DIAGNOSTIC VALUE OF SERUM INSULIN- LIKE GROWTH FACTOR BINDING PROTEIN- 3 IN CHILDREN WITH OR WITHOUT GROWTH HORMONE DEFICIENCY

OBJECTIVE: To study the value of serum insulin-like growth factor binding protein-3 (IGFBP-3) levels in differential diagnosis of growth hormone deficiency (GHD). METHODS: To measure serum IGFBP-3 levels by RIA in normal children and adolescents, GHD children and short-stature children without GHD. RESULTS: Serum level of IGFBP-3 in 129 children with untreated GHD and with no pubertal development was 1.6 +/- 0.9 mg/L, which was less than that in normal group of the same age, but overlapped with the normal children in Tanner stage I. After six-month treatment with recombinant human growth hormone (rhGH), serum level of IGFBP-3 in 59 GHD significantly increased from 1.3 +/- 0.7 mg/L to 2.7 +/- 0.9 mg/L, accompanied by an increase of body heights, growth velocities and serum level of IGF-1. Serum level of IGFBP-3 in 55 short-stature children without GHD was 3.3 +/- 2.2 mg/L, which was not significantly different from that in normal group. CONCLUSION: Serum IGFBP-3 level can reflect the status of GH secretion in children with GHD and is a useful marker for differential diagnosis of GHD.

A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levels

AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.

The Relationship between Nigerian Bonnylight Crude Oil-Induced Hypoglycaemia and Endogenous Serum Insulin Concentration in Male Wistar Rats: The Role of Antioxidant Vitamins C and E

The relationship between Nigerian Bonny Light crude oil (NBLCO) induced hypoglycaemia and endogenous serum insulin concentration;the role of antioxidant vitamin C or E supplementation was the focus of this study. Forty adult male Wistar rats were randomly divided into group I, which served as the control, group II, which was oral gavaged 6 ml/kg of NBLCO, groups III and IV, which were in addition to 6 ml/kg of NBLCO supplemented with 9 ml/kg and 1 mg/kg of vitamin E or C, respectively for 28 days. Results showed that NBLCO significantly (p < 0.05) lower body weight and food intake compared with control. These effects exerted by NBLCO were however significantly (p < 0.05) reversed by vitamin E or C supplementation. The NBLCO significantly (p < 0.05) reduced fasting blood glucose (FBG) when compared with control, the antioxidant vitamins supplementation significantly (p < 0.05) reversed the crude oil effect. The mean serum insulin level in NBLCO, vitamin E or C supplemented groups is not significantly different from the control. There was no significant correlation between FBG and fasting serum insulin concentrations in all the groups on day 28. It has been demonstrated in this study that direct oral ingestion of crude oil (NBLCO) could reduce food intake, body weight and cause hypoglycemia;the hypoglycemia may not be a function of serum insulin concentration. Interestingly, the hazardous effects of NBLCO could be ameliorated with antioxidant vitamin C or E supplementation.

The effect of polymorphism in gene of insulin-like growth factor-Ⅰ on the serum periparturient concentration in Holstein dairy cows

Objective:To investigate the relationship between polymorphism within the 5'-untranslated region(5'-UTR)of IGF-I gene and its periparturient concentration in Iranian Holstein dairy cows.Methods:Blood samples(5 mL,n=37)were collected by caudal venipuncture from each animal into sample lubes containing the EDTA and DNA was extracted from blood.In order to measure ICF-I concentration the collection of blood samples(n=111)was also done at 14 d before calving(prepartum),25 and 45 d postpartum.Results:We found evidence for a significant effect of C to T mutation in position 512 of IGF-I gene on its serum concentration in dairy cows in Iran.Cows with CC genotype had significantly higher concentration(Mean-SD)of IGF-I at 14 d prepartum(91.8±18.1)μg/L compared to those with TT genotype(73.3±14.4)μg/L(P=0.04).A significant trend(quadratic)was found for IGF-I concentration,as higher in CC cows compared to ones with TT genotype,during the 14 d before calving to 45 d postpartum(P=0.01).Conclusions:We concluded that C/T transition in the promoter region of IGF-I gene can influence the serum concentration of ICF-I in periparturient dairy cows.

Effect of Insulin-Transferrin-Selenium on Goat Oocytes Maturation and Embryo Development

[Objective] The research aimed to enhance culture efficiencies of oocyte and embryo of goat in vitro and to explore serum-free culture system in vitro.[Method] At present,the conventional solutions of oocyte maturation and embryo development in vitro were always added into 1% ITS(Insulin-transferrin-selenium) or using 1% ITS to replace FBS in 2 kinds culture solutions for conducting in vitro cultures of goat oocyte and parthenogenetic embryo.The influences of ITS on their developments were detected.[Result] ITS in maturation liquid of oocytes could not increase oocytes maturation rate but significantly increased blastocyst rate (58.06% vs. 48.19%)of parthenogenetic embryo.If FBS in maturation liquid of oocytes was replaced by ITS, the maturation rate, cleavage rate and blastocyst rate were basically unchanged.Adding ITS into embryo medium could increase blastocyst rate (68.30% vs. 56.82%)of parthenogenetic embryo of goat.If FBS in embryo medium was replaced by ITS,the cleavage rate didn’t change basically,while the blastocyst rate in ITS was obviously lower than that in FBS group(42.33% vs.56.82%).[Conclusion] ITS could promote maturation of oocyte in vitro and early embryonic development, in addition,ITS could replace serum in maturation medium of oocyte as serum-free culture system for conducting relevant researches.

Elevated alanine aminotransferase activity is not associated with dyslipidemias,but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results.

EFFECT OF ACUPUNCTURE ON HYPERLEPTINAEMIA AND HYPERINSULINEMIA IN OBESITY RATS

Objective: To observe the effect of acupuncture on hyperleptinaemia and hyperinsulinemia for studying its underlying mechanism about anti-obesity and reducing blood lipid in obesity rats. Methods: A total of 80 SD rats were randomized into normal control, model, acupuncture and medication groups, with 20 cases in each group. Hypothalamic obesity model was established by subcutaneous injection of 15% sodium glutamate (0.2 mL/10 g body weight), once daily and continuously for 5 days. “Zusanli” (足三里 ST 36), “Sanyinjiao”(三阴交 SP 6), “Guanyuan”(关元 CV 4) and “Zhongwan”(中脘 CV 12) were punctured and stimulated electrically (100 Hz, dense-sparse waves, and a suitable strength inducing local muscular tremor) for 15 min, once daily. In medication group, rats were fed with Sibutramine 4 mg/kg, once daily. After 4 weeks’ treatment, Lee’s index was detected, and serum leptin and insulin contents were determined by radioimmunoassay (RIA). Results: Compared with normal control group, Lee’s index, serum leptin and insulin contents of model group increased significantly (P<0.01). Comparison between acupuncture and model groups, Lee’s index and serum leptin of acupuncture group decreased significantly (P<0.01), and serum insulin level also lowered. In comparison with model group, Lee’s index, serum leptin and insulin levels of medication group also lowered. Comparison between acupuncture and medication groups showed that Lee’s index and serum leptin level of acupuncture group were significantly lower than those of the later group (P<0.01), displaying that the therapeutic effect of acupuncture is better than that of Sibutramine in lowering Lee’s index and serum leptin. No significant differences were found between acupuncture and medication groups in body weight and length and serum insulin(P>0.05). Conclusion: Acupuncture can effectively reduce Lee’s index, serum leptin and insulin contents in fasting obese rats, which may contribute to its effect in anti-obesity.

Low serum amylase and obesity, diabetes and metabolic syndrome: A novel interpretation

For the last decade, low serum amylase(hypoamylasemia) has been reported in certain common cardiometabolic conditions such as obesity, diabetes(regardless of type), and metabolic syndrome, all of which appear to have a common etiology of insufficient insulin action due to insulin resistance and/or diminished insulin secretion. Some clinical studies have shown that salivary amylase may be preferentially decreased in obese individuals, whereas others have revealed that pancreatic amylase may be preferentially decreased in diabetic subjects with insulin dependence. Despite this accumulated evidence, the clinical relevance of serum, salivary, and pancreatic amylase and the underlying mechanisms have not been fully elucidated. In recent years, copy number variations(CNVs) in the salivary amylase gene(AMY1), which range more broadly than the pancreatic amylase gene(AMY2A and AMY2B), have been shown to be well correlated with salivary and serum amylase levels. In addition, low CNV of AMY1, indicating low salivary amylase, was associated with insulin resistance, obesity, low taste perception/satiety, and postprandial hyperglycemia through impaired insulin secretion at early cephalic phase. In most populations, insulin-dependent diabetes is less prevalent(minor contribution) compared with insulin-independent diabetes, and obesity is highly prevalent compared with low body weight. Therefore, obesity as a condition that elicits cardiometabolic diseases relating to insulin resistance(major contribution) may be a common determinant for low serum amylase in a general population. In this review, the novel interpretation of low serum, salivary, and pancreas amylase is discussed in terms of major contributions of obesity, diabetes, and metabolic syndrome.

镁补充改善糖尿病患者血清胰岛素水平的Meta分析

系统评价口服镁补充改善糖尿病患者血清胰岛素水平的效果。采用计算机检索PubMed、EBSCO、The Cochrane Library、CNKI、Web of Science数据库,搜集口服镁补充改善糖尿病患者血清胰岛素水平的相关研究,独立筛查文献、提取资料并评价纳入研究的偏倚风险后采用R studio软件进行Meta分析。亚组分析结果显示,口服镁补充在镁缺乏糖尿病患者中[SMD=-0.29,95%CI(-1.07,0.48),P>0.01]、4~6周补充周期[SMD=-0.74(-1.69,0.20),P>0.01]、250~300 mg/d剂量[SMD=-63(-1.25,0),P<0.01]改善血清胰岛素水平效果更佳,说明口服镁补充对于改善糖尿病患者血清胰岛素水平具有良好的效果。

营养干预对生长迟缓患儿血清IGF-1水平的影响探讨

目的 对本院收治的营养干预对生长迟缓患儿血清IGF-1水平的影响进行分析,为生长迟缓患儿营养干预措施的制定与优化提供依据。方法 以本院2021年4月-2022年4月期间就诊的40例0~3岁生长迟缓患儿作为观察组,同时选取40例0~3岁的正常儿童作为对照组。对观察组患儿进行营养干预,测定干预前后观察组患儿血清IGF-1水平相关生长指标,以对照组为参考,比较2组各项指标。结果 营养干预前,观察组血清IGF-1水平显著低于对照组(P<0.05)营养干预后,观察组血清IGF-1水平显著高于本组营养干预前差异有统计学意义(P<0.05),且与同时段的对照组相当差异无统计学意义(P>0.05)。此外,观察组营养干预后的生长指标(HtSDS、生长速率)均显著优于营养干预前差异有统计学意义(P<0.05)。结论 血清IGF-1水平是判断儿童生长迟缓情况的重要指标,通过早期个性化的营养干预可提升生长迟缓患儿血清IGF-1水平,促进其生长发育。

Serum hepcidin concentrations and type 2 diabetes

Hepcidin is a peptide hormone with both paracrine and endocrine functions that help in maintaining body iron stores.Type 2 diabetes(T2D) is one of the sequelae of excess body iron stores; thus,iron regulatory hormone hepcidin may have a direct or at least an indirect role in the aetiopathogenesis of T2 D.Both human and animal studies at molecular and genetic levels have attemptedto establish a role for hepcidin in the development of T2 D,and a few epidemiologic studies have also showed a link between hepcidin and T2 D at population level,but the findings are still inconclusive.Recent data have suggested different pathways in which hepcidin could be associated with T2 D with much emphasis on its primary or secondary role in insulin resistance.Some of the suggested pathways are via transcription modulator of hepcidin(STAT3); ferroportin 1 expression on the cells involved in iron transport; transmembrane protease 6 enzyme; and pro-inflammatory cytokines,interleukin(IL)-1,IL-6,tumor necrosis factor-α and IL-10.This review briefly reports the existing evidence on the possible links between hepcidin and T2 D and concludes that more data are needed to confirm or refute hepcidin's role in the development of T2 D.Examining this role could provide a further evidence base for iron in the aetiopathogenesis of T2 D.

2型糖尿病患者血清胰岛素样生长因子-1水平与颈动脉不稳定性斑块的相关性

目的:分析2型糖尿病患者血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平与颈动脉不稳定性斑块的相关性。方法:选取孝感市中心医院内分泌科2022年2月至2023年2月住院治疗的2型糖尿病患者213例,使用彩色多普勒超声诊断仪测定双侧颈总动脉、分叉及颈内动脉、颈外动脉的内壁,根据超声影像特征将研究对象分为无斑块组(73例)、稳定性斑块组(51例)、不稳定性斑块组(89例)。检测并比较各组临床资料、实验室指标及血清IGF-1水平;采用Spearman相关分析探讨2型糖尿病患者合并颈动脉不稳定斑块组血清IGF-1水平与各指标的关系;采用多因素Logistic回归分析2型糖尿病患者颈动脉斑块不稳定的影响因素。结果:与无斑块组比较,稳定性斑块组年龄、收缩压、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平较高,IGF-1水平较低;不稳定斑块组年龄、HbA1c、TG、LDL-C水平较高,IGF-1水平较低,差异均有统计学意义(P<0.05)。与稳定性斑块组比较,不稳定性斑块组HbA1c、TG、LDL-C水平较高,收缩压、IGF-1水平较低,差异有统计学意义(P<0.05)。Spearman相关分析显示,2型糖尿病合并颈动脉不稳定斑块组患者血清IGF-1水平与年龄、收缩压、HbA1c、LDL-C呈负相关(P<0.05)。Logistic回归分析显示,血清HbA1c、LDL-C、TG、IGF-1为2型糖尿病患者颈动脉斑块不稳定的影响因素(P<0.05)。结论:IGF-1低水平可能为2型糖尿病患者颈动脉斑块不稳定的影响因素,可辅助评估斑块的形成及进展。

IGF-1、β-CTX与胫骨平台骨折术后感染及骨痂X线评分的关系

目的分析血清胰岛素样生长因子-1(IGF-1)、β-Ⅰ型胶原羧基端肽(β-CTX)水平与胫骨平台骨折患者术后感染及骨痂X线评分的关系。方法回顾性分析2020年1月至2023年1月北京市仁和医院收治的90例胫骨平台骨折患者的临床资料,根据术后感染情况分为感染组(n=23例)和未感染组(n=67例)。对比两组的临床资料,应用二元Logistic回归模型分析胫骨平台骨折患者术后感染影响因素;采用Spearman相关系数分析IGF-1、β-CTX与术后3个月的骨痂X线评分的相关性,绘制受试者工作特征(ROC)曲线分析IGF-1和β-CTX对患者术后骨折愈合情况的预测价值。结果两组一般资料中性别、损伤机制、骨质疏松情况、合并糖尿病情况、手术时间、联合应用抗生素情况以及住院天数比较差异均无统计学意义(P>0.05);感染组中年龄≥60岁、开放性骨折损伤类型、有遗留死腔的比例均高于未感染组,血清IGF-1和β-CTX水平均低于未感染组,差异有统计学意义(P<0.05);骨痂X线分级Ⅰ~Ⅱ级患者的血清IGF-1和β-CTX水平低于骨痂X线分级Ⅲ~Ⅳ级患者,差异有统计学意义(P<0.05);年龄≥60岁(OR=3.840,95%CI:1.803~8.178)、开放行骨折损伤类型(OR=3.656,95%CI:1.705~7.834)、有遗留死腔(OR=3.407,95%CI:1.670~6.955)、<中位数水平的血清IGF-1(OR=2.578,95%CI:1.388~4.789)和β-CTX(OR=2.550,95%CI:1.262~5.153)的胫骨平台骨折患者术后感染风险更高(P<0.05);血清IGF-1和β-CTX水平与胫骨平台骨折患者术后骨痂X线评分均呈正相关(r=0.671、0.699,P<0.05);血清IGF-1、β-CTX水平及二者联合预测胫骨平台骨折患者术后骨折愈合情况的AUC分别为0.799、0.832、0.884,敏感度分别为0.727、0.727、0.909,特异性分别为0.785、0.798、0.772。结论胫骨平台骨折患者术后感染情况与年龄、损伤类型、遗留死腔、血清IGF-1和β-CTX水平有关,临床可通过检测IGF-1和β-CTX水平变化预测患者术后骨折愈合情况。

多囊卵巢综合征不孕女性血清胰岛素样生长因子结合蛋白-3、游离睾酮指数水平及与卵巢储备功能的关系

目的 分析多囊卵巢综合征(PCOS)不孕女性血清胰岛素样生长因子结合蛋白-3(IGFBP-3)、游离睾酮指数(FAI)水平及其与卵巢储备功能的关系。方法 回顾性分析青岛市第八人民医院收治的120例PCOS不孕女性(观察组)和42名健康体检女性(对照组)的临床资料。比较观察组和对照组研究对象血清IGFBP-3及FAI水平,并统计观察组患者卵巢储备功能情况,比较卵巢储备功能正常、卵巢储备功能低下患者的基线资料,分析PCOS不孕女性卵巢储备功能低下的影响因素,血清IGFBP-3、FAI水平与PCOS不孕女性卵巢储备功能的关系及其对PCOS不孕女性卵巢储备功能低下的预测效能。结果 与对照组比较,观察组患者血清IGFBP-3水平更低,FAI水平更高(P<0.05)。120例PCOS不孕女性中,38例存在卵巢储备功能低下。与卵巢储备功能正常患者比较,卵巢储备功能低下患者的盆腔炎发生率、婚姻不满意占比及FAI水平更高(P<0.05),血清IGFBP-3水平更低(P<0.05);多因素Logistic回归分析显示盆腔炎(95%CI:1.151~6.290)、婚姻满意程度(95%CI:1.033~4.952)、血清IGFBP-3水平(95%CI:0.040~0.286)及FAI水平(95%CI:10.024~185.807)是PCOS不孕女性的卵巢储备功能低下的影响因素(P<0.05)。Pearson分析显示血清IGFBP-3水平与卵巢储备功能呈正相关关系(r=0.513,P<0.05),FAI水平与卵巢储备功能呈负相关关系(r=-0.495,P<0.05)。ROC曲线分析血清IGFBP-3、FAI水平及两者联合预测PCOS不孕女性卵巢储备功能低下的AUC分别为0.786、0.845、0.912,且联合预测的AUC值更高(P<0.05)。结论 与正常人群比较,PCOS不孕女性血清IGFBP-3水平更低,与卵巢储备功能呈正相关关系;FAI水平更高,与卵巢储备功能呈负相关关系,即血清IGFBP-3水平越低,FAI水平越高,卵巢储备功能越低下,血清IGFBP-3联合FAI水平对卵巢储备功能低下具有较好的预测效能。

子宫内膜癌患者血清sVEGFR1、YKL-40、IGF-1表达水平及临床意义研究

目的探究子宫内膜癌患者血清可溶性血管内皮生长因子受体1(sVEGFR1)、甲壳质酶蛋白40(YKL-40)、胰岛素样生长因子1(IGF-1)表达水平及临床意义。方法择取本院100例子宫内膜癌患者作为观察组;另选取同期100例健康体检者作为对照组。比较两组sVEGFR1、YKL-40、IGF-1表达水平并分析观察组不同分期表达水平。结果观察组sVEGFR1表达水平较对照组低,YKL-40、IGF-1表达水平较对照组高,差异有统计学意义(P<0.05)。观察组Ⅰ~Ⅳ期sVEGFR1表达水平明显降低,YKL-40、IGF-1表达水平升高,差异有统计学意义(P<0.05)。结论在子宫内膜癌患者中,sVEGFR1、YKL-40、IGF-1均出现异常表达,不同分期患者存在较大差异,可为疾病诊断与分期提供可靠的数据参考。

血清LH、IGF-ⅠSDS、IGF-bp3诊断女童快速进展型中枢性性早熟的价值研究

目的分析血清黄体生成素(LH)、胰岛素样生长因子Ⅰ标准差积分(IGF-ⅠSDS)及胰岛素样生长因子结合蛋白3(IGF-bp3)在早期识别快速进展型中枢性性早熟(RP-CPP)和缓慢进展型中枢性性早熟(SP-CPP)患儿中的有效性,为临床进一步提高对女童RP-CPP的诊疗水平提供参考资料。方法回顾性分析2021年4月至2023年6月西安交通大学附属儿童医院收治的120例中枢性性早熟(CPP)女童患儿的临床资料,将其纳入研究组,按照线性生长或骨龄成熟加速等条件,将其分为RP-CPP组(71例),SP-CPP组(49例);纳入同期在院体检的青春期发育正常女童64例为对照组。比较不同人群LH、IGF-ⅠSDS及IGF-bp3水平的变化情况,采用多元Logistic回归分析影响儿童RP-CPP的相关危险因素,采用受试者工作特征(ROC)曲线评估LH、IGF-ⅠSDS及IGF-bp3预测RP-CPP的效能。结果研究组的LH、IGF-ⅠSDS、IGF-bp3及骨龄均明显高于对照组,经比较差异均有统计学意义(t值分别为26.256、47.930、20.390、14.008,P<0.05)。LH、IGF-ⅠSDS、IGF-bp3与骨龄均呈正相关(r值分别为0.435、0.502、0.397,P<0.05)。RP-CPP组的LH、IGF-ⅠSDS水平均明显高于SP-CPP组,经比较差异均有统计学意义(t值分别为7.867、33.943,P<0.05),但RP-CPP组与SP-CPP组的IGF-bp3水平比较,差异无统计学意义(P>0.05)。经多元Logistic回归分析显示,LH[OR(95%CI):1.962(1.172~3.285)]、IGF-ⅠSDS[OR(95%CI):1.707(1.142~2.552)]及IGF-bp3[OR(95%CI):2.314(1.221~4.384)]均是影响RP-CPP发生的危险因素(P<0.01)。经ROC曲线分析显示,LH、IGF-ⅠSDS及IGF-bp3单独预测RP-CPP的曲线下面积(AUC)从高到低依次为0.799、0.762、0.714,三者联合预测RP-CPP的AUC为0.864,其明显高于各指标单独预测的结果(P<0.001)。结论CPP女童的血清LH、IGF-ⅠSDS及IGF-bp3水平均存在异常,通过检测患儿的上述指标变化,可有效地预测病情的进展,LH、IGF-ⅠSDS及IGF-bp3水平较高者发生RP-CPP的风险相对较大。

2型糖尿病患者血清铁蛋白水平与体脂分布的相关性分析

目的探讨2型糖尿病(T2DM)患者血清铁蛋白水平与体脂分布的关系。方法收集2020年6-11月在兰州大学第一医院内分泌科住院的151例T2DM患者进行回顾性分析。所有患者根据血清铁蛋白水平分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。测量两组患者的血糖、血脂,以及内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、肝脂肪、身高、体重和腰围(WC),计算体重指数(BMI)和内脏肥胖指数(VAI),并进行组间比较;采用Pearson或Spearman相关性分析及多元线性回归分析血清铁蛋白水平与体脂分布的相关性。结果高血清铁蛋白组VAI和WC均明显高于正常血清铁蛋白组[分别为3.13(2.16,4.58)vs.2.66(1.66,3.81),(96.66±7.78)cm vs.(91.96±9.75)cm,P<0.05]。高血清铁蛋白组中心性肥胖和血脂异常的患病率明显高于正常血清铁蛋白组(分别为88.0%vs.68.3%,90.0%vs.75.2%,P<0.05),且血糖控制差、胰岛素抵抗的构成比也高于正常血清铁蛋白组(分别为96.0%vs.78.2%、62.0%vs.40.6%,P<0.05),而两组间BMI、VFA、SFA水平,以及降糖药物使用情况和糖尿病慢性并发症差异无统计学意义(P>0.05)。T2DM患者血清铁蛋白水平与VAI、WC、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂异常、血清肌酐(SCr)呈正相关(r=0.171、0.207、0.187、0.243、0.270、0.162、0.162,P<0.05),与年龄、性别和糖尿病病程呈负相关(r=-0.191、-0.434、-0.352,P<0.05)。多元线性回归显示,在男性T2DM患者中,糖尿病病程和FPG是血清铁蛋白水平增高的危险因素,但WC及VAI对血清铁蛋白的影响不明显;而在女性T2DM患者中,糖尿病病程、TG和VAI是血清铁蛋白水平增高的危险因素(P<0.05)。结论女性T2DM患者的血脂紊乱和内脏脂肪增加是血清铁蛋白水平增高的危险因素。

2型糖尿病血糖控制中二甲双胍联合门冬胰岛素治疗的作用价值

目的探究二甲双胍与门冬胰岛素联合治疗2型糖尿病(Diabetes Mellitus Type 2,T2DM)对血糖的控制效果。方法选取2021年6月—2023年6月吉林省人民医院收治的100例T2DM患者为研究对象,以投掷硬币法分为参照组(n=50,二甲双胍治疗)、观察组(n=50,二甲双胍与门冬胰岛素联合治疗)。比较两组临床治疗效果、不良反应总发生率、血糖控制情况及血清炎性因子水平。结果观察组治疗总有效率(96.00%)高于参照组(84.00%),差异有统计学意义(χ^(2)=4.000,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。与治疗前相比,两组治疗半年后血糖水平、白细胞介素-6、白细胞介素-12水平均降低、白细胞介素-10水平升高,且观察组上述指标优于参照组,差异有统计学意义(P均<0.05)。结论二甲双胍与门冬胰岛素联合治疗T2DM患者时可提高疗效,患者血糖控制情况更佳,血清炎性因子水平也得到明显改善,安全性较高。

扶元散加减联合门冬胰岛素治疗糖尿病肾病患者的临床效果及对其血清炎性因子水平及肾血流的影响

目的探讨扶元散加减联合门冬胰岛素治疗糖尿病肾病的临床效果。方法72例糖尿病肾病患者随机分为两组,对照组给予门冬胰岛素治疗,观察组给予扶元散加减联合门冬胰岛素治疗,比较两组的治疗效果、血清炎性因子水平和肾血流指标。结果治疗后,观察组的总有效率高于对照组,血清TNF-α、IL-6、CRP水平均低于对照组,EDV、PSV均高于对照组,PI低于对照组(P<0.05)。结论扶元散加减联合门冬胰岛素治疗糖尿病肾病可明显改善患者的血清炎性因子水平,促进肾血流恢复。

妊娠糖尿病母亲的新生儿血清25-羟维生素D_(3)、胰岛素水平与胰岛素抵抗的相关性

目的分析妊娠糖尿病母亲的新生儿血清25-羟维生素D_(3)[25(OH)D_(3)]、胰岛素水平与胰岛素抵抗的相关性。方法选取2023年1月至6月普宁市人民医院接收60例妊娠糖尿病患者娩出的新生儿作为观察组,并选取2023年1月至6月普宁市人民医院接收60例健康孕妇娩出的新生儿作为对照组。两组新生儿在出生后不同时间点采集血样,比较两组新生儿在出生后不同时间点血糖、血清25(OH)D_(3)、胰岛素水平与胰岛素抵抗指数的差异,并分析妊娠糖尿病患者娩出的新生儿血清25(OH)D_(3)、胰岛素水平与血糖、胰岛素抵抗指数的相关性。结果观察组出生24、48 h的血糖、血清25(OH)D_(3)水平高于出生12 h,血清胰岛素、胰岛素抵抗指数低于出生12 h,差异有统计学意义(P<0.05);对照组出生12、24、48 h血糖、血清25(OH)D_(3)、血清胰岛素、胰岛素抵抗指数比较,差异无统计学意义(P>0.05)。观察组出生12 h的血糖、血清25(OH)D_(3)水平低于对照组,血清胰岛素、胰岛素抵抗指数高于对照组,差异有统计学意义(P<0.05)。妊娠糖尿病患者娩出新生儿出生12、24、48 h的血清25(OH)D_(3)与血糖水平呈正相关性(P<0.05),与胰岛素抵抗指数呈负相关性(P<0.05);妊娠糖尿病患者娩出新生儿出生12、24、48 h的胰岛素水平与血糖水平呈负相关性(P<0.05),与胰岛素抵抗指数呈正相关性(P<0.05)。结论妊娠糖尿病患者娩出新生儿的血清25(OH)D_(3)相比于健康孕妇娩出新生儿要更低,胰岛素水平相比于健康孕妇娩出新生儿要更高,且与血糖水平、胰岛素抵抗指数存在相关性,可通过观察这两个指标评估妊娠糖尿病患者娩出新生儿的健康状况。