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Objective Metabolites produced by metabolic imbalance such as free fatty acids and lipopolysaccharides can result in a state of chronic low-grade inflammation, or metabolic inflammation, which plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders are closely related with the metabolic inflammation, which always coexist. Therefore, we proposed the concept ofmetabolic inflammatory syndrome ( MIS). According to our study, patients with two or more metabolic disorders above could be diagnosed as MIS. The current research is aimed to investigate the prevalence of MIS and its components, and to compare the clinical values of MIS and metabolic syndrome ( MS) . Methods 2 001 in patients with type 2 diabetes from 6 hospitals in Shanghai were recruited in the current multi-center cross-sectional study. The diagnostic rates of MIS and MS and their components of both syndromes were compared. Results In the patients with type 2 diabetes, the detective rate of MIS was 96. 2%, which was higher than that of MS (71. 3%). Among 4 components of MIS, atherosclerosis showed the highest detective rate (75.6%). MIS[OR=2.252(95%CI1.026-4.942),P=0.043],atherosclerosis[OR=2.726(95% CI1.953-3. 804),P<0. 001], and MS[OR=1. 915 (95%CI 1. 444-2. 540),P<0. 01] were the risk factors of coronary heart disease. Conclusion With atherosclerosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and obesity as its 4 components, MIS has a high detective rate in patients with metabolic disorders, and seems to be more sensitive than MS to distinguish inflammation-related metabolic diseases. The concept of MIS will promote the screening and prevention of atherosclerosis in its early stage.
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Objective To compare the efficacy and tolerability of nateglinide with those of acarbose in Chinese type 2 diabetes mellitus (T2DM) patients.Methods This multi-center,randomized,double-blind,parallel-arm study compared the efficacy and tolerability of nateglinide( 120 mg,3/d,n = 119) and those of acarbose( 100 mg,3/d,n = 118) during a 12-week treatment in T2DM patients uncontrolled by diet with glycosylated haemoglobin (HbA1c) 6.5% - 11.0% .Results Monotherapy with nateglinide (120 mg,3/d)or acarbose (100 mg,3/d)decreased HbA1c to a similar extent during 12-week treatment.The mean change from baseline to end-point in HbAlc was ( -0.90±0.98)% and ( -0.83±0.81 )% in patients receiving nateglinide and acarbose,respectively,with no significant difference between the two groups (P>0.05).The decrease in fasting plasma glucose (FPG)was similar between nateglinide and acarbose (P > 0.05).The mean change in 2-hour postprandial plasma glucose ( PG2h ) was ( - 1.45 ± 2.74) mmol/L and ( -2.20±2.21 ) mmol/L in patients receiving nateglinide and acarbose(P =0.0017).Body weight was significantly decreased in both groups at the end-point ( P < 0.05 ),although the decrease was more with acarbese than nateglinide [( -0.66±1.79)kg vs (-2.06±2.00) kg,P=0.0000].And the proportion of patients experiencing any presumed drug related adverse events was not significantly different between the two groups.Conclusions Nateglinide ( 120 mg,3/d) is effective and well tolerated in T2DM patients uncontrolled by diet,demonstrating similar HbA1c reductions as compared with acarbose (100 mg,3/d).
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Objective To understand treatment outcomes of patients diagnosed with type 2 diabetes aged over 30 years in Jiangninglu Neighborhood of downtown Shanghai. Methods Total 642 patients diagnosed as type 2 diabetes aged over 30 were investigated by cluster sampling in Jiangninglu Neighborhood of downtown Shanghai. Status of optimal control of diabetes in them was analyzed based on the recommendations proposed by International Diabetes Federation (IDF) for Western Pacific Region. Results and serum level of glycosylated hemoglobin Alc (HbAlc) of less than 6.5% was achieved in 37.5% (241/were achieved in 23.8% (153/642) and 18.1% (116/642) of them, respectively, and beth systolic and mmol/L was achieved in 21.7% (139/642) of all the participants investigated, triglyceride of less than 1.5 mmol/L in 46.6% (299/642), low-deusity lipoprotein-cholesterol (LDL-C) of less than 2.5 mmol/L in 23.7% (152/642) and high-density lipoprotein-cholesterol of greater than 1.1 mmol/L in 62.1% (399/of their blood glucose, blood pressure and serum LDL-C (defined as HbAlc less than 6.5%, blood pressure less than 130/80 mm Hg and LDL-C less than 2.5 retool/L). Conclusions Only 2.6% of all the patients diagnosed with diabetes aged over 30 in downtown Shanghai get optimal control of their blood glucose, blood pressure and serum lipid, so comprehensive prevention and control for diabetes shall be strengthened for them at community-level of urban areas.
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Objective To raise the level of clinical diagnosis for the patients with pituitary stalk interruption syndrome (PSIS). Methods Five patients (4 males) with PSIS were retrospectively analyzed with respects to the clinical features, endocrine status and image characteristics. Magnetic resonance imaging (MRI) scan was performed at hypothalamic-pituitary region. Results The clinical manifestations of all patients consisted of growth retardation and delayed puberty without polyuria. Deficiency of multiple anterior pituitary hormones was revealed in all patients by the evaluation of endocrine status. The features of MRI included a lack of visible pituitary stalk, absence of posterior lobe hypersignal in the sella turcica and a hyperintense spot in the region of the thalamus opticus. Conclusion The clinical characteristics of patients with PSIS are growth retardation and delayed puberty. The evaluation of anterior pituitary function is necessary. The detection of an anatomical abnormality around hypothalamic-pituitary region by MRI is important diagnostic evidence.
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Purpose To observe the effects of the intervention or prevention of astragalus polysaccharide(APS)on type 1 diabetes in non-obese diabetic(NOD) mice. Methods the APS group was compared withthe normal solution(NS)group by the incidence of diabetes, the serum C-peptide levels and GAD-Ab levels,the proportion of CD4 or CD8 T subsets in splencytes, pancreatic histopathology and immunocyto-chemistry.Results It shows that the APS group has lower incidence of diabetes, higher serum C-P levels, decreaseddegree of the lymphocytic inflammation of pancreatic islets, stronger proliferation of CD8 T subsets and lowerratio of CD4/CD8 subgroup in splencytes than those of the NS group. Conclusions It proves thepreventive effects of APS on the onset of type 1 diabetes in NOD mice.
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PurposeTo investigate the effect of gasoline on the skin barrier function.MethodsA rat skin model in vitro was used in this study. The amount of 3H-water penetrated throught the skin was applied as the index of evaluating the barrier function.ResultsThe results showed that the amount of 3H-water was not obviously increased in those exposed to gasoline for 0.5,1 and 2 h(P > 0.05), but the 3H-water penetration amount through the skin increased linearly with the time. In the group exposed to gasoline 4 h, the 3H-water penetration amount through the skin was significantly higher than that in the control group (P 0.05). The skin barrier function of the group (expopsed to gasoline 4 h) was disrupted.Conclusions Gasoline may disrupt the skin barrier function. Gasoline would remove the lipids within the intercellular domains of the stratum corneum and then lead to damage the skin.
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The effect of diet with various fatty acid composition on insulin resistance in male OLETF ratswas observed. The results showed that it was beneficial to insulin sensitivity in rats fed with ? 3 polyunsaturated fatty acid rich food.
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Objective To evaluate the clinical efficacy and safety of orlistat in Chinese overweight and obese patients. Methods In six research centers, 444 overweight and obese patients (body mass index 25～40 kg/m 2) were divided into orlistat group (296 patients) and placebo group (148 patients) with a low-energy diet for 24 weeks by a randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 286 orlistat-treated and 142 placebo-treated subjects were evaluated. After 24 weeks, orlistat-treated patients lost more weight 〔(6.1?3.6)kg,( x ?s)〕 than placebo-treated patients did (3.0?3.5)kg (P
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To investigate the effect of pancreatic elastase on diabetic nephropathy,104 cases of type Ⅱ diabetic patients were selected as control group and group treated with elastase separately for a course of 6 months.The results showed that pancreatic elastase reduced microproteinuria significantly,especially mi- croalbuminuria and microtransfer rrinuria which reflect the glomerular filtration rate.It was concluded that elastase could improve early diabetic nephropathy and might have some protective effect as well.At the same time,elastase had some good effect on lipid and lipoprotein metabolism.
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AIM:To observe the effect of Shexiang Baoxin Pills on pathologic changes and heart function of streptozotocin(STZ)-induced diabetic rats. METHODS:The rats were randomly divided into the control group,Shexiang Baoxin Pill group and STZ group.The rats in Shexiang Baoxin Pill group took Shexiang Baoxin Pill(50 mg/kg) to perfuse the stomach every day.The cardiac functions in 8 weeksafter treatment were determined.Meantime,the cardiac pathologic changes were observed through electron microscope and immunohistochemistry. RESULTS: Shexiang Baoxin Pills could reduce the interstitial fibrosis of myocardium in STZ rats.it could obviously improve the cardiac contraction and diastolic functions in STZ rats. CONCLUSION: Shexiang Baoxin Pills can(amendment) cardiac pathologic changes and improve cardiac function in STZ rats.
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Serum Ca, P, AKP, plasma iPTH, cAMP, urinary Hyp and BMC were measured in 31 cases of Graves' disease. The results showed that about 66.67% of the patients (including 21 controlled and 10 uncontrolled cases) had a decreased BMC, while serum Ca, P, plasma iPTH, cAMP were within the normal range. The data also showed that about 54.6% of the patients had increased serum AKP, but it would not exceed 25 U if no hepatic disease existed. There were positive correlations between serum T, and urinary Hyp, and between urinary Hyp and serum AKP, but a negative correlation between urinary Hyp and BMC. It was suggested that serum AKP and urinary Hyp could be considered as the indices of negative balance of bone metabolism in Graves' disease, and probably it was induced by excessive thyroid hormone directly.
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Objective To investigate the relationship between serum nitric oxide (NO) and bone metabolism in streptozotocin induced early diabetic (STZ DM) rats. Methods Twenty SD rats were divided into 2 groups, 12 STZ DM rats and 8 controls. Fasting blood glucose, HbA 1c , serum insulin, bone mineral density (BMD) (whole body, lumbar and femoral bone), bone metabolic parameters 〔such as serum calcium, vitamin D 3, parathyroid hormone (PTH), calcitonin, osteocalcin, and urinary pyridinoline/creatinine〕, as well as serum NO were measured. Results Compared with the controls, serum NO in STZ DM group significantly elevated 〔(51.3?11.9 vs 38.1?12.0)?mol/L, P
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The insulinogenic index and RBC membrane insulin receptor analysis in 53 middle-aged and senile normal subjects and 66 cases of NIDDM showed that the amounts of insulin secreted in middle-aged and senile normal subjects were increased, whereas the insulin sensitivity of peripheral tissues and the numbers of RBC insulin receptors were decreased This might be one of the causative factors for glucose intolerance in middle-aged and senile normal subjects. In middle-aged and senile diabetics,the insulinogenic index,the insulin receptor number and the insulin binding capacity were lowered conspicuously than those in normal subjects with similar age.The diagnosis and treatment of senile diabetes were discussed. As to the management, stress may be placed on diet regulation, suitable physical exercise to prevent and control obesity and hypertension, etc. As long as hypoglycemic agent is indicated, sulfonylurea drugs capable of enhancing the glucose utilization in peripheral tissues should be the drug of choice and hypoglycemia be specially watched during the course.
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One hundred and eight cases of Type II diabetics were observed for microcirculation changes on finger nail bed and bulbar conjunctiva before and after 1 year of treatment. The results were compared with respect to the presence or absence of clinical microangiopathy and the status of diabetic control.After treatment, only in those without clinical microangiopathy and those with fairly good control had improvement of microcirculation been observed, suggesting the prime importance of early strict diabetic control in the prevention and treatment of diabetic microangiopathy.