Serum insulin, insulin resistance, p-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: A community-based study in Kinmen, Taiwan

AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.     

陈旧性脑梗死对急性心肌梗死患者死亡因素的影响

目的 分析陈旧性脑梗死对急性心肌梗死(AMI)患者住院死亡的影响.方法 回顾分析首都医科大学宣武医院2002-2009年连续住院的3572例AMI患者资料.结果 3572例AMI患者中伴陈旧性脑梗死564例(15.8%),与不伴陈旧性脑梗死相比,年龄较大[(69.4±9.9)岁比(64.2±12.9)岁,P=0.000].高血压、糖尿病、陈旧性心肌梗死、非ST段抬高性心肌梗死比例较高(71.0%比57.3%,41.0%比25.7%,12.9%比9.5%,14.9%比10.7%,P＜0.01),且住院病死率较高(16.5%比10.0%,P=0.000).陈旧性脑梗死增加住院死亡(OR 1.368,P=0.022),且独立于年龄(OR 1.048),性别(OR 1.148)、糖尿病(OR 1.337)、陈旧性心肌梗死(OR 1.294)、广泛前壁心肌梗死(OR 1.888)、介入性治疗(OR 0.506)等因素.结论 陈旧性脑梗死增加AMI患者住院死亡风险.

Abstract：

Objective To investigate the impact of prior cerebral infarction (PCI) on in-hospital mortality in patients with Acute Myocardial Infarction (AMI).MethodsA retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan.1 to 2009 Dec.31 were performed.Results There were 564 patients ( 15.8% )with PCI.Compared with the group of without PC1,the group with PCI were substantially older[(69.4 ±9.9) vs (64.2 ± 12.9)years,P =0.000],and had a higher prevalence of hypertensive disease,diabetes mellitus,prior myocardial infarction (MI) and non-ST-segment elevation myocardial infarction(NSTEMI)( respectively,71.0% vs 57.3%; 41.0% vs 25.7%,12.9% vs 9.5%; 14.9% vs 10.7%,P ＜ 0.01 ),and a higher in-hospital mortality ( 16.5% vs 10.0%,P= 0.000).Univariate analysis demonstrated that in-hospital mortality associated with age,gender,extensive anterior MI,anterior MI,diabetes mellitus,prior cerebral infarction,prior myocardial infarction,coronary angiography and percutaneous coronary intervention.Logistic regression analysis found that risk factors were age,extensive anterior MI,anterior MI,diabetes mellitus and prior cerebral infarction,and protective factors were coronary angiography and percutanous coronary intervention.PCI was independently associated with in-hospital mortality,OR 1.368,95% CI 1.047-1.787,P = 0.022.Conclusion In patients with acute myocardial infarction,the presence of PCI increases the risk of worse in-hospital outcome.     

出血性转化对急性缺血性卒中患者转归的影响

Objective To investigate the effect of hemorrhagic transformation (HT) on the outcome of acute ischemic stroke.Methods One hundred and one patients with acute ischemic stroke were divided into cerebral infarction without HT,hemorrhagic infarction (HI),and parenchymal hematoma (PH) according to the CT and/or MRI findings.The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after onset,and the good outcome was defined as mRS ≤ 2.The multivariate logistic regression analysis was used to identify the predictors of outcome in patients with acute ischemic stroke.Results There were 53 patients without HT,44 HI,and 4 PH,respectively in 101 patients with acute ischemic stroke.HI (OR =0.07,95% CI0.01-0.30;P ＜0.001),＜65 years (OR =52.94,95% CI9.12-307.27;P＜0.001),and NIHSS score ＜ 15 (OR= 0.63,95% CI 0.50-0.78;P＜0.001) were the independent predictors of good outcome for patients with acute ischemic stroke.Conclusions HI is one of the independent predictors of good outcome at 3 months after acute ischemic stroke.     

ABO blood type,long-standing diabetes,and the risk of pancreatic cancer

AIM: To retrospectively study pancreatic cancer patients with respect to their ABO blood type and diabetes. METHODS: Our analysis included a cohort of 1017 patients with pancreatic ductal cancer diagnosed at our hospital in Tokyo. They were divided into two groups: 114 patients with long-standing type 2 diabetes (DM group, defined as diabetes lasting for at least three years before the diagnosis of pancreatic cancer) and 903 patients without diabetes (non-DM group). Multivariate analysis was performed to identify factors that are associated with long-standing diabetes. The DM group was further divided into three subgroups according to the duration of diabetes (3-5 years, 5.1-14.9 years, and 15 years or more) and univariate analyses were performed. RESULTS: Of the 883 pancreatic cancer patients with serologically assessed ABO blood type, 217 (24.6%) had blood type O. Compared with the non-DM group, the DM group had a higher frequency of blood type B [odds ratio (OR) = 2.61, 95%CI: 1.24-5.47; reference group: blood type A]. Moreover, male (OR = 3.17, 95%CI: 1.67-6.06), older than 70 years of age (OR = 2.19, 95%CI: 1.20-3.98) and presence of a family history of diabetes (OR = 6.21, 95%CI: 3.38-11.36) were associated with long-standing type 2 diabetes. The mean ages were 64.8 ± 9.2 years, 67.1 ± 9.8 years, and 71.7 ± 7.0 years in the subgroups with the duration of diabetes, 3-5 years, 5.1-14.9 years, and 15 years or more, respectively (P = 0.007). A comparison of ABO blood type distribution among the subgroups also showed a significant difference (P = 0.03). CONCLUSION: The association of pancreatic cancer with blood type and duration of diabetes needs to be further examined in prospective studies.     

Glycemic Control for Patients With Acute Myocardial Infarction

The risk of myocardial infarction increases in patients with diabetes mellitus. The incidence of myocardial infarction is similar in patients with type 2 diabetes without history of myocardial infarction and in non-diabetic patients with history of myocardial infarction. Diabetes mellitus was considered as a coronary disease equivalent by the National Cholesterol Education Program. Strict glycemic control can improve the long-term outcome of both type 1 and type 2 diabetes mellitus. Whatever with diabetic or non-diabetic, strict glycemic control with intensive insulin therapy can reduce the mortality of critically ill patients in hospital. After myocardial infarction,     

高龄老年人不同程度脑白质损害的危险因素分析

Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.     

高龄老年人不同程度脑白质损害的危险因素分析

Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.     

Clinical features and risk factors of patients with fatty liver in Guangzhou area

AIM:There is still no accepted conclusion regarding the clinical features and related risk factors of patients with fatty liver.The large-scale clinical studies have not carried out yet in Guangzhou area. The aim of the present study was to investigate the clinical features and related risk factors of patients with fatty liver in Guangzhou area.METHODS:A total of 413 cases with fatty liver were enrolled in the study from January 1998 to May 2002. Retrospective case-control study was used to evaluate the clinical features and related risk factors of fatty liver with logistic regression.RESULTS: Obesity (OR：21.204), alcohol abuse (OR：18.601),type 2 diabetes mellitus (OR：4.461), serum triglyceride (TG)(OR：3.916), serum low-density lipoprotein cholesterol (LDL-C) (OR：1.840) and fasting plasma glucose (FPG) (OR：1.535) were positively correlated to the formation of the fatty liver.The levels of serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) increased mildly in the patients with fatty liver and were often less than 2-fold of the normal limit.The higher abnormalities of aspartate aminotransferase (AST) levels (42.9%) with AST/ALT more than 2(17.9%) were found in patients with alcoholic fatty liver (AFL) than those with nonalcoholic fatty liver (NAFL) (16.9% and 5.0% respectively).The elevation of serum TG, cholesterol (CHOL), LDL-C was more common in patients with NAFL than with AFL.CONCLUSION:Obesity, alcohol abuse, type 2 diabetes mellitus and hyperlipidernia may be independent risk factors of fatty liver.The mildly abnormal hepatic functions can be found in patients with fatty liver.More obvious damages of liver function with AST/ALT usually more than 2 were noted in patients with AFL.     

Antidiabetic therapy and increased risk of hepatocellular carcinoma in chronic liver disease

AIM： To explore the association between hepatocellular carcinoma （HCC） and type 2 diabetes mellitus, describe the temporal relations between the onset of diabetes and the development of HCC and evaluate the possible effects of antidiabetic therapy on HCC risk,METHODS： We recruited 465 HCC patients, 618 with cirrhosis and 490 control subjects. We evaluated the odds ratio （OR） for HCC by univariate and multivariate analysis. Moreover, OR for HCC in diabetic subjects treated with insulin or sulphanylureas and with metformin were calculated.RESULTS： The prevalence of diabetes mellitus was 31.2% in HCC, 233% in cirrhotic patients and 12.7% in the Control group. By univariate and multivariate analysis, the OR for HCC in diabetic patients were respectively 3.12 （CI 2.2-4.4, P 〈 0.001） and 2.2 （CI 1.2-4.4, P = 0.01）. In 84.9% of cases, type 2 diabetes mellitus was present before the diagnosis of HCC. Moreover, we report an OR for HCC of 2.99 （CI 1.34-6.65, P = 0.007） in diabetic patients treated with insulin or sulphanylureas, and an OR of 0.33 （CI 0.1-0.7, P = 0.006） in diabetic patients treated with metformin.CONCLUSION： Our study confirms that type 2 diabetes mellitus is an independent risk factor for HCC and pre-exists in the majority of HCC patients. Moreover, in male patients with type 2 diabetes meUitus, our data shows a direct association of HCC with insulin and sulphanylureas treatment and an inverse relationship with metformin therapy.     

40 Hz听性稳态反应在脑干卒中患者中的近期预后价值

Objective To investigate the predictive value of the 40 Hz auditory steady state response (40-Hz ASSR) in the short-term prognosis of patients with brainstem stroke.Methods The 40-Hz ASSR and brainstem auditory evoked potentials (BAEP) examinations were recorded and graded from 36 patients with brainstem stroke admitted in the Neurological Intensive Care Unit (NICU). Tue end point of short-term prognostic evaluation was at the time of leaving the NICU. Tue patients with brainstem stroke were divided into the survival group (n =21) and the death group (including brain death,n = 15). The correlation between the grade of the 40-Hz ASSR or BAEP and the short-term prognosis was analyzed. Results The grade of the 40-Hz ASSR (r=0.571,P =0.000) or BAEP (r =0.441,P =0.001 ) was significantly correlated with the short-term prognosis in patients with brainstem stroke. The sensitivity,specificity and accuracy of the 40-Hz ASSR were 60.00％,100％ and 83.33％,respectively,and those for BAEP were 66. 67％,71.43％ and 69. 44％,respectively. Conclusions Tue 40-Hz ASSR has a certain short-term prognostic value in patients with brainstem stroke. The higher the grade of 40-Hz ASSR is,the more serious the illness,and the worse the prognosis.     

脑干梗死与糖尿病的相关性

目的 探讨脑干梗死与糖尿病的关系。方法 纳入确诊急性脑梗死患者,首先分为脑干梗死组和非脑干梗死组,然后根据是否伴有糖尿病分为脑干梗死伴糖尿病组、脑干梗死不伴糖尿病组、非脑干梗死伴糖尿病组和非脑干梗死不伴糖尿病组。多普勒超声检测颈动脉内膜一中膜厚度（intima-media thickness,IMT）和确定颈动脉粥样硬化;弥散加权成像确定脑干梗死及其部位;磁共振血管造影（magnetic resonance angiophy,MRA）检测基底动脉粥样硬化。多变量logistic回归分析筛选影响脑干梗死的不同危险因素。改良Rankin量表(modified Rankin Scale,mRS)评分评价神经功能缺损。结果 共纳入286例急性脑梗死患者：脑干梗死63例,其中34例伴有糖尿病;非脑干梗死223例,其中77例伴有糖尿病。脑干梗死组糖尿病（54.0％对34.5％,x2=7.816,P=0.005）、既往脑梗死（38.1％对24.2％,x2=4.771,P=0.029）、基底动脉粥样硬化（73.0％对57.4％,x2=5.028,P=0.025）比例以及糖化血红蛋白（hemoglobin AIC,HbA1c）[(7.30 ±2.42)％对(6.46±1.82)％,t=-2.531,P=0.011]和载脂蛋白B（apoproteinB,ApoB）[(0.97±0.33) mmol/L对(0.90±0.34) mmol/L,t=-2.180,P=0.029]水平均显著高于非脑干梗死组。多变量logistic回归分析表明,糖尿病（优势比2.150,95％可信区间1.214～3.808;P =0.009）和既往脑梗死(优势比1.835,95％可信区间1.004～3.352,P=0.048)是脑干梗死的独立危险因素。在伴糖尿病的脑干梗死组、不伴糖尿病的脑干梗死组、伴糖尿病的非脑干梗死组和不伴糖尿病的非脑干梗死组之间,HbA1c( P＜0.001)、空腹血糖（fasting blood glucose,FBG）(P＜0.001)、ApoB(P =0.007)和高密度脂蛋白一胆固醇(P=0.018)水平以及基底动脉粥样硬化比例(P=0.001)均存在显著差异,其中脑干梗死伴糖尿病组HbA1c[ (8.81±2.36)％]、FBG[ (8.23 ±3.12) mmol/L]和ApoB[(1.04±0.41) mmol/L]水平以及基底动脉粥样硬化比例(85.3％)最高。与非糖尿病脑干梗死相比,糖尿病脑干梗死患者脑桥梗死更为多见(79.4％,P =0.039)。结论 糖尿病与脑干梗死关系密切,糖尿病更容易导致脑桥梗死。     

FPG等三项指标和糖尿病并发CHF患者心功能的关系

目的 探讨入院空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(HbA1c)、C肽水平及是否并发糖尿病与慢性心力衰竭(CHF)患者心功能的关系.方法 选取健康体检者100例作为对照组.选取CHF患者235例,划分为非糖尿病组(n=143)与糖尿病组(n=92),比较非糖尿病组与糖尿病组心功...     

Apolipoprotein H is increased in type 2 diabetic patients with microalbuminuria

BACKGROUND AND AIM: Serum apolipoprotein H (Apo H) levels are increased in hyperlipidemic subjects and type 2 diabetics, but unknown in microalbuminuria, another disorder with an increased cardiovascular risk. We looked to see whether increased Apo H levels are associated with microalbuminuria in type 2 diabetes. METHODS AND RESULTS: Serum Apo H was calculated in 20 normoalbuminuric and 17 microalbuminuric type 2 diabetics matched for age, sex, body mass index (BMI), glycosylated haemoglobin, plasma lipids and duration of diabetes, and also compared with 20 non-diabetic controls matched for age, sex, BMI and plasma lipids. Mean serum Apo H was significantly higher in the microalbuminuric patients (31.12 +/- 1.58 SEM vs 25.25 +/- 1.52 and 24.72 +/- 0.99 mg/dL, p = 0.003). CONCLUSION: Serum apo H levels are increased in type 2 diabetics with microalbuminuria.     

个性化护理干预对脑梗死合并糖尿病患者治疗依从性的影响

目的探究对脑梗死合并糖尿病患者实施人性化护理的临床效果。方法该次研究所有病例均为脑梗死合并糖尿病患者,共计120例,所有患者均选自该院2019年1月—2020年1月收治。应用随机数字表法对所有120例患者进行分组,分别为对照组和实验组,每组60例,两组患者分别接受一般护理干预和个性化护理干预,进行对照试验。对比两组患者护理前后的神经功能缺损评分(NIHSS)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)和糖化血红蛋白(HbAlc)、治疗依从性、护理满意率。结果对照组患者护理前的NIHSS评分比较差异无统计学意义(P>0.05);对照组护理后的NIHSS评分高于实验组,组间差异有统计学意义(P<0.05);同时对照组患者护理后的FPG、2 hPG、HbA1c等临床指标均明显高于实验组,差异有统计学意义(P<0.05);在护理满意率和治疗依从优良率方面,对照组明显低于实验组,组间差异有统计学意义(P<0.05);实验组患者护理后Fugl—Meyer及Barthel评分与对照组相比更高,组间差异有统计学意义(P<0.05)。结论个性化护理干预能够有效提高脑梗死合并糖尿病患者的护理满意率和治疗依从性,同时对于改善患者血糖水平和神经缺损情况具有重要意义,具有在临床中广泛推广的应用价值。     

Comparison of Fasting Glucose with Post-Load Glucose Values and Glycated Hemoglobin for Prediction of Type 2 Diabetes: The Isfahan Diabetes Prevention Study

OBJECTIVES: The aim of this study was to compare the ability of fasting plasma glucose (FPG), post-load plasma glucose values and glycated hemoglobin (HbA1c) to predict progression to diabetes in non-diabetic first-degree relatives (FDR) of patients with type 2 diabetes. METHODS: A total of 701 non-diabetic FDR of diabetic patients aged 20-70 years surveyed in 2003 to 2005 were followed until 2008 for the onset of type 2 diabetes mellitus. At baseline and at follow-ups, participants underwent a standard 75 g 2-hour oral glucose tolerance test (OGTT). Prediction of progression to type 2 diabetes was assessed by using area under the receiver-operating characteristic (ROC) curves based upon measurement of FPG, post-load glucose values and HbA1c. RESULTS: The incidence of type 2 diabetes was 33.9 per 1000 person-years in men and 48.6 in women. The incidence rates were 4.6, 50.7, and 99.7 per 1000 person-years in FDR with normal glucose tolerance, impaired fasting glucose and impaired glucose tolerance respectively. FPG value was a better predictor of progression to diabetes than any post-load glucose values or HbA1c. The areas under the ROC curves were 0.811 for fasting, 0.752 for 1/2-hour, 0.782 for 1-hour and 0.756 for 2-hour glucose vs. 0.634 for HbA1c (p < 0.001). CONCLUSIONS: FPG had more discriminatory power to distinguish between individuals at risk for diabetes and those who were not at risk than post-load glucose values during OGTT or HbA1c. Our findings support the American Diabetes Association recommendation of using FPG concentration to diagnose diabetes.     

空腹血糖、餐后2h血糖及糖化血红蛋白对糖尿病的诊断价值

目的探讨空腹血糖(FPG)、餐后2 h血糖(2 hPG)及糖化血红蛋白(HbA1c)的检测对糖尿病诊断的参考价值。方法选取2018年5月—2020年4月期间于该院接受检查的62例2型糖尿病患者、57例空腹血糖受损患者及60名健康体检人员作为研究对象,分为A组、B组和C组,通过对FPG、2 hPG以及HbA1c的检测,分析各组的检测结果。结果A组患者的FPG、2 hPG以及HbA1c检测结果分别为(7.81±1.93)mmol/L、(13.76±2.04)mmol/L和(8.16±1.05)%,显著高于B组(t=3.945、21.621、10.953)和C组(t=9.942、40.440、16.331),差异有统计学意义(P<0.05),B组、C组患者在FPG、HbA1c检测结果上差异有统计学意义(P<0.05)。在A组确诊为2型糖尿病的患者中,以FPG≥7.0 mmol/L、2 hPG≥11.1 mmol/L、HbA1c≥6.5%为诊断标准,对糖尿病的确诊率分别为53.23%、85.48%和87.10%。而在FPG、2 hPG以及HbA1c的联合检测中,检测结果糖尿病的确诊率为98.39%,与其他3项诊断标准对比,差异有统计学意义(χ²=34.474、6.961、4.313,P<0.05)。结论在糖尿病的临床诊断中,通过对受检者FPG、2 hPG以及HbA1c等指标的检测,可以根据检测结果,对糖尿病的发生做出判断。采取联合检测的方式,对检测结果进行综合分析,可以有效提高糖尿病诊断的准确性,其对糖尿病的防治有着重要的参考价值。     

Serum adiponectin concentrations are not related to glycosylated hemoglobin levels (HbA1c) in obese diabetic and non-diabetic caucasians.

Although circulating adiponectin has been inversely correlated with obesity, type 2 diabetes and serum glycosylated hemoglobin (HbA1c) in humans, contradictory reports on that subject exist. In this study, serum concentrations of adiponectin in obese non-diabetic and diabetic humans were measured to examine whether they were associated with levels of HbA1c. The WHO definitions of obesity and diabetes were used. One hundred and five obese euglycemic subjects and 49 obese diabetics (aged 51+/-6.9, and 52+/-6.7 years, respectively) were studied. Their BMI, HbA1c and % of body fat were measured. Adiponectin was determined by an enzyme-linked immunosorbent assay. Although the serum adiponectin concentrations differed between diabetics and non-diabetics ( P<0.01), they were not correlated with HbA1c (r=-0.0814; P=0.5823, and r=-0.1861; P=0.1099, for diabetics and non-diabetics, respectively). Both diabetics and non-diabetics were segregated into tertiles according to their HbA1c levels. Plasma adiponectin did not differ significantly between the high (H), intermediate (I), and low (L) HbA1c tertiles. CONCLUSION: Concentrations of adiponectin were not correlated with levels of glycosylated hemoglobin in the diabetic and non-diabetic subjects examined.     

Sex differences in risk factors, etiology, and short-term outcome of cerebral infarction in young patients

Investigations to date have demonstrated that the underlying etiology, causes and burden of stroke may be different for women and men. However, data regarding sex differences among young cerebral ischemic stroke patients remains scarce. We conducted this study in 669 young Chinese adults with acute ischemic stroke as determined by the modified Rankin Scale at discharge. Stepwise multiple logistic regression analysis confirmed that NIHSS score (OR 1.277; 95% CI 1.179-1.383, p=0.000), diabetes mellitus (OR 0.121; 95% CI 0.0209-0.718, p=0.020) and serum glucose levels on admission (OR 1.135; 95% CI 0.997-1.293, p=0.046) independently predict short-term outcomes at discharge in young female patients with acute stroke, but the significant variables related to male patients appeared to be Apo A1 (OR 0.165; 95% CI 0.035-0.776, p=0.023) and NIHSS score on admission (OR 1.458; 95% CI 1.325-1.605, p=0.000). In our series, our data suggest that there are several sex differences for risk of cerebral infarction in young patients, which have important implications for the diagnosis, management and prognosis of stroke in young adults.     

2型糖尿病合并脑梗死患者脂联素水平的变化及其意义

目的探讨2型糖尿病合并脑梗死患者血清脂联素的变化规律及其与脑梗死的相关性。方法采用前瞻性观察研究临海市第一人民医院住院的2型糖尿病合并脑梗死患者38例(A组)、单纯2型糖尿病32例(B组)及正常对照组38例(C组),用酶联免疫法分别测定各组患者血清脂联素及C反应蛋白水平(CRP),并分析血清脂联素浓度与体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)及CRP等各项指标的相关性。结果 A组、B组脂联素水平均显著低于C组(P<0.01),A组脂联素又显著低于B组(P<0.01);脂联素与BMI(r=-0.50,P<0.01)、HbA1c(r=-0.56,P<0.01)、CRP(r=-0.24,P<0.05)呈负相关,与HDL呈正相关(r=0.35,P<0.01);进入回归方程的因素为BMI(b=0.04,P<0.05)、HDL(b=-0.29,P<0.01)、HbA1c(b=0.03,P<0.01)、CRP(b=0.02,P<0.01)、脂联素(b=-0.32,P<0.01)。结论低脂联素水平是2型糖尿病合并脑梗死的独立危险因素。     

糖化血红蛋白与血浆致动脉粥样硬化指数对中老年2型糖尿病发生风险的联合预测价值

目的:探讨糖化血红蛋白（HbA 1c）和血浆致动脉粥样硬化指数（AIP）对中老年2型糖尿病（T2DM）发生风险的联合预测价值。 方法:本研究依托中国T2DM患者肿瘤发生风险的流行病学研究（REACTION）,对2011至2014年在大连社区40周岁及以上人群中开展的流行病学调查资料进行回顾性分析,...