2型糖尿病合并代谢综合征患者心外膜脂肪特点

目的探讨2型糖尿病合并代谢综合征患者心外膜脂肪特点。方法选择2型糖尿病患者120人为研究对象,测量身高、体重、腰围、臀围和血压,抽空腹血测量血糖、糖化血红蛋白、甘油三酯和高密度脂蛋白胆固醇,利用双能X线测量身体脂肪和肌肉,超声心动图测量心外膜脂肪。Logistic多元回归分析用于评价心外膜脂肪和各变量的联系程度。结果合并代谢综合征的糖尿病患者腰围、腰臀比、甘油三酯、全身脂肪、男性型脂肪、心外膜脂肪、高血压和冠心病患病率均高于未合并代谢综合征者,腰围、甘油三酯和男性型脂肪是心外膜脂肪增加的独立危险因素,而高密度脂蛋白胆固醇属于独立保护因素。结论 2型糖尿病合并代谢综合征者的心外膜脂肪较未合并代谢综合征者增多,且其厚度与腰围、甘油三酯、男性型脂肪和高密度脂蛋白胆固醇密切相关。     

2型糖尿病与冠状动脉侧枝循环

冠状动脉侧枝循环 (CCVs)形成是慢性或反复心肌缺血继发的一种代偿机制 ,它可以在一定程度上增加冠脉血流储备 ,缩小急性心肌梗死的面积 ,降低急性冠脉事件后的死亡率 ,对冠脉狭窄病人有着重要的功能和预后价值[1] ,但临床上常发现不同病人的冠脉病变后 ,心肌CCVs的建立情况有着较大的差异 ,特别是2型糖尿病 (DM )合并冠脉病变后 ,CCVs的建立明显不足[2 ,3] ,和非DM相比 ,DM发生冠脉事件后 ,死亡率增加 3～ 4倍 ,而且更易发生梗死后心绞痛 ,梗死的延展及充血性心力衰竭[4 ] ,其确切机制不明 ,CCVs建立不足可能是一个重要原因。1　CC…     

Perivascular Adipose Tissue and Its Role in Type 2 Diabetes and Cardiovascular Disease

Obesity is associated with insulin resistance, hypertension, and cardiovascular disease, but the mechanisms underlying these associations are incompletely understood. Microvascular dysfunction may play an important role in the pathogenesis of both insulin resistance and hypertension in obesity. Adipose tissue-derived substances (adipokines) and especially inflammatory products of adipose tissue control insulin sensitivity and vascular function. In the past years, adipose tissue associated with the vasculature, or perivascular adipose tissue (PAT), has been shown to produce a variety of adipokines that contribute to regulation of vascular tone and local inflammation. This review describes our current understanding of the mechanisms linking perivascular adipose tissue to vascular function, inflammation, and insulin resistance. Furthermore, we will discuss mechanisms controlling the quantity and adipokines secretion by PAT.     

Relationship Between Epicardial Adipose Tissue,Inflammation and Volume Markers in Hemodialysis and Transplant Patients

Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin‐6 [IL‐6] and high sensitive C‐reactive protein [Hs‐CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs‐CRP, IL‐6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein‐cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs‐CRP, IL‐6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC‐CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD.     

Epicardial Adipose Tissue: New Kid on the Block

Over the last 2 decades, understanding of epicardial adipose tissue (EAT) significantly changed from an innocent bystander, protecting the coronary arteries from physical damage, to an inflammatory active endocrine organ that may influence development of atherosclerosis in the coronary arteries. EAT is a visceral adipose tissue, surrounding the heart and the coronary arteries. It is associated with cardiovascular risk factors and with coronary artery plaque burden. In addition, increasing evidence identifies a link of EAT with prevalent and incident coronary heart disease in patient cohorts as well as general population-based studies. This review article will give an overview over the existing literature on this emerging topic with special focus on the implications of EAT as a potential novel marker of cardiovascular risk burden.     

Vascular and Endothelial Function in Youth with Type 2 Diabetes Mellitus

Purpose of Review

This review aims to discuss the burden of type 2 diabetes in youth and summarize the studies that have utilized noninvasive techniques to assess early vascular disease in youth with type 2 diabetes.

Recent Findings

Noninvasive imaging modalities provide researchers with tools to investigate the vasculature in adolescents with type 2 diabetes. The data published to date consistently show adolescents with type 2 diabetes have greater vascular thickness and stiffness and worse endothelial function compared to their obese and lean peers.

Summary

As the prevalence of type 2 diabetes continues to increase adolescent youth, there is concern adolescents with type 2 diabetes are at risk to develop early onset cardiovascular disease and complications. Future studies need to address treatments that have the potential to improve or reverse vascular dysfunction and decrease the rate of cardiovascular disease and complications.

     

The Role of Adipose Tissue and Lipotoxicity in the Pathogenesis of Type 2 Diabetes

The widespread epidemics of obesity and type 2 diabetes mellitus (T2DM) suggest that both conditions are closely linked. An increasing body of evidence has shifted our view of adipose tissue from a passive energy depot to a dynamic “endocrine organ” that tightly regulates nutritional balance by means of a complex crosstalk of adipocytes with their microenvironment. Dysfunctional adipose tissue, particularly as observed in obesity, is characterized by adipocyte hypertrophy, macrophage infiltration, impaired insulin signaling, and insulin resistance. The result is the release of a host of inflammatory adipokines and excessive amounts of free fatty acids that promote ectopic fat deposition and lipotoxicity in muscle, liver, and pancreatic β cells. This review focuses on recent work on how glucose homeostasis is profoundly altered by distressed adipose tissue. A better understanding of this relationship offers the best chance for early intervention strategies aimed at preventing the burden of T2DM.     

内脏脂肪素在2型糖尿病大鼠脂肪组织中的表达及意义

目的:检测实验性2型糖尿病大鼠脂肪组织中内脏脂肪素(visfatin) mRNA表达的情况,探讨visfatin与2型糖尿病相关性.方法:高糖高脂饮食喂养大鼠4周加尾静脉注射小剂量链脲佐菌素(STZ) 30mg/kg复制2型糖尿病大鼠模型,继续高糖高脂饮食喂养8周后取材,测定空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、血清胰岛素(FINS)并计算胰岛素抵抗指数(IR);检测内脏脂肪组织中visfatin mRNA表达水平.结果:2型糖尿病大鼠FBG、FINS、TC、TG水平、IR值升高;内脏脂肪组织中visfatin mRNA表达量明显增高并与FBG、TG、IR呈显著正相关.结论:visfatin mRNA的表达在2型糖尿病胰岛素抵抗中起重要作用.     

Adipose Tissue, Hormones, and Treatment of Type 1 Diabetes

Type 1 diabetes (T1D) is a serious disease with increasing incidence worldwide, with fatal consequences if untreated. Traditional therapies require direct or indirect insulin replacement, which involves numerous limitations and complications. While insulin is the major regulator of blood glucose, recent reports demonstrate the ability of several extra-pancreatic hormones to decrease blood glucose and improve metabolic homeostasis. Such hormones mainly include adipokines originating from adipose tissue (AT), while specific factors from the gut and liver also contribute to glucose homeostasis. Correction of T1D with adipokines is progressively becoming a realistic option, with the potential to overcome many problems associated with insulin replacement. Several recent studies demonstrate insulin-independent reversal or amelioration of T1D through administration of specific adipokines. Our recent work demonstrates the ability of healthy AT to compensate for the function of endocrine pancreas in long-term correction of T1D. This review discusses the potential of AT-related therapies for T1D as viable alternatives to insulin replacement.     

糖尿病护理门诊在2型糖尿病治疗中的效果观察

目的探究糖尿病护理门诊在2型糖尿病治疗中的效果观察。方法选取该院2014年1—7月期间收治的2型糖尿病患者140例,在取得患者的同意之后将患者分为对照组和观察组各70例。对照组的患者入院治疗只进行常规治疗,护理门诊不进行患者治疗的干预,观察组在该院常规治疗的基础上同时增加护理门诊对治疗进行健康教育等干预措施。两组只在护理门诊干预条件不同之下进行治疗,其他护理治疗项目都一致。在住院治疗一段时间以后,对观察组和对照组的遵医行为和患者自身控制血糖能力进行比较分析。结果在接受护理门诊的健康教育等干预措施之后观察组的各项指标明显优于对照组(P0.05),差异有统计学意义。结论在2型糖尿病的治疗中,患者在常规治疗的基础上增加护理门诊干预的措施可以提高糖尿病患者的治疗效果,患者可以很好的自行控制血糖,提高糖尿病患者的生活质量,在临床上糖尿病护理门诊的应用有着重要的意义。     

Clinical Characteristics and Coronary Angiographic Findings in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus

Diabetes mellitus is the most important risk factor of coronary heart disease ( CHD ) . In the recent years, diabetes has been recognised as a condition being as risky as CHD; so, much attention is being laid on the relationship between type 2 diabetes mellitus (T2DM) and CHD. There are a whole lot of cardiovascular risk factors which gather under T2DM. These include: dis- turbances of the clotting and fibrinolytic system, in- flammation , dysfunction of the endothelial cells and ir- reg…     

组织多普勒成像技术在冠心病合并糖尿病患者右心功能评价的应用研究

目的探讨应用组织多普勒成像技术评价冠心病合并糖尿病患者的右心室舒缩功能的可行性。方法选取冠心病组(CHD组)51例,糖尿病组(DM组)30例及冠心病合并糖尿病组(CHD+DM组)46例,同时选取门诊健康体检者40例作为对照组(NC组),行常规二维超声心动图检查。结果各组间左室舒张末期内径(LVED)、右室舒张末期内径(RVED)、右房上下径(RA1)、右房左右径(RA2)及左室射血分数(LVEF)比较,差异无统计学意义(P0.05)。CHD组、DM组及CHD+DM组左房内径(LA)较对照组明显升高,差异有统计学意义(P0.05);CHD组、DM组及CHD+DM组左房室瓣血流E/A比值(MVE/A)较对照组明显降低,差异有统计学意义(P0.05)。各组右房室瓣隔瓣环、右房室瓣外侧瓣环及右房室瓣环整体收缩期峰值运动速度(Sm)比较,差异均无统计学意义(P0.05)。CHD组、DM组及CHD+DM组右房室瓣隔瓣环、外侧瓣环及瓣环整体舒张早期峰值运动速度(Em)、Em/舒张晚期峰值运动速度(Am)较对照组均明显减低,差异有统计学意义(P0.01)。糖尿病病程与右房室瓣环Em/Am呈负相关(r=-0.636,P0.05)。结论冠心病、糖尿病及冠心病合并糖尿病主要或首先表现为对心室舒张功能的影响。糖尿病病程长短可能是影响右室舒张功能的因素之一。