目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=...目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=28)、良好组(n=90),比较两组基线资料、治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW水平,应用Spearman及偏相关性分析治疗前、治疗后7 d FFA、HOMAIR/PAB、RDW与mRS评分关系,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW预测病情转归的价值。结果不良组入院时NIHSS评分与良好组比较,差异有统计学意义(P<0.05);不良组治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW均高于良好组(P<0.05);治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW与mRS评分呈正相关(P<0.05);将入院时NIHSS评分控制后,治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW仍与mRS评分相关(P<0.05);治疗7 d后FFA、HOMA-IR/PAB、RDW及联合预测病情转归不良的AUC依次为0.868、0.867、0.881、0.920,均大于治疗前对应指标的AUC。结论ACI病情不良转归患者FFA、HOMA-IR/PAB、RDW升高,均与病情转归有关,联合检测有望成为预测患者病情转归的标志物,为临床提供准确、客观、量化的参考信息。展开更多
Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal env...Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.展开更多
<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a...<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), median (IQR);p < 0.001]. Conclusions: GDM is associated with both insulin resistance and inadequate insulin secretion.展开更多
文摘目的探讨游离脂肪酸(FFA)、胰岛素抵抗指数与前清蛋白比值(HOMA-IR/PAB)、红细胞分布宽度(RDW)预测急性脑梗死(ACI)患者病情转归的价值。方法选取2019年4月—2021年1月西安市第三医院收治的118例ACI患者,根据30 d病情转归分为不良组(n=28)、良好组(n=90),比较两组基线资料、治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW水平,应用Spearman及偏相关性分析治疗前、治疗后7 d FFA、HOMAIR/PAB、RDW与mRS评分关系,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW预测病情转归的价值。结果不良组入院时NIHSS评分与良好组比较,差异有统计学意义(P<0.05);不良组治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW均高于良好组(P<0.05);治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW与mRS评分呈正相关(P<0.05);将入院时NIHSS评分控制后,治疗前、治疗后7 d FFA、HOMA-IR/PAB、RDW仍与mRS评分相关(P<0.05);治疗7 d后FFA、HOMA-IR/PAB、RDW及联合预测病情转归不良的AUC依次为0.868、0.867、0.881、0.920,均大于治疗前对应指标的AUC。结论ACI病情不良转归患者FFA、HOMA-IR/PAB、RDW升高,均与病情转归有关,联合检测有望成为预测患者病情转归的标志物,为临床提供准确、客观、量化的参考信息。
文摘Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.
文摘<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), median (IQR);p < 0.001]. Conclusions: GDM is associated with both insulin resistance and inadequate insulin secretion.
