血糖化血红蛋白/载脂蛋白A1比值和C反应蛋白/高密度脂蛋白胆固醇比值及中性粒细胞与淋巴细胞绝对值比值与冠心病的关系

目的 分析血糖化血红蛋白/载脂蛋白A1比值(HbA1c/ApoA1)、C反应蛋白/高密度脂蛋白胆固醇比值(CHR)、中性粒细胞与淋巴细胞绝对值比值(NLR)与冠心病患者的关系。方法 选取2020年3月至2022年3月因胸痛来徐州市中心医院检查并治疗的200例冠心病患者(冠心病组)及同期100例非冠心病患者(非冠心病组)为研究对象,依据Syntax评分将冠心病患者分为冠状动脉轻度病变组、中度病变组、重度病变组,对比3组的外周血HbA1c/ApoA1、CHR、NLR比值,分析冠心病患者HbA1c/ApoA1、CHR、NLR比值与Syntax评分的相关性,绘制ROC曲线分析HbA1c/ApoA1、CHR、NLR比值对冠状动脉重度病变的预测价值,同时对比发生主要心血管不良事件(MACE)组与未发生MACE组的HbA1c/ApoA1、CHR、NLR差异,多因素logistic回归分析法分析影响冠状动脉病变程度的独立影响因素。结果 冠心病组血HbA1c/ApoA1、CHR、NLR比值高于非冠心病组(P<0.05);随冠状动脉病变程度增加,冠心病患者HbA1c/ApoA1、CHR、NLR比值增加(P<0.05);冠心病患者HbA1c/ApoA1、CHR、NLR比值与Syntax评分呈正相关(r=0.289、0.279、0.277,P<0.05);HbA1c/ApoA1、CHR、NLR比值联合预测冠心病患者发生重度冠状动脉病变的ROC曲线下面积为0.863,高于各指标单独诊断,发生MACE组的血HbA1c/ApoA1、CHR、NLR比值高于未发生MACE组(P<0.05);多因素logistic回归分析显示,HbA1c/ApoA1、CHR、NLR比值为影响冠心病冠状动脉重度程度的独立影响因素(P<0.05)。结论 冠心病患者血HbA1c/ApoA1、CHR、NLR比值与其冠状动脉病变程度有密切关系,尽早检测可对其预后(MACE事件)予以预测。

非糖尿病高血压患者血糖化血红蛋白、B型利钠肽和颈动脉硬化的关系

目的探讨非糖尿病高血压患者血糖化血红蛋白(Hb A1c)、B型利钠肽(BNP)水平与颈动脉硬化的关系。方法根据颈动脉超声结果将225例非糖尿病高血压患者分为颈动脉硬化组(=129)和颈动脉正常组(=96)。分别记录两组性别、年龄、身高、体质量、体质量指数(BMI)、吸烟和用药情况。所有患者清晨测量血压3次,取平均值。次日检测患者空腹Hb Alc、BNP、血脂和改良糖耐量实验(OGTT)。通过颈动脉超声测量颈动脉管壁内膜中层厚度(IMT)并检查斑块形成情况。结果两组性别、年龄、BMI、吸烟状况、舒张压、餐后2 h血糖、三酰甘油等差异均无统计学意义(均>0.05)。颈动脉硬化组HbA1C、BNP、空腹血糖、总胆固醇、低密度脂蛋白和收缩压均高于颈动脉正常组(均<0.05)。多因素logistic回归分析显示Hb A1c、BNP、空腹血糖及低密度脂蛋白均与颈动脉硬化呈正相关(=2.23、1.05、1.60、1.60,均<0.05)。HbA1c的曲线下面积为0.64,预测颈动脉硬化的切点为5.5%(约登指数=0.214),BNP的曲线下面积为0.80,预测颈动脉硬化的切点为101.1ng/L(约登指数=0.523)。结论非糖尿病高血压患者的血HbA1c、BNP水平与颈动脉硬化相关,可能是颈动脉硬化的危险因素。

超敏C反应蛋白、尿微量白蛋白及全血糖化血红蛋白联合检测在早期糖尿病肾病中的应用价值

目的探析早期糖尿病肾病患者诊断中,超敏C反应蛋白(hs-CRP)、尿微量白蛋白(UmAlb)、全全血糖化血红蛋白(HbA1c)的联合检测价值。方法选取2021年1—12月于北京怀柔医院就诊的130例2型糖尿病患者为研究对象,按照尿白蛋白肌酐比值(UACR)分为UACR正常组(UACR<30 mg/g,65例)、UACR轻度增高组(30 mg/g≤UACR≤299 mg/g,65例)。通过检测hs-CRP、HbA1c及UmAlb,探讨联合检测对早期糖尿病肾病的应用价值。结果hs-CRP、UmAlb、HbA1c水平比较,UACR轻度增高组高于UACR正常组,差异有统计学意义(P<0.05)。单独hs-CRP、UmAlb、HbA1c检测相比,早期糖尿病肾病准确率对比,差异无统计学意义(P>0.05),联合3项指标检测早期糖尿病肾病的灵敏度、特异度、准确度均高于单独检测,差异有统计学意义(P<0.05)。结论早期糖尿病肾病患者诊断中,联合应用hs-CRP、UmAlb、HbA1c指标,可以为临床诊断和治疗提供相应的实验室依据,对早期糖尿病肾病患者的早期治疗和预后具有积极意义。

脐血糖化血红蛋白与新生儿血糖水平、出生体重的关系分析

目的研究脐血糖化血红蛋白(HbA1c)与新生儿血糖水平、出生体重的关系,为临床早期干预提供依据。方法192例妊娠期糖尿病母亲新生儿,根据出生时脐血HbA1c水平不同分为N1组(HbA1c<3.46%,47例)、N2组(HbA1c 3.46%~4.25%,112例)、N3组(HbA1c>4.25%,33例)。在生后即刻抽取脐静脉血送检血糖、HbA1c水平,同时取脐血和足底血检测快速血糖水平,记录出生体重;分别于生后12、24、36、48 h检测新生儿的微量血糖水平。比较三组新生儿脐血HbA1c、血糖水平,生后不同时间(12、24、36、48 h)血糖水平,脐血实验室血糖水平、脐血快速血糖水平、足底快速血糖水平,BWR、出生体重恢复时间;分析新生儿脐血HbA1c水平与脐血血糖水平、生后不同时间血糖水平、出生体重比值(BWR)、出生体重恢复时间的相关性;分析新生儿脐血与足底血血糖水平的相关性。结果N1组新生儿脐血HbA1c为(3.25±0.18)%,脐血血糖水平为(3.4±0.3)mmol/L,N2组新生儿分别为(3.68±0.17)%、(3.6±0.4)mmol/L,N3组新生儿分别为(4.41±0.22)%、(3.8±0.6)mmol/L。N3组新生儿脐血HbA1c、血糖水平高于N1组、N2组,N2组高于N1组,差异具有统计学意义(P<0.05);三组新生儿生后12、24、36、48 h血糖水平比较差异无统计学意义(P>0.05)。Pearson相关分析显示:新生儿脐血HbA1c水平与脐血血糖水平呈正相关(r=0.402,P<0.05),与生后12、24、36、48 h血糖水平无相关性(P>0.05)。N1组新生儿脐血实验室血糖、脐血快速血糖和足底快速血糖水平分别为(3.4±0.3)、(3.4±0.5)、(3.4±0.6)mmol/L,N2组新生儿分别为(3.6±0.4)、(3.6±0.5)、(3.6±0.4)mmol/L,N3组新生儿分别为(3.8±0.6)、(3.8±0.4)、(3.8±0.5)mmol/L。N3组新生儿脐血实验室血糖、脐血快速血糖和足底快速血糖水平高于N1组、N2组,N2组高于N1组,差异具有统计学意义(P<0.05)。Pearson相关分析显示:新生儿脐血实验室血糖水平与脐血快速血糖水平、足底快速血糖水平均呈正相关(r=0.842、0.810,P<0.05),脐血快速血糖水平与足底快速血糖水平呈正相关(r=0.825,P<0.05)。N3组新生儿BWR(0.83±0.06)低于N1组的(1.16±0.05)和N2组的(1.02±0.08),N2组低于N1组,差异具有统计学意义(P<0.05);三组新生儿出生体重恢复时间比较差异无统计学意义(P>0.05)。Pearson相关分析显示:新生儿脐血HbA1c水平与新生儿BWR呈负相关(r=-0.617,P<0.05),与出生体重恢复时间无相关性(P>0.05)。结论脐血HbA1c可反映胎儿宫内发育的大致状况和出生时的血糖水平,但不能作为生后血糖水平变化和体重变化的预估指标。对妊娠期糖尿病母亲新生儿需密切监测48 h血糖变化,防止低血糖发生。可用无创脐血查快速血糖代替足底血血糖的测定,减少新生儿的创伤。

全血糖化血红蛋白、Lp(a)联合检测在糖尿病血管并发症诊治中的应用价值

目的探究全血糖化血红蛋白A1c(GhbA1c)、血清脂蛋白a[Lp(a)]联合检测在糖尿病血管并发症防治中的作用。方法选取2021年1—12月该院86例糖尿病血管并发症确诊患者为观察组,选取同期86名健康体检者为对照组,均接受全血糖化血红蛋白与血清脂蛋白水平的测定,统计分析处理结果。结果全血GhbA1c百分比、Lp(a)浓度比较,观察组高于对照组,差异有统计学意义(P<0.05)。结论针对糖尿病血管并发症患者,需要同时检测其全血糖化血红蛋白水平与血清脂蛋白浓度水平,并采取积极的措施,从而控制疾病发展,以此为糖尿病血管并发症的预防、诊断、治疗提供有力的依据。

全自动生化分析仪测定全血糖化血红蛋白一种改进型方法的研究

目的:提高全自动生化分析仪检测HbA1C的准确性,减少手工样品预处理所造成的误差。方法采用英国朗道免疫比浊法糖化血红蛋白试剂及配套的质控品、校准品,应用日立7600全自动生化分析仪检测朗道质控品及本院内分泌科收集的100份EDTA-K2抗凝新鲜全血HbA1C,其中朗道质控品采用原始方法和改良方法重复测定20次。结果同一浓度朗道质控品分别用两种方法在同一仪器上平行测定20次,得到批内变异CV值。两法精密度均符合实验室要求(P<5%),但改良法(批内变异CV值均小于3.2%)的重复性较原始方法(批内变异CV值均小于4.5%)好。而且改良法测定值更接近目标均值。两法结果比较分析院两法测定结果差异比较有统计学意义(P<0.001),但相关性较好(r=0.992)。结论两种方法测定糖化血红蛋白的结果具有很好的相关性,但改良方法的准确性及重复性均较高,更加有助于临床医生做出正确的判断,值得推荐。

西宁市健康体检者静脉血糖化血红蛋白检测结果分析

目的：分析1 424例健康体检者静脉血糖化血红蛋白（Hb A）水平。方法：选择西宁地区体检合格的健康成人1 424例,采用罗氏Cobas501全自动生化分析工作站及配套试剂进行静脉血Hb A测定,并对检测结果进行统计学分析。结果：西宁市健康体检者静脉血红蛋白含量为4.46%~5.92%;不同性别组Hb A含量为：男性（5.20±0.77）%,女性（5.19±0.60）%;不同年龄组为（20~29）岁（5.17±0.80）%,（30~39）岁（5.23±0.65）%,（40~49）岁（5.17±0.71）%,（50~59）岁（5.29±0.81）%,60岁以上（5.27±0.75）%。结论：不同性别、年龄组间Hb A水平差异无统计学意义。

超敏C反应蛋白、尿微量白蛋白及全血糖化血红蛋白联合检测在早期糖尿病肾病中的应用价值

探讨C-反应蛋白、尿微量清蛋白和全血糖化血红蛋白三种指标对 DN的诊断意义。方法选择了我县2021年12月至2022年12月收治的60例糖尿病肾病患者,将其纳入了观察组,并按照其血糖水平的不同,将其分成了低水平组、中水平组和高水组各20例,另外,还将同期的健康成年人60例作为了对照。对两组病人进行 C反应蛋白,尿微量清蛋白和全血糖化血红蛋白进行了对比分析。结果血清中 C反应蛋白,尿微量清蛋白,全糖化血红蛋白,在高浓度血清中均明显升高(P<0.05)。两组间比较,两组间比较,两组间比较,两组间比较有显著性差异(P<0.05)。结论 超敏C-反应蛋白与尿微量清蛋白和全糖化血红蛋白的结合对 DN的诊断价值,为 DN的诊断和预后评估奠定基础。

相同存储条件下三种全血糖化血红蛋白A1c检测系统检测结果对比

目的:比较相同存储条件下三种全血糖化血红蛋白A1c检测系统检测结果,进一步探究不同检测方法的稳定性。方法:选取2018年7月~2019年7月在本院接受的体检人群50例,选取体检人群清晨空腹以及饭后2h的2份血液样本,注入乙二胺四乙酸二钾(EDTA-K2)抗凝试管中,随后用Bio-Rad variant Ⅱ Turbo、Primus UItra2以及Roch Modular PPI三种检测方法检测,比较三种检测方法结果的差异性以及稳定性。结果:三种检测方法检测结果比较不具有差异性(P>0.05);在检测结果稳定性方面,Bio-Rad variant Ⅱ Turbo>Primus UItra2>Roch Modular PPI(P>0.05)。结论:在检测结果方面,三种检测方法的差异性并不明显,但是在检测结果稳定性方面,Bio-Rad variantⅡTurbo检测方法的结果稳定性最高。

糖化血红蛋白与果糖胺在妊娠糖代谢异常诊断中的临床应用

目的探讨糖化血红蛋白与果糖胺诊断妊娠糖代谢异常的临床价值。方法检测并比较观察组280例,其中正常妊娠妇女222例(正常妊娠组),妊娠期糖耐量受损(gestational impaired glucose tolerance,GIGT)患者20例(GIGT组),妊娠期糖尿病(gestational diabetes mellitus,GDM)患者38例(GDM组)及对照组60例孕妇的空腹血糖(FBG)、果糖胺(FRU)和糖化血红蛋白(HbAlc)水平。GDM组和GIGT组孕妇进行口服葡萄糖耐量试验(OGTT)检测FBG和FRU水平并分析比较。结果 GDM组FBG和HbAlc水平分别为(8.50±0.92)mmol/L和(8.95±0.69)%显著高于GIGT组(5.50±0.68)mmol/L和(5.95±0.58)%、正常妊娠组(4.62±0.90)mmol/L和(5.15±0.22)%及对照组(5.29±0.87)mmol/L和(5.03±0.24)%,差异均有显著性意义(P<0.01)。GDM组和GIGT组FRU水平明显高于正常妊娠组和对照组;正常妊娠组FRU水平明显低于对照组,差异均有显著性意义(P<0.05)。GDM组和GIGT组孕妇进行OGTT检测FRU时,糖耐量各检测时间点(空腹、1、2、3 h)FRU结果比较恒定,差异无显著性意义(P>0.05)。直线相关分析:GDM组FBG与FRU和HbAlc均呈正相关(P<0.01),相关系数分别为r=0.59,r=0.75,差异均有显著性意义(P<0.01)。结论 FBG与FRU和HbAlc联合检测,将更有助于妊娠糖代谢异常患者的诊断及疗效监测。

Ⅱ型糖尿病患者血清游离脂肪酸水平与糖脂代谢的相关性研究

探讨Ⅱ型糖尿病（T2DM）患者空腹血清游离脂肪酸（FFAs）水平与其他糖、脂代谢参数间的相关性。方法收集2015年6月至10月在南京医科大学第一附属医院就诊的113例新近诊断Ⅱ型糖尿病患者、55例糖尿病前期者，同时选取62例健康体检者。根据甘油三酯（TG）是否〉1．72mol／L以及总胆固醇（TC）是否〉5．7mol／L分为血脂正常组，混合高脂血症组，高TC、TG组。测定其空腹血清FFAs，空腹血糖（FPG），餐后两小时血糖（2hPG），糖化血红蛋白（HbAle）及糖化白蛋白（GA）水平及相关脂代谢参数，并进行统计学分析。将糖尿病组根据糖化血红蛋白（HbAlC）结果分为血糖控制满意组（〈7％），血糖控制一般组（7％～7．9％），血糖控制不理想组（8％～8．9％），血糖控制较差组（≥9％），比较各组间FFA水平。结果T2DM患者空腹FFAs水平为（806．4±352．8）mol／L高于糖尿病前期及健康体检组（P〈0．01）；血糖控制较差组FFAs水平明显高于血糖控制较好组（P〈0．01）；FFAs与FPG、2hPG、HbAlc、GA、TG等指标有正相关（r分别为0．394，0．4，0．31，0．227，0．43l，P〈0．01），与HDL—C呈负相关（r=-0．156，P〈0．05）；血糖异常人群中，约49．7％的FFA水平并无明显升高（P〉0．05）；而伴高脂血症者占67．9％，其中FFA升高者占74．1％（P〈0．01）。结论FFAs在调节糖、脂代谢方面有重要的意义，FFAs水平与T2DM血糖控制情况有一定相关性，可能是糖尿病与高脂血症之间的联系分子。

血液生化检测在早期糖尿病肾病诊断中应用

目的:探讨血清同型半胱氨酸(Hcy)、血清胱抑素(CysC)、全血糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs–CRP)在诊断早期糖尿病肾病患者中的应用价值。方法:选择2016年9月至2017年9月卢氏县人民医院收治的早期糖尿病肾病(DN)患者75例作为观察组,并选择同期糖尿病无肾病住院患者75例作为对照组,两组患者均于入院24 h内抽取3 mL空腹肘静脉血进行相关指标检查,比较两组患者血清Hcy、CysC、HbA1c及hs–CRP水平及DN患者单一检测与联合检测阳性率。结果:观察组各血清Hcy、CysC、HbA1c及hs–CRP水平均高于对照组,差异具有统计学意义(P<0.05);DN患者联合检测阳性率显著高于单一检测阳性率,差异具有统计学意义(P<0.05)。结论:Hcy、CysC、HbA1c及hs–CRP均为反映DN患者早期疾病发展的重要指标,在该疾病早期诊断中有着较高的应用价值。

达格列净治疗2型糖尿病合并慢性心力衰竭患者的疗效分析

目的 观察达格列净治疗慢性心力衰竭(CHF)合并2型糖尿病(T2DM)患者的疗效和结局。方法 选择我院及青岛大学附属医院80例CHF合并T2DM住院患者,分为对照组(常规治疗组)、联合达格列净组,按照随机数字法分析法分组;观察两组患者治疗前后相关指标、临床疗效随访结果的变化情况。结果 对照组及实验组治疗前后对比糖化血红蛋白(HbAC1)、N末端脑钠肽前体(NT-praBNP)、左室射血分数(LEFV)、6分钟步行距离均有统计学意义(P<0.05),对照两组患者住院治疗6月后临床总有效率比较,差异有统计学意义(P<0.01),联合治疗组总有效率高于常规治疗组。两组患者心衰再住院率和主要不良心血管事件(M A C E)发生率差异有统计学意义(P<0.01),联合治疗组心衰再住院率达格列净、沙库巴曲缬沙坦联合治疗组心衰总体生存率明显好于对照组。结论 达格列净联合沙库巴曲缬沙坦治疗临床疗效改善明显,有效控制血糖的同时可降低患者心衰再住院率及主要恶性心血管事件(MACE)发生率。

Glycemic and blood pressure control in older patients with hypertension and diabetes： association with carotid atherosclerosis

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness （CIMT） in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w＇. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects （508 males and 162 females） aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure： tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc （HbAlc） level： tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% （352/670） subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT （≥ 1.1 ram）. The mean CIMT was significantly different between Bp control categories （7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03） but not between glycemic control categories （8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13） using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque （OR = 1.08 and OR=1.42, respectively）, or elevated CIMT [Odd ratio （OR） = 1.17, 95% confidence interval （CI） 1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.

Diabetes onset before or after the age of 65 does it affect the progression of renal and cardiovascular diseases in the elderly patient？

Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,

Number of medications is associated with outcomes in the elderly patient with metabolic syndrome

Background The diagnosis of metabolic syndrome indicates a clustering of metabolic imbalances which in sum have been recognized as a major predictor of cardiovascular and all-cause mortality. The aim of this study was to assess the level of under-pharmacy and poly-pbarmacy and its prognostic impact in elderly patients with metabolic syndrome. Methods Retrospective chart-review at a tertiary medical center, of 324 patients greater than 65 years of age who met the International Diabetes Foundation criteria for metabolic syndrome diagnosis [Body Mass Index （BMI） 〉 30 kg/m2, diagnosis of type 2 diabetes, hypertension, and dyslipidemia]. Results There were 60 （18.5%） patients in the low （〈 5） medication burden group, 159 （49.1%） in the medium （〉 5 and 〈 10） medication burden group, and 105 （32.4%） in the high （〉 10） medication burden group. At baseline, the groups differed only by systolic blood pressure. At two years follow-up, the medium group had significantly better improvement in high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, HbAlc, and systolic blood pressure compared to the low medication burden group and significantly better improvement in triglycerides, Haemoglobin Alc （HbAlc） and systolic blood pressure compared to the high medication group. Decrease in HDL-C was the only variable associated with strokes. High medication burden predicted hospitalization burden. The number of anti-hypertensives, history of tobacco use, low and high medication burdens and decrease in HDL-C were all associated with death. Conclusions Both poly-pharmacy and under-pharmacy are associated with a decreased therapeutic benefit among patients with metabolic syndrome in terms of important laboratory measurements as well as clinical outcomes such as myocardial infarctions, hospitalization, and death.

Efficacy and safety of saxagliptin in patients with type 2 diabetes mellitus:a meta-analysis of randomized controlled trials

As a new oral hypoglycemic agent, saxagliptin belongs to the class of dipeptidyl peptidase-4 （DPP-4） inhibitors. However, it remains inconclusive whether saxagliptin is associated with increased risk of adverse events （AE） and efficacy as add-on treatment. Therefore, we performed an up-to-date meta-analysis to compare the efficacy and safety of saxagliptin with placebo and other oral hypoglycemic agents in adult patients with type 2 diabetes mellitus （T2DM）. Randomized clinical trials （RCTs） comparing saxagliptin with comparators were retrieved by selecting articles from Pubmed, Embase, Cochrane Library and Clinical Trials Registry Platform up to Oct. 2013. Weighted mean difference （WMD） was used to analyze the effect of hypoglycemic agents on HbAlc, weight and fasting plasma glucose （FPG）. While the patients who achieved HbAlc〈7.0% and had AE were analyzed as relative risks （RR）. A total of 18 articles from 16 RCTs and one clinic trial from the WHO International Clinical Trials Registry Platform met the included criterion. Clinically significant decrease from baseline HbAlc compared with placebo was certified for 2.5 mg/day saxagliptin （WMD = -0.45%, 95% CI, -0.48% to -0.42%） and 5 mg/d saxagliptin （WMD = -0.52%, 95% CI, -0.60% to -0.44%）. Saxagliptin as add-on therapy was superior to thiazolidinediones, up-titrated glyburide, up-titrated metformin or metformin monotherapy in achieving HbA1c〈7.0%. Treatment with saxagliptin had negligible effect on weight, and it was considered weight neutral. Saxagliptin treatment did not increase the risk of hypoglycemia （RR = 1.28, 95% CI 0.72 to 2.27, P = 0.40） and serious adverse experiences （RR = 1.25, 95% CI 0.94 to 1.66, P = 0.13）. No statistically significant differences were observed between saxagliptin and comparators in terms of the risk of infections. The present study showed that saxagliptin was effective in improving glycaemic control in T2DM with a low risk of hypoglycaemia and incidence of infections in either monotherapy or add-on treatment. This founding should be further certified by large-sample size and good-designed RCT.

四项生化指标联合检测在糖尿病早期肾损伤诊断中的临床价值

目的探讨胱抑素C(Cystatin C,Cys C)、同型半胱氨酸(Homocysteine,HCY)、尿β2-微球蛋白(β2-microglobulin,β2-MG)、全血糖化血红蛋白(Hemoglobin A1C,HbA1C)联合检测对糖尿病早期肾损伤患者的诊断价值。方法回顾性分析2016年10月至2018年1月在我院治疗的131例糖尿病患者的临床资料,依据mAlB/Cr将所有入选患者分为单纯糖尿病组(mAlB/Cr<30μg/mg)76例与糖尿病肾病组(30μg/mg≤mAlB/Cr<300μg/mg)55例,另选取同期在我院接受健康体检的21例健康人群作为对照组。对所有入选者Cys C、HCY、β2-MG、HbA1C水平进行检测,并分析检测结果。结果糖尿病肾病组Cys C、HCY、β2-MG、HbA1C水平均高于单纯糖尿病组与对照组,Cys C、HCY、β2-MG、HbA1C联合检测阳性检出率均高于单纯糖尿病组与对照组,差异有统计学意义(P<0.05)。结论 Cys C、HCY、β2-MG、HbA1C均为反映糖尿病患者早期肾功能损伤情况的良好指标,将四项生化指标联合检测,可有效提高阳性检出率。

Effects of 95%ethanol extract of Aquilaria sinensis leaves on hyperglycemia in diabetic db/db mice

The leaves of Aquilaria sinensis（Lour.） Gilg have been used in folk medicine for the treatment of diabetes in Guangdong Province,China.In this study,effects of ethanol extract of Aquilaria sinensis leaves on hyperglycemia were investigated in diabetic db/db mice.After 4 weeks of administration,the 95%ethanol（EtOH） extract of Aquilaria sinensis leaves （AE）,especially at high dose level（600 mg/kg）,activated AMP-activated protein kinase（AMPK）,resulting in reduced fasting blood glucose and glycosylated hemoglobin levels in db/db mice.In addition,the oral glucose tolerance test（OGTT test） showed that AE could remarkably improve insulin resistance.Compared to Thiazolinediones（TZDs）,no weight gain was observed after AE administration,which is a severe side effect of TZDs.The data suggested that AE could act as an activator of AMPK,and might be used as an alternative to TZDs in the management of obesity-related diabetes.

A preliminary evaluation of VEGF-A, VEGFR1 and VEGFR2 in patients with well-controlled type 2 diabetes mellitus

Objective： Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the concentration of vascular endothelial growth factor A （VEGF-A） and its receptors in patients with well-controlled diabetes. Methods： The study was conducted on 31 patients with well-controlled type 2 diabetes without microor macroangiopathy. Thirty healthy volunteers were enrolled in a control group. Serum concentrations of VEGF-A, VEGF receptors 1 and 2 （VEGFR1 and VEGFR2）, fasting glucose, and lipid profiles were measured, and the plasma concentration of glycated hemoglobin （HbAlc） was determined. Results： No significant differences were observed between the concentration of VEGF-A, VEGFR1 or VEGFR2 in the subject group and that in the control group. Positive correlations were noted between the levels of VEGF-A, VEGFR2, and triglyceride, and there was a negative correlation between the levels of VEGFR2 and high-density lipoprotein （HDL）-cholesterel in the study group. Conclusions： The concentrations of VEGF-A and its receptors 1 and 2 in patients with well-controlled diabetes are comparable to those of healthy individuals, which may indicate that appropriate control of glucose levels delays the occurrence of vascular complications. A negative correlation between VEGFR2 and HDL-cholesterol levels, and positive correlations between VEGF-A, VEGFR2, and triglyceride levels, suggest that lipid abnormalities occurring in diabetes may be involved in the modulation of angiogenesis.