OBJECTIVETo explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).

METHODSClinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.

RESULTSThe average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.

CONCLUSIONAs for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.

Adolescent ; Adult ; Aged ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Weights and Measures ; C-Peptide ; blood ; physiology ; Caloric Restriction ; Combined Modality Therapy ; Comorbidity ; Coronary Disease ; complications ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Diet Therapy ; methods ; Diet, Diabetic ; Endoscopy ; Fatty Liver ; complications ; surgery ; Female ; Food, Formulated ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Gout ; complications ; surgery ; Hashimoto Disease ; complications ; Humans ; Hypertension ; complications ; surgery ; Insulin ; blood ; physiology ; Lipids ; blood ; physiology ; Male ; Menstruation Disturbances ; complications ; surgery ; Middle Aged ; Obesity ; complications ; therapy ; Perioperative Care ; methods ; Thyroiditis ; complications ; Treatment Outcome ; Triglycerides ; blood ; physiology

PURPOSE: The current study was conducted in order to identify health and nutritional status of Korean underweight women in their twenties by comparing with normal, overweight, and obese women. METHODS: Data from the 2010~2012 Korea National Health and Nutrition Examination Survey were used in this study. Subjects were 897 women aged 20~29 years. Subjects were classified according to underweight, normal weight, overweight, and obese groups based on body mass index. Health status was assessed using data from the health questionnaire and examination. Nutritional status was assessed using data from 24-hour dietary recall and a food frequency questionnaire. RESULTS: The underweight group had higher education and exercised less than the obese group. Means of blood chemistry and blood pressure of the underweight group did not differ from those of the normal weight group. Means of fasting glucose, insulin, lipid profiles, blood cell counts, and blood pressure in the underweight group were different from those of the overweight or obese group. Proportions of delivery, breast feeding, and irregular menstruation in the underweight group were lower compared with the other groups. Except retinol intake, means of nutrient intake did not differ among four groups. There were significant differences among four groups in the intakes of cereals and eggs and frequency of consumption of dairy products. CONCLUSION: The current findings showed that health and nutritional status of underweight women in their twenties did not differ from those of normal weight women. In particular, health status of underweight women in their twenties was better than that of obese women of the same ages. Further study on health and nutritional status of extremely underweight women is necessary.
Blood Cell Count ; Blood Pressure ; Body Mass Index ; Breast Feeding ; Edible Grain ; Chemistry ; Dairy Products ; Education ; Eggs ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Korea* ; Menstruation ; Nutrition Surveys* ; Nutritional Status* ; Overweight ; Ovum ; Thinness* ; Vitamin A

Menopause is the time at which menstruation stops in women. After menopause, women are more susceptible to some diseases, especially osteoporosis and cardiovascular disease. Vitamin D has a protective effect against osteoporosis by facilitating the absorption of calcium and affecting parathyroid hormone. Vitamin D also affects cardiovascular function by lowering the blood pressure, which affects the renin–angiotensin system and alters the low-density lipoprotein receptor activity. This paper discusses supplemental vitamin D in postmenopausal women with osteoporosis and cardiovascular disease.
Absorption ; Blood Pressure ; Calcium ; Cardiovascular Diseases ; Female ; Humans ; Menopause ; Menstruation ; Osteoporosis ; Parathyroid Hormone ; Receptors, Lipoprotein ; Vitamin D* ; Vitamins*

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.
Adult ; Aging/blood ; Anti-Mullerian Hormone/*blood ; Female ; Follicle Stimulating Hormone/*blood ; Humans ; Luteinizing Hormone/*blood ; Menstruation/blood/physiology ; Middle Aged ; Ovarian Reserve/*physiology ; Ovulation/*blood/physiology ; Retrospective Studies ; Young Adult

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.
Adult ; Aging/blood ; Anti-Mullerian Hormone/*blood ; Female ; Follicle Stimulating Hormone/*blood ; Humans ; Luteinizing Hormone/*blood ; Menstruation/blood/physiology ; Middle Aged ; Ovarian Reserve/*physiology ; Ovulation/*blood/physiology ; Retrospective Studies ; Young Adult

OBJECTIVETo observe the clinical efficacy of acupuncture combined with auricular point sticking for menstrual headache and to discuss its mechanism.

METHODSEighty-five patients with menstrual headache were randomly divided into an observation group (43 cases) and a control group (42 cases). The observation group was treated with body acupuncture combined with auricular point sticking and the control group was treated with flunarizine hydrochloride capsules orally. The treatments of 3 menstrual cycles were required. The clinical efficacy was observed in the two groups. The content of serum prostaglandin F2α, (PGF2α) and plasma arginine vasopressin (AVP) in the menstrual periods of some patients randomly selected in the two groups was tested before and after treatment and was compared with that of 20 cases in a normal group. Results The total effective rate was 95.4% (41/43) in the observation group which was obviously superior to 81.0% (34/42) in the control group (P<0.01). Before treatment, the content of serum PGF2α and plasma AVP of patients in the two groups was higher than that in the normal group (all P<0.01). After treatment,the content of serum PGF2α and plasma AVP was lower than that before treatment in the two groups (P<0.01, P<0.05). The content of serum PGF2α in the observation group was decreased significantly compared with that in the control group (P<0.05) and returned to the level of the normal group.

CONCLUSIONBody acupuncture combined with auricular point sticking achieves positive efficacy for menstrual headache and its mechanism could be related to regulating the abnormal levels of serum PGF2α and plasma AVP.

Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Arginine Vasopressin ; blood ; Dinoprost ; blood ; Female ; Headache ; blood ; physiopathology ; therapy ; Humans ; Menstruation ; Premenstrual Syndrome ; blood ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

BACKGROUND: We analyzed the relationship between meal frequency and nutrition with mental health status, and provide basic data on health promotion for breakfast and dinner skippers compared to non-skippers. METHODS: This is a cross-sectional study of 2,114 women aged 20-39 years who participated in the KNHANES in 2010-2012. We compared differences such as marital status, weight change, obesity, and under-weightness, smoking, high-risk alcohol consumption, exercise, suicide ideation, stress perception, depression, blood pressure, lipid profile, 25-Hydroxyvitamin-D, and ferritin levels among meal-skipping groups by cross tabulation analysis and general linear model analysis. RESULTS: The proportion of respondent undergoing weight loss efforts was over 50%, and of those roughly 75% were using a specific diet (e.g., fasting, skipping meals, single food diet). The breakfast and dinner skippers tended to be young, unmarried, and, had higher stress perception and suicide ideation than the non-skipping meal group. There were significantly higher incidents of obesity (body mass index > or =25 kg/m2, P=0.004), weight loss efforts, smoking, high-risk alcohol consumption, suicide ideation, and irregular menstruation in dinner skippers. In addition, there were significantly higher levels of under-weightness (P=0.004) and frequent eating out (over 5-6/week, P=0.005) in breakfast skippers. CONCLUSION: There were more physical and mental problems in dinner skippers in regards to high-risk alcohol consumption, suicide ideation, stress perception, and irregular menstruation. In the future, long-term studies are needed to reveal the correlation of meal frequency and nutrition with mental health status in patients who skip meals.
Alcohol Drinking ; Blood Pressure ; Breakfast ; Cross-Sectional Studies ; Depression ; Diet ; Eating ; Fasting ; Female ; Ferritins ; Health Promotion ; Humans ; Korea ; Linear Models ; Marital Status ; Meals ; Menstruation ; Mental Health ; Nutrition Surveys ; Obesity ; Single Person ; Smoke ; Smoking ; Suicide ; Surveys and Questionnaires ; Weight Loss

Adolescent ; Amenorrhea ; diagnosis ; etiology ; Androgen Antagonists ; pharmacology ; Androgens ; blood ; Contraceptive Agents ; pharmacology ; Female ; Humans ; Hyperandrogenism ; complications ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Luteinizing Hormone ; blood ; Menstruation Disturbances ; diagnosis ; etiology ; Obesity ; complications ; Ovary ; diagnostic imaging ; pathology ; Polycystic Ovary Syndrome ; diagnosis ; etiology ; therapy ; Ultrasonography ; Young Adult

OBJECTIVE: To explore the forensic application value of detection of matrix metalloproteinase-11 (MMP-11) in menstrual blood by enhanced chemiluminescence method. METHODS: Menstrual blood, vaginal swab, peripheral blood, saliva stain, urine stain and semen stain were collected to detect whether or not there were MMP-11 using enhanced chemiluminescence method. The specificity and reliability of the MMP-11 assay along with its sensitivity were evaluated. RESULTS: The positive detection rate of MMP-11 in menstrual blood was 89.47%, whereas no MMP-11 was found in vaginal swab, peripheral blood, saliva stain, urine stain and semen stain. When 25 microL sample was added, the mass concentration of protein was 1.329 microg/microL, then MMP-11 could be detected. A positive detection rate of 89.58% was observed in MMP-11 positive menstrual blood samples after stored at 4 degrees C for 20 months. CONCLUSION Enhanced chemiluminescence method is sensitive and specific for detecting MMP-11, and can be applied to distinguish menstrual blood from common stain such as peripheral blood, vaginal fluid.
Biomarkers/blood* ; Blood Stains ; Blotting, Western ; Female ; Forensic Medicine/methods* ; Humans ; Luminescent Measurements/methods* ; Matrix Metalloproteinase 11/blood* ; Menstruation ; Reproducibility of Results ; Saliva/chemistry* ; Sensitivity and Specificity ; Urine/chemistry* ; Vagina/chemistry*

OBJECTIVE: To explore the tissue-specific gene expressions of the peripheral blood and the menstrual blood, and to search some specific factors to establish an effective method for identifying the peripheral blood and the menstrual blood. METHODS: The specific products of the peripheral blood and the menstrual blood were detected by RT-PCR and separated by electrophoretic technology. RESULTS: Beta-spectrin (SPTB) as one specific marker of peripheral blood and 18S rRNA as a kind of the housekeeping gene were expressed in both the peripheral blood and the menstrual blood. However, matrix metalloproteinase 7 (MMP7) as one specific marker of menstrual blood and human beta defensin 1 (HBD1) as one specific marker of vaginal discharge were only found in the menstrual blood. CONCLUSION There are differences of specific gene expressions between the peripheral blood and the menstrual blood. They could be accurately distinguished from each other by using the combination of fluorescence technology and RT-PCR to detect the specific identification of mRNA.
Biomarkers ; Blood/metabolism* ; Female ; Gene Expression ; Gene Expression Profiling ; Humans ; Matrix Metalloproteinase 7/genetics* ; Menstruation/genetics* ; RNA, Messenger/genetics* ; Reverse Transcriptase Polymerase Chain Reaction ; beta-Defensins