水平的变化规律及相关性

背景：目前对去卵巢大鼠的研究较多,而对不同时间点大鼠骨量、骨转换指标、雌激素水平的变化规律及各因素的相关性研究报道较少。 目的：分析去卵巢大鼠不同时期骨量、骨转换指标、雌激素水平的变化规律并探讨其相关性。 方法：34只3月龄雌性SD大鼠,随机分为基线组、假手术组和去卵巢组。实验开始先将基线组处死,假手术组及去卵巢组于术后第4,8,12周分次处死。双能X射线吸收法(DXA)测定L1-3及股骨不同分区(头颈部R1区、转子部R2区、股骨干R3区、股骨整体R4区)的骨矿含量、骨密度、骨面积;酶联免疫吸附法(ELISA)检测血清Ⅰ型前胶原氨基端原肽、Ⅰ型胶原羧基端肽及雌激素水平。对大鼠体质量、离体骨密度、Ⅰ型前胶原氨基端原肽、Ⅰ型胶原羧基端肽、雌激素水平、月龄间的相关性进行分析。 结果与结论：①去卵巢后4周去卵巢组离体腰椎及股骨骨矿含量、骨密度均较基线组、假手术组明显降低(P < 0.05),第8,12周时均显著改善(P < 0.05),腰椎、股骨各区域骨量丢失幅度最大的为L1及股骨转子区。       ②去卵巢后4周去卵巢组血清Ⅰ型前胶原氨基端原肽、Ⅰ型胶原羧基端肽水平较基线组、假手术组均显著升高(P < 0.05),第8,12周差异无显著性意义。③去卵巢组第8,12周血清雌激素较假手术组及基线组明显降低(P < 0.01,P < 0.05)。④月龄与大鼠体质量、腰椎及股骨骨密度呈正相关,Ⅰ型前胶原氨基端原肽、Ⅰ型胶原羧基端肽与腰椎及股骨骨密度呈负相关(P < 0.01)。提示去卵巢后大鼠腰椎、股骨骨量变化呈先快速降低、再缓慢回升的趋势,其中L1及股骨转子部受影响最大;骨转换指标在去卵巢后显著加快、后期逐渐回归正常;雌激素水平变化规律为第1个月先升高、后期快速降低;体质量、骨转换指标及雌激素水平与骨量密切相关。  中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

地特胰岛素或甘精胰岛素联合使用口服药物治疗2型糖尿病疗效及对体重的影响分析

目的 观察地特胰岛素或甘精胰岛素联合口服药物治疗T2DM的疗效及对体重的影响。方法 80例T2DM患者随机分为Det组和Gla组,每组40例。Det组采用阿卡波糖+二甲双胍+地特胰岛素治疗,Gla组采用阿卡波糖+二甲双胍+甘精胰岛素治疗。治疗12周后对比两组患者治疗前后HbA1C、FPG、2hPG、基础胰岛素用量、体重变化以及低血糖发生率。结果 两组患者FPG、2hPG及HbA1C均到有效控制,Det组HbA1C由（9.6±2.1）%降至（6.8±0.6）%,Gla组HbA1C由（9.2±2.1）%降至（6.4±0.7）%。Det组及Gla组FPG分别由（10.5±2.3）mmol/L、（10.6±2.4）mmol/L降至（6.1±0.6）mmol/L、（6.3±0.7）mmol/L;2hPG分别由（14.9±2.3）mmol/L、（14.5±2.1）mmol/L降至（9.1±1.1）mmol/L、（9.2±1.3）mmol/L,差异均具有统计学意义（P＜0.05）。达到同样空腹血糖水平,Det组基础胰岛素用量为（0.40±0.05）U/kg,少于Gla组的（0.60±0.04）U/kg,差异具有统计学意义（P＜0.05）。治疗12周后,Det组体重增加（1.3±0.4）kg,Gla组体重增加（2.5±0.3）kg,Det组体重增加低于Gla组,差异具有统计学意义（P＜0.05）。Gla组低血糖发生率为5.00%,Det组低血糖发生率为2.50%,两组间比较,差异无统计学意义（P＞0.05）。结论 T2DM患者口服药物联合基础胰岛素控糖是一种安全有效的选择,地特胰岛素对体重增加方面更有优势。