盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病的疗效观察

目的探讨盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病的临床疗效。方法选取2014年8月—2015年8月在武安市第一人民医院内分泌科接受治疗的肥胖2型糖尿病患者96例为研究对象,按治疗方案的差别分为对照组和治疗组,每组各48例。对照组口服磷酸西格列汀片,100 mg/次,1次/d。治疗组在对照组基础上口服盐酸小檗碱片,0.3 g/次,3次/d,餐前口服。两组患者均连续治疗12周。观察两组的临床疗效,比较两组患者的血糖指标和炎症指标。结果治疗后,对照组和治疗组的总有效率分别为83.33%、95.83%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者的空腹血糖(FPG)、餐后2 h血糖及糖化血红蛋白(Hb A1c)均明显降低,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、内皮素-1(ET-1)及血栓素2(TXB2)均显著下降,而前列腺素Fla(PGFla)、一氧化氮(NO)均显著上升,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病具有较好的临床疗效,能明显降低患者血糖,改善炎症指标,具有一定的临床推广应用价值。     

Effect of zinc supplementation on insulin resistance and metabolic risk factors in obese Korean women

Zinc deficiency is known to be associated with insulin resistance in obese individuals. This study was performed to evaluate the effect of zinc supplementation on insulin resistance and metabolic risk factors in obese Korean women. Forty obese women (body mass index (BMI) ≥ 25 kg/m²) aged 19-28 years were recruited for this study. Twenty women of the study group took 30 mg/day of supplemental zinc as zinc gluconate for 8 weeks and 20 women of control group took placebo. Usual dietary zinc intake was estimated from 3-day diet records. Insulin resistances were measured using Homeostasis model assessment (HOMA) indices, and insulin sensitivities Matsuda indices, which were calculated using oral glucose tolerance test data. Metabolic risk factors, such as waist circumference, blood pressure, fasting glucose, triglyceride, high density lipoprotein (HDL) cholesterol, and adipocyte hormones such as leptin, and adiponectin were also measured. At the beginning of study, dietary zinc averaged 7.31 mg/day and serum zinc averaged 12.98 µmol/L in the study group. Zinc supplementation increased serum zinc by 15% and urinary zinc by 56% (P < 0.05). HOMA values tended to decrease and insulin sensitivity increased slightly in the study group, but not significantly so. BMI, waist circumference, blood pressure, blood glucose, triglyceride, HDL cholesterol, and adipocyte hormones did not change in either the study or control group. These results suggest that zinc status may not affect insulin resistance and metabolic risk factors in obese Korean women. Further research is required on a larger cohort with a longer follow-up to determine the effects of zinc status on insulin resistance and metabolic variables.     

Can physical activity improve the health of the overweight without weight loss?

The prevalence of obesity continues to rise, with over one quarter of the UK adult population in 2010 being classified as obese. Obesity has a severe impact on health and is associated with an array of serious health conditions. Physical inactivity is another major contributor to the global burden of disease and is also associated with a range of negative health outcomes. Research suggests that maintaining or improving fitness through physical activity is associated with a lower risk of developing obesity‐related conditions regardless of weight change. Therefore, healthcare professionals should place an emphasis on advising their patients to increase their physical activity levels to meet UK guidelines, as well as on eating a healthy, balanced diet and maintaining a healthy bodyweight.     

7～17岁超重肥胖儿童青少年代谢综合征流行现况

目的描述7～17岁超重肥胖儿童青少年中代谢综合征(MS)的流行现况。方法采用分层多阶段整群随机抽样方法,对7～17岁儿童青少年2752人进行分析。采用Cook标准进行代谢综合征判定。结果研究人群代谢综合征患病率为3.2%,在体重正常、超重、肥胖的儿童青少年中,MS患病率分别为0.7%、8.0%、23.9%。在控制了其他影响因素后,MS各组分患病率、MS患病率在超重和肥胖儿童青少年中都成倍增加。较多发生的异常为腹型肥胖(超重、肥胖者:41.6%和77.9%)、高血清甘油三酯(超重、肥胖者:36.4%和50.7%)和高血压(超重、肥胖者:19.6%和39.0%)。在体重正常、超重和肥胖者中,至少有1项MS组分的分别为40.3%、65.6%和90.6%;肥胖者中有62.9%至少有2项MS异常;3项以上异常聚集者在肥胖者中为23.9%;有4项以上异常聚集的均为超重和肥胖儿童青少年。结论超重肥胖儿童青少年多存在明显的代谢紊乱。     

Melanin-concentrating hormone-1 receptor antagonism and anti-obesity effects of ethanolic extract from Morus alba leaves in diet-induced obese mice

Ethnopharmacological relevance

In Korea, Morus alba leaves have been traditionally administered as natural therapeutic agent for the alleviating dropsy and diabetes.

Aim of the study

The present study was performed to evaluate melanin-concentrating hormone receptor subtype 1 (MCH1) antagonism of the ethanol extract of Morus alba leaves (EMA) and its anti-obesity effect in diet-induced obese (DIO) mice.

Materials and methods

The binding affinity of EMA for the MCH1 receptor with europium-labeled MCH (Eu-MCH), the function of recombinant MCH1 receptors expressed in CHO cells, and the anti-obesity effects in DIO mice were evaluated.

Results

MCH1 receptor binding studies showed, EMA exhibited a potent inhibitory activity with IC₅₀ value of 2.3 ± 1.0 μg/ml. EMA (10–100 μg/ml) also inhibited the intracellular calcium mobilization with the recombinant MCH1 receptors expressed in CHO cells. In an anti-obesity study with DIO mice, long-term oral administrations of EMA for 32 consecutive days produced a dose-dependent decrease in body weight and hepatic lipid accumulation.

Conclusions

These results suggest that chronic treatment with EMA exerts an anti-obesity effect in DIO mice, and its direct MCH1 receptor antagonism may contribute to decrease body weight.     

不同体脂含量成年男子能量代谢研究

目的了解我国异常体重成年男子能量代谢状况。方法随机选择BMI>25、18.5相似文献   

实时剪切波弹性成像定量评价肥胖儿童脂肪肝的价值

目的 探讨实时剪切波弹性成像(SWE)在定量评价肥胖儿童脂肪肝中的价值,为肥胖儿童脂肪肝的早期诊断、干预和治疗提供更多依据。方法 选取2018年4月-2020年4月西安交通大学第二附属医院儿童青少年肥胖门诊就诊的331例肥胖脂肪肝儿童(脂肪肝组)及100例正常儿童(对照组),以临床诊断为参考标准,分别对两组儿童应用实时剪切波弹性成像测量其肝脏的剪切波速度(SWV)及杨氏模量值(EI),比较两组间的差异,绘制ROC曲线,确定肥胖儿童脂肪肝的最佳诊断界点值。并记录受检儿童一般资料,收集相关血液生化检测结果,比较肥胖脂肪肝儿童SWV值和EI值与临床指标的相关性。结果 肥胖脂肪肝儿童组与正常儿童组在年龄、身高以及丙氨酸转氨酶方面的差异无统计学意义(P>0.05);而在体重、体重指数、腰臀比、血清总胆固醇、甘油三酯方面的差异有统计学意义(t＝3.681、4.010、4.587、3.562、7.015,P<0.05)。脂肪肝组SWV测值为(1.83±0.24)m/s,显著高于对照组(1.01±0.19)m/s,通过绘制ROC曲线确定肥胖儿童脂肪肝SWV的最佳诊断界点值为1.35m/s,灵敏度0.94,特异度0.81,ROC 曲线下面积0.932;脂肪肝组EI测值为(7.11±0.39) kPa,显著高于对照组(5.94±0.26) kPa,通过绘制ROC曲线确定肥胖儿童脂肪肝EI的最佳诊断界点值为6.32 kPa,灵敏度0.96,特异度0.72,ROC曲线下面积0.879。肥胖脂肪肝儿童SWV值和EI值均与体重、体重指数、腰臀比、总胆固醇、血清甘油三酯呈正相关(r_SWV=0.401、0.450、0.488、0.352、0.697, r_EI=0.377、0.463、0.501、0.331、0.611,P<0.05)。结论 实时剪切波弹性成像能够准确无创的定量评价肥胖儿童的脂肪肝情况,对肥胖儿童脂肪肝的早期诊断、干预和治疗具有重要的意义。     

Interaction of intracerebroventricular insulin and glucose in the regulation of the activity of sympathetic efferent nerves to brown adipose tissue in lean and obese Zucker rats

The effects of injection of insulin and glucose into the third cerebral ventricle on the firing rate of the sympathetic efferent nerves to interscapular brown adipose tissue was investigated in anaesthetized lean and obese Zucker rats. Injection of insulin resulted in a dose-dependent (70–480 pmol) inhibition of nerve firing rate, whereas in combination with glucose (140 pmol of insulin and 139 nmol of glucose), insulin strongly potentiated the increase in firing rate seen with glucose alone. Although basal levels of nerve firing rates were lower in the obese rat, responses to insulin, glucose, and insulin plus glucose were qualitatively similar to those seen in the lean rat. These results are consistent with the hypothesis that insulin acts in the central nervous system as a physiological signal in the control of thermogenesis after feeding, and that this effector system is intact in the obese rat.