Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose...Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM. Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors. Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR. Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.展开更多
Somatostatinomas are very rare endocrine tumors, accounting for less than 1% of all gastrointestinal endocrine tumors. It usually arises within the pancreas and some from extrapancreafic sites, including the duodenum,...Somatostatinomas are very rare endocrine tumors, accounting for less than 1% of all gastrointestinal endocrine tumors. It usually arises within the pancreas and some from extrapancreafic sites, including the duodenum, ampulla, jejunum, or cystic duct,with an annual incidence of 1 in 40 million. Since the first case of pancreatic somatostafinoma was reported in 1977 by Larsson et al,4 less than 200 cases of somatostatinoma have been reported in literature, and only a few cases have been reported in China. The most described features of patients with somatostatinoma induced by excessive somatostatin secretion are characterized by cholelithiasis, steatorrbea, achlorhydria, hypochlorhydria and mild hyperglycemia, As somatostafin inhibits the secretion of insulin from pancreatic islets,展开更多
To the editor： A 44-year-old man was admitted because of metastatic lower abdominal pain. He had a history of acute chest pain and progressively increased troponin that occurred 13 years ago. A coronary angiogram per...To the editor： A 44-year-old man was admitted because of metastatic lower abdominal pain. He had a history of acute chest pain and progressively increased troponin that occurred 13 years ago. A coronary angiogram pertbrmed at the time of chest pain showed normal coronary arteries. The patient quit smoking and received warfarin therapy for two years. On admission, measurement of cardiac enzymes revealed no evidence of acute myocardial infarction.展开更多
文摘Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM. Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors. Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR. Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.
文摘Somatostatinomas are very rare endocrine tumors, accounting for less than 1% of all gastrointestinal endocrine tumors. It usually arises within the pancreas and some from extrapancreafic sites, including the duodenum, ampulla, jejunum, or cystic duct,with an annual incidence of 1 in 40 million. Since the first case of pancreatic somatostafinoma was reported in 1977 by Larsson et al,4 less than 200 cases of somatostatinoma have been reported in literature, and only a few cases have been reported in China. The most described features of patients with somatostatinoma induced by excessive somatostatin secretion are characterized by cholelithiasis, steatorrbea, achlorhydria, hypochlorhydria and mild hyperglycemia, As somatostafin inhibits the secretion of insulin from pancreatic islets,
文摘To the editor： A 44-year-old man was admitted because of metastatic lower abdominal pain. He had a history of acute chest pain and progressively increased troponin that occurred 13 years ago. A coronary angiogram pertbrmed at the time of chest pain showed normal coronary arteries. The patient quit smoking and received warfarin therapy for two years. On admission, measurement of cardiac enzymes revealed no evidence of acute myocardial infarction.
