美国牛津糖尿病中心的Karpe F等近期发表的"Fatty acids,obesity,and insulin resistance:time for a reevaluation"(Diabetes,2011,60:2441)。根据他们自己的研究和文献对脂肪酸(FA)在肥胖和IR中的关系撰文提出新认识。首先...美国牛津糖尿病中心的Karpe F等近期发表的"Fatty acids,obesity,and insulin resistance:time for a reevaluation"(Diabetes,2011,60:2441)。根据他们自己的研究和文献对脂肪酸(FA)在肥胖和IR中的关系撰文提出新认识。首先,非酯化脂肪酸(NEFA)的基本功能现在认为NEFA是将储存在脂肪组织的TG转运到其利用处的转运工具,而不只是供肝、心肌等利用。第二,上身和腹部皮下脂肪堆积是NEFA主要来源,不同于普遍认为只有一小部分NEFA来自腹内脂肪组织。第三,空腹血浆NEFA几乎全部来自脂肪细胞内TG水解,但餐后血浆NEFA约40%～50%来自食物脂肪乳糜颗粒中的TG被LPL水解,脂肪利用被胰岛素抑制,在富含碳水化合物餐后NEFA浓度下降。第四,NEFA升高伴急性IR,常见于肥胖,控制不良的糖尿病患者,IR伴异位脂肪——脂肪组织以外的胰岛素效应组织如骨骼肌细胞脂质增加(细胞TG),反映脂肪清除损害甚于摄取。现撷其精要摘译并如以评论,供广大读作者参考。展开更多
Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies...Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies of acupuncture and related therapies for hyperlipidemia.Databases PubMed,EMBASE,Cochrane Library,the China Biology Medicine(CBM),the China National Knowledge Infrastructure(CNKI),Wanfang Data and the Chinese Scientific Journal Database(VIP)were searched to collect randomized controlled trials(RCTs)of acupuncture and related therapies in the treatment of hyperlipidemia.The data were analyzed using Stata 15.0 and WinBUGS 1.4.3 software after two researchers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Results We analyzed a total of 36 eligible studies that included 3124 patients,involving 12 types of acupuncture and related therapies and comprehensive therapies.The results of the NMA showed that:for the total cholesterol(TC),acupoint catgut embedding(ACE),simple acupuncture(ACU),acupoint injection(AI),electroacupuncture(EA),western medicine of statins(WM),and combination of acupuncture and related therapies(combined therapies)were all more effective than placebo(P<0.05).For triacylglycerol(TG),ACU,EA,warming acupuncture(WA),WM and combined therapies were better than placebo(P<0.05),while WA was better than Chinese herb(CH)(P<0.05).For low-density lipoprotein cholesterol(LDL-C),combined therapies were more effective than lifestyle modification(LM)(P<0.05).For high-density lipoprotein cholesterol(HDL-C),auricular acupoint stimulation(AAS),ACE,ACU,AI,CH,EA,LM,moxibustion(MOX),WM,combined therapies and placebo were all worse than WA(P<0.05),while WM and combined therapies were better than ACU(P<0.05).Combined ranking results suggest that ACU and combined therapies may be the optimal intervention.Conclusions The efficacy of all kinds of acupuncture-related therapies in patients with hyperlipidemia is better than lifestyle changes.However,for展开更多
文摘美国牛津糖尿病中心的Karpe F等近期发表的"Fatty acids,obesity,and insulin resistance:time for a reevaluation"(Diabetes,2011,60:2441)。根据他们自己的研究和文献对脂肪酸(FA)在肥胖和IR中的关系撰文提出新认识。首先,非酯化脂肪酸(NEFA)的基本功能现在认为NEFA是将储存在脂肪组织的TG转运到其利用处的转运工具,而不只是供肝、心肌等利用。第二,上身和腹部皮下脂肪堆积是NEFA主要来源,不同于普遍认为只有一小部分NEFA来自腹内脂肪组织。第三,空腹血浆NEFA几乎全部来自脂肪细胞内TG水解,但餐后血浆NEFA约40%～50%来自食物脂肪乳糜颗粒中的TG被LPL水解,脂肪利用被胰岛素抑制,在富含碳水化合物餐后NEFA浓度下降。第四,NEFA升高伴急性IR,常见于肥胖,控制不良的糖尿病患者,IR伴异位脂肪——脂肪组织以外的胰岛素效应组织如骨骼肌细胞脂质增加(细胞TG),反映脂肪清除损害甚于摄取。现撷其精要摘译并如以评论,供广大读作者参考。
基金We thank for the funding support from the“Qihuang”Project on the Inheritance and Innovation of Traditional Chinese Medicine funded by National Administration of Traditional Chinese Medicine(No.284,2018).
文摘Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies of acupuncture and related therapies for hyperlipidemia.Databases PubMed,EMBASE,Cochrane Library,the China Biology Medicine(CBM),the China National Knowledge Infrastructure(CNKI),Wanfang Data and the Chinese Scientific Journal Database(VIP)were searched to collect randomized controlled trials(RCTs)of acupuncture and related therapies in the treatment of hyperlipidemia.The data were analyzed using Stata 15.0 and WinBUGS 1.4.3 software after two researchers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Results We analyzed a total of 36 eligible studies that included 3124 patients,involving 12 types of acupuncture and related therapies and comprehensive therapies.The results of the NMA showed that:for the total cholesterol(TC),acupoint catgut embedding(ACE),simple acupuncture(ACU),acupoint injection(AI),electroacupuncture(EA),western medicine of statins(WM),and combination of acupuncture and related therapies(combined therapies)were all more effective than placebo(P<0.05).For triacylglycerol(TG),ACU,EA,warming acupuncture(WA),WM and combined therapies were better than placebo(P<0.05),while WA was better than Chinese herb(CH)(P<0.05).For low-density lipoprotein cholesterol(LDL-C),combined therapies were more effective than lifestyle modification(LM)(P<0.05).For high-density lipoprotein cholesterol(HDL-C),auricular acupoint stimulation(AAS),ACE,ACU,AI,CH,EA,LM,moxibustion(MOX),WM,combined therapies and placebo were all worse than WA(P<0.05),while WM and combined therapies were better than ACU(P<0.05).Combined ranking results suggest that ACU and combined therapies may be the optimal intervention.Conclusions The efficacy of all kinds of acupuncture-related therapies in patients with hyperlipidemia is better than lifestyle changes.However,for
