Effects of Chinese Patent Drug Zishen Pills in Treatment of Elderly Patients with Impaired Glucose Tolerance(IGT)

[Objectives]To evaluate the efficacy of Zishen Pills(ZSP),a Chinese patent drug,in the treatment of elderly patients with impaired glucose tolerance(IGT)and its effects on the prevention of diabetes mellitus(DM).[Methods]Thirty-five IGT patients were randomized to receive 10 g of ZSP three times daily(ZSP group,n=24)or no drug intervention(control group,n=11)for 12 weeks.Oral glucose tolerance test,glycated hemoglobin A1c(HbA1c),body mass index,blood lipids levels,fasting insulin,and insulin resistance calculated using homeostatic model assessment(HOMA-IR)of all the patients were observed and compared before and after the treatment.[Results]Thirty participants completed the trial(20 in ZSP group and 10 in the control group).There were statistically significant decreases in plasma triglycerides(TG),fasting blood-glucose(FBG),2-h plasma glucose(2-h PG),HbA1c,and HOMA-IR in ZSP group compared with the control group after 12 weeks of treatment(P<0.05 or P<0.01).After 12 weeks of treatment,2(20.0%)patients returned to normal blood glucose,and 2(20.0%)patients turned into DM in control group,while in the ZSP group,9(45.0%)patients returned to normal blood glucose and 1(5.0%)patient turned into DM.[Conclusions]ZSP effectively improved glucose control,increased the conversion of IGT to normal glucose,and improved the insulin resistance in elderly patients with IGT.This Chinese patent drug may have a clinical value for IGT.

Risk factors for impaired glucose tolerance in obese children and adolescents

AIM:To investigate which obese children have an increased risk for impaired glucose tolerance(IGT),a risk factor for later diabetes.METHODS:We studied 169 European untreated obese children and adolescents with normal glucose tolerance at baseline.Waist circumference,fasting glucose,lipids,blood pressure,pubertal stage,2 h glucose in oral glucose tolerance test(oGTT),and HbA1c were deter mined at baseline and 1 year later.RESULTS:One year after baseline,19(11.2) children demonstrated IGT,4(2.4) children had impaired fas ting glucose,no(0) child suffered from diabetes,and 146(86) children still showed normal glucose tolerance.At baseline,the children with IGT and with normal glucose tolerance in a one-year follow-up did not differ significantly in respect of any analyzed parameter,apart from pubertal stage.The children developing IGT entered puberty significantly more frequently(37 vs 3,P < 0.001).One year after baseline,the childr en with IGT demonstrated significantly increased waist circumference,blood pressure values,insulin and triglyceride concentrations,and insulin resistance index HOMA.The children remaining in the normal glucose tolerance status 1 year after baseline did not demonstrate any significant changes.CONCLUSION:During the study period of 1 year,more than 10 of the obese children with normal glucose tolerance converted to IGT.Repeated screening with oGTT seems meaningful in obese children entering puberty or demonstrating increased insulin resistance,waist circumference,blood pressure,or triglyceride concen trations.

Effects of Metformin and Pioglitazone on impaired glucose tolerance patients—An open level prospective study

Introduction: impaired glucose tolerance (IGT) often leads to type 2 diabetes (T2DM) and macro vascular disease;and usually associated with insulin resistance. Pioglitazone and metformin are commonly used insulin sensitizers (IS);and can prevent or delay the development T2DM and macro vascular disease. This study was deployed to search the better IS between these two in relation to plasma glucose and lipid control;and physical parameter altering effect. Materials and methods: 100 IGT patients selected randomly from outpatients department following prefixed inclusion and exclusion criteria. Pioglitazone and metformin were administered sequentially. Washout period was 2 weeks. Total follow up period was 24 weeks. Results: 70 IGT patients had completed the study. Metformin had reduced plasma glucose (fasting & postprandial), lipids and physical parameters significantly (p < 0.05) more than Pioglitazone. Discussion: Metformin, a hepatic insulin sensitizer, is more effective than PPAR-□ agonist Pioglitazone in the treatment of IGT;and this is due to the expression of PPAR-□ is more in adipose tissue but postprandial utilization of plasma glucose is more in muscle tissue.

Vascular endothelial growth factor B improves impaired glucose tolerance through insulin-mediated inhibition of glucagon secretion

BACKGROUND Impaired glucose tolerance(IGT)is a homeostatic state between euglycemia and hyperglycemia and is considered an early high-risk state of diabetes.When IGT occurs,insulin sensitivity decreases,causing a reduction in insulin secretion and an increase in glucagon secretion.Recently,vascular endothelial growth factor B(VEGFB)has been demonstrated to play a positive role in improving glucose metabolism and insulin sensitivity.Therefore,we constructed a mouse model of IGT through high-fat diet feeding and speculated that VEGFB can regulate hyperglycemia in IGT by influencing insulin-mediated glucagon secretion,thus contributing to the prevention and cure of prediabetes.AIM To explore the potential molecular mechanism and regulatory effects of VEGFB on insulin-mediated glucagon in mice with IGT.METHODS We conducted in vivo experiments through systematic VEGFB knockout and pancreatic-specific VEGFB overexpression.Insulin and glucagon secretions were detected via enzyme-linked immunosorbent assay,and the protein expression of phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)was determined using western blot.Further,mRNA expression of forkhead box protein O1,phosphoenolpyruvate carboxykinase,and glucose-6 phosphatase was detected via quantitative polymerase chain reaction,and the correlation between the expression of proteins was analyzed via bioinformatics.RESULTS In mice with IGT and VEGFB knockout,glucagon secretion increased,and the protein expression of PI3K/AKT decreased dramatically.Further,in mice with VEGFB overexpression,glucagon levels declined,with the activation of the PI3K/AKT signaling pathway.CONCLUSION VEGFB/vascular endothelial growth factor receptor 1 can promote insulin-mediated glucagon secretion by activating the PI3K/AKT signaling pathway to regulate glucose metabolism disorders in mice with IGT.

Scleredema Diabeticorum in a Patient with the Normal Range of the Hemoglobin A1c Level and Impaired Glucose Tolerance

Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.

Effect of Jiangtang Bushen Recipe (降糖补肾方) in Intervention Treatment of Patients with Impaired Glucose Tolerance

Objective:To evaluate the intervention effect of diet, exercise and Jiangtang Bushen Recipe (JBR, 降糖补肾方), a Chinese herbal recipe, in preventing the progress of patients with impaired glucose tolerance ( IGT ) to diabetes mellitus (DM) type 2. Methods: Fifty-one IGT patients with their diagnosis conformed to the diagnosis standard of WHO, 1999, were randomly divided into the control group (n = 26) and the TCM group (n=25). Patients in the control group attended to the educational course for DM and received dietotherapy and kinetotherapy, and to those in the TCM group, under these treatments, JBR was given additionally. Oral glucose tolerance test (OGTT), body weight index (BWI), levels of blood lipids and fasting insulin of all the patients were examined after 3 months, 6 months and 12 months of treatment. The total observation time was 1 year. Results:Except the 6 cases out of the 51 patients (11.7%), on whom the observa-tion discontinued, in the control group, as compared with before treatment, levels of fasting insulin and fasting blood glucose after treatment were not changed significantly ( P > 0. 05 ) , also insignificant difference was shown in levels of total cholesterol (TC) and triglyceride (TG), thoughthe two indexes lowered slightly after treatment (P>0. 05), but significant difference was shown in comparison of OGTT/2h, blood glucose and BWI (P<0. 05). While in the TCM group, fasting blood glucose was changed insignificantly (P> 0. 05) , but there was significant difference in comparison of fasting insulin, TC, BWI, OGTT/2h and plasma glucose levels (P<0. 01) respectively before and after treatment. At the end of the stud-y, the cumulative cases with conversion to diabetes were 3 (13. 6%) in the control group, and 1 (4. 3%) in the TCM group, x2 test showed insignificant difference in comparison of diabetes conversion rate between the two groups (P>0. 05), however, the TCM group showed a better year conversion rate of normal glucose tolerance than that in the control group (x2 = 8. 31, P<0. 01). Conclusion: TCM intervention is possibly effective in delaying the conversion of IGT to DM type 2, and plays integrative effeciency in impelling IGT patients to health. The favorable education and treatment of DM controlling, including dieto- and kineto-therapy may also be advantageous in IGT intervention, but could not be effective in blocking the advance of IGT.Original article on CJITWM (Chin) 2004 ;24 (4): 317

Meta-analysis of clinical efficacy and safety of the treatment of impaired glucose tolerance by Tianqijiangtang Capsule

Objective： To evaluate the clinical efficacy and safety of Tianqijiangtang Capsule （TG） during the treatment ofimpaired glucose tolerance （IGT）. Methods： Using Chinese words of “impaired glucose tolerance, abnormalglucose tolerance, IGT” and “TG” as search terms, China National Knowledge Infrastructure, VIP, Wanfang Dataand Pubmed were searched from database inception until October 2017. All the controlled clinical researches on thetreatment of IGT by TG meeting the inclusion and exclusion criteria were retrieved and analyzed by ReviewManager 5.3 software. Results： A total of 7 articles including 1082 participants were enrolled. Meta-analysisshowed that the OR value of inversion rate was 2.17, 95% CI （1.65, 2.84）. Weighted mean difference （WMD） valueof fasting plasma glucose was -0.25, 95% CI （-0.39, -0.11）. After 2 h, the WMD value of serum glucose was -0.73,95% CI （-0.96, -0.51）, all of which were better than these of control group. The OR value of progression rate （type2 diabetes mellitus） was 0.44, 95% CI （0.32, 0.59）, less than the control group. All of the differences werestatistically significant. No hepatic and renal toxicity case was reported. Only 1 article reported adverse reactions inthe course of treatment. Conclusion： TG could treat IGT effectively, delay and even invert the progress of IGT, butits security still needed further discussion.

Mechanism Analysis of Gui Jianyu in treating Hypertension complicated with Impaired Glucose Tolerance Based on Network Pharmacology and Molecular Docking

Objective To explore the mechanism of Gui Jianyu(Euonymus alatus(Thunb.)Sieb.)in treating hypertension(HT)complicated with impaired glucose tolerance(IGT)based on network pharmacology and molecular docking technology.Methods The main chemical components and targets of Gui Jianyu were obtained from TCMSP database.The Swiss Target Prediction platform was used to predict drug-related targets for supplement.Main disease targets of HT complicated with IGT were obtained from GenCards,OMIM and DrugBank databases.The intersection targets of drugs and two diseases were obtained by R and Veen Diagram was drawn.The protein-protein interaction(PPI)network model was constructed in STRING platform and visualized by Cytoscape tool.GO and KEGG analysis on Metascape platform were used to analyse the common targets.Network of main drug components-disease targets-pathways was established with Cytoscape tool.Finally,the molecular docking between the core regulatory active components of Gui Jianyu and the core targets were verified by Autodock vina.Results Eight active components and 357 corresponding targets were obtained.681 HT related targets and 727 IGT related targets,196 disease intersection targets,and 57 Gui Jianyu targets in the treatment of HT complicated with IGT were confirmed.20 GO and 19 KEGG main pathways were enriched.Molecular docking of 2 key active ingredients with 2 key targets showed that all results scores were less than-5.0 kcal·mol-1.Quercetin and kaempferol,the key active components,had good binding activity with AKT1 and TP53.Conclusion Gui Jianyu may play a key role in the treatment of HT complicated with IGT by reducing insulin resistance.This work explored the common pathogenesis of HT complicated with IGT,and also provided a reference for further pharmacological research and exploration the efficacy of Gui Jianyu for HT complicated with IGT.

益气健脾汤治疗脾气亏虚型IGT患者的临床观察及对血糖变异系数的影响

目的:研究益气健脾汤治疗脾气亏虚型糖耐量减低(IGT)患者的疗效以及对血糖波动指数的影响。方法:纳入2023年12月—2024年2月在黑龙江中医药大学附属第三医院内分泌(老年病)科门诊、住院部的60例IGT(脾气亏虚型)患者,按照随机数字表法分为对照组和治疗组,每组30例。两组患者均给予饮食、宣教、运动等一般基础治疗。对照组在基础治疗的基础上给予阿卡波糖胶囊;治疗组在对照组基础上加用益气健脾汤联合治疗。两组患者均治疗6周。观察两组在治疗前后的空腹血糖(FPG)、2 h血糖(2 h PG)、糖化血红蛋白(HbA1c);甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL);血糖变异系数(GLUCV)、血糖标准差(GLUsd)、平均血糖值(GLUmean)、日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)及中医证候评分,并观察其疗程结束时的随访转归情况。结果:治疗6周后,两组患者的糖代谢指标、GLUsd、GLUmean、GLUCV、MAGE、中医证候评分均显著降低(P<0.05),治疗组的糖代谢指标、GLUsd、GLUCV、MAGE、中医证候评分显著低于对照组,差异有统计学意义(P<0.05)。结论:益气健脾汤能有效改善IGT患者症状,调节糖代谢,并能缩小血糖波动,延缓2型糖尿病发生发展,比单纯生活方式干预和阿卡波糖治疗持久有效。

Oral glucose tolerance test in diabetes,the old method revisited

The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.

Repetitiveness of the oral glucose tolerance test in children and adolescents

BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.

Retinal microcirculation changes in prediabetic patients with shortterm increased blood glucose using optical coherence tomography angiography

BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.

老年人群糖尿病和IGT患病率及其影响因素

目的:了解重庆市老年人群糖尿病(DM)和糖耐量低减(IGT)的患病情况及其主要患病风险因素,为城市社区人群制定适宜的预防和干预措施提供科学依据。方法:采用整群分层抽样方法,对60岁以上1 791例自然人群进行了横断面调查。结果:DM患病率14.45%,IGT患病率21.70%,随着年龄增加,DM和IGT患病率亦逐渐升高。超重者(BMI≥25)DM和IGT患病率为17.51%和28.02%,肥胖者(BMI≥30)DM和IGT患病率为21.43%和37.14%,按腰臀比(WHR)划分,向心性肥胖者DM和IGT患病率为17.45%和25.09%。影响DM患病风险的因素主要有:DM家族史、BMI、WHR、高收缩压、高甘油三酯。结论:在社区人群中,倡导健康合理的膳食习惯、控制血压、体重是降低糖尿病发生的重要措施,老年人是DM防治工作的主要对象。

深圳市DM、IGT患病率与性别、年龄和文化程度的关系

目的 探讨深圳市糖尿病 (DM)、糖耐量减低 (IGT)患病率与性别、年龄及文化程度的关系。方法 对 2 0岁以上的 82 0 0例行糖尿病流行病学调查。结果 1DM患病率为 4.2 3% ,其中男性 3.5 6 % ,女性 4.6 5 % ;IGT为 11.94% ,其中男性 10 .19% ,女性 13.0 1%。 2 DM在 5 9岁以前和 IGT在 49岁以前 ,其患病率随年龄增加呈倍数增长。 3低文化程度 (初中以下 )者 DM、IGT患病率明显高于高文化程度 (高中以上 )者。 4绝经后 DM、IGT患病率明显高于绝经前。 5有生育巨大儿史的女性 DM、IGT患病率较无生育巨大儿史的女性高。结论 深圳市女性 DM、IGT患病率高于男性 ,且随年龄增大而增高。DM治疗的重点在 5 0岁以后 ;而 IGT的干预重点在 49岁以前。应重视女性和低文化程度人群的糖尿病教育。更年期前后的内分泌改变可能促进了 DM、IGT的发生。有生育巨大儿的女性是 DM。

餐后有氧联合抗阻运动对糖耐量减低(IGT)人群干预效果研究

目的:观察规律性餐后有氧联合抗阻运动干预对糖耐量减低(impaired glucose tolerance,IGT)人群的血糖、血脂与胰岛素敏感性的影响。方法:选取60例糖耐量减低(IGT)受试者,年龄42~58岁,随机分为餐后运动干预组与餐前运动干预组,分别在晚餐后与晚餐前1 h进行12周有氧联合抗阻运动干预(50 min/次,3次/周),比较2组空腹血糖、餐后血糖、糖化血红蛋白、血脂和胰岛素敏感性相关指标。结果:组内比较餐后干预组与餐前干预组受试者的空腹血糖、餐后血糖、糖化血红蛋白与运动前相比均降低;餐后运动干预组与餐前组相比,餐后2 h血糖明显降低(P<0.05);餐后运动干预组与餐前组相比,胰岛素敏感性相关指标及血脂指标胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇均明显改善,差异有显著性。结论:12周餐后有氧联合抗阻运动干预,有效改善糖耐量减低人群的血糖、血脂与胰岛素敏感性,餐后血糖降低效果显著;运动方式与运动时间点的选择在IGT人群运动干预中同样重要。本研究可为进一步提高IGT人群运动干预的效率提供科学依据。

二甲双胍对IGT的干预治疗疗效观察

近年来糖尿病（ＤＭ）和糖耐量减低（ＩＧＴ）患病率有逐年增高的趋势，研究发现几乎所有的ＤＭ患者在发生ＤＭ之前，均经过ＩＧＴ阶段。本文通过对３２例ＩＧＴ者随机分为二甲双胍治疗组及非药物干预治疗组比较分析，结果提示，二甲双胍治疗组比非药物干预治疗组ＤＭ发生率明显减少，而ＩＧＴ向糖耐量正常（ＮＧＴ）人转化者则明显增多，这可能是二甲双胍具有不刺激胰岛β细胞分泌胰岛素，且能预防和减轻胰岛素抵抗，减轻高胰岛素血症之特点，进而能针对ＩＧＴ的基本缺陷——胰岛素抵抗和胰岛素分泌异常进行干预治疗，结果可纠正ＩＧＴ患者的糖代谢紊乱，防止ＩＧＴ向ＤＭ转化，同时又能使ＩＧＴ向糖耐量正常（ＮＧＴ）人转化。因此，用二甲双胍对ＩＧＴ的干预治疗对提高ＩＧＴ人群的生活质量，减少ＤＭ的发病率具有重要的意义。

营养干预对IGT人群糖脂代谢及胰岛素抵抗的临床研究

目的:通过营养干预的手段观察其对糖耐量减低(IGT)人群糖脂代谢及胰岛素水平的影响。方法:通过流调,以服糖耐量试验(OGTT)筛查IGT患者,随机分为对照组和干预组,干预组通过营养师进行善食调查,营养教育,饮食评价指导总计1.5年,对照组不进行任何指导教育。两组于试验前后检查空腹血糖(FPG),餐后2小时血糖(2hpG),胰岛素(Ins)水平及胰岛素抵抗指数(HOMA-IR)等。结果:饮食干预组体质指数(BMI),FPG、Ins及HomA-IR等较对照组明显下降(P<0.01)仅2人转为糖尿病(DM),对照组试验前后各项指标无显著变化,有6人转为DM,两组经t检验,DM的患病率有统计学意义(P<0.05)。结论:营养干预对改善IGT患者的糖脂代谢,胰岛素抵抗有重要作用。

单纯IGT和单纯IFG个体高敏C反应蛋白水平的差异及相关因素分析

目的比较正常空腹血糖/正常糖耐量(NFG/NGT)、空腹血糖受损(IFG)、糖耐量减低(IGT)及IFG/IGT个体的血清高敏C反应蛋白(hsC-RP)水平的差异,并对其相关因素进行分析。方法将443名39～65岁非糖尿病(DM)个体根据OGTT分为以下4组:NFG/NGT、单纯IFG、单纯IGT和IFG/IGT组。比较各组间血清hsC-RP的差异,并对与之相关的变量进行统计学分析。结果IGT组比IFG组hsC-RP水平明显升高(P<0.05),IFG组与NFG/NGT组以及IGT组与IFG/IGT组间的hsC-RP水平没有明显统计学差异(P>0.05)。多元逐步回归分析显示,BMI和胰岛素抵抗指数是hsC-RP的独立预告因子。结论IGT比IFG个体的血清hsC-RP水平明显升高,hsC-RP与胰岛素抵抗和代谢综合征的多种组分相关。

武汉地区IGT患者瘦素受体基因变异与高血压关系的研究

目的:研究瘦素受体(LR)基因Gln223Arg变异与武汉地区糖耐量减低(IGT)合并高血压的关系。方法:运用聚合酶链反应-限制性片段长度多态性(PCR-RELP)方法,测定无亲缘关系,且有完整临床资料的572例(包括252例糖耐量正常者及320例IGT患者)武汉地区汉族人群的LR基因Gln223 Arg变异频率。同时测血糖、血脂、身高、体重,按公式计算体重指数(BMI)。结果:(1)IGT合并高血压病组Gln 223 ArgAA、AG和GG基因型及A、G等位基因频率与正常对照组比较有非常显著性差异(均P<0.01);(2)男性IGT合并高血压病组与女性IGT合并高血压病组Gln 223 Arg变异基因型及等位基因比较具有显著统计学差异(均P<0.01);(3)IGT合并高血压病组Gln 223 Arg变异与收缩压和舒张压显著正相关(r分别为0.91和0.90,均P<0.05),A等位基因与肥胖型IGT合并高血压男性患者收缩压和舒张压呈正相关,携带A等位基因的肥胖型男性IGT其高血压发生的比数比(OR)为3.88(95%CI为2.77～5.44)。结论:LR基因Gln 223 Arg变异与肥胖男性IGT合并高血压相关,且与收缩压和舒张压均相关。

阿卡波糖对IGT患者血浆内皮素、C反应蛋白和纤维蛋白原的影响

目的 观察糖耐量减低患者应用阿卡波糖干预治疗前后对血浆内皮素、C反应蛋白和纤维蛋白原的影响.方法 100例IGT患者随机分为治疗组（n=50）和对照组（n=50）,两组患者均制订个性化的饮食方案及运动方案,在此基础上治疗组服用阿卡波糖.观察治疗前及治疗24周、48周后两组的ET、CRP、Fg变化及随访1年的转归情况.结果 糖耐量减低患者应用阿卡波糖治疗24周、48周后,血浆内皮索、C反应蛋白、纤维蛋白原均显著下降,而对照组三者均无显著性改变;随访1年内,治疗组比对照组DM发生率明显减少,心血管事件的总发生率也明显降低,差异有统计意义.结论 阿卡波糖缓解糖耐量异常患者血管炎症反应,改善血管内皮功能,改善患者的血液高凝倾向,进而减少心血管事件的发生.