| Background:With the development of economy, lifestyle has changed greatly. The number of type2diabetes mellitus (type2diabetes mellitus, T2DM) patients is increasing rapidly. T2DM is a metabolic disorder that is characterized by high levels of blood glucose as a result of insulin resistance and relative insulin deficiency, and can cause eyes, kidney, nerves, blood vessels and other tissues of chronic disease. Glucagon-like peptide-1(GLP-1) is closely associated with diabetes. In the early twentieth century, it was discovered that nutrients can cause the release of some unkown factors by intestinal, which can regulate the body’s glucose metabolism. Furthermore, it was found that the secretion of insulin stimulated by oral glucose is significantly greater than that stimulated by intravenous glucose. This phenomenon was known as "incretin effect". GLP-1is mainly synthesized and secreted by the Langerhans cells of duodenum, ileum, colon, which regulates the secretion of glucagon and insulin with glucose-dependent manner to maintain the stability of the blood sugar of T2DM patients. This paper investigates the immediate effect of different components meals with the same calory on the GLP-1, to explore the effects of different nutrients on GLP-1. It provided a new idea for the early prevention and treatment of diabetes mellitus, as well as its complications. Objective:To investigate the immediate effect of different components meals with the same calory on the plasma GLP-1in type2diabetes patients.Methods:This study is performed according to the World Health Organization (WHO) standard diagnosis and classification of diabetes (1999).52patients matched in the age, sex and body mass index (BMI) were recruited and randomly divided into four groups and were given meal consists of glucose powder, steamed buns, protein and butter, respectively. We tested the plasma GLP-1, insulin and blood glucose before meal intake and at the60min,120min,180min after meal intake respectively.Results:The level changes of GLP-1in the four groups before and after meal intake: There are no significant differences statistically in comparison between any two groups at the Omin (P>0.05). At the60min, the GLP-1levels of the four groups are (from high to low):steamed buns group, glucose powder group, protein group, butter group, there are significant differences statistically in comparison between any two groups (P<0.05). The GLP-1levels at the120min (from high to low):protein group, steamed buns group, glucose powder group, butter group, there are significant differences statistically in comparison between any two groups (P<0.05). The GLP-1levels of the protein and the butter group reached to peak at this point of time, while the GLP-1in the protein group is the highest one. On the other hand, the GLP-1levels at the180min are all decreased in four groups (from high to low):protein group, steamed buns group, glucose powder group, butter group, there are significant differences between any two groups (P<0.05).The level changes of INS and GLU in the four groups before and after meal intake:there was no significant difference when compared group by group in the Omin (P>0.05). In the120min after meal intake, the levels of INS and GLU reached to the peak level in the glucose powder group and the steamed buns group, while the glucose powder group was significantly higher than the steamed buns group (P<0.05). As to the protein group and the butter group, the level changes of INS and GLU was not significant after meal intake, while the difference was significant when compared to the glucose powder group and the steamed buns group (P<0.05).Conclusions:The carbohygrates may promote the secretion of GLP-1prior to protein and lipid. Mean while, high carbohydrate food may promote the secretion of GLP-1superior to pure sugar food. On the other hand, the high protein food has the most significant effect of stimulate the secretion of GLP-1. Background:Hyperhomocysteinemia is a well known risk factor for cardiovascular disease. However, although increased plasma homocysteine levels have been widely documented in overt hypothyroidism patients, it remains controvertial in patients with subclinical hypothyroidism (SCH).Objective:The aim of this meta-analysis is to demonstrate plasma homocysteine levels in adult patients with SCH.Methods:We searched PUBMED, EMBASE and COCHRANE LIBRARY databases prior to September2013to identify studies that reported plasma homocysteine levels in patients with SCH compared with euthyroid subjects. Two reviewers independently evaluated every potential study for eligibility, assessed the methodological quality, and extracted the data.Results:We finally included nine studies with443patients and367controls from33articles in this meta-analysis. The pooled result of the weighted mean difference (WMD) was0.96μmol/L (95%CI:0.14,1.78; P=0.022). And the analysis of metabolic parameters showed that SCH was associated with a significant increase of body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG) levels, total cholesterol (TC) levels, and low-density lipoprotein (LDL-C) levels. Though the analysis of folate showed lack of statistical difference, there was a decrease tendency in SCH patients (P=0.051).Conclusions:Our analysis of nine observational studies with443patients showed that SCH is associated with an increased plasma homocysteine levels. Given the final included studies are observational studies, prospective studies with more patients should be performed to confirm this conclusion. |
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