The present study enrolled 251 diabetic patients, including 101 with neuropathy and 150 without neuropathy. Of the 150 patients, 100 had no complications, such as retinopathy, nephropathy, or neuropathy. Polymerase ch...The present study enrolled 251 diabetic patients, including 101 with neuropathy and 150 without neuropathy. Of the 150 patients, 100 had no complications, such as retinopathy, nephropathy, or neuropathy. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to identify methylenetetrahydrofolate reductase gene variants. Plasma homocysteine levels were also measured. Homocysteine levels and the frequency of hyperhomocysteinemia were significantly higher in patients with diabetic peripheral neuropathy compared with diabetic patients without neuropathy （P 〈 0.05）. In logistic regression analysis with neuropathy as the dependent variable, the frequency of C677T in methylenetetrahydrofolate reductase was significantly higher in patients with diabetic peripheral neuropathy compared with patients without diabetic complications. Homocysteine levels were significantly higher in patients with diabetic peripheral neuropathy carrying the 677T allele and low folic acid levels. In conclusion, hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in Chinese patients with diabetes. The C677T polymorphism in methylenetetrahydrofolate reductase and low folic acid levels may be risk factors for diabetic peripheral neuropathy in Chinese patients with diabetes.展开更多
BACKGROUND： Ceramide galactosyltransferase （CGT） protein and mRNA expression defect can cause the abnormal morphology and slowing conduction velocity of peripheral nerve. Morphologic change and functional disorder ...BACKGROUND： Ceramide galactosyltransferase （CGT） protein and mRNA expression defect can cause the abnormal morphology and slowing conduction velocity of peripheral nerve. Morphologic change and functional disorder of myelin sheath and axon appear when diabetic peripheral neuropathy （DPN） occurs. Whether electroacupuncture at Zusanfi（ST 36） and Shenshu（BL 32） points can enhance the expression of CGT protein and mRNA in the DPN tissue？ OBJECTIVE： To observe the effect of electroacupuncture at Zusanfi and Shenshu points on motor, sensory conduction velocity and CGT mRNA and its protein expression of sciatic nerve in rats with DPN. DESIGN： A randomized and controlled animal experiment SETTING ： Department of Neurology and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine, Shanghai University of Traditional Chinese Medicine. MATERIALS ： Totally 60 healthy male Wistar rats of clean grade, aged 4 month, with body mass of 200 to 220 g, were enrolled in this study. Streptozotocin （STZ, Sigma Company of USA, Batch No. S-0130）. METHODS： This study was carried out in the Animal Experimental Center and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine during February 2005 to March 2006. （1） Fifteen rats were randomly chosen,serving as normal group.AU the other rats were intraperitoneally injected once with STZ to develop experimental diabetic rat models. If fasting blood glucose was ≥ 15 mmol/L,sensory nerve and motor nerve conduction velocity of sciatic nerve was obviously slowed, tail-swaying temperature threshold was increased and myelinated nerve fiber of sciatic nerve changed, DPN models were successful. The successful model rats were randomly assigned into 3 groups： model group, control group（electroacupuncture at non-meridian-non-acupoint）and electroacupuncture group [electroacupuncture at Zusan/i and Shenshu points], with 15 rats each. The rats in the normal group and model group were untouched. In the electroacupuncture group （electroacupuncture at Zusanfi and Shenshu points）, Shenshu point （double） and Zusanfi point （double） were chosen referencing to The Atlas of the Rat＇s Acupoints. G6805- Ⅱ electric acupuncture apparatus was used, and current intensity was controlled at 20 min/time, once every other day, 12 times within 24 days. In the control group, the tip of rat-tail was stimulated, and the concrete procedures were the same as in the electroacupuncture at Zusanfi and Shenshu points. （2） Motor nerve conduction velocity and sensory nerve conduction velocity of rats were detected with neuroelectrophysiology detector in the end of the treatment, and the expressions of CGT protein and mRNA of sciatic nerve were detected with immunohistochemical method and fluorescent quantitative PCR technique. MAIN OUTCOME MEASURES： （1） Motor and sensory nerve conduction velocity. （2） The expression of CGT protein and its mRNA. RESULTS： All the 60 rats entered the stage of result analysis. （1） Comparison of motor and sensory nerve conduction velocity of rats after electroacupuncture： Motor nerve conduction velocity of rats in the model group[（31.37±3.69） m/s], control group [（32.74±5.42） m/s] and electroacupuncture group [（41.30 ±1.15） m/s] was significantly lower than that in the normal group [（41.30±1.15） m/s, P 〈 0.01]; The sensory nerve conduction velocity of rats in the model group[（18.17±9.54） m/s], control group [（21.39±5.61） m/s]and electroacupuncture group [（35.81 ±4.59） m/s] was significantly lower than that in the normal group [（46.38± 6.32） m/s,P 〈 0.01]; The motor and sensory nerve conduction velocity of electroacupuncture group was significantly higher than that in the model group [（38.04±2.01） m/s vs. （32.74±5.42） m/s,（35.81±4.59） m/s vs. （21.39±5.61） m/s,P 〈 0.01]. （2） Comparison of the expression of CGT protein of sciatic nerve of rats： The number of CGT positive cells of sciatic nerve in model group, control group or electroacupuncture group was significantly smaller than that in normal group [（9 770.33±1 461.73）, （10 588.13±1119.52）, （27 518.27± 9 078.29）, （37 769.67±4 021.81）/μm^2,P 〈 0.01]; The number of CGT positive cells of the sciatic nerve in the electroacupuncture group was significantly larger than that in the model group and control group （P 〈 0.01）. The number of CGT positive cells of sciatic nerve was close between control group and electroacupuncture group （P 〉 0.05）. （3） Comparison of CGT mRNA expression of sciatic nerve of rats： Ct value of CGT mRNA of sciatic nerve of rats in the model group,control group and electroacupuncture group was significantly higher than that in the normal group （13.75±2.60,14.81±2.80,11.67±1.75,9.30±0.98, P 〈 0.01 ）; Ct value of CGT mRNA of sciatic nerve of rats in the electroacupuncture group was significantly lower than that in the model group and control group （P 〈 0.01）, and that was close between electroacupuncture group and control group （P 〉 0.05）. CONCLUSION ： Electroacupuncture at Zusanfi and Shenshu points can increase motor and sensory nerve conduction velocity of rats with DPN. It might be associated with up-regulating the expression of CGT mRNA and its protein.展开更多
基金supported by the Natural Science Foundation of Beijing, No. 7102161
文摘The present study enrolled 251 diabetic patients, including 101 with neuropathy and 150 without neuropathy. Of the 150 patients, 100 had no complications, such as retinopathy, nephropathy, or neuropathy. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to identify methylenetetrahydrofolate reductase gene variants. Plasma homocysteine levels were also measured. Homocysteine levels and the frequency of hyperhomocysteinemia were significantly higher in patients with diabetic peripheral neuropathy compared with diabetic patients without neuropathy （P 〈 0.05）. In logistic regression analysis with neuropathy as the dependent variable, the frequency of C677T in methylenetetrahydrofolate reductase was significantly higher in patients with diabetic peripheral neuropathy compared with patients without diabetic complications. Homocysteine levels were significantly higher in patients with diabetic peripheral neuropathy carrying the 677T allele and low folic acid levels. In conclusion, hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in Chinese patients with diabetes. The C677T polymorphism in methylenetetrahydrofolate reductase and low folic acid levels may be risk factors for diabetic peripheral neuropathy in Chinese patients with diabetes.
基金the National Nat-ural Science Foundation of Chi-na, No. 30472238 the Grantfrom Bureau of Public Health ofShanghai City, No. 05JC14053Shanghai Key Subjects Con-struction Program, No. T0302
文摘BACKGROUND： Ceramide galactosyltransferase （CGT） protein and mRNA expression defect can cause the abnormal morphology and slowing conduction velocity of peripheral nerve. Morphologic change and functional disorder of myelin sheath and axon appear when diabetic peripheral neuropathy （DPN） occurs. Whether electroacupuncture at Zusanfi（ST 36） and Shenshu（BL 32） points can enhance the expression of CGT protein and mRNA in the DPN tissue？ OBJECTIVE： To observe the effect of electroacupuncture at Zusanfi and Shenshu points on motor, sensory conduction velocity and CGT mRNA and its protein expression of sciatic nerve in rats with DPN. DESIGN： A randomized and controlled animal experiment SETTING ： Department of Neurology and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine, Shanghai University of Traditional Chinese Medicine. MATERIALS ： Totally 60 healthy male Wistar rats of clean grade, aged 4 month, with body mass of 200 to 220 g, were enrolled in this study. Streptozotocin （STZ, Sigma Company of USA, Batch No. S-0130）. METHODS： This study was carried out in the Animal Experimental Center and Central Laboratory, Yueyang Hospital of Traditional Chinese ＆ Western Medicine during February 2005 to March 2006. （1） Fifteen rats were randomly chosen,serving as normal group.AU the other rats were intraperitoneally injected once with STZ to develop experimental diabetic rat models. If fasting blood glucose was ≥ 15 mmol/L,sensory nerve and motor nerve conduction velocity of sciatic nerve was obviously slowed, tail-swaying temperature threshold was increased and myelinated nerve fiber of sciatic nerve changed, DPN models were successful. The successful model rats were randomly assigned into 3 groups： model group, control group（electroacupuncture at non-meridian-non-acupoint）and electroacupuncture group [electroacupuncture at Zusan/i and Shenshu points], with 15 rats each. The rats in the normal group and model group were untouched. In the electroacupuncture group （electroacupuncture at Zusanfi and Shenshu points）, Shenshu point （double） and Zusanfi point （double） were chosen referencing to The Atlas of the Rat＇s Acupoints. G6805- Ⅱ electric acupuncture apparatus was used, and current intensity was controlled at 20 min/time, once every other day, 12 times within 24 days. In the control group, the tip of rat-tail was stimulated, and the concrete procedures were the same as in the electroacupuncture at Zusanfi and Shenshu points. （2） Motor nerve conduction velocity and sensory nerve conduction velocity of rats were detected with neuroelectrophysiology detector in the end of the treatment, and the expressions of CGT protein and mRNA of sciatic nerve were detected with immunohistochemical method and fluorescent quantitative PCR technique. MAIN OUTCOME MEASURES： （1） Motor and sensory nerve conduction velocity. （2） The expression of CGT protein and its mRNA. RESULTS： All the 60 rats entered the stage of result analysis. （1） Comparison of motor and sensory nerve conduction velocity of rats after electroacupuncture： Motor nerve conduction velocity of rats in the model group[（31.37±3.69） m/s], control group [（32.74±5.42） m/s] and electroacupuncture group [（41.30 ±1.15） m/s] was significantly lower than that in the normal group [（41.30±1.15） m/s, P 〈 0.01]; The sensory nerve conduction velocity of rats in the model group[（18.17±9.54） m/s], control group [（21.39±5.61） m/s]and electroacupuncture group [（35.81 ±4.59） m/s] was significantly lower than that in the normal group [（46.38± 6.32） m/s,P 〈 0.01]; The motor and sensory nerve conduction velocity of electroacupuncture group was significantly higher than that in the model group [（38.04±2.01） m/s vs. （32.74±5.42） m/s,（35.81±4.59） m/s vs. （21.39±5.61） m/s,P 〈 0.01]. （2） Comparison of the expression of CGT protein of sciatic nerve of rats： The number of CGT positive cells of sciatic nerve in model group, control group or electroacupuncture group was significantly smaller than that in normal group [（9 770.33±1 461.73）, （10 588.13±1119.52）, （27 518.27± 9 078.29）, （37 769.67±4 021.81）/μm^2,P 〈 0.01]; The number of CGT positive cells of the sciatic nerve in the electroacupuncture group was significantly larger than that in the model group and control group （P 〈 0.01）. The number of CGT positive cells of sciatic nerve was close between control group and electroacupuncture group （P 〉 0.05）. （3） Comparison of CGT mRNA expression of sciatic nerve of rats： Ct value of CGT mRNA of sciatic nerve of rats in the model group,control group and electroacupuncture group was significantly higher than that in the normal group （13.75±2.60,14.81±2.80,11.67±1.75,9.30±0.98, P 〈 0.01 ）; Ct value of CGT mRNA of sciatic nerve of rats in the electroacupuncture group was significantly lower than that in the model group and control group （P 〈 0.01）, and that was close between electroacupuncture group and control group （P 〉 0.05）. CONCLUSION ： Electroacupuncture at Zusanfi and Shenshu points can increase motor and sensory nerve conduction velocity of rats with DPN. It might be associated with up-regulating the expression of CGT mRNA and its protein.
文摘目的在中国汉族2型糖尿病患者中探讨皮肤自发荧光(skin autofluorescence,SAF)与糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)之间的关系。方法2015年12月至2016年6月从上海市静安区医联体慢病管理库中纳入资料完整的115名2型糖尿病患者。所有纳入者均进行SAF检查及神经传导功能检查(nerve conduction studies,NCS),并根据NCS的检查结果分为DPN组和非DPN组。结果115名2型糖尿病患者中,DPN组39人,非DPN组76人。DPN组SAF测量值为(2.67±0.45)AU,显著高于非DPN组的( 2.28 ±0.41)AU( P <0.001)。根据SAF测量值的第25百分位数和第75百分位数将所有纳入者分为低、中、高SAF组,NCS检查参数包括运动神经传导速度、感觉神经传导速度、远端潜伏期和感觉神经动作电位波幅,3组间差异有统计学意义( P <0.05)。Logistic回归分析显示,SAF为DPN的独立危险因素(OR=8.947,95%CI:1.675~47.793, P =0.010)。ROC曲线显示SAF诊断DPN的曲线下面积为0.726 (95%CI:0.630~0.821, P < 0.001 )。结论SAF为DPN的独立危险因素,对中国汉族2型糖尿患者中DPN患病风险筛查可能存在一定的价值。
