BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relatio...BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.展开更多
To investigate the effects of impaired glucose metabolism （IGM） on cardiovascular autonomic nervous systems in essential hypertensive （EH） patients by comparing heart rate variability （HRV） and blood pressure va...To investigate the effects of impaired glucose metabolism （IGM） on cardiovascular autonomic nervous systems in essential hypertensive （EH） patients by comparing heart rate variability （HRV） and blood pressure variability （BPV） in EH patients with or without type 2 diabetes mellitus （T2DM）. Simultaneous 24-h recordings of ambulatory ECG and blood pressure monitoring were performed in 36 male old patients with simple EH and 33 male old patients with EH combined with T2DM. HRV analysis included time domain parameters such as SDNN, SDANN, SDNNi, rMSSD and pNN50, and total spectral power （TP） of HRV, which mainly consists of VLF, LF and HF component along with LF/HF ratio, was also obtained. The value of ambulatory blood pressure was represented as the mean blood pressure （mean systolic/mSBP, diastolic/mDBP and pulse pressure/mPP） during different periods （24 h/24 h, day time/d and night time/n）. Standard deviation （SD） as well as coefficient of variance （CV） of blood pressure during each above-mentioned period were obtained to reflect the long-term BPV. Our result showed that SDNN, SDNNi, SDANN, rMSSD, PNN50, TP and HF of HRV in cases of EH with T2DM were all significantly lower than those in simple EH subjects （P〈0.05）. No significant differences in VLF or LF was found between the two groups （P〉0.05）, while LF/HF ratio was significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.01）. Moreover, dmSBP, 24 h-mPP and dmPP were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while nmSBP, 24 h-mSBP, 24 h-mDBP, dmDBP, nmDBP or nmPP showed no significant difference between this two groups of patients （P〉0.05）. And dSBPSD, dSBPCV and 24 h-SBPSD were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while the other BPV indexes showed no significant difference between this two groups （P〉0.05）. It is concluded that the cardiovascular autonomic nervous systems in EH patients was further impaired by T2DM, displaying lowering of HRV and enlargement of BPV, which in turn induced abnormal structural and functional changes of cardiovascular systems. Therefore, improving cardiovascular autonomic nervous systems might reduce the occurrence of cardiovascular complications in the EH patients with IGM.展开更多
Local cerebral metabolic rate of glucose(LCMRGlc) is an important index for the description of neural function.Dynamic 18 F-fluoro-2-deoxy-D-glucose(FDG) positron emission tomography(PET) has been used for quantitativ...Local cerebral metabolic rate of glucose(LCMRGlc) is an important index for the description of neural function.Dynamic 18 F-fluoro-2-deoxy-D-glucose(FDG) positron emission tomography(PET) has been used for quantitative imaging of LCMRGlc in humans,but is seldom used routinely because of the difficulty in obtaining the input function noninvasively.A reference tissue-based Patlak plot model(rPatlak) was proposed to generate parametric images of LCMRGlc in a quantitative dynamic FDG-PET study without requiring blood sampling.Dynamic emission scans(4×0.5,4×2 and 10×5 min) were acquired simultaneously with an IV bolus injection of 155 MBq of FDG.Arterial blood samples were collected during the scans via a catheter placed in the radial artery.Simulation data were also generated using the same scan sequence.The last ten scan data sets were used in a graphical analysis using the Patlak plot.The ratio of LCMRGlc estimated from the original Patlak(oPatlak,using plasma input) was used as the gold standard,and the standardized uptake value ratio(SUVR) was also calculated for comparison.Eight different tissues including white matter,gray matter,and whole brain were chosen as reference tissues for evaluation.Regardless of the reference region used,the slopes in the linear regression between oPatlak and rPatlak were closer to unity than the regression slopes between oPatlak and SUVR.The intercepts for the former were also closer to 0 than those for the latter case.The squared correlation coefficients were close to 1.0 for both cases.This showed that the results of rPatlak were in good agreement with those of oPatlak,however,SUVR exhibited more deviation.The simulation study also showed that the relative variance and bias for rPatlak were less than those for SUVR.The images obtained with rPatlak were very similar to those obtained with oPatlak,while there were differences in the relative spatial distribution between the images of SUVR and oPatlak.This study validates that the rPatlak method is better than the SUVR method and is a good approximation to the oPatlak method.The new method is suitable for generating LCMRGlc parametric images noninvasively.展开更多
目的探讨代谢综合征(MS)患者葡萄糖代谢率(M)与血浆抵抗素(resistin)、脂联素(adiponectin)、瘦素(leptin)水平变化及水飞蓟宾(Silibinin)的治疗作用。方法筛选15例MS病例和20例健康对照组。采用高胰岛素-正常血糖钳夹技术检测M,评估胰...目的探讨代谢综合征(MS)患者葡萄糖代谢率(M)与血浆抵抗素(resistin)、脂联素(adiponectin)、瘦素(leptin)水平变化及水飞蓟宾(Silibinin)的治疗作用。方法筛选15例MS病例和20例健康对照组。采用高胰岛素-正常血糖钳夹技术检测M,评估胰岛素抵抗(IR)程度;采用EILSA法检测血浆resistin、adiponectin与leptin浓度;检测空腹胰岛素(FINS)、血糖、血脂等生化指标;MS患者给予水飞蓟宾70mg口服,一日3次,治疗12 w,于治疗结束后重复检测M、血浆resistin、adiponectin与leptin浓度。结果①MS组腰围(WC)、体重指数(BMI)、空腹血糖(FPG)、2 h血糖(2 h PG)、FINS及甘油三酯(TG)等均显著高于对照组,高密度脂蛋白-胆固醇(HDL-C)明显低于对照组(P均<0.05)。高胰岛素正常血糖钳夹试验稳态时(120～150 min),MS组M显著低于对照组(P<0.01)。两组血浆resistin水平无显著差异(P>0.05);MS组血浆leptin水平显著高于对照组,adiponectin水平显著低于对照组(P均<0.05)。②与治疗前相比,治疗12 w后MS组TG、2 h PG及FINS明显降低(P均<0.05),BMI、WC有所降低,但与治疗前比较无显著差异(P>0.05),FPG、HDL-C、TC及LDL-C等与治疗前比较无显著差异(P>0.05)。③治疗前后M分别为(4.24±1.42)和(6.16±1.58)mg.kg-1.min-1,治疗12 w后,MS组M明显升高(P<0.05)。④治疗前后MS组血浆resistin,adiponectin,leptin水平等无显著变化(P均>0.05)。结论水飞蓟宾治疗后能减轻IR,MS患者IR改善不依赖于体重的减轻。水飞蓟宾治疗后IR改善未伴有血浆resistin、adiponectin、leptin水平的明显变化;提示水飞蓟宾治疗减轻MS患者IR的机制可能并非通过影响resistin、adiponectin、leptin等脂肪因子途径,而可能主要与其抗氧化应激机制及减轻脂毒性作用有关。展开更多
基金Supported by the“SDF-sweet doctor cultivation”Project of Sinocare Diabetes Foundation,No.2022SD11 and No.2021SD09.
文摘BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.
文摘To investigate the effects of impaired glucose metabolism （IGM） on cardiovascular autonomic nervous systems in essential hypertensive （EH） patients by comparing heart rate variability （HRV） and blood pressure variability （BPV） in EH patients with or without type 2 diabetes mellitus （T2DM）. Simultaneous 24-h recordings of ambulatory ECG and blood pressure monitoring were performed in 36 male old patients with simple EH and 33 male old patients with EH combined with T2DM. HRV analysis included time domain parameters such as SDNN, SDANN, SDNNi, rMSSD and pNN50, and total spectral power （TP） of HRV, which mainly consists of VLF, LF and HF component along with LF/HF ratio, was also obtained. The value of ambulatory blood pressure was represented as the mean blood pressure （mean systolic/mSBP, diastolic/mDBP and pulse pressure/mPP） during different periods （24 h/24 h, day time/d and night time/n）. Standard deviation （SD） as well as coefficient of variance （CV） of blood pressure during each above-mentioned period were obtained to reflect the long-term BPV. Our result showed that SDNN, SDNNi, SDANN, rMSSD, PNN50, TP and HF of HRV in cases of EH with T2DM were all significantly lower than those in simple EH subjects （P〈0.05）. No significant differences in VLF or LF was found between the two groups （P〉0.05）, while LF/HF ratio was significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.01）. Moreover, dmSBP, 24 h-mPP and dmPP were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while nmSBP, 24 h-mSBP, 24 h-mDBP, dmDBP, nmDBP or nmPP showed no significant difference between this two groups of patients （P〉0.05）. And dSBPSD, dSBPCV and 24 h-SBPSD were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while the other BPV indexes showed no significant difference between this two groups （P〉0.05）. It is concluded that the cardiovascular autonomic nervous systems in EH patients was further impaired by T2DM, displaying lowering of HRV and enlargement of BPV, which in turn induced abnormal structural and functional changes of cardiovascular systems. Therefore, improving cardiovascular autonomic nervous systems might reduce the occurrence of cardiovascular complications in the EH patients with IGM.
基金supported by the National Natural Science Foundation of China (30840033,30770615 and 30970818)the National Basic Research Program of China (2011CB707701)the Joint Research Foundation of Beijing Education Committee (JD100010607)
文摘Local cerebral metabolic rate of glucose(LCMRGlc) is an important index for the description of neural function.Dynamic 18 F-fluoro-2-deoxy-D-glucose(FDG) positron emission tomography(PET) has been used for quantitative imaging of LCMRGlc in humans,but is seldom used routinely because of the difficulty in obtaining the input function noninvasively.A reference tissue-based Patlak plot model(rPatlak) was proposed to generate parametric images of LCMRGlc in a quantitative dynamic FDG-PET study without requiring blood sampling.Dynamic emission scans(4×0.5,4×2 and 10×5 min) were acquired simultaneously with an IV bolus injection of 155 MBq of FDG.Arterial blood samples were collected during the scans via a catheter placed in the radial artery.Simulation data were also generated using the same scan sequence.The last ten scan data sets were used in a graphical analysis using the Patlak plot.The ratio of LCMRGlc estimated from the original Patlak(oPatlak,using plasma input) was used as the gold standard,and the standardized uptake value ratio(SUVR) was also calculated for comparison.Eight different tissues including white matter,gray matter,and whole brain were chosen as reference tissues for evaluation.Regardless of the reference region used,the slopes in the linear regression between oPatlak and rPatlak were closer to unity than the regression slopes between oPatlak and SUVR.The intercepts for the former were also closer to 0 than those for the latter case.The squared correlation coefficients were close to 1.0 for both cases.This showed that the results of rPatlak were in good agreement with those of oPatlak,however,SUVR exhibited more deviation.The simulation study also showed that the relative variance and bias for rPatlak were less than those for SUVR.The images obtained with rPatlak were very similar to those obtained with oPatlak,while there were differences in the relative spatial distribution between the images of SUVR and oPatlak.This study validates that the rPatlak method is better than the SUVR method and is a good approximation to the oPatlak method.The new method is suitable for generating LCMRGlc parametric images noninvasively.
文摘目的探讨代谢综合征(MS)患者葡萄糖代谢率(M)与血浆抵抗素(resistin)、脂联素(adiponectin)、瘦素(leptin)水平变化及水飞蓟宾(Silibinin)的治疗作用。方法筛选15例MS病例和20例健康对照组。采用高胰岛素-正常血糖钳夹技术检测M,评估胰岛素抵抗(IR)程度;采用EILSA法检测血浆resistin、adiponectin与leptin浓度;检测空腹胰岛素(FINS)、血糖、血脂等生化指标;MS患者给予水飞蓟宾70mg口服,一日3次,治疗12 w,于治疗结束后重复检测M、血浆resistin、adiponectin与leptin浓度。结果①MS组腰围(WC)、体重指数(BMI)、空腹血糖(FPG)、2 h血糖(2 h PG)、FINS及甘油三酯(TG)等均显著高于对照组,高密度脂蛋白-胆固醇(HDL-C)明显低于对照组(P均<0.05)。高胰岛素正常血糖钳夹试验稳态时(120～150 min),MS组M显著低于对照组(P<0.01)。两组血浆resistin水平无显著差异(P>0.05);MS组血浆leptin水平显著高于对照组,adiponectin水平显著低于对照组(P均<0.05)。②与治疗前相比,治疗12 w后MS组TG、2 h PG及FINS明显降低(P均<0.05),BMI、WC有所降低,但与治疗前比较无显著差异(P>0.05),FPG、HDL-C、TC及LDL-C等与治疗前比较无显著差异(P>0.05)。③治疗前后M分别为(4.24±1.42)和(6.16±1.58)mg.kg-1.min-1,治疗12 w后,MS组M明显升高(P<0.05)。④治疗前后MS组血浆resistin,adiponectin,leptin水平等无显著变化(P均>0.05)。结论水飞蓟宾治疗后能减轻IR,MS患者IR改善不依赖于体重的减轻。水飞蓟宾治疗后IR改善未伴有血浆resistin、adiponectin、leptin水平的明显变化;提示水飞蓟宾治疗减轻MS患者IR的机制可能并非通过影响resistin、adiponectin、leptin等脂肪因子途径,而可能主要与其抗氧化应激机制及减轻脂毒性作用有关。
