2型糖尿病患者脂肪肝的患病率及相关危险因素分析

目的了解2型糖尿病患者脂肪肝的患病率,观察其与2型糖尿病非脂肪肝患者的性别、病程、糖化血红蛋白、C肽、血脂、血糖、体重指数等因素的关系。方法对436例2型糖尿病患者进行肝脏B超检查及血糖、糖化血红蛋白、C肽、血脂、体重指数的检测。结果2型糖尿病患者脂肪肝患病率为52.29%,该组患者的体重指数、血甘油三酯与非脂肪肝组比较,差异有统计学意义(P<0.01)。结论2型糖尿病患者脂肪肝患病率明显高于正常人群,体重指数、血甘油三酯为其重要危险因素。     

老年男性2型糖尿病患者骨质疏松相关因素分析

目的 探讨与老年男性2型糖尿病（type 2 diabetes mellitus,T2DM）骨质疏松（osteoporosis,OP）发生相关的因素。方法 选取老年男性T2DM患者288例,根据OP诊断标准分为骨量正常组（72例）、骨量减少组（118例）和骨质疏松组（98例）。测量身高、体重,计算体质指数（body mass index,BMI）;测定空腹血糖（fasting blood glucose,FBG）、糖化血红蛋白（glycosylated hemoglobinA1c,HbA1c）、甲状旁腺素（parathyroid hormone,PTH）、血清钙（serum calcium,Ca）、血清磷（serum phosphonium,P）、25羟维生素D （serum 25-hydroxyvitamin D,25-OH-VD）及尿白蛋白/肌酐（urinary albumin/creatinine ratio,ACR）,记录患者病程、降糖药物使用和糖尿病慢性并发症情况。结果 与骨量正常组比较,骨质疏松组和骨量减少组病程较长和HbA1c较高,BMI减低,差异均有统计学意义（均有P<0.05）。相关分析显示股骨颈、三角区、大转子、腰椎（lumbar vertebrae,L）2-4节骨密度（bone mineral density,BMD）与BMI均呈正相关（均有P<0.05）,但与HbA1C均呈负相关（均有P<0.05）。骨质疏松组糖尿病肾病、糖尿病视网膜病变发生率均高于骨量正常组、骨量减少组（均有P<0.05）;骨质疏松组糖尿病神经病变发生率高于骨量正常组（χ2=6.168,P=0.013）。Logistic回归分析显示BMI、HbA1c及糖尿病肾病与糖尿病骨质疏松发生相关（均有P<0.05）。结论 低BMI,血糖控制不佳和糖尿病肾病是老年男性T2DM患者OP发生的危险因素。     

影响2型糖尿病老年患者并发周围神经病变的logistic分析

目的 探讨2型糖尿病老年患者并发周围神经病变的影响因素。方法 选取2016年2月—2018年7月本院治疗的2型糖尿病老年患者120例作为研究对象,统计并发周围神经病变发生情况,根据有无发生周围神经病变分为DPN组57例和非DPN组63例,并对其影响因素进行调查分析。结果 DPN组患者与非DPN组患者的年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平差异有统计学意义(P<0.05),DPN组患者与非DPN组患者的性别、ALT、AST水平差异无统计学意义(P>0.05);Logisitic回归分析结果显示,年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素。结论 年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素,应积极采取有效措施进行控制糖尿病周围神经病变的发生与发展,提高2型糖尿病老年患者的生活质量。     

2型糖尿病患者糖化血红蛋白控制与自我管理相关因素的关系研究

目的了解2型糖尿病患者血糖化血红蛋白(HbA1c)控制水平与自我管理相关因素的关系。方法采用横断面调查的方法,从4个城市15家医院内分泌科门诊连续募集现患病例。由经过统一培训的调查员采用问卷调查的方式收集患者的一般人口学信息、自我管理信息,同时采集患者5μl指尖血送各城市指定医院进行HbA1c检测。运用logistic回归模型探讨自我管理相关因素与患者HbA1c控制水平的关系。结果共收集有效问卷1524份。多因素分析结果显示控制饮食(OR=0.49,95%CI:0.34～0.72),遵从医嘱(OR=0.63,95% CI:0.40～0.98),监测血糖(≤4次/月:OR=0.66,95% CI:0.50～0.87;>4次/月:OR=0.51。95% CI:0.36～0.73),知晓糖尿病相关知识(OR=0.60,95% CI:0.46～0.80)和检测HbA1c(≥3次/年:OR=0.33,95% CI:0.23～0.48;0～3次/年:OR=0.57,95% CI:0.43～0.74)是HbA1c控制的促进因素。结论自我管理有助于2型糖尿病患者的HbA1c控制,建议加强患者的自我管理以促进HbA1c控制。     

2型糖尿病患者并发轻度认知功能障碍危险因素的Meta分析

目的 系统评价2型糖尿病患者并发轻度认知功能障碍的危险因素。方法 检索CNKI、WanFang、VIP、CBM、Medline(PubMed)、EMbase、Web of Science和The Cochrane Library 数据库从建库至2020年12月2日有关2型糖尿病患者并发轻度认知功能障碍危险因素的所有文献后进行Meta分析。结果 共纳入文献18篇,研究对象3083例。各危险因素的合并OR(95%CI)为:年龄1.20(1.09,1.33)、文化程度0.67(0.55,0.82)、吸烟史1.41(0.69,2.89)、糖尿病病程1.17(1.06,1.29)、糖化血红蛋白(HbA1c)1.33(1.09,1.62)、空腹血葡萄糖(fasting blood glucose,FBG)0.88(0.75,1.03)、空腹血清C肽(Fasting c-peptide,FCP)0.41(0.16,1.04)、餐后2h血糖(2h plasma glucose,2hPG)1.90(0.52,6.87)、低密度脂蛋白胆同醇(LDL-C)1.42(1.26,1.59)、超敏C反应蛋白(high sensitive C reactive protein,hs-CRP)1.52(1.06,2.20)、胰岛素抵抗指数(HOMA-IR)1.00(0.48,2.08)、冠心病2.57(1.93,3.43)、高血压2.58(1.62,4.13)、周围神经病变1.10(0.10,12.57)。结论 高龄、文化程度低、糖尿病病程长、高HbA1c、高LDL-C、高hs-CRP、冠心病、高血压是2型糖尿病患者并发轻度认知功能障碍的主要危险因素。     

综合管理对老年2型糖尿病患者血糖控制达标的促进作用

目的了解综合管理对老年2型糖尿病(T2DM)患者血糖、糖化血红蛋白(HbA1c)达标的促进作用及影响因素。方法经过多年采取糖尿病综合防治措施,于2009年度体检时对长期在我院保健的老年T2DM患者进行综合评估。常规体检项目包括测量身高、体重和坐位血压,静脉采血测定空腹血糖、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG),糖尿病患者均测定HbA1c。各项控制标准按美国糖尿病学会T2DM指南。结果 2009年评估的老年T2DM患者共688例,占参检人数的34.9。其中男652例,女36例,年龄60~95(78.2±9.1)岁。HbA1c平均值为(6.6±0.9),达标率以<6.5和<7.0分别计算,各为50.6和76.3。TC、LDL-C、HDL-C、TG、血压和体重指数(BMI)的达标率分别为77.1、46.4、66.1、67.8、36.3、57.4。相关影响因素分析显示糖尿病病程、降血糖需用药情况、血压控制情况、LDL-C、HDL-C、TG、BMI与HbA1c的控制有关(P<0.05)。10年来无1例因糖尿病酮症、高血糖高渗状态急诊入院,因中重度低血糖就...     

A review of nateglinide in the management of patients with type 2 diabetes

Impaired insulin secretion occurs early in the pathogenesis of type 2 diabetes mellitus (T2DM) and is chronic and progressive, resulting initially in impaired glucose tolerance (IGT) and eventually in T2DM. As most patients with T2DM have both insulin resistance and insulin deficiency, therapy for T2DM should aim to control not only fasting, but also postprandial plasma glucose levels. While oral glucose-lowering treatment with metformin and thiazolidinediones corrects fasting plasma glucose, these agents do not address the problem of mealtime glucose spikes that have been shown to trigger atherogenic processes. Nateglinide is a derivative of the amino acid D-phenylalanine, which acts directly on the pancreatic beta-cells to stimulate insulin secretion. Nateglinide monotherapy controls significantly mealtime hyperglycemia and results in improved overall glycemic control in patients with T2DM by reducing glycosylated hemoglobin (HbA1c) levels. The combination of nateglinide with insulin-sensitising agents, such as metformin and thiazolidinediones, targets both insulin deficiency and insulin resistance and results in reductions in HbA1c that could not be achieved by monotherapy with other antidiabetic agents. In prediabetic subjects with IGT, nateglinide restores early insulin secretion and reduces postprandial hyperglycemia. Nateglinide has an excellent safety and tolerability profile and provides a lifetime flexibility that other antidiabetic agents could not accomplish. The aim of this review is to identify nateglinide as an effective "gate-keeper" in T2DM, since it restores early-phase insulin secretion and prevents mealtime glucose spikes throughout the day and to evaluate the results of ongoing research into its potential role in delaying the progression to overt diabetes and reducing its complications and mortality.     

Seroprevalence of Helicobacter pylori in children with type 1 diabetes mellitus in Sardinia

A few studies have reported an increased prevalence of Helicobacterpylori (HP) infection in diabetic subjects, which may be one of the causes of gastrointestinal symptoms and chronic atrophic gastritis frequently seen in diabetes of long duration. We determined the prevalence of HP infection in children and adolescents with Type 1 diabetes mellitus (T1DM) in the area of Sassari (northern Sardinia, Italy), which is characterized by an ethnically homogenous population at high risk of T1DM. HP IgG and IgA titres were measured in 138 patients with T1DM and 138 age-matched healthy controls. The percentage of infected subjects did not differ between T1DM patients (29.7%) and controls (32.6%). Globally, infected subjects were more than 1 yr older (13.0 +/- 2.7 yr) than non-infected ones (11.8 +/- 2.9 yr), independently of the presence of T1DM; in most HP-positive subjects infection was asymptomatic, and only 2 subjects in each group reported clinically relevant symptoms. HP-positive and HP-negative diabetic patients had the same duration of the disease (5.6 +/- 3.5 vs 5.5 +/- 3.6 yr) and received very similar doses of insulin (0.94 +/- 0.27 vs 0.96 +/- 0.4 IU/kg/d), whereas mean HbA1c was significantly lower in HP-positive patients (7.8 +/- 1.6% vs 8.6 +/- 1.7%,p=0.02). We conclude that the prevalence of HP infection is not higher in Sardinian children with T1DM as compared to controls of similar age, and the overall clinical impact of HP infection in terms of gastrointestinal symptoms and diabetic control seems to be low.     

Effects of a 12-Month Hybrid (In-Person + Virtual) Education Program in the Glycemic Status of Arab Youth

This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12–18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p < 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population.     

2型糖尿病患者睡眠质量和焦虑的相关性研究

目的 探讨2型糖尿病（type 2 diabetes mellitus,T2DM）患者睡眠质量和焦虑之间的关系。方法 采用多阶段整群随机抽样方法,应用自行设计调查表和匹兹堡睡眠质量指数量表、焦虑自评量表对T2DM患者进行调查,并检测患者糖化血红蛋白。组间比较采用χ2检验,以是否焦虑为因变量拟合多因素的Logistic回归分析。结果 本次共有效调查578例患者,其中睡眠质量差者所占比例为31.83%,焦虑发生率为44.12%。按照睡眠质量好差分层,睡眠质量好者焦虑的发生率为35.53%（140/394）,睡眠质量差者焦虑的发生率为62.50%,两者差异有统计学意义（χ2=37.00,P<0.001）。以血糖控制是否达标分层,血糖达标组中不同睡眠质量焦虑发生率差异无统计学意义（χ2=1.45,P=0.228）;血糖不达标组中,睡眠质量差者焦虑的发生率高于睡眠质量好者（χ2=37.82,P<0.001）。调整性别、年龄、文化程度、并发症等混杂因素后,睡眠质量与患者焦虑的发生相关联（OR=2.73,95%CI:1.87～3.98）;3个睡眠维度（主观睡眠质量差、睡眠障碍和日间功能障碍）与焦虑存在关联（OR值分别为1.84,1.82,2.49）。结论 T2DM患者睡眠质量与焦虑之间存在关联。     

Drug-induced severe hypoglycaemia in Type 2 diabetic patients aged 80 years or older

Our knowledge about the risk of hypoglycaemia associated with diabetes treatment is derived from studies that often exclude elderly people. Aim of this study was to determine the incidence and risk factors for developing severe hypoglycaemia among persons aged 80 yr or older, with Type 2 diabetes mellitus (T2DM). During a 2-yr period, all episodes of severe hypoglycaemia occurred in T2DM patients aged 80 yr or older were identified. Hypoglycaemia was defined as a symptomatic event requiring treatment with i.v. glucose and confirmed by a blood glucose determination of less than 50 mg/dl. A detailed history and blood laboratory profile were obtained for each patient. During the period of the survey a total of 124 diabetic subjects aged 80 yr or older were hospitalised and severe hypoglycaemia was reported in 31 patients (25%). This group of patients had a marked comorbidity and was found to have HbA1c values of 5.1% indicating that their diabetes was well controlled. Of these hypoglycaemic episodes, 23 (74%) occurred in patients taking glibenclamide. Diabetes therapy was prescribed by general practitioners in 24 of these patients. Seventeen subjects concomitantly received drugs that potentiated hypoglycaemia. Only 10 patients performed regular blood glucose self-monitoring. In conclusion, severe hypoglycaemia is a serious and not uncommon problem among elderly patients with T2DM; it is more frequent in patients undergoing aggressive diabetes management and in users of a long-acting sulphonylurea (eg, glibenclamide). A normal HbA1c level in this age group appears to be a powerful indicator of the risk of severe hypoglycaemia and should alert clinicians to change therapy. Finally, each patient's risk for hypoglycaemia should be considered and therapy should be individualised accordingly; in our opinion, a great number of episodes of serious hypoglycaemia may be prevented by teaching the principles of blood glucose monitoring and involving general practitioners in outpatient management of diabetes mellitus in the elderly.     

上海市延吉社区2型糖尿病患者糖尿病视网膜病变巢式病例对照研究

目的 分析上海市延吉社区2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的发病率及其相关的影响因素,为早期预防及干预治疗提供依据。 方法 选取在2017年7月基线调查中无糖尿病视网膜病变(non-diabetic retinopathy,NDR)的597名研究对象,随访2年后2019年8月再次进行眼底检查,统计2型糖尿病患者DR的发病率。采用1∶2匹配巢式病例对照研究方法,计算各个相关因素OR值及95%可信区间,用Cox回归模型拟合配伍logistic回归模型,探讨DR的影响因素。 结果 上海市延吉社区2型糖尿病患者DR 2年累积发病率为21.94%,其中轻度非增殖期糖尿病视网膜病变(non proliferatine diabetic retinopathy,NPDR)93人(男性44人,女性49人),中度NPDR 38人(男性20人,女性18人)。多因素分析显示饮酒(OR=2.839,95%CI:1.025~7.859)、糖尿病家族史(OR=3.867,95%CI:1.826~8.188)、空腹血糖(OR=3.648,95%CI:1.668~7.978)、糖化血红蛋白(OR=6.066,95%CI:2.815~13.071)、血压(OR=2.076,95%CI:1.097~3.929)、动脉粥样硬化性心血管疾病史(OR=2.415,95%CI:1.208~4.827)是发生DR的影响因素。 结论 上海市延吉社区2型糖尿病患者DR 2年累积发病率为21.94%,饮酒、血压、糖尿病家族史、空腹血糖、糖化血红蛋白、动脉粥样硬化性心血管疾病史是DR发病的影响因素。     

Reduced body cell mass in type 2 diabetes mellitus: reversal with a diabetes-specific nutritional formula

Subjects with type 2 diabetes are in a continuous catabolic state due to increased neoglycogensis during most of the fasting and the postprandial period. We compared the body cell mass index (BCMI) of 257 subjects with type 2 diabetes mellitus (T2DM) and 216 non-diabetic controls and found a statistically significant lower value in the diabetic subjects. This abnormality was reversed after 6 months of treatment with a diabetes-specific nutritional formula. Furthermore, in a population of 715 diabetic subjects without other diseases, we found that the BCMI was inversely correlated with the prevailing HbA1c and the duration of the disease.     

常熟市2型糖尿病患者血糖控制影响因素分析

目的 了解常熟市2型糖尿病(T2DM)患者血糖控制情况,初步探索患者血糖控制的影响因素,为采取有效干预措施提供参考依据。 方法 调查时间为2013年10月-2014年2月,采用多阶段分层整群抽样的方法,对常熟市纳入基本公共卫生服务的2型糖尿病患者10 246人进行糖尿病问卷调查、糖尿病患者身体测量和空腹血糖、糖化血红蛋白(HbA1c)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)的实验室指标检测。以HbA1c是否达标作为因变量,进行非条件logistic回归分析,将单因素非条件logistic回归分析中P<0.1的影响因素纳入多因素分析,用逐步回归法进行多因素非条件logistic回归分析,探讨血糖控制的影响因素。 结果 获得10 238名2型糖尿病患者的完整数据,常熟市2型糖尿病患者糖化血红蛋白(HbA1c)平均值为(7.6±1.6)%,控制未达标者(HbA1c≥7%)占59.2%。单因素非条件logistic回归分析结果显示性别、地区、文化程度、BMI、腰围、血脂、吸烟、饮酒对HbAlc的影响有统计学意义( P<0.01),多因素非条件logistic回归分析结果显示,地区(农村/城市OR=1.359,95%CI:1.252～1.475, P<0.001)、吸烟(OR=1.474,95%CI:1.327～1.638, P<0.001)、血脂异常(OR=1.240,95%CI:1.143～1.346, P<0.001)、腰围(中心性肥胖OR=1.294,95%CI:1.192～1.405, P<0.001)、文化程度(以未接受正规教育为参照,小学OR=0.825,95%CI:0.741～0.920, P<0.001;初中及以上OR=0.895,95%CI:0.808～0.991, P<0.001)是血糖控制的独立影响因素。 结论 常熟市2型糖尿病患者血糖控制情况不佳,血糖控制状况受地区、吸烟、血脂异常、中心性肥胖和文化程度的影响,应积极开展综合措施控制血糖和糖尿病并发症的发生。     

2型糖尿病患者血糖和氧化应激水平相关性研究

目的探讨2型糖尿病（T2DM）患者血糖和氧化应激的改变及临床价值。方法测定92例T2DM患者空腹血糖和餐后2 h血糖（FPG,2 hPG）、糖化血红蛋白（HbA1c）,超氧化物歧化酶（SOD）、丙二醛（MDA）,并将90例健康体检者作为对照组进行比较。结果 T2DM组空腹和餐后2 h SOD水平显著低于正常对照组,相比较差异有统计学意义（P〈0.05）;空腹和餐后2h MDA水平显著高于正常对照组,相比较差异有统计学意义（P〈0.05）;T2DM组中SOD与FPG2、hPG、HbA1c呈显著负相关（r=0.712、0.863、0.631,P=0.000、0.000、0.003）,MDA与FPG2、hPG、HbA1c呈显著正相关（r=0.672、0.583、0.471,P=0.000、0.000、0.004）。结论 2型糖尿病患者血糖与氧化应激水平有显著相关性,FPG2、hPG及HbA1c的改变影响2型糖尿病患者的氧化应激水平。     

Self-reported exercise and quality of life in young type 1 diabetic subjects

Evaluation of quality of life is important in treatment strategies of chronic illnesses, such as diabetes mellitus. The present study aimed at measuring the impact of self-reported exercise on quality of life in T1DM patients. Fifty-three young T1DM patients on intensive insulin-treatment regime who were regularly attending the Diabetes Clinic were selected. At the end of the scheduled clinic visit, they were asked to fill in an Italian version of the Diabetes Quality of Life (DQOL) questionnaire; 30 patients exercised regularly, whereas 23 were sedentary. Patients with clinical and laboratory evidence of major eye, renal and cardiovascular diseases were excluded. A significant difference in the scale of satisfaction (1.9 +/- 0.3 vs 2.2 +/- 0.5; p = 0.009), along with a better HbA1c level (7.0 +/- 1.0 vs 7.8 +/- 1.2; p = 0.014), was observed in physically active patients as compared to sedentary ones, whereas there were no differences between the 2 groups with respect to the impact and worry scale. Moreover, there were no significant correlations between glucose control parameters and the quality of life scores. In conclusion, we showed that self-reported exercise is associated with both a better quality of life and a better metabolic control in young T1DM patients. Further efforts should however be made to recognize all factors that can help motivate patients to exercise.     

血清内脂素水平与2型糖尿病的关系

目的 探讨血清内脂素(visfitin)水平与2型糖尿病(T2DM)之间的相关性.方法 采用酶联免疫吸附(ELISA)法对临床上糖调节受损(IGR)40例患者(IGR组)、T2DM 106例患者(T2DM组)和健康对照者86例(对照组)进行空腹血清visfatin水平的检测.结果 空腹血清visfatin水平在IGR组[(19.93±6.89)μg/L]、T2DM组[(29.53±11.33)μg/L]依次增高,且与对照组[(16.12±5.24)μg/L]相比均显著增高(P＜0.01);空腹血清visfatin水平与腰臀比呈正相关(r=0.161,P＜0.05),与三酰甘油、低密度脂蛋白胆固醇、糖化血红蛋白、空腹血糖、空腹胰岛素、lg稳态模型胰岛素抵抗指数(HOMA-IR)呈显著正相关(r=0.189、0.266、0.643、0.574、0.285、0.526,P＜0.01),与高密度脂蛋白胆固醇呈显著负相关(r=-0.377,P＜0.01);以visfatin为应变量进行多重线性回归分析,糖化血红蛋白(β=0.512,P=0.000)、lgHOMA-IR(β=0.172,P=0.026)、腰臀比(β=0.119,P=0.036)进入方程.结论 visfatin可能参与了血糖、血脂代谢的调节,且与胰岛素抵抗密切相关;visfatin可能是T2DM的危险因素之一.

Abstract：

Objective To investigate the correlation between serum level of visfatin and type 2 diabetes mellitus (T2DM). Methods Impaired glucose regulation (IGR) group consisted of 40 patients,T2DM group consisted of 106 patients, while control group consisted of 86 subjects. The serum visfatin levels of all groups were detected by enzyme linked immunosorbent assay (ELISA). Results Fasting serum visfatin levels in IGR group and T2DM group were significantly higher than those in control group [(19.93 ±6.89) μg/L and (29.53 ± 11.33) μg/L vs. (16.12 ± 5.24) μ g/L, P ＜ 0.01]. Fasting serum visfatin levels positively correlated with waist-to-hipratio (WHR) (r = 0.161, P ＜ 0.05); significantly positively correlated with triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c),fasting plasma glucose (FPG), fasting insulin (FINS), lg Homeostasis model assessment-insulin resistance index (HOMA-IR) (r = 0.189,0.266,0.643,0.574,0.285,0.526,P ＜ 0.01), and significantly negatively correlated with high density lipoprotein cholesterol (HDL-C)(r =-0.377,P ＜0.01). When visfatin was analyzed as a dependent variable in multiple linear regression, HbA1c (β = 0.512, P = 0.000), lg HOMA-IR (β= 0.172, P = 0.026), WHR (β = 0.119, P = 0.036) were into the equation. Conclusion Visfatin may be involved in glucose and lipid metabolism regulation, and closely related with insulin resistance; visfatin may be a risk factor for T2DM.     

Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study

Despite well-controlled blood glucose levels, diabetic complications still inevitably take place via several mechanisms including excessive generation of free radicals in patients who suffer from diabetes mellitus (DM). A randomized double-blind placebo-controlled clinical trial to investigate the effectiveness of oral supplementation of DL-alpha-lipoic acid (ALA) on glycemic and oxidative status in DM patients was conducted. Thirty eight outpatients with type 2 DM were recruited and randomly assigned to either placebo or treatment in various doses of ALA (300, 600, 900, and 1200 mg/day) for 6 months. Following the treatment, all subjects were evaluated for glucose status and oxidative biomarkers. Results showed that fasting blood glucose, HbA1c trended to decrease in a dose-dependent manner. Increase of urinary PGF2α-Isoprostanes (F2α-IsoP) was noted in placebo but not ALA-treated groups, indicating possible suppressing action of ALA on lipid peroxidation in DM subjects. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) levels, however, were similar in both placebo and ALA groups as well as urinary microalbumin and serum creatinine. Safety evaluation was monitored and treatment was found to be well tolerated despite some minor side effects. Results from this study reflected the benefits of ALA in glucose status with slight efficiency on oxidative stress-related deterioration in DM patients.     

Cigarette smoking is a risk factor for nephropathy and its progression in type 2 diabetes mellitus

Cigarette smoking is a risk factor for diabetic nephropathy in Type 1 diabetes (T1DM); a few reports support this possibility in Type 2 diabetes (T2DM) as well. Since heterogeneity among populations could exist, we investigated the association of cigarette smoking and nephropathy, and progression of nephropathy in Italian T2DM patients. A retrospective study was conducted in 273 long-duration T2DM subjects with a 3-year follow-up in the out-patient clinic, and at least one access per year. Albumin excretion rate, serum creatinine, and a number of other parameters implicated in the development of diabetic renal disease were evaluated. Progression of nephropathy was defined as the passage from different stages of renal involvement (no renal derangement, microalbuminuria, proteinuric disease or severe nephropathy). At baseline, 13.2% of the subjects had microalbuminuria, and 3.7% proteinuric disease. Microalbuminuria and proteinuric disease were more frequent in actual smokers than in non- and former smokers (chi2=8.35; p=0.015). Progression of nephropathy was less common in non- and former smokers than in smokers (31 of 134, 23%, and 15 of 67, 22%, and 30 of 72, 42%, respectively; chi2=9.32;p=0.009). From logistic regression analysis, smoking (p=0.0012) emerged as the most important factor associated with progression of nephropathy, followed by packyears (p=0.011), HbA1c mean value at follow-up (p=0.024), and total cholesterol (p=0.038). In conclusion, cigarette smoking is a risk factor for progression of nephropathy also in Italian T2DM patients; reducing or quitting smoking should be part of the therapy or of the preventive measures in these patients and their relatives.     

2型糖尿病大血管病变与视黄醇结合蛋白4及高敏C反应蛋白关系的研究

目的 探讨2型糖尿病(T2DM)大血管病变患者血清视黄醇结合蛋白4(RBP4)及高敏C反应蛋白(hs-CRP)水平的变化.方法 入选研究对象115例,其中单纯T2DM组40例,T2DM大血管病变(病变T2DM)组40例,对照组35例.检测其空腹血清RBP4、hs-CRP,同时测空腹血糖(FBG)、身高、体重、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆同醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),计算体重指数(BMI)和稳态模型评估法胰岛素抵抗指数(HOMA-IR).分析三组RBP4水平的变化,及其与上述其他指标的相关性.结果 hs-CRP、RBP4在病变T2DM组和单纯T2DM组显著高于对照组[hs-CRP分别为(9.12±4.21)、(2.01±1.96)、(0.98±0.36)mg/L,RBP4分别为(30.10±5.45)、(20.02±5.32)、(12.02±3.45)mg/L](P<0.01),病变T2DM组显著高于单纯T2DM组(P<0.01).单因素相关分析显示RBP4与LDL-C、BMI、FBG、hs-CBP、FINS、HOMA-IR呈正相关(相关系数分别为0.325、0.597、0.323、0.571、0.275、0.463,P<0.05或<0.01).结论 血清RBP4、hs-CRP在糖尿病患者中显著升高,其水平变化与糖尿病大血管并发症的发生、发展密切相关.