Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; ho...Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear. Methods A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test （OGTT-IRT） and serum HbAlc measurement. Indexes including homeostasis model assessment-IR （HOMA-IR）, Matsuda index, HOMA-β, early phase insulinogenic index （△I30 / △G30）, AUC-I180 and oral disposition index （DIo） were calculated for the assessment of insulin resistance and pancreatic β-cell function. Results Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups （P 〈0.05）. Serum HbA1c levels were highest in subjects with severe OSAS （P 〈0.05）. In contrast, compared with normal subjects, HOMA-β, △I30/△G30 and DIo were lower in severe OSAS group （P 〈0.05）. In stepwise multiple linear regressions, 0-min glucose and HbAlc were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% （T90） （Beta = 0.215 and 0.368, P 〈0.05）; 30-min and 60-min glucose was negatively correlated with the lowest SpO2 （LSpO2） （Beta = -0.214 and -0.241, P 〈0.05）. HOMA-β and Dlowere negatively correlated with T90 （Beta = -0.153 and -0.169, P 〈0.05） while body mass index （BMI） was the only determinant of HOMA-IR and Matsuda index. Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.展开更多
目的：探讨2型糖尿病胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的相关关系。方法入选2型糖尿病患者524例，测量身高、体质量、腰围及血压。采集静脉血测量空腹血糖（FPG）、血脂、糖化血红蛋白（HbA1c）、空腹 C 肽（FPC），留取24 h ...目的：探讨2型糖尿病胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的相关关系。方法入选2型糖尿病患者524例，测量身高、体质量、腰围及血压。采集静脉血测量空腹血糖（FPG）、血脂、糖化血红蛋白（HbA1c）、空腹 C 肽（FPC），留取24 h 尿测量尿白蛋白排泄率（UAER），胰岛β细胞功能（HOMA-B）及胰岛素抵抗（HOMA-IR）采用 C 肽稳态模型评估，根据 HOMA-B 及 HOMA-IR 四分位数，分别将受试者分为四个亚组，即 q1～q4及 Q1～Q4。采用非参数趋势性检验对 HOMA-B 及 HOMA-IR 四分位分组人群各临床指标进行趋势分析，采用多因素 Logistic 回归分析评价2型糖尿病患者胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的关系。结果趋势性检验显示，随 HOMA-B 升高，UAER 逐渐减少，q1、q2、q3、q4组分别为8．92（5．53～28．65）、8．55（5．52～20．95）、7．57（4．79～19．83）、7．84（5．23～14．38）μg／min，趋势有统计学意义（z ＝－2．1， P ＜0．05），随 HOMA-IR 升高，UAER 逐渐增加，Q1、Q2、Q3、Q4组分别为6．73（4．85～16．52）、8．61（5．2～20.37）、8．31（4．88～27．04）、8．75（6．03～25．21）μg／min，趋势有统计学意义（z ＝2．41，P ＜0．05）。多因素Logistic 回归分析，HOMA-B 最高四分位比最低四分位人群微量白蛋白尿发病风险降低（校正 OR q4 vs q1＝0.39，95％CI：0．20-0．76，Wald ＝7．59，P ＝0．006），相反，HOMA-IR 最高四分位比最低四分位人群有较高微量白蛋白尿发病风险（校正 OR Q4 vs Q1＝2．00，95％CI：1．08-3．72，Wald ＝4．84，P ＝0．028）。结论胰岛素抵抗与2型糖尿病患者微量白蛋白尿发生增加有关，而较好胰岛β细胞功能与微量白蛋白尿发生降低有关。展开更多
目的观察中药复方益糖康对气阴两虚型2型糖尿病(T2DM)患者胰岛β细胞功能及炎症因子的影响。方法选取符合纳入标准的90例初诊断气阴两虚证T2DM患者,随机分成对照组和观察组,各45例。对照组予以糖尿病教育、饮食、运动治疗及二甲双胍治疗...目的观察中药复方益糖康对气阴两虚型2型糖尿病(T2DM)患者胰岛β细胞功能及炎症因子的影响。方法选取符合纳入标准的90例初诊断气阴两虚证T2DM患者,随机分成对照组和观察组,各45例。对照组予以糖尿病教育、饮食、运动治疗及二甲双胍治疗,观察组患者在对照组基础上给予中药复方益糖康,观察治疗前后两组患者的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、胰岛β细胞功能[空腹C肽(FCP)、餐后2 h C肽(2 h PCP)]、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、中医证候积分、血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)]变化情况。结果治疗2周后,两组患者血糖水平较治疗前均显著下降(P<0.05),但组间比较差异无统计学意义(P>0.05);观察组患者血糖水平、HbA1c、FCP、2 h CP、HOMA-IR、CRP、IL-6、TNF-α均低于对照组(P<0.05),而HOMA-β高于对照组(P<0.05);观察组中医证候积分明显改善(P<0.05)。结论中药复方益糖康能够改善气阴两虚型T2DM患者的胰岛β细胞功能,增加胰岛素敏感性,减轻胰岛素抵抗,增强血糖控制效果,并可以一定程度的改善患者的乏力、手足心热、酸胀沉重等临床表现。展开更多
Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The st...Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The study group consisted of 89 patients with type 2 diabetes mellitus and tuberculosis infection who were admitted to Jingzhou Chest Hospital between March 2019 and March 2021. Gender and duration of diabetes were matching conditions. The control group was made up of 89 patients with type 2 diabetes who were admitted to Jingzhou Central Hospital’s endocrinology department during the same period. The two patient groups provided general information such as gender, age, length of diabetes, and blood biochemical indexes such as glycosylated hemoglobin (HbA1c), fasting glucose (FPG), and fasting C-peptide (FC-P). The HOMA calculator was used to calculate the HOMA-β and the HOMA-IR, and intergroup comparisons and correlation analyses were carried out. Results: Regarding gender, age, disease duration, FC-P, and HbA1c, the differences between the two groups were not statistically significant (P > 0.05). However, BMI, FPG, HOMA-β, and HOMA-IR showed statistically significant differences (P < 0.05). In comparison to the control group, the study group’s HOMA-β was lower and its HOMA-IR was greater. According to Spearman’s correlation analysis, HOMA-β had a negative association (P th FPG, HbA1c, and the length of the disease, and a positive correlation with BMI and FC-P. A positive correlation was found between HOMA-IR and BMI, FPG, and FC-P (P < 0.01), as well as a correlation with the length of the disease (P > 0.05) and HbA1c. Conclusions: In type 2 diabetes mellitus combined with tuberculosis infection, the patients had higher FPG levels and lower FC-P levels, the secretory function of pancreatic β-cells was more severely impaired, and insulin resistance was more obvious.展开更多
文摘Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear. Methods A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test （OGTT-IRT） and serum HbAlc measurement. Indexes including homeostasis model assessment-IR （HOMA-IR）, Matsuda index, HOMA-β, early phase insulinogenic index （△I30 / △G30）, AUC-I180 and oral disposition index （DIo） were calculated for the assessment of insulin resistance and pancreatic β-cell function. Results Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups （P 〈0.05）. Serum HbA1c levels were highest in subjects with severe OSAS （P 〈0.05）. In contrast, compared with normal subjects, HOMA-β, △I30/△G30 and DIo were lower in severe OSAS group （P 〈0.05）. In stepwise multiple linear regressions, 0-min glucose and HbAlc were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% （T90） （Beta = 0.215 and 0.368, P 〈0.05）; 30-min and 60-min glucose was negatively correlated with the lowest SpO2 （LSpO2） （Beta = -0.214 and -0.241, P 〈0.05）. HOMA-β and Dlowere negatively correlated with T90 （Beta = -0.153 and -0.169, P 〈0.05） while body mass index （BMI） was the only determinant of HOMA-IR and Matsuda index. Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.
文摘目的观察中药复方益糖康对气阴两虚型2型糖尿病(T2DM)患者胰岛β细胞功能及炎症因子的影响。方法选取符合纳入标准的90例初诊断气阴两虚证T2DM患者,随机分成对照组和观察组,各45例。对照组予以糖尿病教育、饮食、运动治疗及二甲双胍治疗,观察组患者在对照组基础上给予中药复方益糖康,观察治疗前后两组患者的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、胰岛β细胞功能[空腹C肽(FCP)、餐后2 h C肽(2 h PCP)]、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、中医证候积分、血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)]变化情况。结果治疗2周后,两组患者血糖水平较治疗前均显著下降(P<0.05),但组间比较差异无统计学意义(P>0.05);观察组患者血糖水平、HbA1c、FCP、2 h CP、HOMA-IR、CRP、IL-6、TNF-α均低于对照组(P<0.05),而HOMA-β高于对照组(P<0.05);观察组中医证候积分明显改善(P<0.05)。结论中药复方益糖康能够改善气阴两虚型T2DM患者的胰岛β细胞功能,增加胰岛素敏感性,减轻胰岛素抵抗,增强血糖控制效果,并可以一定程度的改善患者的乏力、手足心热、酸胀沉重等临床表现。
文摘Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The study group consisted of 89 patients with type 2 diabetes mellitus and tuberculosis infection who were admitted to Jingzhou Chest Hospital between March 2019 and March 2021. Gender and duration of diabetes were matching conditions. The control group was made up of 89 patients with type 2 diabetes who were admitted to Jingzhou Central Hospital’s endocrinology department during the same period. The two patient groups provided general information such as gender, age, length of diabetes, and blood biochemical indexes such as glycosylated hemoglobin (HbA1c), fasting glucose (FPG), and fasting C-peptide (FC-P). The HOMA calculator was used to calculate the HOMA-β and the HOMA-IR, and intergroup comparisons and correlation analyses were carried out. Results: Regarding gender, age, disease duration, FC-P, and HbA1c, the differences between the two groups were not statistically significant (P > 0.05). However, BMI, FPG, HOMA-β, and HOMA-IR showed statistically significant differences (P < 0.05). In comparison to the control group, the study group’s HOMA-β was lower and its HOMA-IR was greater. According to Spearman’s correlation analysis, HOMA-β had a negative association (P th FPG, HbA1c, and the length of the disease, and a positive correlation with BMI and FC-P. A positive correlation was found between HOMA-IR and BMI, FPG, and FC-P (P < 0.01), as well as a correlation with the length of the disease (P > 0.05) and HbA1c. Conclusions: In type 2 diabetes mellitus combined with tuberculosis infection, the patients had higher FPG levels and lower FC-P levels, the secretory function of pancreatic β-cells was more severely impaired, and insulin resistance was more obvious.
