Glycemia

血糖
  • 文章类型: Journal Article
    背景:使用MedtronicMiniMed780G(MM780G)AHCL的1型糖尿病(T1D)患者的多个临床医生可调节参数对血糖的影响。这些包括葡萄糖目标,碳水化合物比率(CR),和活性胰岛素时间(AIT)。基于算法的决策支持建议在潜在的设置调整可以增强临床决策。
    方法:单臂,两阶段探索性研究开发决策支持,以开始和维持AHCL。参与者开始调查MM780G,然后8周阶段1-初始优化工具评估,涉及基于算法的决策支持,每周AIT和CR建议。临床医生根据每个方案的感知安全性批准或拒绝CR和AIT建议。共同设计导致在进一步相同配置的阶段2中评估的优化算法。第2阶段参与者也在“QuickStart”(使用每日胰岛素剂量和体重确定初始AHCL设置的算法衍生工具)之后过渡到商用MM780G。我们评估了疗效,安全,以及使用血糖指标的决策支持的可接受性,以及每个阶段接受的CR和AIT设置的比例。
    结果:53名参与者开始第一阶段(平均年龄24.4;Hba1c为61.5mmol/7.7%)。临床医生接受的CR和AIT比例分别在第1阶段和第2阶段之间增加:CR89.2%与98.6%,p<0.01;AIT95.2%vs.99.3%,p<0.01。在阶段之间,平均葡萄糖百分比时间<3.9mmol(<70mg/dl)减少(2.1%vs.1.4%,p=0.04);平均TIR3.9-10mmol/L(70-180mg/dl)的变化无统计学意义:72.9%±7.8和73.5%±8.6。快速启动导致稳定的TIR,和血糖指标与国际指南的比较。
    结论:共同设计的决策支持工具能够提供安全有效的治疗。它们可以潜在地减轻医疗保健从业人员和患者的糖尿病管理相关决策的负担。
    背景:于2021年3月30日在澳大利亚/新西兰临床试验注册中心(ANZCTR)进行了前瞻性注册,作为研究ACTRN12621000360819。
    BACKGROUND: Multiple clinician adjustable parameters impact upon glycemia in people with type 1 diabetes (T1D) using Medtronic Mini Med 780G (MM780G) AHCL. These include glucose targets, carbohydrate ratios (CR), and active insulin time (AIT). Algorithm-based decision support advising upon potential settings adjustments may enhance clinical decision-making.
    METHODS: Single-arm, two-phase exploratory study developing decision support to commence and sustain AHCL. Participants commenced investigational MM780G, then 8 weeks Phase 1-initial optimization tool evaluation, involving algorithm-based decision support with weekly AIT and CR recommendations. Clinicians approved or rejected CR and AIT recommendations based on perceived safety per protocol. Co-design resulted in a refined algorithm evaluated in a further identically configured Phase 2. Phase 2 participants also transitioned to commercial MM780G following \"Quick Start\" (algorithm-derived tool determining initial AHCL settings using daily insulin dose and weight). We assessed efficacy, safety, and acceptability of decision support using glycemic metrics, and the proportion of accepted CR and AIT settings per phase.
    RESULTS: Fifty three participants commenced Phase 1 (mean age 24.4; Hba1c 61.5mmol/7.7%). The proportion of CR and AIT accepted by clinicians increased between Phases 1 and 2 respectively: CR 89.2% vs. 98.6%, p < 0.01; AIT 95.2% vs. 99.3%, p < 0.01. Between Phases, mean glucose percentage time < 3.9mmol (< 70mg/dl) reduced (2.1% vs. 1.4%, p = 0.04); change in mean TIR 3.9-10mmol/L (70-180mg/dl) was not statistically significant: 72.9% ± 7.8 and 73.5% ± 8.6. Quick start resulted in stable TIR, and glycemic metrics compared to international guidelines.
    CONCLUSIONS: The co-designed decision support tools were able to deliver safe and effective therapy. They can potentially reduce the burden of diabetes management related decision making for both health care practitioners and patients.
    BACKGROUND: Prospectively registered with Australia/New Zealand Clinical Trials Registry(ANZCTR) on 30th March 2021 as study ACTRN12621000360819.
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  • 文章类型: Journal Article
    背景:本研究旨在研究各种体重成分的减少对肥胖者(PWO)红细胞氧化状态和血糖状态的影响。
    方法:共有53个PWO遵循六个月的个性化低热量饮食和运动,在此期间,人体测量学,生物化学,并测量氧化参数。参与者根据体重(W)分组,内脏脂肪面积(VFA),全身水(TBW),和骨骼肌质量(SMM)损失,以及血糖正常(NG)和高血糖(HG)。
    结果:体重减少使血糖正常化并影响红细胞酶活性。无论丢失的组织类型如何(VFA,TBW,或SMM),谷胱甘肽过氧化物酶活性在所有组下降,伴随着谷胱甘肽还原酶活性的增加。无论组织丢失的类型如何,脂褐素(LPS)和丙二醛(MDA)浓度均降低。在减重>10%的人群中,α-/γ-生育酚比例增加,>15%VFA,TBW>5%。在NG组中,与HG组相比,谷胱甘肽过氧化物酶减少,谷胱甘肽还原酶增加,这些变化在HG组中更强。两组LPS和MDA浓度均降低。观察到葡萄糖减少和过氧化氢酶变化之间存在显着相关性,视黄醇,和α-生育酚,以及VFA减少和维生素E变化之间,L-LPS,以及L-GR和L-GST的活性。
    结论:这项分析强调了葡萄糖代谢之间的复杂相互作用,氧化状态,和红细胞膜的完整性,对于了解糖尿病及其管理至关重要。这项研究表明,红细胞对肥胖和高血糖引起的全身性变化具有显着的代谢适应性,提示潜在的治疗靶点,以改善肥胖个体的代谢健康。
    BACKGROUND: This study aimed to investigate the impact of reductions in various body mass components on the erythrocyte oxidative status and glycemic state of people with obesity (PWO).
    METHODS: A total of 53 PWO followed a six-month individualized low-calorie diet with exercise, during which anthropometric, biochemical, and oxidative parameters were measured. The participants were divided into groups based on weight (W), visceral fat area (VFA), total body water (TBW), and skeletal muscle mass (SMM) losses, as well as normoglycemia (NG) and hyperglycemia (HG).
    RESULTS: Weight reduction normalized glycemia and influenced erythrocyte enzyme activity. Regardless of the tissue type lost (VFA, TBW, or SMM), glutathione peroxidase activity decreased in all groups, accompanied by an increase in glutathione reductase activity. Lipofuscin (LPS) and malondialdehyde (MDA) concentrations decreased regardless of the type of tissue lost. The α-/γ-tocopherol ratio increased in those losing >10% body weight, >15% VFA, and >5% TBW. In the NG group, compared to the HG group, there was a decrease in glutathione peroxidase and an increase in glutathione reductase, with these changes being stronger in the HG group. The LPS and MDA concentrations decreased in both groups. Significant correlations were observed between glucose reduction and changes in catalase, retinol, and α-tocopherol, as well as between VFA reduction and changes in vitamin E, L-LPS, and the activities of L-GR and L-GST.
    CONCLUSIONS: This analysis highlights the complex interactions between glucose metabolism, oxidative state, and erythrocyte membrane integrity, crucial for understanding diabetes and its management. This study shows the significant metabolic adaptability of erythrocytes in response to systemic changes induced by obesity and hyperglycemia, suggesting potential therapeutic targets to improve metabolic health in obese individuals.
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  • 文章类型: Journal Article
    背景:我们以前记录了米糠油(RBO)对男性冠状动脉疾病患者心功能和致动脉粥样硬化心脏代谢因子的有益作用。因此,该领域的现有证据旨在通过调查在日常标准饮食中添加RBO对新出现的胰岛素抵抗替代标志物的影响来扩展。脂质过氧化,抗氧化状态,和代谢综合征个体的代谢紊乱(MetSyn)通过开放标签对照试验。
    方法:将50名超重/肥胖的成年人(平均体重指数(BMI)=31.08kg/m2)随机分配到对照组中,接受了标准的饮食计划,或干预组,补充30g/dRBO,持续8周。BMI,MetSyn组件,胰岛素抵抗代谢评分(METS-IR),甘油三酯葡萄糖BMI(TyGBMI),丙二醛(MDA),总抗氧化能力(TAC),在这个开放标签试验之前和之后测量血浆多酚水平。
    结果:对基线值进行校正的协方差分析(ANCOVA)显示,与仅接受标准饮食的患者相比,补充30g/dRBO的人总胆固醇显着降低(P值=0.005;效应大小(ES):-0.92),LDL-胆固醇(P值=0.048;ES:-0.62),空腹血糖(P值=0.014;ES:-0.77),MDA(P值=0.002;ES:-1.01),METS-IR(P值<0.001;ES:-1.24),8周后,TyG-BMI(P值=0.007;ES:-0.85)。此外,RBO消耗导致显著更高水平的HDL-C(P值=0.004;ES:0.94)和TAC(P值<0.0001;ES:2.05)。然而,BMI没有显著变化,腰围,血清甘油三酯,血浆多酚,或血压。
    结论:尽管目前的研究结果表明低胆固醇血症,抗高血糖,30g/dRBO的抗氧化作用似乎对MetSyn患者很有希望,他们应该被认为是初步的。因此,需要进一步设计良好的临床试验和更大的样本量和更长的持续时间来证实这些发现.
    BACKGROUND: We previously documented the beneficial effects of rice bran oil (RBO) on cardiac function and atherogenic cardiometabolic factors in men with coronary artery disease. Therefore, the existing evidence in this area aims to be expanded by investigating the impact of adding RBO to a daily standard diet on emerging insulin resistance surrogate markers, lipid peroxidation, antioxidant status, and metabolic disturbances in individuals with metabolic syndrome (MetSyn) through an open-label controlled trial.
    METHODS: A total of 50 overweight/obese adults (mean body mass index (BMI) = 31.08 kg/m2) with at least 3 MetSyn components were randomly allocated to either the control group, which received a standard diet plan, or the intervention group, which was supplemented with 30 g/d RBO for 8 weeks. BMI, MetSyn components, metabolic score for insulin resistance (METS-IR), triglyceride‒glucose‒BMI (TyG‒BMI), malondialdehyde (MDA), total antioxidant capacity (TAC), and plasma polyphenol levels were measured before and after this open-label trial.
    RESULTS: Analysis of covariance (ANCOVA) adjusted for baseline values revealed that, compared with patients who received only a standard diet, those who were supplemented with 30 g/d RBO presented significantly lower total cholesterol (P value = 0.005; effect size (ES):-0.92), LDL-cholesterol (P value = 0.048; ES:-0.62), fasting blood glucose (P value = 0.014; ES:-0.77), MDA (P value = 0.002; ES: -1.01), METS-IR (P value < 0.001; ES: -1.24), and TyG-BMI (P value = 0.007; ES:-0.85) after 8 weeks. Additionally, RBO consumption resulted in significantly higher levels of HDL-C (P value = 0.004; ES:0.94) and TAC (P value < 0.0001; ES:2.05). However, no significant changes were noted in BMI, waist circumference, serum triglycerides, plasma polyphenols, or blood pressure.
    CONCLUSIONS: Although the current findings suggest that the hypocholesterolemic, antihyperglycemic, and antioxidative effects of 30 g/d RBO seem to be promising for MetSyn patients, they should be considered preliminary. Therefore, further well-designed clinical trials with larger sample sizes and longer durations are needed to confirm these findings.
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  • 文章类型: Journal Article
    本研究旨在阐明血糖与接受冠状动脉造影的参与者发生多血管病变之间的关联。
    我们分析了2,533例冠状动脉疾病患者行冠状动脉造影。其中,1,973名患者,通过多血管病变的终点识别,使用单变量和多变量逻辑回归分析来确定血糖水平与多血管病变发生之间的关系。
    分析包括1,973名参与者,其中474例患者被确定为冠状动脉多支血管病变.单因素logistic回归分析显示血糖与冠状动脉多支病变的发生呈正相关(OR1.04;95%CI1.01-1.08;p=0.02)。调整后的模型表明,血糖每增加一个单位,发生冠状动脉多支血管病变的风险增加了4%,表现出显著的相关性(p<0.05)。亚组分析显示,血糖对PCI患者多支血管病变的影响因性别而异。年龄,和吸烟状况,这种影响在男性中更为明显,老年患者,和吸烟者。
    我们的发现建立了血糖与多血管病变发生率之间的显著关联,在男性患者中尤其明显,45岁以上的人和吸烟者。
    UNASSIGNED: This study aims to elucidate the association between glycemia and the occurrence of multi-vessel lesions in participants undergoing coronary angiography.
    UNASSIGNED: We analyzed 2,533 patients with coronary artery disease who underwent coronary angiography. Of these, 1,973 patients, identified by the endpoint of multi-vessel lesions, were examined using univariate and multivariate logistic regression analyses to determine the relationship between glycemia levels and multi-vessel lesion occurrence.
    UNASSIGNED: The analysis included 1,973 participants, among whom 474 patients were identified with coronary multi-vessel lesions. Univariate logistic regression analysis demonstrated a positive correlation between glycemia and the occurrence of coronary multi-vessel lesions (OR 1.04; 95% CI 1.01-1.08; p = 0.02). The adjusted model indicated that for each unit increase in glycemia, the risk of developing coronary multi-vessel lesions increased by 4%, showing a significant correlation (p < 0.05). Subgroup analyses revealed that the impact of glycemia on multi-vessel lesions in patients with PCI varied according to gender, age, and smoking status, with the effect being more pronounced in men, older patients, and smokers.
    UNASSIGNED: Our findings establish a significant association between glycemia and the incidence of multi-vessel lesions, particularly pronounced in male patients, individuals over 45, and smokers.
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  • 文章类型: Journal Article
    人类腺病毒36(HAdV-36)感染与肥胖有关,低脂水平,以及改善动物模型和人类的血糖水平和胰岛素敏感性,尽管流行病学研究仍存在争议。因此,这项研究调查了青少年HAdV-36血清阳性与血糖控制之间的关系.这项观察性研究检查了460名年轻人(体重正常的246名和肥胖的214名受试者)。所有参与者都接受了人体测量评估,血压,循环空腹血糖水平,脂质,胰岛素,和抗HAdV-36抗体;此外,计算胰岛素抵抗的稳态模型评估(HOMA-IR).总之,57.17%的受试者为HAdV-36血清阳性。此外,与正常体重的受试者相比,肥胖受试者的HAdV-36血清阳性率更高(59%vs.55%)。BMI(33.1vs.32.3kg/m2,p=0.03),和腰围(107vs.104厘米,p=0.02),胰岛素水平(21vs.16.3µU/mL,p=0.003),和HOMA-IR(4.6与与血清阴性受试者相比,HAdV-36阳性肥胖受试者的3.9,p=0.02)更高。在肥胖组中,在校正总胆固醇的模型中,HAdV-36血清阳性与降低血糖水平有关。甘油三酯水平,年龄和性别(β=-10.44,p=0.014)。此外,在肥胖组中,观察到HAdV-36血清阳性与胰岛素水平之间存在统计学显著的正相关.这些发现表明,自然HAdV-36感染可以改善肥胖受试者的血糖控制,但不能改善高胰岛素血症。
    Human adenovirus-36 (HAdV-36) infection has been linked to obesity, low lipid levels, and improvements in blood glucose levels and insulin sensitivity in animal models and humans, although epidemiological studies remain controversial. Therefore, this study investigated the relationship between HAdV-36 seropositivity and glycemic control in youths. This observational study examined 460 youths (246 with normal weight and 214 obese subjects). All participants underwent assessments for anthropometry, blood pressure, circulating fasting levels of glucose, lipids, insulin, and anti-HAdV-36 antibodies; additionally, the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. In all, 57.17% of the subjects were HAdV-36 seropositive. Moreover, HAdV-36 seroprevalence was higher in obese subjects compared to their normal weight counterparts (59% vs. 55%). BMI (33.1 vs. 32.3 kg/m2, p = 0.03), and waist circumference (107 vs. 104 cm, p = 0.02), insulin levels (21 vs. 16.3 µU/mL, p = 0.003), and HOMA-IR (4.6 vs. 3.9, p = 0.02) were higher in HAdV-36-positive subjects with obesity compared to seronegative subjects. In the obese group, HAdV-36 seropositivity was associated with a reducing effect in blood glucose levels in a model adjusted for total cholesterol, triglyceride levels, age and sex (β = -10.44, p = 0.014). Furthermore, a statistically significant positive relationship was observed between HAdV-36 seropositivity and insulin levels in the obesity group. These findings suggest that natural HAdV-36 infection improves glycemic control but does not ameliorate hyperinsulinemia in obese subjects.
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  • 文章类型: Journal Article
    目的:本研究评估了糖尿病(DM)视网膜病变患者抗胰岛素抗体(AIA)的水平以及某些抗糖尿病药物对AIA的影响。患者和方法:一项观察性横断面研究。结果:与对照组相比,在糖尿病视网膜病变(DR)和仅DM研究类别中观察到较低的AIAIgG滴度[DR=86(5-560),DM-only=50(5-500),对比对照组=200(7-565);p=0.017]。DR组服用硝苯地平和二甲双胍与AIAIgE水平呈负相关(r=-0.32,p=0.04)。结论:在DR研究类别中观察到循环AIA的滴度降低,提示AIA可能与DR的发病机制无关。
    在资源匮乏的国家,糖尿病视网膜病变(DR)是人们失明的主要原因。抗胰岛素抗体,或AIA,帮助身体抵抗感染,并可能在DR的发展中发挥作用。该研究调查了DR患者中AIA的含量以及一些糖尿病药物如何影响AIA水平。在DR患者中,硝苯地平和一种AIA(IgE)之间存在负相关,但是二甲双胍和另一种AIA(IgG)之间存在正相关。DR研究组的AIA水平较低,这表明友邦保险可能不会导致DR。
    Aim: This study evaluated the levels of anti-insulin antibodies (AIAs) and the influence of some antidiabetic medications on AIA in diabetes mellitus (DM) patients with retinopathy. Patient & methods: An observational cross-sectional study. Results: A lower titer of AIA IgG was observed in the diabetic retinopathy (DR) and DM-only study categories compared with the control group [DR = 86 (5-560), DM-only = 50 (5-500), versus control = 200 (7-565); p = 0.017]. Taking nifedipine and metformin were negatively correlated (r = -0.32, p = 0.04) with the levels of AIA IgE in the DR group. Conclusion: A decreased titer of circulating AIAs was observed in the DR study category, suggesting that AIA may not contribute to the pathogenesis of DR.
    Diabetic retinopathy (DR) is the main reason people lose their sight in countries with few resources. Anti-insulin antibodies, or AIAs, help the body fight off infections and may play a role in the development of DR. The study looked at how much AIA was in DR patients and how some diabetes drugs affected AIA levels. There was a negative link between nifedipine and one AIA (IgE) in people with DR, but a positive link between metformin and another AIA (IgG). AIA levels were lower in the DR study group, which suggests that AIA may not cause DR.
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  • 文章类型: Journal Article
    小马甲,俗称yacon,是菊科家族的一员.由于其药用和食用价值,yacon被不同的人群消费。雪莲果因其低聚果糖和菊粉含量高而独具特色,以及类黄酮,倍半萜内酯,和酚酸。根可以用来生产面粉,不易变质,可应用于各种工业产品。这篇系统的综述集中在yacon面粉对代谢参数的影响上。PubMed,科克伦,Embase,科学直接,Scopus,WebofScience,和谷歌学者数据库被咨询,在选择研究时遵循PRISMA指南。总的来说,在数据库中找到526篇文章,其中,只有28个全文符合纳入条件.在应用纳入和排除标准后,最终纳入了七项研究。结果表明,使用yacon面粉可以降低血糖,HbA1c,晚期糖基化末端,血浆脂质,身体脂肪量,体重,和腰围,改善肠道菌群和抗氧化状态。有必要进一步探索雪莲果面粉的效果,和额外的临床试验是必要的,以确定所需的最佳日消费水平,以帮助改善代谢参数。
    Smallanthus sonchifolius, popularly known as yacon, is a member of the Asteraceae family. Due to its medicinal and edible value, yacon is consumed by different populations. Yacon is unique due to its high fructo-oligosaccharide and inulin content, as well as flavonoids, sesquiterpene lactones, and phenolic acids. Roots can be used to produce flour, which is less perishable and can be applied in various industrial products. This systematic review focuses on the effects of yacon flour on metabolic parameters. PubMed, Cochrane, Embase, Science Direct, Scopus, Web of Science, and Google Scholar databases were consulted, and PRISMA guidelines were followed in the selection of the studies. In total, 526 articles were found in the databases, and of these, only 28 full texts were eligible for inclusion. After applying the inclusion and exclusion criteria, seven studies were finally included. The results showed that the use of yacon flour can reduce glycemia, HbA1c, advanced glycation ends, plasma lipids, body fat mass, body weight, and waist circumference and improve intestinal microbiota and the antioxidant status. Further exploration of the effects of yacon flour is warranted, and additional clinical trials are necessary to determine the optimal daily consumption levels required to assist in improving metabolic parameters.
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  • 文章类型: Journal Article
    低血糖是新生犬临床常规中最常见的代谢改变,作为这些患者死亡率的预测因子。新生犬显示肝功能不全和体内平衡机制尚未完全发育,糖原储备有限,糖原分解和糖异生能力有限。这些生理特性使新生犬在禁食时特别容易发生低血糖,即使是很短的时间。一些母亲和新生儿因素可能与新生儿发生低血糖的风险较高有关。本文综述了血糖稳态,新生儿低血糖的病理生理学,涉及的主要原因以及这种情况的诊断和治疗方法。
    Hypoglycemia is the most common metabolic alteration in the clinical routine of newborn dogs, acting as a predictor of mortality in these patients. The neonatal dog shows hepatic insufficiency and homeostatic mechanisms not yet fully developed, with limited glycogen reserves and limited capacity to perform glycogenolysis and gluconeogenesis. These physiological particularities make newborn dogs particularly susceptible to hypoglycemia when of fasting, even for short periods. Several maternal and neonatal factors may be related to a higher risk of developing hypoglycemia in neonates. This paper reviews glycemic homeostasis, the pathophysiology of neonatal hypoglycemia, the main causes involved and the diagnostic and therapeutic approaches to this condition.
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  • 文章类型: Journal Article
    背景:墨西哥人口表现出几种心血管危险因素(CVRF),包括高血压(HBP),血糖异常,血脂异常,超重,和肥胖。这项研究是对墨西哥六个人口最多的城市中最重要的CVFR的广泛观察。方法:在297,370名参与者的队列中(54%为女性,平均年龄43±12.6岁),人体测量(体重指数(BMI)),代谢(血糖和总胆固醇(TC)),并获得血压(BP)数据。结果:从40岁开始,40%和30%的队列参与者超重或肥胖,分别。在27%的参与者中发现HBP。然而,所有高血压患者中只有8%得到控制.50岁及以上的受试者中有50%是高胆固醇血症。血糖与年龄有恒定的线性关系。BMI与SBP呈线性相关,血糖,TC,在所有情况下和性别都有较高的系数。BMI的β1系数在所有方程中都比其他β更显著,表明它对其他CVRF有很大影响。结论:TC,血糖,和SBP,最关键的动脉粥样硬化因素,与BMI直接相关。
    Background: The Mexican population exhibits several cardiovascular risk factors (CVRF) including high blood pressure (HBP), dysglycemia, dyslipidemia, overweight, and obesity. This study is an extensive observation of the most important CVFRs in six of the most populated cities in Mexico. Methods: In a cohort of 297,370 participants (54% female, mean age 43 ± 12.6 years), anthropometric (body mass index (BMI)), metabolic (glycemia and total cholesterol (TC)), and blood pressure (BP) data were obtained. Results: From age 40, 40% and 30% of the cohort\'s participants were overweight or obese, respectively. HBP was found in 27% of participants. However, only 8% of all hypertensive patients were controlled. Fifty percent of the subjects 50 years and older were hypercholesterolemic. Glycemia had a constant linear relation with age. BMI had a linear correlation with SBP, glycemia, and TC, with elevated coefficients in all cases and genders. The β1 coefficient for BMI was more significant in all equations than the other β, indicating that it greatly influences the other CVRFs. Conclusions: TC, glycemia, and SBP, the most critical atherogenic factors, are directly related to BMI.
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  • 文章类型: Journal Article
    背景:糖尿病的治疗干预措施在新发病阶段最有效,然而,在实践中确定确切的发作时刻可能是难以捉摸的。NOD小鼠中的自发性自身免疫性糖尿病在12至32周龄之间随机出现,发病率范围为60至90%。此外,这种疾病通常在几天内迅速发展为严重的糖尿病,导致新开始阶段的窗口很短,这对早期诊断提出了重大挑战。传统上,通常需要在几个月内对大型队列进行广泛的血糖(BG)测试,以进行前瞻性调查。我们将超敏尿糖(UG)检测纳入普通BG调查过程,最初旨在阐明在小鼠模型中糖尿病进展过程中葡萄糖从血液泄漏到尿液所需的滞后期。
    结果:观察结果出乎意料地表明,尿液中检测到的少量葡萄糖通常与,有时甚至在诊断BG升高前几天。因此,我们在另一个队列中进行了基于UG的调查协议,该协议经过验证可以准确识别每个接近发作的个体,然后可以通过以下几个BG测试来确认,以满足连续的BG标准。这种方法需要少于95个BG测试,与传统BG调查的700多项测试相比,诊断出60只糖尿病小鼠中的37-38只。诊断时的平均BG水平略低于350mg/dl,低于常规BG监测观察到的约400mg/dl。
    结论:我们在前瞻性调查中证明了BG+和超灵敏UG+结果之间近乎完美的相关性,在每周两次的测试频率下没有检测到滞后期。这导致了基于非侵入性UG测试的调查的完善协议,允许早期识别新发病的糖尿病小鼠,每只小鼠只需要进行几次BG测试。该协议大大减少了大量血液采样的需要,刺血针的使用,劳动,和动物的痛苦,符合3Rs原则。它提供了一个方便的,准确,和动物友好的替代早期糖尿病诊断,促进诊断研究,发病机制,预防,和治疗。
    BACKGROUND: Therapeutic interventions for diabetes are most effective when administered in the newly onset phase, yet determining the exact onset moment can be elusive in practice. Spontaneous autoimmune diabetes among NOD mice appears randomly between 12 and 32 weeks of age with an incidence range from 60 to 90%. Furthermore, the disease often progresses rapidly to severe diabetes within days, resulting in a very short window of newly onset phase, that poses significant challenge in early diagnosis. Conventionally, extensive blood glucose (BG) testing is typically required on large cohorts throughout several months to conduct prospective survey. We incorporated ultrasensitive urine glucose (UG) testing into an ordinary BG survey process, initially aiming to elucidate the lag period required for excessive glucose leaking from blood to urine during diabetes progression in the mouse model.
    RESULTS: The observations unexpectedly revealed that small amounts of glucose detected in the urine often coincide with, sometimes even a couple days prior than elevated BG is diagnosed. Accordingly, we conducted the UG-based survey protocol in another cohort that was validated to accurately identified every individual near onset, who could then be confirmed by following few BG tests to fulfill the consecutive BG + criteria. This approach required fewer than 95 BG tests, compared to over 700 tests with traditional BG survey, to diagnose all the 37-38 diabetic mice out of total 60. The average BG level at diagnosis was slightly below 350 mg/dl, lower than the approximately 400 mg/dl observed with conventional BG monitoring.
    CONCLUSIONS: We demonstrated a near perfect correlation between BG + and ultrasensitive UG + results in prospective survey with no lag period detected under twice weekly of testing frequency. This led to the refined protocol based on surveying with noninvasive UG testing, allowing for the early identification of newly onset diabetic mice with only a few BG tests required per mouse. This protocol significantly reduces the need for extensive blood sampling, lancet usage, labor, and animal distress, aligning with the 3Rs principle. It presents a convenient, accurate, and animal-friendly alternative for early diabetes diagnosis, facilitating research on diagnosis, pathogenesis, prevention, and treatment.
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