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
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
Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some othe...Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the study. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73±.1.1inthe H. pylori-negative group, whereas it was 2.56 ±.1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance.展开更多
目的探讨术前血清胰岛素水平对非糖尿病乳腺癌患者预后的价值。方法选择2010年1月至2014年12月于重庆三峡中心医院进行治疗的286例原发性乳腺癌患者,经排除后,216例非糖尿病乳腺癌患者纳入研究,设为乳腺癌组,按1∶2比例匹配年龄、血脂...目的探讨术前血清胰岛素水平对非糖尿病乳腺癌患者预后的价值。方法选择2010年1月至2014年12月于重庆三峡中心医院进行治疗的286例原发性乳腺癌患者,经排除后,216例非糖尿病乳腺癌患者纳入研究,设为乳腺癌组,按1∶2比例匹配年龄、血脂、体质指数的健康女性设为对照组,比较两组的临床资料及血糖指标;采用受试者工作特征(ROC)曲线分析计算乳腺癌组血清胰岛素的截断值,按最佳节点值分为高低两组;采用Kaplan-Meier法绘制患者生存曲线;获得完整随访资料的有196例非糖尿病乳腺癌患者,采用Cox回归模型对乳腺癌患者预后影响因素进行分析。结果乳腺癌组空腹血糖、胰岛素、HOMA-IRI显著高于健康对照组(P<0.05),两组糖化血红蛋白比较差异无统计学意义(P>0.05);ROC确定血清胰岛素为10.3 m U/L作为乳腺癌患者疾病进展的最佳截断点;Kaplan-Meier分析10.3 m U/L及<10.3 m U/L两组无进展生存时间比较差异有统计学意义(P<0.05),血清胰岛素≥10.3 m U/L组预后差;Cox单因素分析影响无进展生存时间(PFS)的有肿瘤分级(HR=1.43,95%CI 1.05~1.95)、肿瘤分期(HR=1.52,95%CI 1.16~1.98)、空腹胰岛素(HR=1.79,95%CI 1.07~2.98)(P<0.05);Cox多因素分析影响无进展生存时间的有肿瘤分级(HR=1.38,95%CI 1.03~1.85)、肿瘤分期(HR=1.83,95%CI 1.12~2.98)、空腹胰岛素(HR=2.02,95%CI 1.90~3.78)(P<0.05)。结论术前血清胰岛素水平对非糖尿病乳腺癌患者的无进展生存时间的预测有临床意义。展开更多
To examine the association between socioeconomic position and insulin resistance in children from three countries in northern Europe (Denmark), eastern Europe (Estonia), and southern Europe (Portugal) that have differ...To examine the association between socioeconomic position and insulin resistance in children from three countries in northern Europe (Denmark), eastern Europe (Estonia), and southern Europe (Portugal) that have different physical, economic, and cultural environments. Design: Cross sectional study. Participants: 3189 randomly selected schoolchildren aged 9 and 15 years from Denmark (n = 933), Estonia (n = 1103), and Portugal (n = 1153). Main outcome measure: Insulin resistance (homoeostasis model assessment). Results: Family income and pare ntal education were inversely associated with insulin resistance in Danish children but were positively associated with insulin resistance in Estonian and Portuguese children. Among Danish children, insulin resistance was 24% lower (95% confidence interval - 38% to - 10% ) in those whose fathers had the most education compared with those with the least education. The equivalent results were 15% (2% to 28% ) higher for Estonia and 19% (2% to 36% ) higher for Portugal. These associations remained after adjustment for a range of covariates: - 20% (- 36% to - 5% ) for Denmark, 10% (- 4% to 24% ) for Estonia, and 18% (- 1% to 31% ) for Portugal. Strong statistical evidence supported differences between the associations in Denmark and those in the other two countries in both unadjusted and adjusted models (all P < 0.03). Conclusions: Among Danish children, those with the most educated and highest earning parents had least insulin resistance, whereas the opposite was true for children from Estonia and Portugal.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Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the study. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73±.1.1inthe H. pylori-negative group, whereas it was 2.56 ±.1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance.
文摘目的探讨术前血清胰岛素水平对非糖尿病乳腺癌患者预后的价值。方法选择2010年1月至2014年12月于重庆三峡中心医院进行治疗的286例原发性乳腺癌患者,经排除后,216例非糖尿病乳腺癌患者纳入研究,设为乳腺癌组,按1∶2比例匹配年龄、血脂、体质指数的健康女性设为对照组,比较两组的临床资料及血糖指标;采用受试者工作特征(ROC)曲线分析计算乳腺癌组血清胰岛素的截断值,按最佳节点值分为高低两组;采用Kaplan-Meier法绘制患者生存曲线;获得完整随访资料的有196例非糖尿病乳腺癌患者,采用Cox回归模型对乳腺癌患者预后影响因素进行分析。结果乳腺癌组空腹血糖、胰岛素、HOMA-IRI显著高于健康对照组(P<0.05),两组糖化血红蛋白比较差异无统计学意义(P>0.05);ROC确定血清胰岛素为10.3 m U/L作为乳腺癌患者疾病进展的最佳截断点;Kaplan-Meier分析10.3 m U/L及<10.3 m U/L两组无进展生存时间比较差异有统计学意义(P<0.05),血清胰岛素≥10.3 m U/L组预后差;Cox单因素分析影响无进展生存时间(PFS)的有肿瘤分级(HR=1.43,95%CI 1.05~1.95)、肿瘤分期(HR=1.52,95%CI 1.16~1.98)、空腹胰岛素(HR=1.79,95%CI 1.07~2.98)(P<0.05);Cox多因素分析影响无进展生存时间的有肿瘤分级(HR=1.38,95%CI 1.03~1.85)、肿瘤分期(HR=1.83,95%CI 1.12~2.98)、空腹胰岛素(HR=2.02,95%CI 1.90~3.78)(P<0.05)。结论术前血清胰岛素水平对非糖尿病乳腺癌患者的无进展生存时间的预测有临床意义。
文摘To examine the association between socioeconomic position and insulin resistance in children from three countries in northern Europe (Denmark), eastern Europe (Estonia), and southern Europe (Portugal) that have different physical, economic, and cultural environments. Design: Cross sectional study. Participants: 3189 randomly selected schoolchildren aged 9 and 15 years from Denmark (n = 933), Estonia (n = 1103), and Portugal (n = 1153). Main outcome measure: Insulin resistance (homoeostasis model assessment). Results: Family income and pare ntal education were inversely associated with insulin resistance in Danish children but were positively associated with insulin resistance in Estonian and Portuguese children. Among Danish children, insulin resistance was 24% lower (95% confidence interval - 38% to - 10% ) in those whose fathers had the most education compared with those with the least education. The equivalent results were 15% (2% to 28% ) higher for Estonia and 19% (2% to 36% ) higher for Portugal. These associations remained after adjustment for a range of covariates: - 20% (- 36% to - 5% ) for Denmark, 10% (- 4% to 24% ) for Estonia, and 18% (- 1% to 31% ) for Portugal. Strong statistical evidence supported differences between the associations in Denmark and those in the other two countries in both unadjusted and adjusted models (all P < 0.03). Conclusions: Among Danish children, those with the most educated and highest earning parents had least insulin resistance, whereas the opposite was true for children from Estonia and Portugal.
