新疆维吾尔族2型糖尿病人群肠道中Faecalibacterium prausnitzii的定量研究

目的定量检测新疆维吾尔族2型糖尿病(T_2DM)和糖耐量正常(NGT)人群肠道中的普拉梭菌(Faecalibacterium prausnitzii)水平。方法提取上述人群粪便细菌总DNA后,采用16SrDNA基因实时荧光定量PCR对普拉梭菌水平进行定量检测;运用Pearson分析普拉梭菌水平与研究对象的空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、体重和体重指数(BMI)的相关性。结果 (1)16S rDNA基因实时定量PCR结果显示:与新疆维吾尔族NGT组相比,普拉梭菌水平在T_2DM中较低(t=2.590,P=0.014),差异有统计学意义。(2)新疆维吾尔族上述人群肠道中普拉梭菌水平与FBG呈负相关(r=-0.434,P=0.012),体重呈负相关(r=-0.359,P=0.044),TG呈负相关(r=-0.410,P=0.034)。结论 Faecalibacterium prausnitzii水平在肠道中降低可能与2型糖尿病的发病有关,其机制需进一步研究探讨。     

慢性肾病患者肠道菌群特征及与 微炎症因子水平的相关性

目的 探究慢性肾病(CKD)患者肠道菌群特征及与微炎症因子水平的相关性。方法 选取2018年6月至2018年12月在莆田学院附属医院诊断及治疗的CKD患者25例(CKD组)和健康体检者25例(对照组),对两组研究对象进行肠道微生物检测,同时比较两组研究对象炎症因子水平,应用Pearson模型探究患者肠道微生态特征与炎症因子水平的相关性。结果 CKD组与对照组研究对象的肠道菌群构成具有显著差异,其中对照组双歧杆菌、乳杆菌、产甲酸草酸杆菌、草酸杆菌属、草酸杆菌科和普拉梭菌相对丰度高于CKD组,CKD组克雷伯菌属、大肠埃希菌属、肠杆菌科、瘤胃菌科、毛螺菌科、梭杆菌属和拟杆菌目相对丰度高于对照组,CKD组患者的IL-6、TNF-α、CRP和LPa水平显著高于对照组(t=3.876、4.177、2.236、3.354,P=0.000、0.000、0.030、0.002),Pearson相关性分析显示,双歧杆菌与IL-6、TNF-α水平呈明显负相关(r=-0.272、-0.482,P=0.009、0.002),乳杆菌与IL-6、LPa水平呈明显负相关(r=-0.438、-0.384,P=0.005、0.014),普拉梭菌与TNF-α水平呈明显负相关(r=-0.407,P=0.009),瘤胃菌科与IL-6、CRP水平呈明显正相关(r=0.477、0.508,P=0.002、0.001)。结论 CKD患者肠道菌群与健康人群存在明显差异,其中益生菌水平与炎症因子呈负相关,瘤胃菌科与炎症因子呈明显的正相关。     

新疆维、哈两民族粪样中奇异菌簇和产气柯林斯菌属水平与2型糖尿病的相关性研究

目的检测新疆维吾尔族、哈萨克族糖耐量正常人群及2型糖尿病患者粪便中奇异菌簇和产气柯林斯菌属的水平,分析奇异菌簇和产气柯林斯菌属与2型糖尿病的相关性。方法收集新疆维吾尔族、哈萨克族糖耐量正常人群及2型糖尿病患者血样和粪便样本,采用16S r DNA实时荧光定量PCR技术检测粪便样本中奇异菌簇和产气柯林斯菌属的水平;运用Pearson分析目标菌属水平与4组人群的空腹血糖(FBG)、年龄、身高、体重、体重指数(BMI)、腰围、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)的相关性。结果 (1)与哈萨克族糖耐量正常组比较,该民族T2DM组中奇异菌簇、产气柯林斯菌属水平均降低(P=0.012,P=0.024),两民族糖耐量正常组之间奇异菌簇、产气柯林斯菌属水平差异有统计学意义(P=0.025,P=0.007);(2)奇异菌簇水平与HDL-C(r=0.281,P=0.031)呈正相关,与体重(r=-0.514,P=0.000)、BMI(r=-0.400,P=0.002)、TC(r=-0.503,P=0.000)、LDL-C(r=-0.581,P=0.000)水平呈负相关;产气柯林斯菌属水平与HDL-C(r=0.550,P=0.000)水平呈正相关,与体重(r=-0.449,P=0.000)、BMI(r=-0.432,P=0.001)水平呈负相关。结论肠道中奇异菌簇和产气柯林斯菌属,可能与与新疆维吾尔族、哈萨克族2型糖尿病患者的脂代谢紊乱密切相关。     

乳腺癌患者抑郁症状与肠道微生物相关性研究

目的 探究乳腺癌患者抑郁症状与肠道微生物的相关性。方法 选取辽宁省肿瘤医院2018年1月至2019年1月诊断及治疗的乳腺癌伴抑郁患者28例,作为抑郁组,同时选取无抑郁的乳腺癌患者28例作为对照组。对两组患者进行肠道微生物检测,使用Pearson模型探究患者肠道微生态特征与抑郁水平的相关性。结果 两组肠道菌群的组成存在一定差异,两组拟杆菌目、肠杆菌科、普氏菌属、克雷伯菌属、链球菌属、埃格特菌属、乳杆菌属、拟杆菌属、帕拉拟杆菌属、瘤胃球菌属的丰度具有差异(P0.05),两组样本菌群多样性具有差异。Pearson相关性分析显示,乳杆菌属与抑郁自评量表(BDI)评分呈显著负相关(r=-0.792,P0.001);拟杆菌目、克雷伯菌属与BDI评分呈显著正相关(r=0.458,0.477,P=0.003,0.002)。结论 乳腺癌患者抑郁症状与肠道菌群中的拟杆菌目、乳杆菌属、克雷伯菌属具有相关性。     

脑梗死患者肠道菌群特征及其与血清代谢标志物水平的相关性

目的探究脑梗死患者肠道菌群特征,分析其与血清代谢标志物水平的相关性。方法对2018年1月至2018年8月间于我院就诊的43例急性脑梗死患者(脑梗死组)和43例健康体检者(对照组)的肠道菌群特征进行检测,采用16S rDNA实时荧光定量PCR技术对两组患者肠道菌群进行测定、分析,并对两组患者血清代谢标志物(血肌酐、尿素氮、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白及超敏C反应蛋白)水平进行比较,应用Pearson相关系数模型探究患者肠道菌群特征与常用血清代谢标志物水平的相关性。结果脑梗死组患者的空腹血糖、HbA1c、TC、TG、LDL-C和hs-CRP水平显著高于对照组,HDL-C水平显著低于对照组(Ps0.05)。16S rDNA分析结果显示,兼性厌氧菌是肠道的主要菌群,专性厌氧菌其次,需氧菌的比例最小。脑梗死组患者肠道主要优势菌为链球菌、大肠埃希菌和葡萄球菌,而对照组患者为双歧杆菌、乳杆菌等。脑梗死组患者肠道艰难梭菌、肠球菌、链球菌和葡萄球菌水平明显高于对照组(Ps0.05),双歧杆菌、奇异菌和乳杆菌水平明显低于对照组(Ps0.05)。Pearson相关性分析显示,奇异菌和罗伊乳杆菌水平与HbA1c水平呈明显负相关(r=-0.225,-0.348,Ps0.05),植物乳杆菌数量与TC水平呈明显负相关(r=-0.177,P=0.019),双歧杆菌与TG和LDL-C水平呈明显负相关(r=-0.214,-0.305,Ps0.05),艰难梭菌和葡萄球菌分别与LDL-C和hs-CRP呈明显正相关(r=0.375,0.213,Ps0.05)。结论脑梗死患者与健康人群肠道菌群存在明显差异,其中双歧杆菌、乳杆菌及奇异菌水平与糖、脂代谢指标呈负相关,艰难梭菌和葡萄球菌与低密度脂蛋白胆固醇和超敏C反应蛋白呈明显正相关。     

新疆维、哈两民族粪样中韦荣球菌属和梭菌属水平与2型糖尿病的相关性研究

目的探讨目标差异肠道菌群与新疆维吾尔族、哈萨克族2型糖尿病(T2DM)的相关性。方法采用16S r DNA实时荧光定量PCR对新疆维吾尔族、哈萨克族正常糖耐量及2型糖尿病患者粪样中韦荣球菌属和梭菌属水平进行检测。两组间均数比较采用t检验,运用Pearson分析方法对差异肠道菌群与新疆维、哈两民族正常糖耐量及2型糖尿病人群的体检及生化指标进行相关性分析。结果 (1)16S r DNA实时定量PCR结果显示,韦荣球菌属及梭菌属水平在哈萨克族2型糖尿病组粪样中显著高于该民族正常糖耐量组(P=0.035,P=0.028)。(2)新疆维吾尔族、哈萨克族正常糖耐量人群和2型糖尿病人群粪样中韦荣球菌属水平与体重及体重指数(BMI)显著正相关(r=0.469,P=0.009;r=0.623,P=0.002),与高密度脂蛋白胆固醇(HDL-C)水平显著负相关(r=-0.466,P=0.025);梭菌属水平与体重、空腹血糖(FBG)、甘油三酯(TG)水平显著正相关(r=0.375,P=0.049;r=0.398,P=0.033;r=0.375,P=0.041)。结论肠道中Veillonella spp和C.coccoides subgroup水平的变化可能与新疆哈萨克族、维吾尔族2型糖尿病的发病有关,需进一步深入探讨。     

孕晚期GDM孕妇阴道菌群与阴道上皮细胞的自噬和应激水平的相关性

目的探究孕晚期妊娠期糖尿病(GDM)孕妇阴道菌群与阴道上皮细胞的自噬和应激水平的相关性。方法选取陆军军医大学第一附属医院2018年9月至2019年1月诊断及治疗的孕晚期GDM孕妇23例作为GDM组,选取同时段、同年龄段产检正常的孕妇23例作为对照组。对两组孕妇阴道菌群及自噬和应激水平进行检测,使用Pearson相关性分析探究菌群指标与自噬和应激水平间的相关性。结果两组阴道细菌构成存在差异,GDM组在毛螺菌科、双歧杆菌目、普雷沃菌属、詹氏乳杆菌、双歧杆菌科、加德纳菌属的相对丰度大于对照组,对照组在乳杆菌属、卷曲乳杆菌、惰性乳杆菌、假单胞菌目、假单胞菌属、气球菌科的相对丰度大于GDM组。GDM组p62相对表达量显著低于对照组(t=3.903,P0.001),hsp70相对表达量显著高于对照组(t=5.704,P0.001)。Pearson相关性分析结果显示,双歧杆菌目、加德纳菌属与p62水平呈显著负相关(r=-0.407、-0.482,P=0.009、0.002),双歧杆菌科与hsp70呈显著正相关(r=0.448,P=0.004);乳杆菌属与p62呈显著正相关(r=0.437,P=0.011),与hsp70水平呈显著负相关(r=-0.475,P=0.005)。结论孕晚期GDM孕妇阴道菌群与阴道上皮细胞自噬和应激水平存在一定相关性。     

糖尿病患者肠道菌群特征及其相关性的系统评价

目的对糖尿病患者肠道菌群特征及其相关性进行系统评价。方法检索知网、维普、万方、PubMed、Cochrane library、Embase等数据库关于糖尿病患者肠道菌群特征及其相关性的文献,同时追踪纳入文献的参考文献,时限为2009年3月至2019年3月,采用统一提取表,由两名研究者独立按照规定的纳入排除标准进行文献提取和方法学质量评估。最后采用RevMan 5.3软件进行Meta合并,Stata 12.0软件进行亚组分析与发表性偏倚识别。结果共纳入25篇研究,合计2 209例患者。Meta分析显示:(1)糖尿病患者菌群总量(SMD=-0.30,P=0.53)、乳杆菌数量(SMD=-0.79,P=0.20)下降,拟杆菌数量(SMD=1.43,P=0.12)、梭菌数量(SMD=0.28,P=0.40)增加,差异均无统计学意义,双歧杆菌数量(SMD=-1.82,P=0.02)下降,差异有统计学意义。(2)糖尿病患者菌群Shannon指数I~2=91%,r=-0.21[-0.32,0.09],P0.05;Chao1指数I~2=0%,r=-28.17[-40.85,-15.48],P0.05;均下降。(3)拟杆菌、双歧杆菌、梭菌与空腹血糖的相关性分别为:I~2=0%,r=-0.15[-0.27,-0.03];I~2=0%,r=-1.16[-1.42,0.91];I~2=0%,r=-0.28[-0.42,-0.14],均P0.05。而乳杆菌的相关性差异无统计学意义:I~2=47%,r=-0.00[-0.30,0.29],P=0.98。(4)乳杆菌和拟杆菌与炎症因子(TNF-α、IL-6)呈负相关,乳杆菌(r=-0.43;r=-0.60),P0.05;拟杆菌(r=-0.58;r=-0.58),P0.05,差异有统计学意义。结论糖尿病患者肠道菌群总量无明显变化,但有益菌含量和多样性下降,拟杆菌、双歧杆菌和梭菌含量与血糖水平呈负相关,而乳杆菌无相关,其结果还需要大样本、高质量的研究加以论证。     

老年类风湿关节炎患者血清25-羟维生素D_3水平与肠道微生态的关系探讨

目的探讨老年类风湿关节炎(RA)患者血清25-羟维生素D_3[25(OH)D_3]水平与肠道微生态的关系。方法回顾性分析2018年8月至2020年4月甘肃中医药大学附属医院风湿骨病科住院收治的83例老年RA患者的临床资料,并选择同期进行体检的80例健康者的体检资料,分别记为A组、B组。对比2组研究对象血清25(OH)D_3水平以及肠道微生物菌群组成;采用Pearson相关性分析,分析老年RA患者血清25(OH)D_3水平与肠道微生物菌群丰富度的相关性。结果 A组患者血清25(OH)D_3水平明显低于B组(t=23.297,P0.05);A组患者肠道微生物菌群Chaol指数、Observed species指数和Shannon指数均低于B组(t=11.258、14.681、22.157,均P0.05);A组患者肠道微生物菌群拟杆菌门、放线菌门、变形菌门、普雷沃菌属、梭状芽胞杆菌属、戈登菌属的相对丰度均高于B组(t=19.472、12.011、27.354、20.304、15.637、24.414,均P0.05),厚壁菌门、乳杆菌属、类杆菌属、嗜血杆菌属、韦荣球菌属、真杆菌属的相对丰度均低于B组(t=10.095、3.663、6.787、12.848、7.786、9.122,均P0.05);RA患者25(OH)D_3水平与厚壁菌门、乳杆菌属、类杆菌属、嗜血杆菌属、韦荣球菌属、真杆菌属的相对丰度呈正相关(r=8.126、8.031、8.415、8.057、8.236、8.467,均P0.05),与拟杆菌门、放线菌门、变形菌门、普雷沃菌属、梭状芽胞杆菌属、戈登菌属呈负相关(r=-7.639、-7.856、-8.135、-8.127、-7.536、-7.865,均P0.05)。结论 RA患者血清25(OH)D_3水平降低,肠道微生物菌群拟杆菌门、放线菌门、变形菌门、普雷沃菌属、梭状芽胞杆菌属、戈登菌属的相对丰度增加,厚壁菌门、乳杆菌属、类杆菌属、嗜血杆菌属、韦荣球菌属、真杆菌属的相对丰度减少,老年RA患者血清25(OH)D_3水平与肠道微生物菌群分布相关。     

新疆昆仑雪菊水提物对小鼠肠道短链脂肪酸的调节作用

目的研究新疆昆仑雪菊水提物对小鼠肠道短链脂肪酸的影响。方法 C57BL/6小鼠随机分为4组:空白对照组(n=10)、高剂量组(n=10)、中剂量组(n=10)和低剂量组(n=10),给药14 d,用气相色谱法测定粪样中乙酸、丙酸、丁酸水平。结果相比空白对照组,低剂量组小鼠肠道粪样中乙酸水平显著升高(F=4.662,P=0.011),丙酸水平显著降低(F=3.097,P0.007),中剂量组与高剂量组比较差异无统计学意义。乙酸与乳杆菌属呈正相关(r=0.491,P=0.017),丙酸与乳杆菌属呈负相关(r=-0.425,P=0.038)。结论新疆昆仑雪菊水提物对小鼠肠道短链脂肪酸具有一定的调节作用。     

新疆维吾尔族、哈萨克族2型糖尿患者群肠道菌群中直肠真杆菌与多形拟杆菌的定量研究

目的分析新疆维吾尔族、哈萨克族正常糖耐量人群和2型糖尿患者群肠道菌群中直肠真杆菌与多形拟杆菌的量变差异,探讨肠道菌群与2型糖尿病（T2DM）的相关性。方法采用16S rDNA实时荧光定量RT-PCR技术相对定量法。结果分别比较4组人群肠道菌群中直肠真杆菌与多形拟杆菌数量的对数值,与维吾尔族正常组比较,该民族T2DM组中直肠真杆菌的量差异有统计学意义（P=0.0125）,与哈萨克族正常组比较,该民族T2DM组中直肠真杆菌的量差异有统计学意义（P=0.0261）,两民族正常组、T2DM组之间直肠真杆菌的量差异均未见统计学意义;与维吾尔族正常组比较,该民族T2DM组中多形拟杆菌的量差异有统计学意义（P=0.0003）,哈萨克族T2DM组与正常组中多形拟杆菌的量差异有统计学意义（P=0.0055）,两民族正常组之间多形拟杆菌的量差异有统计学意义（P=0.0154）,两民族T2DM组之间多形拟杆菌的量差异未见统计学意义。结论直肠真杆菌与多形拟杆菌数量的变化,与新疆维吾尔族、哈萨克族2型糖尿病的发生（可能）相关,需要进一步深入探讨。     

新疆维吾尔族、哈萨克族血浆LBP，sCD14的含量测定及其与2型糖尿病的相关性研究

目的通过分析新疆维吾尔族、哈萨克族正常糖耐量人群和2型糖尿病患者血浆中脂多糖结合蛋白（LBP）、可溶性白细胞分化抗原14（sCDl4）及LBP／sCDl4水平的变化,探讨LBP、sCDl4、LBP／sCDl4与新疆维吾尔族、哈萨克族2型糖尿病（T2DM）的相关性。方法采用酶联免疫吸附法（Elisa）检测LBP、sCDl4在血浆中的浓度。两组问均数比较采用t检验,运用Pearson分析方法对血浆LBP、sCDl4、LBP／sCDl4与新疆维吾尔族、哈萨克族2型糖尿病和糖耐量正常人群的空腹血糖（FBG）、年龄、身高、体重、体重指数（BMI）、腰围、胆固醇（Tc）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）做相关性分析。结果与哈萨克族糖耐量正常组相比较,该民族T2DM组中LBP和LBP／sCDl4的表达量升高且差异均有统计学意义（P=0．012,P=0．003）;与哈萨克族糖耐量正常组相比,维吾尔族糖耐量正常组血浆LBP和LBP／sCDl4的表达量升高且差异均有统计学意义（P=0．005,P=0．006）。血浆LBP的含量与相对应的FBG、体重、BMI、TC、TG、HDL—C存在一定的相关性及LBP／sCDl4与FBG、TG显著正相关性。结论与哈萨克族糖耐量正常组相比较,LBP和LBP／sCDl4的表达量在哈萨克族2型糖尿病组和维吾尔族糖耐量正常组均显著升高。     

Human Gut Microbiota Changes Reveal the Progression of Glucose Intolerance

To explore the relationship of gut microbiota with the development of type 2 diabetes (T2DM), we analyzed 121 subjects who were divided into 3 groups based on their glucose intolerance status: normal glucose tolerance (NGT; n = 44), prediabetes (Pre-DM; n = 64), or newly diagnosed T2DM (n = 13). Gut microbiota characterizations were determined with 16S rDNA-based high-throughput sequencing. T2DM-related dysbiosis was observed, including the separation of microbial communities and a change of alpha diversity between the different glucose intolerance statuses. To assess the correlation between metabolic parameters and microbiota diversity, clinical characteristics were also measured and a significant association between metabolic parameters (FPG, CRP) and gut microbiota was found. In addition, a total of 28 operational taxonomic units (OTUs) were found to be related to T2DM status by the Kruskal-Wallis H test, most of which were enriched in the T2DM group. Butyrate-producing bacteria (e.g. Akkermansia muciniphila ATCCBAA-835, and Faecalibacterium prausnitzii L2-6) had a higher abundance in the NGT group than in the pre-DM group. At genus level, the abundance of Bacteroides in the T2DM group was only half that of the NGT and Pre-DM groups. Previously reported T2DM-related markers were also compared with the data in this study, and some inconsistencies were noted. We found that Verrucomicrobiae may be a potential marker of T2DM as it had a significantly lower abundance in both the pre-DM and T2DM groups. In conclusion, this research provides further evidence of the structural modulation of gut microbiota in the pathogenesis of diabetes.     

Accelerated aging as evidenced by increased telomere shortening and mitochondrial DNA depletion in patients with type 2 diabetes

Although shortened telomeres were shown associated with several risk factors of diabetes, there is lack of data on their relationship with mitochondrial dysfunction. Therefore, we compared the relationship between telomere length and mitochondrial DNA (mtDNA) content in patients with type 2 diabetes mellitus (T2DM; n = 145) and in subjects with normal glucose tolerance (NGT; n = 145). Subjects were randomly recruited from the Chennai Urban Rural Epidemiology Study. mtDNA content and telomere length were assessed by Real-Time PCR. Malonodialdehyde, a marker of lipid peroxidation was measured by thiobarbituric acid reactive substances (TBARS) using fluorescence methodology. Adiponectin levels were measured by radioimmunoassay. Oxidative stress as determined by lipid peroxidation (TBARS) was significantly (p < 0.001) higher in patients with T2DM compared to NGT subjects. In contrast, the mean telomere length, adiponectin and mtDNA content were significantly (p < 0.001) lower in patients with T2DM compared to NGT subjects. Telomere length was positively correlated with adiponectin, HDL, mtDNA content and good glycemic/lipid control and negatively correlated with adiposity and insulin resistance. On regression analysis, shortened telomeres showed significant association with T2DM even after adjusting for waist circumference, insulin resistance, triglyceride, HDL, adiponectin, mtDNA & TBARS. mtDNA depletion showed significant association with T2DM after adjusting for waist circumference and adiponectin but lost its significance when further adjusted for telomere length, TBARS and insulin resistance. Our study emphasizes the clustering of accelerated aging features viz., shortened telomeres, decreased mtDNA content, hypoadiponectinemia, low HDL, and increased oxidative stress in Asian Indian type 2 diabetes patients.     

Plasma HMGB-1 Levels in Subjects with Obesity and Type 2 Diabetes: A Cross-Sectional Study in China

Object

To detect the levels of plasma High-Mobility Group Box-1(HMGB1) in Chinese subject with obesity and type 2 diabetes mellitus (T2DM), and to investigate the correlations between plasma HMGB1 concentration and parameters of body fat, insulin resistance (IR) metabolism and inflammation.

Methods

This study recruited 79 normal glucose tolerance (NGT) subjects and 76 newly diagnosed T2DM patients. NGT and T2DM groups were divided into normal weight (NW) and obese (OB)subgroups respectively. Anthropometric parameters such as height, weight, waist circumference, hip circumference and blood pressure were measured. Plasma concentrations of HMGB1, IL-6, fasting plasma glucose (FPG), 2 hours post challenge plasma glucose (2hPG), serum lipid, glycated hemoglobin (HbA_1C) and fasting insulin (FINS) were examined. The homeostasis model assessment (HOMA) was performed to assess IR status.

Results

Plasma HMGB1 levels were higher in T2DM group than that in NGT group. The concentrations of serum HMGB1 were also higher in subjects with OB than those in subjects with NW both in NGT and T2DM groups. Plasma levels of HMGB1 were positively correlated with waist hip ratio (WHR), blood pressure, FPG, FINS, HOMA-IR, TG, IL-6 and negatively correlated with HOMA-βand high-density lipoprotein-cholesterol (HDL-c) independent of age, gender and BMI. Plasma levels of HMGB1 were significantly correlated with diabetes in fully adjusted models.

Conclusion

Plasma HMGB1 levels were increased in Chinese subjects with pure T2DM, which might be caused by IR. Serum HMGB1 participated in the pathological process of obesity and T2DM via its proinflammatory effect.     

冠心病患者胰岛素抵抗程度的影响因素分析

目的:分析冠心病患者胰岛素抵抗程度的影响因素。方法:选择我院收治的冠心病住院患者166例,根据胰岛素抵抗指数(HOMA-IR)水平将其分成四组。A组:HOMA-IR≤1.53(n=36);B组:1.53HOMA-IR≤3.46(n=30);C组:3.46HOMA-IR≤5.13(n=36);D组:HOMA-IR≥5.14(n=64)。检测和比较各组一般临床资料和相关生化指标的差异,并进一步分析影响冠心病患者胰岛素抵抗程度的危险因素。结果:C、D组腰围、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、低密度脂蛋白胆固醇(LDL-C)均高于A、B组;D组空腹胰岛素(INS)均高于A、B组,B、C组INS、LDL-C均高于A组;D组体质量、TC高于A组。上述差异均有统计学意义(P0.05)。多因素分析结果显示BMI、腰臀比(WHR)、FBG、INS、TC、HDL-C均是HOMA-IR的影响因素(P0.05)。结论:体重、腰围、FBG、2h PBG、INS、TC、HDL-C的上升均为加重冠心病患者胰岛素抵抗程度的危险因素。     

Basal and dynamic proinsulin-insulin relationship to assess beta-cell function during OGTT in metabolic disorders

The fasting proinsulin-to-insulin ratio is a currently used marker of beta-cell dysfunction. This ratio is calculated at the basal condition, but its behavior in dynamic conditions, i.e., during glucose stimulation, could be more informative. Given the different kinetics of the peptides, a mathematical model was necessary to analyze the oral glucose tolerance test (OGTT) data of insulin, C-peptide, and proinsulin in 55 healthy (NGT), 30 impaired glucose-tolerant (IGT), and 31 type 2 diabetic (T2DM) subjects. The model provided for secretion and disappearance of the peptides and an index of beta-cell function under dynamic conditions. Total proinsulin secretion during the OGTT was not different (P > 0.053) among NGT (0.17 +/- 0.01 mmol/l in 3 h), IGT (0.22 +/- 0.02), and T2DM (0.21 +/- 0.02) subjects. The proinsulin-to-insulin molar ratio measured from basal samples was higher (P < 0.0001) in T2DM (0.39 +/- 0.05) than in NGT (0.14 +/- 0.01) and IGT (0.13 +/- 0.02) subjects, and similar results (P < 0.003) were found by the dynamic index (0.27 +/- 0.04, 0.14 +/- 0.01, 0.15 +/- 0.01 in T2DM, NGT, IGT subjects, respectively). The basal ratio significantly correlated with the dynamic index, and the regression line slope was lower than 1 (0.43 +/- 0.08, 0.61 +/- 0.10, and 0.56 +/- 0.03 in NGT, IGT, and T2DM subjects, respectively, P < 0.0001). Impaired beta-cell function in T2DM could then be indicated by proinsulin-to-insulin indexes at both basal and dynamic phases.     

The effect of insulin on net lipid oxidation predicts worsening of insulin resistance and development of type 2 diabetes mellitus

Suppression of lipid oxidation (L(ox)) by insulin is impaired in obesity and type 2 diabetes mellitus (T2DM). Here we tested whether high L(ox) represents a primary or acquired characteristic in the pathogenesis of T2DM. Hood-indirect calorimetry was performed under postabsorptive conditions and during a two-step hyperinsulinemic euglycemic clamp (insulin infusion rates in mU.m(-2).min(-1): 40 low and 400 high) in 465 Pima Indians: 317 with normal glucose tolerance (NGT), 117 with impaired glucose tolerance (IGT), and 31 with T2DM. The predictive effect of net lipid oxidation (L(ox)) on development of T2DM was assessed in 296 subjects (51 of whom developed T2DM), whereas the predictive effect of L(ox) on followup changes in insulin-mediated glucose disposal (M) and acute insulin response (AIR) was studied in 190 subjects with NGT at baseline. Cross-sectionally, after adjustment for age, sex, body fat (BF), and M low, L(ox) low was increased in T2DM compared with NGT and IGT subjects (P < 0.05). Prospectively, after adjustment for followup duration, age, sex, BF, M, and AIR, increased clamp L(ox) predicted T2DM [hazard rate ratios (95% CI): L(ox) low, 1.5 (1.1, 2.0), P < 0.01; L(ox) high, 1.3 (1.0, 1.8), P = 0.05]. High L(ox) low at baseline was also associated with subsequent worsening of M low (P = 0.04). These data indicate that the inability of insulin to suppress L(ox) may represent an early risk marker for insulin resistance and T2DM that is independent of adiposity, acute insulin secretion, and insulin action on glucose uptake.     

Altered Circulating Levels of Retinol Binding Protein 4 and Transthyretin in Relation to Insulin Resistance,Obesity, and Glucose Intolerance in Asian Indians

Objective: Retinol binding protein 4 (RBP4) has been implicated in metabolic disorders including type 2 diabetes mellitus (T2DM), but few studies have looked at transthyretin (TTR) with which RBP4 is normally bound to in the circulation. We report on the systemic levels of RBP4 and TTR and their associations with insulin resistance, obesity, prediabetes, and T2DM in Asian Indians.Methods: Age-matched individuals with normal glucose tolerance (NGT, n = 90), impaired glucose tolerance (IGT, n = 70) and T2DM (n = 90) were recruited from the Chennai Urban Rural Epidemiology Study (CURES). Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). RBP4 and TTR levels were measured by enzyme-linked immunosorbent assay (ELISA).Results: Circulatory RBP4 and TTR levels (in μg/mL) were highest in T2DM (RBP4: 13 ± 3.9, TTR: 832 ± 310) followed by IGT (RBP4: 10.5 ± 3.2; TTR: 720 ± 214) compared to NGT (RBP4: 8.7 ± 2.5; TTR: 551 ± 185; P<.001). Compared to nonobese NGT individuals, obese NGT, nonobese T2DM, and obese T2DM had higher RBP4 (8.1 vs. 10.6, 12.1, and 13.2 μg/mL, P<.01) and TTR levels (478 vs. 737, 777, and 900 μg/mL, P<.01). RBP4 but not TTR was significantly (P<.001) correlated with insulin resistance even among NGT subjects. In regression analysis, RBP4 and TTR showed significant associations with T2DM after adjusting for confounders (RBP4 odds ratio [OR]: 1.107, 95% confidence interval [CI]: 1.008–1.216; TTR OR: 1.342, 95% CI: 1.165–1.547).Conclusion: Circulatory levels of RBP4 and TTR showed a significant associations with glucose intolerance, obesity, T2DM and RBP4 additionally, with insulin resistance.Abbreviations: BMI = body mass index CI = confidence interval HDL = high-density lipoprotein IGT = impaired glucose tolerance LDL = low-density lipoprotein NGT = normal glucose tolerance OGTT = oral glucose tolerance test OR = odds ratio RBP4 = retinol binding protein 4 T2DM = type 2 diabetes mellitus TTR = transthyretin WC = waist circumference     

Use of randomly cloned DNA fragments for identification of Bacteroides thetaiotaomicron.

Randomly cloned fragments of DNA from Bacteroides thetaiotaomicron were used as hybridization probes for differentiation of B. thetaiotaomicron from closely related Bacteroides species. HindIII digestion fragments of DNA from B. thetaiotaomicron (type strain) were inserted into plasmid pBR322 and labeled with [alpha-32P]dCTP by nick translation. These labeled plasmids were screened for hybridization to HindIII digests of chromosomal DNA from type strains of the following human colonic Bacteroides species: B. thetaiotaomicron, Bacteroides ovatus, reference strain 3452-A (formerly part of B. distasonis), Bacteroides uniformis, Bacteroides fragilis, Bacteroides vulgatus, Bacteroides distasonis, Bacteroides eggerthii, and reference strain B5-21 (formerly B. fragilis subsp. a). Two of the five cloned fragments hybridized only to DNA from B. thetaiotaomicron. Each of these two fragments hybridized to the same DNA restriction fragment in five strains of B. thetaiotaomicron other than the strain from which the DNA was cloned. One of the cloned fragments (pBT2) was further tested for specificity by determining its ability to hybridize to DNA from 65 additional strains of colonic Bacteroides.