Indium-111 platelet kinetics in patients with diabetes mellitus

We performed in vitro aggregation and indium-111 labeled platelet kinetic and biodistribution studies in seven patients with diabetes mellitus and in five control subjects. All subjects were male. All diabetic patients were poorly controlled at the time of study with blood glucose greater than 140 mg % and hemoglobin A1c greater than 10%. In vivo kinetic and biodistribution studies were performed following reinjection of autologous platelets labeled with indium-111 oxine in a dose of approximately 50 microCi (42-67 microCi). Images obtained at 4 and 24 h were computer-analyzed to determine splenic and hepatic uptake, and platelet survival times were calculated using four mathematical models. Unexpectedly, diabetic patients with fewer vascular complications tended to have shorter platelet survival times than patients with advanced vascular disease. However, no significant differences were observed between diabetic and control groups for any of the parameters of platelet function evaluated.     

Technetium-99m ECD: a new brain imaging agent: in vivo kinetics and biodistribution studies in normal human subjects

Lipophilic neutral 99mTc complexes of diaminedithiol (DADT) ligands cross the brain-blood barrier. A new derivative of DADT family, 99mTc ethyl cysteinate dimer (ECD) showed high brain uptake in nonhuman primates. We report here the in vivo kinetics and biodistribution results in 16 normal human subjects. Dynamic images of brain obtained for 10 min following an i.v. administration of [99mTc]ECD showed that the maximum 99mTc brain activity reached within 1 min and remained near that level for the next 10 min. The blood clearance of the tracer was very rapid and the activity remaining in blood after 5 min was less than 10%. Within 2 hr 50% of 99mTc activity was excreted in urine. Anterior and posterior total-body images were obtained at 5, 30, 60 min, 2, 4, 24, and 48 hr using a moving table at 20 cm/min. Percent injected dose was calculated for different organs and tissues. The brain uptake was 6.5 +/- 1.9% at 5 min postinjection and remained relatively constant over several hours. Two-compartment analysis of brain time-activity curve showed that 40% of brain activity washed out faster (T 1/2 = 1.3 hr) while the remaining 60% had a slower clearance rate (T 1/2 = 42.3 hr). Some of the tracer was excreted through the hepatobiliary system. Lung uptake and retention of [99mTc]ECD was negligible. Radiation dosimetry is favorable for the administration of up to 20-40 mCi of [99mTc]ECD. These results show that [99mTc]ECD is rapidly extracted and retained by the brain providing favorable conditions for single photon emission computed tomography imaging.     

Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus

BACKGROUND: 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for diagnosing cardiac autonomic neuropathy (CAN) in non-insulin-dependent diabetes mellitus (NIDDM). However, the long-term prognostic value for cardiac events or mortality in NIDDM has not been clarified. METHODS AND RESULTS: We investigated the long-term prognostic value of cardiac MIBG imaging for both cardiac event and mortality owing to a variety of causes of death in NIDDM. 144 NIDDM patients were analyzed retrospectively with the end-points of a cardiac event and various causes of mortality. The heart-to-mediastinum uptake ratio on the delayed image (H/M [d]) was obtained from anterior planar imaging. The mean follow-up period was 7.2+/-3.2 years. Seventeen patients had a cardiac event onset and 7 patients died during observation. During the same observation course, 16 patients died, including some who died of cardiac event. Both multivariate and univariate analyses revealed that decreased H/M (d) (<1.7) was the independent predictor of long-term mortality for a variety of causes of death. Although the value of H/M (d) was not a significant prognostic factor for predicting a cardiac event, CAN, diagnosed by a combination of H/M (d) and coefficient variance of RR interval, was an independent predictor for the cardiac event in NIDDM. CONCLUSION: MIBG myocardial scintigraphy was useful for predicting cardiac events and long-term mortality in NIDDM.     

In vivo proton MR spectroscopy of chorea-ballismus in diabetes mellitus

The most common cause of chorea-ballismus (CB) is a vascular lesion; it is also associated with nonketotic hyperglycaemia in diabetes mellitus (DM) and may be the first manifestation of this disorder. We describe the CT, MRI and proton MR spectroscopy (¹H-MRS) of CB in eight patients. Six had hemichorea-hemiballismus (HC-HB) and two bilateral CB. Single-voxel (SV) ¹H-MRS was performed using point-resolved spectroscopy (PRESS). Voxels were positioned in the basal ganglia of the patients and control subjects. PRESS was also used to obtain spectroscopic imaging (¹H-MRSI) of the slice of interest in two patients. CT showed a slightly dense striatum in all the patients with CB, and T1-weighted images revealed high signal. The CB correlated well with the neuroimaging findings. SV ¹H-MRS showed the mean ( ± SD) N-acetylaspartate (NAA)/ creatine (Cr) ratio to be 1.45 ± 0.19 in HC-HB and 1.82 ± 0.06 on the opposite normal side (P = 0.01). The choline (Cho)/Cr ratio was 1.3 ± 0.12 in HC-HB and 1.11 ± 0.13 on the opposite normal side (P = 0.005). A lactate peak was seen in seven patients. The NAA/Cr ratio was 1.44 ± 0.15 in bilateral CB and 1.74 ± 0.16 in the controls (P = 0.017); the Cho/Cr ratios were 1.36 ± 0.1 and 1.19 ± 0.07 (P = 0.015). The low NAA/Cr suggests neuronal loss or damage and the high Cho/Cr probably indicates gliosis. The presence of lactate may suggest mild ischaemia due to acute vascular events during hyperglycaemia and underlying chronic focal cerebrovascular diseases in DM. Received: 8 September 2000 Accepted: 9 November 2000     

~(13)C-辛酸呼吸试验测定糖尿病胃固体排空功能的重复性研究

目的　观察13 C 辛酸呼吸试验测定糖尿病患者胃固体排空时间及其变异性 ,以及心自主神经病变和病理性胃排空状况对其的影响。方法　 9例对照者和 15例糖尿病患者 [平均糖基化血红蛋白 (HbA1c) 7 8% ]1周内行 2次13 C 辛酸呼吸试验 ,采用非线性回归法计算半排空时间 (t1/ 2 )和缓慢期时间 (tlag) ,同时采用心自主神经功能试验判断有无心自主神经病变。结果　对照组t1/ 2 批内CV为 11 7%、tlag批内CV为 19 4% ,糖尿病患者t1/ 2 批内CV为 17 8%、tlag批内CV为 2 8 2 % ,对照者和糖尿病患者间差异无显著性。t1/ 2 和tlag的批内CV在糖尿病患者伴有和无心自主神经病变之间以及在正常胃排空时间和延迟性胃排空时间之间差异无显著性。结论　13 C 辛酸呼吸试验测定胃固体排空功能有较高的重复性 ,并不受心自主神经病变和病理性胃排空的影响。     

^13C—辛酸呼吸试验测定糖尿病胃固体排空功能的重复性研究

目的 观察^13C-辛酸呼吸试验测定糖尿病患者胃固体排空时间及其变异性,以及心自主神经病变和病理性胃排空状况对其的影响。方法 9例对照者和15例糖尿病患者[平均糖基化血红蛋白（HbA1c)7.8%]1周内行2次^13C-辛酸呼吸试验,采用非线性回归法计算半排空时间（t1/2)和缓慢期时间（tlag)同时采用心自主神经功能试验判断有无心自主神经病变。结果 对照组t1/2批内CV为11．7％,tlag批内CV为19．4％,糖尿病患者t1/2批内CV为17．8％,tlag批内CV为28．2％,对照者和糖尿病患者间差异无显著性。t1/2和tlag的批内CV在糖尿病患者伴有无心自主神经病变之间以及在正常胃排空时间和延迟性胃排空时间之间差异无显著性。结论 ^13C-辛酸呼吸试验测定胃固体排空功能有较高的重复性,并不受心自主神经病变和病理性胃排空的影响。     

In vivo SPECT imaging of CNS D-2 dopamine receptors: initial studies with iodine-123-IBZM in humans

Iodobenzamide (IBZM) is a D-2 dopamine receptor antagonist. In this paper the results of Phase I clinical studies of iodine-123-(123I)IBZM in humans are reported. Preliminary imaging studies, both planar and single-photon emission tomography (SPECT), of no-carrier added [123I]IBZM in humans show specific localization in the basal ganglia of the brain. At 2 hr after an i.v. injection, the brain uptake was 3.72% of the dose, and at 20 hr later the uptake diminished to 0.7%. Radiation dosimetry calculation indicated that the radiation dose to the brain was minimum, 0.039 rad/mCi, while the large intestine wall received the highest dose, 0.28 mrad/mCi. The radiation dosimetry and pharmacology data suggest that this agent is safe for human use.     

非胰岛素依赖型糖尿病患者骨密度变化的探讨

目的 研究非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的骨密度变化,以了解ＮＩＤＤＭ患者是否易合并骨质疏松及其特点。方法 采用双能Ｘ线骨密度仪（简称为ＤＸＡ）,４８例ＮＩＤＤＭ患者及３５例３０￣３５岁正常人腰椎正侧位、髋部及全身骨密度。病例选择是根据１９８５年世界卫生组织（ＷＨＯ）糖尿病专家委员会提出的诊断和分型标准,结果均经统计学处理分析。结果 ４８例ＮＩＤＤＭ患者的骨密度都有不同程度下降,按ＳＨＯ推     

An evaluation of iodine-123 iodoazomycinarabinoside as a marker of localized tissue hypoxia in patients with diabetes mellitus

Peripheral vascular disease is a serious and common complication in patients with diabetes mellitus (DM). Evaluation is, conventionally, by transcutaneous oxygen tension measurements (TcpO₂), although this technique has some limitations in the evaluation of tissue viability. We have evaluated a new, radiolabelled, in vivo marker of tissue hypoxia, iodoazomycinarabino-side (IAZA), by comparing TcpO₂ measurements with patterns of iodine-123 IAZA uptake in ten patients (19 lower limbs) with DM and peripheral vascular disease using conventional gamma camera imaging techniques. Normal uptake patterns were seen in limbs in which normal TcpO₂ measurements were obtained. Diffusely increased uptake of [¹²³I]IAZA was seen in limbs with reduced TcpO₂ Focally increased uptake was seen in ulcers or in areas of atrophic skin change. A semiquantitative measure showed an inverse correlation between [¹²³I]IAZA and TcpO₂ values. These data suggest that tissue hypoxia can be imaged in this population of patients and that severity of disease can be assessed. A longitudinal prospective trial is now being developed.     

Cardiac iodine-123 metaiodobenzylguanidine uptake in animals with diabetes mellitus and/or hypertension

The aim of the present study was to evaluate the use of the noradrenaline analogue iodine-123 metaiodobenzylguanidine ([¹²³I]MIBG) for the assessment of cardiac sympathetic activity in the presence of diabetes mellitus and/or hypertension in animal models. One model used Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR) rendered diabetic at 12 weeks of age by an intravenous injection of streptozotocin (STZ). The other model used lean and obese Zucker rats. In all groups basic haemodynamic values were established and animals received an intravenous injection of 50 Ci [¹²³I]MIBG. Initial myocardial uptake and washout rates of [¹²³I]MIBG were measured scintigraphically during 4 h. After sacrifice, plasma noradrenaline and left cardiac ventricular -adrenoceptor density was determined. The diabetic state, both in STZ-treated rats (direct induction) and in obese Zucker rats (genetic induction), appeared to induce a lower cardiac density of -adrenoceptors, indicative of increased sympathetic activity. Cardiac [¹²³I]MIBG then showed increased washouts, thereby confirming enhanced noradrenergic activity. This parallism of results led to the conclusion that [¹²³I]MIBG wash-out measurements could provide an excellent tool to assess cardiac sympathetic activity non-invasively. However, in hypertension (WKY vs SHR), both parameters failed to show parallelism: no changes in -adrenoceptor density were found, whereas [¹²³I]MIBG wash-out rate was increased. Thus, either [¹²³I]MIBG washout or ß-adrenoceptor density may not be a reliable parameter under all circumstances to detect changes in the release of noradrenaline. Changes in the initial uptake of [¹²³I]MIBG were observed as well. This may be a good marker for the disappearance of cardiac innervation, but it seems not to be a good parameter for distinguishing between loss of sympathetic innervation and enhanced uptake of noradrenaline in pathological conditions.     

In vitro and in vivo studies of three radiolabelled somatostatin analogues:123I-Octreotide (OCT),123I-Tyr-3-OCT and111In-TIRA-d-Phe-1-OCT

Scintigraphy with long-acting somatostatin (SST) analogues may be useful for the localization of tumours expressing receptors (R) for SST. In this study we have analysed the in vitro and in vivo binding properties of three SST analogues,¹²³I-octreotide (OCT),¹²³I-Tyr-3-OCT and¹¹¹In-DTPA-d-Phe-l-OCT. In vitro binding studies performed with a variety of primary tumours (n=48) as well as with several tumour cell lines (A431, HT29, PANC1, COLO320, HMC1, KU812) indicated significant in vitro binding of these three radiolabelled SST analogues to two subpopulations of SSTR, high (K _d 0.2–2.0 nM) and low (K _d 5–15 nM) affinity ones. The number of SSTR on tumour cells was at least a 1000-fold higher as compared with normal peripheral blood cells. Comparative scintigraphic studies using¹²³I-OCT and/or¹²³I-Tyr-3-OCT and/or¹¹¹In-DTPA-d-Phe-1-OCT were performed in 21 patients with histologically verified intestinal carcinoid tumours. Corresponding scintigraphic results were obtained in 18 of 21 patients investigated with two different SSTR ligands, either¹²³I-OCT/¹²³I-Tyr-3-OCT (four of five),¹²³I-OCT/¹¹¹In-DTPA-d-Phe-1-OCT (eight of nine), or¹²³I-Tyr-3-OCT/¹¹¹In-DTPA-d-Phe-1-OCT (six of seven). We conclude that various tumours express high amounts of SSTR which are recognized by three radiolabelled SST analogues:¹²³I-OCT,¹²³I-Tyr-3-OCT and¹¹¹In-DTPA-d-Phe-1-OCT. Differences between these SST analogues in their in vitro binding and/or in vivo scanning properties are observed in a minority of patients. Thus, the labelling of OCT with iodine may be an alternative approach for those nuclear medicine departments for which¹¹¹In-DTPA-d-Phe-1-OCT is not easily available, or is too expensive.     

Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using 123I-BMIPP myocardial scintigraphy]

PURPOSE: We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using 123I-BMIPP myocardial scintigraphy. METHODS: We performed 123I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP + DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of 123I-BMIPP was obtained using the time activity curve. Myocardial washout rate of 123I-BMIPP was calculated using the polar images of early and delayed SPECT images. RESULTS: Myocardial uptake rate of 123I-BMIPP (%) were AP: 4.9 +/- 0.6, AP + DM: 5.5 +/- 0.5, DM 5.7 +/- 0.5 and N: 5.0 +/- 0.4. 123I-BMIPP myocardial uptake rate was increased in AP + DM and DM. 123I-BMIPP myocardial washout rate (%) were AP: 30.2 +/- 4.3, AP + DM: 24.5 +/- 3.9, DM: 16.1 +/- 2.8 and N: 19.4 +/- 3.2. 123I-BMIPP myocardial washout rate was increased in AP and AP + DM. 123I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. 123I-BMIPP myocardial washout rate was decreased in DM. CONCLUSION: The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout.     

Phosphorus nuclear magnetic resonance spectroscopy: In vivo magnesium measurements in the skeletal muscle of normal subjects

³¹P nuclear magnetic resonance spectroscopy was used to study the skeletal muscle of 33 normal males and 32 females. Free intracellular magnesium levels and the ratios of the phosphorus metabolites were determined. Males had significantly lower free magnesium levels (499.8 μM ± 26.3 μM vs. 530.7 μM ± 36.0 μM, P = 0.001, d.f. = 63, analysis of variance). The free magnesium level (r_s = −0.5431, P = 0.001) and the phosphocreatine/inorganic phosphate ratio in males (r_s = −0.4102, P = 0.018), and the phosphocreatine/inorganic phosphate ratio in females (r_s = −0.4759, P = 0.009) fell with the increasing Minnesota Heart Health Program Questionnaire score.     

Influence of age and gender on iodine-123 MIBG kinetics in normal lung

Materials and Methods

Seventeen healthy volunteers and 14 patients with no cardiac or pulmonary disorders were included in this study (age range: 24 to 88 years, mean age 50.2 ± 17.6 years; 16 males, 15 females). Planar images were obtained 15 min (early) and 3 h (delayed) after injection of I-123 MIBG (111 MBq). Pulmonary uptake of I-123 MIBG was quantified based on the lung-to-mediastinum ratio (LMR) on early and delayed images. The lung clearance rate (LCR) was calculated from both the early and delayed images.

Results

Both early and delayed LMR values increased slightly, although they showed no significant correlations with age. There was a significant inverse correlation between LCR and age (r = ?0.57, p < 0.001). Neither LCR nor LMR differed significantly between male and female patients, but the mean age of the men was lower than that of the women.

Conclusions

Pulmonary I-123 MIBG kinetics may reflect age-dependent changes in NE metabolism. The effects of age should be taken into account when assessing pulmonary NE metabolism with I-123 MIBG.     

Ornithine metabolism in normal subjects and patients with cancer

The metabolism of L-(1-14C)ornithine monohydrochloride was monitored in patients with histologically proven cancer and in normal volunteers. Following i.v. injection of 8 microCi C-14 ornithine (160 nmoles), the decarboxylation of ornithine--yielding 14CO2--was monitored for a 2.5-hr period using the ionization chamber and vibrating-reed electrometer of Tolbert, as modified by Davidson and Schwabe. Twelve normal subjects exhaled 7.3-15.7% of the administered C-14 (mean 12.6% s.d. 3.11%). In ten patients tested before initiation of therapy, recovery ranged from 18.2-32.1% (mean 23.02%, s.d. 4.52%). A t-test indicates a confidence level of > 99.5% that a significant difference exists between the two means. Re-testing of two normal volunteers showed little or no change in ornithine metabolism over a 2-5-mo period. Results from testing three cancer patients before and after therapy correlate well with clinical evidence of the presence of tumor burden.     

Imaging serotonin and dopamine transporters with 123I-beta-CIT SPECT: binding kinetics and effects of normal aging.

[123I]beta-carbomethoxy-3-beta-(4-iodophenyl)-tropane (CIT) is a useful ligand for dopamine transporters (DATs) and serotonin transporters (5-HTTs). Previous SPECT studies have shown a state of sustained equilibrium in the striatum on day 2 after injection that allows quantification of striatal DATs using a simple ratio of specific-to-nondisplaceable binding. The aim of this study was to investigate the kinetics of [123I]beta-CIT uptake in the thalamus, hypothalamus, and midbrain, areas known to contain 5-HTTs in high densities. METHODS: SPECT with a triple-head camera was performed on 16 healthy volunteers (13 women, 3 men; mean age [+/-SD], 32 +/- 11 y) after intravenous bolus injection of 130 +/- 20 MBq (3.5 +/- 0.5 mCi) [123I]beta-CIT. Two individuals were scanned 1, 2, 4, 7, 10, 13, 16, and 24 h after injection, and the remaining 14 were scanned 4, 7, 10, 20, and 24 h after injection. Values from 19 previously examined healthy volunteers (8 women, 11 men; mean age, 52 +/- 20 y) were included in the analysis to study the age dependency of beta-CIT binding in striatal and 5-HTT-rich brain areas in a larger control sample. RESULTS: Peak uptake 4 h after injection, followed by stable uptake until 10 h and a slow decrease until 24 h, was observed in the thalamus-hypothalamus region. Activity in the midbrain-pons region peaked 2 h after injection. Because of a concomitant slow but steady decline of uptake in reference regions starting 4 h after injection, a higher stability of binding ratios for 5-HTT-rich brain areas was observed on day 2, suggesting that a state of transient equilibrium is reached between 20 and 24 h but that conditions are only close to transient equilibrium between 4 and 10 h after injection for 5-HTT-rich brain areas. In addition to an age-related decline of striatal [123I]beta-CIT binding of 6.6% per decade, a significant age-associated decrease of beta-CIT binding of 3-4% per decade was found in 5-HTT-rich brain areas. The decline of beta-CIT binding in these regions may be explained, at least in part, by a loss of monoamine transporters with age but may also be related to age-associated morphologic changes. CONCLUSION: [123I]beta-CIT appears to be a suitable ligand for imaging serotonin transporters with SPECT. However, careful age matching is warranted for [123I]beta-CIT SPECT studies of 5-HTT changes in patients with neuropsychiatric disorders.     

Role of insulin resistance in heart and skeletal muscle F-18 fluorodeoxyglucose uptake in patients with noninsulin-dependent diabetes mellitus

BACKGROUND: Altered heart and skeletal glucose usage has been reported in patients with non-insulin-dependent diabetes mellitus (NIDDM). Although elevations in plasma free fatty acid (FFA) concentrations have been implicated in reduced myocardial 18fluorine-fluoro-2-deoxy-D-glucose uptake (MFU), the specific role of whole-body insulin resistance in MFU in patients with NIDDM compared with skeletal muscle metabolism remains controversial. PURPOSE: MFU and skeletal muscle 18fluorine-fluoro-2-deoxy-D-glucose uptake (SMFU) were compared with positron emission tomography and the whole-body glucose disposal rate (GDR) during hyperinsulinemic euglycemic clamping in 26 normotensive asymptomatic patients with NIDDM who were not taking medication. These factors were also compared in 12 age-matched control subjects to increase the knowledge of the influence of whole-body insulin resistance on MFU. In addition, independent factors for both SMFU and MFU were investigated. RESULTS: GDR in control subjects (10.0 +/- 2.97 mg/min per kilogram) was significantly higher than in patients with NIDDM (4.05 +/- 2.37 mg/min per kilogram, P < .01). SMFU in patients with NIDDM (0.826 +/- 0.604 mg/min per 100 g) was significantly lower than that in control subjects (1.86 +/- 1.06 mg/min per 100 g, P < .01). MFU in patients with NIDDM (5.35 +/- 2.10 mg/min per 100 g) was also significantly lower than that of control subjects (7.05 +/- 1.66 mg/min per 100 g, P = .0182). SMFU significantly correlated with GDR (r = .727, P < .01) and FFA (r = -.52, P < .01) in patients with NIDDM. MFU also correlated with GDR (r = .778, P < .01) and FFA (r = -.72, P < .01) in patients with NIDDM. Multivariate stepwise regression analysis showed that GDR (F = 36.8) was independently related to MFU (r = .85, P < .01) whereas FFA was not (F = 1.763), where F is the value for statistical analysis of multivariate stepwise regression analysis. CONCLUSION: Insulin resistance is the most essential factor for both heart and skeletal muscle FDG uptake in patients with NIDDM.     

替米沙坦对老年2型糖尿病合并高血压患者糖脂代谢及胰岛素敏感性的影响

 目的 探讨血管紧张素受体拮抗药替米沙坦对老年2型糖尿病合并高血压患者糖脂代谢及胰岛素敏感性的作用.方法 48例老年2型糖尿病合并高血压患者按体重指数(body mass index,BMI)分为非肥胖组和肥胖组.每位患者每天空腹口服80 mg替米沙坦,共24周.测定治疗前后BMI、腰臀比(waist-to-hip ratio,WHR)、胰岛素、血糖、血脂、血压、肝功能、肾功能、血管紧张素Ⅱ,计算稳态模型胰岛素抵抗指数(HOMA-IR).结果 替米沙坦治疗前,与非肥胖组相比,肥胖组收缩压(SBP)、舒张压(DBP)、三酰甘油(triglyceride,TG)、胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素值(fasting insulin,FINS)、HOMA指数(homeostasis model assessment - insulin resistance index,HOMA-IR)和血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)均升高,差异有统计学意义(P<005).非肥胖组替米沙坦治疗后,SBP、FINS、HOMA-IR水平与治疗前相比均下降,ANGⅡ水平升高,差异有统计学意义.肥胖组替米沙坦治疗后,SBP、DBP、TG、TC、FPG、FINS、HOMA-IR水平与治疗前相比均下降,差异有统计学意义(P<005).结论 替米沙坦能够有效降低老年2型糖尿病合并高血压患者的血压,明显改善其糖、脂代谢状态,增强机体对胰岛素的敏感性.     

Demonstration of disturbed free fatty acid metabolism of myocardium in patients with non-insulin-dependent diabetes mellitus as measured with iodine-123-heptadecanoic acid

Myocardial free fatty acid metabolism and left ventricular function were evaluated in 15 middle-aged patients with non-insulin-dependent diabetes mellitus (NIDDM) and in 8 healthy control subjects. The study subjects had no evidence of coronary heart disease on the basis of clinical history, exercise ECG or myocardial perfusion scintigraphy. During peak exercise, iodine-123 hepatadecanoic acid (HDA) was intravenously injected. Myocardial activity distribution of 123I-HDA was measured 10, 30, and 50 min after exercise using single-photon emission tomography (SPET); and then further corrected by free 123I-iodine. Venous blood samples were drawn for detecting the plasma activity of 123I. The net extraction of 123I-HDA into the myocardium was obtained by dividing the corrected tissue 123I concentration by the integral of the plasma time activity curve. The net extraction was 0.40 +/- 0.06 min-1 (mean +/- SD) patients with NIDDM and 0.38 +/- 0.06 min-1 in control subjects (P greater than 0.1), respectively. The faster elimination rate of 123I-HDA was found in patients with NIDDM (0.029 +/- 0.008 min-1) than in control subjects (0.022 +/- 0.004 min-1; P less than 0.01). There was no statistically significant difference in left ventricular ejection fraction (LVEF) at rest between patients with NIDDM (53 +/- 9%) and control subjects (56 +/- 2%), whereas the increase of LVEF during exercise remained lower in patients with NIDDM (3.4 +/- 8.2%) than in control subjects (11.8 +/- 5.8%; P less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)