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| 1 | Resolution of non-alcoholic steatohepatitis by rosuvastatin monotherapy in patients with metabolic syndrome显示文摘AIM: To investigate the effect of rosuvastatin monotherapy on non-alcoholic steatohepatitis(NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form NASH.METHODS: This prospective study included 20 biopsy proven patients with NASH, metabolic syndrome(Met S) and dyslipidaemia. Biochemical parameters of the blood of the patients and an ultrasonography of the liver were performed at baseline. Then patients receivedlifestyle advice and were treated for a 12 mo period with rosuvastatin(10 mg/d) monotherapy. Patients were re-evaluated during the study at 3 mo intervals, during which biochemical parameters of the blood were measured including liver enzymes. A repeat biopsy and ultrasonography of the liver were performed at the end of the study in all 20 patients. Changes in liver enzymes, fasting plasma glucose, serum creatinine, serum uric acid(SUA), high sensitivity C reactive protein(hs CRP) and lipid profile were assessed every 3 mo. The primary endpoint was the resolution of NASH and the secondary endpoints were the changes in liver enzyme and lipid values.RESULTS: The repeat liver biopsy and ultrasonography showed complete resolution of NASH in 19 patients, while the 20 th, which had no improvement but no deterioration either, developed arterial hypertension and substantial rise in triglyceride levels during the study, probably due to changes in lifestyle including alcohol abuse. Serum alanine transaminase, aspartate transaminase, and γ-glutamyl transpeptidase were normalised by the 3rd treatment month(ANOVA P < 0.001), while alkaline phosphatase activities by the 6th treatment month(ANOVA, P = 0.01). Fasting plasma glucose and glycated haemoglobin were significantly reduced(P < 0.001). Lipid values were normalised by the 3rd treatment month. No patient had Met S by the 9th treatment month. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function should be attributed solely to rosuvastatin treatment. A limitation of the study is the absence of a control group.CONCLUSION: These findings suggest that rosuvastatin monotherapy could ameliorate biopsy proven NASH and resolve Met S within 12 mo. These effects and the reduction of fasting plasma glucose and SUA levels may reduce the risk of vascular and liver morbidity and mortality in NASH patients. These findings need confirmation in larger studies. | Konstantinos Kargiotis Vasilios G Athyros Olga Giouleme Niki Katsiki Evangelia Katsiki Panagiotis Anagnostis Chrysoula Boutari Michael Doumas Asterios Karagiannis Dimitri P Mikhailidis | 2015 | World Journal of Gastroenterology2015，21，25： | 18 |
| 2 | Reducing preoperative fasting time: A trend based on evidence显示文摘Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time. | JoséEduardo de Aguilar-Nascimento Diana Borges Dock-Nascimento | 2010 | World Journal of Gastrointestinal Surgery2010，2，3： | 17 |
| 3 | Silymarin in non alcoholic fatty liver disease显示文摘AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered. | Fulvio Cacciapuoti Anna Scognamiglio Rossella Palumbo Raffaele Forte Federico Cacciapuoti | 2013 | World Journal of Hepatology2013，5，3： | 17 |
| 4 | 妊娠合并糖尿病诊治指南(2014)(一)显示文摘妊娠合并糖尿病包括孕前糖尿病(pre-gestational diabetes mellitus,PGDM)和妊娠期糖尿病(gestational diabetes mellitus.GDM),PGDM可能在孕前已确诊或在妊娠期首次被诊断。随着糖尿病发病率日益升高,以及GDM筛查诊断受到广泛重视,妊娠合并糖尿病患者不断增多。 | 杨慧霞 | 2014 | 健康管理2014，0，11： | 16 |
| 5 | Value of fasting plasma glucose to screen gestational diabetes mellitus before the 24th gestational week in women with different pre-pregnancy body mass index显示文摘Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity. | Yu-Mei Wei Xin-Yue Liu Chong Shou Xing-Hui Liu Wen-Ying Meng Zi-Lian Wang Yun-Feng Wang Yong-Qing Wang Zhen-Yu Cai Li-Xin Shang Ying Sun Hui-Xia Yang | 2019 | Chinese Medical Journal2019，，8： | 13 |
| 6 | Prediabetes diagnosis and treatment: A review显示文摘Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, it remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between prediabetes and complications of diabetes such early nephropathy, small fiber neuropathy, early retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes. While there is increasing evidence to prove the efficacy of pharmacotherapy in prevention of diabetes in adults with prediabetes, pharmaceutical treatment options other than metformin are associated with adverse effects that limit their use for prediabetes. There are no reports of systematic evaluation of health outcomes related to prediabetes in children. The effects of pharmacotherapy of prediabetes on growth and pubertal development in children remains unknown. Secondary intervention with pharmacotherapy with metformin is advocated for high-risk individuals but criteria for such consideration benefit of early intervention, long term cost effectiveness of such interventions and the end point of therapy remain unclear. Pharmacotherapy must be used with caution in children with prediabetes. Prediabetes is a condition defined as having blood glucose levels above normal but below the defined threshold of diabetes. It is considered to be an at risk state, with high chances of developing diabetes. While, prediabetes is commonly an asymptomatic condition, there is always presence of prediabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence prediabetes can not be considered an entirely benign condition. This aim of this review is to describe the challenges associated with diagnosis of prediabetes, the possible adverse medical outcomes associated with prediabetes and the treatment options and rationale for their use in context of prediabetes. | Nidhi Bansal | 2015 | World Journal of Diabetes2015，6，2： | 12 |
| 7 | Antihyperglycemic effect of Hypericum perforatum ethyl acetate extract on streptozotocin-induced diabetic rats显示文摘Objective:To evaluate the antihyperglycemic activity of ethyl acetate extract of Hypericum perforatum(H.perforatum)in streptozotocin(STZ)-induced diabetic rats.Methods:Acute toxicity and oral glucose tolerance lest were performed in normal rats.Male albino rats were rendered diabetic by ST/(40 mg/kg,intraperitoneally).H.perforatum ethyl acetate extract was orally administered to diabetic rats at SO,100 and 200 mg/kg doses for 15 days to determine the antihyperglycemic activity.Biochemical parameters were determined at the end of the treatment.Results:H.perforatum ethyl acetate extract showed dose dependant fall in fasting blood glucose(FBG).After 30 min of extract administration,FBG was reduced significantly when compared with normal rats.H.perforatum ethyl acetate extract produced significant reduction in plasma glucose level,serum total cholesterol,triglycerides,glucose-6-phosphatase levels.Tissue glycogen content,HDL-cholesterol,glucose-6-phosphate dehydrogenase were significantly increased compared with diabetic control.No death or lethal effect was observed in the toxic study.Conclusions:The results demonstrate that H.perforatum ethyl acetate extract possesses potent antihyperglycemic activity in STZ induced diabetic rats. | Arokiyaraj S Balamurugan R Augustian P | 2011 | Asian Pacific Journal of Tropical Biomedicine2011，1，5： | 9 |
| 8 | Preventive effect of danhong huayu koufuye on diabetic retinopathy in rats显示文摘· AIM: To study the effects of danhong huayu koufuye (DHK) on fasting blood glucose (FBG) and diabetic retinopathy (DR) in streptozotocin (STZ)-induced type 1 diabetic rats to facilitate the rational usage of this drug. · METHODS: Diabetic rats were induced by injection of a single dose of STZ intraperitoneally at 50mg/kg. Flash electroretinogram (FERG) and oscillatory potentials (OPs) were used to measure retinal function. The microvascular perfusion of ears was performed to study the microcirculation in rats. FBG, body-weight, and 24-h urine volume, water intake and diet intake were also assessed. · RESULTS: DHK had no effect on FBG in normal rats. However, STZ + DHK group were significantly different from those of Model and moved toward those of normal control. It reversed the increase in diet intake(P≤0.05 vs model control) and the loss in body-weight(P≤0.05 vs model control) in diabetic rats. DHK decreased the FBG of diabetic rats by 25.6% (P ≤0.05) and 37.9% (P ≤0.01) after 14 and 21 days administration as compared with the model control, respectively. Moreover, DHK significantly increased the FERG b-wave amplitude by 80% (P ≤0.05 vs model control) and decreased the FERG b-wave latency by 15.3% (P ≤0.01 vs model control) after 24 days administration. The OP1 and OP2 amplitudes in DHK group were 2.6 (P ≤0.01) and 2.0 (P ≤0.01) times of model group after 24 days of DHK treatment, respectively. At the same time, OP1 and OP2 latencies in DHK group reduced by 16.0% (P ≤0.001) and 14.7% (P ≤0.001) as compared with the model control, respectively. Furthermore, the microvascular perfusion of DHK group was 2.4 times of model group (P≤0.001) after 21 days administration. · CONCLUSION: DHK had no effect on normal FBG. But it had antihyperglycemic activity, and had a preventive and therapeutic effect on DR in diabetic rats. · | Bao-Qin Lin Jiu-Yao Zhou Yan Ma Ying-Jun Deng Chuan-Jie Zheng and Jun-Li Lin | 2011 | International Journal of Ophthalmology(English edition)2011，4，6： | 9 |
| 9 | New-onset diabetes after kidney transplantation:Incidence and associated factors显示文摘AIM To determine the incidence and associated factors of new-onset diabetes after transplantation(NODAT) in a Portuguese central hospital. METHODS This single-center retrospective study involved consecutive adult nondiabetic transplant recipients, who had undergone kidney transplantation between January 2012 and March 2016. NODAT was diagnosed according to the criteria of the American Diabetes Association. Data were collected from an institutional database of the Nephrology and Kidney Transplantation Department(Santa Maria Hospital, Lisbon, Portugal) and augmented with data of laboratorial parameters collected from the corresponding patient electronic medical records. Exclusion criteria were preexisting diabetes mellitus, missing information and follow-up period of less than 12 mo. Data on demographic and clinical characteristics as well as anthropometric and laboratorial parameters were also collected. Patients were divided into two groups: With and without NODAT-for statistical comparison.RESULTS A total of 156 patients received kidney transplantduring the study period, 125 of who were included in our analysis. NODAT was identified in 27.2% of the patients(n = 34; 53% female; mean age: 49.5 ± 10.8 years; median follow-up: 36.4 ± 2.5 mo). The incidence in the first year was 24.8%. The median time to diagnosis was 3.68 ± 5.7 mo after transplantation, and 76.5% of the patients developed NODAT in the first 3 mo. In the group that did not develop NODAT(n = 91), 47% were female, with mean age of 46.4 ± 13.5 years and median follow-up of 35.5 ± 1.6 mo. In the NODAT group, the pretransplant fasting plasma glucose(FPG) levels were significantly higher [101(96.1-105.7) mg/d L vs 92(91.4-95.8) mg/d L, P = 0.007] and pretransplant impaired fasting glucose(IFG) was significantly more frequent(51.5% vs 27.7%, P = 0.01). Higher pretransplant FPG levels and pretransplant IFG were found to be predictive risk factors for NODAT development [odds ratio(OR): 1.059, P = 0.003; OR: 2.772, P = 0.017, respectively]. CONCLUSION NODAT incidence was high in our renal transplant recipients, particularly in the first 3 mo posttransplant, and higher pretransplant FPG level and IFG were risk factors. | Vania Gomes Florbela Ferreira JoséGuerra Maria Joao Bugalho | 2018 | World Journal of Diabetes2018，9，7： | 8 |
| 10 | Gluconeogenesis during starvation and refeeding phase is affected by previous dietary carbohydrates levels and a glucose stimuli during early life in Siberian sturgeon(Acipenser baerii)显示文摘Gluconeogenesis responses was assessed during a short starvation period and subsequent refeeding in Siberian sturgeon(Acipenser baerii) previously fed different dietary carbohydrates levels and experienced to a glucose stimuli during early life. The sturgeon larvae were previously fed either a high glucose diet(G) or a low glucose diet(F) from the first feeding to yolk absorption(8 to 12 d post-hatching [dph]). Each group of fish was sub-divided into 2 treatments at 13 dph and was fed either a high-carbohydrate diet(H) or a low carbohydrate diet(L) until 20 wk. In the current study, the fish in 4 groups(GL, FL, GH and FH) were experienced to starvation for 21 d following by re-feeding of their corresponding diets for 21 d.Fish were sampled at postprandial 6 and 24 h before starvation(P6 h and P24 h), starvation 7,14 and 21 d(S7, S14 and S21) and 1, 7,14 and 21 d during refeeding(R1, R7, R14 and R21). Plasma samples during refeeding were taken at P6 h at each time point. Glycaemia levels, liver and muscle glycogen contents,activities and mRNA levels of hepatic gluconeogenic enzymes were examined. We found that both dietary carbohydrate levels and early glucose stimuli significantly affected the metabolic responses to starvation and refeeding in Siberian sturgeon(P < 0.05). During prolonged starvation, Siberian sturgeon firstly mobilized the liver glycogen and then improved gluconeogenesis when the dietary carbohydrates were abundant, whereas preserved the liver glycogen stores at a stable level and more effectively promoted gluconeogenesis when the dietary carbohydrates are absent to maintain glucose homoeostasis.During refeeding, as most teleostean, Siberian sturgeon failed controlling the activities and mRNA levels of phosphoenolpyruvate carboxykinase cytosolic forms(PEPCK-C), fructose-1,6-bisphosphatase(FBPase),but particularly controlled phosphoenolpyruvate carboxykinase mitochondrial forms(PEPCK-M) activities and mRNA expression of glucose-6-phosphatase(G6 Pase, except in GL group). Siberian sturgeon has a full compensatory ability on growth, but this ability would be obstructed by early glucose stimuli when refeeding the low carbohydrate diet after S21. | Xiaofang Liang Jia Wang Guan Gong Min Xue Yingchao Dong Xiufeng Wu Xin Wang Chunshan Chen Xufang Liang Yuchang Qin | 2017 | Animal Nutrition2017，，3： | 8 |
| 11 | Increased liver markers are associated with higher risk of type 2 diabetes显示文摘AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG. | Sun-Hye Ko Myong Ki Baeg Kyung-Do Han Seung-Hyun Ko Yu-Bae Ahn | 2015 | World Journal of Gastroenterology2015，21，24： | 8 |
| 12 | Gestational diabetes mellitus: Screening with fasting plasma glucose显示文摘Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman. | Mukesh M Agarwal | 2016 | World Journal of Diabetes2016，7，14： | 7 |
| 13 | Intermittent energy restriction in type 2 diabetes: A short discussion of medication management显示文摘AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included 'VLCD' or 'very low energy diet' or 'very low energy restriction' or 'IER' or 'intermittent fasting' or 'calorie restriction' or 'diabetes mellitus type 2' and 'type 2 diabetes'. Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss. | Sharayah Carter Peter M Clifton Jennifer B Keogh | 2016 | World Journal of Diabetes2016，7，20： | 6 |
| 14 | Risk factors for endophthalmitis after cataract surgery in diabetic patients: a case control study显示文摘AIM: To identify risk factors associated with post-cataract surgery endophthalmitis(PCE) in type 2 diabetic patients.METHODS: A hospital-based retrospective case-control study was conducted on 194 type 2 diabetic patients undergoing cataract surgery in Rajavithi Hospital from January 2007 to December 2015. Fifteen patients with PCE were included as the case group and 179 patients without PCE were included as the control group. Potential factors associated with PCE among both groups including demographics, pre-operative characteristics, surgical settings and complications, were statistically analyzed using Chi-square testing and a logistic regression model.RESULTS: Within the case group, 53% were females and the median age was 68 y. Univariate analysis of pre-operative characteristics, surgical settings and complications revealed that recent pre-operative fasting plasma glucose, insulin therapy, presence of diabetic retinopathy, and severe non-proliferative or proliferative diabetic retinopathy were significantly associated with PCE. In a multivariate analysis adjusting for blood glucose level, insulin treatment was the only significant factor associated with an increased risk of PCE(OR 3.9, 95%CI 1.0-15.0, P=0.04) compared to patients without insulin treatment. The most common causative organisms were gram-positive bacteria(89%). Staphylococcus species represented the most common group(67%). Median best corrected visual acuity at 1-month and 3-month follow-up was equal at 0.7 logMAR(20/100).CONCLUSION: The authors identify insulin treatment as the only risk factor associated with endophthalmitis after cataract surgery in type 2 diabetic patients. Further studies with serum levels of pre-operative glycated hemoglobin(HbA_(1c)) and post-operative fasting plasma glucose level are essential to truly demonstrate the role of peri-operative glycemic markers as a risk factor for PCE. | Sukhum Silpa-archa Apichaya Papirachnart Panisa Singhanetr Janine M Preble | 2019 | International Journal of Ophthalmology(English edition)2019，12，3： | 6 |
| 15 | Elevated alanine aminotransferase activity is not associated with dyslipidemias,but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease显示文摘Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results. | Mohammad Ebrahim Ghamar-Chehreh Mohsen Amini Hossein Khedmat Seyed Moayed Alavian Fatemeh Daraei Reza Mohtashami Reza Hadi Bent-Al-Hoda Beyram Saeed Taheri | 2012 | Asian Pacific Journal of Tropical Biomedicine2012，2，9： | 5 |
| 16 | Dual probiotic strains suppress high fructose-induced metabolic syndrome显示文摘AIM:To investigate the effect of novel probiotics on the clinical characteristics of high-fructose induced metabolic syndrome.METHODS:Male Wistar rats aged 4 wk were fed a 70% w/w high-fructose diet(n = 27) or chow diet(n = 9) for 3 wk to induce metabolic syndrome,the rats were then randomized into groups and administered probiotic [Lactobacillus curvatus(L.curvatus) HY7601 and Lactobacillus plantarum(L.plantarum) KY1032] at 109 cfu/d or 1010 cfu/d or placebo by oral gavage for 3 wk.Food intake and body weight were measured once a week.After 6 wk,the rats were fasted for 12 h,then anesthetized with diethyl ether and sacrificed.Blood samples were taken from the inferior vena cava for plasma analysis of glucose,insulin,C-peptide,totalcholesterol,triglycerides and thiobarbituric acid-reacting substances.Real-time polymerase chain reaction was performed using mouse-specific Taqman probe sets to assess genes related to fatty acid β-oxidation,lipogenesis and cholesterol metabolism in the liver.Target gene expression was normalized to the housekeeping gene,glyceraldehyde-3-phosphate dehydrogenase.RESULTS:Rodents fed a high-fructose diet developed clinical characteristics of the metabolic syndrome including increased plasma glucose,insulin,triglycerides,total cholesterol and oxidative stress levels,as well as increased liver mass and liver lipids compared to chow fed controls.Probiotic treatment(L.curvatus HY7601 and L.plantarum KY1032) at high(1010 cfu/d) or low dosage(109 cfu/d) lowered plasma glucose,insulin,triglycerides and oxidative stress levels.Only high-dose probiotic treatment reduced liver mass and liver cholesterol.Probiotic treatment reduced lipogenesis via downregulation of SREBP1,FAS and SCD1 mRNA levels and increased β-oxidation via up-regulation of PPARα and CPT2 mRNA levels.CONCLUSION:Probiotic L.curvatus HY7601 and L.plantarum KY1032 combined suppressed the clinical characteristics of high-fructose-induced metabolic syndrome,therefore,may provide a natural alternative for the treatment of diet-induced metabolic syndrome. | Do-Young Park Young-Tae Ahn Chul-Sung Huh Robin A McGregor Myung-Sook Choi | 2013 | World Journal of Gastroenterology2013，19，2： | 5 |
| 17 | Hypoglycemic and anti-hyperglycemic study of Gynura procumbens leaf extracts显示文摘Objective:To study the antidiabetic activity of Gynura procumbens(G.procumbens)used in the traditional management of diabetes in Southern Asia.Methods:G.procumbens leaves were extracted sequentially with graded percentage of ethanol in water(95%,75%,50%,25%and 0%),and the extracts were tested for antidiabetic activity using acute(7 h),subcutaneous glucose tolerance test and sub-chronic(14 d)test in non-diabetic and streptozotocin-induced diabetic rats.The extracts were further subjected to phytochemical studies.Results:In acute dose(1 g/kg),the extracts significantly lowered fasting blood glucose(FBG)in streptozotocin-induced diabetic rats(P<0.05).However,the FBG-lowering effect of the 25%extract compared to the other extracts,was rapid(47%after 2 h)and the highest:53%,53%and 60%in the 3rd,5th,and 7th h,respectively(P<0.05),comparable only to the effect of metformin.Furthermore,the extracts suppressed peak FBG in subcutaneous glucose tolerance test,but only the 0%and 25%extracts,and metformin sustained the decrease until the 90th min(P<0.05).Moreover,in the 14 days study,the 25%extract exerted the highest FBG-lowering effect,namely 49.38%and 65.43%on days 7 and 14,respectively(P<0.05),similar to the effect of metformin(46.26%and 65.42%).Total flavanoid and phenolic contents in the extracts were found to decrease with increase in polarity of extraction solvents.The composition of reference compounds(chlorogenic acid,rutin,astragalin and kaempferol-3-O-nrtinoside)followed a similar trend.Conclusions:G.procumbens contains antidiabetic principles,most extracted in 25%ethanol.Interaction among active components appears to determine the antidiabetic efficacy,achieved likely by a metformin-like mechanism. | Khalid Algariri Kuong Y Meng Item J Atangwho Mohd Z Asmawi Amirin Sadikun Vikneswaran Murugaiyah Norhyati Ismail | 2013 | Asian Pacific Journal of Tropical Biomedicine2013，3，5： | 4 |
| 18 | Treatment of prediabetes显示文摘Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed. | Mustafa Kanat Ralph A De Fronzo Muhammad A Abdul-Ghani | 2015 | World Journal of Diabetes2015，6，12： | 4 |
| 19 | Incretin-based therapies in prediabetes: Current evidence and future perspectives显示文摘The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of T2 D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2 D. The huge burden resulting from the complications of T2 D created the need of therapeutic strategies in an effort to prevent or delay its development. The beneficial effects of incretin-based therapies, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists, on β-cell function in patients with T2 D, together with their strictly glucose-depended mechanism of action, suggested their possible use in individuals with prediabetes when greater β-cell mass and function are preserved and the possibility of β-cell salvage is higher. The present paper summarizes the main molecular intracellular mechanisms through which GLP-1 exerts its activity on β-cells. It also explores the current evidence of incretin based therapies when administered in a prediabetic state, both in animal models and in humans. Finally it discusses the safety of incretin-based therapies as well as their possible role in order to delay or prevent T2 D. | Georgios S Papaetis | 2014 | World Journal of Diabetes2014，5，6： | 4 |
| 20 | Diagnosis and treatment of insulinoma: report of 105 cases显示文摘Objective: To study the methods for diagnosis andtreatment of insulinoma.Methods: Clinical data from 105 patients with insuli-noma who had been admitted to our hospital from Ju-ly 1966 to December 1999 were retrospectively re-viewed.Results: Fasting blood glucose values were less than2.75 mmol/L in all the patients. Fasting serum insulinvalues in 60 patients were higher than 25 mU/L, av-erage 65 mU/L. Before operation, carcinoma was de-tected in 2 of 45 patients by ultrasound scan, and in10 of 35 by CT. Enucleation of insulinoma was per-formed in 60 patients. Operations included insulinomaresection (35 patients), distal resection of the pancreas(8), and biopsy (2).Conclusion: Whipple’s triad and the index of insulinrelease>0.3 are the major variables for diagno-sis Intraoperative exploration and ultrasound scan are themethods for the localization of insulinoma Enucleation ofbenign insulinoma is preferred, but proximal or distal re-sections of the pancreas are required only for large, deep ormultiple | Liu--Shun Feng Xiu-Xian Ma Zhe Tang Yong-Fu Zhao Xue-Xiang Ye Pei-Qin Xu From the Department of Surgery First Affiliated Hospital,Zhengzhou University, Zhengzhou, 450052, China | 2002 | Hepatobiliary & Pancreatic Diseases International2002，1，1： | 3 |
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