In recent years,there are gradually increasing attentions on diabetic osteoporosis.Diabeticosteoporosis is characterized by insidious onset,high incidence,and risk of disability.Metabolic disorders caused bydiabetes mellitus are related to an imbalance between osteoblastic bone formation and osteoclastic resorption.Diabetesalters bone mass and increases the risk of fracture.In this review the influence of diabetes on osteoporosis isdiscussed.

Objectives To investigate the variation of serum ghrelin levels in simple obesity and its clinical implication.Methods Serum ghrelin level was measured by EIA and compared with healthy controls to understand its relationship with insulin,height,body weight and BMI.Results ①The serum ghrelin level of simple obesity group was significantly lower than that of normal group(P

Objective To lower immunogenesis of human adult islets,reduce the dose of immunosuppressors and promote wide development of transplantation of adult islets,isolated adult islets were in vitro pretreated.Methods Isolated adult islets were cultured at 24 ℃ for 2 days(24 ℃ group) or pretreated using MHC-II monoclonal antibody(monoclonal antibody and complements were added and cultivated for another day following one-day-24 ℃-culture,antibody group) as observation groups.Adult islets were cultured at 37 ℃ in CMRL 1066 medium plus 20 % fetal bovine serum for 2 days as control.The immunogenics of the islets was detected using lymphocyte-islet mixed culture(MILC) and immunohistochemical staining of HLA-DR and lymphocyte common antigen(LCA).The function and activity of the islets were identified using()~3H-leucine incorporation assay,insulin release test and in situ apoptosis assay.Results Compared with control,MILC stimulation index was remarkably lower in the antibody group(P(0.05)).The percentage of HLA-DR and LCA positive cells in the antibody groupand in the 24 ℃ group was much lower than that in control(All P

To exclude the interfering factors in islet cell antibodies(ICA) determination some pretreatments on both pancreatic sections and serum samples were made. The results revealed that the islet structures of pretreated pancreatic frozen section appeared clearly. The positive rate of ICA by ABC enzyme-labelled method was higher than that by indirect immunofluorescence method. Comparing the ICA results of exchange sera provided by Immunology and Diabetes Workshop with the reference results,the validity、consistency、sensitivity and specificity was 81%、63%、75%and 88%, respectively. These results suggest that ABC method with the pretreated pancreatic frozen section is a stable method of ICA determination.

[Summary] This retrospective analysis showed that the level of apolipoprotein E was significantly higher in diabetic nephropathy group compared with normal albuminuria group [50.4 (40.8,65.9) vs 46.2 (38.6,56.8)mg/L,P＜0.01].Difference in urinary albumin to creatinine ratio (ACR) among the groups based on the tertile of apolipoprotein E were significant (P＜ 0.01).Multiple linear regression analysis demonstrated that apolipoprotein E was independently associated with ACR (β =0.14,P＜0.05).

Objective To investigate the relationship between serum uric acid ( SUA) concentration and urinary albumin excretion rate ( UAER) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitua (T2DM). Methods The clinical data of 372 patients with T2DM. including 184 males and 188 females, were collected. The correlations between SUA and the other clinical indexes were analysed by Pearson method, and multiple regression analysis was employed to examine the effects of various factors on UAER and CIMT. Results SUA concentration was higher in males than in females with T2DM (P <0. 01). and was positively correlated with UAER both in males and females with T2DM, even after adjustment for the creatinine clearance (r = 0.24, P < 0.01 for males; r = 0. 29, P < 0.01 for females). Positive correlation was found between SUA concentration and CIMT in females (r =0. 29, P < 0. 01). Multiple regression analysis demonstrated that SUA concentration was an independent determinant of UAER for males as well as females (β=0.16, P<0.05 for males; β=0. 20, P < 0. 05 for females), and was also an independent determinant of CIMT for females (β =0.16, P <0.05). Conclusion SUA plays an important role in the progression of diabetic nephropathy and cardiovascular diseases in patients with T2DM. SUA control may provide a novel approach for the treatment of diabetic nephropathy and vascular complications.

Objective To examine the association between vitamin D and alendronate response,and to investigate the proper vitamin D levels for the efficacy of alendronate treatment of osteoporosis.Methods In this retrospective study,559 post-menopausal women with osteoporosis were devided into two groups:non-responders and responders,based on the European Study of Forsteo (EUROFORS).Demographic and clinical data including mean 25-hydroxy vitamin D (25-OHD) levels between dual-energy X-ray absorptiometry (DEXA) scans were obtained.Mean 25-OHD levels were compared between responders and non-responders and multiple logistic regression analysis was performed to identify factors associated with non-response.Results There were 437 (75.5％) responsers to alendronate therapy and 142 (24.5％) non-responders.Responders with a mean serum 25-OHD level of (59.96 ±12.56) nmol/L,obtained a more favorable result than non-responders,whose serum 25-OHD level was (47.50 ±9.92) nmol/L (P＜0.01).25-OHD level was significantly associated with response.Conclusion Patients with a mean 25-OHD ≥50 nmol/L had a substantially greater likelihood of maintaining bisphosphonate response.

Objective To explore the characteristics of the gene expression in Cushing′s adrenal corticoadenoma and its associated molecular mechanism. Methods cDNA libraries of human normal adrenal and the adenoma were constructed. Large scale sequencing and bioinformatics were used. Results From the tumor library, 2089 expressed sequence tags (ESTs) were obtained with a successful rate of 98.9%. The functional distribution of the known genes in the tumor coincided with that in normal adrenal. Some synthases such as 3bHSDⅡ and P450c17A involved in steroidogenesis were expressed more highly in the adenoma than those in normal adrenal, especially 3bHSDⅡ. By comparison with the expression abundance of genes and statistic analysis, the differences were significant in 45 genes between the tumor and normal adrenal libraries. Interestingly, some genes associated with tumorigenesis, including heat shock protein 90, metallopanstimulin (MPS1), adenine nucleotide translocators etc, were highly expressed in the adenoma. However, those genes related to apoptosis and suppressing proliferation were not found in the tumor library. Conclusion The adenoma shows exuberant activities in steroid synthesis. Not only does the tumor highly express the genes associated with tumorigenesis, but also those related to apoptosis and suppressing proliferation lowly existed in the tumor.

Diabetic patients with secondary sulfonylureas failure were shifted to glipizide plus glargine ( n = 20) or neutral protamine hagedorn (n =32). Sixteen weeks later, blood glucose and HbAIC were decreased and serum C peptide level increased in both groups. Hypoglycemia occurred less frequently and?-cell function was improved in glargine group.

Objective To explore the difference involved in the activation of inflammation pathway and the plasma level of inflammatory factors in the subjects with different sorts of insulin sensitivity. Methods The study was carried out in 38 women, consisting of obesity (n = 22 ) and control (n = 16 ) groups according to body mass index. The insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMAIR). Plasma concentrations of interleukin-6 (II-6) and IL-1β were determined by enzyme immunoassay. Western blot analysis was used to examine total protein expression and phosphorylation levels of IκB kinase (IKK) ,inhibitor of nuclear factor-κB ( IκB ) in peripheral blood leukcocytes. Electrophoretic mobility shift assay (EMSA)was used to detect the binding activity of NFκB. Results The levels of fasting plasma insulin[62.2 ( 20.0-127. 0) pmol/L vs 19. 15 ( 14. 2-47. 8 ) pmol/L, P<0. 01], HOMA-IR[2. 32 ( 0. 76-5.49 ) vs 0.70(0.53-1.7),P<0.0l], HbA1 C[(5.42±0. 45 ) % vs ( 5.08 ±0. 38) %, P<0. 05], triglyceride[( 1.75 ±0. 68 vs 1.22 ±0. 58 )mmol/L, P<0. 05], plasma IL-6[3. 15 (0. 03-22. 2) pg/ml vs 1.26 (0. 74-6.06 ) pg/ml, P<0. 01], and IL-1 β[6. 53 ( 0. 84-36 ) pg/ml vs 3. 16( 1.48-8. 86 ) pg/ml, P<0. 01]in obesity group were significantly higher than those in control group. Compared with control group, the levels of IKKo, IKKβ expression and IκBα serine phosphorylation in obesity group were markedly increased, while the expression of IκBα was significantly reduced. Accompanied with the degradation of IκBα protein, the binding activity of NFκB in obesity group was significantly increased. Conclusions The plasma levels of IL-6 and IL-1β were significantly raised in obesity group. The activation of IKK-IκB-NFκB pathway is closely associated with the genesis and development of insulin resistance in obese subjects.