<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the...<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>展开更多
OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate ...OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.展开更多
目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月...目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。展开更多
目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察...目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。展开更多
目的:探究度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病患者糖脂代谢紊乱的影响。方法:采用随机数字表法将84例2021年1月—2023年1月来单县中心医院内分泌科就诊的老年糖尿病患者分为对照组(42例)和试验组(42例),两组均予...目的:探究度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病患者糖脂代谢紊乱的影响。方法:采用随机数字表法将84例2021年1月—2023年1月来单县中心医院内分泌科就诊的老年糖尿病患者分为对照组(42例)和试验组(42例),两组均予以常规药物治疗,在此基础上,对照组予以低碳水化合物早餐饮食疗法治疗,试验组则在对照组治疗基础上加用度拉糖肽注射液治疗,疗程均为3个月,对比两组治疗前后糖代谢水平、血脂指标水平、体重指数(BMI)、胰岛素水平。结果:经治疗后,两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)均较于治疗前明显下降,且试验组均低于对照组(P<0.05);试验组低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)均比对照组低(P<0.05),而高密度脂蛋白胆固醇(HDL-C)比对照组高(P<0.05);试验组BMI、空腹胰岛素(FINS)、餐后2 h胰岛素均低于对照组(P<0.05)。结论:采用度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病治疗具有较好的效果,能够有效改善糖脂代谢异常和胰岛素功能,降低血糖与体质量。展开更多
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>
文摘OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.
文摘目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。
文摘目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。
文摘目的:探究度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病患者糖脂代谢紊乱的影响。方法:采用随机数字表法将84例2021年1月—2023年1月来单县中心医院内分泌科就诊的老年糖尿病患者分为对照组(42例)和试验组(42例),两组均予以常规药物治疗,在此基础上,对照组予以低碳水化合物早餐饮食疗法治疗,试验组则在对照组治疗基础上加用度拉糖肽注射液治疗,疗程均为3个月,对比两组治疗前后糖代谢水平、血脂指标水平、体重指数(BMI)、胰岛素水平。结果:经治疗后,两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)均较于治疗前明显下降,且试验组均低于对照组(P<0.05);试验组低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)均比对照组低(P<0.05),而高密度脂蛋白胆固醇(HDL-C)比对照组高(P<0.05);试验组BMI、空腹胰岛素(FINS)、餐后2 h胰岛素均低于对照组(P<0.05)。结论:采用度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病治疗具有较好的效果,能够有效改善糖脂代谢异常和胰岛素功能,降低血糖与体质量。
