可乐定对慢性神经病理性痛大鼠背根神经节GAP-43 mRNA表达的影响

目的 探讨可乐定对慢性神经病理性痛大鼠生长相关蛋白(GAP-43)mRNA表达的影响.方法 雄性成年SD大鼠36只,体重180～220 g,随机分为假手术组(S组)、慢性压迫性损伤组(CCI组)和可乐定组(CL组),每组12只.采用结扎坐骨神经法制备慢性压迫性损伤模型,S组仅暴露坐骨神经,不结扎.CL组于坐骨神经结扎术后3～14 d每天腹腔注射可乐定1 mg/kg.S组和CCI组腹腔注射生理盐水1 ml.于术前、术后3、7、14 d时测定机械痛阈和热痛阈,术后3、7、14 d测定痛阈后随机取4只大鼠断头处死,取腰段脊髓(L_(4～6))及背根神经节,采用RT-PCR法检测GAP-43 mRNA的表达水平.结果 与S组比较,CCI组和CL组术后机械痛阈和热痛阈降低,背根神经节GAP-43 mRNA表达上调(P<0.05);与CCI组比较,CL组术后7、14 d时机械痛阈和热痛阈升高,背根神经节GAP-43 mRNA表达下调(P<0.05).结论 坐骨神经结扎术后3～14 d每天腹腔注射可乐定1 mg/kg可有效减轻大鼠慢性神经病理性痛,其机制可能与其抑制背根神经节GAP-43 mRNA表达上调有关.     

氯胺酮与可乐定对神经病理性痛大鼠脊髓P2X4R mRNA表达的影响

目的 评价氯胺酮与可乐定对神经病理性痛大鼠脊髓P2X4受体mRNA(P2X4R mRNA)表达的影响.方法 雄性SD大鼠80只,体重180～220 g,随机分为假手术组(S组)、神经病理性痛组(NP组)、氯胺酮组(K组)、可乐定组(CL组)和氯胺酮+可乐定组(KC组),每组16只.采用坐骨神经慢性压迫(CCI)法制备大鼠神经病理性痛模型.K组、CL组、KC组于CCI后3～21 d每天分别腹腔注射氯胺酮10 mg/kg、可乐定1 mg/kg和氯胺酮5 mg/kg+可乐定0.5 mg/kg.S组和NP组腹腔注射等容量生理盐水.分别于CCI前1 d、CCI后3、7、14和21 d且腹腔注射前,随机取4只大鼠,测定机械痛阈和热痛阈,并于CCI前1 d、CCI后7、14和21 d痛阈测定结束后断头处死,测定脊髓P2X4R mRNA表达水平.结果 与CCI前1 d比较,CCI后S组热痛阈、机械痛阈和脊髓P2X4R mRNA表达差异无统计学意义(P>0.05),其余4组热痛阈和机械痛阈降低,脊髓P2X4R mRNA表达上调(P<0.05);与NP组比较,K组、CL组、KC组CCI后热痛阈及机械痛阈升高,脊髓P2X4R mRNA表达下调(P<0.05);与K组比较,KC组CCI后热痛阈和机械痛阈升高,脊髓P2X4R mRNA表达下调(P<0.05),CL组上述指标差异无统计学意义(P>0.05).结论 氯胺酮与可乐定减轻大鼠神经病理性痛的机制可能与下调脊髓P2X4R mRNA的表达有关.     

氯胺酮对CCI大鼠背根神经节GAP-43 mRNA表达的影响

目的 观察氯胺酮对坐骨神经慢性压迫损伤(CCI)模型大鼠背根神经节(DRG)生长相关蛋白(GAP-43) mRNA表达的影响.方法 36只成年雄性SD大鼠.体重180～220g,随机均分为三组.氯胺酮组(K组)和CCI组(C组)均采用CCI模型,假手术组(S组)仅暴露坐骨神经,不结扎.K组大鼠于CCI后3～14d每天腹腔注射氯胺酮10mg/kg,C组和S组腹腔注射等容量生理盐水.在术前(To)、术后3d(T1)、7d(T2)、14d(T3)时测定机械痛阈和热痛阈值;T1～T3时测定痛阈后,每组随机取4只大鼠取腰段脊髓背根神经节(DRG)检测GAP-43 mRNA的水平.结果 与S组比较,K组和C组术后机械痛阈和热痛阈降低,GAP-43 mRNA表达升高(P<0.05);与NP组比较,T2、T3时K组机械痛阈和热痛阈升高,GAP-43 mRNA表达降低(P<0.05).结论 腹腔注射氯胺酮10mg/kg可减轻CCI大鼠疼痛,其机制可能与抑制DRG中GAP-43 mRNA表达升高有关.     

鞘内注射NaV 1.8反义寡核苷酸对慢性神经病理性疼痛大鼠的镇痛作用

目的探讨鞘内注射Nav1．8反义寡核苷酸对慢性神经病理性疼痛大鼠的镇痛作用。方法雄性SD大鼠24只，随机分为4组（n=6）：Ⅰ组（CCI＋生理盐水组）；Ⅱ组（CCI＋Nav1．8错义寡核苷酸45μg组）；Ⅲ组（CCI＋Nav1．8反义寡核苷酸45μg组）；Ⅳ组（CCI＋Nav1．8反义寡核苷酸90μg组）。按Bennett法制作CCI模型，CCI5d鞘内置管，CCI8d开始鞘内给药，每日给药2次，连续5d。于CCI前2d和CCI1、3、5、7、9、11、13d测定机械痛阈和热痛阈，CCI 14d取双侧L4-6背根神经节（DRG），测定钠通道Nav1．8mRNA的表达。结果与CCI前2d前比较，Ⅰ、Ⅱ组在CCI5～13d术侧机械痛阈降低，热痛阈缩短；Ⅲ组CCI5～13d术侧机械痛阈降低，CCI3．9d热痛阈缩短，Ⅳ组CCI5—9d术侧机械痛阈降低，CCI3～7d热痛阈缩短（P〈0．05或0．01）。与Ⅰ、Ⅱ组比较，Ⅲ、Ⅳ组CCI 11、13d术侧机械痛阈增加，热痛阈延长（P〈0．05或〈0．01）。CCI14dⅢ、Ⅳ组术侧DRG中Nayl．8mRNA表达低于Ⅰ、Ⅱ组（P〈0．01），Ⅳ组DRGNay1．8mRNA表达低于Ⅲ组（P〈0．01）。结论鞘内注射45、90μg/次Nayl．8反义寡核苷酸对大鼠神经病理性疼痛有镇痛作用，90μg/次剂量效果较好，其机制是通过下调DRG中Nay1．8mRNA钠通道表达实现。     

神经病理性疼痛大鼠背根神经节钠离子通道β亚基mRNA表达的变化

目的观察神经病理性疼痛大鼠背根神经节（DRG）电压门控性钠离子通道β亚基mRNA表达的变化。方法雄性sD大鼠32只，体重250～400g，随机分为2组，假手术组（Sham组，n=12）和神经病理性疼痛组（PSNL组，n=20），PSNL组参照Seltzer等的方法建立大鼠坐骨神经部分结扎模型，Sham组手术操作与PSNL组基本相同，但不结扎坐骨神经。于PSNL前及PSNL1、2、3、5、8、11、14、28d测定机械痛阈和热痛阈；PSNL14d时分别处死PSNL组的8只大鼠和Sham组的4只大鼠，取L4,5，的DRG，做冰冻切片，以地高辛标记的三种β比较，PSNL组PSNL3～28d时热痛阈和机械痛阈降低（P＜0．01）；各组区亚基mRNA表达无明显变化，β2亚基mRNA表达较少，与Sham组和PSNL组结扎对侧比较，PSNL组结扎侧β2亚基mRNA表达增加（P＜0．05）。结论DRG中钠离子通道β3亚基mRNA表达上调在神经病理性疼痛中起重要作用。     

神经病理性痛大鼠背根神经节TRESK mRNA表达的变化

目的 探讨神经病理性痛大鼠背根神经节(DRG) 孔钾离子通道TRESK mRNA表达的变化.方法 雄性SD大鼠32只,体重22、0～250 g,采用随机数字表法,将大鼠随机分为2组(n=16):假手术组(S组)和神经病理性痛组(NP组).采用坐骨神经分支选择性损伤法制备神经病理性痛模型.S组仅暴露神经,不结扎.于术前1 d和术后1、3、5、7、14 d取8只大鼠,测定左后肢机械缩足反应阈值(MWT)和热缩足潜伏期(TWL).于术前1 d和术后14 d痛阈测定结束后取L4,5术侧DRG,采用RT-PCR法测定TRESK mRNA的表达.结果 与S组比较,NP组MWT明显降低,DRG TRESK mRNA表达明显下调(P<0.05或0.01),TWL差异无统计学意义(P>0.05).结论 神经病理性痛大鼠DRG TRESK mRNA表达下调,该变化可能与神经病理性痛的形成有关.     

神经病理性痛大鼠背根神经节TRESK mRNA表达的变化

目的 探讨神经病理性痛大鼠背根神经节(DRG) 孔钾离子通道TRESK mRNA表达的变化.方法 雄性SD大鼠32只,体重22、0～250 g,采用随机数字表法,将大鼠随机分为2组(n=16):假手术组(S组)和神经病理性痛组(NP组).采用坐骨神经分支选择性损伤法制备神经病理性痛模型.S组仅暴露神经,不结扎.于术前1 d和术后1、3、5、7、14 d取8只大鼠,测定左后肢机械缩足反应阈值(MWT)和热缩足潜伏期(TWL).于术前1 d和术后14 d痛阈测定结束后取L4,5术侧DRG,采用RT-PCR法测定TRESK mRNA的表达.结果 与S组比较,NP组MWT明显降低,DRG TRESK mRNA表达明显下调(P<0.05或0.01),TWL差异无统计学意义(P>0.05).结论 神经病理性痛大鼠DRG TRESK mRNA表达下调,该变化可能与神经病理性痛的形成有关.     

慢性神经病理性疼痛大鼠背根神经节和脊髓背角pCREB表达的变化

目的 探讨背根神经节和脊髓背角磷酸化cAMP反应元件结合蛋白（pCREB）表达在慢性压迫性神经损伤（CCI）致神经病理性疼痛大鼠痛觉过敏中的作用。方法 成年雌性SD大鼠32只，体重230-270g，随机分为4组（n=8）：空白组、sham组、CCI 2w组和CCI 4w组。CCI前测定痛阈[机械缩足反射阈值（MWT）和热缩足反射潜伏期（TWL）]基础值，CCI后（空白组、sham组和CCI 2w组于CCI 14d；CCI 4w组于CCI28d）再次测定痛阈。最后一次测定痛阈后次日，取I4-5脊髓和I5背根神经节，免疫组织化学染色，计数pCREB免疫反应阳性（pCREB-IR）神经细胞数量。结果 MWT：CCI后sham组、CCI2w组、CCI 4w组均低于基础值，CCI后sham组低于空白组，CCI2w组低于sham组（P〈0．01）；1wL：CCI2w组短于基础值，CCI2w组短于sham组，CCI后CCI4w组长于CCI2w组（P〈0．01）。sham组背根神经节pCREB-IR神经细胞数量多于空白组，CCI2w组背根神经节及脊髓背角pCREB-IR神经细胞数量多于sham组，CCI4w组背根神经节及脊髓背角pCREB-IR神经细胞数量少于CCI2w组（P〈0．05或0．01）。结论 CCI致慢性神经病理性疼痛大鼠背根神经节和脊髓背角pCREB表达增加，这可能是外周神经损伤后中枢和外周敏感化的分子机制。     

骨癌痛大鼠背根神经节电压依赖性钠通道Nav1.8 mRNA的表达

目的 探讨骨癌痛大鼠背根神经节(DRG)电压依赖性钠通道Nav1.8 mRNA的表达.方法 成年雌性SD大鼠16只,体重180～200 g,随机分为对照组和骨癌痛组,每组8只.对照组腹腔注射10%水合氯醛300 mg/kg麻醉后处死,冰上取L5,6 DRG.骨癌痛组采用胫骨内注射肿瘤细胞的方法制备大鼠骨癌痛模型,术前及术后14 d测定大鼠机械痛阈和CO2激光热痛阈,术后14 d处死大鼠,取L5,6 DRG.采用定量PCR方法测定DRG Nav1.8 mRNA的表达.结果 骨癌痛组机械痛阈与热痛阈较术前明显降低(P＜0.01);与对照组相比,骨癌痛组术后14 d DRG Na 1.8 mRNA表达上调(P＜0.01).结论 骨癌痛大鼠DRG Nav1.8 mRNA表达上调,该通道可能参与骨癌痛的发生.     

神经病理性痛大鼠背根神经节JNK的表达

目的 探讨神经病理性痛大鼠背根神经节C-Jun氨基末端蛋白激酶(JNK)的表达.方法 雄性SD大鼠88只,体重200～250 g.随机分为2组(n=44):假手术组(SH组)和慢性压迫性损伤组(CCI组).结扎大鼠右侧坐骨神经建立CCI模型.各组取8只大鼠,于CCI前、CCI后1、3、5、7、14 d时,测定热刺激缩足反射潜伏期(TWL).各组于CCI前、CCI后1、3、5、7、14 d时,各取6只大鼠测定背根神经节磷酸化JNK(p-JNK)的表达.结果 与CCI前比较,CCI组CCI后各时点TWL降低,p-JNK表达增加(P＜0.01);与SH组比较,CCI组CCI后3、5、7、14 d时TWL降低,p-JNK表达增加(P＜0.01).结论 背根神经节JNK表达升高可能参与了大鼠神经病理性痛的形成.     

Osseointegration by bone morphogenetic protein-2 and transforming growth factor beta2 coated titanium implants in femora of New Zealand white rabbits

Background:

Intramembranous bone formation is essential in uncemented joint replacement to provide a mechanical anchorage of the implant. Since the discovery of bone morphogenic proteins (BMPs) by Urist in 1965, many studies have been conducted to show the influence of growth factors on implant ingrowth. In this study, the influence of bone morphogenetic protein-2 (rhBMP-2) and transforming growth factor β2 (TGF-β2) on implant osseointegration was investigated.

Materials and Methods:

Thirty-two titanium cylinders were implanted into the femoral condyles of both hind legs of New Zealand White Rabbits. Four experimental groups were investigated: controls without coating, a macromolecular copolymer + covalently bound BMP-2, adsorbed BMP-2, and absorbed BMP-2+TGF-β2. All samples were analyzed by ex vivo high-resolution micro-computed-tomography after 28 days of healing. Bone volume per total volume (BV/TV) was recorded around each implant. Afterward, all samples were biomechanically tested in a pull-out setup.

Results:

The highest BV/TV ratio was seen in the BMP-2 group, followed by the BMP-2+TGF-β2 group in high-resolution micro-computed-tomography. These groups were significantly different compared to the control group (P < 0.05). Copolymer+BMP-2 showed no significant difference in comparison to controls. In the pull-out setup, all groups showed higher fixation strength compared to the control group; these differences were not significant.

Conclusions:

No differences between BMP-2 alone and a combination of BMP-2+TGF-β2 could be seen in the present study. However, the results of this study confirm the results of other studies that a coating with growth factors is able to enhance bone implant ingrowth. This may be of importance in defect situations during revision surgery to support the implant ingrowth and implant anchorage.     

Transcutaneous CO2/O2 and CO2/air suction in patients undergoing cataract surgery with retrobulbar anaesthesia

We investigated transcutaneous partial CO2 and O2 pressures and respiratory rate in unpremedicated elderly patients of ASA physical status 1 to 3 who underwent cataract surgery under retrobulbar anaesthesia. In group A no air suction was used. In group B suction was applied under the sterile drapes to avoid rebreathing of CO2. In group A transcutaneous partial CO2 pressure and respiratory rate significantly increased compared with baseline, whereas in group B they remained constant. In both groups transcutaneous partial O2 pressure and oxygen saturation as measured by pulse oximetry significantly rose after insufflating oxygen 31.min-1. Heart rate and mean arterial blood pressure remained constant. Our results demonstrate that the application of suction near the patient's head prevents CO2 rebreathing and subsequent hypercapnia associated with an elevated respiratory rate. The use of suction makes it unnecessary to raise oxygen administration. Suction combined with monitoring of partial CO2 pressure using transcutaneous sensors should be used in all ophthalmological operations under retrobulbar anaesthesia.     

β2微球蛋白与透析相关淀粉样变

β2微球蛋白(β2M)是典型的中分子尿毒症毒素，是透析相关淀粉样变的前体蛋白。透析相关淀粉样变是终末期肾脏病患者的一种严重并发症，主要表现为骨关节病变，如腕管综合征、骨囊肿、骨关节病、破坏性脊柱关节病等，晚期也可出现其他系统受累。本文就透析相关淀粉样变的发病机制、临床表现、诊断方法和防治等方面的研究进展进行了综述。     

β-cell dysfunction: Its critical role in prevention and management of type 2 diabetes

Type 2 diabetes(T2DM) is characterized by insulin resistance and β-cell dysfunction. Although, in contrast to type 1 diabetes, insulin resistance is assumed to be a major pathophysiological feature of T2 DM, T2 DM never develops unless β-cells fail to compensate insulin resistance. Recent studies have revealed that a deficit of β-cell functional mass is an essential component of the pathophysiology of T2 DM, implying that β-cell deficit is a common feature of both type 1 and type 2 diabetes. β-cell dysfunction is present at the diagnosis of T2 DM and progressively worsens with disease duration. β-cell dysfunction is associated with worseningof glycemic control and treatment failure; thus, it is important to preserve or recover β-cell functional mass in the management of T2 DM. Since β-cell regenerative capacity appears somewhat limited in humans, reducing β-cell workload appears to be the most effective way to preserve β-cell functional mass to date, underpinning the importance of lifestyle modification and weight loss for the treatment and prevention of T2 DM. This review summarizes the current knowledge on β-cell functional mass in T2 DM and discusses the treatment strategy for T2 DM.     

腹腔镜胆囊切除术CO2气腹对脉搏血氧饱和度的影响

目的:观察腹腔镜胆囊切除术(laparoscop ic cholecystectomy,LC)CO2气腹对脉搏血氧饱和度的影响。方法:按照美国麻醉医师协会体格情况分级(ASA)标准,选择ASAⅠ~Ⅱ级600例患者全麻下行LC,在围手术期对脉搏血氧饱和度(SpO2)进行连续监测。结果:CO2充气后3m in SpO2明显下降(P<0.01),放气后恢复到术前水平。结论:CO2气腹对脉搏血氧饱和度存在一定程度的影响,因此CO2气腹压力不宜过大,应限制在10~12mm Hg为宜,对老年患者伴有心、肺功能不全及肥胖者更要加强麻醉管理,加强SpO2、呼气末二氧化碳分压(PETCO2)监测。     

Re-testing and misclassification of HIV-2 and HIV-1&2 dually reactive patients among the HIV-2 cohort of The West African Database to evaluate AIDS collaboration

Introduction

West Africa is characterized by the circulation of HIV-1 and HIV-2. The laboratory diagnosis of these two infections as well as the choice of a first-line antiretroviral therapy (ART) is challenging, considering the limited access to second-line regimens. This study aimed at confirming the classification of HIV-2 and HIV-1&2 dually reactive patients followed up in the HIV-2 cohort of the West African Database to evaluate AIDS collaboration.

Method

A cross-sectional survey was conducted from March to December 2012 in Burkina Faso, Côte d’Ivoire and Mali among patients classified as HIV-2 or HIV-1&2 dually reactive according to the national HIV testing algorithms. A 5-ml blood sample was collected from each patient and tested in a single reference laboratory in Côte d’Ivoire (CeDReS, Abidjan) with two immuno-enzymatic tests: ImmunoCombII^® (HIV-1&2 ImmunoComb BiSpot – Alere) and an in-house ELISA test, approved by the French National AIDS and hepatitis Research Agency (ANRS).

Results

A total of 547 patients were included; 57% of them were initially classified as HIV-2 and 43% as HIV-1&2 dually reactive. Half of the patients had CD4≥500 cells/mm³ and 68.6% were on ART. Of the 312 patients initially classified as HIV-2, 267 (85.7%) were confirmed as HIV-2 with ImmunoCombII^® and in-house ELISA while 16 (5.1%) and 9 (2.9%) were reclassified as HIV-1 and HIV-1&2, respectively (Kappa=0.69; p<0.001). Among the 235 patients initially classified as HIV-1&2 dually reactive, only 54 (23.0%) were confirmed as dually reactive with ImmunoCombII^® and in-house ELISA, while 103 (43.8%) and 33 (14.0%) were reclassified as HIV-1 and HIV-2 mono-infected, respectively (kappa= 0.70; p<0.001). Overall, 300 samples (54.8%) were concordantly classified as HIV-2, 63 (11.5%) as HIV-1&2 dually reactive and 119 (21.8%) as HIV-1 (kappa=0.79; p<0.001). The two tests gave discordant results for 65 samples (11.9%).

Conclusions

Patients with HIV-2 mono-infection are correctly discriminated by the national algorithms used in West African countries. HIV-1&2 dually reactive patients should be systematically investigated, with a standardized algorithm using more accurate tests, before initiating ART as at least 4 out of 10 of them could initiate an effective first-line ART for HIV-1 and optimize their second-line treatment options.     

雌、孕激素受体和表皮生长因子受体2在乳腺癌分型中的应用

目的 研究乳腺癌分子亚型的临床病理特征及预后.方法 SP法检测509例手术切除的乳腺癌雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、表皮生长因子受体2(erbB-2,Her-2)表达并对其分型,Her-2-、ER/PR+为腔上皮样A亚型(Luminal A),Her-2+、ER/PR+为腔上皮样B亚型(Luminal B),Her-2-、ER-、PR-为三阴性型(Tripie-negative)、Her-2+、ER-、PR-为ERBB2+亚型(ERBB2+).χ~2检验比较亚型的临床病理特征,Kaplan-Meier法分析5年无瘤生存率(DFS),单因素和Cox多因素分析与复发和转移相关的因素.结果 Luminal A占所有病例40.5%(206/509),Luminal B占18.5%(94/509),Tripie-negative占21.4%(109/509),ERBB2+19.6%(100/509).三阴性型乳腺癌中髓样癌的比例高于其他类型乳腺癌(P<0.05),4种亚型复发转移率差异有统计学意义(P=0.029).多因素分析发现淋巴结状态和l临床分期是独立的预后影响因素(P=0.000).ERBB2+和Triple-negative的DFS分别为81%、78.9%,低于Luminal A和Luminal B的DFS(88.8%、90.4%)(P=0.025).结论 在本组乳腺癌患者中,Luminal A亚型所占比例最高,Triple-negative和ERBB2+复发转移率高,预后较Luminal A和Luminal B亚型差.     

Soluble interleukin 2 receptor (Tac chain) is not a reliable marker in kidney transplant recipient monitoring

T lymphocyte expansion is triggered through interaction of interleukin 2 (IL-2) with its high-affinity receptor (IL-2R). This molecule is a heterodimer comprising an antigen-inducible component, the Tac chain (P55). Activation of T lymphocytes also generates a soluble form of this P55 called S-IL-2R. S-IL-2R is elevated in many T-cell-related pathologies (leukaemia, autoimmunity, etc.). In graft recipients, rejection is a result of T-cell activation by graft antigens and therefore might induce a release of S-IL-2R in the circulation; this parameter is now said to be a good indicator of rejection. We have performed a study in renal graft recipients in order to assess the usefulness of circulating S-IL-2R particularly to discriminate the origin of renal failure in cases of rejection or of cyclosporin-A (CsA)-induced nephrotoxicity. We demonstrated that there are no differences between isolated values in the clinical groups at the time of diagnosis. Variations in S-IL-2R are increased compared to steady-state periods during rejection and cytomegalovirus infections, although not in CsA toxicity episodes. However, at the individual level there are too many false-positive and false-negative results, making this parameter no more meaningful than serum creatinine levels alone or even in association (as tested in logistic discriminant analysis). In addition, it seems that the variations in S-IL-2R are patly related to renal function itself, as suggested by the correlation between S-IL-2R levels and serum creatinine levels. This association may explain the increase in S-IL-2R that can be observed without T cell activation. In conclusion, S-IL-2R may not be of major interest in discriminating between rejection of kidney and CsA-induced nephrotoxicity episodes in kidney allograft recipients.     

Association of β-cell function and insulin resistance with pediatric type 2 diabetes among Chinese children

BACKGROUNDIn addition to insulin resistance, impaired insulin secretion has recently been identified as a crucial factor in the pathogenesis of type 2 diabetes mellitus (T2DM). Scarce clinical data exist for pediatric T2DM.AIMTo investigate the association of β-cell function and insulin resistance with pediatric T2DM in the first Chinese multicenter study.METHODSThis multicenter cross-sectional study included 161 newly diagnosed T2DM children and adolescents between January 2017 and October 2019. Children with normal glycemic levels (n = 1935) were included as healthy control subjects. The homeostasis models (HOMAs) were used to assess the β-cell function (HOMA2-%B) and insulin resistance (HOMA2-IR) levels. The HOMA index was standardized by sex and age. We performed logistic regression analysis to obtain odds ratios (ORs) for T2DM risk using the standardized HOMA index, adjusted for confounding factors including sex, Tanner stage, T2DM family history, body mass index z-score, and lipid profile.RESULTSThe male-female ratio of newly diagnosed T2DM patients was 1.37:1 (OR = 2.20, P = 0.011), and the mean ages of onset for boys and girls were 12.5 ± 1.9 years and 12.3 ± 1.7 years, respectively. The prevalence of related comorbidities including obesity, elevated blood pressure, and dyslipidemia was 58.2%, 53.2%, and 80.0%, respectively. The T2DM group had lower HOMA2-%B levels (P < 0.001) and higher HOMA2-IR levels (P < 0.001) than the control group. Both the decrease in HOMA2-%B z-score (OR = 8.40, 95%CI: 6.40–11.02, P < 0.001) and the increase in HOMA2-IR z-score (OR = 1.79, 95%CI: 1.60–2.02, P < 0.001) were associated with a higher risk of T2DM, and the decrease in HOMA2-%B z-score always had higher ORs than the increase in HOMA2-IR z-score after adjusting for confounding factors.CONCLUSIONBesides insulin resistance, β-cell function impairment is also strongly associated with Chinese pediatric T2DM. Gender difference in susceptibility and high comorbidities warrant specific T2DM screening and prevention strategies in Chinese children.