ABSTRACT
Objective To compare and explore impact of subclinical hypothyroidism on metabolic risk factors of type 2 diabetes mellitus.Methods A total of 204 inpatients with type 2 diabetes mellitus.The patients were divide into two groups according to whether complicated with subclinical hypothyroidism:combination of simple type 2 diabetes mellitus (150 cases) and type 2 diabetes mellitus with SCH group(54 cases),two groups of age,gender,duration were no statistical difference.and collecting the clinical data of two groups of patients by Professional people,detection of blood lipids,glycated hemoglobin (HbA1c),uric acid (UA),Oral glucose tolerance test (OGTT),insulin and C peptide releasing test were taken in all groups.The improvement of insulin,C peptide index [HOMR-islet(CP)] and whole body insulin sensitivity index (ISIcomp) were used to estimate insuhn sensitivity,and improvement of insulin,C peptide secretion index [HOMR-isle (CP)] was used to evaluate the function of pancreatic islet β cell.T test was used for statistic alanalysis.Risk factors of type 2 diabetes mellitus with microvascular Complication by using Logistic regression analysis.Results (1) Compared with type 2 diabetes mellitus group,blood pressure,body mass index (BMI),triglycerides(TC),Low density lipoprotein cholesterol (LDL-C),UA,fasting C peptide(C-P0),postprandial 120 min C peptide(C-Pm),HOMA-IR(CP) were increased (P ＜ 0.05),while fasting blood glucose(FPG),bloods glucose in postprandial 120 min (G120),HbA1c,ISI-comp were decreased (P ＜ 0.05).(2) The incidence of diabetic nephropathy was higher in diabetic patents with subclinical hypothyroidism than those without subchnical hypothyroidism,the difference was statistically significant (P ＜ 0.05).(3) Logistic analysis showed that duration,SBP,TSH were the major risk factors of type 2 diabetes mellitus with nephropathy (P ＜ 0.05).Conclusions Type 2 diabetes mellitus patients with subclinical hypothyroidism compared to pure insulin resistance is more obvious,the degree of lipid metabolism disorders more severe.Elevated TSH can predict the occurrence of diabetic nephropathy in type 2 diabetes mellitus.
ABSTRACT
Objective To investigate the ultrastructure changes of pancreatic islets alpha cells in rats with impaired glucose tolerance.Methods 16 Wistar rats were randomly assigned into normal glucose tolerance group(NGT group,n =8)and impaired glucose tolerance group(IGT group,n =8).NGT group were fed with routine diet and IGT-group were fed with high-sugar high-fat diet.At the 12th week,IGT models were considered successful if the level of 2-hour peripheral blood glucose(2 h PG)was between 7.8 and 11.1 mmol/L in oral glucose tolerance test and continued for more than a week.The pancreas tail of animals in the NGT group and IGT group rats was removed for ultrastructure observation.Alpha cells were observed under transmission electron microscope.Results The big-plump secretory granule with aureole appeared in pancreatic islets alpha cells of NGT group,and it contained a round dense core.The nuclear chromatin and contents were evenly distributed.Mitochondria and en-doplasmic reticulum arranged tightly and orderly.Compared with NGT group,the quantities of secretory granule increased significantly in IGT group.The gap between dense core and membrane was narrower.The quantities of mitochondria and rough endoplasmic reticulum increased significantly.There was no significant change for the structure of the other cell organelle.Conclusion The pathogenesis of IGT is associated with ultrastructural changes and dysfunction of pancreas islets alpha cells.
ABSTRACT
Objective To investigate the effect of glucagon-like peptide-1 agonist (exendin-4) on expression of glucose transporter 4 (GLUT4) in the skeletal muscle of rats with impaired glucose tolerance (IGT).Methodis 54 Wistar rats were randomly assigned into normal glucose tolerance group (NGT group,n =18) and impaired glucose tolerance group(IGT group,n =36).The rats in NGT group were fed with routine diet and the rats in IGT group were fed with high-sugar high-fat diet.At the 12th week,IGT models were tested successful.Then,half of the rats were allocated to intervention group (Ex group) and the rest were set as IGT control group.The rats in Ex group were subject to exendin-4 subcutaneous injection (5 μg/kg,twice daily).Each rat in NGT group and IGT control group was given the same volume of saline as injection.FBG and 2 h BG were measured before intervention and after 4 weeks.The expression of GLUT4 mRNA and GLUT4 in the skeletal muscle were respectively measured by real time quantitative polymerase chain reaction and immunohistochemistry.Inter-group comparison was conducted using analysis of variance (ANOVA) and least square deviation-test (LSD-t).Results Before intervention,compared with NGT-group,the 2 h BG in IGT control group and Ex group were higher,the GLUT4 mRNA of skeletal muscle in IGT control group and Ex group were lower (respectively P ＜ 0.05).The skeletal muscle cells in IGT control group and Ex group were less colored while the skeletal muscle cells in NGT group were colored extensively,and more colored granules.After 4 weeks of exendin-4 intervention,compared with IGT control group and Ex group of non-intervention,the 2 h BG level in Ex group was lower and the expression level of GLUT4 mRNA of skeletal muscle was higher (respectively P ＜ 0.05).After intervened with exendin-4 for 4 weeks,the GLU protein mainly expressed in cytoplasma of skeletal muscle cells.Its expression was higher in Ex group than in IGT group and in Ex group before intervention.Conclusion Exendin-4 may up-regulate the expression of GLUT4,increase glucose intake of the skeletal muscle,and reduce postprandial blood sugar.