解偶联蛋白2基因启动子-866G／A多态性与2型糖尿病的相关性研究

研究解偶联蛋白-2基因启动子常见-866G／A基因多态性（UCP2—866G／A）与2型糖尿病发病相关性。用多聚酶链反应-限制内切酶长度多态性技术检测了76例非糖尿病对照（NDM）和115例糖尿病患者（DM）的UCP2—866G／A基因型分布,并分析各基因型与胰岛功能、代谢参数的差异性。结果DM的AA基因型分布显著高于NDM（32．2％vs15．8％,χ^2=6．526,P〈0．038）。在NDM组GG型携带者空腹C肽（FCP）水平高于AA和GG组（两两比较分别为t=2．99,P=0．005和t=2．229,P=0．03）;在DM各基因型之间FCP和餐后2小时C肽（2hCP）情况与NDM对照相似,各基因型混和餐刺激后2hCP差异更加明显。结论为UCP2—866G／A基因多态性与大连地区2型糖尿病发病相关,该基因多态性主要影响胰岛β细胞分泌功能。     

多因素强化干预对2型糖尿病患者低脂联素血症的影响

探讨多因素强化干预对2型糖尿病患者低脂联素血症的影响。89例2型糖尿病患者实施血糖、血脂、血压强化控制,随诊1年并检测相关指标变化,统计学分析显示多因素强化干预可改善低脂联素血症,糖化血红蛋白和甘油三酯的变化值是影响血清脂联素水平变化的主要因素。因此,多因素强化干预可以有效改善低脂联素血症,可能减低糖尿病并发症发生的风险。     

二甲双胍对糖尿病大鼠脂联素的影响

二甲双胍能够改善胰岛素抵抗,而脂联素与胰岛素抵抗密切相关,因此本研究通过建立糖尿病大鼠模型,并给予二甲双胍治疗,观察胰岛素抵抗和脂联素的变化,研究结果显示二甲双胍的治疗改善胰岛素抵抗的同时,也增加了血清和组织中脂联素的表达,提示二甲双胍改善胰岛素抵抗的机制之一可能是通过增加脂联素的表达而获益。     

Social support,strain, and glycemic control: A path analysis

Social support and strain have been linked with many health outcomes. However, less is known about whether these psychosocial factors are associated with Type 2 diabetes risk. This study uses the Midlife in the United States (MIDUS) dataset to examine the relationship between social support and strain from friends, family members, and spouse/partners and blood hemoglobin A1c levels in married/cohabiting adults who have not been diagnosed with diabetes. In addition, health locus of control is examined as a possible mediator. The study's findings suggest that support from friends is negatively associated with HbA1c levels, indicating a relationship between better glycemic control and social support from friends, and an indirect association for spouse/partner support. A direct effect for internal health locus of control was also found.     

单纯糖耐量受损的冠心病患者临床及冠脉造影特点分析

入选空腹血糖正常并通过冠脉造影（CAG）确诊为冠心病（CAD）的患者104例行糖耐量试验（OGTT ）,将糖耐量正常（NGT ）者、单纯负荷后2h 血糖受损者（I-IGT ）与同期合并糖尿病（DM ）并通过 CAG 确诊为 CAD 的患者38例对照。结果,（1）DM 组甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（LDL-C）、载脂蛋白（Apo）、高敏-C 反应蛋白（hs-CRP）、尿微量白蛋白、尿酸（UA）高于 NGT 组（P＜0．05或 P＜0．01）,且 I-IGT 组体质量指数（BMI）最大,与 NGT组及 DM 组比较有统计学意义（P＜0．01）;（2）I-IGT 、DM 组冠状动脉病变支数、重度狭窄、闭塞、弥漫性病变、病变总积分、右冠状动脉病变比例均高于 NGT 组（P＜0．05或 P＜0．01）;（3）DM 组三支病变、弥漫性病变、冠状动脉病变总积分均高于 I-IGT 组（P＜0．05）。因此,空腹血糖正常的 CAD 患者均应行 OGTT 检查,以降低糖耐量异常的漏诊率;I-IGT 患者发生心血管疾病的危险性增加,且随着糖代谢异常的加重而加剧,应及早干预。     

网络心理教育在1型糖尿病青少年患者自我管理中的作用

探讨网络心理健康教育在1型糖尿病青少年患者中的实证效果,选取1型糖尿病青少年100例,随机分成对照组和干预组各50例.干预组实施网络健康教育,通过网络视频,讲授糖尿病的相关知识,进行定期随访;对照组采用常规健康管理模式,只发放糖尿病知识宣传册由1型糖尿青少年患者和家属自己学习.干预组糖尿病青少年患者自我管理、生活质量、心理状态情况有明显改善,干预后糖化血红蛋白水平下降,对照组上述指标无明显改变.网络心理教育课程是一种新型的有效的健康教育管理模式,能够让1型糖尿病青少年患者病情稳定,同时减少并发症的发生.     

暴发性1型糖尿病：一种不可忽视的重症糖尿病

暴发性1型糖尿病以起病急骤、代谢紊乱严重、胰酶升高并缺乏糖尿病相关抗体为特征。本文回顾分析我院收治的3例暴发性l型糖尿病的临床资料并结合文献与经典1型糖尿病进行对比复习,以提高对该病的认识。3例患者平均病程5．3天,入院平均血糖27．8mmol／L,平均糖化血红蛋白（HbAlC）6．8％,平均空腹C肽0．043ng／ml,平均餐后2hC肽0．04ng／ml,平均胰岛素使用剂量0．50U／（kg·d）。随访6个月HbAlC平均值为7．5％,胰岛8细胞功能无改善。暴发性1型糖尿病较经典1型糖尿病有更严重的胰岛素缺乏、代谢紊乱,更强烈的免疫反应,预后较差。     

以健脾改变人体对治疗反应性的思考与实践

从辩证法的观点看,欲使疗效最大化,不仅要考虑外在治疗自身对疾病的作用,还要考虑人体对治疗的反应性,两者兼顾,不得偏颇,但目前缺乏改变人体对治疗反应性的手段;中医脾主运化,具有运化食(药)物的功能,“主管”着药物在体内的命运,提示通过中医健脾,极有可能改变人体对治疗的反应性,从而提升临床疗效;通过对糖尿病、高血压、高血脂、缺钙、皮肤病等疾病的研究与观察,证实健脾确实可以改变人体对治疗的反应性,提高临床疗效;以健脾改变人体对治疗的反应性具有重大临床意义,值得今后进一步研究.     

Is spousal support always helpful to patients with asthma or diabetes? A prospective study

The current study examined effects of three ways of providing spousal support (active engagement, protective buffering, and overprotection) on self-efficacy and physical and mental health in patients with diseases imposing a high demand on self-management routines (36 asthma patients and 21 diabetic patients). Employing a nine-month prospective design, we hypothesized that active engagement would be positively related to health and self-efficacy, that overprotection would have a negative impact, and that the impact of protective buffering would depend on symptom level at baseline. Results confirmed the latter hypothesis while either positive or negative effects of active engagement and overprotection were absent. These findings are discussed with respect to the role of spousal support in diseases requiring self-management behaviour.     

Can the onset of type 2 diabetes be delayed by a group-based lifestyle intervention? A randomised control trial

This study was a randomised control trial with a waiting control group. It was designed to evaluate the effectiveness of a 6-month, group-based diabetes prevention programme, The Healthy Living Course and assess whether participation in the programme led to changes in modifiable risk factors for type 2 diabetes among an already at-risk pre-diabetic population. Individuals designated at risk for diabetes by their general practitioners (GPs) were screened using an Oral Glucose Tolerance Test. Volunteers (N?=?307) with pre-diabetes were assigned to an intervention or wait-control group in the ratio of approximately 2?:?1. The sample was pre-tested on biochemical, anthropometric and self-report behavioural, cognitive and mood variables and post-tested either at the end of the educational/support-based lifestyle programme or the end of the wait period. The intervention group significantly improved their diabetes knowledge, motivation to change, positive affect, healthy eating and activity levels and showed significantly greater reductions in weight, body mass index, waist circumference, diastolic blood pressure and fasting plasma glucose in comparison with controls. The intervention group also changed their diagnostic status from pre-diabetes to non-diabetes at a greater rate than the wait group (43% vs. 26%) who received standard care from their GPs.