OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate ...OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.展开更多
Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin a...Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.展开更多
Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendo...Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendously over the years,but certain aspects of its estimation still remain elusive to researchers and clinicians.The quantitative assessment of insulin sensitivity is not routinely used during biochemical investigations for diagnostic purposes,but the emerging importance of insulin resistance has led to its wider application research studies.Evaluation of a number of clinical states where insulin sensitivity is compromised calls for assessment of insulin resistance. Insulin resistance is increasingly being assessed in various disease conditions where it aids in examining their pathogenesis,etiology and consequences. The hyperinsulinemic euglycemic glucose clamp is the gold standard method for the determination of insulin sensitivity,but is impractical as it is labor-and time-intensive.A number of surrogate indices have therefore been employed to simplify and improve the determination of insulin resistance.The object of this review is to highlight various aspects and methodologies for current and upcoming measures ofinsulin sensitivity/resistance.In-depth knowledge of these markers will help in better understanding and exploitation of the condition.展开更多
Background Hyperinsulinemic euglycemic clamp is the gold standard to evaluate the insulin sensitity, but it is too complicated and expensive to use in clinic.We tried to find an alternative indicator to reflect insuli...Background Hyperinsulinemic euglycemic clamp is the gold standard to evaluate the insulin sensitity, but it is too complicated and expensive to use in clinic.We tried to find an alternative indicator to reflect insulin sensitivity.To evaluate the association between the four adipokines, adiponectin, leptin, resistin and tumor necrosis factor-α （TNF-α） with insulin sensitivity, we used a hyperinsulinemic euglycemic clamp to test insulin sensitivity in Chinese patients with obesity and type 1 or type 2 diabetes mellitus versus controls.Methods In this parallel control study, we tested insulin sensitivity using a hyperinsulinemic euglycemic clamp in different groups, then examined levels of adiponectin, leptin, resistin and TNF-α in serum, and the relationship between the different adipokines and glucose disposal rate （M value）, as well as insulin sensitivity index （M value/insulin, M/I）,which are the ＂gold standard＂ indices of insulin sensitivity.Results There were significant differences in mean leptin values in the four adipokines from the four different groups （P〈0.001; comparison of the variation between different groups was analyzed by variance analysis）.Compared to controls （using multiple comparison two-way Dunnett t test）, only the leptin level showed significant differences in the four adipokines from the four different groups at the same time （P 〈0.001）.The association analysis between the different adipokines and M or M/I values also showed that only leptin negatively correlated with M （r=-0.64, P 〈0.001） or M/I values （r=-0.56, P〈0.001）; there was no relationship between the other three adipokines and M or M/I values.Conclusion Only leptin was associated with M or M/I values.Therefore, leptin might be one of the predictive factors of the degree of insulin resistance and risk of the accompanying disease.展开更多
文摘OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.
文摘Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.
文摘Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendously over the years,but certain aspects of its estimation still remain elusive to researchers and clinicians.The quantitative assessment of insulin sensitivity is not routinely used during biochemical investigations for diagnostic purposes,but the emerging importance of insulin resistance has led to its wider application research studies.Evaluation of a number of clinical states where insulin sensitivity is compromised calls for assessment of insulin resistance. Insulin resistance is increasingly being assessed in various disease conditions where it aids in examining their pathogenesis,etiology and consequences. The hyperinsulinemic euglycemic glucose clamp is the gold standard method for the determination of insulin sensitivity,but is impractical as it is labor-and time-intensive.A number of surrogate indices have therefore been employed to simplify and improve the determination of insulin resistance.The object of this review is to highlight various aspects and methodologies for current and upcoming measures ofinsulin sensitivity/resistance.In-depth knowledge of these markers will help in better understanding and exploitation of the condition.
文摘Background Hyperinsulinemic euglycemic clamp is the gold standard to evaluate the insulin sensitity, but it is too complicated and expensive to use in clinic.We tried to find an alternative indicator to reflect insulin sensitivity.To evaluate the association between the four adipokines, adiponectin, leptin, resistin and tumor necrosis factor-α （TNF-α） with insulin sensitivity, we used a hyperinsulinemic euglycemic clamp to test insulin sensitivity in Chinese patients with obesity and type 1 or type 2 diabetes mellitus versus controls.Methods In this parallel control study, we tested insulin sensitivity using a hyperinsulinemic euglycemic clamp in different groups, then examined levels of adiponectin, leptin, resistin and TNF-α in serum, and the relationship between the different adipokines and glucose disposal rate （M value）, as well as insulin sensitivity index （M value/insulin, M/I）,which are the ＂gold standard＂ indices of insulin sensitivity.Results There were significant differences in mean leptin values in the four adipokines from the four different groups （P〈0.001; comparison of the variation between different groups was analyzed by variance analysis）.Compared to controls （using multiple comparison two-way Dunnett t test）, only the leptin level showed significant differences in the four adipokines from the four different groups at the same time （P 〈0.001）.The association analysis between the different adipokines and M or M/I values also showed that only leptin negatively correlated with M （r=-0.64, P 〈0.001） or M/I values （r=-0.56, P〈0.001）; there was no relationship between the other three adipokines and M or M/I values.Conclusion Only leptin was associated with M or M/I values.Therefore, leptin might be one of the predictive factors of the degree of insulin resistance and risk of the accompanying disease.
