Abdominal Obesity Associated with Elevated Serum Butyrylcholinesterase Activity,Insulin Resistance and Reduced High Density Lipoprotein-Cholesterol Levels

Abdominal obesity (AO) has a strong correlation with cardiovascular disease and has been linked to Alzheimer’s disease and type 2 diabetes. We investigated the association between AO and elevated serum butyrylcholinesterase (BChE) activity, insulin resistance and the serum lipid profile, including triglyceride (TG), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels in AO and non-AO women subjects. A total of 500 AO subjects (age 49.1 ± 10.5 years), and 142 non-AO women subjects (age 49.9 ± 11.9 years) were enrolled for the general biochemistry tests, serum BChE, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Body mass index, waist circumference, Blood pressure (BP), plasma glucose (Glu), triglyceride (TG), BChE, insulin, HOMA-IR were significantly higher and HDL-C levels were significantly lower in AO subjects (p < 0.05). Waist circumference was significantly correlated with BP, Glu, TG, BChE, insulin and HOMA-IR in AO subjects. Multiple logistic regression demonstrated that AO was associated with elevated BChE, HOMA-IR, hypertension and reduced HDL-C after adjusting for these variables. AO is associated with elevated BChE, insulin resistance, HT and reduced HDL-C. These may predict the development of type 2 diabetes mellitus and may be associated with cognitive disorder in the future, both are mediated through insulin resistance.     

Association of Elevated Serum Uric Acid with the Components of Metabolic Syndrome and Oxidative Stress in Abdominal Obesity Subjects

Abdominal obesity (AO) and metabolic syndrome (MetS) are associated with the cardiovascular disease and type 2 diabetes. Serum uric acid (SUA) is often elevated in subjects with the AO. We aimed to investigate the association of elevated SUA with the components of MetS, oxidative stress and TG/HDL-C ratio in AO subjects. This cross-sectional study used data from a Health Survey for Prevention of Hypertension and Type 2 Diabetes Mellitus in residents of two districts in Phitsanulok province, including 443 subjects. Anthropometric, blood pressure (BP) and biochemical variables were measured. We categorized the participants to two-group as 248 AO subjects (median age = 58, interquartile range 50.0–65.0 years) and 195 non-AO subjects (median age = 53, interquartile range 47.0–62.0 years). Waist circumference was significantly correlated with SystBP, DiastBP, Glu and SUA (P < 0.05) and SUA was significantly correlated with Glu, TG, HDL-C and TG/HDL-C ratio (P < 0.05). By using multiple logistic regression, we found the association of elevated SUA with abdominal obesity, hyperglycemia, hypertriglyceridemia, reduced HDL-C, elevated TG/HDL-C ratio, MetS and increased oxidative stress after adjusting for their covariates. Our study demonstrated that circulating UA is a major antioxidant and might help protect against free-radical oxidative damage. However, elevated SUA concentrations associated with oxidative stress, MetS, insulin resistance, and components of MetS. Then, SUA may be a marker of increased oxidative stress, insulin resistance and MetS, implying an increased risk of vascular disease and T2DM.     

Additive Effect of Lipid Lowering Drug (Simvastatin) in Combination with Antidiabetic Drug (Glibenclamide) on Alloxan Induced Diabetic Rats with Long Term Dyslipidemia

High blood glucose level, elevated level of liver enzyme, necrosis and shrinkage of islets of Langerhans has been implicated in the pathogenesis of type 2 diabetes. High blood glucose cause oxidative stress, production of free radical as well as elevated SGPT and SGOT level. Both glibenclamide and simvastatin in fixed dose used as antihyperglycemic antidyslipidemic and antioxidative agents for type 2 diabetes treatment. This study therefore aimed to evaluate the antihyperglycemic, antidyslipidemic and antioxidative effect of fixed dose combination of glibenclamide (0.6 mg/70 kg body weight) and simvastatin (5 mg/70 kg body weight) on long term alloxan induced diabetic rats with cardiovascular disease using various diagnostic kits as a parameter of phamacotherapeutic and pharmacological effect. The study was carried out using 96 Swiss Albino male rats weighing about 200–220 g. Combination therapy induced a significant decrease in blood glucose level in alloxan induced diabetic rats, from 33.75 ± 1.65 to 5.80 ± 0.07 mmol/l 2 h after last dose administration, after 4 weeks treatment. In case of dyslipidemic effect, combination therapy reduced total cholesterol (45 %), triglyceride (36 %) and low density lipoprotein-cholesterol (32 %) levels significantly and increased high density lipoprotein-cholesterol level (57 %) in comparison with their respective diabetic control groups. Results of this study showed that combination therapy effectively decreased SGPT (ALAT) (55 %) and SGOT (ASAT) (51 %) in comparison with diabetic control group. It was also observed that catalase and superoxide dismutase enzyme activity was increased by 58 and 91 % respectively in comparison with diabetic control group after 4 weeks treatment with combination of both drugs. In conclusion, these findings of combination therapy (glibenclamide and simvastatin) on alloxan induced diabetes in rats are significantly better than monotherapy using single drug. The results of the present study suggest that, combination of the fixed dose of glibenclamide and simvastatin might be efficacious in patients with diabetic dyslipidemia and increased oxidative stress. Furthermore, this combination therapy offer dosage convenience to the patients and by virtue of its dual mode of action might be a useful addition to the therapeutic armamentarium for patients with diabetic dyslipidemia and oxidative stress.     

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.     

Hypoadiponectinemia in Obesity: Association with Insulin Resistance

Obesity is risk factor for insulin resistance, diabetes, and other chronic diseases. Adiponectin, an adipose-specific protein with antiatherogenic and antiinflammatory effects, were found to be associated with obesity, type 2 diabetes, and insulin resistance. Our aim to identify possible relationships between circulating adiponectin and obesity as well as obesity related phenotypes. A total of 642, obese and non-obese individuals were included in this cross-sectional study. Hormone and glucose levels were estimated using standard protocols. The adiponectin levels showed a significant decrease with increasing quartiles of insulin resistance index. Subjects in lowest quartile of adiponectin level had a significantly higher risk than those in the highest quartile, with higher body mass index, waist circumference, blood pressure, percentage body fat, fat mass, fasting insulin, insulin resistance index, total cholesterol (p < 0.001), low density lipoprotein–cholesterol (p = 0.001), very low density lipoprotein–cholesterol (p = 0.002), and Triglyceride (p = 0.002). The present study indicates that adiponectin is significantly associated with obesity, insulin resistance and other obesity related phenotypes.     

Dyslipidemia in pregnancy may contribute to increased risk of neural tube defects -a pilot study in north Indian population

Neural tube defects are congenital structural abnormalities of the brain and vertebral column resulting from improper or non-timely closure of the neural tube. Prevalence of neural tube defects is reported to be higher among women with diabetes mellitus and obesity. This study was designed to investigate the relation between the presence of dyslipidemia in antenatal patients and the risk of fetal neural tube defects. The present study was an observational, cross-sectional study involving 129 pregnant women in 16 to 18 weeks gestation period. Of these, 80 women had normal pregnancies and 49 were clinically high-risk cases for neural tube defects. Fasting blood samples were analyzed for blood sugar and lipid profile by enzymatic assay and alpha-fetoprotein levels using Enzyme Immunoassay. Alpha-fetoprotein (AFP) values were converted to Multiples of Median (MoM) appropriate for the gestational age. Based on AFP values, women were labeled as screen negative (AFP <2 MoM, n= 102) and screen positive (AFP > 2 MoM, n =27). Screen positive women were further evaluated by ultrasound and 21 women were found to carry a neural tube defects positive pregnancy. Statistical analysis was done on SPSS software. Body weight of the women showed a significant positive correlation with serum triglycerides, plasma sugar and AFP MoM values. A significant difference was observed in serum cholesterol levels (p= 0.038), triglycerides (p=0.001) and plasma sugar levels (p=0.002) between normal women and those with neural tube defects positive pregnancy. The Odds ratio for neural tube defects risk in dyslipidemic cases was 24.23 (CI 4.73 − 148.60) with a relative risk of 12.12. Dyslipidemia especially hypertriglyceridemia was found to be significantly associated with fetal neural tube defects.     

Angiogenic Potential,Circulating Angiogenic Factors and Insulin Resistance in Subjects with Obesity

Altered vascular function and pathological angiogenesis are important factors common to the development of obesity and obesity-associated diseases. Most human studies relating obesity and angiogenesis have compared levels of angiogenic factors in obesity without looking at the serum angiogenic capacity which reflects the balance between the effects of angiogenic and angiostatic factors. Therefore, in this cross-sectional study, the serum angiogenic potential and levels of angiogenic factors in serum of obese (BMI > 25 kg/m²) and lean subjects (BMI < 23 kg/m²), with no history of obesity associated co-morbidities, were assessed. Serum angiogenic potential was significantly higher (p < 0.0001) in both male (n = 67) and female (n = 35) obese subjects and showed a positive correlation (r = 0.4, p < 0.0001) with BMI. Serum levels of the angiogenic factors, vascular endothelial growth factor (VEGF) and angiopoietin were significantly higher in obese subjects. Levels of angiostatic factors such as angiostatin, endostatin were not altered in obese male subjects but were elevated in female obese subjects. Angiogenic potential and levels of VEGF did not vary in obese subjects with high HOMA-IR compared to obese subjects with low HOMA-IR. These results suggest that the angiogenic potential of serum was elevated in obesity and that insulin resistance may not contribute to the increased angiogenic potential in obesity.     

Haptoglobin Polymorphism and Association with Complications in Ghanaian Type 2 Diabetic Patients

There is scanty information on the role of genetic factors, especially those relating to haptoglobin (Hp) phenotypes in the expression of complications among diabetes mellitus patients in Ghana. In this study, we investigated whether there is any association between Hp phenotypes and diabetic complications and to determine if association of the Hp phenotypes with diabetic complications in Ghanaian diabetics differ from those in Caucasians. A total of 398 participants were randomly recruited into the study. These comprised diabetic patients numbering 290 attending a diabetes Clinic in Ghana and 108 non-diabetic controls from the same community. Analyses of the results indicate that most of the diabetics with complications were of the Hp 2–2 (35%) and Hp 2–1 (23.9%) phenotypes. Fewer diabetics were found to be of the Hp 2–1 M phenotype. The controls were mostly of Hp 1–1 and Hp 2–1 M phenotypes. The odds ratio of having complications in a diabetic with an Hp 2–2 phenotype was 18.27 times greater than that for Hp 0–0. Hp 2–2 phenotype with its poor antioxidant activity may therefore be a useful predictor for the propensity of an individual to develop diabetes complications.     

糖尿病并发症与载脂蛋白、自由基的关系

为了解糖尿病血管病变与载脂蛋白（Apo)含量及超氧化物歧化酶（SOD）活性、过氧化脂质（Lpo)的关系。对48例Ⅱ型糖尿病患者和60例同龄的对照组进行检测分析，得知Ⅱ型糖尿病患者的ApoA-1、T-SOD、CuZn-SOD、Mn-SOD明显降低，ApoB、Lpo显著增高，Ⅱ型糖尿病并发症的发生率与ApoA-1水平、ApoB水平、Lpo含量有关。提示Ⅱ型糖尿病时机体存在脂质过氧化作用增强可能是引起并发症的重要原因之一。     

模糊神经网络在腹痛的中医临床诊断中的应用

运用模糊神经网络(FNN)模型,对254例腹痛中的大肠聚、肝郁肋痛、湿热黄疸、湿热泄泻、食滞胃痛、大肠痈、虚寒泄泻、脾心痛、气滞腹痛9种中医临床病症进行辅助诊断,得到9种腹痛病症的准确率达到95.4%以上,从而FNN模型可以用在临床上作辅助诊断。     

Oxidative Stress Correlates with Complications Among Diabetic Patients Attending a Diabetic Clinic in Muhimbili National Hospital, Dar es Salaam, Tanzania

In diabetes, persistent hyperglycemia results in increased production of free radicals especially oxygen free radicals, which can cause cell destruction and tissue injury resulting in cell dysfunction. With the premise that oxidative stress is a major cause of diabetic complications, we conducted a controlled laboratory based investigation on level of lipid peroxide levels in the serum of Type 1 and Type 2 diabetic patients attending Muhimbili National Hospital. From our clinical data it was observed that majority of the patients had higher waist to hip ration and body mass index, which suggests that the patients were either overweight or obese. The enrolled diabetic patients had higher lipid peroxide levels than controls and also Type 2 patients had higher lipid peroxide levels than Type 1 patients. Moreover, patients with known complications had higher lipid peroxide levels than patients without complications. The lipid peroxide levels in the diabetic patients were significantly different from that of the control subjects enrolled in the study. A majority of the diabetic patients had a poorly controlled blood sugar. Our finding hints that despite the fact that diabetic patients in our clinic are on follow up, they are at a risk of developing coronary heart diseases, neuropathy and other secondary diabetic complications.     

Evaluation of Antioxidants in the Kidney of Streptozotocin Induced Diabetic Rats

Diabetes mellitus is one of the most common endocrine metabolic disorders. Dual endocrine deficits of impaired insulin action (insulin resistance) and inadequate insulin secretion create an environment of chronic hyperglycemia and general metabolic disarray. Oxidative stress plays an important role in diabetic pathogenesis. Oxidative stress induced by streptozotocin (STZ) has been shown to damage pancreatic beta cell and produce hyperglycemia in rats. The present study was made to evaluate the antioxidant activity of ethanolic extract of the Evolvulus alsinoides in STZ induced rats. The antioxidant activities were done by using standard protocols. For histopathological analysis, the pancreatic tissues of all experimental groups were fixed with 10 % formalin for 24 h then the samples were stained with hematoxylin–eosin for the microscopic observation. Our results showed the significant decrease in lipid peroxidation and increases in the antioxidant (both enzymatic and nonenzymatic) levels after treatment with standard as well as the E. alsinoides. There is no significant difference between control and plant alone group rats. The histopathology reports also revealed non-toxic effect and protective effect of E. alsinoides in the kidney of STZ induced diabetic rats. Our result indicated that the E. alsinoides extract effectively increased the antioxidant level thereby it prevents oxidative stress during diabetes mellitus and also it showed the protective effect on kidney of STZ induced rats. Hence it can be used to maintain the antioxidant level during diabetes mellitus.     

老年糖尿病患者睡眠质量与口腔健康生活质量的观察分析

目的:调查老年糖尿病患者睡眠质量与口腔健康生活质量现状并分析多模式健康教育干预效果.方法:选取右江民族医学院附属医院2020年1月至2020年12月收治的100例老年糖尿病患者为研究对象,利用匹兹堡睡眠质量指数量表、中文版老年人口腔健康生活质量评价指数对两组老年糖尿病患者睡眠情况、口腔健康情况进行调查,采用随机数字表法...     

PBL教学法在腹部体格检查教学中的应用

目的:探讨PBL教学法在腹部体格检查教学中应用的效果。方法:选取2018年8月到2019年1月的80名本院学生作为研究对象,采取表格随机分组的方式进行分组。对对照组学生采取传统教学方法,对观察组学生采取PBL教学法,最后对两组学生的学习成绩进行比较。结果:观察组学生的理论学习成绩和实践成绩明显优于对照组学生,差异存在统计学意义(P<0.05)。结论:在体格检查教学中,采用PBL教学法能够有效提高教学质量,对于培养学生的临床思维具有良好的作用,为学生以后的临床实习打下了坚实的基础。     

Antidyslipidemic and Antioxidant Activities of Hibiscus rosa sinensis Root Extract in Alloxan Induced Diabetic Rats

The antidyslipidemic activity of Hibiscus rosa sinensis (Malvaceae) root extract has been studied in alloxan induced diabetic rats. In this model, oral administration of root extract (500 mg/kg bw. p.o.) for 15 days resulted in significant decreased in the levels of blood glucose, plasma lipids and reactivated post heparin lipoprotein lipase activity in alloxan induced diabetic rats. Furthermore, the root extract (50–500 μg) when tested for its antioxidant activity, inhibited the generation of super oxide anions and hydroxyl radicals, in both enzymic and non enzymic systems in vitro. The results of the present study demonstrated antidyslipidemic and antioxidant activities in root extract of H. rosa sinensis which could be used in prevention of diabetic-dyslipidemia and related complications.     

Analysis of Modification of Liver Proteome in Diabetic Rats by 2D Electrophoresis and MALDI-TOF-MS

The uncontrolled hyperglycemia can lead to disturbances in the cell structure and functions of organs. This study was performed to analyze the “differential proteome” change in rat liver associated with diabetes mellitus in relation to effects of an anti-diabetic herb, Cynodon dactylon leaf extracts. Rats were intraperitoneally injected with alloxan (150 mg/kg/bw) and treated with C. dactylon leaf extracts (450 mg/kg/bw/day/orally). The liver proteins were subjected to proteome analysis using the advanced technologies i.e., 2D electrophoresis (2-DE) and mass spectrometry. Comparison of 2-DE protein distribution profiles among the livers from normal, alloxan-induced diabetic rats and alloxan-induced diabetic rats treated with C. dactylon leaves identified three proteins that were up-regulated in alloxan-induced diabetic rats i.e., nucleophosmin, l-xylulose reductase and carbonic anhydrase III which are known to be mainly involved in ribosome biogenesis, centrosome duplication, cell proliferation, tumor suppression, glucose metabolism, osmo-regulation, water–CO₂ balance and acid–base balance. These results help us to understand the elucidation of molecular mechanism connected to liver function and insulin associated with diabetes mellitus. These identified proteins were primarily involved in cell proliferation and homoeostasis of liver tissues upon the treatment with C. dactylon leaf extracts.     

Antidyslipidemic Effect of Ocimum sanctum Leaf Extract in Streptozotocin Induced Diabetic Rats

The antidyslipidemic activity of Ocimum sanctum leaf extract was studied in streptozotocin induced diabetic rats. In this model, there was significant increase in plasma markers of diabetic-dyslipidemia following diminution of lipid metabolizing enzymes. Oral administration of leaf extract (500 mg/kg b.w.p.o.) for 15 days resulted in significant decrease in diabetogenic and dyslipidemia parameters; namely blood glucose, glycosylated hemoglobin, lipid peroxide, free fatty acids, small dense low density lipoprotein, lipid and protein components of plasma lipoproteins, adipose and liver. The regulation of lipids was accompanied by stimulation of postheparin lipolytic activity, reactivation of lecithin cholesterol acyl transferase and hepatic lipoprotein lipase enzymes. The results of the present study demonstrated antidyslipidemic and antioxidant activities in leaf extract of O. sanctum which could be used in prevention of diabetic-dyslipidemia and related complications.     

血镁与2型糖尿病视网膜病变的相关研究

为了探讨血镁在糖尿病视网膜病变发生中的作用及糖尿病视网膜病变的相关危险因素，测定了30例正常对照组，30例糖尿病无视网膜病变级（NDR组），30例糖尿病合并视网膜病变组（DR组）病人血清镁浓度，并对糖尿病病人行空腹血糖、糖化血红蛋白（HbAlc）、尿微量白蛋白排泄量的测定，记录病程，行眼底检查，结果发现，与正常相比较，血镁降低在NDR组P＜0．05，DR组P＜0．01。NDR组与DR组比较血镁降低亦有显著性意义（P＜0．01），且两组比较病程、空腹血糖、糖化血红蛋白和尿白蛋白排泄是均有显著性差异（P＜0．01）。作者认为糖尿病病人有缺镁的倾向，且糖尿病视网膜病变者的血镁比糖尿病无视网膜病变的患者更低，低镁与病程、空腹血糖、糖化血红蛋白、尿白蛋白排量一样，是糖尿病视网膜病变的危险因素。     

四氧嘧啶致小鼠、大鼠糖尿病模型研究

目的:研究四氧嘧啶尾静脉注射小鼠和大鼠诱导糖尿病模型,观察不同剂量四氧嘧啶诱导糖尿病模型的稳定性.方法1分别对小鼠尾静脉注射四氧嘧啶60、70、80mg/kg和对大鼠尾静脉注射四氧嘧啶30、40、50mg/kg,测定不同时点小鼠和大鼠的血糖值及体重.结果60、70和80mg/kg四氧嘧啶剂量均可导致小鼠糖尿病模型,但70和80mg/kg剂量组小鼠死亡率较大,而60mg/kg组小鼠糖尿病模型稳定;30mg/kg四氧嘧啶剂量不能造成大鼠糖尿病模型,40和50mg/kg四氧嘧啶剂量均可导致大鼠糖尿病模型,但四氧嘧啶50mg/kg剂量组大鼠死亡率较大,只有40mg/kg组糖尿病大鼠模型稳定.结论:造成小鼠和大鼠糖尿病模型最佳剂量分别为60mg/kg和40mg/kg.