赤芝中新颖杂萜-三萜杂聚体的分离纯化及其改善C2C12细胞胰岛素抵抗作用

目的赤芝(Ganoderma lucidum)在民间被用于糖尿病治疗,但缺乏数据支撑,需探索其化学成分及其是否具有抗糖尿病作用以利于临床推广。方法采用多种分离技术,如MCI gel CHP 20P、RP-18、Sephadex LH-20、硅胶柱色谱、制备薄层色谱(Preparative Thin-Layer Chromatography,PTLC)和高效液相色谱(High Performance Liquid Chromatography,HPLC)等,对云南产赤芝的低极性成分进行研究,利用一维(One Dimensional,1D)和二维(Two Dimensional,2D)核磁共振波谱(Nuclear Magnetic Resonance Spectroscopy,NMR)等方法鉴定化合物结构,在C2C12细胞胰岛素抵抗体外模型中研究其活性。结果从云南2个产地赤芝中分离鉴定8个杂萜-三萜杂聚体类新化合物,ganolucinins D-K(1-8),其中化合物7和8可上调胰岛素受体底物1(Insulin Receptor Substrate 1,IRS1)和蛋白激酶B(Protein Kinase B,PKB/Akt)磷酸化,8可促进C2C12细胞葡萄糖摄取。结论赤芝中可能存在一系列杂萜-三萜杂聚体类化合物,其中化合物8具有改善胰岛素抵抗潜力,可能是灵芝抗糖尿病的药效物质之一。

OSAHS与氧化应激及其相关并发症的最新研究进展

阻塞性睡眠呼吸暂停/低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)是最常见的睡眠呼吸障碍性疾病。大量临床研究、细胞培养和动物模型利用间歇性缺氧表明,OSAHS可以导致氧化应激(oxidative stress,OS),并且氧化应激在OSAHS及其合并症的发生和发展中起核心作用。OSAHS的重要致病机制是其特征性的慢性间歇性缺氧,后者可以促进活性氧(reactive oxygen species,ROS)和诱导氧化应激的形成。过量的ROS可以在生理或者病生条件下破坏生物分子、改变细胞功能,如引起胰岛B细胞凋亡及胰岛功能损伤,促进炎症、血管内皮功能障碍和心血管疾病发病率。氧化应激(OS)是OSAHS的重要特征,并能直接促使OSAHS相关并发症如血管内皮异常,高血压,高血脂和2型糖尿病/胰岛素抵抗等疾病的发生与发展。因此,氧化应激是OSAHS及其并发症的发生发展的最重要的环节。现就OS与OSAHS及其并发症的相关性在近几年的最新研究进展作一综述。

Adiponectin Gene Variation -4522C/T Is Associated with Type 2 Diabetic Obesity and Insulin Resistance in Chinese

The authors investigated the possible association of -4522C/T variation of adiponectin gene with coronary heart disease （CHD） and type 2 diabetes mellitus （T2DM）. Genotyping of SNP --4522C/T in 304 patients with CHD, 389 patients with T2DM, and 405 age and sex-matched healthy control subjects was carried out by means of PCR-RFLP approach. No significant difference in the genotype or allele frequencies was found, either between patients with CHD and control subjects, or between patients with T2DM and control subjects. However, in the subgroup analysis, an association of the TAr genotype and T allele with type 2 diabetes combined with obesity （BMI ≥ 25 kg/m2） was found （P = 0.014 and P = 0.034, respectively）. Also the homeostasis model assessment of insulin resistance （HOMA-IR） in T2DM patients with T/T genotype was significantly higher than that in T2DM patients carrying C allele （P = 0.0069）. The authors＇ findings for the first time demonstrated that SNP --4522 in the adiponectin gene was associated with T2DM that combined with obesity and higher insulin resistance index in patients with T2DM. This indicated that the variation might associate with an increased susceptibility to type 2 diabetic obesity and insulin resistance. But -4522C/T polymorphism did not contribute to the susceptibility of CHD.

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

To summarise the literature data on hepatitis C virus (HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODSWe conducted a PubMed search and selected all studies found with the key words 'HCV' or 'hepatitis C virus' and 'diabetes' or 'insulin resistance'. We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].RESULTSHCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSIONGlucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.

Clinical expression of insulin resistance in hepatitis C and B virus-related chronic hepatitis:Differences and similarities

AIM： To investigate the prevalence of the clinical pa- rameters of insulin resistance and diabetes in patients affected by chronic hepatitis C （CHC） or chronic hepa- titis B （CHB）. METHODS： We retrospectively evaluated 852 consec- utive patients （726 CHC and 126 CriB） who had under- gone liver biopsy. We recorded age, sex, ALT, type 2 diabetes and/or metabolic syndrome （MS）, body mass index （BMI）, and apparent disease duration （ADD）. RESULTS： Age, ADD, BMI, prevalence of MS and diabetes in patients with mild/moderate liver fibrosis were significantly higher in CHC. However, the degree of steatosis and liver fibrosis evaluated in liver biop- sies did not differ between CHC and CHB patients. At multivariate analysis, age, sex, BMI, ALT and diabetes were independent risk factors for liver fibrosis in CHC, whereas only age was related to liver fibrosis in CHB. We also evaluated the association between significant steatosis （〉 30%） and age, sex, BMI, diabetes, MS and liver fibrosis. Diabetes, BMI and liver fibrosis were associated with steatosis 〉 30% in CHC, whereas only age and BMI were related to steatosis in CriB. CONCLUSION： These data may indicate that hepatitis C virus infection is a risk factor for insulin resistance.

A paradox:Insulin inhibits expression and secretion of resistin which induces insulin resistance

AIM: To confirm whether insulin regulates resistinexpression and secretion during differentiation of 3T3-L1preadipocytes and the relationship of resistin with insulinresistance both in vivo and in vitro.METHODS: Supernatant resistin was measured duringdifferentiation of 3T3-L1 preadipocytes. L6 rat myoblastsand hepatoma cell line H4IIE were used to confirm thecellular function of resistin. Diet-induced obese ratswere used as an insulin resistance model to study therelationship of resistin with insulin resistance.RESULTS: Resistin expression and secretion wereenhanced during differentiation 3T3-L1 preadipocytes.This cellular differentiation stimulated resistin expressionand secretion, but was suppressed by insulin. Resistinalso induced insulin resistance in H4IIE hepatocytes andL6 myoblasts. In diet-induced obese rats, serum resistinlevels were negatively correlated with insulin sensitivity,but not with serum insulin.CONCLUSION: Insulin can inhibit resistin expressionand secretion in vitro, but insulin is not a major regulatorof resistin in vivo . Fat tissue mass affects insulinsensitivity by altering the expression and secretion ofresistin.

Phosphatase and Tension Homolog Overexpression in Insulin Resistant Diabetic Adipose Tissue

Objective To investigate the expression of phosphatase and tension homolog(PTEN) in adipose tissue of KKAy diabetic mice, a mouse model of type 2 diabetes. Methods KKAy diabetic mice were fed with high fat diet for 4 weeks. After blood glucose met the criteria of diabetes(over 16.7 mmol/L), mice were randomly divided into 3 groups: a control group(without any treatment), a rosiglitazone group(treated with rosiglitazone 12.5 mg/kg·d once per day), and a metformin group(treated with metformin 3 g/kg·d twice daily). After 4 weeks, we then determined the expression of PTEN and phosphoserine 473-Akt(pS473-Akt) in the epididymal adipose tissue with Western blots. The mice in each group were further divided into the insulin(-) subgroup and insulin(+) subgroup, which were intraperitoneally injected with saline and insulin(5 mU/g body weight), respectively. Results The expression of PTEN was elevated in the epididymal adipose tissue obtained from KKAy diabetic mice compared with that from the C57BL/6J mice(P<0.001). In accordance with the enhanced expression of PTEN, the level of pS473-Akt stimulated by insulin was decreased in the adipose tissue of KKAy mice compared to the C57BL/6J mice(P<0.001). Treatment with the insulin-sensitizing agents, rosiglitazone and metformin did not inhibit the elevated expression of PTEN in adipose tissue of KKAy diabetic mice. Conclusion PTEN may play an important role in the development of insulin resistance in adipose tissue of type 2 diabetes mice model.

Relationship between insulinase activity of erythrocytes and insulin resistance in patients with type2diabetes mellitus

Objective:To investigatetherelationshipbetweeninsulinaseactivityof erythrocytes(EIA)andinsulin resistanceinpatientswithtype2diabetesmellitus.Methods:EIAwas determinedwiththemethodof radioassayof enzymeactivityin65healthysubjects,and109patientswithtype2diabetesmellitusdividedinto3subgroupsac-cordingto theirtherapy andplasmaglucosecontrol.Fastingplasmainsulin(FINS)andotherrelatedindiceswereal-so measuredinallthesubjects.Moreover,insulinsensitiveindex(ISI)wascalculatedforestimationof insulinsensi-tivity.Re sults:EIAandFINSareincreasedin two subgroupsof diabeticpatientson hypoglycemics(subgroupA andsubgroupB),andespeciallyhigherinthepoorcontrolled subgroupof patients(subgroupA).EIAandFINSare normalinsubgroupof patientswithoutmedication(subgroupC).Moreover,ISIis decreasedin allthesubgroupsof patientsas comparedwithnormalsubjects.CorrelationanalysisshowthatEIAis inverselycorrelatedwithISIinall subgroupsof patientsandnormalsubjects,andpositivelycorrelatedwithFINSin normalsubjects.Conclusions:Therateof insulindegradationin erythrocytesis increasedin patientswithtype2diabetes,and increasedinsulin degradationmayresultintheirinsulin-resistantstate.Moreover,EIAmaybe usedas oneof theindicesforestima-tionof insulinsensitivity.

Silkworm Extract Ameliorates Type 2 Diabetes Mellitus and Protects Pancreaticβ-cell Functions in Rats

Objective The aim of the present study was to investigate the hypoglycemic effects of silkworm extract(SE)on experimental type 2 diabetes mellitus(T2DM)rats.Methods SE was prepared by dissolving freeze-dried silkworm powder in 70%(v/v)aqueous ethanol.T2DM rats were induced by feeding them a high fat diet and an intraperitoneal injection of streptozotocin(STZ).The blood glucose,free fatty acid(FFA),malondialdehyde(MDA),tumor necrosis factor alpha(TNF-α)and superoxide dismutase(SOD)levels were detected by enzyme-linked immunosorbent assay(ELISA).The quality of SE was controlled by high performance liquid chromatography(HPLC;Agilent 1260,Agilent,USA).Hematoxylin-eosin(HE)staining was performed for histological evaluation.Antibody expression was assessed via immunohistochemistry(IHC)staining.Results SE could improve insulin resistance and islet cell function by reducing FFA,MDA and TNF-αlevels and increasing SOD level.In addition,pancreatic HE staining analysis revealed that SE has a protective effect on isletβ-cells.Conclusions The present study indicates that SE has hypoglycemic as well as pancreatic protective effects in T2DM model rats.

Clinical significance of glycemic parameters on venous thromboembolism risk prediction in gastrointestinal cancer

To investigate the possible predictive role of routinely used glycemic parameters for a first venous thromboembolism (VTE) episode in gastrointestinal (GI) cancer ambulatory patients - with or without clinically diagnosed type 2 diabetes (T2D) or obesity - treated with chemotherapy.METHODSPre-treatment fasting blood glucose, insulin, glycated hemoglobin (HbA1c) and homeostasis model of risk assessment (HOMA) were retrospectively evaluated in a cohort study of 342 GI cancer patients. Surgery was performed in 142 (42%) patients with primary cancer, 30 (21%) and 112 (79%) of whom received neoadjuvant and adjuvant therapies, respectively. First-line chemotherapy was administered in 200 (58%) patients with metastatic disease. The study outcome was defined as the occurrence of a first symptomatic or asymptomatic VTE episode during active treatment.RESULTSImpaired glucose tolerance (IGT) or T2D were diagnosed in 30% of GI cancer patients, while overweight/obesity had an incidence of 41%. VTE occurred in 9.4% of patients (7% of non-diabetic non-obese), especially in those with a high ECOG score (P = 0.025). No significant association was found between VTE incidence and T2D, obesity, different tumor types, metastatic disease, Khorana class of risk, or different anti-cancer drugs, although VTE rates were substantially higher in patients receiving bevacizumab (17% vs 8%, P = 0.044). Conversely, all glucose metabolic indexes were associated with increased VTE risk at ROC analysis. Multivariate Cox proportional analyses confirmed that HOMA index (HR = 4.13, 95%CI: 1.63-10.5) or fasting blood glucose (HR = 3.56, 95%CI: 1.51-8.39) were independent predictors of VTE occurrence during chemotherapy.CONCLUSIONThe results here reported demonstrate that evaluating glucose metabolic asset may allow for VTE risk stratification in GI cancer, helping to identify chemotherapy-treated patients who might benefit from thromboprophylaxis. Further multicenter prospective studies involving a larger number of patients are presently needed.

Yi-Qi-Zeng-Min-Tang,a Chinese medicine,ameliorates insulin resistance in type 2 diabetic rats

AIM:To investigate the effects of the Chinese herbal decoction,Yi-Qi-Zeng-Min-Tang(YQZMT),on insulin resistance in type 2 diabetic rats.METHODS:Sprague-Dawley rats were divided into two dietary regiments by feeding either normal pellet diet(NPD) or high fat diet(HFD).Four weeks later,the HFD-fed rats were injected intraperitoneally with lowdose streptozotocin(STZ).Rats with non-fasting blood glucose level ≥ 16.67 mmol/L were considered type 2 diabetic and further divided into five subgroups:the type 2 diabetes model group,low-dose,medium-doseand high-dose YQZMT groups,and rosiglitazone group.Age-matched NPD-fed rats served as controls.YQZMT or rosiglitazone were administered for 8 wk.Intraperitoneal glucose and insulin tolerance tests were performed before and after the treatment to measure the glucose tolerance and insulin sensitivity.Serum levels of biochemical parameters,adipocytokines,such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),as well as free fatty acids(FFAs),were also analyzed.RESULTS:There was significant elevation of insulin resistance and serum levels of fasting glucose(12.82 ± 1.08 mmol/L vs 3.60 ± 0.31 mmol/L,P < 0.01),insulin(7197.36 ± 253.89 pg/mL vs 4820.49 ± 326.89 pg/mL,P < 0.01),total cholesterol(TC)(8.40 ± 0.49 mmol/L vs 2.14 ± 0.06 mmol/L,P < 0.01),triglyceride(2.24 ± 0.12 mmol/L vs 0.78 ± 0.05 mmol/L,P < 0.01),low-density lipoprotein cholesterol(LDL-c)(7.84 ± 0.51 mmol/L vs 0.72 ± 0.04 mmol/L,P < 0.01) and decrease in high-density lipoprotein cholesterol(HDL-c)(0.57 ± 0.03 mmol/L vs 1.27 ± 0.03 mmol/L,P < 0.01) in the low-dose STZ and high-fat diet induced type 2 diabetic group when compared with the control group.Administration of YQZMT induced dose-and timedependent changes in insulin resistance,glucose and lipid profile,and reduced levels of FFA,TNF-α and IL-6 in the type 2 diabetic rats.After the treatment,compared with the diabetic group,the insulin resistance was ameliorated in the high-dose YQZMT(2.82 g/100 g per day) group,with a significant reduction in serum glucose(12.16 ± 1.00 mmol/L vs 17.65 ± 2.22 mmol/L,P < 0.01),homeostasis model assessment of basal insulin resistance(22.68 ± 2.37 vs 38.79 ± 9.02,P < 0.05),triglyceride(0.87 ± 0.15 mmol/L vs 1.99 ± 0.26 mmol/L,P < 0.01),TC(3.31 ± 0.52 mmol/L vs 6.50 ± 1.04 mmol/L,P < 0.01) and LDL-c(2.47 ± 0.50 mmol/L vs 6.00 ± 1.07 mmol/L,P < 0.01),and a signif icant increase in HDL-c(0.84 ± 0.08 mmol/L vs 0.50 ± 0.03 mmol/L,P < 0.01).But the body weight was not changed signif icantly.CONCLUSION:YQZMT,which ameliorates insulin resistance and does not cause increase in body weight,may be a suitable therapeutic adjunct for the treatment of type 2 diabetes.

Relationship between β3-AR Gene and Obesity, Type 2 Diabetes, Insulin Resistance in Chinese Han Population

Objective: To explore the relationship between the β 3-adrenergic receptor(β 3-AR)gene and obesity, T2DM, insulin resistance in Chinese Han population. Methods: Fifty-three healthy subjects, 105 subjects with simple obesity, 63 type 2 diabetic patients without obesity, and 114 type 2 diabetic patients with obesity were studied with the technique of PCR-RFLP in codon 64 of the exon region of β 3-AR gene representing the variation Trp/Arg. Results: Compared with the subjects of Trp homozygous group, the individuals with Arg allele were more elevated in WHR,MBP,SBP,DBP,FBS,PBS,FINS,PINS,FCP,PCP and lower in ISI. Frequency of Arg allele was higher in HINS subgroup without T2DM. Conclusion: The results indicate that the Trp/Arg variation might lead to insulin resistance, obesity and T2DM.β 3-AR gene is supposed to be the candidate gene of insulin resistance, obesity and T2DM in Chinese Han population.

Prognostic value of glycated hemoglobin in colorectal cancer

AIM To investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer(CRC) patients.METHODS Pre-treatment fasting blood glucose, insulin, Hb A1 c and homeostasis model of risk assessment(HOMA-IR) were retrospectively evaluated in a case-control study of 224 CRC and 112 control subjects matched for sex, obesity and diabetes frequency and blood lipid profile.Furthermore, the prognostic value of routinely used glycemic parameters towards progression-free(PFS) and overall survival(OS) was prospectively evaluated.RESULTS Fasting blood glucose, insulin, HOMA-IR and HbA 1c(all P < 0.0001) levels were higher in non-diabetic CRC patients compared with obesity-matched controls. All parameters were associated with increased CRC risk at ROC analysis, but no relationship with clinical-pathological variables or survival outcomes was observed for glycemia, insulinemia or HOMA-IR. Conversely, advanced CRC stage(P = 0.018) was an independent predictor of increased Hb A1 c levels, which were also higher in patients who had disease progression compared with those who did not(P = 0.05). Elevated Hb A1 c levels showed a negative prognostic value both in terms of PFS(HR = 1.24) and OS(HR = 1.36) after adjustment for major confounders, which was further confirmed in a subgroup analysis performed after exclusion of diabetic patients.CONCLUSION HbA 1c might have a negative prognostic value in CRC, thus suggesting that glycemic metabolic markers should be carefully monitored in these patients, independently of overt diabetes.

Mangiferin ameliorates hyperglycemia by inhibiting oxidation and α-glucosidase activity

Objective： Mangiferin （MF） is a polyphenol isolated from the root of Anemarrhena asphodeloides Bge.. This study wasaimed to investigate the effects of MF on hyperglycemia in animal models of insulin resistance and streptozotocin（STZ）-induced diabetes. Methods： The diabetes mellitus model was established in mice by receiving a multiplehypodermic injection of hydrocortisone sodium succinate （HCSS） （70 mg/kg） or a single intravenous injection of STZ（130 mg/kg）. Meanwhile MF at different dosage （50, 100 and 200 mg/kg） were oral administrated for consecutive 10days. Data of blood glucose were collected at different time after intraperitoneal injection of insulin （0.5 U/kg） toinvestigate the insulin resistant. As well as the oxygen radical absorbance capacity （ORAC） and superoxide dismutase（SOD） activity of kidney were measured. The in vitro experiment was established to investigate the inhibitory capacity ofMF to α-glucosidase. Results： Oral administration of MF significantly prevented insulin resistance caused by HCSSinjection. STZ-induced diabetic symptoms were also improved, including fasting blood glucose, glycated hemoglobin,plasma triglycerides, hepatic glycogen, kidney SOD and ORAC level. The in vitro experiment demonstrated that MF hadpotent α-glucosidase inhibitory activity. Conclusion： The obtained results demonstrate that MF ameliorates insulinresistance and STZ-induced glucose metabolism disturbance. The MF exerts the protective effects through improving theantioxidant ability, promoting hepatic glycogen synthesis and inhibiting α-glucosidase activity.

Study of the Effects of FFA and Obesity on Diabetes Through Numerical Simulation of the Mathematical Model

Aim of the study is to analyze the effect of FFA together with the obesity on the glucose - insulin dynamics of NIDD people through a mathematical model. An attempt has been made to capture the glucose and insulin concentration levels for NIDD people having raised level of FFA and obesity through numerical simulation of the model. It has been observed fi＇om the simulation of the model that elevated level of plasma FFA inhibit glucose uptake, glucose utilization, decrease insulin sensitivity and increase insulin resistance in NIDD people in comparison to the normal people.

HOMA-ESTIMATED INSULIN RESISTANCE IN NONDIABETIC INDIVIDUALS

Objective To assess the relationship between HOMA-estimated insulin resistance and risk fac-tors of cardiovascular disease in the general population. Methods 268 eligible subjects of Pudong ShangGan community, aged 45-80 years, volunteered to participate in this cross-sectional survey. Fasting insulin was measured by means of a radioimmunoassay. Results Anthropometric parameters ,fasting blood glucose and insulin, increased in a linear fashion across quartiles of HOMA-IR after adjustment for age and sex. HOMA-IR was significantly associated with measures of anthropometry (BMI,r = 0. 30; waist circumference, r =0. 35; and waist-to-hip ratio,r =0.21), fasting (glucose,r =0. 41; insulin,r=0. 71), and cardiovascular risk factors ( cholesterol, r = 0. 23; triglyceride,r = 0. 31; systolic blood pressure,r= 0. 25; and diastolic blood pressure, r = 0. 20; all P < 0. 0001). In logistic regression analysis, odds ratios indicate that individuals with obesity ( high levels of BMI and waist circumference) were more than 4 times likely to have elevated HOMA-IR. With increase of log triglycerides, the risk of having elevated HOMA-IR increased more than 2. 4 times. For increase in systolic and diastolic blood pressure, the likelihood of having elevated HOMA-IR increased >1. 8 times. Conclusion HOMA-IR was significantly and independently associated with risk factors of cardiovascular disease in this study.

Effect of acupuncture on insulin and resistin in type 2 diabetes mellitus rats

Objective To explore the effect of acupuncture on insulin and resistin in type 2 diabetes mellitus （DM） rats. Methods Successfully modeled rats were randomly divided into the acupuncture group, the western medicine group, and the model control group, 8 cases in each group. Meanwhile, 8 rats fed with common food were set up as the normal control group. Rats in the acupuncture group were put in the fixator, and acupuncture was conducted at ＂Housanli＂（后三里 ST 36）, ＂Neiting＂（内庭 ST 44） and ＂Yishu＂（胰俞 Extra）. Rosiglitazone was given to rats in the western medicine group by gastrogavage. Double distilled water was given to rats in the model group by gastrogavage. The treatment was conducted once daily in all the 3 groups for 4 successive weeks. After ending the experiments, the blood in rats samples were got. The insulin and resistin were detected. Results The serum levels of insulin and resistin were significantly lowered in the acupuncture group, accompanied with significantly lowered blood glucose and blood lipids. Compared with the model group, the resistin was obviously lowered in the western medicine group, with no significant lowering of insulin. Conclusion Acupuncture showed obvious effects in lowering serum insulin and rsistin in type 2 DM rats, thus effectively improving insulin resistance.

Insulin sources and types: a review of insulin in terms of its mode on diabetes mellitus

Insulin is involved in regulation of glucose utilization in the body. Inability of the body to synthesize insulin or human cells resistance to insulin leads to a condition called Diabetes mellitus which is characterized by chronic hyperglycaemia. There are two types of diabetes; type 1 and type 2. Exogenous supply of insulin is needed consistently for type 1diabetes treatment and type 2 diabetes also needs to be cured by the exogenous supply of insulin in advance stages of the disease. These sources have been proved very useful to meet the needs of the patients. However, these insulin types are expensive for the large population of patients in the developing countries. Furthermore, the incidence of diabetes is advancing at an alarming rate. Hence production systems with even higher capabilities of production are desired. Therefore, currently plants are being investigated as alternative production systems. Based on the mode of action of insulin various formulations of insulin have been developed that have different onset of action, peak effect and duration of action according to the needs of the patients.

A prospective study (SCOPE) comparing the cardiometabolic and respiratory effects of air pollution exposure on healthy and pre-diabetic individuals

Air pollution is known to be a major risk factor for cardiopulmonary disease, but this is unclear for cardiometabolic disease (e.g.diabetes). This is of considerable public health importance, given the nationwide epidemic of diabetes, accompanied by severe air pollution, in China. The evidence so far remained inadequate to answer questions of whether individuals with cardiometabolic dysfunctions are susceptible to air pollution and whether air pollution exacerbates diabetes development via certain biological pathways. In this manuscript, we summarize the results and limitations of studies exploring these two topics and elaborate our design of a prospective panel study (SCOPE) as a solution. We assessed and compared the health effect of air pollution among pre-diabetic individuals and matched healthy controls through four repeated clinical visits over 1 year. Comprehensive evaluation was made to both health endpoints and exposure. The primary biomarkers were assessed to reveal the impact on multiple biological pathways, including glycolipid metabolism and insulin resistance, endothelial function, and inflammation. Detailed chemical and size fractional components of particulate matter were measured in this study, along with the application of personal monitors.The work should increase our understanding of how air pollution affects individuals with cardiometabolic dysfunction and the underlying mechanisms.

Observation of the efficacy and safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation for patients with prediabetes

Objective:To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods:One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method,with 51 cases in each group.All patients received the general behavioral intervention for prediabetes,with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group.Both groups received the intervention for six months.Results:Fourteen patients dropped out during the treatment,and a total of 88 patients completed the trial,including 45 cases in the manipulation group and 43 cases in the control group.After the treatment,the prediabetes control rate was 93.3%in the manipulation group and 74.4%in the control group,and the difference between the two groups was statistically significant(P<0.05);no patient in the manipulation group progressed to diabetes,while the rate of conversion to diabetes in the control group was 6.9%,with a significant difference between the two groups(P<0.05).After the treatment,the body mass index(BMI),glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2-hour postload plasma glucose(2hPG)level during an oral glucose tolerance test(OGTT),fasting insulin(FINS),homeostasis model assessment-2 of insulin resistance(HOMA2-IR),total cholesterol(TC),and triglycerides(TG)decreased in both groups versus baseline,with significant differences within the groups;the levels of all indicators were lower in the manipulation group than in the control group(P<0.05),and the differences between the two groups were more prominent at the sixth month(P<0.01).At the sixth month,the high-density lipoprotein cholesterol(HDL-C)in the manipulation group was increased,while there was no significant change in the control group.In the control group,three patients reported mild gastrointestinal reactions at the initial dosing,which improved after medication adjustment.No other adverse events were observed in either group.Conclusion:Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes,but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.