Hypoadiponectinemia predicts impaired endothelium-independent vasodilation in newly diagnosed type 2 diabetic patients: an 8-year prospective study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adiponectin is an adipokine with insulin-sensitising and anti-atherogenic properties. The aim of this study was to investigate whether low adiponectin levels predict the impairment of endothelial function in newly diagnosed type 2 diabetic patients in an 8-year prospective study.</p><p><b>METHODS</b>In the prospective study, we enrolled 133 newly diagnosed type 2 diabetic patients without subclinical atherosclerosis and gave them intensive therapy; the mean treatment period was 8 years. Intensive treatment was a stepwise implementation of behavior modification and pharmacological therapy targeting hyperglycaemia, hypertension, dyslipidaemia and obesity. We measured baseline circulating adiponectin with an enzyme-linked immunosorbent assay, endothelium-dependent and -independent vasodilation by high-resolution vascular ultrasound. At year 8, 102 patients were reexamined for endothelium-dependent and -independent vasodilation.</p><p><b>RESULTS</b>Sex-adjusted adiponectin level was positively correlated with endothelium-independent vasodilation both at baseline (r = 0.150, P = 0.043) and at year 8 (r = 0.339, P = 0.001), whereas no association was found between adiponectin and endothelium-dependent vasodilation. In a stepwise multivariate linear regression model, adiponectin was an independent predictor for impaired endothelium-independent vasodilation at year 8 (P = 0.001).</p><p><b>CONCLUSIONS</b>Plasma adiponectin concentration was associated with endothelium-independent vasodilation and hypoadiponectinemia predicted the impairment of endothelium-independent vasodilation in newly diagnosed type 2 diabetic patients under multifactorial intervention. These data support the causative link of impairment of endothelium-independent vasodilation with hypoadiponectinemia.</p>

Comparison of 3 working definitions of metabolic syndrome in male medical examinees / 中南大学学报(医学版)

OBJECTIVE@#To compare the prevalence of the metabolic syndrome (MS) using 3 working definitions proposed respectively by the World Health Organization (WHO, 1999) , the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults ( ATP III, 2001 ), and the Chinese Diabetes Society ( CDS, 2003).@*METHODS@#MS was diagnosed in 739 male medical examinees by the 3 working definitions respectively, then the prevalence and the concordance of 3 working definitions was compared.@*RESULTS@#Among 739 participants the prevalence was 36.9% by the WHO definition, 11.8% by the ATP III definition and 21.0% by the CDS definition. Among all the testees 68.6% were classified as either having or not having the MS under the 3 definitions. The consistency in the diagnosis of MS was 72.5% by the WHO definition and the ATP III definition, 81.2% by the WHO definition and the CDS definition, and 83.5% by the ATP III definition and the CDS definition. The prevalence of insulin resistance was the highest among the components of the WHO definition. The prevalence of hypertension was the highest while the prevalence of obesity was the lowest by the ATP III definition. Among the components of the CDS definition, the prevalence of obesity was the highest. The fasting insulin and insulin resistant index (HOMA-IR) were both significantly higher in the MS subjects than that in the non-MS subjects.@*CONCLUSION@#A universally accepted definition of the metabolic syndrome is needed.

Risk factors for the progress of subclinical atherosclerosis in newly diagnosed type 2 diabetics with multifactorial intervention / 中华全科医师杂志

Objective To investigate risk factors for the progress of subclinical atherosclerosis (AS)in newly diagnosed type 2 diabetics with muhifactorial intervention.Methods One hundred and fifty- six patients of type 2 diabetes,aged 35～70 years,with course of less than one year and without subclinical AS,were observed prospectively.After two-year intervention based on anti-platelet therapy integrated with intensive control of blood glucose,blood lipid,blood pressure and body weight,dynamic changes in all metabolic indicators and subclinical AS in the patients and differences between those with subclinical AS and without it were analyzed to study the risk factors for its progress by logistic regression analysis.Results There were no significant differences in intima-medial thickness(IMT)of common carotid artery(CCA) and femoral artery(FA)in the patients between baseline and two years after intervention,but those in them were significantly increased two years after intervention than those one year after intervention(P＜0.O1). Two years after intervention,increased IMT or atherosclerotic plaques could be found in 45 of 156 patients (28.8%),significantly higher than those one year after intervention(11.5%,P＜0.01).Levels of glycosylated hemoglobin Alc(HbAlc),total cholersterol(TC),high-density lipoprotein-cholesterol (HDL-C)and HOMA-insulin resistance(IR)showed an increased trend two years after intervention,as compared with those one year after intervention(P＜0.01).Proportions of those with normal level of HbAlc two years after intervention was significantly lower than that one year after intervention(P＜0.01). Proportions of those with normal level of HbAlc and low-density lipoprotein-cholesterol(LDL-C)were significantly lower in patients with subclinical AS than those without it two years after intervention(P＜0.01).Logistic regression analysis showed that relative risk(RR)for subclinical AS could reduce by 83% with normal level of LDL-C and 59% by normal HbAlc,respectively,but there was an 82% increase in RR for it with an increase of age by ten years.Conclusions Subclinical AS could not be absolutely prevented in patients with newly diagnosed type 2 diabetics after two-year intensive multifactorial intervention.Subclinical AS could present a progressive trend with time,as well as levels of blood glucose and blood lipid.Levels of LDL-C and HbAlc,as well as age,were major risk factors for occurrence of subclinical AS in patients with newly-diagnosed type 2 diabetes.