Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.

Interplay of serum biomarkers bilirubin andγ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus

This editorial synthesizes insights from a series of studies examining the interplay between metabolic and oxidative stress biomarkers in cardiovascular disease(CVD),focusing particularly on type-2 diabetes mellitus(T2DM)and acute coronary syndrome(ACS).The central piece of this synthesis is a study that investigates the balance between oxidative stress and antioxidant systems in the body through the analysis of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)levels in T2DM patients with ACS.This study highlights serum bilirubin as a protective antioxidant factor,while elevatedγ-GGT levels indicate increased oxidative stress and correlate with major adverse cardiovascular events.Complementary to this,other research contributions revealγ-GGT’s role as a risk factor in ACS,its association with cardiovascular mortality in broader populations,and its link to metabolic syndrome,further elucidating the metabolic dysregulation in CVDs.The collective findings from these studies underscore the critical roles ofγ-GGT and serum bilirubin in cardiovascular health,especially in the context of T2DM and ACS.By providing a balanced view of the body’s oxidative and antioxidative mechanisms,these insights suggest potential pathways for targeted interventions and improved prognostic assessments in patients with T2DM and ACS.This synthesis not only corroborates the pivotal role ofγ-GGT in cardiovascular pathology but also introduces the protective potential of antioxidants like bilirubin,illuminating the complex interplay between T2DM and heart disease.These studies collectively underscore the critical roles of serum bilirubin andγ-GGT as biomarkers in cardiovascular health,particularly in T2DM and ACS contexts,offering insights into the body’s oxidative and antioxidative mechanisms.This synthesis of research supports the potential of these biomarkers in guiding therapeutic strategies and improving prognostic assessments for patients with T2DM and some CVD.

Vitamin D,selenium,and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto's thyroiditis

BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.

Evaluation of teplizumab's efficacy and safety in treatment of type 1 diabetes mellitus:A systematic review and meta-analysis

BACKGROUND Islets of Langerhans beta cells diminish in autoimmune type 1 diabetes mellitus(T1DM).Teplizumab,a humanized anti-CD3 monoclonal antibody,may help T1DM.Its long-term implications on clinical T1DM development,safety,and efficacy are unknown.AIM To assess the effectiveness and safety of teplizumab as a therapeutic intervention for individuals with T1DM.METHODS A systematic search was conducted using four electronic databases(PubMed,Embase,Scopus,and Cochrane Library)to select publications published in peerreviewed journals written in English.The odds ratio(OR)and risk ratio(RR)were calculated,along with their 95%CI.We assessed heterogeneity using Cochrane Q and I2 statistics and the appropriate P value.RESULTS There were 8 randomized controlled trials(RCTs)in the current meta-analysis with a total of 1908 T1DM patients from diverse age cohorts,with 1361 patients receiving Teplizumab and 547 patients receiving a placebo.Teplizumab was found to have a substantial link with a decrease in insulin consumption,with an OR of 4.13(95%CI:1.72 to 9.90).Teplizumab is associated with an improved Cpeptide response(OR 2.49;95%CI:1.62 to 3.81)and a significant change in Glycated haemoglobin A1c(HbA1c)levels in people with type 1 diabetes[OR 1.75(95%CI:1.03 to 2.98)],and it has a RR of 0.71(95%CI:0.53 to 0.95).CONCLUSION In type 1 diabetics,teplizumab decreased insulin consumption,improved C-peptide response,and significantly changed HbA1c levels with negligible side effects.Teplizumab appears to improve glycaemic control and diabetes management with good safety and efficacy.

State of art on the mechanisms of laparoscopic sleeve gastrectomy in treating type 2 diabetes mellitus

Obesity and type-2 diabetes mellitus(T2DM)are metabolic disorders.Obesity increases the risk of T2DM,and as obesity is becoming increasingly common,more individuals suffer from T2DM,which poses a considerable burden on health systems.Traditionally,pharmaceutical therapy together with lifestyle changes is used to treat obesity and T2DM to decrease the incidence of comorbidities and allcause mortality and to increase life expectancy.Bariatric surgery is increasingly replacing other forms of treatment of morbid obesity,especially in patients with refractory obesity,owing to its many benefits including good long-term outcomes and almost no weight regain.The bariatric surgery options have markedly changed recently,and laparoscopic sleeve gastrectomy(LSG)is gradually gaining popularity.LSG has become an effective and safe treatment for type-2 diabetes and morbid obesity,with a high cost-benefit ratio.Here,we review the mechanism associated with LSG treatment of T2DM,and we discuss clinical studies and animal experiments with regard to gastrointestinal hormones,gut microbiota,bile acids,and adipokines to clarify current treatment modalities for patients with obesity and T2DM.

Chiglitazar and Thiazolidinedione in patients with type 2 diabetes:Which is better?

This published Meta-Analysis by Lin et al is an indirect comparison between two drugs Chiglitazar and Thiazolidinedione which are commonly used for glycemic control in type-Ⅱ diabetes mellitus.In terms of safety and efficacy,this Meta-Analysis is inconclusive.

Gastrointestinal metabolic surgery for the treatment of type 2 diabetes mellitus

Medical therapy for type 2 diabetes mellitus is ineffective in the long term due to the progressive nature of the disease, which requires increasing medication doses and polypharmacy. Conversely, bariatric surgery has emerged as a cost-effective strategy for obese diabetic individuals; it has low complication rates and results in durable weight loss, glycemic control and improvements in the quality of life, obesity-related co-morbidity and overall survival. The finding that glucose homeostasis can be achieved with a weight loss-independent mechanism immediately after bariatric surgery, especially gastric bypass, has led to the paradigm of metabolic surgery. However, the primary focus of metabolic surgery is the alteration of the physio-anatomy of the gastrointestinal tract to achieve glycemic control, metabolic control and cardio-metabolic risk reduction. To date, metabolic surgery is still not well defined, as it is used most frequently for less obese patients with poorly controlled diabetes. The mechanism of glycemic control is still incompletely understood. Published research findings on metabolic surgery are promising, but many aspects still need to be defined. This paper examines the proposed mechanism of diabetes remission, the efficacy of different types of metabolic procedures, the durability of glucose control, and the risks and complications associated with this procedure. We propose a tailored approach for the selection of the ideal metabolic procedure for different groups of patients, considering the indications and prognostic factors for diabetes remission.

Progress in experimental models to investigate the in vivo and in vitro antidiabetic activity of drugs

Diabetes mellitus is one of the world's most prevalent and complex metabolic disorders,and it is a rapidly growing global public health issue.It is characterized by hyperglycemia,a condition involving a high blood glucose level brought on by deficiencies in insulin secretion,decreased activity of insulin,or both.Prolonged effects of diabetes include cardiovascular problems,retinopathy,neuropathy,nephropathy,and vascular alterations in both macro-and micro-blood vessels.In vivo and in vitro models have always been important for investigating and characterizing disease pathogenesis,identifying targets,and reviewing novel treatment options and medications.Fully understanding these models is crucial for the researchers so this review summarizes the different experimental in vivo and in vitro model options used to study diabetes and its consequences.The most popular in vivo studies involves the small animal models,such as rodent models,chemically induced diabetogens like streptozotocin and alloxan,and the possibility of deleting or overexpressing a specific gene by knockout and transgenic technologies on these animals.Other models include virally induced models,diet/nutrition induced diabetic animals,surgically induced models or pancreatectomy models,and non-obese models.Large animals or non-rodent models like porcine(pig),canine(dog),nonhuman primate,and Zebrafish models are also outlined.The in vitro models discussed are murine and human beta-cell lines and pancreatic islets,human stem cells,and organoid cultures.The other enzymatic in vitro tests to assess diabetes include assay of amylase inhibition and inhibition ofα-glucosidase activity.

The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type-2 diabetes

Background: Diabetes mellitus (DM) has become a serious chronic disease.Self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals.Objective: To examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support,self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.Method: This study is a cross-sectional design.The sample included 401 Thai adults diagnosed with type 2 diabetes,aged 20-65 years old who had at least one HbA1c test in the last three months were recruited.Participants completed four questionnaires to measure self-management activities,as well as self-efficacy,Buddhist values and social support as moderating factors on self-management activities and HbA1 c,Results: The self-management activities were negatively associated (β =-2.05,p ≤ 0.001) with HbA1c.The Social support,self-efficacy and Buddhist values had a significant interaction effect between selfmanagement activities and HbA1c (β =-0.97,p ≤ 0.05,β =-0.18,p ≤ 0.05 and β =-2.76,p ≤ 0.001).Conclusion: The diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support,self-efficacy and health beliefs with Buddhist values.Future interventions for T2DM self-management programs should incorporate mechanisms to measure and support these factors.

Prevalence and Risk of Anemia in Type-2 Diabetic Patients

Aim: To determine the prevalence and risk of anemia in type-2 diabetes mellitus. In addition, the incidence and risk of anemia in these patients were assessed according to gender and glycemic control status. Methods: The study group comprised 200 patients with type-2 diabetes. Patients were divided into groups according to glycemic control and gender. Glycated hemoglobin (HbA1c), blood glucose level, hemoglobin concentration, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) of subjects were evaluated. The presence of anemia was defined by a hemoglobin level 6.5%, fasting blood glucose >126 mg/dl and random blood glucose >200 mg/dl. Result: 63% of diabetic patients had anemia. There was higher incidence and risk of anemia in females (36%) as compared to males (27%) (p 7.5% (49.5%) compared to those with controlled diabetes HbA1C < 7.5% (13.5%) (p < 0.05). Conclusion: This study indicated that poor glycemic control and gender difference are associated with the incidence of anemia in type II diabetes. Our findings suggest the need of screening for anemia in diabetes out-patient clinics. Routine hematological tests along with blood glucose level should be mandatory in order to make therapeutic decisions for the treatment of anemia in type II diabetes mellitus.

Incidence and risk of anemia in type-2 diabetic patients in the absence of renal impairment

Aim: To determine the incidence of anemia in type-2 diabetic patients with normal renal function and assess the association of other factors related to diabetes with the risk of anemia. Methods: The study group comprised 72 patients with type-2 diabetes. Patients were divided into groups according to glycemic control, gender and age. Serum creatinine, hematocrit, hemoglobin concentration, blood glucose and glycated hemoglobin (HbA1c) of subjects were measured. The presence of anemia was defined by a he- moglobin level 7.5%) compared to those with controlled diabetes (≤7.5%) and in patients of age ≥ 60 yrs compared to those of age < 60 yrs (p < 0.05). The odds of anemia was similar in males and females (p = 0.26). Conclusion: This study indicated that poor glycemic control and old age are associated with the incidence of anemia in type-2 diabetics with normal renal function. Our findings suggest that treatment criteria for diabetes should include routine hematological tests and take into consideration the inevitable consequences of ageing, and poor glycemic control.

网络药理学探讨雾水葛防治Ⅱ型糖尿病的物质基础及作用机制

通过网络药理学探讨雾水葛防治Ⅱ型糖尿病的物质基础及作用机制.首先通过文献调研获取雾水葛的活性成分,Pubchem等数据库分析雾水葛主要成分核心靶点,运用GeneCards获取Ⅱ型糖尿病靶点,通过微生信软件筛选雾水葛-Ⅱ型糖尿病的靶点交集,进一步构建“活性成分-靶点-疾病”网络和蛋白质相互作用(PPI)网络,并进行KEGG和GO分析.研究发现雾水葛中含有丰富的熊果酸、东莨菪素、槲皮素及芹菜素等,这些活性成分通过调控INSR、ERBB2、AKT1及TEK等重要靶点,进一步影响PI3K/Akt通路、HIF-1通路及5-羟色胺能突触等信号通路发挥防治Ⅱ型糖尿病的作用.

Effect of Sanhuang Jiangtang (三黄降糖) Recipe on Insulin Peripheral Resistance in Type Ⅱ Diabetes Mellitus

Objective: To observe the effect of Sanhuang Jiangtang recipe (三黄降糖, SAT) on insulinperipheral resistance in Type Ⅱdiabetes mellitus (DM). Methods:Ninety-five patients with type Ⅱ DM wererandomly divided into two groups. Fifty-three cases of SHJT group were given decoction and tablets of SAT orally for 4 -- 6 months. The efficacy was compared with that of 42 cases treated with Glipizide as the control.Before and after treatment standard steamed bread meal test was performed to measure the insulin peripheralsensitivity, insulin release to glucose and insulin sensitivity index. Results: (1 ) The total effective rates of improving insulin peripheral resistance and reducing blood sugar in SHJT group were 79. 2 % and 80. I %, whichwas equivalent to levels in the control group, but SAT recipe was more effective in relieving symptoms of Qideficiency and signs of blood stasis. (2) In SalT group, the insulin peripheral sensitivity and insulin sensitivityindex were significantly increased (P < 0. 05 and 0. of ), meanwhile the fasting blood sugar and blood sugar areawere reduced (P < 0. 05), but the change of insulin release to glucose was blunted. (3 )The lowering of bloodsugar in SHJT group was significantly negative correlated with the changing of degree of insulin peripheral sensitivity and index of insulin sensitivity (P < 0. 01 and 0. 05), but not with that of insulin area. Conclusion: Itsuggested that the treatment of SHJT recipe might decrease insulin peripheral resistance (partial reversal) bymeans of reducing hyperinsulinemia and improving insulin sensitivity.

三黄降糖方对Ⅱ型糖尿病患者外周胰岛素抵抗的影响

目的：观察三黄降糖方（即加味桃核承气汤）对Ⅱ型糖尿病患者外周胰岛素抵抗的影响。方法：９５例Ⅱ型糖尿病患者随机分为中药组和西药组，中药组以三黄降糖方的水煎剂和片剂同时使用；西药组用美吡达治疗。两组疗程均为４～６个月，治疗前后进行标准馒头餐试验，并计算外周胰岛素敏感度（ＳＩ）、胰岛素释放率（ＩＲＧ）及胰岛素敏感性指数。结果：（１）中药组改善外周胰岛素抵抗疗效的总有效率为７９．２％（其中逆转率２６．４％），降糖疗效的总有效率为８０．１％，与西药组的疗效相当（Ｐ＞０．０５）；但中药组的气虚证候及瘀血征象的改善较为明显。（２）中药组的ＳＩ明显增加，胰岛素敏感性指数（ＩＡＩ）显著改善（Ｐ＜０．０５和Ｐ＜０．０１），而空腹胰岛素及其面积明显降低（Ｐ＜０．０５），但ＩＲＧ无明显改善。（３）中药组的血糖降低与ＳＩ、ＩＡＩ的改变呈明显负相关（ｒ＝－０．７７和－０．４２，Ｐ＜０．０１和Ｐ＜０．０５），而与胰岛素面积的改变无相关性（ｒ＝０．１２７，Ｐ＞０．０５）。结论：三黄降糖方治疗Ⅱ型糖尿病可能通过降低高胰岛素血症、增强机体对胰岛素的敏感性的胰外作用途径，达到减轻外周胰岛素抵抗的治疗目的。

加味桃核承气汤治疗Ⅱ型糖尿病的临床和实验研究

本文报道用加味桃核承气汤治疗Ⅱ型糖尿病106例,总有效率79%,与西药优降糖组疗效相当;但降糖幅度和临床主要症状的改善方面均较优降糖组为优。动物实验表明,加味桃核承气汤能降低糖尿病及正常大鼠的空腹血糖浓度,促进β细胞分泌内源性胰岛素,抑制胰及胰外组织分泌胰高血糖素,对胰岛内分泌细胞有一定的修复功能及增加胰岛β细胞的分泌颗粒,刺激肝糖原的合成,抑制肝糖原的分解。认为加味桃核承气汤的作用机理是"益气养阴、活血化瘀、润肠通下"的协同作用。

STZ糖尿病大鼠心肌细胞凋亡及葡萄糖、血管紧张素Ⅱ、瘦素对心肌细胞凋亡影响的观察

目的 观察链脲佐菌素(STZ)糖尿病大鼠心肌细胞凋亡情况及葡萄糖、血管紧张素Ⅱ、瘦素对正常SD大鼠心肌细胞凋亡的影响。方法 主动脉插管逆行灌流分离培养STZ糖尿病大鼠和正常SD大鼠心肌细胞,通过Annexin V FITC +PI双染法,采用流式细胞术,检测细胞凋亡情况,并运用细胞免疫荧光染色法检测心肌细胞膜瘦素受体的表达。结果 (1)STZ糖尿病大鼠心肌细胞凋亡较对照组明显增高(P <0 .0 1) ;(2 )在体外培养条件下,血管紧张素Ⅱ、瘦素使心肌细胞凋亡明显增加,且与浓度相关,差异均有显著性(P <0 .0 1) ,在葡萄糖5 .6、2 5mmol/L的培养环境中,心肌细胞凋亡变化不明显(P >0 .0 5 ) ;(3)细胞免疫荧光染色检测瘦素受体表达,在荧光显微镜下可见到心肌细胞膜呈现绿色荧光。结论 STZ糖尿病大鼠的心肌细胞凋亡增高;在体外培养条件下,血管紧张素Ⅱ、瘦素可促进SD大鼠心肌细胞凋亡,且与浓度相关,增加培养环境中的葡萄糖浓度,对SD大鼠心肌细胞的凋亡无明显影响,而瘦素可能通过与心肌细胞膜上瘦素受体结合而发挥作用。

男性Ⅱ型糖尿病患者骨密度改变及影响因素初探

目的 探讨男性Ⅱ型糖尿病 (DM2 )患者骨密度 (BMD)改变及其影响因素。方法 测定 5 9例男性Ⅱ型糖尿病患者及3 6例健康男性对照者股骨近端 (Neck、Troch、Ward三角区 )及腰椎 (L2～ 4)正侧位BMD ,血钙 (Ca)、磷 (P)、骨钙素、甲状旁腺素 (PTH )、睾酮 (T)和尿Ca Cr、I型胶原羧基末端肽 (CTX) Cr浓度。根据BMD将DM2 患者又分为无骨质疏松组 (DM A1 )和并发骨质疏松组(DM A2 ) ,测定两组患者的空腹血糖、胰岛素、C肽 ,餐后血糖、胰岛素以及糖化血红蛋白。结果 DM2 组L2～ 4及Ward三角区的BMD明显低于对照组 (P <0 .0 5 ) ,而L2～ 4侧位BMD下降更明显 (P <0 .0 0 1)。DM2 组的骨钙素较对照组显著降低 (P <0 .0 5 ) ;血Ca、P、PTH、T和尿CTX Cr浓度与对照组差异不显著 (P >0 .0 5 ) ;尿Ca Cr比对照组高 2 5 % ,但差异无显著意义 (P =0 .13 7)。DM A2 组的体重指数、血T、尿Ca Cr、餐后血糖和糖化血红蛋白与DM A1 组差异显著 (P <0 .0 5 )。结论 Ⅱ型糖尿病患者由于骨形成和骨转换率降低而骨密度下降 ,腰椎侧位的骨密度检查有助于早期诊断骨质疏松。男性患者中体重指数低、血清睾酮浓度低及血糖控制不良者更易并发骨质疏松。

Ⅱ型糖尿病高胰岛素血症患者血浆同型半胱氨酸的水平检测

为探讨血浆同型半胱氨酸(Hcy)水平与 型糖尿病高胰岛素血症及胰岛素抵抗之间的关系,采用酶联免疫法测定了30例正常人和78例 型糖尿病患者(其中有高胰岛素血症患者38例)的血浆Hcy水平。检测结果表明,对照组血浆Hcy水平空腹时为11.90±3.90μmol/L,葡萄糖耐量试验(OralGlucoseToleranceTest,OGTT)后1h时为9.21±2.83μmol/L,2h时为10.43±3.84μmol/L。 型糖尿病无高胰岛素血症及并发症患者Hcy水平空腹时为21.80±7.89μmol/L,OGTT后1h时为17.98±6.83μmol/L,2h时为12.58±6.73μmol/L。 型糖尿病有高胰岛素血症者Hcy水平空腹时为19.80±7.98μmol/L,OGTT后1h时为14.50±7.69μmol/L,2h时为11.07±6.52μmol/L。统计结果显示,对照组、 型糖尿病无高胰岛素血症组及有高胰岛素血症组之间Hcy水平有显著性差异(P<0.001,P<0.01)。糖尿病高胰岛素血症组的Hcy水平明显低于糖尿病非高胰岛素血症组(P<0.01)。表明高血浆Hcy水平与 型糖尿病及高胰岛素血症、胰岛素抵抗有一定的相关性。

胃癌Billroth Ⅱ式胃切除术对合并2型糖尿病患者的治疗价值

目的探讨胃癌BillrothⅡ式胃切除术对合并2型糖尿病患者糖代谢的影响。方法回顾性观察7例体重指数(BMI)<35kg/m2合并2型糖尿病的病人因胃癌接受BillrothⅡ式胃切除手术前后血糖控制情况以及糖尿病治疗的变化。结果7例均成功完成了根治性BillrothⅡ式胃切除术,4例行腹腔镜手术,3例行开腹手术。术后未发生严重并发症。术前空腹血糖(FPG)6.6～9.0mmol/L,平均8.1mmol/L;糖化血红蛋白(HbA1c)6.8%～9.5%,平均7·8%。术后1～8个月复查FPG4.8～7.9mmol/L,平均6.4mmol/L;HbA1c5.5%～7.2%,平均6.3%。据美国糖尿病协会(ADA)糖尿病疗效判断标准,4例治愈,3例改善。结论胃癌BillrothⅡ式胃切除术可治疗胃癌患者合并的2型糖尿病。

发酵桦褐孔菌对链脲佐菌素诱导的Ⅱ型糖尿病大鼠降血糖作用的影响

通过高脂饮食联合腹腔注射链脲佐菌素(streptozotocin,STZ)的方法建立Ⅱ型糖尿病(type 2diabetes mellitus,T2DM)大鼠模型,探讨发酵桦褐孔菌(fermented Inonotus obliquus,FIO)对T2DM大鼠的血糖、血脂及抗氧化作用的影响。结果表明:与模型组相比较,FIO可显著降低T2DM大鼠的空腹血糖(fasting blood glucose,FBG)、促进肝糖原(hepatic glycogen,HGln)合成、改善胰岛素(insulin,INS)抵抗,使总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、游离脂肪酸(free fatty acids,FFA)、低密度脂蛋白(low density lipoprotein,LDL)及丙二醛(malondialdehyde,MDA)含量显著下降,高密度脂蛋白(high density lipoprotein,HDL)含量和超氧化物歧化酶(superoxide dismutase,SOD)的活性显著上升。说明FIO能够降低Ⅱ型糖尿病大鼠血糖,改善脂质代谢及氧化应激水平。