The reproducibility of the oral glucose tolerance test over long (5 years) and short periods (1 week)

Summary Three oral glucose tolerance tests (oGTT) have been performed in 312 non-diabetic relatives of diabetics over a period of 10 years. In a second study 6 identical oGTT's have been performed at weekly intervals in 55 individuals. In this study the variance, calculated from the logarithmic values, increased in the following order: fasting (0.026), 1 h (0.035), 2 h (0.044) and 3 h values (0.047). The sum of the 1 h and 2 h values showed the lowest variance (0.024). No significant difference of the variances was found in the 43 individuals in whom both the long-term and the short-term studies have been performed. Thus, a great proportion of the total variance of glucose observed over longer periods only represents a random variation. This random variation is much higher than most other factors which might influence the result of an oGTT. A diagnosis based on a single oGTT is of only limited value.Supported by a grant from Deutsche Forschungsgemeinschaft (Ko 457/8)     

老年糖调节受损者不同转归情况应对方式的比较研究

目的：探讨老年糖调节受损（IGR）者的应对方式特点,并比较不同转归情况的老年IGR者应对方式的差异.方法：对220例老年IGR者的空腹血浆葡萄糖（FPG）及口服葡萄糖试验2小时血浆葡萄糖（OGTT2hPG）进行测定,并用特质应对方式问卷（TCSQ）对其应对方式进行评定,对不同转归情况的老年IGR者应对方式的差异进行比较.结果：老年IGR者的应对方式总体上是比较积极的,积极应对得分高于国内常模（P＜0.001）;有27.73%～78.64%的老年IGR者采用不同形式的积极应对方式,而4.09%～18.18%采取消极应对方式;不同转归组的老年IGR者应对方式的差异无显著性（P＞0.05）.结论：在老年IGR者的心理干预中应多关注采用积极应对方式较少、消极应对方式较多的这些人群.     

降糖方对糖耐量异常大鼠糖脂代谢及骨骼肌组织IκB-α和NF-κBp65的影响

目的:探讨降糖方对糖耐量异常大鼠糖脂代谢及骨骼肌组织κB抑制蛋白α(IκB-α)、核转录因子肽p65(NF-κBp65)的影响。方法:SD大鼠随机分为正常组、模型组、盐酸二甲双胍组、降糖方低、高剂量组,采用高脂饮食喂养4周,链脲佐菌素(STZ)腹膜内注射建立糖耐量异常大鼠模型,治疗8周后,观察骨骼肌组织病理变化,测定空腹血糖(FPG)、血清胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、骨骼肌组织IκB-α mRNA、NF-κBp65 mRNA水平、骨骼肌组织白细胞介素-4(IL-4)、白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)蛋白水平。结果:正常组大鼠骨骼肌组织结构正常,模型组骨骼肌排列紊乱、肌纤维断裂、可见明显炎症细胞浸润;盐酸二甲双胍及降糖方干预后,骨骼肌炎症细胞浸润减少,肌纤维排列趋于整齐。模型组大鼠FPG、FINS、HOMA-IR水平、血清TG、TC、LDL-C水平、骨骼肌IκB-α mRNA、NF-κBp65 mRNA和蛋白水平、骨骼肌组织IL-4、IL-12、TNF-α蛋白水平高于对...     

Impaired glucose tolerance, diabetes mellitus, and gallstone disease: An extended study of male self-defense officials in Japan

Few studies have investigated the relation between glucose tolerance status and ultrasonographically determined gallstone disease. Using a 75-g oral glucose tolerance test, we examined the association of impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) with gallstone disease in Japanese men. Subjects were men aged 48 to 59 of the Japan Self-Defense Forces who received a preretirement health examination between October 1986 to December 1994. After exclusion of 12 men under insulin treatment in the consecutive series of 7637 men, 174 were found to have gallstones; 103 were at the state of postcholecystectomy, and 6899 had normal gallbladder. IGT and NIDDM were associated with a modestly increased risk of gallstone disease; adjusted odds ratios were 1.3 (95% confidence interval [CI]: 0.9–1.8) for IGT and 1.3 (95% CI: 0.8–2.0) for NIDDM after adjustment for hospital, rank, smoking, alcohol use, and body mass index. Adjusted odds ratio for IGT and NIDDM combined was 1.3 (95% CI: 1.0–1.7, p=0.08). When prevalent gallstones and postcholecystectomy were considered separately, NIDDM showed a significant, positive association with postcholecystectomy, but not with prevalent gallstones. The findings add to evidence that glucose intolerance is associated with a modest increase in the risk of gallstone disease.     

Insulin resistance is associated with decreased clinical status in cystic fibrosis

Patients with cystic fibrosis (CF) frequently have impaired glucose tolerance and progression to diabetes (DM) with clinical features of both insulin-dependent and non-insulin-dependent diabetes. One feature of non-insulin-dependent DM is decreased insulin sensitivity, also known as insulin resistance. The goal of this study was to determine whether patients with CF exhibit insulin resistance and to determine the potential effect of insulin resistance on clinical status. We also sought to determine whether insulin resistance is associated with a specific CF genotype. We studied 18 patients with CF (8 with normal glucose tolerance, 5 with impaired glucose tolerance, 5 with DM), and 20 lean control subjects matched for age, weight, and sex. All control subjects had normal glucose tolerance. The clinical status for each CF patient was determined according to a modified National Institutes of Health scoring system. Each subject underwent a three-step hyperinsulinemic euglycemic clamp (insulin doses of 10, 40, 120 mU/m ² per minute). Results from the 120 mU/m ² per minute infusion defined maximal glucose disposal rate (defined in milligrams per kilogram body weight per minute) at steady state with peripheral insulin levels 195 ± 20 mU/ml. Subjects with CF demonstrated insulin resistance (control subjects = 13.6 ± 1.1, patients with CF = 10.2 ± 1.6 mg/kg per minute; p = 0.003). When each subgroup was compared separately with control subjects, all subgroups were statistically insulin resistant (glucose disposal rate, patients with CF and normal glucose tolerance = 10.8; those with impaired glucose tolerance = 8.4; those with DM = 10.1 mg/kg per minute), and the patients with CF with impaired glucose tolerance were the most insulin resistant. When plotted versus glucose disposal rate, a striking positive correlation between worsened clinical status and insulin resistance ( r = 0.85) is demonstrated. Furthermore, there is no correlation between insulin resistance and fasting blood glucose, subject age, or percent ideal body weight (all r values not significant). In conclusion, patients with CF exhibit insulin resistance that is associated with worsened clinical status. We believe it is the combination of insulin resistance and decreased insulin secretion that is responsible for the high incidence of CF-related diabetes. (J Pediatr 1997;130:948-56)     

阿卡波糖对糖耐量减低者早期干预的影响

目的比较不同糖耐量水平者颈动脉内膜-中层厚度(IMT)和血清C-反应蛋白(CRP)水平;观察糖耐量减低(IGT)者应用阿卡波糖早期干预后的变化。方法256例受试者,行口服75g葡萄糖耐量试验(OGTT)并以1997年ADA定义分三组:糖耐量正常(NGT)组、糖调节受损(IGR)组和2型糖尿病(T2DM)组。测定颈动脉IMT及血清CRP浓度。将IGR组中的IGT及空腹血糖受损(IFG)+IGT患者随机分为治疗组(应用阿卡波糖)和对照组。结果(1)三组颈动脉IMT和血清CRP水平逐渐升高(P<0.05),Spearman等级相关分析显示颈动脉IMT及血清CRP浓度和糖耐量水平呈负相关(P<0.01)。(2)治疗16周后,治疗组与对照组相比颈动脉IMT及血清CRP浓度差异有统计学意义(P<0.01)。结论IGR程度越重,动脉粥样硬化(AS)病变也越重;对IGT患者使用阿卡波糖早期干预可能有益于减缓AS的发生和发展。     

鹅不食草煎液对小鼠肝损伤的保护作用

目的:观察鹅不食草煎液对小鼠3种肝损伤模型的保护作用.方法:采用四氯化碳(CCl4)、对乙酰氨基酚(APAP)、D-氨基半乳糖 脂多糖(D-GalN LPS)致3种小鼠肝损伤模型,测定血清谷丙转氨酶(ALT).结果:鹅不食草煎液能明显降低CCl4,APAP,D-GalN LPS引起的肝损伤后小鼠血清中升高的ALT水平.结论:鹅不食草煎液对实验性肝损伤有明显的保护作用.