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Sardeli AV, Gáspari AF, Santos WMD, Moraes DFG, Gadelha VB, Santos LDC, Ferreira MLV, Prudêncio SMDJ, Bonfante ILP, Rodrigues B, Cavaglieri CR, Fernhall B, Chacon-Mikahil MPT. Time-course of health-related adaptations in response to combined training in hypertensive elderly: immune and autonomic modulation interactions. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201800040007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Amanda V. Sardeli
- Universidade Estadual de Campinas, Brazil; Universidade Estadual de Campinas, Brazil
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Kim SE, Park KM, Park J, Ha SY, Kim SE, Lee BI, Shin KJ. Vascular factors and neuropathy in lower limb of diabetic patients. J Clin Neurosci 2018; 59:130-135. [PMID: 30420207 DOI: 10.1016/j.jocn.2018.10.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/27/2018] [Indexed: 01/30/2023]
Abstract
Asymmetric clinical presentation in some patients with diabetic polyneuropathy may result from the different vascular environments in both lower limbs. The aim of the study is to determine the association of neuropathy with vascular factors in each lower limb of diabetic patients. A total of 102 patients (204 lower limbs) given a diagnosis of diabetic polyneuropathy were enrolled. The primary end points are sensory nerve action potential (SNAP) amplitude and conduction velocity (CV) of the sural nerve and independent variables are vascular and nonvascular factors. Vascular factors include mean arterial pressure and pulse pressure at the ankle, ankle-brachial index, and arterial stiffness assessed by pulse wave velocity. Nonvascular factors include age, gender, height, body weight, body mass index, total cholesterol, and hemoglobin A1C. Age, hemoglobin A1C, and ankle pulse pressure were inversely correlated with SNAP amplitude of the sural nerve, while no factors were correlated with CV of the sural nerve. Increased arterial stiffness was significant in the limbs group with abnormal SNAP amplitude of the sural nerve, while increased height was significant in the limbs group with abnormal CV of the sural nerve. Vascular factors were more significantly associated with decreased SNAP amplitude rather than decreased CV of the sural nerve in the nerve conduction study of diabetic patients.
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Affiliation(s)
- Si Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Jinse Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Sam Yeol Ha
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Byung In Lee
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea.
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Jaeger A, Zollinger L, Saely CH, Muendlein A, Evangelakos I, Nasias D, Charizopoulou N, Schofield JD, Othman A, Soran H, Kardassis D, Drexel H, Eckardstein AV. Circulating microRNAs -192 and -194 are associated with the presence and incidence of diabetes mellitus. Sci Rep 2018; 8:14274. [PMID: 30250222 PMCID: PMC6155281 DOI: 10.1038/s41598-018-32274-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/31/2018] [Indexed: 01/19/2023] Open
Abstract
We sought to identify circulating microRNAs as biomarkers of prevalent or incident diabetes. In a pilot study of 18 sex- and age-matched patients with metabolic syndrome, nine of whom developed diabetes during 6 years of follow-up, an array of 372 microRNAs discovered significantly elevated serum levels of microRNAs -122, -192, -194, and -215 in patients who developed diabetes mellitus type 2 (T2DM). In two cross-sectional validation studies, one encompassing sex- and age-matched groups of patients with T2DM, impaired fasting glucose (IFG) and euglycemic controls (n = 43 each) and the other 53 patients with type 1 diabetes and 54 age- and BMI-matched euglycemic controls, serum levels of miR-192, miR-194, and mi215 were significantly higher in diabetic subjects than in probands with euglycemia or IFG. In a longitudinal study of 213 initially diabetes-free patients of whom 35 developed diabetes during 6 years of follow-up, elevated serum levels of microRNAs 192 and 194 were associated with incident T2DM, independently of fasting glucose, HbA1c and other risk factors. Serum levels of miR-192 and miR-194 were also elevated in diabetic Akt2 knockout mice compared to wild type mice. In conclusion, circulating microRNAs -192 and -194 are potential biomarkers for risk of diabetes.
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Affiliation(s)
- Andrea Jaeger
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Lukas Zollinger
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Christoph H Saely
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Axel Muendlein
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Ioannis Evangelakos
- University of Crete Medical School and Institute of Molecular Biology and Biotechnology-FORTH, Heraklion, Greece
| | - Dimitris Nasias
- University of Crete Medical School and Institute of Molecular Biology and Biotechnology-FORTH, Heraklion, Greece
| | - Nikoleta Charizopoulou
- University of Crete Medical School and Institute of Molecular Biology and Biotechnology-FORTH, Heraklion, Greece
| | - Jonathan D Schofield
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Alaa Othman
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Handrean Soran
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Dimitris Kardassis
- University of Crete Medical School and Institute of Molecular Biology and Biotechnology-FORTH, Heraklion, Greece
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Arnold von Eckardstein
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland.
- Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
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Hammoudi N, Jeong D, Singh R, Farhat A, Komajda M, Mayoux E, Hajjar R, Lebeche D. Empagliflozin Improves Left Ventricular Diastolic Dysfunction in a Genetic Model of Type 2 Diabetes. Cardiovasc Drugs Ther 2018. [PMID: 28643218 DOI: 10.1007/s10557-017-6734-1] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Cardiovascular (CV) diseases in type 2 diabetes (T2DM) represent an enormous burden with high mortality and morbidity. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently emerged as a new antidiabetic class that improves glucose control, as well as body weight and blood pressure with no increased risk of hypoglycemia. The first CV outcome study terminated with empagliflozin, a specific SGLT2 inhibitor, has shown a reduction in CV mortality and in heart failure hospitalization, suggesting a beneficial impact on cardiac function which remains to be demonstrated. This study was designed to examine the chronic effect of empagliflozin on left ventricular (LV) systolic and diastolic functions in a genetic model of T2DM, ob/ob mice. METHODS AND RESULTS Cardiac phenotype was characterized by echocardiography, in vivo hemodynamics, histology, and molecular profiling. Our results demonstrate that empagliflozin significantly lowered HbA1c and slightly reduced body weight compared to vehicle treatment with no obvious changes in insulin levels. Empagliflozin also improved LV maximum pressure and in vivo indices of diastolic function. While systolic function was grossly not affected in both groups at steady state, response to dobutamine stimulation was significantly improved in the empagliflozin-treated group, suggesting amelioration of contractile reserve. This was paralleled by an increase in phospholamban (PLN) phosphorylation and increased SERCA2a/PLN ratio, indicative of enhanced SERCA2a function, further supporting improved cardiac relaxation and diastolic function. In addition, empagliflozin reconciled diabetes-associated increase in MAPKs and dysregulated phosphorylation of IRS1 and Akt, leading to improvement in myocardial insulin sensitivity and glucose utilization. CONCLUSION The data show that chronic treatment with empagliflozin improves diastolic function, preserves calcium handling and growth signaling pathways and attenuates myocardial insulin resistance in ob/ob mice, findings suggestive of a potential clinical utility for empagliflozin in the treatment of diastolic dysfunction.
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Affiliation(s)
- Nadjib Hammoudi
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Sorbonne Universités, UPMC University Paris 06, Institut de Cardiologie (AP-HP), Centre Hospitalier Universitaire Pitié-Salpêtrière, Institute of Cardiometabolism and Nutrition (ICAN), INSERM UMRS 1166, Paris, France
| | - Dongtak Jeong
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Rajvir Singh
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ahmed Farhat
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Graduate School of Biological Sciences, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Michel Komajda
- Sorbonne Universités, UPMC University Paris 06, Institut de Cardiologie (AP-HP), Centre Hospitalier Universitaire Pitié-Salpêtrière, Institute of Cardiometabolism and Nutrition (ICAN), INSERM UMRS 1166, Paris, France
| | - Eric Mayoux
- Boehringer Ingelheim Pharma GmbH & Co. KG, Cardio-metabolic Diseases, Binger Straße 173, 55216, Ingelheim am Rhein, Germany
| | - Roger Hajjar
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Djamel Lebeche
- Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. .,Graduate School of Biological Sciences, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. .,Diabetes, Obesity and Metabolism Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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55
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Jung SY, Jung J, Byun JY, Park MS, Kim SH, Yeo SG. The effect of metabolic syndrome on Bell's palsy recovery rate. Acta Otolaryngol 2018; 138:670-674. [PMID: 29374993 DOI: 10.1080/00016489.2018.1425902] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study investigated the effects metabolic syndrome (MetS) and its factors such as diabetes mellitus (DM), hypertension (HTN), obesity, hypertriglyceridemia (high TG) and low high-density lipoprotein cholesterol (low HDL-C) on the recovery rate of patients with BP. METHODS The medical records of 124 patients with BP were retrospectively reviewed. Patients were divided into a MetS group and a Non-MetS group according to the diagnostic criteria of MetS, and the demographic and clinical characteristics of the two groups at baseline and six months after BP onset were analyzed. RESULTS Age was significantly higher in the MetS group than in the Non-MetS group (p < .05), but there were no significant differences in sex ratio, initial House-Brackmann (H-B) grade, initial electroneurography and initial electromyography (p > .05). The most common comorbidity of BP was high TG, followed by low HDL-C, HTN, obesity and DM. There were no differences in initial H-B grade in patients with and without each component of the MetS (p > .05). The recovery rate of BP was significantly lower in the MetS than in the Non-MetS group and was particularly affected by DM, obesity and high TG. CONCLUSIONS Recovery rate op BP is lower in patients with than without MetS.
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Affiliation(s)
- Su Young Jung
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Junyang Jung
- Department of Anatomy, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jae Yong Byun
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Moon Suh Park
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Sang Hoon Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung Geun Yeo
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
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Dorsey-Treviño EG, Contreras-Garza BM, González-González JG, Álvarez-Villalobos N, Salcido-Montenegro A, Díaz González-Colmenero A, Farrell AM, González-Nava V, Rodríguez-Tamez G, Montori VM, Rodriguez-Gutierrez R. Systematic review and meta-analysis of the effect of SGLT-2 inhibitors on microvascular outcomes in patients with type 2 diabetes: a review protocol. BMJ Open 2018; 8:e020692. [PMID: 29961013 PMCID: PMC6042602 DOI: 10.1136/bmjopen-2017-020692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Sodium glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new drug-class of glucose-lowering medications. Several trials and systematic reviews have demonstrated their beneficial effect on some macrovascular outcomes. Their effect on microvascular outcomes has been reported as positive in several trials, however, their effect remains uncertain. Therefore, we report the protocol of a systematic review and meta-analysis aimed at determining the effect of SGLT-2 inhibitors regarding patient-important and surrogate microvascular outcomes in patients with type 2 diabetes. METHODS AND ANALYSIS A comprehensive search will be conducted to find eligible articles from each database's earliest inception to November 2017. These databases will include Ovid, MEDLINE, EMBASE, Web of Science, and Scopus. We will search for randomized controlled trials (RCTs) that compare any of the SGLT-2 inhibitors with any other active treatment or placebo assessing microvascular outcomes in either their primary or secondary outcomes. Reviewers working independently and in duplicate will review all abstracts, and full-text manuscripts for eligibility, and will systematically extract the data and will assess the risk of bias in the included studies. Random-effects models will also be used. ETHICS AND DISSEMINATION The results of the systematic review will be disseminated via publication in a peer-reviewed journal regardless of outcome and will be presented at relevant conferences. The data we will use do not include individual patient data, so ethical approval is not required PROSPERO REGISTRATION NUMBER: CRD42017076460.
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Affiliation(s)
- Edgar Gerardo Dorsey-Treviño
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - Belinda Maricela Contreras-Garza
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - José Gerardo González-González
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
- ResearchUnit, University Hospital “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Neri Álvarez-Villalobos
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
- Knowledge andEvaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Alejandro Salcido-Montenegro
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - Alejandro Díaz González-Colmenero
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - Ann M Farrell
- Mayo Medical Library, Mayo Clinic, Rochester, MN, USA
| | - Victoria González-Nava
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - Giselle Rodríguez-Tamez
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
| | - Victor M Montori
- Knowledge andEvaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - René Rodriguez-Gutierrez
- Endocrinology Division, Department of Internal Medicine, Hospital University "Dr. José E. González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Plataforma INVEST Medicina UANL – KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, México
- Knowledge andEvaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Caldwell A, Morick JN, Jentsch AM, Wegner A, Pavlovic D, Al-Banna N, Lehmann C. Impact of insulin on the intestinal microcirculation in a model of sepsis-related hyperglycemia. Microvasc Res 2018; 119:117-128. [PMID: 29778648 DOI: 10.1016/j.mvr.2018.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/22/2018] [Accepted: 05/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sepsis involves dysfunctional glucose metabolism. Among patients with sepsis, hyperglycemia is frequent and insulin administration has been evaluated for glycemic control to improve patient outcomes. Only few studies have examined the hyperglycemic microcirculation and the impact of insulin on the microvasculature in sepsis. OBJECTIVE To study the functional capillary density (FCD) and leukocyte activation within the intestinal microcirculation in endotoxin-induced experimental sepsis. METHODS In 50 male Lewis rats, endotoxemia was induced with lipopolysaccharide (LPS; 5 mg/kg). Low dose (LD) glucose was administered to avoid insulin-induced hypoglycemia. High dose (HD) glucose was administered to model sepsis-related hyperglycemia. Animals in LD and HD glucose groups received an insulin bolus (1.4 IU/kg). Two hours after LPS administration, intravital microscopy (IVM) of the terminal ileum was performed, and FCD and leukocyte adherence were measured in a blinded fashion. Blood glucose levels were measured every 30 min following the onset of endotoxemia. Plasma samples were collected 3 h after the onset of endotoxemia to measure IFN-γ, TNF-α, IL-1α, IL-4, GM-CSF and MCP-1 levels using multiplex bead immunoassay. RESULTS Endotoxemia significantly reduced FCD and increased leukocyte adherence within the intestinal microvasculature. LD and HD glucose administration combined with insulin improved the FCD and decreased the adherence of leukocytes in endotoxemic animals as did HD glucose administration alone. Consistent with these results, IL-4, IL-1α, GM-CSF and IFN-γ levels were decreased following combined HD glucose and insulin administration in endotoxemic animals. CONCLUSIONS Insulin administration, as well as an endogenous insulin response triggered by HD glucose administration, improved the FCD and decreased leukocyte activation in endotoxemic rats. The results of this study give insight into the immune and vaso-modulatory role of insulin administration during experimental endotoxemia, and may be extrapolated for clinical sepsis and other critical illnesses with marked microcirculatory dysfunction.
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Affiliation(s)
- Alexa Caldwell
- Department of Pharmacology, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada
| | - Jan Niklas Morick
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Anne-Marie Jentsch
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Annette Wegner
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Dragan Pavlovic
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Nadia Al-Banna
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada
| | - Christian Lehmann
- Department of Pharmacology, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada; Department of Microbiology and Immunology, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada; Department of Physiology and Biophysics, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada.
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Park KH, Kim U, Choi KU, Nam JH, Lee JH, Lee CH, Son JW, Park JS, Shin DG, Won KC, Moon JS, Kim YK, Suh JS. Hemorheologic Alterations in Patients with Type 2 Diabetes Mellitus Presented with an Acute Myocardial Infarction. Diabetes Metab J 2018; 42:155-163. [PMID: 29676545 PMCID: PMC5911519 DOI: 10.4093/dmj.2018.42.2.155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/06/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Hemorheologic indices are known to be related to vascular complications in variable clinical settings. However, little is known about the associations between hemorheologic parameters and acute myocardial infarction (AMI) in type 2 diabetes mellitus (T2DM). The purpose of this study was to demonstrate the changes of hemorheologic environment inside of blood using hemorheologic parameters, especially the elongation index (EI) and critical shear stress (CSS) in diabetics with versus without AMI. METHODS A total of 195 patients with T2DM were enrolled. Patients were divided into the study group with AMI (AMI+, n=77) and control group (AMI-, n=118) who had no history of coronary artery disease. Hemorheologic parameters such as EI and CSS were measured and compared between the two groups. RESULTS The EI was lower (30.44%±1.77% in AMI+ and 31.47%±1.48% in AMI-, P<0.001) but the level of CSS was higher (316.13±108.20 mPa in AMI+ and 286.80±85.34 mPa in AMI-, P=0.040) in the AMI+. The CSS was significantly related to the erythrocyte sedimentation rate (R²=0.497, P<0.001) and use of dipeptidyl peptidase-4 inhibitors (R²=0.574, P=0.048). CONCLUSION Diabetics with AMI resulted in adverse hemorheologic changes with lower EI and higher CSS compared to diabetic subjects without AMI. Evaluation of the hemorheologic parameters may provide valuable supplementary information for managing patients with AMI and T2DM.
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Affiliation(s)
- Kyu Hwan Park
- Department of Internal Medicine, Daegu Veterans Hospital, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Ung Kim
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
| | - Kang Un Choi
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong Ho Nam
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jung Hee Lee
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Chan Hee Lee
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jang Won Son
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong Seon Park
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Dong Gu Shin
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyu Chang Won
- Division of Endocrinology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jun Sung Moon
- Division of Endocrinology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Yu Kyung Kim
- Department of Chemical Pathology, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Jang Soo Suh
- Department of Chemical Pathology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
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Strand E, Rebnord EW, Flygel MR, Lysne V, Svingen GFT, Tell GS, Løland KH, Berge RK, Svardal A, Nygård O, Pedersen ER. Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients With Suspected Stable Angina Pectoris. J Clin Endocrinol Metab 2018; 103:1033-1041. [PMID: 29325058 DOI: 10.1210/jc.2017-02139] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/04/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Carnitine and its metabolites are centrally involved in fatty acid metabolism. Although elevated circulating concentrations have been observed in obesity and insulin resistance, prospective studies examining whether these metabolites are associated with incident type 2 diabetes mellitus (T2D) are sparse. OBJECTIVE We performed a comprehensive evaluation of metabolites along the carnitine pathway relative to incident T2D. DESIGN A total of 2519 patients (73.1% men) with coronary artery disease, but without T2D, were followed for median 7.7 years until the end of 2009, during which 173 (6.9%) new cases of T2D were identified. Serum levels of free carnitine, its precursors trimethyllysine (TML) and γ-butyrobetaine, and the esters acetyl-, propionyl-, (iso)valeryl-, octanoyl-, and palmitoylcarnitine were measured by liquid chromatography/tandem mass spectrometry. Risk associations were explored by logistic regression and reported per (log-transformed) standard deviation increment. RESULTS Median age at inclusion was 62 years and median body mass index (BMI) 26.0 kg/m2. In models adjusted for age, sex, fasting status, BMI, estimated glomerular filtration rate, glycated hemoglobin A1c, triglyceride and high-density lipoprotein cholesterol levels, and study center, serum levels of TML and palmitoylcarnitine associated positively [odds ratio (95% confidence interval), 1.22 (1.04 to 1.43) and 1.24 (1.04 to 1.49), respectively], whereas γ-butyrobetaine associated negatively [odds ratio (95% confidence interval) 0.81 (0.66 to 0.98)] with T2D risk. CONCLUSION Serum levels of TML, γ-butyrobetaine, and the long-chained palmitoylcarnitine predict long-term risk of T2D independently of traditional risk factors, possibly reflecting dysfunctional fatty acid metabolism in patients susceptible to T2D development.
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Affiliation(s)
- Elin Strand
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Eirik W Rebnord
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Malin R Flygel
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Vegard Lysne
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Gard F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kjetil H Løland
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Rolf K Berge
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Asbjørn Svardal
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Ottar Nygård
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R Pedersen
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
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Dogiparthi SN, Muralidhar K, Seshadri KG, Rangarajan S. Cutaneous manifestations of diabetic peripheral neuropathy. DERMATO-ENDOCRINOLOGY 2018; 9:e1395537. [PMID: 29484103 PMCID: PMC5821163 DOI: 10.1080/19381980.2017.1395537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/17/2017] [Indexed: 12/25/2022]
Abstract
There is a rise in number of people diagnosed with Diabetes Mellitus. The incidence is rising in modern Indian society because of Industrial development and drastically changing lifestyles. Diabetic neuropathies are microvascular disorders that are usually associated with the duration of Diabetes. Among the various forms, the most common is Diabetic Peripheral Neuropathy. The disease if neglected leads to chronic ulcer formation leading to amputations frequently. Hence the aim of this study is to document the early cutaneous changes and create an early awareness in the importance of controlling Diabetes. The study consisted of 205 patients with Type 2 DM. Participant's neuropathy status was determined based on Neuropathy Disability Score and Diabetic Neuropathy Symptom Score. Among the Skin changes documented, the common changes seen were: Peripheral hair loss in 185 (90.2%), Xerosis in 168 (82%), Anhydrosis in 162 (79%), Plantar Fissures in 136 (66.3%), Plantar Ulcer in 80 (39%), common nail changes documented were Onychomycosis in 165 (80.5%) and Onychauxis in 53 (25.8%) patients in relation to the occupation and duration of Diabetes mellitus. In conclusion, it is important to control glycemic levels in the all stages of Diabetes and institute foot care measures to prevent the complications of neuropathy.
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Affiliation(s)
- S N Dogiparthi
- Department of Dermatology, Venereology and Leprosy, Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamilnadu, India
| | - K Muralidhar
- Department of Dermatology, Venereology and Leprosy, Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamilnadu, India
| | - K G Seshadri
- Department of Dermatology, Venereology and Leprosy, Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamilnadu, India
| | - S Rangarajan
- Department of Dermatology, Venereology and Leprosy, Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamilnadu, India
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Larsen AU, Grimnes G, Jorde R. The effect of high-dose vitamin D 3 supplementation on bone mineral density in subjects with prediabetes. Osteoporos Int 2018; 29:171-180. [PMID: 28921338 DOI: 10.1007/s00198-017-4222-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/06/2017] [Indexed: 01/09/2023]
Abstract
UNLABELLED The rationale of this study was to determine the effect of high-dose vitamin D3 supplementation on bone mineral density (BMD). Prediabetic males given vitamin D had significantly less reduction in BMD at the femoral neck compared to the controls. The clinical implications of our findings require further investigation. INTRODUCTION Type 2 diabetes mellitus is associated with increased fracture risk, and recent studies show crosstalk between bone and glucose metabolism. Few studies have investigated the effect of vitamin D supplementation on the bone without additional calcium. In the present study, we aimed to determine whether a high dose of vitamin D3 could improve bone mass density (BMD) in prediabetic subjects. METHODS The current study was conducted as a secondary research on a previously performed trial, in which 511 subjects with prediabetes were randomized to vitamin D3 (20,000 IU per week) versus placebo for 5 years. BMD was measured using dual-energy X-ray absorptiometry (DEXA). RESULTS Two hundred and fifty-six subjects were randomized to vitamin D and 255 to placebo. Mean baseline serum 25-hydroxyvitamin D (25(OH)D) level was 60 nmol/L. Two hundred and two and 214 in the vitamin D and placebo groups, respectively, completed BMD measurements, whereas one in each group was excluded due to use of bisphosphonates. Males given vitamin D had significantly less reduction in BMD at the femoral neck measurement site compared to the controls (0.000 versus - 0.010 g/cm2, p = 0.008). No significant differences between intervention groups were seen at the total hip measurement site, regarding both males and females. CONCLUSIONS Vitamin D3 supplementation alone may be beneficial in males with prediabetes, but confirmatory studies are needed.
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Affiliation(s)
- A U Larsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
| | - G Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038, Tromsø, Norway
| | - R Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038, Tromsø, Norway
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Zaleska-Żmijewska A, Piątkiewicz P, Śmigielska B, Sokołowska-Oracz A, Wawrzyniak ZM, Romaniuk D, Szaflik J, Szaflik JP. Retinal Photoreceptors and Microvascular Changes in Prediabetes Measured with Adaptive Optics (rtx1™): A Case-Control Study. J Diabetes Res 2017; 2017:4174292. [PMID: 29238728 PMCID: PMC5697118 DOI: 10.1155/2017/4174292] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/15/2017] [Accepted: 09/28/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Patients with prediabetes are at risk for diabetes, cardiovascular events, and microvascular complications. The rtx1 (Imagine Eyes, France) permits early detection of changes in the retinal photoreceptors and vessels. OBJECTIVE Cone parameters and retinal microvasculature were analyzed with the rtx1 in 12 prediabetic patients and 22 healthy subjects. The analysis was based on cone density (DM), interphotoreceptor distance (SM), cone packing regularity, and retinal vessel parameters: wall thickness, lumen diameter (LD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall. RESULTS DM in the prediabetic group was not significantly lower than that in the control group (18,935 ± 1713 cells/mm2 and 19,900 ± 2375 cells/mm2, respectively; p = 0.0928). The LD and WLR means differed significantly between the prediabetic and the control groups (LD 94.3 ± 10.9 versus 101.2 ± 15, p = 0.022; WLR 0.29 ± 0.05 versus 0.22 ± 0.03, p < 0.05). A multivariate regression analysis showed that the WLR was significantly correlated with BMI and total cholesterol. CONCLUSIONS Abnormalities found in rtx1 examinations indicated early signs of arteriolar dysfunction, prior to impaired glucose tolerance progressing to diabetes. The rtx1 retinal image analysis offers noninvasive measurement of early changes in the vasculature that routine clinical examination cannot detect.
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Affiliation(s)
- Anna Zaleska-Żmijewska
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Piątkiewicz
- Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Barbara Śmigielska
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Anna Sokołowska-Oracz
- Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Warsaw, Poland
- Retinopathy Outpatient Clinic, Masovian Hospital Bródno, Warsaw, Poland
| | - Zbigniew M. Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, Warsaw, Poland
| | - Dorota Romaniuk
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Warsaw, Poland
| | - Jerzy Szaflik
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Jacek P. Szaflik
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, Warsaw, Poland
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Dimova R, Tankova T, Chakarova N. Vitamin D in the Spectrum of Prediabetes and Cardiovascular Autonomic Dysfunction. J Nutr 2017; 147:1607-1615. [PMID: 28768837 DOI: 10.3945/jn.117.250209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/27/2017] [Accepted: 06/30/2017] [Indexed: 11/14/2022] Open
Abstract
Vitamin D is a fat-soluble secosteroid hormone with pleiotropic effects. 1,25-Dihydroxyvitamin D coordinates the biosynthesis of neurotransmitters in the central nervous system, which regulate cardiovascular autonomic function and may explain its putative role in the development of cardiovascular autonomic neuropathy (CAN). CAN is an independent risk factor for mortality in patients with diabetes and prediabetes and is associated with an increased risk of developing type 2 diabetes and cardiovascular disease. Accumulating data indicate the presence of peripheral nerve injury at these early stages of dysglycemia and its multifactorial pathogenesis. Prediabetes is associated with vitamin D insufficiency. Vitamin D is proposed to prevent the progression of glucose intolerance. The putative underlying mechanisms include maintenance of the intracellular calcium concentration, direct stimulation of insulin receptor expression, and enhancement of the insulin response to glucose transporters. Vitamin D exerts a protective effect on peripheral nerve fibers by decreasing the demyelination process and inducing axonal regeneration. The effects of vitamin D supplementation on glucose tolerance and related autonomic nerve dysfunction have been a recent focus of scientific interest. Although well-designed observational studies are available, the causative relation between vitamin D deficiency, glucose intolerance, and CAN is still debatable. One reason might be that interventional studies are unpersuasive with regard to the beneficial clinical effects of vitamin D supplementation. Because of its favorable side effect profile, vitamin D supplementation might represent an attractive therapeutic option for treating the pandemic prevalence of prediabetes and vitamin D deficiency. Vitamin D supplementation can improve glucose tolerance and cardiovascular autonomic function and can thus reduce cardiovascular mortality among subjects with different stages of glucose intolerance and autonomic dysfunction. However, more patient-centered trials on the use of vitamin D supplementation in different conditions are needed.
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Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University, Sofia, Sofia, Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University, Sofia, Sofia, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University, Sofia, Sofia, Bulgaria
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Miyazaki T, Miyazaki A. Dysregulation of Calpain Proteolytic Systems Underlies Degenerative Vascular Disorders. J Atheroscler Thromb 2017; 25:1-15. [PMID: 28819082 PMCID: PMC5770219 DOI: 10.5551/jat.rv17008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chronic vascular diseases such as atherosclerosis, aneurysms, diabetic angiopathy/retinopathy as well as fibrotic and proliferative vascular diseases are generally complicated by the progression of degenerative insults, which are characterized by endothelial dysfunction, apoptotic/necrotic cell death in vascular/immune cells, remodeling of extracellular matrix or breakdown of elastic lamella. Increasing evidence suggests that dysfunctional calpain proteolytic systems and defective calpain protein metabolism in blood vessels contribute to degenerative disorders. In vascular endothelial cells, the overactivation of conventional calpains consisting of calpain-1 and -2 isozymes can lead to the disorganization of cell-cell junctions, dysfunction of nitric oxide synthase, sensitization of Janus kinase/signal transducer and activator of transcription cascades and depletion of prostaglandin I2, which contributes to degenerative disorders. In addition to endothelial cell dysfunctions, calpain overactivation results in inflammatory insults in macrophages and excessive fibrogenic/proliferative signaling in vascular smooth muscle cells. Moreover, calpain-6, a non-proteolytic unconventional calpain, is involved in the conversion of macrophages to a pro-atherogenic phenotype, leading to the pinocytotic deposition of low-density lipoprotein cholesterol in the cells. Here, we discuss the recent progress that has been made in our understanding of how calpain contributes to degenerative vascular disorders.
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Affiliation(s)
- Takuro Miyazaki
- Department of Biochemistry, Showa University School of Medicine
| | - Akira Miyazaki
- Department of Biochemistry, Showa University School of Medicine
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65
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Jonasson H, Bergstrand S, Nystrom FH, Länne T, Östgren CJ, Bjarnegård N, Fredriksson I, Larsson M, Strömberg T. Skin microvascular endothelial dysfunction is associated with type 2 diabetes independently of microalbuminuria and arterial stiffness. Diab Vasc Dis Res 2017; 14:363-371. [PMID: 28482676 DOI: 10.1177/1479164117707706] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Skin and kidney microvascular functions may be affected independently in diabetes mellitus. We investigated skin microcirculatory function in 79 subjects with diabetes type 2, where 41 had microalbuminuria and 38 not, and in 41 age-matched controls. The oxygen saturation, fraction of red blood cells and speed-resolved microcirculatory perfusion (% red blood cells × mm/s) divided into three speed regions: 0-1, 1-10 and above 10 mm/s, were assessed during baseline and after local heating of the foot with a new device integrating diffuse reflectance spectroscopy and laser Doppler flowmetry. Arterial stiffness was assessed as carotid-femoral pulse wave velocity. Subjects with diabetes and microalbuminuria had significantly higher carotid-femoral pulse wave velocity compared to subjects without microalbuminuria and to controls. The perfusion for speeds 0-1 mm/s and red blood cell tissue fraction were reduced in subjects with diabetes at baseline and after heating, independent of microalbuminuria. These parameters were correlated to HbA1c. In conclusion, the reduced nutritive perfusion and red blood cell tissue fraction in type 2 diabetes were related to long-term glucose control but independent of microvascular changes in the kidneys and large-vessel stiffness. This may be due to different pathogenic pathways in the development of nephropathy, large-vessel stiffness and cutaneous microvascular impairment.
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Affiliation(s)
- Hanna Jonasson
- 1 Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Sara Bergstrand
- 1 Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Fredrik H Nystrom
- 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Toste Länne
- 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Carl Johan Östgren
- 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Niclas Bjarnegård
- 2 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ingemar Fredriksson
- 1 Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- 3 Perimed AB, Stockholm, Sweden
| | - Marcus Larsson
- 1 Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Tomas Strömberg
- 1 Department of Biomedical Engineering, Linköping University, Linköping, Sweden
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Diabetes Complications and Depressive Symptoms: Prospective Results From the Montreal Diabetes Health and Well-Being Study. Psychosom Med 2017; 79:603-612. [PMID: 28060138 DOI: 10.1097/psy.0000000000000447] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Prospective studies testing the potential impact of diabetes complications on depression are limited. The present study examined the longitudinal associations between diabetes complications and the risk and recurrence/persistence of depressive symptoms. METHODS Data were from a prospective community cohort telephone survey of adults with diabetes (N = 1314). Diabetes complications and depressive symptoms were assessed via self-report (Diabetes Complications Index and Patient Health Questionnaire-9, respectively) at baseline and annually for 5 years. Statistical models adjusted for sociodemographic, lifestyle, and diabetes characteristics. RESULTS The number of diabetes complications at baseline was positively associated with a greater risk of elevated depressive symptoms, with the highest risk found for those with four to six complications at baseline (risk ratio = 2.73, 95% confidence interval = 1.64-4.56). Cerebrovascular disease was the complication most strongly associated with incident depressive symptoms (risk ratio = 2.22, 95% confidence interval = 1.59-3.10). Coronary artery disease, peripheral vascular disease, and neuropathy were also associated with the risk of depression, whereas foot problems and eye problems were not. In addition, a greater number of diabetes complications were associated with recurrent/persistent depression, though with a small effect size (Δr = .02). A parallel process latent growth curve model indicated that increases in diabetes complications were associated with increases in depressive symptoms during the course of the follow-up period (β = .74, p < .001). CONCLUSIONS This study demonstrates the temporal relation between diabetes complications and depressive symptoms and underscores the psychological burden of diabetes complications by prospectively demonstrating the increased risk and recurrence of depressive symptoms associated with diabetes complications.
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Messaoudi I, Handu M, Rais M, Sureshchandra S, Park BS, Fei SS, Wright H, White AE, Jain R, Cameron JL, Winters-Stone KM, Varlamov O. Long-lasting effect of obesity on skeletal muscle transcriptome. BMC Genomics 2017; 18:411. [PMID: 28545403 PMCID: PMC5445270 DOI: 10.1186/s12864-017-3799-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Reduced physical activity and increased intake of calorically-dense diets are the main risk factors for obesity, glucose intolerance, and type 2 diabetes. Chronic overnutrition and hyperglycemia can alter gene expression, contributing to long-term obesity complications. While caloric restriction can reduce obesity and glucose intolerance, it is currently unknown whether it can effectively reprogram transcriptome to a pre-obesity level. The present study addressed this question by the preliminary examination of the transcriptional dynamics in skeletal muscle after exposure to overnutrition and following caloric restriction. RESULTS Six male rhesus macaques of 12-13 years of age consumed a high-fat western-style diet for 6 months and then were calorically restricted for 4 months without exercise. Skeletal muscle biopsies were subjected to longitudinal gene expression analysis using next-generation whole-genome RNA sequencing. In spite of significant weight loss and normalized insulin sensitivity, the majority of WSD-induced (n = 457) and WSD-suppressed (n = 47) genes remained significantly dysregulated after caloric restriction (FDR ≤0.05). The MetacoreTM pathway analysis reveals that western-style diet induced the sustained activation of the transforming growth factor-β gene network, associated with extracellular matrix remodeling, and the downregulation of genes involved in muscle structure development and nutritional processes. CONCLUSIONS Western-style diet, in the absence of exercise, induced skeletal muscle transcriptional programing, which persisted even after insulin resistance and glucose intolerance were completely reversed with caloric restriction.
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Affiliation(s)
- Ilhem Messaoudi
- School of Biological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
| | - Mithila Handu
- Division of Cardiometabolic Health, Oregon National Primate Research Center, L584 505 NW 185th Ave., Beaverton, OR, 97006, USA
| | - Maham Rais
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
| | - Suhas Sureshchandra
- School of Biological Sciences, University of California, Irvine, Irvine, CA, 92697, USA
| | - Byung S Park
- Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Suzanne S Fei
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, 97006, USA
| | - Hollis Wright
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, 97006, USA
| | - Ashley E White
- Division of Cardiometabolic Health, Oregon National Primate Research Center, L584 505 NW 185th Ave., Beaverton, OR, 97006, USA
| | - Ruhee Jain
- Department of Neuroscience and Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Judy L Cameron
- Department of Neuroscience and Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Kerri M Winters-Stone
- Department of School of Nursing, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Oleg Varlamov
- Division of Cardiometabolic Health, Oregon National Primate Research Center, L584 505 NW 185th Ave., Beaverton, OR, 97006, USA.
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Dimova R, Tankova T, Chakarova N, Grozeva G, Dakovska L. Cardio-metabolic profile of subjects with early stages of glucose intolerance and cardiovascular autonomic dysfunction. Diabetes Res Clin Pract 2017; 126:115-121. [PMID: 28242436 DOI: 10.1016/j.diabres.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/02/2017] [Indexed: 01/25/2023]
Abstract
AIMS The present study evaluates the cardio-metabolic profile of subjects with early stages of glucose intolerance and presence of cardiovascular autonomic dysfunction (CAD). MATERIALS AND METHODS 478 subjects, of mean age 49.3±13.7years and mean BMI 31.0±6.2kg/m2, divided according to glucose tolerance: 130 with normal glucose tolerance, 227 with prediabetes, and 121 with newly-diagnosed type 2 diabetes, were enrolled. Glucose tolerance was studied during OGTT applying 2006 WHO criteria. Anthropometric indices, blood pressure, HbA1c, serum lipids, hsCRP, and albumin-to-creatinine ratio (ACR) were measured. Body fat distribution was estimated by a bioimpedance method (InBody720, BioSpace). Tissue AGEs accumulation was assessed by skin autofluorescence (AGE-Reader-DiagnOptics™). CAD was assessed by ANX-3.0 method. RESULTS CAD was found in 24.1% of subjects with any disorder of glucose tolerance in comparison to 12.3% in NGT, OR 2.0 (95% CI: 1.2-3.2), p=0.005. Sympathetic and parasympathetic tone declined with the progression of glucose intolerance. Age, waist circumference, visceral fat area, fasting and 120-min plasma glucose, HbA1c, AGEs, ACR and QTc interval were higher in subjects with CAD, p<0.05. In a logistic regression analysis the panel of age >53years (76% sensitivity, 61% specificity), HbA1c >6.0% (66% sensitivity, 60% specificity), QTc interval >423ms (65% sensitivity, 61% specificity) and presence of arterial hypertension (83% sensitivity, 55% specificity) was related to the presence of CAD - AUC 0.778 (95% CI: 0.73-0.83), p<0.001. CONCLUSION Our results demonstrate a high prevalence of CAD in early stages of glucose dysmetabolism. Age, HbA1c, QTc interval and presence of arterial hypertension are related to the presence of CAD in this population.
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Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria
| | - Greta Grozeva
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia 1431, Bulgaria
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Soluble urokinase receptor (suPAR) predicts microalbuminuria in patients at risk for type 2 diabetes mellitus. Sci Rep 2017; 7:40627. [PMID: 28091558 PMCID: PMC5238426 DOI: 10.1038/srep40627] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/08/2016] [Indexed: 01/29/2023] Open
Abstract
Early identification of patients at risk of developing diabetic nephropathy is essential. Elevated serum concentrations of soluble urokinase receptor (suPAR) associate with diabetes mellitus and predict onset and loss of renal function in chronic kidney disease. We hypothesize, that suPAR may be an early risk indicator for diabetic nephropathy, preceding microalbuminuria. The relationship of baseline suPAR and incident microalbuminuria was assessed in a prospective long-term cohort of subjects at increased risk for type 2 diabetes (TULIP, n = 258). Association with albuminuria at later stages of disease was studied in a cross-sectional cohort with manifest type 2 diabetes (ICEPHA, n = 266). A higher baseline suPAR was associated with an increased risk of new-onset microalbuminuria in subjects at risk for type 2 diabetes (hazard ratio 5.3 (95% CI 1.1-25.2, p = 0.03) for the highest vs. lowest suPAR quartile). The proportion of subjects with prediabetes at the end of observation was higher in subjects with new-onset microalbuminuria. suPAR consistently correlated with albuminuria in a separate cohort with manifest type 2 diabetes. Elevated baseline suPAR concentrations independently associate with new-onset microalbuminuria in subjects at increased risk of developing type 2 diabetes. suPAR may hence allow for earlier risk stratification than microalbuminuria.
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Kamada Y, Masuda T, Tanaka S, Akiyama A, Nakamura T, Hamazaki N, Okubo M, Kobayashi N, Ako J. Muscle Weakness Is Associated With an Increase of Left Ventricular Mass Through Excessive Blood Pressure Elevation During Exercise in Patients With Hypertension. Int Heart J 2017; 58:551-556. [DOI: 10.1536/ihj.16-293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yumi Kamada
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
- Sohbudai Nieren Clinic
| | - Takashi Masuda
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences
| | - Shinya Tanaka
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | - Ayako Akiyama
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | - Takeshi Nakamura
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | - Nobuaki Hamazaki
- Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences
| | | | | | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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Hu J, Ye M, Zhou Z. Aptamers: novel diagnostic and therapeutic tools for diabetes mellitus and metabolic diseases. J Mol Med (Berl) 2016; 95:249-256. [PMID: 27847965 DOI: 10.1007/s00109-016-1485-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 02/08/2023]
Abstract
Diabetes mellitus is one of the most common chronic diseases that threatens human health in worldwide populations. Despite enormous efforts invested in the study of diabetes mellitus, the development of precise diagnoses and treatments for this disease remains difficult due to the limitations of current techniques. Therefore, new methods are currently being developed. Aptamers are oligonucleotides that bind to specific target molecules and have been widely applied as diagnostic and therapeutic tools. In recent years, aptamers have been utilized in the study of diabetes mellitus and metabolic diseases. In this review, we highlight recent developments and new perspectives on aptamers in the field of diabetes mellitus and other metabolic diseases. Aptamers could potentially provide the means for efficient diagnoses and therapies against diabetes mellitus.
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Affiliation(s)
- Jingping Hu
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.,Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, 410011, China
| | - Mao Ye
- Molecular Science & Biomedicine Laboratory; State Key Laboratory of Chemo/Biosensing & Chemometrics, College of Chemistry & Chemical Engineering; College of Biology, Collaborative Innovation Center for Molecular Engineering for Theranostics, Hunan University, Changsha, Hunan, 410082, China
| | - Zhiguang Zhou
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. .,Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, 410011, China.
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Ahmadi Majd S, Rabbani Khorasgani M, Moshtaghian SJ, Talebi A, Khezri M. Application of Chitosan/PVA Nano fiber as a potential wound dressing for streptozotocin-induced diabetic rats. Int J Biol Macromol 2016; 92:1162-1168. [DOI: 10.1016/j.ijbiomac.2016.06.035] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/31/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
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Abstract
UNLABELLED Aim The purpose of our study was to evaluate the association between insulin resistance and left ventricular size and function in obese children. Material and methods A total of 79 cases aged 10-16 years and diagnosed with obesity and 79 healthy and non-obese cases as controls were included in the study. Patient and control groups were divided into three groups in terms of age as group 1 (10-12 years), group 2 (12-14 years), and group 3 (14-16 years). Fasting blood glucose, lipid profile, and fasting insulin levels of the cases were assessed. Mitral valve E and A waves, left ventricular ejection fraction, fractional shortening, end-diastolic and end-systolic diameters, left atrium diameter, and septal wall thickness were measured using echocardiography. RESULTS Measurements of septal diastolic thicknesses, left atrium diameter, and left ventricular end-systolic diameter of all the three groups obtained by echocardiography were statistically higher compared with the controls. In all the patient groups, the mitral valve E/A ratio was >1. In groups 2 and 3, there was a positive correlation between fasting insulin levels and HOMA-IR and left ventricular end-systolic diameter, end-diastolic diameter, and septal systolic and diastolic wall thicknesses. CONCLUSION In paediatric obesity, identification of early cardiac changes will be significant in allowing early diagnosis and treatment of cardiovascular diseases.
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Saraf R, Huang T, Mahmood F, Owais K, Bardia A, Khabbaz KR, Liu D, Senthilnathan V, Lassaletta AD, Sellke F, Matyal R. Early Cellular Changes in the Ascending Aorta and Myocardium in a Swine Model of Metabolic Syndrome. PLoS One 2016; 11:e0146481. [PMID: 26766185 PMCID: PMC4713205 DOI: 10.1371/journal.pone.0146481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 12/17/2015] [Indexed: 01/10/2023] Open
Abstract
Background Metabolic syndrome is associated with pathological remodeling of the heart and adjacent vessels. The early biochemical and cellular changes underlying the vascular damage are not fully understood. In this study, we sought to establish the nature, extent, and initial timeline of cytochemical derangements underlying reduced ventriculo-arterial compliance in a swine model of metabolic syndrome. Methods Yorkshire swine (n = 8 per group) were fed a normal diet (ND) or a high-cholesterol (HCD) for 12 weeks. Myocardial function and blood flow was assessed before harvesting the heart. Immuno-blotting and immuno-histochemical staining were used to assess the cellular changes in the myocardium, ascending aorta and left anterior descending artery (LAD). Results There was significant increase in body mass index, blood glucose and mean arterial pressures (p = 0.002, p = 0.001 and p = 0.024 respectively) in HCD group. At the cellular level there was significant increase in anti-apoptotic factors p-Akt (p = 0.007 and p = 0.002) and Bcl-xL (p = 0.05 and p = 0.01) in the HCD aorta and myocardium, respectively. Pro-fibrotic markers TGF-β (p = 0.01), pSmad1/5 (p = 0.03) and MMP-9 (p = 0.005) were significantly increased in the HCD aorta. The levels of pro-apoptotic p38MAPK, Apaf-1 and cleaved Caspase3 were significantly increased in aorta of HCD (p = 0.03, p = 0.04 and p = 0.007 respectively). Similar changes in coronary arteries were not observed in either group. Functionally, the high cholesterol diet resulted in significant increase in ventricular end systolic pressure and–dp/dt (p = 0.05 and p = 0.007 respectively) in the HCD group. Conclusion Preclinical metabolic syndrome initiates pro-apoptosis and pro-fibrosis pathways in the heart and ascending aorta, while sparing coronary arteries at this early stage of dietary modification.
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Affiliation(s)
- Rabya Saraf
- Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Thomas Huang
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Khurram Owais
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Amit Bardia
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kamal R. Khabbaz
- Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - David Liu
- Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Venkatachalam Senthilnathan
- Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Antonio D. Lassaletta
- Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Rhode Island Hospital, Brown Alpert School of Medicine, Providence, Rhode Island, United States of America
| | - Frank Sellke
- Department of Surgery, Rhode Island Hospital, Brown Alpert School of Medicine, Providence, Rhode Island, United States of America
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Dimova R, Tankova T, Kirilov G, Chakarova N, Dakovska L, Grozeva G. Is vaspin related to cardio-metabolic status and autonomic function in early stages of glucose intolerance and in metabolic syndrome? Diabetol Metab Syndr 2016; 8:46. [PMID: 27462373 PMCID: PMC4960717 DOI: 10.1186/s13098-016-0165-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 07/10/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study aims to assess serum vaspin in early stages of glucose intolerance and in the presence of metabolic syndrome (MetS); and to evaluate vaspin correlation to different cardio-metabolic parameters and autonomic tone in these subjects. METHODS 185 subjects (80 males and 105 females) of mean age 45.8 ± 11.6 years and mean BMI 31.2 ± 6.3 kg/m(2), divided into groups according to: glucose tolerance, presence of MetS and cardio-vascular autonomic dysfunction (CAD), were enrolled. Glucose tolerance was studied during OGTT. Anthropometric indices, blood pressure, HbA1c, serum lipids, hsCRP, fasting immunoreactive insulin and serum vaspin were measured. Body composition was estimated by impedance analysis. AGEs were assessed by skin fluorescence. CAD was assessed by ANX-3.0. RESULTS There was no difference in vaspin levels between the groups according to glucose tolerance, presence of MetS, and CAD. Regression analysis revealed independent association between serum vaspin and total body fat in newly diagnosed type 2 diabetes (NDT2D) group, and between serum vaspin and age and total body fat in MetS group. Vaspin negatively correlated with both sympathetic and parasympathetic activity in normal glucose tolerance (NGT) and just with parasympathetic tone in NGT without MetS. CONCLUSION Our results demonstrate no overt fluctuations in vaspin levels in the early stages of glucose intolerance and in MetS. Total body fat seems to be related to vaspin levels in MetS and NDT2D. Our data show negative correlation between vaspin and autonomic function in NGT, as vaspin is associated with parasympathetic activity even in the absence of MetS.
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Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia, 1431 Bulgaria
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia, 1431 Bulgaria
| | - Georgi Kirilov
- Department of Radioimmunology Laboratory, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia, 1431 Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia, 1431 Bulgaria
| | - Greta Grozeva
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, 2, Zdrave Str., Sofia, 1431 Bulgaria
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Lv Z, Li Y, Wu Y, Qu Y. Association of ICAM-1 and HMGA1 Gene Variants with Retinopathy in Type 2 Diabetes Mellitus Among Chinese Individuals. Curr Eye Res 2015; 41:1118-1122. [PMID: 26717491 DOI: 10.3109/02713683.2015.1094093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate the association of intercellular cell-adhesion molecule 1 (ICAM-1) and high-mobility group A1 (HMGA1) gene variants with diabetic retinopathy (DR) in a Chinese type 2 diabetes mellitus (T2DM) cohort. METHODS A total of 792 patients with T2DM were enrolled and categorized into two groups: (1) the DR group consisted of 448 patients, which was further subclassified into the proliferative DR (PDR) group with 220 patients and the nonproliferative DR (NPDR) group with 228 patients; (2) the diabetes without retinopathy (DNR) group comprised 344 patients who had no signs of DR. The single-nucleotide polymorphism (SNP) rs5498 in ICAM-1 gene and IVS5-13insC variant in HMGA1 gene were genotyped. RESULTS No evident association was found in the allele frequencies between SNP rs5498 in ICAM-1 gene and DR patients; the combined p values for the additive, dominant, and recessive models in genotype were greater than 0.05. No significant association was identified between the IVS5-13insC variant in HMGA1 gene and DR individuals. CONCLUSIONS Our results revealed that SNP rs5498 in ICAM-1 gene and IVS5-13insC variant in HMGA1 gene were not associated with the susceptibility of DR in the Chinese T2DM cohort.
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Affiliation(s)
- Zhiping Lv
- a Department of Ophthalmology , Qilu Hospital of Shandong University , Jinan , China
| | - Ying Li
- a Department of Ophthalmology , Qilu Hospital of Shandong University , Jinan , China
| | - Yongzhong Wu
- b State Key Lab of Crystal Materials, Shandong University , Jinan , China
| | - Yi Qu
- a Department of Ophthalmology , Qilu Hospital of Shandong University , Jinan , China
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Farhad K, Traub R, Ruzhansky KM, Brannagan TH. Causes of neuropathy in patients referred as “idiopathic neuropathy”. Muscle Nerve 2015; 53:856-61. [PMID: 26561790 DOI: 10.1002/mus.24969] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/30/2015] [Accepted: 11/06/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Khosro Farhad
- Peripheral Neuropathy Center, Neurological Institute of New York; Columbia University Medical Center; 710 West 168th Street New York New York 10032 USA
| | - Rebecca Traub
- Peripheral Neuropathy Center, Neurological Institute of New York; Columbia University Medical Center; 710 West 168th Street New York New York 10032 USA
| | - Katherine M. Ruzhansky
- Peripheral Neuropathy Center, Neurological Institute of New York; Columbia University Medical Center; 710 West 168th Street New York New York 10032 USA
| | - Thomas H. Brannagan
- Peripheral Neuropathy Center, Neurological Institute of New York; Columbia University Medical Center; 710 West 168th Street New York New York 10032 USA
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Abstract
Length-dependent neuropathy is the most common and costly complication of diabetes and frequently causes injury primarily to small-diameter cutaneous nociceptive fibers. Not only persistent hyperglycemia but also metabolic, endocrine, and inflammatory effects of obesity and dyslipidemia appear to play an important role in the development of diabetic neuropathy. Rational therapies aimed at direct control of glucose or its increased entry into the polyol pathway, oxidative or nitrosative stress, advanced glycation end product formation or signaling, microvascular ischemia, or adipocyte-derived toxicity have each failed in human trials of diabetic neuropathy. Aerobic exercise produces salutary effects in many of these pathogenic pathways simultaneously and, in both animal models and human trials, has been shown to improve symptoms of neuropathy and promote re-growth of cutaneous small-diameter fibers. Behavioral reduction in periods of seated, awake inactivity produces multimodal metabolic benefits similar to exercise, and the two strategies when combined may offer sustained benefit to peripheral nerve function.
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Affiliation(s)
| | - A Gordon Smith
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Robin L Marcus
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA
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Asghar O, Arumugam P, Armstrong IS, Ray SG, Schmitt M, Malik RA. Individuals with impaired glucose tolerance demonstrate normal cardiac sympathetic innervation using I-123 mIBG scintigraphy. J Nucl Cardiol 2015; 22:1262-8. [PMID: 25698476 DOI: 10.1007/s12350-015-0070-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 12/16/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Impaired glucose tolerance (IGT) is associated with an increased risk of type 2 diabetes (T2DM) and cardiovascular disease. Some but not all studies have reported cardiac autonomic dysfunction in subjects with IGT and there is only one direct study of cardiac innervation in subjects with IGT. The purpose of this study was to assess global and regional cardiac sympathetic innervation and cardiac autonomic function in individuals with IGT. METHODS AND RESULTS We undertook (123)I-mIBG scintigraphy and cardiac autonomic function in 15 subjects with IGT and 15 age and sex-matched healthy controls. Early heart to mediastinum ratio (HMR) (1.71 ± 0.17 vs 1.67 ± 0.13, P = .49), late HMR (1.73 ± 0.18 vs 1.73 ± 0.16, P = .97) and washout rate (WR) (18.6 ± 4.2 vs 19.1 ± 7.6%, P = .84), did not differ between subjects with IGT and control subjects. More detailed regional analysis revealed reduced tracer uptake at the apex, base and inferior wall in all subjects and the anterior wall in a minority of subjects. There were no differences in total score (56.6 ± 4.0 vs 53.3 ± 8.4, P = .193), modified score (48.5 ± 3.3 vs 46.2 ± 6.0, P = .215), anterior wall score (10.2 ± 1.3 vs 10.1 ± 1.6, P = .898), inferior wall score (8.9 ± 1.9 vs 7.7 ± 2.6, P = .163), basal score (18.7 ± 1.9 vs 18.2 ± 3.3, P = .636) and tests of cardiac autonomic function between the groups. CONCLUSION Global and regional measures of MIBG uptake and washout as well as cardiac autonomic function did not differ between subjects with IGT and healthy controls.
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Affiliation(s)
- O Asghar
- Institute of Cardiovascular Sciences, University of Manchester & Manchester Heart Centre, Central Manchester Foundation Trust, Manchester, United Kingdom.
| | - P Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, United Kingdom
| | - I S Armstrong
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, United Kingdom
| | - S G Ray
- North West Heart and Transplant Centre, University Hospital of South Manchester, Manchester, United Kingdom
| | - M Schmitt
- North West Heart and Transplant Centre, University Hospital of South Manchester, Manchester, United Kingdom
| | - R A Malik
- Centre for Endocrinology & Diabetes, Institute of Human Development, University of Manchester, Manchester, United Kingdom.
- Weill Cornell Medical College, Doha, Qatar.
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Meme N, Amwayi S, Nganga Z, Buregyeya E. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study. Pan Afr Med J 2015; 22:286. [PMID: 26966482 PMCID: PMC4769056 DOI: 10.11604/pamj.2015.22.286.7395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/20/2015] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Hypertension (HTN) and diabetes mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked: one cannot be properly managed without attention to the other. The aim of this study was to determine the prevalence of undiagnosed diabetic and pre-diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya. METHODS We conducted a cross-sectional study from February 2014 to April 2014. Hypertensive patients aged ≥ 18 attending the out-patient medical clinic were included in the study. Pregnant and known diabetic patients were excluded. Data was collected on socio-demographics, behavior, and anthropometrics. Diabetes status was based on a Glycated Haemoglobin (HbA1C) classification of ≥ 6.5% for diabetes, 6.0-6.4% for pre-diabetes and ≤ 6.0% for normal. AGR was the dependable variable and included two diabetic categories; diabetes and pre-diabetes. RESULTS We enrolled 334 patients into the study: the mean age was 59 years (Standard deviation = 14.3). Of these patients 254 (76%) were women. Thirty two percent (107/334; 32%) were found to have AGR, with 14% (46) having un-diagnosed DM and 18%(61) with pre-diabetes. Factors associated with AGR were age ≥ 45 (OR = 3.23; 95% CI 1.37 ≥ 7.62), basal metabolic index (BMI) ≥ 25 Kg/m(2) (OR = 3.13; 95% CI 1.53 - 6.41), low formal education (primary/none)(OR= 2; 95%CI 1.08 - 3.56) and family history of DM (OR = 2.19; 95%CI 1.16 - 4.15). CONCLUSION There was a high prevalence of undiagnosed AGR among hypertensive patients. This highlights the need to regularly screen for AGR among hypertensive patients as recommended by WHO.
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Affiliation(s)
- Nkatha Meme
- Field Epidemiology Training Program, Ministry of Health, Kenya
| | - Samuel Amwayi
- Field Epidemiology Training Program, Ministry of Health, Kenya
| | | | - Esther Buregyeya
- Makerere University, College of Health Sciences School of Public Health, Uganda
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Endothelial cell injury in acute and chronic glomerular lesions in patients with IgA nephropathy. Hum Pathol 2015; 49:135-44. [PMID: 26826420 DOI: 10.1016/j.humpath.2015.10.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/18/2015] [Accepted: 10/21/2015] [Indexed: 11/20/2022]
Abstract
Endothelial cell injury may contribute to the progression of various glomerular diseases. In the present study, we examined glomerular capillary injury in acute and chronic glomerular lesions in patients with Immunoglobulin A nephropathy (IgAN). We selected renal biopsy samples of IgAN (n = 200), and glomerular capillary injury in the acute and chronic glomerular lesions was assessed using immunohistochemistry for CD34 and electron microscopy. We examined the correlations between acute and chronic glomerular lesions and proteinuria, hematuria, and the renal function. The injured glomerular capillaries in the acute glomerular lesions were characterized morphologically by the separation of CD34+ endothelial cells from the glomerular basement membrane and the loss of glomerular endothelial cells and capillaries, together with inflammatory cell infiltration, fibrin exudation, rupture of the glomerular basement membrane, and/or crescent formation. In addition, the injured capillaries in the chronic glomerular lesions were characterized by the loss of CD34+ glomerular endothelial cells and capillaries exhibiting segmental and global glomerular sclerosis with or without fibrous crescents. In the acute glomerular lesions, the presence of endocapillary hypercellularity, fibrinoid necrosis, and cellular and fibrocellular crescents correlated significantly with hematuria, with or without proteinuria. In the chronic glomerular lesions, a significant relationship was evident between segmental or global sclerosis and proteinuria and/or the serum creatinine level. In conclusion, injuries of glomerular capillaries and the loss of endothelial cells occurred in the acute and chronic glomerular lesions in IgAN and may contribute to the development of hematuria, proteinuria, and renal dysfunction.
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Mohan M, McSwiggan S, Baig F, Rutherford L, Lang CC. Metformin and its effects on myocardial dimension and left ventricular hypertrophy in normotensive patients with coronary heart disease (the MET-REMODEL study): rationale and design of the MET-REMODEL study. Cardiovasc Ther 2015; 33:1-8. [PMID: 25545400 DOI: 10.1111/1755-5922.12101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Left ventricular hypertrophy (LVH) is a common and independent risk factor for cardiovascular events in patients with coronary artery disease (CAD). Controlling blood pressure is the standard approach to the management of LVH, but this is only partially effective as LVH also persists in normotensive patients. Apart from blood pressure (BP), other main risk factors associated with LVH are insulin resistance (IR) and central obesity. The diabetic medication, Metformin, reduces IR and aids weight loss and may therefore regress LVH. The MET REMODEL study will investigate the ability of Metformin to regress LVH in 64 patients with CAD. The MET-REMODEL trial is a single-center, phase IV, double blind, randomized, placebo-controlled trial to investigate the efficacy of Metformin in regression of the independent cardiac risk factor of LVH in patients with CAD who are insulin resistant. A minimum of 64 adults with a history of CAD with LVH and IR will be randomized into two groups to receive, either Metformin XL or placebo. The primary endpoint of this trial is to investigate any change in left ventricular mass index. Secondary endpoints include changes to insulin resistance measured using fasting insulin resistance index (FIRI), obesity, LV size, and function and improvement in endothelial function. A positive result will assist clinicians to identify a new mechanism for LVH regression by administering Metformin XL. This may also lead to investigating the mortality benefit of Metformin in patients with CAD and LVH.
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Affiliation(s)
- Mohapradeep Mohan
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, Dundee, Angus, UK
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Azmi S, Ferdousi M, Petropoulos IN, Ponirakis G, Alam U, Fadavi H, Asghar O, Marshall A, Atkinson AJ, Jones W, Boulton AJM, Tavakoli M, Jeziorska M, Malik RA. Corneal Confocal Microscopy Identifies Small-Fiber Neuropathy in Subjects With Impaired Glucose Tolerance Who Develop Type 2 Diabetes. Diabetes Care 2015; 38:1502-8. [PMID: 25877814 PMCID: PMC4512140 DOI: 10.2337/dc14-2733] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/27/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Impaired glucose tolerance (IGT) through to type 2 diabetes is thought to confer a continuum of risk for neuropathy. Identification of subjects at high risk of developing type 2 diabetes and, hence, worsening neuropathy would allow identification and risk stratification for more aggressive management. RESEARCH DESIGN AND METHODS Thirty subjects with IGT and 17 age-matched control subjects underwent an oral glucose tolerance test, assessment of neuropathic symptoms and deficits, quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy (CCM) to quantify corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) at baseline and annually for 3 years. RESULTS Ten subjects who developed type 2 diabetes had a significantly lower CNFD (P = 0.003), CNBD (P = 0.04), and CNFL (P = 0.04) compared with control subjects at baseline and a further reduction in CNFL (P = 0.006), intraepidermal nerve fiber density (IENFD) (P = 0.02), and mean dendritic length (MDL) (P = 0.02) over 3 years. Fifteen subjects who remained IGT and 5 subjects who returned to normal glucose tolerance had no significant baseline abnormality on CCM or IENFD but had a lower MDL (P < 0.0001) compared with control subjects. The IGT subjects showed a significant decrease in IENFD (P = 0.02) but no change in MDL or CCM over 3 years. Those who returned to NGT showed an increase in CNFD (P = 0.05), CNBD (P = 0.04), and CNFL (P = 0.05), but a decrease in IENFD (P = 0.02), over 3 years. CONCLUSIONS CCM and skin biopsy detect a small-fiber neuropathy in subjects with IGT who develop type 2 diabetes and also show a dynamic worsening or improvement in corneal and intraepidermal nerve morphology in relation to change in glucose tolerance status.
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Affiliation(s)
- Shazli Azmi
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Maryam Ferdousi
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Ioannis N Petropoulos
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. Weill-Cornell Medical College, Doha, Qatar
| | - Georgios Ponirakis
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. Weill-Cornell Medical College, Doha, Qatar
| | - Uazman Alam
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Hassan Fadavi
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Omar Asghar
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Andrew Marshall
- Department of Clinical Neurophysiology, Central Manchester NHS Foundation Trust, Manchester, U.K
| | - Andrew J Atkinson
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Wendy Jones
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Andrew J M Boulton
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Mitra Tavakoli
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Maria Jeziorska
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Rayaz A Malik
- Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and Central Manchester National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K. Weill-Cornell Medical College, Doha, Qatar
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Dimova R, Tankova T, Chakarova N, Groseva G, Dakovska L. Cardiovascular autonomic tone relation to metabolic parameters and hsCRP in normoglycemia and prediabetes. Diabetes Res Clin Pract 2015; 109:262-70. [PMID: 26036955 DOI: 10.1016/j.diabres.2015.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/05/2015] [Accepted: 05/06/2015] [Indexed: 01/02/2023]
Abstract
AIMS The aim of the study was to evaluate cardiovascular autonomic function (CAF) at different stages of obesity and in the presence of metabolic syndrome (MetS), and its association with metabolic parameters and hsCRP in subjects with normal glucose tolerance (NGT) and prediabetes. METHODS A total of 259 subjects (mean age 47.1 ± 14.6 years, mean BMI 31.4 ± 8.1 kg/m(2)), divided in 2 groups: NGT and prediabetes, and subdivided according to glucose tolerance, BMI and MetS, were enrolled. Anthropometric indices, glucose tolerance, blood pressure, serum lipids and hsCRP were measured. Body composition was estimated by impedance analysis. CAF was assessed by ANX-3.0 method. RESULTS Sympathetic and parasympathetic activity were decreased in severe obesity and MetS as compared to controls in NGT. Negative correlation was observed between sympathetic and parasympathetic tone and BMI, waist circumference, total body fat, visceral fat area (VFA), blood pressure, total and LDL cholesterol, and hsCRP in NGT; and VFA, HbA1c and glycemia in prediabetes. CONCLUSION Obesity and MetS seem to be associated with CAF deterioration, and metabolic parameters and hsCRP correlate with CAF and probably increase cardiovascular risk in NGT, whilst VFA, HbA1c and glycemia significantly influence CAF alterations in prediabetes.
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Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Greta Groseva
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
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85
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Ince H, Taşdemir HA, Aydin M, Ozyürek H, Tilki HE. Evaluation of Nerve Conduction Studies in Obese Children With Insulin Resistance or Impaired Glucose Tolerance. J Child Neurol 2015; 30:989-99. [PMID: 25342307 DOI: 10.1177/0883073814550188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 08/07/2014] [Indexed: 01/22/2023]
Abstract
The aim of the study was to investigate nerve conduction studies in terms of neuropathic characteristics in obese patients who were in prediabetes stage and also to determine the abnormal findings. The study included 69 obese adolescent patients between April 2009 and December 2010. All patients and control group underwent motor (median, ulnar, tibial, and peroneal) and sensory (median, ulnar, sural, and medial plantar) nerve conduction studies and sympathetic skin response test. Sensory response amplitude of the medial plantar nerve was significantly lower in the patients with impaired glucose tolerance and insulin resistance. To our knowledge, the present study is the first study demonstrating the development of sensory and autonomic neuropathy due to metabolic complications of obesity in adolescent children even in the period without development of diabetes mellitus. We recommend that routine electrophysiological examinations be performed, using medial plantar nerve conduction studies and sympathetic skin response test.
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Affiliation(s)
- Hülya Ince
- Department of Pediatric Neurology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Haydar Ali Taşdemir
- Department of Pediatric Neurology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Murat Aydin
- Department of Pediatric Endocrinology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hamit Ozyürek
- Department of Pediatric Neurology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hacer Erdem Tilki
- Department of Neurology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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86
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Zhang WW, Wang X, Xie P, Yuan ST, Liu QH. Anthrax lethal toxin suppresses high glucose induced VEGF over secretion through a post-translational mechanism. Int J Ophthalmol 2015; 8:453-8. [PMID: 26085990 DOI: 10.3980/j.issn.2222-3959.2015.03.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 12/29/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To prove anthrax lethal toxin (LeTx) blocks the mitogen activated protein kinases (MAPKs) activation by degrading the MAPK/ERK kinases (MEKs) to suppress vascular endothelial growth factor (VEGF) secretion. METHODS Human adult retinal pigmented epithelium (ARPE) cells were cultured and treated with normal glucose, high glucose or high glucose with LeTx for additional 24, 48 or 72h for viable cell count. Total RNA from the ARPE was isolated for reverse transcription polymerase chain reaction (RT-PCR). The conditioned medium of ARPE cells treated in different group for 48h was filtered and diluted to detect the concentration of VEGF by enzyme-linked immunosorbant assays. Evaluate the role of MEK/MAPK pathway in the secretion of VEGF by immunoblotting. RESULTS In this study, we proved high glucose induced activation of the MAPK extracellular signal-regulated kinase (ERK1/2) and p38 in the ARPE cell line was blocked by anthrax LeTx. LeTx also inhibited high glucose induced ARPE cell over proliferation. CONCLUSION LeTx suppressed high glucose induced VEGF over secretion in the ARPE cells, mainly through a post-translational mechanism.
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Affiliation(s)
- Wei-Wei Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Xin Wang
- Department of Endocrinology, Jiangsu Province Hospital of TCM, Nanjing 210029, Jiangsu Province, China
| | - Ping Xie
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Song-Tao Yuan
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Qing-Huai Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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Abstract
PURPOSE OF REVIEW This article provides an overview for understanding the diagnosis, pathogenesis, and management of diabetic neuropathy. RECENT FINDINGS New information about the pathogenesis of diabetic neuropathy continues to emerge, which will lead to identifying new drug targets. It is clear that the natural history of diabetic neuropathy is changing and the rate of progression is slowing. This is likely because of a combination of earlier diagnosis, improved glycemic management, and improved control of related complications such as hyperlipidemia and hypertension. Early diagnosis is critical, and small fiber neuropathy or subclinical diabetic neuropathy may be reversed or significantly improved with appropriate intervention. The American Academy of Neurology recently published guidelines for the treatment of painful diabetic neuropathy. SUMMARY Diabetic neuropathy is common and can present with varied clinical presentations discussed in this article. Although treatment currently focuses on pain management, attention should be paid to potential risk factors for neuropathy. For example, glycemic control, hyperlipidemia, and hypertension should be managed with diet, exercise, and medications. Class I or II clinical studies indicate that pregabalin, duloxetine, amitriptyline, gabapentin, and opioids are effective in the management of diabetic neuropathic pain.
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88
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Yanagida K, Maejima Y, Santoso P, Otgon-Uul Z, Yang Y, Sakuma K, Shimomura K, Yada T. Hexosamine pathway but not interstitial changes mediates glucotoxicity in pancreatic β-cells as assessed by cytosolic Ca2+ response to glucose. Aging (Albany NY) 2015; 6:207-14. [PMID: 24704640 PMCID: PMC4012937 DOI: 10.18632/aging.100647] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Hyperglycemia impairs insulin secretion as well as insulin action, being recognized as the glucotoxicity that accelerates diabetes. However, the mechanism underlying the glucotoxicity in pancreatic β-cells is not thoroughly understood. Hyperglycemia alters glucose metabolism within β-cells and interstitial conditions around β-cells, including elevated osmolarity and increased concentrations of insulin and ATP released from overstimulated β-cells. In this study, to explore direct effects of these alterations on β-cells, single β-cells isolated from rat islets were cultured for 3 days with high (22.3 mM) glucose (HG), compared with control 5.6 mM glucose, followed by their functional assessment by measuring cytosolic Ca2+ concentration ([Ca2+]i). The [Ca2+]i response to a physiological rise in glucose concentration to 8.3 mM was impaired in b-cells following culture with HG for 3 days, while it was preserved in β-cells following culture with non-metabolizable L-glucose and with elevated osmolarity, insulin and ATP. This HG-induced impairment of [Ca2+]i response to 8.3 mM glucose was prevented by adding azaserine, a hexosamine pathway inhibitor, into HG culture. Conversely, culture with glucosamine, which increases the hexosamine pathway flux, impaired [Ca2+]i response to 8.3 mM glucose, mimicking HG. These results suggest that the HG-associated abnormal glucose metabolism through hexosamine pathway, but not elevated osmolarity, insulin and ATP, plays a major role in the glucotoxicity to impair the secretory function of pancreatic β-cells.
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Affiliation(s)
- Kazuhiro Yanagida
- 2nd Department of Internal Medicine, Kagoshima University School of Medicine, Kagoshima, Japan
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89
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A novel animal model of impaired glucose tolerance induced by the interaction of vitamin E deficiency and (60)Co radiation. BIOMED RESEARCH INTERNATIONAL 2015; 2015:457246. [PMID: 25954750 PMCID: PMC4411448 DOI: 10.1155/2015/457246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/21/2015] [Accepted: 03/01/2015] [Indexed: 11/18/2022]
Abstract
Impaired glucose tolerance (IGT), known as the prediabetes stage, is usually induced by habits of life or environmental factors. Established IGT animal models are mostly conducted with chemical compounds such as streptozocin or genetic modification. However, the occasion of exposure to these factors in daily life is seldom. The objective of this study was to establish a new animal model of IGT induced by VE deficiency in diet and exposure to radiation. SD rats were treated individually or in combination of these two factors. In the combination group, the calculated insulin sensitivity index decreased; then HOMA-β value increased. Oxidative damage and IGT were observed. Insulin secretion level in perfusate from pancreas response to glucose was characterized by a rapid but reduced first phase and an obviously defective second phase upon pancreas perfusion. Histopathological images demonstrated the pathological changes. Western blotting analysis showed that the insulin signaling pathway was downregulated. The interaction of VE deficiency in diet and exposure to radiation could break the equilibrium of oxidation and antioxidation and result in IGT. More importantly, a new IGT model was successfully established which may be conducive to further research into development of drugs against human IGT.
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90
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Maternal salt and fat intake causes hypertension and sustained endothelial dysfunction in fetal, weanling and adult male resistance vessels. Sci Rep 2015; 5:9753. [PMID: 25953742 PMCID: PMC4424661 DOI: 10.1038/srep09753] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 03/18/2015] [Indexed: 01/09/2023] Open
Abstract
Maternal salt and fat intake can independently programme adult cardiovascular status, increasing risk of cardiovascular disease in offspring. Despite its relevance to modern western-style dietary habits, the interaction between increased maternal salt and fat intake has not been examined. Female virgin Sprague-Dawley rats were fed, a standard control diet (CD) (10% kcal fat, 1% NaCl), High-fat diet (HF) (45% kcal fat, 1% NaCl), High-salt diet (SD) (10% kcal fat, 4% NaCl), High-fat high-salt diet (HFSD) (45% kcal fat, 4% NaCl) prior to pregnancy, during pregnancy and throughout lactation. Fetal, weanling and adult vessels were mounted on a pressure myograph at fetal day 18, weaning day 21 and day 135 of adulthood. Increased blood pressure in SD, HFD and HFSD male offspring at day 80 and 135 of age was consistent with perturbed vascular function in fetal, weanling and adult vessels. Maternal salt intake reduced EDHF and calcium-mediated vasodilation, maternal fat reduced NO pathways and maternal fat and salt intake, a combination of the two pathways. Adult offspring cardiovascular disease risk may, in part, relate to vascular adaptations caused by maternal salt and/or fat intake during pregnancy, leading to persistent vascular dysfunction and sustained higher resting blood pressure throughout life.
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91
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Zhang Y, Meng N, Lv Z, Li H, Qu Y. The gene polymorphisms of UCP1 but not PPAR γ and TCF7L2 are associated with diabetic retinopathy in Chinese type 2 diabetes mellitus cases. Acta Ophthalmol 2015; 93:e223-9. [PMID: 25274455 DOI: 10.1111/aos.12542] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 07/23/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was designed to investigate the association between the polymorphisms in three insulin resistance-related genes, uncoupling protein-1 (UCP1), peroxisome proliferator-activated receptor γ (PPARγ) and transcription factor 7-like 2 (TCF7L2) and the susceptibility to diabetic retinopathy (DR) in a Chinese type 2 diabetes mellitus (T2DM) cohort. METHODS A total of 792 patients with T2DM were enrolled and categorized into two groups: (1) the DR group consisted of 448 patients, which was further subclassified into a proliferative DR (PDR) group with 220 patients and a non-proliferative DR (NPDR) group with 228 patients; (2) the diabetes without retinopathy (DNR) group, comprised 344 patients who had no signs of DR. Single-nucleotide polymorphisms (SNPs), rs1800592 in the UCP1 gene, rs1801282, rs3856806 and rs1249719 in the PPARγ gene and rs11196205 in the TCF7L2 gene were genotyped in this study. RESULTS For SNP rs1800592 of the UCP1 gene, the frequency of allele G and genotype GG was significantly higher in the PDR group than in the DNR group (allele OR: 1.32, 95% CI: 1.03-1.68, p = 0.03; genotype OR: 1.72, 95%CI: 1.06-2.79, p = 0.03). No evident association was found between the allele frequencies and genotype distributions of any individual SNP in the PPARγ or TCF7L2 genes and DR, PDR or NPDR. Haplotype analyses of the PPARγ gene did not provide any evidence for an association with DR, PDR or NPDR in this Chinese T2DM cohort. CONCLUSIONS This study suggests that the SNP rs1800592 in the UCP1 gene is associated with increased risk of PDR in the Chinese T2DM population.
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Affiliation(s)
- Yue Zhang
- Department of Health Care, Qilu Hospital of Shandong University, Jinan, China
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92
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Hanssen NMJ, Russell N, Cooper ME. Recent advances in glucose-lowering treatment to reduce diabetic kidney disease. Expert Opin Pharmacother 2015; 16:1325-33. [PMID: 25912195 DOI: 10.1517/14656566.2015.1041502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The epidemic of diabetes has now taken on epic proportions and therefore reducing the impact of diabetic complications represents one of the major global challenges in improving health and well-being worldwide. Preventing the development of diabetic kidney disease (DKD) is particularly important, as diabetes is one of the main risk factors for the development of chronic kidney disease, which in turn is strongly linked to development of cardiovascular disease, end-stage renal failure, hospitalization and premature death. Intensive glucose-lowering treatment has been shown to prevent and slow progression of DKD, yet to date, only certain populations have benefited from this intervention. AREAS COVERED We review the evidence for existing glucose-lowering treatments in the prevention of DKD, and research into techniques to better target individuals who will benefit from these therapies. EXPERT OPINION Diabetic patients with established kidney disease may benefit from glucose-lowering treatment, particularly if a safer side-effect profile of these treatments is achieved. Better understanding of glucose homeostasis and evaluation of compounds inhibiting its downstream effects are required in order to improve the outlook for individuals with DKD. An additional approach to improve the success rate of glucose-lowering treatment is to improve the selection of individuals who may benefit from treatment. A potential means to identify such subjects could involve the use of biomarkers.
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Affiliation(s)
- Nordin M J Hanssen
- Maastricht University, CARIM School of Cardiovascular Diseases, Department of Internal Medicine , Maastricht , The Netherlands
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93
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Vivian EM. Dapagliflozin: A new sodium–glucose cotransporter 2 inhibitor for treatment of type 2 diabetes. Am J Health Syst Pharm 2015; 72:361-72. [DOI: 10.2146/ajhp140168] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Eva M. Vivian
- School of Pharmacy, University of Wisconsin, Madison
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94
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Okada R, Yasuda Y, Tsushita K, Wakai K, Hamajima N, Matsuo S. Within-visit blood pressure variability is associated with prediabetes and diabetes. Sci Rep 2015; 5:7964. [PMID: 25589061 PMCID: PMC4295087 DOI: 10.1038/srep07964] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/02/2015] [Indexed: 12/21/2022] Open
Abstract
We investigated the associations between within-visit blood pressure variability (BPV) and risk factors for cardiovascular disease (CVD). The study subjects included 17,795 people aged 40–74 years who underwent health check-ups in Aichi Prefecture, Japan, and completed two blood pressure measurements. Subjects were categorized into three groups according to the difference of systolic blood pressure (ΔSBP), namely, low-BPV (≤10 mmHg), moderate-BPV (11–20 mmHg), and high-BPV (>20 mmHg). Subjects were also divided into three categories as those without prediabetes (glycosylated hemoglobin A1c [HbA1c] < 5.7%), prediabetes (HbA1c 5.7–6.4%) and diabetes (HbA1c ≥ 6.5% or under treatment for diabetes). The proportion of prediabetes and diabetes were significantly higher in subjects with high-BPV than in those with low-BPV after adjusting for age, sex, and mean SBP (odds ratio [95% confidence interval] was 1.16 [1.01–1.33] for prediabetes and 1.33 [1.06–1.66] for diabetes). Other CVD risk factors were not associated with high-BPV after the adjustment. In conclusion, increased within-visit BPV was significantly associated with the prevalence of prediabetes and diabetes, independent of mean SBP, in a large general population. Therefore, assessing BPV in a single visit may help to identify subjects at increased risk of impaired glycemic control.
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Affiliation(s)
- Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinari Yasuda
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyo Tsushita
- Comprehensive Health Science Center, Aichi Health Promotion Foundation, Aichi, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Young Leaders' Program in Health Care Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiichi Matsuo
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Malavazos AE, Cereda E, Ermetici F, Caccialanza R, Briganti S, Rondanelli M, Morricone L. The "lipid accumulation product" is associated with 2-hour postload glucose outcomes in overweight/obese subjects with nondiabetic fasting glucose. Int J Endocrinol 2015; 2015:836941. [PMID: 25792981 PMCID: PMC4352415 DOI: 10.1155/2015/836941] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 11/17/2022] Open
Abstract
"Lipid accumulation product" (LAP) is a continuous variable based on waist circumference and triglyceride concentration previously associated with insulin resistance. We investigated the accuracy of LAP in identifying oral glucose tolerance test (OGTT) abnormalities and compared it to the homeostasis model assessment of insulin resistance (HOMA-IR) in a population of overweight/obese outpatients presenting with nondiabetic fasting glucose. We studied 381 (male: 23%) adult (age: 18-70 years) overweight/obese Caucasians (body mass index: 36.9 ± 5.4 Kg/m(2)) having fasting plasma glucose < 7.0 mmol/L. OGTT was used to diagnose unknown glucose tolerance abnormalities: impaired glucose tolerance (IGT) and type-2 diabetes mellitus (T2-DM). According to OGTT 92, subjects had an IGT and 33 were diagnosed T2-DM. Logistic regression analysis detected a significant association for both LAP and HOMA-IR with single (IGT and T2-DM) and composite (IGT + T2-DM) abnormal glucose tolerance conditions. However, while the association with diabetes was similar between LAP and HOMA-IR, the relationship with IGT and composite outcomes by models including LAP was significantly superior to those including HOMA-IR (P = 0.006 and P = 0.007, resp.). LAP seems to be an accurate index, performing better than HOMA-IR, for identifying 2-hour postload OGTT outcomes in overweight/obese patients with nondiabetic fasting glucose.
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Affiliation(s)
- Alexis Elias Malavazos
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Emanuele Cereda
- U.O. di Diabetologia e Malattie Metaboliche, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milano, Italy
- *Emanuele Cereda:
| | - Federica Ermetici
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Riccardo Caccialanza
- U.O. di Diabetologia e Malattie Metaboliche, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milano, Italy
| | - Silvia Briganti
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
| | - Mariangela Rondanelli
- Ambulatorio di Dietologia, Dipartimento di Scienze Sanitarie Applicate e Psicocomportamentali, Sezione di Nutrizione, Azienda di Servizi alla Persona di Pavia, Università degli Studi di Pavia, via Emilia No. 12, 27100 Pavia, Italy
| | - Lelio Morricone
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy
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Fysekidis M, Cosson E, Banu I, Duteil R, Cyrille C, Valensi P. Increased glycemic variability and decrease of the postprandial glucose contribution to HbA1c in obese subjects across the glycemic continuum from normal glycemia to first time diagnosed diabetes. Metabolism 2014; 63:1553-61. [PMID: 25308444 DOI: 10.1016/j.metabol.2014.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 09/14/2014] [Accepted: 09/19/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The contribution of postprandial glycemia (PPG) to hyperglycemia has been shown to decrease as HbA1c increased in type 2 diabetic patients. This study aimed at examining, in a series of overweight/obese patients without known glycemic disorder, the contribution of PPG to a "relative" hyperglycemia (glucose values≥5.5 mmol/L) and the presence of glycemic variability according to HbA1c levels. METHODS Seventy overweight/obese inpatients (body mass index 35.2±6.8 kg/m2) without known glycemic disorder were included. Participants were classified according to an oral glucose tolerance test (according to the American Diabetes Association criteria) as patients with normoglycemia (n=33), with intermediate hyperglycemia (n=24) or diabetes (n=13). They were separated into HbA1c quartiles (Q1 to Q4). A 24 hour continuous glucose monitoring was used under a 1800 kcal diet and minimal physical activity. We assessed PPG contribution (3 hour period after each meal) to the "relative" 24 hour hyperglycemia (glucose values ≥5.5 mmol/L); the remaining time was considered as the fasting/post-absorptive period. RESULTS HbA1c range was from 5.1% to 7.4% (32 to 57 mmol/mmol). From the lowest to the highest HbA1c quartile, the area under the curve (AUC) for the "relative" hyperglycemia presented a 17-fold increase for the fasting/post-absorptive (p<0.001) period and a 7-fold increase postprandially (p<0.001). The percent of PPG contribution to the "relative" hyperglycemia was calculated with the following formula [100×(postprandial 3 hour AUC-3 h AUC for a constant 5.5 mmol/L glycemia)/(total 24 h AUC-24 h AUC for constant 5. 5 mmol/L glycemia)] and decreased from Q1 to Q4 of HbA1c (81.2%, 66%, 65.8%, 57%; p<0.001). Increasing HbA1c quartiles were associated with higher daily mean blood glucose level (p<0.001) and higher levels of daily glucose variability indices, including mean amplitude of glycemic excursions (p<0.01). CONCLUSIONS In overweight/obese patients, HbA1c was associated with lower PPG contribution to "relative" hyperglycemia and greater glycemic variability. The present findings support the importance of postprandial period in glycemic exposure even before the appearance of diabetes.
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Affiliation(s)
- Marinos Fysekidis
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Emmanuel Cosson
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Isabela Banu
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Régine Duteil
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Chantal Cyrille
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Paul Valensi
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France.
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97
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Xu H, Wu X, Qin H, Tian W, Chen J, Sun L, Fang M, Xu Y. Myocardin-Related Transcription Factor A Epigenetically Regulates Renal Fibrosis in Diabetic Nephropathy. J Am Soc Nephrol 2014; 26:1648-60. [PMID: 25349198 DOI: 10.1681/asn.2014070678] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/09/2014] [Indexed: 11/03/2022] Open
Abstract
Diabetic nephropathy (DN) is one of the most common complications associated with diabetes and characterized by renal microvascular injury along with accelerated synthesis of extracellular matrix proteins causing tubulointerstitial fibrosis. Production of type I collagen, the major component of extracellular matrix, is augmented during renal fibrosis after chronic exposure to hyperglycemia. However, the transcriptional modulator responsible for the epigenetic manipulation leading to induction of type I collagen genes is not clearly defined. We show here that tubulointerstitial fibrosis as a result of DN was diminished in myocardin-related transcription factor A (MRTF-A) -deficient mice. In cultured renal tubular epithelial cells and the kidneys of mice with DN, MRTF-A was induced by glucose and synergized with glucose to activate collagen transcription. Notably, MRTF-A silencing led to the disappearance of prominent histone modifications indicative of transcriptional activation, including acetylated histone H3K18/K27 and trimethylated histone H3K4. Detailed analysis revealed that MRTF-A recruited p300, a histone acetyltransferase, and WD repeat-containing protein 5 (WDR5), a key component of the histone H3K4 methyltransferase complex, to the collagen promoters and engaged these proteins in transcriptional activation. Estradiol suppressed collagen production by dampening the expression and binding activity of MRTF-A and interfering with the interaction between p300 and WDR5 in renal epithelial cells. Therefore, targeting the MRTF-A-associated epigenetic machinery might yield interventional strategies against DN-associated renal fibrosis.
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Affiliation(s)
- Huihui Xu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and
| | - Xiaoyan Wu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and Laboratory Center for Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Hao Qin
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and
| | - Wenfang Tian
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and
| | - Junliang Chen
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and School of Basic Medical Sciences, Jiangnan University, Wuxi, China
| | - Lina Sun
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and Department of Pathology and Pathophysiology, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China; and
| | - Mingming Fang
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and Department of Medicine and Nursing, Jiangsu Jiankang Vocational University, Nanjing, China
| | - Yong Xu
- State Key Laboratory of Reproductive Medicine, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Pathophysiology and
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98
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Childhood obesity and insulin resistance: how should it be managed? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2014; 16:351. [PMID: 25293340 DOI: 10.1007/s11936-014-0351-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OPINION STATEMENT Concomitant with the rise in global pediatric obesity in the past decades, there has been a significant increase in the number of children and adolescents with clinical signs of insulin resistance. Given insulin resistance is the important link between obesity and the associated metabolic abnormalities and cardiovascular risk, clinicians should be aware of high risk groups and treatment options. As there is no universally accepted biochemical definition of insulin resistance in children and adolescents, identification and diagnosis of insulin resistance usually relies on clinical features such as acanthosis nigricans, polycystic ovary syndrome, hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Treatment for reducing insulin resistance and other obesity-associated comorbidities should focus on changes in health behaviors to achieve effective weight management. Lifestyle interventions incorporating dietary change, increased physical activity, and decreased sedentary behaviors, with the involvement of family and adoption of a developmentally appropriate approach, should be used as the first line treatment. Current evidence suggests that the primary objective of dietary interventions should be to reduce total energy intake and a combination of aerobic and resistance training should be encouraged. Metformin can be used in conjunction with a lifestyle intervention program in obese adolescents with clinical insulin resistance to achieve weight loss and to improve insulin sensitivity. Ongoing evaluation and research are required to explore optimal protocol and long-term effectiveness of lifestyle interventions, as well as to determine whether the improvements in insulin sensitivity induced by lifestyle interventions and weight loss will lead to a clinical benefit including reduced cardiovascular morbidity and mortality.
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99
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Danilova IG, Sarapultsev PA, Medvedeva SU, Gette IF, Bulavintceva TS, Sarapultsev AP. Morphological restructuring of myocardium during the early phase of experimental diabetes mellitus. Anat Rec (Hoboken) 2014; 298:396-407. [PMID: 25251897 DOI: 10.1002/ar.23052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 08/06/2014] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to determine the specific features of the morphological restructuring of the myocardium in the early stage of experimental diabetes mellitus (DM). Experimental type 1 DM rat model was developed by intraperitoneal injection of alloxan solution at a dose of 30 mg per 100 g body mass. After 1 month, 3 mL of blood was drawn by heart puncture and the plasma separated by centrifugation for biochemical analysis. Plasma glucose, insulin, and glycosylated haemoglobin in whole blood were determined. Light microscopy and morphometric studies were conducted of histological slices of the hearts of experimental animals. The investigation of heart morphology showed a statistically significant alteration in chamber wall thickness in the right auricle in rats with alloxan-induced DM. A change in cardiomyocyte diameter in myocardium slices was observed in all chambers of DM rats except for the left ventricle. Average cardiomyocyte diameter in rats with experimental DM increased by 26.6% and 15.5% in the right auricle and right ventricle, respectively, while average cardiomyocyte diameter in the left auricle decreased by 20.8%. Histological investigation of the heart following alloxan injection demonstrated, under the epicardium, distended vessels of the venous collecting microcirculatory system. Aggregation and agglutination of red blood cells and endothelial cell destruction were found in some vessels. In the early stage of DM development, structural alterations in the microcirculatory channels and myocardiocytes can be observed in the heart. These structural alterations were most evident in the right chambers of the heart.
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Affiliation(s)
- I G Danilova
- Institute of Immunology and Physiology of the Ural Branch of the RAS, Ekaterinburg, Russian Federation; Federal State Autonomous Educational Institution of Higher Professional Education, Ural Federal University named after the first President of Russia B. N. Yeltsin, Ekaterinburg, Russian Federation
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Sohrabipour S, Kharazmi F, Soltani N, Kamalinejad M. Biphasic effect of Solanum nigrum fruit aqueous extract on vascular mesenteric beds in non-diabetic and streptozotocin-induced diabetic rats. Pharmacognosy Res 2014; 6:148-52. [PMID: 24761120 PMCID: PMC3996752 DOI: 10.4103/0974-8490.129036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 06/18/2013] [Accepted: 03/18/2014] [Indexed: 12/03/2022] Open
Abstract
Background: In Asia, Solanum nigrum fruit is traditionally used to manage, control, and treat diabetes. Objective: This study was carried out to investigate the endothelium and nitric oxide roles in Solanum nigrum-induced vasorelaxation in non-diabetic and diabetic rat vessels. Materials and Methods: Diabetes was induced by a single i.p. injection of streptozotocin. Eight weeks later, superior mesenteric arteries of non-diabetic and diabetic groups were isolated and perfused according to the McGregor method. Solanum nigrum fruit extract (SNE) at concentrations of 0.00001 to 0.6 mg/ml was added to the medium and perfusion pressure was recorded. Results: Baseline perfusion pressure of diabetic group was significantly higher than non-diabetic rats in both intact and denuded endothelium. The low concentrations of SNE have vasodilatory effect in the diabetic and non-diabetic, but high concentrations of SNE produce initial significant contractions, followed by secondary relaxations in normal and diabetic rats. We observed vasorelaxation at low and high concentrations of SNE in both diabetic and non-diabetic groups after endothelium denudation. SNE-induced vasorelaxation in diabetic group is mediated by both endothelium and smooth muscle, but the relaxatory effect of SNE in non-diabetic group is not mediated by endothelium, and SNE has direct action on the smooth muscle. Conclusion: Although the part of SNE-induced relaxation in diabetic vessel was mediated by endothelium, nitric oxide didn’t play any role in this action, and maybe we can use SNE in the management of diabetes vessel complications in future.
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Affiliation(s)
- Shahla Sohrabipour
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ; Department of Physiology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemah Kharazmi
- Department of Physiology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nepton Soltani
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ; Department of Physiology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Kamalinejad
- Department of Pharmacognosy, Faculty of Pharmacy, Shahid Bahashti University of Medical Sciences, Tehran, Iran
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