Allelochemicals and activities in a replanted Chinese fir (Cunninghamia lanceolata (Lamb.) Hook) tree ecosystem

Autotoxicity is a major reason for replant problems in managed tree ecosystems. Studies have related phenolics-based allelochemicals to autotoxicity. We selected a 20-year-old replanted Chinese fir [Cunninghamia lancealata (Lamb.) Hook] tree ecosystem to isolate, identify, determine the biological activity of, and quantify soil phytotoxins. Eight common phenolics (coumarin, vanillin, isovanillin, and p-hydroxybenzoic, vanillic, benzoic, cinnamic, and ferulic acids), friedelin, and a novel cyclic dipeptide (6-hydroxy-1,3-dimethyl-8-nonadecyl-[1,4]-diazocane-2,5-diketone) were obtained by using the bioassay-guided isolation technique from toxic soil of the replanted Chinese fir tree ecosystem. Chemical structures were determined by spectroscopic means, including 2D-NMR (COSY, HMQC, HMBC, and NOESY) experiments. High concentrations of soil phenolics and friedelin were observed in the natural evergreen broadleaf forest (CK) rather than in the Chinese fir tree ecosystem. The phenolics and friedelin were not phytotoxic to Chinese fir trees. However, the cyclic dipeptide inhibited Chinese fir growth at soil concentrations determined in the replanted Chinese fir tree ecosystem. There was a significantly higher soil concentration of cyclic dipeptide in the replanted Chinese fir tree ecosystem than in a fresh Chinese fir tree ecosystem. The results suggest that phenolics and friedelin are not key allelochemicals since they are weakly phytotoxic and are detected in low concentrations in the replanted Chinese fir tree ecosystem, while cyclic dipeptide is a highly active allelochemical with a phytotoxic effect that limits offspring growth in the replanted Chinese fir tree ecosystem. The discovery of cyclic dipeptide, as well as a further understanding of its potential action mechanism in the replanted Chinese fir tree ecosystem, may contribute to solving the replant problems in managed tree ecosystems.

Temporal and spatial expression of TGF-beta2 in tooth crown development in mouse first lower molar

Transforming Growth Factor beta2 (TGF-beta2) is involved in the regulation of many important cellular processes during tooth development. In this study we systematically characterized the expression pattern of TGF-beta2 in vivo and further analyzed its possible roles during different developmental stages of mouse first lower molar using immunofluorescence histochemical method with confocal microscopy. TGF-beta2 signaling was detected in different developing stages in both dental epithelium and surrounding dental mesenchyme. For the first time, we found that the basement membrane and epithelial cells in the basal layer showed no immunostaining from embryonic day 11 to 13; the primary enamel knot and secondary enamel knot exhibited pronounced immunostaining with different expression patterns at embryonic day 14 and 16. In addition, the mature ameloblast lost immunoreactivity, but the secretory ameloblast still exhibited positive immunoreaction at day 2 of postnatal development. Collectively, the temporospatial distribution patterns of TGF- beta2, especially in the basement membrane, epithelial cells in the basal layer, enamel knot, mature odontoblast and ameloblast, suggested a close association between TGF-beta2 signaling and tooth crown development, and indicated that TGF-beta2 might participate in tooth initiation, epithelial morphogenesis, formation of dentine matrix, and ameloblast differentiation.

Catalytic growth of metallic tungsten whiskers based on the vapor-solid-solid mechanism

Metallic W whiskers with tip diameters of 50-250 nm and lengths of 2-4 µm have been successfully synthesized in large quantities using Co-Ni alloyed catalysts. The relatively low growth temperature of 850 °C and the large catalyst size (over 100 nm) suggest that the growth of the W whiskers must be governed by the vapor-solid-solid mechanism. Our results show that the vapor-solid-solid model is suitable not only for the growth of nano-scaled whiskers with diameters below 100 nm, but also for submicro-scaled whiskers with diameters well above 100 nm. This technique has great potential to synthesize well controlled metallic whiskers.

Atmospheric distribution of particulate- and gas-phase phthalic esters (PAEs) in a Metropolitan City, Nanjing, East China

Phthalic acid esters (PAEs) are used in many branches of industry and are produced in huge amounts throughout the world. An investigation on particulate- and gas-phase distribution of PAEs has been conducted in Nanjing (China). The 12-h daily sampling program (from 8:00 am to 8:00 pm) for ten consecutive days was conducted in April, July and October 2005, and in January 2006 at about 1.5m above the ground level. For comparative purposes, sampling events were simultaneously conducted at two stations, one at the urban center and the other about 12 km from city center for suburban background monitoring. It was observed that the most abundant members of the PAE group were dimethyl phthalate (DMP) (10.1 ng m(-3), average), diethyl phthalate (DEP) (3.4 ng m(-3)), dibutyl phthalate (DBP) (58.8 ng m(-3)), butylbenzyl phthalate (BBP) (3.2 ng m(-3)), di-2-ethylhexyl phthalate (DEHP) (20.3 ng m(-3)) and di-n-octyl phthalate (DOP) (1.2 ng m(-3)). The average contribution of PAEs in the gas phase to the total PAE concentration (Sigma(6)PAE, sum of six PAE congeners) ranged from 75.0% to 89.2%. Both particulate- and gas-phase Sigma(6)PAE concentrations decreased with increasing temperature. Experimentally determined gas-particle partitioning (K(p)) of PAEs is well-correlated with their vapor pressure. The Sigma(6)PAE levels in the urban area are approximately 3.5 times as high as the levels found at the suburban station. The vertical profiles from 1.5 to 30.0m above the ground display slight height dependence.

In vitro cell culture model for anti-cataract drug penetration studies

Immortalized human corneal epithelial cells (HCECs) and human lens epithelial cells (HLECs) were cultured in vitro. Cells were observed under a phase-contrast microscope and the integrity of cell monolayers was assayed by transepithelial electrical resistance (TEER) determination. The permeability of disulfiram (DSF) through a HCECs monolayer was compared with that of DSF through an excised rabbit cornea. The permeability coefficients of DSF through a HCECs monolayer and excised rabbit cornea were 29.5 +/- 4.8 x 10(-6) cm/s and 34.7 +/- 5.2 x 10(-6) cm/s, respectively. Diethyldithiocarbamate (DDC) had high permeability through HLECs monolayer with a permeability coefficient of 44.6 +/- 7.1 x 10(-6) cm/s. The cytotoxicity of DDC against HLECs was investigated using the trypan blue exclusion test. For a DDC concentration of 5 mmol/l, more than 85% cells were viable. DH3a1 mRNA was expressed in cultured HLECs. The expression of aldehyde dehydrogenase 3a1 (ALDH3a1), which may be be responsible for DSF-DDC conversion, was detected using RT-PCR and agarose gels electrophoresis. These results demonstrate that the permeability of DSF can be detected and intra-ocular drug action may be predicted using the cultured HCEC and HLEC monolayers as model.

Nitric oxide mediates the inhibitory effect of ethanol on the motility of isolated longitudinal muscle of proximal colon in rats

The aim of the present study was to investigate the effect of ethanol on colon motility in rats and to test the possibility that nitric oxide (NO) mediates this effect. Proximal colon longitudinal muscle strips (LM) (8 x 3 mm) cut parallel to the longitudinal muscle fibres of the colon were isolated and mounted in an organ bath. Ethanol (0.57, 0.87 and 1.30 mmol L(-1)) dose-dependently inhibited the motility of LM. Longitudinal muscle strips from female rats were more sensitive to the inhibitory effect of ethanol than that from male rats. L-NAME (N-nitro-L-arginine methyl ester) (100 micromol L(-1)), AG (aminoguanidine) (10 micromol L(-1)), ODQ (1H-[1,2,4]Oxadiazolo[4,3-a]quinoxalin-1-one) (10 micromol L(-1)) and PTIO (2-Phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl 3-oxide) (200 micromol L(-1)) partly blocked the inhibitory effect of ethanol on LM. Pretreatment with L-NAME, AG, ODQ and PTIO abolished the sex difference of the inhibitory effect of ethanol on LM. Tetrodotoxin (TTX) (10 micromol L(-1)) partly blocked the inhibitory effect but did not influence the sex difference. The relaxation of LM induced by SNP (sodium nitroprusside) (0.1-10 micromol L(-1)) in female rats was greater than that in male rats. In conclusion, ethanol inhibited the colon motility in vitro. This inhibitory effect on LM was mediated by NO through the iNOS - NO - cGMP pathway.

The removal and recovery of Cr(VI) by Li/Al layered double hydroxide (LDH)

Hexavalent Cr has been identified as one of the toxic metals commonly present in industrial effluents. Among the treatment techniques developed for removing Cr(VI) from waste waters, sorption is most commonly applied, due to its simplicity and efficiency. However, few adsorbents can be recycled and reused cost-effectively. In this study, the removal and recovery of Cr(VI) from water using Li/Al LDH was investigated. The removal of Cr(VI) by Li/Al LDH was evaluated in a batch mode. The results demonstrated that Cr(VI) adsorption onto Li/Al LDH occurs by replacing the Cl(-) that originally exists in the interlayer of the adsorbent. The degree of Cr(VI) adsorption observed for Li/Al LDH was relatively high and the process occurred rapidly; however, a portion of adsorbed Cr(VI) was gradually desorbed, due to the Li de-intercalation of Li/Al LDH. Lithium de-intercalation from Li/Al LDH with interlayer Cl(-) and interlayer Cr(VI) follows the first order kinetics and has the activation energies of 76.6 and 41.5 kJ mol(-1), respectively. The properties of thermal unstability and the high adsorption capacity of Li/Al LDH may lead to the development of an innovative technique for the removal of Cr(VI) from Cr(VI)-containing wastewater. That is, Li/Al LDH may be used as an effective adsorbent for the adsorption of Cr(VI) in an ambient environment. Following the adsorptive process, the adsorbed Cr(VI) may be released, using heated water to treat the Cr(VI)-containing Li/Al LDH particles. Through this hydrothermal treatment of the used adsorbent, Cr(VI) can be recovered and the solid product (gibbsite) can be recycled for further use.

Histamine induces interleukin-6 expression in the human synovial sarcoma cell line (SW982) through the H1 receptor

METHODS

The effect of histamine on inositol phosphate generation and interleukin-6 (IL-6) release from the synovial sarcoma cell line SW982 was investigated.

RESULTS

SW982 cells express functional H1 and H2 receptors. The H1 receptor antagonist [3H]-mepyramine binds to membranes from SW982 cells with high affinity and the binding was potently blocked by H1 antagonists. Histamine potently stimulated phosphoinositide (PI) hydrolysis and Ca2+ mobilization with EC50 of 4.0 +/- 0.8 microM and 1.3 +/- 0.6 microM respectively and these activities were blocked by the H1 selective antagonist mepyramine. Histamine (EC50 = 1.8 +/- 1.1 microM) stimulated the release of IL-6 that was attenuated by selective H1 antagonists. The PKC inhibitor, GF1090203X, blocked the histamine stimulated IL-6 release. The H2 selective antagonist, cimetidine, had no significant effect on histamine-induced PI turnover, Ca2+ mobilization and IL-6 release.

CONCLUSION

We conclude that histamine stimulates IL-6 release from SW982 cells by binding to the H1 receptor and this is coupled to the PI/PKC signal transduction pathway. Development of an H1 antagonist that inhibits the release of IL-6 from synoviocytes may be beneficial for the treatment of inflammatory joint disease.

A frequent Y chromosome b2/b3 subdeletion shows strong association with male infertility in Han-Chinese population

BACKGROUND

Azoospermia factor c (AZFc) subdeletions were reported to be significant risk factors for spermatogenesis. In this study, we assessed the occurrence of classical AZF deletions and AZFc subdeletions and their impact on male infertility in a Han-Chinese population.

METHODS

This study analysed a population of 699 subjects, including 451 idiopathic infertile patients with a range of fertility disorders and 248 fertile controls, using a retrospective design. Deletions were identified by multiplex PCR.

RESULTS

The prevalence and phenotypes of the classical AZF deletions were similar to previous studies. Subdeletions of the AZFc region in patients showed similar overall frequencies in all sperm concentration categories of gr/gr (7.0%) and b2/b3 (8.9%). For controls, these subdeletions were also found with a prevalence of gr/gr (7.7%) and b2/b3 (3.2%). b1/b3 deletions were not found either in the patients or in the controls.

CONCLUSION

Our data showed a higher frequency of deletion events in this Han-Chinese population than in populations elsewhere in the world. The classical AZF deletions were the primary genetic factors for spermatogenic failure, while no significant association was found for AZFc subdeletions with sperm concentration. However, the b2/b3 subdeletion was significantly associated with idiopathic male infertility (odds ratio, 2.93; 95% confidence interval 1.34-6.39) (P = 0.005), indicating a potential impairment of male fertility.

The inhibitory effect of magnolol from Magnolia officinalis on glucosyltransferase

Dental caries has been an intractable disease in spite of intense dental research. Glucosyltransferase (GTF) enzyme plays the most important role in the development of dental caries. In our previous studies, magnolol, a compound from Magnolia officinalis Rehder et Wilson (Magnoliaceae), was shown to possess a strong anti-GTF activity. The purpose of the present study was to examine the effect of magnolol on the functional domains of GTF for the purpose of defining its anti-GTF activity mechanism. GTF-I which was prepared from Streptococcus milleri transformant KSB8 cells expressing the gtfB gene was used. The results demonstrated magnolol reduced total glucan synthesis, depending on the magnolol concentration. There were no significant differences in Michaelis constant (K(m)) values between the presence and absence of magnolol as determined by Lineweaver-Burk plot, and maximum velocity (V(m)) in the presence of magnolol was lower than that in its absence. Magnolol significantly inhibited both sucrose hydrolysis and glucosyl transfer to glucan by GTF-I. Free glucose in the presence of magnolol was reduced by 33-48% as compared to in its absence, while the quantity of glucan was reduced by 75-82%. These findings suggested that magnolol inhibited both two sequential reaction phases of GTF non-competitively by operating on the glucan-binding domain, but not on the catalytic domain. Magnolol could be a valuable resource for the exploration of novel bioactive compounds in natural products.

A novel mutation in ALK-1 causes hereditary hemorrhagic telangiectasia type 2

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal-dominant bleeding disorder and has two variants, HHT1 and HHT2, associated with mutations in the ENG and ALK-1 genes, respectively. We identified one Chinese HHT2 family to investigate the pathogenic gene and its possible mechanism of action by mutation screening and functional study. One substitution mutation (1717C>T) in exon 10 of the ALK-1 was found by sequencing of all exons of ENG and ALK-1 and caused a R479X mutation in the ALK-1 protein. ALK-1 mRNA and plasma thrombomodulin were measured by real-time quantitative PCR and ELISA, respectively. There was no significant difference in the expression levels of ALK-1 mRNA between patients and healthy individuals. A significantly higher level of thrombomodulin was found in HHT patients. These findings indicate that the mutation causes truncation of the ALK-1 protein at the post-transcriptional level; the plasma thrombomodulin may provide an easy diagnostic indicator in HHT patients.

Bone marrow cells can give rise to ameloblast-like cells

Post-eruptive loss of ameloblasts requires identification of alternative sources for these cells to realize tooth-tissue-engineering strategies. Recent reports showed that bone-marrow-derived cells can give rise to different types of epithelial cells, suggesting their potential to serve as a source for ameloblasts. To investigate this potential, we mixed c-Kit(+)-enriched bone marrow cells with embryonic dental epithelial cells and cultured them in re-association with dental mesenchyme. Non-dividing, polarized, and secretory ameloblast-like cells were achieved without cell fusion. Before basement membrane reconstitution, some bone marrow cells migrated to the mesenchyme, where they exhibited morphological, molecular, and functional characteristics of odontoblasts. These results show, for the first time, that bone-marrow-derived cells can be reprogrammed to give rise to ameloblast-like cells, offering novel possibilities for tooth-tissue engineering and the study of the simultaneous differentiation of one bone marrow cell subpopulation into cells of two different embryonic lineages.

Temperature variation of film tension above the bulk smectic-A-isotropic transition in freestanding liquid-crystal films

We have measured the temperature variation of film tension above the bulk smectic-A-isotropic transition in freestanding films of two liquid-crystal compounds. Above the transition, the tension increases sharply with temperature, and the slope is proportional to the film's thickness regardless of whether or not the compound exhibits regular layer-by-layer thinning. The data can be interpreted in the context of theoretical models for layer thinning.

Study on the relation between occupational fenvalerate exposure and spermatozoa DNA damage of pesticide factory workers

AIMS

To determine sperm nuclear DNA integrity and to investigate the relation between fenvalerate (FE) exposure and spermatozoa DNA damage.

METHODS

Sperm DNA fragmentation was detected by a modified alkaline single cell gel electrophoresis (Comet) assay and a terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) assay. The olive tail moment (OTM) and percentage tail DNA were measured by the Comet assay, and cell positive percentage was measured by the TUNEL assay for DNA damage evaluation.

RESULTS

The DNA integrity of spermatozoa of external and internal control groups were both significantly greater than that of the FE exposed group. The median value of tail DNA percentage in the exposure group was 11.30, which was significantly higher than 5.60 in the internal control group and 5.10 in the external control group. The median value of OTM was 3.80 in the exposure group, significantly higher than 1.50 in the internal control group and 2.00 in the external control group. Mean cell positive was 31.2% in the exposure group, significantly higher than 17.4% in the internal control and 19.6% in the external control groups. Cell positive (%) was significantly correlated with tail DNA percentage and with OTM of whole subjects (n = 63).

CONCLUSIONS

Results showed that occupational FE exposure is associated with an increase in sperm DNA damage. A combination of the Comet and TUNEL assays would offer more comprehensive information for a better understanding of sperm DNA damage, and the biological significance of sperm DNA damage in sperm function and male infertility.

Demetalation of the Regioselective Oxygenation Product of an N-Confused Porphyrin Complex

[structure: see text] The demetalation of M(III)(HCTPPO)Br (M = Mn or Fe) afforded two hydroxylated N-confused porphyrinoids. CTPPOH retains the tautomer form of the N-confused porphyrin with a hydroxyl group substituted in the inner-core carbon. The further attack of OH(-) to the meso carbon afforded a dihydroxylated N-confused macrocycle, CTPP(OH)(2).

Destruction of parotid glands affects nitrate and nitrite metabolism

The role of salivary glands in nitrate and nitrite metabolism is poorly understood. The aim of the present study was to investigate the effect of parotid gland ablation on dynamic metabolism of nitrate and nitrite in miniature pigs. The parotid glands of 5 healthy miniature pigs were bilaterally ablated by methyl violet. Concentrations of nitrate and nitrite of whole saliva, serum, and urine samples were analyzed by high-performance liquid chromatography. Results showed that bilateral ablation of the parotid glands led to a significant decrease of nitrate secretion from blood to saliva (P < 0.05) and thus low nitrite levels. Dysfunction of the parotid glands temporarily increased the systemic level of nitrate in miniature pigs after nitrate loading. This study suggests that the parotid glands play an important role in the balance of nitrate and nitrite levels in both whole saliva and the body.

[Stable expression of human cytochrome P450 2E1 cDNA in nasopharyngeal cancer cell line CNE-2]

OBJECTIVE

This study as designed to investigate the function of CYP2E1 protein in chemical carcinogen metabolism in vitro and its action mechanisms in nasopharyngeal carcinogenesis.

METHODS

DAN recombination technique was used to construct a eukaryotic expression vector pcDNA3.1-2E1 of human cytochrome P450 2E1 cDNA. The vector was introduced into a nasopharyngeal cancer cell line CNE-2 mediating by lipofectamine. After these transforming cells were treated with G418 for 2 weeks, several G418-resistant clones were selected and amplified in culture.

RESULTS

The authors acquired two cell clones CNE2-2E1-1 and CNE2-2E1-2 with stable integration and expression of exogenous CYPE2E1 cDNA. After Southern blot analysis, RT-PCR and Western blot were fulfilled.

CONCLUSION

The cell models setting here will be a good tool in the further study of CYP2E1. At the same time, its use will help to screen chemical carcinogenesis and to elucidate the mechanism of carcinogenesis which is related to chemical carcinogen activated by CYP2E1.

Distribution of nitric oxide synthase in stomach myenteric plexus of rats

AIM: To study the distribution of nitric oxide synthase (NOS) in rat stomach myenteric plexus.

METHODS: The distribution of NOS in gastric wall was studied in quantity and location by the NADPH-diaphorase (NDP) histochemical staining method and whole mount preparation technique.

RESULTS: NOS was distributed in whole stomach wall, most of them were located in myenteric plexus, and distributed in submucosal plexus. The shape of NOS positive neurons was basically similar, most of them being round and oval in shape. But their density, size and staining intensity varied greatly in the different parts of stomach. The density was 62 ± 38 cells/mm² (antrum), 43 ± 32 cells/mm² (body), and 32 ± 28 cells/mm² (fundus), respectively. The size and staining intensity of NOS positive neurons in the fundus were basically the same, the neurons being large and dark stained, while they were obviously different in antrum. In the body of the stomach, the NOS positive neurons were in an intermediate state from fundus to antrum. There were some beadlike structures which were strung together by NOS positive varicosities in nerve fibers, some were closely adherent to the outer walls of blood vessels.

CONCLUSION: Nitric oxide might be involved in the modulation of motility, secretion and blood circulation of the stomach, and the significant difference of NOS positive neurons in different parts of stomach myenteric plexus may be related to the physiologic function of stomach.

Synthesis and characterization of fluorinated metal arsenates with a layer structure: (C4H12N2)(1.5)[M3F5(HAsO4)2(AsO4)] (M = Fe, Ga)

Two fluorinated metal arsenates, (C(4)H(12)N(2))(1.5)[M(3)F(5)(HAsO(4))(2)(AsO(4))] (M = Fe, Ga), have been synthesized under hydrothermal conditions and characterized by single-crystal X-ray diffraction, magnetic susceptibility, Mössbauer spectroscopy, and (71)Ga NMR spectroscopy. The two compounds are isostructural and crystallize in the monoclinic space group P2(1)/c (No. 14) with a = 8.394(1) A, b = 21.992(3) A, c = 10.847(1) A, beta = 96.188(2) degrees, and Z = 4 for the Fe compound, and a = 8.398(1) A, b = 21.730(3) A, c = 10.679(1) A, beta = 95.318(2) degrees, and Z = 4 for the Ga compound. The structure consists of infinite chains of corner-sharing MX(6) (X = O, F) octahedra and dimers of edge-sharing MO(3)F(3) octahedra, which are linked into two-dimensional sheets through arsenate tetrahedra with diprotonated piperazinium cations between the sheets. Magnetic susceptibility and Mössbauer spectroscopy confirm the presence of Fe(III). The (71)Ga MAS NMR spectrum clearly shows a line shape consisting of three components, corresponding to three crystallographically distinct Ga sites.

A miniaturized liquid core waveguide-capillary electrophoresis system with flow injection sample introduction and fluorometric detection using light-emitting diodes

A novel miniaturized capillary electrophoresis (CE) system is described where a Teflon AF-coated silica capillary serves both as the separation channel and as a transversely illuminated liquid core waveguide. This device uniquely uses flow injection (FI)-based split-flow sample introduction through a falling-drop interface. An H-channel structure fixed on a microscope glass slide utilizes a horizontal separation capillary with tubular sidearms on each end that serve as inlet and outlet flow-through electrode reservoirs. The inlet reservoir also functions as a falling-drop interface for coupling to the FI system. A blue LED is used as excitation source. A large-core optical fiber takes the emitted fluorescence to an inexpensive PMT with two layers of green plastic used for optical filtering. No focusing arrangement is needed. Continuous FI introduction of a series of 30-microL samples containing a mixture of of fluorescein isothiocyanate (FITC)-labeled amino acids allowed a throughput rate up to 144 samples/ h, with approximately 2% carryover and good precision (3.2% RSD). Baseline separation was achieved for FITC-labeled arginine, phenylalanine, glycine, and FITC in sodium tetraborate buffer (pH 9.5) with plate heights of 5.4-5.5 microm and plate numbers of 2.34 x 10(4)-2.37 x 10(4) under electrical field strengths of 214 V/cm for injection and 500 V/cm for separation (14-cm capillary, 48-microm i.d.). Detection limits (S/N = 3) were 1.3 microM for arginine and 1.9 microM for phenylalanine and glycine.

Risk factors for cardiovascular mortality and morbidity: the WHO Mutinational Study of Vascular Disease in Diabetes

AIMS/HYPOTHESIS

We aimed to examine the associations between classic cardiovascular risk factors and diabetes specific factors and the incidence of fatal and non-fatal end-points in a large cohort of diabetic patients.

METHODS

A cohort of 4,743 diabetic patients participating in the WHO Multinational Study of Vascular Disease in Diabetes (WHO MSVDD) has been followed up for about 12 years and the incidence of fatal and non-fatal cardiovascular disease outcomes assessed.

RESULTS

The importance of blood pressure, serum cholesterol and proteinuria as predictors for cardiovascular disease mortality, fatal and non-fatal myocardial infarction and stroke is confirmed for patients with Type I (insulin-dependent) and Type II (non-insulin-dependent diabetes mellitus. Serum triglyceride was associated with cardiovascular disease death in Type II diabetes and in women with Type I diabetes and with MI incidence in Type II diabetes and stroke in Type II diabetic women. Fasting plasma glucose was associated with cardiovascular disease death, incidence of myocardial infarction and stroke in Type II diabetes only. In Type II diabetes, multivariate analysis confirmed that fasting plasma glucose was related to cardiovascular disease mortality independent of other risk factors. The independent relation of triglyceride to cardiovascular disease death was statistically significant only for Type II diabetic men. The presence of retinopathy was related to cardiovascular disease death and incidence of myocardial infarction in both types of diabetes and to stroke in Type II diabetes.

CONCLUSION/INTERPRETATION

This large cohort study shows that the assessment of cardiovascular disease risk in diabetes must include 'diabetes-related' variables such as glycaemic control, proteinuria and retinopathy, as well as the classic risk factors, blood pressure, smoking and dyslipidaemia. [Diabetologia

Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes

AIMS/HYPOTHESIS

We aimed to examine the mortality rates, excess mortality and causes of death in diabetic patients from ten centres throughout the world.

METHODS

A mortality follow-up of 4713 WHO Multinational Study of Vascular Disease in Diabetes (WHO MSVDD) participants from ten centres was carried out, causes of death were ascertained and age-adjusted mortality rates were calculated by centre, sex and type of diabetes. Excess mortality, compared with the background population, was assessed in terms of standardised mortality ratios (SMRs) for each of the 10 cohorts.

RESULTS

Cardiovascular disease was the most common underlying cause of death, accounting for 44 % of deaths in Type I (insulin-dependent) diabetes mellitus and 52 % of deaths in Type II (non-insulin-dependent) diabetes mellitus. Renal disease accounted for 21% of deaths in Type I diabetes and 11% in Type II diabetes. For Type I diabetes, all-cause mortality rates were highest in Berlin men and Warsaw women, and lowest in London men and Zagreb women. For Type II diabetes, rates were highest in Warsaw men and Oklahoma women and lowest in Tokyo men and women. Age adjusted mortality rates and SMRs were generally higher in patients with Type I diabetes compared with those with Type II diabetes. Men and women in the Tokyo cohort had a very low excess mortality when compared with the background population.

CONCLUSION/INTERPRETATION

This study confirms the importance of cardiovascular disease as the major cause of death in people with both types of diabetes. The low excess mortality in the Japanese cohort could have implications for the possible reduction of the burden of mortality associated with diabetes in other parts of the world.

Risk factors for renal failure: the WHO Mulinational Study of Vascular Disease in Diabetes

AIMS/HYPOTHESIS

We aimed to examine risk factors for, and differences in, renal failure in diabetic patients from 10 centres.

METHODS

Risk factors for renal failure were examined in 3,558 diabetic patients who did not have renal disease at baseline in the WHO Multinational Study of Vascular Disease in Diabetes (WHO MSVDD).

RESULTS

In 959 subjects with Type I (insulin-dependent) diabetes mellitus and 2,559 with Type II (non-insulin-dependent) diabetes mellitus, the average follow-up was 8.4 years (+/- 2.7). By the end of the follow-up period 53 patients in the Type I diabetic group and 134 patients in the Type II diabetic group had developed renal failure (incidence rate 6.3:1,000 person years). Increasing age and duration of diabetes were associated with renal failure in Type II and Type I diabetes. In Type II diabetes duration of diabetes was a more important risk factor than age. In both Type I and Type II diabetic retinopathy and proteinuria were strongly associated with renal failure. Systolic blood pressure was associated with renal failure in Type I but not in Type II diabetic patients. ECG abnormalities at baseline, self-reported smoking and cholesterol were not associated with renal failure. Triglycerides were measured in a subset of centres. Among those with Type II, but not Type I diabetes, triglycerides were associated with renal failure independently of systolic blood pressure, proteinuria or retinopathy. In Type II diabetes fasting plasma glucose was associated with renal failure independently of other risk factors.

CONCLUSION/INTERPRETATION

We have confirmed the role of proteinuria and retinopathy as markers of renal failure and the importance of hyperglycaemia in renal failure in Type I and Type II diabetes. Plasma triglycerides seem to be an important predictor of renal failure in Type II diabetes. In Type I diabetes systolic blood pressure is an important predictor of renal failure.