Objective　To determine serum true insulin (TI) and proinsulin (PI) levels in patients with coronary heart disease (CHD), and to explore the relationships of them to other cardiovascular risk factors. Methods　Highly specific ELISA assays for TI and PI and RIA for immunoreactive insulin (IRI) were used. The fasting serum IRI, TI, PI levels in 30 nondiabetic patients with CHD and 30 healthy, age-matched control subjects were investigated. And the fasting and 2h postprandial plasma glucose, serum lipids and blood pressure were also determined in each individuals. Results　The levels of serum IRI, TI and PI were significantly higher in patients with CHD than those in controls (P＜0.05), while the value of insulin sensitivity index (ISI) was lower in patients with CHD than in controls (P＜0.05). There were significant independent correlations between TI, PI and age, BMI, plasma glucose, serum lipids. Conclusion Nondiabetic patients with CHD have hyperinsulinemia and insulin resistance and there is an independent association between proinsulin and dyslipidemia.

Objective To determine the causative organisms and antimicrobial susceptibility of community- and hospital-acquired pneumonia (CAP and HAP) in type 2 diabetes in Fujian Provincial Hospital. Methods The data of becteria spectrum and their drug susceptibility in patients with type 2 diabetes complicated by pulmonary infection were retrospectively analyzed in January 1995 to October 2006. Results The isolated bacteria of sputum culture of 494 cases included 73 gram-positive cocci(16.7%),139 gram negative bacilli(31.9%)and 224 fungus(51.4%).G+ cocci mainly included staphylococci,G-bacilli mainly included Klebsiella pneumoniae,Bowman immovability bacillus and Pseudomonas aeruginosa.In both CAP and HAP,fungus and G- bacilli were the dominant pathogens.The pathogenic bacteria were resistant to multi-antibiotics,and the resistant rates from HAP patients was higher than those from CAP. Of the bacterial strains isolated from blood culture,G-bacilli constituted 87.5%. Conclusions Fungus and G-bacilli were the dominant pathogens.Phlegm culture and drug sensitive test are helpful for reasonable use of antibiotics for patients with type 2 diabetes complicated by pulmonary infection in clinical practice.

[Summary] Kisspeptin is vital for the neuroendocrine regulation of GnRH secretion. Kisspeptin neurons are now recognized as a central pathway responsible for conveying key homeostatic information to GnRH neurons. A number of metabolic modulators have been proposed as regulators of kisspeptin including leptin, adiponectin, insulin, ghrelin, POMC, and neuropeptide Y. Recent data indicate that kisspeptin may have a direct role in regulating energy balance by its regulation of food intake and glucose homeostasis. Thus, kisspeptin may serve as a new connection between reproductive function and energy metabolism.

Objective To investigate the relation between paraoxonase (PON) 1 Q191R gene polymorphism and type 2 diabetes mellitus complicated with hypertension. Methods Genomic DNA was extracted from peripheral blood leukocytes. The studied DNA was amplified by PCR, and then digested with the restriction endonuclease AlwⅠ and separated on 2% agarose gel electrophoresis. PON activity was estimated by spectrophotometer. Serum insulin and C-peptide were measured by radioimmunoassay. Results The frequencies of QQ genotype and Q allele in type 2 diabetes mellitus with hypertension group were significantly higher than those in type 2 diabetes mellitus group (P

Objective To assess the effect of pharmacological and non pharmacological interventions on Chinese subjects with impaired glucose tolerance (IGT). Methods In this 3 year prospective study, 321 subjects aged above 25 years with IGT were included. IGT was defined by 1985 WHO criteria utilizing a 75 g oral glucose tolerance test (OGTT). The subjects were divided into control (C), diet plus exercise (D+E), Acarbose (Glucobay, A) and Metformin (M) groups. The subjects in the group D+E underwent an individually designed diet and exercise program, the importance of which was reiterated annually. The group C only received conventional education on diabetes prevention. The two pharmacological groups were orally given Acarbose (50 mg, t.i.d) and Metformin (0.25 g, t.i.d) respectively. OGTT, weight, height, blood pressure, lipids were measured yearly during the follow up. The t test, Chi square test and proportional hazard regression analysis were used to analyze the risk reduction in diabetes conversion from each group. Results The baseline data of 4 groups had no statistical differences. By the end of study, both the fasting plasma glucose (FPG) and the 2h postprandial plasma glucose (2hPG) in group C elevated (FPG from 6.02 mmol/L to 6.59 mmol/L, 2hPG from 8.83 mmol/L to 9.13 mmol/L), and the annual diabetes incidence was 11.6%. The corresponding changes in group D+E were FPG from 6.11 mmol/L to 6.21 mmol/L, PG2h from 9.28 mmol/L to 8.98 mmol/L, and 8.2% of annual diabetes incidence. In contrast, both the FPGandthe2hPG significantly decreased in group A (FPG from 6.03 mmol/L to 5.47 mmol/L, 2hPG from 8.34 mmol/L to 7.21 mmol/L)andingroup M (FPG from 6.01 mmol/L to 5.85 mmol/L, 2hPG from 9.05 mmol/L to 7.92 mmol/L). Theannualdiabetesincidencedecreasedto2.0% in group A, and 4.1% in group M. Proportional hazard regression analysis showd that the annual diabetes incidence was positively correlated with the baseline 2hPG and body mass index (OR=1.33, P=0.006 and OR=1.11, P=0.008, respectively), and negatively correlated with group C and group M (OR=0.12, P=0.0001 and OR=0.23, P=0.0002, respectively). Conclusion Thenaturaldiabetesincidenceis 11.6% in IGT population, and 8.2% in population with conventional diet and exercise interventions, between them there is no significant difference. The pharmacological interventions with Acarbose or Metformin significantly decrease diabetes incidence of IGT population.

Objective To investigate the association of the polymorphism of endothelial nitric oxide synthase (eNOS) gene 27bp variable number of tandem repeats (VNTR) with essential hypertension (EH) and type 2 diabetes mellitus (DM) in Chinese population. Methods (1) Genotypes were determined by polymerase chain reaction (PCR)-agarose gel electrophoresis. (2) Fasting serum nitric oxide metabolites (NOx) were measured by nitrate reductase. (3) During oral glucose tolerance test (OGTT) serum immunoreactive insulin (IRI) and C peptide (CP) were measured by radioimmunoassay. Results (1) The frequenciesofaalleleinEHandtype2DMgroupwere significantly higher than that in control group (0.109 vs 0.051; 0.129vs 0.051, P

Objective To investigate the association of interleukin 1 receptor antagonist (IL 1Ra) gene polymorphism with osteoporosis in Chinese old men. Methods The allele frequency and the genotype distribution of the second intron of IL 1Ra gene in the groups of senile control (normal bone mineral density, n=65) and senile men with osteoporosis (n=68) were detected by polymerase chain reaction (PCR). Results The frequencyofA 2alleleincontrolgroup was higher than that in osteoporosis group (0.192 vs 0.103, P

Type B insulin resistance (TBIR) is a rare disease caused by the presence of insulin receptor autoantibodies (IRA).African middle-aged women are predisposed to it.Most patients have an underlying autoimmune disease,most commonly systemic lupus erythematosus (SLE).The patients predominantly present with abnormalities of glucose homeostasis ranging from extreme insulin resistance and symptomatic hyperglycemia to lifethreatening hypoglycemia,usually accompanied with manifestation of insulin resistance such as acanthosis nigricans,hyperandrogenism,and polycystic ovary.The diagnosis can be established by the elevation of IRA.We herewith report a ease of TBIR complicated with SLE,and the clinical features,diagnosis and treatment of TBIR are reviewed.

Objective To investigate the relationship between the single nucleotide polymorphisms of exon 6 C161→T of peroxisome proliferators activated receptor γ(PPART)gene and osteoporosis in elderly male. Methods Polymerase chain reaction restriction-fragment length polymorphism(PCR-RFLP)was used to analyze the gene frequency distribution in the groups of nonosteoporosis and osteoporosis in elderly male.Bone mineral density of lumbar and hip(neck of femur,greater trochanter,Ward's triangle)were measured by dual energy X-ray absorptiometry.Serum osteocalcin level was measured by enzyme-labeled immunosorbent assay(ELISA). Results The exon 6 of PPARγ had 3 genotypes(CC,CT and TT).The frequency of T allele in osteoporosis was higher than that in non-osteoporosis.Compared with the control group,serum bone glaprotein level and bone mineral density was lower in osteoporosis group.The bone mineral density in the genotype of CT and TT groups were lower than that in the genotype of CC group. Conclusions The study shows that the single nucleotide polymorphisms of 6th exons of PPARγ may relate to osteoporosis in elderly male.T allele of PPARγ may be a predisposing factor of osteoporosis in elderly male.PPARγmay be a candidate gene of osteoporosis in elderly males.

17α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare cause of congenital adrenal hyperplasia.The patient predominantly presents with low-renin hypertension,hypokalemia,lack of secondary sexual development,and in women with primary amenorrhea,in male with pseudohermaphroditism.We herewith analyse the clinical features of a case of 17OHD diagnosed by gene sequencing.And the etiology,clinical manifestations,genetic features,diagnosis and treatment for 17OHD were reviewed.