某部机关中老年干部代谢综合征现况调查

目的:了解某部机关中老年干部代谢综合征(Metabolic syndrome,MS)的患病情况,为该类人群疾病的防治提供依据。方法:收集2013年4~5月年在解放军第309医院体检的452例某部机关中老年干部查体资料,按2007年《中国成人血脂异常防治指南》提出的代谢综合征诊断标准进行诊断,分析代谢综合征及代谢指标异常患病情况。结果:受检人群MS患病率11.73%,男性高于女性(P0.05)。年龄组患病率以60~69岁组最高(23.08%)。单项代谢异常检出率从高至低依次为血脂异常(41.15%)、超重和/肥胖(38.5%)、血压升高(25.0%)和血糖升高(9.73%)。不同年龄组代谢指标异常分布情况不同。代谢异常类型以血压升高+血脂升高+超重/肥胖模式人数最多。除MS外,仍有34.52%的人群存在1-2种代谢指标异常。结论:MS可防可控,应注重以胰岛素抵抗(Insulin Resistance,IR)为靶点的多危险因素综合治疗。     

阻塞型睡眠呼吸暂停低通气综合征与代谢综合征组分关系探讨

目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)组分关系。方法:对我院2003年1月至2010年7月39例诊断为OSAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果:1.OSAHS组与对照组比较,体重指数(BMI)、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1升高,高密度脂蛋白胆固醇降低(P<0.05);2.OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义(P<0.05);3.OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI≥25Kg/m2,血脂紊乱的比例,均高于对照组,差异有统计学意义(P<0.05)。结论:OSAHS患者易合并代谢综合征组分。     

孕期个性化营养干预对妊娠期糖尿病孕妇糖脂水平及妊娠结局的影响

目的:探讨孕期个性化营养干预对妊娠期糖尿病孕妇糖脂水平及妊娠结局的影响。方法:选择2016年8月-2017年10月期间于我院产检的妊娠期糖尿病孕妇160例,以随机数字表法分为研究组(n=80)和对照组(n=80)。对照组给予常规营养干预,研究组则予以孕期个性化营养干预。比较两组干预前后空腹血糖、餐后2h血糖、总胆固醇(TC)、三酰甘油(TG)、高密低脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,观察孕妇及新生儿并发症发生情况。结果:干预后两组孕妇空腹血糖、餐后2 h血糖显著降低,且研究组低于对照组(P0.05)。干预后对照组孕妇TC、TG、LDL-C较干预前显著升高(P0.05),HDL-C差异无统计学意义(P0.05),研究组血脂水平与干预前比较差异无统计学意义(P0.05),与对照组比较,研究组孕妇TC、TG、LDL-C水平更低(P0.05)。研究组妊娠期高血压、胎膜早破发生率均明显低于对照组(P0.05),两组感染、产后出血发生率比较无统计学差异(P0.05)。与对照组比较,研究组新生儿窘迫、巨大儿、新生儿低血糖、早产儿的发生率降低(P0.05)。结论:孕期个性化营养干预可有效改善妊娠期糖尿病孕妇的糖脂水平,且能够有效降低并发症发生率,从而改善妊娠结局。     

2型糖尿病患者社区综合干预效果评价

目的:研究社区综合干预措施对2型糖尿病患者的干预效果.方法:80例糖尿病患者随机分为干预组和对照组,干预组在常规药物治疗的基础上采取社区综合干预措施.对照组仅采用常规药物治疗.观察两组患者的体质指数(BMI),腰臀比(WHR),收缩压(systolic blood pressure,SBP),舒张压(diastolic blood pressure,DBP),空腹血糖(fasting blood glucose,FBG),餐后2h血糖(postprandial 2h blood glucose,P2hBG),糖化血红蛋白(HbAlc),总胆固醇(Total cholesterol,TC)和甘油三酯(Triglyceride,TG)的水平.结果:进行干预后干预组的WHR、FBG、P2hBG、HbAlc、TC和TG等指标均显著的低于对照组,且有统计学意义(P＜0.05).并且干预组在干预后WHR、FBG、P2hBG、HbAlc、TC和TG等指标均显著的低于干预前,且有统计学意义(P＜0.05).结论:通过对2型糖尿病患者进行社区干预,有效控制糖尿病患者的血糖和危险因素,从而提高患者的生活质量.     

短期胰岛素泵强化治疗对2型糖尿病患者血脂血糖水平的影响

目的:探讨短期胰岛素泵强化治疗对2型糖尿病患者血脂血糖代谢的影响。方法:选取76例2型糖尿病患者,按给药方式不同分为两组,对照组(38例)给予门冬胰岛素常规治疗,观察组(38例)给予胰岛素泵强化治疗,依据两组治疗前后的血糖、血脂指标变化及治疗前、治疗后1周、2周的ADL量表评分评价短期胰岛素泵强化治疗对2型糖尿病患者血脂血糖代谢的影响。结果:治疗后,两组患者的空腹血糖(FPG)、糖化血红蛋白(Hb Alc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前显著降低,高密度脂蛋白胆固醇(HDL-C)水平均明显升高,且观察组FPG、Hb Alc、TC、TG、LDL-C水平均明显低于对照组,HDL-C水平显著高于对照组(P0.05)。治疗后1周、2周,两组ADL评分均较治疗前明显提高,且观察组显著高于对照组(P0.05)。结论:短期胰岛素泵强化治疗能显著改善2型糖尿病患者的血糖血脂代谢紊乱,并提高患者的日常生活能力。     

平衡针灸治疗成人肥胖型糖耐量减低的临床观察

目的:探讨平衡针干预成人肥胖型糖耐量减低(IGT)的疗效。方法:选取成人肥胖型糖耐量减低患者320例,采用随机、双盲法将患者分为治疗组和对照组,每组各160例患者。对照组采用控制饮食与运动干预治疗方法,治疗组则需要在控制饮食与运动干预治疗的基础上采用平衡针针刺降糖穴、降脂穴治疗,治疗6个月后观察两组治疗前后空腹血糖(FBG)、餐后2 h血糖(PBG)、甘油三脂(TG)、身体质量指数(BMI)、腰围、总胆固醇(CHO)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的水平。以及治疗后糖尿病(DM)发生率和IGT逆转率。结果:治疗组转为DM者为6.2%,对照组为30.6%;治疗组IGT转为糖耐量正常(NGT)为46.9%,对照组为15.6%,两组比较差异有统计学意义(均P0.05);治疗后,两组患者的PBG、FBG、TG、BMI、腰围均显著降低,差异有统计学意义(P0.05)。与治疗后对照组比较,治疗组FBG、PBG、TG、BMI、LDL-C、CHO、腹围水平均显著降低,差异有统计学意义(P0.05)。结论:平衡针可以改善血糖、血脂,能减轻体重,治疗腹型肥胖,对成人肥胖型糖耐量减低的干预有助于逆转为正常糖耐量,降低糖尿病的发病率。     

两种不同营养配方预进餐对2型糖尿病住院患者血糖影响研究

目的：比较低血糖指数（GI）全营养素与高蛋白营养素2种不同营养配方预进餐对2型糖尿病患者血糖控制效果的影响。方法：回顾性分析115例2型糖尿病患营养治疗记录,其中高蛋白营养素治疗组31例为高蛋白组、低GI全营养素治疗组39例为低GI组、无肠内营养治疗干预组45例为对照组,每组都进行糖尿病饮食指导、教育并编制糖尿病膳食食谱。观察比较3组患者营养干预前,营养干预后第1d、第3d、第7d的空腹、餐后2h血糖控制情况。结果：与对照组相比,高蛋白组与低GI组空腹血糖在干预前后均没有明显差异,无统计学意义（P＞005）;餐后2h血糖在干预前、第1d没有差异,无统计学意义（P＞005）,而在第3d、第7d血糖明显下降,有统计学意义（P＜005）。与低GI组相比,高蛋白组空腹血糖和餐后2h血糖干预前后均没有明显差异,无统计学意义（P＞005）。结论：不同营养配方预进餐有利于2型糖尿病患者血糖控制,尤其是餐后2h血糖控制,2种营养配方控制血糖效果相似。     

吡格列酮治疗对2 型糖尿病合并代谢综合征患者血糖、胰岛素抵抗和炎症因子的影响

目的:探讨吡格列酮治疗对2型糖尿病合并代谢综合征患者血糖、胰岛素抵抗和炎症因子的影响。方法:回顾性分析我院2013年8月-2015年2月收治的96例2型糖尿病合并代谢综合征患者病例资料,根据治疗方法的不同分为观察组和对照组,每组48例,两组患者均给予糖尿病常规基础治疗,在此基础上,观察组患者给予吡格列酮治疗,治疗3个月。检测治疗前后血糖指标包括空腹血糖(FPG)、餐后2小时血糖(2h PG)以及糖化血糖蛋白(Hb A1c),胰岛素抵抗指标包括空腹胰岛素(FINS)和胰岛素抵抗指数(HOMA-IR)和炎症因子包括超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果:观察组治疗后FPG、2 h PG、Hb A1c分别为(6.19±2.24)mmol/L、(8.30±2.48)mmol/L和(6.01±1.23)%,均显著低于治疗前和对照组治疗后,差异有统计学意义(P0.05);观察组治疗后FINS和HOMA-IR分别为(6.60±1.92)m IU/L和2.08±1.00,均较治疗前和对照组治疗后显著降低,差异有统计学意义(P0.05);观察组治疗后hs-CRP、IL-6和TNF-α分别为(6.12±1.67)ng/L、(62.65±10.30)ng/L和(83.16±16.55)ng/L,均较治疗前和对照组治疗后显著降低,差异有统计学意义(P0.05)。结论:吡格列酮治疗可以显著降低2型糖尿病合并代谢综合征患者血糖水平,改善胰岛素抵抗,降低炎症反应,值得进一步研究。     

慢性阻塞性肺疾病与代谢综合征及颈动脉内膜厚度的相关性研究

目的:研究慢性阻塞性肺疾病与代谢综合征及颈动脉内膜厚度的关系。方法:选择2014年8月至2015年4月在我院就诊的慢性阻塞性肺疾病患者60例作为研究组,另选择同期在我院接受健康体检的60名志愿者作为对照组。比较两组空腹血糖、甘油三酯及高密度脂蛋白胆固醇水平、代谢综合征的发生率、颈动脉内膜厚度以及合并与不合并代谢综合征的慢性阻塞性肺疾病患者的肺功能和颈动脉内膜厚度,并采用多元回归分析颈动脉内膜厚度与慢性阻塞性肺疾病及代谢综合征的相关性。结果:与对照组相比,研究组患者空腹血糖(FPG)明显升高,而甘油三酯(TG)水平明显降低,差异具有统计学意义(P0.05);两组高密度脂蛋白胆固醇(HDL-C)比较差异无统计学意义(P0.05)。研究组代谢综合征的发病率、颈动脉内膜厚度均明显高于对照组,差异具有统计学意义(P0.05);慢性阻塞性肺疾病合并代谢综合征患者的肺功能明显优于无代谢综合征的慢性阻塞性肺疾病患者,差异具有统计学意义(P0.05);合并代谢综合征的慢性阻塞性肺疾病患者FEV1占预计值百分比及FEV1/FVC均明显高于无代谢综合征慢性阻塞性肺疾病患者的对应值,差异具有统计学意义(P0.05)。Logistic回归分析结果显示慢性阻塞性肺疾病与颈动脉内膜厚度呈独立相关性,而代谢综合征与颈动脉内膜厚度无直接相关性。结论:慢性阻塞性肺疾病与颈动脉内膜厚度呈独立相关,且慢性阻塞性肺疾病合并代谢综合征患者发生颈动脉粥样硬化的风险更高。     

糖尿病预进餐专用营养粉对妊娠糖尿病患者血糖的影响研究

目的：探讨糖尿病专用营养粉对妊娠糖尿病患者血糖及妊娠结局的影响。方法：收集第三军医大学新桥医院妇产科门诊确诊为妊娠糖尿病患者66例,按照随机病例编号奇偶数分为干预组和对照组,每组33例,分别给予不同营养干预方式,然后比较2组患者干预前及分娩前空腹血糖（FBG）、餐后2h血糖（2h PBG）水平以及患者分娩方式、新生儿出生体重等之间的差异。结果：营养干预前空腹血糖、餐后2h血糖无差异（P＞0.05）;分娩前空腹血糖、餐后血糖均有显著差异（P＜0.01）;干预前和分娩前空腹血糖变化幅度以及餐后2h血糖变化幅度均有显著差异（分别为P＜0.05和P＜0.01）;新生儿体重和孕妇分娩方式等均无明显差异（P＞0.05）。结论：糖尿病预进餐专用营养粉对辅助控制妊娠糖尿病患者空腹血糖及餐后血糖水平有益。     

Role for dopamine in malonate-induced damage in vivo in striatum and in vitro in mesencephalic cultures

Defects in mitochondrial energy metabolism have been implicated in the pathology of several neurodegenerative disorders. In addition, the reactive metabolites generated from the metabolism and oxidation of the neurotransmitter dopamine (DA) are thought to contribute to the damage to neurons of the basal ganglia. We have previously demonstrated that infusions of the metabolic inhibitor malonate into the striata of mice or rats produce degeneration of DA nerve terminals. In the present studies, we demonstrate that an intrastriatal infusion of malonate induces a substantial increase in DA efflux in awake, behaving mice as measured by in vivo microdialysis. Furthermore, pretreatment of mice with tetrabenazine (TBZ) or the TBZ analogue Ro 4-1284 (Ro-4), compounds that reversibly inhibit the vesicular storage of DA, attenuates the malonate-induced DA efflux as well as the damage to DA nerve terminals. Consistent with these findings, the damage to both DA and GABA neurons in mesencephalic cultures by malonate exposure was attenuated by pretreatment with TBZ or Ro-4. Treatment with these compounds did not affect the formation of free radicals or the inhibition of oxidative phosphorylation resulting from malonate exposure alone. Our data suggest that DA plays an important role in the neurotoxicity produced by malonate. These findings provide direct evidence that inhibition of succinate dehydrogenase causes an increase in extracellular DA levels and indicate that bioenergetic defects may contribute to the pathogenesis of chronic neurodegenerative diseases through a mechanism involving DA.     

Scurvy in capybaras bred in captivity in Argentine

In order to determine if the absence of vitamin C in the diet of capybaras (Hydrochoerus hydrochaeris) causes scurvy, a group of seven young individuals were fed food pellets without ascorbic acid, while another group of eight individuals received the same food with 1 g of ascorbic acid per animal per day. Animals in the first group developed signs of scurvy-like gingivitis, breaking of the incisors and death of one animal. Clinical signs appeared between 25 and 104 days from the beginning of the trial in all individuals. Growth rates of individuals deprived of vitamin C was considerably less than those observed in the control group. Deficiency of ascorbic acid had a severe effect on reproduction of another population of captive capybaras. We found that the decrease in ascorbic acid content in the diet affected pregnancy, especially during the first stages. The results obtained suggest that it is necessary to supply a suitable quantity of vitamin C in the diet of this species in captivity.     

Changes in lactate dehydrogenase activity in chicken tissues in hyperthyreosis in ontogenesis

The lactate dehydrogenase activity in reactions of lactate oxidation and synthesis was studied in subfractions of the chicken brain, heart and liver at the embryonal, early postembryonal and adult stages of development after thyroxine administration. It has been shown that during embryogenesis thyroxine predominantly enhanced the rate of lactate oxidation in the mitochondrial tissues. A marked increase in the lactate synthesis was found in cytoplasm of the adult chicken tissues. Specificity of enzyme activity alterations was detected in the chicken brain during ontogenesis after thyroxine administration.     

SSTR5 ablation in islet results in alterations in glucose homeostasis in mice

Somatostatin (SST) peptide is a potent inhibitor of insulin secretion and its effect is mediated via somatostatin receptor 5 (SSTR5) in the endocrine pancreas. To investigate the consequences of gene ablation of SSTR5 in the mouse pancreas, we have generated a mouse model in which the SSTR5 gene was specifically knocked down in the pancreatic beta cells (betaSSTR5Kd) using the Cre-lox system. Immunohistochemistry analysis showed that SSTR5 gene expression was absent in beta cells at three months of age. At the time of gene ablation, betaSSTR5Kd mice demonstrated glucose intolerance with lack of insulin response and significantly reduced serum insulin levels. Insulin tolerance test demonstrated a significant increase of insulin clearance in vivo at the same age. In vitro studies demonstrated an absence of response to SST-28 stimulation in the betaSSTR5Kd mouse islet, which was associated with a significantly reduced SST expression level in betaSSTR5Kd mice pancreata. In addition, betaSSTR5Kd mice had significantly reduced serum glucose levels and increased serum insulin levels at 12 months of age. Glucose tolerance test at an older age also indicated a persistently higher insulin level in betaSSTR5Kd mice. Further studies of betaSSTR5Kd mice had revealed elevated serum C-peptide levels at both 3 and 12 months of age, suggesting that these mice are capable of producing and releasing insulin to the periphery. These results support the hypothesis that SSTR5 plays a pivotal role in the regulation of insulin secretion in the mouse pancreas.