Correlation between early life exposure to PM 2.5 and risk of autism spectrum disorder among school aged children / 中国学校卫生

Objective@#To investigate the associations between early life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM 2.5 ) and the risk of autism spectrum disorder (ASD) among school aged children.@*Methods@#A total of 165 children with ASD and 165 age and gender matched typical development (TD) children were recruited. Children s basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early life PM 2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early life exposure to PM 2.5 with the risk and the ASD severity symptoms, respectively.@*Results@#The PM 2.5 exposure of ASD group during preconception[(55.08±9.34)μg/m 3], entire pregnancy[(50.44±8.71)μg/m 3], the first year after birth [(45.04± 8.25 )μg/m 3] and the second year after birth [(40.19±7.12)μg/m 3] were significant higher than those in TD children [(47.66± 7.63 , 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m 3]( t =7.94, 7.13, 7.70, 6.32, P <0.05). After adjusting for potential confounding, each increase of 1 μg/m 3 in PM 2.5 was associated with higher risk of ASD during preconception ( OR=1.21, 95%CI =1.13-1.29), entire pregnancy( OR=1.18, 95%CI =1.11-1.26), the first year after birth ( OR=1.30, 95%CI =1.18-1.43) and the second year after birth ( OR=1.29, 95%CI =1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub scale scores( P >0.05).@*Conclusion@#Early life exposure to PM 2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early life prevention and control of ASD.

Influence of short-term intensive insulin therapy on plasma concentration of lipoprotein-associated phospholipase A2 and secretory phospholipase A2 in newly diagnosed type 2 diabetic patients / 中华内科杂志

[Summary] The aim of the study was to explore the effect and its clinical relevance of short -term intensive insulin treatment on plasma concentrations of lipoprotein-associated phospholipase A 2 ( Lp-PLA2 ) and secretory phospholipase A2(sPLA2) in newly diagnosed type 2 diabetes mellitus (T2DM).Ninety newly diagnosed T2DM patients were recruited and received continuous subcutaneous insulin infusion (CSII) for about 2 weeks.After CSII, sPLA2 levels [173.78 (80.95, 278.09) μg/L] were significantly decreased compared with the levels before [219.33 (130.03, 337.30) μg/L], P <0.01, while no statistic significant changes could be viewed in Lp-PLA2 levels.Correlation analysis showed that the changes of Lp-PLA2 and sPLA2 were both positively correlated with the changes of homeostasis model assessment of insulin resistance(HOMA-IR)after CSII (r=0.537,0.493 respectively, all P<0.05).The Lp-PLA2 and sPLA2 level reduction after CSII might help to protect the patients from diabetic macroangiopathy . Trial registration Chinese Clinical Trial Registry , ChiCTR-TRC-10001618.

Features of lipid ratios in patients with newly diagnosed T2DM and effects of intensive insulin treatment on them / 实用医学杂志

Objective To investigate the features of lipid ratios in patients with newly diagnosed T2DM, and the effects of intensive insulin treatment on them. Methods 90 patients with newly diagnosed T2DM and 58 matched people with normal glucose were enrolled to assess height,weight,waist circumference,blood glucose and lipid profiles. BMI,TC/HDL-C,TG/HDL-C,log(TG/HDL-C),LDL-C/HDL-C,HOMA-B and HOMA-IR were calculated respectively. All the patients received the continuous subcutaneous insulin infusion with insulin pump. The treatment continued for more 10~14 days after blood glucose reached the standard. All the above indi-cators were reexamined after treatment. Results Dyslipidemia in patients with newly diagnosed T2DM mainly showed as hypertriglyceridemia and decreased HDL-C compared to the control group(P<0.05). TC/HDL-C,TG/HDL-C,log(TG/HDL-C)and LDL-C/HDL-C significantly increased in these patients(P<0.01). After short-term intensive insulin therapy,all lipid ratios were significantly decreased and the changes of lipid ratios were positively correlated with the change of HOMA-IR(P<0.05). Conclusion Short-term intensive insulin therapy for patients with newly diagnosed type 2 diabetes can significantly lower the lipid ratios related to HDL-C. The effects may be closely related to improvement of insulin resistance.

Decrease in glycemic load benefits glycemic control in patients with impaired glucose regulation / 实用医学杂志

Objective To investigate the effect of dietary glycemic load (GL) on the blood glucose level in women with impaired glucose regulation. Methods A total of 120 women with impaired glucose regulation aged from 40 to 79 were enrolled from Guangzhou community to participate in the epidemiological survey on dia-betes mellitus, and were followed up for 12 months. Continues 24 -hour dietary review of 3 days were completed before and after intervention. The dietary GI, GL and the changes of blood glucose level during the 12-month follow-up were analyzed. Results Ninety-nine subjects completed the 12-month follow-up. According to the GL change percentage (ΔGL), all of the subjects were divided into three groups, including group Ⅰ(ΔGL < -30%)、group Ⅱ(ΔGL -30% ~ -10%) and group Ⅲ (ΔGL≥-10%). The reductions of HbA1c in group Ⅰ and groupⅡ were greater than that in group Ⅲ (P < 0.05). Conclusion To lowering dietary GL at 10% or more should be conductive to reduce HbA1C of women with inpaired glucose regulation.

Association of dietary fiber and glycemic load with abnormal glucose metabolism / 中华内分泌代谢杂志

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.

Plasma levels of lipoprotein-associated phospholipase A2 and secretory phospholipase A2 in patients with newly diagnosed type 2 diabetes and their relationships to atherosclerosis / 中华内分泌代谢杂志

_ Objective_ To evaluate plasma concentrations of lipoprotein-associated phospholipase A2 (LP-PLA2)andsecretoryphospholipaseA2(sPLA2)inpatientswithnewlydiagnosedtype2diabetes,andtoexplore their clinical significance. Methods Oral glucose tolerance test ( OGTT) was carried out in our hospital to all the subjects without history of diabetes. According to the results of OGTT, they were divided into two groups:patients with newly diagnosed type 2 diabetes and subjects with normal fasting glucose and normal glucose tolerance. Anthropometric data such as height, weight, waist circumference, and blood pressure were measured and concentrations of blood glucose, insulin, lipid profile ( including total cholesterol, triglycerides, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol), LP-PLA2, and sPLA2 were determined in both groups. Results Ninety patients with newly diagnosed type 2 diabetes and fifty-eight subjects with normal glucose tolerance were enrolled in our study. As to gender, age, body mass index, blood pressure, and lipid profile, there were no statistically differences between these two groups (P>0. 05). Plasma levels of LP-PLA2 and sPLA2 in diabetic patients were significantly higher than normoglycemic participants [102. 98(76. 34,134. 31) vs 50. 89(23. 71,90. 40) ng/ml, 219. 33 (130. 03,337. 330) vs 78. 55 (75. 15,87. 02) ng/ml, both P<0. 01]. Plasma concentrations of LP-PLA2 and sPLA2 in diabetic patients with atherosclerosis were significantly higher than those without [ 133. 43 ( 111. 54, 145. 17 ) vs 99. 11 ( 63. 02, 130. 85) ng/ml,235. 73 (180. 48, 416. 46) vs 182. 97 (9. 08, 280. 79) ng/ml, both P<0. 05]. LP-PLA2 and sPLA2 were both positively correlated with homeostasis model assessment for insulin resistance (HOMA-IR), while negatively correlated with insulin function index. In a multiple linear regression analysis, LP-PLA2 and sPLA2 were independent correlative factors of HOMA-IR(both P<0. 05). Conclusions Plasma levels of LP-PLA2 and sPLA2 were significantly higher in patients with newly diagnosed type 2 diabetes than in individuals with normal glucose tolerance, even more significant in diabetic patients with atherosclerosis. And their concentrations were both closely related to insulin resistance.

The relationship between dietary glycemic load and levels of blood glucose and lipid in patients with newlydiagnosed type 2 diabetes / 中华内分泌代谢杂志

To discuss the relationship between dietary glycemic load (GL) and blood glucose and lipid,201 patients with newly-diagnosed type 2 diabetes and 126 subjects with normal glucose tolerance were enrolled,who were all above 40 years old and permanently lived in communities of Guangzhou.GL,blood glucose and lipid were assessed based on 3-d dietary records.The results showed that the level of dietary glycemic load in diabetic patients was significantly higher than control group (169.61 ± 44.83 vs 157.50 ± 38.47,P＜0.05).Correlation analysis showed that dietary GL was positively correlated with body mass index and HbA1C,and negatively correlated with HDL-C in diabetic patients (all P＜0.05).Adjusted for age and sex by multiple regression,the result was the same.Therefore,dietary with high level of GL may be associated with the occurrence of type 2 diabetes,and is closely related to glucose control and blood lipid metabolism suggesting the necessity to control the level of dietary GL in the nutritional therapy for diabetic patients.

Influence of the smooth of bile duct examined by choledochoscope during the common bile duct exploration on patients / 中国实用护理杂志

Objective To discuss the influence of the smooth of bile duct examined by choledochoscope during the coInnlon bile duct exploration on the biliary tract theology.Methods Forty patients who were to undergo common bile duct exploration were divided into the control group and the test group with 20 eases in each group.The smooth of the distal common bile duct was examined by choledochoscope in the test group while by routine method in the control group.The T tube drainage volume for 24 h,the pressure,flow volume and resistance of common bile duct and amylase content of drainage were monitored in the two groups within 72 h.Results The T tube drainage volume of the second day increased.the pressure and the resistance of the common bile duct decreased,the flow volunle and amylase content of drainage reduced in the control group,which had statistical difference from those of the test group(P＜0.05).Condusion Avoidance of damaging examination of the distal common bile duct,monitoring of the pressure;flow volume and resistance of the common bile duct within 72 h after operation contributed to the confirmation of the time for clamping T tube early.