目的分析非酮症糖尿病患者糖化血红蛋白(HbA_(1c))与红细胞分布宽度变异系数(RDW-CV)和甲状腺过氧化物酶抗体(TPOAb)阳性率的相关性,并探讨HbA_(1c)变化的影响因素。方法选取2014年3月—2016年4月在益阳市中心医院内分泌科住院的符合纳...目的分析非酮症糖尿病患者糖化血红蛋白(HbA_(1c))与红细胞分布宽度变异系数(RDW-CV)和甲状腺过氧化物酶抗体(TPOAb)阳性率的相关性,并探讨HbA_(1c)变化的影响因素。方法选取2014年3月—2016年4月在益阳市中心医院内分泌科住院的符合纳入标准的非酮症糖尿病患者413例。依据患者HbA_(1c)进行分组:HbA_(1c)≤7.5%组(A组,n=128)、7.5%<HbA_(1c)<10.0%组(B组,n=190)、HbA_(1c)≥10.0%组(C组,n=95)。比较3组患者性别、年龄、病程、体质指数(BMI)、RDW-CV、低密度脂蛋白(LDL)、总胆固醇(TC)、24 h尿微量清蛋白(24 h UAE)、C反应蛋白(CRP)、空腹C肽(FCP)、餐后2 h C肽(PCP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、谷氨酸脱羟酶抗体(GADA)阳性率、TPOAb阳性率,分析HbA_(1c)与上述指标的相关性及影响患者HbA_(1c)变化的独立危险因素。结果 B组、C组患者病程长于A组,RDW-CV大于A组,TSH及TPOAb阳性率高于A组(P<0.05);C组患者病程长于B组,RDW-CV大于B组,TSH、TPOAb阳性率高于B组(P<0.05)。Spearman秩相关分析结果显示,患者HbA_(1c)与病程、RDW-CV、TPOAb阳性率、TSH呈正相关(rs值分别为0.681、0.630、0.432、0.438,P值分别为<0.001、<0.001、0.001、0.001)。RDW-CV[OR=2.024,95%CI(1.237,4.103)]、TPOAb阳性率[OR=1.243,95%CI(1.134,1.548)]、TSH[OR=1.814,95%CI(1.567,3.234)]是非酮症糖尿病患者HbA_(1c)变化的独立危险因素(P<0.05)。结论非酮症糖尿病患者HbA_(1c)与RDW-CV、TPOAb阳性率呈正相关,且RDW-CV、TPOAb阳性率是患者HbA_(1c)变化的独立危险因素,因此,血糖控制越差,红细胞形态改变越明显,免疫性甲状腺疾病发生的可能性越大。展开更多
Background/Aims: Hereditary hemochromatosis (HHC) is a disorder of iron metabolism with variable penetrance. Oxidative stress plays a central role in the progression to cirrhosis. Several enzymes involved in the produ...Background/Aims: Hereditary hemochromatosis (HHC) is a disorder of iron metabolism with variable penetrance. Oxidative stress plays a central role in the progression to cirrhosis. Several enzymes involved in the production or degradation of reactive oxidants, like myeloperoxidase (MPO) and heme oxygenase (HO)-1 are influenced by promotor polymorphisms. This study assessed the impact of polymorphisms of the MPO (-463G/A) and the HO-1 promotors of Vienna (GT) n on the evolution of cirrhosis in patients with HHC. Methods: One hundred and fifty-eight C282Y homozygotes without cofactors for fibrosis progression (119 males; mean age: 51.0±13.3) were studied. All patients underwent liver biopsy. Hepatic iron content was measured by atom absorption spectrophotometry. MPO polymorphism was assessed by RFLP analysis; HO-1 microsatellite polymorphism by a laser-based semi-automated DNA sequencer. Results: The MPO genotypes GG, GA, and AA were found in 102 (64.6%), 45 and 11 patients, respectively. The GG-genotype was more common in patients with cirrhosis than in those without (78.7 vs. 55.7%, P=0.003). The distribution of HO-1 genotypes was not different. Logistic regression analysis revealed MPO genotype-GG, serum ferritin, age and male sex as independent predictors for cirrhosis. Conclusions: MPO genotype GG is associated with cirrhosis in patients with hereditary hemochromatosis.展开更多
文摘目的分析非酮症糖尿病患者糖化血红蛋白(HbA_(1c))与红细胞分布宽度变异系数(RDW-CV)和甲状腺过氧化物酶抗体(TPOAb)阳性率的相关性,并探讨HbA_(1c)变化的影响因素。方法选取2014年3月—2016年4月在益阳市中心医院内分泌科住院的符合纳入标准的非酮症糖尿病患者413例。依据患者HbA_(1c)进行分组:HbA_(1c)≤7.5%组(A组,n=128)、7.5%<HbA_(1c)<10.0%组(B组,n=190)、HbA_(1c)≥10.0%组(C组,n=95)。比较3组患者性别、年龄、病程、体质指数(BMI)、RDW-CV、低密度脂蛋白(LDL)、总胆固醇(TC)、24 h尿微量清蛋白(24 h UAE)、C反应蛋白(CRP)、空腹C肽(FCP)、餐后2 h C肽(PCP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、谷氨酸脱羟酶抗体(GADA)阳性率、TPOAb阳性率,分析HbA_(1c)与上述指标的相关性及影响患者HbA_(1c)变化的独立危险因素。结果 B组、C组患者病程长于A组,RDW-CV大于A组,TSH及TPOAb阳性率高于A组(P<0.05);C组患者病程长于B组,RDW-CV大于B组,TSH、TPOAb阳性率高于B组(P<0.05)。Spearman秩相关分析结果显示,患者HbA_(1c)与病程、RDW-CV、TPOAb阳性率、TSH呈正相关(rs值分别为0.681、0.630、0.432、0.438,P值分别为<0.001、<0.001、0.001、0.001)。RDW-CV[OR=2.024,95%CI(1.237,4.103)]、TPOAb阳性率[OR=1.243,95%CI(1.134,1.548)]、TSH[OR=1.814,95%CI(1.567,3.234)]是非酮症糖尿病患者HbA_(1c)变化的独立危险因素(P<0.05)。结论非酮症糖尿病患者HbA_(1c)与RDW-CV、TPOAb阳性率呈正相关,且RDW-CV、TPOAb阳性率是患者HbA_(1c)变化的独立危险因素,因此,血糖控制越差,红细胞形态改变越明显,免疫性甲状腺疾病发生的可能性越大。
文摘Background/Aims: Hereditary hemochromatosis (HHC) is a disorder of iron metabolism with variable penetrance. Oxidative stress plays a central role in the progression to cirrhosis. Several enzymes involved in the production or degradation of reactive oxidants, like myeloperoxidase (MPO) and heme oxygenase (HO)-1 are influenced by promotor polymorphisms. This study assessed the impact of polymorphisms of the MPO (-463G/A) and the HO-1 promotors of Vienna (GT) n on the evolution of cirrhosis in patients with HHC. Methods: One hundred and fifty-eight C282Y homozygotes without cofactors for fibrosis progression (119 males; mean age: 51.0±13.3) were studied. All patients underwent liver biopsy. Hepatic iron content was measured by atom absorption spectrophotometry. MPO polymorphism was assessed by RFLP analysis; HO-1 microsatellite polymorphism by a laser-based semi-automated DNA sequencer. Results: The MPO genotypes GG, GA, and AA were found in 102 (64.6%), 45 and 11 patients, respectively. The GG-genotype was more common in patients with cirrhosis than in those without (78.7 vs. 55.7%, P=0.003). The distribution of HO-1 genotypes was not different. Logistic regression analysis revealed MPO genotype-GG, serum ferritin, age and male sex as independent predictors for cirrhosis. Conclusions: MPO genotype GG is associated with cirrhosis in patients with hereditary hemochromatosis.
