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Objective To observe the clinical efficacy of liraglutide combined with metformin in the treatment of newly diagnosed type2 diabetes mellitus (T2DM) accompanying non-alcoholic fatty liver disease (NAFLD).Methods 40 newly diagnosed patients with type 2 diabetes combined with fatty liver were randomly divided into observation group and control group.On the basis of lifestyle intervention,the observation group was given metformin 500 mg,oral,3 times/d,Liraglutide Injection 1.8 mg,subcutaneous injection,1 times/d,and the control group was given metformin 500 mg,orally,3 times/d.The treatment process lasted for 12 weeks.Waist circumference,body mass index (BMI),fasting plasma glucose (FPG),2 hour postprandial glucose (2 h PG),glycosylated hemoglobin A1 c (HbA1 c),alanine aminotransferase (ALT),aspartate transaminase (AST),glutamyl transpeptidase (GGT),total cholesterol (TC),triglyceride (TG),Transforming growth factor beta (TGF-β) and the degree of fatty liver were compared before and after treatment,and the adverse events were recorded.Results Compared with the control group,the degree of WC,BMI,FPG,2 h PG,HbA1c,TG,TGF-beta and fatty liver were significantly improved in the observation group (P ＜ 0.05).There was no significant difference in adverse reactions between the two groups (P ＞ 0.05).Conclusions Liraglutide combined with metformin is a new kind of safe and effective treatment for T2DM accompanying NAFLD.
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Objective To investigate the possibility of neutrophil-to-lymphocyte ratio (NLR),platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) as biomarker for early atherosclerosis in patients with newly diagnosed type 2 diabetes.Methods 420 newly diagnosed type 2 diabetes were enrolled in the study.They were divided into three groups:patients with normal carotid artery were group A (n =152),patients with unilateral carotid plaque were group B (n =138),patients with bilateral carotid plaque were group C (n =130).Their neutrophil,lymphocyte,mean platelet volume,lipid and glucose,carotid intimal medial thickness (CIMT),ankle brachial index (ABI) were all performed in these individuals.Results Compared with group A,the age,systolic pressure,neutrophil count (NC),platelet count (PLT),NLR,PLR,low density lipoprotein-cholesterol (LDL-C),total cholesterol (TC),fasting blood glucose (FBG),hemoglobin A1c (HbA1c) and CIMT were higher while ABI were lower in group B and group C;Compared with group B,the age,systolic pressure,NC,PLT,NLR,PLR,LDL-C,TC,CIMT and were higher while ABI was lower in group C (P ＜ 0.05).CIMT was positively correlated to age,systolic pressure,NLR,PLR,LDL-C,TC,FBG and HbA1c (P ＜ 0.05) while ABI was negtively correlated to age,NLR,PLR,LDL-C,FBG and HbA1c (P ＜ 0.05).In multiple linear regression analyses,after adjustment for age,lipid,glucose and so on,NLR and PLR were also significantly correlated to CIMT and ABI.Conclusions NLR and PLR were significantly correlated with CIMT and ABI in newly diagnosed type 2 diabetes.Therefore,NLR and PLR may have the potential to serve as biomarkers for early arteriosclerosis in type 2 diabetic patients.
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Objective To investigate the correlation of serum brain derived neurotrophic factor (BDNF),visceral adipose and cognitive dysfunction in elderly patients with type 2 diabetes.Methods From July 2016 to August 2017,72 patients with type 2 diabetes in our department of inpatient were selected as subjects.According to whether there was cognitive dysfunction,they were divided into 2 groups,type 2 diabetes mellitus combined with cognitive impairment group (A group) and simple type 2 diabetes group (B group).Another 40 healthy persons in the same period were selected as the control group.The indexes of glycolipid metabolism,visceral adipose and BDNF were measured in two groups.The logistic regression analysis was used to analyze the risk factors of cognitive dysfunction,and the relationship between visceral adipose,BDNF and cognitive function was analyzed by Pearson correlation.Results (1) The total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),fasting insulin (FINS),fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),insulin resistance index (HOMA-IR),and visceral fat hormone level of the three groups were from high to low in A group ＞ B group ＞ C group (P ＜ 0.05);while the high density lipoprotein cholesterol (HDL-C),the expression level of BDNF and Montreal Cognitive Assessment (MoCA) score of the three groups were from high to low in C group ＞ B group ＞ A group (P ＜ 0.05);(2) The logistic regression analysis showed that visfatin,HOMA-IR,BDNF for the risk of cognitive impairment factors in elderly patients with type 2 diabetes;(3) Correlation analysis showed that the score and visceral fat MoCA and HOMA-IR were negatively correlated with the MoCA score was positively related to BDNF;HOMA-IR and visfatin was positively correlated,negatively correlated with BDNF.Conclusions The cognitive function of elderly patients with type 2 diabetes is related to serum visfatin and BDNF.Increased visfatin and BDNF may lead to cognitive dysfunction.
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Objective To investigate the relationship between the expression level of serum zinc α2 glycoprotein (ZAG) and type 2 diabetes mellitus (T2DM) complicated with hyperuricemia (HUA).Methods A total of 220 patients with T2DM and normal uric acid (group A),100 patients with T2DM complicated with hyperuricemia (group B),and 80 cases of normal healthy people (group C) were randomly selected.The clinical and biochemical indexes and expression levels of serum ZAG among three groups were determined and compared.The relationship between expression level of serum ZAG and related indexes was analyzed with Pearson correlation and multiple linear stepwise regression analysis.Results The serum ZAG levels showed significant differences among groups A,B and C [(58.89 ± 23.17)mg/L vs (86.42 ± 25.36) mg/L vs (40.65 ± 16.48) mg/L] (P ＜ 0.05).Pearson correlation analysis showed that serum ZAG level was positively correlated with body mass index (BMI),triglyceride (TG),glycosylated hemoglobin (HbAlc),creatinine (Cr),urea nitrogen (BUN),and serum uric acid (SUA) (P ＜ 0.05),and negatively correlated with high density lipoprotein cholesterol (HDL-C) (P ＜ 0.05).Multiple linear stepwise regression analysis showed that BMI,TG and HDL-C were independent factors influencing serum ZAG level.Conclusions Serum ZAG level is significantly higher in patients with T2FM,especially in patients complicated with HUA.The increased level may be related to obesity and dyslipidemia,showing that serum ZAG may be involved in the pathogenesis of T2DM complicated with HUA.
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Objective To predict the value of advanced glycation end products (AGEs) in the risk and severity of coronary heart disease in diabetic patients.Methods Totally 120 cases were divided into 3 groups.Group A had no diabetes mellitus (DM) and no coronary atherosclerotic heart disease (CAD).Group B had DM without CAD.Group C had DM with CAD.The levels of AGEs,low density lipoprotein cholesterol (LDL-C),glycosylated hemoglobin,and the severity of coronary stenosis were detected.Receiver operating characteristic (ROC) curve was used to evaluate the sensitivities and specificities of AGEs for the diagnosis of DM with CAD.Results The highest level of AGEs,LDL-C,glycosylated hemoglobin and carotid plaque was in the C group,with a statistically significant difference (P ＜ 0.05).The severity of AGEs was significantly correlated with the severity of CAD and the Gensini score of AGEs (r =0.445).ROC curve showed that the sensitivity,specificity and area under ROC curve of AGEs determination of DM with CAD were 80.0％,75.0％,and 0.86,respectivity.Conclusions The level of AGEs is significantly correlated with atherosclerosis and prognosis in DM.The severity of CAD was higher in the patients with higher AGEs,and the incidence and severity of restenosis increased.
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Objective To explore the relationship between blood levels of visfatin and glycolipid metabolism and mild cognitive impairment (MCI) in patients with type 2 diabetes (T2DM).Methods From February 2016 to January 2017,a total of 91 patients with T2DM were recruited as investigation objects.Cognitive function was measured by Montreal Cognitive Assessment (MoCA),and fasting serum was collected to determine the relevant laboratory indexes.Results In the 91 patients,50 cases developed MCI.Compared to non-MCI group,MCI group had significant difference in age,total cholesterol,insulin,insulin resistance index,visfatin,MoCA score and diabetic retinopathy (P ＜ 0.05).Pearson correlation analysis showed that the MoCA score was negatively correlated with visfatin and insulin resistance index (P ＜0.05).Further logistic regression analysis showed that age,diabetic retinopathy,insulin resistance index and visfatin were independent risk factors for MCI in T2DM patients.Conclusions MCI in T2DM patients increases with the increasing of elder,diabetic retinopathy,insulin resistance index,and visfatin.
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Objective To investigate risk factors that affect type 2 diabetic cardiac arrhythmia.Methods Clinical data of 292 diabetic patients who were performed examination of low limb vascular were analyzed retrospectively.Based on electrocardiogram,the patients were divided into cardiac arrhythmia group and non-cardiac arrhythmia group with case-control study,and the clinical data and evaluation indexes of lower extremity vascular disease were compared between two groups.Results Data comparison between two groups indicated age [(59 ± 14) years vs (54 ± 12) years],symptoms of low limbs [40.7％ vs 29.0％] had statistical significance (P ＜ 0.05).Glycosylated hemoglobin,hypertension history,results of color Doppler ultrasound for lower limbs artery,ankle-brachial index,toe-brachial index,transcutaneous oxygen pressure,heat-controlled laser Doppler between two groups had no statistical significance (P ＞ 0.05).Age,gender,history of high blood pressure,symptoms of low limbs,and heat-controlled laser Doppler were analyzed with multiple logistic regression,which indicated that age was risk factor of type 2 diabetic arrhythmia.Conclusions Age is correlated with type 2 diabetic arrhythmia,and evaluation indexes of lower limb vascular disease have no significant correlation with type 2 diabetic arrhythmia.
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Objective To investigate the factors of hospitalization expense in patients with type 2 diabetes mellitus undergoing non-emergency surgery.Methods A retrospective study included diabetic (109 cases) and control (162 cases) groups.Hospitalization expense and other observation indices were compared between two groups and subgroups.The factors that contribute to hospitalization expense were analyzed with multifactor regression analysis model.Results The median hospitalization expense was 12 014.74 yuan in the diabetic group,1.24 times than that in the control group (P =0.001).Diabetic group has higher American Society of Anesthesiologists (ASA) classification,longer wound healing time,higher postoperative infection rate,and longer hospital stay (P ＜ 0.01).Multifactor analysis revealed that the significant factors that influence the hospitalization expense were ASA classification (β =0.442,P =0.000),postoperative fasting plasma glucose (β =0.204,P =0.020),and postoperative infection (β =0.204,P =0.019).No significant difference was found in postoperative infection rate and hospitalization expense between two groups,when patients had received minimally invasive surgeries (P ＞ 0.05).Conclusions Type 2 diabetes patients have higher hospitalization expense;ASA classification,postoperative fasting plasma glucose,and postoperative infection are the main influence factors.Giving priority to minimally invasive surgeries and enhancing perioperative glucose control can help to reduce hospitalization expense in patients with type 2 diabetes mellitus.
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Objective To investigate the relationship between infection of Helicobacter pylori (HP) and early renal damage in type 2 diabetes.Methods Materials of 223 customer cases who received physical examination in our department were collected and analyzed.They were divided into two groups:HP positive group and HP negative group according to the HP infection.The basic information,blood lipid,lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,erythrocyte sedimentation rate,and blood urea nitrogen and creatinine were compared between two groups,respectively.Results There was no significant difference in basic information,blood glucose,glycosylated hemoglobin and blood lipid (P ＞ 0.05).The results of lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate in HP positive group were higher than those in HP negative group (P ＜ 0.05).Conclusions The infection of Helicobacter pylori played a part in the early renal damage of type 2 diabetes.
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ObjectiveTo investigate the correlation factors in older type 2 diabetes patients with osteoporosis.MethodsThe related risk factors including their age,body mass index(BMI),history of disease and bone mineral density(BMD) were analyzed in 106 older type 2 diabetes patients with osteoporosis,who were hospitalized in the first affiliated hospital of Guangzhou Medical College during January 2000 to December 2010.Results BMD of lumbar[ (0.756 ± 0.099) g/cm2 ],neck of femur [ (0.658 ± 0.111 ) g/cm2 ] and wards triangle [ (0.525 ± 0.064) g/cm2 ] in the eighty group were distinctly reduced than the sixty group[ (0.883 ±0.112)g/cm2,(0.781 ±0.130) g/cm2,(0.627 ±0.118) g/cm2] ( P ＜0.05).BMD of lumbar[ (0.738 ± 0.114) g/cm2 ) ] and neck of femur [ ( 0.664 ± 0.112 ) g/cm2 ) ] in low weight patients ( BMI≤20 kg/m2 ) were distinctly reduced than normal BMI group [ ( 0.816 ± 0.138 ) g/cm2,( 0.727 ±0.134)g/cm2] ( P ＜0.05).BMD of lumbar[ (0.743 ±0.122) g/cm2] and neck of femur[ (0.719 ±0.147)g/cm2] in patients with course of diabetes more than 10 years were distinctly reduced than the patients with less course[ (0.886 ± 0.132 ) g/cm2,( 0.792 ± 0.122 ) g/cm2 ] ( P ＜ 0.05 ).BMD was negatively correlated with age and history of diabetes ( P ＜ 0.05 ).BMD was positively correlated with BMI ( P ＜ 0.05).ConclusionsOlder,low BMI and long history of diabetes are the risk factors of older type 2 diabetes patients with osteoporosis.
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Objective To investigate the relationship between plasma visfatin levels and type 2 diabetes mellitus patients with carotid atherosclerosis.Methods 60 subjects were divided into 3 groups,T2DM no carotid atherosclerosis group (20 cases),T2DM with carotid atherosclerosis group (20 cases)and normal control group (20cases).Carotid IMT,plasma visfatin,waist circumference (WC),fasting plasma glucose (FPG),HbA1C,blood lipids,fasting serum insulin (FINS) were assayed or measured in all subjects.Results Plasma visfatin levels in T2DM with carotid atherosclerosis were significantly higher than those in normal control group and T2DM group [ (50.85 ± 20.14) ng/ml vs (18.50 ± 4.60) ng/ml,(50.85 ±20.14) ng/ml vs (35.52 ± 10.18) ng/ml,F = 105.983,P ＜0.01].Correlation analysis showed that plasma levels of visfatin were positively correlated with carotid IMT(r =0.476,P ＜0.01),TG (r =0.328,P ＜0.01),WC (r =0.206,P ＜0.05) and it was negatively correlated with HDL-C(r=-0.298,P ＜0.01).Conclusion Plasma visfatin was correlated with the development of macrovascular complications in T2DM patients,and it might be involved in the atherosclerotic pathological and physiological basis.
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ObjectiveTo investigate the therapeutic effect of mefformin on type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD).MethodsThe model rats of T2DM complicated with NAFLD were established by feeding high-glucose and high-fat diet, and injection of low dose streptozotocin.The model rats were randomly divided into 2 groups, model group (n = 16) and metformin group (n = 16).Twenty normal rats were set for normal control group.Intragastric administration lasted for 12 weeks.At the end of 16th week (after treated 8 weeks) and 20th week (after treated 12weeks), the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), fasting blood glucose (FBG),fasting insulin (FINs), triglyceride (TG), total cholesterol (TC) and free fatty acid (FFA) in each group were determined and the level of insulin sensitivity index (ISI) was determined.Meanwhile, pathological changes of liver, the expression of uncoupling protein-2 (UCP-2) mRNA and UCP-2 protein of liver tissues in each group were detected.ResultsThe levels of serum ALT, AST, FBG,FINs, serum TG , TC and FFA were significantly higher and ISI was significantly lower and the expression of UCP-2 protein significantly increased in model group, compared with control group (all P ＜ 0.01).The expression of UCP-2 mRNA at 16th and 20th week in model group were significantly higher than that in control group [(1.789 +0.301) vs (0.245 ±0.087), t =11.02, P ＜0.01 and (1.989 +0.207) vs (0.262+ 0.058), t = 17.93, P ＜ 0.01, respectively].Fatty degeneration of liver tissues was significantly exacerbated in model group.After treatment for 8 weeks and 12 weeks with mefformin, the levels of serum ALT,AST, FBG, serum TG, TC and FFA significantly decreased, ISI significantly increased, fatty degeneration of liver tissues was significantly improved, and the expression of UCP-2 protein significantly decreased,compared with model rats (P ＜ 0.01 or P ＜ 0.05).The expression of UCP-2 mRNA at 16th and 20th week in metformin group were significantly lower than that in model group [(0.665 + 0.088) vs (1.789 ±0.301), t = 7.81, P ＜ 0.01 and (0.610 ± 0.1 02) vs (1.989 ± 0.207), t = 9.98, P ＜ 0.01, respectivelv].ConclusionsMetformin has therapeutic effect on T2DM complicated with NAFLD.
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Objective To evaluate the clinical and biochemical characteristics of type 2 diabetics with hyperuricemia and to investi-gate the association between serum uric acid and the number of metabolic syndrome components. Method In the cross-sectional study of 547 type 2 diabetics, we recorded body mass index (BMI), systolic blood pressure(SBP), diastolic blood pressure (DBP), and collected blood samples to measure serum uric acid (UA), fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), creatinine (Cr) and blood lipid profile, including tfiglyceride (TG), total cholesterol (TC), low-density cholesterol LDL-C) and high-density cholesterol (HDL-C). Results Compared with the normal UA group, the diabetic patients in the high UA group had significantly increased levels of BMI, SBP, DBP, FPG, Cr, TG, TC and HbA1c (P <0.05, P <0.01, P <0.05, P <0.01, P <0.01), and decreased level of HDL-C(P < 0.05). There was no significant difference in the level of LDL-C between the two groups (P > 0.05). According to their possession of 1, 2, 3 or 4 components of metabolic syndrome, 547 cases were divided into four groups (MSI, MS2,MS3 and MS4). There were significant difference in the levels of UA, BMI, SBP, DBP, Cr, TG, TC, LDL-C and HDL-C among MSI, MS2, MS3 and MS4 (All P < 0.05). Multiple regression analysis showed that UA concentration was positively correlated with sex, TG and Cr (Beta:0. 088,0. 350, 0. 124; P < 0.05, P <0.01, P <0.01) and negatively correlated with HDL-C and HbA1 c(Beta: -0.107, -0.124 ; P <0.01, P <0.01). The con-centration of UA was strongly correlated with serum TG. Conclusions Serum UA level in type 2 diabetics was significantly elevated as the number of metabolic components increased. Abnormal TG had great influence on serum UA. Hyperuricemia was considered to be a dangerous factor of the metabolic syndrome.