Research progress of autophagy in non-alcoholic fatty liver disease / 上海交通大学学报（医学版）

Non-alcoholic fatty liver disease is a type of metabolic liver injury which is closely related to insulin resistance. Now it has become the leading cause of chronic liver diseases worldwide, which is closely related to the high incidence of type 2 diabetes and arteriosclerotic cardiovascular disease. It can progress into cirrhosis and hepatocellular carcinoma. The pathogenesis of non-alcoholic fatty liver disease is complicated and not yet fully elucidated. In recent years, studies have found that autophagy plays an important role in the development of non-alcoholic fatty liver disease, mainly through regulation of insulin resistance, endoplasmic reticulum stress, mitochondrial dysregulation, lipid-toxicity caused by lipid deposition and inflammation.

Relationship between waist circumference and elevation of carotid intima-media thickness in newly-diagnosed diabetic patients / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Waist circumference, as a brief indicator of visceral obesity, is associated with multi-metabolic disorders and cardiovascular diseases. The present study was aimed to find out the relationship between waist circumference and carotid intima media thickness (C-IMT), as well as the best waist circumference cutoff for identifying C-IMT elevation in Chinese male patients with newly-diagnosed diabetes.</p><p><b>METHODS</b>Five hundred and seventy-eight patients from Department of Endocrinology and Metabolism in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University were enrolled. Both physical examination (for measurement of waist circumference) and carotid ultrasonography (for measurement of C-IMT) were performed.</p><p><b>RESULTS</b>After grouping according to the quartiles of C-IMT, the waist circumference increased across all its quartiles. The waist circumference in 3rd and 4th quartiles (90.7±9.8 cm and 90.8±9.6 cm) was significant higher than in 1st and 2nd quartiles (P<0.05). When subjects were divided into 4 groups according to waist circumference, the C-IMT of subjects with waist circumference 90-95 cm was significant higher than that of subjects with waist circumference 85-90 cm and less than 85 cm respectively (P<0.05). Both spearman and partial correlation analysis showed that C-IMT was positively correlated with waist circumference (P<0.01). C-IMT was found significantly elevated with the increase of waist circumference. Multiple stepwise regression analysis showed that waist circumference was one of the independent risk factors of C-IMT. After an average of 2.23±0.85 years follow up, there was a significant elevation of C-IMT in the group with baseline waist circumference over 90 cm P<0.05), while no significant difference was detected in the group with baseline waist circumference less than 90 cm (P=0.27). Logistic regression showed that baseline waist circumference over 90 cm was associated with a relative risk to C-IMT elevation of 1.132 (95% CI 1.043-1.431, P<0.05).</p><p><b>CONCLUSION</b>Among newly-diagnosed diabetic male patients, waist circumference over 90 cm not only reflects sub-clinical atherosclerosis in early stage, but also predicts the progression of atherosclerosis.</p>

Correlation between waist circumference and carotid intima-media thickness in women from Shanghai, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate whether waist circumference (WC) ≥85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China.</p><p><b>METHODS</b>A total of 2365 females aged ≥20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness (C-IMT) was measured.</p><p><b>RESULTS</b>The C-IMT was significantly higher in overweight or obese women with their BMI ≥25.0 kg/m2(P<0.01) and in those with their WC ≥85 cm than in those with their WC <85 cm (P<0.01). Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC <85 cm (P<0.01) while no significant tendency was found in the subgroup with its WC≥85 cm (P=0.07).Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC ≥80 cm, ≥80 cm and <85 cm and ≥85 cm for evaluating the risk of C-IMT elevation was 1.632, 1.501, and 1.878, respectively.</p><p><b>CONCLUSION</b>WC is significantly correlated with C-IMT in women from Shanghai, China, and WC≥85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.</p>

Association of a SLC30A8 genetic variant with monotherapy of repaglinide and rosiglitazone effect in newly diagnosed type 2 diabetes patients in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate a potential relationship between Solute carrier family 30 (zinc transporter) member 8 (SLC30A8) rs13266634 variant and efficacy of rosiglitazone or repaglinide in treating newly diagnosed Chinese type 2 diabetes patients.</p><p><b>METHODS</b>A total of 209 diabetic patients without any antihyperglycemic history were recruited and treated with repaglinide or rosiglitazone randomly for 48 weeks (104 and 105 patients, respectively). Anthropometric measurements and clinical laboratory tests were carried out before and after the treatment. An non-synonymous variant rs13266634 was genotyped by matrix-assisted laser desorption ionization-time of flight mass spectroscopy.</p><p><b>RESULTS</b>Ninety-one patients in repaglinide group and ninety-three patients in rosiglitazone group completed the study. Δ value of homeostasis model assessment of beta cell function (HOMA-B) and Δ value of fasting proinsulin levels were statistically significant between three genotype groups (P=0.0149 and 0.0246, respectively) after rosiglitazone treatment. However, no genotype association was observed in the repaglinide or rosiglitazone group with other parameters.</p><p><b>CONCLUSION</b>The SLC30A8 variant was associated with the efficacy of insulin sensitizer monotherapy on insulin secretion in patients with newly diagnosed type 2 diabetes mellitus in Shanghai, China.</p>

A case with insulinoma localized by combined use of various means / 中华医学杂志(英文版)

A patient with insulinoma diagnosed by clinical features and localized preoperatively using a combination of contrast-enhanced ultrasonography (CEUS), dual phase contrast enhanced spiral computed tomography (DPSCT) and arterial stimulation and venous sampling (ASVS) was reported. A 37-year-old man was admitted to our hospital because of hypoglycemic attacks, palpitations, and muscular weakness. Fajans' ratio reported to be an index for insulinoma was positive. Transabdominal computed tomography and ultrasonography failed to detect any abnormalities. CEUS showed a small low echoic lesion in the pancreatic body with blood flow and the early arterial phase of DPSCT revealed a small strengthening focus, which mimicked a pancreatic tumor in the pancreatic body. ASVS showed that the insulin levels in the hepatic vein were extremely increased by calcium injection to the gastroduodenal artery. An open intra-abdominal operation was performed and an insulinoma was confirmed in the pancreatic body. Enucleation of tumor was undertaken and histopathological examination showed an adenoma, insulin expression was positive in immunofluorescence staining. Symptomatic hypoglycemia never happened even without glucose infusion since the operation. His blood glucose level improved to within the normal range.

Comparison of body mass index with body fat percentage in the evaluation of obesity in Chinese / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate the present Chinese body mass index (BMI) criteria with body fat percentage (BF%) in determining obesity in Chinese population.</p><p><b>METHODS</b>A total of 4 907 subjects (age: 20-90 yrs) were enrolled in the baseline survey of a longitudinal epidemiological study, and 2 638 of them were reevaluated in 5.5 years later. The Chinese BMI and WHO BF% were used to define obesity, respectively.</p><p><b>RESULTS</b>The diagnostic agreement between the Chinese BMI and WHO BF% definitions for obesity was poor for both men (kappa: 0.210, 95% CI: 0.179-0.241) and women (kappa: 0.327, 95% CI: 0.296-0.358). However, BMI had a good correlation with BF% both in men (r: 0.785, P<0.01) and women (r: 0.864, P<0.01). The age and sex-adjusted relative risks (RR) for incidence of type 2 diabetes (T2DM) were significantly higher in subjects with intermediate BF% (BF%:20.1%-25% for men, 30.1%-35% for women) (RR: 2.35, 95% CI: 1.23-4.48) and high BF%(BF%>25% for men and > 35% for women)(RR: 2.89, 95% CI: 1.43-5.81), or in subjects with high BMI (BMI>or=28 kg/m(2)) (RR: 2.46, 95% CI: 1.31-4.63) when compared to those with low BF% (BF%<or=20% for men and<or=30% for women) or low BMI (BMI24 kg/m(2)) respectively. No difference in risk could be found in those with intermediate BMI (BMI: 24-27.9 kg/m(2)) (RR: 1.44, 95% CI: 0.86-2.40), as compared to those with low BMI (BMI<24 kg/m(2)), whose BF% ranged widely from 7.8 to 50.3%.</p><p><b>CONCLUSION</b>BMI was correlated with BF%. Both BMI and BF% were associated with high risk for T2DM. However, BMI had its limitations in the interpretation of subjects with BMI between 24 and 27.9 kg/m(2).</p>

Precise microdeletion detection of Prader-Willi Syndrome with array comparative genome hybridization / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Prader-Willi Sydrome (PWS) is a human disorder related to genomic imprinting defect on 15q11-13. It is characterized by a series of classic features such as hypotonia, hyperphagia, obesity, osteoporosis, typical facial and body dysmorphosis, hypogonadism, mental and behaviour disorders. Our study was designed to precisely detect the microdeletions, which accounts for 65%-70% of the PWS.</p><p><b>METHODS</b>Physical and laboratory examinations were firstly performed to diagnose PWS clinically, and to discover novel clinical features. Then the patient was screened with bisulfite-specific sequencing and precisely delineated through high-density array CGH.</p><p><b>RESULTS</b>With the bisulfite-specific sequencing, the detected CpG island in the PWS critical region was found homozygously hypermethylated. Then with array CGH, a 2.22 Mb type II microdeletion was detected, covering a region from MKRN3, MAGEL2, NDN, PWRN2, PWRN1, C12orf2, SNURF-SNRPN, C/D snoRNAs, to distal of UBE3A.</p><p><b>CONCLUSIONS</b>Array CGH, after the fast screening of Bisulfite-specific sequencing, is a feasible and precise method to detect microdeletions in PWS patients. A novel feature of metacarpophalangeal joint rigidity was also presented, which is the first time reported in PWS.</p>

Association of apelin genetic variants with type 2 diabetes and related clinical features in Chinese Hans / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Apelin is an adipokine that contributes to the pathogenesis of type 2 diabetes. The plasma levels of apelin increased in obese patients and diabetic subjects. This study aimed to investigate the effects of apelin genetic variants on type 2 diabetes and related quantitative traits.</p><p><b>METHODS</b>We selected three single nucleotide polymorphisms (SNPs) that could capture all common variants in APLN gene region and genotyped them in 1892 type 2 diabetic patients and 1808 normal glucose regulation controls. The clinical features related to glucose metabolism were measured in the controls. The comparison of allele and genotype distribution in the cases and controls were performed by using chi(2) tests. The association between SNPs and quantitative traits were analyzed using Wilcoxon's rank-sum test.</p><p><b>RESULTS</b>None of the SNPs or haplotypes showed evidence of association to type 2 diabetes. However, rs2235306 was nominally associated with fasting plasma glucose levels in the male subjects with normal glucose regulation ((4.93 +/- 0.03) vs (5.01 +/- 0.03) mmol/L, P = 0.04). No significant difference was observed between all three SNPs and other variables.</p><p><b>CONCLUSIONS</b>APLN SNP rs2235306 was associated with fasting plasma glucose levels in males. It suggests that APLN genetic variants may contribute to clinical features related to glucose metabolism in Chinese population.</p>

Intracellular retention of human melanocortin-4 receptor: a molecular mechanism underlying early-onset obesity in F261S pedigree of Chinese / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate how F261S mutation identified from Chinese obese patients affects the function of melanocortin 4 receptor (MC4R) and to analyze the obesity-related phenotypes in subjects carrying the F261S mutation.</p><p><b>METHODS</b>F261S mutant of MC4R was generated by site-directed mutagenesis. Plasmids encoding wild-type or F261S mutant of MC4R were transfected into HEK293 and COS-7 cells to examine their functional characteristics. Signaling properties of F261S MC4R were assessed by measuring intracellular cAMP levels in response to alpha-MSH stimulation. Cell surface expression of F261S MC4R was compared with that of wild-type MC4R. Clinical examinations were performed in subjects carrying F261S mutation and in non-mutated controls.</p><p><b>RESULTS</b>The alpha-MSH-stimulated reporter gene activity was significantly reduced in cells expressing F261S MC4R, with a maximal response equal to 57% of wild-type MC4R. The F261S mutation also led to a significant change in the Es50 value compared with the wild-type receptor (P<0.01). Immunofluorescent assay revealed a marked reduction in plasma membrane localization of the MC4R in cells expressing the F261S mutant receptor. The resting metabolic rate and fat composition of the mutant carriers were not significantly different from those of the non-mutated obese controls.</p><p><b>CONCLUSIONS</b>The decreased response to alpha-MSH due to the intracellular retention of MC4R may cause early-onset obesity in the F261S pedigree of Chinese.</p>

Orthogonal factor analysis on metabolic syndrome / 中华流行病学杂志

To elucidate the principal of orthogonal factor analysis, using an example of factor analysis of metabolic syndrome. The basic structures and the fundamental concepts of orthogonal factor analysis were introduced and data involving 1877 women aged of 35-65 years, selected from a cross-sectional study, which was conducted in 1998 - 2001 in Shanghai, were included in this study. Factor analysis was carried out using principle components analysis with Varimax orthogonal rotation of the components of the metabolic syndrome. The different components of the metabolic syndrome were not linked closely with the other components and loaded on the six different factors,which mainly reflected by the variables of obesity, blood pressure, plasma glucose, plasma insulin, triglycerides and HDL-cholesterol respectively. Six major factors of the metabolic syndrome were uncorrelated with each other and explained 86% of the variance in the original data. The factor score and total factor score for the individual could be obtained according to the component score coefficient matrix. Although the components of the metabolic syndrome were related statistically, the finding of six factors suggested that the components of the metabolic syndrome did not show high degrees of intercorrelation. As a linear method of data reduction, the mode reduced a large set of measured intercorrelation variables into a smaller set of uncorrelated factors, which explained the majority of the variance in the original variables. Factor analysis was well suited for revealing underlying patterns or structure among variables showing high degrees of intercorrelation.

Relationship between the level of fasting plasma glucose and beta cell functions in Chinese with or without diabetes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We aimed to elucidate the association between the changes of insulin responsiveness and the fasting plasma glucose (FPG) during the development of diabetes.</p><p><b>METHODS</b>A total of 1192 Chinese individuals with normal blood glucose or hyperglycemia were enrolled for the analysis. The early insulinogenic index (DeltaI30/DeltaG30), the area under the curve of insulin (AUC-I), and homeostasis model assessment were applied to evaluate the early phase secretion, total insulin secretion, and insulin resistance respectively. Polynomial regression analysis was performed to estimate the fluctuation of beta cell functions.</p><p><b>RESULTS</b>The DeltaI30/DeltaG30 decreased much more rapidly than the AUC-I accompanying with the elevation of FPG. At the FPG of 110 mg/dl (a pre-diabetic stage), the DeltaI30/DeltaG30 lost 50% of its maximum while the AUC-I was still at a compensated normal level. The AUC-I exhibited abnormal and decreased gradually at the FPG of from 130 mg/dl to higher (overt diabetes), while the DeltaI30/DeltaG30 almost remained at 25% of its maximum value. When hyperglycemia continuously existed at > 180 mg/dl, both the DeltaI30/DeltaG30 and AUC-I were totally lost.</p><p><b>CONCLUSION</b>The increased fasting plasma glucose reflects progressive decompensation of beta cell functions, and could be used to guide the strategy of clinical treatments.</p>

Serum lipid profile changes of the adults in Shanghai communities / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the adult lipid profile of Huayang community from 1998 to 2000 and Caoyang communities in 2001.</p><p><b>METHODS</b>Representative serum samples of 5628 adults (aged 20 - 95 years) were obtained in Huayang and Caoyang communities during 1998.9 and 2001.11. Standard epidemiology questionnaire, physical check-ups and serum lipids data were analyzed.</p><p><b>RESULTS</b>After standardization to Chinese census statistics of 2000, the age-and sex-standardized means of total cholesterol, HDL-C, LDL-C and triglycerides of the two communities (Huayang vs. Caoyang) were 5.01 mmol/L vs. 4.43 mmol/L, 1.28 mmol/L vs. 1.32 mmol/L, 3.37 mmol/L vs. 2.99 mmol/L, 1.97 mmol/L vs. 1.60 mmol/L respectively, and the age- and sex- standardized prevalence of dyslipidemia was 52.9% vs. 25.1%, and the prevalence for borderline dyslipidemia was 76.0% vs. 56.2%, respectively. The decreasing order of dyslipidemia prevalence of the two communities was: elevated TG, decreased HDL-C, elevated LDL-C and TC. The standardized proportions of optimal HDL-C level were only 15.7% and 16.1% in Huayang and Caoyang respectively which was much lower than these of TG, LDL and TC.</p><p><b>CONCLUSIONS</b>The standardized prevalence of adult dyslipidemia and borderline dyslipidemia in the two communities were high. Dyslipidemia of the two communities was TG and decreased.</p>

Application of extended hyperinsulinemic euglycemic clamp in the assessment of insulin sensitivity in obese individuals with glucose intolerance / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the changes of insulin sensitivity in individuals with impaired glucose tolerance and diabetes and the relationship between insulin sensitivity and over weight/obesity (OW/OB) .</p><p><b>METHODS</b>Fifty-two individuals were divided into 4 groups according to WHO diagnostic criteria of obesity (1998) and diabetes (1999): normal weight with normal glucose tolerance (NW-NGT) group, OW/OB with normal glucose tolerance (OW/OB-NGT) group, OW/OB with impaired glucose tolerance (OW/OBIGT) group and OW/OB with diabetes mellitus (OW/OB-DM) group. Individuals in OW/OB-NGT group were further classified into 3 subgroups: over weight subgroup, mild obesity subgroup, and mediate obesity subgroup. Abdominal fat area was measured with magnetic resonance imaging. Visceral obesity was defined as intra-abdominal fat area over 100 cm(2). All subjects with NGT were divided into visceral obesity (VA) group and non-visceral obesity ( Non-VA) group. Extended hyperinsulinemic euglycemic clamp was performed to assess the peripheral tissue insulin sensitivity in all subjects.</p><p><b>RESULTS</b>The rates of insulin mediated glucose disappearance (Rd) were (3. 25+/-0. 13) mg x kg (-1) min (-1) in OW/OB-NGT group, (3. 06+/-0. 26) mg x kg(-1) x min(-1) in OW/OB-IGT group, and (3.19+/-0.44) mg x kg(-1) x min (-1) in OW/OB-DM group, which were significantly lower than that in NW-NGT group [ (5. 86+/-0. 65) mg x kg (-1) min (-1) ] (P < 0. 05, P < 0.01). The Rd in over weight subgroup [(3.50+/-0. 19) mg kg(-1) x min(-1) ] , mild obesity subgroup [(3. 03+/-0. 13) mg x kg (-1) min(-1)] , and mediate obesity subgroup [(2. 75 +/-0. 24) mg x kg (-1) min(-1)] were significantly lower than that of NW-NGT group (P <0. 05, P <0. 01). The Rd [ (2. 97+/-0. 12) mg kg(-1) x min(-1) vs (4.55+/-0.43) mg x kg(-1) x min(-1)] and glucose oxidation [(1.47 +/-0. 19) mg x kg(-1) min(-1) vs (2.24 +/-0. 19) mg kg(-1) x min(-1) in VA group were significantly decreased than that in non-VA group (P < 0. 05, P < 0. 01). Body mass index, waist and hip ratio, waist circumference, and intra-abdominal fat area were negatively correlated with Rd, respectively (P < 0. 01). Multiple regression analysis showed that body mass index, intra-abdominal fat area and abdominal subcutaneous fat area were the main risk factors of insulin sensitivity.</p><p><b>CONCLUSIONS</b>Insulin sensitivity decreased in OW/OB individuals with or without hyperglycemia. Insulin sensitivity is lower in subjects with visceral obesity. Total body fat and abdominal fat are the main risk factors of insulin sensitivity.</p>

Characteristic of hypertensive subjects with metabolic syndrome and its components in communities / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the clinical characteristics of hypertensive subjects with metabolic syndrome and its components in communities.</p><p><b>METHODS</b>Totally 5628 subjects aged over 20 years were included. Measurement indicators included height, weight, waist circumference (W) , hip circumference, systolic pressure (SP) , diastolic pressure (DP) , total cholesterol ( TC) , triglyceride (TG) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , fasting plasma glucose (FPG) , 2 h postprandial plasma glucose (2hPG) , fasting serum insulin (FIN) , and 2 h postprandial serum insulin (2hIN). Body mass index (BMI) , waist to hip ratio (WHR), and homeostatic model approach-insulin resistance index (HOMA-IR) were calculated. According to 1999 WHO definition of metabolic syndrome, these individuals were divided into 4 groups: non-metabolic disorder group, isolated hypertension group, hypertension with one component of metabolic syndrome group, hypertension with two components of metabolic syndrome group, and hypertension with three components of metabolic syndrome group.</p><p><b>RESULTS</b>Among subjects with hypertension, 15. 37% were patients with isolated hypertension, 32. 40% with one component of metabolic syndrome, 33. 36% with two components of metabolic syndrome, and 18. 87% with three components of metabolic syndrome. BMI, W, WHR, TC, TG, LDL-C, FPG, 2hPG, FIN, 2hIN and HOMA-IR in three groups (hypertension with one component of metabolic syndrome group, hypertension with two components of metabolic syndrome group, and hypertension with three components of metabolic syndrome group) significantly increased than those in isolated hypertension group (P < 0. 01 ). The hypertensive patients showed a higher insulin resistance, despite other metabolic disorders. Furthermore, the hypertensive patients with more components of metabolic syndrome showed a higher chance to get insulin resistance. Multiple stepwise regression analysis showed FPG, 2hPG, FIN, 2hIN, BMI, SP and TC were risk factors of HOMA-IR.</p><p><b>CONCLUSIONS</b>Patients with isolated hypertension are rare in community-based population. About 85% of hypertensive patients have more than one metabolic disorders, more than half of were metabolic syndrome. The percentage of total body fat, levels of plasma glucose, serum insulin, total cholesterol and systolic blood pressure are independent risk factors of insulin resistance.</p>

Primary assessment of enzymatic measurement of glycated albumin / 上海第二医科大学学报

Objective To evaluate the clinical significance of glycated albumin(GA),a parameter in reflection of recent glycemic control in patients with diabetes mellitus. Methods Four hundred and forty-five patients with type 2 diabetes mellitus who were hospitalized in our hospital from May to November 2006 were enrolled into the study.The fasting plasma glucose(FPG),postprandial 2-hour blood glucose(P2hBG) and glycated hemoglobin(HbA1c) were measured,the enzymatic measurement of GA was conducted and the CGMS was performed.The correlation between GA and the other parameters monitored was analysed. Results The correlation analysis indicated that GA was well correlated with HbA1c(r=0.818,P0.05),respectively for those with HbA1c more than 7.5%,between 6.5% and 7.5%,and less than 6.5%. Conclusion GA is well correlated with HbA1c,especially in those with poor glycemic control for a long time.The correlation between GA and long-term glycemic control is stronger than that between GA and instant plasma glucose or MBG in three days.

Characteristics and clinical significance of daily blood glucose profiles of insulinoma detected by continuous glucose monitoring system / 上海第二医科大学学报

Objective To analyse the characterisitics of daily blood glucose profiles of insulinoma using continuous glucose monitoring system(CGMS) and to investigate the value of CGMS in the diagnosis of insulinoma. Methods The blood glucose of 6 patients with pathologically-confirmed insulinoma(insulinoma group) were detected by CGMS for 3 consecutive days.The mean blood glucose(MBG),M-value of Schlichtkrull(M-value),frequency distribution of glucose levels and the hypoglycemic episodes of CGMS were measured,and the results were compared with those of normal glucose regulation(n=6,control group) and patients with newly-diagnosed type 2 diabetes with reactive hypoglycemia(n=5,diabetes group). Results The M-value of insulinoma group was significantly higher than that of control group(P0.05).The M-value and MBG of diabetes group were higher than those of insulinoma group and control group(P

Resting energy expenditure and its relationship with patterns of obesity and visceral fat area in Chinese adults / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the relationship between resting energy expenditure (REE) and patterns of obesity/regional fat parameters in Chinese adults.</p><p><b>METHODS</b>Body mass index (BMI), fat mass (FM), fat-free mass (FFM) were assessed in 109 Chinese adults (52 men and 57 women), and their abdominal visceral adipose tissue area (VA) and subcutaneous fat area (SA) were measured using magnetic resonance imaging (MRI) measurements. REE was measured with indirect calorimetry and compared with normal and obese subjects. Multivariate analysis was used to study the factors related to REE.</p><p><b>RESULTS</b>The resting energy expenditure per kilogram of body weight (REE/kg) was closely related with the area of abdominal visceral fat measured with MRI. REE/kg was significantly lower in overweight/obesity subjects than in normal-weighted subjects, and significantly lower in subjects with abdominal obesity (VA > or = 100 cm2) than in subjects with non-abdominal obesity (VA < 100 cm2, BMI > or = 25 kg/m2). In the stepwise regression analysis of REE/kg on regional fat parameters, VA in men and women and SA in women were independent factors reversely related to REE/kg.</p><p><b>CONCLUSION</b>REE/kg is associated with the visceral fat area and more prominent in men. REE/kg can be used as an index in the pathophysiology of intra-abdominal obesity.</p>

Effect of polymorphism of uncoupling protein 3 gene -55 (C>T) on the resting energy expenditure, total body fat and regional body fat in Chinese / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of the C to T variant at the -55 site of the promoter region of uncoupling protein 3 gene (UCP3) with the resting energy expenditure and the parameters of body fat in Chinese population.</p><p><b>METHODS</b>Three hundred Chinese (91 normal weight subjects, 209 overweight/obesity subjects) were genotyped for the UCP3 gene -55(C>T) by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Resting energy expenditure (REE), fat mass (FM), fat free mass (FFM) and the parameters for regional adipose tissue distribution were measured.</p><p><b>RESULTS</b>Genotype frequencies of UCP3 gene -55(C>T) were not associated with obesity and different types of obesity. The REE level in normal weight subjects with TT homozygotes was higher than that in those with CT heterozygotes and CC homozygotes (P=0.0200). Similar tendency was also observed in overweight/obesity subjects. The FM/FFM exhibited significant difference between the overweight/obesity subjects with a TT genotype and those with a CT or CC genotype (P=0.0096).</p><p><b>CONCLUSION</b>The level of difference in REE caused by the polymorphism of promoter region of UCP3 -55(C>T) may play a role in energy metabolism in Chinese.</p>

Prediction of abdominal visceral obesity from body mass index, waist circumference and waist-hip ratio in Chinese adults: receiver operating characteristic curves analysis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity.</p><p><b>METHODS</b>BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter.</p><p><b>RESULTS</b>1) MRI showed that 61.7% of overweight/obese individuals (BMI > or = 25 kg/m2) and 14.2% of normal weight (BMI < 25 kg/m2) individuals had abdominal visceral obesity (VA > or = 100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r = 0.73-0.77, P < 0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI > or = 28 kg/m2 or WC > or = 95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity.</p><p><b>CONCLUSION</b>Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.</p>

Correlation of adipose content and distribution of thigh with insulin resistance in subjects with normal glucose tolerance / 中华内分泌代谢杂志

Objective To establish a method of measuring adipose content and fat distribution of the thigh in normal glucose tolerance (NGT) subjects,and to investigate its relation to insulin resistance.Methods Insulin sensitivity was evaluated by hyperinsulinemic and euglycemic clamp technique,and femoral adipose content and fat distribution were determined by MRI in 30 individuals with NGT including 15 with normal weight and 15 overweighted or obese subjects.Results Compared to normal weight group,the subscutaneous adipose tissue of thigh (SCAT) [(176.7?21.6) cm~2 vs (115.0?12.8 ) cm~2,P＜0.05],adipose tissue of thigh beneath the fascia (SFAT) [(75.4?4.4 ) cm~2 vs (57.5?4.7 ) cm~2,P＜0.01] and intermuscular adipose tissue (IMAT) [(28.3?3.2) cm~2 vs (14.5?1.1 ) cm~2,P＜0.01] were greater in overweight/obesity group.Overweight/ obesity group had lower insulin sensitivity( glucose disposal rate under steady state of hyperinsulinemic euglycemic clamp:4.54?0.43 vs 7.88?0.75,P＜0.01).SFAT and IMAT were significantly correlated with insulin sensitivity.SFAT showed the most marked correlation with insulin sensitivity.Multiple stepwise regression analysis showed that the increased SFAT played a pivotal role in insulin resistance.Conclusion The adipose content and fat distribution are highly correlated with insulin sensitivity and the adipose tissue of thigh beneath fascia may play the most significant role in insulin sensitivity.