PURPOSE:To examine the association of short-chain fatty acids (SCFAs), gut microbiota and obesity in individual twins and to control for genetic and shared environmental effects by studying monozygotic intrapair differences. PATIENTS AND METHODS:The study recruited 20 pairs of monozygotic twins. Body composition measurements were performed by using the multi-frequency bioelectrical impedance technique. SCFAs were extracted from feces and quantified by gas chromatography-mass spectrometer. Gut microbiota was evaluated by 16S rRNA gene sequencing. RESULTS:Fecal SCFAs were negatively correlated with adiposity parameters including body mass index, visceral adipose tissue and waist circumference (all P < 0.05). Metastat analysis showed that the top 5 relatively abundant bacterial taxa of viscerally obese and non-obese groups were Bacteroides, Collinsella, Eubacterium rectale group, Lachnoclostridium, and Tyzzerella. Participants with visceral obesity had lower abundance of Bacteroides and Collinsella compared to non-obese patients (P < 0.05). Among them, the abundance of Collinsella was positively correlated with acetic acid concentrations (r = 0.63, P = 0.011). There were no significant intrapair differences in each SCFA concentrations between the twins in our study (P > 0.05). CONCLUSION:Low fecal concentrations of SCFAs were associated with visceral obesity, and the gut microbiota might be involved in the underlying mechanism.

肥胖症是指体内脂肪总含量的增多或分布异常而造成的慢性代谢性疾病,可以引起糖、脂、尿酸等代谢异常,增加心脑血管疾病的发生率;肥胖患者睡眠呼吸暂停、骨性关节炎等生物力学相关并发症的发生率也比普通人高 [1].

目的 调查2型糖尿病患者在新型冠状病毒肺炎流行期间的心理状态及行为改变,为更好地进行血糖管理和心理、行为指导提供依据.方法 纳入首都医科大学附属北京潞河医院标准化代谢性疾病管理中心(National Metabolic Management Center,MMC)内576名2型糖尿病患者,采用自编问卷结合焦虑、抑郁筛查量表开展横断面调查,并与同期未入MMC管理的2型糖尿病患者进行焦虑、抑郁发生率进行比较.结果 在新型冠状病毒肺炎流行期间,68.4％的患者近2周指尖血糖浓度控制在空腹4.4～7.0 mmol/L、餐后2 h血糖10 mmol/L以下,69.1％的2型糖尿病患者运动量较前减少.MMC管理内的2型糖尿病患者的焦虑和抑郁发生率分别为27.1％和23.6％,低于同期未入MMC管理的患者,独居状态(OR=0.393,95％CI:0.160～0.965)、存在合并症或存在合并症个数多(OR=15.544,95％CI:9.632～25.084)的患者发生焦虑症状的风险高(均P<0.05);年龄较小(OR=0.541,95％CI:0.389～0.751)、独居患者(OR=0.398,95％CI:0.167～0.948)、存在合并症或合并症个数多(OR=7.409,95％CI:4.962～11.065)、血糖控制水平差(OR=0.659,95％CI:0.506～0.859)的患者发生抑郁症状的风险较高(均P<0.05).结论 在新型冠状病毒肺炎流行期,MMC管理的2型糖尿病患者焦虑、抑郁发生率较非MMC管理的患者低,多数患者血糖控制水平达标,对新型冠状病毒的认知较充分且行为以积极健康为主.

目的 评价强化血糖健康教育对1型糖尿病患者自我管理行为及心理状态的改善效果.方法 选取医院随访管理的1型糖尿病患者152例,随机分为强化组及常规组,对强化组进行为期1年的血糖健康教育干预,常规组正常门诊就诊,评价2组患者糖尿病自我管理行为及心理状态的改善情况.结果 1型糖尿病患者的糖化血红蛋白水平与焦虑、抑郁状态正相关(r = 0.370,P＜0.01;r = 0.372,P＜0.01),糖尿病病程与抑郁状态呈正相关(r = 0.331,P＜0.01)、文化程度和糖尿病自我管理行为得分与焦虑(r=-0.523,P＜0.01;r =-0.212,P＜0.05)、抑郁状态负相关(r=-0.554,P＜0.01;r=-0.233,P＜0.01).干预后强化组糖化血红蛋白值为(7.7±1.4)％,糖尿病自我管理行为量表评分为(53.1±6.7)分,焦虑评分为(31.2±6.3)分,抑郁评分为(29.3±7.8)分,均优于常规组及干预前自身得分,差异均有统计学意义(P＜0.05).结论 "一对一"模式线下血糖健康管理,联合线上及电话随访进行血糖健康教育的方式对1型糖尿病患者进行干预,可提高患者糖尿病自我管理行为、改善血糖控制水平,并有助于调节患者的抑郁及焦虑状态.

LADA (latent autoimmune diabetes in adults), a special subtype of type 1 diabetes, turns out to exhibit phenotypes mimicking the type 2 diabetes, which results in serious misdiagnosis issues. In order to better distinguish LADA from other diabetes subtypes, specific diagnostic and prognostic biomarkers of LADA are required. Circulating microRNAs (miRNAs) are recently shown to be promising biomarkers for disease diagnosis and subtyping. In this study, serum samples from LADA patients and type 2 diabetes patients were collected during the first diagnosis of diabetes and the miRNA transcriptomes of these patients and healthy individuals were profiled. Comparative analysis shows that the differentially expressed miRNAs between groups and their predicted target genes are enriched for several functions including immune regulation. Besides, a few miRNAs showing distinct expression pattern in LADA patients could discriminate LADA from type 2 diabetes, as validated by further qRT-PCR assay. In all, our study implies potential miRNA biomarkers which would be investigated in further clinical researches.