El ayuno intermitente y sus efectos en la salud metabólica en humanos / Intermittent fasting and human metabolic health

Intermittent fasting (IF) has gained increasing scientific and general attention. Most studied forms of IF include alternate-day fasting, modified alternate-day fasting, and time-restricted eating (TRE). Several cardiometabolic effects of IF have been described in animal models and, to a lesser extent, in humans. This review analyzes the impact of IF on weight loss, glucose metabolism, blood pressure, and lipid profile in humans. A literature search was conducted in the Pubmed/Medline, Scopus, and Google Scholar databases. Controlled observational or interventional studies in humans, published between January 2000 and June 2021, were included. Studies comparing IF versus religious fasting were not included. Most studies indicate that the different types of IF have significant benefits on body composition, inducing weight loss and reducing fat mass. Changes in cardiometabolic parameters show more divergent results. In general, a decrease in fasting glucose and insulin levels is observed, together with an improved lipid profile associated with cardiovascular risk. High heterogeneity in study designs was observed, particularly in studies with TRE, small sample sizes, and short-term interventions. Current evidence shows that IF confers a range of cardiometabolic benefits in humans. Weight loss, improvement of glucose homeostasis and lipid profile, are observed in the three types of IF protocols evaluated.

Study of auditory pathways in type 1 diabetes mellitus through brainstem auditory evoked potentials and contralateral acoustic reflex / Estudo das vias auditivas em diabetes mellitus tipo 1 através dos potenciais auditivos evocados de tronco encefálico e reflexo acústico contralateral

ABSTRACT Purpose To investigate the functionalities of the neural pathways through the auditory evoked potentials of the brainstem and the contralateral stapedial acoustic reflexes in normal-hearing individuals with type 1 diabetes mellitus, in order to detect possible alterations in the central auditory pathways. Methods This is a cross-sectional study with a comparison group and a convenience sample, consisting of 32 individuals with type 1 diabetes mellitus and 20 controls without the disease. All subjects had hearing thresholds within normal limits and type A tympanometric curves. The acoustic reflex arc and brainstem auditory potentials were investigated. Statistical analyses were performed using the SPSS 17.0. The Chi-square test, Student´s t-test, and Multiple linear regression were used. Results The auditory thresholds of the acoustic reflex were statistically lower in the group with the disease at frequencies of 0.5 kHz and 1.0 kHz in the left ear (p=0.01 and p=0.01, respectively). The absolute latencies III and V of the auditory potentials of the brainstem in the right ear and V in the left ear were increased in subjects with type 1 diabetes mellitus (p=0.03, p=0.02 and p=0.03, respectively). Conclusion The findings suggest that subjects with type 1 diabetes mellitus are more likely to present alterations in the central auditory pathways, even with auditory thresholds within normal limits.

RESUMO Objetivo Investigar a funcionalidade das vias neurais por meio dos potenciais evocados auditivos de tronco encefálico e os reflexos acústicos estapedianos contralaterais em sujeitos com diabetes mellitus tipo 1 normo-ouvintes, a fim de detectar possíveis alterações nas vias auditivas centrais. Método Trata-se de um estudo transversal com grupo de comparação, e amostra de conveniência, composta por 32 sujeitos com diabetes mellitus tipo 1 e 20 controles sem a doença. Todos os sujeitos apresentavam limiares auditivos dentro dos padrões de normalidade e curva timpanométrica tipo A. Foram investigados o arco-reflexo acústico e os potenciais auditivos de tronco encefálico. As análises dos resultados foram realizadas no SPSS 17.0. Utilizou-se o Teste Qui Quadrado, Teste T de Studant e Regressão linear múltipla. Resultados Os limiares auditivos do reflexo acústico foram estatisticamente menores no grupo com a doença nas frequências de 0,5 kHz e 1,0 kHz na orelha esquerda (p=0,01 e p=0,01, respectivamente). As latências absolutas III e V dos potenciais auditivos de tronco encefálico da orelha direita e V da orelha esquerda estavam aumentadas em sujeitos com diabetes mellitus tipo 1 (p=0,03, p=0.02 e p=0,03, respectivamente). Conclusão Os achados sugerem que sujeitos com diabetes mellitus tipo 1 estão mais propensos a apresentar alterações nas vias auditivas centrais, mesmo com limiares auditivos dentro dos padrões de normalidade.

Diabetes mellitus y ataxia de Friedreich en un niño: una difícil coexistencia / Diabetes mellitus and Friedreich´s ataxia in a child: a complicated coexistence

La ataxia de Friedreich, de herencia autosómica recesiva causada por una expansión repetida de trinucleótidos se asocia, entre otras complicaciones sistémicas, con diabetes mellitus. La aparición de torpeza motriz, con dificultad en la carrera y el salto en un varón de 6 años motivaron el estudio genético para ataxia de Friedrich y permitieron confirmar el diagnóstico. Tres años más tarde, se diagnosticó diabetes mellitus y se inició el tratamiento con insulina. Durante el seguimiento, presentó un importante deterioro neurológico, con necesidad de usar silla de ruedas, lo que dificultó un adecuado control metabólico. Se presenta el manejo y la evolución de un paciente con ataxia de Friedreich y diabetes mellitus

Friedreich's ataxia is an autosomal recessive disease caused by trinucleotide repeat expansion, presenting among other systemic complications, diabetes mellitus. The appearance of motor clumsiness, with running and jumping difficulties in a 6-year-old boy prompted the genetic study of Friedreich's ataxia, confirming his diagnosis. After diagnosis,it was evaluated by Pediatric Cardiology, detecting the presence of non-obstructive hypertrophic cardiomyopathy, and by Pediatric Endocrinology, due to overweight. At 9 years of age, he was diagnosed with diabetes mellitus, a regimen of insulin treatment was initiated. During follow-up, he presented significant neurological deterioration, reaching the use of a wheelchair,which hinders adequate metabolic control. This is a report of a pediatric patient with Friedrich ataxia and diabetes mellitus.

Exposure to glyphosate-based herbicide during early stages of development increases insulin sensitivity and causes liver inflammation in adult mice offspring

ABSTRACT Objective: To investigate the effect of pre and postnatal exposure to a glyphosate-based herbicide on glucose metabolism and liver histology in adult F1 mice offspring. Methods: Female mice (C57Bl/6) received 0.5% of glyphosate (Roundup Original DI®) in drinking water or purified water (Glyphosate Group and Control Group respectively) during pregnancy and lactation. Offspring (F1) were submitted to glucose and insulin tolerance tests and euthanized on postnatal day 150. Body and plasma parameters, and liver histology were analyzed. Results: Exposure to glyphosate reduced maternal body weight gain during pregnancy and lactation, with no impacts on litter size. Pre and postnatal exposure to glyphosate did not affect body parameters but increased glucose tolerance on postnatal day 60. In spite of glucose tolerance normalization by postnatal day 143, this effect was associated with higher insulin sensitivity relative to mice in the Control-F1 Group. Mice in the Glyphosate-F1 Group had mild and moderate lobular inflammation in the liver. Conclusion: Maternal exposure to glyphosate affected insulin sensitivity and caused hepatic inflammation in adult F1 mice offspring.

Xiaoyao San, a Chinese herbal formula, ameliorates depression-like behavior in mice through the AdipoR1/AMPK/ACC pathway in hypothalamus / 中西医结合学报

OBJECTIVE@#Depression and metabolic disorders have overlapping psychosocial and pathophysiological causes. Current research is focused on the possible role of adiponectin in regulating common biological mechanisms. Xiaoyao San (XYS), a classic Chinese medicine compound, has been widely used in the treatment of depression and can alleviate metabolic disorders such as lipid or glucose metabolism disorders. However, the ability of XYS to ameliorate depression-like behavior as well as metabolic dysfunction in mice and the underlying mechanisms are unclear.@*METHODS@#An in vivo animal model of depression was established by chronic social defeat stress (CSDS). XYS and fluoxetine were administered by gavage to the drug intervention group. Depression-like behaviors were analyzed by the social interaction test, open field test, forced swim test, and elevated plus maze test. Glucose levels were measured using the oral glucose tolerance test. The involvement of certain molecules was validated by immunofluorescence, histopathology, and Western blotting. In vitro, hypothalamic primary neurons were exposed to high glucose to induce neuronal damage, and the neuroprotective effect of XYS was evaluated by cell counting kit-8 assay. Immunofluorescence and Western blotting were used to evaluate the influences of XYS on adiponectin receptor 1 (AdipoR1), adenosine 5'-monophosphate-activated protein kinase (AMPK), acetyl-coenzyme A carboxylase (ACC) and other related proteins.@*RESULTS@#XYS ameliorated CSDS-induced depression-like behaviors and glucose tolerance impairment in mice and increased the level of serum adiponectin. XYS also restored Nissl bodies in hypothalamic neurons in mice that exhibited depression-like behaviors and decreased the degree of neuronal morphological damage. In vivo and in vitro studies indicated that XYS increased the expression of AdipoR1 in hypothalamic neurons.@*CONCLUSION@#Adiponectin may be a key regulator linking depression and metabolic disorders; regulation of the hypothalamic AdipoR1/AMPK/ACC pathway plays an important role in treatment of depression by XYS.

Research progresses on brain glucose metabolism induced by changes of neurons and astrocytes under hyperglycemia / 中国医学影像技术

Diabetes is a common clinical metabolic disease, which can affect cardiovacular, cerebrovascular, eye, kidney and other organs, among which the clinical manifestations of diabetes-associated cognitive decline are not obvious and difficult to diagnose. 18F-FDG PET/CT has the ability to early identify metabolic changes and is widely used to diagnose neurological diseases, also can be used to evaluate abnormal brain glucose metabolism in diabetic patients. Neurons and astrocytes are closely related to brain glucose metabolism, and abnormal changes of cell number, function and metabolic activity may lead to cognitive decline in diabetes. The effects of abnormal changes of neuronal and astrocytes under hyperglycemia on cerebral glucose metabolism were reviewed, and the causes of brain glucose metabolism changed in diabetic were analyzed in this article, in order to provide theoretical basis for diagnosing diabetes-related neurological diseases.

Biochemical and Molecular Mechanisms of Glucose Uptake Stimulated by Physical Exercise in Insulin Resistance State: Role of Inflammation / Mecanismos Bioquímicos e Moleculares da Captação da Glicose Estimulada pelo Exercício Físico no Estado de Resistência à Insulina: Papel da Inflamação

Abstract Obesity associated with systemic inflammation induces insulin resistance (IR), with consequent chronic hyperglycemia. A series of reactions are involved in this process, including increased release of proinflammatory cytokines, and activation of c-Jun N-terminal kinase (JNK), nuclear factor-kappa B (NF-κB) and toll-like receptor 4 (TLR4) receptors. Among the therapeutic tools available nowadays, physical exercise (PE) has a known hypoglycemic effect explained by complex molecular mechanisms, including an increase in insulin receptor phosphorylation, in AMP-activated protein kinase (AMPK) activity, in the Ca2+/calmodulin-dependent protein kinase kinase (CaMKK) pathway, with subsequent activation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), Rac1, TBC1 domain family member 1 and 4 (TBC1D1 and TBC1D4), in addition to a variety of signaling molecules, such as GTPases, Rab and soluble N-ethylmaleimide-sensitive factor attached protein receptor (SNARE) proteins. These pathways promote greater translocation of GLUT4 and consequent glucose uptake by the skeletal muscle. Phosphoinositide-dependent kinase (PDK), atypical protein kinase C (aPKC) and some of its isoforms, such as PKC-iota/lambda also seem to play a fundamental role in the transport of glucose. In this sense, the association between autophagy and exercise has also demonstrated a relevant role in the uptake of muscle glucose. Insulin, in turn, uses a phosphoinositide 3-kinase (PI3K)-dependent mechanism, while exercise signal may be triggered by the release of calcium from the sarcoplasmic reticulum. The objective of this review is to describe the main molecular mechanisms of IR and the relationship between PE and glucose uptake.

Resumo A obesidade associada à inflamação sistêmica induz resistência à insulina (RI), com consequente hiperglicemia crônica. Este processo envolve o aumento na liberação de citocinas pró-inflamatórias, ativação da enzima c-Jun N-terminal cinase (JNK), do fator nuclear kappa-B (NF-κB) e dos receptores do tipo Toll 4 (TLR4). Dentre as ferramentas terapêuticas disponíveis, o exercício físico (EF) tem efeito hipoglicemiante conhecido, explicado por mecanismos moleculares complexos. Dentre eles, ocorre aumento na fosforilação do receptor da insulina, na atividade da proteína quinase ativada por AMP (AMPK), na via da proteína cinase cinase dependente de Ca+2/calmodulina (CaMKK), com posterior ativação do coativador-1α do receptor ativado por proliferador do peroxissoma (PGC-1α), proteínas Rac1, TBC1 membro das famílias de domínio 1 e 4 (TBC1D1 e TBC1D4), além de uma variedade de moléculas de sinalização, como as proteínas GTPases, Rab e proteína solúvel de fusão sensível a N-etil-maleimida (SNARE); estas vias promovem maior translocação de transportador de glicose do tipo 4 (GLUT4) e consequente captação de glicose pelo músculo esquelético. A cinase fosfatidilinositol-dependente (PDK), proteína quinase C atípica (aPKC) e algumas das suas isoformas, como a PKC-iota/lambda também parecem desempenhar papel fundamental no transporte de glicose. Nesse sentido, a associação entre autofagia e EF também tem demonstrado papel relevante na captação de glicose muscular. A insulina, por sua vez, utiliza um mecanismo dependente da fosfatidilinositol-3-quinase (PI3K), enquanto que o sinal do EF pode ter início mediante liberação de cálcio pelo retículo sarcoplasmático e concomitante ativação da AMPK. O objetivo desta revisão é descrever os principais mecanismos moleculares da RI e da relação entre o EF e a captação de glicose.

Metabolic and hormonal assessment of adolescent and young adult women with prior premature adrenarche

OBJECTIVE: Follow-up studies of girls with premature adrenarche have reported the development of polycystic ovary syndrome, insulin resistance, and dyslipidemia and a propensity to cardiovascular disease. The aim of this study was to analyze the presence of these conditions in patients previously treated at the Universidade Federal do Triângulo Mineiro. METHODS: A total of 130 medical records reported premature adrenarche. One hundred and twenty-two patients were invited to participate, of whom 54 accepted; 34 patients were selected, as they had reached their final height. Anthropometric, blood glucose, insulin, and lipid and hormonal profile (LH, FSH, estradiol, 17α-OH-progesterone, androstenedione, dehydroepiandrosterone sulfate, testosterone) data were obtained, the HOMA-IR index was calculated, and pelvic ultrasonography was performed. To characterize polycystic ovary syndrome and metabolic syndrome, the Rotterdam and International Diabetes Federation criteria, respectively, were used. Data were analyzed according to measures of dispersion, frequency and correlations of interest. RESULTS: The age of the participants ranged from 15.2 to 28.2 years/months; 23.5% of the patients were overweight, 11.8% were obese, 29.4% had a large waist circumference, and 8.8% were hypertensive. None of the patients had altered glucose levels, and insulin levels and HOMA-IR were elevated in 29.4% and 38.2% of the participants, respectively; 14.7% of the patients exhibited acanthosis nigricans. The lipid profiles of the participants were variable, and one patient (2.9%) had metabolic syndrome. Polycystic ovary syndrome was found in 41.2% of patients. CONCLUSION: The percentage of patients with polycystic ovary syndrome who also had overweight, obesity and insulin resistance corroborates the literature data about the need for follow-up aiming at interventions, especially for conditions associated with cardiometabolic risk.

Obstetric anesthesia-associated endocrine emergencies: An update / 第二军医大学学报

During pregnancy, physiological state and hormone level of maternal endocrine system have great changes, providing a suitable environment for fetal growth and development. These physiologic changes have a significant impact on anesthetic physiology, pharmacology and the management techniques. With the progression of pregnancy, the changes of endocrine organs, including pituitary, thyroid, pancreas and adrenal gland are more obvious, and may cause correlated emergencies. Obstetric operations are mostly emergency operations. Any endocrine emergency during pregnancy may be life-threatening for both mothers and fetuses. This review summarizes the common endocrine emergencies during pregnancy and the key steps of diagnosis and treatment, aiming to help anesthesiologists fully understand the changes of maternal physiology, the treatment methods of the emergencies, and the key points of anesthesia management.

Diagnostic value of oral glucose tolerance-insulin/C peptide release test in chronic pancreatitis patients with impaired glucose tolerance / 中华胰腺病杂志

Objectives To investigate the value of oral glucose tolerance (OGTT)-insulin/C peptide release test in early diagnosis of chronic pancreatitis (CP)-associated abnormal glucose tolerance.Methods Sixty patients with CP who were admitted to the Department of Gastroenterology,Changhai Hospital from June 2017 to February 2018 were divided into CP with normal glucose tolerance (CP-NGT),CP with impaired glucose tolerance (CP-IGT),CP with newly diagnosed diabetes(CP-new-DM) and CP with the previous history of diabetes (CP-history-DM) according to previous medical records and data from OGTT-insulin/C peptide release test.The characteristics of glucose metabolism,the changes of blood glucose,insulin and C peptide released among the four groups were compared.Results In 43 cases of patients with CP without diabetes,the abnormal glucose metabolism was detected in 6 cases (14.0％) by fasting blood glucose or glycosylated hemoglobin,and in 30 cases (69.8％) by OGTT-insulin/C-peptide release test.The detection rate of abnormal glucose metabolism was increased by 55.8％.In the group of CP-history-DM,the peak secretion of blood glucose,insulin,C peptide was all at 120 min,and the multiplication of increased release of C peptide (peak/baseline) [4.1 (3.4,4.4) vs (6.1 ± 2.2) 、(6.4 ± 2.5)、(6.8 ± 3.8)],the C peptide area under curve (C-PAUC) [(3.6 ± 1.4)]μg · h-1 · L-1 vs 8.6(7.1,9.7),(8.1 ±3.1),(6.9 ±2.7) μg · h-1 L-1] and the homeostasis model of assessment for β cell (HOMA-β) [24.4 (11.4,37.4) vs 52.4 (44.6,92.1),(89.8 ± 57.2),(72.4 ± 57.0)] were all significantly lower,and the difference was statistically significant(all P＜0.05).In the group of CP-new-DM,the peak of blood glucose was at 60 min,while the peak of insulin,C peptide was at 1 20 min,the early insulin secretion index (/ I30/A G30) [2.2 (0.8,4.2)vs (11.4 ± 9.4)] and insulin secretion sensitivity index-2 (ISSI-2) [256.1 (160.1,340.7) vs (548.5 ± 173.2)] in group of CP-new-DM were significantly lower than those in the group of CP-NGT,and the difference was statistically significant (all P ＜0.05).Conclusions The insulin /C peptide secretion was insufficient in the early stage of CP-related diabetes mellitus.Routine OGTT-insulin / C peptide release test for patients with CP can increase the detection rate of abnormal glucose metabolism.

Effect of Isoflavones and Genistein on Glucose Metabolism in Peri- and Post-Menopausal Women: An Overview of Meta-Analysis

The purpose of the present overview of meta-analysis is to summarize and critically assess the effect of isoflavones and genistein on glucose metabolism among the peri- and post-menopausal women. Two independent authors searched the databases of MEDLINE, Scopus and Cochrane Library for meta-analysis. Three databases were searched from inception to January 2018. Methodological quality of each meta-analysis of randomized controlled trials was evaluated using the AMSTAR (a measurement tool used to assess systematic reviews). Four meta-analyses were included to the current overview. Fasting insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were significantly lower in peri-menopausal and postmenopausal. Two meta-analyses showed that treatment with isoflavones could not alter fasting blood glucose. However, one meta-analysis depicted that isoflavones significantly improved blood glucose levels in non-Asian postmenopausal women. Treatment with genistein could have significant beneficial effects on fasting insulin, blood glucose and HOMA-IR in comparison to the control group. Regardless of the population, the treatment with genistein is effective in improving fasting insulin, HOMA-IR and glucose levels. Nevertheless, the high heterogeneity among studies and poor methodology of reviews made it difficult to draw a definite conclusion on the positive impacts of soy on glucose metabolism.

Early Assessment of the Risk for Gestational Diabetes Mellitus: Can Fasting Parameters of Glucose Metabolism Contribute to Risk Prediction?

BACKGROUND: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication.METHODS: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included. A metabolic characterization was performed before 15+6 weeks of gestation by assessing fasting plasma glucose (FPG), fasting insulin (FI), fasting C-peptide (FCP), and glycosylated hemoglobin (HbA1c). Thereafter, the patients were followed-up until the delivery.RESULTS: Females with NGT had lower levels of FPG, FI, FCP, or HbA1c at the early stage of pregnancy, and therefore, showed an improved insulin action as compared to that in females who developed GDM. Higher fasting levels of FPG and FCP were associated with a higher risk of developing GDM. Moreover, the predictive accuracy of this metabolic profiling was also good to distinguish the patients who required glucose-lowering medications. Indices of glucose disposal based on C-peptide improved the predictive accuracy compared to that based on insulin. A modified quantitative insulin sensitivity check index (QUICKIc) showed the best differentiation in terms of predicting GDM (area under the receiver operating characteristics curve [ROC-AUC], 72.1%) or need for pharmacotherapy (ROC-AUC, 83.7%).CONCLUSION: Fasting measurements of glucose and C-peptide as well as the surrogate indices of glycemic condition could be used for stratifying pregnant females with higher risk of GDM at the beginning of pregnancy.

Chinese ischemic stroke classification in relation with cerebral infarction due to migration to different climatic zones in autumn and winter / 中华老年心脑血管病杂志

Objective To study the characteristics of Chinese ischemic stroke subclassification (CISS) in relation with migration to different climatic zones in autumn and winter.Methods Ninety-six subjects who travelled from northeast China,northwest China and north China to Hainan Province from September 2012 to February 2017 and were admitted to our hospital due to cerebral infarction occurred within 3 weeks after they arrived at Hainan were included in this study.Their demographic data,risk factors for cerebrovascular disease,laboratory blood test and imaging parameters were recorded.The patients were classified according to their medical history,auxiliary examination findings and CISS.The recorded data were statistically analyzed.Results CISS showed that penetrating artery disease,large artery atherosclerosis,cardiogenic stroke,and undetermined etiology accounted for 50.0％,38.5％,4.2％,7.3％ respectively.Hypertension (70.8 ％) and abnormal glucose metabolism (61.5％) were the major risk factors for cerebral in farction.Conclusion The incidence of penetrating artery disease is the highest,followed by that of large artery atherosclerosis in cerebral infarction patients.Alert to cerebral infarction should thus be stressed for those with hypertension and abnormal glucose metabolism who are going to travel in autumn and winter.

Regulation effect of Danqi Yishen capsule on laboratory indicators in patients with diabetic nephropathy / 中国基层医药

Objective To observe the efficacy of Danqi Yishen capsule in the treatment of diabetic nephrop-athy(DN),and the effect on laboratory indicators.Methods From March 2016 to December 2016,70 patients with DN in the Traditional Chinese Medicine Hospital of Shanxi Province were selected and divided into control group and observation group according to the different treatment method,with 35 cases in each group.The control group was given basic symptomatic treatment,and the observation group was given Danqi Yishen capsule on the basis of treat-ment in the control group.Both two groups were treated for 8 weeks.The clinical efficacy and changes of laboratory indicators were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (88.57% vs.62.86%),and the difference was statistically signifi-cant(P＜0.05).After treatment,the levels of fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),total cholesterol(TC),triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C) in the observation group were (5.81 ±0.75)mmol/L,(7.64 ±2.12) mmol/L,(4.91 ±1.03) mmol/L,(1.71 ±0.46) mmol/L,(2.25 ± 0.69)mmol/L,respectively,which were significantly lower than those in the control group [(6.37 ±0.92)mmol/L,(8.96 ±1.97)mmol/L,(4.91 ±1.03)mmol/L,(2.17 ±0.52)mmol/L,(3.26 ±1.05)mmol/L](t ＝2.791,2.698,3.321,3.920,4.756,all P＜0.05).The levels of 24h urinary protein excretion(UAER),urinary β2-micro-globulin(β2-MG),urinary albumin and creatinine ratio(ACR) in the observation group were (104.12 ±0.61)mg/24h,(256.72 ±96.43)μg/L,(73.86 ±33.12),respectively,which were significantly lower than those in the control group [(139.87 ±38.45 ) mg/24h,( 431.12 ±97.84 ) μg/L,( 125.84 ±38.96 )] ( all P ＜0.05 ). Conclusion Danqi Yishen capsule can significantly relieve the clinical symptoms in patients with DN,and improve the therapeutic effect.Its mechanism may be associated with lowering blood glucose,regulating blood lipids and reducing urinary protein.

Influence of gestational abnormal glucose metabolism on the birth outcome and long-term weight of neonates / 中国基层医药

Objective To investigate the influence of gestational abnormal glucose metabolism on the birth outcome and long-term weight of neonates.Methods Thirty pregnant women with gestational diabetes mellitus (GDM) were enrolled in this study.30 pregnant women with gestational impaired glucose tolerance (GIGT) were selected,and 30 normal pregnant women(NGT) were selected as control group.The weight,length and weight index (PI) of the three groups were collected.The incidence rates of adverse outcomes were collected in the three groups.The long-term weight of the newborns was investigated.According to whether breastfeeding,they were divided into breastfeeding group and non-breastfeeding group.The body mass index (BMI) was compared between 42 days,3 months,6 months and 12 months,respectively.Results There were statistically significant differences in body weight and PI of neonates except length between the control group and the GDM group (t =1.60,P =0.06;t =5.09,P =0.00;t =6.94,P =0.00).There were statistically significant differences in body weight and PI of neonates except length between the control group and the GIGT group(t =1.57,P =0.06;t =4.21,P =0.01;t =5.88,P =0.00).There were no statistically significant differences in the above indices between the GDM group and the GIGT group(all P ＞ 0.05).The incidence rate of macrosomia in the GDM group and the GIGT group was significantly higher than that of the control group (x2 =10.59,P =0.00).The incidence rates of respiratory failure syndrome,cardiovascular disease,hyperbilirubinemia and birth injury among the three groups had no statistically significant differences(x2 =1.23,P =0.54;x2 =2.09,P=0.35;x2 =2.02,P=0.36;x2 =2.09,P=0.35;x2 =4.03,P=0.13).At the birth of 42 days,3 months,6 months,12 months,the BMI of neonates in the GDM group and the GIGT group were slightly higher than those in the control group,but there were no statistically significant differences in BMI index among the three groups of breasffed newborns (F =0.71,P =0.28;F =0.97,P =0.12;F =0.98,P =0.12;F =0.77,P =0.22).At the birth of 42 days,3 months,6 months,12 months,the BMI of neonates in the GDM group and the GIGT group were slightly higher than those in the control group,but there were no statistically significant differences in BMI index among the three groups of breasffed newborns (F =0.77,P =0.34;F =0.89,P =0.10;F =1.12,P =0.09;F =0.55,P =0.67).Conclusion Abnormal glucose metabolism in pregnant women can lead to a significant increase in the incidence of neonatal macrosomia.The body weight and PI of neonates are higher than those without abnormal glucose metabolism in pregnant women,but the abnormal maternal glucose metabolism in pregnant women has no significant influence on the long-term body weight of neonates,and there is no significant difference between NGT and neonates.

Improving Effect of Curcumin Analogue H8 on Glucose and Lipid Metabolism Disorder in db/db Mice / 医药导报

Objective To investigate the influence of curcumin and its analogue H8 on glucose and lipid metabolism disorder in db/db mice. Methods The type 2 diabetes mouse model (db/db mice) was intragastrically administrated with curcumin and analogue H8 for 8 weeks.The blood biochemical indexes were measured.The expression of PEPCK and G6Pase mRNA was detected by real-time PCR in liver tissues.The expression of PEPCK and G6Pase protein was detected by Western blotting. Results Curcumin analogue H8 reduced blood glucose and lipids in db/db mice (P<0.01) and improved liver function related enzymes significantly.The levels of PEPCK and G6Pase mRNA in db/db mice were significantly decreased (P<0.01) and the expression levels of PEPCK and G6Pase protein were significantly decreased(P<0.01). Conclusion Curcumin analogue H8 improves the glucose and lipid metabolism disorder in db/db mice,and it is related to inhibiting the expression of PEPCK and G6Pase gene and protein.

Effects of impaired glucose regulation on large and small fibers in peripheral nerve / 中华神经科杂志

Objective To use nerve conduction study (NCS) to evaluate the function of large fibers,skin sympathetic response (SSR) and contact heat evoked potential (CHEP) to evaluate the function of small fibers in patients with impaired glucose regulation (IGR),and to analyze the occurrence of peripheral neuropathy and damage characteristics.Methods According to the classification criteria of glucose metabolism proposed by WHO in 2006,we selected 120 patients with IGR from January 2015 to December 2016 in our hospital,including 37 impaired fasting glucose (IFG) patients,83 impaired glucose tolerance (IGT) patients,and 60 normal subjects served as control group.All subjects received median,ulnar,tibial,peroneal,sural NCS,SSR and CHEP using the Keypoint.net (Medoc Ltd) electromyogram device.IGR patients were evaluated using the Michigan Neuropathy Screening Instrument (MNSI).Results The abnormal rate of MNSI score in IGR patients was 18.3％ (22/120);the abnormal rate of NCS was 22.5％ (27/120),and the abnormal rate of SSR was 39.2％ (47/120).In IFG group,the abovementioned abnormal rates were 8.1％ (3/37),13.5％ (5/37),29.7％ (11/37) respectively,and 22.9％ (19/83),26.5％ (22/83),43.4％ (36/83) in IGT group.Compared with control group,the tibial,sural nerve sensory nerve action potential amplitude decreased in IGT group (1.3 (0.1,1.9) μV vs 1.4(1.1,3.2) μV,Z=-3.05,P=0.002;(10.5±2.0)μV vs (7.6 ± 1.9)μV,t=0.60,P=0.001);and there was no significant difference between IFG patients and control group.Compared with control group,IFG patients' SSR amplitude reduced in lower limbs (0.7 (0.4,0.8) mV vs 0.8 (0.6,1.0) mV,Z =-2.95,P =0.003),CHEP amplitude decreased in dorsum hand and peroneal area stimuli ((63.0 ±10.0)μV vs(52.4 ±15.3)μV,t=0.61,P=0.003;(44.7 ±12.5)μV vs (28.2 ± 10.6)μV,t=0.31,P =0.000);and in IGR group,SSR amplitude reduced in upper and lower limbs (1.1 (0.5,2.2) mV vs 1.3(0.7,2.6)mV,Z=-2.12,P=0.030;0.4(0.2,0.8)mV vs 0.8(0.6,1.0) mV,Z=-5.96,P=0.000),CHEP amplitude decreased in dorsum hand and peroneal area stimuli ((63.0 ± 10.0) μV vs (38.7± 13.5)μV,t =0.37,P=0.000;(44.7 ±12.5)μV vs(21.9 ± 13.6)μV,t =0.35,P=0.000).Conclusions There is peripheral neuropathy in IGR patients,and the incidence of neuropathy in patients with IGT is higher than those with IFG.Neurophysiological methods are earlier than clinical scores to detect neuropathy.There are only small fiber damages in IFG patients,and IGT patients present by large and small fibrous lesions,mainly in small fibers and lower sensory nerve fibers,characterized by axonal damage and length dependence.

Chronic pancreatitis affecting the basal levels of several pancreas-related endocrine hormones: a clinical trial / 中华胰腺病杂志

Objective to determine the basal levels of several pancreas-related endocrine hormones in patients with chronic pancreatitis.Methods according to inclusion and exclusion criteria,consecutive patients from February 2016 to August 2016 in Department of Gastroenterology,Changhai Hospital,Second Military Medical University and ten healthy control (matched for age and gender) were included.Basal levels of glucagon-like peptide 1,pancreatic polypeptide,Secretin,glucagon,somatostatin between groups of CP vs healthy control,CP with abnormal glycometabolism vs CP with normal glycometabolism and alcoholic CP vs non-alcoholic CP were compared.Results a total of 53 patients with chronic pancreatitis and 8 healthy subjects were included in this study.(1) CP vs healthy controls:the level of secretin in healthy control patients is significant lower than that in CP patients;(2) CP with abnormal glycometabolism vs CP with normal glycometabolism:the level of triglyceride and somatostatin is significant lower than that in CP patients;the prevalence of patients with chronic alcohol consumption and the level of glucagon-like peptide 1 in CP with abnormal glycometabolism is significant higher than that in CP with normal glycometabolism;(3) the prevalence of abnormal glycometabolism in alcoholic CP group is significant higher than that in non-alcoholic CP.The results above are all of statistical significance.Conclusions in addition to dysfunction of islets/3-cells,CP also easily affects the level of other pancreas-related hormones such as secretin,somatostatin and glucagon-like peptide 1.Otherwise,chronic alcohol consumption is also strongly related with abnormal glycometabolism,the mechanism deserves further researches.

Correlation of reversely increased level of plasma glucose during pregnancy to the pregnancy outcome / 解放军医学杂志

Objective To explore the correlation of the reversely increased results of 75g oral glucose tolerance test (OGTT) during pregnancy to the pregnancy outcome, so as to provide a reliable theoretical basis of the early intervention for the pregnant women with high plasma glucose.Methods The clinical data of 461 cases were retrospectively analyzed. Patients were chosen from the pregnant women undergoing routine antenatal examination in our hospital during 2014. According to the results of 75g OGTT, 226 patients were analyzed as the observation group, in whom the level of postprandial 2-hour plasma glucose was higher than that of postprandial 1-hour plasma glucose. Meanwhile 235 pregnant women with or without gestational diabetes mellitus (GDM) were randomly selected as the control group.Results The levels of fasting plasma glucose and 1-hour postprandial plasma glucose were lower, but those of 2-hour postprandial plasma glucose was higher in observation group than in control group (P0.05) in the incidences of polyhydramnios, oligohydramnios, fetal growth restriction (FGR), premature labor (PTL), pregnancy induced hypertension (PIH), complicated with premature rupture of membrane (PROM), intrauterine fetal death (IUFD) and non scar uterus cesarean section rate (CSR). Compared with the observation group, the rates of neonatal dysplasia and neonatal asphyxia and the newborn transfer rate were lower in the control group, of which the newborn transfer rate was statistically different (P<0.01).Conclusions There might be a delayed plasma glucose metabolism in the patients with reversely increased result of 75g OGTT during pregnancy, which may affect the long-term prognosis of the newborn. Therefore, more attention should be paid to such patients with reversely increased result of 75g OGTT.

Metabolic deregulation and metastasis of tumor / 国际外科学杂志

Metabolic deregulation is a major essential feature in the development of cancer,wbich also correlates with invasion and metastasis of tumor.Metabolic characteristic of tumor cells which deviate significantly from those of normal cells.In this review,we summarize the research about the relationship between cellular metabolic abnormalities and capability of tumor's invasion and metastasis.