Opposite fates of fructose in the development of metabolic syndrome

This short review comments on the recently published work of Ishimoto et al regarding the opposing effects of fructokinase C and A isoforms on fructose-induced metabolic syndrome in mice. The framework for the commentary is the preexisting background of epidemiological and experimental data regarding the association between ingestion of fructose, as present in sweetened beverages, and the development of metabolic syndrome. The work of Ishimoto et al clearly confirms the negative effect of fructose on lipid and glucose metabolism, independently from the amount of energy provided by the ingested sugar. It also confirms the absolute requirement of liver fructose metabolism, driven by fructokinase activity, in order to develop the full spectrum of metabolic syndrome alterations.     

胰岛素抗炎机制研究进展

胰岛素是体内唯一降低血糖的激素,目前,临床上主要使用胰岛素治疗糖尿病.然而,胰岛素不仅是一个重要的代谢调节激素,而且是一个重要的抗炎因子.其发挥抗炎作用的具体机制可能为:直接调节炎性反应因子,抑制氧化应激,调节一氧化氮的表达,在血管水平发挥抗炎作用,促进辅助性T细胞(Th)-2的转化,抑制白细胞介素-6-信号转导与转录激活因子(IL-6-STAT)炎性反应通路,降低C反应蛋白水平,下调Toll样受体等.     

高血糖与动脉瘤性蛛网膜下腔出血后迟发性脑缺血

高血糖在动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者中很常见,而且与aSAH后迟发性脑缺血(delayed cerebral ischemia,DCI)具有重要联系,并可导致预后不良.文章对aSAH后血糖升高的机制、引发DCI的原因以及相应的治疗措施进行了总结.     

An exploratory study of health behaviors and the risks for triple H (hypertension,hyperlipidemia, and hyperglycemia) in young adults with disabilities between 20 and 39 years of age

Metabolic syndrome is highly prevalent and has important implications for the health care sector. However, information on the implications of metabolic syndrome for people with disabilities is limited. The purpose of this study was to explore the relationship between health behaviors and the risk for triple H (hypertension, hyperlipidemia, and hyperglycemia) in young adults with disabilities. The present study analyzed the annual health examination charts of 705 young adults with disabilities between ages 20 and 39 in Taiwan. Results found that the prevalence of hyperglycemia, hyperlipidemia, and hypertension in adults with disabilities was 5%, 15% and 17.7%, respectively. These prevalence figures were higher than those for the general population of the same age group in Taiwan. Multivariate logistic regression analyses revealed that almost none of the health behaviors were significantly correlated with the occurrence of triple H disorders among young adults with disabilities. Only one factor, BMI, independently predicted the occurrence of triple H disorders. We suggest that future studies should scrutinize the effects of health behaviors on triple-H disorders in people with disabilities to initiate personalize health promotion programs for this group.     

Higher rate of hyperglycemia than hypoglycemia during Ramadan fasting in patients with uncontrolled type 1 diabetes: Insight from continuous glucose monitoring system

Background

Patients with uncontrolled type 1 diabetes mellitus (T1DM) are at a high risk for Ramadan fasting and are exempt from fasting; however, most still insist on fasting. The aim of this study was to examine glucose level fluctuations in those patients during Ramadan fasting using a real-time continuous glucose monitoring system (RT-CGMS).

当归芍药散对糖尿病认知障碍性疾病的研究进展

经典古方当归芍药散最初记载于《金匮要略》,主要用于治疗妇科疾病。现代方剂学将其归入理血剂中,当归芍药散的临床使用范围已经大大拓宽。本文总结了当归芍药散治疗糖尿病认知障碍性疾病的研究,从其对胰岛素代谢,细胞凋亡,炎症损伤,糖尿病心肌病,雌激素的影响以及抗氧化作用,降血糖作用和对神经保护等方面进行了综述研究。     

Effective reduction in stress induced postoperative hyperglycemia in bariatric surgery by better carb loading

BackgroundPreoperative carbohydrate loading is a recommended component of enhanced recovery protocols (ERP’s), however the impact on postoperative stress-induced insulin resistance remains poorly studied in both diabetics and non-diabetics.MethodsUsing our ERP, a preoperative grape juice group (Grape) was compared to the use of 25 g maltodextrin/3 g citrulline (G.E.D.™, SOF Health, LLC) for carbohydrate loading.ResultsThe population included 171 patients (Grape n = 96; GED n = 75). Glycemic variability was significantly worse for the Grape group on POD 0 in both non-diabetic (70% vs 41%; p < 0.05) and diabetic patients (66% vs 34%; p < 0.05). Significantly more Grape patients required postoperative insulin regardless of diabetic status.ConclusionFollowing bariatric surgery, the impact of stress induced hyperglycemia is primarily on POD 0 in non-diabetics whereas the effect extends into POD 1 for diabetics. Preoperative loading with G.E.D.™ versus grape juice is associated with a significantly lower rate of glycemic variation and postoperative insulin requirement, demonstrating that drink composition and treatment process reduces the severity of postoperative stress induced hyperglycemia in bariatric surgery patients.     

胃肠术后应激性高血糖患者实施早期低能量肠内营养支持的临床研究

目的 研究胃肠切除术后出现应激性高血糖患者实施早期肠内营养支持对血糖控制、胃肠道功能恢复、营养状况改善、并发症预防等方面的效果。方法 将40例胃肠切除术后出现应激性高血糖患者分成标准肠外营养支持组（30kcal/kg/d）、标准肠内营养支持组（30kcal/kg/d）、允许性低热量肠外营养支持组（20kcal/kg/d）及允许性低热量肠内营养支持组（20kcal/kg/d），监测各组术前、术后血常规、肝肾功能、IgA等，并观察有无感染发生现象。结论 术后短期的允许性低能量摄入并不妨碍患者肠功能、营养状况、免疫功能等的恢复及改善，而在此基础上的允许性低能量肠内营养支持依然是适用的。     

高血糖对脑出血疾病预后的影响

目的:观察高血糖对脑出血患者预后的影响。方法:128例脑出血患者根据血糖有无异常分为高血糖组与血糖正常组,2组患者治疗方法相似,观察2组患者生存率以及治疗效果。结果:高血糖组存活率为58.14%,血糖正常组为75.29%,后者显著高于前者,P<0.05。存活者经相似的治疗,血糖正常组治疗效果显著优于高血糖组,P<0.01。结论:高血糖对脑出血患者预后有不利影响,应加强血糖监测与控制。