目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治...目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治的46例T2DM患者作为观察组,另选取同期32名健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)测定两组血清omentin-1水平,比较观察组治疗前与对照组及观察组治疗前后体重指数(BMI)、腰臀比(WHR)、血压、糖脂水平、胰岛素指标及血清omentin-1水平,分析T2DM患者治疗前后omentin-1水平与HOMA-IR的相关性。结果观察组治疗前与对照组BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)水平比较差异均无统计学意义;观察组治疗前空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及HOMA-IR均高于对照组,稳态模型评估-胰岛β细胞功能指数(HOMA-β)、血清omentin-1水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组WHR、BMI、FBG、2 h PG、HbA1c、HOMA-IR水平均低于治疗前,HOMA-β、血清omentin-1水平均高于治疗前,差异有统计学意义(P<0.05)。Pearson直线相关分析结果显示,T2DM患者血清omentin-1水平与HOMA-IR呈负相关(r<0,P<0.05)。结论T2DM患者糖脂、血清omentin-1水平和胰岛β细胞功能异常,血清omentin-1与HOMA-IR呈负相关,达格列净能有效降低T2DM患者糖脂水平,提高血清omentin-1水平,进而可改善胰岛β细胞功能。展开更多
Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. P...Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. Patient(s): Two hundred seventy-one PCOS patients and 260 eumenorrheic, non-hirsute, control women. I ntervention(s): History and physical examination and blood sampling. Main Outcom e Measure(s): Total T, free T, DHEAS, sex hormone-binding globulin, and fasting glucose and insulin levels; homeostatic model assessment values for IR (HOMA-I R) and percent β-cell function (HOMA-%β-cell). Result(s): Patients with PC OS and controls differed significantly in all parameters studied, except fasting glucose. Because the HOMA-IR and HOMA-%β-cell values were variably associa ted with race, age, and body mass index, the HOMA-IR and HOMA-%β-cell value s were then adjusted for these cofounders. After adjustment, 64.4%of PCOS patie nts were noted to be insulin resistant, and 2.6%had β-cell dysfunction. Compa red with PCOS patients without IR (n = 96), patients with IR (n = 174) were more obese and had higher β-cell function. Conclusion(s): In patients with PCOS, t he prevalence of IR was 64%according to the HOMA-IR measurement, after adjustm ent. Patients with IR were more clinically affected. Although IR is a common abn ormality in PCOS, it does not seem to be a universal feature.展开更多
目的:观察外科感染病人胰岛素抵抗(IR)状况,研究其临床意义,并探讨如何应用临床常用参数评价感染病人的胰岛素敏感性(ISI)。方法:检测外科不同病情严重程度感染患者空腹血糖(FBG)、空腹胰岛素(FINS),以正常健康人为对照,利用稳态模式评...目的:观察外科感染病人胰岛素抵抗(IR)状况,研究其临床意义,并探讨如何应用临床常用参数评价感染病人的胰岛素敏感性(ISI)。方法:检测外科不同病情严重程度感染患者空腹血糖(FBG)、空腹胰岛素(FINS),以正常健康人为对照,利用稳态模式评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-)β,观察外科感染病人ISI,并且分析不同病情严重程度和不同病种感染病人之间ISI是否存在显著差异。使用多元线性回归方程和多因素Logistic进行多因素分析,应用临床常用的参数评价感染ISI状况。结果:①外科感染病人中IR发生率为92.06%(58/63)。不同病种,包括急性重症胰腺炎病人、肠瘘病人和急性胆管炎病人,不论HOMA-IRl、gHOMA-IR还是HOMA-β均无显著差异(P>0.05)。②按病情严重度和最终预后对病人分组:SIRS病人IR发生率为20%(7/35),脓毒症病人IR发生率为86.20%(25/29),脓毒性休克和MODS组病人IR发生率为95.83%(23/24),死亡组病人IR发生率为100%(10/10)。各组间IR有显著差异(P<0.01),而HOMA-β无显著差异(P>0.05)。③临床各常用参数与ISI之间相关性分析显示器官功能衰竭连续评分(sequential organ failure assessment,SOFA)、FINS、FBG、转铁蛋白、脓毒症评分(sepsis scores,SS)评分、C-反应蛋白(CRP)、前白蛋白、三酰甘油(TG)和胰岛素用量/葡萄糖用量与ISI呈独立正相关,方程的R2为0.900。各临床参数对IR的多因素Logistic回归显示FINS、FBG、低密度脂蛋白(LDL)和SOFA进入模型,其中FBG和FINS与IR的回归关系更明显,而其他临床指标与IR未显示有意义的回归关系。结论:①外科感染病人中普遍存在IR,并与引起感染的病种无关;②IR与疾病严重程度最终预后密切相关,可作为判断危重病人病情转归和预后的预警指标;③临床常用参数SOFA评分、FINS、FBG、转铁蛋白、SS评分、CRP、前白蛋白和TG与感染病人ISI的关系更为密切。展开更多
To determine the prevalence of insul in resistance(IR)in women with polycystic ovary syndrom e(PCOS)using baseline fasting blood measurement s of glucose and insulin.Prospective clinical study.Academ ic endocrinology ...To determine the prevalence of insul in resistance(IR)in women with polycystic ovary syndrom e(PCOS)using baseline fasting blood measurement s of glucose and insulin.Prospective clinical study.Academ ic endocrinology unit in Palermo,Italy.Two hundred and sixty -sevenwomenwith PCOS,consecutively evaluated,and50consecutively se-lected ovulating controls.Fasting blood was obtained for glucose and insulin measurements fr om all women.For 60women with PCOS and 20controls an insulin tolerance test(ITT)was also performed.Assessment of normal and ab-normal values for fasting insulin,g lucose /insulin ratio,and the calculated indices of the hom eostasis model as-sessment (HOMA),quantitative sensitivity check in dex(QUICKI ),as well as Kitt(kinetic disappearance of glu-cose)values after ITT.Evaluation was performed of the ability to detect IR using these meth ods in obese and nonobese women with PCOS.Normal insulin sensitivity was defined by insulin levels<12mU /mL,glucose /insulin ratios of>6.4,HOMA values of<47,and QUICKI values of>0.333.In the entire PCOS groups,IR w as diagnosed in 65.4%of women using glucose /insu lin ratios and in77%and 79.2%using HOMA and QUICKI.I n obese women(body mass index >28in 48%of group),IR was present in 76.7%as measured by gluco se /insulin ratios but was significantly higher(95.3%)using values of ei-ther HOMA or QUICKI (P<.01).All indices correlated with Kitt values with QUICKI showing the best correlation.Insulin resistance was detected in a pproximately 80%of women with PCOS,and in 95%of obese wo men.The detection of IR is superior using the calculated indices HOMA and QUICKI.展开更多
文摘目的分析达格列净治疗2型糖尿病(T2DM)对患者糖脂水平和胰岛素指标及血清网膜素-1的影响及血清网膜素-1与稳态模型评估-胰岛素抵抗指数(HOMA-IR)的相关性。方法选取2018年11月至2019年10月于长江大学附属仙桃市第一人民医院内分泌科收治的46例T2DM患者作为观察组,另选取同期32名健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)测定两组血清omentin-1水平,比较观察组治疗前与对照组及观察组治疗前后体重指数(BMI)、腰臀比(WHR)、血压、糖脂水平、胰岛素指标及血清omentin-1水平,分析T2DM患者治疗前后omentin-1水平与HOMA-IR的相关性。结果观察组治疗前与对照组BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)水平比较差异均无统计学意义;观察组治疗前空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及HOMA-IR均高于对照组,稳态模型评估-胰岛β细胞功能指数(HOMA-β)、血清omentin-1水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组WHR、BMI、FBG、2 h PG、HbA1c、HOMA-IR水平均低于治疗前,HOMA-β、血清omentin-1水平均高于治疗前,差异有统计学意义(P<0.05)。Pearson直线相关分析结果显示,T2DM患者血清omentin-1水平与HOMA-IR呈负相关(r<0,P<0.05)。结论T2DM患者糖脂、血清omentin-1水平和胰岛β细胞功能异常,血清omentin-1与HOMA-IR呈负相关,达格列净能有效降低T2DM患者糖脂水平,提高血清omentin-1水平,进而可改善胰岛β细胞功能。
文摘Objective: To determine the prevalence of insulin resistance (IR) in a large p opulation of patients with the polycystic ovary syndrome (PCOS). Design: Prospec tive, case-control. Setting: University medical center. Patient(s): Two hundred seventy-one PCOS patients and 260 eumenorrheic, non-hirsute, control women. I ntervention(s): History and physical examination and blood sampling. Main Outcom e Measure(s): Total T, free T, DHEAS, sex hormone-binding globulin, and fasting glucose and insulin levels; homeostatic model assessment values for IR (HOMA-I R) and percent β-cell function (HOMA-%β-cell). Result(s): Patients with PC OS and controls differed significantly in all parameters studied, except fasting glucose. Because the HOMA-IR and HOMA-%β-cell values were variably associa ted with race, age, and body mass index, the HOMA-IR and HOMA-%β-cell value s were then adjusted for these cofounders. After adjustment, 64.4%of PCOS patie nts were noted to be insulin resistant, and 2.6%had β-cell dysfunction. Compa red with PCOS patients without IR (n = 96), patients with IR (n = 174) were more obese and had higher β-cell function. Conclusion(s): In patients with PCOS, t he prevalence of IR was 64%according to the HOMA-IR measurement, after adjustm ent. Patients with IR were more clinically affected. Although IR is a common abn ormality in PCOS, it does not seem to be a universal feature.
文摘目的:观察外科感染病人胰岛素抵抗(IR)状况,研究其临床意义,并探讨如何应用临床常用参数评价感染病人的胰岛素敏感性(ISI)。方法:检测外科不同病情严重程度感染患者空腹血糖(FBG)、空腹胰岛素(FINS),以正常健康人为对照,利用稳态模式评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-)β,观察外科感染病人ISI,并且分析不同病情严重程度和不同病种感染病人之间ISI是否存在显著差异。使用多元线性回归方程和多因素Logistic进行多因素分析,应用临床常用的参数评价感染ISI状况。结果:①外科感染病人中IR发生率为92.06%(58/63)。不同病种,包括急性重症胰腺炎病人、肠瘘病人和急性胆管炎病人,不论HOMA-IRl、gHOMA-IR还是HOMA-β均无显著差异(P>0.05)。②按病情严重度和最终预后对病人分组:SIRS病人IR发生率为20%(7/35),脓毒症病人IR发生率为86.20%(25/29),脓毒性休克和MODS组病人IR发生率为95.83%(23/24),死亡组病人IR发生率为100%(10/10)。各组间IR有显著差异(P<0.01),而HOMA-β无显著差异(P>0.05)。③临床各常用参数与ISI之间相关性分析显示器官功能衰竭连续评分(sequential organ failure assessment,SOFA)、FINS、FBG、转铁蛋白、脓毒症评分(sepsis scores,SS)评分、C-反应蛋白(CRP)、前白蛋白、三酰甘油(TG)和胰岛素用量/葡萄糖用量与ISI呈独立正相关,方程的R2为0.900。各临床参数对IR的多因素Logistic回归显示FINS、FBG、低密度脂蛋白(LDL)和SOFA进入模型,其中FBG和FINS与IR的回归关系更明显,而其他临床指标与IR未显示有意义的回归关系。结论:①外科感染病人中普遍存在IR,并与引起感染的病种无关;②IR与疾病严重程度最终预后密切相关,可作为判断危重病人病情转归和预后的预警指标;③临床常用参数SOFA评分、FINS、FBG、转铁蛋白、SS评分、CRP、前白蛋白和TG与感染病人ISI的关系更为密切。
文摘To determine the prevalence of insul in resistance(IR)in women with polycystic ovary syndrom e(PCOS)using baseline fasting blood measurement s of glucose and insulin.Prospective clinical study.Academ ic endocrinology unit in Palermo,Italy.Two hundred and sixty -sevenwomenwith PCOS,consecutively evaluated,and50consecutively se-lected ovulating controls.Fasting blood was obtained for glucose and insulin measurements fr om all women.For 60women with PCOS and 20controls an insulin tolerance test(ITT)was also performed.Assessment of normal and ab-normal values for fasting insulin,g lucose /insulin ratio,and the calculated indices of the hom eostasis model as-sessment (HOMA),quantitative sensitivity check in dex(QUICKI ),as well as Kitt(kinetic disappearance of glu-cose)values after ITT.Evaluation was performed of the ability to detect IR using these meth ods in obese and nonobese women with PCOS.Normal insulin sensitivity was defined by insulin levels<12mU /mL,glucose /insulin ratios of>6.4,HOMA values of<47,and QUICKI values of>0.333.In the entire PCOS groups,IR w as diagnosed in 65.4%of women using glucose /insu lin ratios and in77%and 79.2%using HOMA and QUICKI.I n obese women(body mass index >28in 48%of group),IR was present in 76.7%as measured by gluco se /insulin ratios but was significantly higher(95.3%)using values of ei-ther HOMA or QUICKI (P<.01).All indices correlated with Kitt values with QUICKI showing the best correlation.Insulin resistance was detected in a pproximately 80%of women with PCOS,and in 95%of obese wo men.The detection of IR is superior using the calculated indices HOMA and QUICKI.
