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Objective To explore the relationship between serum retinol binding protein 4 and serum Lipasin levels and vascular complications in gestational diabetes mellitus(GDM).Methods From Jan.2016 to Jan.2018,80 pregnant women with gestational diabetes diagnosed as GDM in Wenzhou Central Hospital of Zhejiang Province were selected as the study group.They were divided into two groups according to whether they had vascular lesions.Group A included patients with gestational diabetes mellitus complicated with vascular complications and group B included patients without vascular complications.Forty healthy pregnant women were selected as the control group(group C).The levels of fasting plasma glucose (FPG),fasting serum insulin (FINS),homeostatic model assessment of insulin resistance (HOMA-IR),serum retinol binding protein 4 (RBP4) and serum Lipasin were compared among three groups of pregnant women.The vascular complications of GDM were analyzed.Results The levels of FPG,FINS and HOMA-IR in gestational diabetes mellitus pregnant women were higher than those in healthy pregnant women (P＜0.05),and those in group A were higher than those in group B (P＜0.05).The levels of RBP4 and Lipasin in serum of pregnant women with GDM were higher than those of healthy pregnant women (P＜0.05),and those of group A were higher than those of group B (P＜0.05).Spearman univariate correlation analysis showed that serum RBP4 levels were positively correlated with FPG and FINS(P＜0.05),and serum Lipasin levels were positively correlated with FPG and FINS (P＜0.05).Logistic regression analysis showed that the levels of FPG,FINS,RBP4 and Lipasin increased,which were independent risk factors for diabetic retinopathy (P＜0.05).Conclusion In GDM with vascular complications,the serum RBP4 and Lipasin levels are higher,which are independent risk factors for vascular complications in GDM,and may participate in the occurrence and development of vascular complications in gestational diabetes mellitus.
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Objective To elaborate the changes of the soluble B cell-activating factor of the tumor necrosis factor family (BAFF) in the peripheral blood of chronic human immunodeficiency virus (HIV)-infected patients ,and to study the correlation between the soluble BAFF in HIV-infected patients and the progressions of acquired immune deficiency syndrome (AIDS).Methods Fifty untreated HIV outpatients and 30 healthy controls were recruited .According to the counts of CD4+T lymphocytes ,HIV-infected patients were divided into three groups ,＜ 200 cells／μL group , (200 － 350 ) cells／μL group and ＞350 cells／μL group .B cell counts and the BAFF levels were compared among the three groups and the healthy controls .The correlation analysis was conducted for the levels of BAFF ,the counts of CD4+T lymphocytes and B cells ,and viral load in HIV-infected patients .The value of BAFF in staging of HIV disease was identified by receiver operating characteristic (ROC) curve.Results The B cell counts were (90.3 ± 43.1)cells／μL in ＜200 cells／μL group ,(114 .4 ± 28 .8) cells／μL in (200 －350) cells／μL group ,and (162 .1 ± 29 .5) cells／μL in ＞350 cells／μL group and (307.1 ± 97 .0) cells／μL in healthy controls ,which was significantly different among the four groups (F＝47.92 ,P＜0.05).The concentrations of BAFF in the four groups were (1 737.5 ± 719.7) ,(962.8 ± 341.1) ,(859.8 ± 270.4) ,and (456.9 ± 163.7) ng／L ,with significant difference among the groups (F＝36.72 ,P＜0.05).The level of BAFF was negatively correlated with both B cell counts and CD4+T lymphocyte counts (r＝ －0.722 and －0.568 ,respectively ;both P＜0.05) ,and positively correlated with viral load (r＝0.607 ,P＜0 .05).The area under the ROC curve was 0 .881.If the level of BAFF was 1 281.5 ng／L ,the sensitivity and specificity to predict the period of AIDS were 74 .1% and 87.0%,respectively .Conclusion The levels of soluble BAFF in HIV-infected patients are significantly increased and related with the reduction of B cell counts and disease progression.
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Objective To study the correlation between CD169 expression of monocytes and disease progression in human immunodeficiency virus (HIV )-infected patients .Methods Sixty HIV-infected patients and 30 healthy controls were recruited .According to the CD4 + T lymphocyte counts ,HIV-infected patients were divided into three groups including < 200 cells/μL ,200 — 350 cells/μL and > 350 cells/μL groups . The differences in monocytes counts ,the proportions of CD16 + and CD169 + monocytes were analyzed among the three groups and healthy controls .The correlations between proportion of CD169 + monocytes and CD4 + T lymphocyte counts ,viral load ,and proportion of CD16 + monocytes were analyzed .Results The monocyte counts in CD4 + T lymphocytes < 200 cells/μL group , (200 — 350 ) cells/μL group , >350 cells/μL group and healthy control group were (342 ± 99) ,(396 ± 145) ,(365 ± 80) ,and (404 ± 106)/μL ,respectively ,which were not significantly different (F= 2 .55 , P > 0 .05) .The proportions of CD16 + monocytes in the four groups were (19 .8 ± 8 .8)％ ,(14 .3 ± 2 .8)％ ,(9 .7 ± 2 .0)％ and (4 .0 ± 0 .8)％ ,respectively ,which were significantly different ( F = 30 .90 , P < 0 .05 ) . The proportions of CD169 + monocytes in the four groups were (72 .6 ± 11 .4)％ ,(59 .4 ± 14 .7)％ ,(33 .3 ± 14 .5)％ and (2 .6 ± 0 .8)％ ,respectively ,which were significantly different (F = 152 .40 , P< 0 .05) .The proportion of CD169 + monocytes was negatively correlated with CD4 + T lymphocyte counts (r = 0 .792 , P< 0 .05) , while positively correlated with both viral load (r= 0 .485 ,P< 0 .05) and proportion of CD16 + monocytes (r= 0 .395 , P< 0 .05) .Conclusions The CD169 expressions of monocytes in HIV-infected patients are significantly increased and correlated with both monocyte activation and disease progression .
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Objective To elucidate the changes of the peripheral blood B cells in acquired immunodeficiency syndrome (AIDS) patients after the initiation of the highly active antiretroviral therapy (HAART ) ,and to investigate the effect of B cell count on the curative effect of HARRT .Methods Fifty‐three cases of AIDS outpatients and 26 healthy controls were collected between April 2011 and December 2014 . CD4+ T and B lymphocytes counts were compared between the two groups before HAART treatment ,3 ,6 and 12 months after the treatment .The correlation between ΔCD4+ T cells andΔB cells (i .e .the difference value of CD4+ T cells and B cells before HAART treatment and after 12‐month treatment , respectively ) were analyzed . According to whether the CD4+ T lymphocyte count increased by 100/μL after 1 year of the first HAART ,patients were divided into treatment response and nonresponse groups .B cell counts were compared between the two groups ,and the most suitable B cell count to initiate HAART was identified by mean of receiver operating characteristic (ROC) curve .Pre‐and post‐treatment results were compared by paired samples t test .Comparison of measurement data between multiple groups were analyzed by one‐way ANOVA analysis .Correlation between the two groups were analyzed by Pearson correlation analysis .Results B cell counts of AIDS patients before treatment ,3 ,6 and 12 months after treatment were (115 .0 ± 41 .0)/μL ,(130 .3 ± 54 .1)/μL ,(154 .2 ± 68 .1)/μL and (193 .9 ± 84 .0)/μL ,respectively ,while the B cell count of healthy controls was (299 .4 ± 125 .1)/μL . Significant differences among the five groups were observed (F= 24 .8 ,P< 0 .01) .Increases of the B lymphocyte counts with varying degrees were observed after treatments ,which were slow in the initial 3 months and faster afterwards .ΔCD4+ T cell was positively correlated with ΔB cell (r= 0 .493 , P<0 .05) .The B cell counts before treatment in the treatment response and nonresponse groups were (130 .6 ± 40 .4)/μL and (87 .2 ± 24 .5)/μL ,respectively ,which was significantly different (t=4 .77 ,P<0 .05) .The area under the ROC curve was 0 .848 .If the B cell count before treatment was 99 .5/μL ,the sensitivity and specificity to predict effective treatment were 82 .4% and 84 .2% , respectively . Conclusions B cell counts increase with varying degrees during HAART .B cell count before treatment can predict the therapeutic effect of HAART .
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Objective The incidence of cardiovascular and cerebrovascular diseases in postmenopausal women with type 2 diabetes is grim.The study was designed to explore the effect of ω-3 polyunsaturated fatty acids (PUFA) on endothelial function in postmenopausal women with type 2 diabetes. Methods 50 patients admitted to Dingli Medical College of Wenzhou Medical Univer-sity from March 2014 to October 2014 were divided into group A and Group B by random number table .Cross-design of two stages ( I, II) was applied in the investigation .At stage I(3 months ahead of the experiment ), Group A took oral ω-3 PUFA while Group B took placebo .At stage II ( 3 months after the experiment ) , Group B was given oral ω-3 PUFA, while Group A was given placebo .T1 and T3 time was the beginning of the stage I and stage II experiment , while T2 and T4 time was the end of stage I and stage II experiment .At the beginning and end of each stage , detection was made on LDL-C, TG, IL-6, plasminogen activator inhibitor-1 (PAI-1) and endothelium-dependent flow-mediated vasodilation (FMD). Results After the intervention on Group A at stage I , FDM at T2 time was significantly increased compared with that at T 1 time([7.23 ±3.28]% vs [3.62 ±2.13]%, P<0.05), while all the other indexes at T2 time decreased significantly in comparison with T1 time: LDL-C ([2.85 ±0.47]mmol/L vs [3.36 ±0.57] mmol/L), TG([2.41 ±1.06]mmol/L vs [2.96 ±1.12] mmol/L), IL-6([2.83 ± 0.30]ng/L vs [3.42 ±0.32]ng/L), PAI-1 ([7.23 ±3.28]ng/L vs [3.62 ±2.13]ng/L) (P<0.05).After receiving ω-3 PUFA intervention on Group B at stage II , FDM at T4 time was significantly increased compared with that at T 3 time([6.88 ±2.06]% vs [3.60 ±2.18]%, P<0.05), while all the other indexes at T4 time decreased significantly in comparison with T3 time: LDL-C ([3.26 ±0.77]mmol/L vs [3.63 ±0.73] mmol/L), TG([2.28 ±0.94]mmol/L vs [2.77 ±1.25] mmol/L), IL-6([2.91 ± 0.48]ng/L vs [3.30 ±0.52]ng/L), PAI-1 ([45.7 ±24.4]ng/L vs [56.3 ±24.4]ng/L) (P<0.05).Two-period crossover design analysis of variance showed that there was significant difference effect on LDL -C(F=2.754, P=0.019), TG(F=3.115, P=0.011), IL-6(F=1.825, P=0.032), PAI-1(F=2.324, P=0.023) and FMD(F=3.784, P=0.006)between ω-3 PUFA and placebo . Conclusion ω-3 PUFA can improve endothelial function in postmenopausal women with type 2 diabetes , which is of great significance for the primary prevention of cardiovascular disease .