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Objective To analyze the clinical situation and related factors of subclinical hypothyroidism in patients with abnormal glucose metabolism, and to provide theoretical basis for the prevention and treatment of subclinical hypothyroidism in patients with abnormal glucose metabolism. Methods A total of 428 patients with abnormal glucose metabolism who were treated in the Department of Endocrinology of Tianmen First People's Hospital from March 2018 to March 2020 were selected, and serum FT3, FT4 and TSH levels were determined by automatic immune analysis system. Automatic analyzer was used to measure the levels of FBG, HbA1c, TC, TG, LDL-C and UA. A self-made questionnaire was used to investigate the basic information of all subjects, including gender, age, abnormal course of glucose metabolism, BMI and blood pressure. The survey method was combined with telephone inquiry and field investigation. Logistic regression was used to analyze the independent risk factors for subhypothyroidism in patients with abnormal glucose metabolism. Results Among 428 patients with abnormal glucose metabolism, 89 patients were accompanied by subclinical hypothyroidism, including 39 males and 43 females, with an average age of (45.12±8.13) years. The prevalence of subhypothyroidism in females was higher than that in males, and the difference was statistically significant (χ2=4.353 , P0.05). The serum TSH level in experimental group was significantly higher than that in control group (P<0.05). Univariate analysis showed statistically significant differences in age, gender, abnormal course of glucose metabolism, BMI, BMI, FBG, HbA1c, UA, TC, LDL-C and SBP between the two groups (P<0.05). Logistic regression analysis showed that old age, high levels of FBG, TC, SBP and UA were independent risk factors for subclinical hypothyroidism in patients with abnormal glucose metabolism (P<0.05). Conclusion The incidence rate of patients with abnormal glucose metabolism complicated with subclinical hypothyroidism is high. The biochemical indexes such as blood glucose, blood lipid, blood pressure and uric acid should be monitored regularly. The early regulation of glucose metabolism disorder is an effective way to prevent and treat subclinical hypothyroidism.
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Objective To understand the current situation and influencing factors of abnormal glucose metabolism in junior middle school students in Yanqing District, Beijing. Methods With the mothod of stratified cluster random sampling, the questionnaire, physical examination and fasting capillary blood glucose were conducted in 2 493 students from 4 junior high schools. Results The prevalence of diabetes, impaired fasting glucose, and abnormal glucose metabolism were 2.5%, 11.4%, and 13.9%, respectively. The prevalence of abnormal glucose metabolism varied significantly among different ages, grades, regions, obesity, central obesity and hypertension (all P<0.05); Unconditional multiple Logistic regression analysis showed that urban, centripetal obesity, and hypertension were positively associated with the risk of abnormal glucose metabolism in middle school students in Yanqing District; daily breakfast was negatively associated with the risk of abnormal glucose metabolism. Conclusion The prevalence of abnormal glucose metabolism is high among junior middle school students, urban, central obesity, high blood pressure and daily breakfast are influencing factors of abnormal glucose metabolism in Yanqing District of Beijing.
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Objective To investigate the effects of levothyroxine (Levo-thyroid hormone,L-TH4) in pregnancy subclinical hypothyroidism (SCHT), and study the relationship between L-TH4 with thyroid peroxidase (TPO) and glucose metabolism. The research could provide theoretical basis for the treatment of SCHT. Methods Sixty pregnant women were selected and signed the medical informed consent. The pregnancy were divided into three groups, 20 cases in each group.Normal control group: pregnancy underwent routine thyroid function normal; SCHT group: SCHT pregnancy patients who did not use drugs to treat SCHT; L-TH4 group: SCHT pregnancy patients given L-TH4 treatment. The blood was taken to test the contents of glucose level and HbA1c were observed; the activity of TSH and TPO were tested by ELISA method; HE staining method was used to observe the changing of placenta tissue. Results Compared with normal control group, the glucose and HbA1c were significantly increased in SCHT group (P<0.05). However, L-TH4 could decrease these index, compare with the SCHT group, and reduce the level of TSH and the activity of TPO, the difference was statistically significantly (P<0.05). Moreover, L-TH4 could improve the changing of placenta tissue. Conclusion L-TH4 could reduce blood glucose and HbA1c levels, also reduced the level of TSH and the activity of TPO in SCHT. L-TH4 could improve the changing of placenta tissue.
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Objective@#This study aimed at determining the characteristics of the glucose homeostasis and its relationship with iron overload of the patients with β-thalassemia major (β-TM).@*Method@#From Sun Yat-sen Memorial Hospital between January 2014 and December 2015, a total of 57 transfusion-dependent β-TM patients with 5-18 years old were enrolled in this study and fasting blood glucose(FBG) and insulin level, serum ferritin (SF), serum iron, transferrin, total iron binding capacity, unsaturated iron binding capacity were determined.Insulin resistance index (IRI), insulin sensitivity index and β-cell function index (BFI) were also estimated. Besides, in 36 patients cardiac T2* and liver T2* were estimated.@*Result@#(1) Four patients(7%) with β-TM were diagnosed diabetes mellitus, and 14(24%) had impaired fasting glucose. (2) The incidence of abnormal glucose metabolism was significantly different according to levels of SF and degrees of the cardiac iron overload(χ2=9.737, P<0.05; χ2=17.027, P<0.05). It rose while the level of SF increased and the degree of cardiac iron overload aggravated. (3) The incidence of abnormal glucose level was not significantly different in cases with different degree of liver iron overload.The severe group of liver iron overload had significantly higher levels of INS, HOMA-βFI, HOMA-ISI, HOMA-βFI than the non-severe group (Z=-2.434, -2.515, F=8.658, all P<0.05), while no differences were found in the level of FBG, HOMA-βFI between two groups. (4) The result of logistic regression analysis indicated that the cardiac T2* was a significant predictor for the incidence of abnormal glucose metabolism in TM patients (P=0.035, OR=1.182%, 95%CI=1.048 to 1.332).@*Conclusion@#The high prevalence of abnormal glucose metabolism in β-TM patients was mainly closely related with the internal iron overload, especially in organs.The cardiac T2* was an independent risk factor for the incidence of abnormal glucose metabolism in TM patients.
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Objective To investigate the status of dietary fiber ( DF ) and dietary glycemic load ( GL ) in middle-aged and elderly population, and to analyze the correlation of DF and GL with abnormal glucose metabolism. Methods Subjects aged 40-79 years came from Guangzhou community. Dietary nutrients intakes were assessed by continuous 24 hours review for 3 days. Correlation of abnormal glucose metabolism with GL and DF and their interaction were analyzed as quintiles of the distribution. Results Of 1 832 subjects, there were 990 subjects (54. 0%) with normal glucose tolerance, 640 (34. 9%) with IGR, and 202 (11. 0%) newly-diagnosed diabetes mellitus(DM). AverageDFintakeofsubjectswas(11.5±4.5)g/dandaverageGLintakewas(181.0±7.5)/d. Compared with the highest quintile group of total DF intake, the risk of abnormal glucose metabolism in the lowest quintile group was increased[OR=1. 99, 95% CI (1. 48,2. 67)], with increased IGR risk[OR=1. 85, 95% CI (1.34,2.57)]andDMrisk[OR=2.36,95% CI(1.50,3.73)]. ComparedwiththelowestquintilegroupofGL intake, the risk of abnormal glucose metabolism in the highest quintile group was increased [ OR=1. 58, 95% CI (1. 18, 2. 13)], and with increased IGR risk[OR=1. 75, 95%CI(1. 26, 2. 42)] and DM risk[OR=1. 22, 95%CI(0. 77, 1. 94)]. The lowest quintile of DF and the highest quintile of GL was associated with the risk of increased abnormal glucose metabolism[OR=3. 43, 95%CI(1. 41, 8. 36)]. Conclusion Abnormal glucose metabolism was negatively related with DF and positively related with GL.
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Objective To assess the screening capacity of Ezscan for abnormal glucose metabolism .Methods A total of 1 732 permanent residents of Chongqing city underwent physical examination from August 2013 to August 2014 were selected as subjects ,questionnair survey ,physical examination and Ezscan measurement were performed .Additionally ,the levels of fasting blood‐glucose(FPG) ,OGTT 2h blood glucose ,HbA1c and serum lipid were detected .Results The prevalence rate of abnormal glucose metabolism for residents with high Ezscan score was higher than that in those with low Ezscan score .The AUC of Ezscan screening for abnormal glucose metabolism was 0 .616 ,the optimum diagnosis tangent point was 24 .0% ,the sensitivity was 67 .0% .The optimum diagnosis tangent point of FPG was 5 .5 mmol/L for abnormal glucose metabolism ,the sensitivity and speci‐ficity was 70 .5% and 61 .7% respectively ,and the AUC was 0 .824 .The sensitivity of FPG for screening abnormal glucose metabo‐lism was 47 .2% ,when the cut‐off value of FPG was 6 .1 mmol/L .Conclusion The sensitivity of Ezscan for screening abnormal glucose metabolism is higher than that of FPG (when the cut‐off value was 6 .1 mmol/L) ,Ezscan can be used as an efficiency meth‐od for early detection of abnormal glucose metabolism in the asymptomatic population .
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Objective Glucose metabolism trend was dynamicly mornitored following liver transplantation, and its affecting factors were assessed. Methods The glucose metabolism status were assessed at four time points respectively after liver transplants, then they were divided into two groups:normal glucose metabolism (NGM) and abnormal glucose metabolism (AGM). The clinical data were univariate analyzed and multivariate analyzed to screen the risk factors. Results At 1 month, 3 months, 1 year and 3 years post-transplantation, the incidence of AGM were 74.0%, 43.9%, 29.4%, 24.1% respectively Between these two groups, age > 45 y had a significant difference at 1 month, 3 months, 1 year and 3years post-transplantation; the use of tacrolimus had a significant difference at 3 months, 1 year and 3years post-transplantation, but the dose of tacrolimus or tacrolimus blood concentration showed no significant difference; high dose of glucocorticoid had significant difference at 1 month , 3 months post-transplantation; high BMI and acute rejection had significant difference at 1 month post-transplantation. Conclusions There is a high incidence of abnormal glucose metabolism (AGM) in the early stage post-transplantation, and a considerable number of patients' glucose metabolism improved in the later period. Age>45 y and tacrolimus affect glucose metabolism for a longer period post-transplants. High BMI and acute rejection have an impact on glucose metabolism only in the early stage post-transplantation. Large dose of glucocorticoid affect glucose metabolism for at least 3 months post-transplantation , and there is no significant difference after 1 year.
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Objective To investigate the influnce factors of new diagnosed abnormal glucose metabolism in patients with acute cerebral ischemic stroke .Methods One hundres and twenty stroke patients without history of diabetes were divide into large artery atherosclerotic stroke (LAA), small arterial occlusive stroke(SAO), cardiac embolic stroke(CES), undeterminined etiology stroke (UND) subgroups according to the Trial of ORG 10172 in Acute Stroke Treatment(TOAST) classfication.The patients were tested oral glucose tolerance test (OGTT) one week later after stroke. The impaired glucose regulation ( IGR ) and diabetes patients called the abnormal glucose metabolism group ,compare related indicators and make multivariate Logistic regression analysis .Results There were 68 patients(56.7%) with normal metabolism, 52 patients (43.3%) with abnormal glucose metabolism.Among them, 38 cases were IGR (31.7%), 14 cases were diabetes (11.7%).The rate of abnormality of impaired glucose metabolism in LAA subgroup(63.8%) was significantly higher than the other subgroups (27.3%-31.4%)(all P<0.05).There was no statistically significant difference between the other subgroups .Compared with normal glucose metabolism group, age, the rate of hyperlipidemian and family history of diabetes were significant higher in abnormal glucose metabolism group (P<0.05 -0.01).Multivariate logistic regression analysis showed that hyperlipidemia ( OR=1.671,95%CI:1.208 -2.311,P=0.012), family history of diabetes (OR =1.421,95%CI:1.114 -1.813,P=0.042) and LAA(OR=2.825,95%CI:1.706-4.674,P=0.023) were independent risk factors of new diagnosed abnormal glucose metabolism in ischemic stroke .Conclusion There is a high prevalence of new diagnosed abnormal glucose metabolism in ischemic stroke .Hyperlipidemia , family history of diabetes and LAA are independent risk factors of it .
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Objective To understand effects of hyperthyroidism on glucose metabolism and its clinical significance.Methods 65 patients admitted in Xixi Street Community Health Center were divided into 3 groups according to their accompanying disease:group A,22 cases of hyperthyroidism accompanying with diabetes mellitus,group B,23 cases of diabetes,and group C,20 cases of hyperthyroidism.Group A and B were treated with intensive insulin therapy.Group B patients took oral methimazole or propylthiouracil.Group C patients were treated with conventional treatment of hyperthyroidism.All patients were treated for three weeks.Fasting plasma glucose (FPG) and postprandial 2h plasma glucose (2hBG),heart rate,serum triiodothyronine three (TT3),serum total thyroxine (TT4)and other indicators were recorded before and after treatment.Results After intensive insulin therapy,FPG and 2h BG of patients in group A and B were controlled in ideal range.After treatment,TT3 and TT4 decreased significantly faster than before treatment(P ＜ 0.05).Patients in group A needed more insulin than in group B to bring the blood glucose to the normal level(P ＜0.05),but after three weeks,patients in group A and group B needed similar dose of insulin.Patients in group A needed more time than patients in group B to bring down the blood glucose level.(P ＜ 0.05).In addition,change of heart rate in group A before and after treatment were greater than the other two groups,and patients' heart rate in group A returned to normal after three weeks of treatment.(P ＜ 0.05).Conclusions Thyroid hormones affects glucose metabolism.Diabetes complicated with hyperthyroidism mainly caused by patient's abnormal glucose metabolism and insulin resistance.Intensive insulin therapy for these patients can improve β cell function,lower blood glucose rapidly.Compared with diabetes patient without complication of hyperthyroidism,early intensive insulin therapy should be considered.
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Objective To investigate the relationship between SOCS-3 gene polymorphism and abnormal glucose metabolism in Xinjiang Uygur population.Methods According to different plasma glucose levels,1232individuals in Xinjiang Hetian area were divided into 3 groups,451 patients with pre-diabetes,252 patients with type 2 diabetes mellitus,and 529 healthy people as normal controls.Based on HapMap,the polymorphisms rs12953258,rs4969168,rs9914220 were selected as haplotypes,tagging SNP (htSNP) sufficiently covering the genetic variation of the whole gene.Associations of rs12953258,rs4969168,and rs9914220 within SOCS-3 with abnormal glucose metabolism in three groups of Xinjiang Uygur population were examined ; The genotype and allele frequencies and relative clinic data were compared among groups.Results The type 2 diabetes mellitus study with 451 individuals showed that the homozygosity for the C allele of rs12953258 polymorphism of SOCS-3 was associated with increased diabetes risk(OR=1.756,95％ CI 1.168-2.640).In addition,association between rs4969168 or rs9914220 and abnormal glucose metabolism in the Xinjiang Uygur population was not found.Age,total cholesterol,and body mass index were risk factors of diabetes mellitus,total cholesterol and low high density lipoprotein-cholesterol were risk factors of pre-diabetes in Uygur people.Conclusions The C allele of rs12953258 polymorphism of SOCS-3 gene may be an independent risk factor for abnormal glucose metabolism in Xinjiang Uygur population.
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Objective To analyze the occurrence of insulin resistance ( IR ) and abnormal glucose metabolism in adolescent polycystic ovary syndrome (PCOS). Methods PCOS group included 141 patients aged 15-19 years old, who were diagnosed as PCOS according to criteria by reference to the European Society of Reproduction and Embryology/American Society for Reproductive Medicine proposed in 2003, at Rotterdam; and 266 age-matched female students,with regular menstrual cycles and no family history of diabetes, were enrolled in control group. Fasting insulin(FINS),fasting plasma glucose(FPC) ,and homeostasis model assessment for insulin resistance ( HOMA-IR) were measured in control group. 73% percentile value of control group was set as physical upper limits of FINS and HOMA-IR. PCOS patients were divided into obese ( OB-PCOS) and non-obese (NOB-PCOS) groups, and oral glucose tolerance test(OGTT) were performed. Results According to 75% percentile value of control group,the physical upper limits of FINS and HOMA-IR were 13.13 mIU/ L and 2.69, respectively. FINS and HOMA-IR values in PCOS group were higher than those in control group [ (17.68±16. 13 vs 10.40±5. 33)mIU/L,2. 64±2.01 vs 2. 01 ±1. 61,both P<0.01]. FINS and HOMA-IR values in OB-PCOS group were higher than those in the NOB-PCOS group [ (22.04± 18.01 vs 13.06± 12. 60) mIU/L,4. 62±3. 87 vs 2.38±2.26,both P<0.01]. In PCOS group,FINS of 75 cases(53.19% )and HOMA-IR of 67 patients(47.52% ) exceeded the physical upper limits. In 79 OB-PCOS patients, FINS of 56 cases (70. 89% ) and HOMA-IR of 52 patients (65.82% ) exceeded the physical upper limits while in 62 NOB-PCOS patients there were 19(30.65% ) and 15 (24. 19% )patients. In PCOS group,2(1.42% ) patients were diagnosed diabetes mellitus,and both FINS and HOMA-IR of these two cases increased. Meanwhile, 12 cases(8.51% ) were impaired glucose tolerance(ICT) ,of whom 11 patients FINS and HOMA-IR increased. Conclusion Pathological IR is prevalent in adolescent PCOS, more severe and popular in obese-PCOS, a part of them with abnormal glucose metabolism.
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Objective To explore the influence of nursing intervention on knowledge,attitude and behavior on patients with abnormal glucose metabolism during pregnancy.Methods 220 cases of abnormal glucose metabolism during pregnancy were randomly divided into the experimental group and the control group,110 patients in each group.The patients in the control group were given only the general health education.The patients in the experimental group were given a series of nursing interventions on this basis.Mter treatment patients were investigated with influence of nursing intervention on knowledge,auimde and behavior.Results The gestational diabetes knowledge and treatment compliance of awareness in the experimental group were better than the control group.Conclusions During the blood glucose control treat-ment for patients with abnormal glucose metabolism during pregnancy,taking some care interventions can improve the patients' knowledge awareness and treatment compliance,and thus effectively control blood sugar levels,reduce the incidence of complications,making pregnancy safer and healthier.
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Objective To investigate impact of abnormal slucose metabolism on major adverse cardiac event in patients after coronary artery stent implantation.Methods Two hundred and fifteen patients whose data were available were enrolled in this study,and the patients were divided into 3 groups,diabetes group(group A),abnormal glucose metabolism group(group B),normal glucose tolerance group(group C).The clinica,coronary artery lesion characteristics and major adverse cardiac event(MACE)rate during in hospital and follow up periods were compared.Resuits There was a higher occurrence of MACE in group A and group B than that in group C(P＜0.01).There was no significant difference between group A and group B.Conclusion The patients of coronary heart disease with abnormal slucose metabolism have higher MACE rate than abnormal slueese metabolism.