2型糖尿病患者的抑郁症状与人格特质和运动行为的关系

目的:分析2型糖尿病患者的抑郁症状及其与人格特质、运动行为的关系。方法:选取2型糖尿病患者718人,基于病人健康问卷抑郁自评量表(PHQ-8)、大五人格量表简式版(CBF-PI-B)建立logistic模型,分析抑郁症状与人格特质的关系及运动行为的调节作用。结果:存在抑郁症状的患者161人(22.4%)。神经质与宜人性得分与抑郁症状正向关联(OR=1.08、1.08)。已经开始锻炼、男性、诊断时间较长的患者抑郁症状比例较低(OR=0.44、0.47、0.62),已使用药物/胰岛素的患者抑郁症状比例较高(OR=2.23);参与锻炼会降低神经质与抑郁症状之间的关系(OR=0.95),但对宜人性与抑郁之间的关系无影响(P>0.05)。结论:糖尿病患者的神经质、宜人性与抑郁症状关系密切;参与运动可以有效减弱神经质对抑郁的影响。     

Prevalence of overweight/obesity and its associated factors among a sample of Moroccan type 2 diabetes patients

BackgroundObesity constitutes a major risk factor for the development of diabetes, and has been linked with poor glycaemic control among type 2 diabetic patients.AimsThis study examines the prevalence of overweight/obesity and associated factors in type 2 diabetic patients in the Beni-Mellal Khenifra region in Morocco.MethodsA questionnaire-based cross-sectional study was conducted in 2017 among 975 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews. Anthropometric measurements, including body weight, height and waist circumference, were taken using standardized techniques and calibrated equipment.ResultsThe prevalence of overweight was 40.4%, the general obesity was 28.8% and the abdominal obesity was 73.7%. Using multivariate analysis, we noted that the general obesity was associated with female sex (AOR= 3,004, 95% CI: 1.761–5.104, P<0.001), increased age (AOR=2.192, 95% CI: 1.116–4.307, P<0.023) and good glycaemic control (AOR=1.594, 95% CI: 1.056–2.407, P=0.027), whereas abdominal obesity was associated wih female sex (AOR=2.654, 95% CI: 1.507–4.671, P<0.001) and insulin treatment (AOR=2.927, 95% CI: 1.031–8.757, P=0.048).ConclusionOverweight, general obesity and abdominal obesity were high among participants, especially among women. Taken together, these findings urge the implementation of a roadmap for this diabetic subpopulation to have a new lifestyle.     

艾塞那肽对血糖控制不佳的肥胖糖尿病患者疗效分析

目的：观察血糖控制不佳的肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者加用艾塞那肽后的疗效。方法：选取研究对象60例(退出3例,实际完成57例),根据不同体重指数(BMI)分为A组(25 kg/m2≤BMI<30 kg/m2)23例,B组(30 kg/m2≤BMI<35 kg/m2)27例,C组(35 kg/m2≤BMI<40 kg/m2)7例,连续给予艾塞那肽治疗12周,比较治疗前后3组患者的临床疗效及血清指标变化。结果：随访结束后,所有患者平均空腹血糖(fasting blood glucose,FBG)水平、HbA1c、体重和BMI、血脂(TC、TG、LDL)等较基线有明显下降(P<0.05);所有患者平均空腹胰岛素(fasting serum insulin,FINS)水平较治疗前有所升高(P>0.05),所有患者HOMA-IR较治疗前明显降低(P均<0.05),HOMA-β较治疗前无显著变化(P>0.05)。3组间比较显示,各组FBG下降幅度C组>B组>A组(P>0.05);HbA1c下降幅度水平C组>A组(P<0.05);体重减轻幅度和BMI的下降幅度依次为C组>B组>A组(P均<0.05)。结论：艾塞那肽可以有效控制血糖控制不佳的肥胖T2DM患者的FBG、HbA1c,改善血脂水平和胰岛功能,减轻体重和BMI。其中,艾塞那肽对FBG、HbA1c、体重、BMI的疗效,在BMI较高组中疗效更显著。     

自噬介导运动改善2型糖尿病骨代谢紊乱的作用机制

文题释义：骨代谢：骨作为生命活动的重要器官之一,其细胞在不断进行代谢,细胞之间还会产生相互作用,在此过程中还存在骨髓中的红细胞生成细胞和基质细胞的相互作用,进而完成骨的修复和重建。 骨自噬：在骨组织细胞内发生的一种分化和吸收的循环过程,是骨组织细胞代谢的重要组成部分和必要的环节,正常状态下的自噬维持着骨中细胞的吸收和分化,在受到内部或外部刺激后,骨自噬水平会加强,以完成对骨细胞代谢的调控和对病态的应激。 背景：研究发现,自噬可通过核因子κB受体活化因子配体、哺乳动物雷帕霉素靶蛋白、Wnt/β-连环蛋白途径和p38丝裂原活化蛋白激酶等信号通路来调控2型糖尿病骨代谢。 目的：分析总结近年来自噬在运动改善2型糖尿病骨代谢紊乱中的作用及可能分子机制。 方法：以“自噬;运动;2型糖尿病;骨代谢”“autophagy;exercise;type 2 diabetes mellitus;bone metabolism”作为关键词在PubMed、中国知网等文献资料库中查询有关自噬介导运动改善2型糖尿病骨紊乱的相关文献,并对其进行研究,然后按照一定逻辑进行分析和综述。 结果与结论：①研究发现自噬可以通过PPAR-γ、Hedgehog、MITF和过氧化物酶体增殖激活受体等信号通路作用,从而在运动改善2型糖尿病骨代谢紊乱中发挥调控作用;②自噬在2型糖尿病中能上调成骨细胞的分化能力以及下调破骨细胞吸收能力,并对成骨细胞形成骨组织细胞和骨钙素的矿化产生重要影响。 ORCID: 0000-0001-5058-0101(陆鹏程) 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     

Body weight reduction to avoid the excess risk of type 2 diabetes

Background

It is recognised that people who are overweight have an increased risk of diabetes but the quantitative relationship is less well recognised and the extent of weight reduction needed to avoid the excess risk of diabetes through being overweight, is not well appreciated

Aim

To derive a simple clinical algorithm to calculate the weight change needed to achieve a specified goal for reduction of body mass index (BMI, weight/height squared [kg/m²]) that would avoid the excess risk of diabetes and quantify the preventive effect.

Design and setting

Analysis of the results from two large published cohort studies of the incidence of diabetes in relation to BMI.

Method

Epidemiological data show that the risk of diabetes doubles for every 2.5 unit increase in BMI above a BMI of 22 kg/m² and halves for every 2.5 unit decrease in BMI down to 22 kg/m². The risk of diabetes also approximately doubles for every 10 years of age. From these relationships, a simple algorithm was derived to specify a person''s weight-reduction goal to avoid the excess risk of diabetes.

Results

Converting a BMI-reduction goal (for example, 27 kg/m² to 22 kg/m²) into a percentage reduction (in this example, 19%) specifies the same percentage weight reduction (19%) because, as a percentage, the reduction is independent of height. This percentage can then easily be converted into an absolute risk reduction (in this example, a 75% reduction in risk).

Conclusion

The algorithm achieves two objectives: (i) it specifies the weight-reduction goal to reverse a person''s excess risk of diabetes due to being overweight, and (ii) it quantifies the risk reduction.     

Crystallization of oral fluid components in patients with type 2 diabetes mellitus

Crystal aggregations of oral fluid from normal subjects and patients with type 2 diabetes mellitus were examined. Morphological signs characterizing crystal aggregations of salivary pools from patients with type 2 diabetes mellitus are described and classified. Translated fromByulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 138, No. 9, pp. 345–347, September, 2004     

Crystallization of oral fluid components in patients with type 2 diabetes mellitus

Crystal aggregations of oral fluid from normal subjects and patients with type 2 diabetes mellitus were examined. Morphological signs characterizing crystal aggregations of salivary pools from patients with type 2 diabetes mellitus are described and classified.Translated from Byulleten Eksperimentalnoi Biologii i Meditsiny, Vol. 138, No. 9, pp. 345–347, September, 2004     

Association of adiposity, cardiorespiratory fitness and exercise practice with the prevalence of type 2 diabetes in Brazilian elderly women

BACKGROUND: Diabetes incidence in people with advanced age is increasing at an alarming rate, and for this reason the screening of high-risk individuals such as elderly women is critically important. OBJECTIVE: To analyze the association of adiposity, cardiorespiratory fitness and exercise practice with type 2 diabetes (T2D) in elderly Brazilian women. METHODS: Participated of this cross sectional study 1,059 elderly women (mean 69.5 yr; SD 6.1), who self-reported family history of cardiovascular disease, smoking status, hypertension, and T2D diagnosed previously by a physician. The following independent variables were assessed: exercise practice, body mass index, waist circumference, and cardiorespiratory fitness. Logistic regression analysis was used to investigate the association between each independent variable with T2D using adjusted-models. RESULTS: T2D prevalence was 16%. General and central adiposity were directly associated with T2D, whereas cardiorespiratory fitness was inversely related with T2D. The joint effect of exercise practice and central adiposity showed that inactive women had higher odds ratio for T2D when compared with active ones, within the same WC group. Inactive women with WC > or = 94.0 cm had an odds ratio of 5.8 (95%IC 1.3-25.3). CONCLUSIONS: A direct positive association was found between general and central adiposity, as well as an inverse relation between CRF and exercise practice with T2D. Elderly women who practice exercise regularly had lower odds for T2D. Health professionals should encourage individuals of all ages to engage on regular exercise practice, which could reduce body fatness and may be beneficial in reducing the prevalence of T2D in older ages.     

TNF-alpha polymorphisms and type 2 diabetes mellitus in Taiwanese patients

Type 2 diabetic mellitus (type 2 DM) comprises more than 95% of all Taiwanese patients with DM. Tumor necrosis factor-alpha (TNF-alpha) expression is linked with insulin resistance, and is under strong genetic control. The correlation between TNF promoter genotypes and type 2 DM is still controversial, because discrepancies among different studies exist. Ethnic differences play certain roles in these conflicting results, because the distribution of TNF promoter polymorphisms is different among study subjects with different racial origins. Therefore, we examined the relationship between the incidence of type 2 diabetes in Taiwanese and two polymorphisms of the TNF-alpha promoter region (positions -238 and -308) as well as the correlation between these polymorphisms and the patients' biochemical manifestations. Genomic DNA was extracted from peripheral blood cells of 261 Taiwanese patients with type 2 DM and 189 non-diabetic control study subjects, and their TNF promoter G-238A and G-308A polymorphisms were analyzed by PCR-RFLP analysis. No significant association between TNF-alpha G-238A and G-308A polymorphisms with type 2 diabetic incidence was observed. However, associations between TNF-alpha G-238A and low-density lipoprotein-cholesterol and between G-308A promoter polymorphism and high-fasting plasma glucose levels, using multiple linear regression analysis with adjustment for the subjects' age, sex, body mass index and diabetic status, were found. Our results suggested that though TNF-alpha G-238A and G-308A polymorphisms were not involved in the pathogenesis of type 2 DM, type 2 diabetic patients carrying TNFA-A or TNF-308*2 genotype might be more susceptible to diabetic complications such as atherosclerosis.     

抑郁症共病2型糖尿病患者的认知功能及神经内分泌指标

目的:探讨共病糖尿病后抑郁症的认知功能特点及其与神经内分泌的相关性。方法:按照目的抽样的方法,选取符合中国精神障碍分类方案与诊断标准第3版诊断标准的门诊和住院抑郁症患者84例,其中合并2型糖尿病的患者为共病组(n=42);未合并糖尿病的患者为非共病组(n=42)。对两组进行汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、伦敦塔、言语流畅性、言语记忆、Stroop、连线测验、威斯康星卡片(WCST)测查,并测定血浆皮质醇(COR)与促肾上腺皮质激素(ACTH)、促甲状腺激素(TSH)、游离甲状腺素(F4)、游离三碘甲状腺原氨酸(F3)浓度。共病组28例和非共病组25例完成认知功能和血浆测查。结果:共病组HAMD总分和躯体化障碍、认知障碍因子分高于非共病组(均P0.05),ACTH和COR的水平高于非共病组(均P0.05),两组TSH、F4、F3差异无统计学意义。共病组的WCST的完成第一分类所需的应答数、错误应答数、持续应答数、持续性错误数和非持续性错误数均高于非共病组(均P0.05);共病组的伦敦塔因子分评分和认知功能的语言记忆评分方面的评分低于非共病组(P0.05);而WCST完成分类数和连线测验、言语流畅性和Stroop等得分差异无统计学意义(P0.05)。共病组TOL与HAMD得分之间呈负相关(r=-0.53,P0.01);COR水平同WCST持续性错误得分呈正相关(r=0.38,P0.05),与RVR和Stroop得分呈负相关(r=-0.56,-0.55;均P0.01);ACTH水平同WCST持续性错误呈正相关(r=0.528,P0.01),与HVLT-R和Stroop得分呈负相关(r=-0.64,-0.60;均P0.01)。非共病组认知功能和HAMD评分、HAMA评分以及神经内分泌指标之间无统计学相关。结论:共病糖尿病后抑郁程度加重,认知功能受损严重,主要表现在执行功能、注意力和语言记忆方面,可能与皮质醇和促肾上腺皮质激素升高有关。     

葛根素治疗2型糖尿病的药理机制和临床进展

葛根素具有降血糖、降血脂、改善胰岛素抵抗、抗氧化应激、减轻炎性反应等作用。葛根素干预可部分改善糖尿病并延缓其并发的视网膜、肾脏、心血管及神经病变等并发症的发生发展,可能成为临床治疗糖尿病的有效药物。     

初诊2型糖尿病患者踝肱指数异常率及相关因素分析

目的了解初诊2型糖尿病患者踝肱指数异常率及其影响因素。方法采用多普勒血流探测仪测定85例初诊2型糖尿病患者踝肱指数（ABI）并进行分组,ABI〈0.9为糖尿病下肢血管病变组（低ABI组）,0.9≤ABI〈1.3为非糖尿病下肢血管病变组（正常组）,ABI≥1.3为下肢动脉硬化组（高ABI组）,记录各组患者年龄、性别体重指数、血压、吸烟史等一般情况,并检测糖脂等代谢指标,通过回归分析探讨影响ABI的危险因素。结果初诊2型糖尿病患者的异常ABI为21.2%,与正常组比较,低ABI组和高ABI组年龄、吸烟率、HbA1c、TG、收缩压、UA均明显升高,其糖尿病视网膜病变、糖尿病肾病、糖尿病周围神经病变发生率亦明显升高。结论初诊糖尿病患者有较高的外周动脉病变（PAD）患病率;高龄、高血压、长期血糖控制不佳、脂质代谢紊乱是糖尿病下肢血管病变的危险因素。     

Epigenetic mechanisms of macrophage activation in type 2 diabetes

The alarming rise of obesity and type 2 diabetes (T2D) has put a tremendous strain on global healthcare systems. Over the past decade extensive research has focused on the role of macrophages as key mediators of inflammation in T2D. The inflammatory environment in the obese adipose tissue and pancreatic β-cell islets creates and perpetuates imbalanced inflammatory macrophage activation. Consequences of this chronic low-grade inflammation include insulin resistance in the adipose tissue and pancreatic β-cell dysfunction. Recently, the emerging field of epigenetics has provided new insights into the pathogenesis of T2D, while also affording potential new opportunities for treatment. In macrophages, epigenetic mechanisms are increasingly being recognized as crucial controllers of their phenotype. Here, we first describe the role of macrophages in T2D. Then we elaborate on epigenetic mechanisms that regulate macrophage activation, thereby focusing on T2D. Next, we highlight how diabetic conditions such as hyperlipidemia and hyperglycemia could induce epigenetic changes that promote an inflammatory macrophage phenotype. In conclusion we discuss possible therapeutic interventions by targeting macrophage epigenetics and speculate on future research directions.     

Thymic emigration patterns in patients with type 2 diabetes treated with metformin

Recent data suggest that thymic output, which provides the naive T cells necessary for the normal functioning of T‐cell‐dependent immunosurveillance cellular immunity including anti‐cancer protection, can be disturbed in the course of type 2 diabetes. Metformin, an anti‐diabetic drug commonly confirmed as an agent with many potential anti‐cancer activities, might be helpful in this immune correction. The profile of thymic output was evaluated in the current study on the basis of the signal‐joint T‐cell receptor excision circle (sjTREC) concentration in peripheral blood polymorphonuclear cells and thymic emigrant content in peripheral blood evaluated from CD127 and/or CD132 antigen expression. It was revealed that recent thymic emigrants and more differentiated CD127⁺ CD132⁺ cell populations were decreased among naive T cells and CD8⁺ T cells, whereas RTE count was increased in CD4⁺ T cells, and the CD127⁺ CD132⁺ cell population was less numerous than in non‐diabetic participants. Terminally differentiated thymic emigrants, i.e. CD127^? CD132⁺ cells, were increased in naive T cells and in CD8⁺ T cells. Metformin affects mainly the early phases of thymic export, increasing CD127⁺ CD132^? and CD127⁺ CD132⁺ cell populations in naive T cells and the CD127⁺ CD132^? population in CD4⁺ T lymphocytes. It could be concluded that type 2 diabetes deteriorates thymic immunostasis. The decreased thymic output could be compensated by metformin, especially with regard to CD4⁺ naive T cells. It is the first time that therapy with metformin has been documented by us as particularly useful in the control and normalization of thymus function, regarding correction of early populations of thymic emigrants.     

2型糖尿病患者海马体脑功能连接的磁共振成像研究

目的:应用功能磁共振成像技术研究2 型糖尿病（T2D）患者静息状态下海马功能连接的变化。方法:采集27 例 T2D患者和32例正常人的脑功能磁共振成像信号,选择海马的4个分区作为种子点计算功能连接,对海马与其他脑区的 功能连接强度与临床指标进行相关性分析。结果:与正常人相比,T2D患者的右前海马与梭状回、枕中回之间的功能连接 减弱;左前海马与梭状回功能连接增强;右后海马与距状回功能连接减弱;左后海马与舌回功能连接增强。结论:T2D患 者相关脑区功能连接的改变可能与视觉相关认知功能的损伤有关,这为理解T2D患者海马体的功能提供线索。     

由胰岛素信号通路筛选糖尿病药物作用靶点

胰岛素是维持血糖稳定的一种重要激素,通过效应细胞受体将胰岛素信号传递到细胞内,引发胞内一系列反应而发挥功能。随着对胰岛素信号通路的了解逐渐增多,已经从中筛选到一些用于治疗糖尿病的药物作用靶点,它们主要涉及增强靶细胞对胰岛素的敏感性和促进对葡萄糖的利用等环节。     

2型糖尿病患者糖尿病足的危险因素分析

目的总结分析2型糖尿病患者糖尿病足（DF）的患病情况及相关危险因素,为临床治疗和预防DF提供依据。方法选择2型糖尿病患者189例为研究对象,根据病情分为DF组和非DF组,回顾分析其性别、年龄、病程、入院时血压、空腹血糖、餐后2h血糖、糖化血红蛋白、血肌酐、尿素氮,以及尿白蛋白、糖尿病肾病、糖尿病视网膜病变、周围神经病变等因素。结果 DF所占比例为15%。DF组与非DF组相比,病程、餐后2h血糖、糖化血红蛋白、血肌酐、尿素氮、尿白蛋白、糖尿病肾病、糖尿病视网膜病变、周围神经病变等因素差异均有统计学意义（P〈0.05）。其中病程、糖尿病肾病、糖尿病视网膜病变、周围神经病变进入回归模型亦有统计学意义（P〈0.05）。结论 2型糖尿病的病程、肾病、视网膜病变、周围神经病变是DF发生的独立危险因素。     

2型糖尿病并发视网膜病变的骨密度分析

目的：探讨2型糖尿病患者合并视网膜病变其骨密度的变化。方法：选择2型糖尿病患者111例,按糖尿病视网膜病变分为糖尿病视网膜病变组和糖尿病眼底正常对照组,采用全自动生化检测仪测定甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸,骨密度采由美国Norland公司XR-36型双能X线骨密度仪测定,分别测定腰椎正位(L2、L3、L4)、左侧股骨颈、大粗隆区、Ward’s三角区的骨密度。结果：1)糖尿病视网膜病变组股骨颈、大粗隆区、Ward’s三角区的骨密度低于对照组,差异有统计学意义(P<0.05);而在腰椎正位两者的差异无统计学意义(P>0.05);2)糖尿病患者的骨密度与体重指数、尿酸呈正相关,与年龄、糖尿病病程、甘油三脂、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇呈负相关。结论：2型糖尿病合并视网膜病变其骨密度降低。     

Liver enzymes and psychological well-being response to aerobic exercise training in patients with chronic hepatitis C

Background

Chronic hepatitis C (CHC) is a medical condition that has broad implications for a person''s physical and psychological health.

Objective

The aim of this study was to detect changes in liver enzymes and psychological well-being in response to aerobic exercise training in patients with CHC.

Material and Methods

Fifty CHC patients were included in two equal groups. The first group (A) received aerobic exercise training in addition to their regular medical treatment. The second group (B) received no training and only has their regular medical treatment. The program consisted of three sessions per week for three months.

Results

There was a significant decrease in mean values of Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma - Glutamyltransferase (GGT), Beck Depression Inventory (BDI ) & Profile of Mood States(POMS) and increase in Rosenberg Self-Esteem Scale (RSES) in group (A) after treatments, but the changes in group (B) were not significant. Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study.

Conclusion

Aerobic exercise training improves hepatic enzymes and psychological well-being in patients with chronic hepatitis C.