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1.
J Dent Sci ; 18(2): 689-695, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37021230

ABSTRACT

Background/purpose: Advanced glycation end products (AGEs) are known to accumulate in the periodontal tissues of patients with diabetes mellitus (DM). Through this study, we aimed to investigate the distribution of AGEs and the receptor of AGEs (RAGE) in the gingival tissues of patients with chronic periodontitis with and without non-insulin-dependent diabetes mellitus (NIDDM). Materials and methods: Gingival biopsy samples from 13 patients with both NIDDM and periodontitis and 6 patients with both non-DM (NDM) and periodontitis were collected. The tissue sections were processed using immunohistochemical (IHC) staining to detect the distributions of AGEs and RAGE. Spearman correlation coefficients of all samples were calculated (P < 0.05) for the AGE and RAGE rankings of the following clinical parameters: plaque score (PI), probing depth (PD), bleeding on probing (BOP), and tooth loss (TL). Results: IHC analysis revealed that AGEs among patients with NIDDM had a significantly higher ranking than those of the NDM group (P < 0.05). Positive staining for RAGE was observed in both groups but was not significantly different (P > 0.05). A positive correlation between AGE ranking and TL was observed in the NIDDM group, but not between AGE ranking and PI, PD, or BOP. The distribution of RAGE was not correlated with PI, PD, BOP, or TL. Conclusion: AGEs were particularly distributed in the highly inflamed gingiva of patients with NIDDM-associated periodontitis and was statistically correlated with the long-term parameter TL.

2.
J Infect Dev Ctries ; 16(4): 644-649, 2022 04 30.
Article in English | MEDLINE | ID: mdl-35544626

ABSTRACT

INTRODUCTION: Diabetes mellitus (DM) is a known risk factor for tuberculosis (TB), leading to an approximate three-fold higher risk of developing active TB. However, epidemiological studies on the prevalence of latent TB infection (LTBI) in DM patients are lacking. In this study, we investigated the presence of LTBI and determined risk factors for LTBI in DM patients. METHODOLOGY: We conducted a cross-sectional study at Taipei Medical University-Shuang Ho Hospital in northern Taiwan. The study population comprised DM patients (aged 20-70 years) attending a metabolism outpatient clinic between February 2011 and February 2013, excluding patients who were suspected or confirmed to have active TB. Venous blood samples were drawn from patients to detect LTBI using the QuantiFERON-TB Gold In-Tube (QFT-GIT) method. RESULTS: We enrolled 1120 patients with DM. The QFT-GIT showed positive results for 241 people (21.5%) and negative results for 879 people (78.5%). The mean age at QFT-GIT positivity was 58.2 years, which was significantly dissimilar to the mean age at QFT-GIT negativity, which was 55.0 years (p < 0.001). Multivariate logistic regression indicated that the trend of QFT-GIT positivity increased after the age of 50 years. Effective glycemic control did not differ significantly between QFT-GIT-positive and -negative patients. Moreover, men were predominant were predominant in both QFT-GIT-positive and -negative patients. CONCLUSIONS: More than one-fifth of DM patients have LTBI. Among the DM patients, those older than 50 years may have a higher risk of LTBI. Moreover, effective glycemic control did not differ significantly in patients with LTBI.


Subject(s)
Diabetes Mellitus , Latent Tuberculosis , Tuberculosis , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Humans , Interferon-gamma Release Tests/methods , Latent Tuberculosis/diagnosis , Latent Tuberculosis/epidemiology , Male , Prevalence , Risk Factors , Taiwan/epidemiology , Tuberculin Test/methods , Tuberculosis/diagnosis
3.
J Diabetes Res ; 2022: 5779276, 2022.
Article in English | MEDLINE | ID: mdl-35308093

ABSTRACT

Aims: To investigate the applicability of deep learning image assessment software VeriSee DR to different color fundus cameras for the screening of diabetic retinopathy (DR). Methods: Color fundus images of diabetes patients taken with three different nonmydriatic fundus cameras, including 477 Topcon TRC-NW400, 459 Topcon TRC-NW8 series, and 471 Kowa nonmyd 8 series that were judged as "gradable" by one ophthalmologist were enrolled for validation. VeriSee DR was then used for the diagnosis of referable DR according to the International Clinical Diabetic Retinopathy Disease Severity Scale. Gradability, sensitivity, and specificity were calculated for each camera model. Results: All images (100%) from the three camera models were gradable for VeriSee DR. The sensitivity for diagnosing referable DR in the TRC-NW400, TRC-NW8, and non-myd 8 series was 89.3%, 94.6%, and 95.7%, respectively, while the specificity was 94.2%, 90.4%, and 89.3%, respectively. Neither the sensitivity nor the specificity differed significantly between these camera models and the original camera model used for VeriSee DR development (p = 0.40, p = 0.065, respectively). Conclusions: VeriSee DR was applicable to a variety of color fundus cameras with 100% agreement with ophthalmologists in terms of gradability and good sensitivity and specificity for the diagnosis of referable DR.


Subject(s)
Artificial Intelligence/standards , Diabetic Retinopathy/diagnosis , Ophthalmoscopes/standards , Software Design , Adult , Artificial Intelligence/statistics & numerical data , Chi-Square Distribution , Diabetes Mellitus/diagnostic imaging , Diabetic Retinopathy/diagnostic imaging , Female , Humans , Male , Middle Aged , Ophthalmoscopes/statistics & numerical data , Reproducibility of Results
4.
PLoS One ; 13(5): e0197212, 2018.
Article in English | MEDLINE | ID: mdl-29734369

ABSTRACT

[This corrects the article DOI: 10.1371/journal.pone.0189115.].

5.
Pharmacotherapy ; 38(5): 503-510, 2018 05.
Article in English | MEDLINE | ID: mdl-29601105

ABSTRACT

STUDY OBJECTIVE: To investigate the efficacy and safety of rituximab in patients with Graves' orbitopathy (GO). DESIGN: Systematic review and meta-analysis of four randomized controlled trials. PATIENTS: A total of 293 patients with GO who received rituximab or control (either glucocorticoids, the established first-line therapy [three trials], or saline [one trial]). MEASUREMENTS AND RESULTS: Relevant studies published before February 2018 were identified from the PubMed, EMBASE, Cochrane Library, and Scopus databases and the ClinicalTrials.gov registry. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using a random-effects model. Treatment efficacy was assessed by measuring the following outcomes: clinical activity score (CAS), sight visual acuity reduction (NOSPECS) score, proptosis, diplopia, changes in eye volume, quality of life, and adverse events. In the four included trials, 113 patients in the rituximab group and 108 patients in the control group were evaluated. Compared with the control group, CAS (weighted mean difference 0.57, 95% confidence interval 0.25-0.89) was significantly reduced at 24 weeks in the rituximab group. Compared with the control group, considerable proptosis reduction was also observed in the rituximab group; however, the difference was not significant. The proportion of adverse events in the rituximab group was not significantly higher than that in the glucocorticoid control group, but one of the included trials indicated that the rituximab group had more serious adverse events than the saline control group. CONCLUSION: Rituximab is a relatively safe and viable treatment that is superior to glucocorticoids or saline for patients with moderate to severe GO. However, the incidence of serious adverse events was disparate among the included trials. Additional studies involving a larger sample size and investigating the optimal rituximab dosage, frequency, and method of administration are warranted.


Subject(s)
Graves Ophthalmopathy/drug therapy , Immunologic Factors/therapeutic use , Rituximab/therapeutic use , Glucocorticoids/adverse effects , Glucocorticoids/therapeutic use , Graves Ophthalmopathy/physiopathology , Humans , Immunologic Factors/adverse effects , Quality of Life , Randomized Controlled Trials as Topic , Rituximab/adverse effects , Treatment Outcome
6.
PLoS One ; 13(1): e0189115, 2018.
Article in English | MEDLINE | ID: mdl-29377927

ABSTRACT

AIM: The present study evaluated the relative influence of body mass index (BMI) on insulin resistance (IR), first-phase insulin secretion (FPIS), second-phase insulin secretion (SPIS), and glucose effectiveness (GE) at a fixed fasting plasma glucose level in an older ethnic Chinese population. METHODS: In total, 265 individuals aged 60 years with a fasting plasma glucose level of 5.56 mmol/L were enrolled. Participants had BMIs of 20.0-34.2 kg/m2. IR, FPIS, SPIS, and GE were estimated using our previously developed equations. Pearson correlation analysis was conducted to assess the correlations between the four diabetogenesis factors and BMI. A general linear model was used to determine the differences in the percentage of change among the four factor slopes against BMI. RESULTS: Significant correlations were observed between BMI and FPIS, SPIS, IR, and GE in both women and men, which were higher than those reported previously. In men, BMI had the most profound effect on SPIS, followed by IR, FPIS, and GE, whereas in women, the order was slightly different: IR, followed by FPIS, SPIS, and GE. Significant differences were observed among all these slopes, except for the slopes between FPIS and SPIS in women (p = 0.856) and IR and FPIS in men (p = 0.258). CONCLUSIONS: The contribution of obesity to all diabetes factors, except GE, was higher than that reported previously. BMI had the most profound effect on insulin secretion in men and on IR in women in this 60-year-old cohort, suggesting that lifestyle modifications for obesity reduction in women remain the most important method for improving glucose metabolism and preventing future type 2 diabetes mellitus.


Subject(s)
Diabetes Mellitus, Type 2/metabolism , Obesity/complications , Blood Glucose/metabolism , Body Mass Index , China , Diabetes Mellitus, Type 2/blood , Ethnicity , Fasting/blood , Fasting/metabolism , Female , Glucose , Glucose Tolerance Test , Humans , Insulin/blood , Insulin Resistance/physiology , Male , Middle Aged , Obesity/blood
7.
Int J Endocrinol ; 2017: 5940367, 2017.
Article in English | MEDLINE | ID: mdl-28951739

ABSTRACT

BACKGROUND: Papillary thyroid carcinoma (PTC) is the most common type of malignant thyroid neoplasm. However, the incidence of PTC with autoimmune thyroid disease (AITD) varies between studies. This study aims to investigate whether patients with AITD have increased incidence of PTC. We also analyzed the relationship of serum thyroid-stimulating hormone (TSH) levels and PTC in relation to AITD based on histopathological data. METHODS: A total of 533 participants who underwent thyroidectomy were enrolled in this retrospective study based on clinicohistopathological data and known thyroid autoantibodies. Patients were divided into PTC and benign groups according to histopathologic diagnosis. Age, gender, body mass index, and serum TSH level before thyroidectomy were recorded. RESULTS: Of the 533 enrolled patients, 159 (29.8%) were diagnosed with PTC, of which 38 (35.5%) had Hashimoto's thyroiditis (HT). More patients with HT were female, and patients with HT, Graves' disease, and thyroid nodules with higher TSH level had a higher incidence of PTC. CONCLUSIONS: A high proportion of the patients with PTC had HT. There was a trend that a higher serum TSH level was associated with a greater risk of thyroid cancer.

10.
J Diabetes ; 9(4): 386-395, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27171508

ABSTRACT

BACKGROUND: This study determined the efficacy and safety of once-daily oral alogliptin in patients from mainland China, Taiwan, and Hong Kong with type 2 diabetes mellitus. METHODS: In this Phase 3 multicenter double-blind placebo-controlled 16-week trial, 506 patients were randomized to receive once-daily alogliptin 25 mg or placebo: 185 in the monotherapy group, 197 in the add-on to metformin group, and 124 in the add-on to pioglitazone group. The primary efficacy variable was the change from baseline (CFB) in HbA1c at Week 16; other efficacy measures included CFB to Week 16 in fasting plasma glucose (FPG), incidence of marked hyperglycemia (FPG ≥11.1 mmol/L), and the incidence of clinical HbA1c ≤6.5 % (48 mmol/mol) and ≤7.0 % (53 mmol/mol) at Week 16. Safety was assessed throughout the trial. RESULTS: Alogliptin monotherapy provided a significantly greater decrease in HbA1c from baseline to Week 16 compared with placebo (-0.58 %; 95 % confidence interval [CI] -0.78 %, -0.37 %; P < 0.001). As an add-on to metformin or pioglitazone, alogliptin also significantly decreased HbA1c compared with placebo (-0.69 % [95 % CI -0.87 %, -0.51 %; P < 0.001] and -0.52 % [95 % CI -0.75 %, -0.28 %; P < 0.001], respectively). In any treatment group versus placebo, alogliptin led to greater decreases in FPG (P ≤ 0.004) and a higher percentage of patients who achieved an HbA1c target of ≤6.5 % and ≤7.0 % (P ≤ 0.003). No weight gain was observed in any treatment group. A similar percentage of patients experienced drug-related, treatment-emergent adverse events in the alogliptin and placebo arms. Four and two patients in the alogliptin and placebo arms, respectively, experienced mild or moderate hypoglycemia. CONCLUSIONS: Alogliptin 25 mg once daily reduced HbA1c and FPG and enhanced clinical response compared with placebo when used as monotherapy or as an add-on to metformin or pioglitazone. Therapy with alogliptin was well tolerated.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Piperidines/therapeutic use , Uracil/analogs & derivatives , Adult , Aged , Asian People , Blood Glucose/metabolism , China , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/ethnology , Double-Blind Method , Drug Therapy, Combination , Fasting/blood , Female , Glycated Hemoglobin/metabolism , Hong Kong , Humans , Hypoglycemic Agents/therapeutic use , Male , Metformin/therapeutic use , Middle Aged , Pioglitazone , Taiwan , Thiazolidinediones/therapeutic use , Treatment Outcome , Uracil/therapeutic use
11.
Metabolism ; 64(9): 1183-92, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26059853

ABSTRACT

BACKGROUND: Sliding-scale insulin has been widely used in treating inpatient hyperglycemia. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the efficacy and possible adverse effects of sliding-scale insulin in hospitalized patients. METHODS: PubMed, EMBASE, Cochrane Library, Scopus, and ClinicalTrials.gov registry were searched for studies published up to May 2015. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects models. RESULTS: Eleven RCTs containing a total of 1322 patients were identified. Among eight studies in which the RISS was compared with other regimens, no significant difference was observed in the percentage of patients who achieved the mean blood glucose level between the two groups, which was determined according to the numbers of blood samples (RR: 2.84; 95% CI: 0.94 to 8.59) and patients (RR: 1.75; 95% CI: 0.86 to 3.55). The mean blood glucose level (weighted mean difference=27.33, 95% CI: 14.74 to 39.92) and incidence of hyperglycemic events were significantly higher in the RISS group than in the non-sliding-scale group. No significant difference in the incidence of severe hypoglycemia and length of hospitalization between the groups was identified. CONCLUSIONS: The overall results of the meta-analysis indicated that applying the RISS alone or in combination with other antidiabetic medications did not provide any benefits in blood glucose control, but was accompanied by an increased incidence of hyperglycemic events. Therefore, we suggest that the use of sliding-scale insulin be discontinued in hospitals.


Subject(s)
Blood Glucose/metabolism , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/therapeutic use , Insulin/administration & dosage , Insulin/therapeutic use , Hospitalization , Humans , Hyperglycemia/blood , Hyperglycemia/drug therapy , Hypoglycemia/chemically induced , Hypoglycemia/epidemiology , Hypoglycemic Agents/adverse effects , Insulin/adverse effects , Randomized Controlled Trials as Topic
12.
Clin Endocrinol (Oxf) ; 83(5): 702-10, 2015 Nov.
Article in English | MEDLINE | ID: mdl-25370124

ABSTRACT

BACKGROUND: Recombinant human thyrotropin (rhTSH) can be used to enhance radioiodine therapy for shrinking multinodular goitre. The aim of this meta-analysis was to compare the effectiveness of rhTSH pretreatment and radioiodine therapy with that of radioiodine alone for treating benign nodular goitre. METHODS: The PubMed, EMBASE, Cochrane Library, Scopus and ClinicalTrials.gov databases were searched to identify studies published before September 2014. A meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the reduction in thyroid volume. Secondary outcomes included thyroid function, extent of tracheal compression, radioactive iodine uptake, incidence of hypothyroidism and other complications. RESULTS: Nine RCTs including 416 patients were selected. The reductions in thyroid volume were significantly greater in the rhTSH pretreatment groups than those in the radioiodine alone groups at 12 months (weighted mean difference: 14·42%; 95% CI: 4·51-24·34% in high-dose rhTSH vs radioiodine alone; weighted mean difference: 19·66%; 95% CI: 3·67-35·65% in low-dose rhTSH vs radioiodine alone). The incidence of hypothyroidism in the high-dose rhTSH groups was significantly higher than that in the radioiodine alone groups. No significant difference in the incidence of hypothyroidism occurred between the low-dose rhTSH groups and the radioiodine alone groups. CONCLUSIONS: The overall results indicated that using rhTSH before radioiodine therapy resulted in a greater thyroid volume reduction than radioiodine therapy alone. An increased incidence of hypothyroidism was observed in patients receiving high-dose rhTSH. Low-dose rhTSH before radioiodine therapy is more efficacious than radioiodine therapy alone for treating nontoxic benign thyroid nodules.


Subject(s)
Goiter, Nodular/drug therapy , Iodine Radioisotopes/therapeutic use , Thyroid Gland/drug effects , Thyrotropin/administration & dosage , Chemotherapy, Adjuvant , Humans , Hypothyroidism/chemically induced , Randomized Controlled Trials as Topic , Recombinant Proteins/administration & dosage
13.
Ann Acad Med Singap ; 43(2): 113-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24652432

ABSTRACT

INTRODUCTION: Decreased insulin action (insulin resistance) is crucial in the pathogenesis of type 2 diabetes. Decreased insulin action can even be found in normoglycaemic patients, and they still bear increased risks for cardiovascular disease. In this study, we built models using data from metabolic syndrome (Mets) components and the oral glucose tolerance test (OGTT) to detect insulin resistance in subjects with normal glucose tolerance (NGT). MATERIALS AND METHODS: In total, 292 participants with NGT were enrolled. Both an insulin suppression test (IST) and a 75-g OGTT were administered. The steady-state plasma glucose (SSPG) level derived from the IST was the measurement of insulin action. Participants in the highest tertile were defined as insulin-resistant. Five models were built: (i) Model 0: body mass index (BMI); (ii) Model 1: BMI, systolic and diastolic blood pressure, triglyceride; (iii) Model 2: Model 1 + fasting plasma insulin (FPI); (iv) Model 3: Model 2 + plasma glucose level at 120 minutes of the OGTT; and (v) Model 4: Model 3 + plasma insulin level at 120 min of the OGTT. RESULTS: The area under the receiver operating characteristic curve (aROC curve) was observed to determine the predictive power of these models. BMI demonstrated the greatest aROC curve (71.6%) of Mets components. The aROC curves of Models 2, 3, and 4 were all substantially greater than that of BMI (77.1%, 80.1%, and 85.1%, respectively). CONCLUSION: A prediction equation using Mets components and FPI can be used to predict insulin resistance in a Chinese population with NGT. Further research is required to test the utility of the equation in other populations and its prediction of cardiovascular disease or diabetes mellitus.


Subject(s)
Glucose/metabolism , Insulin Resistance , Adult , Blood Glucose , Cross-Sectional Studies , Female , Glucose Tolerance Test , Humans , Male , Metabolic Syndrome/metabolism , Middle Aged , Models, Statistical
14.
Diabetes Res Clin Pract ; 100(3): 391-7, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23587481

ABSTRACT

AIMS: The aim of this study was to evaluate the relative importance of insulin sensitivity (SI), and the first (1st ISEC) and second phase insulin secretion (2nd ISEC) in the development of type 2 diabetes (T2D) in Chinese subjects. METHODS: A total of 96 subjects, including 19 with normal fasting glucose, 21 with pre-diabetes, and 56 with T2D were enrolled. Subjects underwent a modified low dose graded glucose infusion (M-LDGGI; a simplified version of Polonsky's method) and frequently sampled intravenous glucose tolerance test. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. By observing the respective percentage reduction, the deterioration rate of each parameter was compared. RESULTS: As fasting plasma glucose (FPG) levels increased, SI decreased mildly and non-significantly, while the 1st and 2nd ISECs decreased more dramatically and significantly. More importantly, the decrease of the 1st ISEC from baseline was greater than that of the 2nd ISEC. CONCLUSIONS: Since the 1st ISEC decreased the most with increasing FPG levels, it is concluded that the 1st ISEC is the key trigger of T2D development. On the contrary, the 2nd ISEC remained more stable across increasing FPG levels. This latter finding may explain the effectiveness of insulin secretagogues during the early stage of T2D. The results of this study can be helpful in the development of interventions aimed at stopping the progression and/or treating T2D in Chinese populations.


Subject(s)
Diabetes Mellitus, Type 2/physiopathology , Insulin Resistance/physiology , Insulin-Secreting Cells/physiology , Adult , Aged , Asian People , Diabetes Mellitus, Type 2/metabolism , Female , Humans , Insulin/metabolism , Male , Middle Aged
15.
Lipids Health Dis ; 10: 228, 2011 Dec 06.
Article in English | MEDLINE | ID: mdl-22142413

ABSTRACT

OBJECTIVES: To evaluate the association between AGEs and atherosclerotic lipid profiles among aging diabetic patients in Taiwan. DESIGN AND METHODS: After age and gender matching, we selected 207 diabetic subjects and 174 diabetic subjects with proteinuria. Lipid profiles, including total cholesterol (TC), triglycerides (TG), high density cholesterol-lipoprotein (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were measured using standard methods. AGEs were measured with the immunoassay method. RESULTS: In general, males were heavier; however, females had higher AGEs, fasting glucose (GLU), TC, HDL-C and LDL-C levels than males, and had higher TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C ratios compared to males. AGEs were more strongly correlated with TG levels and TCL/LDL-C, LDL-C/HDL-C and TG/HDL-C ratios when compared to glucose or hemoglobin A1c. Subjects had higher AGEs levels (≧ 2.0 AU) with more adverse lipid profiles. CONCLUSION: AGEs seem to be a good biomarker to evaluate the association between diabetes and atherosclerotic disorders in aging diabetes.


Subject(s)
Atherosclerosis/blood , Diabetes Mellitus, Type 2/blood , Glycation End Products, Advanced/blood , Lipids/blood , Aged , Atherosclerosis/etiology , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/complications , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Multivariate Analysis , Regression Analysis , Statistics, Nonparametric
16.
Nutrition ; 27(9): 943-8, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21333494

ABSTRACT

OBJECTIVE: Non-alcoholic steatohepatitis (NASH) is a common cause of liver disease, and it may progress to fibrosis or cirrhosis. The aim of this study was to investigate the effects of soy protein on hepatic steatosis and insulin resistance in NASH. METHODS: Forty male Sprague-Dawley rats were fed a high-fat diet for 4 wk to induce NASH and then were allocated to one of four diets: a NASH-inducing diet, a standard diet, a NASH-inducing diet plus soy protein, and a standard diet plus soy protein. RESULTS: After the 10-wk experimental period, the results showed that soy protein significantly lowered plasma cholesterol concentrations and body fat accumulation. Soy protein intake also decreased the hepatic lipid depots of triacylglycerols and cholesterol and decreased the concentrations of lipid peroxides. In an analysis of antioxidative status, rats fed the soy protein diet showed improved antioxidative potential due to increases in superoxide dismutase and catalase activities and a decrease in the protein expression of cytochrome P450 2E1. CONCLUSION: Soy protein may improve the liver function in patients with NASH by lowering lipid levels in the blood and liver, increasing the antioxidative capacity, and improving insulin resistance.


Subject(s)
Adipose Tissue/metabolism , Antioxidants/metabolism , Fatty Liver/diet therapy , Insulin Resistance , Lipid Metabolism/drug effects , Liver/drug effects , Soybean Proteins/therapeutic use , Animals , Catalase/metabolism , Cholesterol/metabolism , Cytochrome P-450 CYP2E1/metabolism , Dietary Fats/adverse effects , Disease Progression , Fatty Liver/etiology , Fatty Liver/metabolism , Lipid Peroxidation/drug effects , Liver/metabolism , Male , Non-alcoholic Fatty Liver Disease , Phytotherapy , Rats , Rats, Sprague-Dawley , Soybean Proteins/pharmacology , Glycine max/chemistry , Superoxide Dismutase/metabolism , Triglycerides/metabolism
17.
Arch Pharm Res ; 33(3): 411-6, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20361306

ABSTRACT

The traditional sulfonylureas with long half-lives have sustained stimulatory effects on insulin secretion compared to the short-acting insulin secretagogue. In this study, we used the frequently sampled intravenous glucose tolerance test (FSIGT) to evaluate the insulin sensitivity (IS), glucose sensitivity (SG), and acute insulin response after glucose load (AIRg) after 4 months treatment with either gliclazide or repaglinide. The design of study was randomizedcrossover. We enrolled 20 patients with new-onset type 2 diabetes (mean age, 49.3 years). Totally three FSIGTs were performed, one before and one after each of the two treatment periods as aforementioned. No significant differences in fasting plasma glucose, insulin, body mass index, blood pressure, glycated hemoglobin, or lipids were noted between the two treatments. After the repaglinide treatment, higher AIRg, lower IS, and lower SG were noted, but they did not reach statistical significance. The disposal index (DI) was also not significantly different between the two treatments. In conclusion, since non-significantly higher DI, AIRg, lower IS and SG were noted after repaglinide treatment, it might be a better treatment for diabetes, relative to gliclazide.


Subject(s)
Blood Glucose/drug effects , Carbamates/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Gliclazide/therapeutic use , Hypoglycemic Agents/therapeutic use , Insulin Resistance , Insulin/blood , Piperidines/therapeutic use , Adult , Blood Glucose/metabolism , Blood Pressure/drug effects , Body Mass Index , Cross-Over Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/physiopathology , Female , Glucose Tolerance Test , Glycated Hemoglobin/metabolism , Humans , Lipids/blood , Male , Middle Aged , Time Factors , Treatment Outcome
18.
Ann Acad Med Singap ; 39(1): 4-8, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20126806

ABSTRACT

INTRODUCTION: There is no single method of measuring insulin resistance that is both accurate and can be easily performed by general researchers. We validate the accuracy of oral glucose insulin sensitivity (OGIS) in the Chinese by comparing the OGIS120 and OGIS180, homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (OUICKI) with steady-state plasma glucose (SSPG) in different glucose tolerance subjects. MATERIALS AND METHODS: We enrolled 515 subjects, aged between 20 and 75 years old, during routine health evaluations. All subjects were divided into normal, obese, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2D) groups. Participants had a 3-hour oral glucose tolerance test (OGTT) and SSPG with an insulin suppression test. The relationships between SSPG and OGIS120, OGIS180, HOMA-IR, and QUICKI were evaluated. RESULTS: The normal group had the highest OGIS120, OGIS180 and lowest SSPG as compared with the other 4 groups. OGIS180, HOMA-IR and QUICKI in all 5 groups were significantly related to SSPG (r = 0.397-0.621, all P <0.05). OGIS120 in all 5 groups was not significantly related to SSPG (r = 0.003-0.226). Additionally, the r value of OGIS180 against SSPG was not higher than the other 2 insulin sensitivity surrogates from OGTT. CONCLUSIONS: Although OGIS180 was more accurate in estimating insulin sensitivity than OGIS120 in the Chinese, it was not superior to the traditional surrogates such as HOMA-IR or QUICKI.


Subject(s)
Glucose Tolerance Test/methods , Insulin Resistance , Prediabetic State/diagnosis , Adult , Aged , Case-Control Studies , China , Female , Humans , Male , Middle Aged , Young Adult
19.
Metabolism ; 59(6): 780-6, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20005535

ABSTRACT

Impaired insulin secretion (ISEC) has been recognized as one of the most important pathophysiologies of type 2 diabetes mellitus. There are 2 phases of ISEC: the first phase (first ISEC) and second phase (second ISEC). This study aimed to evaluate the 2 phases of ISEC in newly diagnosed type 2 diabetes mellitus patients. Fifty-two drug-naive type 2 diabetes mellitus patients were given 2 tests: a modified low-dose graded glucose infusion (M-LDGGI) and frequent sample intravenous glucose tolerance test. The M-LDGGI is a simplified version of the Polonsky method. Two stages of intravenous infusion of glucose with different rates were given, starting from 2 mg/(kg min) and then followed by 6 mg/(kg min). Each stage was maintained for 80 minutes. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slope of these curves was regarded as the second ISEC and used as the criterion for grouping-the responders and nonresponders. The responders are older and had higher body mass index and log (homeostasis model assessment of beta-cell function) (log HOMA-beta) but lower fasting plasma glucose and hemoglobin A(1c) (HbA(1c)) than the nonresponders. Significant correlations were only noted between the second ISEC and first ISEC (r = 0.278, P = .046) and between the second ISEC and log HOMA-beta (r = 0.533, P = .000). Correlation between different parameters and HbA(1c) was also evaluated. Only second ISEC and log HOMA-beta were correlated significantly with HbA(1c) (r = -0.388, P = .015 and r = -0.357, P = .026, respectively). In type 2 diabetes mellitus, subjects with higher second ISEC are older and have higher body mass index. At the same time, second ISEC is the most important factor for determining glucose levels in naive Chinese type 2 diabetes mellitus patients. The first and second ISECs were only modestly correlated, which indicated that the deterioration of these 2 phases was not synchronized. Finally, we also recommend using the M-LDGGI for quantifying second ISEC. This practical method could be done in many centers without difficulty.


Subject(s)
Diabetes Mellitus, Type 2/metabolism , Insulin/metabolism , Adult , China , Female , Glucose , Glucose Tolerance Test , Glycated Hemoglobin/metabolism , Humans , Infusions, Intravenous , Insulin Resistance , Male , Middle Aged
20.
J Occup Environ Med ; 46(7): 707-13, 2004 Jul.
Article in English | MEDLINE | ID: mdl-15247810

ABSTRACT

The objective of this study was to investigate the effects of 2-ME on hepatic function in exposed workers. Fifty-three impregnation workers from two copper-clad laminate-manufacturing factories using 2-ME as a solvent were recruited as the exposed group. Another group of 121 lamination workers with indirect exposure to 2-ME was recruited as the comparison group. Environmental monitoring of air 2-ME concentrations and biological monitoring of urine 2-methoxy acetic acid concentrations were performed. Venous blood was collected for blood biochemistry analyses. Liver function examination results showed that the aspartate amino transferase, alanine amino transferase, and gamma-glutamyl transferase in the 2-ME-exposed workers were not significantly different from those in the comparison workers. After adjustment for hepatitis carrier status, gender, body mass index, and duration of employment, no difference were found between exposed and comparison groups. We conclude that 2-ME was not a hepatotoxin.


Subject(s)
Ethylene Glycols/toxicity , Liver/drug effects , Liver/enzymology , Occupational Exposure , Solvents/poisoning , Teratogens/toxicity , Adult , Alanine Transaminase/pharmacology , Aspartate Aminotransferases/pharmacology , Case-Control Studies , Female , Humans , Industry , Male , gamma-Glutamyltransferase/pharmacology
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