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Objective:To systematically evaluate the effect of glucagon-like peptide 1 receptor agonists(GLP-1RA)on the brain structure of rat or mouse Alzheimer’s disease(AD)models.Methods:Data of randomized controlled trials from January 2000 to January 2018 for the effect of GLP-1RA on the brain structure of AD rats or mice were searched from all databases, including the Cochrane Library, EMbase, PubMed, Chinese Journal Full-text Database, the Chinese biomedical literature database, Chinese PSTP VIP and Wanfang database.Literature was selected based on inclusion and exclusion criteria defined in advance, and the quality was evaluated using the SYRCLE as animal experimental bias risk assessment tools.Valid data were retrieved and a meta-analysis was performed using the RevMan 5.3software.Results:A total of 9 articles with 207 rats and mice were included.Among the 207 cases, 123cases were in the experimental group and 84 cases in the control group.After treatment with GLP-1RA, there were significant differences in the amyloid plaque load[Low dose group: mean difference(MD)=-5.55, 95% CI: -6.92 to-4.17, P<0.01, High dose group: MD=-4.81, 95% CI: -6.63to-2.98, P<0.01], the amount of p-tau protein(MD=-3.16, 95% CI: -4.29 to-2.02, P<0.01), and the activation of microglia in rat or mouse brain(liraglutide treatment group: MD=-7.85, 95% CI: -12.66 to-3.04, P<0.01, lixisenatide treatment group: MD=-7.60, 95% CI: -9.56 to-5.65, P<0.01)between the treatment group and the control group. Conclusions:GLP-1RA can reduce the amyloid plaque load, decrease the number of neurofibrillary tangles and inhibit the activation of microglia in the rat or mouse brain.
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Objective To systematically evaluate the effects of metformin on serum vitamin B12,folic acid and homocysteine (Hcy) levels in the patients with type 2 diabetes mellitus (T2DM).Methods The databases of Cochrane Library,EMbase,PubMed,CBM,CNKI,VIP and Wanfang were retrieved by computer to collect the randomized controlled trials (RCTs) on the association between metformin and serum vitamin B12 level in T2DM patients.Two researchers independently screened the literatures,assessed the risk of bias of included RCTs and extracted the data.The RevMan5.3 software was used for conducting the meta analysis.Results A total of 5 RCTs were included.The Meta-analysis results showed that serum vitamin B12 level in the metformin group was significantly decreased compared with the placebo group (MD=-55.86,95 ％ CI(-86.89,-24.84),P =0.000 4);the subgroup analysis showed that serum vitamin B12 level was negatively correlated with the duration of diabetes,metformin use time and dose.The serum Hcy level in the metformin group was increased compared with the placebo group (MD=2.44,95 ％ CI(1.41,3.46),P＜0.01);the serum folic acid level had no statistical differences between the two groups [MD=-2.39,95 ％CI (-4.93,0.15),P=0.06];the incidence rate of adverse reactions in the metformin group was higher than that in the placebo group[RR=2.0,95 ％ CI(1.32,3.03),P =0.001].Conclusion Metformin treatment may lead to decrease of serum vitamin B12 level and increase of Hcy level while has no obvious influence on the folic acid level in T2DM patients,but has higher incidence rate of adverse reactions.
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Objective To explore the optimal HbAlc diagnostic cutpoint in different glucose tolerance populations in the plateau region.Methods (1) 472 diabetes mellitus (DM) patients and highrisk groups accepting diabetes screening in the First Affiliated Hospital of Kunming Medical College (217 males and 255 females,≥20 years old,median age 54 years old) were collected,oral glucose tolerance test (OGTT) and HbAlc were tested.(2) the research subjects were divided into normal glucose adjustment group (NGT),Impaired fasting glucose group (IFG) and (or) Impaired glucose tolerance IGT group and diabetes mellitus (DM) group.The receiver-operating characteristic curve (ROC) was explored to determine the optimal HbA1c diagnostic cut point for IFG,IGT and DM status respectively.Results The average HbA1 c values of NGT,IFG and (or) IGT,DM groups were (6.06 ± 0.11) ％,(6.63 ± 0.11) ％,(8.70 ± 2.08)％ respectively,for IFG and IGT groups,the optimal HbA1c diagnostic cut points were 6.7％ and 6.6％,respectively; If use either FBG or 2 h PG to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％ ; If use anyone of FBG or 2hPG to diagnose DM,the corresponding optimal HbA1c diagnostic cut point was 7.0％ ; If both FBG and 2hPG were used to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％.Conclusion Preliminarily confirm the optimal HbA1c diagnostic cut point in different glucose tolerance populations in the plateau region of Kunming,and provide the evidence for further clinical application of HbA1c.
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Objective To investigate the correlation of bone mineral density (BMD) with plasma Klotho levels and its related factors in type 2 diabetic patients (T2DM) . Methods BMD was measured by Dual-energy X-ray absorptiometry (DEXA) in 159 T2DM patients. The patients were divided into three groups:normal bone mass, reduced bone mass and osteoporosis. The fasting plasma levels of Klotho were detected in these patients using enzyme linked immuno sorbent assay (ELISA), clinical and biochemical parameters also were tested, the difference and related factors were compared and analyzed in each group. Results Plasma Klotho levels were not significantly different among the three groups (4.95±0.48 vs 4.96±0.47 vs 4.91±0.49,P>0.05) . BMD at the first, second, third, fourth and total lumbar spine, femoral neck, trochanter and total body were not associated with plasma Klotho levels in these patients (P>0.05) . Age, diabetic duration, HDL-C and BMI were independent determinants for BMD in T2DM patients. Conclusions BMD might be not associated with plasma Klotho level in T2DM patients. But age,diabetic duration,HDL-C and BMI are associated with reduced BMD and osteoporosis in T2DM patients.
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Objective To investigate the relationship of the level of serum C-peptide(C-P)with albumin-to-creatinine ratio(ACR)and nerve conduction velocity(NCV)in patients with T2DM.Methods The study included 132 patients with T2DM and 30 healthy controls.The NCV,ACR,fasting C-P and C-P at 2hOGTT(FC-P and 2hC-P)and plasma glucose(PG)were measured.The patients were separated into three groups of Ⅰ(45 cases),Ⅱ(52 cases)and Ⅲ(35 cases).The patients were further classified into two groups of normal NCV(70 cases)and abnormal NCV(62 cases).Results ①The differences of FC-P and 2hC-P among the ACR groups were significant(all P<0.05).②The ACR was correlated with course,2hC-P,2hPG significantly(all P<0.01).The sequence of the impact degree on ACR was from course(Beta:0.592)to 2hC-P(Beta:-0.297)and to 2hPG(Beta:0.201).③The levels of serum 2hC-P were significantly and gradually decreased in the groups of NCV(P<0.01).④The serum 2hC-P concentration was associated with ACR and NCV in different stages(P<0.01).Conclusions ①The level of serum C-P is tightly correlated with the vascular and neural dysfunction in T2DM.②Course,2hPG and 2hC-P may be the risk factors for ACR
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Objective To observe the changes in plasma leptin in type 2 diabetic patients after treatment with ?-glucosidase inhibitor (Acarbose) and investigate the relationships between them.Methods A 8-week randomized double-blind was performed to compare the effects of treatment with Acarbose (50mg, tid) in 43 type 2 diabetic patients. Results (1) When type 2 diabetics compared with non-diabetic controls, fasting plasma glucose(FPG), 2-hr of postprandial plasma glucose (2hBG), A1C, fasting insulin(FIns), triglyceride(TG) and cholesterol(TC)were elevated significantly,2-hr of postprandial insulin(PIns), HDL-C were decreased(P0.05).(3)In type 2 diabetes, there were positive relationships between leptin and BMI, leptin and fasting insulin , leptin and 2-hr of postprandial insulin.(4)After 8 weeks of treatment with acarbose, FPG, 2hBG, A1C, FIns, PIns,Ch and TG decreased significantly (P0.05).Conclusions: When age, gender, and BMI were matched with the controls, the level of leptin in type 2 diabetic patients still has no difference. Acarbose may lower the change in leptin and improve hyperinsulinemia.