Objective To systematically evaluate the correlation between type 2 diabetes mellitus (T2DM) in Chinese population and K121Q polymorphism in exon-4 of plasma cell glycoprotrin-1 (PC-1) gene. Methods The following databases such as CNKI, VIP, CBM, PubMed, EMbase, The Cochrane Library (Issue 3, 2012) and WanFang Data were searched to collect case-control studies on the correlation between T2DM and K121Q polymorphism in exon-4 of PC-1 gene. The retrieval time was from 1980 to 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality. Then the meta-analysis was conducted by using RevMan 5.0 and Stata 12.0 software, and the publication bias was analyzed by means of Egger’s linear regression. Results A total of 11 studies involving 1 637 T2DM patients and 1 730 healthy volunteers were included. The results of meta-analyses showed that, for Chinese population, the risk of T2DM was higher in those with K/Q genotype than K/K genotype (OR=1.84, 95%CI 1.19 to 2.85, P=0.006), in Q/Q+K/Q genotype than K/K genotype (OR=1.92, 95%CI 1.18 to 3.14, P=0.009), and also in allele Q than allele K (OR=1.83, 95%CI 1.16 to 2.89, P=0.010). Conclusion The K121Q polymorphism in exon-4 of PC-1 gene in Chinese population is significantly associated with T2DM. For the quantity and quality limitation of the included studies, this conclusion has to be further proved by more studies.
Objective To assess the efficacy and safety of rosiglitazone in treating type 2 diabetes mellitus (T2DM) with essential hypertension (HBP). Methods Such databases as The Cochrane Library (Issue 4, 2009), PubMed (1970 to May 2010), CBM (1978 to May 2010), CNKI (1996 to May 2010), WanFang Database (1999 to May 2010), VIP (1996 to May 2010), and Google Scholar were searched on computer, and the relevant journals such as Chinese Journal of Diabetes Mellitus were also hand researched to investigate references and collect randomized controlled trials (RCTs) about rosiglitazone (experimental group) compared with non-rosiglitazone (control group) in treating T2DM with HBP. The data were extracted according to the inclusion and exclusion criteria by two reviewers independently, the quality of the included studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0, and meta-analysis was conducted by using RevMan 5.0 software. Results Among 10 RCTs involving 738 patients, one was in English from Greece, while nine were in Chinese. The average score quality of the included studies was in C level. The results of meta-analyses showed that the experimental group was more effective than the control group in lowering blood pressure levels (SBP: WMD= –17.83 mmHg, 95%CI –27.63 to –8.02; DBP: WMD=–7.81 mmHg, 95%CI –10.18 to –5.44), blood glucose levels (FBG: WMD= –1.66 mmol/L, 95%CI –3.08 to –0.23; PBG: WMD= –2.38 mmol/L, 95%CI – 4.12 to –0.64), triglyceride (TG) levels (WMD= –0.29 mmol/L, 95%CI –0.43 to –0.14), low-density lipoprotein cholesterol (LDL-C) levels (WMD= –0.76 mmol/L, 95%CI –1.02 to –0.50), insulin levels (FINS: WMD= –7.06 mU/L, 95%CI –9.47 to –4.65; PINS: WMD= –98.86 mU/L, 95%CI –116.38 to –81.34), glycosylated hemoglobin (HbA1c) levels (WMD=–0.75%, 95%CI –1.07 to –0.42), and insulin resistance index (HOMA-IR) (WMD= –1.61, 95%CI –2.18 to –1.05); the experimental group was more effective than the control group in increaseing the high-density lipoprotein cholesterol levels (HDL-C) (WMD=0.21 mmol/L, 95%CI 0.12 to 0.30), and insulin sensitivity index (ISI) (WMD=1.64, 95%CI 1.48 to 1.80); the therapeutic effect for hypertension was greater in the experimental group than in the control group (OR=9.35, 95%CI 4.76 to 18.35); there were no significant differences in cholesterol levels (TC) (WMD= –0.22 mmol/L, 95%CI –0.55 to 0.10), body mass index (BMI) (WMD= –0.26 kg/m2, 95%CI –0.86 to 0.33), heart rates (HR) (WMD=0.50 bpm, 95%CI –4.98 to 5.98), and urine albumin excretion (UAE) (WMD= –16.00mg/24h, 95%CI –37.90 to 5.90); additionally, there were also no significant differences in adverse reactions between the two groups, such as edema (OR=3.01, 95%CI 0.62 to 14.54), gastro-intestinal discomfort (OR=1.19, 95%CI 0.63 to 2.24), headache and fatigue (OR=9.79, 95%CI 0.51 to 186.95), and anemia (OR=2.38, 95%CI 0.09 to 59.90). Conclusion To treating patients suffering from T2DM with HBP, the rosiglitazone is much effective than the control group in lowering blood pressure, blood glucose and lipid, reducing insulin resistance and improving β-cell function.
Objective To review systematically the effectiveness and safety of astragaulus membranaceus in the treatment of diabetic nephropathy (DN). Methods A Cochrane systematic review of all relevant randomized or quasi-randomized controlled trials of astragaulus membranaceus for diabetic nephropathy was performed. Clinical trials were searched for in the Cochrane Central Refister of Controlled Trials, MEDLINE, EMBASE, the Chinese Biological Medicine Database, and the Chinese Science and Technology Journal Full-text Database as well as in the references lists of all included trials. Two reviewers works independently to select studies, assess methodological quality and extract data. The following indexes were included to assess the clinical effectiveness and safety of astragaulus membranaceus: 24-hour urinary albumin excretion rate (UAER), 24-hour urinary protein, clearance of creatinine (Ccr), serum creatinine (Scr), blood urea nitrogen (BUN), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), triglyceride (TG), total cholesterol (TC), and serious adverse events. Results Thirty-four clinical trials involving 2 356 patients met the inclusion criteria, but most of these trials were small and of low quality . A “funnel plot” showed asymmetry, which indicated possible publication bias, such that trials with negativeresults might not have been published. Meta-analyses showed that astragaulus membranaceus had some effects on the decrease of the 24-hour UAER, 24-hour urinary protein, Scr and BUN, and also on the improvement of Ccr. Therefore, astragaulus membranaceus, to a certain extent, was found to be effective in improving renal functions of DN patients. However, astragaulus membranaceus might have similar effects in decreasing the 24-hour UAER and Scr compared with angiotensin-converting enzyme inhibitor and angiotensin receptor blockers. Compared with other Chinese medicines, astragaulus membranaceus was more effective in decreasing the 24-hour urinary protein. No serious adverse events were observed during the treatment period. Conclusion Astragaulus membranaceus has some effect and is relatively safe in treating patients with diabetic nephropathy. However, the present evidence was not enough to support the recommendation of astragaulus membranaceus as a routine drug in the clinical management of DN.Since most included trials are small and of low quality, high-quality, large-sample, multi-centre, randomized, double-blind and placebo-controlled trials of astragaulus membranaceus for DN are needed.
Objective To formulate an evidence-based treatment plan for a patient with gestational diabetes mellitus. Methods Based on the clinical questions raised from a real-life patient of gestational diabetes mellitus, we searched ACP Journal Club (1991 to Dec. 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1966 to Dec. 2006) and Chinese Biological Medical Database (1980 to Dec. 2006) for systematic reviews, randomized controlled trials, cohort and case-control studies. We used the following keywords: gestational diabetes, metformin, and pregnancy complication. The quality of the included studies was assessed.Results One meta-analysis (from MEDLINE) and two randomized controlled trials (from the Cochrane Central Register of Controlled Trials) were included. These studies concluded that there was no clear evidence on the benefits of metformin for gestational diabetes. Based on the current evidence, integrated with clinical expertise and the patient’s values, metformin was not used for this patient. Instead, intensive dietary control, blood glucose control, and appropriate exercise were administered. After this individual treatment, the patient gave birth to a healthy baby in 39+4 Weeks. Conclusion The appropriate management for gestational diabetes mellitus has been formulated with the approach of evidence-based medicine. Large-scale, methodologically-sound trials are required.
ObjectiveTo systematically evaluate the correlation between type-2 diabetes mellitus (T2DM) and T/C polymorphism in 190 locus ofβ3-adrenergic receptor (β3-AR) gene in Chinese population. MethodsThe following databases such as CNKI, VIP, CBM, PubMed, EMbase, the Cochrane Library (Issue 8, 2012) and WanFang Data were searched to collect case-control studies on the correlation between T2DM and T/C polymorphism in 190 locus of β3-AR gene. The retrieval time was from October 1980 to October 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality. Then the meta-analysis was conducted by using RevMan 5.0 and Stata 12.0 software, and the publication bias was analyzed by means of Egger's linear regression. ResultsA total of 11 studies involving 1 602 T2DM patients and 1 773 healthy volunteers were included. The results of meta-analyses showed that, for Chinese population, TC genotype in case group was more than that in control group[OR=1.19, 95%CI (1.01, 1.40), P=0.04]. CC+TC genotype in case group was more than that in control group[OR=1.23, 95%CI (1.05, 1.45), P=0.01]. Allele C in case group was more than that in control group[OR=1.24, 95%CI (1.08, 1.43), P=0.003]. ConclusionsThe allele C in 190 locus of β3-AR gene in Chinese population is significantly associated with T2DM. For the quantity and quality limitation of the included studies, this conclusion has to be further proved by more studies.
ObjectiveTo investigate the clinical efficacy and safety of carvedilol in the treatment of arrhythmia in patients with hypertension complicated with diabetes mellitus. MethodsWe selected the patients with hypertension complicated with diabetes mellitus who were hospitalized in the Harrison International Peace Hospital Affiliated to Hebei Medical University for treatment from Oct. 2011 to Oct. 2013. The cases were divided into a trial group and a control group. The control group was given routine treatment (eg., hypoglycaemic drugs, angiotensin converting enzyme inhibitors). On the basis of the same treatment of the control group, the trial group was given carvedilol. The efficacy and adverse reaction were observed, recorded and then analyzed between the two groups. ResultsA total of 140 patients were included (70 cases in each group). With the loss of 10 cases in the control group, the data of 70 cases in the trial group and 60 cases in the control group were finally analyzed. The results showed that the trial group was superior to the control group in the total effectiveness (χ2=8.320, P=0.004) and the dynamic ECG improvement of premature ventricular contraction (χ2=5.333, P=0.014) with significant differences. Both groups were significantly improved in blood pressure and heart beats compared with the situation before treatment (Both P < 0.05), and the trial group was better than the control group with a significant difference. During the treatment, three cases in the trial group had mild gastrointestinal symptoms which spontaneously disappeared later. ConclusionThe clinical effectiveness of carvedilol for arrhythmia in patients with hypertension complicated with diabetes mellitus is significant. It is safe and effective which is recommended in clinical application.