Cellular immunity in insulin-dependent diabetes mellitus (type 1)

Cell-mediated immunity was investigated with T-cell blastic transformation stimulated by phytohaemagglutinin and/or insulin in patients with diabetes mellitus type 1. T-cell blastic transformation was determined in the whole blood by the intake of labelled thymidine intake by the lymphocytic DNA. Healthy individuals and patients with diabetes mellitus type 2 served as control groups. It was found that T-cell blastic transformation stimulated with phytohaemagglutinin is markedly diminished in patients with diabetes mellitus type 1 and to a lesser degree in patients with diabetes mellitus type 2. Insulin increased T-cell blastic transformation in insulin-dependent diabetic patients but has no effect in diabetes mellitus type 2. The obtained results suggest that induction and central phases of the cell-mediated immunological response are diminished in diabetes mellitus independently on its type. Such disorders may have different etiology depending on the type of diabetes mellitus.     

A study of features of the inheritance of latent autoimmune diabetes of adults (LADA)

A study of the genetic determination of latent autoimmune diabetes of adults (LADA) is conducted on data consisting of clinical and genealogical data on 51 patients with LADA, 400 patients with insulin-dependent diabetes mellitus (type 1 diabetes mellitus), and 504 patients with insulin-independent diabetes mellitus (type 2 diabetes mellitus), along with relatives of these patients (first degree of consanguinity). Testing of the Smith model revealed the genetic independence of LADA and both type 1 and type 2 diabetes mellitus. A study of genetic heterogeneity in accordance with the Smith model showed that LADA shares roughly the same number of common genes with type 1 diabetes mellitus and with type 2 diabetes mellitus, which also determines the clinical course of this form of diabetes. The inheritance of LADA is described by parameters of a polygenic threshold model. Within the framework of this model, it is found that genetic factors are responsible for 60.4% of the development of the disease.     

Secretin-stimulated amylase release into blood is impaired in type 1 diabetes mellitus.

BACKGROUND: Prior studies have provided data indicating the existence of close interaction between pancreatic endocrine and exocrine function, but few clinical studies have explored this relationship in depth. We compared pancreatic exocrine function non-endoscopically in individuals with type 1 diabetes mellitus, type 2 diabetes mellitus, and normal glucose tolerant controls, to assess the importance of local insulin production to pancreatic exocrine function. METHODS: The plasma amylase response to intravenous secretin challenge was measured in men with type 1 diabetes mellitus (n = 5), type 2 diabetes mellitus (n = 5), and normal controls (n = 3). Patients were characterized by their urinary excretion of c-peptide and albumin over 24 hours. Autonomic neuropathy was non-invasively assessed by measuring RR variation (with deep respiration on EKG). RESULTS: Post-secretin amylase responses were generally absent with low baseline levels in the patients with type 1 diabetes mellitus. Patients with type 2 diabetes mellitus and controls showed similar twofold increases over baseline after secretin administration. When normal glucose tolerant and type 2 diabetic patients were pooled and compared against type 1 diabetes mellitus, the differences were statistically significant (p < 0.03). Total amylase response correlated positively, but weakly, with 24 h urinary C-peptide excretion (r = 0.507; p < 0.112), but not with glycemic control, duration of diabetes, or indices of autonomic neuropathy. CONCLUSIONS: Patients with type 1 diabetes mellitus, but not type 2 diabetes mellitus, have reduced pancreatic exocrine function, supporting the concept of a local paracrine effect of insulin on pancreatic acinar cells. Further studies are needed to determine the clinical impact of this deficiency, and whether such patients with type 1 diabetes mellitus would benefit from therapy with pancreatic enzyme supplementation.     

The Association of Handgrip Strength and Type 2 Diabetes Mellitus in Six Ethnic Groups: An Analysis of the HELIUS Study

We investigated whether ethnic differences in handgrip strength, a marker of poor muscle strength and quality, is a potential cause of ethnic disparities in type 2 diabetes mellitus. We included 2086 Dutch, 2216 South Asian Surinamese, 2084 African Surinamese, 1786 Ghanaian, 2223 Turkish and 2199 Moroccan origin participants from the HELIUS study. We analyzed ethnic differences in handgrip strength, and its association with type 2 diabetes mellitus using logistic regression analyses adjusted for socio-demographic factors, body composition and lifestyle factors. Additionally, we investigated whether handgrip strength explained the ethnic differences in type 2 diabetes mellitus. We found that handgrip strength differed significantly across ethnic groups. After full adjustment, we found an inverse association with type 2 diabetes mellitus (OR 0.95; 95% CI 0.92–0.97) that did not differ substantially between ethnic groups, men and among women, and lean and overweight individuals. The association was not affected by the measure used to define type 2 diabetes mellitus, but was attenuated by exclusion of people with known diabetes. The ethnic differences in type 2 diabetes mellitus were not explained by handgrip strength (e.g. the OR for the South Asian Surinamese vs. Dutch changed from 5.03; 3.69–6.68 to 4.87; 3.57–6.65). In conclusion, we found large ethnic differences in handgrip strength and a consistent association of low handgrip strength with prevalent type 2 diabetes mellitus. This suggests that handgrip strength may be investigated as a target for intervention or a marker to identify people at risk of type 2 diabetes mellitus.     

磺酰脲类受体基因多态性与2型糖尿病的相关性研究

研 究磺酰脲类受体1（SUR1）基因外显子16-3c/t多态性在中国某南方汉族人群中是否为2型糖尿病的致病基因座。采用聚合酶链反应-限制酶酶切片段长度多态性（PCR-RFLP）方法对南方汉族46个2型糖尿病高发家系成员的SUR1基因外显子16的多态性进行分析。利用Mantel-Haenszel分层分析研究该基因座多态性与2型糖尿病的关系。在高发家系人群中,SUR1基因外显子16-3c/t多态性的基因型频率为：cc型29.3%、ct型507%、tt型20%,c等位基因频率为54.7%;患者组基因型频率为：cc型30.2% 、ct型53.8%、tt型16.0% ,c等位基因频率为57.1% ;未患病亲属组基因型频率为：cc型28.3% 、ct型47.2%、tt型24.5%,c等位基因频率为519%,两组间基因型和等位基因的差异经检验无统计学意义（分别为χ2=3.224,P=0.199;χ2=1.250,P=0264）。在性别、吸烟、饮酒、肥胖、高血压等混杂因素中的频率差异亦无显著性。c等位基因频率低于北方汉族人。在中国某南方汉族2型糖尿病高发家族人群中,未发现SUR1基因外显子16-3c/t多态性与2型糖尿病存在关联,该基因座可能不是该人群的致病基因。 Abstract:To study whether the 3c/t polymorphism of the sulfonylurea receptor 1 (SUR1) gene exon16 increased the risk of type 2 diabetes mellitus in type 2 diabetes mellitus pedigrees in Han population in south area of China.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used in 46 type 2 diabetes mellitus pedigrees.The polymorphism in SUR1 was tested and analyzed by Mantel-Haenszel χ2 test.Frequencies of SUR1-3c/t polymorphism had no significant difference between type 2 diabetes mellitus and normal relatives（genotypes χ2=3.224,P=0.199;frequency of allele χ2=1.250,P=0.264）.In all subjects,type 2 diabetes mellitus and normal relatives,SUR1-3c/t genotypes were listed (cc:29.3%,30.2%,28.3%;ct:50.7%,53.8%,47.2%;tt:20%,16.0%,24.5% respectively).The frequencies of c were 54.7%,57.1% and 51.9% respectively.The frequency of c is lower than Han population in northern China.The results show that SUR1 exon16-3c/t polymorphism is not associated with type 2 diabetes mellitus in the population.     

Effect of C111T polymorphism in exon 9 of the catalase gene on blood catalase activity in different types of diabetes mellitus

Hydrogen peroxide plays a major role in the pathomechanism of diabetes mellitus and its main regulator is enzyme catalase. The blood catalase and the C111T polymorphism in exon 9 was examined in type 1, type 2 and gestational diabetes mellitus. Compared to the control group (104.7 +/- 18.5 MU/l) significantly decreased (p < 0.001) blood catalase activities were detected in type 2 (71.2 +/- 14.6 MU/l), gestational (68.5 +/- 12.2 MU/l) diabetes mellitus and without change in type 1 (102.5 +/- 26.9 MU/l). The blood catalase decreased (p = 0.043) with age for type 2 diabetics and did not change (p>0.063) for type 1, gestational diabetic patients and controls. Blood catalase showed a weak association with hemoglobin A1c for type 1 diabetic patients (r = 0.181, increasing). The mutant T allele was increased in type 1 and gestational diabetes mellitus, and CT+TT genotypes showed decreased blood catalase activity for type 1 and increased activities for type 2 diabetic patients. The C111T polymorphism may implicate a very weak effect on blood catalase activity in different types of diabetes mellitus.     

实验性链脲佐菌素诱导的大、小鼠糖尿病动物模型研究进展

糖尿病正呈快速上升趋势,而糖尿病的病因、发病机制尚未完全阐明,糖尿病及其并发症的预防和治疗仍不完善。因此,在糖尿病研究领域优化糖尿病实验动物模型的研究,寻找更接近人类糖尿病自然发病过程的动物模型,对于深入研究糖尿病具有重要的科学意义。     

2型糖尿病家族史对患者及其同胞患病影响的分析

目的：分析明确的2型糖尿病家族史对患者及其同胞患病的影响。方法：收集我院内分泌门诊4年来就诊的具有明确糖尿病家族史的2型糖尿病患者143例,对患者的父母、同胞进行糖尿病患病情况调查,并对调查结果进行统计学分析。结果：（1）在143例糖尿病患者中,来自糖尿病母亲家族史的占55．6％,来自糖尿病父亲家族史的占31．0％,两者有显著差异（P〈0．01）。（2）具有糖尿病家族史的同胞兄弟姐妹中,二人或多人患病的比例高达52．4％。结论：（1）来自糖尿病母亲的家族史对子代糖尿病患病的影响超过父亲。（2）2型糖尿病具有明显的家族聚集性。     

Increasing Trends of Diabetes Mellitus and Body Weight: A Ten Year Observation at Gondar University Teaching Referral Hospital,Northwest Ethiopia

Background

Diabetes mellitus is becoming one of the major causes of premature adult mortality in developing countries. However, there is a very little documentation of the morbidity trend in such countries.

Objective

To assess the ten-year trend of diabetes mellitus at Gondar University Teaching Referral Hospital, northwest Ethiopia.

Methods

A hospital-based retrospective record review was done at the main referral hospital in northwest Ethiopia. Data were obtained from medical records of all registered diabetic patients in the Diabetic Follow up Clinic between 2000 and 2009. An Extended Mantel-Haenzel chi-square test for the linear trend was used to examine the trend over time.

Result

Out of the total 354,524 patients who visited the Outpatient Department of the hospital during the study period, 1553 (4.4/1000) were diabetes patients, of which 50.1% was type 1 and 49.9% type 2 diabetes mellitus. The average increase in the proportion of both Type 1 and Type 2 diabetes mellitus cases between 2000 and 2009 was 125%. The mean (±SD) age for Type 1 diabetes mellitus was 29.1 (±12), and 53.5 (±12) for Type 2 diabetes. Overall 42.5% of the diabetes mellitus patients were female and 31.7% were rural residents. The mean body mass index for both type of diabetes mellitus increased from 15.9 to 18.3 kg for type 1 and from 23.8 to 24.6 for type 2 between 2000 and 2009, respectively.

Conclusion

The number of diabetes mellitus cases seen at Gondar Referral Hospital is rising steadily. A comprehensive diabetes prevention, treatment, and care program is needed to improve the quality of life of the increasing diabetes mellitus cases in Ethiopia.     

胰升血糖素样肽-1及其受体与 2 型糖尿病的治疗

胰岛素对治疗 2 型糖尿病有一定效果,但长期使用会引起低血糖反应;双胍类药物降糖疗效显著,但会引起消化道不良反应 . 因此,寻找一种安全有效的药物是 2 型糖尿病治疗的当务之急 . 胰升血糖素样肽-1 作为一种胰岛素分泌促进剂和胰岛素增敏剂越来越受人们的关注,将它用于治疗糖尿病不会产生低血糖,对 1 型和 2 型糖尿病都有疗效 . 讨论胰升血糖素样肽-1及其受体的最新研究状况 .     

Type 2 diabetes mellitus as risk factor for colorectal cancer

Colorectal cancer occurs more frequently in patients with type 2 diabetes mellitus. The hyperinsulinemia-hypothesis suggests that elevated levels of insulin and free IGF-1 promote proliferation of colon cells and lead to a survival benefit of transformed cells, ultimately resulting in colorectal cancer. In patients with type 2 diabetes mellitus, epidemiological studies show an increased risk for colorectal cancer and an even higher risk if patients are treated with sulphonylureas or insulin. Moreover, tumour progression at hyperinsulinemia is more rapid and tumour-associated mortality is increased. Colorectal cancer can be avoided by screening. Recommendations for colorectal cancer screening should employ the recent epidemiologic evidence. All patients with type 2 diabetes mellitus should be recommended to undergo colonoscopy before starting insulin therapy, and screening intervals should not exceed 5 years. For this concept, a review of the evidence is presented, and a screening algorithm for colorectal cancer in patients with type 2 diabetes mellitus is proposed.     

膀胱尿路上皮肿瘤合并2型糖尿病患者临床和病理特点的比较性研究

目的:对比分析膀胱尿路上皮肿瘤合并2型糖尿病患者的临床和病理特点,为临床诊疗工作提供一定的参考。方法:回顾性分析2015年1月至2019年2月于我院泌尿外科手术治疗且经病理确诊为原发性膀胱尿路上皮肿瘤的患者资料,合并2型糖尿病的膀胱肿瘤患者59例设为糖尿病组(T2DM组),根据性别和年龄按照1:2的比例匹配同时期未合并2型糖尿病的膀胱肿瘤118例患者为非糖尿病组(NT2DM组),比较两组患者的临床特征和病理特点。结果:T2DM组的高血压患者比例和血肌酐值高于NT2DM组(P<0.05),而在教育程度、吸烟、饮酒、BMI、前列腺增生、泌尿系感染、血常规、肝功、尿常规、肿瘤大小、数量方面无明显统计学差异(P>0.05)。T2DM组和NT2DM组在膀胱尿路上皮肿瘤良恶性分类、肿瘤数量、肿瘤大小的构成比上无明显统计学差异(P>0.05);然而,对膀胱恶性肿瘤患者进行亚组分析显示,T2DM亚组中肌层浸润性癌的比例和高级别癌的比例明显高于NT2DM亚组,差异有统计学意义(P<0.05)。结论:2型糖尿病可能使膀胱癌的病理分级和分期更高,导致患者预后更差,临床上应更加关注膀胱恶性肿瘤合并2型糖尿病患者的诊治。     

青春双歧杆菌对2型糖尿病模型大鼠肠道菌群和脂质代谢的影响

目的通过观察青春双歧杆菌对2型糖尿病模型大鼠肠道菌群的变化,和血清中总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、超氧化物歧化酶（SOD）和丙二醛（MDA）的水平,探讨青春双歧杆菌对2型糖尿病模型大鼠肠道功能和脂质代谢的影响。方法采用青春双歧杆菌灌胃2型糖尿病模型大鼠,取粪便检查正常菌群,取血和脏器检测TC、TG、HDL-C、SOD和MDA含量。结果青春双歧杆菌导致肠道内双歧杆菌、乳杆菌的数量增加,而肠杆菌、肠球菌数量下降;TC、TG和MDA水平下降,而HDL-C和SOD水平升高。结论青春双歧杆菌具有改善2型糖尿病模型大鼠肠道功能和降血脂作用,与二甲双胍联合应用效果更佳。     

Adenovirus vector-mediated macrophage erythroblast attacher (MAEA) overexpression in primary mouse hepatocytes attenuates hepatic gluconeogenesis

Japanese patients with type 2 diabetes mellitus present a different responsiveness in terms of insulin secretion to glucose and body mass index (BMI) from other populations. The genetic background that predisposes Japanese individuals to type 2 diabetes mellitus is under study. Recent genetic studies demonstrated that the locus mapped in macrophage erythroblast attacher (MAEA) increases the susceptibility to type 2 diabetes mellitus in East Asians, including Japanese individuals. MAEA encodes a protein that plays a role in erythroblast enucleation and in the normal differentiation of erythroid cells and macrophages. However, the contribution of MAEA to type 2 diabetes mellitus remains unknown. In this study, to overexpress MAEA in the mouse liver and primary mouse hepatocytes, we generated a MAEA-expressing adenovirus (Ad) vector using a novel Ad vector exhibiting significantly lower hepatotoxicity (Ad-MAEA). Blood glucose and insulin levels in Ad-MAEA-treated mice were comparable to those in control Ad-treated mice. Primary mouse hepatocytes transduced with Ad-MAEA showed lower levels of expression of gluconeogenesis genes than those transduced with the control Ad vector. Hepatocyte nuclear factor-4α (HNF-4α) mRNA expression in primary mouse hepatocytes was also suppressed by MAEA overexpression. These results suggest that MAEA overexpression attenuates hepatic gluconeogenesis, which could potentially lead to improvement of type 2 diabetes mellitus.     

Arachidonic acid and lipoxin A4 as possible endogenous anti-diabetic molecules

In both type 1 and type 2 diabetes mellitus, increased production of pro-inflammatory cytokines and reactive oxygen species (ROS) occurs that induce apoptosis of β cells and cause peripheral insulin resistance respectively though the degree of their increased production is higher in type 1 and less in type 2 diabetes mellitus. Despite this, the exact mechanism(s) that lead to increased production of pro-inflammatory cytokines: interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and ROS is not known. Studies showed that plasma concentrations of arachidonic acid (AA) and lipoxin A₄ (LXA₄) are low in alloxan-induced type 1 diabetes mellitus in experimental animals and patients with type 2 diabetes mellitus. Prior administration of AA, eicosapentaenoic and docosahexaenoic acids (EPA and DHA, respectively) and transgenic animals that produce increased amounts of EPA and DHA acids were protected from chemical-induced diabetes mellitus that was associated with enhanced formation of LXA₄ and resolvins, while protectin D₁ ameliorated peripheral insulin resistance. AA, LXA₄, resolvins and protectins inhibit IL-6 and TNF-α production and suppress ROS generation. Thus, AA and lipoxins, resolvins and protectins may function as endogenous anti-diabetic molecules implying that their administration could be useful in the prevention and management of both types of diabetes mellitus.     

Effect of C111T polymorphism in exon 9 of the catalase gene on blood catalase activity in different types of diabetes mellitus

Hydrogen peroxide plays a major role in the pathomechanism of diabetes mellitus and its main regulator is enzyme catalase.

The blood catalase and the C111T polymorphism in exon 9 was examined in type 1, type 2 and gestational diabetes mellitus.

Compared to the control group (104.7 ± 18.5 MU/l) significantly decreased (p < 0.001) blood catalase activities were detected in type 2 (71.2 ± 14.6 MU/l), gestational (68.5 ± 12.2 MU/l) diabetes mellitus and without change in type 1 (102.5 ± 26.9 MU/l). The blood catalase decreased (p = 0.043) with age for type 2 diabetics and did not change (p>0.063) for type 1, gestational diabetic patients and controls. Blood catalase showed a weak association with hemoglobin A1c for type 1 diabetic patients (r = 0.181, increasing).

The mutant T allele was increased in type 1 and gestational diabetes mellitus, and CT+TT genotypes showed decreased blood catalase activity for type 1 and increased activities for type 2 diabetic patients.

The C111T polymorphism may implicate a very weak effect on blood catalase activity in different types of diabetes mellitus.     

花生油对2型糖尿病大鼠海马CA1区神经生长因子及胆碱乙酰转移酶表达的影响

目的通过观察2型糖尿病大鼠海马CA1区神经生长因子（NGF）和胆碱乙酰转移酶（ChAT）表达的改变,研究花生油对2型糖尿病大鼠海马神经元NGF及ChAT表达的影响,探讨花生油在防治糖尿病脑病中的作用。方法 60只健康雄性SD大鼠随机分为4组：正常对照组（C组）、2型糖尿病组（T2DM组）、2型糖尿病给予2 mL花生油组（T2DM＋2 mL组）及2型糖尿病给予5 mL花生油组（T2DM＋5 mL组）。其中C组给予正常饮食,糖尿病组大鼠给予高脂饮食喂养,2个月后,按25 mg/kg体质量腹腔注射链脲佐菌素（STZ）制成2型糖尿病模型,T2DM组、T2DM＋2 mL组及T2DM＋5 mL组大鼠继续给予高脂饮食。糖尿病造模1个月后处死全部大鼠,行脑冰冻切片,用免疫组织化学方法检测各组大鼠海马CA1区NGF和ChAT的表达。结果 （1）T2DM组大鼠海马CA1区NGF表达比C组明显降低（P〈0.05）,T2DM＋2 mL组及T2DM＋5 mL组大鼠海马CA1区NGF表达均明显高于未给予花生油的T2DM组（P〈0.05）。（2）T2DM组大鼠海马CA1区ChAT表达显著低于C组（P〈0.05）,T2DM＋2 mL组和T2DM＋5 mL组大鼠海马CA1区ChAT表达均明显高于未给予花生油的T2DM组（P〈0.05）。结论 2型糖尿病大鼠海马CA1区神经生长因子表达降低,胆碱能神经元数量减少,这可能是2型糖尿病脑病发生的原因之一。花生油能增加2型糖尿病大鼠海马区内神经生长因子表达,促进胆碱能神经元存活,表明花生油具有一定的保护大鼠糖尿病脑病的作用。     

诱导型一氧化氮合酶基因多态性与2型糖尿病关系研究

目的：观察诱导型一氧化氮合酶（iNOs）基因Ser608Leu位点基因多态性与2型糖尿病的相关性。方法：采用测序法测定261例2型糖尿病患者和128例正常对照者iNOS基因Ser608Leu位点基因多态性。结果：两组间iNOS基因Ser608Leu位点基因型及等位基因频率构成存在差异。结论：iNOS基因Ser608Leu位点多态性与2型糖尿病有关。     

Islet amyloid polypeptide inhibits glucose-stimulated insulin secretion from isolated rat pancreatic islets

Islet amyloid polypeptide has 37 amino acids and is a major component of amyloid deposition in pancreatic islets of patients with type 2 diabetes mellitus. To determine whether the peptide is involved in the impaired insulin secretion in this type of diabetes mellitus, we synthesized islet amyloid polypeptide and its fragments and examined its effect on insulin secretion. Islet amyloid polypeptide inhibited the glucose-stimulated insulin secretion from isolated rat pancreatic islets, as calcitonin gene-related peptide did, but the fragments failed to inhibit the secretion. Thus, we propose that amyloid deposition may be an important factor in the impairment of insulin secretion in type 2 diabetes mellitus.     

一个2型糖尿病家系中新发现的线粒体DNA G7444A 突变分析

应用PCR-RFLP和测序对一个2型糖尿病家系的线粒体DNA G7444A的突变进行检测, 并分析其临床资料的特点。结果发现, 27例家系成员中, 11例母系亲属均存在线粒体DNA G7444A突变, 而配偶及父系亲属中未发现该突变。11例突变者中确诊为2型糖尿病患者5例, 糖耐量受损1例, 均表现为乳酸和血糖增高。因此, 线粒体DNA G7444A突变是该家系中糖尿病的遗传易感因素, 是导致2型糖尿病的一个新的突变位点。