目的:探讨2型糖尿病患者胰岛素抵抗替代指标(甘油三酯–葡萄糖指数和胰岛素抵抗代谢评分)与骨质疏松严重程度的相关性研究。方法:纳入387例T2DM患者,根据骨密度分为骨密度正常组(135例)、低骨量组(164例)和骨质疏松组(88例)。收集患者的一般资料和骨密度值,计算甘油三酯–葡萄糖指数(TyG)、胰岛素抵抗代谢评分(METS-IR)。采用单因素与多因素logistic回归方法分析TyG、METS-IR与骨密度之间的关系。结果:合并OP组、低骨量组METSIR、TyG均高于骨密度正常组;合并OP组METS-IR、TyG高于低骨量组;METS-IR、TyG与糖尿病发生骨质疏松的疾病进展呈正相关(p Objective: To investigate the correlation between insulin resistance replacement indexes (triglyceride-glucose index and insulin resistance metabolic score) and the severity of osteoporosis in patients with type 2 diabetes. Methods: 387 T2DM patients were included and divided into normal bone mineral density group (135 cases), low bone mass group (164 cases) and osteoporosis group (88 cases) according to BMD. General data and bone mineral density were collected, and triglyceride-glucose index (TyG) and insulin resistance metabolic score (METS-IR) were calculated. Univariate and multivariate logistic regression methods were used to analyze the relationship between TyG, MET-IR and bone mineral density. Results: METSIR and TyG in OP group and low bone mass group were higher than those in normal bone density group. METS-IR and TyG in OP group were higher than those in low bone mass group. METS-IR and TyG were positively correlated with the disease progression of osteoporosis caused by diabetes (p < 0.05);METS-IR and TyG were independent factors of type 2 diabetes mellitus combined with osteoporosis (all p < 0.05). Conclusion: The higher the degree of insulin resistance, the greater the risk of osteoporosis.
肥胖已成为全球性公共健康问题,其与心力衰竭(HF)的关联日益受到关注。该综述旨在梳理肥胖导致心力衰竭的流行病学、治疗、预后等方面的相关研究进展。阐述了肥胖通过多种病理生理机制,如血液动力学改变、神经激素激活、脂肪因子和脂肪毒性等增加心力衰竭发病风险。还提及肥胖悖论现象及其可能原因,最后对肥胖合并心力衰竭的治疗策略进行综述,强调综合管理的重要性,以增进对这一领域的理解并为临床实践提供参考。Obesity has become a global public health problem, and its association with heart failure (HF) has received increasing attention. The aim of this review is to sort out the research progress related to the epidemiology, treatment, and prognosis of obesity-induced heart failure. It is described that obesity increases the risk of developing heart failure through various pathophysiological mechanisms, such as hemodynamic alterations, neurohormonal activation, adipokines, and adipotoxicity. The phenomenon of the obesity paradox and its possible causes are also mentioned, and finally, a review of therapeutic strategies for obesity-combined heart failure is presented, emphasizing the importance of comprehensive management in order to improve the understanding of this field and to inform clinical practice.
目的:本研究旨在评价鼓室注射神经节苷脂在难治性突聋患者中的疗效。方法:入选发病在11~42 d、经常规治疗无效、平均听阈(500~4000 Hz)>60 dB的突发性聋、年龄18~65岁的患者120例,前瞻性平行随机分为对照组61例和试验组59例,对照组按照中华医学会推荐方案(耳后注射甲泼尼龙)治疗,试验组鼓室注射单唾液酸四己糖神经节苷脂钠+耳后注射甲泼尼龙治疗,2组同时口服银杏提取物和胞磷胆碱片。治疗结束2周后复查听力,对2种不同治疗方法的疗效进行比较分析。结果:对照组有效率为29.51%,试验组有效率为54.24%(P<0.01)。对照组平均听阈改善了11.57 dB HL,试验组平均听阈改善22.50 dB HL(P<0.05)。结论:耳后注射甲泼尼龙联合鼓室注射神经节苷脂较单纯耳后注射甲泼尼龙治疗难治性突发性聋疗效好,并且治疗越早,疗效更佳。
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