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Objective: To investigate the influence of insulin resistance on male reproductive hormones and semen quality., Methods: Using the electrochemiluminescence method, we measured the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and testosterone (T) in the serum of 83 infertile males. We detected the levels of fasting plasma glucose (FPG) and fasting insulin (FINS) and calculated the insulin resistance index presented as homeostasis model assessment of insulin resistance (HOMA-IR). Based on HOMA-IR, we divided the patients into three tertile groups, T1 (HOMA-IR 0.36－0.55, n = 27), T2 (HOMA-IR 0.56－0.80, n = 28) and T3 (HOMA-IR 0.81－1.97, n = 28), obtained their semen parameters by computer-assisted semen analysis (CASA) and analyzed the correlation of HOMA-IR with male reproductive hormone levels and semen parameters., Results: With the elevation of HOMA-IR, the patients of the T1, T2 and T3 groups showed significant decreases in the serum T level (［14,26 ± 4.27］ vs ［14.75 ± 5.00］ vs ［11.62 ± 3.68］ nmol/L, P <0.05) and the percentage of progressively motile sperm (PMS) (［51.04 ± 15.10］% vs ［48.04 ± 16.24］% vs ［37.84 ± 18.23］%, P <0.05). HOMA-IR was correlated negatively with the serum T level (r = －0.333, P = 0.002), semen volume (r = －0.23, P = 0.029) and PMS (r = －0.27, P = 0.015), and so was FINS with the serum T level (r = －0.327, P = 0.003) and PMS (r = －0.315, P = 0.004), while the semen volume was correlated positively with the levels of serum T (r = 0.221, P = 0.048) and FSH (r = 0.222, P = 0.047). Multivariate linear regression analysis showed that HOMA-IR was an independent influencing factor for PMS and the body mass index (BMI) was that for the semen volume and total sperm count., Conclusions: Insulin resistance may reduce semen quality by changing the levels of male reproductive hormones.

Objective: To investigate the relationship between menopausal status at different FPG levels and the risk of new onset of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). Methods: Female subjects were selected from the females who joined in the epidemiological survey between May and September in 2009 in six counties of Guanlin Village and Xushe Village in Yixing City in Jiangsu Province by cluster sampling method. Subjects with diabetes at baseline or pre-menopause with age above 65 years old or surgical menopause were excluded. Finally there were 2 084 eligible subjects included in this study. According to FPG at baseline, subjects were categorized into two groups as normal FPG group (FPG<5.6 mmol/L) and IFG group (5.6≤FPG≤6.9 mmol/L). Follow-up study was conducted from May in 2014 to January in 2016. Cox regression model was used to investigate the association between menopausal factors and IFG and T2DM among groups based on FPG. Results: The average age of subjects at baseline was 58.08 (51.74-65.82) years old, and the number of post-menopausal women was 1 631 (78.3%). The number of subjects in normal FPG group was 1 569 (75.3%), and in IFG group was 515 (24.7%). There were 104 subjects with new onset T2DM among which 34 subjects from normal FPG group and 70 subjects from IFG group. And there were 199 subjects with new onset IFG in normal FPG group. Among subjects with normal FPG, the incidence density of IFG in post-menopausal women (2 752/100 000 person-years) was statistically higher than that in premenopausal women (1 670/100 000 person-years) ( P< 0.001). After age and BMI adjusted, post-menopausal women had a higher risk of having IFG in normal FPG subjects with hazard ratio ( HR ) at 2.60 ( P <0.001). Among subjects with normal FPG, the risk of new onset IFG decreased in post-menopausal women with menopause age increasing after age and BMI adjusted, with HR at 0.96 ( P= 0.046). No statistical association was found between menopausal factors and risk of T2DM either in the overall subjects or in the subgroups( P >0.05). Conclusion: Menopause can increase the risk of IFG incidence in subjects with normal FPG. The incidence of IFG decreases with the menopause age increasing.

Objective: To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes., Methods: Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥ 8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed., Results: 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ 2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG≥8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%., Conclusions: FBG≥8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Objective: To observe the effect and safety of acupoint catgut embedding for prediabetes., Methods: Eighty-six patients with prediabetes were randomly assigned into an observation group and a control group, 43 cases in each one. Diabetes health education was applied in the two groups. Catgut embedding was used at bilateral Pishu (BL 20), Weiwanxiashu (EX-B 3), Ganshu (BL 18), Shenshu (BL 23), and Zusanli (ST 36) in the observation group, once every 15 days for 6 times. The type and number of postoperative reactions of the last time had been recorded since the second embedding, and the situation of the last postoperative reactions was observed 15 days after treatment. Total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), empty stomach insulin (Ins) and TCM syndrome score were tested before and after treatment as well as 6 months after treatment. The clinical efficacy was evaluated., Results: After treatment, the levels of TC, TG, FPG, 2hPG, HbA1c of the observation group were lower than those before treatment and those of the control group (all P <0.05). The Ins changed little after treatment and was not significantly different from that of the control group (both P >0.05). All the above indices had no significant difference at follow-up compared with those before treatment (all P >0.05). After treatment, the TCM syndrome score in the observation group was lower than that before treatment and that in the control group (both P <0.05). The TCM syndrome score at follow-up was better than that before treatment in the observation group ( P <0.05). The total effective rate of the observation group was 76.7% (33/43) after treatment, which was superior to 30.2% (13/43) of the control group ( P <0.05). The rates at follow-up was 37.2% (16/43) in the observation group and was 25.6% (11/43) in the control group ( P >0.05). 18 postoperative reactions occurred 168 times totally after embedding, which could be divided into 5 categories, including 75 times (44.6%) of dietary inhibition, 41 times (24.4%) of abnormal feeling, 23 times (13.7%) of local discomfort, 21 times (12.5%) of general malaise, and 8 times (4.8%) of other symptoms. The postoperative peak responses were after the second and third operations., Conclusions: 3-month catgut embedding can improve some of the indices of prediabetes, but long-term healthy living habits need to be kept. There exist various postoperative reactions after embedding without blocking the treatment.

Objective: To investigate the effect of laparoscopic sleeve gastrectomy(LSG) on sex hormone in male patients with severe obesity., Methods: Retrospective analysis was performed in 31 male patient with severe obese [body mass index(BMI) ≥28 kg/m 2 , obesity group] who underwent LSG in Shanghai Tenth People's Hospital of Tongji University from December 2012 to May 2016. The anthropometric parameters(weight, BMI, waist circumference, hip circumference, waist-hip ratio, body fat percentage), glucose metabolic indices [fasting plasma glucose(FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance index(HOMA-IR)], and sex hormone parameters [estradiol(E2), total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] were collected preoperatively and 1, 3, 6 months postoperatively. In addition, 31 healthy male volunteers with normal BMI were consecutively recruited in this study as control group. The above-mentioned parameters were also determined in control group. Changes of these variables before and after surgery were analyzed. Pearson method was used to analyze the correlation of TT with anthropometric parameters and glucose metabolic indices before and after surgery., Results: The average age of patients in obesity and control group was (32.9±9.7) (18 to 56) years and (30.7±8.9) (18 to 49) years. Compared to the control group, obesity group had significantly higher anthropometric parameters and glucose metabolic indices before surgery (all P<0.05). In obesity group, the anthropometric and glucose metabolic indices significantly decreased at 1 to 6 months after surgery compared to those before surgery (all P<0.05). At 1 month after surgery, the anthropometric parameters and glucose metabolic indices in obesity group were significantly higher than those in control group (all P<0.05). At 3, and 6 months after surgery, there were no significant differences in glucose metabolic indices between obesity and control group (all P>0.05), while the anthropometric parameters in obesity group were still significantly higher than those in control group(all P<0.05). The sex hormone parameters in control and obesity group before surgery were as follows: E2: (100.2±23.5) pmol/L and (129.2±81.9) pmol/L; TT: (18.0±4.9) nmol/L and (8.4±4.5) nmol/L; FSH: (4.5±3.1) IU/L and (4.3±2.5) IU/L; LH: (4.4±1.7) IU/L and (5.3±2.6) IU/L. Compared to control group, the TT level of obese patients before surgery significantly decreased(P=0.000), while no significant differences were observed in the levels of E2, FSH, and LH(all P>0.05). The TT levels were significantly increased at 1, 3, 6 months after surgery[(13.1±7.0), (13.6±5.7), (21.0±19.3) nmol/L, respectively, all P<0.05] and the E2 level was significantly decreased at 6 months after surgery [(91.4±44.9) pmol/L, P<0.05], while no significant differences were observed at 1 and 3 months after surgery (all P>0.05). Furthermore, the FSH and LH levels did not exhibit significant change at 1, 3, and 6 months after surgery compared to those before surgery (all P>0.05). At 1 month after surgery, no significant correlations were examined in the change value of TT levels (▹TT) with the changes of BMI(▹BMI), FPG(▹FPG), FINS(▹FINS), HOMA-IR(▹HOMA-IR), and E2(▹E2) (all P>0.05). At 3 months after surgery, ▹TT was negatively correlated with ▹BMI (r=-0.441, P=0.015), ▹FINS (r=-0.375, P=0.041), and ▹HOMA-IR(r=-0.397, P=0.030), but not correlated with ▹FPG and ▹E2 (all P>0.05). At 6 months after surgery, ▹TT was negatively correlated with ▹BMI(r=-0.510, P=0.018) and ▹HOMA-IR (r=-0.435, P=0.049), but not correlated with ▹FPG, ▹FINS and ▹E2 (all P>0.05)., Conclusions: Male severe obese patients are accompanied with abnormal sex hormone levels. LSG has a significant effect on weight loss and blood glucose improvement, and may ameliorate the sex hormone unbalance by improving the insulin resistance in men with severe obesity.

Objective: To investigate the effect of nucleolin on cardiac cell apoptosis in Type 2 diabetic cardiomyopathy mice.
 Methods: Mice were fed with high-fat and high-sugar food for 20 weeks (mice were injected intraperitoneally with 60 mg/kg streptozotocin in the 5th and 6th weeks) to establish a mouse model of Type 2 diabetes. The mice were divided into 4 groups: a wild type (WT) control group, a nucleolin transgenic (TG) control group, a WT diabetic group, a TG diabetic group. Diabetes-related indicators were detected at the end of the 8th week. At the end of the 20th week, HE staining was used to observe myocardial morphological changes; TUNEL staining and caspase-3 activity were used to detect the extent of apoptosis of cardiac myocytes.
 Results: The level of fasting blood glucose was significantly increased in the diabetic group than that in the control group. In WT diabetic group, myocardial disarrangement, fragmentation and dissolution were observed (determined by HE staining); cellular apoptosis (determined by TUNEL staining and caspase-3 activity) also increased markedly in the WT diabetic group. Compared with the wild mice in the diabetic group, myocardial morphological changes and cardiac myocytes apoptosis were alleviated significantly. 
 Conclusion: Nucleolin overexpression affectes the occurrence and development of diabetic cardiomyopathy through inhibition of cardiac myocyte apoptosis.

Objective: To observe the effects of electroacupuncture(EA) at different acupoints for fasting blood glucose(FBG) and oral glucose tolerance in type 2 diabetes rats so as to verify the glucose-lowering effects of EA., Methods: Total 100 SD male rats were seen as experimental objects,among which 13 were randomly assigned into a blank group. Other rats were fed with high fat and high sugar diet combined with intraperitoneal injection of small dose streptozotocin (STZ) to establish type 2 diabetes model. Sixty diabetic rats were randomly assigned into a model group,a Weiwanxiashu group,a Xinshu group,a Shenshu group and a Housanli group,12 cases in each one. Combined with the improved diet habits and routines,EA (2 Hz and 2 mA) was used at "Weiwanxiashu" (EX-B 3),"Xinshu" (BL 15),"Shenshu" (BL 23) and "Housanli" (ST 36) in the corresponding groups,6 times a week for 4 weeks. There was no treatment in the blank group and in the model group. The observation indexes were the FBG on the 7th,14th,21st,and 28th day of intervention,the instant glucose-lowering effect on the 21st day during treatment,and the area under the curve of oral glucose tolerance test (OGTT) after intervention. Also,the glucose regulation condition was observed., Results: Type 2 diabetes model could be established by high fat and high sugar diet combined with intraperitoneal injection of small dose STZ. Glucose decreased apparently at the end of the 1st week or the 2nd week compared with that before treatment in the Weiwanxiashu,Xinshu and Shenshu groups( P <0.05, P <0.01). The instant FBG of the Weiwanxiashu and Xinshu groups was obviously lower than that of the model and Housanli groups at the end of the 3rd week(all P <0.01). The area under the curve of OGTT of the Weiwanxiashu group was apparently smaller than that of the model group ( P <0.05),and the results of the index in the other groups were not significantly different from that of the model group(all P >0.05)., Conclusions: Low frequency EA at "Weiwanxiashu"(EX-B 3),"Xinshu"(BL 15) and "Shenshu"(BL 23) can reduce glucose with different onset times,effects,and durations. And "Weiwanxiashu"(EX-B 3) is more effective.

Objective: To explore the value of using fasting plasma glucose (FPG) and lipid profiles between 7 and 15 gestational weeks to predict gestational diabetes mellitus (GDM). Methods: The medical records of 2 138 pregnant women who had prenatal care in Beijing Obstetrics and Gynecology Hospital from August 2011 to February 2012 were analyzed retrospectively. According to results of the oral glucose tolerance tests, women were devided into the GDM group ( n =240) and the normal group ( n= 1 898). Maternal characteristics, FPG and lipid levels between 7 and 15 gestational weeks were compared between the two groups. Logistic regression analysis and receiver operator characteristics(ROC) curve were used in the analysis. Results: Potential markers for the prediction of GDM included total cholesterol, triglyceride (TG) , low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratios (LDL-C/HDL-C) , triglyceride to high-density lipoprotein cholesterol ratios (TG/HDL-C) and FPG. After adjustment of confounding factors, age ( OR= 1.046, 95% CI: 1.003-1.090), pre- pregnancy body mass index ( OR= 1.104, 95% CI: 1.049-1.161), gravidity>3 ( OR= 1.768, 95% CI: 1.071-2.920), FPG ( OR= 8.137, 95% CI: 5.412-12.236), TG ( OR= 1.460, 95% CI: 1.148-1.858) were independently associated with the risk of developing GDM. Equation, P GDM =1/{1+exp[-(-16.542+0.045×age+0.103×pre-pregnancy body mass index+0.551×gravidity>3+2.110×FPG+0.372×TG)]}, was constructed by the logistic regression analysis. Sensitivity (67.5%) and specificity (70.5%) were determined by the calculated risk score, with a cut-off value of 0.11 (area under the curve: 0.751, 95% CI: 0.718-0.783, P< 0.001). Conclusions: FPG and TG, together with clinical characteristics may have a better predictive value for the risk of GDM.

Objective: To assess the association of a disintegrin and metallo-proteinase with thrombospondin type 1 motifs (ADAMTS-1) gene polymorphism and ischemic stroke caused by large artery atherosclerosis (LAA)., Methods: In total 767 patients and 506 controls were recruited. Single nucleotide polymorphisms (SNPs) rs416905 (T/C) and rs402007 (G/C) of the ADAMTS-1 gene were genotyped by polymerase chain reaction and DNA sequencing., Results: Frequencies of the rs402007 GC+CC genotype and the C allele were significantly different between the two groups (68.84% vs. 60.67%, χ2=9.012, P=0.003, OR=1.432; 45.24% vs. 38.54%, χ2=11.208, P=0.001, OR=1.318). Binary logistic regression has confirmed that the above difference was significant (P=0.001, OR=1.521, 95%CI: 1.183-1.955). The frequencies of TC+CC and GC+CC genotypes were similar between the two groups, and so was it with the C allele. The two SNPs had been in complete linkage disequilibrium (D'=1.0, r2=1.0)., Conclusion: The rs416905 and rs402007 polymorphisms of the ADAMTS-1 gene may be associated with ischemic stroke caused by LAA. The C allele of the rs402007 locus may be a susceptibility factor for this subtype of stroke.

Objective: To explore the role of mitochondrial DNA 5178 C/A (Mt5178) polymorphism of NADH-dehydrogenase subunit 2 (ND2) gene in type-2 diabetes mellitus (T2DM) among ethnic Han Chinese through a case-control study., Methods: The Mt5178C/A polymorphism was determined by sequencing 1103 T2DM patients and 791 healthy controls. Logistic regression analysis was conducted to estimate odds ratios (OR) and 95% confidence intervals (CI). To confirm the results, a meta-analysis was conducted based on published literature on the association of Mt5178 variant with T2DM., Results: No significant association was found between the Mt5178C/A variant and T2DM either by our study or the meta-analysis which included eight published studies. Nevertheless, it was found that the T2DM patients with 5178C genotype were at a higher risk for nephropathy complication (OR=1.49, 95%CI: 1.005-2.197, P<0.05) and at significantly lower risk for hypertension complication (OR=0.744, 95%CI: 0.556-0.996, P<0.05) compared with those carrying a 5178A genotype., Conclusion: No association was found between the Mt5178C/A polymorphism of mitochondrial ND2 gene with the increased risk of T2DM. However, the polymorphism may affect the development of nephropathy and hypertension complications among T2DM patients.

Objective: To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia, China., Method: A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003. Patients with IFG (5.6 mmol/L≤FPG<7.0 mmol/L) but without history of diabetes were selected as the study subjects. A follow-up study was conducted in 2013. Multinomial logistic regression analysis was used to evaluate the correlated factors., Results: There were 384 patients with IFG recruited in the study. Out of them, 150 (39.1%) progressed to normoglycaemia, 174 (45.3%) remained as IFG, and 60 (15.6%) developed into type 2 diabetes mellitus. Through adjustment multivariately, patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR = 0.692, 95%CI:0.502-0.952, P < 0.05)and those developed to diabetes were significantly associated with factors as age(OR = 1.052, 95%CI:1.014-1.090, P < 0.05) or obesity (OR = 2.924, 95% CI:1.353-6.320, P < 0.05)., Conclusion: 15.6% of the IFG patients developed diabetes mellitus among the Inner Mongolian population. Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.

Objective: To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese., Methods: 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history, physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level, association between FPG and SUA. Levels of hyperuricemia (HUA) were evaluated., Results: The SUA levels and the incidence of HUA showed trends of increasing, with the increasing FPG levels in women, with statistically significant differences seen among all the FPG groups (P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group (DM group) and impaired fasting glucose (IFG) groups were non-significant (P > 0.05) but it was higher than normal FPG group in men (P < 0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age, smoking status, drinking status, physical activity, hypertension, body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group, the risk of women suffering from HUA increased by 40% (95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals, the risk of diabetic patients suffering from HUA also increased by 44% (95% CI:1.15-1.79) in women. However, the risk of suffering from HUA did not relate to the increase of FPG in men., Conclusion: The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA, but not in men.

Objective: To investigate the role of visfatin in the pathogenesis of gestational diabetes mellitus (GDM) and its correlation with insulin resistance., Methods: The study recruited 58 pregnant women of 24 to 28 gestational weeks in People's Hospital of Hebei Province from January to June 2013. Among them, 30 were patients with GDM (GDM group), 28 had normal oral glucose tolerance test and was referred as healthy pregnancy group (NGT group). Fourteen age-matched female who were first-degree relatives (FDR1) of type 2 diabetes mellitus patients, and 27 healthy nonpregnant women with normal oral glucose tolerance test were referred as high-risk group and normal controls (NC), respectively. The fasting plasma glucose (FPG), 1 hour and 2 hours postprandial glucose levels were measured by glucose oxidase method. The fasting insulin (FIN) levels were measured by radioimmunoassay and the homeostatic model assessment-insulin resistance index (HOMA- IR) was calculated. The levels of total cholesterol (TC), triglycerdes (TG), high density lipoprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL) were determined. The visfatin levels were measured by ELISA., Results: (1)The levels of FPG were significantly higher in GDM, FDR1 and NC group [(5.5 ± 0.7), (5.1 ±0.6), (5.2 ± 0.4)mmol/L] than that in NGT group [(4.5 ± 0.3) mmol/L], respectively (P < 0.05). (2) The levels of INS [(14 ± 6)mU/L], HOMA- IR (4.0 ± 2.0), 1 hour [(10.9 ± 1.8) mmol/L] and 2 hours [(8.6 ± 1.8) mmol/L] postprandial glucose levels of GDM group were significantly higher than those in NGT group [(12 ± 4) mU/L, 2.0 ± 1.0, (7. 4 ± 1.3) and (6.2 ± 0.9) mmol/L], respectively (P < 0.05). (3) The levels of TC, TG, HDL and LDL levels in GDM group were (5.5 ± 0.9), (2.8 ± 0.8), (1.8 ± 0.4) and (3.3 ± 0.8) mmol/L, and were(5.9 ± 0.8), (2.5 ± 0.7), (1.9 ± 0.4) and (3.4 ± 0.6) mmol/L in NGT group. The levels of lipid in the two groups were significantly higher than those in FDR1 or NC group, respectively(P < 0.05).(4)The levels of visfatin in GDM group and NGT group [(43 ± 10), (45 ± 12) µg/L] were significantly higher than that in FDR1 or NC group [(29 ± 9), (36 ± 7) µg/L], respectively (P < 0.05), but the visfatin levels in FDR1 group were significantly lower than that in NC group (P < 0.05). The visfatin levels in GDM group were slightly lower than that in NGT group, but the difference was not statistically significant (P > 0.05). (5)The visfatin levels in NGT group were negatively correlated to the levels of FPG, HOMA-IR and TC (r = -0.38, -0.44, -0.47, respectively, P < 0.05). But the visfatin levels in GDM group were not correlated with the levels of FPG, HOMA-IR, TC (r = -0.16, -0.01, 0.33, respectively, P > 0.05). While in NC group, the levels of visfatin were negatively correlated with FPG and 2 hours postprandial glucose(r = -0.48, -0.42, respectively, P < 0.05)., Conclusion: Visfatin may be an important adipokine that involved in the carbohydrate and lipid metabolism in GDM, and is related to the pathogensis of GDM and insulin resistance.

Objective: To investigate the relationship of different types of gestational diabetes mellitus (GDM) and pregnancy outcomes., Methods: A total of 4090 cases, who received prenatal examination and delivered in Peking University First Hospital and performed a 75 g oral glucose tolerance test (75 g OGTT) at 24-28 gestational weeks, from January. 1(st), 2011 to Jul 31(st), 2012 , were divided into 2 groups. Normal blood glucose group:the result of OGTT (fasting plasma glucose, 1 hour glucose and 2 hour glucose ) was normal; Gestational diabetes mellitus group (GDM group): the result of OGTT was abnormal at any time point. GDM group were separated into A, B and C. GDM A means fasting plasma glucose annormal but others were normal, GDM B:fasting plasma glucose, 1 hour and/or 2 hour glucose abnormal, GDM C:fasting plasma glucose normal. To analyse the effect of different number of abnormal result of OGTT on pregnancy outcomes, GDM group were divided into I, II and III.GDMI means one abnormal blood glucose of OGTT result, GDM II: two abnormal blood glucose and GDM III:three abnormal blood glucose. We analyzed the pregnant outcomes of each group., Results: (1) Among the 4090 cases, 858 cases (21.98%) were diagnosed as GDM (GDM group), and 82 cases (9.6%, 82/858) were treated with insulin.other 3232 cases with normal blood glucose (normal blood glucose group). In GDM group, the rate of cesarean section (51.9%, 445/858), premature delivery (8.4%, 72/858) and LGA (5.9%, 51/858) were respectively significantly higher than those of normal blood glucose group [ (43.5%, 1406/3232), (5.8%, 189/3232) and(4.2%, 137/3232)] (P < 0.05). But, there was no statistically significant differences for the rate of macrosomia (P > 0.05) between the GDM group(6.8%, 58/858) and normal blood glucose group (6.2%, 199/3232) . (2) In the GDM group, GDM A was 317 cases (36.9%), GDM B 239 cases (27.8%), GDM C 302 cases (35.2%). The incidence of Macrosomia and LGA in GDM B was significantly higher than that in GDM C and normal blood glucose group (P < 0.05). Comparing with GDM A , there was no statistically significance in GDM B and GDM C (P > 0.05). (3) In GDM group, GDMIwas 521 cases (60.7%), GDM II203 cases (15.6%), GDM III 134 cases (23.7%). Compared with the normal blood glucose group, GDM III had a significantly higher incidence of macrosomia and LGA and cesarean section(P < 0.01);and GDM IIhad only a significantly higher incidence of cesarean section(P < 0.01). (4) Among the 4090 cases, there were 1118 patients (27.3%) whose fasting blood glucose was below 4.4 mmol/L, of which 55 cases were diagnosed as GDM. There were 4 premature infants and 1 macrosomia., Conclusions: The GDM group with more than FBG ≥ 5.1 mmol/L had a higher incidence of adverse pregnancy outcomes, it suggested that we should pay more attention and take actively intervented; the pregnant woman is not recommended for 75g OGTT detection when fasting blood glucose was below 4.4 mmol/L because of the low rate of GDM and adverse pregnancy outcomes among them.

Objective: To investigate the effects of barley flake (BF) on the glucose-lipid metabolism in patients with impaired fasting glucose (IFG)., Methods: 100 patients with IFG were divided into the oat meal (OM) control group and barley flake experimental group for three months intervention according to randomized controlled trail (RCT). Biochemical indicators, glucose-lipid metabolism related enzymes, the area under curve (AUC) of blood glucose and insulin after oral glucose tolerance test (OGTT) were assessed before and after intervention. In addition, the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated by FBG (mmol/L) x INS (microU/L)/ 22.5., Results: At the end of the three month active intervention, the mean fasting blood glucose (FBG) and insulin (INS) in the patients with BF treatment decreased by 9.26% (P < 0.001) and 13.37% (P = 0.001) separately compared with that in patients with OM treatment; meanwhile, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in patients with BF treatment also decreased by 7.20% (P < 0.001) and 9.42% (P = 0. 002), respectively. Glycosylated hemoglobin (HbA1c), HOMA-IR, total glyceride (TG), Apo-B, the AUC of blood glucose and insulin after OGTT were also significantly decreased separately (P < 0.01 or < 0.05 ). However, statistically significant differences failed to be found in HDL-C, Apo-A, ALP and SOD between these two groups., Conclusion: BF had favorable effect on improvement of glucose-lipid metabolism in the patients with impaired fasting glucose.

Objective: To investigate the association between fasting blood glucose levels and the prevalence of carotid plaque in a community-based population of Beijing and to further explore the association between fasting glucose levels concomitant wand other cardiovascular risk factors as well as the prevalence of carotid plaque., Methods: This study was a part of the Chinese Multi-provincial Cohort Study conducted in the communities of Beijing University in 2007. All the members aged 50 - 79 years from the community were recruited, with 1046 of them qualified as without missing data. Case of diabetes was defined if the fasting glucose level was greater than 7.0 mmol/L or on anti-diabetic drugs., Results: The mean level of fasting glucose was 5.89 mmol/L, and the prevalence of carotid plaque was 56.3%. For the reference on normal levels of fasting glucose, the risk on carotid plaque had an increase along with the increase of fasting glucose levels only under the univariate and multivariate analyses, after adjusting for age. However, the risk on carotid plaque in women was increased when there was an increase on the levels of fasting glucose. Specifically, for the reference on normal levels of fasting glucose, after adjusting for other cardiovascular risk factors, the odds of developing a carotid plaque was more than two folds in diabetic women. When combining the groups of risk factors (normal and abnormal) among the three groups of fasting glucose and assigning the normal level of risk factors concomitant with normal fasting glucose as a reference for both genders, the risk of developing a carotid plaque in diabetic women with abnormal level of risk factors ranked the highest, with statistical significance. When the diabetic patients combined with a decreased levels of HDL but increased levels of LDL, blood pressure, waist circumference, there appeared 2.8-(P = 0.014), 2.7-(P = 0.010), 2.4-(P = 0.013) and 2.1-times (P = 0.031) higher risks of developing carotid plaque than those in the reference group, respectively., Conclusion: In this study, the prevalence of carotid plaque driven by increased fasting glucose was different on gender but the difference was only statistically significant in women. There also appeared a joint association of fasting glucose combined with other cardiovascular risk factors on the risk of developing a carotid plaque.

Objective: To study the relationship between serum leptin and insulin resistance, and to analyze the effect of acupuncture on serum leptin level in patients with type-II diabetes mellitus (DM)., Methods: A total of 80 type-II DM patients were randomized into acupuncture and medication groups. Acupuncture was applied to Yishu (EX), Feishu (BL13), Pishu (BL 20), etc. according to syndrome identification. The treatment was given once every other day for 12 weeks. For patients in the medication group, Glibenclamide (2.5-7.5 mg/time, 1-2 times/d according to blood sugar level) was given for 12 weeks. Fasting blood glucose (FBG), fasting insulin (FINS) and fasting leptin (FLP) were detected by using glucose oxidase method, radioimmunoassay and ELISA, respectively. Insulin sensitivity index (ISI) and homeostasis model assessment-insulin resistance (HOMA-IR) were calculated., Results: In comparison with pre-treatment, FBG levels and HOMA-IR in both acupuncture and medication groups, and FINS and FLP levels in the acupuncture group were decreased significantly (P < 0.01), while ISI in both acupuncture and medication groups, and FINS level in the medication group were increased remarkably after the treatment (P < 0.01). Comparison between two groups showed that after the treatment, FINS and FLP levels, and HOMA-IR of the acupuncture group were considerably lower than those of the medication group (P < 0.01), while ISI of the acupuncture group was significantly higher than that of the medication group (P < 0.01)., Conclusion: Acupuncture therapy is effective in lowering FLP level, which may contribute to its clinical effect in improving type-II DM.

Objective: To investigate characteristics of glucose metabolism of non-obese and obese women with polycystic ovary syndrome (PCOS)., Methods: From May 2006 to April 2009, 1928 PCOS patients treated in Reproductive Medicine Center of Shandong Provincial Hospital Affiliated to Shandong University were enrolled in this study, which were divided into 901 cases [body mass index (BMI) ≥ 25 kg/m²] in obese group and 1027 cases in non-obese (BMI < 25 kg/m(2)) group. The prevalence of type 2 diabetes mellitus (T2DM), oral glucose tolerance test, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) were compared between the two groups., Results: (1) Blood glucose levels: at the time of fasting, 30, 60, 120 and 180 minutes, the levels of glucose were (5.3 ± 1.1), (9.0 ± 2.4), (9.3 ± 4.4), (7.5 ± 2.8), (5.3 ± 1.8) mmol/L in obese group and (5.0 ± 0.8), (8.4 ± 3.5), (8.0 ± 4.2), (6.5 ± 3.2), (4.9 ± 1.6) mmol/L in non-obese group, which all showed statistical difference at every time point (P < 0.01). (2)The level of insulin: at the time of fasting, 30, 60, 120 min, the level of insulin were (13 ± 7), (81 ± 51), (102 ± 65), (83 ± 63) mU/L in obese group and (8 ± 5), (57 ± 35), (62 ± 44), (46 ± 39) mU/L in non-obese group, which all showed statistical difference at every time point (P < 0.01). However, at time point of 180 minutes, the level of insulin did not exhibit significantly difference between obese and non-obese group (P > 0.05). (3) The prevalence of abnormal glucose metabolism: the rate of IFG was 4.98% (96/1928). The rate of abnormal glucose tolerance was 23.08% (445/1928). The rate of IGT were 13.05% (134/1027) in non-obese group and 24.20% (218/901) in obese group, which also showed remarkable difference (P < 0.01). The rate of T2DM were 2.53% (26/1027) in non-obese group and 7.44% (67/901) in obese group, which reached significant difference (P < 0.01)., Conclusion: Abnormal glucose metabolism was observed more frequently in overweight or obese PCOS women.

Objective: To study the genetic determination of fast plasma glucose (FPG) and correlation with its potential correlated traits, anthropometric measures and blood pressure., Methods: Two hundred and eighteen Type 2 diabetes mellitus (T2DM) pedigrees composed of 1383 Chinese Han individuals residing in the East and South-East China were analyzed. Univariate variance decomposition analyses were used to estimate the narrow-sense heritability (h(2)) of FPG, anthropometric indices and blood pressure, and bivariate quantitative genetic analyses were used to estimate the genetic and environmental correlations between FPG and anthropometric measures or blood pressure., Results: We found that FPG, blood pressure and all anthropometric indices except for waist to hip ratio were under significant genetic determination, and the h(2) was from 0.28 to 0.43. We did not find significant genetic and environmental correlation between FPG and anthropometric indices and blood pressure., Conclusion: The present study demonstrated that T2DM, obesity and hypertension were controlled by some genetic factors, and FPG shares little common genetic and environmental factors with obesity-related anthropometric indices and blood pressure in our Chinese sample population.

Objective: To evaluate the metabolic characteristics of insulin secretion and insulin sensitivity in isolated impaired fasting glucose (iIFG) and isolated fasting hyperglycemia (IFH) and to clarify the factors responsible for the development of IFH., Methods: Receiver operating characteristic curve (ROC) analysis was conducted in 1852 subjects. Three groups were classified according to a 75 g oral glucose tolerance test (OGTT): (1) normal glucose tolerance (NGT), n = 557; (2) iIFG, n = 221; (3) IFH, n = 81. The three groups were compared with insulin secretion (insulinogenic index) and insulin sensitivity (insulin sensitivity index)., Results: Using ROC analysis, the optimal cut point of fasting plasma glucose (FPG) related to diabetes diagnosis with OGTT was 6.695 mmol/L and the optimal cut point of FPG related to impaired glucose to lerance (IGT) diagnosis with OGTT was 5.590 mmol/L. From NGT to iIFG and IFH in these subjects, the insulinogenic index and insulin sensitivity index showed gradual decrease., Conclusion: Subjects with iIFG and IFH exhibit distinctly impaired early-phase insulin secretion and insulin sensitivity, indicating that both reduced insulin secretion and insulin resistance are the determinants of deterioration from NGT to iIFG and IFH.

Objective: To investigate the influences of fetal growth retardation (FGR) and postnatal high fat diet (HF) on the development of insulin resistance (IR), puberty development and fertility problems in female rat offspring., Methods: FGR model was induced by maternal low protein diet. 32 newborn FGR rats and 32 control rats were randomly divided into two equal groups: FGR/HF group (with the mother rats given with high fat diet for 3 weeks after delivery), FGR/N (with the mother rats given with normal diet), C/HF group (control newborn rat group with the mother rats given with high fat diet), and C/N group (control newborn rat group with the mother rats given with normal diet). The pups were fed by mother milk. All pups were weaned at the 4th week of age and then fed with the diet the same diet as that during the lactation period until the end of experiment. From day 30 onwards, vaginal opening and oestrous cycle were inspected daily on 10 pups in each group. At the 13th week, body weight, length and perirenal fat weight/body weight (Fw/Bw) were recorded for 10 pups in each group. At the same time, fasting plasma glucose (FPG), fasting insulin (FINS), and testosterone level were measured. From the 13th week onwards, mating test was performed for 6 pups in each group., Result: At the 13th week, there was an obesity tendency in the FGR/N, FGR/HF and C/HF groups. The FINS levels were all higher, and insulin sensitivity index (ISI) levels were all significantly lower in these three groups than in the C/N group (all P < 0.05). The homeostasis model assessment insulin resistance index (HOMA-IR) levels of the FGR/N and FGR/HF groups were significantly higher than that of the C/N group (both P < 0.05), the FINS and HOMA-IR of the FGR/HF group were significantly higher than that of the FGR/N group (both P < 0.05). There was oligoovulation in the FGR and high fat diet rats, the pregnancy rate of the FGR/HF group was significantly lower than that of the C/N group (P < 0.05). FGR/HF group had the most serious obesity, IR and fertility problems., Conclusion: There are puberty disturbance, oligoovulation and IR in FGR and high fat diet rats. IR, puberty development and fertility problems are linked and occur independently of the postnatal nutrition, but can be exacerbated by postnatal high fat diet.

Objective: To investigate the association of serum concentration of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) with insulin resistance in women with gestational diabetes mellitus (GDM)., Methods: Forty normal pregnant women (NGT group) and 23 women with GDM (GDM group) were enrolled in this study with another 25 women of child-bearing age as the control group. Radio immunoassay (RIA) was used to measure the fasting serum IL-6 levels, and immunoturbidimetry performed to evaluate serum hs-CRP levels. The homeostasis model assessment-insulin resistance (HOMA-IR) and the homeostasis model assessment-B (HOMA-B) were calculated., Results: Compared with NGT group and control group, GDM group had significantly elevated serum IL-6 and hs-CRP (P<0.01), but the levels were comparable between the former two groups (P>0.05). HOMA-IR was the highest in GDM group (P<0.001), and NGT group had significantly higher HOMA-IR than the control group (P<0.05), whereas the reverse was true for HOMA-B (P<0.01). Pearson correlation analysis showed that fasting blood glucose (FBG), fasting insulin (FINS), IL-6 and hs-CRP had significant association with HOMA-IR (P<0.01). Multiple regression analysis identified FINS, FBG, IL-6, and hs-CRP as the factors significantly affecting HOMA-IR (regression coefficient of 0.563, 0.992, 0.325, and 0.231, respectively, P<0.01)., Conclusions: Serum levels of IL-6 and hs-CRP are elevated in women with GDM, which are the most significant factors affecting HOMA-IR. IL-6 and CRP may aggravate insulin resistance through various mechanisms and participate in the pathogenesis of GDM.

Objective: To investigate the expression of phosphatidylinositol 3-kinase (PI-3K) in adipose tissue of polycystic ovary syndrome patients (PCOS), and explore molecular mechanisms of insulin resistance (IR) in PCOS., Methods: Samples from patients with PCOS with IR (n = 19), PCOS without IR (n = 10) and controls (n = 15) were collected. Serum fasting insulin (FIN) and fasting plasma glucose (FPG) were measured. Insulin resistance index was calculated using homeostasis model assessment (HOMA) to analyze the relationship between these markers and IR. Western blot technique was used to detect the PI-3K p85 subunit. Gene expression of PI-3K p85 subunit was detected by reverse transcription polymerase chain reaction (RT-PCR) method. Kinase activity was detected by immunoprecipitation, thin-layer chromatography and gamma scintillation counting., Results: (1) The levels of FIN [(25.2 +/- 3.8) mU/L] and HOMA-IR (1.6 +/- 0.3) in PCOS with IR were significantly higher than those in PCOS without IR [(13.4 +/- 3.8) mU/L, 0.9 +/- 0.3] and controls [(9.5 +/- 2.6) mU/L, 0.5 +/- 0.3; all P < 0.05). (2) There was no significant difference in the protein (0.65 +/- 0.10) and gene expression (0.92 +/- 0.12) of PI-3K p85 subunit in PCOS with IR compared with PCOS without IR (0.72 +/- 0.10, 1.01 +/- 0.10) and control groups (0.73 +/- 0.14, 1.00 +/- 0.12; P > 0.05). (3) PI-3K activity in PCOS with IR (81%) and PCOS without IR (89%) was significantly decreased (P < 0.01, P < 0.05) and negatively correlated with HOMA-IR (r = -0.69, P < 0.01; r = -0.62, P < 0.05)., Conclusions: No significant difference in the protein and gene expression of PI-3K p85 subunit in PCOS with IR is found. The decreased PI-3K activity may lead to IR of PCOS.

Objectives: Metabolic syndrome (MS) in adolescents was reported to be closely associated with cardiovascular diseases in adulthood. However, no unified treatment measure for MS in adolescents is currently available. The aim of this study was to measure the changes of serum adiponectin levels, insulin sensitivity and other biochemical markers after metformin therapy in adolescents with MS, which might provide some information for set up a unified therapeutic measure for MS in adolescents., Methods: In this study, 348 moderately or severely obese adolescents and 24 non-obese healthy adolescents matched in age and sex were enrolled. The obese group included 208 males and 140 females aged from 7 to 16 years (11.5 +/- 2.1 years). Oral glucose tolerance test and biochemical markers measurement were done to all these subjects. Whole body insulin sensitivity index (WBISI), homeostasis model assessment-insulin resistance (HOMA-IR) and fasting serum adiponectin were compared among 36 adolescents with MS (who had two or three abnormalities of hyperglycosemia, hypertension or dyslipidemia), 61 simple obese subjects without abnormality of biochemical markers and 24 healthy controls. Moreover, the changes of WBISI, HOMA-IR and adiponectin levels in 20 cases with MS after metformin therapy for 3 months were measured., Results: (1) HOMA-IR in control group (1.3), simple obese group (2.3) and MS group (4.9) increased by turns (F = 54.08, P < 0.001). WBISI and serum adiponectin in control group, simple obese group and MS group decreased by turns with significant difference [89.6, 22.8 and 10.7, F = 30.06; (7.1 +/- 2.6), (5.9 +/- 1.9), (2.8 +/- 0.9) mg/L, F = 64.93; P < 0.01 for all]. (2) HOMA-IR after metformin therapy decreased [5.7 (1.9-12.4) vs. 2.9 (0.9-7.4), t = 5.05, P < 0.01]; while the serum adiponectin levels increased with significant differences [(3.0 +/- 0.9) mg/L vs. (6.1 +/- 1.9) mg/L, t = 6.19, P < 0.01]. Systolic blood pressure [(132.4 +/- 7.5) mm Hg vs. (116.6 +/- 9.1) mm Hg, t = 8.36, P < 0.01], 2-hour glucose [(8.2 +/- 2.9) mmol/L vs. (5.3 +/- 1.0) mmol/L, t = 3.96, P < 0.01], triglyceride [(2.8 +/- 1.2) mmol/L vs. (1.3 +/- 0.9) mmol/L, t = 4.22, P < 0.01], total cholesterol [(4.9 +/- 0.6) mmol/L vs. (4.0 +/- 0.6) mmol/L, t = 4.72, P < 0.01], alanine aminotransferase [80.5 (29.0-286.0) U/L vs. 56.0 (23.0-163.0) U/L, t = 3.80, P < 0.01]., Conclusion: Insulin sensitivity in adolescents with MS was lower than that of simple obese group. Metformin can improve or ameliorate adiponectin levels, insulin sensitivity and some clinical markers.

Objective: Obesity is an important risk factor of insulin resistance and type 2 diabetes. Adipocyte is a cell that can actively secrete a series of factors to regulate the pathway responsible for energy balance. Resistin is one of these factors. The purpose of this study was to investigate possible correlation between resistin and certain parameters, including body parameters and other parameters of glucose metabolism and roles of resistin in hyperinsulinemia or insulin resistance in obese children., Methods: The serum resistin concentration was measured in 34 obese children (18 boys, 16 girls; age 8.9-15.9 years) and 31 normal subjects (16 boys, 15 girls; age 7.8-14.5 years) by using ELISA. Anthropometric parameters, fasting glucose and insulin were measured in all subjects. Insulin resistance was assayed by homeostasis model assessment ratio (HOMA-R). Beta cell function was determined by using homeostasis model assessment beta cell (HOMA-beta). Correlation analysis was performed between resistin and other parameters., Results: (1) The serum resistin concentration (common logarithmic transformation) was 3.1 +/- 0.5 in obese subjects and 2.7 +/- 0.8 in normal subjects. (P < 0.05). (2) The serum resistin concentration was not significantly correlated with sex, age, systolic and diastolic blood pressures, but was positively correlated with BMI, percent body fat (BF%), waist-hip ratio (WHR) (r = 0.299, r = 0.304, r = 0.322, P < 0.01); and positively correlated with fasting glucose, insulin, HOMA-R (r = 0.299, r = 0.303, r = 0.324, P < 0.05), but not significantly correlated with HOMA-beta. (3) Multiple linear regression analysis showed that only HOMA-R was the factor that significantly influenced resistin, R(2) = 0.105, the standard partial coefficient was 0.279 (P < 0.01)., Conclusions: The serum resistin concentration in obese children were higher than that in normal children. The serum resistin concentration significantly correlated with the degree of obesity and the distribution of fat. Resistin is probably related to occurrence of hyperinsulinemia and/or insulin resistance in obese children.

Objective: To study whether insulin resistance exists in the Chinese individuals with impaired glucose regulation (IGR) defined by the modified cut-point value (5.6 mmol/L) in 2003 version of ADA criteria for impaired fasting glucose (IFG)., Methods: We selected 9 persons [aged (44 +/- 5) years, body mass index (BMI) (24.0 +/- 0.8) kg/m(2)] with normal glucose regulation [NGR, fasting plasma glucose (FPG) < 5.6 mmol/L, plasma glucose-2h (PG2h) < 7.8 mmol/L], 9 [aged (49 +/- 3) years, BMI (29.0 +/- 0.8) kg/m(2)] with isolated IFG defined by the new criteria (n-i-IFG, FPG < 5.6 mmol/L, PG2h < 7.8 mmol/L), 20 with combined impaired glucose tolerance (c-IGT) including 10 [aged (45 +/- 4) years, BMI (26.0 +/- 1.3) kg/m(2)] defined by the new criteria (n-c-IGT, FPG 5.6 - 6.0 mmol/L, PG2 h 7.8 - 11.0 mmol/L) and 10 [aged (49 +/- 3) years, BMI (27.0 +/- 1.1) kg/m(2)] defined by the old criteria (o-c-IGT, FPG 6.1 - 6.9 mmol/L, PG2h 7.8 - 11.0 mmol/L), 10 [aged (43 +/- 5) years, BMI (29.0 +/- 2.8) kg/m(2)] with type 2 diabetes mellitus (DM). Insulin resistance of the subjects was measured by using hyperinsulin-euglycemic clamp in which the glucose infusion rate (GIR) was the major index. Beta-cell function was assessed by intravenous glucose tolerance test. The DM patients only underwent the hyperinsulin-euglycemic clamp., Results: (1) The GIR of n-i-IFG group and n-c-IGT group was significantly lower than that of the NGR group [(7.2 +/- 0.8), (7.0 +/- 1.5) vs (10.3 +/- 0.9) mg.kg(-1).min(-1), P < 0.05]. The GIR of o-c-IGT group was the least [(4.8 +/- 0.4) mg.kg(-1).min(-1)], which was similar to that of the DM group [(5.6 +/- 1.0) mg.kg(-1).min(-1)], the GIR of the two groups was significantly reduced compared with the NGR goup [(4.8 +/- 0.4), (5.6 +/- 1.0) vs (10.3 +/- 0.9) mg.kg(-1).min(-1), P < 0.01]. (2) As compared with the NGR group, the fasting insulin level was increased in all the IGR groups and was decreased in the DM group. (3) The first phase of insulin secretion were similar in NGR and n-i-IFG group [(37.0 +/- 8.6) vs (31.7 +/- 9.2) mU/L, P > 0.05], and the n-i-IFG group had greater amount than the n-c-IGT group [(31.7 +/- 9.2) vs (25.9 +/- 9.8) mU/L, P > 0.05]. But it was the least in the o-c-IGT group that significantly less than the NGR group [(17.2 +/- 4.8) vs (37.0 +/- 8.6) mU/L, P < 0.05]. As compared with the NGR group, the second phase of insulin secretion was slightly increased in the n-i-IFG group [(16.6 +/- 2.9) vs (21.9 +/- 3.6) mU/L, P > 0.05], and was even greater in the n-c-IGT group [(16.6 +/- 2.9) vs (38.7 +/- 13.7) mU/L, P < 0.05]. But it was reduced in the o-c-IGT group [(20.7 +/- 2.9) mU/L]., Conclusions: (1) The IGR subjects defined by the new cut-point value already has insulin resistance. (2) Deficit in insulin secretion is worsening as the IGR deteriorates.

In order to analyze the relationship between fasting insulin level and body mess index (BMI), blood pressure and lipids, and to discuss the effect of hypertensive family history, 317 healthy children aged 8-11 years including 74 overweighted and 243 non-overweighted were selected randomly from 4 primary schools in Beijing. Anthropometry, fasting insulin and lipids were measured, and the family history of hypertension (FHH) was recorded. After adjusting of age and sex, the levels of blood fasting insulin, cholesterol and triglyceride were significantly higher (P < 0.01) and the ratio of HDL/LDL and apoA/apoB were significantly lower (P < 0.01) in the overweighted than that in non-overweighted children. After controlling BMI, the partial correlation coefficients between fasting insulin and TG, systolic pressure was 0.20 (P < 0.01) and 0.12 (P < 0.01) respectively. Moreover, among the overweighted children, but not among non-overweighted children, those with FHH had a significantly higher fasting insulin than those without FHH (P < 0.01). It is concluded that hypertensive family history may play an important role in contributing to the higher level of serum insulin of overweighted children, and higher serum insulin may concerted with some metabolic disorders in overweighted children.