高血压病的复俣超声心动图研究

现常用于检测高血压病的彩色、脉冲多普勒及二维、Ｍ型超声心动图几种方法,各有其优点与不足。本文利用其各自的优点,运用上述复合超声心动图法检测９６例高血压病患者及９６例正常人,进行了分析研究,认为,此法检诊高血压病是实用、可行的。     

Ⅱ型糖尿病的红细胞膜GPA基因表达

为了研究Ⅱ型糖尿病（ＮＩＤＤＭ）患者红细胞膜血型糖蛋白Ａ（ＧＰＡ）的基因表达,采用不连续聚蔗糖（Ｐｅｒｃｏｌ）密度梯度法分离１５名正常人和２５例ＮＩＤＤＭ患者外周血的网织红细胞,提取其总ＲＮＡ,继以Ｎｏｒｔｈｅｒｎ斑点杂交观测此两组的红细胞膜ＧＰＡ基因的表达水平．采用碱性磷酸酶酶联免疫检测完成红细胞膜ＧＰ的Ｗｅｓｔｅｒｎ印迹．结果表明,ＮＩＤＤＭ患者组红细胞膜ＧＰＡ的ｍＲＮＡ含量较正常人组显著增加（分别为１１．９２±１０．５和１０．１８±１．０８积分光密度,Ｐ＜０．０１）．免疫印迹图谱显示,有６例ＮＩＤＤＭ患者的区带３ａ、３ｂ界限模糊,３例的区带３ａ、３ｂ和４明显浅染．推测ＮＩＤＤＭ患者红细胞膜ＧＰＡ减少可能引起其基因表达呈代偿性增强,而障碍或许出现在翻译环节上,这些与ＮＩＤＤＭ患者红细胞变形能力（ＲＣＤ）的明显降低甚为相符．     

胰岛素抗性与膜糖蛋白PC－1过量表达有关

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高血压病的复合超声心动图研究

现常用于检测高血压病的彩色、脉冲多普勒及二维、M型超声心动图几种方法,各有其优点与不足。本文利用其各自的优点,运用上述复合超声心动图法检测96例高血压病患者及86例正常人,进行了分析研究。认为,此法检诊高血压病是实用、可行的。     

发现与非胰岛素依赖性糖尿病相关的基因座

发现与非胰岛素依赖性糖尿病相关的基因座一个国际协作组在今年６月出版的ＮａｔｕｒｅＧｅｎｅｔｉｃ上报道,他们鉴定了一个与成人非胰岛素依赖性糖尿病（ＮＩＤＤＭ）相关的基因座。ＮＩＤＤＭ１位于２号染色体长臂末端即２ｑ３７。（李潇摘译自ＭｉｃｈａｅｌＭｃＣａ...     

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Insulin resistance in Fibrocalculous (tropical) pancreatic diabetes

Insulin resistance was assessed by Insulin Tolerance Test (ITT) in 12 patients with FCPD, 10 with NIDDM and 12 age and sex matched control subjects. The mean BMI of the FCPD was lower than the NIDDM and control groups (P less than 0.001). There was no significant difference between the mean fasting plasma glucose or HbA1 between the FCPD and NIDDM patients. The mean fasting C-peptide of the FCPD group was significantly lower than the NIDDM and control groups (P less than 0.001). The mean glucose disposal rate (KITT) was 5.57 +/- 2.28 in the control group, 2.15 +/- 2.00 in the FCPD and 1.77 +/- 0.91 in the NiDDM group (P less than 0.001, control vs FCPD and NIDDM). The difference in KITT between FCPD and NIDDM groups was not significant statistically. The data suggests that patients with FCPD have evidence of insulin resistance and this is similar to that seen in NIDDM patients.     

DNA polymorphisms of the insulin receptor gene in Japanese subjects with non-insulin-dependent diabetes mellitus

Genotypes identified by two restriction fragment length polymorphisms (RFLPs) of the insulin receptor gene (IRG) with the restriction endonuclease Sst-1 were determined in a Japanese group comprising 51 patients with non-insulin-dependent diabetes mellitus (NIDDM) and 50 control subjects. Southern hybridization using a probe for the beta subunit of the human IRG identifies 4 alleles, termed S1(+) (5.3 kb), S1(-) (5.8 kb), S2(+) (7.0 and 2.4 kb) and S2(-) (9.4 kb). The frequencies of genotypes possessing the S1(-) allele in Japanese controls and Japanese NIDDM patients were 0.11 and 0.16, respectively. Unlike the previously reported association of the S1(-) allele with NIDDM found in Caucasians there was no significant difference in the frequency of the S1(-) allele between non-diabetic and NIDDM Japanese patients. There was a significant difference in the frequency of the S2(+) allele between Caucasian control subjects (0.14) and Japanese controls (0.0) and NIDDM patients (0.02).     

Association of low plasma high density lipoprotein (HDL)-cholesterol concentration with documented coronary artery disease in males with non-insulin dependent diabetes mellitus

Plasma lipid and lipoprotein concentrations were determined in 30 males without diabetes or symptomatic coronary artery disease (CAD), and compared to the values in age-matched and weight-matched males (n = 55) with non-insulin-dependent diabetes mellitus (NIDDM). Patients with NIDDM were further subdivided into those with (n = 30) and without (n =25) CAD. Mean (+/- SEM) plasma triglyceride concentrations were significantly increased (P less than 0.001) over control values (96 +/- 5 mg/dl) in patients with NIDDM, whether with (172 +/- 14 mg/dl) or without documented CAD (164 +/- 25 mg/dl). Plasma cholesterol concentrations were also higher (P less than 0.001) than normal (168 +/- 5 mg/dl) in both groups of patients with NIDDM (201 +/- 11 and 199 +/- 7 mg/dl, respectively, in patients with and without evidence of CAD). Plasma LDL-cholesterol concentrations were also greater (P less than 0.001) than normal (104 +/- 4 mg/dl) in patients with NIDDM, but were again similar in the group of diabetics (120 +/- 9 vs 128 +/- 6 mg/dl). However, plasma HDL-cholesterol concentrations were only reduced below control values in diabetes patients with CAD (30 +/- 1 mg/dl), whereas patients with NIDDM and no subjective evidence of CAD had HDL-cholesterol concentrations (37 +/- 3 mg/dl) which were similar to normal values (38 +/- 2 mg/dl). As a result, the ratio of LDL-cholesterol to HDL-cholesterol was highest in patients with NIDDM and CAD (4.2 +/- 0.3), lowest in the control population (2.8 +/- 0.2), and intermediate in those patients with NIDDM without subjective or objective evidence of CAD (3.6 +/- 0.3).(ABSTRACT TRUNCATED AT 250 WORDS)     

Urinary platelet-activating factor excretion is elevated in non-insulin dependent diabetes mellitus.

Proteinuria is currently considered a very sensitive predictor of diabetic nephropathy, but 20-25% of all diabetic patients with negative Albustix reaction excrete higher than normal (< 20 mg/24 h) amounts of albumin in their urine. It is our hypothesis that platelet-activating factor (PAF), a potent glycerophospholipid that acts as a chemical mediator for a wide spectrum of biological activities, including increased vascular permeability, may be produced in significant amounts during periods preceding microalbuminuria. In this study, we compared urinary PAF excretion in Mexican-American subjects who were diagnosed with non-insulin dependent diabetes mellitus (NIDDM) with their healthy control counterparts. The age of the NIDDM subjects (45.9 +/- 2.1 years) was not significantly different from the healthy control group, which was 39.4 +/- 2.7 years (P < 0.0672). The NIDDM subjects (body mass index, 29.9 +/- 1.1 compared to 26.1 +/- 0.9 kg/m2 in healthy controls) were characterized by significantly increased (P < 0.05) fasting plasma glucose (192 +/- 11 vs. 97 +/- 4 mg/dl in healthy controls), fasting insulin (20.9 +/- 2.4 vs. 12.3 +/- 1.6 microU/ml), fasting C-peptide (2.93 +/- 1.26 vs. 1.48 +/- 0.51 ng/ml), and hemoglobin A1c (10.3 +/- 0.7 vs. 5.6 +/- 0.3%), respectively. The urine output for the NIDDM and control subjects were 1942 +/- 191 ml/24 h and 1032 +/- 94 ml/24 h, respectively, and urinary albumin excretion (UAE) rates were estimated to be 38 +/- 7 micrograms/min and 11 +/- 1 micrograms/min, respectively. The NIDDM subjects produced significantly increased levels of urinary PAF (2606.3 +/- 513.1 ng/24 h compared with 77.9 +/- 14.1 ng/24 h in controls (or 1706.3 +/- 420.8 ng/ml compared with 85.4 +/- 17.8 pg/ml of urine, in NIDDM and control subjects, respectively). We found that urinary PAF excretion was significantly correlated with microalbumin excretion (r = 0.7) especially at UAE rates greater than 30 mg/day and more importantly, some NIDDM patients with negative Albustix reaction (i.e. normal UAE) produced significantly more PAF, suggesting that PAF excretion may precede microalbuminuria and that subtle injury to the kidneys are present in NIDDM long before overt albuminuria ensues, urinary PAF measurements could potentially therefore serve as a sensitive indicator of renal injury in diabetes mellitus. These results lend further credence to our hypothesis that PAF may be the biochemical compound linking the various members of the insulin resistance syndrome.     

Distribution of antioxidants among blood components and lipoproteins: significance of lipids/CoQ10 ratio as a possible marker of increased risk for atherosclerosis.

Total CoQ10 levels were evaluated in whole blood and in plasma obtained from a group of 83 healthy donors. Extraction with light petroleum ether/methanol was more efficient, for whole blood, than the extraction which is often used for plasma and serum, i.e., ethanol hexane. An excellent correlation was present between plasma CoQ10 and whole blood CoQ10. CoQ10 is mainly associated with plasma rather than with cellular components. Positive, significant correlations were found between the LDL-chol/CoQ10 ratio and the total-chol/HDL-chol ratio, which is usually considered a risk factor for atherosclerosis. The proportion of CoQ10 carried by LDL was 58 +/- 10%, while the amount carried by HDL was 26 +/- 8%. In VLDL + IDL CoQ10 was 16 +/- 8%. The content of CoQ10 in single classes of lipoproteins is strictly correlated with CoQ10 plasma concentration. In a parallel study conducted on a population of diabetic patients (one IDDM group and one NIDDM) CoQ10 plasma levels were generally higher compared to the control group, also when normalised to total cholesterol. In particular the LDL fraction showed a CoQ10/chol ratio higher in NIDDM but not in IDDM patients, compared to controls. The CoQ10/triglycerides ratio was lower in NIDDM respect to controls and even lower in IDDM patients.     

NIDDM新候选基因KCNA7的cSNP在东北人群中的分布及意义

为研究NIDDM新候选基因KCNA7的cSNP在东北人群中的分布及意义,本实验采用PCR-RFLP技术检测了97例NIDDM患者、141例健康对照者KCNA7基因418M（C/T）多态;并利用SSCP技术筛查了该位点附近其他未知SNP。发现CNA7 基因T418M（C/T）基因型频率在正常人群中分布符合Hardy-Weinberg平衡,基因频率和基因型频率在NIDDM组和正常对照组中分布无显著性差异（P＞0.05）;NIDDM组和正常对照组中各基因型间临床生化指标无显著性差异;该位点附近尚未发现其他SNP。结果提示,T418M（C/T）仅为KCNA7基因多态性标志,但不排除KCNA7基因其余结构变异与NIDDM存在相关性的可能。     

APOC3基因SstⅠ单核苷酸多态性与冠心病、Ⅱ型糖尿病合并高甘油三酯血症的关联性研究

对许多人群研究表明 ,位于APOA1/C3/A4 /A5基因簇上的载脂蛋白C3基因 (APOC3)SstⅠ多态性与高甘油三酯血症 (Hypertriglyceridaemia ,HTG)密切相关 ,高甘油三酯是冠心病和糖尿病的独立危险因素。为探讨中国人群APOC3基因SstⅠ单核苷酸多态性与冠状动脉粥样硬化性心脏病 (coronaryatheroscleroticheartdisease,CHD)合并高甘油三酯血症 (HTG)、Ⅱ型糖尿病 (non insulin dependentdiabetesmellitus,NIDDM)合并高甘油三酯血症 (HTG)患者的相关性 ,应用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)的方法 ,分析了 2 6 7例CHD患者、2 4 6例NIDDM患者及 4 91例健康对照APOC3基因SstⅠ位点 (S1/S2 )多态性。CHD组、NIDDM组和对照组的APOC3基因SstⅠ多态位点S2等位基因频率分别为 0 30 1、0 30 7和 0 2 86 ,其基因型频率和等位基因频率分布与对照组比较均无显著性差异 (P >0 0 5 )。以TG >1 90mmol/L为标准将CHD组、NIDDM组分为正常甘油三酯组 (NTG)和高甘油三酯组(HTG)发现 ,在CHD患者 ,HTG亚组S1S2基因型频率显著高于NTG亚组 (0 5 4 2 >0 35 7,χ2 =8 77,P =0 0 12 4 ) ;在NIDDM患者 ,HTG亚组S2S2基因型频率显著高于NTG亚组 (0 2 0 0 >0 0 5 5 ,χ2 =2 0 2 1,P =0 0 0 0 0 ) ,两亚组间等位基因频     

Interrelationship of antioxidative status, lipid peroxidation, and lipid profile in insulin-dependent and non-insulin-dependent diabetic patients

This study aimed to investigate the interrelationship of plasma lipid profile, lipid peroxidation, and erythrocyte antioxidative defense in patients with insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes mellitus. Plasma levels of total cholesterol, triglycerides, and lipid peroxides and the activities of copper, zinc superoxide dismutase (CuZnSOD), catalase, glutathione peroxidase (GSH-Px), as well as the amount of glutathione in erythrocytes, were determined in IDDM, NIDDM, and nondiabetic control subjects. Additionally, morphology of erythrocytes in all subjects was examined. Plasma levels of total cholesterol and triglycerides were significantly increased in NIDDM compared with controls. Also, the lipid peroxide level was higher in NIDDM than in either control or IDDM subjects. CuZnSOD activity in erythrocytes was elevated in NIDDM patients compared with the control. In NIDDM patients, more extensive erythrocyte spherocytosis and echinocytosis compared with both control and IDDM subjects were observed. In contrast with the IDDM group, the observed abnormality in lipid metabolism in NIDDM patients is closely associated with increased lipid peroxidation, changes in antioxidative defense, and erythrocyte morphology.     

Insulin-stimulated glucose uptake and fasting blood glucose.

Changes in insulin-stimulated glucose metabolism were studied in young and aged subjects, subjects with impaired glucose tolerance, and patients with NIDDM by means of the glucose clamp technique. The diabetic group includes obese and non-obese patients treated without insulin and non-obese patients treated with insulin. The glucose disposal rate (GDR) was decreased in aged subjects (5.8 +/- 0.4 mg/kg/min) compared with young controls (7.4 +/- 0.3 mg/kg/min). In patients with IGT, it was further decreased to 3.6 +/- 0.5 mg/kg/min, which was comparable to the rate in NIDDM without insulin treatment (3.3 +/- 0.4 mg/kg/min). There were no differences in the GDR between obese (3.0 +/- 0.3 mg/kg/min) and non-obese (3.4 +/- 0.6 mg/kg/min) diabetic patients. In insulin-treated diabetic patients, GDR ranged widely, but the mean value was partially normalized (5.2 +/- 0.9 mg/kg/min). In the diabetic group, no correlation was observed between fasting blood glucose and GDR. These results suggest that in the course of developing NIDDM, a decrease in insulin-stimulated glucose uptake precedes a rise in fasting blood glucose. Thus, as previously reported for Caucasian NIDDM patients, resistance to insulin-stimulated glucose uptake may be one of the basic defects in Japanese patients with NIDDM. The degree of glycemia, however, is not directly related to the magnitude of the defect in insulin action.