男性2型糖尿病患者血清睾酮、雌二醇、性激素结合蛋白的变化

目的观察男性2型糖尿病患者血清总睾酮、总雌二醇、性激素结合蛋白的变化,探讨该种变化与男性2型糖尿病及其并发症发生的关系。方法①选择2003-10/2005-06在中南大学湘雅二医院代谢内分泌研究所门诊就诊及住院男性2型糖尿病患者89例为男性糖尿病组,年龄40～60岁。选择同期本院健康体检男性66人为男性对照组,年龄40～60岁。均对检测项目知情同意。②采用葡萄糖氧化酶法测定血糖,采用酶联免疫吸附法测定血清总睾酮、总雌二醇、性激素结合蛋白、胰岛素水平。③计量资料差异分析采用t检验;胰岛素与性激素的关系用直线相关分析。结果男性2型糖尿病患者89例,健康男性66人均进入结果分析。①男性2型糖尿病组空腹血糖、餐后120m in血糖、空腹胰岛素和餐后120m in胰岛素、血清总雌二醇、性激素结合蛋白水平均明显高于男性对照组(P<0.05)。男性糖尿病组血清总睾酮水平明显低于男性对照组(P<0.05)。②血清空腹胰岛素、餐后120m in胰岛素与总睾酮、总雌二醇、性激素结合蛋白无明显相关性(P>0.05)。结论①血浆性激素是反映男性2型糖尿病患者代谢变化的指标之一。②男性2型糖尿病患者人体内存在性激素分泌功能紊乱,其改变可对糖尿病及其并发症的发生发展起重要作用。     

2型糖尿病男性患者血清睾酮、雌二醇、性激素结合蛋白的变化

【目的】观察男性2型糖尿病（T2DM）患者血清总睾酮（T）、总雌二醇（E2）、性激素结合蛋白（SH—BG）的变化,探讨该变化与男性T2DM及其并发症发生发展的关系。【方法】男性T2DM89例为糖尿病组,同期健康男性66人为对照组。比较两组血糖、T、E2、SHBG、胰岛素水平。并对胰岛素与性激素的关系进行相关分析。【结果】①T2DM组空腹血糖、餐后120min血糖、空腹胰岛素和餐后120min胰岛素均高于对照组（P〈0．05）。血清T水平明显低于对照组（P〈0．05）;血清E2、sHBG水平明显高于对照组（P〈0．05）。②T2DM组T、E2、SHBG与空腹胰岛素、120分胰岛素之间无明显相关性（P〉0．05）。【结论】①血清性激素是反映男性T2DM代谢变化的指标之一。②男性T2DM存在性激素分泌功能紊乱,其改变可对糖尿病及其并发症的发生发展起重要作用。     

糖尿病患者血清胰岛素、性激素与脂质变化相互关系的探讨

目的 为探讨非胰岛素依赖型糖尿病（NIDDM）患者血清脂质、胰岛素与性激素变化异常间的关系。方法 检测了40例50岁以上NIDDM患者血清雌二醇（E2）、睾酮（T）水平及胰岛素、脂质和空腹血糖的变化,并与健康对照组比较,观察Ⅱ型糖尿病患者性激素与脂质、胰岛素和空腹血糖的关系。结果 发现男性患者E升高,E2／T比值显著增高;女性患者E2降低,B／T显著降低,伴高胰岛素血症及胰岛素抵抗。B／T与空腹血糖（FBG）、空腹胰岛素（FINS）呈正相关,与总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）呈负相关;T与HDL—C呈正相关,与甘油三酯（TG）呈负相关。结论 提示NIDDM患者存在严重的性激素失调、脂代谢紊乱及胰岛素抵抗。     

老年男性2型糖尿病与血清睾酮的相关性分析

目的探讨老年2型糖尿病与血清睾酮的相关性。方法选择1012例老年男性,分成糖尿病和非糖尿病组,测定两组体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、餐后血糖（PBG）、甘油三酯（TG）、胆固醇（CHO）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、空腹血清胰岛素（FINS）、餐后血清胰岛素（PINS）、血清睾酮（T）、雌二醇（E2）。结果与非糖尿病组相比,老年男性糖尿病组的FBG、PBG、FINS、PINS、TG、E2水平升高（P〈0.05）,而HDL-C、T水平降低（P〈0.05）。多因素逐步回归分析显示影响T的因素从大到小依次为HDL-C、FINS、PINS和TG。结论TG、HDL-C、FINS、PINS与老年2型糖尿病男性的T水平密切相关。     

2型糖尿病患者空腹及餐后性激素分泌的研究

目的研究2型糖尿病(T2DM)患者性激素分泌状况,并分析其原因。方法化学发光法测定T2DM患者空腹和餐后血清垂体泌乳素、促卵泡生成素、促黄体生成素、雌二醇、黄体酮、睾酮等性激素水平,进行空腹、餐后统计学比较,并分析性激素变化规律。结果 T2DM患者餐后2h性激素较空腹明显降低。结论 T2DM患者存在细胞膜转运障碍,形成餐后细胞分泌功能缺陷,导致餐后性激素分泌下降,其与胰岛素分泌缺陷密切相关。     

男性2型糖尿病患者伴非酒精性脂肪肝病的性激素变化——附53例报告

目的：探讨男性2型糖尿病（T2DM）伴非酒精性脂肪肝病（NAFLD）患者性激素变化情况。方法：53例男性T2DM患者按有无合并NAFLD分为脂肪肝组（26例）和对照组（27例）,检测两组性激素水平、糖脂代谢指标及氨基转移酶水平,比较两组间的差异。结果：脂肪肝组HDL-C、性激素结合蛋白（SHBG）、卵泡刺激素（FSH）显著低于对照组（P〈0．05）,体质量指数、腰臀比、三酰甘油、ALT、AST、雌二醇高于对照组（P〈0．05）,两组总睾酮、黄体生成素、催乳素比较差异均无统计学意义（P〉0．05）。结论：与单纯T2DM男性患者相比,他DM伴NAFLD男性患者雌二醇水平升高,SHBG、FSH降低。     

脑梗塞与性格,性激素,血脂间的关系

对29例脑梗塞患者和59例正常人进行性格评定，且测定了23例男性脑梗塞患者的血清性激素：睾酮（T）、雌二醇（E2）和血脂：总胆固醇（TC）、甘油三酯（TG），及56例男性正常对照者的血清性激素（T、E2）。结果发现：（1）脑梗塞组A型性格所占百分率明显高于对照组（P＜0．001）；（2）男性脑梗塞患者尤其是A型性格患者存在性激素失衡，即血清T水平降低（P＜0．05）、E2／T比值增高（P＜0．05）；（3）脑梗塞组中A型性格患者的血清TC、TG高于B型性格（但P＞0．05）。结论：A型性格对脑梗塞的影响至少有一部分是通过影响血清性激素（T、E2）及血脂而发生的。     

老年性糖尿病患者体内性激素含量的改变及其意义

目的 :为明确老年性糖尿病人体内性激素的分泌情况以便为该病的防治打下基础 ,我们对老年性糖尿病人血清睾酮和雌二醇的含量作了研究。方法 :检测了老年性糖尿病病人48人(男31人 ,女17人)和正常对照15人(男8人 ,女7人)的血糖含量、血清胰岛素含量、血清果糖胺含量、糖化血红蛋白和血清睾酮和雌二醇含量。结果 :(1)糖尿病病人血清胰岛素含量与正常对照没有明显差异 ,而其血糖含量、血清果糖胺含量、糖化血红蛋白含量显著高于正常对照。(2)男性糖尿病病人血清睾酮含量显著低于正常对照 ,雌二醇含量和雌二醇与睾酮的比值(E2/T)均高于正常对照 ;而女性糖尿病患者睾酮含量明显高于正常对照 ,而雌二醇含量和E2/T均低于正常对照。结论 :老年性糖尿病人体内存在性激素分泌功能紊乱     

2型糖尿病患者胰岛素抵抗与胰高血糖素的关系

目的 探讨2型糖尿病患者胰高血糖素变化与胰岛素抵抗的关系。方法 2型糖尿病患者33例（糖尿病组）、正常对照者30例（正常对照组），行口服75g葡萄糖耐量试验，分别于0、30、60、120min取静脉血，测定血糖、胰岛素、胰高血糖素。结果 ①糖尿病组30、60、120min胰高血糖素水平均明显高于正常对照组（P〈0．05或P〈0．01）。②糖尿病组稳态型评价胰岛素抵抗（HOMA-IR）明显高于正常对照组（P〈0．01）。③HOMA-IR与空腹胰岛素，葡萄糖耐量试验60min后胰高血糖素60及胰高血糖素60／胰岛素60水平呈正相关（r值分别为0．64、0．61、0．79，P〈0．05或P〈0．01）。结论 2型糖尿病患者胰高血糖素升高，胰高血糖素可能是胰腺α细胞对胰岛素抵抗的标志。     

胰岛素治疗初诊2型糖尿病的临床观察

目的：探讨胰岛素治疗对初诊2型糖尿病患者血糖控制及胰岛β细胞功能的影响。方法：42例初诊2型糖尿病患者接受胰岛素治疗1个月，观察治疗前后血糖、糖化血红蛋白及血C肽水平的情况，并随访胰岛素治疗后对长期血糖控制的影响。结果：胰岛素治疗1个月后，患者空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）均明显下降（P〈0．05），空腹及餐后2小时血C肽水平明显升高（P〈0．05），有35例患者停用胰岛素，改口服降糖药物治疗，随访6个月，血糖控制理想。结论：胰岛素治疗初诊2型糖尿病不仅能较好控制血糖及明显降低HbA1C，而且在一定程度上能恢复胰岛β细胞的功能。     

齐齐哈尔地区达斡尔族ABO、MN、P、Rh血型分布

达斡尔族是我国55个少数民族之一.达斡尔族是辽国契丹人的后裔,其先民就已定居黑龙江中、上游北岸,现主要居住在内蒙古自治区和黑龙江省,少数居住在新疆.人口12万余.齐齐哈尔地区是达斡尔族的主要聚居地.笔者调查了齐齐哈尔地区达斡尔族ABO、MN、P、Rh血型分布及血型分布的群体遗传特征,现报告如下. 1 材料与方法 1.1 调查对象齐齐哈尔地区达斡尔族人,随机采样,被检3代均系达斡尔族. 1.2 试剂抗-A、-B、-M、-N、-P1、-C、-c-D、-E、-e. 1.3 试验方法按文献[1]进行;计算方法(基因频率,基因组合体频率,吻合度测验)均参照文献[2]进行.     

Meaning, values, needs, and multiculturalism in bereavement

Meaning, Values, Needs, and Multiculturalism in Bereavement A review of Personal Care in an Impersonal World: A Multdimesional Look at Bereavemenl, edited by John D. Morgan. Amityville, NY: Baywood, 1993. 261 pp. ISBN 0-89503-109-4. $31.95. Keviewed by Kevin Ann Oltjenhruns.     

Nutrition, exercise, work, and sex in pregnancy

This article focuses on the effect of daily living on pregnancy outcome. Although most patients can continue their everyday activities without any concern about effect on pregnancy outcome, all pregnant patients want and need their physician's advice about all of these areas.     

Pathophysiology of prenatal drug-exposure: in utero, in the newborn, in childhood, and in agencies

Medical communities are documenting an increase in the numbers of infants being born with prenatal drug exposure. Medical, educational, and social agencies are serving large numbers of these infants, toddlers, and their families. These infants and toddlers constitute a population whose short-term and long-term needs have not been adequately identified or addressed in the health, social, emotional, or developmental domains. This article discusses the pathophysiology in prenatal drug exposure and the role of the nurse when providing services to these infants, toddlers, and their families.     

Association between serum ferritin, hemoglobin, iron intake, and diabetes in adults in Jiangsu, China

OBJECTIVE: To investigate the association between iron status, iron intake, and diabetes among Chinese adults. RESEARCH DESIGN AND METHODS: This cross-sectional household survey was carried out in 2002 in Jiangsu Province, China. The sample contained 2,849 men and women aged > or =20 years with a response rate of 89.0%. Iron intake was assessed by food weighing plus consecutive individual 3-day food records. Fasting plasma glucose (FPG), serum ferritin, and hemoglobin were measured. RESULTS: The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin and serum ferritin increased across groups with increasing FPG. The prevalence of anemia among women was 15.0% in individuals with FPG >7.0 mmol/l compared with 32.6% in individuals with FPG <5.6 mmol/l. There was a similar, however not significant, trend among men. In women, after adjusting for known risk factors, the odds ratio (OR) of diabetes was 2.15 (95% CI 1.03-4.51) for subjects in the upper quartile of hemoglobin compared with the rest, and the corresponding OR for the upper quartile of serum ferritin was 3.79 (1.72-8.36). Iron intake was positively associated with diabetes in women; fourth quartile intake of iron yielded an OR of 5.53 (1.47-20.44) compared with the first quartile in the multivariate analyses. In men, similar trends were suggested, although they were not statistically significant. CONCLUSIONS: Iron status and iron intake was independently associated with risk of diabetes in Chinese women but not in men.     

Brotizolam, a triazolothienodiazepine, in insomnia

Sixty-three outpatients with chronic insomnia were treated for 3 weeks under double-blind conditions with either brotizolam (n = 29) at a dose of 0.25 mg or 0.5 mg or placebo (n = 34). A 3-day placebo period preceded and followed the double-blind treatment phase. Brotizolam consistently produced significantly more sleep improvement than placebo but also more adverse effects. In those patients switched abruptly from brotizolam to placebo, rebound insomnia was observed, being most marked at the first post-brotizolam placebo night.     

Peak expiratory flow in healthy,young, non-active subjects in seated,supine, and prone postures

Objective: To compare the PEFs in healthy, young, non-active subjects in seated, supine, and prone postures. Methods: A total of 30 healthy volunteers (15 male, mean age 22.7 years, non-smokers, sedentary) underwent a physical examination, spirometry to confirm normal pulmonary function, and PEF using the Mini-Wright Peak Flow Meter while wearing a nose clip. PEF measurements were repeated three times in each of three positions (seated, prone, and supine) in random order and differed by less than 20 L/min for a given position. Paired Student’s t-tests were used to analyze the results, and the significance level was set at 5%. Results: The PEF values obtained when the study participants were in a seated position (481.0 ± 115.1 L/min) were higher than those obtained when participants were in prone (453.7 ± 112.1 L/min) or supine (453.2 ± 114.3 L/min) positions (p < 0.05). No significant difference in PEF values was observed between the prone and supine positions. Conclusion: Body posture affects PEF in healthy, young, non-active subjects. PEFs are higher when subjects are in a seated position compared to prone or supine positions, but no difference in PEF is observed between the prone and supine positions.