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Objective:To investigate the relationship between blood glucose fluctuation and carotid intima-media thickness (CIMT) in newly diagnosed patients with type 2 diabetes mellitus (T2DM) and the predictive value of betatrophin.Methods:A total of 180 newly diagnosed T2DM patients in Taiyuan Central Hospital from June 2018 to December 2019 were included for the study. And they were divided into normal intima-media group (81 cases), intima-media thickening group (60 cases) and plaque formation group (39 cases) according to the results of carotid ultrasound. The body test indexes, glucose and lipid metabolism indexes, blood glucose fluctuation and betatrophin level were compared among the three groups, and the correlation of these indexes with CIMT and risk factors of CIMT were analyzed.Results:The mean and maximal amplitude of glycemic excursions (AGE) in the plaque formation group and intima-media thickening group were significantly higher than those in the normal intima-media group [(5.08±0.62), (4.06±0.54) vs (3.17±0.41) mmol/L and (5.20±0.72), (4.26±0.54) vs (3.34±0.59) mmol/L] (all P<0.05), and these indexes in the plaque formation group were significantly higher than the intima-media thickening group (all P<0.05). Betatrophin levels in intima-media thickening group and plaque formation group were significantly higher than those in normal intima-media group [(423.35±76.24) and (490.68±97.84) vs (358.29±92.27) ng/L] (both P<0.05). Hip circumference and triglyceride (TG) in plaque formation group were obviously higher than those of the normal intima-media group and intima-media thickening group [(103.5±6.3) vs (97.6±7.0), (99.5±7.4) cm and 2.99 (1.32, 3.92) vs 1.70 (1.21, 2.39), 1.84(1.43, 2.93) mmol/L] (all P<0.05), and waist circumference, systolic blood pressure, fasting blood glucose (FBG), total cholesterol (TC), insulin resistance of homeostasis model assessment (HOMA-IR) levels in plaque formation group were significantly higher than those in normal intima-media group [(94.0 (86.0, 102.0) vs 88.0 (82.5, 94.0) cm, (136.2±18.0) vs (125.9±15.3) mmHg, 10.16 (8.43, 13.23) vs 8.49 (6.98, 9.97) mmol/L, (6.31±0.90) vs (4.99±0.99) mmol/L, 4.90 (3.50, 7.13) vs 2.77 (1.32, 5.07)] (all P<0.05). CIMT was positively correlated with waist circumference, hip circumference, systolic blood pressure (SBP), FBG, TC, TG, HOMA-IR, betatrophin, the mean and maximal AGE, blood glucose fluctuation coefficient (BGFC) (all P<0.05), and it was negatively correlated with time in range (TIR) ( P<0.05). The mean and maximal AGE, TC, TG and betatrophin were independent risk factors of CIMT (all P<0.05). Conclusion:Blood glucose fluctuation is closely related to CIMT in patients with T2DM, and betatrophin is expected to be an early predictor of diabetic macroangiopathy.
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Objective:To observe the therapeutic effects of human umbilical cord mesenchymal stem cells (HUC-MSCs) on insulin resistance, and to investigate the molecular mechanisms in T2DM rats.Methods:The T2DM rats were induced by a high fat and high glucose diet for 10 weeks combined with low-dose streptozocin. Four weeks after infusion of HUC-MSCs via tail vein of the rats, fasting blood glucose, triglycerides, cholesterol were measured. Intraperitoneal glucose tolerance test, intraperitoneal insulin tolerance test and hyperinsulinemic-euglycaemic clamp test were performed to evaluate the islet function and insulin resistance level of rats. The protein expression levels of lipid metabolism signal pathway adenine monophosphate activated protein kinase (AMPK) and acetyl CoA carboxylase (ACC) in liver tissue were detected by western blot.Results:Compared with the T2DM group, HUC-MSCs treatment can significantly reduce fasting blood glucose, triglycerides, total cholesterol levels ( P<0.01), and the values of area under the curve of glucose tolerance and insulin tolerance ( P<0.05) in the T2DM+ HUC-MSCs group. Hyperinsulinemic-euglycaemic clamp test found that compared with the T2DM group, after HUC-MSCs treatment, the glucose infusion rate level was significantly higher in the T2DM+ HUC-MSCs group( P<0.01); Western blot showed that compared with the T2DM group, the ratio of p-AMPK to AMPK and p-ACC to ACC in liver tissues of T2DM+ HUC-MSCs group were significantly increased( P<0.01). Conclusion:Human umbilical cord mesenchymal stem cells treatment may improve lipid metabolism and insulin resistance by activating AMPK/ACC signaling pathways in type 2 diabetic rats.
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Objective To investigate the effects of vitamin D3 supplementation combined with standard-ized hypoglycemic regimen on islet β cell function and macroangiopathy of T2DM patients. Methods A total of 192 patients with type 2 diabetes mellitus were selected and randomly divided into control group and observation group with 96 patients in each group. Patients in two groups were given standardized hypoglycemic regimen, and the observation group was treated with vitamin D3 supplementation in addition. The changes of the indexes of body examination, glycolipid metabolism, islet β cell function and macrovascular complications before and 6 months after treatment were compared between the two groups. Results After 6 months of treatment, BMI, SBP, TG, FBG, FINS, HbA1c and HOMA-IR decreased, while HOMA-β increased in both groups ( P<0. 05) . Compared with the control group, the serum levels of 25 ( OH) D increased, and vaspin and CRP de-creased significantly after 6 months of treatment in the observation group ( P<0. 05) . CIMT and other indicators showed no significant difference. 25 (OH) D was negatively correlated with FBG, FINS, vaspin and CRP, and positively correlated with 1PH and ISI (P<0.05). Conclusion Vitamin D3 is closely related to T2DM and its macrovascular complications, but it has not been found that vitamin D3 supplementation can further improve islet β cell function and macrovascular complications in patients with T2DM.
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Objective To investigate the effects of vaspin on insulin resistants of 3T3-L1 adipocyte through the insulin receptor substrates (IRS) /phosphatidylinositol 3-kinase (PI3K) /protein kinase B (Akt) /glucose transporter (Glut) signaling pathway.Methods 3T3-L1 cells cultured by palmitic acid (PA) were used to establish insulin resistance models,which were divided into PA group,PA + 100 ng/ml vaspin group,PA+200 ng/ml vaspin group,PA+400 ng/ml vaspin group and PA+400 ng/ml vaspin+wortmannin (PI3K inhibitor) group.Glucose uptake and consumption were assessed by 2-deoxy H3-D-glucose incorporation and glucose oxidase-peroxidase respectively.IRS/PI3K/Akt/Glut signaling pathway was evaluated using reverse transcription polymerase chain reaction and Western blot analysis.Results Compared with PA group,glucose uptake and consumption increased gradually with the increasing of vaspin concentration in other groups (P ＜ 0.05).mRNA levels of IRS-1,Akt and Glut 4 increased gradually as vaspin concentration increasing (P＜0.05),and the ratios of p-IRS-1 to IRS-1,p-Akt to Akt and Glut 4 protein level also showed the same trends (P＜0.05).However,glucose uptake and consumption in PA+400 ng/ml vaspin+wortmannin group were less than that of PA +400 ng/ml vaspin group (P＜0.05).PA+400 ng/ml vaspin+wortmannin group showed lower mRNA and protein phosphorylation levels of IRS-1,Akt and Glut 4 (P＜0.05),and that the ratios of p-IRS-1 to IRS-1,p-Akt to Akt and Glut 4 protein levels decreased (P＜0.05).Conclusions Vaspin can improve the insulin sensitivity of 3T3-L1 adipocyte by activating IRS/PI3K/Akt/Glut signaling pathway.
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Objective Through the detection of the levels of serum betatrophin,anthropometric and biochemical indices,to determine the alteration of betatrophin levels in patients with polycystic ovary syndrome (PCOS) and the relationship between betatrophin levels and metabolic indexes such as 25-hydroxy vitamin D3 [25 (OH) D3].Methods The study group was composed of 24 women with PCOS and 20 age-natched healthy women as controls.Following general physical examination of the subjects,anthropometrie measurements were performed (height,weight,waist circumference,hip circumference).Body mass index (BMI) and waist-hip ratio were calculated;25 (OH) D3,Ca2+,fasting blood glucose,fasting insulin,triglycerides,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were also measured and homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated in all subjects.Serum betatrophin levels were examined with an enzyme-linked immunosorbent assay (ELISA).Using independent sample T test to compare the differences between groups,the linear correlation analysis was performed to study the correlation of betatrophin with anthropometric and biochemical indices,the influencing factors of betatrophin were analyzed by multiple linear regression.Results Circulating betatrophin levels [(0.341±0.034) ng/ml vs.(0.810±0.162) ng/ml,t=4.271,P＜0.001] and HDL-C [(1.014±0.321) mmol/L vs.(1.419±0.287) mmol/L,t=2.218,P＜0.05] significantly decreased in women with PCOS compared with controls,and BMI [(27.691±4.392) kg/m2 vs.(23.310±4.781) kg/m2,t=-2.073,P＜0.05],fasting blood glucose [(5.950±0.411) mmol/L vs.(4.883±0.314) mmol/L,t=-2.142,P＜ 0.05],HOMA-IR [(4.946 ± 0.741) vs.(3.387± 0.397),t=-2.493,P＜0.05],triglycerides [(1.510± 0.848) mmol/L vs.(1.037±0.402) mmol/L,t=-2.223,P＜0.05],LDL-C [(3.431±0.479) mmol/L vs.(2.396±0.435) mmol/L,t=-2.433,P＜0.05] were obviously increased.Moreover,there was a postive correlation between betatrophin and HOMA-IR (r=0.425,P＜0.05) as well as 25(OH)D3 (r=0.577,P＜0.05) and Ca2+ (r=0.448,P＜0.05),while the betatrophin was negatively related to BMI (r=-0.451,P＜0.05),triglycerides (r=-0.454,P＜0.05),LDL-C (r=-0.551,P＜0.05).Circulating betatrophin levels were higher when 25 (OH) D3 levels were beyond 35 nmol/L in PCOS patients [(0.539±0.092) ng/ml vs.(0.199±0.031) ng/ml,t=3.072,P＜0.001],and the multiple linear regression analysis showed that the main factors affecting the levels of betatrophin were BMI (OR=-0.260),HOMA-IR (OR=0.218),25(OH)D3 (OR=0.238),and glycerol (OR=-0.162).Conclusion It is speculated that betatrophin may be a valuable predictive factor of PCOS because betatrophin is closely associated with insulin resistance,lipid metabolism disorders and the lack of 25-hydroxy vitamin D3 in PCOS patients.