实验性糖尿病心肌病大鼠模型建立及心脏功能和结构相关性分析

目的建立实验性糖尿病心肌病大鼠模型,观察心功能和结构变化,初步分析心脏功能和结构指标相关性。方法雄性Wistar大鼠随机分为正常对照组、高糖高脂膳食组和糖尿病心肌病模型组,采用高糖高脂膳食12周负荷一次性小剂量STZ腹腔注射建立糖尿病心肌病模型,观察各组动物心脏功能、心脏重量和心重指数、左心室形态和胶原含量等的变化。结果 (1)与正常对照组比较,糖尿病心肌病模型组大鼠左心室舒张末压(LVEDP)和最大舒张速率(-dp/dtmax)值显著升高(P0.05),心率(HR)、左心室收缩压(LVSP)、左心室最大收缩速率(+dp/dtmax)、每搏输出量(SV)和心排量(CO)明显降低(P0.05);全心重指数(HW/BW)和左心室重量指数(LVW/BW)明显升高(P0.01);常规HE染色显示心肌细胞排列紊乱,心肌细胞肥大,细胞核边缘不清等,室间隔和左心室壁厚度明显增加(P0.001,P0.05);心肌胶原含量明显增加(P0.05)。(2)大鼠心脏功能参数±dp/dtmax和CO值分别与结构参数HW/BW和LVW/BW呈现明显的相关性(P0.01或P0.05)。结论大鼠高糖高脂膳食喂养负荷小剂量STZ一次性腹腔注射,可造成心脏舒张和收缩功能紊乱以及心肌结构重塑,心脏功能与结构变化呈显著相关性,可复制实验性糖尿病心肌病模型。     

实验性2型糖尿病心肌病大鼠模型的建立与评价

目的建立和评价2型糖尿病心肌病（DC）大鼠模型,探究高糖脂饮食在模型建立中的作用。方法将雄性Wistar大鼠随机分成正常对照组、高糖脂饮食组和高糖脂负荷小剂量STZ组。高糖高脂膳食诱导11周负荷小剂量链脲佐菌素（STZ）（30 mg/kg）腹腔注射建立DC模型,并观察糖代谢、脂代谢和心功能的变化。结果①大鼠经高糖高脂饲料诱导4周后,与正常对照组相比,胆固醇（TCH）和甘油三酯（TG）均显著增高（P〈0.05）,血糖值没有明显变化（P〉0.05）。②大鼠注射30 mg/kg STZ后72 h,血糖水平开始升高,继续以高糖高脂饲料喂养6周后,与正常对照组比较,高糖脂饮食组和高糖脂负荷小剂量STZ组大鼠TG、TCH维持高水平,差异有显著性（P〈0.05）;高糖脂负荷小剂量STZ组大鼠血糖值持续高水平,与正常对照组差异有显著性（P〈0.001）。③心功能测量结果显示,高糖脂饮食组大鼠出现温和的心脏功能异常（左心室收缩压降低,左心室舒张末压升高）;高糖脂负荷小剂量STZ组大鼠左心室收缩和舒张功能均出现异常（LVSP、每搏输出量、心排量降低,LVEDP、左心室最大舒张速率升高）,但以舒张功能异常为主。结论大鼠高糖脂饮食诱导负荷小剂量STZ可建立类似临床症状的2型DC模型,高糖脂饮食在糖脂代谢紊乱和心脏功能损伤过程中有重要作用,结合糖、脂代谢指标和心脏功能指标可以有效简便评价糖尿病心肌病模型。     

SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响

摘要 目的：研究SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响。方法：选取我院2019年1月~2020年6月收治的2型糖尿病合并稳定性心功能不全患者106例为研究对象,采用随机数字表法将患者分为两组,所有患者均给予2型糖尿病饮食控制治疗方案,并给予心功能不全对症药物治疗。对照组患者在此基础上给予二甲双胍,观察组在对照组的基础上给予SGLT2抑制剂达格列净。比较两组患者的血糖、血尿酸（uric acid,UA）、血清脑钠肽(brainnatriureticpeptide,BNP)水平、心脏功能及生活质量。结果：治疗前两组的餐后2 h血糖（2- hour postprandial glucose,2 h PBG）、空腹血糖（fasting blood glucose,FBG）及糖化血红蛋白（glycosylated hemoglobin,HbAIc）水平比较无差异（P＞0.05）,治疗后两组的上述指标均显著降低,且观察组显著低于对照组（P<0.05）;治疗前两组的UA和BNP水平比较无差异（P＞0.05）,治疗后两组的上述指标均显著降低,且观察组显著低于对照组（P<0.05）;治疗前两组的左室射血分数（left ventricular ejection fraction,LVEF）和左室舒张末期内径（left ventricular end diastolic diameter,LVEDD）水平比较无差异（P＞0.05）,治疗后观察组的LVEF水平显著升高,LVEDD水平显著降低（P<0.05）,但对照组治疗前后比较无差异（P＞0.05）;治疗前两组的SF-36健康调查量表(the SF-36 Health Survey,SF-36)评分比较无差异（P＞0.05）,治疗后两组的SF-36评分均显著上升,且观察组显著高于对照组（P<0.05）,两组的不良反应发生率比较无统计学差异（P＞0.05）。结论：达格列净可显著改善2型糖尿病合并稳定性心功能不全患者的血糖、血尿酸水平,还能够改善患者的心脏功能,值得临床借鉴。     

金耳菌丝体多糖对实验性2型糖尿病大鼠的降血糖作用研究

本文研究了金耳菌丝体多糖(TMP)对实验性2型糖尿病大鼠血糖、血脂、胰岛素敏感性和抗氧化能力的影响。采用烟酰胺,链脲佐菌素和高脂饲料诱导2型糖尿病大鼠模型,以50和100mg/(kg.d)剂量的TMP连续灌胃48d,监测血糖,测定血清胰岛素、体重、脂代谢及抗氧化系统部分相关指标,并进行口服糖耐量实验。结果显示,TMP可明显降低2型糖尿病大鼠的血清葡萄糖、总胆固醇、甘油三酯和丙二醛水平,并极显著提高受试模型鼠的胰岛素敏感指数,血清超氧化物歧化酶活性和肝脏过氧化氢酶活性。此外,TMP能显著降低糖耐量实验中糖负荷后120min时糖尿病大鼠的血糖含量。上述结果表明TMP可有效降低实验性2型糖尿病大鼠的血糖水平,纠正脂代谢紊乱,改善胰岛素抵抗,增强抗氧化能力。     

酒精性心肌病大鼠心肌解偶联蛋白2表达及能量代谢变化

目的:观察心肌解偶联蛋白2(uncoupling protein 2,UCP2)在酒精性心肌病(alcoholic cardiomyopathy,ACM)时表达变化及对心肌能量代谢的影响.方法:将Wistar大鼠分为三组,酒精组(A组,10只)、少量饮酒组(B组,7只)和对照组(C组,7只),三组给予相同饮食,酒精组通过采取逐渐增加饮用酒精浓度并长期定量摄入的方法建立ACM模型,少量饮酒组长期饮用少量低浓度酒精,对照组以水代酒.6个月后心脏彩超测定心功能;计算左室/体重指数;RT-PCR法测定心肌组织UCP2 mRNA表达;Western blot法测定心肌UCP2蛋白表达;高效液相色谱分析法测定心肌三磷酸腺苷酸(ATP)、二磷酸腺苷酸(ADP)、单磷酸腺苷酸(AMP)和磷酸肌酸(PCr)含量.结果:酒精组左心室射血分数和左心室短轴缩短率均低于对照组和少量饮酒组(P均＜0.01),左心室舒张末期内径则高于对照组和少量饮酒组(P＜0.01),左室/体重指数明显增加(P＜0.01);酒精组UCP2 mRNA及蛋白表达高于对照组和少量饮酒组(P均＜0.01);酒精组ATP、ADP、AMP和PCr较对照组和少量饮酒组明显减少(P均＜0.01),相关性分析显示心肌组织ATP水平与UCP2蛋白表达呈显著负相关(r=0.896,P＜0.01).结论:ACM时心肌UCP2表达明显增加,导致心肌能量代谢障碍,恶化心脏功能.     

小檗碱对2型糖尿病ICR小鼠模型的治疗作用

目的比较小檗碱及小檗碱与添加剂对2型糖尿病ICR小鼠模型的降糖、降脂效果。方法100只三周龄雄性ICR小鼠随机分为正常组、模型组、小檗碱组、小檗碱加低剂量添加剂组、小檗碱加高剂量添加剂组及二甲双胍组,以高糖高脂加尿链佐菌素诱导小鼠2型糖尿病模型,并分别以小檗碱、小檗碱加低剂量添加剂、小檗碱加高剂量每天灌胃干预治疗6周。检测血糖、血清血脂、肾功指标的变化情况;给药前后做糖耐量胰岛素耐量实验。每周量小鼠体重,动态观察小鼠体重变化。代谢笼中测量小鼠饮食水量变化。结果模型组血糖较普食组显著上升（P〈0.01）,且维持较好;血脂指标CHO、HDL-c、LDL-c均较普食组升高（P〈0.05）;其他各检测生化指标差异不显著。小檗碱组空腹血糖较模型组总体下降趋势明显且维持较好（P〈0.01）;血脂较模型组有降低;糖耐量胰岛素耐量较模型组有改善。二甲双胍组血糖较模型组有下降趋势,血脂较模型组无显著差别。小檗碱加低剂量添加剂组较模型组血糖血脂无显著差别。小檗碱加高剂量添加剂组血糖较模型有下降趋势,血脂较模型组有下降趋势,其他各项生化指标均无差别。结论小檗碱降糖效果优于二甲双胍,小檗碱加低剂量添加剂,小檗碱加高添加剂。     

葛根素对2型糖尿病大鼠的治疗作用*

目的:观察葛根素对2型糖尿病(T2DM)大鼠的治疗作用。方法:采用高糖高脂饲料喂养加一次性腹腔注射60 mg/kg链脲佐菌素的方法建立T2DM 大鼠模型,随机分为正常组,模型组,二甲双胍(40 mg/kg)组,葛根素低、中、高剂量(40,80,160 mg/kg)组,每组10只大鼠;造模成功后,灌胃给药4周,每周测量大鼠体重和空腹血糖(FBG),末次给药24 h后取血,收集血清,检测各组大鼠的血糖、血清甘油三酯(TG)、总胆固醇(TC) 、低密度脂蛋白-胆固醇(LDL-C)水平、高密度脂蛋白-胆固醇(HDL-C),血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)活性,血清尿素氮(BUN)、肌酐(SCr)、尿酸(UA)水平。结果:干预4周后,与正常组比较,模型组大鼠体重显著降低(P＜0.01),FBG,TC,TG,LDL-C,ALT,AST,BUN,SCr,UA均显著升高(P＜0.01),而HDL-C 显著降低(P＜0.01);与模型组比较,二甲双胍组和葛根素各剂量组大鼠体重均显著增加(P＜0.01),FBG,TC,TG,LDL-C,ALT,AST,BUN,SCr,UA均显著降低(P＜0.01),而HDL-C显著升高(P＜0.01)。结论:葛根素能够减少T2DM大鼠体重降低幅度,降低血脂、血糖水平,可用于T2DM的治疗。     

岩藻多糖在2型糖尿病大鼠模型的作用及机制研究

目的:研究岩藻多糖(Fucoidan)对链脲佐菌素诱导实验性2型糖尿病大鼠的治疗作用.方法:在SD大鼠建立2型糖尿病动物模型,随机分为5组,分别用生理盐水、岩藻多糖高、中、低剂量(600mg/kg、400mg/kg、150mg/kg)、二甲双胍(200mg/kg)灌胃给药30天,同时采用正常SD大鼠为正常对照.测定各组大鼠体重、空腹血糖、血脂和血清胰岛素水平.结果:高、中剂量岩藻多糖能够明显降低模型动物空腹血糖水平,降低空腹胰岛素水平,改善胰岛素抵抗,降低血清胆固醇、甘油三酯、低密度脂蛋白胆固醇含量(P<0.05),升高高密度脂蛋白胆固醇含量(P<0.05),其作用效果与阳性对照药二甲双胍效果相当.低剂量岩藻多糖作用效果不明显.结论:岩藻多糖有降血糖、调节血脂紊乱的功能,时实验性2型糖尿病大鼠有治疗作用.     

2型糖尿病鼠类模型的研究进展

小鼠、大鼠糖尿病模型对基础与临床防治研究十分重要,不同的研究目标对应不同的动物模型载体。本文就目前常用的2型糖尿病鼠类模型的构建、主要疾病特征及应用等进行评述,为研究者了解、选择适合的动物模型提供参考。     

Attenuation of diabetic cardiomyopathy by relying on kirenol to suppress inflammation in a diabetic rat model

Diabetic cardiomyopathy is characterized by diabetes‐induced myocardial abnormalities, accompanied by inflammatory response and alterations in inflammation‐related signalling pathways. Kirenol, isolated from Herba Siegesbeckiae, has potent anti‐inflammatory properties. In this study, we aimed to investigate the cardioprotective effect of kirenol against DCM and underlying the potential mechanisms in a type 2 diabetes mellitus model. Kirenol treatment significantly decreased high glucose‐induced cardiofibroblasts proliferation and increased the cardiomyocytes viability, prevented the loss of mitochondrial membrane potential and further attenuated cardiomyocytes apoptosis, accompanied by a reduction in apoptosis‐related protein expression. Kirenol gavage could affect the expression of pro‐inflammatory cytokines in a dose‐dependent manner but not lower lipid profiles, and only decrease fasting plasma glucose, fasting plasma insulin and mean HbA1c levels in high‐dose kirenol‐treated group at some time‐points. Left ventricular dysfunction, hypertrophy, fibrosis and cell apoptosis, as structural and functional abnormalities, were ameliorated by kirenol administration. Moreover, in diabetic hearts, oral kirenol significantly attenuated activation of mitogen‐activated protein kinase subfamily and nuclear translocation of NF‐κB and Smad2/3 and decreased phosphorylation of IκBα and both fibrosis‐related and apoptosis‐related proteins. In an Electrophoretic mobility shift assay, the binding activities of NF‐κB, Smad3/4, SP1 and AP‐1 in the nucleus of diabetic myocardium were significantly down‐regulated by kirenol treatment. Additionally, high dose significantly enhanced myocardial Akt phosphorylation without intraperitoneal injection of insulin. Kirenol may have potent cardioprotective effects on treating for the established diabetic cardiomyopathy, which involves the inhibition of inflammation and fibrosis‐related signalling pathways and is independent of lowering hyperglycaemia, hyperinsulinemia and lipid profiles.     

糖尿病动物模型心功能评价方法

糖尿病心血管并发症（ cardiovascular complications of diabetes , CCD）是糖尿病患者最主要的死亡原因,其中糖尿病心肌病（ diabetic cardiomyopathy , DC）是心力衰竭的主要原因。对于分析糖尿病心肌病的机制、早期诊断以及改进和优化治疗,心脏功能评估起到重要桥梁作用,而糖尿病动物模型直接或间接反映糖尿病的发生和发展过程,是一个良好的研究载体。本文旨在综述国内外糖尿病动物模型心脏功能评价的重要方法。     

The association between cardiac autonomic neuropathy and heart function in type 2 diabetic patients

Abstract

Aim: Cardiac autonomic neuropathy (CAN) is a common and important chronic complication in diabetic patients. Heart failure resulting from cardiomyopathy is also a lethal complication in diabetic patients. However, data showing the exact association between CAN and heart failure in diabetic patients are relatively scarce. Therefore, our study aimed to determine the association between the parameters assessing CAN and heart function in diabetic patients.

Method: The medical records of type 2 diabetic patients who underwent an autonomic function test with heart rate variability (HRV) and echocardiography were reviewed from January 2018 to December 2018. A total of 100 type 2 diabetic patients were included, and the association between the parameters assessing CAN and heart function was analysed.

Results: Among the 100 analysed patients, 65 were diagnosed with CAN and 26 showed diastolic dysfunction. Moreover, 19 (73.1%) diabetic patients with diastolic dysfunction were complicated with CAN. The occurrence of diastolic dysfunction was higher in diabetic patients with CAN than in diabetic patients without CAN (29.2% vs 20.0%, p?<?0.05), and the occurrence of CAN was higher in diabetic patients with diastolic dysfunction than in patients without diastolic dysfunction (73.1% vs 62.2%, p?<?0.05). However, there were no significant associations between HRV parameters and heart function.

Conclusion: We demonstrated that diastolic dysfunction is more common in diabetic patients complicated with CAN than in diabetic patients without CAN, although several diabetic patients without diastolic dysfunction are also diagnosed with CAN. Moreover, further studies about the long-term serial monitoring of heart function according to the progression of CAN are required to confirm the exact association between CAN and heart function.     

4‐O‐methylhonokiol protects against diabetic cardiomyopathy in type 2 diabetic mice by activation of AMPK‐mediated cardiac lipid metabolism improvement

Diabetic cardiomyopathy (DCM) is characterized by increased left ventricular mass and wall thickness, decreased systolic function, reduced ejection fraction (EF) and ultimately heart failure. The 4‐O‐methylhonokiol (MH) has been isolated mainly from the bark of the root and stem of Magnolia species. In this study, we aimed to elucidate whether MH can effectively prevent DCM in type 2 diabetic (T2D) mice and, if so, whether the protective response of MH is associated with its activation of AMPK‐mediated inhibition of lipid accumulation and inflammation. A total number of 40 mice were divided into four groups: Ctrl, Ctrl + MH, T2D, T2D + MH. Five mice from each group were sacrificed after 3‐month MH treatment. The remaining animals in each group were kept for additional 3 months without further MH treatment. In T2D mice, the typical DCM symptoms were induced as expected, reflected by decreased ejection fraction and lipotoxic effects inducing lipid accumulation, oxidative stress, inflammatory reactions, and final fibrosis. However, these typical DCM changes were significantly prevented by the MH treatment immediately or 3 months after the 3‐month MH treatment, suggesting MH‐induced cardiac protection from T2D had a memory effect. Mechanistically, MH cardiac protection from DCM may be associated with its lipid metabolism improvement by the activation of AMPK/CPT1‐mediated fatty acid oxidation. In addition, the MH treatment of DCM mice significantly improved their insulin resistance levels by activation of GSK‐3β. These results indicate that the treatment of T2D with MH effectively prevents DCM probably via AMPK‐dependent improvement of the lipid metabolism.     

山茱萸总萜对糖尿病小鼠心肌病变的保护作用

目的:研究山茱萸总萜(TFC)对糖尿病小鼠心肌病变的保护作用。方法:雄性小鼠一次性腹腔注射四氧嘧啶220 mg/kg造成糖尿病模型。第15天后将血糖高于13.9 mmol/L的小鼠随机分为模型组和TFC组。药物以生理盐水混悬后灌胃(P.O,80 mg/kg),连续8周。结果:与正常组比较,模型组的心脏脏器系数升高;心肌组织中超氧化物歧化酶(SOD)活力明显下降,丙二醛(MDA)含量明显升高,肿瘤坏死因子-α(TNFα-)及白细胞介素-6(IL-6)升高;病理学显示模型组心肌细胞排列紊乱、肿胀,细胞间隙增大,可见炎症细胞和成纤维细胞浸润,TFC组明显得到改善。结论:山茱萸总萜对四氧嘧啶诱导的糖尿病小鼠心肌损伤有明显的改善作用,其机制可能与降血糖、抗氧化及炎症因子有关。     

H2S generated by heart in rat and its effects on cardiac function

Hydrogen sulfide (H2S), which was considered as a novel gasotransmitter, is produced endogenously from L-cysteine in mammalian brain and vessels, and might be a physiological function regulator to these organs. Here, we showed that mRNA for H2S producing enzyme, cystathionine gamma-lyase, was expressed in myocardial tissues and H2S could endogenously be produced in myocardial tissues. Negative inotropic effect of H2S was proved in present study in vitro and in vivo experiments, and the effect could partly be blocked by glibenclamide, a KATP channel blocker. An intravenous bolus injection of NaHS provoked a decrease in central venous pressure. The present findings suggested that H2S could be endogenously produced by heart tissues, as a physiological cardiac function regulator, mediated by KATP channel pathway.     

Expression of farnesyl pyrophosphate synthase is increased in diabetic cardiomyopathy

Farnesyl pyrophosphate synthase (FPPS)-catalyzed isoprenoid intermediates are involved in diabetic cardiomyopathy. This study investigated the specific role of FPPS in the development of diabetic cardiomyopathy. We demonstrated that FPPS expression was elevated in both in vivo and in vitro models of diabetic cardiomyopathy. FPPS inhibition decreased the expression of proteins related to cardiac fibrosis and cardiomyocytic hypertrophy, including collagen I, collagen III, connective tissue growth factor, natriuretic factor, brain natriuretic peptide, and β-myosin heavy chain. Furthermore, FPPS inhibition and knockdown prevented phosphorylated c-Jun N-terminal kinase 1/2 (JNK1/2) activation in vitro. In addition, a JNK1/2 inhibitor downregulated high-glucose-induced responses to diabetic cardiomyopathy. Finally, immunofluorescence revealed that cardiomyocytic size was elevated by high glucose and was decreased by zoledronate, small-interfering farnesyl pyrophosphate synthase (siFPPS), and a JNK1/2 inhibitor. Taken together, our findings indicate that FPPS and JNK1/2 may be part of a signaling pathway that plays an important role in diabetic cardiomyopathy.     

Allopurinol reduces oxidative stress and activates Nrf2/p62 to attenuate diabetic cardiomyopathy in rats

Allopurinol (ALP) attenuates oxidative stress and diabetic cardiomyopathy (DCM), but the mechanism is unclear. Activation of nuclear factor erythroid 2‐related factor 2 (Nrf2) following the disassociation with its repressor Keap1 under oxidative stress can maintain inner redox homeostasis and attenuate DCM with concomitant attenuation of autophagy. We postulated that ALP treatment may activate Nrf2 to mitigate autophagy over‐activation and consequently attenuate DCM. Streptozotocin‐induced type 1 diabetic rats were untreated or treated with ALP (100 mg/kg/d) for 4 weeks and terminated after heart function measurements by echocardiography and pressure‐volume conductance system. Cardiomyocyte H9C2 cells infected with Nrf2 siRNA or not were incubated with high glucose (HG, 25 mmol/L) concomitantly with ALP treatment. Cell viability, lactate dehydrogenase, 15‐F2t‐Isoprostane and superoxide dismutase (SOD) were measured with colorimetric enzyme‐linked immunosorbent assays. ROS, apoptosis, was assessed by dihydroethidium staining and TUNEL, respectively. The Western blot and qRT‐PCR were used to assess protein and mRNA variations. Diabetic rats showed significant reductions in heart rate (HR), left ventricular eject fraction (LVEF), stroke work (SW) and cardiac output (CO), left ventricular end‐systolic volume (LVVs) as compared to non‐diabetic control and ALP improved or normalized HR, LVEF, SW, CO and LVVs in diabetic rats (all P < .05). Hearts of diabetic rats displayed excessive oxidative stress manifested as increased levels of 15‐F2t‐Isoprostane and superoxide anion production, increased apoptotic cell death and cardiomyocytes autophagy that were concomitant with reduced expressions of Nrf2, heme oxygenase‐1 (HO‐1) and Keap1. ALP reverted all the above‐mentioned diabetes‐induced biochemical changes except that it did not affect the levels of Keap1. In vitro, ALP increased Nrf2 and reduced the hyperglycaemia‐induced increases of H9C2 cardiomyocyte hypertrophy, oxidative stress, apoptosis and autophagy, and enhanced cellular viability. Nrf2 gene silence cancelled these protective effects of ALP in H9C2 cells. Activation of Nrf2 subsequent to the suppression of Keap1 and the mitigation of autophagy over‐activation may represent major mechanisms whereby ALP attenuates DCM.