镁补充对2 型糖尿病大鼠糖脂代谢的影响

目的:研究镁补充对2型糖尿病大鼠糖脂代谢的影响。方法:将用高脂饮食联合链脲佐菌素(STZ)方法诱发的2型糖尿病大鼠随机分为四个组,糖尿病对照组喂饲高脂饲料,高、中、低剂量组在高脂饲料中分别加入2000、1000、200 mg/kg的镁(以镁离子计)。自由饮食喂养四周,处死动物。用放射免疫法测血清胰岛素(Ins)水平、用葡萄糖氧化酶法测空腹血浆葡萄糖(fasting plasmaglucose,FPG),并计算胰岛素敏感指数(insulin sensitivity index,ISI)。比色法检测糖化血红蛋白(glycosylated hemoglobin,HbA1c)。用全自动生化分析仪测高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDLC)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)。结果:高剂量组的空腹血糖、空腹血清、糖化血红蛋白、甘油三酯、总胆固醇水平均较糖尿病对照组显著性降低(P<0.05),而高密度脂蛋白胆固醇、胰岛素敏感指数较糖尿病对照组显著性升高(P<0.05)。结论:镁补充可以提高2型糖尿病大鼠胰岛素敏感性,改善糖尿病大鼠的糖脂代谢情况。     

骨钙素对糖代谢影响的研究进展

骨钙素,亦称γ-羧基骨蛋白、骨谷氨酸蛋白和骨依赖维生素K蛋白,是一种由非增殖期成骨细胞合成的分泌蛋白,经过翻译后加工生成羧化骨钙素而参与骨骼发育。既往研究认为它是骨形成和骨转化的标志。然而最新研究发现,未发生羧化修饰的骨钙素对糖代谢有一定的影响作用,可促进胰腺β细胞增殖和胰岛素分泌,减弱胰岛素抵抗。多项研究证实高血糖可影响骨钙素合成,骨钙素在糖尿病患者中降低,糖尿病患者因胰岛素分泌和作用缺陷对胰岛素受体作用减弱,影响成骨细胞摄取核酸、氨基酸、胶原纤维合成,使其合成分泌骨钙素减少。这些研究确立了骨钙素为一种可以影响糖代谢的重要激素,拓展了对骨骼功能影响的同时也为新型降血糖药物的开发提供了新靶点。本文针对骨钙素对糖代谢的影响做一综述。     

膳食来源中硒的生物利用率研究进展

介绍了硒元素对生物体的健康功效及不合理摄入硒对人体造成的危害,从硒在人体的吸收、转运角度解释了硒的生物利用率的含义,总结了硒在人体的吸收代谢情况、生物利用率的测定方法及当前研究现状、硒生物利用率的影响因素,初步得出补硒关键控制点,为提高硒的生物利用率提供理论依据。     

Modulation of Glucose Transporter Protein by Dietary Flavonoids in Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is a metabolic diseases characterized by hyperglycemia due to insufficient or inefficient insulin secretory response. This chronic disease is a global problem and there is a need for greater emphasis on therapeutic strategies in the health system. Phytochemicals such as flavonoids have recently attracted attention as source materials for the development of new antidiabetic drugs or alternative therapy for the management of diabetes and its related complications. The antidiabetic potential of flavonoids are mainly through their modulatory effects on glucose transporter by enhancing GLUT-2 expression in pancreatic β cells and increasing expression and promoting translocation of GLUT-4 via PI3K/AKT, CAP/Cb1/TC10 and AMPK pathways. This review highlights the recent findings on beneficial effects of flavonoids in the management of diabetes with particular emphasis on the investigations that explore the role of these compounds in modulating glucose transporter proteins at cellular and molecular level.     

妊娠期糖尿病对子代主要先天畸形风险的影响

目的:探讨孕妇妊娠期糖尿病对子代先天畸形风险的影响,为优生优育提供参考。方法:对我院妇产科收治的124例糖尿病孕妇的临床资料进行前瞻性分析,同时选取150正常孕妇作为对照组,运用产前超声对糖尿病孕妇和正常孕妇的胎儿的先天畸形进行对比分析。结果:妊娠期糖尿病孕妇子代的先天畸形的风险明显高于正常孕妇(RR=2.24,95%CI=0.85-5.88)。结论:孕妇妊娠期糖尿病可对子代的各系统先天畸形造成较大影响,对孕早期进血糖监测是必要的。     

西格列汀治疗对初发2 型糖尿病患者血浆vaspin 水平的影响

目的：观察西格列汀治疗对初发2 型糖尿病（T2DM）患者血浆丝氨酸蛋白酶抑制物（vaspin）水平的影响,探讨其与胰岛素抵 抗的关系。方法：60 例初发2 型糖尿病患者使用西格列汀治疗12 周,采用酶联免疫法测定正常人及T2DM患者使用西格列汀治 疗前后的血浆vaspin 水平, 分析血浆vaspin水平与体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA- IR )、胰岛素分泌指 数(HOMA- IS )、空腹血糖（FPG）、餐后2 小时血糖（2hPG）、糖化血红蛋白（HbA1C）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋 白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）等的关系。结果：2 型糖尿病组血浆vaspin 水平高于对照组（P＜ 0.05）;2 型糖 尿病组经西格列汀治疗12 周后BMI、WHR、HbA1c、FPG 、2hPG、TG和HOMA-IR 显著下降（P＜0.05）,而HOMA-IS 显著升高 （P＜0.05）,同时西格列汀治疗后血浆vaspin 水平也显著降低（P＜0.01）,且vaspin 水平的降低与HOMA-IR 的改变呈明显正相 关。胰岛素抵抗指数及体重指数是影响血浆vaspin水平的独立相关因素。结论：西格列汀治疗能有效改善2 型糖尿病患者糖脂代 谢和胰岛素敏感性,降低血浆vaspin 水平。     

2型糖尿病患者血糖漂移水平与动脉脉搏波速度的相关性研究

目的:研究2型糖尿病患者血糖漂移水平与动脉脉搏波速度的关系。方法:共入选82例2型糖尿病患者作为研究对象。所有研究对象应用自动脉搏波速度测定仪测定颈动脉-股动脉脉搏波速度(CFPw V);采用动态血糖检测系统(CGMS)及全自动生化分析仪进行检测,收集空腹血糖(FBG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、血糖水平标准差(SDBG)、平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、昼间血糖漂移幅度(MODD)等血糖参数。根据CGMS检测结果将82例2型糖尿病患者分为血糖低漂移组(47例)和血糖高漂移组(35例),比较两组中各血糖参数及CFPw V水平,计算两组动脉硬化发生率,并将各血糖参数与CFPw V进行Pearson相关性分析。结果:与血糖低漂移组比较,2hPG、SDBG、MAGE、LAGE、MODD、CFPw V在血糖高漂移组中升高(P0.05);血糖高漂移组中动脉硬化的发生率高于血糖低漂移组(P0.05);Pearson相关性分析分析显示2hPG、MAGE、LAGE、MODD与CFPw V相关(P0.05)。结论:本研究中,82例2型糖尿病患者存在不同程度的动脉硬化;2hPG、MAGE、LAGE、MODD是2型糖尿病患者CFPw V升高的相关因素,提示血糖漂移进一步加重动脉硬化,参与动脉硬化的发生发展。应该重视对血糖漂移的控制,减少动脉硬化的发生率,延缓动脉硬化的发展。     

Visfatin 与2 型糖尿病研究新进展

Visfatin是Fukuhara等发现的一种蛋白质细胞因子,由内脏脂肪细胞分泌,受多种因素调节,有烟酰胺磷酸核糖转移酶活性,类胰岛素作用,促炎作用等多种生物学作用。2型糖尿病是一种内分泌代谢性疾病,由多基因遗传因素、环境因素综合作用引起,visfatin与其有密切的关系。Visfatin对于寻找糖尿病新的药物靶点,开发新的疾病生物标志物有非常重要临床意义。     

阿加曲班与葛根素联合治疗糖尿病下肢动脉硬化闭塞症的临床研究

目的:研究阿加曲班与葛根素联合治疗糖尿病动脉硬化闭塞症的临床效果。方法:选择糖尿病动脉硬化闭塞症患者124例。随机分为观察组与对照组,各62例。观察组给予阿加曲班与葛根素联合治疗,对照组单用阿加曲班治疗。治疗前使用降糖和降压药物使血糖和血压保持稳定。观察治疗前后临床症状改善的情况,检测治疗前后足背动脉血流量及踝/肱动脉压比值。结果:单用阿加曲班组及联合葛根素组在改善糖尿病动脉硬化闭塞症的临床症状方面均有良好的效果,但联合葛根素组比单用阿加曲班组的治疗效果更佳(P<0.01)。在足背动脉血流量,踝/肱动脉压比值治疗前后各项指标的改善方面,联合葛根素组比单用阿加曲班组的治疗效果更佳,差异亦有统计学意义(均为P<0.05)。两组治疗期间和治疗后均无明显不良反应,耐受性好。结论:糖尿病动脉硬化闭塞症患者经使用阿加曲班与葛根素联合治疗,效果良好,二者具有协同作用。     

小檗碱抗氧化和抗炎作用用于糖尿病治疗的机制研究进展

研究表明氧化应激反应和慢性炎症反应是2型糖尿病糖、脂代谢紊乱和胰岛素抵抗发生的重要病理机制。小檗碱是中药黄连的主要有效成分之一。体内、外研究证实小檗碱可通过抗氧化和抗炎作用发挥对2型糖尿病的治疗作用。本文就小檗碱抗氧化和抗炎作用用于2型糖尿病治疗的分子机制研究进展作一综述。小檗碱抗氧化和抗炎作用机制复杂,目前的研究显示小檗碱可通过AMPK通路、MAPK通路、Nrf2通路和NF-κB通路发挥抗氧化和抗炎作用。然而,小檗碱的抗氧化和抗炎作用仍需进一步的深入研究证实。明确小檗碱的抗氧化和抗炎作用的分子机制,有助于进一步了解小檗碱治疗糖尿病作用的机理,为探寻治疗糖尿病的天然药物提供理论依据。     

Characterization of Free Radical Defense System in High Glucose Cultured HeLa-tat Cells: Consequences for Glucose-induced Cytotoxicity

HeLa cell line stably transfected with the tat gene from human immunodeficiency virus type 1 has a decreased antioxidant potential. In this work, we used this model to investigate the effect of a high glucose level (20 mM) on the glucose induced cytotoxicity and on the antioxidant system. In comparison to cell culture under control medium, HeLa-wild cell cultured under 20 mM glucose did not exhibit necrosis or apoptosis, contrary to HeLa-tat cell presenting a significant increase in necrotic or apoptotic state. Moreover after 48 h culture under high glucose level the HeLa-tat proliferation rate was not higher than the one of HeLa-wild cells. In HeLa-wild cell high glucose level resulted in an induction of glutathione reductase activity in opposition to HeLa-tat cells where no change was observed. High glucose level resulted in 20% increase in GSSG/GSH ratio in HeLa-wild cells and 38% increase in HeLa-tat cells. Moreover, high glucose level resulted in a dramatic cytosolic thiol decrease and an important lipid peroxidation in HeLa-tat cells. No significant change of these two parameters was observed in HeLa-wild cells. In both cell lines, high glucose resulted in an increase of total SOD activity, as a consequence of the increase in Cu,Zn-SOD activity. High glucose did not result in an increase of Mn-SOD activity in both cell lines. As a consequence of tat tranfection Mn-SOD activity was 50% lower in HeLa-tat cells in comparison to HeLa-wild cells. This work emphasizes the importance of the antioxidant system in the glucose induced cytotoxicity.     

Kinetic Modeling of Human Hepatic Glucose Metabolism in Type 2 Diabetes Mellitus Predicts Higher Risk of Hypoglycemic Events in Rigorous Insulin Therapy

A major problem in the insulin therapy of patients with diabetes type 2 (T2DM) is the increased occurrence of hypoglycemic events which, if left untreated, may cause confusion or fainting and in severe cases seizures, coma, and even death. To elucidate the potential contribution of the liver to hypoglycemia in T2DM we applied a detailed kinetic model of human hepatic glucose metabolism to simulate changes in glycolysis, gluconeogenesis, and glycogen metabolism induced by deviations of the hormones insulin, glucagon, and epinephrine from their normal plasma profiles. Our simulations reveal in line with experimental and clinical data from a multitude of studies in T2DM, (i) significant changes in the relative contribution of glycolysis, gluconeogenesis, and glycogen metabolism to hepatic glucose production and hepatic glucose utilization; (ii) decreased postprandial glycogen storage as well as increased glycogen depletion in overnight fasting and short term fasting; and (iii) a shift of the set point defining the switch between hepatic glucose production and hepatic glucose utilization to elevated plasma glucose levels, respectively, in T2DM relative to normal, healthy subjects. Intriguingly, our model simulations predict a restricted gluconeogenic response of the liver under impaired hormonal signals observed in T2DM, resulting in an increased risk of hypoglycemia. The inability of hepatic glucose metabolism to effectively counterbalance a decline of the blood glucose level becomes even more pronounced in case of tightly controlled insulin treatment. Given this Janus face mode of action of insulin, our model simulations underline the great potential that normalization of the plasma glucagon profile may have for the treatment of T2DM.     

Circadian Variation in Alloxan Sensitivity of Mice as Indicated by Mortality and Blood Glucose Alteration

The objective of this study was to determine in mice if a time-dependent pancreatic β-cell susceptibility to alloxan could be correlated to daily changes in blood glucose levels and to monitor the pattern of blood glucose at various times of day as mice became diabetic. Food was removed from mice standardized to a 12-h light:dark cycle (lights on at 0600 h CST, during the month of June) at 12 h before subcutaneous injection with 0.27 mg/g of alloxan. Six groups of 30 fasted mice were injected at 4-h intervals. Blood glucose levels were measured from each group immediately prior to injection, and at 2, 4, 8, 12, 24, 48, and 216 h after treatment. Animals receiving alloxan during the early- to middark period had an increase in blood glucose after 2 h, followed by a decline to hypoglycemic levels between 4 and 8 h, and recovery to hyperglycemic levels 48 h after alloxan exposure. Three and 30% of these animals were dead at 8 and 48 h, respectively. Mice treated during the midlight span had decreased blood glucose levels 2 h after alloxan treatment followed by an increase to diabetic hyperglycemia within 48 h. Twenty-three and 70% of the animals treated at 1430 h were dead at 8 and 48 h, respectively. At 216 h, total mortality was 45.6% and 81 of the 98 surviving mice were hyperglycemic. These data suggest a greater sensitivity to alloxan during the midlight resting period of the mice. This may be the result of increased sensitivity to the insulin released from the β cells when alloxan was given during the light span.     

长春新碱对糖尿病兔肾小管间质损伤的影响

目的观察长春新碱对糖尿病兔肾小管-间质损伤的影响。方法 24只日本大白兔随机分成正常对照组（control组）、糖尿病组（DM组）、糖尿病长春新碱治疗组（DV组）;耳缘静脉注射四氧嘧啶造成糖尿病兔模型,DV组每周进行一次长春新碱耳缘静脉注射;胰岛素控制DM组、DV组血糖16.0～25.0mmol/L。8周时测各组兔血糖、肾重、体重、尿β2-MG、RBP、NAG,肾组织病理观察肾小管-间质变化。结果给药后7hDV组、DM组血糖明显升高形成稳定糖尿病模型;8周时,DV组体重明显高于DM组（P〈0.05）、肾重/体重值明显低于DM组（P〈0.05）;DM组、DV组尿β2-MG阳性反应率较低;DM组尿RBP、NAG明显高于control组（P〈0.05）,长春新碱可抑制糖尿病兔尿RBP、NAG增加（P〈0.05）,并减轻糖尿病兔肾小管间质损伤指数（P〈0.05）。结论长春新碱可减轻糖尿病兔肾小管间质损伤。     

促葡萄糖转运蛋白基因家族的分子进化研究

葡萄糖转运蛋白是一个在结构上相似功能上不同的多基因家族（ＧＬＵＴ１－ＧＬＵＴ５）。由于这一组蛋白和体内的葡萄糖利用有关,因此被认为是糖尿病胰岛素抵抗（抗性）的一个候选基因。本文比较了不同种生物这一基因家族的氨基酸和核苷酸顺序;推测了亲水性和疏水性分布;计算了蛋白质和核苷酸的进化距离,并在此基础上构建了分子进化树。研究表明：这一基因家族具有高度的同源性、极为相似的亲水性和疏水性分布以及结构的对称性。提示这一基因家族起源于一个共同的祖先并可能通过基因的重复而形成。这一进化机制可能有利于氨基酸结构的稳定及抵抗突变的作用。由于邻元法构建的进化树其分支长度存在差异,提示在这一基因家族的进化过程中,各分支上的进化速率并不相同。蛋白质进化距离和核苷酸进化距离所构建进化树的差异提示了在基因组中可能存在隐匿替换。两种方法构建的进化树都提示了ＧＬＵＴ１、３、４在结构和功能上要更为保守。     

2型糖尿病大鼠模型的肾脏和动脉血管并发症

目的制备发病过程类似人类2型糖尿病的动物模型,并观察其肾脏和主动脉的病变特点。方法8周龄SD大鼠高脂、高糖饮食一个月后给予小剂量STZ腹腔注射建立2型糖尿病模型,于成模后4周及8周观察血管功能指标和肾脏功能指标,并对肾脏和血管的病理改变进行观察。结果模型组于成模后4周及8周出现高血糖、高血脂、胰岛素抵抗、肾功能改变和血管功能改变。肾脏光镜下见肾小球内皮及系膜细胞增生;肾小管水肿,管腔内有大量蛋白管型和细胞管型;肾盂区有大量淋巴细胞浸润。动脉血管电镜下见内皮细胞局部损伤严重;内皮细胞与内弹力板连接处空隙增加等。结论用高脂高糖饮食加小剂量STZ腹腔注射可成功制备2型糖尿病大鼠模型,成模后4周及8周后观察肾脏及大血管相继出现病变,是2型糖尿病血管病变研究的理想模型。     

综合护理干预对老年住院糖尿病患者影响的临床观察

目的：观察综合护理干预对老年住院糖尿病患者的临床影响,探讨改善老年住院糖尿病患者临床表现及预后的护理方式。方法：选择老年住院糖尿病患者160例,随机均分为对照组和观察组,对照组采取常规专科护理,观察组加行综合护理干预,治疗2周后比较两组患者焦虑自评量表（SAS）和抑郁自评量表（SDS）评分;出院3个月后比较两组患者自我管理和生活质量（GQOL-100）评分结果：治疗2周和出院3个月后,两组患者在上述方面比较,差异具有统计学意义（P〈0.01,P〈0.05）,观察组优于对照组。结论：对老年住院DM患者施行综合护理干预措施,具有积极的临床意义。     

藏药小檗皮对糖尿病模型小鼠血糖水平影响的初步研究

目的:观察藏药小檗皮对糖尿病小鼠模型及正常小鼠血糖的影响,并以血糖为指标确定其治疗糖尿病及其并发症的有效剂量范围.方法:以6.72 9·kg-1、3.36 9·kg-1、1.68 g·kg-1、0.84 9·kg-1、0.42 g.· kg-1剂量的小檗皮浸膏灌胃四氧嘧啶糖尿病小鼠10d,GOD-CE-PAP法测定小鼠血糖水平,以确定小檗皮的有效降糖剂量范围;6.72 g·kg-1、1.68 g·kg-1、0.84 g·kg-1剂量的小檗皮浸膏灌胃正常小鼠7d,GOD-CE-PAP法测定小鼠血糖水平,观察小檗皮对正常小鼠血糖的影响.结果:与模型对照组相比,盐酸二甲双胍、盐酸小檗碱、生物碱复配及6.72 g·kg-1、1.68 9·k-1、0.84 9·kg-1、3.36 g·kg-1、0.42 g·kg-1的小檗皮浸膏均有较好的降糖作用,5个剂量的小檗皮浸膏降糖作用依次为:6.72 9·kg-1＞ 1.689·kg-1＞ 0.849·kg-1＞3.36 g·kg-1＞0.429·kg-1;盐酸二甲双胍、羟苯磺酸钙、盐酸小檗碱、复配生物碱及6.72 9·kg-1、1.68 g·kg-1、0.849·kg-1剂量的小檗皮浸膏对正常小鼠血糖无明显作用.结论:藏药小檗皮对四氧嘧啶所致糖尿病模型小鼠血糖有明显降糖作用,对正常小鼠血糖无明显作用.     

Exogenous Selenium Mitigates Salt Stress in Soybean by Improving Growth,Physiology, Glutathione Homeostasis and Antioxidant Defense

The mechanism of selenium (Se)-induced salt tolerance was studied in moderately sensitive soybean (Glycine max L.) plants. To execute this view, soybean plants were imposed with salt stress (EC 6 dS m⁻¹ ) applying NaCl. In other treatments, Se (0, 25, 50 and 75 µM Na₂SeO₄) was sprayed as co-application with that level of salt stress. Plant height, stem diameter, leaf area, SPAD value decreased noticeably under salt stress. Altered proline (Pro) level, together with decreased leaf relative water content (RWC) was observed in salt-affected plants. Salt stress resulted in brutal oxidative damage and increased the content of H₂O₂, MDA level and electrolyte leakage. Exogenous Se spray alleviated oxidative damage through boosting up the antioxidant defense system by increasing the activity of antioxidant enzymes such as catalase (CAT), peroxidase (POD) and glutathione reductase (GR), as well as by improving non-enzymatic antioxidants like glutathione (GSH) and GSH/glutathione disulfide (GSSG). The upregulated antioxidant defense system, restored Pro and leaf RWC, higher SPAD value conferred better growth and development in Se-sprayed salt-affected soybean plants which altogether put forth for the progressive yield contributing parameters and finally, seed yield. Among different doses of Se, soybean plants sprayed with 50 µM Na₂SeO₄ showed better salt tolerance.     

糖尿病患者外周血Th17/Treg细胞及相关细胞因子的表达变化

目的:探讨糖尿病患者外周血Th17细胞和Treg细胞数量以及相关细胞因子表达的变化。方法:以本院2013年1月至2015年12月收治的50例糖尿病患者为研究对象,其中1型糖尿病患者25例,2型糖尿病患者25例,同时以25例健康体检人群为正常对照,检测各组外周血Th17/Treg细胞数量以及血清IL-17、IL-10和TGF-β水平。结果:糖尿病患者外周血中Th17细胞比例均显著高于正常对照组(P0.05)而Treg细胞的比例均显著低于正常对照组(P0.05),且1型糖尿病患者Treg细胞比例显著低于2型糖尿病患者(P0.05)。糖尿病患者血清中IL-10和TGF-β水平均显著低于正常对照组(P0.05)而IL-17水平均显著高于正常对照组(P0.05),且1型糖尿病患者的IL-10水平显著低于2型糖尿病患者(P0.05)。结论:糖尿病患者体内Treg细胞数量及相关细胞因子低于正常而Th17细胞数量及相关细胞因子高于正常,这可能与患者体内的自身免疫失调有关。