Objective To investigate and analyze the relationships among glucagon-like peptide-1 (GLP-1) level, chronic inflammation, and atherosclerosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods From October 2016 to February 2017, using cross-sectional investigation, the GLP-1 level, chronic inflammation, and atherosclerosis were investigated in 80 subjects (40 NAFLD patients in NAFLD group, and 40 non-fatty liver disease participants in control group) who underwent physical examination at Xi’an Road Community Hospital. Results Compared with those in the control group, GLP-1 fasting level in patients with NAFLD [(9.09±1.03) vs. (9.15±1.06) pmol/L, P=0.807] and postprandial plasma GLP-1 [(15.96±3.37) vs. (17.46±4.76) pmol/L, P=0.108] had no changes. The correlations of GLP-1 level with chronic inflammation and insulin resistance (IR) were not significant either. The increased risk of carotid intima-media thickness related cardiovascular disease (CVD) in the NAFLD group was greater than that in the control group, and the difference was statistically significant [22 (55.0%)vs.13 (32.5%), P=0.043]. When the plasma lipoprotein-associated phospholipase A2 level increased, the risk of NAFLD increased [odd ratio (OR)=1.16, 95% confidence interval (CI) (1.02, 1.32), P=0.023]. Plasma ceramide kinase (CERK) in the NAFLD group was lower than that in the control group, and the difference was statistically significant [(12.36±2.45) vs. (18.33±3.71) ng/mL, P<0.001]. When the plasma CERK level of the fasting plasma was elevated, the risk of NAFLD decreased [OR=0.30, 95%CI (0.12, 0.78), P=0.014]. The homeostasis model assessment of insulin resistance (HOMA-IR) in the NAFLD group was higher than that in the control group, and the difference was statistically significant (2.46±2.53 vs. 1.11±0.66, P=0.002). The Matsuda index in the NAFLD group was less than that in the control group, and the difference was statistically significant (5.88±4.09 vs. 10.46±7.90, P=0.002). When HOMA-IR increased, the risk of NAFLD increased [OR=2.75, 95%CI (2.49, 3.12), P=0.036]. Conclusions Plasma GLP-1 level is not a sensitive indicator of chronic inflammation and IR in patients with NAFLD. Patients with NAFLD are in an increased risk of atherosclerosis and CVD. It suggests that NAFLD might be involved in chronic inflammation and IR. Chronic inflammation can cause IR, and then chronic inflammation and IR can cause NAFLD and subclinical atherosclerosis. In return for this, NAFLD increases chronic inflammation and IR.
ObjectiveTo explore a surgery of effective weight loss concentrating on gut hormone release. MethodsWistar rats were fed with high-fat diet for inducing obesity and which randomly divided into sleeve gastrectomy plus decent jejunoileal bypass (SJB) group (n=12), sleeve gastrectomy (SG) group (n=12), and sham operation (SO) group (n=11), the body weight reduction, food intake, plasma ghrelin level, and glucagon like peptide-1 (GLP-1) level were compared among three groups. ResultsThere were no differences of the body weight and food intake before operation among three groups (Pgt;0.05). Compared with the SO group, the body weight descended and the food intake decreased obviously on 1-8 weeks after operation in the SJB group (Plt;0.05), the body weight of rats on 1-8 weeks after operation in the SJB group significantly descended as compared with the SG group (Plt;0.05), and the food intake of rats on week 3, 6, 7, and 8 in the SJB group signicantly decreased as compared with the SG group (Plt;0.05). There were no differences of the levels of the plasma ghrelin and GLP-1 before operation among three groups (Pgt;0.05). Compared with SO group, the plasma ghrelin level decreased and the GLP-1 level increased in the SJB group and the SG group, meanwhile the SJB group significantly decreased level of plasma ghrelin and elevated level of plasma GLP-1 as compared with the SG group on week 8 after operation(Plt;0.05). ConclusionThe data demonstrate that SJB could represent an effective way of losing weight by interfering with food intake and obesity related hormone levels.
摘要:目的:探討經尿道前列腺電切術中糖尿病患者血糖變化以及處理對策。方法:2006年7月~ 2009年1月共對80例患有前列腺增生合并糖尿病患者行TURP,同期對80例單純性前列腺增生患者進行相同手術,回顧分析其術前、術中30 min、60 min、90 min 指尖血糖變化及干預情況。結果:治療組80例患者,51例術中血糖值明顯低于術前,分別為1.8～3 mmol/L;對照組術前與術中血糖值基本一致,血糖波動于4.5～5.6 mmol/L。結論:糖尿病患者糖的儲備能力差,在行經尿道電切術中易發生低血糖綜合征,術中及時的血糖監測及干預對保證患者的安全有重要意義。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
目的 探討肝癌合并低血糖的診斷及治療。方法 對中國醫科大學附屬第四醫院2010年1月至2013年4月期間收治的27例肝癌伴低血糖患者的臨床資料進行回顧性分析。結果 27例患者中轉移性肝癌2例，原發性肝癌25例；其中伴肝硬變9例。所有患者均給予護肝、補充能量治療；22例行手術治療后血糖全部控制在正常或僅輕度升高，5例因腫瘤無法切除而放棄手術治療，其中1例伴肝硬變肝癌患者2個月后再次低血糖癥狀發作后死亡。結論 低血糖是肝癌少見的并發癥，早期診斷及治療有助于避免后遺癥的發生并改善預后。
Objective To assess the differences between a glucose meter and autoanalyzer at home and broad.Method MEDLINE, CNKI, FMJS, and CBM were searched electronically (1995 to May, 2008). The statistical analysisof included studies was performed according to the Cochrane systematic reviews method. Result Twenty four studies, including 11 English records and 19 Chinese records involving 4 963 specimens, were included in this study. Meta-analysis showed us the blood glucose values of Abbott, Roche, and Johnson abroad subgroups are higher than the laboratory method, and their WMD (95%CI) are 0.57 (0.34,0.80), 0.43 (0.04,0.81), 0.41 (0.11,0.71). The blood glucose values of the Abbot and Roche domestic subgroups are comparable to the laboratory method [WMD= 0.60, 95%CI (– 0.79, 1.99); WMD= – 0.13, 95%CI (– 0.56, 0.29)]. The blood glucose value of the Johnson domestic subgroup is lower than laboratory method [WMD= – 0.95, 95%CI (– 1.42, – 0.48)]. Conclusion The results of the abroad studies are relatively consistent, and the blood glucose values of all abroad subgroups are higher than laboratory method. The domestic studies are different because of other factors.
【摘要】 目的 老年綜合評估法篩查75歲以上2型糖尿病（type 2 diabetes mellitus，T2DM）合并老年綜合征的情況，并觀察以甘精胰島素為基礎的治療方法對老年綜合征、血糖、低血糖事件、治療滿意度等的影響。 方法 應用老年綜合評估中的日常生活能力、工具性日程生活能力、簡易智能量表、老年抑郁量表、微型營養評定法，分別評估2005年12月—2009年12月老年門診及病房住院的日常生活能力、認知功能狀態、情緒障礙和營養狀態，對其合并功能障礙、癡呆、抑郁、營養障礙、傷害性跌倒等老年綜合征的患病情況進行橫斷面調查；篩選至少合并一種老年綜合征和一個其他合并疾病，血糖控制差、預期壽命有限的患者進行以甘精胰島素為基礎的降糖治療，采用自身前后對照的方法了解對糖化血紅蛋白（hemoglobin A1c， HbA1c）、低血糖事件、治療滿意度的影響，并觀察甘精胰島素治療方案對上述老年綜合征的影響。 結果 132例老年門診及病房住院的75歲以上T2DM患者功能障礙者高達50.0%（66例），罹患包括輕度認知功能障礙在內的癡呆比例為39.4%（52例）；合并抑郁癥28.0%（37例）；營養失衡30.0%（39例）。33例患者符合甘精胰島素治療納入標準，經過2年的隨訪發現，以甘精胰島素為基礎的治療方案在適當降低HbA1c水平時，不增加老年綜合征的患病率，但可以減少胰島素多次皮下注射的次數，降低低血糖事件發生次數（由1.58次/例降為0.81次/例），提高患者治療滿意度。 結論 75歲以上T2DM患者合并老年綜合征的比例高，老年綜合評估能及時發現老年綜合征；以甘精胰島素為基礎的治療方案不增加老年綜合征的發生，并能顯著降低低血糖事件數、改善營養狀態、提高患者對治療的滿意度。【Abstract】 Objective To screen geriatric syndrome in patients older than 75 years with type 2 diabetes mellitus (T2DM) by the method of comprehensive geriatric assessment, and observe the impact of glargin-based therapy on geriatric syndrome, blood glucose level, the event of hypoglycemia and treatment satisfaction degree in patients older than 75 years with T2DM who suffered at least one kind of Geriatric syndromes. Methods From December 2005 to December 2009, activity of daily living (ADL), instrument activity of daily living (IADL), mini-mental state examination, geriatric depression scale and mini-nutritional assessment in comprehensive geriatric assessment were used to assess daily living ability, cognitive function status, emotional disorder and nutritional status of out/in-patients older than 75 years with T2DM in the Department of Geriatrics. Cross-sectional study was carried out to investigate geriatric syndromes such as combined functional disorder, dementia, depression, nutritional disorder and impairment falls in those patients, and patients with T2DM combined with at least one kind of geriatric syndrome and another kind of combined disease were screened out. A glargin-based anti-hyperglycemic therapy was carried out for those patients with poor blood glucose control limited remaining life time. The effects of this therapy on hemoglobin A1c (HbA1c), the event of hypoglycemia and treatment satisfaction degree of the patients were studied through a self-comparison method. Then, its effect on the above-mentioned geriatric syndromes was observed. Results Among all the 132 out/in patients older than 75 years with T2DM, the prevalence rates of functional disorder (including ADL and IADL), dementia including mild cognitive disorder, depression, and malnutrition were respectively 50.0% (66), 39.4% (52), 28.0% (37), and 30.0% (39). Only 33 patients met the criteria of glargin-based treatment. After 2 years of follow-up, we found that the glargin-based treatment could properly decrease the level of HbA1c without increasing the prevalence rate of geriatric syndrome. Moreover, it could reduce the frequency of insulin injection and the events of hypoglycemia, and treatment satisfaction degree was also significantly improved. Conclusions Geriatric syndrome has a relatively high prevalence rate in patients older than 75 years with T2DM. Comprehensive geriatric assessment is beneficial in finding out the geriatric syndrome, and glargin-based hypoglycemic therapy can significantly reduce the events of hypoglycemia, improve nutritional status, and increase treatment satisfaction degree without increasing the rate of geriatric syndrome .
Polycystic ovary syndrome (PCOS) affects many women of reproductive age, including ovarian and metabolic dysfunction. Major therapeutic goals include weight loss and improved insulin resistance. The effects of weight loss and increased insulin sensitivity of glucagon-like peptide-1 (GLP-1) receptor agonists provide another opportunity and pathway for the treatment of PCOS patients, especially those with metabolic abnormalities. This paper reviews the metabolism and reproductive outcomes about GLP-1 receptor agonists for PCOS by searching for literatures of clinical trials from PubMed in the past 10 years, in oder to provide new ideas and clinical evidence for clinical treatment of PCOS.
ObjectiveTo investigate the effect and mechanism of gastric bypass surgery (GBP) on fasting bloo-glucose (FBG) in type 2 diabetic rats. MethodsThe models of type 2 diabetic rats were induced by stretozotocin and 20 diabetic rats were randomly divided into two groups: diabetes-operation group (DO group, n=10) and diabetes-control group (DC group, n=10). Another twenty normal rats were randomly divided into two groups: normaloperation group (NO group, n=10) and normal-control group (NC group, n=10). The rats underwent GBP in DO group and NO group and sham operation in DC group and NC group. The FBG levels, serum dipeptidyl peptidase Ⅳ (DPPⅣ), and glucagon-like peptide-1 (GLP-1) concentrations of rats in each group were detected before operation and at 72 h, on 1 week, 4 weeks, and 8 weeks after operation. ResultsThe FBG levels of rats before operation were not significantly different between DO group and DC group or between NO group and NCgroup (Pgt;0.05). After operation, the FBG levels of rats in DO group gradually declined, reached the bottom on 4 weeks after operation and rose slightly on 8 weeks; The FBG levels of rats in DO group were lower after operation than before operation (Plt;0.05); After operation the FBG levels of rats in DO group were higher than that in NO group and NC group at the same time point (Plt;0.05); In DC group, the difference of FBG levels of rats at different time point was not statistically significant (Pgt;0.05); The inter-group and intra-group difference of FPG levels of rats for NO group and NC group was not statistically significant (Pgt;0.05). The concentrations of serum DPP-Ⅳ of rats before operation were not significantly different in each group (Pgt;0.05). After operation, the concentrations of serum DPP-Ⅳ of rats in DO group and NO group gradually decreased and markedly lower than that before operation, respectively (Plt;0.05). The concentrations of serum DPP-Ⅳ of rats after operation in DO group and NO group were significantly lower than that at the same time point in DC group and NC group, respectively (Plt;0.05); The intragroup difference of serum DPP-Ⅳ concentrations of rats for DC group and NC group was not statistically significant (Pgt;0.05). The concentrations of serum GLP-1 of rats before operation were not significantly different between DO group and DC group or between NO group and NC group (Pgt;0.05). After operation, the concentrations of serum GLP-1 of rats in DO group and NO group gradually increased, reached the top on 4 weeks after operation and declined slightly on 8 weeks; The concentrations of serum GLP-1 of rats in DO group and NO group were higher after operation than before operation (Plt;0.05);After operation, the concentrations of serum GLP-1 of rats in NO group were higher than that in NC group (Plt;0.05), but the concentrations of serum GLP-1 of rats at different time point in NO group were not different (Pgt;0.05). The intragroup difference of serum GLP-1 concentrations of rats for DC group and NC group was not statistically significant (Pgt;0.05). ConclusionsThere is obvious hypoglycemic effect of GBP on FBG levels of type 2 diabetic rats other than normal rats, in which high secretion of GLP-1 and low secretion of DPP-Ⅳ may be play an important role.
Objective To investigate the effect of glucagon-like peptide-1(GLP-1) on impaired glucose tolerance due to stress postoperatively. Methods The rats were allocated randomly to one of three groups, group Ⅰ was subdivided into group Ⅰg which received an intravenous glucose load (0.5 g/kg glucose), and group Ⅰglp which received the same glucose load with GLP-1 (0.3 nmol/kg) during intravenous glucose tolerance test (IVGTT). Rats in group Ⅱg and group Ⅱglp in group Ⅱ were infused respectively the same intravenous glucose tolerance test as group Ⅰ on the first, third and fifth day after 65% liver resection. And rats in group Ⅲ were injected the same glucose load with GLP-1 (0.45 nmol/kg) during IVGTT on the first day after hepatectomy. The peak glucose levels, glucose levels at 30 minutes and the area under the curve (AUC0-30) were investigated among groups. Results The peak glucose levels, glucose levels at 30 minutes and AUC0-30 were significantly lower in group Ⅰglp than those in group Ⅰg. And the values were significantly higher in group Ⅱg than those in group Ⅰg on the first, third and fifth day after operation. There was no significant difference between group Ⅱglp and group Ⅱg in the peak glucose levels on the first day after liver resection, but the peak glucose levels and AUC0-30 were significantly lower in group Ⅲ than those in group Ⅱg and group Ⅱglp, and the glucose levels at 30 minutes were significantly lower in group Ⅲ than those in group Ⅱg too on the first day. The peak glucose levels were significantly lower in group Ⅱglpthan those in group Ⅱg on the third and fifth postoperative day and in group Ⅱglp on the first day too, and the glucose levels at 30 minutes and AUC0-30 were also significantly lower in group Ⅱglp than those in group Ⅱg, but they were similar between group Ⅱglp and group Ⅰg. Conclusion Glucose intolerance is a feature of stress after hepatectomy, and GLP-1, injected in conjunction with the IVGTT, increased the clearance of glucose. The contribution of GLP-1 to reducing blood glucose was decreased significantly at early phase postoperatively, but its action was enhanced by the way of dosage dependence. The action of GLP-1 was enhanced with the degree of stress reduction and then returned to normal.
目的:比較優泌樂(賴脯胰島素)與優泌林R(常規人胰島素)改善餐后2 h血糖波動療效。方法:報道本院369例糖尿病患者強化治療。結果:優泌樂治療組餐后2 h血糖水平及血糖波動均顯著降低,且無任何顯著性不良事件或持久性低血糖發生.結論:優泌樂能夠快速有效控制2型糖尿病患者的餐后血糖,方便患者,順應性好,獲得患者的喜愛。