糖尿乐胶囊联合吡格列酮治疗2型糖尿病的临床研究

目的 探讨糖尿乐胶囊联合盐酸吡格列酮片治疗2型糖尿病的临床疗效。方法 选取2020年4月—2023年3月华北医疗健康集团峰峰总医院收治的100例2型糖尿病患者,将100例患者随机分为对照组（50例）和治疗组（50例）。对照组患者口服盐酸吡格列酮片,2片/次,1次/d。治疗组患者在对照组患者的基础上口服糖尿乐胶囊,4粒/次,3次/d。两组患者持续治疗3个月。比较两组临床效果、临床症状消失时间、血糖指标和血清指标。结果 治疗后,治疗组的总有效率为94.00%,对照组的总有效率为78.00%,组间差异显著（P＜0.05）。治疗后,治疗组多饮、多尿、乏力消失时间均明显短于对照组（P＜0.05）。治疗后,两组的空腹血糖（FPG）、餐后血糖（PPG）、糖化血红蛋白（HbA1c）均低于治疗前（P＜0.05）,且治疗组血糖指标较对照组更低（P＜0.05）。治疗后,两组的血清中性粒细胞与淋巴细胞比率（NLR）、血清肾损伤分子-1（KIM-1）、中性粒细胞明胶酶相关载脂蛋白（NGAL）水平低于治疗前（P＜0.05）;治疗组的血清NLR、KIM-1、NGAL水平低于对照组（P＜0.05）。结论 糖尿乐胶囊联合盐酸吡格列酮片可提高2型糖尿病的疗效,促进症状好转,进一步降低血糖,有助于降低肾损伤。     

Plasma vaspin concentrations are decreased in acute coronary syndrome,but unchanged in patients without coronary lesions

Objective

Previous studies suggested that decreased serum vaspin levels were associated with coronary artery disease (CAD). The present study aimed to investigate the association between plasma vaspin levels and different states of CAD.

Design and methods

A total of 162 patients with coronary angiography (CAG) proved that CAD was enrolled. Additional 103 patients complained with “chest discomfort” with negative CAG, and 60 normal subjects were enrolled in this study. The levels of plasma vaspin, adiponectin, clinical parameters, lipid profile and C reactive protein (CRP) were measured.

Results

The levels of plasma vaspin were significantly lower in the CAD group (0.47 ± 0.63 μg/L) than those in the healthy group and CAG (−) group (all p < 0.001). In CAD group, the pos hoc analysis showed that serum vaspin concentration in acute myocardial infarction group (0.21 ± 0.19 μg/L) was significantly lower than that in the unstable angina pectoris group (0.40 ± 0.37 μg/L) (p = 0.012), and serum vaspin concentration in unstable angina pectoris was significantly lower than that in stable angina pectoris group (0.92 ± 0.94 μg/L) (p = 0.013). The plasma vaspin concentration was also negatively correlated with the severity of CAD (1-vessel: 0.86 ± 0.90 μg/L; 2-vessel: 0.36 ± 0.39 μg/L; 3-vessel: 0.21 ± 0.16 μg/L). The plasma vaspin concentration in CAG (−) group with “chest discomfort” (1.93 ± 2.57 μg/L) was similar to the healthy control group (2.18 ± 3.49 μg/L).

Conclusions

The plasma vaspin concentration correlated to the severity of CAD. Furthermore, plasma vaspin has a value of avoiding patients without CAD from unnecessary CAG.     

The efficacy of omega-3 fatty acid for gestational diabetes: a meta-analysis of randomized controlled trials

Introduction: The efficacy of omega-3 fatty acid to treat gestational diabetes remains controversial. We conduct a systematic review and meta-analysis to explore the influence of omega-3 fatty acid versus placebo on gestational diabetes.

Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2018 for randomized controlled trials (RCTs) assessing the effect of omega-3 fatty acid versus placebo on gestational diabetes. This meta-analysis is performed using the random-effect model.

Results: Five RCTs are included in the meta-analysis. Overall, compared with control group for gestational diabetes, omega-3 fatty acid can significantly reduce fasting plasma glucose (FPG) (mean difference (MD)?=??4.91; 95% confidence interval (CI)?=??8.16 to ?1.66; p?=?.003), homeostatic model of assessment for insulin resistance (HOMA-IR, MD?=??0.99; 95% CI?=??1.61 to ?0.37; p?=?.002), high sensitivity C-reactive protein (hs-CRP, MD?=??1.43; 95% CI?=??2.54 to ?0.31; p?=?.01), but has no remarkable influence on preterm delivery (RR?=?1.61; 95% CI?=?0.36–7.16; p?=?.53), gestational age (MD?=?0.09; 95% CI?=??0.01 to 0.20; p?=?.08), macrosomia (RR?=?0.64; 95% CI?=?0.26–1.62; p?=?.3), newborn weight (MD?=?3.37; 95% CI?=??15.75 to 22.50; p?=?.73), and 5-min Apgar score (MD?=?0; 95% CI?=??0.02 to 0.02; p?=?.92).

Conclusions: Omega-3 fatty acids is associated with significantly reduced FPG, HOMA-IR, and hs-CRP in patients with gestational diabetes.     

糖化血红蛋白在对糖耐量减退患者血糖水平的评价

目的 通过回顾分析糖耐量减退(IGT)患者空腹血糖(FPG)、餐后2 h血糖(2 hPG)与糖化血红蛋白(HbA1c)的关系,比较评价它们对血糖的控制价值.方法 选择我院2008年1月～2009年12月IGT患者105例,随机记录某一日FPG及2hPG,并检测HbA1c.并以空腹血糖(FPG)及餐后2 h血糖(2 hP...     

Ameliorative effect of Withania coagulans on dyslipidemia and oxidative stress in nicotinamide–streptozotocin induced diabetes mellitus

Present study aims to evaluate the effect of Withania coagulans fruit (aqWC) on diabetic-dyslipidemia and antioxidant/oxidant status in DM. Diabetic animals were treated with aqWC at a dose of 250 mg/kg bw for 30 days. Lipid profile, MDA, GSH, SOD, FRAP, HMG CoA reductase and acetyl CoA carboxylase activities were estimated in blood and tissues. Total cholesterol, TAG and LDL were significantly elevated whereas HDL was decreased in diabetic animals (p < 0.05), simultaneously the lipid content and HMG CoA reductase activities were also increased, whereas acetyl CoA carboxylase activity decreased significantly in tissues of diabetic animals. MDA was increased and antioxidants such as SOD, GSH and FRAP decreased significantly in DM (p < 0.05). Oral administration of aqWC to diabetic animals produced significant improvement in serum lipid profile and tissue lipid content. Activity of HMG CoA reductase decreased, whereas acetyl CoA carboxylase activity increased significantly in tissues after aqWC treatment. Administration of aqWC to diabetic animals also showed significant increase in antioxidant levels i.e., GSH, SOD, FRAP and reduced level of MDA in blood and tissue homogenates as compared to diabetic controls (p < 0.05). These results suggest that aqWC treatment improved lipid profile and decreased oxidative stress in diabetes mellitus.     

联合检测血流变、血糖及糖化血红蛋白在2型糖尿病诊断中的意义

目的检测2型糖尿病(T2DM)患者的血液流变学几项指标、空腹血糖、糖化血红蛋白水平及其相关性,探讨3项联合检测在T2DM的应用价值。方法对245例T2DM患者及84例健康体检者进行血液流变学检测,同时检测空腹血糖和糖化血红蛋白,并进行相关关系检验。结果 245例T2DM患者血液流变学指标(全血黏度和血浆黏度)、空腹血糖和糖化血红蛋白均较对照组有明显增高(P<0.05、P<0.01、P<0.05);血液流变学的低切和高切的改变与FPG和HbA1c呈良好正相关性(r=0.514、r=0.584和r=0.649、r=0.716)。结论联合检测T2DM患者的血液流变学、空腹血糖和糖化血红蛋白指标有利于评估其血糖控制及疾病进展程度。     

Randomized and double-blinded pilot clinical study of the safety and anti-diabetic efficacy of the Rauvolfia-Citrus tea, as used in Nigerian traditional medicine

Aim of the study

The aim of this randomized and double blinded pilot clinical trial was to investigate the anti-diabetic efficacy of the Rauvolfia-Citrus (RC) tea in humans. We have earlier shown that a combination of calorie-restriction and chronic administration of the RC tea to the genetic diabetic (BKS-db) mice resulted in the normalization of blood sugar, reduction in lipid accumulated in the mice eyes and prevention of the degeneration of the otherwise brittle BKS-db pancreas. The tea is made by boiling foliage of Rauvolfia vomitoria and fruits of Citrus aurantium and is used to treat diabetes in Nigerian folk medicine.

Materials and methods

The RC tea was produced using the Nigerian traditional recipe and tested in the traditional dosage on 23 Danish type 2 diabetes (T2D) patients. The participants were divided into two equivalent groups after stratification by sex, age and BMI, in a 4-month double-blinded, placebo-controlled and randomized clinical trial. Most of the study subjects (19/23) were using oral anti-diabetic agents (OADs). Mean disease duration was 6 ± 4.6 years, mean age was 64 ± 7 years and mean BMI was 28.7 ± 3.8 kg/m². Prior to starting the treatment, the participants received individual dietician consultations.

Results

At the end of the 4-month treatment period, the treated group showed an 11% decrease in 2-h postprandial plasma glucose relative to the 3% increase in the placebo group (p = 0.004). The improvement in blood glucose clearance with RC tea treatment was reflected in a 6% reduction in HbA_1c (p = 0.02) and in a 10% reduction in fasting plasma glucose (p = 0.02), when comparing the post 4-month treatment to pre-treatment baseline values. Though the basal levels of phosphorylated acetyl CoA carboxylase enzyme in skeletal muscle were significantly reduced in the treated group (p = 0.04), as compared to the placebo, only the pattern of reductions in the tissue fatty acids (FAs) differed in the two groups. While all types of FAs were reduced in placebo, only saturated (SFA) and monounsaturated (MUFA) FAs were reduced with treatment. Interestingly, a modest increase in the polyunsaturated FAs fraction was observed in the RC treated group. In addition, the reduction in SFA and MUFA with RC tea treatment came solely from the triglyceride fractions, as there was an increase in the skeletal muscle phospholipids.

Conclusions

Chronic administration of the RC tea to overweight T2D on OADs caused significant improvements in markers of glycaemic control and modifications to the fatty acid profile of skeletal muscle, without adverse effects or hypoglycaemia. Further exploration of the anti-diabetic effects of the RC tea is warranted.     

Relationship between response of gamma-glutamyltransferase to alcohol consumption and levels of fasting plasma glucose

To examine whether the response of fasting plasma glucose (FPG) to alcohol consumption differs among individuals, a cross-sectional study was conducted in 6100 men with a body-mass index below 24 who did not take medication for diabetes. Information regarding current medication and lifestyle habits was obtained by a self-reported questionnaire. The subjects were divided into four groups according to their level of alcohol consumption: non-drinkers, light drinkers (1–188 ml/week), intermediate drinkers (189–377 ml/week), and heavy drinkers (378 ml/week). The frequency of subjects with an FPG of 110 mg/dl or more rose significantly as alcohol consumption increased, from 6.7% in non-drinkers to 10.1% in intermediate drinkers and 12.1% in heavy drinkers. In contrast, when only the subjects with a γ-glutamyltransferase level of less than 40 IU/L were analyzed, no difference was observed in the frequency of subjects with an FPG level of 110 mg/dl or more among the four groups. Multiple logistic regression analysis also revealed similar results. The findings suggested individual variability in the response of FPG to drinking. Appropriate levels of drinking could be different among individuals.     

消渴清颗粒联合恩格列净治疗2型糖尿病的临床研究

目的探讨消渴清颗粒联合恩格列净治疗2型糖尿病的临床疗效。方法选取2019年7月—2020年7月商丘市第三人民医院收治的150例2型糖尿病患者为研究对象,根据用入院号的奇偶数分成对照组(75例)和治疗组(75例)。对照组口服恩格列净片,10 mg/次,1次/d;治疗组在对照组治疗基础上口服消渴清颗粒,6 g/次,3次/d。两组均经8周治疗后进行效果评价。观察两组的临床疗效,比较两组治疗前后血糖相关指标、血糖波动指标和血清学因子的变化情况。结果经治疗,治疗组的总有效率为98.67%,明显高于对照组(82.67%,P<0.05)。经治疗,治疗组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、胰岛素(FINS)水平均较治疗前显著降低(P<0.05);治疗后,治疗组血糖相关指标低于对照组(P<0.05)。经治疗,两组HOMA-β均增高,而HOMA-IR均降低(P<0.05);治疗后,治疗组HOMA-β高于对照组,而HOMA-IR低于对照组(P<0.05)。经治疗,两组患者血糖标准差(SDBG)、平均血糖波动幅度(MAGE)、24h血糖波动次数(NGE)及24h血糖平均绝对差(MODD)均较治疗前显著降低(P<0.05);且治疗后,治疗组血糖波动指标显著低于对照组(P<0.05)。经治疗,两组血清趋化素、生长分化因子-15(GDF-15)、单核细胞趋化蛋白-1(MCP-1)、淀粉样蛋白A(SAA)水平均显著降低,但1-磷酸鞘氨醇(SIP)显著升高(P<0.05);治疗后,治疗组趋化素、GDF-15、MCP-1、SAA水平低于对照组,而SIP高于对照组(P<0.05)。结论消渴清颗粒联合恩格列净治疗2型糖尿病患者具有较好的临床疗效,可有效降低患者血糖水平,改善机体趋化素、GDF-15、MCP-1、SAA、SIP水平,并有效保护胰岛β细胞功能,有着良好的临床应用价值。