The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

Microbiome and metabolome dysbiosis analysis in impaired glucose tolerance for the prediction of progression to diabetes mellitus

Gut microbiota and circulating metabolite dysbiosis predate important pathological changes in glucose metabolic disorders;however,comprehensive studies on impaired glucose tolerance(IGT),a diabetes mellitus(DM)precursor,are lacking.Here,we perform metagenomic sequencing and metabolomics on 47 pairs of individuals with IGT and newly diagnosed DM and 46 controls with normal glucose tolerance(NGT);patients with IGT are followed up after 4 years for progression to DM.Analysis of baseline data reveals significant differences in gut microbiota and serum metabolites among the IGT,DM,and NGT groups.In addition,13 types of gut microbiota and 17 types of circulating metabolites showed significant differences at baseline before IGT progressed to DM,including higher levels of Eggerthella unclassified,Coprobacillus unclassified,Clostridium ramosum,L-valine,L-norleucine,and L-isoleucine,and lower levels of Eubacterium eligens,Bacteroides faecis,Lachnospiraceae bacterium 3_1_46FAA,Alistipes senegalensis,Megaspaera elsdenii,Clostridium perfringens,α-linolenic acid,10E,12Z-octadecadienoic acid,and dodecanoic acid.A random forest model based on differential intestinal microbiota and circulating metabolites can predict the progression from IGT to DM(AUC=0.87).These results suggest that microbiome and metabolome dysbiosis occur in individuals with IGT and have important predictive values and potential for intervention in preventing IGT from progressing to DM.

Comparison of Serum Lipid Profile between Gestational Diabetes Mellitus and Pregnant Women with Normal Glucose Tolerance

Background: Aberrant lipid metabolism presumed to have important relationship with gestational diabetes mellitus (GDM), though previous studies revealed inconsistent results on this area. Objectives: To identify the difference of serum lipid profile between gestational diabetes mellitus (GDM) and pregnant woman with normal glucose tolerance (NGT). Methods: This cross sectional study was conducted from January 2017 to December 2017 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with 31 GDM and equal number of NGT pregnant women diagnosed on the basis of WHO criteria-2013, during 24 - 40 weeks of gestation. Glucose was measured by glucose oxidase method and fasting serum lipid profile [Total cholesterol (TC), High Density Lipoprotein-cholesterol (HDL-C) and Triglyceride (TG)] was measured by enzymatic-colorimetric method. Data were analyzed and compared by statistical tests. Results: Among total sixty-two (62) study subjects, 31 were GDM (age: 27.52 ± 4.8 years, body mass index (BMI): 27.17 ± 3.3 kg/m2) and 31 were pregnant women with NGT (age: 24.94 ± 4.2 years, BMI: 25.43 ± 6.5 kg/m2). Mean age of GDM group was significantly higher than that of NGT group (p = 0.028). Women with GDM showed relatively higher BMI than NGT women but that was not statistically significant (p = 0.194). Fasting lipid profiles between GDM and NGT (GDM vs. NGT;total cholesterol: 194.21 ± 42.18 vs. 208.52 ± 42.18 mg/dl, p = 0.187;HDL-C: 47.50 ± 16.17 vs. 47.18 ± 11.71 mg/dl, p = 0.928;LDL-C: 109.25 ± 28.80 vs. 119.30 ± 34.76 mg/dl, p = 0.220 and triglyceride 204.78 ± 58.50 vs. 202.34 ± 79.18 mg/dl, p = 0.891) were not significantly different. The variations in all lipid fraction values were not statistically significant among GDM women when analyzed between BMI groups holding BMI cut-off at 23 kg/m2. No significant differences of any values of lipid profile were found in GDM women according to various age categories (Age < 25 years vs. ≥25 years). Conclusions: Lipid profile does not differ between women with GDM and pregnant woman with NGT.

Oral glucose tolerance test in diabetes,the old method revisited

The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.

Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes:Towards personalized care

BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.

Scleredema Diabeticorum in a Patient with the Normal Range of the Hemoglobin A1c Level and Impaired Glucose Tolerance

Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.

Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis

AIM: To determine if subclinical abnormal glucose tolerance (SAGT) has influence on survival of non-diabetic patients with liver cirrhosis.

Study on the correlation and predictive value of serum pregnancyassociated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Prevalences of Diabetes and Hypertension and Their Relationship in Community Population of Jiangsu Province

To determine the prevalences of non-insulin-dependent-diabetes mellitus (NIDDM),impaired glucose tolerance (IGT) and hypertension on urban and rural communities of Jiangsu province,8734 subjects sampled from six areas of Jiangsu were investigated. Blood glucose of 2 h after oral administration of 75 g glucose (2 h BG) was measured. WHO criteria were used for the diagnosis of NIDDMand IGT. Meanwhile epidemiological data were collected. Blood pressure, height, weight, waist and hip girths were measured. The crude prevalence was found to be 5. 82% (men 4.62%,woman 6. 69%) for NIDDM, 5. 87% (men 5. 30%, women 6. 29% ) for IGT and 14. 72% (men 16. 50%, women 13. 43 % ) for hypertension in the population obove 20 years of age. Age-adjusted prevalence was 4. 63% for NIDDM, 5. 07 % for IGT and 11. 19% for hypertension. Age increase (>40 years), obesity (BMI≥27) and central fat distribution (WHR≥0.88) were the risk factors for both diabetes and hypertension. The subjects≥40 years of age and obesity were the high risk population of NIDDM, IGT and hypertension. They were the target population for theprevention and treatment of diabetes and hypertension in the community level. High prevalences of NIDDM,IGT and hypertension were observed in the community population in Jiangsu province. To reinforce the prevention and treatment of these disorders in the province is imperative.

Insulin Sensitivity and Insulin Secretion Estimated by Homeostatic Model Assessment (HOMA) in Gestational Diabetes Mellitus

Background: 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. Aims: To determine indices of insulin resistance (IR) and β-cell function in gestational diabetes mellitus (GDM). Methods: 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), β-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. Results: 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 β-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.

Protective effect of modified Yu-Ye decoction on type 2 diabetes mellitus rats

Background:Yu-Ye decoction is a classic prescription therapy that is widely used in the treatment of type 2 diabetes mellitus(T2DM).In this study,we evaluate and exhibit the protective effect of modified Yu-Ye decoction on T2DM rats.Methods:Sixty rats with T2DM were included in this study that was induced by high-fat high-glucose diet for 6 weeks.following 6 weeks later,1%streptozotocin 30 mg/kg was injected intraperitoneally,and the T2DM rats were randomly divided into the model group,the metformin(90 mg/kg)positive control group,and the modified Yu-Ye decoction(6.4 g/kg,12.7 g/kg,25.4 g/kg)group.In contrast,standard chow was provided to the 10 rats in the control group.The drug was administered for four weeks,and fasting blood glucose was monitored.After four weeks of treatment,oral glucose tolerance test experiments were carried out.Serum was collected for the detection of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,high density lipoprotein,and total cholesterol,triglyceride.Hematoxylin-eosin staining was used to assess potential pathological changes in the liver,kidneys,and pancreas.Results:Results from fasting blood glucose monitoring and oral glucose tolerance test showed that modified Yu-Ye decoction could significantly improve the blood glucose concentration and insulin resistance,compared to the model group.In addition,modified Yu-Ye decoction could significantly reduce the serum levels of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,total cholesterol,triglyceride,and increase the level of high density lipoprotein.At the same time,hematoxylin-eosin results exhibited that modified Yu-Ye decoction could increase the number of islet cells,reduce the volume of islet cells,improve liver edema and inflammation,and improve renal glomerular hypertrophy.Conclusion:This study shows that modified Yu-Ye decoction ameliorates T2DM because it can reduce fasting blood glucose concentration,improve glucose tolerance,protect liver and kidney function,and improve livers,kidneys,and pancreas tissue morphology.

孕中期GDM患者血清Afamin和SFRP5水平及临床价值分析

目的分析孕中期妊娠期糖尿病(GDM)患者血清α清蛋白(Afamin)和分泌型卷曲相关蛋白5(SFRP5)水平及临床价值。方法选取2019年8月至2021年8月河北省秦皇岛市海港医院120例定期产检并分娩的孕妇为研究对象,其中GDM孕妇50例为GDM组,非GDM孕妇70例为对照组。采用酶联免疫吸附试验(ELISA)检测两组血清Afamin和SFRP5水平;采用口服葡萄糖耐量试验(OGTT)检测OGTT 1 h血糖(1 h PG)、OGTT 2 h血糖(2 h PG);检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FINS)水平;分析Afamin、SFRP5与糖代谢指标之间的相关性;采用受试者工作特征(ROC)曲线评估Afamin、SFRP5单独及联合检测对GDM的诊断价值;分析不同Afamin、SFRP5水平孕妇不良妊娠结局发生情况。结果GDM组FPG、1 h PG、2 h PG、HbA1c和FINS水平明显高于对照组,差异有统计学意义(P<0.05);GDM组Afamin水平明显高于对照组,SFRP5水平明显低于对照组,差异有统计学意义(P<0.05);Afamin水平与FPG、1 h PG、2 h PG、HbA1c和FINS水平呈正相关(P<0.05);SFRP5水平与FPG、1 h PG、2 h PG、HbA1c和FINS水平呈负相关(P<0.05);ROC曲线分析结果显示,血清Afamin和SFRP5单独及联合检测诊断GDM的曲线下面积(AUC)分别为0.747、0.642、0.872,且联合检测的灵敏度为89.3%,特异度为77.9%,联合检测的AUC明显大于单独检测的AUC,差异有统计学意义(P<0.05)。以所有孕妇的Afamin、SFRP5水平均值为界,分为高Afamin组、低Afamin组,以及高SFRP5组、低SFRP5组,高Afamin组母婴不良妊娠结局发生率高于低Af amin组,低SFRP5组母婴不良妊娠结局发生率高于高SFRP5组,差异有统计学意义(P<0.05)。结论Afamin和SFRP5作为诊断GDM的生物标志物具有良好的效能,在临床上可以预测GDM的发展趋势和不良妊娠结局的风险。

妊娠期糖尿病患者血糖水平异常对母婴结局的影响

目的探讨孕期血糖异常变化与妊娠期糖尿病(GDM)患者出现妊娠期高血压(HDP)及妊娠结局的关系。方法通过75 g口服葡萄糖耐量试验来观察孕产妇的特征;血糖升高引起的不良妊娠结局及新生儿的结果;空腹血糖水平和餐后血糖水平、药物干预治疗与巨大儿(LGA)和妊娠期HDP之间的关系。结果305例GDM孕妇中,159例孕妇(52.13%)空腹血糖(FPG)升高,146例(47.87%)餐后1 h和2 h血糖升高。在FPG升高的GDM孕妇中LGA和HDP分别占24.50%和14.50%;在餐后血糖水平升高的GDM孕妇中LGA和HDP分别占9.60%和6.20%。患有GDM的孕妇中,包含空腹血糖升高的3个级别水平需要药物治疗的孕妇比其他级别水平血糖升高的孕妇多,差异有统计学意义(P<0.05)。FPG升高对GDM孕妇HDP和LGA有更高的风险,差异有统计学意义(P<0.01)。药物治疗GDM孕妇,LGA的风险更大,差异有统计学意义(P<0.05)。结论GDM孕妇的FPG升高比餐后血糖升高更能预测LGA和高血压妊娠结局。

子痫风险预测联合脐动脉S/D比值对妊娠期糖尿病患者妊娠结局的预测价值

目的探讨子痫风险预测联合脐动脉收缩期峰值流速与舒张末期流速(peak systolic velocity/end diastolic velocity,S/D)比值对妊娠期糖尿病患者妊娠结局的预测价值。方法选取2021年1月至2023年1月笔者医院产科门诊收治的60例妊娠期糖尿病(gestational diabetes mellitus,GDM)患者作为妊娠糖尿病组;同一时间,选取笔者医院产科门诊孕检正常的健康孕妇30例作为对照组。采用磁微粒化学发光法检测血清胎盘生长因子(placental growth factor,PIGF),超声检测,S/D比值同时按照是否合并不良妊娠结局分为妊娠结局良好组及不良妊娠结局组,比较PIGF及S/D比值;采用受试者操作特征(receiver operating characteristic,ROC)曲线分析PIGF联合S/D比值对GDM患者妊娠结局的预测价值进行预测分析。结果与对照组比较,妊娠糖尿病组患者PIGF降低,S/D升高(P<0.05)。对照组不良妊娠结局的发生率为20.00%,妊娠糖尿病组不良妊娠结局的发生率为46.67%,与对照组比较,妊娠糖尿病组不良妊娠结局的发生率升高(P<0.05)。与妊娠结局良好组比较,不良妊娠结局组的GDM患者PIGF水平降低,S/D比值升高(P<0.05)。ROC曲线分析PIGF、S/D比值对GDM患者不良妊娠结局敏感度及特异性分析发现,S/D比值诊断效果高于PIGF,但联合更高。结论妊娠期糖尿病患者中PIGF水平降低,S/D比值增加,且与患者不良妊娠结局相关,PIGF联合S/D比值对患者不良妊娠结局的诊断效能最高。

化合物A34对糖尿病小鼠的降糖作用及机制探讨

为研究一种新型可溶性环氧化物水解酶(soluble epoxide hydrolase,sEH)抑制剂(A34)对糖尿病小鼠的降糖作用,探讨其作用机制,连续5天给小鼠腹腔注射链脲佐菌素(streptozotocin,STZ,50 mg/(kg·d)),诱导1型糖尿病(type 1 diabetes mellitus,T1DM)小鼠模型。通过饮水给药,考察A34对糖尿病小鼠饮水摄食量、非禁食血糖、空腹血糖、葡萄糖耐量和血浆胰岛素水平的影响,研究A34的降糖作用;通过研究胰岛中sEH表达水平、胰岛形态变化及血浆中细胞因子干扰素-γ(INF-γ)和白介素-4(IL-4)的含量,分析A34降糖的作用机制。结果表明:与模型组相比,A34有效改善了糖尿病小鼠多饮、多食症状及葡萄糖耐量情况(p<0.01),降低了空腹血糖和非禁食血糖(p<0.01),提高了血浆胰岛素水平(p<0.05);小鼠胰岛中sEH表达量降低(p<0.01),胰岛受损减轻,血浆中IFN-γ与IL-4含量比值降低(p<0.05)。A34可能通过调控促炎和抗炎细胞因子的动态平衡,保护胰岛β细胞免受损伤,从而改善小鼠胰岛β细胞功能,发挥降糖作用。

益生菌灌服/健康大鼠肠道微生物群移植对大鼠妊娠期糖尿病的治疗作用及其机制

目的观察益生菌灌服/健康大鼠肠道微生物群移植对大鼠妊娠期糖尿病(GDM)的治疗作用,探讨其作用机制。方法取70只SD雌性大鼠和35只SD雄性大鼠,2:1合笼交配交配成功后随机抽取10只雌鼠为对照组(记为第0天),其余60只雌鼠腹腔注射链脲佐菌素建立GDM大鼠模型,造模成功(大鼠随机血糖≥16.7 mmol/L)后将40只大鼠分为一、二、三、四组,每组各10只。第5天一组大鼠予359.708 mg/kg益生菌补充剂灌胃,二组大鼠予1 mL/100g的健康大鼠粪菌混悬液灌胃,三组大鼠给予359.708 mg/kg益生菌补充剂、1mL/100 g健康大鼠粪菌混悬液灌胃,四组与对照组大鼠予10 mL/kg的PBS缓冲液灌胃,各组大鼠每日灌胃1次,连续14天。第19天取各组大鼠,采用口服葡萄糖耐量试验测算血糖;第20天取各组大鼠,麻醉后留取结肠内容物及结肠组织,采用GC-2010气相色谱仪测算大鼠结肠内容物短链脂肪酸(乙酸、丙酸、丁酸及异丁酸)含量,分别采用RT-qPCR法Western Blotting法检测各组结肠组特异性G蛋白偶联游离脂肪酸受体(GPR43)、胰高血糖素样肽-1(GLP-1)的mRNA及蛋白。结果与对照组相比,第20天四组大鼠糖耐量低,结肠内容物乙酸、丁酸、异丁酸含量低,结肠组织GPR43 mRNA、GLP-1mRNA及蛋白相对表达量均低(P均<0.05)。与四组相比,一、二、三组大鼠糖耐量高,第20天时结肠组织GPR43 mRNA、GLP-1mRNA及蛋白相对表达量均高(P均<0.05)。结论益生菌灌服/健康大鼠肠道微生物群移植可改善大鼠GDM,益生菌灌服/健康大鼠肠道微生物群移植可能通过增加结肠内容物中SCFAs含量,提高结肠组织GPR43、GLP-1mRNA及蛋白表达,改善大鼠的GDM。

饮食干预对妊娠期糖尿病小鼠子代糖尿病易感性的影响

目的探究饮食干预对妊娠期糖尿病(GDM)小鼠子代糖尿病易感性的影响。方法选取72只3周龄健康雌性小鼠,并将其随机均分成GDM组和低脂(LF)组。GDM组以饲喂高脂(HF)饲料建立GDM小鼠模型,LF组则饲喂LF饲料。两组小鼠的子代在3周龄断奶后进行饮食干预,分别饲喂HF饲料和LF饲料,并分为GDM HF(G-HF)组、GDM LF(G-LF)组、LF HF(L-HF)组、LF LF(L-LF)组。干预后测其体重、空腹血糖(FBG),并进行胰岛素耐受性试验(ITT)。结果HF饮食诱导建立的GDM小鼠模型成模率为33.33%,此模型发病过程与人类患GDM的病理生理发展过程较为相似。饮食干预到6周时,G-HF组的体重高于其他三组,且L-HF组体重高于L-LF组(P<0.05);饮食干预到12周时,G-HF组体重高于其他三组(P<0.05)。饮食干预到6周时,G-HF组的FBG水平高于G-LF组、L-LF组,L-HF组的FBG水平高于L-LF组(P<0.05);饮食干预到12周时,G-HF组的FBG水平高于其他三组,L-HF组的FBG水平高于L-LF组(P<0.05)。7周龄时,L-LF组对胰岛素的敏感性要高于G-HF组。结论GDM子代有明显的糖代谢紊乱及体重增加,且LF饮食可降低GDM子代患糖尿病的风险。

疗养军事飞行人员糖代谢现状调查分析

目的 调查疗养军事飞行人员的血糖代谢现状,分析其糖代谢异常的发病特点,为飞行人员的糖尿病(diabetes mellitus,DM)航卫保障提供科学依据。方法 随机抽取2021-01/2023-09月于某中心疗养的军事飞行人员共2591例,行口服葡萄糖耐量试验,测定其空腹血糖(fasting plasma glucose,FPG)、餐后2 h血葡萄糖(2 h postprandial blood glucose,2 hPG)和糖化血红蛋白(glycosylated hemoglobin,HbA_(1)c),统计DM、糖尿病前期(pre-diabetes mellitus,PDM)的患病率,比较不同年龄段(年龄<30岁、30岁≤年龄<40岁、40岁≤年龄<50岁、年龄≥50岁)、不同飞行时间(飞行时间<1000 h、1000 h≤飞行时间<3000 h、3000≤飞行时间<5000 h、飞行时间≥5000 h)、不同勤务类别(空勤、战勤)、不同机种(歼击机、轰炸机、直升机、运输机、其他)飞行人员血糖代谢情况。结果 2591例军事飞行人员中,诊断为PDM 286例(11.04%),诊断为DM 49例(1.89%),血糖正常2256例(87.07%)。在286例PDM患者中,空腹血糖受损(impaired fasting glucose,IFG)、糖耐量减低(impaired glucose tolerance,IGT)、IFG合并IGT及单纯5.7%≤HbA_(1C)≤6.4%者的检出率分别为1.93%、2.82%、2.01%、4.28%。军事飞行人员DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平随年龄增大而增加(P均<0.01),随飞行时间增长而增加(P均<0.01),不同勤务类别、不同机种DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平差异均无统计学意义(P均>0.05)。结论 军事飞行人员血糖代谢问题突出,潜在DM患病风险高,飞行人员DM或PDM患病率及FPG、2hPG、HbA_(1C)水平随年龄及飞行时间增加而增加,而与勤务类别和机种关系不大,应加强飞行人员DM防控措施。

糖尿病前期和早期湿热证老年体检人群客观指标的相关性分析

目的探究老年湿热证体检人群糖尿病前期和早期的影响因素及糖代谢指标与其他代谢紊乱的客观指标的相关性。方法将纳入的325名研究对象分为对照组、糖尿病前期组和糖尿病早期组。记录研究对象的体质量、体质量指数(BMI)、腰围(WC)等一般临床资料并检测心率、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、血清尿酸(UA)、尿微量白蛋白/尿肌酐(UACR)等实验室检查指标的水平,统计分析糖代谢指标与各客观指标的相关性。结果Pearson和Spearman相关性分析的结果表明,WC、BMI、ALT、TG、HDL-C等客观指标与三组的HOMA指数的相关性有统计学意义(P<0.05)。在老年湿热证人群中,多元线性回归显示,糖尿病前期状态下,BMI对胰岛素抵抗水平(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)的影响最强;糖尿病早期时,BMI对HOMA-IR和胰岛素敏感性指数(HOMA-IS)的影响也很大,且心率、UACR、TG和HDL-C等与心血管、血脂和肝、肾功能相关的指标也与HOMA-β有统计学意义(P<0.05)的相关性。典型相关分析显示,糖尿病前期与肥胖指标关系最密切的是BMI,与血脂指标密切程度最高的是TG。发展到糖尿病早期,与肥胖、血脂和肝、肾功能指标关系最密切的分别为WC、HDL-C和UA。结论T2DM前期和早期老年湿热证人群的HOMA指数等糖代谢指标与BMI、TG、HDL-C、UACR等客观指标存在一定的相关性。