2型糖尿病患者早期糖尿病肾病的发生率及危险因素分析

目的 了解2型糖尿病患者早期糖尿病肾病的发生率,并对相关危险因素进行分析.方法 对社区普查的345例2型糖尿病(T2DM)患者进行分析,其中男性831例,女性1 514例.按尿微量白蛋白肌酐比值(urinary allbuminto-creatinine ratio,分为单纯糖尿病组(DM组:ACR＜0.03 mg/g)和早期糖尿病肾病组(DN组:ACR≥0.03 mg/g).计算2型糖尿病患者早期糖尿痛肾病的发生率,同时应用Logistic回归分析2型糖尿病社区居民的性别、年龄、体质指数(BMI)、腰臀比(WHR)、血糖、糖化血红蛋白(HbA1c)、血压、血脂等指标与早期糖尿病肾病的相关性.结果 T2DM患者早期糖尿病肾病的患病率为15.44％.男女患病率分别为15.5％和15.4％,不同性别早期糖尿病肾病患病率差异无统计学差异(P＞0.05);两组比较,DN组空腹血糖、餐后2h血糖、BMI、WHR、HbA1c、平均收缩压、平均舒张压、三酰甘油(TG)及血尿酸均高于DM组,差异有统计学意义(P＜0.05);Logistic回归分析显示,空腹血糖、BMI、WHR、血尿酸、平均收缩压及TG与早期糖尿病肾病的发生呈正相关.结论 空腹血糖、BMI、WHR、血尿酸、平均收缩压及TG为早期糖尿病肾病的危险因素.     

血锌水平与2型糖尿病伴微量白蛋白尿的相关性研究

目的 探讨血锌水平与2型糖尿病(T2DM)伴微量白蛋白尿的相关性.方法 选择2014年8月至2015年5月在郑州大学附属人民医院就诊的188例T2DM患者(包括112例正常白蛋白尿患者和76例微量白蛋白尿患者)和95例健康志愿者,对其性别、年龄、收缩压、舒张压、BMI指数、糖化血红蛋白、血锌水平、血肌酐、肾小球滤过率估计值(eGFR)和尿白蛋白等临床数据进行回顾性分析.结果 与健康对照组相比,T2DM组的血锌浓度较低(P＜0.01).在T2DM患者中,微量白蛋白尿组较正常白蛋白尿组的血锌浓度低(P＜0.05).较低血锌水平的T2DM患者较正常血锌水平者的eGFR低(P＜0.01).经相关性分析,血锌水平与T2DM患者的血肌酐水平(r=-0.289,P＜0.001)、糖化血红蛋白(r=-0.177,P＜0.05)以及微量白蛋白尿(r=-0.478,P＜0.001)均呈负相关,而与eGFR(r=0.183,P＜0.05)呈正相关.结论T2DM患者血锌水平较低,微量白蛋白尿加重其低血锌水平,因此血锌水平可预测T2DM的肾脏损害.     

多种方法对糖尿病肾病早期诊断的价值评价

目的:评价晨尿、随机尿微量白蛋白(mALB)排出率诊断早期糖尿病肾病的可靠性。方法:选择30例健康对照组和42例糖尿病患者,按24h尿白蛋白排出率(UAER)分为无肾病组(UAER<30mg/24h)、早期肾病组(UAER30-300mg/24h)。所有受试对象留取24h总尿量及晨尿、随机尿,检测尿mALB、尿肌酐。以UAER为对照,建立ROC曲线,评估晨尿直接法(MU)、晨尿肌酐矫正法(MC)、随机尿直接法(RU)、随机尿肌酐矫正法(RC)的诊断特异性和敏感性。结果:晨尿、随机尿四种方法的截断点、敏感度、特异度、ROC曲线下面积是,MU法:14.0mg/l、83%、82%、0.934;MC法:1.51mg/l.g、85%、81%、0.915;SU法:20mg/l、75%、64%、0.616;SC法:2.1mg/l.g、82%、71%、0.862。结论:晨尿mALB排出率对糖尿病肾病早期诊断价值优于随机尿;随机尿肌酐矫正法优于直接法,但是肌酐矫正法提高尿mALB假阳性。     

尿微量白蛋白在早期肾损害中的诊断价值

目的探讨尿微量白蛋白在早期肾损害中的诊断价值。方法对本院155例尿常规蛋白均为阴性的糖尿病和高血压患者采用免疫比浊法检测尿微量白蛋白水平,并同时用酶法检测血清肌酐与尿素水平,并进行统计分析。结果 155例尿常规蛋白为阴性的糖尿病和高血压患者中,有尿微量白蛋白异常者80例。其中101例糖尿病患者中55例异常[mAlb=(56.2±32.5)mg/L],为54.5%。54例高血压患者中25例异常[mAlb=(51.3±33.4)mg/L],为46.5%。明显高于其正常范围(mAlb<20 mg/L)。而同时检测的血肌酐与尿素,101例糖尿病患者中12例异常,为11.9%;54例高血压患者中3例异常,为5.6%。结论尿微量白蛋白的检测,在糖尿病肾病早期及高血压的诊治中有重要的临床意义。     

痛风性肾病患者血清胱抑素C和尿微量白蛋白/尿肌酐测定的临床意义

目的探讨痛风性肾病患者胱抑素C(Cys-C)和尿微量白蛋白、尿肌酐水平的变化及意义。方法对109例痛风患者(其中并发痛风性肾病59例,无并发症50例)和正常对照60例采用乳胶颗粒增强免疫比浊法测定血清胱抑素,同时用免疫比浊法测定尿微量白蛋白,用酶法测定尿肌酐。并计算尿微量白蛋白、尿肌酐的比值。结果痛风性肾病组血清胱抑素和尿微量白蛋白/尿肌酐平均明显高于对照组(P<0.01),痛风非肾病组与正常对照组比较无统计学差异(P>0.05)。结论血清胱抑素C和尿微量白蛋白/尿肌酐随着痛风性肾病的发生以及严重程度逐渐增高,可作为早期诊断痛风性肾病较敏感的指标,对于监测早期痛风性肾病的发生、病情发展程度有重要意义。     

联合应用血氧水平依赖及动脉自旋标记MRI评估2型糖尿病早期肾功能改变

目的探讨联合应用血氧水平依赖(BOLD)及动脉自旋标记(ASL)MRI无创评估2型糖尿病(T2DM)患者早期肾功能改变的价值。方法前瞻性收集2019年9月至2022年5月天津市第一中心医院63例T2DM患者, 同期收集30例健康志愿者(对照组)。将T2DM患者根据尿白蛋白/肌酐比值(ACR)分为正常白蛋白尿(NAU, ACR<30 mg/g)组和微量白蛋白尿(MAU, 30 mg/g≤ACR≤300 mg/g)组, 分别为35、28例。所有受试者行腹部BOLD及ASL检查, 测量肾皮、髓质表观弛豫率(R2*)及肾皮质肾血流量(RBF)。采用单因素方差分析比较3组间R2*和RBF的差异。应用受试者操作特征曲线分析相关参数鉴别各组的诊断效能, 曲线下面积(AUC)的比较采用Z检验。结果对照组、NAU组、MAU组间肾髓质R2*及肾皮质RBF差异有统计学意义(F=45.83、34.15, P<0.001), 肾皮质R2*差异无统计学意义(F=2.98, P=0.056)。区分对照组与NAU组时, 肾髓质R2*、肾皮质RBF以及两者联合参数的AUC分别为0.921(95%CI 0.8...     

血清CysC检测在早期诊断2型糖尿病肾病中的意义

目的探讨血清胱抑素C(CysC)在早期糖尿病肾病(DN)患者血液中的变化及其诊断价值。方法对110例2型糖尿病(DM)患者根据尿微量白蛋白排泄率(UAER)分为两组:DM无蛋白尿组(UAER<30 mg/24 h),50例;DM微量蛋白尿组(UAER 30³00 mg/24 h),60例;用免疫比浊法检测2型糖尿病肾病患者和健康体检人群的血清CysC、速率法测定尿素氮(BUN)、酶法测定血肌酐(Scr),并对检测结果进行统计分析。结果 60例2型DM尿微量白蛋白患者CysC、BUN、Scr的异常结果检出率分别为78.3%、10.0%、16.8%,CysC的异常结果检出率明显高于BUN、Scr。结论血清中CysC的浓度可作为2型DN早期诊断指标,且对了解肾脏损伤程度也有较大的临床意义。     

剪切波弹性成像及平面波超敏感血流显像技术在糖尿病肾病评估中的应用价值

目的 探讨剪切波弹性成像(SWE)及平面波超敏感血流显像(Angio PLUS)技术在糖尿病肾病(DN)评估中的应用价值。方法 选取在我院就诊的DN患者125例为DN组,根据尿蛋白/肌酐(ACR)水平不同将其分为DNⅠ～Ⅲ组,DNⅠ组：正常白蛋白尿组(ACR<30 mg/g),DNⅡ组：微量白蛋白尿组(30 mg/g≤ACR≤300 mg/g),DNⅢ组：大量白蛋白尿组(ACR>300 mg/g);另选取同期44例健康志愿者作为对照组。采用SWE及Angio PLUS技术分别测量右肾中部肾实质杨氏模量均值(Emean)及右肾近被膜肾皮质小叶间动脉血流阻力指数(RI),比较各组间Emean及RI值的变化。结果 与对照组相比,DNⅠ～Ⅲ组杨氏模量均值以及小叶间动脉血流阻力指数均升高(P<0.05);且随着ACR值增加,DNⅠ～Ⅲ组肾实质杨氏模量均值及小叶间动脉血流阻力指数逐渐升高,各组间比较差异均有统计学意义(P<0.05)。结论 SWE及Angio PLUS技术均可无创评估DN的严重程度,具有重要的临床意义。     

糖尿病患者采用尿微量白蛋白生化检测的临床效果观察

目的：探讨尿微量白蛋白生化检测在糖尿病患者中的临床效果。方法选取接受治疗的糖尿病肾病患者共62例,将其作为观察组,同期选择健康体检人员共62例,作为对照组。测定两组的尿微量白蛋白及其肌酐,分析测定结果。结果观察组阳性率为41.9％显著高于对照组0％,经χ2检测组间比较差异显著,有统计学意义（χ2＝32.8980,P＜0.05）;观察组尿微量白蛋白值（44.32±11.84）μg／mL高于对照组（9.85±4.78）μg／mL,经χ2检测组间比较差异显著,有统计学意义（χ2＝21.2568,P＜0.05）。结论在糖尿病患者中进行尿微量白蛋白生化检测,对早期糖尿病肾病的诊断具有一定的价值,能够有效评估患者的病情,指导临床治疗。     

GFR和ERPF与早期糖尿病肾病尿微量蛋白相关性研究

目的探讨早期糖尿病肾病(DN)肾小球滤过率(GFR)和肾有效血浆流量(ERPF)与尿微量蛋白的变化特点及其相互关系.方法 2型糖尿病(NIDDM)69例,根据尿白蛋白(Alb)排泄率(UAER)分为3组正常Alb尿组(Ⅰ组,UAER<20 μg/min);微量Alb尿组(Ⅱ组,UAER 20～200 μg/min);大量Alb尿组(Ⅲ组,UAER>200 μg/min).行放射性核素动态显像测定GFR、ERPF,同时测定尿Alb、α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)和血清肌酐(SCr)和尿素氮(BUN).结果Ⅰ组GFR和ERPF值比对照组增高,与尿微量蛋白呈负相关.Ⅱ组GFR比对照组增高,与尿微量蛋白呈正相关;ERPF略低于对照组,与尿微量蛋白呈负相关.Ⅲ组GFR和ERPF明显降低,与尿微量蛋白呈负相关.Alb、α1-MG、β2-MG与SCr、BUN呈明显正相关.结论 GFR、ERPF是反映DN变化的灵敏指标,与尿微量蛋白联合检测判断DN进展程度更有意义.     

Impaired glucose regulation in a Sherpa indigenous population living in the Everest region of Nepal and in Kathmandu Valley

Abstract Lhamo, Sherpa Y., Soonthornpun Supamai, and Chongsuvivatwong Virasakdi. Impaired glucose regulation in a Sherpa indigenous population living in the Everest region of Nepal and in Kathmandu Valley. High Alt. Med. Biol. 9:217-222, 2008.-The aim of this study was to determine the prevalence of impaired glucose regulation status in Sherpa adults living in the Everest area and in Kathmandu valley. A cross-sectional survey was conducted in Chaurikharka village (Everest area) and Kathmandu city on 119 and 121 randomly selected individuals, aged 30-70 years. They were assessed on conventional risk factors for diabetes, and an oral glucose tolerance test was performed. Based on the 2003 American Diabetes Association criteria, the prevalence in the Kathmandu city and Everest region of any impaired glucose regulation (IGR), isolated impaired fasting plasma glucose (isolated IFG), isolated impaired glucose tolerance (isolated IGT), and combined isolated IFG and isolated IGT were 55.4% vs. 23.5%, 42.1% vs. 14.3%, 1.7% vs. 0.8%, 11.6 vs. 8.4%, respectively. Using the subjects with normal glucose tolerance as the referent group and after adjusting for age, sex, physical activity, calories, and waist circumference, the odds ratios for isolated IFG and combined isolated IFG and isolated IGT of living in the highland region were 0.19 (0.08-0.44) and 0.33 (0.09-1.18), respectively. Isolated IFG was more common among the lowland Sherpas. Unlike combined isolated IFG and isolated IGT, this isolated IFG difference could not be explained by the difference of conventional diabetes mellitus risk factors.     

Sexual dimorphism of acetabulum-pubis index in South-Indian population

Accurate sexing of skeletal remains is a vital part of any medicolegal investigation and a challenge to physical anthropologists. Hipbone is considered as the most reliable sex indicator in the human skeleton. Standards of morphological and morphometric sex differences in the skeleton may differ with the population sample involved and thus cannot be applied universally. The acetabulum-pubis index (A-P index) which is one of the reliable criteria for sex differentiation of human hipbones is derived from the measurements of acetabulum diameter and the distance between its anterior rim and symphysis pubis. Sixty-seven adult hipbones of known sex (36 males and 31 females) belonging to South-Indian population were studied to investigate sexual dimorphism of the well established A-P index. The index below 77.5 identified 81% of females and above 77.5 identified 83% males accurately.     

Sex-specific developmental models for Creophilus maxillosus (L.) (Coleoptera: Staphylinidae): searching for larger accuracy of insect age estimates

Differences in size between males and females, called the sexual size dimorphism, are common in insects. These differences may be followed by differences in the duration of development. Accordingly, it is believed that insect sex may be used to increase the accuracy of insect age estimates in forensic entomology. Here, the sex-specific differences in the development of Creophilus maxillosus were studied at seven constant temperatures. We have also created separate developmental models for males and females of C. maxillosus and tested them in a validation study to answer a question whether sex-specific developmental models improve the accuracy of insect age estimates. Results demonstrate that males of C. maxillosus developed significantly longer than females. The sex-specific and general models for the total immature development had the same optimal temperature range and similar developmental threshold but different thermal constant K, which was the largest in the case of the male-specific model and the smallest in the case of the female-specific model. Despite these differences, validation study revealed just minimal and statistically insignificant differences in the accuracy of age estimates using sex-specific and general thermal summation models. This finding indicates that in spite of statistically significant differences in the duration of immature development between females and males of C. maxillosus, there is no increase in the accuracy of insect age estimates while using the sex-specific thermal summation models compared to the general model. Accordingly, this study does not support the use of sex-specific developmental data for the estimation of insect age in forensic entomology.

     

蛋白质摄入水平在头颈肿瘤放化疗中的应用研究

目的:探讨蛋白质摄入量对头颈肿瘤患者根治性放化疗期间黏膜损伤和营养状况的影响。方法:选取2018年7月至2019年12月南京大学医学院附属鼓楼医院收治的72例头颈肿瘤患者的临床资料进行前瞻性研究。采用数字随机表法将患者分为2组,根据剔除标准,最终干预组纳入患者32例[男性27例、女性5例,年龄（51.67±12.92）...     

Sex-specific criteria for interpretation of thallium-201 myocardial uptake and washout studies

A study was undertaken to determine the effect of gender on criteria for the quantitative analysis of exercise-redistribution 201Tl myocardial scintigraphy. The studies of 26 normal females and 23 normal males were subjected to bilinear interpolative background subtraction and horizontal profile analysis. Significant sexual differences were found in both regional uptake ratios and washout rates. These differences primarily reflected a proportionately decreased anterior and upper septal uptake in females, and faster washout in females. Faster myocardial 201Tl washout rates in females could not be clearly ascribed to either a physiological or artifactual explanation. It is concluded that since important differences exist between males and females in the detected pattern of 201Tl myocardial uptake and washout, sex-specific criteria may enhance the predictive accuracy of exercise-redistribution 201Tl myocardial scintigraphy.     

Sex assessment with the radius in Portuguese skeletal populations (late 19th – early to mid 20th centuries)

The assessment of sex is of immense relevance in the analysis of human skeletal remains, as other parameters of the biological profile are usually sex-specific (e.g., age at death or stature). The radius can be used to estimate sex when more dimorphic bones are not available or in the case of incomplete and fragmentary remains. Ten radius measurements collected in a sample of 364 individuals (166 females and 198 males) from the Coimbra Identified Skeletal Collection (late 19th – early 20th centuries) were employed to generate univariable and multivariable models for sex estimation. All models were evaluated with a 10-fold cross-validation method and an independent holdout sample from the Luís Lopes Collection (late 19th – mid 20th centuries) encompassing 50 individuals (25 females and 25 males). Univariable models show an accuracy ranging from 77.7% to 89.8% (cross-validation), and from 70% to 86% (test sample), while accuracy in the multivariable models varies from 88.7% to 93.4% (cross-validation), and 84.0% to 90.0% (test sample). Results suggest that measurements of the radius are useful to develop standard guidelines for sex estimation of anonymous skeletal remains.     

Resistive training can reduce coronary risk factors without altering VO2max or percent body fat

Eleven healthy, untrained males (age = 44 +/- 1 yr; range = 40 to 55 yr) were studied to determine the effects of 16 wk of high-intensity resistive training on risk factors for coronary artery disease. Lipoprotein-lipid profiles, plasma glucose and insulin responses during an oral glucose tolerance test, and blood pressure at rest were determined before and after training. The training program resulted in a 13% increase in high-density lipoprotein-cholesterol (39 +/- 2 vs 44 +/- 3 mg.dl-1, P less than 0.05), a 43% increase in high-density lipoprotein-cholesterol (7 +/- 2 vs 10 +/- 2 mg.dl-1, P less than 0.05), a 5% reduction in low-density lipoprotein cholesterol (129 +/- 5 vs 122 +/- 5 mg.dl-1, P less than 0.05), and an 8% decrease in the total cholesterol/high-density lipoprotein-cholesterol ratio (5.1 +/- 0.3 vs 4.7 +/- 0.3, P less than 0.01), despite no changes in VO2max, body weight, or percent body fat. Glucose-stimulated plasma insulin concentrations during oral glucose tolerance testing were significantly lower, and supine diastolic blood pressure was reduced (P less than 0.05) as a result of the training program. No changes in any of these variables occurred in a sedentary control group. These findings indicate that resistive training can lower risk factors for coronary artery disease independent of changes in VO2max, body weight, or body composition.     

Sweat iron loss of male and female runners during exercise

Male (n = 9) and female (n = 8) collegiate cross-country runners were studied during a training session to determine the amount of iron lost in the sweat. Sweat samples were collected from the arm using polyethylene bags. Total sweat loss was determined by weighing subjects before and after the runs. Average time of sweat collection was 42 min for males and 39 min for females. Sweat rate for the males (717.5 +/- 145.9 g/m2/h) was significantly greater than for the females (460.1 +/- 142.9 g/m2/h); however, the sweat rate per km was not significantly different. Females had a significantly greater sweat iron concentration (0.417 +/- 0.024 mg/l) than males (0.179 +/- 0.011 mg/l). Rate of sweat iron loss was not significantly different for females (0.276 +/- 0.140 mg/h) and males (0.21 +/- 0.13 mg/h). Sweat iron concentration was inversely related with sweat rate (r = -0.64). Our data suggest that although males lose more total sweat than females, the higher sweat iron concentration of females leads to similar rates of iron loss. For female runners, sweat iron loss coupled with a low dietary iron intake may result in a negative iron balance.     

贫血患者大脑静息葡萄糖代谢改变的研究

目的:探讨不同程度贫血患者大脑静息状态下葡萄糖代谢改变的特点。方法:回顾性分析2016年12月至2019年4月经郑州大学人民医院临床诊断为贫血的51例患者的脑部 18F-氟脱氧葡萄糖（FDG）PET/CT影像资料,其中男性16例、女性35例,年龄21~60（41.13±9.78）岁。根据WHO和相关文献中的...     

Influence of cycle ergometer type and sex on assessment of 30-second anaerobic capacity and power

This study examined the influence of cycle ergometer type and sex on assessment of 30-s anaerobic capacity and power. 41 healthy adults performed a 30-s anaerobic cycle test using a mechanically- (ME) and air-braked (AE) ergometer in a randomised order, approximately 7 days apart. Peak heart rate (HR) and rating of perceived exertion were similar between tests with peak HR greater for females compared to males (187.0 ± 9.1 vs. 180.8 ± 9.9 bpm, p<0.05). Peak power (1 100 ± 330 vs. 802 ± 225 W), mean power (793 ± 223 vs. 587 ± 156 W) and total work (23.8 ± 6.7 vs. 17.6 ± 4.7 kJ) were greater for AE compared to ME (p<0.001) and greater for males compared to females (p<0.001). The mean difference for anaerobic capacity and power between AE and ME were similar for males and females (37-41% vs. 33-35%, p>0.05). Peak lactate was greater for AE compared to ME (16.1 ± 3.4 vs. 14.8 ± 2.9 mmol·L (-1); p<0.05) and greater for males compared to females (16.2 ± 3.5 vs. 14.6 ± 2.7 mmol·L (-1); p<0.05). The current study demonstrated that anaerobic power and capacity were substantially greater when assessed using AE compared to the traditional ME with the difference between ergometer types unaffected by sex. Ergometer type should be considered when comparing anaerobic results across populations and/or studies.