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1.
摘要 目的:探讨血清血管细胞黏附分子-1(VCAM-1)、纤溶酶原激活物抑制物-1(PAI-1)、血管生成素样蛋白8(ANGPTL8)与妊娠期糖尿病(GDM)患者妊娠结局的关系。方法:选择2019年4月~2021年3月期间陕西中医药大学第二附属医院收治的GDM孕妇136例作为研究组。选择同时期来陕西中医药大学第二附属医院产检的健康孕妇120例作为对照组。收集研究组患者的人口学及临床资料,采用酶联免疫吸附法检测两组孕妇的血清VCAM-1、PAI-1、ANGPTL8水平,观察两组孕妇的妊娠结局情况。研究组孕妇根据妊娠结局情况分为妊娠结局不良组和妊娠结局良好组,采用单因素及多因素Logistic回归分析GDM孕妇妊娠结局不良的影响因素。结果:研究组的血清VCAM-1、PAI-1、ANGPTL8水平高于对照组(P<0.05)。研究组的妊娠结局不良总发生率高于对照组(P<0.05)。单因素分析结果显示,GDM孕妇妊娠结局不良与年龄、产前体质量指数(BMI)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)、糖尿病家族史、分娩史、居住地、VCAM-1、PAI-1、ANGPTL8水平有关(P<0.05)。多因素Logistic回归分析显示,年龄≥35岁、产前BMI≥28 kg/m2、HbAlc水平较高、居住地为城镇、VCAM-1、PAI-1、ANGPTL8水平升高均是GDM孕妇妊娠结局不良的影响因素(P<0.05)。结论:GDM孕妇血清VCAM-1、PAI-1、ANGPTL8水平异常升高,且三者均为GDM孕妇妊娠结局的影响因素,值得临床关注。  相似文献   

2.
摘要 目的:探讨血清同型半胱氨酸(Hcy)、胰腺衍生因子(PANDER)、肥胖抑制素(Obestatin)与妊娠期糖尿病(GDM)患者血糖控制情况和妊娠结局的关系。方法:选择2021年1月至2022年1月于我院就诊的286例GDM患者,根据分娩前糖化血红蛋白(HbA1c)水平分为血糖控制达标组(HbA1c<7%,173例)和血糖控制不达标组(HbA1c≥7%,113例),检测并比较两组患者入组时血清Hcy、PANDER、Obestatin、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗(HOMA-IR)水平,采用Pearson相关分析Hcy、PANDER、Obestatin与FPG、FINS、HOMA-IR的相关性。根据妊娠结局分为妊娠结局不良组(90例)和妊娠结局良好组(196例),采用多因素Logistic回归分析GDM患者妊娠结局的影响因素。结果:血糖控制不达标组血清Hcy、PANDER、FPG、FINS、HOMA-IR水平均高于血糖控制达标组,而Obestatin水平低于血糖控制达标组(P<0.05)。血清Hcy、PANDER水平与FPG、FINS、HOMA-IR水平均呈正相关,Obestatin水平与FPG、FINS、HOMA-IR水平均呈负相关(P<0.05)。妊娠结局不良组年龄、入组时体质量指数(BMI)、糖尿病家族史、血糖控制不达标比例以及血清Hcy、PANDER、FPG、FINS、HOMA-IR水平均高于妊娠结局良好组,Obestatin水平则低于妊娠结局良好组(P<0.05)。血糖控制不达标、血清Hcy、PANDER水平是GDM患者妊娠结局不良的危险因素,而Obestatin水平是保护因素(P<0.05)。结论:GDM血糖控制不达标患者血清Hcy、PANDER水平增高,Obestatin水平降低,且与胰岛素抵抗和妊娠结局不良有关。  相似文献   

3.
摘要 目的:探讨血清成纤维细胞生长因子2(FGF2)、成纤维细胞生长因子21(FGF21)、成纤维细胞生长因子23(FGF23)与妊娠期糖尿病(GDM)患者新生儿结局的关系。方法:选取2021年1月~2022年12月期间于我院产检的妊娠24~28周孕妇147例,均进行口服葡萄糖耐量试验(OGTT),根据OGTT结果分为GDM组(n=86)和非GDM组(n=61)。其中GDM组根据新生儿结局分为不良组(n=21)和良好组(n=65)。对比非GDM组、GDM组的血清FGF2、FGF21、FGF23水平及新生儿结局情况。对比不良组和良好组的血清FGF2、FGF21、FGF23水平。单因素及多因素Logistic回归分析影响GDM患者新生儿结局的影响因素。结果:GDM组的血清FGF2、FGF21、FGF23水平均高于非GDM组(P<0.05)。GDM组的不良新生儿结局总发生率高于非GDM组(P<0.05)。不良组的血清FGF2、FGF21、FGF23水平均高于良好组(P<0.05)。单因素分析显示,GDM患者不良新生儿结局与年龄、孕前体质量指数(BMI)、分娩前BMI、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)有关(P<0.05)。多因素分析结果显示,年龄偏高、FPG偏高、孕前BMI偏高、2hPG偏高、分娩前BMI偏高、HOMA-IR偏高、FGF2偏高、FINS偏高、FGF21偏高、FGF23偏高均是GDM患者不良新生儿结局的危险因素(P<0.05)。结论:GDM患者血清FGF2、FGF21、FGF23水平升高,其与年龄、孕前BMI、分娩前BMI、FPG、2hPG、FINS、HOMA-IR偏高均是导致GDM患者不良新生儿结局的危险因素。  相似文献   

4.
摘要 目的:探讨血清铁蛋白(Ferritin)、组织蛋白酶S(Cat S)、单核细胞趋化蛋白-1(MCP-1)与妊娠期糖尿病(GDM)患者胰岛素抵抗的关系,并分析影响GDM患者妊娠结局的影响因素。方法:选取2019年4月~2021年12月期间来石家庄市妇幼保健院产检并诊断为GDM的产妇154例纳为GDM组,另取同期来石家庄市妇幼保健院产检的健康产妇100例作为对照组。检测对比两组的血清Ferritin、Cat S、MCP-1水平以及稳态模型胰岛素抵抗指数(HOMA-IR),血清Cat S、Ferritin、MCP-1与HOMA-IR的相关性以Pearson相关系数进行分析。GDM组患者根据妊娠结局分为正常妊娠结局组和不良妊娠结局组,妊娠结局的影响因素采用多因素Logistic回归分析。结果:GDM组血清Ferritin、Cat S、MCP-1水平及HOMA-IR均高于对照组(P<0.05)。Pearson相关性分析结果显示,GDM患者的血清Cat S、Ferritin、MCP-1水平与HOMA-IR均呈正相关(P<0.05)。154例GDM患者中,有58例出现不良妊娠结局,占比37.66%。单因素分析结果显示,GDM患者的妊娠结局与糖尿病家族史、GDM确诊时孕周、年龄、口服葡萄糖耐量试验(OGTT)结果、孕前体质量指数(BMI)、血清Ferritin、Cat S、MCP-1水平以及HOMA-IR有关(P<0.05)。多因素Logistic回归分析结果显示:年龄≥35岁、孕前BMI≥24 kg/m2、OGTT结果>2项异常、血清Ferritin、Cat S、MCP-1水平偏高是GDM患者妊娠结局不良的危险因素(P<0.05)。结论:GDM患者的血清Ferritin、Cat S、MCP-1水平异常升高,且与胰岛素抵抗有关。GDM患者的妊娠结局受到血清Ferritin、Cat S、MCP-1水平、年龄、孕前BMI、OGTT结果等因素影响。  相似文献   

5.
摘要 目的:观察妊娠期糖尿病(GDM)患者糖化白蛋白(GA)、内脂素(Visfatin)、摄食抑制因子-1(Nesfatin-1)水平与胰岛素抵抗的关系,并分析导致妊娠结局不良的危险因素。方法:选取2018年6月~2021年1月期间我院收治的120例GDM患者作为观察组,同一时间段选择来我院行孕检的90例正常孕妇作为对照组。检测受试者血清中Visfatin、Nesfatin-1、GA、空腹胰岛素(FINS)、空腹血糖(FPG)水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)。采用Pearson相关分析Visfatin、Nesfatin-1、GA与胰岛素抵抗的关系。采用多因素Logistic回归分析妊娠结局不良的影响因素。结果:观察组的GA、Visfatin、Nesfatin-1、HOMA-IR高于对照组,HOMA-β低于对照组(P<0.05)。Pearson相关分析结果显示,GA、Visfatin、Nesfatin-1与HOMA-β呈负相关,而与HOMA-IR呈正相关(P<0.05)。观察组的妊娠不良结局发生率明显高于对照组(P<0.05)。单因素分析结果显示:妊娠不良结局与分娩年龄、居住地、糖尿病家族史、产前体质量指数(BMI)、合并多囊卵巢综合征、流产史、分娩史、甲状腺功能情况、产次、FPG、FINS、GA、Visfatin、Nesfatin-1、HOMA-IR、HOMA-β有关(P<0.05),而与文化程度、单/双胎妊娠、孕次无关(P>0.05)。Logistic回归分析结果显示:居住地为城市、产前BMI≥28 kg/m2、分娩年龄≥35岁、合并多囊卵巢综合征、GA≥13%、Visfatin≥82mmol/L、Nesfatin-1≥9 μg/L、流产史、甲状腺功能异常是导致GDM产妇妊娠结局不良的危险因素(P<0.05)。结论:GDM患者中存在GA、Visfatin、Nesfatin-1高表达,且与胰岛素抵抗明显相关。GDM产妇的妊娠不良结局发生率较高,受分娩年龄、居住地、产前BMI、合并多囊卵巢综合征、流产史、GA、Visfatin、Nesfatin-1、甲状腺功能异常等多种因素影响,可考虑针对上述患者采取相关干预措施,以改善患者的妊娠结局。  相似文献   

6.
摘要 目的:探讨血清环磷腺苷效应元件结合蛋白(CREB)、叉头框蛋白O1(FoxO1)、NOD样受体热蛋白结构域相关蛋白3(NLRP3)与妊娠期糖尿病(GDM)患者胰岛素抵抗(IR)的相关性分析及对妊娠结局的影响。方法:选取2019年12月~2022年8月邵阳学院附属第一医院收治的136例GDM患者为GDM组,根据妊娠结局分为结局不良组(42例)和结局良好组(94例),另选取55名健康孕妇为对照组。收集GDM患者临床资料,检测血清CREB、FoxO1、NLRP3水平并计算稳态模型评估-胰岛素抵抗(HOMA-IR)。采用Pearson相关性分析GDM患者血清CREB、FoxO1、NLRP3水平与HOMA-IR的相关性,多因素Logistic回归分析GDM患者妊娠结局不良的影响因素,受试者工作特征(ROC)曲线分析血清CREB、FoxO1、NLRP3水平对GDM患者妊娠结局不良的预测价值。结果:与对照组比较,GDM组血清CREB、FoxO1、NLRP3水平和HOMA-IR升高(P<0.05)。Pearson相关性分析显示,GDM患者血清CREB、FoxO1、NLRP3水平与HOMA-IR呈正相关(P均<0.001)。136例GDM患者妊娠结局不良发生率为30.88%。多因素Logistic回归分析显示,HOMA-IR、CREB、FoxO1、NLRP3升高为GDM患者妊娠结局不良的危险因素(P<0.05)。ROC曲线分析显示,血清CREB、FoxO1、NLRP3水平联合预测GDM患者妊娠结局不良的曲线下面积大于CREB、FoxO1、NLRP3单独预测。结论:血清CREB、FoxO1、NLRP3水平升高与GDM患者IR和妊娠结局不良密切相关,可能成为GDM患者妊娠结局不良的辅助预测指标。  相似文献   

7.
摘要 目的:探讨多囊卵巢综合征(PCOS)患者血清缺血修饰白蛋白(IMA)、缺氧诱导因子1α(HIF1α)、内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、胰岛素样生长因子-1(IGF-1)水平与性激素、糖脂代谢及胰岛素抵抗的相关性。方法:选择2017年1月至2019年12月我院收治的268例PCOS患者(PCOS组),根据体质量指数(BMI)将PCOS患者分为超重/肥胖组(BMI≥24 kg/m2,161例)和正常体重组(18.5 kg/m2≤BMI<24 kg/m2,107例),另选择135例于妇科门诊体检的健康女性志愿者为对照组。检测血清IMA、HIF1α、Vaspin、IGF-1水平以及性激素、糖脂代谢、胰岛素抵抗指标,Pearson相关性分析其相关性。结果:PCOS组血清IMA、HIF1α、Vaspin、IGF-1、睾酮(T)、促黄体生成素(LH)、促卵泡激素(FSH)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、餐后2小时血糖(2hPG)、空腹胰岛素(FINS)水平,胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.001)。PCOS患者超重/肥胖组血清IMA、HIF1α、Vaspin、IGF-1、T、TC、LDL-C、FPG、FINS、2hPG水平,HOMA-IR均高于正常体重组(P<0.001)。PCOS患者血清IMA、HIF1α水平与T、HOMA-IR呈正相关(P<0.05),血清Vaspin、IGF-1水平与TC、LDL-C、FPG、FINS、2hPG 、HOMA-IR呈正相关(P<0.05)。结论:PCOS患者血清IMA、HIF-1α、Vaspin、IGF-1水平均升高,IMA、HIF-1α、Vaspin、IGF-1均与PCOS胰岛素抵抗有关。  相似文献   

8.
摘要 目的:探讨老年2型糖尿病(T2DM)患者人巨细胞病毒(HCMV)感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系。方法:选取2021年2月~2022年3月长沙市第三医院收治的老年T2DM患者100例为研究组,选取同期来体检健康的志愿者60例作为对照组。根据HCMV-脱氧核糖核酸(DNA)检测结果将研究组分为阳性组41例和阴性组59例。检测并比较对照组、研究组HCMV-DNA载量、T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)、脂糖代谢[高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、空腹血糖(FBG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]、胰岛素抵抗[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]。采用Pearson相关性分析老年T2DM患者HCMV感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系。结果:研究组的HCMV-DNA阳性率、HCMV-DNA载量高于对照组,阴性率低于对照组(P<0.05)。阳性组、阴性组的CD4+、CD4+/CD8+低于对照组,且阳性组低于阴性组(P<0.05)。阳性组、阴性组的CD8+高于对照组,且阳性组高于阴性组(P<0.05)。阳性组、阴性组的HbA1c、FBG、TC、TG、LDL-C高于对照组,且阳性组高于阴性组(P<0.05)。阳性组、阴性组的HDL-C低于对照组,且阳性组低于阴性组(P<0.05)。阳性组、阴性组的HOMA-IR、FINS高于对照组,且阳性组高于阴性组(P<0.05)。Pearson相关性分析结果显示,HCMV-DNA载量与CD4+、CD4+/CD8+、HDL-C呈负相关(P<0.05),而与CD8+、HbA1c、FBG、TC、TG、LDL-C、FINS、HOMA-IR呈正相关(P<0.05)。结论:HCMV病毒感染可导致老年T2DM患者脂糖代谢紊乱,促进胰岛素抵抗,加重免疫失衡,加速疾病进展。  相似文献   

9.
摘要 目的:研究燕麦β-葡聚糖对妊娠期糖尿病患者血糖调节及妊娠结局的影响。方法:选取2020年08月至2021年01月在本院产科门诊规律产检并确诊为GDM的孕妇,按照是否服用燕麦β-葡聚糖随机分为观察组和对照组,两组均采取医学营养治疗,观察组为自愿服用燕麦β-葡聚糖的患者,观察两组患者在不同时间段的空腹血糖变化以及胰岛素需求量、孕期BMI增加量、分娩方式、新生儿出生体重、母婴不良妊娠结局之间的差异。结果:两组患者观察期间平均空腹血糖水平整体呈下降趋势;两组患者在不同时间段空腹血糖水平的差异,治疗4周时P>0.05,治疗8周后P<0.05;观察组患者孕期BMI增加量(4.56±2.00 Kg/m2)显著低于对照组(5.34±2.21 Kg/m2,P<0.05);观察组患者剖宫产率(64.62 %)低于对照组(70.77 %),两组患者的剖宫产率、新生儿出生体重、胰岛素需求量无明显差异,P>0.05;两组患者的母婴不良围产期结局无明显差异(P>0.05)。结论:燕麦β-葡聚糖可以降低妊娠期糖尿病患者的空腹血糖水平,控制孕期体重增长的同时不影响胎儿正常的生长发育,对母婴不良妊娠结局无改善作用,不会产生除已知结局之外的其他不良结局。  相似文献   

10.
摘要 目的:探究妊娠糖尿病中肌肉/脂肪质量比与胰岛素抵抗的相关性。方法:选择2015年1月至2020年1月于我院接受治疗的300例产妇为研究对象,按照美国糖尿病学会(American Diabetes Association,ADA)标准将产妇区分为妊娠期糖尿病组(GDM=90例)、妊娠期糖耐量受损组(GIGT=110例)和糖耐量正常组(NGT=100例),分别检测三组产妇的总胆固醇(total cholesterol,TC)、三酰甘油(Triglycerides,TG)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、肌肉/脂肪质量比(muscle / fat mass ratio,M/F)以及空腹血清胰岛素(fasting insulin,FINS)水平。结果:(1)GDM组患者HbAlc、TC以及TG水平均明显高于GIGT组以及NGT组(P<0.05),GIGT组患者HbAlc、TC以及TG水平均明显高于NGT组(P<0.05);(2)GMD组产妇的M/F明显低于GIGT组产妇,GIGT组产妇明显低于NGT组产妇(P<0.05),而GMD组产妇FINS以及胰岛素抵抗(insulin resistance,IR)明显高于GIGT组,GIGT组明显高于NGT组(P<0.05);(3)胰岛素抵抗(IR)同M/F呈现负相关联系(r=-0.218,P<0.05),同时与HbAlc、TC、TG(r=0.346,r=0.412,r=0.372,P<0.05)等呈现正相关。结论:妊娠女性的M/F值不足同胰岛素抵抗的出现具有一定的相关性,过分强调产妇节食可能会使产妇出现较低的肌肉质量,从而增加GDM的发生风险。  相似文献   

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A review is presented of issues relevant to the definition, measurement, and classification of stimuli, situations, and environments. Problems such as the lack of adequate definitions of concepts, error and bias in measurement procedures, confusion between measurement of a concept and measurement of its behavioral effects, and the lack of agreement among alternative measures are emphasized. It is suggested that concepts be defined in terms of objective characteristics while allowing for the study of the transactional relationship between organism and environment. The work of the ethologists in defining stimuli while studying their relationship to different organismic states and situational contexts is emphasized in this regard. Following Brunswik, it is also suggested that wherever possible there be a representative sampling of variables in natural settings. Note from the editors: From time to time, Human Ecology will publish a review article. Our first in this series is a review by a psychologist of basic definitional and conceptual problems in environmental studies.This paper was prepared while the author was a Visiting Research Fellow at the Educational Testing Service. The support of ETS and my colleagues in the Division of Psychological Studies is gratefully acknowledged. The review was also supported in part by a grant from the Rutgers University Research Council.  相似文献   

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We compared the cardiovascular effects evoked in conscious dogs by 1) submaximal exercise; 2) infusion of dobutamine (40 micrograms X kg-1 X min-1); and 3) infusion of a combination of atropine (0.15 mg/kg), norepinephrine (0.19 micrograms X kg-1 X min-1), and epinephrine (0.05 micrograms X kg-1 X min-1). Myocardial O2 demand, as estimated by the double product (heart rate X systolic blood pressure), was similar during all three interventions. Cardiac output and heart rate increased significantly (P less than 0.05) during each of the three interventions. Arteriovenous O2 difference and total body O2 consumption, however, increased only during submaximal exercise. Although myocardial blood flow increased similarly during each of the three interventions, blood flow to skeletal muscle and the tongue increased only during exercise. Exercise and the combined infusion of atropine, norepinephrine, and epinephrine produced similar increases in blood flow to the diaphragm and similar decreases in blood flow to the stomach. These changes in blood flow were associated with appropriate changes in vascular resistance. Additionally, blood flow to the brain, kidney, adrenal glands, liver, and intestine did not change during any of the three interventions. Thus, in dogs, submaximal exercise, infusion of dobutamine, and infusion of a combination of atropine, norepinephrine, and epinephrine to evoke a given level of estimated myocardial O2 consumption produce similar increases in cardiac output, heart rate, and myocardial blood flow. In contrast, the changes in total body O2 consumption, arteriovenous O2 difference, regional blood flow, and regional vascular resistance that occur during each of these three interventions are different.  相似文献   

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2-Dimethylaminomethylene-1-benzosuberone 1 was coupled with diazotized aniline derivatives to afford a series of the hitherto unreported 2-arylazo-1-benzosuberones 3ai. The tautomeric structure and the effect of substituents on the tautomeric form (s) of the products 3ai were discussed. Similar coupling of the enaminone 1 with diazonium salts of heterocyclic amines gave the respective fused azolotriazino-benzosuberones. Some of the newly synthesized compounds showed potent antimicrobial, anti-HCV, antioxidant, antitumor (as topoisomerase I inhibitors), and antimicrobial activities.  相似文献   

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Indians, Markets, and Rainforests: Theory, Methods, and Analysis. Ricardo A. Godoy. New York: Columbia University Press, 2001. 274 pp.  相似文献   

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The Precautionary Principle is in sharp political focus today because (1) the nature of scientific uncertainty is changing and (2) there is increasing pressure to base governmental action on more “rational” schemes, such as cost-benefit analysis and quantitative risk assessment, the former being an embodiment of ‘rational choice theory’ promoted by the Chicago school of law and economics. The Precautionary Principle has been criticized as being both too vague and too arbitrary to form a basis for rational decision making. The assumption underlying this criticism is that any scheme not based on cost-benefit analysis and risk assessment is both irrational and without secure foundation in either science or economics. This paper contests that view and makes explicit the rational tenets of the Precautionary Principle within an analytical framework as rigorous as uncertainties permit, and one that mirrors democratic values embodied in regulatory, compensatory, and common law. Unlike other formulations that reject risk assessment, this paper argues that risk assessment can be used within the formalism of tradeoff analysis—a more appropriate alternative to traditional cost-benefit analysis and one that satisfies the need for well-grounded public policy decision making. This paper will argue that the precautionary approach is the most appropriate basis for policy, even when large uncertainties do not exist, especially where the fairness of the distributions of costs and benefits of hazardous activities and products are a concern. Furthermore, it will offer an approach to making decisions within an analytic framework, based on equity and justice, to replace the economic paradigm of utilitarian cost-benefit analysis.  相似文献   

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Mones Berman's untimely death on 12 August 1982 put an end to his work in the development of theoretical biology. Arguments are examined, and it is concluded that a formal theory of lipoprotein metabolism flourished and expanded under the guidance of Dr. Berman. Not many scientists in the field of biology spend a major portion of their energies on theoretical work xxx was outstanding because of his early decision to follow the theoretical path.  相似文献   

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