Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-cond...Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.展开更多
BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plu...BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plus tenofovir(TDF)(EFV+3TC+TDF)regimen are unclear and warrant investigation.AIM To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV+3TC+TDF regimen for 156 wk.METHODS This study was designed using a follow-up design.Sixty-one male treatmentnaive PLWH,including 50 cases with normal glucose tolerance and 11 cases with prediabetes,were treated with the EFV+3TC+TDF regimen for 156 wk.The glucose metabolism dynamic characteristics,the main risk factors and the differences among the three CD4+count groups were analyzed.RESULTS In treatment-naive male PLWH,regardless of whether glucose metabolism disorder was present at baseline,who accepted treatment with the EFV+3TC+TDF regimen for 156 wk,a continuous increase in the fasting plasma glucose(FPG)level,the rate of impaired fasting glucose(IFG)and the glycosylated hemoglobin(HbA1c)level were found.These changes were not due to insulin resistance but rather to significantly reduced isletβcell function,according to the homeostasis model assessment ofβcell function(HOMA-β).Moreover,the lower the baseline CD4+T-cell count was,the higher the FPG level and the lower the HOMA-βvalue.Furthermore,the main risk factors for the FPG levels were the CD3+CD8+cell count and viral load(VL),and the factors contributing to the HOMA-βvalues were the alanine aminotransferase level,VL and CD3+CD8+cell count.CONCLUSION These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased isletβcell function during antiretroviral therapy with the EFV+3TC+TDF regimen for long-term application.展开更多
Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We ...Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We aimed to elucidate the association between the changes of insulin responsiveness and the fasting plasma glucose (FPG) during the development of diabetes. Methods A total of 1192 Chinese individuals with normal blood glucose or hyperglycemia were enrolled for the analysis. The early insulinogenic index (△I30/△G30), the area under the curve of insulin (AUC-Ⅰ), and homeostasis model assessment were applied to evaluate the early phase secretion, total insulin secretion, and insulin resistance respectively. Polynomial regression analysis was performed to estimate the fluctuation of beta cell functions. Results The △I30/△G30 decreased much more rapidly than the AUC-Ⅰ accompanying with the elevation of FPG. At the FPG of 110 mg/dl (a pre-diabetic stage), the AI30/AG30 lost 50% of its maximum while the AUC-Ⅰ was still at a compensated normal level. The AUC-Ⅰ exhibited abnormal and decreased gradually at the FPG of from 130 mg/dl to higher (overt diabetes), while the △I30/△G30 almost remained at 25% of its maximum value. When hyperglycemia continuously existed at 〉 180 mg/dl, both the AI30/AG30 and AUC-Ⅰ were totally lost. Conclusion The increased fasting plasma glucose reflects progressive decompensation of beta cell functions, and could be used to guide the strategy of clinical treatments.展开更多
Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week bec...Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.展开更多
Background: The conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postp...Background: The conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population. Methods: Nine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A 1 c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis. Results: Among 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P 〈 0.001). For estimation of 2 h-PG 〉 7.8 mmol/L and 2 h-PG ≥ 11.I mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI]: 0.738-0.806) and 0.885 (95% CI:0.850-0.921 ), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 retool/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity fbr detecting glucose abnormalities (84.1% vs. 73.7%, P〈 0.001) and diabetes (82.7% vs. 48.1%, P〈 0.001). Conclusion: FPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.展开更多
The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for hi...The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for high fasting plasma glucose (FPG) levels are not clear. This cross-sectional study recruited 3460 non-diabetic Chinese subjects (1027 men, and 2433 women, aged 35-75 years old) who participated in a health survey. Men and women were classified into tertiles by levels of plasma lipids respectively. In women, the prevalence of impaired fasting glucose (IFG) was decreased with increased HDL-C. A stepwise increase in HDL-C was associated with decreasing FPG levels (lowest tertiles, FPG: 5.376 ± 0.018; middle tertiles, 5.324± 0.018; highest tertiles, 5.276±0.018mmol/L; P = 0.001). Reversely, FPG levels increased from lowest tertiles to highest tertiles of LDL-C, TC, and TG. we found that women in the first tertile with lower HDL-C level had a 1.75-fold increase in risk of IFG compared with non-diabetic women in the third tertile with higher HDL-C level (OR: 1.75; 95% CI: 1.20-2.56). In men, no significant association was found. We took age, BMI, waist/hip ratio, education, smoking, alcohol drinking, and physical exercise as adjusted variables. In Chinese non-diabetic women, dyslipidemia is independently associated with high levels of FPG; TG, HDL-C, and LDL-C are predictors of IFG independent of BMI and waist/hip ratio.展开更多
目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察...目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。展开更多
目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 ...目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。展开更多
Objective To evaluate the association of fasting plasma glucose(FPG)level over 5.3 mmol/L with the development of abnormal glucose metabolism and cardiovascular disease(CVD).Methods This was a retrospec-tive cohort st...Objective To evaluate the association of fasting plasma glucose(FPG)level over 5.3 mmol/L with the development of abnormal glucose metabolism and cardiovascular disease(CVD).Methods This was a retrospec-tive cohort study with 1 064 non-diabetic subjects(980males;84 females)aged 60 or over,who carried out annual health check-up in Chinese PLA General展开更多
文摘Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.
基金Supported by The Twelfth Five-Year Project on Tackling Key Problems of National Science and Technology,No2012ZX10001-003Sichuan Province Health Commission,No. 130430 and No. 17PJ070Chengdu Municipal Health Commission,No. 2019079
文摘BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plus tenofovir(TDF)(EFV+3TC+TDF)regimen are unclear and warrant investigation.AIM To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV+3TC+TDF regimen for 156 wk.METHODS This study was designed using a follow-up design.Sixty-one male treatmentnaive PLWH,including 50 cases with normal glucose tolerance and 11 cases with prediabetes,were treated with the EFV+3TC+TDF regimen for 156 wk.The glucose metabolism dynamic characteristics,the main risk factors and the differences among the three CD4+count groups were analyzed.RESULTS In treatment-naive male PLWH,regardless of whether glucose metabolism disorder was present at baseline,who accepted treatment with the EFV+3TC+TDF regimen for 156 wk,a continuous increase in the fasting plasma glucose(FPG)level,the rate of impaired fasting glucose(IFG)and the glycosylated hemoglobin(HbA1c)level were found.These changes were not due to insulin resistance but rather to significantly reduced isletβcell function,according to the homeostasis model assessment ofβcell function(HOMA-β).Moreover,the lower the baseline CD4+T-cell count was,the higher the FPG level and the lower the HOMA-βvalue.Furthermore,the main risk factors for the FPG levels were the CD3+CD8+cell count and viral load(VL),and the factors contributing to the HOMA-βvalues were the alanine aminotransferase level,VL and CD3+CD8+cell count.CONCLUSION These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased isletβcell function during antiretroviral therapy with the EFV+3TC+TDF regimen for long-term application.
文摘Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We aimed to elucidate the association between the changes of insulin responsiveness and the fasting plasma glucose (FPG) during the development of diabetes. Methods A total of 1192 Chinese individuals with normal blood glucose or hyperglycemia were enrolled for the analysis. The early insulinogenic index (△I30/△G30), the area under the curve of insulin (AUC-Ⅰ), and homeostasis model assessment were applied to evaluate the early phase secretion, total insulin secretion, and insulin resistance respectively. Polynomial regression analysis was performed to estimate the fluctuation of beta cell functions. Results The △I30/△G30 decreased much more rapidly than the AUC-Ⅰ accompanying with the elevation of FPG. At the FPG of 110 mg/dl (a pre-diabetic stage), the AI30/AG30 lost 50% of its maximum while the AUC-Ⅰ was still at a compensated normal level. The AUC-Ⅰ exhibited abnormal and decreased gradually at the FPG of from 130 mg/dl to higher (overt diabetes), while the △I30/△G30 almost remained at 25% of its maximum value. When hyperglycemia continuously existed at 〉 180 mg/dl, both the AI30/AG30 and AUC-Ⅰ were totally lost. Conclusion The increased fasting plasma glucose reflects progressive decompensation of beta cell functions, and could be used to guide the strategy of clinical treatments.
文摘Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
基金This study was funded by the Key Program of Jiangsu Natural Science Foundation,sponsored by the San Chuang Joint Project of Nanjing New and High Technology Industry Development Zone
文摘Background: The conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population. Methods: Nine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A 1 c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis. Results: Among 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P 〈 0.001). For estimation of 2 h-PG 〉 7.8 mmol/L and 2 h-PG ≥ 11.I mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI]: 0.738-0.806) and 0.885 (95% CI:0.850-0.921 ), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 retool/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity fbr detecting glucose abnormalities (84.1% vs. 73.7%, P〈 0.001) and diabetes (82.7% vs. 48.1%, P〈 0.001). Conclusion: FPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.
文摘The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for high fasting plasma glucose (FPG) levels are not clear. This cross-sectional study recruited 3460 non-diabetic Chinese subjects (1027 men, and 2433 women, aged 35-75 years old) who participated in a health survey. Men and women were classified into tertiles by levels of plasma lipids respectively. In women, the prevalence of impaired fasting glucose (IFG) was decreased with increased HDL-C. A stepwise increase in HDL-C was associated with decreasing FPG levels (lowest tertiles, FPG: 5.376 ± 0.018; middle tertiles, 5.324± 0.018; highest tertiles, 5.276±0.018mmol/L; P = 0.001). Reversely, FPG levels increased from lowest tertiles to highest tertiles of LDL-C, TC, and TG. we found that women in the first tertile with lower HDL-C level had a 1.75-fold increase in risk of IFG compared with non-diabetic women in the third tertile with higher HDL-C level (OR: 1.75; 95% CI: 1.20-2.56). In men, no significant association was found. We took age, BMI, waist/hip ratio, education, smoking, alcohol drinking, and physical exercise as adjusted variables. In Chinese non-diabetic women, dyslipidemia is independently associated with high levels of FPG; TG, HDL-C, and LDL-C are predictors of IFG independent of BMI and waist/hip ratio.
文摘目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。
文摘目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。
文摘Objective To evaluate the association of fasting plasma glucose(FPG)level over 5.3 mmol/L with the development of abnormal glucose metabolism and cardiovascular disease(CVD).Methods This was a retrospec-tive cohort study with 1 064 non-diabetic subjects(980males;84 females)aged 60 or over,who carried out annual health check-up in Chinese PLA General