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Free access

Weibin Zhou, Yanyun Gu, Hong Li, and Min Luo

Objective: To assess the cutoff values at different time points for impaired glucose regulation (IGR) and diabetes, the glucose curve and isolated 1-h hyperglycemia were monitored during an oral glucose tolerance test (OGTT).

Methods: Two thousand eight hundred and eighty-six subjects (1300 men and 1586 women) were recruited to have an OGTT. Plasma was collected at 0, 30, 60, 120, and 180 min to analyze glucose and insulin. The diagnosis of impaired fasting glucose, impaired glucose tolerance, and diabetes was based on World Health Organization and American Diabetes Association’s criteria. Those with fasting plasma glucose (FPG)<5.6 and 2-h plasma glucose (PG)<7.8, but 1-h PG≥7.8 and <11.1 mmol/l were defined as 1h-High7.8, and those with FPG<7.0 and 2-h PG<11.1, but 1-h PG≥11.1 mmol/l as 1h-High11.1. The cutoff values were calculated by receiver operating characteristic (ROC) curve. The correlation between β-cell function and the area under the curve of glucose (AUCg) and the shape index was analyzed with linear regression.

Results: The cutoff values for IGR were 5.6, 9.7, 10.1, 7.8 and 6.1 mmol/l for blood glucose at 0, 30, 60, 120 and 180 min, 24 for AUCg and 1.3 mmol/l for the shape index. The cutoff values for diabetes were 6.8, 11.2, 13, 11.1 and 7 mmol/l for 0, 30, 60, 120 and 180 min, 30.9 for AUCg and 2 mmol/l for the shape index. Both AUCg and the shape index were inversely related to β-cell function. The profiles of glucose and insulin in the subgroup with isolated 1-h hyperglycemia were very different from those seen in subjects with normal glucose tolerance or IGR.

Conclusions: The present study provides new information on measures other than the fasting and 2-h PG to evaluate glucose metabolism in vivo and stimulates further research aimed at assessing the value of the OGTT 1-h PG concentration prospectively.

Free access

Jing-Yan Tian, Qi Cheng, Xiao-Min Song, Guo Li, Guo-Xin Jiang, Yan-Yun Gu, and Min Luo

Objective: To investigate the association between birth weight and risk of type 2 diabetes, abdominal obesity and hypertension among Chinese adults.

Research methods and procedures: Nine hundred and seventy-three individuals from a population-based cross-sectional survey for the prevalence of type 2 diabetes conducted in Shanghai in 2002 were enrolled and followed up to 2004 with yearly examination. Birth weight was classified into four categories: <2500, 2500–2999, 3000–3499 and ≥3500 g.

Results: In this study, there were 373 males and 600 females, with a mean age of 46.2±9.9 years. Fasting plasma glucose was higher in subjects with the lowest birth weight (<2500 g) compared with those with the highest birth weight. Waist circumference and systolic blood pressure showed U-shaped relationships with birth weight. Birth weight was found to be an independent risk factor for type 2 diabetes, abdominal obesity and hypertension. For type 2 diabetes, the crude odds ratio (95% confidence interval) was 3.17 (1.48–6.78) in the lowest birth weight category when compared with that in the highest birth weight category (≥3500 g) and the ratio increased to 3.97 (1.71–9.22) after adjustment for related variables. The highest prevalence of type 2 diabetes (34.5%) was observed among those with the lowest birth weight and abdominal obesity.

Conclusions: Birth weight is inversely associated with the risk of type 2 diabetes. Subjects with the lowest or the highest birth weight were associated with a high risk of developing abdominal obesity and hypertension. Low birth weight coupled with abdominal obesity is a strong predictor of type 2 diabetes.

Open access

Xiaoping Luo, Ling Hou, Li Liang, Guanping Dong, Shuixian Shen, Zhuhui Zhao, Chun Xiu Gong, Yuchuan Li, Min-lian Du, Zhe Su, Hongwei Du, and Chaoying Yan

Objective

We assessed the efficacy and safety of a weekly pegylated human growth hormone (PEG-rhGH) (Jintrolong) vs daily rhGH for children with growth hormone deficiency (GHD).

Design

Phase II and III, multicenter, open-label, randomized controlled trials.

Methods

108 and 343 children with treatment-naive GHD from 6 hospitals in China were enrolled in the phase II and III studies respectively. Patients in the phase II study were randomized 1:1:1 to weekly Jintrolong (0.1 mg/kg/week PEG-rhGH complex), weekly Jintrolong (0.2 mg/kg/week PEG-rhGH complex) or daily rhGH (0.25 mg/kg/week) for 25 weeks. Patients in the phase III study were randomized in a 2:1 ratio to weekly Jintrolong (0.2 mg/kg/week) or daily rhGH (0.25 mg/kg/week) for 25 weeks. The primary endpoint for both studies was height velocity (HV) increase at the end of treatment. Other growth-related parameters, safety and compliance were also monitored.

Results

The phase II study established the preliminary efficacy, safety and recommended dose of Jintrolong PEG-rhGH. In the phase III study, we demonstrated significantly greater HV increases in patients receiving Jintrolong treatment (from 2.26 ± 0.87 cm/year to 13.41 ± 3.72 cm/year) vs daily rhGH (from 2.25 ± 0.82 cm/year to 12.55 ± 2.99 cm/year) at the end of treatment (P < 0.05). Additionally, significantly greater improvement in the height standard deviation scores was associated with Jintrolong throughout the treatment (P < 0.05). Adverse event rates and treatment compliance were comparable between the two groups.

Conclusion

Jintrolong PEG-rhGH at a dose of 0.2 mg/kg/week for 25 weeks is effective and safe for GHD treatment and is non-inferior to daily rhGH.