Rosiglitazone is one of thiazolidinediones (TZD),an antidiabetic agent which improves insulin sensitivity,but the cardiovascular safety of the drug remains controversial.The new re-evaluation of the RECORD trial has suggested that rosiglitazone-containing drugs do not show an increased risk of heart attack compared to the standard type 2 diabetes medicines,such as mefformin and sulfonylurea.The post hoc analysis of the BARI 2D also indicates that rosiglitazone may not relate with the increased risk of major ischemic cardiovascular events.According to these new results,there is no clear evidence that rosiglitazone may increase cardiovascular risk.The U.S.Food and Drug Administration announced in July 2013 that it is requiring the removal of some prescribing and dispensing restrictions for rosiglitazone-containing diabetes medicines.

The significance of the study on the human healht effects of inhalable particulates(PM10) was pointed out,specific properties of inhalable particulates,such as chemical components,aerodynamic behavior and transference in respiratory tract,were then presented.The serious harm of inhalable particulates on human health were summarized based on research results of epidemiological study,animal toxicological study and clinical study,and research emphasis to which should pay more attention in the future study of this aspects was also suggested.

Bartter′s syndrome(BS) is a rare renal tubular diseases and an autosomal recessive hereditary disease. The characteristic findings are hypokalemia, metabolic alkalosis, and raised serum renin and aldosterone levels. Combination of metabolic syndrome with Bartter′s syndrome has not been reported so far. Here in, we report a case in order to call attention to the diagnosis and treatment of typical Bartter′s syndrome combined with metabolic syndrome.

Objective To investigate the role of glargine in glucose metabolism improvement and antiinflammation of skeletal muscle in Caveolin-1 silenced type 2 diabetic mice.Methods Multiple low doses of streptozotocin (STZ) intraperitoneal injection and high-fat high-glucose (HFHG) were used to induce type 2 diabetic mice model.The mice were divided into normal control group (NC group) and type 2 diabetic model group (T group).Then according to virus injection and glargine treatment,T group were further divided into type 2 diabetes group (T2DM group),type 2 diabetes with insulin treatment group (insulin group),Caveolin-1 silenced with insulin treatment group (LV-CAV1 group),and scramble virus with insulin treatment group (LV-GFP group).Glucose metabolism was accessed by the fluctuation of blood glucose.TNF-α protein expression in skeletal muscle was detected by Western blot.Results The glycemic control of LV-CAV1 group needed more dosages of glargine (P ＜ 0.05).The expression of TNFαin skeletal muscle was elevated in LV-CAV 1 group than that in LV-GFP and insulin group (P ＜ 0.05).Conclusion The anti-inflammation function and glycemic metabolism improvement of glargine may be associated with the expression of Caveoin-1 in skeletal muscle.

ObjectiveTo investigate the clinical significance of inflammatory factors and adiponectin in type 2 diabetes milletus complicated with non-alcoholic fatty liver disease.Methods Two hundred and ten subjects aging from 25.0 to 65.0 years old,including 106 men and 104 women,were recruited into this study.They were divided into four groups: Forty cases of healthy control (NC),60 cases with newly-diagnosed type 2 diabetes (T2DM),65 cases with simple non-alcoholic fatty liver disease (NAFLD) and other 45 cases with newly-diagnosed T2DM complicated with NAFLD.The physical examination was performed for each patient.Serum levels of alanine aminotransferase (ALT),gamma-glutamyl transpeptidase (GGT),fasting plasma glucose (FPG),glycation hemoglobin A 1 c ( GHbA1c ),creatinine ( Cr),uric acid ( UA ),2 hours postprandic plasma glucose (2hPG),fasting insulin (FINS),lipid profiles were measured.Insulin resistance index (HOMAIR) was calculated.Tumor necrosis factor-α (TNF-α),high sensitive C-reactive protein (hs-CRP) and adiponectin were also detected.Results The serum levels of ALT and GGT,body mass index and waist/hip ratio were higher in the NAFLD,T2DM with NAFLD patient groups than that in T2DM and NC group ( P ＜0.05or P ＜0.01 ).The serum levels of TG and LDL-C were significantly higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.And serum TG levels in T2DM with NAFLD group were higher than that of T2DM group (P ＜ 0.05).FPG and GHbAl c were higher in T2DM and T2DM with NAFLD groups than that of NAFLD and NC groups.The serum levels of TNF-α,hs-CRP and HOMA-IR were higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.T2DM with NAFLD group had higher levels of TNF-α,hs-CRP and HOMA-IR compared with T2DM group.However,serum adiponectin levels of T2DM,NAFLD and T2DM with NAFLD groups were lower than that of NC group.And it was lower in T2DM with NAFLD group when compared with NC group ( P ＜ 0.05 ).Adiponectin was negatively associated with TNF-α,hs-CRP and HOMA-IR (r =-0.635,-0.668,-0.752 respectively,P ＜ 0.0l ).But HOMA-IR was positively associated with TNF-α,hs-CRP( r =0.667,0.706 respectively,P ＜ 0.01 ).ConclusionInflammatory factors and adiponectin may play important roles in the pathophysiology and progression of T2DM and NAFLD.The protective effects of adiponectin may come from its anti-inflammatory activity to relieve insulin resistance for NAFLD.

Objective To investigate the relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus (T2DM) patients with normal uric protein.Methods According to the coronary artery lesion diagnosed by 320-dynamic volume CT,the 126 T2DM patients with normal uric protein were divided into three groups:no coronary stenosis group (group A,32 cases),coronary atherosclerosis group(group B,38 cases),coronary heart disease group (group C,56 cases).Then the serum cystatin C etc were compared among the three groups.Results The levels of serum cystatin C in group A,B,C were (0.89 ± 0.27),(1.31 ± 0.53),(1.54 ± 0.62) mg/L.With the increase of coronary artery lesions,it gradually increased,there was significant difference among the three groups (P ＜ 0.05).The patients were divided into three groups according to the level of serum cystatin C quartile.The incidence of coronary artery lesion in creased with the increased levels of serum cystatin C.The level of serum cystatin C increased from 75th percentile to 100th percentile,the incidence of coronary heart disease increased significantly (OR =8.32,P ＜0.05).The result of multiple Logistic regression analysis showed that history of hypertension (regression coefficient 4.135,P =0.000),glycosylated hemoglobin (regression coefficient 1.257,P =0.002),low density lipoprotein-cholesterol (regression coefficient 3.381,P =0.015),cystatin C (regression coefficient 2.046,P =0.030) were the independent risks of coronary heart disease in patients with T2DM.Conclusion The level of serum cystatin C may be a predictor for coronary heart disease in T2DM patients with normal uric protein.

Objective To investigate the relationship between dyslipidemia,obesity,insulin resistance (IR)and various degrees of non.alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus (T2DM), and the risk factors of NAFLD.Methods Two hundred and sixty-eight patients were divided into three groups(non-NAFLD group,mild NAFLD group,moderate and severe NAFLD group)by liver ultrasonography.Body height(H),weight(W),waist circumference(WC),hip circumference(H)were measured.The levels of fasting blood glucose (FBG),glycosylated hemoglobin A_1c(GHbA_1C),serum total cholesterol(TC),serunl high density lipoprotein(HDL-C),serum low density lipoprotein(LDL-C),serum triglyceride (TG),alanine aminotransferase (ALT)and fasting serum insulin(FINS)were measured.Body mass index(BMI),the waist to hip ratio(WHR)and insulin resistance index(HOMA-IR)were calculated.Unconditional logistic regression model was used to test for the risk factors of NAFLD.Results BMI、WC、WHR、HNS、HOMA.IR、TC、LDL-C、TG and ALT in NAFLD group were significantly higher than those in non-NAFLD group (P<0.05).The levels of BMI、WC、WHR、HNS、HOMA-IR、 TG and ALT increased significantly in moderate and severe NAFLD group compared with mild NAFLD group(P<0.05).TG、WHR and HOMA.IR were the risk factors of NAFLD(P<0.05,OR=2.394,3.273,5.256).Conclusions NAFLD in patients with T2DM had remarkable dyslipidemia,overweight,central obesity and insulin resistance.TG、WHR and HOMA.IR were risk factors of NAFLD.

Objective To study the effects of sulodexide on islet B-cell function in streptozocin induced di-abetic rats. Methods Sprague-Dawley(SD) rats were randomly divided into normal control group (group C), dia-betic group without treatment(group D), and suledexide treatment group(group S), a single dose of streptozotocin were abdominally injected to establish the diabetic rat models. Each animal in sulodexide treated group was addition-ally fed with sulodexide of 10 mg/(kg·d) for 12 weeks,while the remained group (group C and D) were given normal water in the same period. After 12 weeks of treatment, fasting plasma glucose(FPG),fasting plasma insulin (FINS), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), triglyceride (TG), Low-density lipoprotein cholesterol (LDL-C), serum creatinine rates (SCr) and alanine aminotransferase (ALT) were measured. Insulin sensitivity index(ISI) and insulin resistant index (HOMA-IR) were calculated. Results After 12 weeks, the levels of TG, LDL-C and ALT had no significant difference between group D and group S, but were higher than those in group C (P <0.05);There were no significant difference of SCr levels among the three groups. Compared with the group C, APTT, PT, TT and ISI in group D and S were significantly decreased, HOMA-IR were significantly increased (P < 0.05). APTT, PT, TT and ISI in group S had significantly increased compared with that in group D, HOMA-IR was significantly decreased in group S compared with that in group D (P < 0.01). Conclusions Sulodexide can reduce insulin resistant, improve hypercoagulability and insulin sensitiv-ity in streptozocin induced diabetic rats. The effects to blood lipid, liver and renal functions in diabetic rats are not obvious.

[Objective] To investigate the clinical characteristics and risk factors of lower-extremity arterial disease in the patients with newly diagnosed type 2 diabetes mellitus combined with nonalcoholic fatty liver disease (NAFLD). [Methods] One hundred fifty-one patients were investigated respectively. The patients were divided into two groups (NAFLD-Group and non-NAFLD group) by liver ultrasonography and disease history, then their clinical data were collected and compared in order to find the differences of biochemical indicators and the morbidity of lower-extremity arterial disease between two groups. [Results] Ninety-two cases (60.93%) were complicated with NAFLD. NAFLD group had higher levels of fast insulin and C peptide level, postprandial insulin and C peptide level, uric acid, body mass index (BMI), homeostasis model assessment (HOMA-IR) and lower level of high-density lipoprotein cholesterol and insulin sensitive index than those of without NAFLD (P<0.05). One hundred and one cases(66.89%) were complicated with lower-extremity arterial disease. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group (75% vs. 54.24%, P<0.01). [Conclusion] Both lower-extremity arterial disease and NAFLD are common complicated with type 2 diabetes. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group.

Objective To compare the excursion of blood glucose (BG) in the type 2 diabetes mellitus treated with oral antidiabetic drugs (OADs) plus glargine or human isophane insulin (HII). Methods A 1 : 1 randomization schedule assigned 30 type 2 diabetics inadequately controlled on OADs (fasting BG>9.0 mmol/L and HbA1C > 8.5%) to 2 groups additionally treated with glargine or HII. The insulin dose was titrated to achieve fasting capillary BG<6.0 mmol/L. Montoring BG with continuous glucose monitoring system, then the standard deviation of BG (SDBG), maximal excursion of BG (LAGE) and coefficient of variation (CV) of fasting plasma glucose (FPG) were calculated. Results SDBG (1.49±0.35 vs 1.73±0.46), LAGE (3.23±0.76 vs 3.73± 1.00) and CV-FPG (17.26±2.24 vs 20.33±3.21) were lower in glargine group than those in HII group (P< 0.05). No difference could be found in hypoglycaemia between two groups. Conclusion OADs plus glargine could make blood glucose more stable than OADs plus HII without increasing the incidence of hypoglycaemia.