目的探究二甲双胍与门冬胰岛素联合治疗2型糖尿病(Diabetes Mellitus Type 2,T2DM)对血糖的控制效果。方法选取2021年6月—2023年6月吉林省人民医院收治的100例T2DM患者为研究对象,以投掷硬币法分为参照组(n=50,二甲双胍治疗)、观察组(n...目的探究二甲双胍与门冬胰岛素联合治疗2型糖尿病(Diabetes Mellitus Type 2,T2DM)对血糖的控制效果。方法选取2021年6月—2023年6月吉林省人民医院收治的100例T2DM患者为研究对象,以投掷硬币法分为参照组(n=50,二甲双胍治疗)、观察组(n=50,二甲双胍与门冬胰岛素联合治疗)。比较两组临床治疗效果、不良反应总发生率、血糖控制情况及血清炎性因子水平。结果观察组治疗总有效率(96.00%)高于参照组(84.00%),差异有统计学意义(χ^(2)=4.000,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。与治疗前相比,两组治疗半年后血糖水平、白细胞介素-6、白细胞介素-12水平均降低、白细胞介素-10水平升高,且观察组上述指标优于参照组,差异有统计学意义(P均<0.05)。结论二甲双胍与门冬胰岛素联合治疗T2DM患者时可提高疗效,患者血糖控制情况更佳,血清炎性因子水平也得到明显改善,安全性较高。展开更多
目的分析药学干预对2型糖尿病患者用药依从性与药品不良反应的影响。方法100例2型糖尿病患者,利用随机数字表法分为常规组和研究组,每组50例。常规组患者采用常规用药干预,研究组患者采用药学干预。比较两组患者的用药依从性、不良反应...目的分析药学干预对2型糖尿病患者用药依从性与药品不良反应的影响。方法100例2型糖尿病患者,利用随机数字表法分为常规组和研究组,每组50例。常规组患者采用常规用药干预,研究组患者采用药学干预。比较两组患者的用药依从性、不良反应发生情况、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)以及糖化血红蛋白(HbA1c)]水平、血脂指标[甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平以及生活质量。结果研究组患者用药总依从率为96.00%,高于常规组的82.00%(P<0.05)。研究组患者不良反应发生率为6.00%,低于常规组的22.00%(P<0.05)。干预后,研究组患者FPG、2 h PG、HbA1c水平分别为(5.15±1.11)mmol/L、(9.65±1.22)mmol/L、(6.07±1.15)%,均低于常规组的(6.52±1.12)mmol/L、(11.43±1.26)mmol/L、(7.43±1.14)%(P<0.05)。干预后,研究组患者TC(4.52±0.34)mmol/L、TG(2.03±0.12)mmol/L、LDL-C(2.31±0.44)mmol/L均低于常规组的(5.21±0.31)、(2.35±0.12)、(2.82±0.51)mmol/L,HDL-C(1.42±0.14)mmol/L高于常规组的(1.22±0.14)mmol/L(P<0.05)。干预后,研究组患者情感职能、生理功能、社会功能、活力评分分别为(77.56±1.52)、(74.34±1.22)、(77.32±1.25)、(72.64±1.25)分,均高于常规组的(63.76±1.44)、(64.25±1.13)、(63.23±1.21)、(61.31±1.24)分(P<0.05)。结论对2型糖尿病患者采用药学干预,有助于改善患者的生活质量、血脂水平与血糖水平,对降低患者不良反应发生率以及提升患者用药依从性具有积极影响。展开更多
目的分析二甲双胍联合德谷门冬胰岛素治疗难治性2型糖尿病(Diabetes Mellitus Type 2,T2DM)患者的效果及对患者血糖控制、胰岛功能的影响。方法选取2023年1-12月赤峰市肿瘤医院收治的70例难治性T2DM患者为研究对象,以掷骰子法分为两组,...目的分析二甲双胍联合德谷门冬胰岛素治疗难治性2型糖尿病(Diabetes Mellitus Type 2,T2DM)患者的效果及对患者血糖控制、胰岛功能的影响。方法选取2023年1-12月赤峰市肿瘤医院收治的70例难治性T2DM患者为研究对象,以掷骰子法分为两组,各35例。对照组接受二甲双胍联合地特胰岛素治疗,观察组接受二甲双胍联合德谷门冬胰岛素治疗。比较两组治疗效果、血糖指标、胰岛功能指标、不良反应发生情况以及生活质量。结果观察组治疗总有效率、生活质量评分高于对照组,差异有统计学意义(P均<0.05)。观察组血糖指标低于对照组,且胰岛功能指标优于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率比较(14.28%vs 11.42%),差异无统计学意义(χ^(2)=0.128,P>0.05)。结论二甲双胍、德谷门冬胰岛素治疗难治性T2DM的安全性高,促进患者胰岛功能、血糖改善,提升疾病治疗效果。展开更多
BACKGROUND The exact mechanism of proton pump inhibitors(PPIs)-induced hypomagnesemia(PPIH) is largely unknown. Previous studies proposed that PPIH is a consequence of intestinal Mg2+ malabsorption. However, the mecha...BACKGROUND The exact mechanism of proton pump inhibitors(PPIs)-induced hypomagnesemia(PPIH) is largely unknown. Previous studies proposed that PPIH is a consequence of intestinal Mg2+ malabsorption. However, the mechanism of PPIs-suppressed intestinal Mg2+ absorption is under debate.AIM To investigate the effect of 12-wk and 24-wk omeprazole injection on the total,transcellular, and paracellular Mg2+ absorption in the duodenum, jejunum, ileum,and colon of male Sprague-Dawley rats.METHODS The rats received 20 mg/kg·d subcutaneous omeprazole injection for 12 or 24 wk.Plasma and urinary Mg2+, Ca2+, and PO43-levels were measured. The plasma concentrations of 1α,25-dihydroxyvitamin D3(1α,25(OH)2D3), parathyroid hormone(PTH), fibroblast growth factor 23(FGF-23), epidermal growth factor(EGF), and insulin were also observed. The duodenum, jejunum, ileum, and colon of each rat were mounted onto individual modified Using chamber setups to study the rates of total, transcellular, and paracellular Mg2+ absorption simultaneously. The expression of transient receptor potential melastatin 6(TRPM6) and cyclin M4(CNNM4) in the entire intestinal tract was also measured.RESULTS Single-dose omeprazole injection significantly increased the intraluminal p H of the stomach, duodenum, and jejunum. Omeprazole injection for 12 and 24 wk induced hypomagnesemia with reduced urinary Mg2+ excretion. The plasma Ca2+ was normal but the urinary Ca2+ excretion was reduced in rats with PPIH. The plasma and urinary PO43-levels increased in PPIH rats. The levels of1α,25(OH)2D3 and FGF-23 increased, whereas that of plasma EGF decreased in the omeprazole-treated rats. The rates of the total, transcellular, and paracellular Mg2+ absorption was significantly lower in the duodenum, jejunum, ileum, and colon of the rats with PPIH than in those of the control rats. The percent suppression of Mg2+ absorption in the duodenum, jejunum, ileum, and colon of the rats with PPIH compared with the control rats was 81.86%, 70.59%, 69.45%,and 39.25%, respectively. Compared with the control rats, the rats with PPIH had significantly higher TRPM6 and CNNM4 expression levels throughout the intestinal tract.CONCLUSION Intestinal Mg2+ malabsorption was observed throughout the intestinal tract of rats with PPIH. PPIs mainly suppressed small intestinal Mg2+ absorption. Omeprazole exerted no effect on the intraluminal acidic pH in the colon. Thus, the lowest percent suppression of total Mg2+ absorption was found in the colon. The expression levels of TRPM6 and CNNM4 increased, indicating the presence of a compensatory response to Mg2+ malabsorption in rats with PPIH. Therefore, the small intestine is an appropriate segment that should be modulated to counteract PPIH.展开更多
BACKGROUND Dipeptidyl peptidase-4(DPP4)is commonly targeted to achieve glycemic control and has potent anti-inflammatory and immunoregulatory effects.Recent structural analyses indicated a potential tight interaction ...BACKGROUND Dipeptidyl peptidase-4(DPP4)is commonly targeted to achieve glycemic control and has potent anti-inflammatory and immunoregulatory effects.Recent structural analyses indicated a potential tight interaction between DPP4 and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),raising a promising hypothesis that DPP4 inhibitor(DPP4i)drugs might be an optimal strategy for treating coronavirus disease 2019(COVID-19)among patients with diabetes.However,there has been no direct clinical evidence illuminating the associations between DPP4i use and COVID-19 outcomes.AIM To illuminate the associations between DPP4i usage and the adverse outcomes of COVID-19.METHODS We conducted a multicenter,retrospective analysis including 2563 patients with type 2 diabetes who were hospitalized due to COVID-19 at 16 hospitals in Hubei Province,China.After excluding ineligible individuals,142 patients who received DPP4i drugs and 1115 patients who received non-DPP4i oral anti-diabetic drugs were included in the subsequent analysis.We performed a strict propensity score matching(PSM)analysis where age,sex,comorbidities,number of oral hypoglycemic agents,heart rate,blood pressure,pulse oxygen saturation(SpO2)<95%,CT diagnosed bilateral lung lesions,laboratory indicators,and proportion of insulin usage were matched.Finally,111 participants treated with DPP4i drugs were successfully matched to 333 non-DPP4i users.Then,a linear logistic model and mixed-effect Cox model were applied to analyze the associations between inhospital DPP4i use and adverse outcomes of COVID-19.RESULTS After rigorous matching and further adjustments for imbalanced variables in the linear logistic model and Cox adjusted model,we found that there was no significant association between in-hospital DPP4i use(DPP4i group)and 28-d allcause mortality(adjusted hazard ratio=0.44,95%CI:0.09-2.11,P=0.31).Likewise,the incidences and risks of secondary outcomes,including septic shock,acute respiratory distress syndrome,or acute organ(kidney,liver,and cardiac)injuries,were also comparable between the DPP4i and non-DPP4i groups.The performance of DPP4i agents in achieving glucose control(e.g.,the median level of fasting blood glucose and random blood glucose)and inflammatory regulation was approximately equivalent in the DPP4i and non-DPP4i groups.Furthermore,we did not observe substantial side effects such as uncontrolled glycemia or acidosis due to DPP4i application relative to the use of non-DPP4i agents in the study cohort.CONCLUSION Our findings demonstrated that DPP4i use is not significantly associated with poor outcomes of COVID-19 or other adverse effects of anti-diabetic treatment.The data support the continuation of DPP4i agents for diabetes management in the setting of COVID-19.展开更多
Thiopurines are immunomodulators used in the treatment of acute lymphoblastic leukemia and inflammatory bowel diseases.Adverse reactions to these agents are one of the main causes of treatment discontinuation or inter...Thiopurines are immunomodulators used in the treatment of acute lymphoblastic leukemia and inflammatory bowel diseases.Adverse reactions to these agents are one of the main causes of treatment discontinuation or interruption.Myelosuppression is the most frequent adverse effect;however,approximately 5%-20%of patients develop gastrointestinal toxicity.The identification of biomarkers able to prevent and/or monitor these adverse reactions would be useful for clinicians for the proactive management of long-term thiopurine therapy.In this editorial,we discuss evidence supporting the use of PACSIN2,RAC1,and ITPA genes,in addition to TPMT and NUDT15,as possible biomarkers for thiopurine-related gastrointestinal toxicity.展开更多
文摘目的探究二甲双胍与门冬胰岛素联合治疗2型糖尿病(Diabetes Mellitus Type 2,T2DM)对血糖的控制效果。方法选取2021年6月—2023年6月吉林省人民医院收治的100例T2DM患者为研究对象,以投掷硬币法分为参照组(n=50,二甲双胍治疗)、观察组(n=50,二甲双胍与门冬胰岛素联合治疗)。比较两组临床治疗效果、不良反应总发生率、血糖控制情况及血清炎性因子水平。结果观察组治疗总有效率(96.00%)高于参照组(84.00%),差异有统计学意义(χ^(2)=4.000,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。与治疗前相比,两组治疗半年后血糖水平、白细胞介素-6、白细胞介素-12水平均降低、白细胞介素-10水平升高,且观察组上述指标优于参照组,差异有统计学意义(P均<0.05)。结论二甲双胍与门冬胰岛素联合治疗T2DM患者时可提高疗效,患者血糖控制情况更佳,血清炎性因子水平也得到明显改善,安全性较高。
文摘目的分析药学干预对2型糖尿病患者用药依从性与药品不良反应的影响。方法100例2型糖尿病患者,利用随机数字表法分为常规组和研究组,每组50例。常规组患者采用常规用药干预,研究组患者采用药学干预。比较两组患者的用药依从性、不良反应发生情况、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)以及糖化血红蛋白(HbA1c)]水平、血脂指标[甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平以及生活质量。结果研究组患者用药总依从率为96.00%,高于常规组的82.00%(P<0.05)。研究组患者不良反应发生率为6.00%,低于常规组的22.00%(P<0.05)。干预后,研究组患者FPG、2 h PG、HbA1c水平分别为(5.15±1.11)mmol/L、(9.65±1.22)mmol/L、(6.07±1.15)%,均低于常规组的(6.52±1.12)mmol/L、(11.43±1.26)mmol/L、(7.43±1.14)%(P<0.05)。干预后,研究组患者TC(4.52±0.34)mmol/L、TG(2.03±0.12)mmol/L、LDL-C(2.31±0.44)mmol/L均低于常规组的(5.21±0.31)、(2.35±0.12)、(2.82±0.51)mmol/L,HDL-C(1.42±0.14)mmol/L高于常规组的(1.22±0.14)mmol/L(P<0.05)。干预后,研究组患者情感职能、生理功能、社会功能、活力评分分别为(77.56±1.52)、(74.34±1.22)、(77.32±1.25)、(72.64±1.25)分,均高于常规组的(63.76±1.44)、(64.25±1.13)、(63.23±1.21)、(61.31±1.24)分(P<0.05)。结论对2型糖尿病患者采用药学干预,有助于改善患者的生活质量、血脂水平与血糖水平,对降低患者不良反应发生率以及提升患者用药依从性具有积极影响。
文摘目的分析二甲双胍联合德谷门冬胰岛素治疗难治性2型糖尿病(Diabetes Mellitus Type 2,T2DM)患者的效果及对患者血糖控制、胰岛功能的影响。方法选取2023年1-12月赤峰市肿瘤医院收治的70例难治性T2DM患者为研究对象,以掷骰子法分为两组,各35例。对照组接受二甲双胍联合地特胰岛素治疗,观察组接受二甲双胍联合德谷门冬胰岛素治疗。比较两组治疗效果、血糖指标、胰岛功能指标、不良反应发生情况以及生活质量。结果观察组治疗总有效率、生活质量评分高于对照组,差异有统计学意义(P均<0.05)。观察组血糖指标低于对照组,且胰岛功能指标优于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率比较(14.28%vs 11.42%),差异无统计学意义(χ^(2)=0.128,P>0.05)。结论二甲双胍、德谷门冬胰岛素治疗难治性T2DM的安全性高,促进患者胰岛功能、血糖改善,提升疾病治疗效果。
基金Burapha University through National Research Council of Thailand,No.15/2562。
文摘BACKGROUND The exact mechanism of proton pump inhibitors(PPIs)-induced hypomagnesemia(PPIH) is largely unknown. Previous studies proposed that PPIH is a consequence of intestinal Mg2+ malabsorption. However, the mechanism of PPIs-suppressed intestinal Mg2+ absorption is under debate.AIM To investigate the effect of 12-wk and 24-wk omeprazole injection on the total,transcellular, and paracellular Mg2+ absorption in the duodenum, jejunum, ileum,and colon of male Sprague-Dawley rats.METHODS The rats received 20 mg/kg·d subcutaneous omeprazole injection for 12 or 24 wk.Plasma and urinary Mg2+, Ca2+, and PO43-levels were measured. The plasma concentrations of 1α,25-dihydroxyvitamin D3(1α,25(OH)2D3), parathyroid hormone(PTH), fibroblast growth factor 23(FGF-23), epidermal growth factor(EGF), and insulin were also observed. The duodenum, jejunum, ileum, and colon of each rat were mounted onto individual modified Using chamber setups to study the rates of total, transcellular, and paracellular Mg2+ absorption simultaneously. The expression of transient receptor potential melastatin 6(TRPM6) and cyclin M4(CNNM4) in the entire intestinal tract was also measured.RESULTS Single-dose omeprazole injection significantly increased the intraluminal p H of the stomach, duodenum, and jejunum. Omeprazole injection for 12 and 24 wk induced hypomagnesemia with reduced urinary Mg2+ excretion. The plasma Ca2+ was normal but the urinary Ca2+ excretion was reduced in rats with PPIH. The plasma and urinary PO43-levels increased in PPIH rats. The levels of1α,25(OH)2D3 and FGF-23 increased, whereas that of plasma EGF decreased in the omeprazole-treated rats. The rates of the total, transcellular, and paracellular Mg2+ absorption was significantly lower in the duodenum, jejunum, ileum, and colon of the rats with PPIH than in those of the control rats. The percent suppression of Mg2+ absorption in the duodenum, jejunum, ileum, and colon of the rats with PPIH compared with the control rats was 81.86%, 70.59%, 69.45%,and 39.25%, respectively. Compared with the control rats, the rats with PPIH had significantly higher TRPM6 and CNNM4 expression levels throughout the intestinal tract.CONCLUSION Intestinal Mg2+ malabsorption was observed throughout the intestinal tract of rats with PPIH. PPIs mainly suppressed small intestinal Mg2+ absorption. Omeprazole exerted no effect on the intraluminal acidic pH in the colon. Thus, the lowest percent suppression of total Mg2+ absorption was found in the colon. The expression levels of TRPM6 and CNNM4 increased, indicating the presence of a compensatory response to Mg2+ malabsorption in rats with PPIH. Therefore, the small intestine is an appropriate segment that should be modulated to counteract PPIH.
基金Supported by National Key R&D Program of China,No.2019YFC2004702 and No.2020YFC0845500the National Natural Science Foundation of China,No.81970070 and No.81970011the Hubei Science and Technology Support Project,No.2019BFC582 and No.2018BEC473.
文摘BACKGROUND Dipeptidyl peptidase-4(DPP4)is commonly targeted to achieve glycemic control and has potent anti-inflammatory and immunoregulatory effects.Recent structural analyses indicated a potential tight interaction between DPP4 and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),raising a promising hypothesis that DPP4 inhibitor(DPP4i)drugs might be an optimal strategy for treating coronavirus disease 2019(COVID-19)among patients with diabetes.However,there has been no direct clinical evidence illuminating the associations between DPP4i use and COVID-19 outcomes.AIM To illuminate the associations between DPP4i usage and the adverse outcomes of COVID-19.METHODS We conducted a multicenter,retrospective analysis including 2563 patients with type 2 diabetes who were hospitalized due to COVID-19 at 16 hospitals in Hubei Province,China.After excluding ineligible individuals,142 patients who received DPP4i drugs and 1115 patients who received non-DPP4i oral anti-diabetic drugs were included in the subsequent analysis.We performed a strict propensity score matching(PSM)analysis where age,sex,comorbidities,number of oral hypoglycemic agents,heart rate,blood pressure,pulse oxygen saturation(SpO2)<95%,CT diagnosed bilateral lung lesions,laboratory indicators,and proportion of insulin usage were matched.Finally,111 participants treated with DPP4i drugs were successfully matched to 333 non-DPP4i users.Then,a linear logistic model and mixed-effect Cox model were applied to analyze the associations between inhospital DPP4i use and adverse outcomes of COVID-19.RESULTS After rigorous matching and further adjustments for imbalanced variables in the linear logistic model and Cox adjusted model,we found that there was no significant association between in-hospital DPP4i use(DPP4i group)and 28-d allcause mortality(adjusted hazard ratio=0.44,95%CI:0.09-2.11,P=0.31).Likewise,the incidences and risks of secondary outcomes,including septic shock,acute respiratory distress syndrome,or acute organ(kidney,liver,and cardiac)injuries,were also comparable between the DPP4i and non-DPP4i groups.The performance of DPP4i agents in achieving glucose control(e.g.,the median level of fasting blood glucose and random blood glucose)and inflammatory regulation was approximately equivalent in the DPP4i and non-DPP4i groups.Furthermore,we did not observe substantial side effects such as uncontrolled glycemia or acidosis due to DPP4i application relative to the use of non-DPP4i agents in the study cohort.CONCLUSION Our findings demonstrated that DPP4i use is not significantly associated with poor outcomes of COVID-19 or other adverse effects of anti-diabetic treatment.The data support the continuation of DPP4i agents for diabetes management in the setting of COVID-19.
文摘Thiopurines are immunomodulators used in the treatment of acute lymphoblastic leukemia and inflammatory bowel diseases.Adverse reactions to these agents are one of the main causes of treatment discontinuation or interruption.Myelosuppression is the most frequent adverse effect;however,approximately 5%-20%of patients develop gastrointestinal toxicity.The identification of biomarkers able to prevent and/or monitor these adverse reactions would be useful for clinicians for the proactive management of long-term thiopurine therapy.In this editorial,we discuss evidence supporting the use of PACSIN2,RAC1,and ITPA genes,in addition to TPMT and NUDT15,as possible biomarkers for thiopurine-related gastrointestinal toxicity.
