Association of PON1 gene polymorphisms with polycystic ovarian syndrome risk: a meta-analysis of case-control studies

PURPOSE

Evidences showed that paraoxonase 1 (PON1) gene polymorphism has an impact on women's susceptibility to polycystic ovarian syndrome (PCOS) by influencing the expression and activity of PON1. However, the effects of three PON1 polymorphisms (- 108 C>T, L55M and Q192R) on the incidence of PCOS have generated inconsistent results. Here, we conducted a meta-analysis to investigate the association between PON1 polymorphisms and PCOS risk.

METHODS

All eligible trials were identified via systematic searches of multiple literature databases. Outcome data were synthesized by using crude odds ratio with 95% confidence interval. Heterogeneity was assessed with the I² test. Publication bias and subgroup analyses were also performed.

RESULTS

A total of 2449 cases and 1977 controls from nine studies were selected for analysis. The pooled results showed a significant association between PCOS risk and PON1 - 108 C/T polymorphism in the following genetic models [allelic, 0.72 (0.56-0.92); homozygote, 0.51 (0.32-0.82); heterozygote, 0.44 (0.25-0.78); and dominant 0.47 (0.29-0.77)]. For the PON1 192 Q/R polymorphism, a significant relationship was found in the allelic model [0.62 (0.41-0.93)] and recessive model [0.61 (0.37-0.98)]. PCOS risk was also linked to PON1 L55M polymorphism in the heterozygote model [0.62 (0.39-0.98)] and dominant model [0.63 (0.41-0.96)].

CONCLUSIONS

Our study has shown that PON1 - 108 C/T polymorphism might be associated with increased risk of PCOS under the allelic, homozygote, heterozygote, and dominant models. Additionally, PON1 192 Q/R and L55M polymorphisms were significantly related only in the allelic and recessive model, and in the heterozygote and dominant model, respectively.

Exploring spatiotemporal changes of the Yangtze River (Changjiang) nitrogen and phosphorus sources, retention and export to the East China Sea and Yellow Sea

Nitrogen (N) and phosphorus (P) flows from land to sea in the Yangtze River basin were simulated for the period 1900-2010, by combining models for hydrology, nutrient input to surface water, and an in-stream retention. This study reveals that the basin-wide nutrient budget, delivery to surface water, and in-stream retention increased during this period. Since 2004, the Three Gorges Reservoir has contributed 5% and 7% of N and P basin-wide retention, respectively. With the dramatic rise in nutrient delivery, even this additional retention was insufficient to prevent an increase of riverine export from 337 Gg N yr^-1 and 58 Gg P yr^-1 (N:P molar ratio = 13) to 5896 Gg N yr^-1 and 381 Gg P yr^-1 (N:P molar ratio = 35) to the East China Sea and Yellow Sea (ECSYS). The midstream and upstream subbasins dominate the N and P exports to the ECSYS, respectively, due to various human activities along the river. Our spatially explicit nutrient source allocation can aid in the strategic targeting of nutrient reduction policies. We posit that these should focus on improving the agricultural fertilizer and manure use efficiency in the upstream and midstream and better urban wastewater management in the downstream subbasin.

[Clinic pathological and ultrasonographic features of primary thyroid lymphoma]

Objective: To analyze the ultrasonographic and clinicopathological features of primary thyroid lymphoma(PTL). Methods: The ultrasonographic and clinicopathological featuresof 21 cases of pathologically-confirmed PTLs were analyzed retrospectively. Results: Of all 21 PTLs, 15 cases were diffuse large B-cell lymphoma, 4 were mucosal-associated lymphoid tissue extranodular marginal zone B-cell lymphoma, 1 was small B-cell lymphoma and 1 was classical Hodgkin lymphoma. Eight cases were proved by pathology with concomitant Hashimoto's thyroiditis. Ultrasonography observed bilateral or unilateral asymmetric goiter (21/21, 100.0%), marked hypoechogenicity (21/21, 100.0%) with posterior acoustic enhancement (19/21, 90.5%), heterogeneous echo texture with interspersed linear echogenic strands or intensive reticular echogenic strands or cloud echogenic, heterogeneous echo texture of thyroid gland (21/21, 100.0%), focal nodular hypoechoic(2/21, 9.5%) with regular or irregular shape, increased vascularity (13/21, 61.9%) and cervical lymphadenopathy (12/21, 57.1%). Two cases involved the anterior cervical muscle and 1 infiltrated trachea. Rapidly enlarging cervical mass were found in 13 cases (13/21, 61.9%)with associated compressive symptoms such as dyspnea, dysphagia and hoarseness. There was no any indisposed symptom in 3 cases. Conclusion: PTL has some common ultrasonographic and clinical features, core needle biopsy should be warranted to prove PTL.Surgical resection should be considered when needed to reduce misdiagnosis.

Multicentre randomized controlled trial with sensor-augmented pump vs multiple daily injections in hospitalized patients with type 2 diabetes in China: Time to reach target glucose

AIM

Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM).

METHODS

Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day.

RESULTS

When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05].

CONCLUSION

SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.

Biogenic silica composition and δ13C abundance in the Changjiang (Yangtze) and Huanghe (Yellow) Rivers with implications for the silicon cycle

The study was carried out to address a method for separation of terrestrial and marine biogenic silica (BSi) in estuaries based on BSi compositions and δ¹³C values in BSi associated organic matter (δ¹³C_BSi). We used two world-class major rivers - the Changjiang (Yangtze) and Huanghe (Yellow) Rivers as examples to illustrate our approach. Our results for these rivers indicate that riverine BSi is comprised mainly of phytoliths and diatoms. River BSi concentrations vary with terrestrial inputs and in-stream primary production. Although the fluvial BSi sources are complex, the terrestrial δ¹³C_BSi signals are quite unique (-24.7±0.8), significantly lower than the marine δ¹³C_BSi values (-21.3±0.07, central Yellow Sea) (p<0.01). Thus, the variation of δ¹³C within BSi organic matter can provide terrestrial source information on the biogeochemistry of silicon in estuaries and the adjacent shelf. The δ¹³C_BSi combination could potentially act as an efficient tool to study environmental change in coastal areas on decadal time-scales since this index may respond to variable terrestrial fluxes from land, as well as to changed phytoplankton assemblages in the coastal ocean.

Composition and variability in the export of biogenic silica in the Changjiang River and the effect of Three Gorges Reservoir

Silicon (Si) plays an essential role in biogeochemical processes, but is still poorly characterized in the river system. This study addressed the biogenic silica (BSi) composition, origin and variation in the Changjiang River, and estimated the impacts of natural processes and human activities on the river Si cycling. Our results indicate that phytoliths comprised 14%-64% of BSi, while diatoms accounted for 34%-85% of BSi. The Changjiang River transported 620Ggyr(-1) of BSi and 2100Ggyr(-1) of dissolved silicate (DSi) loadings, respectively; 55% of the BSi and 51% of the DSi fluxes are transported during the high discharge period from June to September. The Changjiang River carried phytolith BSi mostly comes from the middle and lower reaches area. The ratio of BSi/(BSi+DSi) has decreased from 0.47 before 1980 to 0.19 in 2013-2014 due to the direct retention of BSi. The BSi sedimentation in the Three Gorges Reservoir would cause a decrease of total reactive silica, but contribute to approximately 4%-16% of the DSi loading at the Jiangyin station due to its dissolution. This study demonstrates that phytoliths represent a significant contribution to the biogeochemical cycle of silica in coastal waters, and in-stream process exerts a great influence on the river Si loading and cycling.

Phosphorus speciation, transformation, and preservation in the coastal area of Rushan Bay

Phosphorus (P) speciation, burial, and transformation are poorly constrained under low-oxygen conditions. Sequential chemical extraction techniques, in-situ incubation, and laboratory incubation were employed to explore P cycling in the low-oxygen area of coastal Rushan. The study determined that the total P concentrations in the coastal area of Rushan Bay were higher than those of other China shelf seas, and largely affected by anthropogenic activities. The phosphate (DRP) fluxes in the study area calculated using an incubation method (0-1960μmolm(-2)day(-)(1)) and measured based on pore water gradients (1.5-50.4μmolm(-2)day(-)(1)) were both highly correlated with oxygen conditions. Sediment incubations showed that DRP diffusion from the sediment mainly originates from Fe-P and Auth-P dissolution and that Org-P recycling contributed only a small portion of the total released P pool. The benthic phosphate flux can be 60 times higher under low bottom-water oxygen levels of 63-150μmolL(-1) than under oxygen levels exceeding 150μmolL(-1) in the study area. The P accumulation rates and burial efficiencies in this study area ranged from 16.5-33.3μmolcm(-2)year(-1) and 81.1-83.4%, respectively, and were regulated by the oxygen level and diffusive DRP flux. This study indicates that low oxygen levels between 63 and 150μmol significantly govern P transformation and preservation in the sediment and P pools in the water column.

Generation and Characterization of Patient-Specific iPSC Model for Cardiovascular Disease

Advances in differentiation of cardiomyocytes from human induced pluripotent stem cell (hiPSC) were emerged as a tool for modeling of cardiovascular disease that recapitulates the phenotype for the purpose of drug screening, biomarker discovery, and testing of single-nucleotide polymorphism (SNP) as a modifier for disease stratification. Here, we describe the (1) retroviral reprogramming strategies in the generation of human iPSC, (2) methodology in characterization of iPSC in order to identify the stem cell clones with the best quality, and (3) protocol of cardiac differentiation by modulation of Wnt signaling and β-catenin pathway.

Systemic lupus erythematosus patients in the low-latitude plateau of China: altitudinal influences

The current study was to investigate the features of hospitalized patients with systemic lupus erythematosus (SLE) at different altitudes. The correlation between SLE activity and altitudinal variations was also explored. Medical records of 1029 patients were retrospectively reviewed. Activity of SLE in each organ system was recorded using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). There was no significant correlation between SLE activity and altitudes (r = 0.003, p = 0.159). Age at onset for SLE patients at high altitudes was significantly younger than that at low and moderate altitudes (p = 0.022 and p = 0.004, respectively). Age at SLE admission at low altitudes was significant older than those at moderate and high altitudes (p = 0.011 and p < 0.001, respectively). Patients at high altitudes had shorter duration from disease onset to admission than those at moderate altitudes (p = 0.009). Incidence of Sm antibodies-positive for resident patients at high altitudes was 36.4%, which were higher than that at moderate altitudes (p = 0.003). We found increasing trends of CNS activity in active patients; immunological and renal activities in inactive patients were correlated with elevated altitudes (p = 0.024, p = 0.004, p = 0.005), while arthritis scores in active patients showed the tendency of decreasing with the rise of elevation (p = 0.002). Hemoglobin level, red blood cell and platelet counts at high altitudes were significantly lower than those at low altitudes (p < 0.05, respectively). There was no significant difference in hemoglobin level between moderate- and low-altitude groups (p > 0.05). No significant difference in platelet counts between moderate- and high-altitude groups was observed (p > 0.05). Our findings suggest that some clinical features, laboratory tests and activity of main organs in SLE are influenced by altitudes. Furthermore, organ activities of active and inactive SLE patients have different patterns of altitudinal variations. These distinctive variations likely reveal that peculiar environmental factors at high altitudes can affect the development of SLE.

Molecular imaging of pancreatic islet transplantation

Islet replacement therapy, pancreatic islet transplantation, is considered as a potential option for curing T1DM. However, the significant loss of implanted islets after islet transplantation prevents it from becoming a mainstream treatment modality. Due to the lack of reliable noninvasive real-time imaging techniques to track the survival of the islets, it is impossible to discover the specific causes for the loss of implanted islets, not to mention taking interventions in the early stage. Current achievements in molecular imaging has provided with several promising techniques, including optical imaging, PET and MRI, for noninvasive visualization, quantification and functional evaluation of transplanted islets in experimental conditions. Optical imaging seems to be the most convenient and cost-efficient modality, but the limited penetration distance hinders its application in large animal and human studies. PET combined with target-specific tracers is characterized by high specificity and sensitivity for detection of islet grafts, but observation time is rather short (i.e., several hours). MRI stands out for its long-term visualization of transplanted islet grafts with the aid of contrast agents. However, quantification of islets remains a problem to be solved. A novel technique, microencapsulation, provides a new perspective in multimodal imaging by optimizing the strengths of several modalities together. Although the application of molecular imaging in clinical settings is still limited, significant success and valuable information is achieved in the basic and clinical trials. However, islet transplantation still remains an experimental procedure, with ongoing researches focusing on islets availability, appropriate sites for implantation, new methods using biomaterials (e.g. microencapsulation), immune modulation and more.

The association of plasma free amino acids with liver enzymes in Type 2 diabetic patients

BACKGROUND

Elevated γ-glutamyl transpeptidase (GGT) and alanine aminotransferase (ALT) could predict the risk of Type 2 diabetes (T2D), but the reason for their elevation was unclear. GGT and ALT mediated the metabolism of many amino acids (AA). Up to now, it was not investigated whether abnormal AA concentration was associated with elevated liver enzymes.

AIM

This study was to investigate the status of AA in T2D and their relationship with liver enzymes.

SUBJECTS AND METHODS

A total of 132 T2D patients and 137 healthy controls were recruited. Plasma free AA were measured by high-performance liquid chromatography. The contribution of individual AA to liver enzymes was assessed by stepwise linear regression.

RESULTS

a) The levels of alanine, valine, leucine, isoleucine, phenylalanine, tyrosine, methionine, glutamate, and lysine were higher while the level of glycine was lower in T2D than in controls (all p<0.01). b) Glutamate contributed to GGT in T2D, and its contribution was even greater than that of waist circumference. Leucine, lysine, and glutamate contributed to ALT.

CONCLUSION

There were significant differences in plasma AA profile between T2D and controls. Abnormal AA might contribute to elevated liver enzymes. The interaction between AA, liver enzymes, and the risk of T2D should be further investigated by prospective studies.

A clinical analysis of diabetic patients with hand ulcer in a diabetic foot centre

AIMS

The aim of the study was to explore the prevalence and clinical characteristics of hand ulcer in hospitalized patients with diabetes.

METHODS

We analysed 17 subjects with hand ulcer among diabetic inpatients, who were admitted to the Diabetic Foot Care Center, Department of Endocrinology and Metabolism at the West China Hospital of Sichuan University from April 2003 to December 2008.

RESULTS

The prevalence of diabetic hand ulcer among hospitalized patients (0.37%) was significantly lower than that of diabetic foot ulcers (9.7%, P = 0.000). The mean age was 62.1 +/- 9.4 years. The average known durations of diabetes and glycated haemoglobin (HbA(1c)) were 5.3 +/- 4.9 years and 10.9 +/- 2.4%, respectively. All patients lived in the subtropical zone. Fifteen patients (88.2%) were diagnosed with diabetic peripheral neuropathy. Ten patients had hand infection. After therapy, the ulcers healed in 13 patients (76.5%) and none of them experienced amputation. The average hospital stay for patients with local infection was characteristically longer than that for patients without infection (P = 0.012). The prognosis of the hand ulcer was poorer in the patients who had diabetes for > 3 years compared with those who had diabetes for < 3 years (P = 0.009).

CONCLUSIONS

Diabetic hand ulcer is a relatively rare complication of diabetes in South-West China. Long duration of diabetes, poorly controlled blood glucose, minor trauma and delayed treatment are the risk factors. Diabetic peripheral neuropathy may play an important role in the pathogenesis of hand ulcer. Early control of blood glucose with insulin and early anti-microbial therapy with appropriate antibiotics are crucial. Debridement and drainage are necessary for hand abscesses.

Sterol regulatory element-binding protein-1c knockdown protected INS-1E cells from lipotoxicity

OBJECTIVE

The reduction in insulin secretory capacity and beta-cell mass has been attributed, at least partially, to lipotoxicity, which may contribute to the development of type 2 diabetes. Chronic free fatty acids (FFA) exposure impairs pancreatic beta-cell function and induces beta-cell apoptosis. This study is to elucidate the underlying molecular mechanisms.

RESEARCH DESIGN AND METHODS

We exposed INS-1E pancreatic beta-cell line to palmitate or oleate, and measured the glucose stimulated insulin secretion (GSIS). The effect of FFA on sterol regulatory element-binding protein (SREBP)-1c lipogenic pathway, and expression of genes involved in beta-cell functions, including AMPK (AMP-activated protein kinase), UCP-2 (uncoupling protein-2), IRS-2 (insulin receptor substrate-2), PDX-1 (pancreatic duodenal homeobox-1), GLUT-2 (glucose transporter-2) and B cell lymphoma/leukaemia-2 (Bcl-2) were investigated. Apoptosis of these exposed cells was determined by MitoCapture, Annexin V-Cy3 or terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Cell lipid accumulation was measured by oil red O staining or TG extraction. Also SREBP-1c expression knockdown were used.

RESULTS

FFA treatment resulted in SREBP-1c overexpression, impaired GSIS, lipid accumulation, apoptosis of INS-1E cells. In addition, the expression of lipogenic genes and UCP-2 were upregulated, but AMPK, IRS-2, PDX-1, GLUT-2 and Bcl-2 were downregulated in the exposed cells. However, these lipotoxic effects of FFA were largely prevented by induction of a SREBP-1c small interfering RNA.

CONCLUSIONS

These data suggest a strong correlation between FFA treatment and SREBP-1c activation in INS-1E cells. SREBP-1c might be a major factor responsible for beta-cell lipotoxicity, and SREBP-1c knockdown could protect INS-1E cells from lipotoxicity, which is implicating a therapeutic potential for treating diabetes related to lipotoxicity.