Lowering fasting blood glucose with non-dialyzable material of cranberry extract is dependent on host genetic background,sex and diet

Background:Type 2 diabetes(T2D)is a polygenic metabolic disease,character-ized by high fasting blood glucose(FBG).The ability of cranberry(CRN)fruit to regulate glycemia in T2D patients is well known.Here,a cohort of 13 lines of the genetically diverse Collaborative Cross(CC)mouse model was assessed for the effect of non-dialyzable material(NDM)of cranberry extract in lowering fasting blood glucose.Methods:Eight-week-old mice were maintained on either a standard chow diet(con-trol group)or a high-fat diet(HFD)for 12 weeks,followed by injections of intraperi-toneal(IP)NDM(50 mg/kg)per mouse,three times a week for the next 6 weeks.Absolute FBG(mg/dl)was measured bi-weekly and percentage changes in FBG(%FBG)between weeks 0 and 12 were calculated.Results:Statistical analysis showed a significant decrease in FBG between weeks 0 and 12 in male and female mice maintained on CHD.However,a non-significant in-crease in FBG values was observed in male and female mice maintained on HFD dur-ing the same period.Following administration of NDM during the following 6 weeks,the results show a variation in significant levels of FBG lowering between lines,male and female mice and under the different diets.Conclusion:The results suggest that the efficacy of NDM treatment in lowering FGB depends on host genetic background(pharmacogenetics),sex of the mouse(phar-macosex),and diet(pharmacodiet).All these results support the need for follow-up research to better understand and implement a personalized medicine approach/uti-lization of NDM for reducing FBG.

Effects of methanolic extract of <i>Pausinystalia yohimbe</i>bark on blood glucose level in normal fasting rats

Background: Pausinystalia yohimbe (L.) is a member of the family Rubiaceae. It is a valuable medicinal tree, distributed in evergreen closed-canopy forests in West Africa. It is traditionally used for treatment of erectile dysfunction and diabetes. Objective: This was an attempt to evaluate the effects of methanolic extract of P. yohimbe bark on blood glucose level in normal fasting rats. Methods: Different doses of methanolic extract of P. yohimbe bark (5, 10, 20, 40 and 80 mg/kg/mL) were orally administered to normal fasting rats to assess their effects on blood glucose levels. Results: The methanolic extract of P. yohimbe bark in different concentrations (5, 10, 20, 40 and 80 mg/kg/mL) when administered to normal fasting rats, only a considerable reduction (26.57 mg/dL) was produced by the dose of 20 mg/kg/mL. Conclusion and Recommendation: Although P. yohimbe has long been reported to regulate blood glucose levels;such effect is unclear and remains requiring further studies.

Impairment of extra-high frequency auditory thresholds in subjects with elevated levels of fasting blood glucose

This study was performed to assess whether there is an association between elevated Fasting Blood Glucose(FBG) and hearing impairment in Bangladeshi population. A total of 142 subjects(72 with elevated FBG; 70 control) were included in the study. The mean auditory thresholds of the control subjects at 1,4,8 and 12 kHz frequencies were 6.35 ± 0.35,10.07 ± 0.91,27.57 ± 1.82, 51.28 ± 3.01 dB SPL(decibel sound pressure level), respectively and that of the subjects with elevated FBG were 8.33 ± 0.66,14.37 ± 1.14, 38.96 土 2.23, and 71.11 ± 2.96 dB.respectively. The auditory thresholds of the subjects with elevated FBG were significantly(p < 0.05) higher than the control subjects at all the above frequencies, although hearing impairment was most evidently observed at an extra-high(12 kHz) frequency. Subjects with a long duration of diabetes(>10 years) showed significantly(p < 0.05) higher level of auditory thresholds at 8 and 12 kHz, but not at 1 and 4 kHz frequencies,compared to subjects with shorter duration of diabetes(≤10 years). In addition, based on the data of odds ratio, more acute impairment of hearing at the extra-high frequency was observed in diabetic subjects of both older(>40 years) and younger(<40 years) age groups compared to the respective controls. The binary logistic regression analysis showed a 5.79-fold increase in the odds of extra-high frequency hearing impairment in diabetic subjects after adjustment for age, gender and BMI. This study provides conclusive evidence that auditory threshold at an extra-high frequency could be a sensitive marker for hearing impairment in diabetic subjects.

Antiamylase Potential of Telfairia occidentalis Leaves from Cameroon and Effect of Their Dietary Supplementation on Fasting Blood Glucose in Wistar Rats

The study of edible plants, especially in developing countries, might provide more affordable means for the management of diabetes. Telfairia occidentalis is one of the plants whose leaves are commonly consumed in Cameroon. This work hereby studied the antiamylasic potential of its aqueous leaves extract and the effect of its dietary supplementation on fasting blood glucose in Wistar rats. An aqueous extract (1:6) was prepared from shed-dried T. occidentalis leaves by maceration. Its antiamylase activity was evaluated in vitro and a phytochemical screening was realized. Its acute toxicity and its effect on an oral glucose tolerance test (OGTT) were evaluated in rats. The effect of T. occidentalis leaves dietary supplementation (10%) on fasting blood glucose was studied for 28 days in rats fed with carbohydrate enriched diet, using Glibenclamide (0.3 mg/kg body weight) as reference hypoglycemic drug. Results showed that there was total inhibition of α-amylase activity in vitro by T. occidentalis aqueous leaves extract at 0.075 mg/ml. The presence of tannins, flavonoids and anthocyanins was revealed by the phytochemical screening. No sign of toxicity was observed in rats after an oral administration of the extract at 2000 mg/kg body weight. The extract significantly hindered a rise in blood glucose at 400 mg/kg body weight during an oral glucose tolerance test. Dietary supplementation with T. occidentalis leaves caused a significant decrease (p < 0.05) in fasting blood glucose as compared to the positive control. Telfairia occidentalis leaves and their aqueous extract could be used in the management of hyperglycemia and diabetes.

Abnormality of peripheral nerve conduction velocity associated with illness course, symptoms and fasting blood glucose in patients with type 2 diabetes mellitus

BACKGROUND: It has shown that abnormality of peripheral nerve conduction velocity during onset of diabetes mellitus is not related to age and sex, but to symptoms, illness course and level of fasting blood glucose. OBJECTIVE: To measure correlation of abnormality of peripheral nerve conduction velocity with various illness courses, symptoms and levels of fasting blood glucose of patients with type 2 diabetes mellitus. DESIGN: Case analysis. SETTING: Department of Neurology, Central People's Hospital of Huizhou. PARTICIPANTS: A total of 128 patients who were diagnosed as type 2 diabetes mellitus were selected from Central People's Hospital of Huizhou from September 2001 to October 2005. There were 75 males and 53 females aged 32-83 years and the illness course ranged from 1 month to 20 years. METHODS: All 128 patients with type 2 diabetes mellitus received neuro-electrophysiological study and their clinical data were retrospectively analyzed to measure peripheral nerve conduction velocity and fasting blood glucose so as to investigate the correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. MAIN OUTCOME MEASURES: Correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. RESULTS: All 128 patients with type 2 diabetes mellitus were involved in the final analysis. ① Among 128 patients, 114 patients had abnormality of peripheral nerve conduction velocity; 110 patients had clinical symptoms, including 102 patients having abnormality of peripheral nerve conduction velocity; 18 patients did not have clinical symptoms, including 12 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=8.275, P =0.04). ② Among 128 patients, illness course of 75 patients was equal to or less than 5 years, including 27 patients having abnormality of peripheral nerve conduction velocity; illness course of 53 patients was more than 5 years, including 35 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=11.469, P =0.003). ③ Among 128 patients, levels of fasting blood glucose of 75 patients was equal to or lower than 11 mmol/L, including 41 patients having abnormality of peripheral nerve conduction velocity; levels of fasting blood glucose of 53 patients was higher than 11 mmol/L, including 38 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=4.023, P =0.134). CONCLUSION: ① Abnormality of peripheral nerve conduction velocity of patients with type 2 diabetes mellitus is related to illness courses and clinical symptoms. The longer the illness course is, the severer the abnormality of peripheral nerve conduction velocity is. Abnormality of peripheral nerve conduction velocity always occurs on patients who have clinical symptoms. ② Abnormality of peripheral nerve conduction velocity is not related to levels of fasting blood glucose.

The Influence of Placement Time of Blood Samples on the Accuracy of Blood Glucose Measurement

This study aims to explore the influence brought by the decrease degree in blood glucose during the period when diabetes patients’ blood samples are collected through fasting blood and sent to the laboratory for detection on the accuracy on blood glucose measurement. Methods: This study is conducted by detecting fasting blood glucose of 150 patients who came to our hospital for physical examination and collecting their general information. Blood glucose concentration is measured through centrifugation after blood samples are placed for 0 min, 60 min, 120 min and 180 min.

瑞格列奈联合格列本脲治疗妊娠期糖尿病的效果及对血清FBG、2 hPG、NGAL的影响

目的探究瑞格列奈联合格列本脲治疗妊娠期糖尿病(GDM)的效果及对血清空腹血糖(FBG)、餐后2 h血糖(2 hPG)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的影响。方法选取2020年1月—2023年1月海南现代妇女儿童医院收治的GDM患者112例,以随机数字表法分为对照组(格列本脲治疗)和观察组(瑞格列奈联合格列本脲治疗),每组56例。比较两组治疗前后糖代谢指标[FBG、2 hPG、糖化血红蛋白(HbA1c)]和NGAL、同型半胱氨酸(Hcy)、胱抑素C(CysC)、Irisin、人源甘丙肽(GAL)水平,统计两组母婴结局。结果观察组治疗前后FBG、2 hPG和HbA1c的差值均高于对照组(P<0.05)。观察组治疗前后血清GAL、Irisin水平的差值均大于对照组(P<0.05)。观察组治疗前后NGAL、Hcy和CysC水平的差值均高于对照组(P<0.05)。观察组与对照组产程延长、妊娠高血压、羊水过多、胎膜早破的发生率比较,差异均无统计学意义(P>0.05);观察组早产儿、新生儿低血糖症的发生率均低于对照组(P<0.05)。结论瑞格列奈联合格列本脲治疗可有效控制GDM患者血糖水平,下调血清NGAL、Hcy、CysC和GAL水平,上调血清Irisin水平,改善胰岛素抵抗,且安全性高,值得临床推荐。

Investigation on Blood Glucose Control Nursing of ICU Severe Patients

Objective:To analyze the effect of blood glucose control mursing in intensive care umit (ICU)patients.Methods:The clinical data of 70 severe patients in ICU of ou hospital fom January 2019 to May 2020 were retrospectively analyzed.The climical data of 34 patients with routine intervention were divided into the control group,and the clinical data of 36 patients with routine intervention and blood glucose control mursing were divided into the observation group,all were intervened for 14 days.The blood glucose levels and prognosis of the two groups were compared before intervention and at the end of 14 days of intervention,the time required o achieve the standard blood glucose level of the two groups was recorded Results:After 14 days of intervention,the fasting blood glucose level of the observation group was lower than the control group,the difference was satisically significant(P<0.05);the time of blood glucose reaching the standard in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);on the 14th day of intervention,the sequential organ failure asessment score(SOFA)score of the two groups was lower than before intervention,the SOFA score of the observation group was lower than control group,the difference was statistically significant(P<0.05).Conclusion:The effect of blood glucose control mursing in ICU is better,which effectively controlled the blood glucose level of patients and improved the prognosis of patients.

2型糖尿病伴DR患者的血清C肽、FBG与HbA1c表达情况及其与眼底病变程度的关系分析

目的分析2型糖尿病伴视网膜病变(Diabetic Retinopathy,DR)患者的血清C肽、空腹血糖(Fasting Blood Glucose,FBG)与糖化血红蛋白(Glycosylated Hemoglobin A1c,HbA1c)表达情况及其与眼底病变程度的关系。方法选取2019年1月-2022年12月济南市济阳区中医医院收治的200例2型糖尿病伴DR患者为研究对象,根据眼底病变程度分为重度组、轻中度组,纳入同期200名例健康体检者为对照组,检测血清C肽、FBG与HbA1c表达,分析2型糖尿病伴DR患者的血清C肽、FBG与HbA1c表达情况及其与眼底病变程度的关系。结果200例2型糖尿病伴DR患者中,93例非增殖期DR患者为轻度,另107例为中重度。中重度组血清C肽低于轻度组、对照组,FBG与HbA1c表达高于轻度组、对照组,差异有统计学意义(P均<0.05)。Spearman相关性检验分析结果显示,血清C肽与眼底病变程度呈负相关(r=-0.420,P<0.05),FBG、HbA1c表达与眼底病变程度呈正相关(r=0.399、0.457,P均<0.05)。结论2型糖尿病伴DR患者的血清C肽低表达、FBG与HbA1c高表达情况与眼底病变程度加重有关。

妊娠期糖尿病孕妇血WBC、FBG、Cr、ALT变化及早期筛查和风险评估价值

目的:探讨妊娠期糖尿病(GDM)患者白细胞计数(WBC)、空腹血糖(FBG)、血肌酐(Cr)与丙氨酸氨基转移酶(ALT)水平及早期筛查和风险评估价值。方法:回顾性分析2020年5月—2021年12月在本院产前检查的孕妇542例临床资料,分为GDM组(n=60)与对照组(n=482),对比两组WBC、FBG、Cr、ALT差异,采用Spearman相关系数分析以上指标与GDM发病关系;绘制受试者工作特征(ROC)曲线分析WBC、FBG、Cr、ALT早期筛查GDM效能;多因素回归分析GDM发病相关风险因子。结果:GDM组Cr、WBC、FBG、ALT表达均高于对照组,且均与GDM发病正相关(均P<0.05);ROC分析,WBC、FBG、Cr、ALT联合检测的曲线下面积最高(0.851),敏感度90.1%、特异度为87.6%;WBC≥6.41×10~9/L、FBG≥5.16mmol/L、ALT≥14.98U/L、体质指数≥22.32kg/m~2、Cr≥50.62μmol/L、吸烟是GDM发生的风险因子,而孕妇本科及以上学历为保护因素。结论:GDM妇女血WBC、FBG、ALT、Cr异常高表达,联合检测对早期筛查GDM有一定效能,控制BMI、降低吸烟频率并提高孕产妇知识储备对降低GDM发生有一定作用。

FBG、HbA1c及血清C肽水平联合检测在糖尿病临床诊断中的应用价值

目的:评价糖尿病(DM)诊断中空腹血糖(FBG)、糖化血红蛋白(HbA1c)以及血清C肽联合检测策略的应用价值。方法:将2021年3月~2022年3月扬州友好医院收治的2型糖尿病(T2DM)患者46例纳入T2DM组,以同期收治的46例糖尿病肾病(DN)归入DN组,另选取同期46例健康体检者作为参照组,均予以FBG、HbA1c及血清C肽检测,对其检测结果进行观察和评价。结果:T2DM组及DN组FBG、HbA1c检测结果均显著高于参照组,同时,与参照组血清C肽相比,T2DM组检测结果明显更高,与T2DM组相比,DN组HbA1c明显更高,但血清C肽检测结果更低,差异均有统计学意义(P<0.05);联合检测方式对T2DM、DN的诊断符合率均高于其他指标单一检测,差异有统计学意义(P<0.05)。结论:与健康人群比较,DM患者FBG、HbA1c可呈高表达水平,而血清C肽能够为DN诊断与预防提供有效指导,联合检测该三项指标对于提高DM及DN诊断效果有积极作用。

Effects of intermittent fasting on health markers in those with type 2 diabetes:A pilot study

AIM To determine the short-term biochemical effects and clinical tolerability of intermittent fasting(IF) in adults with type 2 diabetes mellitus(T2DM).METHODS We describe a three-phase observational study(baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements(using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose(SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase. RESULTS At baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index(BMI) 36.90 kg/m^2]. We report here that a short-term periodof IF in a small group of individuals with T2DM led to significant group decreases in weight(-1.395 kg, P = 0.009), BMI(-0.517, P = 0.013), and at-target morning glucose(SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase(P < 0.001) in daily hours fasted in the IF phase(+5.22 h), although few attained the 18-20 h fasting goal(mean 16.82 ± 1.18). The increased fasting duration improved at-goal(< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values(χ~2 likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG(all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance(HOMAIR), nor inflammatory markers(C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography(Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool(Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity(i.e., every other day or reduced fasting hours).CONCLUSION The results from this pilot study indicate that shortterm daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.

FBG、CEA、CA50在肝外胆管结石患者血清中的表达及相关性研究

目的探讨空腹血糖(FBG)、癌胚抗原(CEA)、糖类抗原50(CA50)在肝外胆管结石患者血清中的表达及相关性。方法收集2020年6月1日至2021年9月30日来廊坊市人民医院就诊的88例肝外胆管结石患者为病例组,另选取同时间段来廊坊市人民医院进行健康体检的65例健康者为对照组。收集并分析患者的临床资料,分析肝外胆管结石发生的相关因素;Pearson相关性分析肝外胆管结石患者血清FBG、CEA、CA50与总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的相关性;绘制受试者工作特征(ROC)曲线,分析各影响因素预测肝外胆管结石的曲线下面积和最佳截断值等;采用Logistic多元回归模型分析影响肝外胆管结石的独立危险因素。结果病例组与对照组在性别、吸烟、饮酒、心脏病、高血压及年龄方面的差异均无统计学意义(P>0.05);病例组血清FBG、CEA、CA50、TC、TG、LDL-C水平较对照组升高(P<0.05),血清HDL-C水平较对照组降低(P<0.05)。Pearson相关性分析发现,血清FBG、CEA、CA50水平与TC、TG、LDL-C水平均呈正相关(r>0,P<0.05);血清FBG、CEA、CA50水平均与HDL-C水平均呈负相关(r<0,P<0.05)。血清FBG、CEA、CA50、TC、TG、HDL-C、LDL-C单项检测及血清FBG、CEA、CA50联合检测诊断肝外胆管结石的曲线下面积分别为0.915、0.940、0.917、0.886、0.870、0.899、0.881、0.995,最佳截断值分别为5.4 mmol/L、4.9 ng/mL、23.1 U/mL、0.646、4.8 mmol/L、1.3 mmol/L、1.1 mmol/L、3.2 mmol/L。FBG、CEA、CA50、TC、TG是肝外胆管结石的独立危险因素(P<0.05),HDL-C是肝外胆管结石的保护因素(P<0.05)。结论肝外胆管结石患者血清FBG、CEA、CA50水平均升高,且其对肝外胆管结石具有较好的诊断价值。

FBG、TG与HbAlc在2型糖尿病患者临床诊断中的联合检测价值分析

目的探讨空腹血糖(FBG)、甘油三酯(TG)、糖化血红蛋白A1c(HbA1c)联合检测诊断2型糖尿病(T2DM)的价值。方法选取100例T2DM患者为观察组,100例健康人为对照组,比较两组的FBG、TG、HbA1c水平。探讨T2DM的独立危险因素,分析FBG、TG与HbAlc诊断T2DM的价值。结果观察组的FBG、TG、HbA1c水平均高于对照组(P<0.05)。多因素Logistic回归分析显示,FBG、TG、HbA1c为T2DM发生的独立危险因素(P<0.05)。FBG、TG、HbA1c联合检测诊断T2DM的AUC高于FBG、TG、HbA1c单独检测(P<0.05)。结论FBG、TG及HbA1c联合检测诊断T2DM的效能较高。

孕早期FBG、HbA1c、TC、TG联合检测在妊娠期糖尿病诊断中的应用价值研究

目的对孕早期孕妇采用空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglo-bin,HbA1c)、血清总胆固醇(serum total cholesterol,TC)、三酰甘油(triglyceride,TG)联合检测在妊娠期糖尿病(gestational diabetes mellitus,GDM)诊断中的临床应用价值。方法选取2020年1月—2022年12月于泉州市丰泽区妇幼保健院就诊的56例妊娠期糖尿病患者为观察组,同时选取本院同期56例健康孕妇为对照组。两组孕妇均在孕12周内进行FBG、HbA1c、TC、TG检测,对比两组孕妇FBG、HbA1c、TC、TG联合诊断妊娠期糖尿病的结果。结果观察组FBG(6.36±1.14)mmol/L高于对照组(4.13±0.52)mmol/L,差异有统计学意义(P<0.05);观察组HbA1c(7.54±1.48)%高于对照组(5.35±0.86)%,差异有统计学意义(P<0.05);观察组TC(5.74±1.15)mmol/L高于对照组(5.15±0.98)mmol/L,差异有统计学意义(P<0.05);观察组TG(1.95±0.84)mmol/L高于对照组(1.60±0.67)mmol/L,差异有统计学意义(P<0.05)。FBG、HbA1c、TC、TG联合诊断的灵敏度、特异度和准确度均高于FBG单独诊断的灵敏度、特异度和准确度,差异有统计学意义(P均<0.05)。结论在孕早期采用FBG、HbA1c、TC、TG联合诊断妊娠期糖尿病,具有较好的灵敏度、特异度和准确度,可为孕早期妊娠期糖尿病的诊断提供依据。

常规体检指标对颈动脉硬化发生的预测价值

目的探讨常规体检指标如性别、年龄、血压、血脂、同型半胱氨酸等在颈动脉硬化发生的预测价值。方法采用回顾性研究方法。选取2016年1月至2021年12月连续6年在我院接受健康体检人群985例作为研究对象。收集受试者一般资料、体格检查指标、实验室检查指标、颈动脉超声结果等信息。受试者在随访中经颈动脉超声诊断为颈动脉内中膜厚度(cIMT)>1mm或有颈动脉斑块形成则被认为出现颈动脉粥样硬化进展并结束随访。受试者若未出现颈动脉粥样硬化进展,则直至2021年12月随访结束。将研究对象按随访过程中cIMT是否增加分为硬化组、进展组和对照组。分析颈动脉硬化发生的影响因素,并采用受试者操作特征曲线分析体检指标对颈动脉硬化的诊断效能。结果进展组在颈动脉硬化发病后TC、LDL-C、FBG、UA、Hcy和SBP均高于发生前,HDL-C低于发病前,差异有统计学意义(P<0.05);硬化组除HDL-C和Hcy指标差异没有统计学意义外,其他指标如男性比例、年龄、TC、TG、LDL-C、FBG、UA、SBP、DBP、BMI指标均高于对照组,差异有统计学意义(P<0.05);其中FBG、LDL-C和SBP为颈动脉硬化发生的独立风险因素(OR=5.505、4.222、1.071,P<0.05),以上指标联合诊断颈动脉硬化的曲线下面积高于各项单独检测,差异有统计学意义(P<0.01)。结论FBG、LDL-C和BMP与颈动脉硬化的发生密切相关,联合检测对颈动脉硬化有较好的诊断效能。

高水平空腹血糖与缺血性卒中患者静脉溶栓后功能结局的关系分析

目的探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。方法回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象,采集相关研究数据(包括空腹血糖等)。研究结局设定为出院时功能结局良好,即mRS评分0~1分。采用多因素logistic回归分析探讨空腹血糖与功能结局的关联性。结果共入组205例患者,平均年龄为(63.21±11.67)岁,其中153例(74.63%)患者为男性,入院NIHSS评分为5(3~9)分。其中117例(57.07%)患者出院时功能结局不良,88例(42.93%)患者出院时功能结局良好。功能结局良好的患者空腹血糖水平低于功能结局不良的患者[5.10(4.46~7.06)mmol/L vs.6.33(5.09~7.79)mmol/L,P=0.001]。多因素logistic回归分析结果显示,校正年龄、性别、NIHSS评分后,空腹血糖水平与接受静脉溶栓功能结局相关(OR0.876,95%CI0.774~0.991,P=0.035);校正年龄、性别、NIHSS评分、桥接取栓后,关联性没有达到统计学意义(OR0.891,95%CI0.791~1.004,P=0.058)。结论对于接受静脉溶栓的缺血性卒中患者,高水平空腹血糖可能会增加静脉溶栓后出院功能结局不良风险。

体检数据对颈动脉粥样硬化发生风险的预测价值

目的探讨体检指标如性别、年龄、血压、血脂等在颈动脉粥样硬化(CAS)风险评估中的价值。方法随机选取2022年1月至2023年1月河北医科大学第一医院体检人群384例,根据颈动脉超声结果分为动脉硬化组(283例)和对照组(101例)。收集入组人群体检数据,分析CAS发生的影响因素,并采用受试者操作特征(ROC)曲线分析体检指标对CAS的诊断效能。结果两组年龄、男性占比、收缩压、舒张压、高血压者占比、体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、血尿酸(URIC)比较,差异有统计学意义(P<0.05)。单因素分析结果显示,年龄、男性、收缩压、舒张压、BMI、TC、TG、LDL-C、FBG、URIC均为CAS的风险因素(P<0.05)。多因素logistic回归分析结果显示,年龄、收缩压、LDL-C、FBG和URIC为CAS发生的独立危险因素(OR=2.415、3.409、3.027、1.759、1.287,P<0.05)。年龄、收缩压、LDL-C、FBG、URIC联合诊断动脉硬化的ROC曲线下面积高于各项指标单独检测(P<0.05)。结论年龄、收缩压、LDL-C、FBG和URIC与CAS的发生密切相关,联合检测对CAS有较好的诊断效能。

空腹血糖水平与高血压患者血栓栓塞事件的相关性研究

目的分析空腹血糖水平与高血压患者血栓栓塞事件的相关性。方法纳入我院在2019年1月至2022年1月期间的高血压患者共987例进行研究,所有患者均随访至2023年7月,依据患者血栓栓塞事件发生情况分为两组,其中260例患者发生血栓栓塞事件设为栓塞组,其余727例患者未发生血栓栓塞事件设为对照组。对两组患者的各项资料进行单因素分析,对有统计学意义的因素行Logistic多因素分析,分析高血压患者血栓栓塞事件发生的危险因素。依据患者入组时空腹血糖水平分为血糖正常组(n=627)、糖尿病前期组(n=107)、血糖控制严格糖尿病组(n=60)、血糖控制一般糖尿病组(n=43)、血糖控制不佳糖尿病组(n=150),比较不同空腹血糖水平患者血液高凝状态指标水平及血栓栓塞事件发生情况,并分析空腹血糖水平和高血压患者血栓栓塞事件的相关性。结果栓塞组患者的年龄、男性占比、体质量指数、非瓣膜病性心房颤动、脑卒中危险评分(CHA_(2)DS_(2)-VASc)、心房颤动抗凝治疗出血风险评分(HAS-BLED)、血管疾病占比、心力衰竭占比、血栓栓塞占比、糖尿病占比、空腹血糖水平、血小板计数水平均高于对照组(P<0.05)。Logistic回归模型结果显示,体质量指数≥26 kg/m^(2)、空腹血糖≥6.1 mmol/L均为高血压患者血栓栓塞事件发生的危险因素(P<0.05)。血糖正常组患者的PT水平高于其他各组,APTT、FIB、D-二聚体水平低于其他各组,其中糖尿病前期组、血糖控制严格糖尿病组、血糖控制一般糖尿病组、血糖控制不佳糖尿病组患者的PT水平依次降低,APTT、FIB、D-二聚体水平依次升高(P<0.05)。血糖控制不佳糖尿病组患者的急性心肌梗死、急性脑梗死、急性肺栓塞发生率明显高于其他各组(P<0.05);各组间短暂性脑缺血发作、下肢静脉血栓发生率比较差异无统计学意义(P>0.05)。Pearson相关性分析,空腹血糖水平与高血压患者血栓栓塞事件呈现正相关(r=0.912,P=0.007)。结论体质量指数、空腹血糖水平均为高血压患者血栓栓塞事件发生的危险因素,且空腹血糖水平与高血压患者血栓栓塞事件呈现正相关。

糖尿病患者空腹血糖与血尿酸对糖尿病视网膜病变的交互作用分析

目的探讨空腹血糖(FBG)与血尿酸(SUA)的交互作用对糖尿病(DM)患者视网膜病变(DR)的影响。方法选取2019年1月至2021年1月于赣南医学院第一附属医院确诊的并接受全面眼科检查的DM患者306例。依据有无DR将所有患者分为DR组(178例)和NDR组(128例)。比较两组患者的一般临床资料,采用最小绝对收缩和选择栓子(LASSO)回归法和多因素Logistic回归分析筛选DM患者发生DR的独立影响因素,并计算危险因素比值比,使用E值法对结果进行敏感性分析。通过相加交互模型分析FBG、SUA对DM患者发生DR的交互作用。构建DM患者发生DR的Nomogram模型并进行内部验证。采用受试者工作特征曲线(ROC)对FBG、SUA及其交互作用对DM患者发生DR的影响进行评估。结果与NDR组患者相比,DR组患者的DM病程较长,有口服药物治疗史比例较低,有胰岛素治疗史患者比例较高,总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿素氮、血肌酐、SUA和FBG水平均明显较高,差异均有统计学意义(均为P<0.05)。胰岛素治疗史、DM病程≥9.66年、甘油三酯≥2.07 mmol•L^(-1)、SUA≥297.73μmol•L^(-1)、FBG≥8.92 mmol•L^(-1)是影响DM患者发生DR的危险因素,口服药物治疗史是影响DM患者发生DR的保护因素。利用以上独立危险因素构建的Nomogram模型在预测DM患者发生DR准确性良好。SUA和FBG对DM患者发生DR具有交互作用。SUA和FBG交互作用对DR的诊断价值大于二者单独对DR的诊断价值。结论SUA≥297.73μmol•L^(-1)及FBG≥8.92 mmol•L^(-1)是影响DM患者发生DR的危险因素。FBG、SUA二者协同交互作用对DM伴DR的诊断价值大于二者单独存在对DR的诊断价值。