老年糖尿病患者肠道菌群与糖化血红蛋白的关系CSCD

目的 研究老年2型糖尿病患者肠道菌群的变化,分析肠道菌群与糖化血红蛋白(HbA1c)的关系,为老年2型糖尿病患者血糖控制提供指导。方法 选择2019年1月至2020年1月我院169例老年2型糖尿病患者为研究对象,分为血糖控制良好组(67例,HbA1c<7.0%)及血糖控制不良组(102例,HbA1c≥7.0%),并选择同期83例健康老年志愿者为对照组,采用光冈法检测3组研究对象肠道菌群,分析肠道菌群变化与HbA1c关系。结果 对照组、血糖控制良好组以及血糖控制不良组对象肠道双歧杆菌、乳杆菌、拟杆菌数量依次降低,肠杆菌数量依次升高,任意组间差异均有统计学意义(均P<0.05);但肠球菌数量在3组间差异无统计学意义(均P>0.05)。2型糖尿病患者肠道双歧杆菌、乳杆菌数量与HbA1c水平呈负相关,相关系数分别为-0.431、-0.356,均有统计学意义(均P<0.05)。结论 2型糖尿病与肠道菌群紊乱相互影响,纠正肠道菌群紊乱对于2型糖尿病患者血糖控制有重要意义。     

2型糖尿病与糖尿病肾病患者微炎症及肠道微生物多样性分析

目的 分析2型糖尿病(T2DM)及糖尿病肾病(DKD)患者微炎症情况和肠道微生物多样性。 方法 将2016年4月至2019年7月在我院进行治疗的68例T2DM患者(T2DM组)和57例DKD患者(DKD组)纳入研究,选择同期于我院进行健康体检的36例志愿者作为对照组。收集3组对象一般资料、血液标本和粪便标本,测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、超敏C反应蛋白(hsCRP)、白细胞介素6(IL6)水平,并对肠道细菌进行16S rDNA序列测序。比较3组对象一般资料,血液指标,肠道菌群门水平构成情况,肠道菌群多样性,肠道菌属差异性,并对患者炎性指标与菌群种类进行相关性分析。 结果 DKD组患者糖尿病病程长于T2DM组(P结论 2型糖尿病患者普遍存在微炎症和肠道菌群失衡,微炎症程度与肾脏病变和肠道菌群数量密切相关。T2DM与DKD患者在肠道菌群结构上具有一致性和差异性,肠道菌群检测有可能成为预测T2DM患者发生肾脏病变的风险指标。     

2型糖尿病合并腹泻患者肠道菌群与肝肾指标的相关性

为进一步了解2型糖尿病合并腹泻患者肠道菌群与肝肾生化指标之间的相关性,收集了26例2型糖尿病合并腹泻患者和26例2型糖尿病患者的菌群数据和肝肾指标数据。采用单因素方差(one-way ANOVA)分析两者的肝肾指标的差异,采用线性回归分析肝肾指标与肠道微生物α多样性的关联,采用PERMANOVA程序分析肠道菌群β多样性结构差异,然后采用Spearman秩相关测试分析肝肾生化指标与肠道菌群的相关性。结果表明:两类人群肝肾指标中的甘油三酯(TG)、血尿素氮(BUN)具有显著性差异(P=0.006,P=0.003);2型糖尿病合并腹泻患者的血清胆红素的升高与肠道菌群的物种多样性的降低相关;2型糖尿病合并腹泻患者的拟杆菌、毛螺菌、普雷沃氏菌的含量降低,但瘤胃菌的含量明显增高;毛螺菌和瘤胃菌含量与血清胆红素呈正相关,与TG的降低有关,与BUN的升高无关。2型糖尿病合并腹泻患者的肝肾指标与肠道菌群存在相关性,可为治疗2型糖尿病合并腹泻提供新菌群靶点。     

多囊卵巢综合征患者肠道菌群和生化免疫分子特征

【目的】比较多囊卵巢综合征(polycysticovariansyndrome,PCOS)患者与健康对照间肠道菌群谱结构特征差异,并探讨多囊卵巢综合征患者差异菌群与生化免疫指标之间的联系。【方法】选取初诊多囊卵巢综合征患者23例和健康女性对照23例,每例患者于初诊时留取粪便标本和血液标本,粪便标本提取DNA进行宏基因组测序,血清用于检测性激素和炎症因子。通过生物信息分析比较多囊卵巢综合征患者与健康对照间肠道菌群谱结构特征差异,以及与相关指标的联系。【结果】发现多囊卵巢综合征患者与健康对照的肠道菌群在门、属、种水平均有明显差异。两组间差异菌种为4个,普通拟杆菌(Bacteroides vulgatus)和弗格森埃希菌(Escherichia fergusonii)在PCOS组中的相对丰度高于对照组,并且这两种菌与PCOS的发病机制密切相关。凸腹真杆菌(Eubacteriumventriosum)和Subdoligranulum unclassified菌的相对丰度低于健康对照组。其中普通拟杆菌、凸腹真杆菌和Subdoligranulum unclassified菌3个菌种彼此间存在相关性...     

益生菌Lactobacillus paracasei subsp.paracasei Zhang对海南地区部分青年人肠道菌群的影响

【目的】以海南地区征集的29名健康青年志愿者为研究对象,分析该地区青年人肠道菌群多样性,并探究益生菌Lactobacillus paracasei subsp. paracasei Zhang (LCZ)对其肠道菌群的影响。【方法】29名健康青年志愿者每日补充2 g益生菌LCZ (0.5×10~(10)CFU/g),为期14 d。采集摄入益生菌LCZ第0、14、28天的志愿者粪便样品,采用Pac Bio SMRT测序技术基于16S rRNA基因全长测序分析志愿者粪便微生物组成和结构,评估益生菌LCZ对其肠道菌群的影响。【结果】在门水平上,Firmicutes (54.46%)和Bacteroidetes (33.79%)在志愿者粪便微生物中含量最高;在属水平上,Bacteroides (23.13%)的相对含量最高;在种水平上,优势菌种为Faecalibacterium prausnitzii (9.72%)、Eubacterium rectale (7.00%)和Prevotella copri (6.07%)等。摄入益生菌LCZ 14 d后,肠道中的优势菌属变化不显著,低丰度菌属如Oscillospira和Parabacteroides等显著增加,Aeromonas和Fusicatenibacter等显著减少(P0.05)。此外根据志愿者粪便中Lactobacillus含量的变化情况,将所有志愿者分为两组。其中一组志愿者在摄入LCZ后粪便中Lactobacillus菌属相对含量显著增加,同时该组志愿者肠道中其他菌种如Butyricicoccus pullicaecorum、Lactococcus raffinolactis和Parabacteroides distasoni亦显著增加;而另一组志愿者,Lactobacillus及上述菌种均未发生显著变化。【结论】连续2周摄入益生菌LCZ对志愿者肠道菌群中优势菌属的相对丰度影响不显著,但对低丰度菌属的相对丰度影响显著。     

基于16S rRNA基因扩增子测序分析日本囊对虾肠道菌群结构与功能的特征

【背景】肠道菌群在对虾的生理活动中起关键作用。日本囊对虾是我国海水养殖虾类中的主要品种之一,迄今为止有关其肠道菌群结构与功能的研究还鲜有报道。【目的】利用高通量测序技术探究日本囊对虾肠道菌群的组成结构与功能作用,揭示虾体肠道菌群与外源菌群结构间的相关性。【方法】60 d的养殖周期结束后,分别采集日本囊对虾肠道样品(归为虾肠组,n=3)、养殖水体样品(归为水体组,n=3)和对虾饲料样品(归为饲料组,n=3),提取各样品总DNA进行16SrRNA基因扩增子测序,基于生物信息学方法分析与比较样品间的菌群结构特征,并使用PICRUSt软件预测日本囊对虾肠道菌群功能。【结果】3组样品测序共获得822 713条有效序列,抽平处理后可聚类为3 416个OTU。虾肠组样品中有28.49%、59.30%的OTU可以依次在水体组、饲料组样品中检测到。门水平上,虾肠组样品中的优势菌门为变形菌门(Proteobacteria)、拟杆菌门(Bacteroidetes)、厚壁菌门(Firmicutes)和梭杆菌门(Fusobacteria)。水体组、饲料组与虾肠组样品中的优势菌门结构不尽相同,但均由变形菌门和拟杆菌门组成。属水平上,虾肠组样品中的优势菌属包括弧菌属(Vibrio)、另类弧菌属(Aliivibrio)、假交替单胞菌属(Pseudoalteromonas)、假黄棕杆菌属(Pseudofulvibacter)、科尔韦尔氏菌属(Colwellia)、小纺锤状菌属(Fusibacter)、发光杆菌属(Photobacterium)、脱硫弧菌属(Desulfovibrio)、嗜冷杆菌属(Psychrobacter)以及弓形杆菌属(Arcobacter)。水体组和饲料组中检出的核心菌属结构与虾肠组相比有明显差异,其中海命菌属(Marivita)和假单胞菌属(Pseudomonas)分别为养殖水体及对虾饲料样品中的最优势菌属。PICRUSt预测结果显示,日本囊对虾肠道菌群的基因功能主要与新陈代谢类功能有关,包含氨基酸代谢、碳水化合物代谢与能量代谢等。【结论】日本囊对虾肠道菌群与其他种类对虾肠道菌群的结构间存在共性,其形成在一定程度上受到了外源菌群的干预,并在虾体的日常代谢活动中发挥了一定的作用。     

老年2型糖尿病合并慢性肾脏病患者肠道菌群变化

目的 探讨合并慢性肾脏病的老年2型糖尿病患者肠道菌群变化情况,为后续研究提供参考。 方法 选择2018年11月至2019年7月在我院内科确诊的老年2型糖尿病及并发慢性肾脏病患者作为糖尿病组(20例)及糖尿病肾病组(20例),选择本院健康老年体检者(30例)为对照组。测定各组对象血清甲状旁腺激素(PTH)、超敏C反应蛋白(hs CRP)、血肌酐(Scr)、血磷(P)、血钙(Ca2+)、碱性磷酸酶(ALP)、糖化血红蛋白(HbA1c)水平,同时分析各组对象肠道大肠埃希菌、双歧杆菌、乳杆菌、酵母菌、真杆菌的差异。 结果 糖尿病肾病组患者肠道大肠埃希菌数量高于糖尿病组和对照组,糖尿病组患者肠道大肠埃希菌数量高于对照组(均P2+水平高于糖尿病组和对照组,糖尿病组患者血清Scr、P、Ca2+水平高于对照组(均P2+、HbA1c、ALP、hs CRP水平呈正相关,双歧杆菌、真杆菌数量与Scr、P、Ca2+、HbA1c、ALP、hs CRP水平呈负相关(均P结论 糖尿病肾病患者肠道菌群失调,其特征为大肠埃希菌数量增多,双歧杆菌、真杆菌数量减少。大肠埃希菌数量升高,双歧杆菌和真杆菌数量降低均为糖尿病并发慢性肾脏病的危险因素。     

健康蒙古族人肠道中乳酸菌和双歧杆菌多样性

【背景】越来越多的研究发现人类的诸多疾病与肠道菌群失衡有关。乳酸菌和双歧杆菌属于肠道中的有益菌,在不同人群肠道中的多样性不尽相同。【目的】在种水平上分析健康蒙古族人群肠道菌群中乳酸菌和双歧杆菌的多样性。【方法】以27名健康蒙古族志愿者为研究对象,其中14名来自中国内蒙古,13名来自蒙古国。首次采用乳酸菌和双歧杆菌的特异性引物扩增与PacBioSMRT三代测序技术相结合,在种水平上探讨志愿者肠道中乳酸菌和双歧杆菌的丰度和生物多样性,并进一步分析性别、BMI(Bodymassindex)值和地域对上述两者可能的影响,以及优势菌种之间的相关性。【结果】在种的水平上,27名志愿者肠道样品中共鉴定到68个乳酸菌和11个双歧杆菌,其中平均相对含量在1%以上的乳酸菌有8个,包括唾液链球菌(Streptococcus salivarius,36.41%)、瘤胃乳酸杆菌(Lactobacillus ruminis,17.94%)、德氏乳杆菌(Lactobacillus delbrueckii,3.11%)、罗氏乳杆菌(Lactobacillus rogosae,2.23%)、轻型链球菌(Streptococcus mitis,2.18%)、阴道乳杆菌(Lactobacillus vaginalis,2.02%)、魏斯氏乳杆菌(Weissella confusa,1.54%)和鼠李糖乳杆菌(Lactobacillus rhamnosus,1.09%);双歧杆菌有5个,包括青春双歧杆菌(Bifidobacterium adolescentis,39.88%)、长双歧杆菌(Bifidobacterium longum,27.15%)、链状双歧杆菌(Bifidobacterium catenulatum,26.30%)、两歧双歧杆菌(B. bifidum,3.92%)和角双歧杆菌(Bifidobacterium angulatum,1.71%),聚类分析分为链状双歧杆菌和青春双歧杆菌2个主要的类群。分析结果显示:性别、BMI值和地域均未能显著影响志愿者肠道中乳酸菌和双歧杆菌的菌群结构(P0.05),但男性和女性之间、中国内蒙古地区和外蒙古国的志愿者之间的个别乳酸菌菌种相对含量存在显著差异(P0.05)。对样品中的优势乳酸菌和双歧杆菌进行Spearman相关性分析发现,乳酸菌和双歧杆菌彼此之间相关性较为密切,不同菌种间相关性不尽相同,与具体的菌种有关。【结论】首次采用PacBio SMRT测序技术在种的水平揭示了健康蒙古族人肠道中乳酸菌和双歧杆菌菌种多样性,为在种水平上解析肠道中乳酸菌和双歧杆菌多样性提供了新的研究思路和实施方案。     

哈尼梯田稻鲤共作与单养模式下福瑞鲤肠道菌群结构比较研究

【目的】分析不同养殖模式的福瑞鲤肠道菌群结构组成和群落特征。【方法】通过16S rRNA高通量测序技术,分析比较哈尼梯田稻鲤共作、传统池单养、水泥池单养模式下的福瑞鲤肠道菌群的结构组成和丰度差异。【结果】梯田稻鲤组(RCIC)、传统池鲤组(YPIC)和水泥池鲤组(HPIC)分别获得了2345、238和118个OTU。RCIC组的Sobs指数及PD指数最高,显著高于YPIC组(P<0.05),极其显著高于HPIC组(P<0.01);池塘单养模式下,两组之间多样性指数也存在显著差异,YPIC组大于HPIC组(P<0.05)。含量大于10%优势菌门：RCIC组主要为变形菌门(39.39%)、梭杆菌门(38.55%)和厚壁菌门(15.4%);YPIC组为变形菌门(21.87%)、梭杆菌门(58.27%);HPIC组为变形菌门(46.63%)、梭杆菌门(53.14%)。变形菌和梭杆菌为3组福瑞鲤肠道样品的优势菌群,其中的鲸杆菌属(Cetobacterium)、气单胞菌属(Aeromonas)为核心优势菌属。LEfSe线性判别分析(LDA>3)显示17个具有差异的标记菌属,...     

基于盲肠菌群和回肠粘膜基因表达探讨解淀粉芽孢杆菌提高蛋鸡生产性能的潜在机制

【背景】我们的前期工作表明,在蛋鸡饲料中添加解淀粉芽孢杆菌BLCC1-0238可显著提高产蛋性能和蛋品质,但其益生机制还不清楚。【目的】从基因组学和转录组学的视角去揭示益生菌提高蛋鸡生产性能的潜在机制。【方法】利用高通量测序技术比较分析基础日粮组(C组)和解淀粉芽孢杆菌BLCC1-0238添加组(0.06%,2.0×1010 CFU/g,T组)盲肠微生物菌群和回肠粘膜基因表达的差异。【结果】基因组学分析发现,与对照组相比,益生菌添加组的盲肠菌群Chao1和Shannon指数升高;在门水平上,厚壁菌门/拟杆菌门(Firmicutes/Bacteroidetes)的比例显著增加,梭杆菌门(Fusobacteria)和变形菌门(Proteobacteria)的相对丰度降低;在属水平上,厚壁菌门中的考拉杆菌属(Phascolarctobacterium)、乳酸杆菌属(Lactobacillus)、瘤胃球菌科UCG-014属(Ruminococcaceae UCG-014)、厌氧棍状菌属(Anaerotruncus)、瘤胃梭菌属(Ruminiclostridium9)、克里斯滕森氏菌(Christensenellaceae_R-7_group)相对丰度明显增加。转录组学结果表明,回肠粘膜组织中共有356个差异表达基因,其中,上调基因199个,下调基因157个。生物信息学分析提示,上调基因参与了淀粉和蔗糖代谢、半乳糖代谢以及甘氨酸、丝氨酸和苏氨酸代谢等促进物质代谢和营养吸收的过程。【结论】日粮中添加解淀粉芽孢杆菌BLCC1-0238,可通过改善盲肠菌群多样性和肠道营养吸收能力提高蛋鸡的饲料利用率和产蛋性能,具有潜在的实用价值。     

Selenium and glycogen levels in diabetic patients

Selenium in serum and selenium and glycogen in erythrocytes were determined in diabetic patients divided into noninsulin-dependent (n=50) and insulin-dependent (n=31) groups according to the etiopathogenesis of their diabetes. Selenium was determined by the method of atomic absorption spectrometry. Serum level of selenium was statistically significantly different in patients with either noninsulin-dependent (59.23±12.2 μg/L) or insulin-dependent (58.23±16.7 μg/L) diabetes mellitus as compared with the control group of 62 subjects (64.2±11.5 μg/L; p<0.05). There was no statistically significant difference in the serum levels of selenium between the groups of patients with noninsulin-dependent and insulin-dependent diabetes mellitus. The levels of erythrocyte glycogen were 2.0580±1.326, 2.0380±1.735, and 2.0036±1.3537 μg/g Hb in the control group, noninsulin-dependent group, and insulin-dependent group, respectively, with no statistically significant between-group difference. The decreased levels of selenium in serum and erythrocytes of diabetic patients suggest the possible role of glutathione peroxidase activity.     

Genetically elevated circulating homocysteine concentrations increase the risk of diabetic kidney disease in Chinese diabetic patients

Diabetic kidney disease (DKD) is a devastating and frequent complication of diabetes mellitus. Here, we first adopted methylenetetrahytrofolate reductase (MTHFR) gene C677T polymorphism as an instrument to infer the possible causal relevance between circulating homocysteine and DKD risk in a Chinese population and next attempted to build a risk prediction model for DKD. This is a hospital‐based case‐control association study. Total 1107 study participants were diagnosed with type 2 diabetes mellitus, including 547 patients with newly diagnosed and histologically confirmed DKD. MTHFR gene C677T polymorphism was determined using the TaqMan method. Carriers of 677TT genotype (14.55 μmol/L) had significantly higher homocysteine concentrations than carriers of 677CT genotype (12.88 μmol/L) (P < 0.001). Carriers of 677TT genotype had a 1.57‐fold increased risk of DKD (odds ratio: 1.57, 95% CI: 1.21‐2.05, P = 0.001) relative to carriers of 677CT genotype after adjusting for confounders. Mendelian randomization analysis revealed that the odds ratio for DKD relative to diabetes mellitus per 5 μmol/L increment of circulating homocysteine concentrations was 3.86 (95% confidence interval: 1.21‐2.05, P < 0.001). In the Logistic regression analysis, hypertension, homocysteine and triglyceride were significantly associated with an increased risk of DKD and they constituted a risk prediction model with good test performance and discriminatory capacity. Taken together, our findings provide evidence that elevated circulating homocysteine concentrations were causally associated with an increased risk of DKD in Chinese diabetic patients.     

Hormone response of diabetic patients to exercise at cool and warm temperatures

Both exercise and high ambient temperatures stimulate the secretion of counterregulatory hormones which can change glucose homeostasis. We studied whether in diabetic patients there are any differences in the hormonal response to exercise performed at cool or warm ambient temperatures. A study was performed on eight male insulin-dependent patients at rest and during exercise at +10 degrees C and +30 degrees C. Exercise consisted of three consecutive 15-min periods at 60% of maximal aerobic capacity. The concentrations of plasma lactate and counterregulatory hormones at rest were similar at warm and cool temperature, whereas prolactin concentration was higher (P less than 0.01) at +30 degrees C. Exercise resulted in an increase in noradrenaline, growth hormone and prolactin (P less than 0.01), prevented the diurnal decrease in cortisol, but had no effect on glucagon. Hormone responses to exercise were similar at +10 degrees C and at +30 degrees C, except for cortisol and noradrenaline which showed greater responses at warm than at cool temperatures. This may have been due to the higher relative work load at warm compared to cool temperatures as suggested by the higher heart rate and greater increase of lactate at +30 degrees C. These data indicate that within a range of ambient temperatures commonly occurring in sports, the response of counterregulatory hormones is largely independent of ambient temperature in insulin-dependent diabetic patients.     

Glycation of fibrinogen in diabetic patients: a practical colorimetric assay

We have developed a practical method for the measurement of glycated fibrinogen which combines purification by glycine precipitation with a nitroblue tetrazolium assay at 56°C in the presence of Zwittergent 3–14. This detergent, at a concentration of 10 g/l, was chosen because it combines solubilization of fibrinogen and low coloration of blanks while increasing the sensitivity of the assay. A positive correlation (r=0.85,P<0.02) was found between this procedure and a previously reported one based on the thiobarbituric acid assay. To validate the method we then measured fibrinogen, glycated fibrinogen, serum fructosamine and erythrocyte glycated haemoglobin in a population of healthy euglycaemic subjects (n=30) and a population of diabetic patients (n=40). Glycated fibrinogen was significantly higher in diabetic patients than in control subjects (15.42±0.70vs 11.52±0.27 nmol of deoxymorpholinofructose equiv. per mg,P<0.005). Given the short half-life of fibrinogen, assay of its glycation may be useful as a short-term marker of glycaemic control.     

Features of insulin receptor interaction in placenta from normal,overt and poorly controlled gestational diabetic patients

Features of insulin binding to trophoblast plasma membranes were studied in six normal pregnant women (NP), six overt diabetes (ODP) and six poorly controlled glycemic gestational patients (PCDP) i.e. women who did not strictly follow the management of diabetes mellitus during pregnancy. A decreased maximum specific insulin receptor binding per 0.1 mg membrane protein in placenta from PCDP (12%) was found comparing with that from ODP or NP (17.5% and 36.2%, respectively, P<0.01), The insulin binding in PCDP declined at a faster rate until it reached minimum when studied at a higher temperature (25–37°C). The binding equilibrium was likewise attained faster at this temperature than that at lower temperature of 4°C for all studied groups.The insulin receptor binding in all studied groups was pH dependent. The maximum binding in ODP and PCDP groups was attained at pH 7.8 while for NP maximum binding was at pH 7.4. The competitive dinding assay was carried out with 14 concentrations of unlabelled insulin and the half maximal displacement of¹²⁵I-insulin was at 8×10^–9 M, 6×10^–9 M and 4×10^–9 M for NP, ODP and PCDP, respectively (P<0.05) suggesting the differences in the effect of glycemic control on the insulin binding. Furthermore the binding yielded curvilinear Scatchard plots with the apparent affinity of the receptors being affected in the ODP and PCDP groups.The molecular characteristics of the receptors in the diabetic patients as revealed by the cross-linking technique used in this study did not reveal any changes in the subunit structures when compared with normals except that the¹²⁵I-insulin bound as shown by the band intensity was much less in PCDP. These findings indicate that control of hyperglycemia could optimize the outcome of insulin receptor function during diabetic pregnancy.     

Glycation of human lens proteins from diabetic and (nondiabetic) senile cataract patients

Glycation (nonenzymatic glycosylation) in the human lens (cortex and nucleus) in senile (nondiabetic) and diabetic cataracts was studied by measuring the extent of early and late glycation products, the content of free -amino groups and the formation of disulfide bonds in the soluble lens proteins. There was a significant (p<0.001) increase in early and late glycation in the lens nucleus compared to the cortex in both the senile and diabetic groups. Overall these changes were much larger in the diabetic group. The concentration of free -amino groups was decreased in the senile nucleus as well as in the diabetic nucleus when compared with the senile and diabetic cortex (p<0.001). Disulfide bond content was in the order of diabetic nucleus > diabetic cortex > senile nucleus > senile cortex. Glycation of the lens proteins is a generalized feature which is enhanced in the diabetic lens compared to senile lens proteins and is associated with a decrease in free -amino groups and an increase in disulfide bonds formation in the lens proteins.     

Effect of dapagliflozin on diabetic patients with cardiovascular disease via MAPK signalling pathway

Clinical studies have shown that dapagliflozin can reduce cardiovascular outcome in patients with type 2 diabetes mellitus (T2DM), but the exact mechanism is unclear. In this study, we used the molecular docking and network pharmacology methods to explore the potential mechanism of dapagliflozin on T2DM complicated with cardiovascular diseases (CVD). Dapagliflozin's potential targets were predicted via the Swiss Target Prediction platform. The pathogenic targets of T2DM and CVD were screened by the Online Mendelian Inheritance in Man (OMIM) and Gene Cards databases. The common targets of dapagliflozin, T2DM and CVD were used to establish a protein-protein interaction (PPI) network; the potential protein functional modules in the PPI network were found out by MCODE. Metascape tool was used for Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment analysis. A potential protein functional module with the best score was obtained from the PPI network and 9 targets in the protein functional module all showed good binding properties when docking with dapagliflozin. The results of KEGG pathway enrichment analysis showed that the underlying mechanism mainly involved AGE-RAGE signalling pathway in diabetic complications, TNF signalling pathway and MAPK signalling pathway. Significantly, the MAPK signalling pathway was considered as the key pathway. In conclusion, we speculated that dapagliflozin played a therapeutic role in T2DM complicated with CVD mainly through MAPK signalling pathway. This study preliminarily reveals the possible mechanism of dapagliflozin in the treatment of T2DM complicated with CVD and provides a theoretical basis for future clinical research.     

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.