Objective To summarize the relationship of diabetes and its complications with microRNA. Methods Domestic and international researches were collected by searching to summarize the role of microRNA in diabetes and its complications. Results MicroRNA could affect the secretion of insulin and interfer metabolism of gulcose in fat cells， muscle cells， and liver cells， which resulting in insulin resistance. At the same time， the microRNA also played an role in damage of vascular endothelial cells and myocardial cell in diabetes. Conclusion MicroRNA acts an important role in the process of diabetes and its complications.
ObjectiveTo explore the clinical curative effect of high flux hemodialysis on diabetic nephropathy (DN) and impact on patients' insulin resistance (IR). MethodsA total of 96 patients with DN meeting the inclusion criteria treated between January 2013 and January 2014 were selected. The patients were randomly divided in to the observation group and control group with 48 in each. The control group received low flux hemodialysis, while the observation group underwent high flux hemodialysis. Before the treatment and in the first half of the year after the treatment, the clinical renal function and inflammatory indexes, lipid metabolism, and glucose metabolism related markers were recorded, and IR index (HOMA-IR) were calculated and compared. ResultsBefore and after the treatment, the Kt/V showed no significant change in the two groups (P > 0.05). Serum creatinine levels was lower after the treatment compared with that before the treatment in both of the two groups; in the observation group, C-reactive protein, interleukin-6 and tumor necrosis factorαwere significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). HOMA-IR and fasting insulin levels in the observation group after the treatment were significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). No significant changes of fasting plasma glucose and glycosylated hemoglobin levels in the two groups before and after the treatment in patients were found (P > 0.05). ConclusionHigh flux hemodialysis therapy is effective on DN, which can effectively remove the body and large molecular type of inflammatory mediators, alleviate the micro inflammatory state, improve the IR status and correct the lipid metabolic abnormalities.
Objective To evaluate the efficacy and safety of testosterone supplementary treatment for the middle-aged and the senile with insulin resistance (IR). Methods Such databases as PubMed (Jan. 1966 to July 2010), EMbase (Jan. 1984 to July 2010), The Cochrane Library (Issue 3, 2010), CBM (1978 to July 2010), CNKI (Jan. 1994 to July 2010), WanFang Data (1994 to July 2010) and VIP Data (1989 to July 2010) were searched. Randomized controlled trials (RCTs) about testosterone treatment for IR were included. Two reviewers independently extracted the data and evaluated the quality of the included studies. Meta-analyses were performed for the results of homogeneous studies by using RevMan 5.0 software, and other results not suitable for meta-analysis were described with qualitative analyses. Results Nine RCTs involving 573 patients were included. Of them, 308 cases were in the testosterone group and 265 in the placebo group. The baseline data of studies was comparable. The results of meta-analyses showed that, a) Efficacy: testosterone was superior to placebo in decreasing insulin resistance index (HOMA-IR) (WMD= –?0.56, 95%CI –?0.75 to –?0.37) and fasting insulin (FINS) (WMD= –2.4, 95%CI –3.25 to –1.56); and b) Safety: no significant difference was found in prostate specific antigen (PSA) (WMD= –?0.02, 95%CI –?0.22 to 0.18). Conclusion The testosterone supplementary treatment for insulin resistance is superior to the placebo, and there is no significant difference in PSA compared to the placebo. More multicenter double-blind RCTs in large-scale are required to verify this conclusion because of lack of high quality literature with large sample size.
ObjectiveTo systematically evaluate the changes in placental protein expressions in gestational diabetes mellitus (GDM) and their correlations with maternal insulin resistance (IR). Methods PubMed, Cochrane Library, Scopus, Web of Science, Embase, China National Knowledge Infrastructure, VIP database, Wanfang Database and CBMdisc were searched for case-control studies published from January 2009 to November 2021, which reported the placental protein expressions in GDM and their correlations with IR. Two researchers independently reviewed the literature, extracted data and evaluated the literature quality. RevMan 5.4 software was used for meta-analysis, and descriptive analysis was performed on data that cannot be combined. ResultsA total of 19 studies were included, comprising 2 012 patients. The results of meta-analysis showed that: the expression level of retinol binding protein 4 (RBP4) [standard mean difference=2.11, 95% confidence interval (CI) (1.64, 2.58), P<0.000 01] and the positive rate of protein tyrosine phosphatase-1B (PTP1B) [relative risk (RR)=1.56, 95%CI (1.29, 1.88), P<0.000 01] were up-regulated, and the positive rate of insulin receptor substrate 1 (IRS-1) [RR=0.69, 95%CI (0.60, 0.78), P<0.000 01] was down-regulated. The protein expression levels of RBP4 (P<0.000 01) and PTP1B (P<0.000 01) were positively correlated with homeostasis model assessment of insulin resistance (HOMA-IR), while the protein expression levels of IRS-1 (P<0.000 01) and APN (P=0.002) were negatively correlated with HOMA-IR, and glucose transporter 4 (GLUT 4) was not correlated with HOMA-IR (P=0.79). Descriptive analysis found that the expression levels or positive rates of adipocytokines (leptin, resistin), oxidative stress markers (xanthione oxidase, malondialdehyde, 8-isoprostaglandin),inflammatory factors (tumor necrosis factor α, Toll-like receptor 4, Galectin-3, Galectin-2, migration inhibitory factor),fetuin-A, forkhead box transcription factor 1, forkhead box transcription factor 3a and estrogen receptor α in GDM placenta were up-regulated and all were positively correlated with HOMA-IR. The expression levels or positive rates of insulin signaling pathway proteins [phosphoinositide 3-kinase (PI3K), protein kinases B (AKT), phospho-protein kinases B (p-AKT), GLUT 4] were down-regulated, PI3K and AKT were negatively correlatedwith HOMA-IR, while p-Akt had no correlation with HOMA-IR. ConclusionsThe dysregulation of placental protein expressions may mediate maternal IR exacerbation, thus promote the occurrence and development of GDM and other pregnancy complications. The causal relationship and regulatory mechanism are still unclear, which need to be further studied.
ObjectiveTo explore the effect of gastric bypass (GBP) on metabolic syndrome (MS) and the related mechanisms. MethodsThe literatures addressed the effect of GBP on glucose metabolism and blood pressure were retrospectively analyzed. ResultsIt showed that GBP achieved durable level of blood glucose, remission of dylipidemia and hypertension, however, which occurred before significant weight loss. The changes of many factors such as food intake, gastrointestinal hormones, adipocytokines, fat distribution might be involved in GBP to improve MS. ConclusionGBP seems to achieve the control of MS as a primary and independent effect, rather than secondary to the treatment of overweight.
Objective To investigate the changes of CD4 + CD25 + Foxp3 + regulatory T cells( Treg) in peripheral blood of patients with acute exacerbation of COPD( AECOPD) , and analyze the relationship of CD4 + CD25 + Foxp3 + Treg with insulin resistance. Methods A total of 79 patients with AECOPD were divided into four groups according to disease severity( 11 cases in stage Ⅰ,31 cases in stage Ⅱ,28 cases in stage Ⅲ, an 9 cases in stage Ⅳ) .42 healthy volunteers were recruited as control. Fast blood glucose( FBG) and fast insulin( FINS) were measured for calculating the insulin resistance index. The CD4 + CD25 + Foxp3 + Treg were detected by flow cytometry. The relationship between the proportion and number of CD4 + CD25 + Foxp3 + Treg with insulin resistance was statistically analyzed. Results Compared with the healthy control group, the levels of FBG, FINS, and insulin resistance index in the AECOPD patients were significantly higher ( P lt; 0. 01, P lt; 0. 05) . The proportion and number of CD4 + CD25 + Foxp3 + Treg in peripheral blood decreased significantly( P lt; 0. 01, P lt; 0. 05) . The insulin resistance index increased with the severity of AECOPD while the proportion and number of CD4 + CD25 + Foxp3 + Treg in peripheral blood decreased. The insulin resistance index in the AECOPD patients of stage Ⅲ and Ⅳ were higher than those of stage Ⅰ and Ⅱ. The proportion and number of CD4 + CD25 + Foxp3 + Treg in the AECOPD patients of stage Ⅲ and Ⅳ were significantly lower than those of stage Ⅰ and Ⅱ. Both the proportion and number of CD4 + CD25 + Foxp3 + Treg were negatively correlated with insulin resistance ( r = - 0. 633, - 0. 871, P lt; 0. 01) . Conclusions CD4 + CD25 + Foxp3 + Treg cells might may play important role in modulating insulin resistance in AECOPD. The more serious the disease, the lower the CD4 + CD25 + Foxp3 + Treg and the worse insulin resistance.
Objective To investigate the risk factors for insulin resistance (IR) after selective operation in the department of general surgery. Methods Two hundred and sixty-three patients including 122 males and 141 females after selective operation between March 2009 and October 2009 in The First Affiliated Hospital of Xi’an Jiaotong University were studied. Sex, age, histories of smoking and drinking, hypertensive disease, history of operation, height, weight, waist circumference, anesthesia method, operation duration, operation method, and volumes of transfusion and liquid injection during operation were recorded. The fasting blood glucose (BG) and fasting plasma insulin (INS) were tested for selectively operative patients on day 1 before and after surgery. Insulin resistance index (HOMA-IR) and the index of insulin secretion (HOMA-β) were calculated with homeostasis model assessment (HOMA). Logarithms of HOMA-IR (lnHOMA-IR) was taken because that HOMA-IR was not normal distribution. Results The levels of fasting BG, fasting plasma INS, and lnHOMA-IR on day 1 after operation were higher than those on day 1 before operation (Plt;0.001). IR was correlated with patients’ sex (P=0.002), the history of smoking (P=0.033), waist circumference (P=0.000), operation method (P=0.007), and the volume of liquid injection during operation (P=0.001). A significant elevation of the change of lnHOMA-IR level was found between abdominal and nonabdominal surgery (Plt;0.001). Conclusions IR occurs in selectively operative patients in the department of general surgery. It is helpful for depressing IR to control the intensity of surgery.
ObjectiveTo review the research progress of the relationship between the insulin resistance, insulin-like growth factor-Ⅰ(IGF-Ⅰ), insulin-like growth factor-Ⅱ(IGF-Ⅱ), and colorectal cancer, and to explore the future research trends. MethodsThe related literatures in recent 5 years from abroad databases (PubMed, Web of Science, and EMBASE)and domestic databases (CNKI, WANFANG, and WEIPU)were collected and reviewed. ResultsThe research on the correlation between the changes and colorectal cancer with insulin resistance and IGF-Ⅰand IGF-Ⅱlevels, epidemiological studies and the mechanism research, indicates that there are complex and close relationship between them. ConclusionsThe research about the relationship between the insulin resistance, IGF-Ⅰ, IGF-Ⅱ, and colorectal cancer is promising.However, many issues need to be further investigated.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
Objective To evaluate the effects of saxagliptin on β cell function of type 2 diabetic patients. Methods The Cochrane Library, PubMed, EMbase, CBM, VIP, and CNKI were searched from their establishment to November, 2011, for relevant randomized controlled trials on the effects of saxagliptin on β cell function in type 2 diabetic patients. Language was limited to Chinese and English only. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results Five RCTs were included. The results of meta-analysis showed that: HOMA-B was significantly increased in the saxagliptin (or saxagliptin plus routine treatment) 2.5 mg, 5 mg, and 10 mg groups (MD=8.03, 95%CI 4.57 to 11.48, Plt;0.000 01; MD=7.50, 95%CI 4.27 to 10.73, Plt;0.000 01; MD=17.45, 95%CI 13.93 to 20.97, Plt;0.000 01); HOMA-IR was similar between saxagliptin 2.5 or 10 mg group, and control group (MD= –0.05, 95%CI –0.18 to 0.08, P=0.47; MD= –0.18, 95%CI –0.60 to 0.24, P=0.4). Conclusion Current evidence shows that saxagliptin is effective in improving β cell function and insulin resistance. Due to short follow-up and small sample size, this conclusion has to be further proved by more high-quality RCTs.