吴茱萸次碱对2型糖尿病肥胖大鼠的干预作用

目的观察吴茱萸次碱(rutaecarpine,Rut)对2型糖尿病肥胖大鼠(T2DM)的干预作用。方法用高脂饲料喂养结合一次性尾静脉注射小剂量链脲佐菌素(streptozotocin,STZ)30 mg.kg-1建立2型糖尿病肥胖大鼠模型。用Rut干预治疗,以二甲双胍片作为阳性对照。给药7 wk后观察对大鼠空腹血糖(FBG)、甘油三脂(TG),总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和血清炎症因子C-反应蛋白(CRP)等的影响,及肾脏、肝脏和胰脏的病理变化。结果 Rut能明显降低T2DM的TC、TG和LDL-C,升高HDL-C(P<0.05);Rut组CRP明显降低(P<0.05),病理切片观察Rut可以改善T2DM肥胖大鼠的肾、肝、胰的病理变化。但对血糖值没有明显降低(P>0.05),与二甲双胍组比较没有统计学意义(P>0.05)。结论 Rut能降低2型糖尿病肥胖大鼠的血脂,减轻炎症反应,改善肾、肝、胰的病理变化。Rut作为治疗T2DM代谢综合征的潜在药物值得进一步的研究。     

2型糖尿病伴发脂肪肝的临床特点

目的探讨2型糖尿病伴发脂肪肝的临床特点。方法测定32例2型糖尿病伴发脂肪肝和30例2型糖尿病不伴发脂肪肝病例的空腹血糖(FBG),空腹胰岛素(FINS),血脂谱及肝功能,计算体重指数(BM I)及胰岛素敏感指数(ISI)。结果2型糖尿病伴发脂肪肝与不伴发脂肪肝者相比,体重指数(BM I),甘油三脂(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),谷丙转氨酶(ALT),谷草转氨酶(AST),谷氨酰转肽酶(r-GT),空腹胰岛素(FINS)均升高(<0.05,P<0.01),而高密度脂蛋白胆固醇(HDL-C),胰岛素敏感指数(ISI)则降低(P<0.05,P<0.01)。结论2型糖尿病伴发脂肪肝比不伴发脂肪肝者存在明显的体重指数增高、脂代谢紊乱、肝功能异常及胰岛素抵抗     

Protective role of 20-OH ecdysone on lipid profile and tissue fatty acid changes in streptozotocin induced diabetic rats

Hyperlipidemia is an associated complication of diabetes mellitus. The association of hyperglycemia with an alteration of lipid parameters presents a major risk for cardiovascular complications in diabetes. The present study was designed to examine the antihyperlipidemic effect of 20-OH ecdysone on lipid profile and tissue fatty acid changes in streptozotocin induced diabetic rats. The levels of blood glucose, cholesterol, triglycerides, free fatty acids, phospholipids, low density lipoprotein, very low density lipoprotein, high density lipoprotein, lipoprotein lipase, lecithin cholesterol acyl transferase, 3-hydroxy 3-methylglutaryl coenzyme A reductase and fatty acid composition were estimated in plasma, liver and kidneys of control and experimental groups of rats. Oral administration of 20-OH ecdysone at a dose of 5 mg/kg bodyweight per day to STZ-induced diabetic rats for a period of 30 days resulted in a significant reduction in fasting blood glucose, cholesterol, triglycerides, free fatty acids, phospholipids, low density lipoprotein, very low density lipoprotein, 3-hydroxy 3-methylglutaryl coenzyme A reductase and elevation of high density lipoprotein, lipoprotein lipase and lecithin cholesterol acyl transferasein comparison with diabetic untreated rats. Moreover, administration of 20-OH ecdysone to diabetic rats also decreased the concentrations of fatty acids, viz., palmitic, stearic (16:1) and oleic acid (18:1), whereas linolenic (18:3) and arachidonic acid (20:4) were elevated. The antihyperlipidemic effect of 20-OH ecdysone was compared with glibenclamide a well-known antihyperglycemic drug. The result of the present study indicates that 20-OH ecdysone showed an antihyperlipidemic effect in addition to its antidiabetic effect in experimental diabetes.     

2型糖尿病患者血清瘦素与脂肪肝的相关性研究

目 的 探讨２型 糖 尿病 患者 血 清瘦 素水 平 与脂 肪 肝、脂 代谢 、性 别、体 重指 数 （ＢＭ Ｉ）及胰 岛 素 抵 抗的相 关 性。 方法 随机 选取１０８例２型糖 尿 病患 者根 据 是否 合并 脂 肪肝 分 为 糖 尿病 合 并 脂 肪 肝组 （ＤＦＬ）和糖 尿 病无 脂肪 肝 组 （ＤＮＦ），测 量 身 高 、体 重 、空 腹 血 清 胆 固 醇 （ＴＣ）、甘 油 三 酯 （ＴＧ ）、高 密 度 脂 蛋 白 （Ｈ ＤＬ）、低 密 度 脂 蛋 白（ＬＤＬ）、载 脂 蛋白Ａ （ＡｐｏＡ ）、载 脂蛋 白Ｂ（ＡｐｏＢ）和 空 腹血 糖 （ＦＰＧ ）、真胰 岛 素 （ＦＴＩ）、瘦 素 （ＬＥＰ）及 馒 头 餐后 ２ ｈ真 胰岛 素 （ＰＴＩ），以 胰 岛素 敏 感 指 数（ＩＳＩ）＝１／（ＦＰＧ ×ＦＴＩ）作 为 胰 岛 素 敏 感 指 数 ，对 瘦 素 与 脂 肪 肝 、ＢＭ Ｉ、及 糖 脂 代 谢 指 标及胰 岛 素敏 感 指数 做相 关 性分 析。 结 果 ①糖 尿 病 合并 脂 肪 肝 的发 病 率 为４３．６％ ；② ＤＦＬ组 的瘦 素 、体重 指 数 和血脂 水 平高 于ＤＮ Ｆ组 ，胰 岛素 敏 感指 数ＤＦＬ组低 于ＤＮ Ｆ组 ；③ Ｄ ＦＬ组和ＤＮ Ｆ组女 性瘦 素 均明 显高 于 男性 ；④多元 素线性 回 归表 明瘦 素 与性 别、体重 指 数、空 腹 胰岛 ?     

Beneficial effects of aloe vera leaf gel extract on lipid profile status in rats with streptozotocin diabetes

The effect of diabetes mellitus on lipid metabolism is well established. The association of hyperglycaemia with an alteration of lipid parameters presents a major risk for cardiovascular complications in diabetes. Many secondary plant metabolites have been reported to possess lipid-lowering properties. The present study was designed to examine the potential anti-hyperlipidaemic efficacy of the ethanolic extract from Aloe vera leaf gel in streptozotocin (STZ)-induced diabetic rats. 2. Oral administration of Aloe vera gel extract at a dose of 300 mg/kg bodyweight per day to STZ-induced diabetic rats for a period of 21 days resulted in a significant reduction in fasting blood glucose, hepatic transaminases (aspartate aminotransferase and alanine aminotransferase), plasma and tissue (liver and kidney) cholesterol, triglycerides, free fatty acids and phospholipids and a significant improvement in plasma insulin. 3. In addition, the decreased plasma levels of high-density lipoprotein-cholesterol and increased plasma levels of low-density lipoprotein-and very low-density lipoprotein-cholesterol in diabetic rats were restored to near normal levels following treatment with the extract. 4. The fatty acid composition of the liver and kidney was analysed by gas chromatography. The altered fatty acid composition in the liver and kidney of diabetic rats was restored following treatment with the extract. 5. Thus, the results of the present study provide a scientific rationale for the use of Aloe vera as an antidiabetic agent.     

Effect of vanadyl sulfate on the status of lipid parameters and on stomach and spleen tissues of streptozotocin-induced diabetic rats.

Diabetes mellitus is a significant risk factor for cardiovascular complications. Experimental evidence suggests that oxidative stress plays a dominant role in the pathogenesis of diabetes mellitus. This study was undertaken to investigate the effect of vanadyl sulfate on blood glucose, serum and tissue lipid profiles and on stomach and spleen tissues in STZ-induced diabetic rats. In this study, male 6-6.5-month-old Swiss albino rats were used. Rats were randomly divided into four groups. Group I: control animals (normal, nondiabetic animals) (n = 13); Group II: vanadyl sulfate controls (n = 5); Group III: streptozotocin (STZ)-diabetic, untreated animals (n = 11); and Group IV: STZ diabetic animals given vanadyl sulfate (n = 11). Experimental diabetes was induced by intraperitoneal (i.p.) injection of STZ in a single dose of 65 mg kg(-1) body weight. Vanadyl sulfate was administered by gavage at a dose of 100 mg kg(-1). The levels of cholesterol, phospholipid, high density lipoprotein-cholesterol (HDL-), low density lipoprotein-cholesterol (LDL-), very low density lipoprotein-cholesterol (VLDL-), triglycerides and lipid peroxidation (LPO) in serum and cholesterol in liver were assayed according to standard procedures. The levels of lipid peroxidation, glutathione (GSH) and nonenzymatic glycosylation (NEG) in stomach and lipid peroxidation and glutathione (GSH) in spleen tissues were analyzed. After 60 days of treatment, serum cholesterol, LDL-cholesterol, triglyceride, phospholipid, VLDL-cholesterol, LPO, blood glucose levels, stomach LPO and NEG, spleen LPO significantly increased, but serum HDL-cholesterol, stomach GSH and spleen GSH levels significantly decreased in the diabetic group. On the other hand, treatment with vanadyl sulfate reversed these effects. These results reveal that diabetes mellitus increased oxidative damage in stomach and spleen tissues and vanadyl sulfate has an ameliorating effect on the oxidative stress via its antioxidant property. The administration of vanadyl sulfate may be able to reduce hyperglycemia and hyperlipidemia related to the risk of diabetes mellitus.     

A study of dyslipidemia and platelet adhesiveness in non-insulin dependent diabetes mellitus

The present study included 50 controls (age 34-64 years) and 50 NIDDM subjects (age 32-72 years) from the diabetic clinic of Government Medical College, Nagpur. It was undertaken with the aim of investigating obesity indices (i.e. body mass index, skin fold thickness, waist hip ratio and % fat in the body); lipid profile (including serum total cholesterol, triglyceride, VLDL, LDL and HDL-cholesterol) levels and platelet adhesiveness in both the groups. On comparison, plasma glucose levels were higher in NIDDM (P > 0.05); obesity indices, cholesterol, triglyceride, VLDL, LDL and platelet adhesiveness index were higher, and HDL levels low in NIDDM group as compared to controls (P < 0.01). Obesity, dyslipidemia and increased platelet adhesiveness are interconnected and make diabetics more susceptible to arterial disease with increased risk of vascular episodes.     

2型糖尿病大血管病变40例临床观察

目的了解2型糖尿病大血管病变与血糖、血脂、糖化血红蛋白、病程、年龄、体重的关系为其防治提供依据。方法对2型糖尿病患者有周围大血管病变40例,分别检侧空腹血糖、餐后2 h血糖（PGZh）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）和低密度脂蛋白（LDL-C）、糖化血红蛋白、病程、体重等指标与同期的40例无周围大血管病变的2型糖尿病患者进行配对分析。结果 2型糖尿病有大血管并发症的空腹及餐后2 h血糖显著高于无血管并发症患者,二者之间差异有统计学意义（P〈0.05）。血脂测定显示有大血管并发症患者TG、糖化血红蛋白和TC显著高于无大血管并发症者,二者之间差异有统计学意义（P〈0.01）。结论 2型糖尿病大血管病变与血糖、血脂、糖化血红蛋白、关系密切,临床治疗的重点不仅要放在降低血糖上,而且不应忽视对血脂、糖化血红蛋白的,这对防止2型糖尿病血管并发症具有重要的意义。     

2型糖尿病患者微量白蛋白尿与心血管危险因素的相关性

目的探讨2型糖尿病(T2DM)患者微量白蛋白尿(MAU)与心血管危险因素的相关性。方法 T2DM患者483例,根据尿白蛋白与肌酐比值(ACR)分为正常白蛋白尿组(A组,248例,ACR<30mg/g)和MAU组(B组,235例,ACR 30-300mg/g)。检测两组血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2-h血糖(PBG)、空腹胰岛素(FIns)。结果与A组比较,B组TG、TC、LDL-C、FBG、PBG、FIns均明显增加(P<0.05);高血压病、冠心病、动脉粥样硬化的发病率升高(P<0.05)。体重指数、收缩压、TC、FBG是发生MAU的独立危险因素。结论 T2DM患者MAU易合并超重、高血压、糖脂代谢紊乱,心血管疾病风险增加。     

二精方多糖提取物对2型糖尿病小鼠血糖、血脂的影响

目的:观察二精方多糖提取物对2型糖尿病模型小鼠的降血糖、血脂的影响。方法:采用高脂高糖饮食喂养后,腹腔注射链脲佐菌素制备2型糖尿病小鼠模型,实施灌胃二精方多糖提取物干预30 d后,测定空腹血糖值后进行糖耐量实验,然后测定血清三酰甘油、总胆固醇值、高密度脂蛋白、低密度脂蛋白,血浆糖化血红蛋白。结果:二精方多糖提取物中剂量组,低剂量组能降低空腹血糖、糖耐量、三酰甘油、总胆固醇、低密度脂蛋白含量,升高高密度脂蛋白含量,降低糖化血红蛋白水平;二精方多糖提取物高剂量组能降低空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白含量,升高高密度脂蛋白含量,降低糖化血红蛋白水平。结论:二精方多糖提取物具有改善实验性2型糖尿病小鼠糖代谢和脂代谢的作用。     

2型糖尿病合并血脂异常患者尿微量白蛋白发生率观察

目的 通过观察2型糖尿病(Type 2 diabetes mellitus,T2DM)合并血脂异常患者尿微量白蛋白的患病率,探讨脂代谢异常与T2DM患者尿中微量白蛋白(Microalbunm inuria,MAU)之间的关系.方法 选择T2DM合并血脂异常患者133例,尿微量白蛋白测试条半定量测定MAU,根据检测结果分为阴性、微量及大量白蛋白尿组,测定各组患者体重指数、腰围、血压、空腹血糖、血脂.结果 在133例T2DM合并血脂异常患者中MAU及大量白蛋白尿的发生率分别为27%和22.6%,微量及大量组较阴性组TG显著增加(P＜0.01).结论 T2DM合并血脂异常惠者中有约50%的患者存在肾损害,推测从尿白蛋白阴性发展为MAU的过程中,高TG加强了高血糖引起的肾损害.     

烟酸及其与他汀类药物联合治疗现状与展望

烟酸是广谱调脂药,能明显降低血浆甘油三酯及升高高密度脂蛋白-胆固醇。缓释型烟酸与他汀类药物联合能达到全面调脂、减少心血管剩留风险的目标,并可能优于他汀与其它类调脂药合用。两者联合为临床工作者提供了一种安全、有效、经济的调脂方案。     

波动性高血糖状态与糖尿病血管病变的关系

目的探讨2型糖尿病患者波动性高血糖状态对糖尿病慢性并发症的影响。方法169例糖化血红蛋白（HbA，c）相近2型糖尿病患者分为两组：慢性持续性高血糖组（Ⅰ组，78例）、慢性波动性高血糖组（Ⅱ组，91例）。测定患者的空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）、空腹胰岛素（FINS）、餐后2h胰岛素（2hINS）、空腹C肽、餐后2hC肽、24h尿白蛋白定量（UAER），并分析其糖尿病慢性并发症的发生情况。结果Ⅱ组2hPG显著高于Ⅰ组（P〈0．01），餐后2h胰岛素与餐后2hC肽水平显著低于Ⅰ组（P〈0．01）。Ⅱ组糖尿病慢性并发症发生率显著高于Ⅰ组（P〈0．01）。结论2型糖尿病在波动性高血糖状态下慢性并发症明显增加。     

吡格列酮和罗格列酮治疗老年2型糖尿病的疗效对比(英文)

目的 探讨吡格列酮和罗格列酮对2型糖尿病患者血糖、血脂水平的影响.方法 将我院内分泌科门诊及病房收治的符合1997年WHO诊断标准的2型糖尿病患者64例.予以饮食控制,运动治疗,且同时口服降糖药物固定在1mo以上,空腹血糖仍≥7 mmol·L-1的患者,随机分为吡格列酮组和罗格列酮组,分别加用吡格列酮或罗格列酮12 wk.结果 ①吡格列酮组和罗格列酮组的空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数均较治疗前明显降低(P＜0.05),两者之间降低的程度没有显著性差异.②毗格列酮组血三酰甘油和总胆固醇水平较治疗前明显降低(P＜0.05),但罗格列酮组无明显变化(P＞0.05).③2组的高密度脂蛋白水平均比治疗前明显升高(P＜0.05和P＜0.01),但吡格列酮组升高的幅度大于罗格列酮组.结论 吡格列酮和罗格列酮治疗后均能有效控制血糖,但吡格列酮能更明显地改善血脂.     

Prevention of type 2 diabetes: role of metformin

Metformin lowers moderate (nondiabetic) fasting hyperglycaemia in individuals at risk for type 2 diabetes without causing hypoglycaemia. In addition, it has demonstrated favourable action on several cardiovascular risk factors that are often present in these individuals: it favours the maintenance of diet-induced weight loss and its associated improvement in fibrinolysis; and it lowers plasma concentrations of fasting insulin, total and low density lipoprotein-cholesterol, free fatty acids, and of two markers of endothelial damage--tissue plasminogen activator antigen and von Willebrand factor. These effects together with the good tolerability profile of the drug position metformin as a first-line agent for the prevention of type 2 diabetes.     

胰岛素抵抗与动脉粥样硬化

目的：探讨胰岛素抵抗与动脉粥样硬化的关系。方法：根据用稳态模型计算出的胰岛素抵抗指数(HOMA-IR)将221例患者分为5组，进行口服75g葡萄糖耐量试验，检查血脂及胰岛素水平，B型超声检查双侧颈总动脉内中膜厚度(IMT)，比较各组的危险因素及颈动脉粥样硬化指标。结果：随着HOMA-IR值升高，糖耐量低战、糖尿病、高血压和冠心病发病率增高，甘油三酯(TG)、低密度脂蛋白(LDL)、空腹血糖、服糖后2h血糖和空腹胰岛素水平增高，高密度脂蛋白(HDL)水平降低，IMT值升高。多元回归分析结果显示，TG、胆固醇、HDL、LDL、Ln(HOMA-IR)与IMT独立相关，是IMT增高的危险因素。结论：胰岛素抵抗参与动脉粥样硬化的形成。     

Cardiovascular disease and dyslipidemia: beyond LDL

Low-density lipoproteins (LDL) are atherogenic and represent a strong cardiovascular risk factor. Therefore, LDL-cholesterol (LDL-C) remains the primary target in lipid lowering therapy. However, since many cardiovascular events occur despite an optimal LDL-C, it is necessary to focus on the remaining cardiovascular risk. Treatment of low high-density lipoprotein-cholesterol (HDL-C) and high triglycerides (TG) are options to achieve cardiovascular risk reduction beyond LDL. HDL mediates reverse cholesterol transport and exerts several other athero-protective effects. Epidemiologic evidence has shown that low HDL-cholesterol (HDL-C) is a strong and independent cardiovascular risk marker. However, since the anti-atherogenic effects of HDL particles rather depend on their functionality rather than on their cholesterol content, an increase in HDL-C concentration does not always have to result in a clinical benefit. Besides established strategies to increase HDL-C, e.g. with fibrates and nicotinic acid, CETP (Cholesteryl ester transfer protein)-inhibition is a promising new therapeutic option. The failure of torcetrapib, the first CETP-inhibitor, seems to be attributed to "off-target" effects. Treatment with the newer CETP-inhibitors dalcetrapib and anacetrapib has been shown to be efficacious and safe - but their usefulness in clinical practice remains to be determined in ongoing clinical endpoint trials. TG concentrations have been shown to correlate with cardiovascular risk. However, interpretation of plasma TG concentrations remains difficult due to considerable intra-individual variability of plasma concentrations. Post-prandial triglyceride concentrations may be better predictors of cardiovascular risk than fasting TG. In patients with hypertriglyceridemia, achievement of the LDL-C goal remains the primary lipid target. The basis of therapy in patients with hypertriglyceridemia are life style modifications. In addition, non-HDL-C should be addressed. For selected patients, treatment with fibrates, nicotinic acid or omega-3 fatty acids are available to lower TG concentrations. In summary, the focus of lipid therapy is the reduction of cardiovascular risk rather than the modification of lipoprotein sub-fractions. Ongoing research points towards a shift of the focus from the HDL-C concentrations to parameters of HDL function and from fasting TG to TG kinetics.     

Lotus (Nelumbo nucifera Gaertn) plumule polysaccharide ameliorates pancreatic islets loss and serum lipid profiles in non-obese diabetic mice

To unravel possible protective effects of a newly isolated lotus plumule polysaccharide (LPPS) on type 1 diabetes (T1D), this study isolated LPPS and administered it to non-obese diabetic (NOD) female mice for 15 weeks. Oral glucose tolerance, serum ketone body, glucose, insulin, and lipid levels, as well as pancreatic islet cell numbers and the insulin secretion ability of the experimental mice were determined. The results showed that LPPS administration in vivo significantly (P < 0.05) increased pancreatic islet cell numbers and slightly enhanced the basal insulin secretion ability compared to the control group. LPPS administration improved serum lipid profiles in the diabetic mice via relatively increasing serum high density lipoprotein-cholesterol, but decreasing low density lipoprotein-cholesterol and total cholesterol levels. The present study suggests that LPPS supplementation may ameliorate T1D progress and its complications through protecting pancreatic islets and modulating serum lipid profiles.     

代谢综合征组分的因子分析

目的探讨代谢综合征(MS)各指标组分的潜在支配因子。方法采用因子分析的方法,对1460名社区人群中的糖代谢异常患者450人、糖耐量正常者1010人及全部对象分别进行分析,探讨MS八项指标组分:血糖、口服75g葡萄糖后2h血糖、三酰甘油、高密度脂蛋白、收缩压、舒张压、体质量指数、腰臀比的潜在支配因子。结果三组对象中,MS组分均得到一个相似的3～4个共性因子构成的模型,各因子分别代表糖耐量、血压、肥胖、脂代谢。共性因子的累积贡献率在三组人群中均为70%左右。不同人群中各因子的位次存在差异。结论 MS的原始指标变量经因子分析可缩减为3～4个潜在的共性因子成分,而非一个。     

脂蛋白脂酶活化剂NO-1886抑制糖尿病兔动脉粥样硬化的形成

目的　合成化合物NO 1886 ,一种脂蛋白脂酶活化观察脂蛋白脂酶活化剂是否降低高脂 /高蔗糖饲料诱发的糖尿病新西兰兔的血浆葡萄糖并减轻其动脉粥样硬化。方法　给予高脂 /高蔗糖饲料升高新西兰兔血浆总胆固醇 ,甘油三酯和葡萄糖及降低高密度脂蛋白胆固醇而导致动脉粥样硬化。饲料中加入 1 0 %NO 1886进行治疗观察。分别在 0、4、8、12、16、2 0及 2 4wk从禁食过夜的兔耳静脉抽取血样测定葡萄糖和脂质水平。第 2 4周末 ,处死动物 ,分离主动脉 ,经苏丹Ⅳ染色固定脂质后 ,计算脂纹病变面积。结果　应用NO 1886后 ,实验动物血浆葡萄糖 ,总胆固醇和甘油三酯降低 ,高密度脂蛋白胆固醇增加。对动脉粥样硬化的发展具有抑制作用。结论　NO 1886不仅可改善脂质紊乱 ,而且可降低血浆葡萄糖 ,减轻糖尿病兔动脉粥样硬化