糖代谢异常和糖尿病患者血浆纤维蛋白原的观察

目的探讨血浆纤维蛋白原在糖代谢异常和糖尿病患者中的变化。方法对155例糖尿病、糖代谢异常患者和正常对照者进行血浆纤维蛋白原、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、尿素氮和血肌酐检测。结果糖尿病、糖代谢异常和正常对照组之间纤维蛋白原和三酰甘油在各组之间比较差异有统计学意义(P<0.01或P<0.05);纤维蛋白原的多因素linear regression分析发现空腹血糖、三酰甘油是纤维蛋白原的相关因子(P<0.05)。结论糖尿病和糖代谢异常患者血浆纤维蛋白原升高,而且纤维蛋白原与空腹血糖水平相关。因此,血浆纤维蛋白原升高可能参与糖尿病患者心脑血管疾病的形成。     

脂蛋白相关磷脂酶A2与妊娠期糖尿病患者产后糖代谢异常的相关性

目的 通过产前脂蛋白相关磷脂酶A2（Lp-PLA2）检测评估妊娠期糖尿病（GDM）患者产后糖代谢异常的发生风险.方法 收集2009年1月至2012年8月系统产检并住院分娩的GDM患者190例作为研究组,同期健康孕妇261例作为对照组.并于妊娠24～28周抽取外周血检测血糖、血脂以及血清Lp-PLA2等.于2012年11月至2013年4月进行随访,其中GDM患者172例,健康孕妇249例,进行口服葡萄糖耐量试验（OGTT）及糖化血红蛋白（HbA1c）.分类计数资料比较采用x2检验.Lp-PLA2与GDM产后糖代谢异常的相关性采用logistic回归分析和ROC曲线分析.结果 （1）GDM患者产后2型糖尿病（T2DM） [4.65％（8/172）比0（0/249）]、糖尿病前期[39.53％ （68/172）比12.45％（31/249）]发生率比健康孕妇高.（2）与健康孕妇相比,GDM患者产后空腹血糖（FBG）[（4.5±0.7）比（4.2±0.3） mmol/L; t=5.6,P＜0.01],空腹胰岛素（FINS）[（9.7±4.9）比（8.7±4.2） mmol/L;t=2.3,P＜0.05],稳态模型胰岛素抵抗指数（HOMA-IR）[（2.0±1.3）比（1.7±1.1）;t=2.6,P＜0.05]均明显升高（P＜0.05）.（3）GDM患者产前血清Lp-PLA2活性明显高于健康孕妇[（33±1 1）比（24±8） nmol·min^-1·ml^-1;t=9.4,P＜0.05].（4）Lp-PLA2活性与GDM产后糖代谢异常显著正相关（OR=1.35,95％CI 1.07～1.66,P=0.001）;受试者工作特征（ROC）曲线分析,以Lp-PLA2活性27.96 nmol· min^-1·ml^-1为产后糖代谢异常诊断切值,其灵敏度为71.3％,特异度为82.1％.结论 GDM患者产后糖代谢异常发生风险显著升高,Lp-PLA2是GDM产后糖代谢异常发生的独立风险因子,对预测GDM产后发生糖代谢异常有一定价值.     

冠心病患者糖代谢异常调查分析

糖尿病患者冠心病的患病率是其他患者的2～3倍,心血管死亡率是其他患者的3倍,在校正了其他危险因素之后,糖尿病仍是冠心病预后不良的独立的危险因素。我们对心内科住院的冠心病患者糖代谢异常的诊治状况进行分析,以促进心内科医生对冠心病合并糖代谢异常患者的重视。     

糖代谢异常和糖尿病患者颈动脉粥样硬化的观察

糖尿病、糖代谢异常是冠心病的主要危险因素,而颈动脉粥样硬化与冠状动脉粥样硬化有很好的相关性,为了探讨糖尿病、糖代谢异常与颈动脉粥样硬化的关系,我们通过多普勒超声检查了糖尿病、糖代谢异常患者颈动脉粥样硬化的情况.     

原发性肝癌患者不同糖代谢异常状态的临床分析

目的探讨原发性肝癌（HCC）患者在不同糖代谢异常状态下的临床特点。方法回顾性分析2003年1月至2007年12月在汕头大学第一、二附属医院住院的698例HCC患者不同糖代谢状态的临床资料。根据糖代谢状态将患者分为4组：糖代谢正常组（472例）、低血糖组（20例）、糖尿病前期组（76例）和糖尿病组（130例）。用方差分析比较各组年龄差异，Kruskal-WallisH检验分析各组血脂代谢等实验室检查的差异。结果纳入本研究698例HCC患者中男性563例，女性135例，平均年龄（55±13）岁。糖尿病前期及糖尿病组患者年龄均高于糖代谢正常组，差异均有统计学意义[分别为（58±13）、（60±13）和（53±15）岁，均P〈0．05]；低血糖症组年龄[（51±14）岁]小于糖尿病组，差异有统计学意义（P〈0．05）。HCC患者糖尿病状态下总胆固醇（TC）水平较糖代谢正常组低，差异有统计学意义[（4．7±1．7）比（4．0±1．7）mmol／L，t=2．266，P〈0．05]。结论HCC合并糖尿病较糖代谢正常组和低血糖症组的年龄大，且HCC合并糖尿病组患者Tc水平较糖代谢正常组低。     

冠心病合并糖代谢异常患者血清游离脂肪酸构成变化

游离脂肪酸（FFA）水平升高可造成糖代谢异常，加重胰岛素抵抗，促进2型糖尿病的发展，使冠心病的风险明显增加。FFA内含有多种成分，冠心病以及合并血糖异常时FFA各成分变化目前尚不清楚。本研究对血清游离脂肪酸组分的变化进行检测，观察冠心病合并2型糖尿病、空腹血糖受损患者血清FFA成分的构成特点。     

妊娠期糖代谢异常的妊娠结局分析与产后随访研究

了解99例妊娠期糖代谢异常患者的妊娠结局以及糖筛查试验（GCT）和BMI与OGTT异常的联系，探讨产后糖代谢异常组与正常组的差异。提示孕期GCT数值、BMI越高，OGTT异常项数越多、孕期用胰岛素患者OGTT异常项次主要分布在第二、三项，产后糖代谢异常组TG明显高于正常组。所以对妊娠期糖代谢异常患者不仅要加强妊娠期母儿监测，还应重视产后随访研究。     

86例肝脏病合并糖代谢异常临床分析

肝脏对调节机体糖代谢起着重要的作用,肝脏功能异常可引起糖类代谢障碍,既可出现高血糖,又可出现低血糖,且以高血糖为多见。我院1989年2月～1998年12月收治肝病合并糖代谢异常的病人86例,现总结分析如下。临床资料1一般资料:86例患者诊断为糖尿病前均有慢性肝病史,男71例,女15例,男女之比近5∶1;年龄25～79岁,<35岁17例,～59岁23例,≥60岁46例,占535%。慢性肝病病程至血糖增高时间为1年以内13例,～5年28例,～10年31例,10年以上14例。糖尿病按WHO1985年诊断标准,既往无糖尿病史及糖尿病家族史,诊断糖尿病前有慢性肝炎病史。病毒性肝炎按199…     

务必重视高血压患者糖代谢异常的诊治

高血压患者常伴有糖尿病,而糖尿病患者常伴有高血压,高血压患者中10%～20%有2型糖尿病(T2DM).大约55%～60%的T2DM患者有高血压,而在30%～50%原发性高血压者有胰岛素抵抗(IR)[1].T2DM伴高血压的特点有:(1)高血压的发病率年龄提前,女性更显著,可比无糖尿病者早10年,甚至在发生糖尿病前就出现高血压;(2)糖尿病人群高血压的发生率比年龄匹配的非糖尿病者高出2～4倍;(3)两者并存,心血管损害和事件更多和更明显;(4)两者并存的治疗更困难.     

缺血性脑血管病患者糖代谢异常研究

最近一系列大规模的流行病学研究显示糖耐量异常会使心血管疾病的危险性显著上升。但脑血管疾病与高血糖之间的关系却少有研究，为了解脑血管病患者的糖代谢异常流行情况，本研究于2005年3月开展了对缺血性脑血管病患者的调查，现报告该研究的基本概况。     

硫化氢对老年空腹血糖调节受损和2型糖尿病的影响

目的 通过检测老年空腹血糖调节受损（IFG）和2型糖尿病患者的血清硫化氢（H2S）水平,探讨气体分子H2S在老年空腹血糖调节受损和2型糖尿病中的临床意义.方法 2型糖尿病患者66例,空腹血糖调节受损患者36例,正常对照组33例,检测入选者的血清H2S浓度.结果 与对照组相比,空腹血糖调节受损患者和2型糖尿病患者HOMA-IR指数明显升高[（3.24±0.93）、（2.34±1.12）比（1.70±1.10）,P＜0.05]、HOMA-β指数降低[（76.41±26.20）、（36.13±23.37）比（93.00±40.46）,P＜0.05],血清H2S水平明显升高[（60.93±12.95）、（63.64±10.96）比（50.07±10.85） μmol/L,P＜0.05].Pearson相关分析结果显示,H2S浓度与空腹血糖调节受损组和糖尿病组患者HOMA-β均呈显著负相关（γ值分别为-0.65、-0.69,P＜0.05）,与HOMA-IR均呈显著正相关（γ值分别为0.73、0.76,P＜0.05）.结论 内源性H2S可能通过抑制β细胞功能和增强胰岛素抵抗参与空腹血糖调节受损和2型糖尿病的发病过程.     

Associations between obesity indices and both type 2 diabetes and impaired fasting glucose among West African adults: Results from WHO STEPS surveys

Background and aimVarious obesity indices such as BMI, waist circumference (WC), waist-hip ratio, (WHR) and waist-to-height ratio (WHtR) are associated with the risk of type 2 Diabetes Mellitus (T2DM). Given few studies examining the strength of the association in this population, we aimed to identify which obesity indices are most strongly associated with T2DM and impaired fasting glucose (IFG) among adults from five West African countries.Methods and resultsData from 15,520 participants from the World Health Organisation (WHO) STEPs surveys in Burkina Faso, Benin, Mali, Liberia, and Ghana were included in analyses. Multinomial logistic regression was used to calculate the relative risk (RR) per standard deviation (SD) of each anthropometric measure, modelled as both continuous variables and as categorical variables based on established cut-points. In the analyses with continuous variables, the unadjusted RRs for T2DM per SD were 1.30 (1.23, 1.37) for body mass index (BMI); 1.56 (1.46, 1.67) for WC; 2.57 (2.15, 3.09) for WHtR and 1.16 (1.03, 1.31) for WHR. WHtR showed the strongest association with T2DM in all adjusted analyses. For models using categorical variables based on established cut-points, obesity defined using waist circumference (OB-WC) and OB-BMI showed the strongest associations with T2DM, and OB-WHR, the weakest association in all adjusted analyses.ConclusionWHtR and WC appear to be the indices most strongly associated with T2DM and IFG respectively. Given its simplicity, WC may be the metric that most usefully conveys risk for T2DM in West African adults.     

Incidence of impaired glucose regulation and progression to type 2 diabetes mellitus in the Tayside region of Scotland

This study assessed incidence of impaired glucose regulation (IGR) and progression to type 2 diabetes (T2D) in adults in one region of Scotland using routinely collected health-care data. Incidence of IGR was 2720 per 100,000 person years. Nine percent of IGR patients progressed to T2D in a mean time of 34 months.     

2型糖尿病预防的药物与非药物干预循证医学研究进展

糖耐量减低(IGT)、空腹血糖受损(IFG)是正常糖代谢发展到糖尿病的一个过渡阶段,与糖尿病的发牛密切相关.研究表明,对此类人群给予药物、非药物干预可以明显减少2型糖尿病的发生,具有重要的临床意义.本文就2型糖尿病的药物与非药物干预的相关研究作一综述.     

二甲双胍和食物纤维在糖耐量低减人群向2型糖尿病发展中的干预作用

目的　观察二甲双胍和食物纤维预防糖耐量低减 (IGT)人群进展为 2型糖尿病 (DM)的作用。　方法　以口服 75 g葡萄糖耐量试验 (OGTT)确诊 (WHO标准 )的 IGT2 93例中男 2 16例 ,女 77例。入选者年龄 35岁以上 ,体重指数 (BMI)在 19kg/ m2以上。随机分为对照组 72例 ,教育组 5 7例 ,食物纤维组 84例 ,二甲双胍组 80例。对照组进行一般的健康教育 ;教育组进行饮食指导 ,每半年1次 ;食物纤维组除健康教育外 ,每日口服食物纤维 12 g;二甲双胍组每日口服二甲双胍 0 .75 g,分 3次餐后口服。对四组参试者每半年作 1次 OGTT,同时测身高、体重、BMI、12 h尿白蛋白 ,复查日当天不服干预药物或食物纤维。共观察 3年。若 2次 OGTT或最后 1次复查结果为 DM,则判断为已发展为 DM。　结果　 2 93例 IGT在观察中有 2 3例 (7.8% )退出。空腹血糖 (FBS)和服糖后 1h血糖 (1hPBS)在对照组、教育组和食物纤维组均较治疗前略有升高 ,但在二甲双胍治疗组均有下降。四组间FBS比较 F=8.118,P<0 .0 1,四组间 1h PBS比较 F=3.6 97,P=0 .0 12。观察期末对照组 16例 (2 5 .0 % )、教育组 11例 (2 1.6 % )、食物纤维组 13例 (16 .3% )、二甲双胍组 7例 (9.3% )转化为 DM,二甲双胍组在治疗后 DM转化率明显低于对照组 (χ2 =6 .318,P<0 .0     

Undiagnosed diabetes and impaired glucose regulation in adult Ghanaians using the ADA and WHO diagnostic criteria

Fasting glucose and oral glucose tolerance test (OGTT) criteria for glucose homeostasis were compared in a cross-sectional cluster, community study in Accra, Ghana. A total of 4636 subjects without prior diagnosis of diabetes had fasting plasma glucose, 2-hour OGTT and measurement of cardiovascular risk factors. Mean age of subjects was 44.2 years; 39.1% of subjects were males. The overall prevalence of undiagnosed diabetes ascertained with both criteria was 4.5% (n=209). The prevalence of undiagnosed diabetes by fasting (3,2%) and OGTT (3.1%) criteria were similar (p>0.05). The prevalence of impaired glucose tolerance (IGT) (15.8%) was higher than that of impaired fasting glucose (IFG) (10.7%). Only 56.5% (n=83) of subjects with diabetes by fasting criteria also had diabetes by OGTT criteria. Sixty-two subjects (42.8%) with diabetes by OGTT had normal or impaired fasting glucose. There was poor agreement between the two diagnostic criteria (kappa=0.31). The concordant normoglycaemic group was the youngest and had the lowest body-mass indey (BMI), waist girth, waist-hip ratio (WHR), total cholesterol, and systolic and diastolic blood pressures. The concordant diabetic group, in contrast, had the highest BMI, waist girth, WHR, total cholesterol and triglyceride levels. Both systems gave similar undiagnosed diabetes rates bur dissimilar IFG and IGT rates. There was poor agreement between the two diagnostic criteria. Diagnostic criteria influenced cardiovascular risk factors. A case may be made for using both criteria in order to ascertain all “diabetes” and all “at-risk” subjects. Received: 4 January 2001 / Accepted in revised form: 18 January 2002     

Daily life activity and risk of developing impaired fasting glucose or Type 2 diabetes in middle-aged Japanese men

Aims/hypothesis The aim of this study was to investigate the association between daily life activity and risk of developing diabetes.Methods The study population included 2924 Japanese male office workers aged 35 to 59 years who did not have IFG (fasting plasma glucose level 6.1–6.9 mmol/l), Type 2 diabetes (fasting plasma glucose level 7.0 mmol/l and/or medication for diabetes) or a history of cardiovascular disease, and were not receiving medication for hypertension. A 1-day activity record during an ordinary weekday was used to estimate daily energy expenditure. Fasting glucose levels were measured at annual health examinations performed in May from 1994 to 2001.Results Over a 7-year follow-up period the relative risk of IFG and Type 2 diabetes decreased with increasing daily energy expenditure after controlling for potential predictors of diabetes (p<0.001 and p=0.001 for trend respectively). The age-adjusted relative risk of IFG or Type 2 diabetes decreased with increasing energy expenditure on occupational physical activity, brisk walking, riding on vehicles (standing position) to and from work and other physical activities (all p<0.001 for trend). The association with riding on vehicles (standing position) and other physical activities remained after controlling for other potential confounders of diabetes (p=0.026 and p=0.003 for trend respectively). Results of stratified analyses by the presence or absence of different risk factors for diabetes revealed that the risk of IFG or Type 2 diabetes was inversely related to daily energy expenditure both in men at low risk of diabetes and those at high risk.Conclusions/interpretation Physical activity in daily life is inversely associated with the risk of developing IFG or Type 2 diabetes.     

Total serum bilirubin and 8-year incident type 2 diabetes mellitus: The Korean Genome and Epidemiology Study

Aim

In this study, the impact of serum bilirubin on new-onset type 2 diabetes mellitus (T2DM) in Korean adults was investigated.

空腹血糖受损与2型糖尿病男性患者血清铁蛋白水平的变化及其临床意义

目的 探讨IFG及T2DM男性患者血清铁蛋白（SF）水平的变化及其临床意义. 方法 选取2011年至2012年于我院查体的男性公务员1146名,依据血糖水平将研究对象分为正常血糖（NC）组、IFG组和T2DM组,测定SF及其他生化指标. 结果 多元线性回归分析显示,男性SF水平与FPG、DBP、BMI及TC呈正相关（R^2 =0.059,P＜0.05）;多分类变量Logistic回归分析显示,男性IFG的危险因素是年龄及BMI[OR（95％CI）分别为1.055（1.027～1.083）及1.102（1.041～1.166）].T2DM的危险因素是年龄、BMI及SF[OR（95％CI）分别为1.106（1.058～1.156）、1.126（1.03～1.231）及1.002（1.001～1.003）]. 结论 男性SF与FPG、DBP、BMI及TC呈正相关;男性T2DM的危险因素是年龄、BMI及SF.