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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.
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BACKGROUND: Resistin decreases insulin's action. Therefore might be a key molecule in the pathogenesis of type 2 diabetes mellitus in obese subjects.OBJECTIVE: To investigate the correlation of resistin gone expression and insulin sensitivity index (ISI) in type 2 diabetic rat models, and to explore the effect of rosiglitazone on resistin gone expression in a rat diabetic model.DESIGN: Randomized controlled animal study.SETTING: Department of Geratology, the First Affiliated Hospital of Zbengzhou University.MATERIALS: Thirty 2-month-old healthy female Wistar rats were provided by Animal Center of Tongji Medical College,Huazhong University of Science and Technology. Common diets were provided by Animal Center of Tongji Medical College, Huazhong University of Science and Technology, and the gross calorific value was 14.88 J/g (mass fraction: 0.2protein, 0.61 carbohydrate, 0.17 fat); furthermore, high-fat diets were mixed with common diets, saccharobiose, rendered lard, egg, and mild powder, and the gross calorific value was 20.083 J/g (mass fraction: 0.09 protein, 0.51 carbohydrate, 0.38fat). Resistin and β -actin were synthesized in Beijing Salbaisheng Company.METHODS: This study was performed in the First Affiliated Hospital of Zhengzhou University from October 2006 to October 2007. The experimental for animal manipulation conforms to criteria of the university's ethnic committee. Two weeks after adaptability, rats were randomly divided into normal chew group (n=8) and high-fat diet group (n=22). Rats in the high-fat diet group underwent vena caudalis injection with streptozotoein (25 mg/kg), and two days later they were continued fed with high-fat diet. For normal chew group rats were injected with sodium citrate-citrate buffer solution (1 mL/kg) and continued normal chew. After 12 weeks, 15 rats in the high-fat diet group were hyperglycemic and were randomly divided into rosiglitazone (n=8) and high-fat diet diabetic group (n=7). Rats were lavaged with rosiglitazone (2 mg/kg/d) in the rosiglitazone group and with distilled water (8 mL/kg/d) in high-fat diet diabetic group; for normal chew group rats were lavaged with the same volume of distilled water. Rats were studied for four successive weeks.MAIN OUTCOME MEASURES: Fasting serum glucose was measured with glucose oxidase method; insulin by magnetic separation enzyme linked immunosorbent assay; triglyceride and total cholesterol levels by enzymic enzymatic method; ISI was calculated as [1/(fasting serum glucose × fasting insulin)]; resistin mRNA expression in greater omental adipose tissue was examined by RT-PCR; correlation between resistin gene and ISI analyzed by Spearman correlation and multivariate stepwise regression.RESULTS: Fifteen high-fat diet rats and eight normal chew rats were included in the final analysis. Resistin gene expression in the greater omental adipose tissue (A value) was 0.27±0.031 in the high-fat diet diabetic group (0.15±0.018) in the normal chew group, and (0.20±0.024) in rosiglitazone group (P < 0.01). Spearman correlation analysis and multiple stepwise regression analysis showed that resistin gene expression was positively correlated with fasting serum glucose (r=0.271, P < 0.01), fasting insulin (r=0.283, P < 0.01), and ISI (r =0.323, P < 0.01), apparent effects of resistin gene expression on ISI was 0.081.CONCLUSION: High-fat diet and diabetes increases resistin gene expression and rosiglitazone ameliorate its expression.The expression of resistin is correlated with ISI.
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In order to investigate the effect of tumor necrosis factor-α (TNFα) on resistin expression in 3T3-L1 adipocytes, and further explore its mechanisms, the differentiated 3T3-L1 adipocytes were incubated with 0, 1, 10, 100 ng/mL TNFα respectively for 24 h, and then the expression of resistin was determined. The differentiated 3T3-L1 adipocytes were incubated with 100 ng/mL TNFα for 3, 6, 24 h respectively, and then the expression of resistin mRNA was analyzed.3T3-L1 adipocytes were induced to differentiate into mature adipocytes. The cells were randomly divided into 4 groups for culture. In the control group, no drugs were added. Cells of TNFα group were treated with 100 ng/mL TNFα. In Ro-31-8220 group, 5μmol/L protein kinase C inhibitor Ro-31-8220 was added. With TNFα+Ro-31-8220 group, 100 ng/mL TNFα were added 1 h after the addition of 5 μmol/L Ro-31-8220. All adipocytes were cultured for 24 h. Reverse transcriptionpolymerase chain reaction (RT-PCR) and Western blotting were employed to detect the expression of resistin gene. Our results showed that resistin protein and mRNA in 3T3-L1 adipocytes were inhibited by TNFα at different concentrations (P＜0.01), and the inhibitory effect increased with the concentration (P＜0.01). At the same concentrations, the inhibitory effect increased with time (P ＜0.01). Ro-31-8220 could inhibit its expression and the inhibitive effect remained unchanged with addition of TNFα(P＞0.05). It was concluded that TNFα could inhibit the expression of resistin in 3T3-L1 adipocytes. The mechanism may be that the expression of resistin is partly controlled by protein kinase C signal conduction pathway.
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The STZ- and high fat diet-induced diabetic rats treated with rosiglitazone had lower FBG, fasting insulin, and serum cholesterol, and higher insulin sensitiviby index compared with (non-treatment) diabetic rats.
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AIM: To investigate the effect of protein kinase C on resistin expression in 3T3-L1 adipocytes.METHODS: The differentiated 3T3-L1 adipocytes were incubated with 50 nmol/L phorbol 12-myristate 13-acetate(PMA) or(5 ?mol/L) Ro-31-8220 for 24 h.Expression of resistin mRNA was detected by RT-PCR and expression of resistin protein was detected by Western blotting.RESULTS: Compared with control,PMA increased the expression of resistin mRNA and protein in 3T3-L1 adipocytes significantly(P