Sex‐specific and dose‐response relationships of urinary cobalt and molybdenum levels with glucose levels and insulin resistance in U.S. adults

Growing studies have linked metal exposure to diabetes risk. However, these studies had inconsistent results. We used a multiple linear regression model to investigate the sex-specific and dose-response associations between urinary metals (cobalt (Co) and molybdenum (Mo)) and diabetes-related indicators (fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and insulin) in a cross-sectional study based on the United States National Health and Nutrition Examination Survey. The urinary metal concentrations of 1423 eligible individuals were stratified on the basis of the quartile distribution. Our results showed that the urinary Co level in males at the fourth quartile (Q4) was strongly correlated with increased FPG (β = 0.61, 95% CI: 0.17–1.04), HbA1c (β = 0.31, 95% CI: 0.09–0.54), insulin (β = 8.18, 95% CI: 2.84–13.52), and HOMA–IR (β = 3.42, 95% CI: 1.40–5.44) when compared with first quartile (Q1). High urinary Mo levels (Q4 vs. Q1) were associated with elevated FPG (β = 0.46, 95% CI: 0.17–0.75) and HbA1c (β = 0.27, 95% CI: 0.11–0.42) in the overall population. Positive linear dose-response associations were observed between urinary Co and insulin (P_nonlinear = 0.513) and HOMA–IR (P_nonlinear = 0.736) in males, as well as a positive linear dose-response relationship between urinary Mo and FPG (P_nonlinear = 0.826) and HbA1c (P_nonlinear = 0.376) in the overall population. Significant sex-specific and dose-response relationships were observed between urinary metals (Co and Mo) and diabetes-related indicators, and the potential mechanisms should be further investigated.     

Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic patients

The efficacy of the insulin infusion pump (CSII) in pregnancy was examined in 12 diabetic patients and compared with intermittent insulin therapy (IIT). In patients poorly controlled on IIT constant and rapid equilibrium was achieved with CSII (mean of glucose levels: CSII versus IIT=84 versus 137 mg/dl; S.D. = 36 versus 63 mg/dl; mean amplitude of glycemic excursion (MAGE)=65 versus 112 mg/dl. In patients well controlled on IIT, CSII led to a reduction in the variation of glucose excursions (S.D.= 29 versus 36 mg/dl; MAGE=48 versus 76 mg/dl). CSII generally produced a reduction of 20–37 per cent of daily insulin dose (in three cases there was an increase of dose with the achievement of glycemic control). Furthermore in CSII treated-patients amniotic glucose, insulin and C-peptide concentrations werefound tobeinthenormalrange(22.1±10.1 mg/dl; 5.2±2.7μ/ml; 1.25±0.71 ng/ml, respectively). All infants were horn at or near-term, had no macrosomia or neonatal problems. It is concluded that CSII is a highly efficient way to achieve normal glucose levels in pregnancy, not only in type I, hut also in type II or gestational diabetes.     

Environmental pollutants and type 2 diabetes: a review of human studies

The incidence of diabetes has increased dramatically in recent decades and become one of the leading health problems worldwide. Lifestyle and dietary changes alone cannot account for the dramatic rise of diabetes, while an increasing number of publications have reported the possible relationships between exposure to environmental pollutants and risk of diabetes. In the present review, our objective was to summarize the human studies on environmental pollutants, which includes persistent organic pollutants, pesticides (not on the Stockholm Convention list), bisphenol A, and phthalates, and the risk of diabetes. Currently published results suggest a positive relationship between certain persistent organic pollutants (dichlorodiphenyldichloroethene, dichlorodiphenyltrichloroethane, hexachlorobenzene, and polychlorinated biphenyls) and bisphenol A exposure and risk of diabetes. For pyrethroids, organophosphates, carbamates, and phthalates, there are insufficient studies to reach conclusions and therefore more studies, especially prospective studies, are needed along with in vivo and in vitro studies to understand the underlying mechanisms.     

IKK inhibition prevents PM2.5-exacerbated cardiac injury in mice with type 2 diabetes

Epidemiological studies have found that individuals with diabetes mellitus(DM) display an increased susceptibility for adverse cardiovascular outcomes when exposed to air pollution.This study was conducted to explore the potential mechanism linking ambient fine particles(PM2.5) and heart injury in a Type 2 DM(T2DM) animal model. The KKay mouse, an animal model of T2DM, was exposed to concentrated ambient PM2.5 or filtered air for 8 weeks via a versatile aerosol exposure and concentrator system. Simultaneously, an inhibitor of IκB kinase-2(IKK-a)(IMD-0354), which is a blocker of nuclear factor κB(NF-κB)nuclear translocation, was administrated by intracerebroventricular injection(ICV) to regulate the NF-êB pathway. The results showed that ambient PM2.5 induced the increase of, NF-êB, cyclooxygenase-2(COX-2) and mitogen activated protein kinase(MAPK) expression in cardiac tissue, and that IMD-0354 could alleviate the inflammatory injury. The results suggested that the NF-êB pathway plays an important role in mediating the PM2.5-induced cardiovascular injury in the T2DM model. Inhibiting NFκB may be a therapeutic option in air-pollution-exacerbated cardiovascular injury in diabetes mellitus.     

铁路糖尿病患病职工血糖控制现状分析

了解某地区铁路糖尿病患病职工血糖控制情况,为改进健康干预措施提供依据。选取新诊断糖尿病职工272人及已确诊糖尿病职工175人,分析其健康体检结果及影响因素。结果表明,目前该地区糖尿病患病职工HbA1c <7%占46.98%,原已确诊糖尿病职工糖化血红蛋白控制率29.14%,入院治疗原因中健康体检检出血糖增高和出现糖尿病症状占75.43%,药物治疗率65.71%,运动和饮食控制率均为21.71%;新诊断与原已确诊糖尿病职工在血脂异常、肥胖、腹型肥胖差异有统计学意义。该地区糖尿病患病职工规范治疗后血脂异常、肥胖等有所降低,但糖尿病患病职工新诊断病例高、血糖控制率低,原已确诊糖尿病患病职工自我健康管理能力不足;提出应充分发挥健康体检筛查作用、早诊断早防治早干预、劝导规范就医、加强精准健康干预等建议。     

The aryl receptor inhibitor epigallocatechin-3-gallate protects INS-1E beta-cell line against acute dioxin toxicity

The aim of this research was to investigate the mechanism(s) underlying the acute toxicity of dioxin in pancreatic beta cells and to evaluate the protective effects of epigallocatechin-3-gallate (EGCG), the most abundant of the green tea’s catechins and a powerful inhibitor of the aryl hydrocarbon receptor (AhR). Using the insulin-secreting INS-1E cell line we have explored the effect of 1 h exposure to different concentrations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), alone or in the presence of EGCG, on: (a) cell survival; (b) cellular ultrastructure; (c) intracellular calcium levels; (d) mitochondrial membrane potential; (e) glucose-stimulated insulin secretion and (f) activation of MAP kinases. Our results demonstrate that TCDD is highly toxic for INS-1E cells, suggesting that pancreatic beta cells should be considered a relevant and sensitive target for dioxin acute toxicity. EGCG significantly protects INS-1E cells against TCDD-induced toxicity in terms of both cell survival and preservation of cellular ultrastructure. The mechanism of this protective effect seems to be related to: (a) the ability of EGCG to preserve the mitochondrial function and thus to prevent the TCDD-induced inhibition of glucose-stimulated insulin secretion and (b) the ability of EGCG to inhibit the TCDD-induced activation of selected kinases, such as e.g. ERK 1/2 and JNK. Our results clearly show that EGCG is able to protect pancreatic beta cells against dioxin acute toxicity and indicate the mitochondrion as the most likely target for this beneficial effect.     

铁路职工糖尿病流行病学调查分析

为进一步精准开展糖尿病防控提供依据,采用分层整群抽样的方法对某地区铁路职工体检情况进行调查分析。结果表明:糖尿病患病率为14.96%,知晓率为24.46%,糖尿病前期患病率为30.03%;糖尿病前期和新诊断糖尿病患者中,单纯糖负荷后2 h血糖升高者分别占91.22%和74.29%;确诊的糖尿病人HbA1c控制率为30.86%。说明该地区铁路职工糖尿病发病率较高,知晓率低,控制率低;应重视糖负荷后2 h血糖检测;建立"疾病预防控制所+职工单位+职工"防控机制,以有效防控糖尿病。     

上海市某区大气污染与居民糖尿病死亡关系的时间序列研究

2001年1月1日～2001年12月31日，采用时间序列的半参数广义相加模型，在控制气象因素，死亡的长期趋势、“星期几效应”等混杂因素的基础上，分析了上海市某区每日大气污染物浓度与居民糖尿病死亡的关系。结果表明，大气PM10、SO2和NO2日平均浓度每增加10μg／m^3，居民因糖尿病而死亡的相对危险度分别为1.017(95％可信限1．000～1．033)、1．029(95％可信限0．990～1．068)和1.059(95％可信限1．000～1．118)。因此，上海市某区目前的PM10、NO2水平对居民糖尿病死亡确有影响。