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Objective To observe the improvement of weight rebound in obese type 2 diabetes mellitus patients who underwent metabolic surgery after low-carbohydrate diet intervention.Methods 38 patients with obese type 2 diabetes mellitus who had underwent metabolic surgery in Changhai Hospital from Jan.2010 to Nov.2015,were randomly divided into two groups and intervened by low carbohydrate (LC) diet or diabetes mellitus (DM) diet.The blood glucose and body weight of the two groups were compared and analyzed.Results There was no statistical difference in fasting blood glucose,HbA1c,fasting C-peptide,body weight,waistline and BMI value(t=0.34,S=1.00-32.5,P＞0.05)in diabetes mellitus diet intervention group;while there was significant statistical difference in fasting blood glucose,body weight,waistline and BMI (t=2.38,S=17-24.5,P＜0.05)in low-carbo hydrate diet intervention group.There was significant differences in body weight difference (Z=2.31,P＜0.05),BMI difference(Z=2.36,P＜0.05),and weight rebound rate(P＜0.05) between the two groups,with the low carbohydrate diet intervention group displaying advantages.Conclusions Low carbohydrate diet intervention can improve fasting blood glucose,obesity indexes in obese type 2 diabetes mellitus patients who underwent metabolic surgery.Compared with diabetes mellitus diet intervention,low carbohydrate diet intervention can more greatly improve weight,weight rebound rate,rebound scale and have more advantages for maintaining the operation effects.
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Objective Glucagon-like peptide-1 (GLP-1) has been reported to be effective in the treatment of nonalcoholic fatty liver disease (NAFLD). However, the molecular mechanism of GLP-1 on NAFLD is remained unclear. The present study was to detect whether the effect of GLP-1 on triglyceride (TG) content in hepatocytes is dependent on Foxos. Methods HepG2 cells were treated with palmitic/oleic acid for 24 h. The knockdown of Foxo1, Foxo3 was conducted through small interfering RNA (siRNA). Real time PCT (RT-PCR) was used to detect the changes of the SREBP1c and Acox2 genes in HepG2 cells after Foxo1/3 knockdown. Results As expected, palmitic/oleic acid increased TG concentration in HepG2 cells [(12.65 ± 1.32) μg/mg vs. (4.32 ± 0.54) μg/mg, P<0.05]. Addition of GLP-1 dose (10, 50, 100nmol/L) dependently lowered the TG content and reached plateau at 100 nmol/L of GLP-1 [TG(8.38±1.47) μg/mg]. The GLP-1 effect on TG remained after knocking down either Foxo1 [(9.09±1.34)μg/mg] or Foxo3 [(8.90± 1.60) μg/mg] alone, but not when knocking down Foxo1 and Foxo3 (Foxo1/3) together [(14.66±1.77)μg/mg]. Moreover, knocking down Foxo1/3 also abolished GLP-1 effect on SREBP1c and Acox2 expression. Conclusion GLP-1 can inhibit the synthesis of TG in hepatocytes depending on Foxo1 and Foxo3. Further studies are needed to explore the specific mechanisms.
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Objective To explore the correlation between thyroid nodules and uric acid levels and to find their gender differences.Methods A total of 68 056 subjects in a regional medical physical examination center of Shanxi Province from January 2013 to June 2015 were enrolled in this study.All the participants′ general information and parameters were recorded.Thyroid nodules were detected by color Doppler ultrasonography.Results The total prevalence of thyroid nodule was 35.5%, 30.7% in males and 40.0% in females.The prevalence of single nodule was 50.1%, and multiple 49.9%.Compared with no nodule group, thyroid nodule group tended to be older, with higher BMI, and with a worse metabolic status(all P<0.01).The uric acid levels were lower[(352.37±78.14 vs 357.70±77.51) μmol/L, P<0.01] in thyroid nodule group in male and higher[(260.22±61.91 vs 253.91±59.18) μmol/L, P<0.01] in female.Conclusion Thyroid nodules may be associated with metabolism and inflammation.In males, hyperuricemia group had lower, while in females, hyperuricemia ones were with a higher prevalence of thyroid nodules.
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[Summary] The incidence of obesity and obesity‐related diseases (such as T2DM) increases year by year in the world. Metabolic surgery has increasingly been applied to patients with severe obesity. Studies have indicated that metabolic surgery is effective in obesity and obesity‐related diseases. Since patients undergoing metabolic surgery are obese or severely obese ,whose physiological and pathological changes are different with those of non‐obese patients ,a comprehensive assessment and management during perioperative period and after the operation were needed. This article mainly expounds preoperative evaluation and preparation ,management of surgery process and postoperative nutrition and endocrine management.
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Adipocyte fatty acid-binding protein ( FABP4 ) is abundantly expressed in adipocytes and macrophages, and the physiologic function of this lipid chaperone is involved in the intracellular trafficking and targeting of fatty acids inside cell. Studies have shown that FABP4 plays a significant role in cholesterol metabolism. FABP4 can affect some key gene expression for cholesterol metabolism, thus regulate the metabolism, storage, and trafficking of cholesterol. As the development of FABP4 inhibitors, drugs targeting FABP4 are possible and can lead to a novel therapeutic strategy to prevent and treat obesity, type 2 diabetes, hypercholesterolemia, and atherosclerosis.
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Objective The cancer risk of patients with diabetes mellitus who are treated by metformin declines remarkably in comparison to patients receiving other drug therapies.The article was to investigate the relationship between antineopastic activity and fatty acid synthase (FASN) of metformin in human hepatocellular carcinoma cell(HCC) line HepG2. Methods HepG2 cells were treated with various concentrations of metformin( 0, 1, 5, 10, 15 mmol/L) for 24, 48 and 72 h respectively and cell growth was assessed by CCK-8 assay.Positive control(paclitaxel 10μg/mL) and negative control(metformin 0mmol/L) were set up simultaneously.After being treated with doses of metformin(0, 5, 10,15mmol/L) for 72h, protein expression levels of AMPKα、P-AMPKα、FASN、P-mTOR and P-Akt were measured by western blotting analysis and FASN mRNA expression levels were measured by RT-PCR. Results Being treated with vari-ous doses of metformin(1, 5, 10, 15 mmol/L) for 24, 48 and 72 h, the growth of HepG2 cells were inhibited by metformin in dose-dependent and time-dependent manner( P0.05) .FASN mRNA expression levels decreased significantly in all metformin-treated groups( P<0.05) . Conclusion Met-formin actitiviates AMPK, inhibits mTOR and downregulates FASN, which are implicated in its antineopastic activity on HCC.Although metformin inhibits mTOR activation, it is not involved in Akt upregulation through a negative loop.
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Weight management is an important step in the treatment and management for type 2 diabetes.Obesity,especially visceral fat accumulation,impairs the metabolism function.Excess of visceral fat is closely related to the development of insulin resistance,metabolic syndrome,type 2 diabetes,and cardiovascular disease.Liraglutide,the (GLP-1) analogue,shows its effects on glycaemic control as well as weight reduction which mainly involves reduction of visceral fat.The efficacy characteristics of liraglutide may benefit the comprehensive management of type 2 diabetes.
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Objective To investigate what kind of obese patients appropriate to adopt the laparoscopic adjustable gastric banding volume reduction surgery.Methods A retrospective study was performed to review the clinical data of 40 patients who required reoperation to remove the gastric banding after LAGB from November 2003 to March 2013 at the Department of Minimally Invasive Surgery,Changhai Hospital.Selected 40 patients who required LAGB from January 2006 to October 2008 as control group.We conducted a case-control study to analyze.Chi-square test and multivariate and non-conditional Logistie regression analysis were used to identify the risk factors of removing of gastric banding.Results Age and gender were not statistically significant different (P ＞ 0.05).Multiple factors of Logistic regression showed that BMI≥35 kg/m2,postoperative clinic visits per year ＜ 3 and on the basis of gastrointestinal disease were risk factors for the removal of gastric banding (Wald =3.908,7.375,5.209,P ＜ 0.05).Conclusion The risk factors for the removal of gastric banding include BMI,postoperative clinic visits and the basis of gastrointestinal disease.In the treatment of obesity with LAGB should take full account of the above factors.
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Sixty male SD rats were separately fed by normal diet or high-fat diet.After eight weeks of highfat diet,these rats were injected low dose streptozotocin (30 mg/kg).Diazoxide or glipizide was administered to the diabetic rats for 4 weeks.The results showed that body weight,serum insulin,and insulin sensitive index were decreased in the obese diabetic rats while the fasting blood glucose,total cholesterol,and triglyceride levels were increased compared with the high-fat diet group ( all P＜0.01 ).Consistent with the results of glipizide,diazoxide treatment lowered blood glucose,improved glucose tolerance,and decreased islet cell apoptosis compared with the diabetes mellitus group ( all P＜0.05 ).The results suggest that diazoxide can improve islet function of obese type 2 diabetic rats via decreasing insulin secretion and thus lessening the load on islet cells.
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Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.
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China is the country with the biggest diabetic population in the world.Diabetes has become a heavy financial burden for diabetic patients,families,and society.This article briefly described pharmacoeconomic concepts and analysis methods,and systemically reviewed literatures in health economic data of DPP-4 inhibitors,in the hope of providing a new perspective for clinicians,researchers,and health care policy makers.
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We have retrospectively analyzed the medical files of 86 consecutive patients who were diagnosed as cases of adrenal or extra-adrenal pheochromocytoma at Changhai hospital between 2001 and 2009. Patients with incidentally detected pheochromocytoma often had lower prevalence of hypertension and lower mean arterial blood pressure compared with those patients suspected of pheochromocytoma on clinical grounds.
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Obesity is associated with numerous metabolic abnormalities, including insulin resistance and type 2 diabetes. Losing weight is an effective way of improving insulin sensitivity, thus decreasing the risk of obesityassociated diabetes and chronic cardiovascular disease. There is evidence that Liraglutide, as a human glucagon-like peptide-1 ( GLP-1 ) analogue, either using alone or combining with other glucose-lowering drugs, has effect on improving glycemic control, protecting β-cell function, and reducing body weight via inhibiting feeding behavior and delaying gastrointestinal motility. Therefore, liraglutide is a new option for treating type 2 diabetes patients.
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Patients with acute myocardial infarction(AMI) are often with elevated blood glucose level when admitted to hospital,this finding is associated with poor prognosis regardless of a history of diabetes.Though numerous studies have addressed some of the questions in this field,many critically important questions are still poorly understood and under debate.This article summarized current findings in hyperglycemia and its potential link withadverse outcomes in AMI patients,and addressed some of the existing controversies in this field.
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Impaired eady phase insulin secretion is an important reason for leading to postprandial hyperglycemia.Nateglinide is a rapid-acting insulin secretagogue,which reduces postprandial blood glucose of type 2diabetic patient by restoring early phase insulin secretion.The efficacy and safety have been fully verified by clinical administration and it is more widely used to treat type 2 diabetic patients.Both sulfonylureas and glinides were named insulin secretagogue agents and regarded as alternative first-line drugs in the 2010 Chinese Guideline for treatment of type 2 diabetes.AACE/ACE Consensus statement claimed that glinides would be one of the important choices after metformin.In order to further guide the clinical application of nateglinide,16 national specialists in the field of endocrinology and metabolism of China discussed,drafted,and edited this consensus.The current consensus combined clinical evidences at home and abroad.systematically reviewed and summarized tlle results of these studies about nateglinide.It will provide guiding recommendations and reference concerning how to reasonably and effectively use nateglinide in the clinical practice.
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Objective To analyze the changes of the intima-media thickness(IMT)of carotid and femoral arteries, serum advanced glycosylation end-products(AGEs),and AGEs soluble receptor(sRAGE)after intensively controlling blood glucose, blood pressure, and lipid. Methods One hundred and thirty-two type 2 diabetic patients were divided into 3 groups and followed for 5 years: 20 patients were treated with intensive control of blood glucose and blood pressure, 80 patients with intensive control of blood glucose, blood pressure, and lipid; and 32 patients with conventional therapy. AGEs, sRAGE, and IMT of carotid and femoral arteries were measured and compared among different groups. Results The IMT of carotid and femoral arteries and serum level of AGEs were significantly decreased after intensive treatment. The ratio of sRAGE and HbA1C(sRAGE/HbA1C)were negatively correlated with the mean of HbA1Cin the past five years(r=-0.417, P＜0.001)and the fluctuation of HbA1C(r=-0.309,P＜0.001). Multinomial regression analysis showed that AGEs were the important risk factors of IMT of femoral artery(β=0.152,P=0.068). Conclusion Intensive treatment is significant in controlling the growing IMT of carotid and femoral arteries, while decreasing serum level of AGEs.
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Objective Hyperglycemia was common during acute myocardiai infarction (AMI). This study investigated the impact of stress hyperglycemia on in-hospital outcomes in patients without diabetes hospitalized with AMI. Methods The study included 107 patients with AMI without diabetes, who were admitted to 81 hospital of PLA of Nanjing, China from January 2000 to May 2010. The in-hospital mortality and in-hospital complications were analyzed retrospectively. The exclusion criteria were: (1 ) patients < 18 years old; (2) patients with history of diabetes; (3) patients who initiated anti-hyperglycemic therapy during their hospital stay though without previously diagnosed diabetes; (4) patients with non-cardiovascular causes for AMI; (5) patients with hepatic failure, kidney failure, serious lung illnesses and end stage of malignant tumour; (6) patients administrated with steroid treatment recently and those with some diseases which had dramatic effect on glucose metabolism such as hyperthyroidism and cushing syndrome. Patients were categorized according to FBG levels into4 mutually exclusive groups; <7.0 mmol/L, ≥7.0 but <8.0 mmol/L, 8.0 to< 11. 1 mmol/L and ≥11.1 mmol/L. The Statistical Package for Stata, version 9.2 was used for statistical analysis. According to corresponding data analysis of /-test, ANOVA, rank test and exact propability were used respectively. Univariate logistics regression analysis was conducted followed by multivariate logistics regression analysis on significant variables. Results The incidence rate of stress hyperglycemia in patients with AMI without diabetes was 43. 9% (n =47). In non-diabetic patients, the mortality of the group of FBG≥7. 0 mmol/L was significantly higher than the group of FBG < 7. 0 mmol/L, which are 27.66% and 6.67%(P=0.0063)respectively,OR=5.35(95%CI 1.61 - 17.75,P = 0.0061). In-hospital complications for example lung infection, congestive heart failure, serious arrhythmias and acute cerebrovas-cular events were increased significantly in AMI patients with stress hyperglycemia. Multivariate logistic regression analysis for mortality were performed adjusting for risk factors which demonstrated FBG was a independent risk factors of in-hospital death , OR = 1.56(95%CIl.09 -2.23). Conclusions In-hospital mortality and in-hospital complications were significantly increased in patients with AMI without diabetes which developed stress hyperglycemia. Stress hyperglycemia was of great prognostic value for short-outcomes of AMI.
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HepG2 ceils were treated with various concentrations of tumor necrosis factor-or (TNF-α) for 24 hours. RT-PCR and Western blot were used to measure protein tyrosine phosphatase-1 B(PTP-1B)expression, and luciferase reporter assay was used to detect NF-kB activity. The results showed that treatment of HepG2 cells with TNF-α for 24 hours led to upregulation of PTP-1B and NF-kB activity in a dose-dependent manner. Inhibition of NF-kB by PI)TC significantly attenuated TNF-α-induced PTP-IB expression in HepG2 cells. Thus, the transactivation of NF-kB seems to play an important role in the expression of PTP-1B in HepG2 cells induced by TNF-α.
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rs of glucose and lipid metabolism in adolescents with abdominal obesity. Determimation of serum A-FABP concentration might be useful in diagnosis and prevention of metabolic syndrome and abdominal obesity in adolescent.
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The aim of this Post-Marketing Surveillance study was to assess efficacy, safety and acceptance of acarbose treatment in Chinese type 2 diabetic patients under day-to-day practice conditions. A total of 2 480 patients were enrolled by 231 physicians throughout China into an open, prospective, uncontrolled, nonrandomised, multi-centre study. Main efficacy parameters were the changes in fasting and postprandial blood glucose concentrations as well as in HbA1c levels after acarbose treatment. The majority of patients had been previously treated with other oral anti-diabetic medication or insulin and received concomitant anti-diabetics during the mean observation period of 13.5 weeks. Most patients started on a daily acarbose dose of 50 mgt. i. d. Acarbose treatment reduced fasting blood glucose concentrations by 56. 1 mg/dl ( 18 mg/dl glucose = 1 mmol/Lglucose) and 2h-postprandial values by 111.3 mg/dl over the studyperiod. HbA1c decreased by 1.9％ and body weight by 0.9 kg. 76 acarbose-related adverse events occurred; two patients experienced serious adverse events.The attending physicians assessed treatment efficacy as "very good" or "good" for 90.1％ of the patients, tolerability for 89.1％ and acarbose acceptance for 87.1％ of the patients. Acarbose is efficacious, safe and well accepted by Chinese type 2 diabetic patients under day-to-day routine conditions, both as anti-diabetic mono therapy and in combination with other anti-diabetic drugs.