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.

FPG、HbA1c水平变化与老年2型糖尿病视网膜病变患者视力严重程度的关系

目的 探究空腹血糖(Fasting Blood Glucose, FPG)、糖化血红蛋白(Glycosylated Hemoglobin A1c, HbA1c)水平变化与老年2型糖尿病视网膜病变患者视力严重程度的关系。方法 选取2020年6月—2022年6月泉州市泉港区医院收治的92例2型糖尿病患者为研究对象,根据有无视网膜病变分为非视网膜病变组48例、视网膜病变组44例;根据视力损伤严重程度将视网膜病变患者分为轻度组15例、中度组14例、重度组15例。所有患者入院次日检测空腹血糖和视力情况,分析不同组间FPG、HbA1c水平;Pearson相关性分析FPG、HbA1c水平变化与患者视力严重程度关系。结果 视网膜病变组FPG和HbA1c水平均明显高于非视网膜病变组,差异有统计学意义(P均<0.05)。中重度组FPG和HbA1c水平均明显高于轻度组,且重度组高于中度组,差异有统计学意义(P均<0.05)。FPG、HbA1c与糖尿病视网膜病变患者视力损伤程度呈正相关(r=0.436、0.531,P均<0.001)。结论 老年2型糖尿病视网膜病变患者FPG与HbA1c水平与视力损伤程度呈正相关。

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.

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.

孕早期血浆FPG、Hcy及Hb A1c对妊娠期糖尿病的预测价值

目的:探究孕早期血浆空腹血糖(FPG)、同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)对妊娠期糖尿病发生的预测价值。方法:回顾性收集医院确诊为妊娠期糖尿病的120例孕妇作为研究组,另取同期于该院产检正常的120例孕妇为对照组,对比两组孕妇FPG、Hcy及HbA1c水平差异,随访两组孕妇不良妊娠结局差异,采用绘制受试者特征曲线(ROC)计算血浆FPG、Hcy及HbA1c对妊娠期糖尿病的诊断效能。结果:研究组孕妇的血浆FPG、Hcy及HbA1c水平均明显高于对照组孕妇(P<0.05);研究组孕妇的不良妊娠结局发生率均明显高于对照组(P<0.05);血浆FPG、Hcy及HbA1c水平对妊娠糖尿病的诊断曲线下面积(AUC)分别为0.6835(P<0.0001)、0.5892(P=0.0409)、0.6501(P=0.0006),而联合检测的AUC为0.9502(P<0.0001),组间比较联合检测的灵敏度和特异度均优于任一种检测指标(P<0.05)。结论:孕早期妊娠糖尿病患者血浆FPG、Hcy及HbA1c水平与健康孕妇存在较大的差异,上述指标在预测妊娠糖尿病及不良妊娠结局方面中具有一定的应用效能,建议临床推广运用。

HbA1c、CK及FPG水平在糖尿病微血管病变筛查中的检测价值

目的 探究糖尿病微血管病变筛查中糖化血红蛋白(glycated hemoglobin A1c, HbA1c)、空腹血糖(fasting plasma glucose, FPG)、肌酸激酶(creatine kinase, CK)水平的检测价值。方法 选取2020年2月—2021年2月厦门市仙岳医院收治的80例糖尿病患者(研究组)以及同期的50名健康人群(参照组)为研究对象,研究组根据是否发生微血管病变又分为发生组(n=37)与未发生组(n=43)。所有研究对象均给予HbA1c、CK及FPG水平检测,采用Spearman分析其与糖尿病微血管病变之间的相关性。结果 研究组的HbA1c、CK、FPG水平均高于参照组,差异有统计学意义(P<0.05);发生组的HbA1c、CK、FPG水平均高于未发生组,差异有统计学意义(P<0.05);糖尿病微血管病变与HbA1c、CK、FPG呈正相关(P<0.05)。结论 HbA1c、CK及FPG水平与糖尿病微血管病变之间存在显著正相关,可反映糖尿病微血管病变的形成情况,进而帮助临床筛查糖尿病微血管病变。

Hcy、FPG、HbA1c、UAlb水平与糖尿病足严重程度的相关性

目的 分析糖尿病足严重程度与血浆同型半胱氨酸(homocysteine,Hcy)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、尿微量白蛋白(urinary microalbumin,UAlb)的相关性。方法 选取2020年1月—2023年3月盐城市第一人民医院检验科收治的60例糖尿病患者为研究对象,依据有无并发糖尿病足分成两组,将并发糖尿病足的患者纳入研究组(21例),未并发糖尿病足患者纳入对照组(39例),检测并对比两组血浆Hcy、FPG、HbA1c与UAlb水平,对比各分级患者(Wagner分级标准)的血浆Hcy、FPG、HbA1c与UAlb水平,并分析此类指标与糖尿病足病变程度间的相关性(Spearman相关分析)。结果 研究组血浆Hcy、FPG、HbA1c与UAlb水平均较对照组高,差异有统计学意义(P<0.05)。研究组中,血浆Hcy、FPG、HbA1c、UAlb水平均伴随Wagner分级的增加而随之升高,不同Wagner分级患者的血浆Hcy、FPG、HbA1c、UAlb水平对比,差异有统计学意义(P<0.05)。经Spearman分析得知,血浆Hcy、FPG、HbA1c、UAlb与糖尿病足病情之间存在紧密相关性(P<0.05)。结论 Hcy、FPG、HbA1c、UAlb水平与糖尿病足病情程度之间存在紧密联系,通过检测此类指标,可提高诊断效能。

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。

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。

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。

妊娠早期血炎症指标、空腹血糖及血脂对妊娠期糖尿病的联合预测价值

目的探讨妊娠早期(孕6~13^(+6)周)孕妇血炎症指标、空腹血糖及血脂与妊娠期糖尿病(GDM)的关系。方法选择2020年11月至2021年10月在新乡医学院第一附属医院进行产检的98例妊娠早期孕妇为研究对象,依据受试者妊娠中期(孕24~28周)的口服葡萄糖耐量试验结果将其分为GDM组(n=35)和糖耐量正常(NGT)组(n=63)。所有受试者于孕6~13^(+6)周时空腹8 h以上,于第2天清晨抽取肘正中静脉血,测定白细胞(WBC)计数、中性粒细胞计数(NC)、淋巴细胞计数(LC)、单核细胞计数(MC)、空腹血糖(FPG)及血清总胆固醇(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)水平,比较GDM组与NGT组孕妇各指标之间的差异。应用多因素logistic回归模型寻求联合预测因子并进行GDM发生的独立危险因素分析,采用受试者操作特征(ROC)曲线评估各危险因素预测GDM发生的效能。结果GDM组孕妇妊娠早期FPG、WBC计数、LC、TC、TG、LDL-C水平显著高于NGT组(P<0.05);GDM组与NGT组孕妇的NC、MC及HDL-C水平比较差异无统计学意义(P>0.05)。Logistic回归模型分析显示,FPG、WBC计数、TC、TG升高是GDM发生的独立危险因素(P<0.05)。以FPG=4.80 mmol·L^(-1)、WBC=9.35×10^(9)L^(-1)、TC=4.05 mmol·L^(-1)、TG=1.61 mmol·L^(-1)为截断值,预测GDM的ROC曲线下面积(AUC)分别为0.779、0.721、0.685、0.762,敏感度分别为0.886、0.514、0.857、0.543,特异度分别为0.587、0.857、0.524、0.873,四者联合预测GDM的AUC为0.876,灵敏度为0.857,特异度为0.810。妊娠早期FPG、WBC计数、TC、TG联合预测GDM的AUC高于FPG、WBC、TC、TG单独预测GDM的AUC。结论妊娠早期(孕6~13^(+6)周)孕妇血FPG、WBC计数、TC、TG是GDM的独立危险因素,可作为早期预测GDM发生的临床指标,且4项指标联合对GDM有更好的预测价值。

不同强度训练方式对2型糖尿病超重或肥胖者体成分及糖代谢影响的Meta分析

目的:系统评价高强度间歇训练(high-intensity interval training,HIIT)与中等强度持续性训练(moderate-intensity continuous training,MICT)对2型糖尿病超重或肥胖患者体成分、糖代谢相关指标干预效果,对比两种运动方式的改善效果,为2型糖尿病超重或肥胖患者运动处方的制定提供参考依据。方法:检索The Cochrane Library、PubMed、EMbase、Web of Science、中国知网、中国生物医学文献数据库(CBM)、万方及美国临床试验注册中心数据库,搜集HIIT与MICT对2型糖尿病超重或肥胖患者体成分和糖代谢相关指标干预效果比较的随机对照试验,检索时间为各数据库建库至2022年6月。由2名研究者对所纳入的研究进行筛选、质量评价和数据提取,采用RevMan 5.4软件对结局指标进行Meta分析。结果:①共纳入13项随机对照试验,包括371例患者,所纳入研究整体质量较高。②HIIT组与MICT组对体成分改善效果无显著性差异(体质量:WMD=2.44,95%CI:-3.01-7.89,P>0.05;体质量指数:WMD=0.28,95%CI:-1.21-1.77,P>0.05;腰围:WMD=2.16,95%CI:-2.04-6.35,P>0.05;体脂百分比:WMD=0.47,95%CI:-2.11-3.05,P>0.05);③两组体质量与体质量指数指标“训练周期≥12周”亚组“训练频率≤3次/周”亚组差异有显著性意义(训练周期≥12周亚组:WMD=4.25,95%CI:0.90-7.59,P=0.01;WMD=2.71,95%CI:1.92-3.51,P<0.00001;训练频率≤3次/周亚组:WMD=5.14,95%CI:1.7-8.57,P=0.003;WMD=1.67,95%CI:0.66-2.67,P=0.001);④敏感性分析结果显示,HIIT组与MICT组体脂百分比指标差异有显著性意义(WMD=2.17,95%CI:1.20-3.14,P<0.0001),两组对糖代谢改善效果无显著性差异(空腹血糖:WMD=0.31,95%CI:-0.17-0.79,P>0.05;糖化血红蛋白:WMD=0.01,95%CI:-0.19-0.20,P>0.05;胰岛素抵抗指数:WMD=-0.14,95%CI:-0.71-0.42,P>0.05);⑤亚组分析结果显示,空腹血糖指标在“训练频率≤3次/周”亚组分析中差异有显著性意义(WMD=0.92,95%CI:0.25-1.60,P=0.007);糖化血红蛋白在“训练频率>3次/周”亚组分析中差异有显著性意义(WMD=-0.2,95%CI:-0.3至-0.1,P<0.0001)。结论:①整体而言,HIIT与MICT对改善2型糖尿病超重或肥胖患者体质量、体质量指数、腰围及体脂百分比等体成分和空腹血糖、糖化血红蛋白及胰岛素抵抗指数等糖代谢指标无显著差异;②当训练周期≥12周、训练频率≤3次/周时,MICT对体质量以及体质量指数的改善效果具有一定优势。

累积空腹血糖水平与冠状动脉钙化的关联

目的:探讨累积空腹血糖水平与冠状动脉钙化(CAC)的关联。方法:选取来自北京社区动脉粥样硬化队列的1 113例研究对象,所有研究对象分别于1998年、2008~2009年、2013~2014年进行人体测量和血糖等生化指标检测,并于2013~2014年进行冠状动脉CT检查。根据累积空腹血糖水平(至少两次空腹血糖的10年加权累积水平)将研究对象分为四组:<50.0 mmol/L组(n=495)、50.0~55.9 mmol/L组(n=345)、56.0~69.9 mmol/L组(n=176)及≥70.0 mmol/L组(n=97)。CAC评分>0分定义为存在CAC。应用Logistic回归模型分析累积空腹血糖水平对CAC的影响,并根据性别、年龄等进行亚组分析。结果:1 113例研究对象的平均年龄为(59.7±6.4)岁,其中男性523例(47.0%),478例(42.9%)存在CAC。随着累积空腹血糖水平升高,CAC比例逐渐增加。多因素Logistic回归分析显示,与累积空腹血糖水平<50.0 mmol/L组相比,50.0~55.9 mmol/L组、56.0~69.9 mmol/L组及≥70.0 mmol/L组研究对象存在CAC的OR (95%CI)分别为1.43 (1.04~1.98)、1.92(1.24~2.99)和2.79(1.35~5.77)(Ptrend<0.05)。累积空腹血糖水平每升高10 mmol/L,CAC风险增加34%(OR=1.34,95%CI:1.12~1.59,P<0.05)。在各亚组中,累积空腹血糖水平每升高10 mmol/L的CAC风险差异无统计学意义(P均≥0.05)。结论:累积空腹血糖水平升高是CAC的危险因素,提示长期维持健康血糖水平的重要性。

糖调节受损与ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术中慢血流或无复流的关系

目的 探讨糖调节受损(IGR)与ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术中慢血流或无复流(SF/NRF)的关系。方法 回顾性收集本院2021年10月—2022年10月收治的80例有SF/NRF的STEMI患者及84例无SF/NRF的STEMI患者的临床资料,包括空腹血糖、总胆固醇(TC)、甘油三酯(TG)、心肌肌钙蛋白Ⅰ(cTnⅠ)、纤维蛋白原、左心室射血分数(LVEF)、D-二聚体、尿酸、同型半胱氨酸、中性粒细胞绝对值与淋巴细胞绝对值比值(NLR)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)以及餐后2 h血糖水平。采用Logistic回归模型分析影响STEMI患者PCI术中SF/NRF发生的影响因素;采用受试者工作特征(ROC)曲线分析空腹血糖、餐后2 h血糖水平对STEMI患者PCI术中SF/NRF的诊断价值。结果 与非SF/NRF组相比,SF/NRF组cTnⅠ、纤维蛋白原、HDL-C水平升高,收缩压(SBP)、舒张压(DBP)、NLR水平降低,差异有统计学意义(P<0.05)。与非SF/NRF组相比,SF/NRF组支架直径、支架长度、胸痛至导管室时间更长,差异有统计学意义(P<0.05)。SF/NRF组空腹血糖、餐后2 h血糖水平高于非SF/NRF组,差异有统计学意义(P<0.05)。Logistic回归分析显示,空腹血糖、餐后2 h血糖水平是STEMI患者PCI术中SF/NRF发生的影响因素,且二者联合诊断STEMI患者PCI术中SF/NRF的曲线下面积(AUC)高于空腹血糖、餐后2 h血糖水平单独诊断的AUC(Z=3.272、4.369,P均<0.001)。结论 IGR与STEMI患者PCI术中SF/NRF有关,空腹血糖、餐后2 h血糖水平是STEMI患者SF/NRF发生的影响因素。