Background Many cytokines have been found to increase the insulin resistance during pregnancy complicated by glucose metabolism disorder. This study aimed to investigate which comes first, the changes of some cytokine...Background Many cytokines have been found to increase the insulin resistance during pregnancy complicated by glucose metabolism disorder. This study aimed to investigate which comes first, the changes of some cytokines or the abnormal glucose metabolism. Methods This nested case-control study was undertaken from January 2004 to March 2005. Twenty-two women with gestational diabetes mellitus （GDM）, 10 with gestational impaired glucose tolerance （GIGT）, and 20 healthy pregnant women were chosen from the women who had visited the antenatal clinics and had blood samples prospectively taken and kept during their visit. The levels of tumor necrosis factor-α （TNF-α）, leptin and adiponectin were determined. One-way ANOVA analysis and bivariate correlation analysis were used to assess the laboratory results and their relationship with body mass index （BMI）. Results Women with GDM have the highest values of TNF-α and leptin and the lowest value of adiponectin compared with those with GIGT and the healthy controls （P 〈0.01） at 14-20 weeks of gestation. This was also found when these women progressed to 24-32 weeks. The significantly increased levels of TNF-α and leptin and the decreased level of adiponectin were found at the different periods of gestation within the same group. Positive correlation was shown between the levels of TNF-α and leptin at the two periods of gestation with the BMI at 14-20 weeks, while adiponectin was negatively correlated （P 〈0.05）. Conclusions The concentrations of TNF-α, leptin and adiponectin may change before the appearance of the abnormal glucose level during pregnancy. Further studies are required to verify the mechanism of this alteration and whether the three cytokines can be predictors for GDM at an early staqe of preqnancy.展开更多
Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis. The pathogenesis of N...Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis. The pathogenesis of NAFLD and nonalcoholic steatohepatitis (NASH) has not been fully elucidated. The “two-hit“ hypothesis is probably a too simplified model to elaborate complex pathogenetic events occurring in patients with NASH. It should be better regarded as a multiple step process, with accumulation of liver fat being the first step, followed by the development of necroinflammation and fibrosis. Adipose tissue, which has emerged as an endocrine organ with a key role in energy homeostasis, is responsive to both central and peripheral metabolic signals and is itself capable of secreting a number of proteins. These adipocyte-specific or enriched proteins, termed adipokines, have been shown to have a variety of local, peripheral, and central effects. In the current review, we explore the role of adipocytokines and proinflammatory cytokines in the pathogenesis of NAFLD. We particularly focus on adiponectin, leptin and ghrelin, with a brief mention of resistin, visfatin and retinol-binding protein 4 among adipokines, and tumor necrosis factor-α, interleukin (IL)-6, IL-1, and briefly IL-18 among proinflammatory cytokines. We update their role in NAFLD, as elucidated in experimental models and clinical practice.展开更多
目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前...目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前指导及宣教,观察组在孕期12周开始对其实施饮食和运动干预,并至分娩结束。记录两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)、脂联素、瘦素的变化及妊娠结局的差异。结果观察组干预后FPG、2 h PG、FINS、HOMA-IR、BMI、瘦素水平显著低于对照组[(5.02±0.68)nmol/L比(7.70±0.38)nmol/L;(7.1±1.7)nmol/L比(9.2±1.2)nmol/L;(11.2±2.5)m U/L比(17.2±3.0)m U/L;2.8±1.2比3.7±1.0;(26.0±1.7)kg/m2比(27.4±1.7)kg/m2;(8.0±1.8)μg/L比(13.8±1.8)μg/L](P<0.01),而脂联素水平高于对照组[(12.5±1.0)g/L比(11.0±1.4)g/L](P<0.01)。观察组妊娠期高血压、羊水过多、剖宫产率、胎儿窘迫、巨大儿、早产、新生儿窒息的发生率显著低于对照组[2.4%(1/42)比19.0%(8/42),0%比16.7%(7/42),23.8%(10/42)比57.1%(24/42),4.8%(2/42)比23.8%(10/42),4.8%(2/42)比21.4%(9/42),2.4%(1/42)比21.4%(9/42),0%比16.7%(7/42)](P<0.05)。结论早期饮食及运动干预能有效降低GDM患者血糖、脂联素、瘦素水平,改善患者胰岛素抵抗,并能有效改善妊娠结局,降低母婴并发症发生率。展开更多
Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver i...Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver is more prevalent in overweight than normal-weight people and liver fat positively correlates with hepatic insulin resistance.Hepatic steatosis is regarded as a benign stage of NAFLD but may progress to NASH in a subgroup of patients.Besides liver biopsy no diagnostic tools to identify patients with NASH are available,and no effective treatment has been established.Visceral obesity is a main risk factor for NAFLD and inappropriate storage of triglycerides in adipocytes and higher concentrations of free fatty acids may add to increased hepatic lipid storage,insulin resistance,and progressive liver damage.Most of the adipose tissue-derived proteins are elevated in obesity and may contribute to systemic inflammation and liver damage.Adiponectin is highly abundant in human serum but its levels are reduced in obesity and are even lower in patients with hepatic steatosis or NASH.Adiponectin antagonizes excess lipid storage in the liver and protects from inflammation and fibrosis.This review aims to give a short survey on NAFLD and the hepatoprotective effects of adiponectin.展开更多
文摘Background Many cytokines have been found to increase the insulin resistance during pregnancy complicated by glucose metabolism disorder. This study aimed to investigate which comes first, the changes of some cytokines or the abnormal glucose metabolism. Methods This nested case-control study was undertaken from January 2004 to March 2005. Twenty-two women with gestational diabetes mellitus （GDM）, 10 with gestational impaired glucose tolerance （GIGT）, and 20 healthy pregnant women were chosen from the women who had visited the antenatal clinics and had blood samples prospectively taken and kept during their visit. The levels of tumor necrosis factor-α （TNF-α）, leptin and adiponectin were determined. One-way ANOVA analysis and bivariate correlation analysis were used to assess the laboratory results and their relationship with body mass index （BMI）. Results Women with GDM have the highest values of TNF-α and leptin and the lowest value of adiponectin compared with those with GIGT and the healthy controls （P 〈0.01） at 14-20 weeks of gestation. This was also found when these women progressed to 24-32 weeks. The significantly increased levels of TNF-α and leptin and the decreased level of adiponectin were found at the different periods of gestation within the same group. Positive correlation was shown between the levels of TNF-α and leptin at the two periods of gestation with the BMI at 14-20 weeks, while adiponectin was negatively correlated （P 〈0.05）. Conclusions The concentrations of TNF-α, leptin and adiponectin may change before the appearance of the abnormal glucose level during pregnancy. Further studies are required to verify the mechanism of this alteration and whether the three cytokines can be predictors for GDM at an early staqe of preqnancy.
文摘Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis. The pathogenesis of NAFLD and nonalcoholic steatohepatitis (NASH) has not been fully elucidated. The “two-hit“ hypothesis is probably a too simplified model to elaborate complex pathogenetic events occurring in patients with NASH. It should be better regarded as a multiple step process, with accumulation of liver fat being the first step, followed by the development of necroinflammation and fibrosis. Adipose tissue, which has emerged as an endocrine organ with a key role in energy homeostasis, is responsive to both central and peripheral metabolic signals and is itself capable of secreting a number of proteins. These adipocyte-specific or enriched proteins, termed adipokines, have been shown to have a variety of local, peripheral, and central effects. In the current review, we explore the role of adipocytokines and proinflammatory cytokines in the pathogenesis of NAFLD. We particularly focus on adiponectin, leptin and ghrelin, with a brief mention of resistin, visfatin and retinol-binding protein 4 among adipokines, and tumor necrosis factor-α, interleukin (IL)-6, IL-1, and briefly IL-18 among proinflammatory cytokines. We update their role in NAFLD, as elucidated in experimental models and clinical practice.
文摘目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前指导及宣教,观察组在孕期12周开始对其实施饮食和运动干预,并至分娩结束。记录两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)、脂联素、瘦素的变化及妊娠结局的差异。结果观察组干预后FPG、2 h PG、FINS、HOMA-IR、BMI、瘦素水平显著低于对照组[(5.02±0.68)nmol/L比(7.70±0.38)nmol/L;(7.1±1.7)nmol/L比(9.2±1.2)nmol/L;(11.2±2.5)m U/L比(17.2±3.0)m U/L;2.8±1.2比3.7±1.0;(26.0±1.7)kg/m2比(27.4±1.7)kg/m2;(8.0±1.8)μg/L比(13.8±1.8)μg/L](P<0.01),而脂联素水平高于对照组[(12.5±1.0)g/L比(11.0±1.4)g/L](P<0.01)。观察组妊娠期高血压、羊水过多、剖宫产率、胎儿窘迫、巨大儿、早产、新生儿窒息的发生率显著低于对照组[2.4%(1/42)比19.0%(8/42),0%比16.7%(7/42),23.8%(10/42)比57.1%(24/42),4.8%(2/42)比23.8%(10/42),4.8%(2/42)比21.4%(9/42),2.4%(1/42)比21.4%(9/42),0%比16.7%(7/42)](P<0.05)。结论早期饮食及运动干预能有效降低GDM患者血糖、脂联素、瘦素水平,改善患者胰岛素抵抗,并能有效改善妊娠结局,降低母婴并发症发生率。
基金Supported by The Faculty of Medicine of the University of Regensburg (ReForM C)The Deutsche Forschungsgemein-schaft
文摘Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver is more prevalent in overweight than normal-weight people and liver fat positively correlates with hepatic insulin resistance.Hepatic steatosis is regarded as a benign stage of NAFLD but may progress to NASH in a subgroup of patients.Besides liver biopsy no diagnostic tools to identify patients with NASH are available,and no effective treatment has been established.Visceral obesity is a main risk factor for NAFLD and inappropriate storage of triglycerides in adipocytes and higher concentrations of free fatty acids may add to increased hepatic lipid storage,insulin resistance,and progressive liver damage.Most of the adipose tissue-derived proteins are elevated in obesity and may contribute to systemic inflammation and liver damage.Adiponectin is highly abundant in human serum but its levels are reduced in obesity and are even lower in patients with hepatic steatosis or NASH.Adiponectin antagonizes excess lipid storage in the liver and protects from inflammation and fibrosis.This review aims to give a short survey on NAFLD and the hepatoprotective effects of adiponectin.
