Plasma polyunsaturated fatty acid profile and delta-5 desaturase activity are altered in patients with type 2 diabetes

Objective

The association between imbalance of polyunsaturated fatty acids (PUFAs), especially low plasma n-3 to n-6 PUFA ratio, and risk of cardiovascular diseases is well known. A balance of plasma PUFAs is determined not only by dietary fatty acid intake, but also by the endogenous fatty acid metabolism, which could be dysregulated by diabetes. In this study, we investigated the plasma n-3 and n-6 PUFA profile and fatty acid desaturase activity in patients with type 2 diabetes (T2D).

Materials/Methods

The subjects were 396 patients with T2D and 122 healthy controls. Plasma eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-γ-linolenic acid (DGLA) levels were measured by capillary gas chromatography.

Results

Plasma DHA, AA, and DGLA levels were significantly higher, and EPA levels tended to be lower in patients with T2D than in the controls. Patients with T2D also exhibited significantly lower EPA/AA, DHA/AA, and (EPA + DHA)/AA ratios, and a higher AA/DGLA ratio than the controls. Multiple regression analyses, including age, sex, body mass index, and metabolic parameters in the total population, revealed that the presence of T2D was independently associated with elevated plasma DHA, AA, and DGLA levels and decreased EPA/AA, DHA/AA, and (EPA + DHA)/AA ratios. Furthermore, T2D was independently and positively related to the AA/DGLA ratio, which serves as an estimate of delta (Δ)-5 desaturase activity.

Conclusions

Elevated plasma AA levels and decreased n-3 PUFA/AA ratios in T2D are attributable, at least partly, to Δ5 desaturase activation.     

Low circulating insulin-like growth factor-1 levels are associated with high serum uric acid in nondiabetic adult subjects

Background and aimsLow insulin-like growth factor-1 (IGF-1) levels and high uric acid concentrations are associated with cardio-metabolic disorders. Acute IGF-1 infusion decreases uric acid concentration in healthy individuals. In this study, we aimed to examine the relationship between IGF-1 and uric acid levels.Methods and results1430 adult non diabetic subjects were stratified into quartiles according to their circulating IGF-1 values. Significant differences in uric acid concentration, measured by the URICASE/POD method were observed between low (quartile 1), intermediate (quartile 2 and 3), and high (quartile 4) IGF-1 levels groups after adjusting for age, gender, and body mass index (P = 0.02). These differences remained significant after adjustment for blood pressure, total cholesterol, high density lipoprotein, triglycerides, fasting and 2 h post-load glucose levels, HOMA-IR index (P = 0.005), liver enzymes (P = 0.03), glucose tolerance status (P = 0.02), growth hormone levels (GH) (P = 0.05), anti-hypertensive treatments (P = 0.04) or diuretics use (P = 0.04)). To clarify the molecular links between IGF-1 and uric acid, we performed an in vitro study, incubating human hepatoma cells with uric acid for 24 or 48 h in the presence of GH and observed a 21% and 26% decrease, respectively, in GH-stimulated IGF-1 mRNA expression (P = 0.02 and P = 0.012, respectively). This effect appears to be mediated by uric acid ability to down regulate GH intracellular signaling; in fact we observed a significant decrease of GH activated JAK2 and Stat5 phosphorylation.ConclusionsThese data demonstrate an inverse relationship between IGF-1 and uric acid levels in adults and suggest that uric acid might affect hepatic IGF-1 synthesis.     

Urinary neutrophil gelatinase-associated lipocalin in type 2 diabetes: Relation to nephropathy and retinopathy

Background

Diabetes mellitus is the leading cause of end stage renal disease worldwide. Early identification of diabetic nephropathy even before appearance of microalbuminuria is a challenge for early prevention of occurrence and progression of this complication. Neutrophil gelatinase-associated lipocalin is a small protein that belongs to the lipocalin protein. Urinary neutrophil gelatinase-associated lipocalin is a promising early marker in different renal problems.

瑞格列奈联合阿卡波糖治疗2型糖尿病的临床效果及HbA1c、FPG、2hPG水平影响评价

目的 分析瑞格列奈联合阿卡波糖治疗2型糖尿病的临床效果及对HbA1c、FPG、2 hPG水平的影响.方法 该次研究中的88例观察对象均抽选于2019年4月—2020年4月在该院接受治疗的2型糖尿病患者当中.应用数字随机分组的方式将患者分为两组,对照组患者接受瑞格列奈联合盐酸二甲双胍治疗,观察组患者给予瑞格列奈联合阿卡波...     

Changes in serum adiponectin concentrations and endothelial function after intensive insulin treatment in people with newly diagnosed type 2 diabetes: a pilot study

Aims

We aimed to assess changes in serum adiponectin and endothelial function after intensive insulin treatment in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Methods

Patients with newly diagnosed T2DM were randomly assigned to Group A (intensive insulin treatment) or Group B (conventional insulin treatment). Before treatment and 2 weeks after plasma glucose concentrations had been maintained at the specified concentrations, blood samples were obtained to measure serum adiponectin and nitric oxide (NO) concentrations. A total of 21 patients were randomized to each Group.

Results

Adiponectin, NO, endothelium-dependent vasodilation (EDD), and endothelium-independent vasodilation (EID) measures were significantly higher post-treatment than pre-treatment in Group A (all P < 0.05). Only EID was significantly higher in Group B (P < 0.05). Post-treatment adiponectin and NO concentrations, and EDD were significantly higher in Group A compared with Group B (all P < 0.05). Both treatment regimens were well tolerated (all patients completed the study). The most common adverse event was hypoglycemia. Thus, early intensive insulin therapy can increase serum adiponectin and NO concentrations and improve endothelial function in patients with newly diagnosed T2DM.

Conclusions

These effects may underlie the reduced incidence of microvascular and macrovascular in patients who receive early intensive hypoglycemic therapy.     

不同空腹血糖水平与非酒精性脂肪性肝病的相关性研究

目的 探讨不同FPG水平与非酒精性脂肪性肝病(NAFLD)的相关性. 方法 选取7896名研究对象进行统一问卷调查、血液生化和肝脏超声检查,根据FPG水平将研究对象分为NGT、IFG和T2DM组,分析NAFLD影响因素. 结果 NGT、IFG、T2DM组NAFLD检出率分别为43.0％、63.0％和67.6％,IFG、T2DM组发生NAFLD的OR值分别是NGT组的1.31、1.77倍(95％CI:1.07～1.60、1.42～2.20,P＜0.01). 结论 IFG和T2DM是发生NAFLD的独立危险因素.     

三级医院-社区糖尿病管理模式的应用

目的探讨三级医院-社区糖尿病管理模式的应用效果。方法选定景德镇市梨树园社区、莲花山社区、太平巷社区、北路社区及赛跑坦社区5个社区,从中抽取100例2型糖尿病患者作为研究对象,并将其随机分为观察组和对照组,各50例,对照组进行常规的糖尿病临床治疗和管理,由社区医师对糖尿病患者进行疾病教育管理,观察组患者采用三级医院-社区糖尿病管理模式,监测FPG、2 hPG、HbA1C等指标,进行健康教育跟踪及随访,建立社区糖尿病患者电子信息数据库,3个月后再次检测两组患者的FPG、2 hPG、 HbA1C等指标。对比两组患者的FPG、2 hPG、 HbA1C水平以及治疗满意度。结果两组患者FPG、2 hPG、 HbA1C等指标比较,差异具有统计学意义(P0.05)。观察组患者的满意度92.0%(46/50)显著高于对照组76.0%(38/50)(P0.05)。结论采用三级医院-社区糖尿病管理模式糖尿病患者在代谢指标方面,效果明显好于采用常规的糖尿病临床治疗和管理的患者,因此在信息化技术手段的支持下,进行三级医院-社区糖尿病管理模式的推广探索具有一定的应用价值。     

参芪降糖颗粒联合米格列醇治疗2型糖尿病的临床研究

目的 探讨参芪降糖颗粒联合米格列醇治疗2型糖尿病的临床疗效。方法 选择2019年9月—2021年9月淮南东方医院集团总医院收治的96例2型糖尿病患者,随机分对照组和治疗组,每组各48例。对照组患者餐前口服米格列醇片,50 mg/次,3次/d。治疗组在对照组基础上口服参芪降糖颗粒,3 g/次,3次/d。两组治疗3个月。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,空腹血糖（FPG）、糖化血红蛋白（Hb A1c）、餐后2 h血糖（2 h PG）、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平,及不良反应。结果 治疗后,治疗组临床总有效率明显高于对照组（97.92%vs 81.25%,P<0.05）。治疗后,治疗组多尿、多食、体质量减轻、皮肤瘙痒等症状缓解时间均明显早于对照组（P<0.05）。治疗后,两组患者FPG、Hb A1c、P2h PG、IL-6、TNF-α、IL-1β和IL-8水平均明显低于治疗前（P<0.05）,且治疗组明显低于对照组（P<0.05）。治疗组不良反应发生率为...     

养阴降糖片联合格列美脲治疗2型糖尿病的临床研究

目的 探讨养阴降糖片联合格列美脲片治疗2型糖尿病的临床疗效。方法 选取2021年3月—2022年3月在山西运城同德医院治疗的106例2型糖尿病患者,根据住院号的奇偶性分为对照组和治疗组,每组各53例。对照组早餐时口服格列美脲片,初始2 mg/次,1次/d,对降糖药敏感者1 mg/次,1次/d,维持剂量1～4 mg/次,1次/d,最大维持量不超过6 mg/次,1次/d;在此基础上治疗组口服养阴降糖片,4片/次,3次/d。两组患者均连续治疗4周进行效果对比。观察两组患者临床疗效,比较治疗前后两组患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbAlc）、血胰岛素（FINS）和胰岛素抵抗指数（HOMA-IR）水平,HFS-II评分、DDS评分、中医证候积分、DSC评分和CDES-SF评分,血清视黄醇结合蛋白4(RBP4)、摄食抑制因子-1(Nesfatin-1)、抑瘤素M(OSM)、鸢尾素和血清网膜素-1(Omentin-1)水平。结果 治疗后,对照组临床有效率为81.13%,明显低于治疗组98.11%(P<0.05)。治疗后,两组FPG、2 h PG、HbAl...     

消渴康颗粒联合洛塞那肽治疗2型糖尿病的临床研究

目的 探讨消渴康颗粒联合聚乙二醇洛塞那肽注射液治疗2型糖尿病的临床疗效。方法 选取2020年2月—2022年1月在天津医科大学第二医院就诊的104例2型糖尿病患者,按照随机数字表法将所有患者分为对照组和治疗组,每组52例。对照组皮下注射聚乙二醇洛塞那肽注射液,0.1 mg/次,1次/周。治疗组在对照组基础上口服消渴康颗粒,1袋/次,3次/d。两组在治疗30 d后统计疗效。观察两组的临床疗效,比较两组血糖指标、血糖波动指标以及脂肪型脂肪酸结合蛋白（A-FABP）、趋化素（chemerin）、白细胞介素-17(IL-17)水平。结果 治疗后,治疗组的总有效率为96.15%,高于对照组的总有效率82.69%,组间比较差异显著（P<0.05）。治疗后,两组患者的空腹血糖（FPG）、糖化血红蛋白（HbA1c）、餐后2 h血糖（2 h BG）显著降低（P<0.05）,治疗组FPG、HbA1c、2 h BG比对照组更低（P<0.05）。治疗后,两组的平均血糖波动幅度（MAGE）、日间血糖平均绝对差（MODD）、血糖水平标准差（SDBG）水平均明显降低（P<0.05）,治疗组M...