Risk factors associated with diabetes retinopathy in patients with coronary heart disease / 中华老年医学杂志

Objective:To study the risk factors for diabetic retinopathy(DR)in patients with coronary artery disease(CAD).Methods:353 patients with diabetes mellitus hospitalized at Beijing Anzhen Hospital between 2013 and 2015 were enrolled, including 96 patients with coronary artery disease(27%)and 156 patients with DR(44%).Medical history and examination/laboratory results of all patients were collected for analysis.Coronary artery disease was diagnosed according to coronary angiography.DR was diagnosed via ophthalmological examinations.The clinical characteristics of patients with and without DR were compared and contrasted between the groups.Results:Compared with patients without DR, patients with DR had a longer duration of diabetes, [15 years(10, 20) vs.8 years(4, 13), P<0.001]and a higher urine albumin/creatine ratio(UACR)[12.1 mg/g(3.2, 71.9) vs.4.8 mg/g(2.2, 3.5), P<0.001].Logistic regression analysis suggested that duration of diabetes( OR=1.107, 95% CI: 1.063~1.153, P<0.001)and UACR( OR=0.003, 95% CI: 1.001~1.006, P=0.008)were independent risk factors for DR.ROC curves revealed that a duration of diabetes >9.5 years or UACR>7.1 mg/g was significantly associated with DR.Also, of all patients with CAD, those with DR had a longer duration of diabetes[15 years(10, 20) vs.10 years(6, 15), P=0.002]and a higher percentage with hypertension(88.1% vs.67.6%, P=0.014).Hypertension history( OR=4.049, 95% CI: 1.099~14.925, P=0.036)and duration of diabetes( OR=1.159, 95% CI: 1.044~1.287, P=0.005)were independent risk factors for DR in patients with CAD.History of hypertension or a duration of diabetes>11.5 years was significantly associated with DR. Conclusions:In patients with coronary heart disease, hypertension history or a long duration of diabetes is significantly associated with an increased risk of DR.

Effects of fasting blood glucose levels on the quality of radionuclide imaging of myocardial metabolism in patients with coronary heart disease / 中华老年医学杂志

Objective:To investigate the effects of fasting blood glucose levels on the quality of myocardial metabolism imaging via positron emission tomography/X-ray computed tomography(PET/CT)in patients with coronary heart disease.Methods:A total of 78 patients with coronary heart disease from 2019 to 2020 undergone 18-fluorine deoxyglucose( 18F-FDG)PET/CT myocardial imaging in Beijing Anzhen Hospital were retrospectively analyzed, with 64 patients meeting the inclusion criteria eventually enrolled in this study.All patients fasted over 8 hours and were injected with insulin and 18F-FDG following an oral glucose load.Then myocardial imaging evaluations were performed.Depending on whether the myocardial image quality(IQ)offered a match with clinical diagnosis, a score between 0-2 from the semiquantitative scoring system was defined as good IQ, while a score between 3-4 defined as poor IQ.Differences in sex, age, rate of diabetes, body mass index, fasting blood glucose(FBG), glycosylated hemoglobin, glycosylated serum albumin, triglycerides and free fatty acids, lipid-regulating drugs, and oral antidiabetic medications were analyzed between the good( n=55)and poor( n=19)image groups, and risk factors were examined. Results:The diabetes mellitus rate was higher in the poor group than in the good group(63.2% vs.33.3%, χ2=4.872, P=0.027). FBG, glycosylated hemoglobin and glycosylated serum albumin levels in the poor group were increased compared with the good group[7.67(6.02, 11.64)mmol/L vs.5.52(4.97, 6.37)mmol/L, 7.30(6.43, 8.70)% vs.6.20(5.60, 6.87)%, 19.8(15.1, 24.1)% vs.14.8(13.9, 16.8)%, U=-3.909, -2.419 and -3.042, P<0.001, P=0.016 and 0.002, respectively]. Multivariate Logistic regression analysis showed that FBG was an independent risk factor for poor imaging( OR=1.62, 95% CI: 1.19-2.20, P=0.002). The area under the receiver operator characteristic(ROC)curve for FBG was 0.811(95% CI: 0.69-0.93, P<0.001), and the cut-off value for FBG was 6.66 mmol/L. Conclusions:FBG is an independent risk factor for myocardial image quality.Patients with diabetes mellitus should rigorously control their blood glucose levels.

Comparative analysis of cardio-metabolic risk factors in coronary artery disease patients with in-stent restenosis after percutaneous coronary intervention / 中华老年医学杂志

Objective:To analyze the characteristics of cardio-metabolic risk factors coronary artery disease(CAD)patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:A total of 169 patients undergone primary(T1)PCI and followed up and rechecked by coronary angiography(T2)in our hospital from 2010 to 2017 were enrolled.According to the results of coronary angiography during follow-up, patients were divided into the ISR group(n=66)and the control group(non-ISR or NISR, n=103). Patients were sub-grouped into the elderly ISR group(the E-ISR group, n=17), the elderly non-ISR group(the E-NISR group, n=19), the young ISR group(the Y-ISR group, n=49)and the young non-ISR group(the Y-NISR group, n=84). Clinical data including medical history, laboratory results, and coronary angiography records during the two hospital stays were collected.Cardio-metabolic risk factors and clinical features of coronary artery disease were analyzed for the groups.Results:The levels of systolic blood pressure, glycated hemoglobin A1c(HbA1c), fasting blood glucose(FBG), the percentage of patients with diabetes or myocardial infarction(MI)history, the coronary Gensini score and the percentage of patients with triple vessel disease were higher in the ISR group than in the NISR group(128.6±16.4) mmHg vs.(123.4±10.7) mmHg, P=0.023; (7.0±1.6)% vs.(6.2±0.9)%, P<0.001; 6.6 mmol/L vs.5.7 mmol/L, P<0.001; 53.0% vs.31.1%, P=0.004; 36.4% vs.20.4%, P=0.022; 40 vs.29, P=0.01; 57.6% vs.40.8%, P=0.033). The E-ISR group had higher systolic blood pressure and a lower glomerular filtration rate than the E-NISR group(135.9±27.2) mmHg vs.(124.1±10.8) mmHg, P=0.013; 77.5±14.4 ml·min -1·1.73 m -2vs.(84.8±9.4) ml·min -1·1.73 m -2, P=0.033), but the Y-ISR group had longer hypertension history, higher levels of low-density lipoprotein and HbA1c, and higher Gensini scores than the Y-NISR group[129.7 months vs.83.1 months, P=0.008; (2.78±1.08) mmol/L vs.(2.31±0.65) mmol/L, P=0.002; (7.2±1.7)% vs.(6.1±0.9)%, P<0.001; 41 vs.29, P=0.009]. Conclusions:Clinical features are different between elderly CAD patients and young and middle-aged CAD patients with ISR after PCI, and metabolic risk factors such as blood pressure, blood lipid and blood glucose levels should be proactively controlled

18F-FDG PET/CT images quality and its impact factors in diabetic and non-diabetic patients with coronary artery disease / 中华核医学与分子影像杂志

Objective:To evaluate the image quality (IQ) of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and identify its influenfial factors in diabetes mellitus (DM) and non-DM patients with coronary artery disease (CAD). Methods:A total of 196 consecutive CAD patients (174 males, 22 females, 68 DM; age: (57±10) years) in Beijing Anzhen Hospital between June 2016 and February 2018 were retrospectively analyzed. All patients underwent 18F-FDG myocardial PET/CT imaging. The standardized fasting+ oral glucose loading (OGL) and intravenously injection of insulin protocol was performed. According to the FDG uptake by myocardium, background activity in blood and other visceral organ nearby the heart, the IQ was visually evaluated and scored by 0-4. Zero-two was considered as good IQ, 3-4 was regarded as poor IQ. Patients were divided into three groups: group 1 (non-DM+ good IQ), group 2 (DM+ good IQ), group 3 (DM+ poor IQ). Factors which may affect IQ were analyzed, which including OGL, the injection dose of insulin, fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose (BG) level at 18F-FDG injection (BG injnection), BG increasing rate ((PBG-FBG)/FBG, %), and BG decreasing rate ((PBG-BG injection)/PBG, %). One-way analysis of variance, Spearman correlation analysis and logistic regression analysis were used for data analysis. Results:There were significant differences ( F values: 13.074-38.371, all P<0.05) of FBG, PBG, OGL, BG decreasing rate and the injection dose of insulin among group 1 ( n=132, 67.3%), group 2 ( n=53, 27.1%), group 3 ( n=11, 5.6%). All those parameters, except for OGL, were positively correlated with FDG PET/CT IQ ( r s values: 0.142-0.262, all P<0.05). OGL was negatively correlated with IQ ( r s=-0.324, P<0.05). Logistic regression analysis showed that FBG (odds ratio ( OR)=0.687, 95% CI: 0.633-0.746), PBG( OR=0.786, 95% CI: 0.746~0.829), BG injection( OR=0.631, 95% CI: 0.595-0.716), OGL( OR=0.897, 95% CI: 0.873-0.922), the injection dose of insulin( OR=0.680, 95% CI: 0.618-0.748) were predictive factors (all P<0.01) for good IQ in all patients. For DM patients, OGL was the only predictive factor for good IQ( OR =0.940, 95% CI: 0.904-0.960; P<0.01). Conclusions:FBG, PBG, BG injection, OGL, the injection dose of insulin can predict IQ for all patients with CAD. For DM patients with CAD, OGL is the only predictive factor for good IQ. A good IQ of 18F-FDG PET/CT could be obtained in majority of CAD patients, with the standardized fasting + OGL and intravenously injection of insulin protocol and adjust according to the personal status, and prevent the hypoglycemia from happening.

Application of in vitro porcine gastric model of submucosal eminence lesion in endoscopic submucosal dissection / 中华消化内镜杂志

Objective@#To establish the in vitro porcine gastric model of submucosal eminence lesion and to evaluate its application to endoscopic submucosal dissection(ESD).@*Methods@#Silicone rubber impression materials and steel balls with diameters of 1 cm, 2 cm, and 3 cm were used to make three pairs of spherical cavities. And then raw ground beef was put into spherical cavities and boiled for 20 minutes to make spherical mass models. Six isolated porcine stomach with esophagus and duodenum were selected. The mass models with diameters of 1 cm, 2 cm and 3 cm were imbedded respectively into the submucosa of fundus, body, and antrum of porcine stomach through the incision on serosal layer. The submucosal masses were observed by endoscopy and endoscopic ultrasonography and ESD was performed.@*Results@#A total of 18 mass models were constructed in 6 porcine stomachs, of which 17 models were successfully established and 1 failed. Typical endoscopic characteristics of gastric submucosal eminence lesions were found in 17 models. Endoscopic ultrasonography showed that these models originated from submucosal layer and demonstrated mixed echo. There were no significant differences between mucosa of lesions and that of surrounding areas. ESD was successfully performed in the porcine gastric models of submucosal eminence lesions, and all models were not broken or detached.@*Conclusion@#The in vitro porcine gastric model of submucosal eminence lesions can well replicate disease status and provide a suitable model for study on endoscopic therapy of submucosal eminence lesion and training of endoscopists.

Analysis and evaluation of the balance function in patients with type 2 diabetes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Evaluation and analyze the characteristics of balance function in patients with type 2 diabetes, and to find out the importance of proprioception, vision and vestibular in postural control.@*METHOD@#All subjects were divided into two groups, 37 normal individuals, 33 patients with type 2 diabetes mellitus. All were assessed by computerized posturography under six upright stance.conditions: including standing on the firm surface and foam with eyes open and closed.@*RESULT@#(1) On anteroposterior,the scores of proprioception, vision and vestibular were 93.96 ± 7.95, 80.22 ± 16.24, 70.87 ± 20.99, the normal were 98.00 ± 2.18, 91.44 ± 6.01, 80.44 ± 7.81. There were significances between diabetes mellitus group and normal control group (P 0.05.@*CONCLUSION@#The balance function of patients with type 2 diabetes decreased. It is the main characteristic that the vision and vestibular decreased more significantly in the postural control.

Comparison of efficacy and safety between biphasic insulin aspart 50 and biphasic human insulin 50：A randomized crossover trial / 中华内分泌代谢杂志

Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.

Endoscopic histoacryl injection combined with ligation in the treatment of severe esophageal and gastric varices / 中国组织工程研究

BACKGROUND:As a commonly used tissue adhesive in China, histoacryl can produce transient polymerization and rapidly solidify biological tissue, and it has good prospect in treatment of esophageal and gastric varicose bleeding. OBJECTIVE: To explore the short- and long-term clinical efficacy of endoscopic histoacryl injection combined with ligation for the treatment of esophageal and gastric varices. METHODS: Ninety patients with esophageal and gastric varices were treated by endoscopic adhesive injection and dense ligation. There were 64 males and 26 females, aged 22-75 years. At 2-4 weeks post-treatment, patients were re-checked under an endoscope. The short-term efficacy and adverse reactions, such as the hemostasis rate, varicose vein, varicose vein diameter, red color sign and portal hypertension gastropathy were observed. Al patients were folowed up for 3-39 months after varicose vein was eradicated, to monitor the middle- and long-term clinical efficacy, including varicose vein, tissue adhesive discharging and local proliferation, rebleeding, recurrence and complications. RESULTS AND CONCLUSION: (1) Short-term efficacy: The number of varicose veins significantly reduced, red color signs reduced, and portal hypertension gastropathy improved (P< 0.01), but three cases appeared early rebleeding. The adhesives began to discharge from 2 weeks to 3 months post-treatment, no case appeared esophageal stenosis, perforation, severe infection, heterotopic embolism and other injection-related complication. (2) Middle- and long-term efficacy: varicose vein recurred in nine cases and five cases developed long-term rebleeding. Experimental findings indicate that, endoscopic histoacryl injection combined with ligation is effective to treat severe esophageal varices or (and) bleeding, with high success rate and good hemostasis effect, and it also prevents long-term rebleeding and recurrence.

Research on isolation and purification method of pancreatic islets in mice / 器官移植

Objective To investigate a method for isolation and purification of pancreatic islets in mice,aiming to enhance the quantity and activity of pancreatic islets.Methods The pancreas were digested by retrograde common bile duct perfusion of collagenase,discontinuous density gradient centrifugation and the islets were selected and purified by manual method.After overnight culture,the pancreatic islets were incubated by static glucose-stimulated insulin secretion (GSIS)and the islet function was assessed.The subcellular structure of islet βcells was observed under transmission electron microscopy.Results Using the modified method,(200 ±20)islets were collected in each mouse with a mean diameter of (175 ±22)μm. The insulin levels in the stimulation of low (2.8 mmol/L)and high glucose (16.7 mmol/L)were (0.33 ± 0.07)and (1.36 ±0.47 )ng/(islet · 60 min),which were detected by GSIS.Insulin levels in the stimulation of high sugar is 4.12 times of those of low sugar with a statistical significance (P <0.05).It was revealed by transmission electron microscopy that the pancreatic βcell membrane and mitochondrial membrane was intact and insulin granules of different sizes could be seen within βcells.Conclusions Retrograde common bile duct perfusion of collagenase,discontinuous density gradient centrifugation combined with manual selection in vitro is a convenient,fast and stable method for isolating mouse islets,which can get pancreatic islets with relatively high output,intact cellular morphology,and good reactivity of GSIS.

The 10-year stroke risk in hypertensive outpatients combined with diabetes in cardiovascular clinics of 36 tertiary hospitals in China / 中华内科杂志

Objective To assess the estimated 10-year risk of stroke among hypertensive outpatients known with diabetes from cardiovascular clinics of 36 tertiary hospitals in China and to analyze the characteristics of the risk factors and the 10-year risk of stroke between the southern and the northern patients.Methods A multi-center prevalence survey was conducted from October 2011 to June 2012.Hypertensive outpatients known with diabetes were enrolled from cardiovascular clinics of 36 tertiary hospitals in China.A total of 15 914 outpatients were included in the final analysis.The 10-year probability of stroke was evaluated by the Framingham stroke risk profile.According to the 10-year probability of stroke,patients were divided into low risk (≤ 5％),medium risk (6％ ～9％) and high risk (≥10％).Results (1) Of all the hypertensive outpatients known with diabetes,the mean age was (64.6 ± 10.1) years and the mean systolic pressure was (138.7 ± 19.3) mmHg(1 mmHg =0.133 kPa).Among them,7.4％ with atrial fibrillation,11.2％ with left ventricular hypertrophy,57.2％ with cardiovascular diseases,17.1％ smokers and 37.0％ using mono-hypoglycemic agent.The southern patients who were older with more smokers had higher proportions of men and left ventricular hypertrophy,lower Levels of systolic blood pressure,and lower proportions of other cardiovascular diseases than those of the northern patients (all P ＜ 0.05).(2) The mean 10-year probability of stroke was (20.9 ± 16.2) ％.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients [(22.4 ± 17.1)％ vs (19.7 ± 15.2)％] (P ＜ 0.01).After adjusted by age and sex,the southern patients still had a higher mean 10-year probability of stroke (P ＜0.05).(3) All the patients had 7.7％ with low risk,17.4％ with medium risk,and 74.9％ with high risk.The southern patients had lower proportions of low and medium risk than those of the northern patients (6.7％ vs 8.4％,15.5％ vs 18.9％),but had a higher proportion of high risk than that of the northern patients (77.7％ vs 72.7％,all P ＜ 0.01).Conclusions Among the hypertensive outpatients known with diabetes from the cardiovascular clinics of our study,most of them were at the 10-year high risk of stroke.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients.

Review of mouse and rat models for type 2 diabetes mellitus / 中国实验动物学报

Mouse and rat models of type 2 diabetes mellitus play a key role in basic and clinical translational stud-ies.Different animal models should match the determined investigational objects and methods .In this review, the estab-lishments and diabetes-specific changes of various animal models were described , which will be helpful for better use of ani-mal models in research of diabetes mellitus .

Study on clinico-histopathological changes of non-alcoholic fatty liver disease in elderly male patients with type 2 diabetes mellitus / 中华老年医学杂志

Objective To observe the incidence rate of non-alcoholic fatty liver disease (NAFLD) in elderly male patients with type 2 diabetes mellitus (T2DM) and the features of pathological changes of liver. Methods The 89 cases with T2DM (T2DM group) and contemporary non-diabetic cases (control group, n=48) from 858 autopsy samples matched for gender and age were selected in the study. The histopathological changes of liver were observed by microscopy,histochemistry and immunohistochemistry. Results The incidence rates of NAFLD and nonalcoholic steatohepatitis(NASH) were 49.4% (44/89) and 14.6% (13/89) in T2DM group, 22.9 %(11/48) and 4.2% (2/48) in control group, respectively. The incidence rates of NAFLD and NASH were significantly higher in T2DM group than in control group(P＜0.01, P＜0.05). All of the NASH patients from T2DM group and one patient from control group were complicated with different stages of liver fibrosis. One patient from T2DM group was diagnosed as cirrhosis, no cirrhosis patient was found in control group. Conclusions Compared with control group, the incidence rate of NAFLD is higher and the damage of liver is more severe in T2DM group. The ratio of the progress from NAFLD to liver cirrhosis is low.

Study on histopathological changes of hepatic portal area in elderly men with type 2 diabetes mellitus / 中华老年医学杂志

Objective To study the histopathological features of hepatic portal area in autopsy specimens of elderly men with type 2 diabetes mellitus (T2DM).Methods One hundred and three autopsy cases with T2DM (diabetic group) and contemporary 48 non-diabetic cases matched by gender and age (control group) were selected in the study.The histopathological changes of hepatic portal area were observed by histochemical and immunohistochemical methods.Results (1) In diabetic group, endothelial denudation, eosinophilie deposits, eccentric intimal thickening and luminal stenosis were found in hepatic interlobular artery (arteriole, the lumen diameter < 100 μm).The medial smooth muscle cells proliferated and migrated into intima, and fibroplasia occurred in adventitia.62.1% (64/103) of the patients with T2DM had microangiopathy and there was statistically significant difference between the two groups (χ2= 27.14, P< 0.01 ).(2) Hyaline collagen fiber tissues deposited around interlobular artery, interlobular vein and interlobular bile ducts, resulting in enlargement of the portal area and the secondary atrophy and disappearance of portal triad.65.0% (67/103) of the patients with T2DM had this pathological changes in the portal area and there was statistically significant difference between the two groups(χ2= 23.27,P<0.01).(3) Terminal portal area was notable.Conclusions Mieroangiopathy can be observed in the hepatic portal areas of elderly men with T2DM, which may induce the fibrotic tissue hyperplasia, the atrophy of the portal triad and the sclerosing portal area.

Research on OGTT and HbAlc levels in patients with newly diagnosed type 2 diabetes mellitus and prediabetes / 中华老年医学杂志

Objective To explore different features and influencing factors of 75 g oral glucose tolerance test (OGTT) and glycated hemoglobin Ale (HbAlc) levels in subjects with newly diagnosed diabetes and prediabetes of natural history of type 2 diabetes. Methods All subjects were classified by OGTT into four groups: (1) normal glucose test (NGT), 31 subjects at age of (48. 4±15. 3) yrs (29-75 years old); (2) impaired fasting glucose (IFG), 33 subjects at age of (50. 8±9. 8) yrs (38-72years old) ; (3) impaired glucose tolerance test (IGT), 34 subjects at age of (54. 5±11.4) yrs (33-74years old), (4) T2DM, 117 subjects at age of (54.3 ± 14.1) yrs (29-75 years old). Glucose metabolism was evaluated by results of OGTT and HbAlc levels. The insulin secretion function and insulin resistance (IR) were evaluated by HOMA-β, △I30/△G330, area under curve of insulin (AUCINS)and HOMA-IR respectively. Results (1) Significant changes of HbAlc values among groups were as following order: T2DM(7. 41%)>IGT(5. 85%)>NGT(5.21%) (P<0. 01). HOMA-β value in T2DM, IGT and IFG decreased by 53. 1% (P<0. 01), 29.3% (P<0. 01) and 23.4% (P<0. 05)respectively as compared with NGT group. HOMA-IR value in diabetes group was 1.66-fold of NGT (P<0.01), 1. 29-fold of IFG (P<0.001) and 1.44-fold of IGT (P<0.05). (2) Only 3 h blood glucose concentration (BG) in 75 g OGTT was independently and positively correlated with HbAlc level (r=0. 71, P<0. 01). △I30/△G330 ratio was independently and negatively correlated with both 1 h and 2 h BG of OGTT (P<0.01). AUCins was positively correlated with only 3 h BG of OGTT (P<0.01). HOMA-β was independently and negatively correlated with all OGTT results except 2 h BG(P<0.01). HOMA-IR was an independently and negatively correlative factor of all OGTT results (P<0. 01 or P<0. 05). TG level was independently and positively correlated to only fasting BG (P<0. 05), and waist circumference value had an independent and positive relationship with only 1/2h BG (P<0. 01). Independently correlative factors of OGTT changes included △I30/△G330, AUCINS,HOMA-β, HOMA-IR and circumference values. Only 3 h BG was probably an independent contributor to HbAlc variation. Conclusions There are obvious HbAlc differences among T2DM,IGT and NGT patients. When HbAlc values are over 8%, no significant changes of glucose and insulin levels at 75 g glucose load test are found among subjects.

A preliminary study on the effects of high glucose and the leucocyte of diabetic patients on endothelial cells / 中华老年医学杂志

Objective To study the effects of high glucose and the leucocyte of diabetic patients on endothelial cells. Methods The leucocyte adhesion percentage to endothelial cells and the (MMP-9) expression of co-culturing endothelial cells and leucocytes were determined under different levels of glucose and at different time. Results (1) The level of MMP-9 was much higher under high glucose culture, and it increased as culture time prolonged. (2) The percentage of leucocyte adhesion to endothelial cells under high level of glucose was increased, and it was further enhanced when (co-culture) with leucocytes of diabetic patients . (3) The level of MMP-9 in supernatant of endothelial cells and leucocytes was increased significantly after culture with leucocytes of diabetic patients. It showed leucocytes were toxic to endothelial cells. Conclusions High glucose increases the level of MMP-9 of endothelial cells and percentage of the leucocyte adhesion to endothelial cells.Leucocytes of diabetic patients are toxic for endothelial cells.