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1.
目的：探讨联合检测超敏C反应蛋白( hs-CRP)和同型半胱氨酸( Hcy)水平在妊娠期糖尿病( GDM)诊断及对妊娠结局的预测价值。方法选择2012年1月至2014年3月在安吉县第三人民医院门诊接受检查的GDM患者35例作为观察组;选择同期经临床排除GDM的正常孕产妇35例作为对照组。检测两组患者的hs-CRP和Hcy、空腹血糖和胰岛素水平,并跟踪两组妊娠结局。结果观察组患者空腹血糖、胰岛素、hs-CRP 和 Hcy 水平均高于对照组,均有显著性差异( t 值分别为13.07、12.02、3.65和12.02,均P<0.05);观察组不良反应发生率为34.3%(12/35),对照组为11.4%(4/35),具有显著性差异(χ2=5.19,P<0.05)。有16例发生不良妊娠结局,其与54例正常妊娠者的hs-CRP和Hcy水平比较均明显增高,并有显著性差异( t值分别为7.88、14.17,均P<0.05)。结论妊娠女性的hs-CRP和Hcy水平与GDM发生具有密切联系,且高水平hs-CRP和Hcy对不良妊娠结局具有一定的预测作用,应该引起产科注意。 相似文献
2.
Siyu Chen Xuhong Hou Yu Sun Gang Hu Xiaoyan Zhou Huijuan Xue Peizhu Chen Jingzhu Wu Yuqian Bao Weiping Jia 《Primary Care Diabetes》2018,12(3):231-237
Aims
To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.Methods
985 adults with diabetes in the Shanghai Taopu community health service center were enrolled at baseline and 907 subjects completed the follow-up. The follow-up levels of the metabolic profiles were assessed by their averages during the follow up period.Results
After a mean 7-year follow-up period, heamoglobin A1c, systolic and diastolic blood pressure levels decreased by 0.6%, 5.7 mmHg, and 1.5 mmHg, respectively (all P < 0.001). There was a non-significant difference in low-density lipoprotein cholesterol, while high-density lipoprotein cholesterol increased 1.9 mg/dL and triglycerides decreased 28.3 mg/dL, respectively (all P < 0.001). The percentage of patients with diabetes who met any one of three Chinese Diabetes Society goals (heamoglobin A1c <7.0%, blood pressure <140/80 mmHg, and low-density lipoprotein cholesterol <100 mg/dL) increased from 58.2% to 70.1%. The chronic diabetes complication screening rates (diabetic retinopathy, diabetic neuropathy, diabetic nephropathy) have significantly increased, from almost zero to 12–78%.Conclusions
This long-term program has increased the proportions of attaining major cardiovascular risk factors control goals and diabetic chronic complication screening rates among patients with diabetes. 相似文献3.
Y.K. Cho Y.M. Kang S.E. Lee J. Lee J.-Y. Park W.J. Lee Y.-J. Kim C.H. Jung 《Diabetes & metabolism》2018,44(5):393-401
Background
This review evaluated the efficacy and safety of a combination therapy comprising a sodium-glucose cotransporter type 2 inhibitor (SGLT2i) and dipeptidyl peptidase-4 inhibitor (DPP4i) in type 2 diabetes.Methods
A literature search through to May 2017 was carried out of PubMed, Embase and the Cochrane Central Register of Controlled Trials. Studies were eligible if they were randomized controlled trials (RCTs) comparing SGLT2i plus DPP4i (SGLT2i/DPP4i) against DPP4i ± placebo or SGLT2i ± placebo and published in English. The primary outcome was change in HbA1c from baseline.Results
Eight RCTs comparing SGLT2i/DPP4i and DPP4i, and five RCTs comparing SGLT2i/DPP4i and SGLT2i, with three RCTs involving both comparisons, were included in the present review. SGLT2i/DPP4i resulted in a greater mean HbA1c reduction [weighted mean difference (WMD]): ?0.62%] than did DPP4i alone, which was a much less marked reduction (WMD: ?0.35%) than with SGLT2i alone. Also, significant differences in body weight loss from baseline were observed only with SGLT2i/DPP4i vs. DPP4i, but not vs. SGLT2i. The risk of hypoglycaemic events was low and similar between treatment groups. When subjects were stratified based on baseline HbA1c, any reduction by SGLT2i/DPP4i in relation to DPP4i was proportional to baseline HbA1c levels. However, compared with SGLT2i, HbA1c reductions with SGLT2i/DPP4i were modest regardless of baseline HbA1c.Conclusion
Combination therapy with SGLT2i and DPP4i is both efficacious and safe. In particular, a marked additional glucose-lowering effect is evident when SGLT2i is combined with or added to DPP4i, and not vice versa. However, baseline HbA1c determined the additional glucose-lowering effects of SGLT2i in combined treatment with DPP4i. 相似文献4.
Chia-Lin Lee Wayne Huey-Herng Sheu I-Te Lee Shih-Yi Lin Wen-Miin Liang Jun-Sing Wang Yu-Fen Li 《Diabetes & metabolism》2018,44(2):121-128
Aim
To investigate the effect of changes in fasting plasma glucose (FPG) variability, as assessed by 2-year trajectories of FPG variability, on mortality risk in patients with type 2 diabetes (T2D).Methods
From 2009 to 2012, outpatients with T2D, aged > 18 years, were enrolled from a medical centre. FPG was measured every 3 months for 2 years in 3569 people. For each of the eight 3-month intervals, FPG variability and means were calculated, with variability defined as the coefficient of variation of FPG. Also, trajectories of FPG variability and means were determined separately, using group-based trajectory analysis with latent class growth models. These models were fitted using the SAS Proc Traj procedure. The primary outcome was all-cause mortality, which was followed-up to the end of 2014.Results
Five distinct trajectories of FPG variability (low, increasing, fluctuating, decreasing and high) and means (well controlled, stable control, worsening control, improving control and poor control) were established. The five trajectories of mean FPG were all associated with the same mortality risk. In contrast, in comparison to the low FPG variability trajectory, the fluctuating, decreasing and high variability trajectories all had significantly higher risks of mortality, with respective hazards ratios of 2.63 (95% CI: 1.40–4.93; P = 0.003), 2.78 (95% CI: 1.33–5.80; P = 0.007) and 4.44 (95% CI: 1.78–11.06; P = 0.001) after multivariable adjustment.Conclusion
Changes in FPG variability were independently associated with increased mortality risk in patients with T2D. 相似文献5.
目的探讨维生素D_3片联合格列美脲片治疗2型糖尿病的临床疗效。方法选取2016年2月—2017年1月在襄阳市中心医院接受治疗的2型糖尿病患者86例,依据治疗方法差别分为对照组与治疗组,每组各43例。对照组初始口服格列美脲片,1 mg/次,1次/d,根据血糖调整用药,最大维持剂量不超过6 mg/d。治疗组在对照组的基础上口服维生素D_3片,1片/次,2次/d。两组患者均治疗4周。比较两组治疗前后临床疗效、血糖指标变化以及内环境稳态模型评估-β(HOMA-β)、HOMA-IR和25(OH)D_3水平。结果治疗后,对照组和治疗组的总有效率分别为81.40%和95.35%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(Hb Alc)及空腹胰岛素(FINS)水平均显著下降(P0.05);且治疗组血糖指标变化水平显著好于对照组(P0.05)。治疗后,两组HOMA-β及25(OH)D_3水平显著升高,并且HOMA-IR水平明显降低,同组比较差异具有统计学意义(P0.05);且治疗组上述指标改善情况显著优于对照组,两组比较差异具有统计学意义(P0.05)。结论维生素D_3片联合格列美脲片治疗2型糖尿病具有较好的临床效果,可有效改善胰岛素抵抗和提高敏感性,具有一定的临床推广应用价值。 相似文献
6.
目的探讨玉蓝降糖联合二甲双胍治疗2型糖尿病患者的有效性和安全性。方法选取河北省第七人民医院2015年12月—2016年12月收治的2型糖尿病患者125例,随机分成对照组(62例)和治疗组(63例)。对照组患者口服盐酸二甲双胍片,2片/次,2次/d,根据病情适当调整剂量。治疗组在对照组基础上口服玉蓝降糖胶囊,4粒/次,3次/d。所有患者均治疗3个月。观察两组患者临床疗效,比较治疗前后两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(Hb A1c)以及临床指标水平和不良反应情况。结果治疗后,对照组临床总有效率为82.26%,显著低于治疗组的96.83%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清FPG、2 h PG和Hb A1c水平显著降低(P0.05);且治疗组患者FPG、2 h PG和Hb A1c水平明显低于对照组(P0.05)。治疗后,两组患者BMI指数、收缩压(SBP)、尿酸(UA)和三酰甘油(TG)水平均显著降低(P0.05);且治疗组患者各指标改善情况均要明显低于对照组(P0.05)。治疗期间,对照组不良反应发生率为19.35%,明显高于治疗组的4.76%,两组比较差异具有统计学意义(P0.05)。结论玉蓝降糖联合二甲双胍治疗2型糖尿病疗效好,安全性高,具有一定的临床推广应用价值。 相似文献
7.
Lise K. Vesterdal Pernille H. DanielsenJanne K. Folkmann Line F. JespersenKarin Aguilar-Pelaez Martin RoursgaardSteffen Loft Peter Møller 《Toxicology and applied pharmacology》2014
Exposure to particles has been suggested to generate hepatosteatosis by oxidative stress mechanisms. We investigated lipid accumulation in cultured human hepatocytes (HepG2) and rat liver after exposure to four different carbon-based particles. HepG2 cells were exposed to particles for 3 h and subsequently incubated for another 18 h to manifest lipid accumulation. In an animal model of metabolic syndrome we investigated the association between intake of carbon black (CB, 14 nm) particles and hepatic lipid accumulation, inflammation and gene expression of Srebp-1, Fasn and Scd-1 involved in lipid synthesis. There was a concentration-dependent increase in intracellular lipid content after exposure to CB in HepG2 cells, which was only observed after co-exposure to oleic/palmitic acid. Similar results were observed in HepG2 cells after exposure to diesel exhaust particles, fullerenes C60 or pristine single-walled carbon nanotubes. All four types of particles also generated oxidatively damaged DNA, assessed as formamidopyrimidine DNA glycosylase (FPG) sensitive sites, in HepG2 cells after 3 h exposure. The animal model of metabolic syndrome showed increased lipid load in the liver after one oral exposure to 6.4 mg/kg of CB in lean Zucker rats. This was not associated with increased iNOS staining in the liver, indicating that the oral CB exposure was associated with hepatic steatosis rather than steatohepatitis. The lipid accumulation did not seem to be related to increased lipogenesis because there were unaltered gene expression levels in both the HepG2 cells and rat livers. Collectively, exposure to particles is associated with oxidative stress and steatosis in hepatocytes. 相似文献
8.
H.-W. Zhang X. Zhao Y.-L. Guo Y. Gao C.-G. Zhu N.-Q. Wu J.-J. Li 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2018,28(10):980-986
Background and aims
The role of lipoprotein (a) [Lp(a)] in coronary artery diseases (CAD) with special clinical background such as type 2 diabetes mellitus (T2DM) has not been fully determined. The aim of the present study was to investigate the relation of Lp(a) to type 2 diabetic patients with or without CAD.Methods and results
A total of 2040 consecutive patients with T2DM who received selective coronary angiography (CAG) due to angina-like chest pain were enrolled. The patients were subsequently divided into CAD and non-CAD groups according to the results of CAG. The severity of CAD was evaluated by the Gensini Score (GS), number of stenotic vessels, and history of myocardial infarction (MI). Data showed that Lp(a) levels were higher in the CAD group than in the non-CAD group (median: 15.00 mg/dL vs. 11.88 mg/dL, P = 0.025). The results from CAD subgroup analysis indicated that the patients with MI, multiple-vessel disease and high GS had higher Lp(a) levels compared with those in their matched subgroups (P < 0.05, respectively). After adjustment for confounders, Lp(a) levels were independently related to the presence and severity of CAD (CAD:OR = 1.564; MI:OR = 1.523; high GS:OR = 1.388; multiple-vessel disease:OR = 1.455; P < 0.05, respectively).Conclusion
Elevated Lp(a) levels were independently associated with the presence and severity of CAD in patients with T2DM. More studies are necessary to confirm our findings. 相似文献9.
Peter Stein Jolene K. Berg Linda Morrow David Polidori Eunice Artis Sarah Rusch Nicole Vaccaro Damayanthi Devineni 《Metabolism: clinical and experimental》2014
Objective
Canagliflozin is a sodium glucose co-transporter 2 inhibitor approved for treating patients with type 2 diabetes. This study evaluated renal and non-renal effects of canagliflozin on postprandial plasma glucose (PG) excursion in patients with type 2 diabetes inadequately controlled with metformin.Materials/Methods
Patients (N = 37) were randomized to a four-period crossover study with 3-day inpatient stays in each period and 2-week wash-outs between periods. Patients received Treatments (A) placebo/placebo, (B) canagliflozin 300 mg/placebo, (C) canagliflozin 300 mg/canagliflozin 300 mg, or (D) canagliflozin 300 mg/canagliflozin 150 mg on Day 2/Day 3 in one of four treatment sequences (similar urinary glucose excretion [UGE] expected for Treatments B–D). A mixed-meal tolerance test (MMTT) was given 20 minutes post-dose on Day 3 of each period.Results
A single dose of canagliflozin 300 mg reduced both fasting and postprandial PG compared with placebo, with generally similar effects on fasting PG and UGE observed for Treatments B–D. An additional dose of canagliflozin 300 mg (Treatment C), but not 150 mg (Treatment D), prior to the MMTT on Day 3 provided greater postprandial PG reduction versus placebo (difference in incremental glucose AUC0–2h, − 7.5% for B vs A; − 18.5% for C vs A; − 12.0% [P = 0.012] for C vs B), leading to modestly greater reductions in total glucose AUC0–2h with Treatment C versus Treatment B or D. Canagliflozin was generally well tolerated.Conclusions
These findings suggest that a non-renal mechanism (ie, beyond UGE) contributes to glucose lowering for canagliflozin 300 mg, but not 150 mg. 相似文献10.
Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia
Andreas Oberbach Jochen Neuhaus Thomas Inge Katharina Kirsch Nadine Schlichting Susann Blüher Yvonne Kullnick Joachim Kugler Sven Baumann Holger Till 《Metabolism: clinical and experimental》2014
