参七散对2型糖尿病患者血游离脂肪酸的影响

目的观察参七散对2型糖尿病(T2DM)患者血游离脂肪酸(FFA)的影响。方法将169例T2DM患者随机分为治疗组89例,对照组80例。治疗组给予口服参七散5g/次,每日3次;对照组给予非诺贝特胶囊200mg/次,每日1次。两组均给药8周为1个疗程。治疗前后测定患者糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2小时血糖(2hPG)、甘油三酯(TG)、FFA的含量,同时记录体重指数(BMI)。结果治疗组治疗后HbA1c、FBG、2hPG及BMI与治疗前比较,差异均有统计学意义(P<0.05或P<0.01);两组患者治疗后血清FFA及TG水平与治疗前比较,差异均有统计学意义(P<0.05),但治疗后两组患者血清FFA及TG水平差异无统计学意义(P>0.05)。结论参七散能有效降低糖尿病患者的TG、FFA及血糖水平。     

高度近视患者的荧光素眼底血管造影与吲哚青绿血管造影对比分析

目的：观察高度近视患者视网膜和脉络膜的形态损害特点。方法：应用荧光素眼底血管造影和吲哚青绿脉络膜血管造影技术对23例高度近视患者（44只眼）视网膜和脉络膜的组织结构进行了形态学检查，并对两种检查结果进行了分析。结果：（1）32只眼中有近视弧，多位于视盘颞侧，4只眼环绕视盘；（2）9只眼中有视网膜色素上皮和脉络膜毛细血管萎缩相对应；（3）5只眼FFA和ICGA检查均发现脉络膜新生血管，其中3只眼的脉络膜新生血管位于萎缩病变的边缘，2只眼在玻璃膜漆裂纹中；（4）2只眼FFA检查未发现脉络膜新生血管而在ICGA检查中发现；（5）4只眼有玻璃膜漆裂纹。结论：高度近视眼的脉络膜损害与视网膜损害相关性；晚期脉络膜的损害重于视网膜的损害。     

Circulating Pro-Neurotensin in gestational diabetes mellitus

Background and aims

Pro-Neurotensin (NT), a stable surrogate parameter of NT, has recently been introduced as a peptide predicting the development of obesity, diabetes mellitus, cardiovascular diseases, and cardiovascular mortality. However, regulation of Pro-NT in gestational diabetes mellitus (GDM) remains uninvestigated.

Lipid accumulation in the myocardium during acute regional ischaemia in cats

Accumulation of lipid material in the myocardium was studied in cat hearts with acute regional ischaemia of 3 h duration. The fractional volume of lipid droplets in cytosol was analysed by electron microscopy of myocardial biopsies using a quantitative stereologic technique. Ischaemic and normally perfused myocardium were identified by fluoresceine injection, and tissue blood flow measurements were performed with labelled microspheres. In normal myocardium only small amounts of lipid droplets were found. A marked accumulation of lipid droplets occurred in borderline tissue between the two types of myocardium, whereas lipid accumulation in ischaemic myocardium was less pronounced. The arterial concentration of nonesterified fatty acids was clearly increased during the 3 h coronary artery occlusion period. Increased triglyceride synthesis from arterial fatty acids, or redistribution of intracellular lipids, are suggested as possible explanations for lipid accumulation during acute myocardial ischaemia.     

Partial pancreatectomy and the role of insulin in carbohydrate metabolism ingallus domesticus

Summary A technique for the partial pancreatectomy of the chicken is described. Following surgery the plasma insulin concentration falls from 78 U/ml to 17.5 U/ml and remains at that level for the subsequent 2 days of observations. No persistent hyperglycaemia was noted and the birds became hypoglycaemic after 2 days. Plasma FFA concentration was significantly reduced throughout. The partially pancreatectomized chicken was found to have a severely impaired glucose tolerance and there was only a slight, non-significant increase in plasma insulin after glucose loading. Its response to glucagon was little changed. It is concluded that insulin plays an essential role in the utilization of glucose but the site of its action remains to be identified.

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Partielle Pankreatektomie und die Bedeutung des Insulins im Stoffwechsel der Kohlenhydrate des Haushuhns (Gallus domesticus)

Zusammenfassung Eine Technik zur partiellen Entfernung der Bauchspeicheldrüse des Huhns wird beschrieben. Nach der Operation fällt die Plasmainsulinkonzentration von 78 U/ml auf 17.5 U/ml und bleibt während der nächsten 2 Beobachtungstage in dieser Höhe. Eine anhaltende Hyperglykämie ließ sich nicht feststellen; die Tiere wurden nach 2 Tagen hypoglykämisch. Die Konzentration der freien Fettsäuren verringerte sich signifikant während der ganzen Zeit. Das partiell pankreatektomierte Huhn weist eine stark beeinträchtigte Glucosetoleranz auf. Es ließ sich nur eine leichte, nicht signifikante Zunahme des Plasmainsulins nach Glucosegabe feststellen. Seine Reaktion auf Glucagon änderte sich wenig. Man kann daraus schließen, daß Insulin eine wichtige Rolle bei der Utilisation der Glucose spielt. Der Wirkungsort muß noch identifiziert werden.

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Ablation partielle du pancréas et rôle de l'insuline dans le métabolisme des hydrates de carbone chez le Gallus domesticus

Résumé On décrit une technique pour l'ablation partielle du pancréas du poulet. Après l'opération chirurgicale, la teneur plasmatique en insuline tombe de 78 U/ ml à 17.5 U/ml et demeure à ce niveau pendant les deux jours suivants. Aucune trace d'hyperglycémie persistante n'est observée, et les oiseaux deviennent hypoglycémiques au bout de deux jours. La teneur en acides gras libres du plasma est considérablement réduite pendant toute la durée de l'expérience. L'ablation partielle du pancréas provoque chez le poulet un affaiblissement très marqué de la tolérance au glucose, et on observe seulement une légère augmentation d'insuline plasmatique, d'importance insignifiante, après charge de glucose. La réponse au glucagon ne change guère. On en conclut que l'insuline joue un rôle essentiel dans l'utilisation du glucose, mais le site même de cette réaction n'a pas encore été localisé.

     

Lipid metabolism by muscle of diabetic rats

Summary This study was undertaken to ascertain whether enhanced oxidation of intracellular lipids could explain the impaired carbohydrate metabolism of diabetes. Pieces of diaphragms removed from diabetic (60–75 mg/kg streptozotocin i.v.) and control rats were incubated for 1 h with palmitate-1-¹⁴C. Tissue lipids from one piece were separated on silicic acid columns and the amount and specific activity of free fatty acids (FFA), triglycerides (TG) and phospholipids (PL) were measured.¹⁴CO₂ production was also assessed in some experiments. The other pieces of tissue were incubated for a subsequent hour (without radioactivity) at which time measurements of tissue lipid content and specific activity and¹⁴CO₂ production were again performed. FFA incorporation into CO₂, tissue TG and PL was normal. TG content was moderately and PL content was slightly reduced in diabetic tissue. Changes in diaphragm TG and PL content and specific activity during the 2nd h of incubation strongly suggested that most of the¹⁴CO₂ produced during this period was derived from TG. Approximately 25% of tissue TG in both control and diabetic muscle was oxidized to CO₂ during the 2nd h of incubation. In diaphragms from diabetic rats, (+)-octanoylcarnitine (an inhibitor of FFA oxidation) decreased TG oxidation considerably but had no effect on the impaired glucose uptake. Thus, these data do not support the hypothesis that the glucose-fatty acid cycle (utilizing either extra- or intracellular lipids) may account for the altered carbohydrate metabolism of diabetic muscle.     

Degree of ketonaemia and its association with insulin resistance after dapagliflozin treatment in type 2 diabetes

Background

Euglycaemic ketoacidosis has been reported after sodium–glucose cotransporter 2 (SGLT2) inhibitor treatment. However, the degree of ketonaemia and its metabolic effects have not been well investigated. Our study examined the degree of ketonaemia induced by SGLT2 inhibition and its association with metabolic profiles in type 2 diabetes mellitus (T2DM).

The effect of elevated arterial free fatty acid concentrations on hemodynamics and myocardial metabolism and blood flow during ischemia

Summary In the present investigation the effect of elevated arterial free fatty acid (FFA) concentrations on regional myocardial blood flow (MBF), myocardial metabolism and hemodynamics during ischemia was studied in anesthetized dogs.Ischemia was induced by stenosis of the left interventricular coronary artery. Mean poststenotic coronary artery pressure was kept constant during ischemia. FFA concentrations were elevated by intravenous injection of heparin (group I), intralipid (group II) or both substances (group III).After elevation of FFA concentrations by heparin alone or together with intralipid, heart rate gradually increased, while aortic pressure tended to decrease.Slight elevation of arterial FFA levels (up to 0.30 mM, group I, and up to 0.53 mM, group II) had no significant effect on total MBF and uptake of glucose, FFA, and oxygen or release of lactate in the ischemic myocardium. However, elevating arterial FFA levels up to 0.81 mM (Group III), significantly decreased total MBF (6%), endo/epicardial blood flow ratio (13%), and oxygen uptake (34%) in the ischemic myocardium and resulted in release of lactate from this area. The release of potassium, inorganic phosphate and H⁺ as well as plasma CO₂ concentration were not influenced. Neither was the uptake of glucose and FFA.These findings suggest that elevated arterial FFA concentrations can decrease MBF and augment lactate production in the ischemic myocardium.With 2 figures and 4 tablesThe investigations were (partly) supported by the Foundation for Medical Research FUNGO, which is subsidized by the Netherlands Organization for the Advancement of Pure Research (ZWO).