Objective To evaluate islet β cell response to intravenous glucagon （ a non-glucose secretagogue） stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes （T1 D） and 131 patients with typ...Objective To evaluate islet β cell response to intravenous glucagon （ a non-glucose secretagogue） stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes （T1 D） and 131 patients with type 2 diabetes （T2D） were recruited in this study. T2D patients were divided into two groups according to therapy： 36 cases treated with insulin and 95 cases treated with diet or oral therapy. The serum C-peptide levels were determined at fasting and six minutes after intra- venous injection of 1 mg of ghicagon. Results Both fasting and 6-minute post-ghicagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients （0. 76±0. 36 ng/mL vs. 1.81±0. 78 ng/mL, P 〈 0.05 ; 0.88±0.42 ng/mL vs. 3.68±0. 98 ng/mL, P 〈 0. 05 ）. In T1D patients, the C-peptide level after injection of ghicagon was similar to the fasting level. In T2D, patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy （2.45±0. 93 ng/mL vs. 1.61±0. 68 ng/mL, P 〈 0.05 ; 5.26±1.24 ng/mL vs. 2.15±0.76 ng/mL, P 〈 0.05 ）. The serum C-peptide level after ghicagon stimulation was positively correlated with C-peptide levels at fasting in all three groups （ r = 0.76, P 〈 0.05 ）. Conclusions The 6-minute ghicagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus. It is helpful for diagnosis and treatment of diabetes mellitus.展开更多
AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to...AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.展开更多
目的:探究有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响。方法:将2021年5月—2023年6月松滋市人民医院的100例妊娠期糖尿病患者依据随机数字表法分为对照组50例和观察组50例。对照组进行常规妊娠期糖尿病干预,...目的:探究有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响。方法:将2021年5月—2023年6月松滋市人民医院的100例妊娠期糖尿病患者依据随机数字表法分为对照组50例和观察组50例。对照组进行常规妊娠期糖尿病干预,观察组则在对照组的基础上加用有氧运动联合抗阻运动。比较两组的干预总有效率、干预前后的胰岛细胞功能[稳态模型评估胰岛素抵抗指数(HOMA-IR)及稳态模型评估β细胞功能指数(HOMA-β)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]及脂代谢指标[总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)]。结果:观察组的干预总有效率高于对照组(P<0.05)。干预前两组的胰岛细胞功能、糖代谢指标及脂代谢指标比较,差异均无统计学意义(P>0.05),干预4、8周后,两组的HOMA-β均高于干预前,且观察组均高于对照组,两组的HOMA-IR、糖代谢指标及脂代谢指标均低于干预前,且观察组均低于对照组(P<0.05)。结论:有氧运动联合抗阻运动在妊娠期糖尿病患者中的应用效果较好,且可显著改善患者的胰岛细胞功能及糖脂代谢状态。展开更多
目的:探讨津力达颗粒辅助治疗对2型糖尿病(T2DM)患者糖代谢指标及氧化应激反应的影响。方法:选取我院2022年1月—2023年4月收治的96例T2DM患者,按随机数字表法分为对照组与观察组,各48例。对照组予常规治疗,观察组基于常规治疗予津力达...目的:探讨津力达颗粒辅助治疗对2型糖尿病(T2DM)患者糖代谢指标及氧化应激反应的影响。方法:选取我院2022年1月—2023年4月收治的96例T2DM患者,按随机数字表法分为对照组与观察组,各48例。对照组予常规治疗,观察组基于常规治疗予津力达颗粒辅助治疗。对比2组糖代谢指标[空腹血糖水平(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)],胰岛细胞功能[胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)],氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]及不良反应。结果:治疗8周,观察组FBG、2 h PBG、Hb A1c、HOMA-IR、MDA水平较对照组低,HOMA-β、SOD水平较对照组高,差异具有统计学意义(P<0.05);观察组与对照组不良反应对比,差异无统计学意义(P>0.05)。结论:T2DM患者采用津力达颗粒辅助治疗可改善糖代谢与胰岛细胞功能,减轻氧化应激反应,且安全性好。展开更多
目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,...目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,按照随机数字表法分成68例A组(聚乙二醇洛塞那肽治疗)与68例B组(利拉鲁肽治疗)。比较治疗前后两组肥胖相关指标、治疗前后两组血脂相关指标、治疗前后两组血糖指标以及治疗后不良反应发生率。结果治疗后两组体质量、腰臀比、体质量指数(BMI)和腰围均下降,B组体质量和BMI[分别为(80.31±7.62)kg和(24.13±1.82)kg·m^(-2)]低于A组体质量[分别为(83.65±7.93)kg和BMI(25.34±1.84)kg·m^(-2)](体质量:t=2.504,P=0.014;BMI:t=3.855,P<0.05);治疗后两组甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL)均下降,高密度脂蛋白胆固醇(HDL-C)上升(均P<0.05);治疗后两组餐后2 h血糖(2 h FBG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)水平均下降,空腹血糖胰岛素(FINS)、β细胞功能指数(HOMA-β)水平均上升,A组2 h FBG、FBG[分别为(7.86±1.12)mmol·L^(-1)、(6.18±0.71)mmol·L^(-1)]低于B组[分别为2 h FBG(8.72±1.34)mmol·L^(-1)和FBG(7.02±0.62)mmol·L^(-1)](2 h FBG:t=4.061,P<0.05;FBG:t=7.349,P<0.05),A组HOMA-β[(74.62±3.78)%]高于B组[(62.79±3.56)%](t=18.937,P<0.05);两组不良反应发生率比较差异无统计学意义(20.59%vs 25.00%,χ^(2)=0.376,P=0.540)。结论对于肥胖2型糖尿病患者,聚乙二醇洛塞那肽与利拉鲁肽均能有效减轻体质量、调节血脂、降低血糖水平以及增强胰岛β细胞的功能,且安全性相似。然而,在降低体质量方面,利拉鲁肽的效果更为显著,而聚乙二醇洛塞那肽在改善胰岛β细胞功能和降低血糖方面则表现更为出色。展开更多
文摘Objective To evaluate islet β cell response to intravenous glucagon （ a non-glucose secretagogue） stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes （T1 D） and 131 patients with type 2 diabetes （T2D） were recruited in this study. T2D patients were divided into two groups according to therapy： 36 cases treated with insulin and 95 cases treated with diet or oral therapy. The serum C-peptide levels were determined at fasting and six minutes after intra- venous injection of 1 mg of ghicagon. Results Both fasting and 6-minute post-ghicagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients （0. 76±0. 36 ng/mL vs. 1.81±0. 78 ng/mL, P 〈 0.05 ; 0.88±0.42 ng/mL vs. 3.68±0. 98 ng/mL, P 〈 0. 05 ）. In T1D patients, the C-peptide level after injection of ghicagon was similar to the fasting level. In T2D, patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy （2.45±0. 93 ng/mL vs. 1.61±0. 68 ng/mL, P 〈 0.05 ; 5.26±1.24 ng/mL vs. 2.15±0.76 ng/mL, P 〈 0.05 ）. The serum C-peptide level after ghicagon stimulation was positively correlated with C-peptide levels at fasting in all three groups （ r = 0.76, P 〈 0.05 ）. Conclusions The 6-minute ghicagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus. It is helpful for diagnosis and treatment of diabetes mellitus.
基金Supported by the National Natural Science Foundation of China,No. 39370343 the National Ministry of Health Youth Talents Foundation, No. Q9420 the Hunan Health Bureau Key Scientific Funds, No. 9736, 2001-Z04
文摘AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.
文摘目的:探究有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响。方法:将2021年5月—2023年6月松滋市人民医院的100例妊娠期糖尿病患者依据随机数字表法分为对照组50例和观察组50例。对照组进行常规妊娠期糖尿病干预,观察组则在对照组的基础上加用有氧运动联合抗阻运动。比较两组的干预总有效率、干预前后的胰岛细胞功能[稳态模型评估胰岛素抵抗指数(HOMA-IR)及稳态模型评估β细胞功能指数(HOMA-β)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]及脂代谢指标[总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)]。结果:观察组的干预总有效率高于对照组(P<0.05)。干预前两组的胰岛细胞功能、糖代谢指标及脂代谢指标比较,差异均无统计学意义(P>0.05),干预4、8周后,两组的HOMA-β均高于干预前,且观察组均高于对照组,两组的HOMA-IR、糖代谢指标及脂代谢指标均低于干预前,且观察组均低于对照组(P<0.05)。结论:有氧运动联合抗阻运动在妊娠期糖尿病患者中的应用效果较好,且可显著改善患者的胰岛细胞功能及糖脂代谢状态。
文摘目的:探讨津力达颗粒辅助治疗对2型糖尿病(T2DM)患者糖代谢指标及氧化应激反应的影响。方法:选取我院2022年1月—2023年4月收治的96例T2DM患者,按随机数字表法分为对照组与观察组,各48例。对照组予常规治疗,观察组基于常规治疗予津力达颗粒辅助治疗。对比2组糖代谢指标[空腹血糖水平(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)],胰岛细胞功能[胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)],氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]及不良反应。结果:治疗8周,观察组FBG、2 h PBG、Hb A1c、HOMA-IR、MDA水平较对照组低,HOMA-β、SOD水平较对照组高,差异具有统计学意义(P<0.05);观察组与对照组不良反应对比,差异无统计学意义(P>0.05)。结论:T2DM患者采用津力达颗粒辅助治疗可改善糖代谢与胰岛细胞功能,减轻氧化应激反应,且安全性好。
文摘目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,按照随机数字表法分成68例A组(聚乙二醇洛塞那肽治疗)与68例B组(利拉鲁肽治疗)。比较治疗前后两组肥胖相关指标、治疗前后两组血脂相关指标、治疗前后两组血糖指标以及治疗后不良反应发生率。结果治疗后两组体质量、腰臀比、体质量指数(BMI)和腰围均下降,B组体质量和BMI[分别为(80.31±7.62)kg和(24.13±1.82)kg·m^(-2)]低于A组体质量[分别为(83.65±7.93)kg和BMI(25.34±1.84)kg·m^(-2)](体质量:t=2.504,P=0.014;BMI:t=3.855,P<0.05);治疗后两组甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL)均下降,高密度脂蛋白胆固醇(HDL-C)上升(均P<0.05);治疗后两组餐后2 h血糖(2 h FBG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)水平均下降,空腹血糖胰岛素(FINS)、β细胞功能指数(HOMA-β)水平均上升,A组2 h FBG、FBG[分别为(7.86±1.12)mmol·L^(-1)、(6.18±0.71)mmol·L^(-1)]低于B组[分别为2 h FBG(8.72±1.34)mmol·L^(-1)和FBG(7.02±0.62)mmol·L^(-1)](2 h FBG:t=4.061,P<0.05;FBG:t=7.349,P<0.05),A组HOMA-β[(74.62±3.78)%]高于B组[(62.79±3.56)%](t=18.937,P<0.05);两组不良反应发生率比较差异无统计学意义(20.59%vs 25.00%,χ^(2)=0.376,P=0.540)。结论对于肥胖2型糖尿病患者,聚乙二醇洛塞那肽与利拉鲁肽均能有效减轻体质量、调节血脂、降低血糖水平以及增强胰岛β细胞的功能,且安全性相似。然而,在降低体质量方面,利拉鲁肽的效果更为显著,而聚乙二醇洛塞那肽在改善胰岛β细胞功能和降低血糖方面则表现更为出色。
