目的探究胰高血糖素样肽1受体激动剂(GLP-1RA)对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)老年患者血浆成纤维细胞生长因子(FGF)-21和肝脏脂肪的疗效。方法选取120例T2DM合并NAFLD老年患者作为研究对象,随机分为观察组和对照组各60...目的探究胰高血糖素样肽1受体激动剂(GLP-1RA)对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)老年患者血浆成纤维细胞生长因子(FGF)-21和肝脏脂肪的疗效。方法选取120例T2DM合并NAFLD老年患者作为研究对象,随机分为观察组和对照组各60例,对照组采用常规治疗,观察组在对照组基础上联合GLP-1RA治疗。治疗5个月后比较两组血糖控制水平、FGF21水平、肝功能、肝脏脂肪含量及炎症指标变化,并对比两组安全性。结果相较于对照组,观察组治疗后空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、FGF-21显著较低,Gutt-胰岛素敏感性指数(Gutt-ISI)显著较高,肝脏脂肪衰减值(CAP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)和肝纤维化4因子指数(Fib-4)显著较低,肝/脾CT比值显著较高,外周血单核细胞趋化蛋白(MCP)-1、白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α浓度显著低(均P<0.05)。两组不良反应发生率无显著差异(P>0.05)。结论GLP-1RA能够显著改善T2DM合并NAFLD老年患者的Gutt-ISI和FGF-21水平,并减少肝脏脂肪含量、抑制炎症,具有潜在的临床应用价值。展开更多
AIM: To study the levels of adiponectin in nondiabetic patients with nonalcoholic fatty liver disease (NAFLD) in comparison with control group.METHODS: Thirty-five patients who had elevated serum aminotransferase leve...AIM: To study the levels of adiponectin in nondiabetic patients with nonalcoholic fatty liver disease (NAFLD) in comparison with control group.METHODS: Thirty-five patients who had elevated serum aminotransferase levels with bright liver and 34 healthy volunteers without liver disease were evaluated. Age,gender and body mass index (BMI) were recorded. Fasting plasma glucose, insulin, adiponectin, proinsulin and lipid profile were measured. A standard oral glucose tolerance test (OGTT) with insulin response was performed and the index of insulin resistance was calculated according to the homeostasis model assessment (HOMA) method.RESULTS: According to the OGTT results, none of the participants had diabetes. Serum adiponectin levels were statistically significantly lower in patients with NAFLD than in control group (8.14±3.4 μg/mL vs12.4±9.4 μg/mL,respectively, P＜0.01). A statistically significant correlation was found between adiponectin and BMI (r: -0.33, P＜0.01),HOMA (r: -0.26, P＜0.05), proinsulin (r: -0.32, P＜0.01),AST (r: -0.25, P＜0.05), ALT (r: -0.26, P＜0.05) or GGT (r: -0.22, P＜0.05). In multiple regression analysis models,adiponectin levels were the only predictor of NAFLD in males, whereas in female group it was the BMI.CONCLUSION: Low adiponectin level might be a predictor of NAFLD especially in male nondiabetics.展开更多
AIM: To evaluate the prevalence and determined the common characteristics of patients diagnosed with non- alcoholic fatty liver disease (NAFLD) at the Philippine General Hospital, Manila, from January 1999 to December...AIM: To evaluate the prevalence and determined the common characteristics of patients diagnosed with non- alcoholic fatty liver disease (NAFLD) at the Philippine General Hospital, Manila, from January 1999 to December 2004. METHODS: NAFLD was diagnosed in 134 from a total of 1102 patients, based on clinical, ultrasonographic and/or histopathological findings. Patients with conditions associated with secondary NAFLD were excluded. Chart review was done to note demographics, co- morbid illnesses, physical characteristics, hepatomegaly, aspartate/alanine aminotransferase (AST/ALT) levels, albumin, lipid levels, alkaline phosphatase, prothrombin time, and partial thromboplastin time. Data obtained were analyzed using the statistical program SPSS version 10. RESULTS: Of the 134 patients included, 71% were female and 29% male. Mean patient age was 42.2 years. Sixty percent of patients were obese, 56% had hepatomegaly, and 69% had diabetes. AST levels were elevated in 45% of subjects and ALT levels in 64%. CONCLUSION: The prevalence of NAFLD at our institution was 12.2%. Patients diagnosed appear to be younger in age in contrast to previous studies. Female sex, obesity, elevated liver enzymes, and diabetes were characteristic features of our NAFLD patients, which is comparable to previous studies from other countries.展开更多
The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly ex...The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly exercise withdrawal and weight gain） have probably heightened the prevalence of nonalcoholic fatty liver disease. Mortality in patients with Nonalcoholic Fatty Liver Disease is significantly higher when compared with that of the same age-gender general population. Hepatologists claim to bear a new burden, being Nonalcoholic Fatty Liver Disease strongly linked to systemic diseases.展开更多
Metabolic disorders are classified clinically as a complex and varied group of diseases including metabolic syndrome,obesity,and diabetes mellitus.Fat toxicity,chronic inflammation,and oxidative stress,which may chang...Metabolic disorders are classified clinically as a complex and varied group of diseases including metabolic syndrome,obesity,and diabetes mellitus.Fat toxicity,chronic inflammation,and oxidative stress,which may change cellular functions,are considered to play an essential role in the pathogenetic progress of metabolic disorders.Recent studies have found that cells secrete nanoscale vesicles containing proteins,lipids,nucleic acids,and membrane receptors,which mediate signal transduction and material transport to neighboring and distant cells.Exosomes,one type of such vesicles,are reported to participate in multiple pathological processes including tumor metastasis,atherosclerosis,chronic inflammation,and insulin resistance.Research on exosomes has focused mainly on the proteins they contain,but recently the function of exosome-associated microR NA has drawn a lot of attention.Exosomeassociated microR NAs regulate the physiological function and pathological processes of metabolic disorders.They may also be useful as novel diagnostics and therapeutics given their special features of non-immunogenicity and quick extraction.In this paper,we summarize the structure,content,and functions of exosomes and the potential diagnostic and therapeutic applications of exosome-associated micro RNAs in the treatment of metabolic disorders.展开更多
文摘目的探究胰高血糖素样肽1受体激动剂(GLP-1RA)对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)老年患者血浆成纤维细胞生长因子(FGF)-21和肝脏脂肪的疗效。方法选取120例T2DM合并NAFLD老年患者作为研究对象,随机分为观察组和对照组各60例,对照组采用常规治疗,观察组在对照组基础上联合GLP-1RA治疗。治疗5个月后比较两组血糖控制水平、FGF21水平、肝功能、肝脏脂肪含量及炎症指标变化,并对比两组安全性。结果相较于对照组,观察组治疗后空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、FGF-21显著较低,Gutt-胰岛素敏感性指数(Gutt-ISI)显著较高,肝脏脂肪衰减值(CAP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)和肝纤维化4因子指数(Fib-4)显著较低,肝/脾CT比值显著较高,外周血单核细胞趋化蛋白(MCP)-1、白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α浓度显著低(均P<0.05)。两组不良反应发生率无显著差异(P>0.05)。结论GLP-1RA能够显著改善T2DM合并NAFLD老年患者的Gutt-ISI和FGF-21水平,并减少肝脏脂肪含量、抑制炎症,具有潜在的临床应用价值。
文摘AIM: To study the levels of adiponectin in nondiabetic patients with nonalcoholic fatty liver disease (NAFLD) in comparison with control group.METHODS: Thirty-five patients who had elevated serum aminotransferase levels with bright liver and 34 healthy volunteers without liver disease were evaluated. Age,gender and body mass index (BMI) were recorded. Fasting plasma glucose, insulin, adiponectin, proinsulin and lipid profile were measured. A standard oral glucose tolerance test (OGTT) with insulin response was performed and the index of insulin resistance was calculated according to the homeostasis model assessment (HOMA) method.RESULTS: According to the OGTT results, none of the participants had diabetes. Serum adiponectin levels were statistically significantly lower in patients with NAFLD than in control group (8.14±3.4 μg/mL vs12.4±9.4 μg/mL,respectively, P＜0.01). A statistically significant correlation was found between adiponectin and BMI (r: -0.33, P＜0.01),HOMA (r: -0.26, P＜0.05), proinsulin (r: -0.32, P＜0.01),AST (r: -0.25, P＜0.05), ALT (r: -0.26, P＜0.05) or GGT (r: -0.22, P＜0.05). In multiple regression analysis models,adiponectin levels were the only predictor of NAFLD in males, whereas in female group it was the BMI.CONCLUSION: Low adiponectin level might be a predictor of NAFLD especially in male nondiabetics.
文摘AIM: To evaluate the prevalence and determined the common characteristics of patients diagnosed with non- alcoholic fatty liver disease (NAFLD) at the Philippine General Hospital, Manila, from January 1999 to December 2004. METHODS: NAFLD was diagnosed in 134 from a total of 1102 patients, based on clinical, ultrasonographic and/or histopathological findings. Patients with conditions associated with secondary NAFLD were excluded. Chart review was done to note demographics, co- morbid illnesses, physical characteristics, hepatomegaly, aspartate/alanine aminotransferase (AST/ALT) levels, albumin, lipid levels, alkaline phosphatase, prothrombin time, and partial thromboplastin time. Data obtained were analyzed using the statistical program SPSS version 10. RESULTS: Of the 134 patients included, 71% were female and 29% male. Mean patient age was 42.2 years. Sixty percent of patients were obese, 56% had hepatomegaly, and 69% had diabetes. AST levels were elevated in 45% of subjects and ALT levels in 64%. CONCLUSION: The prevalence of NAFLD at our institution was 12.2%. Patients diagnosed appear to be younger in age in contrast to previous studies. Female sex, obesity, elevated liver enzymes, and diabetes were characteristic features of our NAFLD patients, which is comparable to previous studies from other countries.
文摘The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly exercise withdrawal and weight gain） have probably heightened the prevalence of nonalcoholic fatty liver disease. Mortality in patients with Nonalcoholic Fatty Liver Disease is significantly higher when compared with that of the same age-gender general population. Hepatologists claim to bear a new burden, being Nonalcoholic Fatty Liver Disease strongly linked to systemic diseases.
基金Project supported by the National Natural Science Foundation of China(Nos.81230018,81430020,81270869,81670796,and 81500595)
文摘Metabolic disorders are classified clinically as a complex and varied group of diseases including metabolic syndrome,obesity,and diabetes mellitus.Fat toxicity,chronic inflammation,and oxidative stress,which may change cellular functions,are considered to play an essential role in the pathogenetic progress of metabolic disorders.Recent studies have found that cells secrete nanoscale vesicles containing proteins,lipids,nucleic acids,and membrane receptors,which mediate signal transduction and material transport to neighboring and distant cells.Exosomes,one type of such vesicles,are reported to participate in multiple pathological processes including tumor metastasis,atherosclerosis,chronic inflammation,and insulin resistance.Research on exosomes has focused mainly on the proteins they contain,but recently the function of exosome-associated microR NA has drawn a lot of attention.Exosomeassociated microR NAs regulate the physiological function and pathological processes of metabolic disorders.They may also be useful as novel diagnostics and therapeutics given their special features of non-immunogenicity and quick extraction.In this paper,we summarize the structure,content,and functions of exosomes and the potential diagnostic and therapeutic applications of exosome-associated micro RNAs in the treatment of metabolic disorders.
