BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS w...BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS women.Research has shown that hyperinsulinemia is correlated with increased bone mass.Given that most women with PCOS are insulin resistant,which is independent from body fat and characterized by hyperinsulinemia,it could be hypothesized that there would be an increased bone mass in the patient as a result.Subsequently,increased bone mass could be measured using the wrist circumference method.AIM To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.METHODS Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group,were enrolled in the study(mean age 24.33±5.36 years).Fasting biochemical parameters,and the Homeostasis Model Assessment of insulin resistance(HOMA-IR)and body composition were evaluated.The nondominant wrist circumference was measured manually,as was the waist circumference(WC),hip circumference,height and weight.Calculated measures included evaluation of body mass index(BMI),Waist-to-Height(WHtR)and Waist-to-hip ratio(WHR).In addition,body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.RESULTS The non-dominant wrist circumference was more closely correlated with HOMAIR(r=0.346;P=0.003)and was the best anthropometrical marker correlated with IR(P=0.011)compared with other anthropometrical markers in women with PCOS:Dominant Wrist Circumference(r=0.315;P=0.007),Waist Circumference(WC)(r=0.259;P=0.028),BMI(r=0.285;P=0.016),WHR(r=0.216;P=0,068)and WHtR(r=0.263;P=0.027).The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic(ROC)curve analysis showed that the area under the ROC curve was 0.72.A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR 展开更多
目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照...目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照组49例和观察组49例,分别给予门冬胰岛素50或门冬胰岛素50联合利格列汀治疗,两组均治疗观察12 w。使用血糖仪检测空腹血糖(FBG)和餐后2 h血糖(2 h PG)水平,采用胶体金法检测血清糖化血红蛋白(HbAlc)水平,并计算HOMA-IR和HOMA-β,使用全自动生化分析仪检测血清肝功能指标。结果在治疗后,观察组FPG水平为(6.3±3.9)mmol/L,显著低于对照组【(7.8±1.2)mmol/L,P<0.05】,2 h PG水平为(8.4±2.6)mmol/L,显著低于对照组【(11.5±2.8)mmol/L,P<0.05】,和HbAlc水平为(7.1±1.6)%,显著低于对照组【(8.3±1.9)%,P<0.05】;治疗后,观察组HOMA-IR为(1.5±0.2),显著低于对照组【(2.4±03),P<0.05】,而HOMA-β水平为(42.9±8.7),显著高于对照组【(33.5±7.2),P<0.05】;观察组血清谷丙转氨酶(ALT)水平为(53.9±13.7)U/L,显著低于对照组【(72.2±19.6)U/L,P<0.05】,谷草转氨酶(AST)水平为(22.1±6.3)U/L,显著低于对照组【(46.4±6.9)U/L,P<0.05】,两组谷氨酰转肽酶、总胆红素和白蛋白水平无显著变化(P>0.05)。结论应用利格列汀联合门冬胰岛素50治疗非酒精性脂肪性肝病合并肝源性糖尿病患者能显著改善血糖水平,有效降低HOMA-IR,升高HOMA-β,改善了胰岛β细胞功能,从而改善患者的肝功能,具有良好的治疗效果。展开更多
目的了解江苏省南京某大型化工企业男性职业人群吸烟状态与胰岛素抵抗和胰岛β细胞功能之间的关系,为职业人群糖尿病防治提供依据。方法于2018年6—12月选取该企业储运车间和化机车间的3135名男性职业人群为调查对象。根据其不同的吸烟...目的了解江苏省南京某大型化工企业男性职业人群吸烟状态与胰岛素抵抗和胰岛β细胞功能之间的关系,为职业人群糖尿病防治提供依据。方法于2018年6—12月选取该企业储运车间和化机车间的3135名男性职业人群为调查对象。根据其不同的吸烟包年数分成不吸烟、轻度吸烟、中度和重度吸烟4组,采用稳态模型(homeostasis model assessment,HOMA)计算出每个对象相应的胰岛素抵抗指数(HOMA-IR)和胰岛β细胞分泌功能指数(HOMA-β),用二分类logistic回归计算吸烟组的OR值。将调查对象每日平均吸烟支数分成0支、1~15支和>15支,采用logistic回归计算OR值。结果该职业人群的糖尿病患病率为6.35%[以空腹血糖(FPG)≥7.0 mmol/L和/或糖化血红蛋白(HbA1c)≥6.5%为标准],随着吸烟量的增加,HbA1C、空腹血糖逐渐升高,空腹胰岛素、HOMA-β逐渐降低,且有显著的剂量–效应关系,HOMA-IR在轻度吸烟者中显著增加,中度和重度吸烟者中逐渐降低。重度吸烟的胰岛β细胞分泌功能缺乏是不吸烟组的3.57倍(95%CI=2.77~4.59),相关变量调整后的OR值是1.64(95%CI=1.22~2.22)。平均每日吸烟>15支人群的胰岛β细胞分泌功能缺乏危险是不吸烟的1.62倍(95%CI=1.33~1.99),变量调整后的OR值是1.10(95%CI=0.87~1.40)。结论吸烟可以剂量依赖性引起胰岛细胞分泌功能下降,且可引起一定程度的胰岛素抵抗。展开更多
文摘BACKGROUND Insulin resistance(IR)is the main complication found in 35%-80%of women with polycystic ovary syndrome(PCOS).However,there is no definite consensus regarding which marker to use for its assessment in PCOS women.Research has shown that hyperinsulinemia is correlated with increased bone mass.Given that most women with PCOS are insulin resistant,which is independent from body fat and characterized by hyperinsulinemia,it could be hypothesized that there would be an increased bone mass in the patient as a result.Subsequently,increased bone mass could be measured using the wrist circumference method.AIM To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.METHODS Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group,were enrolled in the study(mean age 24.33±5.36 years).Fasting biochemical parameters,and the Homeostasis Model Assessment of insulin resistance(HOMA-IR)and body composition were evaluated.The nondominant wrist circumference was measured manually,as was the waist circumference(WC),hip circumference,height and weight.Calculated measures included evaluation of body mass index(BMI),Waist-to-Height(WHtR)and Waist-to-hip ratio(WHR).In addition,body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.RESULTS The non-dominant wrist circumference was more closely correlated with HOMAIR(r=0.346;P=0.003)and was the best anthropometrical marker correlated with IR(P=0.011)compared with other anthropometrical markers in women with PCOS:Dominant Wrist Circumference(r=0.315;P=0.007),Waist Circumference(WC)(r=0.259;P=0.028),BMI(r=0.285;P=0.016),WHR(r=0.216;P=0,068)and WHtR(r=0.263;P=0.027).The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic(ROC)curve analysis showed that the area under the ROC curve was 0.72.A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR
文摘目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照组49例和观察组49例,分别给予门冬胰岛素50或门冬胰岛素50联合利格列汀治疗,两组均治疗观察12 w。使用血糖仪检测空腹血糖(FBG)和餐后2 h血糖(2 h PG)水平,采用胶体金法检测血清糖化血红蛋白(HbAlc)水平,并计算HOMA-IR和HOMA-β,使用全自动生化分析仪检测血清肝功能指标。结果在治疗后,观察组FPG水平为(6.3±3.9)mmol/L,显著低于对照组【(7.8±1.2)mmol/L,P<0.05】,2 h PG水平为(8.4±2.6)mmol/L,显著低于对照组【(11.5±2.8)mmol/L,P<0.05】,和HbAlc水平为(7.1±1.6)%,显著低于对照组【(8.3±1.9)%,P<0.05】;治疗后,观察组HOMA-IR为(1.5±0.2),显著低于对照组【(2.4±03),P<0.05】,而HOMA-β水平为(42.9±8.7),显著高于对照组【(33.5±7.2),P<0.05】;观察组血清谷丙转氨酶(ALT)水平为(53.9±13.7)U/L,显著低于对照组【(72.2±19.6)U/L,P<0.05】,谷草转氨酶(AST)水平为(22.1±6.3)U/L,显著低于对照组【(46.4±6.9)U/L,P<0.05】,两组谷氨酰转肽酶、总胆红素和白蛋白水平无显著变化(P>0.05)。结论应用利格列汀联合门冬胰岛素50治疗非酒精性脂肪性肝病合并肝源性糖尿病患者能显著改善血糖水平,有效降低HOMA-IR,升高HOMA-β,改善了胰岛β细胞功能,从而改善患者的肝功能,具有良好的治疗效果。
文摘目的了解江苏省南京某大型化工企业男性职业人群吸烟状态与胰岛素抵抗和胰岛β细胞功能之间的关系,为职业人群糖尿病防治提供依据。方法于2018年6—12月选取该企业储运车间和化机车间的3135名男性职业人群为调查对象。根据其不同的吸烟包年数分成不吸烟、轻度吸烟、中度和重度吸烟4组,采用稳态模型(homeostasis model assessment,HOMA)计算出每个对象相应的胰岛素抵抗指数(HOMA-IR)和胰岛β细胞分泌功能指数(HOMA-β),用二分类logistic回归计算吸烟组的OR值。将调查对象每日平均吸烟支数分成0支、1~15支和>15支,采用logistic回归计算OR值。结果该职业人群的糖尿病患病率为6.35%[以空腹血糖(FPG)≥7.0 mmol/L和/或糖化血红蛋白(HbA1c)≥6.5%为标准],随着吸烟量的增加,HbA1C、空腹血糖逐渐升高,空腹胰岛素、HOMA-β逐渐降低,且有显著的剂量–效应关系,HOMA-IR在轻度吸烟者中显著增加,中度和重度吸烟者中逐渐降低。重度吸烟的胰岛β细胞分泌功能缺乏是不吸烟组的3.57倍(95%CI=2.77~4.59),相关变量调整后的OR值是1.64(95%CI=1.22~2.22)。平均每日吸烟>15支人群的胰岛β细胞分泌功能缺乏危险是不吸烟的1.62倍(95%CI=1.33~1.99),变量调整后的OR值是1.10(95%CI=0.87~1.40)。结论吸烟可以剂量依赖性引起胰岛细胞分泌功能下降,且可引起一定程度的胰岛素抵抗。