Application of Relative Quality Constant in Grade Evaluation of Codonopsis Radix Slices / 中国实验方剂学杂志

Objective:To establish the grade evaluation method for Codonopsis Radix slices based relative quality constants， in order to provide scientific theoretical basis for grading of Codonopsis Radix slices. Method:Through literature and market research，the main production areas of Codonopsis Radix slices were determined，and 67 batches of Ludangshen slices（52 batches） and Baitiaodang slices （15 batches） were collected. The appearance traits （average quality and average thickness of Codonopsis Radix slices） were observed and measured. According to Chinese Pharmacopoeia （2015 edition）， the extract and the content of Codonopsis pilosula polysaccharide was determined by phenol-sulphoacid method. Then the relative quality constant was calculated，and the results of grade evaluation were evaluated through systematic cluster analysis and correlation analysis. Result:Relative quality constants of 67 batches of Codonopsis Radix slices were between 0.32-2.97. If these samples were divided into three grades：the first-grade relative quality constants were greater than or equal to 2.08，the second grade was greater than or equal to 0.89 but less than 2.08，while the third grade was less than 0.89. The results of systematic cluster analysis showed that 67 batches of Codonopsis Radix slices were clustered into 3 categories，and the results were basically consistent with the classification. The correlation analysis showed a positive correlation between the content of the extracts and the polysaccharide content （P<0.05）. Conclusion:This method links the extrinsic characteristics to the intrinsic quality，and objectively grade Codonopsis Radix slices， so as to provide a basis for its grade standards.

Discontinuation Rate of Newly Prescribed Donepezil in Alzheimer’s Disease Patients in Asia

Background@#and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. @*Methods@#This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). @*Results@#Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. @*Conclusions@#In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

Discontinuation Rate of Newly Prescribed Donepezil in Alzheimer’s Disease Patients in Asia

Background@#and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. @*Methods@#This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). @*Results@#Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. @*Conclusions@#In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

Review of chemical composition, pharmacological effects, and clinical application of Salviae Miltiorrhizae Radix et Rhizoma and prediction of its Q-markers / 中国中药杂志

Salviae Miltiorrhizae Radix et Rhizoma is a Chinese herbal medicine that promotes blood circulation to remove blood stasis, nourishes blood to tranquilize the mind, and cools blood to disperse carbuncles. Salviae Miltiorrhizae Radix et Rhizoma has microcirculation-improving, blood vessel-dilating, atherosclerosis-preventing, anti-inflammatory, anti-tumor, and blood pressure-and blood lipid-lowering activities. As research progresses, the chemical composition, pharmacological effect, and clinical application of Salviae Miltiorrhizae Radix et Rhizoma have attracted much attention. We reviewed the research progress in this field. Based on the concept of quality marker(Q-marker) in traditional Chinese medicine, the Q-markers of Salviae Miltiorrhizae Radix et Rhizoma were predicted and analyzed from the aspects of quality transfer, traceability, ingredient specificity, association between ingredients and pharmacological effects, ingredient predictability, and compounding environment. This review provides a scientific basis for the quality control of Salviae Miltiorrhizae Radix et Rhizoma and its preparations.

Expression of long non-coding RNA linc00467 in childhood acute myeloid leukemia and its role in drug resistance / 中国当代儿科杂志

OBJECTIVE@#To study the expression and function of long non-coding RNA linc00467 in childhood acute myeloid leukemia (AML).@*METHODS@#Bone marrow samples were collected from 5 children with AML who were diagnosed from May 2016 to June 2018. Normal bone marrow samples based on bone marrow examination were collected from 3 children as controls. Quantitative real-time PCR was used to measure the expression of linc00467 in the two groups. A lentivirus system was used to achieve overexpression of linc00467 in AML cells (HL-60) (linc00467 overexpression group), and empty vector expressing green fluorescent protein (GFP) was transfected into AML cells to establish a GFP control group. A lentivirus system was used to insert an interfering sequence into AML cells (sh-linc00467 interfering group), and a random sequence was inserted to establish an sh-NC control group. Cell proliferation and resistance to doxorubicin were observed for all groups.@*RESULTS@#Compared with the normal control group, the children with AML had a significant increase in linc00467 (P=0.018). Overexpression and interference with linc00467 expression had no significant effect on cell proliferation. Compared with the GFP control group, the linc00467 overexpression group had a significant increase in the viability of HL-60 cells at the adriamycin concentrations of 0.1, 0.2, 0.3, 0.4, and 0.5 μg/mL (P<0.05). Compared with the sh-NC control group, the sh-linc00467 interfering group had a significant reduction in the viability of HL-60 cells at the adriamycin concentrations of 0.1, 0.2, 0.3, 0.4, and 0.5 μg/mL (P<0.05). Compared with the untreated group, the adriamycin treatment group had a significant increase in the expression of linc00467 in HL-60 cells (P<0.05).@*CONCLUSIONS@#This study reveals the biological function of linc00467 to promote the resistance to adriamycin in AML, which provides a basis for developing new therapeutic drugs for AML.

Functional research progress of UBIAD1 and pathogenesis of SCCD / 国际眼科杂志(Guoji Yanke Zazhi)

@#The molecular basis of schnyder crystalline corneal dystrophy(SCCD)is UBIAD1 gene mutation. The pathogenesis of SCCD includes conformational change of UBIAD1 protein which leads to loss of combination with GGpp compounds. UBIAD1-HMG CoA reductase complexes can't be separated, and the rate-limiting enzyme can't dissociate from endoplasmic reticulum to cytoplasm, which results in loss of recognition and degradation by the proteasome. The direct consequence is the gradual accumulation and biosynthesis of cholesterol and non-sterol isoprenoids compounds in the cell. This paper reviews the clinical manifestation, molecular basis, pathogenesis of SCCD and the function of UBIAD1 which provide guidance for molecular diagnosis and treatment of SCCD and pave the way for elucidating the function of UBIAD1 <i>in vivo</i>.

Functional research progress of UBIAD1 and pathogenesis of SCCD / 国际眼科杂志(Guoji Yanke Zazhi)

@#The molecular basis of schnyder crystalline corneal dystrophy(SCCD)is UBIAD1 gene mutation. The pathogenesis of SCCD includes conformational change of UBIAD1 protein which leads to loss of combination with GGpp compounds. UBIAD1-HMG CoA reductase complexes can't be separated, and the rate-limiting enzyme can't dissociate from endoplasmic reticulum to cytoplasm, which results in loss of recognition and degradation by the proteasome. The direct consequence is the gradual accumulation and biosynthesis of cholesterol and non-sterol isoprenoids compounds in the cell. This paper reviews the clinical manifestation, molecular basis, pathogenesis of SCCD and the function of UBIAD1 which provide guidance for molecular diagnosis and treatment of SCCD and pave the way for elucidating the function of UBIAD1 <i>in vivo</i>.

Research Progress of Processing in Production Place and Processing Methods of Bupleuri Radix / 中国实验方剂学杂志

Bupleuri Radix is a traditional Chinese medicine commonly used in clinical practice, which has the effects of relieving fever, relieving liver and depression, and promoting Yangqi. At present, the varieties of Bupleuri Radix are relatively chaotic, and the processing in the production areas is relatively extensive. In the processing of Bupleuri Radix, the processed products contained in the 2015 edition of Chinese Pharmacopoeia are raw products and vinegar-processed products. In addition, the specifications on Chinese medicine processing in various provinces and cities contain many processing methods, such as stir-frying with wine, stir-frying with honey, processed with turtle blood, etc. However, there are great differences in processing specifications among provinces and cities, and the processing methods lack clear process parameters, so the quality of Bupleuri Radix decoction pieces produced on these basis is uneven, which affects the clinical application of the decoction pieces. By consulting ancient books and relevant literature, the authors conduct textual research on the varieties of Bupleuri Radix, and systematically summarized the processing methods and processing methods in the producing area, so as to provide reference for the establishment of processing technology specifications and quality standards of Bupleuri Radix decoction pieces.

Effect of Genkwa Flos on Transient Receptor Potential Vanilloid 1 of Thermosensitive Channel / 中国实验方剂学杂志

Objective:To study the effect of Genkwa Flos on the thermosensitive channel, transient receptor potential vanilloid 1 (TRPV1) by electrophysiological whole cell patch clamp technique and animal behavior experiment, in order to explore its mechanism. Method:The whole-cell patch clamp technique was used to measure transmembrane currents induced by 75%ethanol extract from different concentrations of Genkwa Flos in HEK293 cells that expressed human TRPV1.TRPV1 specific antagonist capsaicin was used to observe whether it could inhibit the transmembrane current induced by Genkwa Flos. Totally 30 C57BL/6 mice were taken for behavioral detection, and divided into blank group (6 mice), high-dose group (6 mice), medium-dose group (6 mice), low-dose group (6 mice) and ibuprofen positive control group (6 mice). Genkwa Flos treatment group was given low dose (0.195 g·kg-1·d-1), medium dose (0.39 g·kg-1·d-1) and high dose (0.78 g·kg-1·d-1) by gavage. One hour later, the changes of behavioral latency of cold pain and hot pain in mice were observed in cold plate at (0±2)℃ and hot plate at (55±1)℃. Result:Whole cell patch clamp experiment showed that 75%ethanol extract of Genkwa Flos in hTRPV1/HEK293 cells could activate TRPV1 channel to generate obvious transmembrane current, which was similar with that generated by the known TRPV1 agonist capsaicin in current density and current-voltage relationship. The dose-effect experiments showed that compared with extracellular fluid, 10 g·L-1 ethanol extract of Genkwa Flos could activate hTRPV1/HEK293 cells to induce significant transmembrane current (P-1 ethanol extract of Genkwa Flos was more than 3 g·L-1(P-1 ethanol extract of Genkwa Flos. In the experiment of cold plate and hot plate in mice, there was a dose-effect relationship between the latencies of cold pain behavior and hot pain behavior in mice prolonged by Genkwa Flos. In the experiment of cold plate, compared with the blank group, the cold pain behavior latency of mice in the medium-dose group was significantly prolonged (PPPPPConclusion:More than one TRPV1 agonist was included in 75%ethanol extract of Genkwa Flos. The warm, analgesic and anti-inflammatory effects of Genkwa Flos may be a series of effects after activation of TRPV1.

Study on quality standard of rice as excipients during rice stir-frying method / 中国中药杂志

Commercially available japonica rice and indica rice with different trade names were collected,and then based on the method of rice stir-frying,their many indexes were evaluated,for example the physical and chemical properties such as appearance color,grain type,broken kernel ratio,length-width ratio,1 000-grain weight,specific heat capacity,moisture content,amylose content,and protein content. The discriminant function analysis was used to determine the effective factors affecting the quality of rice as excipients. The results showed that two types of rice could be distinguished by rice color parameter a*,grain parameter circularity,1 000-grain weight and amylose content. These four effective factors can be used as the quality evaluation indexes for fried rice as excipients.Protein is one of the main components of rice,and its content affects the quality of rice. There is a significant difference in the protein content between japonica rice and indica rice. Therefore,protein content should be used as one of the evaluation indexes for rice quality. After comprehensive consideration,it is suggested that the red-green value a*shall not be less than 0. 50; the circularity not less than 53. 0,the 1 000-grain weight not less than 16. 0 g,the amylose content not less than 12. 0% and the protein content not less than4. 0% in the japonica rice; the red-green value a*shall not be lower than-1. 0,the circularity not less than 41. 0,the 1 000-grain weight not less than 13. 0 g,the amylose content not less than 9. 0% and the protein content not less than 3. 5% in the indica rice. In this study,the quality evaluation standards for rice as excipients( japonica rice,indica rice) were supplemented and improved,laying foundation for the development of quality standards for rice as excipients with the rice stir-frying method.

Investigation of aflatoxins,mycobiota,and toxigenic fungi during post-harvest handling of Ziziphi Spinosae Semen / 中国中药杂志

Ziziphi Spinosae Semen is one of the Chinese herbal medicine being susceptible to aflatoxins contamination. To investigate the sources of aflatoxins contamination and toxigenic fungi species on Ziziphi Spinosae Semen,32 samples were collected from multiple steps during the post-harvest processing in this study. Aflatoxins in these samples were determined by immunoaffinity column and HPLC coupled with post-column photochemical derivatization. The dilution-plate method was applied to the fungi isolation. The isolated fungi strains were identified by morphological characterization and molecular approaches. The results showed that aflatoxins were detected in 28 samples from every step during the processing of Ziziphi Spinosae Semen. Three samples were detected with aflatoxin B_1 and 2 samples with both aflatoxin B_1 and total aflatoxin exceeding the limit of Chinese Pharmacopoeia. Especially the samples from the washing step,with the highest detected amounts of AFB_1 and AFs were reached 94. 79,121. 43 μg·kg~(-1),respectively. All 32 samples were contaminated by fungi. The fungal counts on the newly harvested samples were 2. 20 × 10~2 CFU·g~(-1). Moreover,it increased as tphreocessing progresses,and achieved 1. 16×10~6 CFU·g~(-1) after washing. A total of 321 isolates were identified to 17 genera. Aspergillus flavus was the main source of aflatoxins during the processing and storage of Ziziphi Spinosae Semen. One isolate of A. flavus was confirmed producing AFB_1 and AFB_2. The fungal count was significantly increased by composting,and Aspergillus was the predominant genus after shell breaking. The contamination level of aflatoxins was increased by composting and washing.

Tending of wild Heterosmilax yunnanensis / 中国中药杂志

To minimize the predatory harvest of Heterosmilax yunnanensis and maintain the sustainable utilization of its resources, a study on the tending technology of wild H. yunnanensis was carried out. The results showed that the tuber tending model had a higher seed emergence rate, shorter growth period and easier control of male and female ratios than other tending models; by removing shrubs, topping, bending pruning, controlling insects and pests and other effective technical measures, the growth period of H. yunnanensis was shortened; the average annual net income of the tending area was 1 086 yuan/mu (1 mu≈666.67 m²), which was 86.9% higher than before. This study was conducive to increasing the yield and quality of H. yunnanensis in Karst landform area, and instructive for the tending of other wild traditional Chinese medicinal herbs in this area.

Effects of C-type lectin receptors on functional regulation of dendritic cells / 中国免疫学杂志

Dendritic cells are the most potent professional antigen presenting cells.The expression of C-type lectin receptors (CLR) contributes to the intake of glycoprotein and identification of microbial antigens,which results in antigen information presented to T and B lymphocytes and the ensuing adaptive immune response.The process plays an important role in antifungal or anti-parasitic infection immunity,allergic reactions and tumor immunity.Therefore,it is of great significance to explore the effect of C-type lectin receptors on the regulation of DC function and the development of diseases.The review focuses on the recent research findings on the effect of CLR members on the functional regualtion of DC.

Efficacy of the traditional Chinese medicine NAOAN capsule for primary prevention of stroke in high-risk population / 中华健康管理学杂志

Objective To evaluate the efficacy of the traditional Chinese medicine NAOAN capsule in primary prevention of stroke in high?risk populations. Methods A multicenter, randomized controlled study was performed in community setting, involving 1 088 individuals at high risk of stroke, with cerebrovascular function scores<75 and 10?year Framingham stroke risk ≥6%. Subjects were recruited in communities at Beijing, Shanghai, Changsha, and Chengdu communities, through resident committees or the village unit. A total of 559 subjects were randomized into a group treated with the NAOAN capsule, and 529 subjects in an aspirin treatment group. Follow?up was performed every 2 months for 2 years. At the mid?point and end of the intervention, we compared cerebrovascular function differences between the 2 groups. Results During the 2?year community trial, 531 subjects in the NAOAN capsule group and 465 in the aspirin group followed the protocol. Cerebrovascular function scores increased from 45.2±19.7 at baseline to 61.7±26.5 after the 2?year trial (t=－12.931, P<0.001) in the NAOAN capsule group, and from 47.2±18.9 at baseline to 53.7 ± 25.1 (t=－5.058, P<0.001) in the aspirin group; greater increases in cerebrovascular function scores were found in the NAOAN capsule group than that in the aspirin group (t=4.906, P<0.001). Conclusions Cerebrovascular function in individuals at high risk of stroke was improved by taking NAOAN capsule. Cerebrovascular function scores improved more with NAOAN capsules than with aspirin.

Current status of vitamin A deficiency in preschool children in Dongguan, China and the effect of vitamin A on serum ferritin and red blood cell parameters / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the current status of vitamin A deficiency in preschool children in Dongguan, China, as well as the effect of vitamin A on serum ferritin, red blood cell, and reticulocyte parameters.</p><p><b>METHODS</b>Cluster sampling was performed from April 2015 to December 2016 to select 2 085 preschool children (3-6 years old) without any disease in Dongguan. Routine blood test, reticulocyte count, serum ferritin measurement, hemoglobin electrophoresis, and vitamin A measurement were performed for all children. The associations of age and sex with vitamin A and serum ferritin concentrations were analyzed. The effect of vitamin A concentration on serum ferritin, red blood cell, and reticulocyte parameters and the effect of reduced iron storage caused by vitamin A deficiency on red blood cell parameters were evaluated.</p><p><b>RESULTS</b>Of the 2 085 children, 140 (6.71%) had reduced iron storage, and 678 (32.52%) had vitamin A deficiency. Among the 678 children with vitamin A deficiency, 647 (95.4%) had subclinical deficiency and 31 (4.6%) had clinical deficiency. There was no significant difference in vitamin A concentration between boys and girls, however girls had a significantly higher serum ferritin concentration than boys (P<0.05). The clinical vitamin A deficiency group had a significantly higher serum ferritin concentration than the subclinical vitamin A deficiency group and the normal group (P<0.05). In cases of vitamin A deficiency, the reduced iron storage group had significant reductions in mean corpuscular volume and mean corpuscular hemoglobin than the normal iron storage group (P<0.05). Compared with the normal vitamin A group, the vitamin A deficiency group had significantly lower hemoglobin concentration, mean corpuscular hemoglobin, red blood cell count, hematocrit, absolute reticulocyte count, reticulocyte percentage, and reticulocyte hemoglobin content, as well as a significantly higher mean corpuscular volume (P<0.05).</p><p><b>CONCLUSIONS</b>Vitamin A deficiency is prevalent in preschool children in Dongguan, China, and it may adversely affect serum ferritin, red blood cell, and reticulocyte parameters.</p>

Effect of clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris / 中国生化药物杂志

Objective To analyze and discuss the clinical efficacy of clopidogrel bisulfate combined with aspirin in the treatment of unstable angina pectoris. Methods 86 cases of unstable angina pectoris treated in my hospital from July 2015 to September 2016 were taken as the research object, randomly divided into two groups, with 43cases in each group. The observation group received clopidogrel combined with aspirin therapy; The control group received aspirin treatment alone. The clinical efficacy of the two groups was compared. Results There was no significant difference in the incidence of adverse reactions between the observation group and the control group (9.30% vs 6.98%), but the total effective rate of the clinical observation group was significantly higher (93.02% vs 76.74%, P<0.05). Conclusion Clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris is effective, safe and reliable..

Effect of clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris / 中国生化药物杂志

Objective To analyze and discuss the clinical efficacy of clopidogrel bisulfate combined with aspirin in the treatment of unstable angina pectoris. Methods 86 cases of unstable angina pectoris treated in my hospital from July 2015 to September 2016 were taken as the research object, randomly divided into two groups, with 43cases in each group. The observation group received clopidogrel combined with aspirin therapy; The control group received aspirin treatment alone. The clinical efficacy of the two groups was compared. Results There was no significant difference in the incidence of adverse reactions between the observation group and the control group (9.30% vs 6.98%), but the total effective rate of the clinical observation group was significantly higher (93.02% vs 76.74%, P<0.05). Conclusion Clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris is effective, safe and reliable..

Quality of realgar and its influencing factors based on toxicity / 中国中药杂志

The results of a toxicity analysis showed differences from those of the existing experimental data. Therefore, HPLC-ICP-MS was used to analyze the soluble arsenic content at different valences in realgar prepared with water grind processing, which were collected from 3 companies. The results showed that the free arsenic of the 3 companies did not exceed the limit of Chinese Pharmacopoeia. However, if the free arsenic was calculated based on the total value of As(Ⅲ) + As(Ⅴ), free arsenic of 1 company exceeded the limit of Chinese Pharmacopoeia. The method of determining free arsenic in Chinese Pharmacopoeia. was ancient Cai's arsenic detection method, which had a certain limitation and failed to effectively avoid the toxicity of remaining arsenics except for trivalent arsenic. Then, we examined the effects of water and temperature on the content and form of soluble arsenic in realgar. The results showed that the content of soluble arsenic increased with the rise of water content, and the form of soluble arsenic did not change, there were only As (Ⅲ) and As (Ⅴ); With the simple temperature factor, there was an increasing trend in the content of soluble arsenic in the samples, the maximum increment was As (Ⅲ) 2.489 mg•g⁻¹ and As (Ⅴ) 0.546 mg•g⁻¹; When water and temperature played an synergistic effect, the increase of soluble arsenic in the samples significantly changed, the maximum increment was As (Ⅲ) 23.690 mg•g⁻¹, As (Ⅴ) 0.468 mg•g⁻¹, respectively. Through comprehensive analysis, we believed that the quality of realgar was susceptible to water content and temperature. Both of the single effect of water content and the synergistic effect of water and temperature can significantly change the content of soluble arsenic in realgar, and the water content was a high-risk factor. In the current Chinese Pharmacopoeia 2015 version, the free arsenic detection method had limitations, hence new techniques shall be introduced; At the same time, realgar does not have a water content inspection item in the current pharmacopoeia, which shall be added. However, due to the limit of water content, more in-depth studies are required.

Correlation between ectopic fat accumulation and insulin sensitivity in obese individuals with different glucose tolerance levels / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation between liver and skeletal muscle fat contents and insulin resistance in obese individuals with different levels of glucose tolerance.</p><p><b>METHODS</b>RESULTS: Ten non-obese individuals with normal glucose tolerance (NGT), 9 obese individuals with NGT, and 7 obese individuals with impaired glucose tolerance (IGT) were enrolled in this study. All the participants were examined for insulin sensitivity by hyperinsulinemic-euglycemic clamp and for liver and skeletal muscle fat accumulation quantified by proton magnetic resonance spectroscopy (1H MRS). The data were collected from the subjects including somatometric measurements, fasting plasma glucose, 2-h plasma glucose (2hPG), fasting insulin, and blood biochemistry. Linear correlation analysis and multiple linear stepwise regression analysis were used to analyze the relationship between ectopic fat accumulation and insulin resistance.</p><p><b>RESULTS</b>The glucose infusion rates (GIR, presented as the M value) differed significantly among IGT-obese (3.95∓1.66 mg·kg·min), NGT-obese (6.14∓1.90 mg·kg·min) and NGT-non-obese (8.78∓2.46 mg·kg·min) groups (P<0.05). The 3 groups also showed significant differences in liver fat contents [(15.23∓3.09)%, (6.25∓0.38)%, and (1.89∓0.90)%, respectively, P<0.05] and intramyocellular lipids in the tibialis anterior (2.69∓0.95, 2.61∓1.45, and 1.54∓0.66 mmol/kg, respectively, P<0.05). Linear analysis revealed that liver fat content, but not skeletal muscle fat content, was significantly correlated with the M value. Multiple linear stepwise regression analysis using M value as the dependent variable (Y) revealed that liver fat content (X) was an independent factor inversely correlated with the M value (regression equation: Y=-30.562X+9.007, R=0.717, P<0.01).</p><p><b>CONCLUSIONS</b>Liver fat accumulation, but not skeletal muscle fat accumulation, is correlated with insulin resistance and impaired glucose metabolism.</p>

Characteristics and Impact Factors of Renal Threshold for Glucose Excretion in Patients with Type 2 Diabetes Mellitus

Sodium glucose co-transporter 2 (SGLT-2) inhibitors are newly developed but promising medicine for type 2 diabetes. However, patients with a different renal threshold for glucose excretion (RT(G)) may have a different reaction to this medicine. Therefore, the objective of this study was to investigate the characteristics of RT(G) and its impact factors in patients with type 2 diabetes mellitus (T2DM). The clinical and laboratory data of 36 healthy individuals and 168 in-hospital patients with T2DM were collected and analyzed, RTG was calculated using blood glucose (BG) measured by dynamic BG monitoring, urinary glucose excretion (UGE) and estimated glomerular filtration rate (eGFR). The characteristics of RT(G) were investigated. The risk factors for high RT(G) were analyzed using non-conditional logistic regression analysis. Our results found that RT(G) of the T2DM group was higher than that of the healthy individuals (P < 0.05); and 22.22% from the healthy individuals group but 58.33% from the T2DM group had high RT(G). Age, duration of diabetes, body mass index (BMI), and homeostasis model assessment insulin resistance index (HOMA-IR) were independently associated with high RT(G) (P < 0.05). Further stratified analysis revealed that RT(G) in T2DM patients increased with age, duration of diabetes, and BMI. In conclusion, RT(G) is increased in patients with T2DM, especially in those with longer diabetic duration, higher BMI, and those who are older. Therefore, these patients may be more sensitive to SGLT-2 inhibitors.