BACKGROUND The prevalence of glucolipid metabolic disorders(GLMDs)in children and adolescents has a recognized association with cardiovascular diseases and type 2 diabetes mellitus in adulthood.Therefore,it is importa...BACKGROUND The prevalence of glucolipid metabolic disorders(GLMDs)in children and adolescents has a recognized association with cardiovascular diseases and type 2 diabetes mellitus in adulthood.Therefore,it is important to enhance our understanding of the risk factors for GLMD in childhood and adolescence.AIM To explore the relationship between quality of life(QoL)and adolescent GLMD.METHODS This study included 1956 samples in 2019 from a cohort study established in 2014.The QoL scale and glycolipid indexes were collected during follow-up;other covariates of perinatal factors,physical measures,and socioeconomic indicators were collected and adjusted.A generalized linear regression model and logistic regression model were used to analyse the correlation between QoL and GLMD.RESULTS Higher scores of QoL activity opportunity,learning ability and attitude,attitude towards doing homework,and living convenience domains correlated negatively with insulin and homeostasis model assessment insulin resistance(IR)levels.Psychosocial factors,QoL satisfaction factors,and total QoL scores had significant protective effects on insulin and IR levels.Activity opportunity,learning ability and attitude,attitude towards doing homework domains of QoL,psychosocial factor,and total score of QoL correlated positively with high density lipoprotein.In addition,the attitude towards doing homework domain was a protective factor for dyslipidaemia,IR>3,and increased fasting blood glucose;four factors,QoL and total QoL score correlated significantly negatively with IR>3.In subgroup analyses of sex,more domains of QoL correlated with insulin and triglyceride levels,dyslipidaemia,and IR>3 in females.Poor QoL was associated with an increased prevalence of GLMD,and the effect was more pronounced in males than in females.Measures to improve the QoL of adolescents are essential to reduce rates of GLMD.CONCLUSION Our study revealed that QoL scores mainly correlate negatively with the prevalence of GLMD in adolescents of the healthy population.The independent relationship between QoL and GLMD can be illustrated by adjusting for multiple covariates that may be associated with glycaemic index.In addition,among females,more QoL domains are associated with glycaemic index.展开更多
Hepatitis C virus (HCV) infection disrupts the normal metabolism processes, but is also influenced by several of the host’s metabolic factors. An obvious and significantly detrimental pathophysiological fe...Hepatitis C virus (HCV) infection disrupts the normal metabolism processes, but is also influenced by several of the host’s metabolic factors. An obvious and significantly detrimental pathophysiological feature of HCV infection is insulin resistance in hepatic and peripheral tissues. Substantial research efforts have been put forth recently to elucidate the molecular mechanism of HCV-induced insulin resistance, and several cytokines, such as tumor necrosis factor-α, have been identified as important contributors to the development of insulin resistance in the distant peripheral tissues of HCV-infected patients and animal models. The demonstrated etiologies of HCV-induced whole-body insulin resistance include oxidative stress, lipid metabolism abnormalities, hepatic steatosis and iron overload. In addition, myriad effects of this condition have been characterized, including glucose intolerance, resistance to antiviral therapy, progression of hepatic fibrosis, development of hepatocellular carcinoma, and general decrease in quality of life. Metabolic-related conditions and disorders, such as visceral obesity and diabetes mellitus, have been shown to synergistically enhance HCV-induced metabolic disturbance, and are associated with worse prognosis. Yet, the molecular interactions between HCV-induced metabolic disturbance and host-associated metabolic factors remain largely unknown. The diet and lifestyle recommendations for chronic hepatitis C are basically the same as those for obesity, diabetes, and metabolic syndrome. Specifically, patients are suggested to restrict their dietary iron intake, abstain from alcohol and tobacco, and increase their intake of green tea and coffee (to attain the beneficial effects of caffeine and polyphenols). While successful clinical management of HCV-infected patients with metabolic disorders has also been achieved with some anti-diabetic (i.e., metformin) and anti-lipid (i.e., statins) medications, it is recommended that sulfonylurea and insulin be avoided.展开更多
目的:观察消渴调脂方联合辛伐他汀治疗糖尿病伴脂代谢异常的临床疗效并探讨其作用机制。方法:选取150例糖尿病伴脂代谢异常患者进行前瞻性研究,按随机数表法分为观察组与对照组75例。两组均接受糖尿病基础治疗,对照组口服辛伐他汀片,观...目的:观察消渴调脂方联合辛伐他汀治疗糖尿病伴脂代谢异常的临床疗效并探讨其作用机制。方法:选取150例糖尿病伴脂代谢异常患者进行前瞻性研究,按随机数表法分为观察组与对照组75例。两组均接受糖尿病基础治疗,对照组口服辛伐他汀片,观察组在对照组基础上联合消渴调脂方,两组均连服治疗3个月评定疗效,治疗前后检测空腹血糖(FPG)和餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(IR)、血脂(TC、TG、LDL-C)、超敏C反应蛋白(hs-CRP)及血清内脂素(Visfatin)、肿瘤坏死因子(TNF-α)。结果:对照组总有效率为54.7%,观察组总有效率为85.3%,观察组明显高于对照组,差异具有统计学意义(P<0.05);治疗后两组血糖、血脂和胰岛素指标均明显改善,与治疗前比较差异明显(P<0.05),两组间比较差异无明显差异;两组IR、hs-CRP及血清Visfatin、TNF-α水平治疗后均有所下降,两组治疗后比较差异明显(P<0.05)。结论:消渴调脂方可提高辛伐他汀对糖尿病伴脂代谢异常的疗效,减轻胰岛素抵抗,降低心血管事件发生风险。展开更多
基金Supported by Intelligent Medicine Research Project of Chongqing Medical University,No.ZHYX202109The Major Health Project of Chongqing Science and Technology Bureau,No.CSTC2021jscx-gksb-N0001+3 种基金Research and Innovation Team of Chongqing Medical University,No.W0088Joint Medical Research Project of Chongqing Municipal Health Commission and Chongqing Science and Technology Bureau,No.2020MSXM062National Key Research and Development Project of the Ministry of Science and Technology of the People's Republic of China,No.2017YFC0211705Young Scientists Fund Program of the National Natural Science Foundation of China,No.81502826.
文摘BACKGROUND The prevalence of glucolipid metabolic disorders(GLMDs)in children and adolescents has a recognized association with cardiovascular diseases and type 2 diabetes mellitus in adulthood.Therefore,it is important to enhance our understanding of the risk factors for GLMD in childhood and adolescence.AIM To explore the relationship between quality of life(QoL)and adolescent GLMD.METHODS This study included 1956 samples in 2019 from a cohort study established in 2014.The QoL scale and glycolipid indexes were collected during follow-up;other covariates of perinatal factors,physical measures,and socioeconomic indicators were collected and adjusted.A generalized linear regression model and logistic regression model were used to analyse the correlation between QoL and GLMD.RESULTS Higher scores of QoL activity opportunity,learning ability and attitude,attitude towards doing homework,and living convenience domains correlated negatively with insulin and homeostasis model assessment insulin resistance(IR)levels.Psychosocial factors,QoL satisfaction factors,and total QoL scores had significant protective effects on insulin and IR levels.Activity opportunity,learning ability and attitude,attitude towards doing homework domains of QoL,psychosocial factor,and total score of QoL correlated positively with high density lipoprotein.In addition,the attitude towards doing homework domain was a protective factor for dyslipidaemia,IR>3,and increased fasting blood glucose;four factors,QoL and total QoL score correlated significantly negatively with IR>3.In subgroup analyses of sex,more domains of QoL correlated with insulin and triglyceride levels,dyslipidaemia,and IR>3 in females.Poor QoL was associated with an increased prevalence of GLMD,and the effect was more pronounced in males than in females.Measures to improve the QoL of adolescents are essential to reduce rates of GLMD.CONCLUSION Our study revealed that QoL scores mainly correlate negatively with the prevalence of GLMD in adolescents of the healthy population.The independent relationship between QoL and GLMD can be illustrated by adjusting for multiple covariates that may be associated with glycaemic index.In addition,among females,more QoL domains are associated with glycaemic index.
文摘Hepatitis C virus (HCV) infection disrupts the normal metabolism processes, but is also influenced by several of the host’s metabolic factors. An obvious and significantly detrimental pathophysiological feature of HCV infection is insulin resistance in hepatic and peripheral tissues. Substantial research efforts have been put forth recently to elucidate the molecular mechanism of HCV-induced insulin resistance, and several cytokines, such as tumor necrosis factor-α, have been identified as important contributors to the development of insulin resistance in the distant peripheral tissues of HCV-infected patients and animal models. The demonstrated etiologies of HCV-induced whole-body insulin resistance include oxidative stress, lipid metabolism abnormalities, hepatic steatosis and iron overload. In addition, myriad effects of this condition have been characterized, including glucose intolerance, resistance to antiviral therapy, progression of hepatic fibrosis, development of hepatocellular carcinoma, and general decrease in quality of life. Metabolic-related conditions and disorders, such as visceral obesity and diabetes mellitus, have been shown to synergistically enhance HCV-induced metabolic disturbance, and are associated with worse prognosis. Yet, the molecular interactions between HCV-induced metabolic disturbance and host-associated metabolic factors remain largely unknown. The diet and lifestyle recommendations for chronic hepatitis C are basically the same as those for obesity, diabetes, and metabolic syndrome. Specifically, patients are suggested to restrict their dietary iron intake, abstain from alcohol and tobacco, and increase their intake of green tea and coffee (to attain the beneficial effects of caffeine and polyphenols). While successful clinical management of HCV-infected patients with metabolic disorders has also been achieved with some anti-diabetic (i.e., metformin) and anti-lipid (i.e., statins) medications, it is recommended that sulfonylurea and insulin be avoided.
文摘目的 分析存在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与右向左分流(right-to-left shunt,RLS)的急性脑梗死的临床特点。方法 收集2020年7月—2022年11月就诊于福建医科大学附属厦门弘爱医院神经内科的急性脑梗死患者,已完善多导睡眠监测(polysomnography monitoring,PSG)及经颅多普勒超声发泡试验(contrast transcranial Doppler,cTCD)检查。将其分为观察组(OSAHS及RLS均阳性)、对照组(OSAHS及RLS均阴性)。对照两组患者的基本信息、一般临床资料、血液学检验[包括总胆固醇(total cholesterol,TCHO)、三酰甘油(triglyceridetriacyl glyceroltag,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、尿酸、D-二聚体]、是否为醒后卒中、Org10172试验(trial of org 10172 in acute stroke treatment,TOAST)分型病灶分布(前循环/后循环/前后循环)、责任动脉(大动脉/小动脉)等,比较上述指标在观察组与对照组之间的差异。结果 入组患者43例,其中观察组23例,对照组20例,观察组年龄、高血压患病率、TG均明显高于对照组;后循环病灶占比、醒后卒中比例观察组均明显高于对照组(P <0.05)。两组性别、吸烟饮酒史、糖尿病病史、冠心病病史、尿酸、D-二聚体、TOAST分型、颅外责任动脉、颅内累及动脉的大小、病灶同时累及前后循环、洼田饮水试验分级、格拉斯哥昏迷量表评分(Glasgow coma scale,GCS)、出入院美国国立卫生研究院中风量表(National Institute of Health stroke scale,NIHSS)等比较,差异均无统计学意义(P> 0.05)。结论 合并OSAHS与RLS的急性脑梗死患者中高血压更多,更易发生醒后卒中,后循环病灶更为多见。
文摘目的:观察消渴调脂方联合辛伐他汀治疗糖尿病伴脂代谢异常的临床疗效并探讨其作用机制。方法:选取150例糖尿病伴脂代谢异常患者进行前瞻性研究,按随机数表法分为观察组与对照组75例。两组均接受糖尿病基础治疗,对照组口服辛伐他汀片,观察组在对照组基础上联合消渴调脂方,两组均连服治疗3个月评定疗效,治疗前后检测空腹血糖(FPG)和餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(IR)、血脂(TC、TG、LDL-C)、超敏C反应蛋白(hs-CRP)及血清内脂素(Visfatin)、肿瘤坏死因子(TNF-α)。结果:对照组总有效率为54.7%,观察组总有效率为85.3%,观察组明显高于对照组,差异具有统计学意义(P<0.05);治疗后两组血糖、血脂和胰岛素指标均明显改善,与治疗前比较差异明显(P<0.05),两组间比较差异无明显差异;两组IR、hs-CRP及血清Visfatin、TNF-α水平治疗后均有所下降,两组治疗后比较差异明显(P<0.05)。结论:消渴调脂方可提高辛伐他汀对糖尿病伴脂代谢异常的疗效,减轻胰岛素抵抗,降低心血管事件发生风险。
