Association of Aberrations in One Carbon Metabolism with Intimal Medial Thickening in Patients with Type 2 Diabetes Mellitus

The present work was aimed to study the association of one carbon genetic variants, hyperhomocysteinemia and oxidative stress markers, i.e., serum nitrite, plasma malondialdehyde (MDA) and glutathione (GSH) on intimal medial thickening (IMT) in patients with type 2 diabetes mellitus (T2D). A total number of 76 subjects from ACS Medical College and Hospital, Chennai, India were included in the study, i.e., Group I (n = 42) of T2D and Group II (n = 34) of age- and sex matched healthy controls. The glycated haemoglobin was measured by ion-exchange resin method; plasma homocysteine by Enzyme Linked Immunosorbant Assay method; serum nitrite (nitric oxide, NO), plasma MDA and GSH by spectrophotometric methods; the IMT by high frequency ultrasound. The polymorphisms of one carbon genetic variants were genotyped using polymerase chain reaction-restriction fragment length polymorphism and amplified fragment length polymorphism methods. Results indicate that methyltetrahydrofolate homocysteine methyl transferase (MTR) A2756G allele was found to be protective in T2D and the other variants were not significantly associated with T2D. Glutamate carboxypeptidase II (GCP II) C1561T (r = 0.34; p = 0.05) and methylene tetrahydrofolate reductase (MTHFR) C677T (r = 0.35; 0.04) showed positive correlation with plasma homocysteine in T2D cases. In this study, MTR A2756G allele was found to be protective in T2D; GCP II C1561T and MTHFR C677T showed positive association with plasma homocysteine in T2D cases. Among all the genetic variants, MTR A2756G was found influence IMT. RFC 1 G80A and TYMS 5′-UTR 2R3R showed synergistically interact with MTR A2756G in influencing increase in IMT.     

VDR,RXR, Coronin-1 and Interferonγ Levels in PBMCs of Type-2 Diabetes Patients: Molecular Link between Diabetes and Tuberculosis

Diabetes and tuberculosis are world’s most deadly epidemics. People suffering from diabetes are susceptible to tuberculosis. Molecular link between the two is largely unknown. It is known that Vitamin A receptor (RXR) heterodimerizes with Vitamin D receptor (VDR) and Peroxisome proliferator-activator receptor-γ (PPARγ) to regulate Tryptophan-aspartate containing coat protein (TACO) expression and fatty acid metabolism respectively, so it would be interesting to check the expression of these genes in diabetes mellitus (DM) patients which might explain the susceptibility of diabetics to tuberculosis. In this study, we checked the expression of RXR, VDR, TACO and Interferon-γ (IFNγ) genes in type-2 DM patients for understanding the link between the two diseases. We observed down regulation of RXR gene and corresponding up regulation of TACO gene expression. We have not observed significant change in expression of VDR and IFNγ genes in type-2 DM patients. Repression of RXR gene could hamper VDR-RXR heterodimer formation and thus would up regulate TACO gene expression which may predispose the type-2 DM patients to tuberculosis. Also, decrease in RXR-PPARγ heterodimer could be involved in DM.     

Ⅱ型糖尿病患者运动疗法的研究进展

糖尿病已经成为影响发达及发展中国家重大的公共卫生问题,运动疗法在Ⅱ型糖尿病治疗过程中占有重要的地位。国内外学者针对Ⅱ型糖尿病患者的运动处方展开了大量的研究。文章通过文献法,综述、分析Ⅱ型糖尿病运动处方中运动强度、运动持续时间、运动方式的研究进展,为制定Ⅱ型糖尿病运动处方提供科学依据。     

运动对糖尿病大鼠ASP影响的研究

研究运动对链脲佐菌素所致糖尿病大鼠ASP的影响。选用雄性SD大鼠，随机分为4组（每组10只），即：正常对照组，正常运动组，糖尿病模型组，糖尿病模型＋运动组。运动组进行10周的游泳训练。结果表明：1）糖尿病模型组与正常对照组大鼠相比，血浆ASP浓度、血糖、TG、和LDL明显升高，血清FFA有升高趋势，血清胰岛素和ISI明显降低；2）糖尿病模型＋运动组较其非运动组血浆ASP浓度、血糖、TG、TC、FFA和LDL明显降低，血清胰岛素和HDL含量明显升高。提示：糖尿病机体血浆ASP浓度升高，伴随着其活性下降，使得FFA和富舍TG的脂蛋白消除障碍，长期中等负荷运动可以降低血浆中ASP浓度，增加其活性，进而降低FFA和TG水平，升高HDL，改善糖尿病机体的脂质代谢，预防其慢性并发症的发生。     

体育锻炼对老年Ⅱ型糖尿病患者体质及动脉弹性的影响

目的:探讨体育锻炼对老年Ⅱ型糖尿病患者身体形态、身体素质、身体机能及动脉阶段弹性的影响。方法:根据体育锻炼问卷结果将受试者分为锻炼组(n=73)和非锻炼组(n=49)进行相关指标的观察。结果:锻炼组的形态、机能、素质类指标多数优于非锻炼组,锻炼组与不锻炼组相比,除体重和血压不具有统计学差异外,其余指标均具有显著性差异;锻炼组肱动脉—踝动脉脉搏波传导速度显著低于非锻炼组,但踝臂指数与非锻炼组无显著性差异。结论:经常参加体育锻炼可增强老年Ⅱ型糖尿病患者的体质,提高老年Ⅱ型糖尿病患者的动脉顺应性。     

游泳训练及联合补充线粒体营养素α-硫辛酸对wistar2型糖尿病大鼠血脂代谢及脂质过氧化水平的影响

目的:观察2型糖尿病(T2DM)模型大鼠,经8周游泳训练后,血脂代谢、血清氧化应激、血糖(FBG)、胰岛素敏感性(ISI)及肝脏组织二相酶活性变化,检测联合作用方式(游泳训练及联合补充α硫辛酸)对wistarT2DM大鼠血脂代谢及脂质过氧化水平的影响,并探讨其内在影响机制。方法:实验材料wistar大鼠60只,造模完成后随机分成4组,对照组(CON);α硫辛酸(LA);游泳运动组(SEX);α硫辛酸+游泳运动组(LA+SEX),每组15只。进行游泳训练共计8周,观察各组大鼠血脂代谢水平、FBG、ISI及肝脏组织二相酶活性变化。结果:经联合作用方式可极显著性降低wistar大鼠血清总胆固醇和甘油三酯水平,降低LDL-C含量和FFA水平,提高HDL-C;在降低FBG,提高ISI作用上存在叠加效应(P<0.01),对胰岛素水平无显著性影响;在改善血清氧化应激水平作用上(降低ROS和提高SOD),存在增强作用(P<0.01);对肝脏组织二相酶的影响,在对谷胱甘肽-S-转移酶(GST)和谷胱甘肽过氧化物酶(GPX)存在增强作用,对醌氧化还原酶1(NQO-1)则无此作用。结论:联合作用方式可以有效降低血清及肝脏脂质过氧化水平,纠正血脂代谢异常,提高ISI。其保护作用可能是通过降低机体氧化应激水平,维持机体血脂正常代谢水平,减少氧化应激而实现。提示,联合作用方式可以为治疗T2DM提供新思路。     

有氧运动联合膳食干预对2型糖尿病大鼠骨骼肌AMPK含量和活性的影响

目的探讨有氧运动联合膳食干预对2型糖尿病大鼠骨骼肌AMPK活性和蛋白含量的影响。方法 6周龄雄性SD大鼠62只,随机抽取8只大鼠作为正常对照组(C组,n=8),喂以标准普通饲料。其余54只在喂饲高糖高脂膳食的基础上,腹腔注射小剂量的链脲佐菌素(STZ),建立2型糖尿病动物模型。然后将2型糖尿病大鼠随机分成4组:DM对照组(DM,n=9)、DM+运动锻炼组(DME,n=10)、DM+膳食控制组(DMD,n=10)、DM+运动锻炼+膳食控制组(DMED,n=10)。DM组大鼠继续喂饲高脂高糖饲料,不进行运动锻炼;运动锻炼采用每天进行60 min的无负重游泳运动,每周6次;膳食控制采用与DM组等量的标准普通饲料。12周后,检测各组大鼠FPG、FINS、骨骼肌中AMPK含量和活性。结果 (1)与C组相比,DM组大鼠FPG显著升高(P<0.01),FINS显著降低(P<0.01)。双因素方差分析显示,与DM组相比,DME组FPG显著性降(P<0.05),FINS虽有上升,但没有显著性差异(P>0.05);DMD组FINS显著升高(P<0.05),但FPG没有显著性变化(P>0.05);运动联合膳食控制对糖尿病大鼠FPG、FINS均无显著性交互作用。(2)与C组相比,DM组大鼠骨骼肌中AMPK含量和活性均显著性下降(P<0.01,P<0.05);双因素方差分析显示,与DM组相比,DME组骨骼肌中AMPK含量和活性均有显著升高(P<0.05、P<0.01)。DMD组骨骼肌中AMPK含量和活性均无显著性变化。运动联合膳食控制对糖尿病大鼠骨骼肌中AMPK含量和活性均无显著性交互作用。结论 (1)研究成功复制了2型糖尿病大鼠模型,而有氧运动锻炼对2型糖尿病大鼠具有显著的干预作用。(2)2型糖尿病大鼠骨骼肌中AMPK含量和活性显著降低,有氧运动锻炼不仅有效地提高2型糖尿病大鼠骨骼肌AMPK含量,而且可显著增加AMPK活性,对改善2型糖尿病机体的糖脂代谢具有非常重要的作用,但膳食控制对其作用不明显。     

Managing Patient-centered Communication across the Type 2 Diabetes Illness Trajectory: A Grounded Practical Theory of Interactional Sensitivity

This article uses the theoretical and methodological framework of Grounded Practical Theory (GPT) to provide a lens for analyzing and interpreting discourse as a situated form of social action in routine Type 2 diabetes visits. Drawing on a total data-set of 400 audio-recorded routine visits, we randomly selected 55 visits for qualitative analysis. In this article, we use Conversation Analysis to document communication techniques, which we in turn use as evidence to ground our claims within the GPT framework. We use two single cases of interaction to analyze communication techniques physicians use when recommending a change from oral medication to insulin. We argue treatment intensification is a key moment in health communication to reflect about patient centeredness because physicians can find themselves in an interactional dilemma: while insulin may effectively help control unstable disease, an insulin recommendation may simultaneously counter patient values and treatment preferences. Our analysis suggests that physicians use what we call interactional sensitivity to balance medical need and patient preferences when making medical decisions by tailoring their communication according to the local situation and the patient's larger illness trajectory. We propose that interactional sensitivity is a type of communication work and a quality of patient-centered communication characterized by the theoretical relationship between tailoring communication to the contingencies of the local interaction and the global illness trajectory. Overall, this article contributes to health communication scholarship by proposing a normative model for reflecting on how physicians negotiate challenging interactions with patients during routine chronic illness visits.     

妊娠期糖尿病相关炎性因子的研究进展

目前妊娠期糖尿病的发病机制尚不完全清楚,随着研究的进展,免疫炎症假说日益受到学者的重视.妊娠期糖尿病的发病与病人体内的促炎/抗炎细胞因子平衡失常有关,该平衡倾向于促炎细胞因子的分泌,而抗炎细胞因子在疾病的发生、发展中可能发挥保护作用,文章综述了促炎细胞因子(TNF-6、IL-6、IFN-γ、IL-2、IL-17、IL-1β)和抗炎细胞因子(IL-10、IL-37、IL-4)在妊娠期糖尿病发生、发展中的作用,以及它们在临床筛查和诊断中的应用,以期为妊娠期糖尿病的预测和防治提供参考.     

Hypoglycemic, hypolipidemic and antioxidant properties of combination ofCurcumin fromCurcuma longa, Linn, and partially purified product fromAbroma augusta, Linn. in streptozotocin induced diabetes

Dietary spice components ofCurcuma longa andAbroma augusta have been screened for their protective effect against reactive oxygen species induced lipid peroxidation. They have been found to be efficient antioxidant when administered in combination. The purpose of the study was to investigate the effect of oral administration (300mg/Kg) of the aqueous extract of turmeric whose active ingredient isCurcumin andAbromine powder as a hypoglycemic agent mixed with diet. The effect of this aqueous extract on blood glucose, lipid peroxidation (LPO) and the antioxidant defense system in rat tissues like liver, lung, kidney and brain was studied for 8 weeks in streptozotocin induced diabetic rats. The administration of an aqueous extract of turmeric and abromine powder resulted in a significant reduction in blood glucose and an increase in total haemoglobin. The aqueous extract also resulted in decreased free radical formation in the tissues studied. The decrease in thiobarbituric acid reactive substances (TBARS) and increase in reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) clearly showed the antioxidant property of the mixture. It is suggested that these changes initially counteract the oxidative stress in diabetes however, a gradual decrease in the antioxidative process may be one of the factors which results in chronic diabetes. These results indicate that the mixture of the two plants have shown antidiabetic activity and also reduced oxidative stress in diabetes. A combination ofAbroma augusta and Curcuma longa also restored the other general parameters in diabetic animals. The results were statistically analyzed and indicated that combination of herbal extracts showed better efficacy as compared to individual herbal plant extracts used.