阿托伐他汀调控MMP-9、Cleaved Caspase-3、Bcl-2和Bax蛋白表达对胃癌细胞增殖、周期和凋亡的影响

目的探讨阿托伐他汀对胃癌细胞增殖、周期和凋亡的影响及其机制。方法取对数生长期的胃癌SGC-7901细胞,加入终浓度为0、20、60和100μmol/L的阿托伐他汀,采用MTT法检测细胞增殖,流式细胞仪检测细胞周期和凋亡,Western blotting检测细胞中MMP-9、Cleaved Caspase-3、Bcl-2和Bax蛋白的表达。结果阿托伐他汀能够呈时间-浓度依赖性抑制SGC-7901细胞增殖;阿托伐他汀作用48 h后,G_0/G_1期细胞所占比例、细胞凋亡率、Cleaved Caspase-3蛋白和Bax蛋白的表达浓度依赖性升高,S期细胞比例、G_2/M期细胞比例、MMP-9蛋白和Bcl-2蛋白浓度依赖性降低。结论阿托伐他汀能够抑制胃癌细胞增殖和诱导细胞凋亡,其作用机制可能与诱导细胞G_0/G_1期阻滞、上调Cleaved Caspase-3和Bax蛋白和下调MMP-9和Bcl-2蛋白有关。     

萝卜硫素对人胃癌SGC-7901细胞凋亡的影响及其机制研究

目的 研究萝卜硫素对人胃癌SGC-7901细胞凋亡的影响及其可能的作用机制。方法 应用细胞计数试剂盒(CCK-8)检测萝卜硫素对SGC-7901细胞增殖的影响,流式细胞术分析萝卜硫素对SGC-7901细胞周期和凋亡的影响,蛋白免疫印迹法(Western blotting)分析萝卜硫素对SGC-7901细胞中Notch1、Hes1、Bax及Bcl-2蛋白表达的影响。结果 萝卜硫素能够显著抑制SGC-7901细胞的增殖,促使其凋亡,表现出时间和剂量依赖性,萝卜硫素还能将SGC-7901细胞停留在G_1期;萝卜硫素能显著抑制Notch1、Hes1、Bcl-2蛋白表达,诱导促凋亡蛋白Bax表达,与对照组相比,差异均有统计学意义(P0.05)。结论 萝卜硫素可以明显诱导胃癌SGC-7901细胞凋亡,可能通过抑制Notch1/Hes1信号通路、降低Bcl-2/Bax比例实现。     

氯化两面针碱对人胃癌细胞增殖、迁移的抑制作用

目的探讨氯化两面针碱(NC)对人胃癌SGC-7901细胞增殖、迁移的作用及其机制。方法 MTT实验检测NC对SGC-7901细胞的增殖作用;Transwell小室实验检测NC对SGC-7901细胞迁移和侵袭的影响;Western印迹检测NC对人胃癌SGC-7901细胞中Bax,Bcl-2,PCNA,MMP2,MMP1和GAPDH表达的影响。结果 MTT实验表明NC抑制人胃癌SGC-7901细胞增殖,并且呈时间、剂量依赖性(P<0.05);此外,NC显著抑制SGC-7901细胞中PCNA表达,呈剂量依赖性(P<0.05);Transwell小室实验表明NC显著抑制SGC7901细胞迁移和侵袭,呈剂量、时间依赖性(P<0.05);Western印迹表明NC上调凋亡蛋白Bax的表达,下调抗凋亡蛋白Bcl-2表达,抑制MMP1以及MMP2的表达(均P<0.05)。结论 NC通过诱导细胞凋亡抑制SGC-7901细胞增殖,通过降解MMP1和MMP2从而抑制SGC-7901细胞侵袭和迁移。     

大黄素对人胃癌细胞株SGC-7901凋亡的影响与初步机制

目的:探讨大黄素诱导人胃癌细胞株SGC-7901凋亡及其相关机制.方法:采用CCK-8法和Tunel染色法检测不同浓度大黄素处理后,SGC-7901细胞凋亡的变化;免疫印迹法检测Bcl-2、Bax、cleavedCaspase3、cleaved-PARP、pre Caspase3、PARP的蛋白表达水平;JC-1染色荧光显微观察线粒体膜电位的变化.结果:CCK-8法和Tunel染色法显示大黄素呈浓度依赖性促进SGC-7901细胞的凋亡(存活率100.73%±8.97%vs 45.27%±3.75%,P0.05);免疫印迹法显示给予60μm o l/L大黄素处理后,与空白对照组相比,细胞中B c l-2的蛋白表达显著降低(0.31±0.02 v s1.01±0.06,P0.05),而B a x的表达显著增加(1.98±0.12 vs 1.00±0.08,P0.05),导致Bcl-2/Bax比值显著降低(0.14±0.01 vs 1.02±0.13,P0.05);再者,JC-1染色显示线粒体膜电位降低;活性的cleaved-Caspase3(1.73±0.13 vs 0.98±0.06,P0.05)、cleavedPARP(2.29±0.17 vs 1.01±0.08,P0.05)表达增加.结论:大黄素呈浓度依赖性促进SGC-7901细胞的凋亡,其作用机制可能与线粒体途径凋亡有关.     

抗Fas单克隆抗体诱导人胃癌细胞系SGC-7901细胞凋亡

目的探讨抗Fas单克隆抗体诱导胃癌细胞凋亡的规律及在胃癌治疗中的意义.方法应用细胞形态观察、琼脂糖凝胶电泳、流式细胞光度术检测抗Fas 单克隆抗体对胃癌细胞SGC-7901增殖周期的影响以及对细胞杀伤作用的方式,并检测了SGC -7901细胞表面Bcl-2的表达情况..结果抗Fas单克隆抗体有阻滞细胞周期、通过诱发凋亡而抑制肿瘤细胞生长的作用. 经抗Fas单克隆抗体处理后,SGC-7901细胞表面Bcl-2蛋白表达无明显变化. .结论抗Fas单克隆抗体可以诱导胃癌细胞系SGC-7901细胞凋亡. 抗Fas单克隆抗体诱导胃癌细胞凋亡与Bcl-2表达无关.     

蒿甲醚在体外及荷瘤小鼠体内条件下抑制人胃癌SGC-7901细胞增殖的机制

目的:探讨蒿甲醚(artemether,ART)在体外以及荷瘤小鼠体内对于人胃癌SGC-7901细胞的杀伤作用及增殖抑制作用及具体机制.方法:采用MTT法检测不同浓度ART在体外环境下对于人胃癌细胞株SGC-7901的抑制作用,采用流式细胞术对经过不同浓度的A RT处理后的人胃癌S G C-7901细胞进行细胞周期分析,检测凋亡情况.建立人胃癌裸鼠移植瘤模型,通过计算肿瘤体积和抑瘤率探讨ART在荷瘤裸鼠体内的抗肿瘤作用.利用Western blot方法探讨ART抑制肿瘤细胞生长增殖的具体机制.结果:MTT结果显示,相比于对照组ART对该株肿瘤细胞具有显著的杀伤作用(P0.05),分析应用的A RT变化、作用时间和细胞不良反应变化关系发现,ART对于人胃癌细胞株SGC-7901杀伤作用呈现时间依赖和剂量依赖特性(P0.05);FCM检测结果表明,ART抑制癌细胞增殖的机制主要是在于阻滞细胞周期进程,使其细胞周期停滞于G0/G1期和诱导细胞凋亡;与对照组比较,中、高剂量ART组对人胃癌S G C-7901细胞裸鼠移植瘤的生长抑制效果最明显(P0.05),抑瘤率分别为34.5%和41.0%.Westernblot法检测发现A R T处理后细胞增殖细胞核抗原(proliferating cellnuclearantigen,P C N A)、B淋巴细胞瘤-2基因(B-cell lymphoma-2,Bcl-2)蛋白表达量下降,Bcl-2相关X蛋白(Bcl-2associated X protein,Bax)蛋白表达量上升(P0.05).结论:ART对人胃癌细胞株SGC-7901有较明显的细胞毒效应,且具有时间依赖性和剂量依赖性;其抑制作用与阻滞细胞周期进程和诱导细胞凋亡有关.ART对人胃癌SGC-7901细胞裸鼠移植瘤的生长具有明显的抑制作用,ART阻滞细胞周期进程和诱导细胞凋亡可能与抑制PCNA、Bcl-2蛋白表达,促进Bax蛋白表达相关.     

调控线粒体膜电位青蒿琥酯诱导胃癌SGC-7901细胞凋亡作用

目的研究青蒿琥酯(Art)抑制胃癌细胞(SGC-7901)生长作用机制,探讨Art调控SGC-7901细胞线粒体膜电位诱导SGC-7901细胞凋亡作用与Art抑制胃癌细胞生长作用关系。方法利用流式细胞术(FCM)检测不同浓度的Art干预SGC-7901细胞24 h后的细胞凋亡,细胞线粒体膜电位及细胞中B细胞淋巴瘤(Bcl)-2、B细胞淋巴瘤2相关蛋白(Bax)、半胱氨酸天冬氨酸蛋白酶(Caspase)-3蛋白表达水平。选取Art的浓度为30、60、120μmol/L。对照组使用生理盐水代替Art。结果 FCM检测结果显示,Art组SGC-7901细胞凋亡率显著高于对照组(均P0.05),且Art诱导SGC-7901细胞凋亡作用具有Art剂量依赖性。Art组SGC-7901细胞中Bcl-2蛋白表达水平及细胞线粒体膜电位水平显著低于对照组(P0.05),而SGC-7901细胞中的Bax及Caspase-3蛋白表达量显著高于对照组(均P0.05)。结论 Art具有抑制胃癌SGC-7901细胞生长作用,其作用机制与Art降低SGC-7901细胞线粒体膜电位从而诱导细胞凋亡有关。     

莱菔硫烷诱导人胃癌SGC7901细胞凋亡的机制

目的研究莱菔硫烷(sulforaphane,SFN)在体外诱导人胃癌SGC7901细胞的凋亡作用,并探讨其作用机制。方法体外培养人胃癌SGC7901细胞,MTT比色法观察SFN对其增殖的影响。流式细胞术检测早期凋亡率、线粒体跨膜电位;免疫细胞化学法检测细胞Bax、Bcl-2、Bcl-X/L及Fas蛋白的表达;RT-PCR检测细胞Survivin基因mRNA表达。结果 SFN对SGC7901细胞的增殖具有明显抑制作用,SFN浓度在6.25～50μmmol/L之间时诱导SGC7901细胞凋亡的作用呈剂量依赖性(P0.01)。经SFN作用的SGC7901细胞线粒体跨膜电位降低,Bax及Fas蛋白表达水平上调,Bcl-X/L及Bcl-2/Bax表达水平降低;Survivin基因的mRNA表达降低(P0.01)。结论SFN可能通过下调Bcl-2/Bax及抑制Bcl-X/L蛋白的表达,活化Bax蛋白,诱导SGC7901进入内源性途径凋亡,外源性途径也可能起一定作用。SFN对SGC7901细胞的诱导凋亡作用还可能与抑制Survivin基因表达有关。     

As2O3与Aspirin联合应用对人胃癌SGC-7901细胞凋亡的影响

目的:观察As2O3与Aspirin联合应用对人胃癌SGC-7901细胞凋亡的影响并探讨其可能机制.方法:As2O3和Aspirin处理SGC-7901细胞,实验分为:阴性对照组、2 mmol/L Aspirin组、1 mmol/L Aspirin组、4 pmoI/L As2O3组、2μmol/L As2O3组和2 Bmol/L As2O3组 1 mmol/LAspirin组,流式细胞术检测As2O3和Aspirin单独及联合应用对SGC-7901细胞凋亡的作用,免疫细胞化学法检测Bcl-2和Bax蛋白的表达.结果:2 μmol/L As2O3 1 mmol/L Aspirin联合应用组与4 μmol/L As2O3组、2 mmol/L Aspirin 组SGC-7901细胞在细胞周期G1期前均出现明显的亚二倍体凋亡峰,差异无明显统计学意义,与阴性对照组细胞、2 μmol/L As2O3及1 mmol/L Aspirin单药组相比,差异均有统计学意义(均P＜0.05).As2O3与Aspirin联合应用组使Bcl-2表达下降,Bax表达增高,与阴性对照组、2 μmol/L As2O3及1 mmol/L Aspirin单药组相比,差异均具统计学意义(50.21%±5.94% VS 91.65%±11.51%,88.66%±10.53%,89.27%±9.84%;40.72%±9.54% VS 21.03%±4.32%,23.07%±6.23%,22.67%±3.1 6%,均P＜0.05).结论:As2O3和Aspirin可能通过改变Bcl-2和Bax表达诱导SGC-7901细胞凋亡,两者联合应用具有协同作用.     

过氧化物酶体增殖剂激活受体-γ在白藜芦醇抑制胃癌SGC-7901细胞增殖中的作用

目的:探讨过氧化物酶体增殖剂激活受体-γ(PPAR-γ)在白藜芦醇(Res)抑制人胃癌细胞SGC-7901增殖中的作用.方法:体外常规培养人胃癌细胞SGC-7901,MTT法检测Res和GW9662(PPAR-γ特异阻断剂)对SGC-7901细胞的增殖抑制作用,流式细胞仪测定对细胞周期的影响,RT-PCR方法检测PPAR-γ,Cyclin D1的mRNA表达,Western blot检测PPAR-γ蛋白的表达,免疫细胞化学检测Cyclin D1蛋白表达的改变.结果:Res以时间、浓度依赖性方式抑制胃癌细胞SGC-7901的增殖(P<0.05),使细胞周期停留在G1期;胃癌细胞SGC-7901存在PPAR-γmRNA和蛋白的表达,Res呈浓度依赖性的激活PPAR-γmRNA的转录.25,50,75,100μmol/L Res作用于胃癌细胞后,细胞中PPAR-γmRNA相对表达分别是空白对照组的122.2%,195.1%,232.9%和277.1%(P<0.05),而PPAR-γ蛋白的表达几乎没有变化;胃癌SGC-7901细胞高水平表达Cvclin D1,Res显著的抑制Cyclin D1的表达.经25,50,75,100μmol/L Res处理后,Cyclin D1 mRNA抑制率分别为11.3%,24.3%,35.4%,59.5%,而GW9662能够明显降低Res的上述作用.结论:Res在胃癌SGC-7901细胞中部分的通过激活PPAR-γ从而抑制Cyclin D1的表达,使癌细胞停留在G1期,抑制细胞的增殖.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.