Benfotiamine is similar to thiamine in correcting endothelial cell defects induced by high glucose

We investigated the hypothesis that benfotiamine, a lipophilic derivative of thiamine, affects replication delay and generation of advanced glycosylation endproducts (AGE) in human umbilical vein endothelial cells cultured in the presence of high glucose. Cells were grown in physiological (5.6 mM) and high (28.0 mM) concentrations of D-glucose, with and without 150 μM thiamine or benfotiamine. Cell proliferation was measured by mitochondrial dehydrogenase activity. AGE generation after 20 days was assessed fluorimetrically. Cell replication was impaired by high glucose (72.3% ±5.1% of that in physiological glucose, p=0.001). This was corrected by the addition of either thiamine (80.6%±2.4%, p=0.005) or benfotiamine (87.5%±89%, p=0.006), although it was not completely normalized (p=0.001 and p=0.008, respectively) to that in physiological glucose. Increased AGE production in high glucose (159.7%±38.9% of fluorescence in physiological glucose, p0.003) was reduced by thiamine (113.2%±16.3%, p=0.008 vs. high glucose alone) or benfotiamine (135.6%±49.8%, p=0.03 vs. high glucose alone) to levels similar to those observed in physiological glucose. Benfotiamine, a derivative of thiamine with better bioavailability, corrects defective replication and increased AGE generation in endothelial cells cultured in high glucose, to a similar extent as thiamine. These effects may result from normalization of accelerated glycolysis and the consequent decrease in metabolites that are extremely active in generating nonenzymatic protein glycation. The potential role of thiamine administration in the prevention or treatment of vascular complications of diabetes deserves further investigation. Received: November 2000 / Accepted in revised form: August 2001     

螺内酯与贝那普利联合治疗对早期糖尿病肾病尿白蛋白排泄率的影响

目的观察螺内酯和贝那普利联合应用对早期糖尿病(DM)肾病患者尿白蛋白排泄率(UAER)的影响。方法选取早期糖尿病肾病患者65例,随机分为联合治疗组33例和贝那普利组32例,2组控制血糖方法相同,贝那普利组给予贝那普利10mg,每日1次,联合治疗组加服螺内酯20mg,每日1次。均连续治疗6个月,比较治疗前后2组患者血浆白蛋白(Alb)、尿素氮(BUN)、肌酐(Scr)、肌酐清除率(Ccr)及UAER的变化,观察药物不良反应。结果治疗6个月后,2组UAER均显著降低(P<0.01),且与贝那普利组(81μg/min±30μg/min)相比,联合治疗组UAER(51μg/min±28μg/min)进一步显著降低(P<0.01),其他指标差异无统计学意义(P>0.05),未观察到严重不良反应。结论贝那普利与小剂量螺内酯联用降低早期糖尿病肾病患者的UAER效果更显著,且使用安全。     

糖尿病足的病原体分布及其耐药性分析

目的探讨本地区糖尿病足感染病原体分布及其耐药性,为临床合理应用抗菌药物提供依据。方法对糖尿病足感染患者的创面分泌物进行细菌和真菌培养,用K-B法或稀释法行药敏试验。结果95例糖尿病足感染分泌物标本中69例(72.6%)培养出病原体,分离出病原体106株,其中革兰阳性菌51株(占48.1%),革兰阴性菌50株(占47.2%),真菌5株(占4.7%);产超广谱β-内酰胺酶(ESBLs)的细菌15株,占肠杆菌科细菌的34.1%。糖尿病足感染以凝固酶阴性葡萄球菌、金黄色葡萄球菌、变形杆菌和大肠埃希菌为主,也可见真菌感染。药敏试验结果提示多重交叉耐药,革兰阴性菌对亚胺培南及加β-内酰胺酶抑制剂的抗菌药物较为敏感,革兰阳性菌对万古霉素、氯霉素及头孢菌素较敏感;大肠埃希菌对常用抗菌药物均有耐药;凝固酶阴性葡萄球菌和肠球菌除万古霉素外,对其他临床常用抗菌药物也均有耐药性。结论糖尿病足感染的病原体分布广泛,对抗菌药物耐药率高,应选择广谱抗菌药物联合用药。     

糖尿病植物神经病变与脑血管病变的关系探讨

目的了解糖尿病植物神经病变与脑血管病变的关系。方法测定86例2型糖尿病患者的交感神经皮肤电反应(SSR),据此45例被诊为糖尿病植物神经病变(A组).41例无糖尿病植物神经病变(B组)。两组患者均接受经颅多普勒超声(TCD)检查。结果A组TCD检查血流峰速(Vp)中血管异常率、Vp增快血管率明显高于B组(P均<0.01),脑动脉脉动指数(PI)高于B组(P<0.05或0.01)。结论糖尿病植物神经病变可能是促进糖尿病脑血管病变的危险因素之一。     

2型糖尿病及糖尿病肾病患者C反应蛋白检测的临床价值

目的:探讨C反应蛋白(CRP)在2型糖尿病(T_2DM)及其并发肾病患者中的浓度变化及临床价值。方法:根据尿白蛋白排泄率(UAER)将102例T_2DM患者分为单纯糖尿病组(SDM组)、早期糖尿病肾病组(EDN组)和临床糖尿病肾病组(CDN组),30名本院健康体检者作为对照组,应用免疫透射比浊法测定血清CRP,将组间的CRP进行统计学比较,并进行相关分析。结果:各糖尿病组血清C反应蛋白(CRP)水平与对照组比较均具有统计学差异(P<0.05),EDN、CDN组显著高于SDM组(P<0.05),CDN组与EDN组相比亦明显升高(P<0.05)。相关分析显示CRP与UAER呈显著正相关(r=0.485,P<0.01)。结论:CRP水平在T_2DM组和并发DN组中逐渐增高,表明其可能是T_2DM和DN发生的危险因素,CRP与糖尿病及其血管慢性并发症有关。     

Prevalence and associated factors of diabetic retinopathy. The Beijing Eye Study 2006

Background  To evaluate the prevalence and associated factors of diabetic retinopathy in adult Chinese with diabetes mellitus. Methods  The Beijing Eye Study 2006 is a population-based cross-sectional study that included 3,251 (73.2%) subjects (aged 45+ years) out of 4,439 subjects originally participating in the Beijing Eye Study 2001. Diabetes defined as fasting glucose concentrations ≥7.0 mmol/L or self-reported diagnosis of diabetes was detected in 381/3,251 (12.9%) subjects. Diabetic retinopathy was defined by the presence of at least one microaneurysm in the diabetic subjects according to the Early Treatment of Diabetic Retinopathy Study (ETDRS). Results  Gradable fundus photographs were available for 362 (95.0%) subjects. Diabetic retinopathy was detected in 101 subjects (27.9%). Most of the diabetic retinopathy was of the mild type (74/101; 73%). Severe non-proliferative or proliferative diabetic retinopathy was present in 16 (16%) subjects, and clinically significant macular edema in four (4%) subjects. Presence of diabetic retinopathy was significantly associated with rural region (Odds ratio (OR): 3.52), duration of diabetes mellitus (OR: 1.08), fasting plasma glucose concentration (OR: 1.14), type of diabetes treatment (OR: 2.09), and marginally significantly, with hyperopic refractive error (OR: 1.13; P = 0.08). The stage of diabetic retinopathy was associated with rural region (P < 0.001), known duration of diabetes (P = 0.001), type of diabetes treatment (P = 0.001), concentrations of high-density lipoproteins (P = 0.004), and fasting glucose concentrations (P = 0.002). Conclusions  Prevalence of diabetic retinopathy among adult diabetic Chinese was about 27.9%. The stage of retinopathy was mild in 75% of the subjects with diabetic retinopathy. Associated factors were diabetes duration, diabetic treatment type, low metabolic control, rural region, and marginally hyperopia. Supported by the Beijing Natural Science Foundation No. 7071003, Beijing, China.     

光学相干断层扫描对氩激光治疗糖尿病性黄斑水肿的疗效观察

目的应用光学相干断层扫描观察氩激光治疗糖尿病性黄斑水肿的临床疗效。方法对糖尿病性黄斑水肿患者行氩激光光凝术。在光凝前、光凝后3个月分别进行扫描获取光学相干断层扫描图像,记录黄斑中心凹视网膜厚度,作统计学分析。结果平均随访(3.0±0.6)个月。光凝前及光凝后3个月黄斑中心凹区视网膜厚度平均值分别为(397±102)μm和(204±90)μm,差异有统计学意义。结论光学相干断层扫描检测能较准确定量测算黄斑区视网膜厚度,可对比观察氩激光光凝前后视网膜厚度变化,进而判断氩激光光凝的疗效。     

糖末宁颗粒治疗糖尿病性周围神经病变(气虚络阻证)432例临床研究

目的评价糖末宁颗粒治疗糖尿病性周围神经病变(气虚络阻证)的安全性和有效性。方法采用随机、阳性药平行对照、多中心临床试验方法,试验组口服糖末宁颗粒,对照组口服弥可保片,8周为1个疗程。结果糖末宁颗粒对糖尿病性周围神经病变的肌电图疗效的显效率为60.06%,总有效率为68.47%;中医证候疗效的显效率为23.12%,总有效率为90.99%。以15%为非劣效标准,对糖末宁组的肌电图疗效及中医证候疗效进行非劣效性检验,非劣效性检验合格。结论糖末宁颗粒能改善糖尿病性周围神经病变气虚络阻证的病情,同时安全性良好。     

Diabetic mastopathy: a case report with reference to the findings of enhanced computed tomography

We report a case of insulin-dependent diabetic fibrous mastopathy with special reference to the findings of computed tomography (CT). The patient was a 27-year-old woman with a history of insulin-dependent diabetes mellitus from childhood who presented with a right breast tumor. Physical examination showed a stony-hard, ill-defined but freely movable mass under the nipple of the right breast without nipple discharge. Mammography revealed a high-density mass shadow without microcalcifications or spicular formation. Ultrasonographic examination revealed an irregularly-shaped hypoechoic lesion with marked posterior acoustical shadowing. Contrast-enhanced CT revealed poor early phase contrast enhancement and slight delayed phase heterogeneous enhancement. Since core needle biopsy revealed fibrocystic disease, the lesion was suspicious for diabetic mastopathy. Incisional biopsy of the right breast lump was performed. On histopathological examination, the lesion showed fibrosis with dense lymphocytic infiltration around the lobules. Diabetic fibrous mastopathy was diagnosed. Physicians should be aware of the association of long-standing diabetes mellitus with the development of fibrous mastopathy. CT is considered a useful tool to differentiate diabetic mastopathy from breast cancer.     

罗格列酮对早期2型糖尿病肾病患者CRP、PAI-1的影响

目的 观察罗格列酮对早期2型糖尿病肾病患者血清C反应蛋白（CRP）、血浆纤溶酶原激活物抑制物-1（PAI-1）、尿微量白蛋白排泄率（UAER）的影响。方法 78例早期2型糖尿病肾病患者在原有药物治疗基础上采用随机、双盲、安慰剂、平行对照方法 分至罗格列酮组及安慰剂组,进行6个月的临床观察,治疗前及治疗6个月后分别检测空腹血糖（FPG）、糖化血红蛋白（HbA1 c）、胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、空腹胰岛素（FINS）、CRP、PAI-1、UAER,比较各指标的变化。结果 罗格列酮治疗6个月患者FPG、HbA1 c、TG与本组治疗前比较下降,HDL-C则明显上升,差异有统计学意义（P〈0.05）;胰岛素抵抗指数（HOMA-IR）、CRP、PAI-1、UAER与本组治疗前比较出现显著下降,差异有统计学意义（P〈0.01）。结论 早期2型糖尿病肾病患者应用罗格列酮治疗,不仅可以改善胰岛素抵抗及糖脂代谢,还可降低患者体内部分炎症因子及微量白蛋白的水平,可能对延缓早期2型糖尿病肾病的发展有益。