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1.
Article | WPRIM | ID: wpr-830421

ABSTRACT

Background@#Diabetes can complicate hypertension management by increasing the risk of cardiovascular disease (CVD) and all-cause mortality. Studies targeting diabetes detection in hypertensive individuals demonstrating an increased risk of diabetes are lacking.We aimed to assess the performance of hemoglobin A1c (HbA1c) and its cut-off point in detecting diabetes in the abovementioned population. @*Methods@#Data from 4,096 community-dwellers with hypertension but without known diabetes were obtained from the Study on Evaluation of iNnovated Screening tools and determInation of optimal diagnostic cut-off points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) study; these data were randomly split into exploration (70% of the sample) and internal validation (the remaining 30%) datasets. The optimal HbA1c cut-off point was derived from the exploration dataset and externally validated using another dataset from 2,431 hypertensive individuals. The oral glucose tolerance test was considered the goldstandard for confirming diabetes. @*Results@#The areas under the ROC curves for HbA1c to detect diabetes were 0.842, 0.832, and 0.829 for the exploration, internal validation, and external validation datasets, respectively. An optimal HbA1c cut-off point of 5.8% (40 mmol/mol) yielded a sensitivity of 76.2% and a specificity of 74.5%. Individuals who were not diagnosed as having diabetes by HbA1c at 5.8% (40 mmol/mol) had a lower 10-year CVD risk score than those diagnosed as having diabetes (P = 0.01). HbA1c ≤ 5.1% (32 mmol/mol) and ≥ 6.4% (46 mmol/mol) could indicate the absence and presence of diabetes, respectively. @*Conclusions@#HbA1c could detect diabetes effectively in community-dwellers with hypertension.

2.
Chinese Journal of Geriatrics ; (12): 1404-1407, 2019.
Article in Chinese | WPRIM | ID: wpr-800391

ABSTRACT

Objective@#To investigate the effects of acylated ghrelin and des-acylated ghrelin on skeletal muscle atrophy in elderly mice.@*Methods@#Eighteen-month-old wild type(WT)mice and ghrelin-/- mice were selected to perform body composition analysis and wheel-running test under conditions of feeding versus fasting.The gene expressions of myogenic regulatory factors including muscle differentiation factor MyoD, myogenin, atrogin-1, muscle-specific RING finger protein 1(muRF-1), and insulin growth factor 1(IGF-1)in mice gastrocnemius muscle were detected by realtime polymerase chain reaction(PCR).@*Results@#The locomotor activity during the wheel-running test were significantly lower in elderly ghrelin-/- mice than in elderly WT mice(3 929±263 times/h vs.5359±601 times/h, t=4.87, P<0.05). The gene expressions of MyoD, myogenin, atrogin-1, muRF-1 and IGF-1 had no significant difference between the two groups(P>0.05). After 48 h fasting, the decrements of body weight, fat and muscle weight were more in ghrelin-/- mice than in WT mice(P<0.05). In fasting old ghrelin-/- mice, the gene expressions of MyoD and myogenin were increased(improved)(t=232.00 and 121.00, P<0.05), and the gene expressions of atrogin-1 and muRF-1 were decreased(improved)(t=30.40 and 54.00, P<0.05)after treatment with both acylated ghrelin and desacylated ghrelin.@*Conclusions@#The acylated ghrelin and desacylated ghrelin may play protective roles in age-related muscle atrophy.

3.
Chinese Journal of Geriatrics ; (12): 1404-1407, 2019.
Article in Chinese | WPRIM | ID: wpr-824579

ABSTRACT

Objective To investigate the effects of acylated ghrelin and des-acylated ghrelin on skeletal muscle atrophy in elderly mice.Methods Eighteen-month-old wild type (WT)mice and ghrelin-/-mice were selected to perform body composition analysis and wheel-running test under conditions of feeding versus fasting.The gene expressions of myogenic regulatory factors including muscle differentiation factor MyoD,myogenin,atrogin-1,muscle-specific RING finger protein 1 (muRF-1),and insulin growth factor 1 (IGF-1) in mice gastrocnemius muscle were detected by realtime polymerase chain reaction (PCR).Results The locomotor activity during the wheel-running test were significantly lower in elderly ghrelin-/-mice than in elderly WT mice (3 929 ± 263 times/h vs.5359± 601 times/h,t =4.87,P < 0.05).The gene expressions of MyoD,myogenin,atrogin-1,muRF-1 and IGF-1 had no significant difference between the two groups (P > 0.05).After 48 h fasting,the decrements of body weight,fat and muscle weight were more in ghrelin-/-mice than in WT mice(P<0.05).In fasting old ghrelin-/-mice,the gene expressions of MyoD and myogenin were increased(improved) (t =232.00 and 121.00,P < 0.05),and the gene expressions of atrogin-1 and muRF-1 were decreased(improved) (t =30.40 and 54.00,P<0.05)after treatment with both acylated ghrelin and desacylated ghrelin.Conclusions The acylated ghrelin and desacylated ghrelin may play protective roles in age-related muscle atrophy.

4.
Article in Chinese | WPRIM | ID: wpr-498610

ABSTRACT

Objective To assess the effectiveness of a novel mobile health patient management system involving doctors, nurses, and patients ( TRIO mode) on glycemic control and self-monitoring of blood glucose (SMBG) compliance among the type 2 diabetes mellitus ( T2DM) patients using basal insulin standardization treatment in China. Methods From April 2014 to April 2015, 416 hospitals in 110 cities of 30 provinces, municipalities, and autonomous regions across China were selected to participate in the program. A Online-to-Offline ( O2O) integrated mobile health patients management system with mobile terminals for the doctors, nurses, and patients was applied in the program for patient education, follow-up, and data collection. For all the newly recruited patients, the baseline information was collected and a first-day patient education program were provided by a designated nurse. In the 12-week follow-up period, data of basal insulin doses and fasting plasma glucose ( FPG) values were collected from the patients by text messages or tracking phone call by the nurse. The patients also received timely standardized patients health education and glycemic control guidance by participating in thepatient education forum anddoctors' hotline in order to help them achieve the glycemic control goals. Results A total of 102 524 patients using basal insulin treatment were eligible and enrolled in the program. 64 420 patients completed the 12 weeks follow-up and provided at least one FPG value at all five follow-ups. In total, 62. 6% (40 334 / 64 420) of the patients reached the FPG control target(FPG≤7. 0 mmol/ L) at the end of follow-up period. The weekly average FPG for patients with complete SMBG data decreased from 10. 58 mmol/ L to 6. 91 mmol/ L while the FPG control rates increased from 13. 4% to 69. 2% . The weekly average FPG for the patients provided incomplete SMBG data decreased from 10. 54 mmol/ L to 7. 13 mmol/ L while the FPG control rates increased from 13. 6% to 62. 2% . The FPG control rates for the patients provided complete SMBG were 1. 74 times higher than those patients provided incomplete SMBG. Based on a GEE model, the average decline of the FPG and the increase of the FPG control rates were significantly better for patients who provided complete SMBG as compared to the patients with incomplete SMBG data. The results of the multivariate logistic regression analysis showed that factors such as receiving the first-day education, participating in the follow-up patient education forum, and the doctors' hotline were significantly associated with the improvement of the SMBG compliance, the treatment adherence, and the FPG control rates. The SMBG compliance and the treatment adherence for patients who completed first-day education were 1. 68 times and 1. 22 times higher, respectively. For the patients who participated in follow-up education activities, their SMBG compliance and treatment adherence were 3. 17 times and 3. 36 times higher, respectively. Conclusion The innovativeTRIOmobile health patient management mode was feasible and effective for better managing the type 2 diabetes patients initiated on basal insulin treatment in China. Active participation in the first-day education program and the follow-up patient education activities can effectively improve the SMBG compliance and the treatment adherence, and therefore play an important role in helping patient achieving FPG control in a faster manner.

5.
Article in Chinese | WPRIM | ID: wpr-478760

ABSTRACT

Objective To evaluate the efficacy and safety of epalrestat, an aldose reductase inhibitor, and epalrestat plus methylcobalamine on diabetic peripheral neuropathy, as compared with methylcobalamine. Methods A total of 444 subjects with diabetic neuropathy were enrolled in the study, and divided into methylcobalamine group ( n= 145 ) , epalrestat group ( n = 143 ) , and methylcobalamine combined with epalrestat group ( n = 156 ) . Therapeutic efficacay was assessed in terms of clinical symptoms and physical examinations by using Michigan Neuropathy Screening Instrument ( MNSI ) , and electrophysiological assessments. Results After 4 to 12-weeks′treatment, symptoms and signs of neuropathy ( using MNSI ) are significantly improved in the three groups ( P0. 05). Conclusion Epalrestat is effective and safe in the treatment of diabetic neuropathy. Furthermore, epalrestat is more efficacious in ameliorating symptoms and MNCV of neuropathy than methylcobalamine. However, while no improved efficacy is shown with the combined treatment.

6.
Chinese Medical Journal ; (24): 3530-3536, 2014.
Article in English | WPRIM | ID: wpr-240733

ABSTRACT

<p><b>BACKGROUND</b>Insulin injection therapy is one of the most effective treatments for type 2 diabetes mellitus (T2DM). Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self-reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance.</p><p><b>METHODS</b>A multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy.</p><p><b>RESULTS</b>A total of 6 043 patients were surveyed, and 5 961 complete questionnaires (98.6%) were used in the analysis. Just over half the respondents (3 460, 58.0%) reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients (56.1%) whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 (17.9%) were unwilling to start therapy and cited the following reasons: inconvenience (64.3%); concerns over addiction (24.6%); pain (14.3%); side effects (14.1%); and high cost (13.6%). Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications.</p><p><b>CONCLUSIONS</b>Patients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.</p>


Subject(s)
China , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Drug Therapy , Female , Humans , Insulin , Therapeutic Uses , Male , Middle Aged , Patient Acceptance of Health Care , Surveys and Questionnaires
7.
Chinese Medical Journal ; (24): 201-207, 2014.
Article in English | WPRIM | ID: wpr-341686

ABSTRACT

<p><b>BACKGROUND</b>Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.</p><p><b>METHODS</b>In this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.</p><p><b>RESULTS</b>Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.</p><p><b>CONCLUSIONS</b>SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.</p>


Subject(s)
Adult , Blood Glucose , Metabolism , Blood Glucose Self-Monitoring , China , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Blood , Female , Humans , Male , Middle Aged
8.
Article in Chinese | WPRIM | ID: wpr-435996

ABSTRACT

Objective To investigate the benefits and challenges of medical student volunteers'involvement in community diabetes education and to provide evidence for future development and suggestions.Methods Self-made questionnaire survey and interview were conducted among members of community health education volunteer in Southeast University.Data concerning basic group composition,major service contents,intention and gain,sources of motivation,knowledge acquisition and skill training were analyzed.Results 88.t04% volunteers chose professional work as the kind of work they were most interested in,in contrast,69.56% did nonprofessional work in reality.Initial intention of 66.30% volunteers was ‘to beautify curriculum vitae'.‘Morality promotion' was taken as major gain by most volunteers (36.96%) while ‘morality promotion' was the initial intention of only 4.89% volunteers.46.20%volunteers thought that their sources of motivation came from ‘ recognition of society and university'.Through training and voluntary service,it was evident that volunteers gained increased diabetes knowledge,stronger professional identity and confidence as well as deeper understanding of patients' needs,but there were real demand for training in education and clinical skills.Conclusions The introduction of medical student voluntary service into community diabetes education is a win-win cooperation,which can cultivate college students' high morality as well as strengthen the community health education team.However,we still face challenges in volunteer team building and management.

9.
Article in Chinese | WPRIM | ID: wpr-391079

ABSTRACT

Objective To know the influence of short-term hard health education combined with net-working fellow-up on diabetes related costs. Methods Divided 83 diabetes patients into the experimental group (41 cases) and the control group (42 cases) randomly. Short-term hard health education combined with networking fellow-up and traditional health education was used in the two groups respectively, and then evaluat-ed the diabetes related costs between the two groups on the time points of the third, the sixth and the dozenth month. Results The costs of health products in the control group was significant higher than that of in the experimental group from the first month to the third month after the intervention, while the inspection expenses in the experimental group was significant higher than that of in the control group from the fourth month to the sixth month after the intervention. Conclusions Short-term bard health education can not change the average level of diabetes related costs, but it can change the constituent ratio of costs.

10.
Article in Chinese | WPRIM | ID: wpr-397356

ABSTRACT

The effect of rosiglitazone and advanced glycation end products (AGEs) on the expression of fractalkine in cultured human renal mesangial cells (HRMC) were investigated. Rosiglitazone inhibits the upregulation of fractalkine induced by AGEs in HRMC.

11.
Article in Chinese | WPRIM | ID: wpr-396299

ABSTRACT

objective To evaluate the effect of intensive diabetes health education plus web-based follow-up program on metabolic control.Methods One hundred and fifteen patients with type 2 diabetes mellitus (DM) were assigned to receive intensive diabetes health education plus web-based follow-up (treatment group,n=57) or conventional education program (control group,n=58).Hemoglobin Alc(HbAlc),body mass index (BMI),lipid profile,and blood pressure were compared at 3 or 6 month with baseline.Results At 3 month.the patients with HbAlc<6.5% in the treatment group was increased from 26.32% to 80.79%.At 6 month.HbAlC was decreased by 2.10% and 1.13% in the treatment or control group.In contrast to the control group,in the treatment group,the patient with BMI<24 increased from 43.86% to 68.42%.Neither groups showed significant changes in blood pressure.Conclusion Intensive diabetes education may be more effective than conventional program in improving metabolic control.

12.
Chinese Journal of Diabetes ; (12): 495-497,511, 2008.
Article in Chinese | WPRIM | ID: wpr-597995

ABSTRACT

Objective To investigate the effects of gliquidone on the AGEs (advanced glycation end products) -induced RANTES(Regulated upon activation,normal T-cell expressed and secreted) expression of human renal mesangial cells (HRMC). Methods AGEs were prepared by incubation of bovine serum albumin (BSA) with high concentration of glucose at 37℃ in vitro. HRMC was cultured in the presence of AGE-BSA (glucose at 50 mmol/L) with or without gliquidone. RANTES mRNA was analyzed by semi-quantity RT-PCR. The concentration of RANTES in the supernatant was quantified by ELISA. Results Gliquidone significantly inhibited the expression and secretion of RANTES induced by AGE-BSA. The inhibition of RANTES expression and secretion was in dose and time dependent manners. Conclusions AGEs is a potential toxin to induce expression of RANTES in HRMCs, which is inhibited by gliquidone

13.
Article in Chinese | WPRIM | ID: wpr-592445

ABSTRACT

Objective To investigate the effects of gliquidone on the AGEs (advanced glycation end products) -induced RANTES(Regulated upon activation,normal T-cell expressed and secreted) expression of human renal mesangial cells (HRMC). Methods AGEs were prepared by incubation of bovine serum albumin (BSA) with high concentration of glucose at 37℃ in vitro. HRMC was cultured in the presence of AGE-BSA (glucose at 50 mmol/L) with or without gliquidone. RANTES mRNA was analyzed by semi-quantity RT-PCR. The concentration of RANTES in the supernatant was quantified by ELISA. Results Gliquidone significantly inhibited the expression and secretion of RANTES induced by AGE-BSA. The inhibition of RANTES expression and secretion was in dose and time dependent manners. Conclusions AGEs is a potential toxin to induce expression of RANTES in HRMCs, which is inhibited by gliquidone.

14.
Article in Chinese | WPRIM | ID: wpr-567876

ABSTRACT

Objective:To investigate the effects of Yukuiqing (YKQ) on the expression of connective tissue growth factor (CTGF) in cultured human renal mesangial cells (HRMC) incubated with AGEs. Methods:The HRMCs were incubated with AGEs (200 ?g/mL) and 1.25% YKQ which was prepared by Chinese herbal medicine serum pharmacological approach for 0,8,16,24,48 and 72h or different concentrations (0.313%,0.625% and 1.25%) of YKQ for 48h,respectively,which were incubated with DMEM and rat serum (RS) as the control. CTGF mRNA and protein were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western Blotting respectively. Results:In Yukuiqing group,the expression of CTGF mRNA and protein decreased significantly compared with control groups (P

15.
Article in Chinese | WPRIM | ID: wpr-354257

ABSTRACT

nm23-H1 is a proven tumor metastasis suppressive gene, tumor metastasis phenotype could be reversed by transfected nm23-H1 cDNA. This study was conducted to transfect nm23-H1 cDNA into L9981 cells and to explore the function of nm23-H1 in reversing the malignant phenotype of L9981 cells. The plasmid of pLXSN-nm23-H1-EGFP was constructed by gene clone technique, and the transfected nm23-H1 cDNA cell lines of L9981-nm23-H1 was established. The protein expression of nm23-H1 was detected by Western blot. The biologic features of L9981-nm23-H1 cells were studied in vitro and in vivo. The results showed that the fusion protein of nm23-H1-EGFP was stable, continuous and expressed with high efficiency in L9981-nm23-H1 cells. The cell proliferation, colon formation and invasive ability are significantly lowered in L9981 cells transfected nm23-H1 cDNA (P < 0.01); the tumorgenesis and the lung metastasis incidence was lower in tranfected nm23-H1 cells than in L9981 and L9981-Plxsn in nude mice (P < 0.01); the rate for inhibiting tumorgenesis of nm23 -H1 was 82.56%. These data suggest that the malignant phenotype could be reversed by wild nm23-H1 gene in L9981 cells.


Subject(s)
Animals , Cell Line, Tumor , Cell Proliferation , Humans , Lung Neoplasms , Pathology , Mice , Mice, Nude , NM23 Nucleoside Diphosphate Kinases , Genetics , Neoplasm Metastasis , Neoplasm Transplantation , Recombinant Fusion Proteins , Genetics , Transfection , Tumor Suppressor Proteins , Genetics
16.
Article in Chinese | WPRIM | ID: wpr-578181

ABSTRACT

Ankle brachial index(ABI),as a non-invasive and simple detection method,can be used to accurately assess and diagnose the severities and prognosis of the diabetic lower extremity arterial disease,cardiovascular and cerebral vascular diseases.

17.
Article in Chinese | WPRIM | ID: wpr-578179

ABSTRACT

Objective To investigate the correlation of ankle-brachial index(ABI),pulsatility index(PI),resistent index(RI)and vibration perception thresholds(VPT)in type 2 diabetic patients(T2DM).Methods A total of 664 type 2 diabetic patients with 1 328 legs(362 men and 302 women)were divided into three groups based on the ABI test: group A(ABI

18.
Article in Chinese | WPRIM | ID: wpr-532703

ABSTRACT

AIM:To study the effect of fractalkine(CX3CL1,Fkn) on the expression and secretion of matrix metalloproteinase-2(MMP-2) in cultured human monocyte line U937 cells.METHODS:The cultured U937 cells were incubated with recombinant human Fkn,the supernatant of human renal mesangial cells(HRMC) and Fkn neutralizing antibodies for 24 h.The mRNA expression of MMP-2 was analyzed by RT-PCR.The production of MMP-2 in the supernatant was analyzed by gelatin zymography.RESULTS:The level of MMP-2 mRNA and protein in the cells incubated with recombinant human Fkn decreased compared to control group.Similarly,the level of MMP-2 mRNA in the cells incubated with the supernatant of HRMC reduced compared to control group.However,the level of MMP-2 mRNA and protein in the cells incubated with the supernatant of HRMC adding Fkn neutralizing antibodies increased compared to that incubated with the supernatant of HRMC.CONCLUSION:Fkn inhibits the expression and secretion of MMP-2 in cultured U937 cells.HRMC might mediate the expression and secretion of MMP-2 in U937 cells through Fkn.

19.
Article in Chinese | WPRIM | ID: wpr-523682

ABSTRACT

AIM: To investigate the influence of irbesartan (Irb), a new angiotensin II receptor 1 antagonist, on renal hypertrophy in streptozotocin (STZ)-induced diabetic rats. METHODS: Sprague-Dawley (SD) rats were randomly divided into three groups: normal group (Group N, n=7), diabetic group (Group DN, n=6) and irbesartan treated group (Group DNI, n=7). In the experimental group, after the rats subjected to uninephrectomy, STZ was given by peritoneally injection at bolus dose of 50 mg/kg to induce diabetes. Blood glucose (BG), body weight (BW), urinary albumin excretion (Ualb), 24 hour proteinuria (24 h Upro) were measured at week 4, 8, 12, respectively. By the end of experiment at week 12, creatinine clearance (Ccr), kidney weight (KW), indicator of renal hypertrophy (KW/BW), renal total protein content (RTP), glomerular area (AG) and glomerular volume (VG) as well as glomerular basement membrane (GBM) were determined by semi-quantitative pathology technique. RESULTS: It was showed that there was no significant difference in BG between group DN and DNI, while Irb significantly reduced the increasing of Ualb, 24 h Upro in diabetic rats compared to control group (P

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