tbuckley/cabot-search huggingface dataset:
Effects of cooking practice education for diabetics aged over 60 on their nutrient intake and blood glucose control
Authors: 陈超刚, 廖裕洲, 戚以勤, 严励, 黄德芳, 黎锋, 程桦
Journal: BMJ (2007)

目的 探讨烹饪实践课营养教育模式对60岁以上的2型糖尿病(T2DM)患者营养摄入和血糖的影响.方法 采取烹饪实践课营养教育(课时4 h)模式,分批对57例60岁以上T2DM患者(观察组)进行平衡膳食和食物交换份法的讲解,其特点包括:要求患者与家属共同参与,演示生鲜食物和熟食材料;患者根据食谱选择食物并进餐.选取在营养门诊参加营养教育(课时35 min)的60例T2DM患者为对照组.比较营养教育12个月后两组患者食物交换份知识、营养摄入状况和血糖控制的效果.结果 营养教育12个月后,观察组患者的食物交换得分显著高于对照组;能量[(6304±826)kJ]和脂肪[(46±6)g]摄入量显著低于对照组[(6921±860)kJ与(63±9)g];空腹血糖[(7.1±0.8)mmol/L]、餐后2 h血糖[(11.2±1.1)mmol/L]和糖化血红蛋白[(6.2±0.5)%]水平均显著低于对照组[(7.8±0.9)mmol/L、(12.4±1.2)mmol/L和(6.5±0.7)%].结论 烹饪实践课可有效地帮助60岁以上T2DM患者正确地运用食谱、改善营养摄入和控制血糖水平。
Argatroban in treatment of patients with transient ischemic attack
Authors: Xiaoze Li, Qing Liu, Bingqing Wang
Journal: BMJ (2015)

Eighty-three patients with transient ischemic attack (TIA) were randomly divided into study group (n=42) and control group (n=41) from July, 2011 to Mar, 2015. Patients in both groups were given aspirin 100 mg/d; in addition, patients in study group received intravenous infusion of argatroban 10 mg, q12h, for 7 days and those in control group received subcutaneous injection of low molecular weight heparin (LMWH) 2 050 AXa IU, b. i.d for 7 days. The cases with cure, significantly effectiveness and effectiveness in study group and control group were 10, 14, 16 and 6, 12 16, respectively. Compared with the control group, argatroban shows superiority in treatment of TIA with higher safety and lower side effect.


Key words: 
Ischemic attack, transient; Anticoagulants
Histopathological prognostic markers in metastatic lung adenocarcinoma, validation of stromal fibrosis and immunoscore as easy to interpret findings and their correlation with survival.
Authors: Luis Leonardo Rojas Puentes, Alejandro Ruiz-Patiño, Diana Carolina Mayorga, July Katherine Rodríguez, Jenny Mireya Ávila Coy, Melissa Andrea Bravo Espinosa, Oscar Arrieta, Zyanya Lucía Zatarain-Barron, Feliciano Barron Barron, Hernan Carranza, Jorge M. Otero, Carlos Alberto Vargas, Pilar Archila, Diana Carolina Sotelo Rodríguez, Claudio Martin, Gonzalo Recondo, Luis Pino, Christian Diego Rolfo, Rafael Rosell, Andres Felipe Cardona Zorrilla
Journal: Journal of Clinical Oncology (2020)

e21566 Background: Several histopathological markers have been associated with immune system activity and its relationship with clinical outcomes in lung cancer. Determination of tumor infiltrating lymphocytes as well as specific subpopulations could reveal cytotoxic potential. Additionally, changes in stromal composition and fibrosis could also reflect potential cellular interactions with the tumor lesions. In this study we validate these two findings as potential prognostic factors. Methods: A retrospective cohort analysis of patients with advanced lung adenocarcinoma treated in a reference center in Bogota, Colombia was conducted. Demographic as well as treatment variables were collected between January 2018 and December 2019. In addition to clinical outcomes, the percentage of stromal fibrosis and immunoscore were estimated for all biopsy samples by a trained oncological pathologist. Results: A total of 133 patients were included. Male predominance (51.1%) with Karnofsky performance scores (KPS) greater than 80 and 19% of prior cigarette exposure (26 patients) was identified in the cohort. Median overall survival of the cohort was 27.1 months (95%CI 22.1-NA) and progression free survival of 19.4 months (95%CI 18-24.5 months). Percentage of fibrous stroma and immunoscore were associated with a benefit in both OS and PFS. For patients who presented with a low stromal fibrosis, defined as harboring less than 10%, OS reached a median of 25.1 months (95%CI 21.5- 40.5 months) compared to 38.7 months for patients with high fibrosis (95%CI 27.7 months – NA), (p = 0.02). In terms of immunoscore, values under 40% were associated with a longer median OS (38.7 months, [95%CI 31.3- 58.6 months] vs 22.1 months [95%CI19.8- 42.3 months], p &lt; 0.001). Immunoscore and stromal fibrosis were not codependent variables (p &lt; 0.001), suggesting that these markers offer independent prognostic value with regards to OS. Conclusions: Stromal fibrosis and immunoscore serve as prognostic factors that could be easily interpreted and evaluated in order to offer prognostic classification of patients with metastatic adenocarcinoma of the lung.
心脏起搏治疗肥厚梗阻型心肌病伴心脏停搏和反复晕厥三例
Authors: 陈晓春, 葛智平, 周彤, 宫丽斌, 陈美俊, 徐安杰
Journal: BMJ (2008)

心脏起搏治疗肥厚性梗阻型心肌病(HOCM)可改善血流动力学异常及临床症状,国内外已有报道,但对肥厚心肌逆转情况报道较少.我们对3例HOCM伴晕厥者行心脏起搏治疗,并追踪远期疗效和肥厚心肌逆转情况。
Glycemic fluctuation and endothelial function in patients of coronary heart disease complicated with type 2 diabetes mellitus
Authors: Xiao-feng L, Da-kun Zhao, Jian Du, Yu Gao
Journal: BMJ (2012)

Objective To investigate the glycemic fluctuation and endothelial function in patients of coronary heart disease complicated with type 2 diabetes mellitus (T2DM).Methods Fifty eight patients with coronary heart disease were enrolled in the study,including 40 cases complicated with T2DM (group A) and 18 cases without T2DM (group B).All subjects underwent continuous glucose monitoring system (CGMS) and high-resolution ultrasound detection on brachial artery for endothelium-dependent flowmediated dilatation (FMD).According to the results of CGMS,patients with 3 times of standard deviation of blood glucose (SDBG) less than a mean blood glucose in group A were classified as low glucose excursion group (group A1 ),others were classified as high glucose excursion group (group A2 ).The association of glucose fluctuation with FMD in group A was analyzed.Results Compared to group B,the levels of mean amplitude of glycemic excursions (MAGE),the largest amplitude of glycemic excursions (LAGE) and mean postprandial glucose excursion (MPPGE) were elevated and the levels of FMD were lower in group A1 and A2 (P ＜0.05).Compared to group A1 the levels of MAGE,LAGE,MPPGE and absolute means of daily differences were significantly higher [(5.4 ±0.9) vs.(3.7±0.4),(6.3 ± 1.8) vs.(4.6 ±0.8),(4.7±1.0) vs.(3.5±1.2),(2.45 ±0.75) vs.(1.81 ±0.66)mmol/L,respectively]and the FMD levels were lower [ (3.2 ± 1.0) vs.(5.2 ± 1.2) ％ ]in group A2 ( all P ＜ 0.05 ).All CGMS parameters were significantly correlated with FMD in group A2 (P ＜ 0.05 ).Multiple stepwise regression analysis showed that MAGE,systolic blood pressure were the independent impact factors of FMD.Conclusions Patients of coronary heart disease complicated with T2DM have prominent glycemic fluctuation and decreased FMD and the glycemic fluctuation may be associated with the impairment of FMD.

Key words: 
Coronary disease;  Diabetes mellitus, type 2;  Glucose fluctuation;  Vasodilation
Prevention and treatment of diabetic nephropathy
Authors: Jianyang Chen
Journal: BMJ (2017)

糖尿病肾病是糖尿病引起的慢性肾脏疾病，目前已成为导致终末期肾脏病(ESRD)的最主要的病因，预后不佳，也是糖尿病患者最终死亡的主要原因之一。本文通过复习和总结国内外相关糖尿病肾病研究文献，分析糖尿病肾病的分期及各期的预防和治疗策略，着重阐述基于尿微量白蛋白排泄率分期的防治策略，通过对血压、血糖、血脂等达标治疗及饮食、规律随访的综合防治，延缓糖尿病肾病进展；同时对糖尿病肾病ESRD的规范治疗，提高患者生命质量并改善长期生存。
Cancer in Belize: Characteristics of patients presenting to a public oncology clinic.
Authors: Yannis Valtis, Leah Pierson, Philip Garrity, Ramon Argenes Yacab, Franklin W. Huang
Journal: Journal of Clinical Oncology (2020)

e19000 Background: Belize is a middle-income country in Central America with significant inequality. To date, data on the oncologic burden of disease has been imputed from mortality data. The first-ever public oncology program was started in 2018, which allowed us to analyze the presenting characteristics of patients with cancer. Methods: 284 patients were seen at the Karl Heusner Memorial Hospital (KHMH) oncology clinic between April 2018 and July 2019. We performed a retrospective chart review and extracted patient characteristics to understand the burden of cancer in Belize. Results: Of 284 patients seen, 63% had a confirmed pathologic diagnosis of cancer and the remaining were clinically suspected to have cancer. 56% were female and the median age was 55. Breast, cervix, colon, and prostate were the most common types of cancer seen. Breast and cervical cancers disproportionately affected young women with a median age at presentation of 51 and 45 respectively. 28% of patients presented with Stage IV disease. 43% of patients were deemed candidates only for comfort care. Conclusions: The burden of oncologic disease in Belize is significant and represents a wide variety of cancers. Breast and cervical cancers disproportionately affect young women in Belize. A significant proportion of patients presented with late stage disease, likely due to the lack of screening programs and cancer awareness in the country. Addressing the country’s cancer burden will require strengthening local pathology and surgical oncology capabilities, establishing a public chemotherapy treatment program, and referring patients to radiation oncology in nearby countries.
肺栓塞患者的机体和心理康复
Authors: 申远
Journal: BMJ (2006)

一、肺栓塞心理康复的意义 心理/行为异常和心血管疾病之间的相互关系已得到充分证实,如A型行为与冠心病,抑郁焦虑与心肌梗死等.以心肌梗死为例,20世纪70年代,西方兴起早期运动治疗,并提倡同时进行心理行为干预,包括改善焦虑抑郁状态、提高自我评价、矫治A型行为和不良生活习惯等,形成了被誉为心血管医学发展史里程碑的心脏康复医学.20世纪90年代以后,以早期活动和心理治疗为中心的急性心肌梗死综合性心脏康复方案形成,大大推动了治疗成本的降低和长期预后的改善.至此,心理治疗和行为矫治逐渐成为心血管疾病综合治疗的重要手段,健康的心理状态和良好的行为模式也成为疾病康复的重要指标.
The role of combined treatment of metastatic colorectal cancer inpatients with liver metastases.
Authors: Mikhail Trandofilov, Danila Gridnev, Anatoly Popov, Anna Sizova, Dina Islamova, Vladislav Makarov, Semen Kostirev
Journal: Journal of Clinical Oncology (2020)

e16026 Background: Combined treatment for patients with metastatic colorectal cancer (mCRC) offers better long-term outcomes and chemotherapy can increase the rate of hepatic resectability for patients with initially inoperable disease. Methods: The analysis included 132 patients diagnosed with mCRC having metastases in the liver treated from 2015 to 2020. Of these, 62 (47%) were men and 70 (53%) women. The average age of the patients was 63 years. At the beginning of the treatment, the overall condition of all patients met ECOG 0-1 points. Primary metastatic CRC had 93 (71%) patients. A total of 39 (29%) patients were diagnosed with advanced disease. Localization of the primary tumor in 25 patients (18.9%) was in the right part of the large intestine and 107 (81.1%) in the left part of the colon. At the time of the sample, metastases were detected only in the liver in 73 patients (55.3%). In the remaining 59 (44.7%) other organs were affected besides the liver. Various types of surgical treatment of metastases in the liver received 42 (31.8%) patients. The decision on the choice of chemotherapy was made by the attending physician on the basis of the recommendations of NCCN and RUSSCO, taking into account the molecular genetic characteristics of the tumor. The decision to apply and choose the method of surgical treatment was taken in conjunction with the surgeon. Results: From the general population of patients receiving complex therapy, 2 groups were identified, between which a comparison was made. The first group (group A) was 42 (31.8%) patients who received some surgical treatment of the liver. The second group (group B) included 90 (68.2%) patients, who for some reason or another, did not receive any surgical treatment. The groups are fairly homogeneous in their characteristics. The median overall survival (OS) in group A was 40.1 months, and in group B, 22.3 months. A similar trend continued in subgroup analysis. The calculation of the PFS was complicated by the fact that surgical operations were given at different stages of complex treatment. Three-year survival in group A was approximately 50%, and in group B, 28%. "Five-year" survival (In those patients who were observed from the start of the study for all 5 years) in group A was 15 %, and in group B, 5,5%. Conclusions: The inclusion of modern surgical techniques in the complex therapy of metastatic colorectal cancer, if possible, at any stage, can significantly increase the life expectancy of patients.
心脏白塞病的主动脉瓣反流三例
Authors: 牟德华, 倪新海
Journal: BMJ (2005)

白塞病是一种以广泛的血管炎为基本病理组织特征的全身性疾病.当心脏受累时,称为心脏白塞病(cardio-Behcet′s disease).其表现形式复杂多样,特别是出现主动脉瓣反流时,治疗困难,预后差,已引起人们的关注[1,2].现将我们收治的3例出现主动脉瓣反流的心脏白塞病患者报告如下。
椎旁节细胞性神经瘤超声表现一例
Authors: 狄显强, 王祥阁, 裴宝伟, 李昌
Journal: BMJ (2008)

患者男,21岁,因左腰部酸痛半年于2007年10月就诊.查体:一般情况可,肾区无明显叩击痛,输尿管走行区无明显压痛.超声检查:左肾与脊柱之间探及一上下径8.9 cm、左右径4.8 cm、前后径3.3 cm的梭形实性不均质包块,位于肌层之中,包膜完整,内部在中等回声中间可见不规则低回声区及散在细小强光点,其内侧紧靠椎体,似有蒂与脊柱相连,其前方为肾静脉,后方回声略增强(图1～3).包块周围检出血管环绕,但内部未见明显血流信号。
Value of oncologist generated “surprise question” in predicting survival in metastatic cancer.
Authors: Stephen B. Edge, Lu Liu, Amy Allen Case, Tracey L. O'Connor, Boris W. Kuvshinoff, Monica L. Murphy, Mishellene McKinney
Journal: Journal of Clinical Oncology (2020)

12082 Background: Treating patients with metastatic cancer (MCA) requires timely integration of palliative and hospice care (PHC). The Surprise Question (SQ-“Would you be surprised if your patient died in the next year?”) may help predict short-term mortality in patients with chronic disease and prompt initiation of PHC. There limited data on the utility of the SQ in oncology and none controlling for age and cancer site (CS). This study evaluates the SQ in MCA. Methods: SQ data were collected using a clinical oncology pathway program (COP) in which the treating oncologist is required to answer the SQ for all patients with MCA. The cohort includes MCA patients with SQ entries from 5-1-2018 to 4-30-2019 providing cohorts with 6- and 12-months follow-up (f/u) from the date of the SQ. Vital status was determined as of 1-15-20. Over 90% of deaths are reported with 3 months of death. Models using SQ response (yes/no), cancer site and age were tested with logistic regression (LR) with Akaike Information Criterion (AIC) for model selection (lower number best model) and ANOVA to assess the value of the SQ in predicting mortality. Results: There were 655 and 1276 patients with MCA in COP with 1 year and 6 months f/u from the SQ, respectively. The proportion with the SQ response “No” (shorter expected survival) varied by cancer site (range 19% – 82% - e.g. breast 42%; pancreas 81%). The SQ was the best predictor compared to cancer site and age for 6 and 12-month mortality (LR Model A – lowest AIC). The odds ratio of death at one year from SQ-No vs. SQ-Yes was 3.8 (95% CI 2.7, 5.4) with a strong association between SQ response and 1-year and 6-month mortality (p &lt; 0.001). See Table. Conclusions: Oncologist assessment of survival expectancy by the SQ in MCA is a strong predictor of mortality beyond cancer site and age. The treating oncologist’s response to SQ can serve as a simple and reliable predictive tool to identify those with MCA likely to die sooner who may benefit from timely referral to PHC. [Table: see text]
Pivotal DREAMM-2 study: Single-agent belantamab mafodotin (GSK2857916) in patients with relapsed/refractory multiple myeloma (RRMM) refractory to proteasome inhibitors (PIs), immunomodulatory agents, and refractory and/or intolerant to anti-CD38 monoclonal antibodies (mAbs).
Authors: Sagar Lonial, Hans Chulhee Lee, Ashraf Badros, Suzanne Trudel, Ajay K. Nooka, Ajai Chari, Al-Ola A. Abdallah, Natalie Scott Callander, Douglas Weston Sborov, Attaya Suvannasankha, Katja Weisel, Peter Michael Voorhees, Axel Hoos, Eric Zhi, January Baron, Trisha Piontek, Roxanne C. Jewell, Joanna Opalinska, Ira Gupta, Adam D. Cohen
Journal: Journal of Clinical Oncology (2020)

8536 Background: Single-agent belantamab mafodotin (B-cell maturation antigen targeting immunoconjugate) showed clinically meaningful activity and manageable safety in patients with heavily pre-treated RRMM (DREAMM-2, NCT03525678, Lancet Oncol.2020). We report updated results (median follow-up 9 months). Methods: DREAMM-2 is an ongoing single-agent belantamab mafodotin (2.5 or 3.4 mg/kg) study in patients with RRMM after ≥3 prior therapy lines and refractory to an immunomodulatory agent, a PI, and refractory and/or intolerant to an anti-CD38 mAb. Primary endpoint: overall response rate (ORR; ≥partial response per independent review committee). Results: ORR was 31% in the 2.5 mg/kg (19% with ≥very good partial responses [VGPR]) and 35% (24% with ≥VGPR) in the 3.4 mg/kg groups (Table). Duration of response (DoR) was not reached (NR) in the 2.5 mg/kg and 6.2 months in the 3.4 mg/kg groups; 1-year overall survival (OS) estimate was 53%. Common Grade 3/4 AEs ( &gt; 10% in either group) were keratopathy (2.5: 29%; 3.5: 24%), thrombocytopenia (2.5: 21%; 3.4: 32%), anemia (2.5: 20%; 3.4: 27%), pneumonia (2.5: 6%; 3.4: 13%), and neutropenia (2.5: 11%; 3.4: 16%). AEs were managed with dose delays (2.5: 54%; 3.4: 62%) and reductions (2.5: 34%; 3.4: 43%); discontinuations due to AEs were uncommon (2.5: 9%; 3.4: 12%). Conclusions: Single-agent belantamab mafodotin was well-tolerated, and clinically meaningful responses were sustained despite dose modifications with longer follow-up. Funding: GlaxoSmithKline (205678). Drug linker technology licensed from Seattle Genetics; monoclonal antibody produced using POTELLIGENT Technology licensed from BioWa. Clinical trial information: NCT03525678 . [Table: see text]
Characterizing toxicities, body composition, and health-related quality of life (HRQoL) among long-term survivors treated with anti-PD-1.
Authors: James Randall Patrinely, Arissa Caroline Young, Henry Quach, Grant Richard Williams, Fei Ye, Run Fan, Leora Horn, Kathryn Eby Beckermann, Erin Alexis Gillaspie, Jeffrey Alan Sosman, Debra L. Friedman, Javid J Moslehi, Douglas Buckner Johnson
Journal: Journal of Clinical Oncology (2020)

e15158 Background: Anti-PD-1 agents produce durable responses in many cancers. However, the long-term impact of PD-1 blockade in terms of chronic toxicities, medical comorbidities, and HRQoL are not well-defined. Methods: We assessed 217 patients (pts) who received anti-PD-1 for melanoma, renal cell carcinoma or non-small cell lung carcinoma, with survival of &gt; 2 years after treatment. Pt and tumor characteristics, immune related adverse events (irAEs), cardiometabolic parameters, body composition measurements (BCM), and HRQoL outcomes were tracked. Results: Median overall survival (OS) was not reached; 33 (15.2%) died during follow-up primarily from progressive cancer (n = 28). Acute irAEs developed during treatment in 65% of pts, 45.2% were grade 1/2, 35.5% required steroids, and most commonly presented with dermatitis (18.4%), thyroiditis (12.9%), or arthritis (9.7%). At last follow up, most pts were ECOG 0 (38%) or 1 (41%). There was no difference in blood pressure, glucose, or weight from baseline to 2 years after treatment initiation. BCM showed increased adiposity (140.1 vs. 144 cm 2 /m 2 , p = 0.05), skeletal muscle mass (47.05 vs. 47.72 cm 2 /m 2 , p = 0.03), and skeletal muscle gauge (1653.9 vs. 1671 AU, p = 0.04). The most common chronic irAEs at last follow-up included hypothyroidism (10.6%), arthritis (3.2%), adrenal insufficiency (3.2%), neuropathy (2.8%), pneumonitis (1.8%), and type 1 diabetes (0.8%). No pts died from chronic irAEs although one pt had fatal CNS radiation necrosis (with unknown contribution of ICI). Chronic irAEs were more common in pts treated with ipilimumab/nivolumab (49%) vs. those with monotherapy (26%). New comorbidities included type 2 diabetes (6.5%) and hypertension (6.0%). HRQoL at 2 years compared favorably to cancer and general populations, although younger age (p &lt; 0.01) and need for subsequent therapy (p = 0.03) were associated with worse HRQoL using Functional Assessment of Cancer-General questionnaire (FACT-G). Acute irAEs were associated with worse National Comprehensive Cancer Network distress scores (p = 0.019). Conclusions: Durable responses to anti-PD-1 therapy and favorable HRQoL outcomes are encouraging in this long-term survivor population. Chronic irAEs may be more common than previously thought although no clear chronic adverse cardiometabolic effects were observed.
Predictive value of sonoelastography of secondary changed lymphous nodes in the assessment of effectiveness of immunotherapy.
Authors: Fedor Vladimirovich Moiseenko, Vladimir Moiseyenko, Vera Chernobrivtceva, Vitaliy Egorenkov, Arina Zhegalina, Elizaveta Artemeva
Journal: Journal of Clinical Oncology (2020)

e15225 Background: With the use of existing predictors of the effectiveness of immunotherapy it is not possible to identify patients who will have a response to treatment or a rapid progression. The mechanism of the antitumor effect of the modern generation of immunotherapeutic drugs leads to significant changes in the cellular structure of the tumor and, as a consequence of this, in its physical characteristics. Sonoelastography allows to evaluate the stiffness of the tumor. Methods: The study included 17 patients with malignant neoplastic disease with the presence of secondarily affected peripheral lymph nodes (l.n.). 11/17 patients had melanoma, 2/17 - NSCLC, 3/17 - neck cancer. 8/9 - M / F, average age 61.8 years. 5/17 patients received combined immunotherapy (Ipilimumab + Nivolumab), 12/17 - anti-PD-1 (8 people Nivolumab, 4 people Pembrolizumab). Results: An ultrasound examination of the l. n. in a multimodal mode with compression elastography was performed on a Philips Epic 7 device before the first administration of the antitumor drug and every 3 weeks. Before the first objective assessment of the effect was done, in 5/17 patients was registered an increase in the size of the studied lymph nodes by 2 or more times, in 7/17 patients the size of the l. n. did not change, in 5/17 patients the affected l. n. decreased (26% - 64%).The results of control examination after 2 months of treatment: PR - 2/17, CR - 4/17, SD- 9/17, PD- 4/17.In the group with an objective response (PR, CR, SD - 13/17), the average value. St. Ratio before treatment was 5.7 ± 0.4; during treatment decreased to an average of 3.2 ± 0.5 (p &lt; 0.05). In the group with progression during treatment, the average St. Ratio value before treatment was 4.1 ± 0.4, and during treatment increased on average to 5.7 ± 0.5 (p &lt; 0.05).A qualitative analysis of tumor blood flow was carried out, the Resistance Index (RI) was studied. The RI in the first group of patients was 0.65 ± 0.4; after treatment, the RI increased to 0.74. In the second group of patients, the RI before and after treatment did not significantly change. Conclusions: During the immunotherapy treatment, a decrease in the stiffness of the tumor is observed, regardless of the change in size and an increase in the indices of peripheral resistance to blood flow in case of further regression or stabilization of the process. An early change in the sonographic characteristics of tumor foci can identify patients with a subsequent treatment effect, and can also distinguish true progression from pseudoprogression, which requires confirmation in larger studies.
Relationship between insulin resistance and serum levels of adiponectin, leptin and erythrocyte membrane insulin receptor in patients with gestational diabetes
Authors: 于健, 周素娴, 王炎, 林枫, 周燕, 苏珂, 龙艳, 胡永玲, 彭鹰, 马金秀
Journal: BMJ (2007)

目的 探讨妊娠糖尿病患者脂联素、瘦素水平和红细胞膜胰岛素受体的变化及与胰岛素抵抗的关系.方法 对40例妊娠糖尿病患者(GDM组)和34例正常糖耐量妊娠妇女(对照组)测定代谢指标、血清脂联素、瘦素,并检测高、低亲和力红细胞膜胰岛素受体数目和高、低亲和力常数.结果 GDM组瘦素水平为(11.7±2.8)μg/L,明显高于对照组(P＜0.05);脂联素为(7.8±1.6)μg/L,明显低于对照组(P＜0.05).高、低亲和力红细胞膜胰岛素受体数目分别为(43±9)和(2297±525)个/红细胞,明显降低于对照组(P＜0.05).GDM组胰岛素抵抗指数(3.6±1.3)明显高于对照组(P＜0.05).GDM组经多元线性逐步回归分析,进入回归方程的因素有孕前体重指数、脂联素、瘦素和低亲和力红细胞膜胰岛素受体数目(P＜0.01).结论 脂联素、瘦素和红细胞膜胰岛素受体数目的 改变参与了GDM患者胰岛素抵抗的发生过程,可能与GDM的糖脂代谢紊乱有关。