Gut microbiota and circulating metabolite dysbiosis predate important pathological changes in glucose metabolic disorders;however,comprehensive studies on impaired glucose tolerance(IGT),a diabetes mellitus(DM)precurs...Gut microbiota and circulating metabolite dysbiosis predate important pathological changes in glucose metabolic disorders;however,comprehensive studies on impaired glucose tolerance(IGT),a diabetes mellitus(DM)precursor,are lacking.Here,we perform metagenomic sequencing and metabolomics on 47 pairs of individuals with IGT and newly diagnosed DM and 46 controls with normal glucose tolerance(NGT);patients with IGT are followed up after 4 years for progression to DM.Analysis of baseline data reveals significant differences in gut microbiota and serum metabolites among the IGT,DM,and NGT groups.In addition,13 types of gut microbiota and 17 types of circulating metabolites showed significant differences at baseline before IGT progressed to DM,including higher levels of Eggerthella unclassified,Coprobacillus unclassified,Clostridium ramosum,L-valine,L-norleucine,and L-isoleucine,and lower levels of Eubacterium eligens,Bacteroides faecis,Lachnospiraceae bacterium 3_1_46FAA,Alistipes senegalensis,Megaspaera elsdenii,Clostridium perfringens,α-linolenic acid,10E,12Z-octadecadienoic acid,and dodecanoic acid.A random forest model based on differential intestinal microbiota and circulating metabolites can predict the progression from IGT to DM(AUC=0.87).These results suggest that microbiome and metabolome dysbiosis occur in individuals with IGT and have important predictive values and potential for intervention in preventing IGT from progressing to DM.展开更多
Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or ins...Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.展开更多
Objective To investigate the relationship between diabetes mellitus (DM ) including impaired glucose tolerance (IGT) and the factors of age, menopause, and pregnancy Methods A systemic epidemiological survey was con...Objective To investigate the relationship between diabetes mellitus (DM ) including impaired glucose tolerance (IGT) and the factors of age, menopause, and pregnancy Methods A systemic epidemiological survey was conducted in 5153 women, aged 20 years and above Results The prevalence of DM was 458%, and IGT 1283 % In those subjects with DM less than 59 years old and those with IGT less tha n the age of 49, the prevalence was parallel to the increase of age Ten years m i ght lead the IGT subjects into DM Moreover, the prevalence of DM and IGT after menopause were significantly high It was found that the prevalenc e of DM and IGT in mothers who had conceived giant baby was significantly higher than that of the others Conclusions Therapeutic emphasis should be laid on the population of wo men in the age between 50 and 59, while the management of IGT women is equally i mportant The early intervention of IGT subjects in the age between 40 and 49 i s essential in decreasing the prevalence of DM Disorders of the endocrine syste m during climacteric might play an important role in the development of DM and IG T Moreover, the mothers who have conceived giant babies are at great risk for DM, and thus, this population should be closely monitored展开更多
Background:Diabetes mellitus (DM) remains a major health problem worldwide.Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progres...Background:Diabetes mellitus (DM) remains a major health problem worldwide.Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM.This study aimed to evaluate the efficacy of Jinlida (JLD) granule,a Chinese herbal recipe,in the treatment of impaired glucose tolerance (IGT) and its effect on the prevention of DM.Methods:Sixty-five IGT patients were randomized to receive one bag of JLD granules three times daily (JLD group,n =34) or no drug intervention (control group,n =31) for 12 weeks.Oral glucose tolerance test,glycated hemoglobin A1c (HbA1c),body mass index,blood lipids levels,fasting insulin,and insulin resistance calculated using homeostatic model assessment (HOMA-IR) of all the patients were observed and compared before and after the treatment.Results:Sixty-one participants completed the trial (32 in JLD group and 29 in the control group).There were statistically significant decreases in HbA1c (P 〈 0.001),2-h plasma glucose (P 〈 0.001),and HOMA-IR (P =0.029) in JLD group compared with the control group after 12 weeks of treatment.After 12 weeks of treatment,two (6.9%) patients returned to normal blood glucose,and five (17.2%) patients turned into DM in control group,while in the JLD group,14 (43.8%) returned to normal blood glucose and 2 (6.2%) turned into DM.There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups (P =0.001).Conclusions:JLD granule effectively improved glucose control,increased the conversion of IGT to normal glucose,and improved the insulin resistance in patients with IGT.This Chinese herbal medicine may have a clinical value for IGT.展开更多
Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diab...Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.展开更多
To determine the prevalences of non-insulin-dependent-diabetes mellitus (NIDDM),impaired glucose tolerance (IGT) and hypertension on urban and rural communities of Jiangsu province,8734 subjects sampled from six areas...To determine the prevalences of non-insulin-dependent-diabetes mellitus (NIDDM),impaired glucose tolerance (IGT) and hypertension on urban and rural communities of Jiangsu province,8734 subjects sampled from six areas of Jiangsu were investigated. Blood glucose of 2 h after oral administration of 75 g glucose (2 h BG) was measured. WHO criteria were used for the diagnosis of NIDDMand IGT. Meanwhile epidemiological data were collected. Blood pressure, height, weight, waist and hip girths were measured. The crude prevalence was found to be 5. 82% (men 4.62%,woman 6. 69%) for NIDDM, 5. 87% (men 5. 30%, women 6. 29% ) for IGT and 14. 72% (men 16. 50%, women 13. 43 % ) for hypertension in the population obove 20 years of age. Age-adjusted prevalence was 4. 63% for NIDDM, 5. 07 % for IGT and 11. 19% for hypertension. Age increase (>40 years), obesity (BMI≥27) and central fat distribution (WHR≥0.88) were the risk factors for both diabetes and hypertension. The subjects≥40 years of age and obesity were the high risk population of NIDDM, IGT and hypertension. They were the target population for theprevention and treatment of diabetes and hypertension in the community level. High prevalences of NIDDM,IGT and hypertension were observed in the community population in Jiangsu province. To reinforce the prevention and treatment of these disorders in the province is imperative.展开更多
目的分析老年2型糖尿病(T2DM)和糖耐量受损(IGT)患者血清骨钙素、胎球蛋白A水平与胰岛素抵抗(IR)和胰岛β细胞功能的相关性。方法选择2019年1月至2021年3月西安交通大学第二附属医院内分泌科诊治的97例老年T2DM患者(T2DM组)以及59例老年...目的分析老年2型糖尿病(T2DM)和糖耐量受损(IGT)患者血清骨钙素、胎球蛋白A水平与胰岛素抵抗(IR)和胰岛β细胞功能的相关性。方法选择2019年1月至2021年3月西安交通大学第二附属医院内分泌科诊治的97例老年T2DM患者(T2DM组)以及59例老年IGT患者(IGT组)作为研究对象,选择同期63名健康体检者为对照组。分别检测各组糖脂代谢指标[三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2 h BG)、糖化血红蛋白(HbA 1c)]、空腹胰岛素(FINS)、空腹C肽(FCP)、骨钙素、胎球蛋白A水平,并计算稳态模型评估的IR指数(HOMA-IR)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)。结果与对照组相比,T2DM组和IGT组LDL-C、FBG、2 h BG、HbA 1c、FINS、HOMA-IR水平均显著升高(P<0.05),且T2DM组高于IGT组(P<0.05),T2DM组和IGT组FCP、HOMA-β水平均显著降低(P<0.05),且T2DM组低于IGT组(P<0.05);T2DM组TG水平高于对照组(P<0.05),但IGT组与对照组TG水平比较差异无统计学意义(P>0.05)。与对照组相比,IGT与T2DM组患者骨钙素水平均显著降低,胎球蛋白A水平显著升高(P<0.05),且T2DM组骨钙素水平低于IGT组,胎球蛋白A水平高于IGT组(P<0.05)。T2DM患者血清骨钙素水平与HOMA-IR、FINS、HbA 1c呈负相关(均P<0.01),与HOMA-β呈正相关(P<0.01),与FCP无相关性(P>0.05)。T2DM患者血清胎球蛋白A水平与HOMA-IR、FINS、HbA 1c呈正相关(均P<0.01),与HOMA-β、FCP呈负相关(均P<0.01)。结论老年T2DM和IGT患者血清骨钙素、胎球蛋白A水平存在明显差异,两者有望成为评估老年T2DM患者胰岛β细胞功能、IR的可靠指标。展开更多
目的 分析某军飞行人员糖尿病前期(PDM)流行现状,为糖尿病(DM)的防控提供参考依据。方法 采取整群抽样法随机抽取2018年4月至10月在某军两所特勤疗养中心疗养的飞行人员1 092人。设计调查问卷,收集飞行机种、人员类别、年龄、吸烟史、D...目的 分析某军飞行人员糖尿病前期(PDM)流行现状,为糖尿病(DM)的防控提供参考依据。方法 采取整群抽样法随机抽取2018年4月至10月在某军两所特勤疗养中心疗养的飞行人员1 092人。设计调查问卷,收集飞行机种、人员类别、年龄、吸烟史、DM家族史,同时测量受调查者血压、身高、体质量,计算体质量指数(BMI),抽取受调查者空腹肘静脉血,检测空腹血糖(FPG)及服用75 g葡萄糖粉负荷后2 h血糖(2 h PG)水平。结果 飞行人员中PDM的患病率为7.05%(77/1 092),其中空腹血糖受损(IFG)、糖耐量减低(IGT)及IFG合并IGT所占比例分别为27.27%(21/77)、68.83%(53/77)和3.90%(3/77)。不同年龄组的比较显示,20~30岁、>30~40岁、>40~50岁和>50岁飞行人员的PDM患病率分别为3.35%(6/179)、5.98%(30/502)、9.68%(27/279)、11.29%(14/124),各组PDM患病率(P<0.05)、FPG及糖负荷后2 h PG均具有统计学差异(P<0.01),随着年龄的增长,PDM患病率、FPG及2 h PG均逐渐上升。根据BMI将飞行人员分为正常、超重和肥胖组,三组PDM患病率分别为4.35%(20/460)、9.92%(50/554)、11.11%(7/70),差异具有统计学意义(P<0.05),PDM患病率及FPG、2 h PG血糖随着BMI的增大逐渐升高。不同机种(歼击机、轰炸机、直升机、运输机、无人机)飞行人员、不同人员类别飞行人员(飞行员、技勤或战勤人员)PDM患病率无显著差异(P>0.05)。与血糖正常的飞行人员相比,PDM组具有年龄大,BMI、FPG、糖负荷后2 h PG高的特点(P<0.05)。结论 PDM飞行人员以IGT为主,随着年龄的增加及BMI的增大,飞行人员PDM患病率及FPG、糖负荷后2 h PG水平逐步升高。对于年龄超过40岁或体型为超重、肥胖的飞行人员,应当有针对性地进行糖耐量筛查,做好DM防控工作。展开更多
目的:检测脂联素(adiponectin,ADPN)在合并糖代谢异常的冠心病患者血浆中浓度的变化,探讨其临床意义。方法:收集2009年8月至2010年4月在湘雅医院心内科经冠状动脉造影(coronary angiography,CAG)检查证实为冠心病的患者87名,根据糖代谢...目的:检测脂联素(adiponectin,ADPN)在合并糖代谢异常的冠心病患者血浆中浓度的变化,探讨其临床意义。方法:收集2009年8月至2010年4月在湘雅医院心内科经冠状动脉造影(coronary angiography,CAG)检查证实为冠心病的患者87名,根据糖代谢情况分为单纯冠心病组(coronary heart disease group,CHD组,n=31)、冠心病合并糖耐量异常组(CHD combine with impaired glucose tolerance group,CHD+IGT组,n=28)和冠心病合并糖尿病组(CHDcombine with diabetes mellitus group,CHD+DM组,n=28),另选健康体检者31例为正常对照组(normal control group,NC组)。采用酶联免疫吸附法检测血浆ADPN水平;为所有受试对象测身高、体质量、腰围、血压;测空腹血糖、胰岛素、血脂、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、游离脂肪酸(free fatty acid,FFA)和肝、肾功能等,计算体质量指数(body mass index,BMI)和胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)。结果:1)CHD组、CHD+IGT组、CHD+DM组患者血浆ADPN水平均低于NC组(P<0.05);2)与CHD组相比,CHD+DM组ADPN水平最低,CHD+IGT组次之,各组间差异有统计学意义(P<0.05);3)ADPN与HDL-C呈正相关(r=0.483,P<0.01),与hs-CRP和冠脉Gensini积分呈负相关(r=–0.489,P<0.05;r=–0.252,P<0.05)。结论:冠心病患者血浆ADPN浓度降低;合并糖代谢异常的冠心病患者血浆ADPN浓度更低,且随着糖代谢异常程度加重降低更显著;冠心病与糖代谢异常是影响血浆ADPN浓度改变的两个重要因素,血浆ADPN水平显著降低反映了上述两种疾病状态的叠加作用。ADPN联合HDL-C,hs-CRP,Gensini积分等血清学指标可为判断合并糖代谢异常的冠心病患者的疾病严重程度提供一定参考。展开更多
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202001)the National Natural Science Foundation of China(82104835).
文摘Gut microbiota and circulating metabolite dysbiosis predate important pathological changes in glucose metabolic disorders;however,comprehensive studies on impaired glucose tolerance(IGT),a diabetes mellitus(DM)precursor,are lacking.Here,we perform metagenomic sequencing and metabolomics on 47 pairs of individuals with IGT and newly diagnosed DM and 46 controls with normal glucose tolerance(NGT);patients with IGT are followed up after 4 years for progression to DM.Analysis of baseline data reveals significant differences in gut microbiota and serum metabolites among the IGT,DM,and NGT groups.In addition,13 types of gut microbiota and 17 types of circulating metabolites showed significant differences at baseline before IGT progressed to DM,including higher levels of Eggerthella unclassified,Coprobacillus unclassified,Clostridium ramosum,L-valine,L-norleucine,and L-isoleucine,and lower levels of Eubacterium eligens,Bacteroides faecis,Lachnospiraceae bacterium 3_1_46FAA,Alistipes senegalensis,Megaspaera elsdenii,Clostridium perfringens,α-linolenic acid,10E,12Z-octadecadienoic acid,and dodecanoic acid.A random forest model based on differential intestinal microbiota and circulating metabolites can predict the progression from IGT to DM(AUC=0.87).These results suggest that microbiome and metabolome dysbiosis occur in individuals with IGT and have important predictive values and potential for intervention in preventing IGT from progressing to DM.
文摘Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.
文摘Objective To investigate the relationship between diabetes mellitus (DM ) including impaired glucose tolerance (IGT) and the factors of age, menopause, and pregnancy Methods A systemic epidemiological survey was conducted in 5153 women, aged 20 years and above Results The prevalence of DM was 458%, and IGT 1283 % In those subjects with DM less than 59 years old and those with IGT less tha n the age of 49, the prevalence was parallel to the increase of age Ten years m i ght lead the IGT subjects into DM Moreover, the prevalence of DM and IGT after menopause were significantly high It was found that the prevalenc e of DM and IGT in mothers who had conceived giant baby was significantly higher than that of the others Conclusions Therapeutic emphasis should be laid on the population of wo men in the age between 50 and 59, while the management of IGT women is equally i mportant The early intervention of IGT subjects in the age between 40 and 49 i s essential in decreasing the prevalence of DM Disorders of the endocrine syste m during climacteric might play an important role in the development of DM and IG T Moreover, the mothers who have conceived giant babies are at great risk for DM, and thus, this population should be closely monitored
文摘Background:Diabetes mellitus (DM) remains a major health problem worldwide.Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM.This study aimed to evaluate the efficacy of Jinlida (JLD) granule,a Chinese herbal recipe,in the treatment of impaired glucose tolerance (IGT) and its effect on the prevention of DM.Methods:Sixty-five IGT patients were randomized to receive one bag of JLD granules three times daily (JLD group,n =34) or no drug intervention (control group,n =31) for 12 weeks.Oral glucose tolerance test,glycated hemoglobin A1c (HbA1c),body mass index,blood lipids levels,fasting insulin,and insulin resistance calculated using homeostatic model assessment (HOMA-IR) of all the patients were observed and compared before and after the treatment.Results:Sixty-one participants completed the trial (32 in JLD group and 29 in the control group).There were statistically significant decreases in HbA1c (P 〈 0.001),2-h plasma glucose (P 〈 0.001),and HOMA-IR (P =0.029) in JLD group compared with the control group after 12 weeks of treatment.After 12 weeks of treatment,two (6.9%) patients returned to normal blood glucose,and five (17.2%) patients turned into DM in control group,while in the JLD group,14 (43.8%) returned to normal blood glucose and 2 (6.2%) turned into DM.There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups (P =0.001).Conclusions:JLD granule effectively improved glucose control,increased the conversion of IGT to normal glucose,and improved the insulin resistance in patients with IGT.This Chinese herbal medicine may have a clinical value for IGT.
文摘Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.
文摘To determine the prevalences of non-insulin-dependent-diabetes mellitus (NIDDM),impaired glucose tolerance (IGT) and hypertension on urban and rural communities of Jiangsu province,8734 subjects sampled from six areas of Jiangsu were investigated. Blood glucose of 2 h after oral administration of 75 g glucose (2 h BG) was measured. WHO criteria were used for the diagnosis of NIDDMand IGT. Meanwhile epidemiological data were collected. Blood pressure, height, weight, waist and hip girths were measured. The crude prevalence was found to be 5. 82% (men 4.62%,woman 6. 69%) for NIDDM, 5. 87% (men 5. 30%, women 6. 29% ) for IGT and 14. 72% (men 16. 50%, women 13. 43 % ) for hypertension in the population obove 20 years of age. Age-adjusted prevalence was 4. 63% for NIDDM, 5. 07 % for IGT and 11. 19% for hypertension. Age increase (>40 years), obesity (BMI≥27) and central fat distribution (WHR≥0.88) were the risk factors for both diabetes and hypertension. The subjects≥40 years of age and obesity were the high risk population of NIDDM, IGT and hypertension. They were the target population for theprevention and treatment of diabetes and hypertension in the community level. High prevalences of NIDDM,IGT and hypertension were observed in the community population in Jiangsu province. To reinforce the prevention and treatment of these disorders in the province is imperative.
文摘目的分析老年2型糖尿病(T2DM)和糖耐量受损(IGT)患者血清骨钙素、胎球蛋白A水平与胰岛素抵抗(IR)和胰岛β细胞功能的相关性。方法选择2019年1月至2021年3月西安交通大学第二附属医院内分泌科诊治的97例老年T2DM患者(T2DM组)以及59例老年IGT患者(IGT组)作为研究对象,选择同期63名健康体检者为对照组。分别检测各组糖脂代谢指标[三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2 h BG)、糖化血红蛋白(HbA 1c)]、空腹胰岛素(FINS)、空腹C肽(FCP)、骨钙素、胎球蛋白A水平,并计算稳态模型评估的IR指数(HOMA-IR)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)。结果与对照组相比,T2DM组和IGT组LDL-C、FBG、2 h BG、HbA 1c、FINS、HOMA-IR水平均显著升高(P<0.05),且T2DM组高于IGT组(P<0.05),T2DM组和IGT组FCP、HOMA-β水平均显著降低(P<0.05),且T2DM组低于IGT组(P<0.05);T2DM组TG水平高于对照组(P<0.05),但IGT组与对照组TG水平比较差异无统计学意义(P>0.05)。与对照组相比,IGT与T2DM组患者骨钙素水平均显著降低,胎球蛋白A水平显著升高(P<0.05),且T2DM组骨钙素水平低于IGT组,胎球蛋白A水平高于IGT组(P<0.05)。T2DM患者血清骨钙素水平与HOMA-IR、FINS、HbA 1c呈负相关(均P<0.01),与HOMA-β呈正相关(P<0.01),与FCP无相关性(P>0.05)。T2DM患者血清胎球蛋白A水平与HOMA-IR、FINS、HbA 1c呈正相关(均P<0.01),与HOMA-β、FCP呈负相关(均P<0.01)。结论老年T2DM和IGT患者血清骨钙素、胎球蛋白A水平存在明显差异,两者有望成为评估老年T2DM患者胰岛β细胞功能、IR的可靠指标。
文摘目的 分析某军飞行人员糖尿病前期(PDM)流行现状,为糖尿病(DM)的防控提供参考依据。方法 采取整群抽样法随机抽取2018年4月至10月在某军两所特勤疗养中心疗养的飞行人员1 092人。设计调查问卷,收集飞行机种、人员类别、年龄、吸烟史、DM家族史,同时测量受调查者血压、身高、体质量,计算体质量指数(BMI),抽取受调查者空腹肘静脉血,检测空腹血糖(FPG)及服用75 g葡萄糖粉负荷后2 h血糖(2 h PG)水平。结果 飞行人员中PDM的患病率为7.05%(77/1 092),其中空腹血糖受损(IFG)、糖耐量减低(IGT)及IFG合并IGT所占比例分别为27.27%(21/77)、68.83%(53/77)和3.90%(3/77)。不同年龄组的比较显示,20~30岁、>30~40岁、>40~50岁和>50岁飞行人员的PDM患病率分别为3.35%(6/179)、5.98%(30/502)、9.68%(27/279)、11.29%(14/124),各组PDM患病率(P<0.05)、FPG及糖负荷后2 h PG均具有统计学差异(P<0.01),随着年龄的增长,PDM患病率、FPG及2 h PG均逐渐上升。根据BMI将飞行人员分为正常、超重和肥胖组,三组PDM患病率分别为4.35%(20/460)、9.92%(50/554)、11.11%(7/70),差异具有统计学意义(P<0.05),PDM患病率及FPG、2 h PG血糖随着BMI的增大逐渐升高。不同机种(歼击机、轰炸机、直升机、运输机、无人机)飞行人员、不同人员类别飞行人员(飞行员、技勤或战勤人员)PDM患病率无显著差异(P>0.05)。与血糖正常的飞行人员相比,PDM组具有年龄大,BMI、FPG、糖负荷后2 h PG高的特点(P<0.05)。结论 PDM飞行人员以IGT为主,随着年龄的增加及BMI的增大,飞行人员PDM患病率及FPG、糖负荷后2 h PG水平逐步升高。对于年龄超过40岁或体型为超重、肥胖的飞行人员,应当有针对性地进行糖耐量筛查,做好DM防控工作。
文摘目的:检测脂联素(adiponectin,ADPN)在合并糖代谢异常的冠心病患者血浆中浓度的变化,探讨其临床意义。方法:收集2009年8月至2010年4月在湘雅医院心内科经冠状动脉造影(coronary angiography,CAG)检查证实为冠心病的患者87名,根据糖代谢情况分为单纯冠心病组(coronary heart disease group,CHD组,n=31)、冠心病合并糖耐量异常组(CHD combine with impaired glucose tolerance group,CHD+IGT组,n=28)和冠心病合并糖尿病组(CHDcombine with diabetes mellitus group,CHD+DM组,n=28),另选健康体检者31例为正常对照组(normal control group,NC组)。采用酶联免疫吸附法检测血浆ADPN水平;为所有受试对象测身高、体质量、腰围、血压;测空腹血糖、胰岛素、血脂、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、游离脂肪酸(free fatty acid,FFA)和肝、肾功能等,计算体质量指数(body mass index,BMI)和胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)。结果:1)CHD组、CHD+IGT组、CHD+DM组患者血浆ADPN水平均低于NC组(P<0.05);2)与CHD组相比,CHD+DM组ADPN水平最低,CHD+IGT组次之,各组间差异有统计学意义(P<0.05);3)ADPN与HDL-C呈正相关(r=0.483,P<0.01),与hs-CRP和冠脉Gensini积分呈负相关(r=–0.489,P<0.05;r=–0.252,P<0.05)。结论:冠心病患者血浆ADPN浓度降低;合并糖代谢异常的冠心病患者血浆ADPN浓度更低,且随着糖代谢异常程度加重降低更显著;冠心病与糖代谢异常是影响血浆ADPN浓度改变的两个重要因素,血浆ADPN水平显著降低反映了上述两种疾病状态的叠加作用。ADPN联合HDL-C,hs-CRP,Gensini积分等血清学指标可为判断合并糖代谢异常的冠心病患者的疾病严重程度提供一定参考。