小剂量果糖对老年腹部手术后患者血糖和胰岛功能的影响

目的评价小剂量果糖对老年腹部手术后患者血糖和胰岛功能的影响。方法将满足方案标准并获得知情同意的大于60岁的老年腹部手术后患者60例随机分成两组,研究组和对照组各30例。术后第1天开始禁食并静脉注射5%果糖注射液或5%葡萄糖注射液500ml,连续3天。观察用药前和用药中血糖、胰岛素和胰岛素C肽的变化,比较两组间的差别。同时观察用药后血尿酸和乳酸的变化。结果按计划完成研究58例,淘汰2例;对照组和研究组在输液前后3天血糖的平均变化值分别为(2.33±2.32)和(0.28±1.59)mmol/L,两组有显著性差异(P<0.01)。在输注果糖中,研究组血胰岛素和胰岛素C肽的变化值分别为(4.2±11.5)μU/ml和(203±279)pmol/L;对照组在输注葡萄糖中血胰岛素和胰岛素C肽的变化值分别是(13.6±15.2)μU/ml和(559±302)pmol/L,对照组升高的幅度明显大于研究组,两组差异有显著意义(P<0.05);两组血乳酸和尿酸结果相似。结论与葡萄糖比较小剂量输注果糖对老年手术后患者血糖和胰岛功能的影响较小。     

混合糖对老年腹部手术后患者糖代谢、胰岛功能和临床结局的影响

目的评价混合糖对腹部手术后老年患者血糖、胰岛功能以及安全性的影响。方法采用前瞻、随机、双盲、对照的研究方法。满足方案入选标准并获得知情同意的腹部手术后老年患者共40例进入本研究。研究组于术后第1天或第2天开始连续静脉输注混合糖电解质注射液1000ml，对照组静脉输注10％葡萄糖电解质注射液1000ml，连续3d。观察血糖和胰岛素、胰岛素C肽的变化，同时观察临床结局指标和血尿酸、乳酸等的变化以及不良事件。结果按计划完成本研究40例，无淘汰病例；腹部手术后老年患者输注混合糖后第2和3天血糖升高幅度明显少于对照组（P=0．008，P=0．001）；血胰岛素和胰岛素C肽水平两组较术前均有升高趋势，但组间比较差异无统计学意义；研究组的变化值分别为（11．4±7．8）μU／ml和（639±506）pmol／L，对照组的变化值分别为（13．9±13．0）μU／ml和（1062±905）pmol／L，两组比较差异无统计学意义（P=0．612，P=0．213）。研究组术后发生全身性炎症反应综合征（6例）和感染并发症（4例）的病例数与对照组（8和6例）比较差异无统计学意义（P=0．639，P=0．606）；用药后两组患者均未发现血乳酸和尿酸升高，未出现不良事件。结论适量应用混合糖对腹部手术后患者血糖和胰岛功能的影响较小，可能改善临床结局。     

果糖对糖尿病病人血糖影响的临床研究

目的:探讨糖尿病病人静脉给予5%果糖注射液后血糖的变化.方法:对60例糖尿病病人在用药前和用药后1.5、3 h各采集静脉血,观察用药前、后血糖的变化.结果:用药前血糖与用药后1.5和3 h比较差异无显著性意义(P＞0.05).结论:静脉给予5%果糖注射液不会升高糖尿病病人的血糖.     

长期危险性饮酒对高脂血症患者血糖、血脂及胰岛功能的影响探析

目的探讨长期危险性饮酒对高脂血症患者病情的影响,观察其血脂、血糖与胰岛功能变化情况。方法选取2014年9月—2016年12月本院收治的高脂血症患者300例作为研究对象,按照患者是否存在长期危险性饮酒分为饮酒组(139例)与非饮酒组(161例),比较两组血糖、血脂与胰岛功能指标。计量资料采用t检验,P0.05为差异有统计学意义。结果饮酒组糖化血红蛋白(glycosylated hemoglobin a1c,Hb A1c)、餐后2h血糖(2h plasma glucose,2h PG)、空腹血糖(fasting plasma glucose,FPG)水平分别为(10.07±1.16)%、(19.91±2.74)、(13.58±1.97)mmol/L,均高于非饮酒组的(8.36±1.02)%、(17.52±3.69)、(11.74±2.31)mmol/L,差异均有统计学意义(均P0.05)。饮酒组总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平分别为(8.06±1.67)、(5.02±0.27)、(5.73±0.18)mmol/L,均高于非饮酒组的(6.42±1.15)、(3.79±0.61)、(3.57±1.89)mmol/L,高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平为(0.98±0.15)mmol/L,低于非饮酒组的(1.26±0.24)mmol/L,差异均有统计学意义(均P0.05)。饮酒组胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能(homeostatic model assessment ofβ-cell function,HOMA-β)与空腹胰岛素(fasting insulin,fins,FINS)水平分别为(4.68±1.07)、(8.35±2.02)、(7.14±3.46)U/ml,均低于非饮酒组的(3.04±2.36)、(10.64±1.19)、(10.43±3.21)U/ml,差异均有统计学意义(均P0.05)。结论长期危险性饮酒会导致高脂血症病情恶化,出现血糖、血脂水平异常,降低胰岛功能,临床需引起重视。     

低聚果糖对小鼠血糖和血脂作用的影响

目的观察低聚果糖(FOS)对小鼠血糖(G IU)、血甘油三酯(Tg)和血胆固醇(Ch)的影响。方法FOS 0.1g/kg和1g/kg.bw.天,分组ig(灌服)小鼠连续14天后,分别测定血糖、甘油三酯、胆固醇。结果和正常对照组相比,iglg/kg的小鼠Tg、Ch含量下降,G IU含量上升(P<0.01);ig0.1g/kg的小鼠Tg、Ch含量上升(P<0.05),G IU含量上升。结论FOS1g/kg.bw.天×14天的用量,实验小鼠的血脂水平下降,血糖升高。     

短期胰岛素强化治疗对改善2型糖尿病患者的胰岛β细胞功能和血糖控制的影响

目的探讨短期胰岛素强化治疗对改善2型糖尿病患者的胰岛β细胞功能和血糖控制的影响,进而对短期胰岛素强化治疗2型糖尿病的疗效进行评价。方法将我院2010年1月至2011年12月确诊为2型糖尿病的患者98例随机分为2组,治疗组49例给予短期胰岛素强化治疗,对照组49例给予口服降糖药进行治疗。经相同的治疗周期后,分别对2组患者的胰岛β细胞功能指标和血糖水平进行检测。结果治疗组的胰岛β细胞功能较对照组患者得到明显改善。2组患者治疗前后早餐后2h血糖水平均未见明显差异。结论短期胰岛素强化治疗对控制糖尿病自然发展,预防糖尿病并发症具有积极的意义。     

瑞格列奈对2型糖尿病患者血糖及胰岛β细胞分泌功能的影响

目的观察瑞格列奈与格列齐特对2型糖尿病(Type 2 diabetes mellitus,T2DM)患者血糖及胰岛β细胞分泌功能的影响。方法选取2015年7月—2017年4月收治的102例T2DM患者作为研究对象,运用随机数表法将入选者分为两组,各51例。对照组给予格列齐特治疗,观察组给予瑞格列奈治疗。观察两组治疗前后血糖与胰岛β细胞分泌功能的变化,评价两组用药安全性。计量资料比较采用t检验,P0.05为差异有统计学意义。结果治疗前两组空腹血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour Postprandial Blood Glucose,2h PBG)、胰岛素早相分泌指数(IRG)、胰岛素曲线下面积(AUCi)/葡萄糖曲线下面积(AUCg)水平比较,差异无统计学意义(均P0.05);治疗后观察组2h PG低于对照组,IRG、AUCi/AUCg高于对照组,差异有统计学意义(均P0.05);两组均未出现严重不良反应。结论瑞格列奈治疗T2DM安全高效,有效降低餐后血糖水平,提升胰岛β细胞分泌功能。     

南瓜多糖对糖尿病家兔血糖及胰岛组织形态影响的研究

<正>南瓜为葫芦科植物南瓜(Cucurbit moschata Duch.)的果实,其营养价值较高。目前,有关南瓜防治糖尿病的活性成分的报道很多[1,2],其中南瓜多糖(pumpkin polysaccharide,PP)作为抗糖尿病的功能因子近年来研究十分活跃[3-6],但其机制尚不十分清楚。因此,本文着重探讨南瓜     

复合膳食纤维对健康受试者血糖及血脂的影响

目的观察复合膳食纤维对健康受试者血脂及碳水化合物代谢的影响。方法将12名健康志愿者随机分为无纤维试餐组及高纤维试餐组,每组6人。采用双周期Cross-Over设计,按照代谢动力学方法采集受试者摄入试餐后不同时间点的血样,进行血糖和血甘油三酯的测定。受试者完成第1周期试验后,中间经过1周的洗脱期,两组受试者交叉,重复上述试验。结果高纤维试餐组的血糖峰值、达峰时间及餐后0～1小时曲线下面积均明显低于无纤维试餐组(P<0.05);两组间血糖的总曲线下面积差异无显著性。高纤维试餐组餐后血甘油三酯峰高和餐后2～4.5小时内血脂曲线下面积明显低于无纤维试餐组(P<0.05),两组的达峰时间差异无显著性(P>0.05)。结论本试验所用复合膳食纤维能够延迟膳食中碳水化合物的吸收并减少膳食中脂肪的吸收。     

南瓜多糖对糖尿病家免血糖及胰岛组织形态影响的研究

南瓜为葫芦科植物南瓜（Cucurbit moschata Duch．）的果实，其营养价值较高。目前，有关南瓜防治糖尿病的活性成分的报道很多，其中南瓜多糖（pumpkin polysaccharide，PP）作为抗糖尿病的功能因子近年来研究十分活跃，但其机制尚不十分清楚。因此，本文着重探讨南瓜多糖对高血糖模型家兔血糖、血脂的影响，并研究其对胰岛组织形态的影响，为探索南瓜多糖的可能降糖机制提供思路，为相关产品开发和应用提供科学依据。     

The Beneficial Effects of Astaxanthin on Glucose Metabolism and Modified Low-Density Lipoprotein in Healthy Volunteers and Subjects with Prediabetes

Astaxanthin (ASTX) is an antioxidant agent. Recently, its use has been focused on the prevention of diabetes and atherosclerosis. We examined the effects of astaxanthin supplementation for 12 weeks on glucose metabolism, glycemic control, insulin sensitivity, lipid profiles and anthropometric indices in healthy volunteers including subjects with prediabetes with a randomized, placebo-controlled trial. Methods: We enrolled 53 subjects who met our inclusion criteria and administered them with 12 mg astaxanthin or a placebo once daily for 12 weeks. Subsequently, their HbA1c levels, lipid profiles and biochemical parameters were determined. The participants also underwent a 75 g oral glucose tolerance test (OGTT), vascular endothelial function test and measurement of the visceral fat area. Results: After astaxanthin supplementation for 12 weeks, glucose levels after 120 min in a 75 g OGTT significantly decreased compared to those before supplementation. Furthermore, the levels of HbA1c (5.64 ± 0.33 vs. 5.57 ± 0.39%, p < 0.05), apo E (4.43 ± 1.29 vs. 4.13 ± 1.24 mg/dL, p < 0.05) and malondialdehyde-modified low-density lipoprotein (87.3 ± 28.6 vs. 76.3 ± 24.6 U/L, p < 0.05) were also reduced, whereas total cholesterol (TC), triglyceride (TG) and high-density lipoprotein-C (HDL-C) levels were unaltered. The Matuda index, which is one of the parameters of insulin resistance, was improved in the ASTX group compared to that before supplementation. Conclusions: our results suggest that ASTX may have preventive effects against diabetes and atherosclerosis and may be a novel complementary treatment option for the prevention of diabetes in healthy volunteers, including subjects with prediabetes, without adverse effects.     

Fasting-Mimicking Diet Reduces Trimethylamine N-Oxide Levels and Improves Serum Biochemical Parameters in Healthy Volunteers

Elevated plasma levels of trimethylamine N-oxide (TMAO) have been proposed as a diet-derived biomarker of cardiometabolic disease risk. Caloric restriction is the most common dietary intervention used to improve cardiometabolic health; however, novel trends suggest a fasting-mimicking diet (FMD) as a more feasible alternative. FMD is a variation of intermittent fasting, based on caloric restriction and limitation of protein sources of animal origin, applied in daily cycles during a 5-day period. As TMAO is intensively produced by gut microbiota after the consumption of animal-derived products, we aim to investigate whether a 5-day FMD affects plasma TMAO levels and markers of metabolic health. To investigate whether an increase in vegetable intake possesses similar effects on TMAO levels and metabolic parameters, healthy volunteers (n = 24) were subjected to a 5-day FMD and 19 volunteers served as a reference group (VEG). This group of volunteers consumed an additional four servings of vegetables per day, but otherwise stayed on their usual diet. FMD resulted in a twofold decrease in plasma TMAO levels, which was not evident in the volunteers from the VEG group. Moreover, FMD led to a weight loss of 2.8 ± 0.2 kg and a subsequent reduction in BMI compared to baseline. The FMD group exhibited a significant elevation in plasma ketone bodies (14-fold compared to baseline) and a decrease in IGF-1 levels by 37 ± 8 ng/mL. Since fasting glucose and C-peptide levels decreased, all volunteers in the FMD group showed improved insulin sensitivity and a decreased HOMA-IR index. In contrast, in the VEG group, only a slight reduction in plasma levels of fasting glucose and triglycerides was noted. In conclusion, we show that FMD is a viable strategy to reduce plasma levels of TMAO by limiting caloric intake and animal-derived protein consumption. The reduction in the level of TMAO could be an additional benefit of FMD, leading to a reduced risk of cardiometabolic diseases.     

Glucose and Fructose Supplementation and Their Acute Effects on Anaerobic Endurance and Resistance Exercise Performance in Healthy Individuals: A Double-Blind Randomized Placebo-Controlled Crossover Trial

Background: The effects of glucose, fructose and a combination of these on physical performance have been subject of investigation, resulting in diverse findings. Objective: The aim of this study was to investigate how an individualized amount of glucose, fructose, and a combination of these compared to placebo (sucralose) alter endurance performance on a cycle ergometer, lower and upper body resistance exercise performance at individualized thresholds in healthy young individuals. Methods: A total of 16 healthy adults (9 females) with an age of 23.8 ± 1.6 years and a BMI of 22.6 ± 1.8 kg/m² (body mass (BM) 70.9 ± 10.8 kg, height 1.76 ± 0.08 m) participated in this study. During the screening visit, the lactate turn point 2 (LTP2) was defined and the weights for chest-press and leg-press were determined. Furthermore, 30 min prior to each exercise session, participants received either 1 g/kg BM of glucose (Glu), 1 g/kg BM of fructose (Fru), 0.5 g/kg BM of glucose/fructose (GluFru) (each), or 0.2 g sucralose (placebo), respectively, which were dissolved in 300 mL of water. All exercises were performed until volitional exhaustion. Time until exhaustion (TTE) and cardio-pulmonary variables were determined for all cycling visits; during resistance exercise, repetitions until muscular failure were counted and time was measured. During all visits, capillary blood glucose and blood lactate concentrations as well as venous insulin levels were measured. Results: TTE in cycling was 449 ± 163 s (s) (Glu), 443 ± 156 s (Fru), 429 ± 160 s (GluFru) and 466 ± 162 s (Pla) (p = 0.48). TTE during chest-press sessions was 180 ± 95 s (Glu), 180 ± 92 s (Fru), 172 ± 78 s (GluFru) and 162 ± 66 s (Pla) (p = 0.25), respectively. Conclusions: Pre-exercise supplementation of Glu, Fru and a combination of these did not have an ergogenic effect on high-intensity anaerobic endurance performance and on upper and lower body moderate resistance exercise in comparison to placebo.     

酚妥拉明对离体正常大鼠胰岛功能的影响

目的：探讨酚妥拉明对离体正常大鼠胰岛功能的影响。方法：胶原酶和DNA酶联合消化法分离SD大鼠胰岛，RP-MI1640组织培养液过夜培养，采用Millipore Multiscreen系统观察不同浓度葡萄糖及酚妥拉明对胰岛功能的影响。放免法测定孵育液中胰岛素及胰高糖素的浓度。结果：（1）离体胰岛素的分泌依赖于孵育液中的葡萄糖浓度，酚妥拉明明显刺激其释放。Ca^2 通道阻滞剂硝苯吡啶（25μmol/L及K^ 通道开放剂二氮嗪（100μmol/L）可显著抑制胰岛素的释放，但其作用可被酚妥拉明消除。（2）离体胰岛胰高糖素的分泌明显受葡萄糖浓度的抑制，酚妥拉明显著抑制其分泌，其抑制作用呈明显的浓度依赖型，硝苯吡啶和二氮嗪也显著抑制胰高糖素的释放。结论：酚妥拉明可刺激离体胰岛胰岛素的释放，抑制胰岛高糖素的分泌，可能具有降糖作用。     

Acute Metabolic Responses to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial

The aim of this study was to investigate the impact of glucose (Glu), fructose (Fru), glucose and fructose (GluFru) and sucralose on blood glucose response in healthy individuals. Fifteen healthy individuals (five females, age of 25.4 ± 2.5 years, BMI of 23.7 ± 1.7 kg/m² with a body mass (BM) of 76.3 ± 12.3 kg) participated in this double-blind randomized crossover placebo-controlled trial. Participants received a mixture of 300 mL of water with 1 g/kg BM of Glu, 1 g/kg BM of Fru, 0.5 g/kg BM of GluFru (each), and 0.2 g sucralose as a placebo. Peak BG values Glu were reached after 40 ± 13 min (peak BG: 141 ± 20 mg/dL), for Fru after 36 ± 22 min (peak BG: 98 ± 7 mg/dL), for GluFru after 29 ± 8 min (BG 128 ± 18 mg/dL), and sucralose after 34 ± 27 min (peak BG: 83 ± 5 mg/dL). Significant differences regarding the time until peak BG were found only between Glu and GluFru supplementation (p = 0.02). Peak blood glucose levels were significantly lower following the ingestion of Fru compared to the supplementation of Glu and GluFru (p < 0.0001) while Glu and GluFru supplementation showed no difference in peak values (p = 0.23). All conditions led to a significantly higher peak BG value compared to sucralose (p < 0.0001). Blood lactate increased in Glu (p = 0.002), Fru and GluFru (both p < 0.0001), whereas sucralose did not increase compared to the baseline (p = 0.051). Insulin levels were significantly higher in all conditions at peak compared to sucralose (p < 0.0001). The findings of this study prove the feasibility of combined carbohydrate supplementations for many applications in diabetic or healthy exercise cohorts.     

罗红霉素片剂人体生物等效性研究

目的与已上市罗红霉素片为对照,考察另一国产制剂的人体生物等效性。方法18例健康受试者随机交叉单剂量口服两种制剂后,采用微生物法测定血浆中的药物浓度。结果经3P97程序拟合处理,二者的体内过程符合一室模型;试验制剂及参比制剂的罗红霉素实测平均血药峰浓度Cmax分别为(10.869±2.671)μg/ml和(11.250±3.097)μg/ml;实测平均达峰时间Tmax分别为(1.7±0.8)h和(1.6±0.8)h;t1/2(ke)分别为(13.407±2.391)和(12.496±2.231)h;血药浓度-时间曲线下面积AUC0-tn平均值分别为(127.097±32.971)μg·ml-1·h和(134.429±35.783)μg·ml-1·h;AUC0-∞平均值分别为(136.556±33.958)μg·ml-1·h和(143.483±38.052)μg·ml-1·h;试验制剂及参比制剂比较,罗红霉素的相对生物利用度F0-tn、F0-∞分别为(95.79±17.46)%、(96.58±16.66)%;对药动学参数AUC、Cmax、Tmax进行单因素方差分析及双单侧t检验,结果表明两制剂在处方与周期间P>0.05。结论试验与参比制剂的药动学参数具有生物等效性。     

可乐定置换物对正常大鼠离体胰岛功能的影响

目的 探讨可乐定置换物(CDS)对离体正常大鼠胰岛功能的影响。方法 胶原酶和DNA酶联合消化法分离SD大鼠胰岛，RPMI1640组织培养液过夜培养，采用Millipore Multisereen系统观察CDS对胰岛功能的影响。放免法测定孵育液中胰岛素及胰高糖素的浓度。结果 离体胰岛胰高糖素的分泌明显受葡萄糖浓度的抑制，CDS显著抑制胰高糖素的分泌，且抑制强度明显依赖于CDS的浓度。离体胰岛胰岛素的分泌依赖于孵育液中的葡萄糖浓度，CDS明显刺激胰岛素的释放。Ca^2 通道阻滞剂硝苯吡啶(25μmol／L)及K^ 通道开放剂二氮嗪(100μmol／L)可显著抑制胰岛素释放，但其作用可被CDS消除。结论 作为咪唑啉受体的内源性配体，CDS可刺激离体胰岛胰岛素的释放，抑制胰高糖素的分泌。