The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was pr...The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.展开更多
目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,...目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,按照随机数字表法分成68例A组(聚乙二醇洛塞那肽治疗)与68例B组(利拉鲁肽治疗)。比较治疗前后两组肥胖相关指标、治疗前后两组血脂相关指标、治疗前后两组血糖指标以及治疗后不良反应发生率。结果治疗后两组体质量、腰臀比、体质量指数(BMI)和腰围均下降,B组体质量和BMI[分别为(80.31±7.62)kg和(24.13±1.82)kg·m^(-2)]低于A组体质量[分别为(83.65±7.93)kg和BMI(25.34±1.84)kg·m^(-2)](体质量:t=2.504,P=0.014;BMI:t=3.855,P<0.05);治疗后两组甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL)均下降,高密度脂蛋白胆固醇(HDL-C)上升(均P<0.05);治疗后两组餐后2 h血糖(2 h FBG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)水平均下降,空腹血糖胰岛素(FINS)、β细胞功能指数(HOMA-β)水平均上升,A组2 h FBG、FBG[分别为(7.86±1.12)mmol·L^(-1)、(6.18±0.71)mmol·L^(-1)]低于B组[分别为2 h FBG(8.72±1.34)mmol·L^(-1)和FBG(7.02±0.62)mmol·L^(-1)](2 h FBG:t=4.061,P<0.05;FBG:t=7.349,P<0.05),A组HOMA-β[(74.62±3.78)%]高于B组[(62.79±3.56)%](t=18.937,P<0.05);两组不良反应发生率比较差异无统计学意义(20.59%vs 25.00%,χ^(2)=0.376,P=0.540)。结论对于肥胖2型糖尿病患者,聚乙二醇洛塞那肽与利拉鲁肽均能有效减轻体质量、调节血脂、降低血糖水平以及增强胰岛β细胞的功能,且安全性相似。然而,在降低体质量方面,利拉鲁肽的效果更为显著,而聚乙二醇洛塞那肽在改善胰岛β细胞功能和降低血糖方面则表现更为出色。展开更多
目的研究那格列奈对初诊2型糖尿病患者血糖及胰岛β细胞功能的影响。方法初诊2型糖尿病患者40例,分为那格列奈组与格列吡嗪组,干预8周后分别测定治疗前后血浆葡萄糖和胰岛素水平及糖化血红蛋白(HbA1C),同步记录体质量指数(body mass ind...目的研究那格列奈对初诊2型糖尿病患者血糖及胰岛β细胞功能的影响。方法初诊2型糖尿病患者40例,分为那格列奈组与格列吡嗪组,干预8周后分别测定治疗前后血浆葡萄糖和胰岛素水平及糖化血红蛋白(HbA1C),同步记录体质量指数(body mass index,BMI)。结果那格列奈治疗后各点血糖水平及HbA1C均较治疗前下降,空腹血糖及餐后2 h血糖的下降较治疗前有显著性差异(P<0.05);那格列奈组与格列吡嗪组间治疗后餐后2 h血糖有显著性差异(P<0.05)。那格列奈治疗后胰岛素释放试验示胰岛素分泌高峰出现于餐后60 min,较治疗前有显著性差异(P<0.05);较格列吡嗪组同点数值差异亦有显著性(P<0.05)。结论那格列奈在降低空腹血糖和糖化血红蛋白的同时,更好地降低餐后血糖,且促进胰岛素的早期分泌,有效改善胰岛β细胞的功能。展开更多
文摘The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.
文摘目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,按照随机数字表法分成68例A组(聚乙二醇洛塞那肽治疗)与68例B组(利拉鲁肽治疗)。比较治疗前后两组肥胖相关指标、治疗前后两组血脂相关指标、治疗前后两组血糖指标以及治疗后不良反应发生率。结果治疗后两组体质量、腰臀比、体质量指数(BMI)和腰围均下降,B组体质量和BMI[分别为(80.31±7.62)kg和(24.13±1.82)kg·m^(-2)]低于A组体质量[分别为(83.65±7.93)kg和BMI(25.34±1.84)kg·m^(-2)](体质量:t=2.504,P=0.014;BMI:t=3.855,P<0.05);治疗后两组甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL)均下降,高密度脂蛋白胆固醇(HDL-C)上升(均P<0.05);治疗后两组餐后2 h血糖(2 h FBG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)水平均下降,空腹血糖胰岛素(FINS)、β细胞功能指数(HOMA-β)水平均上升,A组2 h FBG、FBG[分别为(7.86±1.12)mmol·L^(-1)、(6.18±0.71)mmol·L^(-1)]低于B组[分别为2 h FBG(8.72±1.34)mmol·L^(-1)和FBG(7.02±0.62)mmol·L^(-1)](2 h FBG:t=4.061,P<0.05;FBG:t=7.349,P<0.05),A组HOMA-β[(74.62±3.78)%]高于B组[(62.79±3.56)%](t=18.937,P<0.05);两组不良反应发生率比较差异无统计学意义(20.59%vs 25.00%,χ^(2)=0.376,P=0.540)。结论对于肥胖2型糖尿病患者,聚乙二醇洛塞那肽与利拉鲁肽均能有效减轻体质量、调节血脂、降低血糖水平以及增强胰岛β细胞的功能,且安全性相似。然而,在降低体质量方面,利拉鲁肽的效果更为显著,而聚乙二醇洛塞那肽在改善胰岛β细胞功能和降低血糖方面则表现更为出色。
