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Objective A multicenter, randomized, controlled and open-labled clinical trial was performed to compare the efficacy and safety of recombinant human insulin injection ( Yousilin R) and treated with Yousilin R versus Novolin R for 12 weeks respectively. Results Compared with baseline,the levels of glycosylated hemoglobin A1c ( HbA1c ) at the end of 12 weeks treatment decreased from 10. 77% to 7. 72% ( P ＜0. 05 ) in Yousilin R group and from 10. 33% to 7. 62% ( P ＜0. 05 ) in Novolin R group,2-hour postprandial plasma glucose ( 2hPG ) decreased from 15.49 mmol/L to 9. 72 mmol/L ( P ＜ 0. 05 ) in Yousilin R group and from 15.33 mmol/L to 10. 07 mmol/L( P ＜ 0. 05 ) in Novolin R group, and fasting plasma glucose (FPG) decreased from 10. 90 mmol/L to 7. 31 mmol/L( P ＜0. 05 ) in Yousilin R group and from 10. 22 mmol/L to 7.21 mmol/L (P ＜0. 05) in Novolin R group. The changes of HbA1c, 2hPG and FPG from baseline to endpoint in Yousilin R group was similar to those in Novolin R group ( P ＞ 0. 05 ).Furthermore, hypoglycemic events(26. 42% vs 30. 48% ), other adverse events( 13.21%vs 16. 19% ) ,and serious adverse events( 1.89%vs 1.90% )were comparable between Yousilin R and Novolin R groups(P ＞0. 05 ). Conclusions Yousilin R has similar efficacy, safety and compliance profiles to Novolin R group in the treatment of diabetic patients.
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BACKGROUND: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord can induce differentiation into islet-like cells.OBJECTIVE: To verify the possibility of human umbilical cord derived mesenchymal stem cells co-cultured with rat pancreatic cells differentiate into islet-like cells, and to observe the effects of transplantation of islet-like cells on blood glucose of diabetic rats.METHODS: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord was separated, induced, passaged, and co-cultured with pancreatic cells to induce differentiation into islet-like clusters. Rats were divided into the normal control, model and experimental groups. Rats in the model group were prepared for diabetic models, and those in the experimental group were transplanted islet-like cells after model preparation. RESULTS AND CONCLUSION: There were cells crawled out of cultured Wharton's Jelly of the human umbilical cord, and morphology of adhered cells turned into fusiform shape at 7 days. The isolated cells are characterized by expressing specific surface markers of mesenchymal stem cells, such as CD44, CD29, CD105, but not expressing CD34, CD45 or CD14. The cells were strongly stained by PDX-1 and human insulin at 7 and 10 days. Compared with the simple culture group, the expression of human insulin and concentration of C-peptide were obviously increased; PDX-1 and human insulin mRNA expressions were highly expressed at 7 and 10 days after induction. Compared with the model group, the streptozotocin test of rats in the experimental group was obvious decreased (P < 0.01), but extremely higher than that of the normal control group at 1 week after transplantation (P < 0.01). Brdu positive nuclei and insulin positive kytoplasms could be seen in the experimental group at 8 weeks after transplantation. The results demonstrated that, umbilical cord derived mesenchymal stem cells existed in Wharton's Jelly. The co-cultured cells promote mesenchymal stem cells differentiating into islet-like cells, which can dramatically decrease blood glucose in diabetic rats.
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ObjectiveTo investigate the risk factors of metabolic syndrome ( MS ) in obese subjects.Methods A seven-year follow-up study was conducted in 413 simple obese subjects and 196 subjects with normal body weight who were recruited from community residents during physical examination in 2000.There was a 7 years follow-up.Anthropometrics,blood pressure,lipid profile,fasting blood glucose,and 2 h blood glucose after glucose loading were measured.Endothelium-dependent dilatation (EDD) test was also performed.Results Among 553 of 609 subjects who were followed up in 2007,there were 381 simple obese subjects ( simple obese group) and 172 normal weight subjects( normal weight group).Seven-year cumulative incidence of MS was 35.17％ in simple obese group and 8.14％ in normal weight group.In simple obese group,subjects with MS showed greater or higher levels of waist circumference( WC ),waist-hip ratio ( WHR ),triglyceride ( TG ),fasting plasma glucose ( FPG ),fasting insulin (FINS),and homeostasis model assessment for insulin resistance index (HOMA-IR) (all P＜0.05 ),and also decreased EDD( P＜0.05 ) as compared with those without MS.WC,WHR,and FINS were higher( all P＜0.05 ) and EDD was lower( P＜0.05 ) in subjects with MS of normal weight group than those without MS.Logistic analysis showed that the male gender,WC,WHR,FPG,HOMA-IR,and EDD were major risk factors of MS.Conclusion Central obesity,insulin resistance,and endothelial dysfunction are important independent risk factors for development of MS.
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Objective To investigate the relationship between Trp64Arg mutation in β3-adrenerglc receptor (β3-AR) gene and the incidence of metabolic syndrome (MS). Methods A seven-year follow-up study was conducted in 386 simple obese subjects and 175 normal weight subjects in whom geno-typing of Trp64Arg mutation in β3-AR gene was examined in 2000. Results There were no differences between a Trp64Trp homozygote group and a Trp64Arg heterozygote group of whether obese or normal weight subjects with respect to adiposity, blood pressure, lipid profile, fasting blood glucose and fasting insulin in the baseline. The results of follow-up indicated that the incidence of MS in the Trp64Arg heterozygote group was higher than that in the Trp64Trp homozygote group of obese males (54. 76% vs 40. 85% ,P <0. 05) but not in the group of obese females. The incidences of MS both in the Trp64Trp homozygote group and Trp64Arg heterozygote group were higher in obese males than in obese females (40. 85% vs 18. 27% and 54. 76% vs 21.28% ,all P <0. 01 ) . No significant differences were found in incidences of MS both in the Trp64Trp homozygote group and Trp64Arg heterozygote group of normal weight subjects whether the comparison was made between males and females respectively or between males and females. The overall incidence of MS in the obese subjects were significantly increased than that in the normal weight subjects whether there was genevariant or not(31.30% vs 6. 03% and 42. 75% vs 12. 73%, all P <0. 01 ). Logistic analysis showed thatβ3-AR gene variant was associated with increased incidence of MS in males. Conclusion β3-AR gene Trp64Arg mutation is an independent risk factor for the incidence of MS in males.Conclusion β3-AR gene Trp64Arg mutation is an independent risk factor for the incidence of MS in males.
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Objective To approach the effect of down regulation of fast glucose damge standard on endothelial funtion. Methods The FBS 、serum lipid、 uric acid of 54101 normal subjects were detected, those subjects were divided by FBG value into four groups: A B C D ,the value of TC、 TG、 uric acid in group B were higher than which in group A, lower than in group C. The value of PBG、FINS、PINS、ET、NO of 655 subjects choiced randomly were detected .At the same time the endodermis dependence angiectasia funtion mediated by bloodstream and the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate were detected . Results The value of group B was lower than which in group A, having no statistical meanings compared with group C、D;the no-endodermis dependence angiectasia funtion mediated by glycerol trinitrate of group B was higher than that of group C, that of group C was lower than group A, the comparison of other two groups has no statistical meanings. Conclusions Down regulation of fast glucose damge standard can effect on the endothelial funtion.
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Insulin pumps go by the name of the second revolution of treatment for diabetes. The result of DCCT publicized in 1993, insulin pumps have been popularized in the world, including China. This article introduces such about insulin pumps as its history, actuality, development trend, advantages and disadvantages.
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Objective To investigate if there are differences of antihypertensive effect of captopril on the patients with essential hypertension(EH)alone and EH complicated with type 2 diabetes mellitus(DM).Methods Sixty three EH patients alone and 112 EH patients complicated with DM were studied. Among the patients complicated with DM, 56 cases who were treated with metformin and received captopril for 4 weeks. The changes of blood pressure,blood glucose,insulin,lipid, norepinephrine(NE),epinephrine(E)and uric acid were observed before and after treatment.Results After treatment by captopril the blood pressure was reduced and insulin sensitivity was increased in EH patients without complications,while no significant changes in EH patients with DM. After captopril in combination with metformine for 4 weeks in EH with DM,the blood pressure was significantly reduced and all examinations cited above were improved.Conclusion Captopril is suitable for EH patients without complications but not for EH patients with DM. After captopril combined with metformine resulted in the improvement of hyperglycemia and hyperinsulinemia, the anti-hypertensive effect of captopril was shown.
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Objective To investigate the relationship between serum leptin levels and insulin resistance(IR)in obesity and hypertensive patients and their role on the occurrence of hypertension or/and obesity.Methods Serum glucose,insulin,total cholesterol(TC),triglycerides(TG),HDL－ C,LDL－ C,uricacid(Ur),insulin sensitivity index(ISI),urinary albumin excretion(UAE)and serum leptin concentrations were determined in 66 men with essential hypertension and 67 male normotensives.The correlations between leptin and IR,and they and body mass index (BMI),blood pressure and other parameters were analyzed.Results Serum leptin levels were signifcantly higher in hypertensive and obesity subjects than in normotensive and nonobesity ones.ISI of nonobesity was higher than obesity in normotensive group,but both obesity and nonobesity ISI was higher in normotensive group than in hypertensive one .No significant change in obesity and nonobesity was found for the decreased levels and ISI(r=－ 0.51,P<0.01 and r="－" 0.38,P< 0.05,respectively ) and the most singificant factors that affected serum leptin levels were BMI,waist hip ratio and ISI and the factors that affected ISI in order of importance were BMI,SBP,DBP,TG,Ur and leptin in obesity subjects of both hypertensive and ISI in above mentioned patients.The multiple regression analysis indicated that BMI was closely correlated with leptin,ISI and TG in obesity patients of both hypertensive and normotensive groups. Conclusion The increase in serum leptin levels in obesity is highly correlated with ISI and is correlated with lipid metabolism.leptin resisitance may has a indirect action in occrrence of hypertension and the correlation with IR remain to be sutdied.
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The results observed in normal weight group (81 subjects), simple obese group (140 subjects) and hyperglycemic obese group (97 subjects) showed that there was a significantly positive correlation between ? cell function and endothelium-dependent vasodilation function (EDV) in hyperglycemic obese group (r=0.52, P
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Objective To explore the relationship between endothelial dysfunction and insulin resistance (IR) during reduction of body weight in obese subjects. Methods 260 obese subjects without metabolic disorders, cardiovascular disease and other clinically detectable diseases were enrolled in this study. Among them 157 patients were found to have impaired endothelial function and 103 with normal endothelial function. They were randomly divided into body weight reduction intervention group and nonintervention group. The measures of intervention included food restriction, exercise, and drugs for weight reduction, and they were continued for two years. 87 subjects with normal weight and without endothelial dysfunction served as normal control. IR index (HOMA-IR) and flow-mediated endothelium-dependent dilatation function were measured before and after the study period. Results After two years, it was found that the endothelial function was markedly improved (4.56?4.79 vs 15.17?5.80, P