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Objective:To examine differences in metabolic characteristics and metabolites between elderly overweight patients with metabolic syndrome and healthy elderly people, and to identify related factors.Methods:A group of 36 MS patients(the MS group)admitted to The Fourth Central Hospital of Tianjin from April to August 2018 and 43 elderly people(the control group)who underwent physical examination during the same period were included in this prospective study.Serum samples of the patients with metabolic syndrome and elderly healthy controls were collected, and ultra-performance liquid chromatography and quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)based non-targeted metabolomics was used to search for differences in metabolites between the serum samples of the two groups.The Pearson correlation statistical method was used to find related clinical factors.Results:Comparison of baseline data of the enrolled participants showed that there were statistically significant differences between the two groups in body mass index[(26.9±2.0)kg/m 2vs.(21.7±1.4)kg/m 2], waist circumference, systolic blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol( P<0.01). Metabolomics results showed that there were differences in 65 serum metabolites between elderly overweight patients with metabolic syndrome and elderly normal controls, and these differences were enriched in 21 pathways.Correlation analysis showed that waist circumference had the largest number of differential metabolites, followed by body mass index.The major differential metabolites were monosaccharides such as mannose, lyxose and glucose, linolenic acid and its derivatives, and pyroglutamate. Conclusions:Compared with normal elderly people, elderly patients with overweight metabolic syndrome have a variety of differential metabolites, and these metabolites are highly correlated with clinical indicators related to overweight, such as body mass index and waist circumference, and they include monosaccharides, linolenic acid derivatives and amino acids.
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Objective To explore the metabolism and chronic complication features of type 2 diabetes mellitus patients with hyperferritemia. Methods:A total of 268 type 2 diabetic patients with a disease course of more than 5 years, who were hospitalized in our hospital between January to December 2019 were included in this retrospective study. Serum ferritin was measured by Chemiluminescence in each participant. Patients with other diseases, which might affect serum ferritin level, were excluded. According to the results of serum ferritin, the patients were divided into hyperferritemia group ( n=115) and normal ferritin group ( n=153). The metabolic indexes, including C-reactive protein, blood glucose, blood lipid, liver and kidney function, were measured. Chronic complications and comorbidities, including diabetic retinopathy, urinary microalbumin excretion, hypertension, coronary heart disease and cerebrovascular disease were evaluated. The correlation between hyperferritemia and various variables was analyzed. Results:Body mass index, the levels of serum urea nitrogen, uric acid, C-reactive protein, alanine aminotransferase and γ-glutamyltranspeptidase, as well as prevalence of diabetic retinopathy, microalbuminuria, hypertension and coronary heart disease, were significantly higher in hyperferritemia group than in normal ferritin group (all P<0.05). Hyperferrinemia was positively correlated with C-reactive protein ( r=0.262, P<0.001), coronary heart disease ( r=0.232, P<0.001), alanine transpeptidase ( r=0.216, P<0.001), urea nitrogen ( r=0.201, P=0.001), diabetic retinopathy ( r=0.169, P=0.008) and microalbuminuria ( r=0.176, P=0.004). Multivariate logistic regression analysis showed that hyperferrinemia was an independent risk factor of coronary heart disease and diabetic retinopathy ( OR=2.246, 95% CI 1.310-3.849, P=0.003; OR=2.232, 95% CI 1.287-3.870, P=0.004, respectively) in this patient cohort. Stepwise linear regression showed that there was a significant correlation between hyperferrinemia and microalbuminuria (β=0.165, P=0.009). Conclusions:Our results show that the level of serum C-reactive protein, alanine aminotransferase, γ-glutamyltranspeptidase, urea nitrogen, uric acid and microalbuminuria are significantly increased and the risk of coronary heart disease and diabetic retinopathy are higher in type 2 diabetic patients with hyperferritemia.
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Objective To examine the effects of Berberine(BBR)on inflammatory pathways related to endoplasmic reticulum stress(ERS) in the penumbra area following focal cerebral ischemia-reperfusion injury in type 2 diabetic rats.Methods A total of 72 healthy male Sprague-Dawley rats were fed a high-fat,high-sugar diet and injected with streptozotocin to establish a type 2 diabetes mellitus model.The diabetic rats were randomly divided by digital lottery method into a Sham operation group(Sham group),a diabetic rat + BBR treatment group(BBR group),a diabetic middle cerebral artery occlusion(MCAO)model group (MCAO group),and a diabetic rats MCAO + BBR treatment group (MCAO + BBR group).Six rats were included in each group.The two treatment groups received prespecified doses of BBR through gastric perfusion at 48 h,24 h before surgery,and 6h after surgery.The MCAO model was prepared by a suture occlusion method.The neurological deficit scores were performed,and the expression of tumor necrosis factor-α(TNF-a)and interleukin-1β(IL-1β) was detected by enzyme-linked immunosorbent assay(ELISA).The mRNA expression of ERS marker protein GRP78 was detected by quantitative real time polymerase chain reaction(RT-qPCR),and the expression of ERS-related inflammatory pathway proteins 678 Glucoseregulated protein(GRP78)、Pancreatic endoplasmic reticul um Rinase (PERK)、nuclear factor-κB (NF-κB)] was detected by Western blot.Results the cerebral ischemic penumbra area,after 2 h of ischemia and 24 h of reperfusion,the neurological deficit score in the MCAO group was higher than that in the MACO+BBR group [(2.83 ± 0.41) vs.(1.67± 0.52),P ＜0.05],and the expression levels of pro-inflammatory cytokines(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78,PERK and NF-κB p65)were also significantly increased(all P＜0.05).However,BBR treatment was able to alleviate the neurological dysfunction caused by cerebral ischemia-reperfusion in type 2 diabetic rats (P＜0.05).Similarly,BBR treatment also reduced the expression levels of pro-inflammatory factors(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78,PERK and NF-κB p65)in the cerebral ischemic penumbra area(all P＜0.05).Conclusions Through inhibiting ERS-related inflammatory pathways,BBR plays a neuroprotective role to alleviate cerebral ischemia-reperfusion injury in type 2 diabetic rats.
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Objective@#To examine the effects of Berberine(BBR)on inflammatory pathways related to endoplasmic reticulum stress(ERS)in the penumbra area following focal cerebral ischemia-reperfusion injury in type 2 diabetic rats.@*Methods@#A total of 72 healthy male Sprague-Dawley rats were fed a high-fat, high-sugar diet and injected with streptozotocin to establish a type 2 diabetes mellitus model.The diabetic rats were randomly divided by digital lottery method into a Sham operation group(Sham group), a diabetic rat + BBR treatment group(BBR group), a diabetic middle cerebral artery occlusion(MCAO)model group(MCAO group), and a diabetic rats MCAO + BBR treatment group(MCAO + BBR group). Six rats were included in each group.The two treatment groups received prespecified doses of BBR through gastric perfusion at 48 h, 24 h before surgery, and 6h after surgery.The MCAO model was prepared by a suture occlusion method.The neurological deficit scores were performed, and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)was detected by enzyme-linked immunosorbent assay(ELISA). The mRNA expression of ERS marker protein GRP78 was detected by quantitative real time polymerase chain reaction(RT-qPCR), and the expression of ERS-related inflammatory pathway proteins[78 Glucoseregulated protein(GRP78)、Pancreatic endoplasmic reticulum Rinase(PERK)、nuclear factor-κB(NF-κB)]was detected by Western blot.@*Results@#the cerebral ischemic penumbra area, after 2 h of ischemia and 24 h of reperfusion, the neurological deficit score in the MCAO group was higher than that in the MACO+ BBR group [(2.83±0.41)vs.(1.67±0.52), P<0.05], and the expression levels of pro-inflammatory cytokines(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)were also significantly increased(all P<0.05). However, BBR treatment was able to alleviate the neurological dysfunction caused by cerebral ischemia-reperfusion in type 2 diabetic rats(P<0.05). Similarly, BBR treatment also reduced the expression levels of pro-inflammatory factors(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)in the cerebral ischemic penumbra area(all P<0.05).@*Conclusions@#Through inhibiting ERS-related inflammatory pathways, BBR plays a neuroprotective role to alleviate cerebral ischemia-reperfusion injury in type 2 diabetic rats.
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Objective To investigate the effect of Berberine on insulin resistance and its mechanism in Otsuka Long-Evans Tokushima Fatty(OLETF) rats with metabolic syndrome(MS).Methods LETO(Long-evans Tokushima Otsuka)rats(the control group receiving standard normal diet,n=10)and diabetic OLETF rats(the MS group receiving high-fat diet for 24 weeks,n=30).Rats in the MS group were randomly divided into 3 subgroups(n=10,each subgroup).Each subgroup was gavaged with normal saline,high-dose Berberine(100 mg · kg-1 · d-1)and low-dose Berberine (50 mg · kg-1 · d-1) respectively,and the high-fat diet remained unchanged.After 6 weeks of berberine treatment,body weight,blood glucose and lipid metabolism parameters were determined.The oral glucose tolerance test(OGTT) and insulin tolerance test(ITT) were used to detect insulin resistance.Expression levels of the protein and mRNA of 78 kDa glucose-regulated protein (GRP7 8),Caspase-12 and CCAAT/enhancer-binding protein(C/EBP) homologous protein(CHOP) in skeletal muscles were detected by Western blot and RT-PCR.Results After Berberine treatment,the body weight,fasting plasma glucose,fasting insulin[(28.9 ± 2.0) mU/L,(31.5± 2.4) mU/L vs.(36.9 ± 4.7) mU/L],total cholesterol,triglycerides,and low-density lipoprotein cholesterol were decreased,while the high-density lipoprotein cholesterol(HDL-C) levels were increased in MS rats with high-dose berberine and low-dose berberine as compared with the control group (P ＜ 0.05) respectively.Berberine treatment could reduce the protein and mRNA expression levels of GRP78,Capase-12 and CHOP in the skeletal muscle of MS rats(P＜0.05).Conclusions Berberine may alleviate insulin resistance in rats with metabolic syndrome by reducing endoplasmic reticulum stress in skeletal muscle.
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Objective To observe the effects of antiplatelet drugs on the incidence of no reflow,main adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD).Methods From January 2010 to February 2011,a total of 84 CHD patients with no-reflow after PCI were selected and randomly divided into observed group and control group (n=42 each group).Patients with no/slow-reflow in observed group were injected with tirofiban through coronary artery with a guiding catheter.If invalid,patients were injected with tirofiban by catheterization again with a micro-pump continuous pumping for 24 h.Patients with no/slow reflow in control group were injected with verapamil by catheterization.If invalid,patients were injected with verapamil by catheterization again.Results The numbers of patients with Thrombolysis in Myocardial Infarction (TIMI) 3 in the first and last angiography after drug administration were much more in observed group than in control group [26 cases (61.9％) vs.17 cases (40.5％),35 cases (83.3％) vs.23 cases (54.8％),respectively,x2 =3.86,8.02,both P＜0.05].The first TIMI frame count (TFC) after drug administration was significantly lower in observed group than in control group,and the difference between groups became larger in the last TFC (t=-3.44,-12.41,both P＜0.05).The number of patients with TIMI myocardial perfusion grade (TMPG) 3 in the first and last angiography after drug administration were much more in observed group than in control group [24 cases (57.1％) vs.13 cases (31.0％),31 cases (73.8％) vs.20 cases (47.6％),respectively,x2=5.84,6.04,both P＜0.05].After 60 days of follow up,there was a significant difference in the incidence of endpoint events between observed and control group [23.8％ (10 cases) vs.52.3％ (12 cases),x2 =7.27.P＜0.01].The predisposing factors of no reflow were age,acute myocardial infarction (AMI),diabetes,hyperlipidemia and hypertension.Conclusions Tirofiban can effectively and safely reduce the incidence of no-reflow after percutaneous coronary intervention in patients with CHD.
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Objective To analyze the clinical effect and complication of trans-radial and femoral artery for percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods Totally 153 patients with coronary heart disease undergoing PCI were divided into radial artery and femoral artery groups.X-ray exposure time,operation time,the success rates of puncture and operation,in-bed time and complication were recorded. Results There were no significant differences in X-ray exposure time[(17±5)min vs.(16±6)min,t=0.61,P=0.57],operation time [(49± 9) min vs. (48 ± 11) min,t=0.59,P =0.61],the success rates of puncture (98.7％ vs.100.0％,x2 =0.47,P=0.53) and operation (96.0％ vs.96.2％,x2 =0.14,P=0.64) between radial artery and femoral artery groups.However,the complication rates was higher in femoral artery group than in radial artery group (17.9％ vs.2.7 ％,x2 =9.54,P=0.002),in-bed time was shorter in radial artery group than in femoral artery group [(4.5 ± 1.2)h vs.(13.2 ±4.6)h,t=2.12,P =0.003]. Conclusions The trans-radial artery PCI is safe,effective and feasible,with less complications and shorter in-bed time.