Gliclazide used for the treatment of type 2 diabetes mellitus(T2DM) stimulates insulin secretion and influences peripheral blood monocytes.The roles of gliclazide in peripheral monocytes of newly diagnosed T2 DM patients were investigated in this study.A total of 105 newly diagnosed T2 DM patients with no history of antihyperglycemic medication were treated with gliclazide-modified release for 16 weeks.The total and differential leukocyte profiles of peripheral blood were measured at baseline and week 16.The peripheral blood monocyte count at week 16 was significantly lower than that at baseline(P=0.019).Peripheral monocytes level at baseline was positively correlated with waist circumference.After gliclazide treatment,the peripheral monocytes were decreased [(320.09±15.13)×10~6/L vs.(294.19±14.22)×10~6/L] in non-abdominal obesity group,but increased in abdominal obesity group [(344.36±17.24)×10~6/L vs.(351.87±16.93)×10~6/L].Compared with non-abdominal obese patients,abdominal obese patients showed higher Δmonocytes(P=0.046) and Δacute insulin secretion(P=0.049),but lower ΔHb A1c(P=0.047).There was significantly positive correlation between Δmonocytes and Δacute insulin secretion(P=0.015),which disappeared after adjusting for age,waist circumference and dosage at baseline.In conclusion,waist circumference is correlated with peripheral monocyte change after gliclazide treatment in Chinese newly diagnosed T2 DM patients.Peripheral monocytes are decreased in non-abdominal obesity group and increased in abdominal obesity group after gliclazide treatment.
BACKGROUND:The prognostic role of diabetes mellitus (DM) coexisting with hepatocellular carcinoma (HCC) remains controversial.To clarify its impact on survival in HCC patients after curative treatments,a meta-analysis was performed.DATA SOURCES:Eligible studies were identified through multiple search strategies in the databases PubMed (MEDLINE),EMBASE,the Cochrane Library and ACP Journal Club between January 1950 and March 2010.Ten studies fulfilled the inclusion criteria,and data were aggregated comparing overall survival and recurrence-free survival in HCC patients according to DM status.RESULTS:The pooled hazard ratios (HRs) estimate for overall survival was 1.34 (95% CI,1.18-1.51;P<0.0001) and for recurrence-free survival was 1.48 (95% CI,1.00-2.18;P<0.0001),showing a worse survival for HCC with coexisting DM.However,the patients with DM had a shorter survival time in HCV-related HCC (HR=1.71;95% CI,1.10-2.66;P=0.016),while HBV-related cases were not significantly different (HR=1.29;95% CI,0.69-2.40;P=0.182).Meanwhile,the coexistence of DM impaired overall survival in HCC patients with a small tumor burden (HR=1.63;95% CI,1.25-2.12;P<0.0001).CONCLUSION:HCC patients with coexisting DM have a shorter survival time and a higher risk for tumor recurrence after curative treatments,while the precise value should be defined in more clinical trials with consistent methodology,especially prospective studies.
Wei-Min Wang,Yang Xu,Xin-Rong Yang,Yao-Hui Wang,Hai-Xiang Sun and Jia Fan Institute of Biomedical Sciences,Fudan University,Shanghai 200032,China
