1.Evaluation on the prevalence of metabolic syndrome and index of insulin resistance in the population screened by oral glucose tolerance test (OGTT)
Fusheng FANG ; Hui TIAN ; Yinghong SHAO
Medical Journal of Chinese People's Liberation Army 1982;0(01):-
Objective To investigate the prevalence of metabolic syndrome (MS) and its risk factors in the population of age between 21 to 78 years in Beijing, and to study the clinical significance of evaluation of MS and hyperinsulinaemia by the use of waist circumference and body mass index (BMI). Methods A standard questionnaire and 75g oral glucose tolerance test (OGTT) were used in the investigation. All the data, including plasma glucose (fasting blood glucose level and postprandial glucose level), blood levels of insulin, blood lipid, blood uric acid, and creatinine, as well as height, weight, waist circumference (WC), blood pressure, body mass, were determined or measured. Obesity was defined by WC and BMI value. The incidence of obesity complicated with two abnormal metabolic disorders (IDF), as well as hyperinsulinaemia in these subjects, were analyzed. Results The prevalence of obesity as determined by WC and BMI were 20.6% and 41.5%, respectively, in the said popalation of Beijing (P0.05) in subjects of obesity complicated with two other metabolic abnormality as defined by WC and BMI criteria, accounting for 1.37% and 3.13% of the whole investigated population (P
2.Significance of the waistline,body mass index and hyperinsulinaemia on evaluating metabolic syndrome
Hui TIAN ; Fusheng FANG ; Yinghong SHAO
Medical Journal of Chinese People's Liberation Army 2001;0(10):-
Objective To analyze the significance of the waistline (WC), body mass index (BMI) and hyperinsulinaemia (HIns) on evaluating the metabolic syndrome. Methods The data of routine clinical examination were collected from the mid-aged and senile individuals (middle-senile group) who received oral glucose tolerance test (OGTT) for diabetes screening, and from a group of subjects who received annual OGTT for diabetes screening (mature group). Data were collected by a specialized person, input into a special computer database, and then analyzed with SAS 5.0 software by specialized staffs. Abnormal WC and BMI were determined according to IDF and CDS criteria. HIns was determined if fasting insulin (FIns) ≥15mU/L and 2-hour insulin after glucose burdening (2hPIns) ≥80mU/L. Results In the middle-senile group, the abnormality frequencies of WC and HIns as well as overall insulin level were obviously higher than that in the mature young group. The abnormality frequency of BMI was higher in mature young group. A higher detection rate of HIns existed in intolerance glucose test (IGT) and normal glucose test (NGT). The coincidence of WC and BMI diagnostic criteria were 77.5% and 74.3%, respectively, on evaluating with or without obesity in the middle-senile group and mature young group. When only WC criterion was used for evaluating the existence of insulin resistance, there would be 28.2% of missed diagnosis rate for MS patients. Conclusion WC, BMI and HIns are all risk factors for abnormal glucose metabolism, hypertension and dyslipidemia. There is different prevalence among different populations. The combination of WC, BMI and HIns might be more helpful for identifying MS at early stage.
3.A cohort study on the association between fasting plasma glucose level over 5.3 mmol/L and risks of abnormal glucose metabolism and cardiovascular diseases in the elderly
Mingxing ZHAO ; Fangfang KAN ; Fusheng FANG ; Hui TIAN
Chinese Journal of Internal Medicine 2016;55(5):340-344
Objective The aim of the study was to evaluate the association of fasting plasma glucose (FPG) level over 5.3 mmol/L to the development of abnormal glucose metabolism and cardiovascular diseases (CVD).Methods This was a retrospective cohort study with 1 064 non-diabetic subjects(980 males;84 females) aged 60 or over, who carried out annual health check-up in Chinese PLA General Hospital from May, 1996 to May, 2015.Based on the average FPG level of 3 years before enrollment, the subjects were divided into four groups : < 5.3 mmol/L, 5.3-< 5.6 mmol/L, 5.6-< 6.1 mmol/L and 6.1-< 7.0 mmol/L.Glucose metabolic changes, complications and mortality were follow-up until May, 2015.Results (1)The initial 3-year average FPG levels were (4.9 ±0.4) mmol/L in the total 1 064 subjects.Among them, 126 subjects developed diabetes mellitus (DM) and 144 subjects developed impaired glucose regulation (IGR) during the follow-up visits.The proportions of IGR and diabetes increased with the FPG levels (P < 0.05).The risk for developing IGR was significantly higher in subjects with FPG≥5.3 mmol/L than in those with FPG < 5.3 mmol/L (RR =3.08, 95% CI 2.02-4.81, P <0.01).The risk for incident DM was markedly increased in subjects with FPG ≥ 5.6 mmol/L than in those with FPG <5.6 mmol/L (RR =6.73, 95% CI 3.90-11.52, P <0.01);(2)The risk for CVD was eight folds higher in subjects with FPG ≥5.3 mmol/L than in subjects with FPG < 5.3 mmol/L (RR =8.42,95% CI 5.11-13.82, P < 0.05);(3) Survival analysis showed that the risk of death was 1.47 times higher in subjects with FPG ≥ 5.3 mmol/L than in subjects with FPG < 5.3 mmol/L after years of followed-up (RR=l.47, 95%CI 1.09-1.98, P=0.0127).Conclusion The risks for IGR, CVD and mortality are higher in the elderly with FPG ≥5.3 mmol/L, which highlights the importance for the disease prevention in elder people with FPG 5.3 mmol/L or more.
4.Clinical Study of Niaoshitong Pill in the Treatment of Urinary Calculus with Syndrome of Qi and Damp Stagnation
Yan MO ; Liuji MO ; Feng LIANG ; Fusheng TIAN ; Jinming JIA
Traditional Chinese Drug Research & Clinical Pharmacology 1993;0(02):-
Objective To evaluate the curative effect and safety of Niaoshit on g pill in the treatment of urinary calculus.Method Multi- center randomized co ntrolled clinical trial was adopted. Three hundred and twenty cases were accepte d to the study, in which 200 cases were treated by Niaoshitong pill and 120 case s by Shilintong tablet as control. The effect of both groups was observed. Resul t 107 cases (53.5 % ) were cured, 53 cases(26.5 % ) effective, the total effe ctive rate being 80.0 % in the treatment group, and 27 cases(24.5 % ), 42 cas es (38.2 % ), and 62.7 % respectively in the control group. In a open group of 120 cases ,54 cases (45.0 % ) were cured, 44 cases (36.6 % ) were effective , the total effective rate being 81,6 % .Conclusion Niaoshitong pill can mark edly improve the clinical symptoms and exerts a strong lithagogue effect. It can promote the elimination of calculi after external blast lithotrity or ureterosc opic lithotrity, prevent the formation of 'stone street', and reduce the strictu re formed by the damage of ureter.
5.ABC Analysis of the Drug Utilization in Our Hospital in the Second Half Year of 2007
Xu YANG ; Shaohua WANG ; Zhenxue TIAN ; Fusheng SUN
China Pharmacy 2007;0(32):-
OBJECTIVE:To probe into the drug utilization data in the second half year of 2007 in our hospital.METHODS:By using ABC analytic method,the consumption amount,consumption sum and the varieties of drugs used in the second half year of 2007 in our hospital were analyzed statistically.RESULTS:Type A,B and C drugs accounted for 16.34%,18.76% and 65.03%,respectively,in terms of the consumption amount.CONCLUSION:The drug utilization structure in our hospital is rational on the whole,but the use of antibiotics is somewhat irrational and thus need to be standardized further.
6.The influence of purine content in diet on serum uric acid of old males
Ying JIA ; Hui TIAN ; Yinghong SHAO ; Fusheng FANG ; Shuangtong YAN ; Rongxin ZHANG ; Changyong XUE
Chinese Journal of Endocrinology and Metabolism 2012;28(9):734-737
Eleven old male patients with hyperuricemia were collected ( hyperuricemia group,65-90 years old ).10 healthy middle-aged males ( middle-aged group,30-40 years old) and 10 healthy old males ( older group 60-70 years old ) with normal blood uric acid level were used as controls.All of the subjects were given low purine content diet ( 250 mg/d ) for 3 days followed by high purine content diet ( 800 mg/d ) consecutively for another three days.The samples of fasting blood and 24 h urine were collected for assay.The results showed that there were no significant changes of serum uric acid ( UA ) concentration in three groups after low purine content diet.But the levels of serum UA in three groups all increased significantly after high purine content diet,and the change was higher in hyperuricemia group than middle-aged group [ ( 507.7 ± 108.1 vs 378.9 ± 80.1 ) μmol/L,P<0.05 ].24 h urine uric acid excretion in three groups was all significantly decreased after low purine content diet and increased after high purine content diet.After high purine content diet,24 h urine uric acid was lower in hyperuricemia group than middle-aged group [ ( 2.99 ± 1.21 vs 3.62 ± 1.02 ) mmol/24 h,P<0.05 ].Blood urea nitrogen levels in all subjects decreased after low purine content diet and increased after high purine content diet ( P<0.05 or P<0.01 ).Creatinine clearance rate in hyperuricemia group was decreased after high purine content diet compared with baseline [ (75.3 ± 20.3 vs 80.7 ±20.0) ml/min ],and there were no significant changes in other groups after low and high purine content diet.24 h urine protein in hyperuricemia group was higher than middle-aged group ( P<0.05 ),and increased after high purine content diet with significant difference ( P<0.05 ).These results suggest that high purine content diet and decreased by renal uric acid clearance mainly contribute to hyperuricemia in old people.
7.The correlation between hyperinsulinemia and pulse wave velocity
Fusheng FANG ; Hui TIAN ; Chunlin LI ; Minyan LIU ; Xinyu MIAO ; Xiaoling CHENG
Chinese Journal of Internal Medicine 2011;50(4):299-302
Objective To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. Methods Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. Results Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemia (NIns) in different glucose metabolism status [normal glucose tolerance, ( 1381.2 ±280. 8) cm/s vs ( 1280. 3 ±218. 7) cm/s; imparied glucose regulation, ( 1557. 5 ±319.3) cm/s vs (1474.7 ±305. 1) cm/s; diabetes, (1764.3 ±476.6) cm/s vs (1664.2 ±374.6)cm/s], especially in subjects with normal glucose tolerance ( P < 0.01 ). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns ( P < 0.01 ). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1. 169-3. 105, P <0.01 ) as compared to the subjects with NIns. Conclusion The subjects with HIns suffered from much more metabolic risk factors than NIns.Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.
8.EXPERIMENTAL STUDY ON THE CHANGES IN THE INTESTINAL FLORA IN RABBITS WITH MULTIPLE SYSTEM ORGAN FAILURE
Yongming YAO ; Huimin TIAN ; Yaping WANG ; Zhiyong SHENG ; Zhiguo SHI ; Fusheng LAN
Medical Journal of Chinese People's Liberation Army 1983;0(05):-
A new animal model of multiple system organ failure (MSOF) in rabbits is used in this experiment. The purpose of the current study is to observe dynamically the changes in the intestinal flora, the relationship between the changes and bacterial translocation to various organs and endotoxemia. The results show that there is no obvious alteration in population of Bacteroides, but a significant increase in enteric bacilli population in the contents of the ileocecum is found. Changes in the intestinal micro-flora correlate to the positive bacterial culture of the blood, viscera, and the level of endotoxin in the plasma. The results of our work suggest that ecological imbalance in the intestinal flora may promote-the gut-derived septic process and the development of MSOF.
9.Different prevalence of impaired glucose tolerance between hyperinsulinemic and normoinsulinemic subjects
Jing XIAO ; Hui TIAN ; Wenwen ZHONG ; Boruo SUN ; Yupeng LI ; Fusheng FANG ; Xiaofei HAN ; Yongquan LIU ; Xiaoling CHENG
Chinese Journal of Internal Medicine 2012;51(4):299-303
Objective To study the impact of different insulin levels on the conversion from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM),through analysis of different glycometabolism condition among quinquagenarian population.Methods Subjects enrolled were Beijing habitants who received annual physical examination [ including oral glucose tolerance test (OGTI) ] in the Chinese PLA General Hospital from 2005-2007.According to the OGTT results,the subjects were divided into three groups,including normal glucose tolerance-non-hyperinsulinemia group (NGT-NHIns),IGT-hyperinsulinemia group (IGT-Hins) and IGT-non-hyperinsulinemia group (IGT-NHINS).The prognosis between the year 2009 and 2010 of the three groups was observed.Hyperinsulinemia was diagnosed with fasting serum insulin ≥ 15 mU/L and/or 2-hour serum insulin ≥ 80 mU/L after glucose loading.Results The rate of case number of conversion to T2DM in IGT-NHIns group (42/133) was higher than that in IGT-Hins group (24/154) or NGT-NHIns group (12/126).The HOMA insulin resistance index (HOMAIR) of individuals with IGT-NHIns was lower than that of IGT-Hins [ 0.96 (0.40,3.53 ) vs 2.04 (0.59,23.20),P < 0.05 ],while whole body insulin sensitivity index (WBISI) was higher than that of IGT-Hins [ 7.48 (3.20,31.35 ) vs 3.28 ( 0.86,7.67 ),P < 0.05 ].Modified β-cell function index ( MBCI ) and insulin secretion index (ISI) in IGT-NHIns was poorer than that of IGT-Hins respectively [ 2.57 (0.58,10.98) vs5.17(1.04,65.09); 7.66 (0.99,28.40) vs 17.56 (4.18,96.46),allPvalues <0.01].Conclusions The risk of IGT-NHIns progressing into T2DM is higher than that of IGT-Hins. For the prevention of T2DM,individuals with IGT-NHIns should be paid more attention than keeping an eye on IGT-Hins patients.Early control of risk factors could protect β cell function and prevent the progression to T2DM.
10.The clinical characteristics and trend of conversion to type 2 diabetes mellitus of individuals with normal glucose tolerance-hyperinsulinemia
Fusheng FANG ; Hui TIAN ; Chunlin LI ; Yinghong SHAO ; Jian LI ; Wenwen ZHONG ; Minyan LIU ; Shuangtong YAN ; Guang YANG ; Xiaoling CHENG ; Qin MA ; Huixian WANG
Chinese Journal of Internal Medicine 2010;49(6):480-483
Objective To study the outcomes and influencing factors of the conversion from normal glucose tolerance -hyperinsulinemia (NCT-HINS) to diabetes in the population of a community in Beijing.Methods All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in May, 2006 and May, 2008. Data were calculated to analyze the outcomes and influencing factors of the conversion. HINS was diagnosed if fasting serum insulin & 15 mIU/L and/or 2-hour serum insulin after glucose loading ≥ 80 mIU/L Results The prevalence of NGT-HINS in the community in 2006 and 2008 was 5.28% and 8.67% (P<0.01) respectively and that of diabetes mellitus (DM) and impaired glucose regulation (IGR) was 3.52% , 6.56% in 2006 and 4.42% ,6.47% in 2008.The probability of the conversion from NGT-HINS to IGR and DM was 18.6% and 2.3% , being much higher than that from normal glucose tolerance- normoinsulinemia (NGT-NINS) (5.4% and 0.7% , P <0.01). However, the probability of the conversion from NGT-HINS to DM was 2.3% , which was much lower than that from IGR (26.3% , P <0.01). The reason might be that individuals with NGT-HINS had a higher waist circumference, BMI, fasting plasma glucose, 2 h plasma glucose and TG but a lower HDL-C than individuals with NGT-NINS in 2006. The HOMA β-cell function index/HOMA insulin resistance index (HBCI/IR) of individuals with NGT-HINS was much lower than that of individuals with NGT-NINS, but much higher than that of individuals with IGR. Logistic regression analysis showed that age, TG and HBCI/IR were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of conversion from NGT to DM was increased remarkably when HINS was diagnosed. The reason might be that individuals with NGT-HINS suffered more metabolic risk factors and had a decreased β-cell function. Therefore, individuals with NGT-HINS should be paid attention to in diabetes prevention study.