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Objective To investigate the clinical effect of Metformin on inflammation,intestinal flora imbalance,and metabolic impairment in elderly patients with type 2 diabetes mellitus(T2DM) Methods A total of 74 elderly patients with T2DM admitted to our hospital from October 2014 to October 2016 were included in this study and assigned into an intervention group(n=37)and a control group(n=37)according to the sequence of admission.The intervention group was treated with 0.5 g Metformin once a day for 2 weeks,while the control group was given a placebo with the same frequency as in the intervention group.Fresh pre-and post-treatment stool samples were collected in sealed sterile anaerobic growth bags for the detection of changes in patient intestinal flora.Serum inflammatory factor levels,blood glucose levels,and blood lipid levels were measured.Results Before treatment,the numbers of beneficial intestinal flora(bacillus bifidus,bacillus acidi lactici,and bacteroides)in the intervention group were lower than in the control group(all P＜0.05);The levels of serum inflammatory factors(CRP,IL-6,and TNF-α)in the intervention group were higher than in the control group(all P ＜0.05);The levels of parameters for glucose and lipid metabolism(HbA1c,FPG,TC,TG,and LDL-C)in the intervention group were higher than in the control group,while the level of HDL-C was lower than in the control group (all P ＜ 0.05).After treatment,the number of beneficial intestinal flora significantly increased in the intervention group(all P＜0.05)but was not different from that in the control group(all P＞0.05);The levels of serum inflammatory factors had significant reductions in the intervention group compared with pre-treatment levels(all P＜0.05)but demonstrated no difference from those in the control group(all P＞0.05);Parameters for glucose and lipid metabolism in the intervention group showed improvement(all P ＜0.05)after treatment but no difference was observed between these two groups(all P＞0.05).Conclusions Metformin can effectively control blood glucose and blood lipid levels in elderly patients with T2DM,improve the chronic inflammatory state,increase the number of beneficial intestinal bacteria,and regulate flora imbalance.
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Objective To investigate the correlation between the expression levels of miRNAs and the pathogenesis of diabetes mellitus.Methods A total of 120 patients with type 2 diabetes recruited from October 2014 to October 2016 and 40 healthy individuals as a control group were included in this study,and diabetic patients were further divided into newly diagnosed group(n=40),prediabetes group(n =40),and susceptibility group (n =40).The fasting blood of four groups were collected,and real-time RT-PCR was applied to measure the expression levels of miRNAs including miR-9,miR-124a,miR-375,miR-29a,miR-126,miR-197,miR-233,and miR-320.The relationship between the pathogenesis of disease and miRNAs expression levels was analyzed.Results The levels of miRNA in the three diabetes groups were obviously higher than in the control group(P＜ 0.05).The miRNA expression level showed a certain trend in diabetic patients.The higher levels of miR-9,miR-124a,miR-375,and miR-29a were observed in the three diabetes groups,while the levels of miR-126,miR-197,miR-233,and miR-320 were decreased in these three groups.The expression levels of miR-9,miR 124a,miR-375,and miR-29a of miRNAs were correlated with the onset of diabetes(RR =5.96,6.32,5.24.5.69,all P＜ 0.05).Conclusions The level of miRNA is associated with the onset of diabetes that suggests it may be used to predict the occurrence and development of diabetes.
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Objective To explore the relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease (NAFLD).Methods Data collected from 97 patients with type 2 diabetes mellitus(T2DM)admitted to the Department of Geriatric Endocrinology of the First Affiliated Hospital of Zhengzhou University from June 2014 to April 2015 were retrospectively analyzed.Patients were divided into the T2DM group(type 2 diabetic patients without NAFLD,n＝ 47)and the NAFLD group(T2DM patients with NAFLD,N ＝ 50).Healthy elderly subjects (n ＝ 30)from the same period served as the control group.Body mass index(BMl),osteocalcin,fasting blood glucose,fasting insulin,homeostasis model assessment for insulin secretion index (HOMA-β) and insulin resistance (HOMA-IR),glycosylated hemoglobin(HbA1c),total cholesterol,triglyceride,high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL C)were compared between the 3 groups.Results Levels of fasting blood glucose,fasting insulin,HbAlc,total cholesterol,triglyceride,LDL-C and HOMA IR were higher,while levels of HDL-C,HOMA-β and osteocalcin were lower in the T2DM and NAFLD groups than in the control group(all P＜＜0.05).Levels of BMI,fasting glucose,fasting insulin,HbAlc,total cholesterol,triglyceride,LDL-C and HOMA-IR were higher and levels of osteocalcin were lower in the T2DM group than in the NAFLD group(all P＜0.05).Pearson correlation analysis showed that the osteocalcin level was negatively correlated with fasting blood glucose,HbA1C,HOMA IR and BMI(r＝-0.701,0.442,-0.337 and 0.543,P＜0.05 or P＜0.01),and positively correlated with HOMA-β (r ＝ 0.341,P ＜ 0.05) in the NAFLD group.With serum osteocalcin as the dependent variable,multiple linear regression results showed that fasting blood glucose was an independent influencing factor for serum osteocalcin(β＝-1.57,P＜0.05)in the fatty liver group.Conclusions Serum osteocalcin levels significantly decrease in elderly T2DM patients with NAFLD,are closely correlated with glucolipid metabolism,and may have some important clinical significance in the prevention and treatment of NAFLD in elderly patients with type 2 diabetes.
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Objective To investigate the prevalence and features of thyroid nodules in middle and aged patients with type 2 diabetes mellitus(T2DM). Methods High-resolution ultrasonography was used to detect thyroid nodules in 132 cases middle and aged patients with type 2 diabetes and 89 patients without diabetes.The nodule features and its relationships with related indicators in diabetic patients were analyzed. Results The prevalence of thyroid nodules in middle and aged patients with type 2 diabetes was higher than that without diabetes (67.4％ vs. 53.9％,P＜0.05),and most occurred in 50 to 59 age group (66.7％ vs. 42.9％) without dependence on changes in thyroid functions and volumes.In diabetes group,the prevalence of thyroid nodules were 59.5％ in male and 81.3％ in female (P＜0.05),no obvious difference was observed in the size and number of thyroid nodules between male and female,multiple nodules and micronodule (＜ 1.0 cm) had the higher incidences in both sexes.The prevalence of thyroid nodules was increased with aging,but not with diabetes duration and glycosylated hemoglobin (HbAlc) level (x2 =0.797,P=0.372; x2 =1.078,P =0.229). Conclusions It is common that thyroid nodules combined with diabetes in middle and aged patients,thyroid ultrasound screening and regular following-up of patients aged ≥50 years have important clinical significance.
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Objective To investigate the characteristics of the blood glucose fluctuation in elderly patients with type 2 diabetes mellitus (T2DM). Methods The 92 elderly patients with T2DM (the elderly group) and 58 young and middle-aged patients with T2DM (the non-elderly group) were monitored using the continuous glucose monitoring system(CGMS). The characteristics of glucose profiles of the two different age groups, and of the different glycosylated hemoglobin (HbA1c) level groups in the elderly were comparatively analyzed. Results (1)There was no significant difference in HbA1c level between the elderly group and the non-elderly group. Compared with the non-elderly group, the elderly group showed the increases in blood glucose fluctuant coefficient [BGFC, (2.68±1.00) mmol/L vs. (2.12±0.74) mmol/L, t=-3.691, P＜0.001], in postprandial glucose excursion (PPGE) of breakfast and supper [(5.96±2.47) mmol/L vs. (5.11±2.44) mmol/L, t=-2.058, P＜0.05; (5.17±2.15) mmol/L vs. (4.16±2.28) mmol/L, t=-2.730, P＜0.01], in the time to postprandial glucose peak of breakfast and lunch [(112.5±29.7) min vs. (97.0±27.2) min, t=-3.225, P＜0.01; (140.0±39.7) min vs. (118.1±42.6) min, t=-3.195, P＜0.01], in the frequency of hypoglycemia (26.3% vs. 5.5%, P＜0.05), and showed the largest amplitude of glycemic excursions [LAGE, (9.66±2.48) mmol/L vs.(8.40±3.13) mmol/L, t=-2.720, P＜0.01]. (2)In the elderly, along with decreased HbA1c, the incidence of hypoglycaemia increased (P＜0.05); And along with increased HbA1c, the amplitude of blood glucose fluctuation increased. There were significant differences in BGFC, PPGE of breakfast and lunch, and LAGE among different HbA1c level groups (P＜0.01, P＜0.05, P＜0.05, P＜0.001). (3)HbA1c was positively correlated with FBG, mean blood glucose (MBG), percentage of time at glycemia (PT7.8, PT11.1), the lowest blood glucose (LBG), the highest blood glucose (HBG), BGFC, PPGE and LAGE (r=0.899-0.289, all P＜0.001). Multiple stepwise regression analysis indicated that MBG, FBG and PT7.8 was the independent influential factor of HbA1c (adjusted R2=0.807, P＜0.05). Conclusions The elderly patients with T2DM are at a particularly high risk for postprandial hyperglycemia and nocturnal hypoglycemic episodes, CGMS could show glucose fluctuation characters of T2DM patients diurnally, and provide a clinical basis for reasonable therapy.