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Chen X, Song Y, Hong Y, Zhang X, Li Q, Zhou H. "NO" controversy?: A controversial role in insulin signaling of diabetic encephalopathy. Mol Cell Endocrinol 2024; 593:112346. [PMID: 39151653 DOI: 10.1016/j.mce.2024.112346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/14/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
Insulin, a critical hormone in the human body, exerts its effects by binding to insulin receptors and regulating various cellular processes. While nitric oxide (NO) plays an important role in insulin secretion and acts as a mediator in the signal transduction pathway between upstream molecules and downstream effectors, holds a significant position in the downstream signal network of insulin. Researches have shown that the insulin-NO system exhibits a dual regulatory effect within the central nervous system, which is crucial in the regulation of diabetic encephalopathy (DE). Understanding this system holds immense practical importance in comprehending the targets of existing drugs and the development of potential therapeutic interventions. This review extensively examines the characterization of insulin, NO, Nitric oxide synthase (NOS), specific NO pathway, their interconnections, and the mechanisms underlying their regulatory effects in DE, providing a reference for new therapeutic targets of DE.
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Affiliation(s)
- Xi Chen
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Ying Song
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China; Hangzhou King's Bio-pharmaceutical Technology Co., Ltd, Hangzhou, Zhejiang, 310007, China.
| | - Ye Hong
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Xiaomin Zhang
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Qisong Li
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Hongling Zhou
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
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152
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Wang X, Ma L, Jiang M, Zhu H, Ni C, Yang X, Hu J, Zhang HH. Analysis of gastric electrical rhythm in patients with type 2 diabetes mellitus. Endocrine 2024; 86:612-619. [PMID: 38861116 PMCID: PMC11489290 DOI: 10.1007/s12020-024-03908-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
AIM To analysis the change of electrogastrogram (EGG) in patients with type 2 diabetes mellitus (T2DM), and evaluate the prevalence of abnormal gastric electrical rhythm (AGER) and its relative influencing factors. METHODS A total of 65 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from Dec. 2020 to Dec. 2021 were included in the cross-sectional study. General information, clinical data, and medical history data of all study subjects, including name, gender, body mass index (BMI), duration of diabetes, anti-diabetic therapies, high blood pressure (HBP) history, smoking history, and medication history, were completely collected. The results of laboratory tests, including biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2 h postprandial C-peptide, 24 h urine total protein (24 hUTP), urine microalbumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were recorded. EGG, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying ultrasound, fundus examination, carotid artery ultrasonography, cardiac autonomic function test, heart rate variability (HRV) were all examined and recorded as well. According to the results of EGG, the subjects were divided into normal gastric electrical rhythm (NGER) group and abnormal gastric electrical rhythm (AGER) group. RESULTS (1) Fasting blood glucose (FBG), HbA1c, the presence of diabetic peripheral neuropathy (DPN) and diabetic cardiac autonomic neuropathy (DCAN) were significantly higher in the AGER group (p < 0.05). Low frequency (LF) and high frequency (HF), the indicators of HRV, were significantly lower in the AGER group (p < 0.05). In addition, the prevalence of feeling excessively full after meals, loss of appetite, and stomach or belly visibly larger after meals of gastrointestinal symptoms of gastroparesis were significantly higher in the AGER group (p < 0.05). Multiple logistic regression analysis showed that FBG and the prevalence of DCAN were the independent risk factors. CONCLUSION AGER was associated with high FBG and the presence of DCAN. EGG examination is recommended for patients with gastrointestinal symptoms and clues of DCAN.
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Affiliation(s)
- Xixi Wang
- The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Lianhua Ma
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Miao Jiang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- NO.2 People's Hospital of Fuyang City, Fuyang, China
| | - Hong Zhu
- The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chendong Ni
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | | | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Hong-Hong Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
- Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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153
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Xie P, He J, Ou Y. RBM15 Promotes High Glucose-Induced Lens Epithelial Cell Injury by Inducing PRNP N6-Methyladenine Modification During Diabetic Cataract. Curr Eye Res 2024; 49:1145-1153. [PMID: 39206850 DOI: 10.1080/02713683.2024.2362855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/15/2024] [Accepted: 05/28/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Diabetic cataract (DC) is a major cause of blindness worldwide. Prion protein (PRNP) was proved to be up-regulated and hypomethylated in DC samples. Here, we investigated whether PRNP was involved in DC progression in N6-methyladenosine (m6A)-dependent manner, and its potential mechanisms. METHODS Levels of genes and proteins were assayed using qRT-PCR and western blotting. Cell proliferation and apoptosis were determined using Cell Counting Kit-8 assay, 5-thynyl-2'-deoxyuridine (EdU) assay, and flow cytometry, respectively. Oxidative stress was analyzed by measuring the production of glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), and malondialdehyde (MDA). The m6A modification was determined by RNA immunoprecipitation (Me-RIP) assay. The interaction between RBM15 (RNA binding motif protein 15) and PRNP was probed using RIP assay. RESULTS PRNP was highly expressed in DC patients and HG-induced HLECs. Functionally, PRNP deficiency reversed HG-induced apoptosis and oxidative stress in HLECs. Mechanistically, RBM15 induced PRNP m6A modification and directly bound to PRNP. Knockdown of RBM15 abolished HG-induced apoptotic and oxidative injury in HLECs, while these effects were rescued after PRNP overexpression. CONCLUSION RBM15 silencing suppressed HG-induced lens epithelial cell injury by regulating PRNP in an m6A-mediated manner, hinting a novel therapeutic strategy for DC patients.
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Affiliation(s)
- Ping Xie
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
| | - Jing He
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
| | - Yangjun Ou
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
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De Luca M, Shikora S, Eisenberg D, Angrisani L, Parmar C, Alqahtani A, Aminian A, Aarts E, Brown WA, Cohen RV, Di Lorenzo N, Faria SL, Goodpaster KPS, Haddad A, Herrera MF, Rosenthal R, Himpens J, Iossa A, Kermansaravi M, Kow L, Kurian M, Chiappetta S, LaMasters T, Mahawar K, Merola G, Nimeri A, O'Kane M, Papasavas PK, Piatto G, Ponce J, Prager G, Pratt JSA, Rogers AM, Salminen P, Steele KE, Suter M, Tolone S, Vitiello A, Zappa M, Kothari SN. Scientific evidence for the updated guidelines on indications for metabolic and bariatric surgery (IFSO/ASMBS). Surg Obes Relat Dis 2024; 20:991-1025. [PMID: 39419572 DOI: 10.1016/j.soard.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 10/19/2024]
Abstract
The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.
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Affiliation(s)
| | - Scott Shikora
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Dan Eisenberg
- Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, Palo Alto, California
| | - Luigi Angrisani
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, UK
| | - Aayed Alqahtani
- New You Medical Center, King Saud University, Riyadh, Saudi Arabia
| | - Ali Aminian
- Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Edo Aarts
- Department of Surgery, Weight Works Clinics and Allurion Clinics, Amersfoort, The Netherlands
| | - Wendy A Brown
- Department of Surgery, Central Clinical School, Alfred Health, Monash University, Melbourne, Victoria, Australia
| | - Ricardo V Cohen
- Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paolo, Brazil
| | - Nicola Di Lorenzo
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - Silvia L Faria
- Gastrocirurgia de Brasilia, University of Brasilia, Brasilia, Brazil
| | | | - Ashraf Haddad
- Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | - Miguel F Herrera
- Endocrine and Bariatric Surgery, UNAM at INCMNSZ, Mexico City, México
| | - Raul Rosenthal
- Cleveland Clinic Florida, The Bariatric Institute, Weston, Florida
| | - Jacques Himpens
- Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium
| | - Angelo Iossa
- Department of Medico Surgical Sciences and Biotechnologies Sapienza Polo Pontino, ICOT Hospital Latina, Latina, Italy
| | - Mohammad Kermansaravi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Hazrat-e Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Marina Kurian
- Department of Surgery, New York University Grossman School of Medicine, New York, New York
| | - Sonja Chiappetta
- Obesity and Metabolic Surgery Unit, Department of General and Laparoscopic Surgery, Ospedale Evangelico Betania, Naples, Italy
| | | | - Kamal Mahawar
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, United Kingdom
| | - Giovanni Merola
- General and Laparoscopic Surgery, San Giovanni di Dio Hospital - Frattamaggiore, Naples, Italy
| | - Abdelrahman Nimeri
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Mary O'Kane
- Department of Nutrition and Dietetics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Pavlos K Papasavas
- Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, Connecticut
| | - Giacomo Piatto
- UOC Chirurgia Generale e d'Urgenza, Ospedale di Montebelluna, Montebelluna, Italy
| | - Jaime Ponce
- Bariatric Surgery Program, CHI Memorial Hospital, Chattanooga, Tennessee
| | - Gerhard Prager
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Janey S A Pratt
- Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, Palo Alto, California
| | - Ann M Rogers
- Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Paulina Salminen
- Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Turku, Finland
| | - Kimberley E Steele
- NIDDK Metabolic and Obesity Research Unit, National Institutes of Health, Bethesda, Maryland
| | - Michel Suter
- Department of Visceral Surgery, University Hospital, Lausanne, Switzerland
| | - Salvatore Tolone
- Department of Surgery, Seconda Universita di Napoli, Naples, Italy
| | - Antonio Vitiello
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Naples, Italy
| | - Marco Zappa
- General Surgery Unit, Asst Fatebenefratelli-Sacco Milan, Milan, Italy
| | - Shanu N Kothari
- Prisma Health, Department of Surgery, University of South Carolina School of Medicine, Greenville, South Carolina
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155
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Rai P, Webb EM, Paulson SL, Kang L, Weger-Lucarelli J. Obesity's Unexpected Influence: Reduced Alphavirus Transmission and Altered Immune Activation in the Vector. J Med Virol 2024; 96:e70032. [PMID: 39466902 DOI: 10.1002/jmv.70032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 09/26/2024] [Accepted: 10/17/2024] [Indexed: 10/30/2024]
Abstract
Chikungunya virus (CHIKV) and Mayaro virus (MAYV) are emerging/re-emerging alphaviruses transmitted by Aedes spp. mosquitoes and responsible for recent disease outbreaks in the Americas. The capacity of these viruses to cause epidemics is frequently associated with increased mosquito transmission, which in turn is governed by virus-host-vector interactions. Although many studies have explored virus-vector interactions, significant gaps remain in understanding how vertebrate host factors influence alphavirus transmission by mosquitoes. We previously showed that obesity, a ubiquitous vertebrate host biological factor, reduces alphavirus transmission potential in mosquitoes. We hypothesized that alphavirus-infected obese bloodmeals altered immune genes and/or pathways in mosquitoes, thereby inhibiting virus transmission. To test this, we conducted RNA sequencing (RNA-seq) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) on midgut RNA from mosquitoes fed on alphavirus-infected lean and obese mice. This approach aimed to identify potential antiviral or proviral genes and pathways altered in mosquitoes after consuming infected obese bloodmeals. We found upregulation of the Toll pathway and downregulation of several metabolic and other genes in mosquitoes fed on alphavirus-infected obese bloodmeals. Through gene knockdown studies, we demonstrated the antiviral role of Toll pathway and proviral roles of AAEL009965 and fatty acid synthase (FASN) in the transmission of alphaviruses by mosquitoes. Therefore, this study utilized obesity to identify factors influencing alphavirus transmission by mosquitoes and this research approach may pave the way for designing broadly effective antiviral measures to combat mosquito-borne viruses, such as releasing transgenic mosquitoes deficient in the identified genes.
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Affiliation(s)
- Pallavi Rai
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Virginia Tech, Blacksburg, Virginia, USA
| | - Emily M Webb
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Virginia Tech, Blacksburg, Virginia, USA
- Department of Entomology, Fralin Life Sciences Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Sally L Paulson
- Department of Entomology, Fralin Life Sciences Institute, Virginia Tech, Blacksburg, Virginia, USA
| | - Lin Kang
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia, USA
- Biomedical Research, Edward Via College of Osteopathic Medicine, Monroe, Los Angeles, USA
- College of Pharmacy, University of Louisiana Monroe, Monroe, Los Angeles, USA
| | - James Weger-Lucarelli
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Virginia Tech, Blacksburg, Virginia, USA
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156
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Naik AR, Save SN, Sahoo SS, Yadav SS, Kumar A, Chugh J, Sharma S. Metabolic perturbations associated with hIAPP-induced insulin resistance in skeletal muscles: Implications to the development of type 2 diabetes. Int J Biochem Cell Biol 2024; 176:106665. [PMID: 39322038 DOI: 10.1016/j.biocel.2024.106665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 09/16/2024] [Accepted: 09/18/2024] [Indexed: 09/27/2024]
Abstract
The human islet amyloid polypeptide (hIAPP) tends to misfold and self-assemble to form amyloid fibrils, which has been associated with the loss of function and viability of pancreatic β-cells in type 2 diabetes mellitus (T2DM). The role of hIAPP in the development of insulin resistance (a hallmark of T2DM) in skeletal muscles - the major sites for glucose utilization - needs further investigation. Even though, insulin-resistant conditions have been known to stimulate hIAPP aggregation, the events that lead to the development of insulin resistance due to hIAPP aggregation in skeletal muscles remain unidentified. Here, we have attempted to identify metabolic perturbations in L6 myotubes that were exposed to increasing concentrations of recombinant hIAPP for different time durations. It was observed that hIAPP exposure was associated with increased mitochondrial and cellular ROS levels, loss in mitochondrial membrane potential and viability of the myotubes. Metabolomic investigations of hIAPP-treated myotubes revealed significant perturbations in o-phosphocholine, sn-glycero-3-phosphocholine and dimethylamine levels (p < 0.05). Therefore, we anticipate that defects in glycerophospholipid metabolism and the associated oxidative stress and membrane damage may play key roles in the development of insulin resistance due to protein misfolding in skeletal muscles. In summary, the perturbed metabolites and their pathways have not only the potential to be used as early biomarkers to predict the onset of insulin resistance and T2DM but also as therapeutic targets for the effective management of the same.
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Affiliation(s)
- Arya R Naik
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India
| | - Shreyada N Save
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India
| | - Soumya S Sahoo
- Department of Chemistry, Indian Institute of Science Education and Research (IISER), Dr. Homi Bhabha Road, Pashan, Pune 411008, India
| | - Saurabh S Yadav
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India
| | - Ashutosh Kumar
- Department of Biosciences and Bioengineering, Indian institute of technology Bombay, Powai, Mumbai, Maharashtra 400076, India
| | - Jeetender Chugh
- Department of Chemistry, Indian Institute of Science Education and Research (IISER), Dr. Homi Bhabha Road, Pashan, Pune 411008, India
| | - Shilpy Sharma
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India.
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157
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Kishore BK. Reverse epidemiology of obesity paradox: Fact or fiction? Physiol Rep 2024; 12:e70107. [PMID: 39472276 PMCID: PMC11521792 DOI: 10.14814/phy2.70107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 10/16/2024] [Accepted: 10/16/2024] [Indexed: 11/02/2024] Open
Abstract
Obesity paradox refers to the clinical observation that when acute cardiovascular decompensation occurs, patients with obesity may have a survival benefit. This apparently runs counter to the epidemiology of obesity, which may increase the risk for non-communicable diseases (NCDs). The scientific community is split on obesity paradox, with some supporting it, while others call it BMI paradox. This review: (a) defines the obesity paradox, and its proposed role in overall mortality in NCDs; (b) delineates evidence for and against obesity paradox; (c) presents the importance of using different indices of body mass to assess the risk in NCDs; (d) examines the role of metabolically healthy obesity in obesity paradox, and emerging importance of cardio-respiratory fitness (CRF) as an independent predictor of CVD risk and all-cause mortality in patients with/without obesity. Evidence suggests that the development of obesity and insulin resistance are influenced by genetic (or ethnic) make up and dietary habits (culture) of the individuals. Hence, this review presents lean diabetes, which has higher total CVD and non-CVD mortality as compared to diabetics with obesity and the possibility of maternal factors programming cardiometabolic risk during fetal development, which may lead to a paradigm shift in our understanding of obesity.
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Affiliation(s)
- Bellamkonda K. Kishore
- Division of Nephrology and Hypertension, Department of Internal MedicineUniversity of Utah HealthSalt Lake CityUtahUSA
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158
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Fentahun S, Tinsae T, Rtbey G, Andualem F, Kelebie M, Kibralew G, Nakie G, Teferi S, Tadesse A, Melkam M, Tadesse G. Quality of Sleep and Its Determinants Among People with Diabetes Mellitus in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Behav Sleep Med 2024; 22:803-819. [PMID: 38877758 DOI: 10.1080/15402002.2024.2367469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
BACKGROUND Poor sleep quality is a serious concern among diabetes mellitus patients, adversely affecting glycemic management and the prognosis of diabetic patients. Therefore, the main aim of this study was to estimate the overall pooled prevalence of poor sleep quality and its associated factors among diabetic patients in Sub-Saharan Africa. METHODS Several search databases were employed to retrieve the eligible studies. A standardized data extraction format was used to extract the data, and the analysis was conducted using STATA version 14. To determine heterogeneity, the I2 test was conducted, and both the funnel plot and Egger's regression test were used to assess the publication bias. A random effects model meta-analysis was performed to estimate the overall prevalence and associated factors of poor sleep quality. RESULTS In the current meta-analysis, a total of 11 studies with 3,766 study participants were included. The overall pooled prevalence of poor sleep quality among diabetic patients was 53.22% (95% CI: 36.26, 70.19). Poor sleep quality was significantly associated with longer duration of diabetes (OR = 2.94, 95% CI: 1.85, 4.67), poor glycemic control (OR = 2.24, 95% CI: 1.51, 3.32), depression (OR = 4.09, 95% CI: 2.07, 8.05) and comorbidity (OR = 1.94, 95% CI: 1.31, 2.88). CONCLUSION In this study, more than half of diabetic patients in Sub-Saharan Africa had poor sleep quality. Therefore, healthcare providers should give more attention to sleep disorders when screening diabetic patients to improve their poor sleep quality.
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Affiliation(s)
- Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulualem Kelebie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Samuel Teferi
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asnake Tadesse
- Department of Neonatal Health Nursing, School of Nursing, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Grant-Alfieri A, Herman WH, Watkins DJ, Batterman S, Karvonen-Gutierrez C, Park SK. Associations of serum persistent organic pollutant concentrations with incident diabetes in midlife women: The Study of Women's Health Across the Nation Multi-Pollutant Study. ENVIRONMENTAL RESEARCH 2024; 260:119582. [PMID: 38992756 DOI: 10.1016/j.envres.2024.119582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/30/2024] [Accepted: 07/07/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) that can negatively impact metabolic health through pathways including endocrine disruption. Few studies have evaluated diabetes risk associated with PBDEs. Little is known about the joint effect of exposure to POP mixtures on diabetes risk. OBJECTIVES We investigated the relationship between POPs, individually and as mixtures, and diabetes development over 18 years (1999-2016) in midlife women. METHODS We measured lipid-standardized serum concentrations of 34 PCBs, 19 OCPs, and 14 PBDEs in 1040 midlife women aged 45-56 years from the Study of Women's Health Across the Nation. We tested the association between POPs measured in 1999/2000 and incident diabetes using Cox proportional hazards models. We evaluated diabetes risk associated with the overall POP mixture using Quantile-Based G-Computation (QBGC). RESULTS For most mixture components, single pollutant and mixtures analyses indicated null associations with diabetes risk, however results were inconsistent. After adjustment, hazard ratios (HRs) of developing diabetes (95% CI) associated with upper exposure tertiles (T2/T3) compared with the first tertile (T1), were 1.7 (1.0, 2.8) at T2 and 1.5 (0.84, 2.7) at T3 for hexachlorobenzene and 1.9 (1.1, 3.3) at T2 and 1.6 (0.88, 2.9) at T3 for PCB 123. A doubling of PBDE 47 was associated with 1.11 (1.00, 1.24) times the risk of T2D. QBGC identified no association for the overall joint effect of the POP mixture on diabetes (HR = 1.04 [0.53, 2.07]). CONCLUSION Exposure to a mixture of PCBs, OCPs, and PBDEs was not associated with incident diabetes in midlife U.S. women, although some individual POPs demonstrated significant yet inconsistent associations with diabetes. Non-linear and non-monotonic dose-response dynamics deserve further exploration. More research is needed on the diabetogenic effects of PBDEs.
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Affiliation(s)
- Amelia Grant-Alfieri
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - William H Herman
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Stuart Batterman
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Sung Kyun Park
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Li E, Waters A, Cunningham A, Silverio A, Han J, Mills G. Patient and Provider Prediabetes Knowledge, Attitudes, and Behaviors in a Large Urban Family Medicine Practice. Am J Lifestyle Med 2024; 18:727-736. [PMID: 39507910 PMCID: PMC11536499 DOI: 10.1177/15598276221123527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2024] Open
Abstract
One-third of U.S. adults have prediabetes, but only 11% are aware of their condition. Many do not receive education or treatment. The purpose of this study is to understand family medicine providers' and patients' attitudes, knowledge, and behaviors regarding prediabetes and its management, to guide future management interventions. Cross-sectional surveys of providers (n = 54, 57% response rate) and patients with prediabetes (n = 148, 16.5% response rate) were administered at a large urban academic family medicine practice. Nearly all providers agree prediabetes screening is important, but over half were unaware of the national Diabetes Prevention Program (DPP) and most do not prescribe metformin to eligible patients. Over half of patients reported being told they have prediabetes but <5% had been referred to DPP and over half were unaware of medication options. In open-ended responses, providers suggested nutrition counseling resources and an improved DPP referral process to improve prediabetes care. Patients requested clear diagnosis, education on treatment options, and nutritional counseling. This study indicates that notable gaps continue to exist in provider and patient understanding and management of prediabetes, suggesting that interventions to improve prediabetes care should include more effective counseling on diagnosis and treatment and expanding access to nutrition and educational resources.
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Affiliation(s)
- Erica Li
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
| | - Alexa Waters
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
| | - Amy Cunningham
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
| | - Alexis Silverio
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
| | - Jasmine Han
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
| | - Geoffrey Mills
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH)
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Kuijper LEN, Lacroix E, Singh G, Champagne M, Beardy B, Dubois R, Wood L, Harper MJ, Muench K, Kisselgoff M, Mann K, Waugh A, Thériault C, Tait M, Bombak A, Riediger ND. Experiences and perspectives of sugar-sweetened beverage consumption among Indigenous adults living in Manitoba. Appetite 2024; 202:107637. [PMID: 39208478 DOI: 10.1016/j.appet.2024.107637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
Sugar-sweetened beverages (SSB) are a health policy target. Indigenous populations are among the highest consumers of SSB in Canada. However, the Truth and Reconciliation Commission calls on governments to recognize health disparities among Indigenous populations as a consequence of colonialism and governmental policies. The purpose of this analysis was to explore emergent perspectives of Indigenous adults on experiences and perspectives of SSB consumption. We conducted a community-based participatory study in partnership with three Indigenous-led organizations. From 2019 to 2022, we completed qualitative interviews with Indigenous adults living in Island Lake Anisininew First Nation, Flin Flon, and Winnipeg's North End, a neighbourhood with high concentration of Indigenous people. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Seventy-four adults participated in interviews, including 46 women, 26 men, and two identifying as two-spirit. Many participants, across all three locations, repeatedly and consistently described SSB or sugar as an addiction, which formed the primary theme for this analysis: addictive-like consumption of SSB. Addictive-like SSB consumption included comparison to other addictive substances, loss of control, and physical symptoms resulting from SSB intake (both positive and adverse) or attempting to reduce SSB intake. We identified two other secondary themes, i) perceived drivers and contexts of SSB consumption, and ii) health outcomes as a motivator for change. Perceived drivers or contexts included consuming SSB as a means to cope with stress, boredom, and poverty; SSB intake as being intertwined with other addictions or addictive substances; and drinking alone. In conclusion, addictive-like SSB consumption was reported by Indigenous adults. To address SSB intake among Indigenous populations, trauma-informed approaches should be explored that consider the colonial context.
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Affiliation(s)
| | - Emilie Lacroix
- Department of Psychology, University of New Brunswick, 38 Dineen Drive, Fredericton, NB, E3C 1N8, Canada.
| | - Gurismrandeep Singh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Michael Champagne
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3.
| | - Byron Beardy
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada.
| | - Riel Dubois
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3
| | - Larry Wood
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Mary Jane Harper
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Krista Muench
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Maria Kisselgoff
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Céleste Thériault
- National Indigenous Diabetes Association, 160 Provencher Blvd, Unit 202, Winnipeg, MB, R2H 0G3, Canada.
| | | | - Andrea Bombak
- Department of Sociology, University of New Brunswick, 9 Macaulay Ln, Fredericton, NB, E3C 1N8, Canada.
| | - Natalie D Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
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Smith C, Lin X, Parker L, Yeap BB, Hayes A, Levinger I. The role of bone in energy metabolism: A focus on osteocalcin. Bone 2024; 188:117238. [PMID: 39153587 DOI: 10.1016/j.bone.2024.117238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/06/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024]
Abstract
Understanding the mechanisms involved in whole body glucose regulation is key for the discovery of new treatments for type 2 diabetes (T2D). Historically, glucose regulation was largely focused on responses to insulin and glucagon. Impacts of incretin-based therapies, and importance of muscle mass, are also highly relevant. Recently, bone was recognized as an endocrine organ, with several bone proteins, known as osteokines, implicated in glucose metabolism through their effects on the liver, skeletal muscle, and adipose tissue. Research efforts mostly focused on osteocalcin (OC) as a leading example. This review will provide an overview on this role of bone by discussing bone turnover markers (BTMs), the receptor activator of nuclear factor kB ligand (RANKL), osteoprotegerin (OPG), sclerostin (SCL) and lipocalin 2 (LCN2), with a focus on OC. Since 2007, some, but not all, research using mostly OC genetically modified animal models suggested undercarboxylated (uc) OC acts as a hormone involved in energy metabolism. Most data generated from in vivo, ex vivo and in vitro models, indicate that exogenous ucOC administration improves whole-body and skeletal muscle glucose metabolism. Although data in humans are generally supportive, findings are often discordant likely due to methodological differences and observational nature of that research. Overall, evidence supports the concept that bone-derived factors are involved in energy metabolism, some having beneficial effects (ucOC, OPG) others negative (RANKL, SCL), with the role of some (LCN2, other BTMs) remaining unclear. Whether the effect of osteokines on glucose regulation is clinically significant and of therapeutic value for people with insulin resistance and T2D remains to be confirmed.
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Affiliation(s)
- Cassandra Smith
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Perth, Western Australia, Australia; Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University and Western Health, St Albans, VIC, Australia
| | - Xuzhu Lin
- Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Alan Hayes
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University and Western Health, St Albans, VIC, Australia; Department of Medicine - Western Health, The University of Melbourne, Footscray, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University and Western Health, St Albans, VIC, Australia; Department of Medicine - Western Health, The University of Melbourne, Footscray, VIC, Australia.
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Hussain MK, Khatoon S, Khan MF, Akhtar MS, Ahamad S, Saquib M. Coumarins as versatile therapeutic phytomolecules: A systematic review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 134:155972. [PMID: 39265442 DOI: 10.1016/j.phymed.2024.155972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/23/2024] [Accepted: 07/11/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Coumarins, abundantly distributed in a plethora of biologically active compounds, serve as a fundamental motif in numerous natural products, drugs, and therapeutic leads. Despite their small size, they exhibit a diverse range of biological activities, intriguing researchers with their immense pharmacological potential. PURPOSE This study consolidates the evidence regarding the essential role of coumarins in modern drug discovery, exploring their broad-spectrum pharmaceutical effects, structural versatility, and mechanisms of action across various domains. METHODS For literature search, we utilized PubMed, Google scholar, and SciFinder databases. Keyword and keyword combinations such as "coumarins", "natural coumarins", "specific natural coumarins for particular diseases", and "therapeutic effects" were employed to retrieve relevant studies. The search encompassed articles published between 2005 and 2023. Selection criteria included studies reporting on the pharmacological activities of natural coumarins against various diseases. RESULTS The results highlight the therapeutic potential of natural coumarins against various diseases, demonstrating anti-cancer, anti-oxidant, and anti-inflammatory activities. They also act as monoamine oxidase inhibitors and phosphodiesterase inhibitors, and as anti-thrombotic, anti-diabetic, and hepatoprotective agents. They also show efficacy against diabetic nephropathy, neurodegenerative diseases, microbial infections and many other diseases. CONCLUSION This review underscores the significant role of natural coumarins in medicinal chemistry and drug discovery. Their diverse biological activities and structural versatility make them promising therapeutic agents. This study serves as a catalyst for further research in the field, aiming to address emerging challenges and opportunities in drug development.
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Affiliation(s)
- Mohd Kamil Hussain
- Department of Chemistry, Govt. Raza P.G. College, Rampur 244901, M.J.P Rohil Khand University, Bareilly, India.
| | | | - Mohammad Faheem Khan
- Department of Biotechnology, Era's Lucknow Medical College, Era University, Lucknow 226003, India
| | - Mohd Sayeed Akhtar
- Department of Botany, Gandhi Faiz-e-Aam College, Shahjahanpur 242001, India
| | - Shakir Ahamad
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, India.
| | - Mohammad Saquib
- Department of Chemistry, University of Allahabad, Prayagraj (Allahabad) 211002, India; Department of Chemistry, G. R. P. B. Degree College, P. R. S. University, Prayagraj (Allahabad) 211010, India.
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Xie R, Sher KHJ, Tang SYC, Yam IYL, Lee CH, Wu Q, Yap DYH. Dysregulation of neutrophil extracellular traps (NETs)-related genes in the pathogenesis of diabetic kidney disease - Results from bioinformatics analysis and translational studies. Clin Immunol 2024; 268:110379. [PMID: 39396625 DOI: 10.1016/j.clim.2024.110379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/24/2024] [Accepted: 10/08/2024] [Indexed: 10/15/2024]
Abstract
The role of Neutrophil extracellular traps (NETs) in the immunopathogenesis of Diabetic Kidney Disease (DKD) remains elusive. We used a machine learning approach to identify differentially expressed genes (DEGs) associated with NETs in human DKD kidney biopsy datasets and validated the results using single-nucleus RNA sequencing datasets. The expressions of these candidate genes and related cytokines were verified in blood obtained from DKD patients. Three NETs-associated genes (ITGAM, ITGB2 and TLR7) were identified, which all showed significant upregulation in both glomerular and tubulointerstitial compartments in human DKD kidneys. DKD patients showed significantly higher number of activated neutrophils with increased ITGAM and ITGB2 expression, higher serum IL-6 but lower IL-10, compared to healthy controls (p all <0.01). This study suggests that dysregulation of NETs-associated genes ITGAM and ITGB2 are related to the pathogenesis of DKD, and may serve as novel diagnostic markers and therapeutic targets in DKD.
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Affiliation(s)
- Ruiyan Xie
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, HKSAR, China
| | - Ka Ho Jason Sher
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, HKSAR, China
| | - Sin Yu Cindy Tang
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, HKSAR, China
| | - Irene Ya Lin Yam
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, HKSAR, China
| | - C H Lee
- Division of Endocrinology & Metabolism, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Shenzhen 518028, HKSAR, China
| | - Qiongli Wu
- Shenzhen Experimental Education School, Shenzhen, China
| | - Desmond Yat Hin Yap
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, HKSAR, China.
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165
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Glintborg D, Christensen LL, Andersen MS. Transgender healthcare: metabolic outcomes and cardiovascular risk. Diabetologia 2024; 67:2393-2403. [PMID: 38958699 DOI: 10.1007/s00125-024-06212-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/21/2024] [Indexed: 07/04/2024]
Abstract
Transgender identity is often associated with gender dysphoria and minority stress. Gender-affirming hormone treatment (GAHT) includes masculinising or feminising treatment and is expected to be lifelong in most cases. Sex and sex hormones have a differential effect on metabolism and CVD in cisgender people, and sex hormone replacement in hypogonadism is associated with higher vascular risk, especially in ageing individuals. Using narrative review methods, we present evidence regarding metabolic and cardiovascular outcomes during GAHT and propose recommendations for follow-up and monitoring of metabolic and cardiovascular risk markers during GAHT. Available data show no increased risk for type 2 diabetes in transgender cohorts, but masculinising GAHT increases lean body mass and feminising GAHT is associated with higher fat mass and insulin resistance. The risk of CVD is increased in transgender cohorts, especially during feminising GAHT. Masculinising GAHT is associated with a more adverse lipid profile, higher haematocrit and increased BP, while feminising GAHT is associated with pro-coagulant changes and lower HDL-cholesterol. Assigned male sex at birth, higher age at initiation of GAHT and use of cyproterone acetate are separate risk factors for adverse CVD markers. Metabolic and CVD outcomes may improve during gender-affirming care due to a reduction in minority stress, improved lifestyle and closer surveillance leading to optimised preventive medication (e.g. statins). GAHT should be individualised according to individual risk factors (i.e. drug, dose and form of administration); furthermore, doctors need to discuss lifestyle and preventive medications in order to modify metabolic and CVD risk during GAHT. Follow-up programmes must address the usual cardiovascular risk markers but should consider that biological age and sex may influence individual risk profiling including mental health, lifestyle and novel cardiovascular risk markers during GAHT.
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Affiliation(s)
- Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Louise L Christensen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marianne S Andersen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Guo S, Liu D, Bi X, Feng Y, Zhang K, Jiang J, Wang Y. Barriers and facilitators to self-management among women with gestational diabetes: A systematic review using the COM-B model. Midwifery 2024; 138:104141. [PMID: 39178483 DOI: 10.1016/j.midw.2024.104141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/24/2024] [Accepted: 08/07/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions. AIM To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women. METHODS This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management. RESULTS Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby). CONCLUSION In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.
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Affiliation(s)
- Shujie Guo
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China; Department of Clinical Nursing, School of Nursing, Air Force Medical University, Xi'an, China
| | - Dongmei Liu
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoxuan Bi
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yuxuan Feng
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Ke Zhang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Jingjing Jiang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yanhong Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
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Mantry S, Behera A, Pradhan S, Mohanty L, Kumari R, Singh A, Yadav MK. Polysaccharide-based chondroitin sulfate macromolecule loaded hydrogel/scaffolds in wound healing- A comprehensive review on possibilities, research gaps, and safety assessment. Int J Biol Macromol 2024; 279:135410. [PMID: 39245102 DOI: 10.1016/j.ijbiomac.2024.135410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 08/20/2024] [Accepted: 09/05/2024] [Indexed: 09/10/2024]
Abstract
Wound healing is an intricate multifactorial process that may alter the extent of scarring left by the wound. A substantial portion of the global population is impacted by non-healing wounds, imposing significant financial burdens on the healthcare system. The conventional dosage forms fail to improve the condition, especially in the presence of other morbidities. Thus, there is a pressing requirement for a type of wound dressing that can safeguard the wound site and facilitate skin regeneration, ultimately expediting the healing process. In this context, Chondroitin sulfate (CS), a sulfated glycosaminoglycan material, is capable of hydrating tissues and further promoting the healing. Thus, this comprehensive review article delves into the recent advancement of CS-based hydrogel/scaffolds for wound healing management. The article initially summarizes the various physicochemical characteristics and sources of CS, followed by a brief understanding of the importance of hydrogel and CS in tissue regeneration processes. This is the first instance of such a comprehensive summarization of CS-based hydrogel/scaffolds in wound healing, focusing more on the mechanistic wound healing process, furnishing the recent innovations and toxicity profile. This contemporary review provides a profound acquaintance of strategies for contemporary challenges and future direction in CS-based hydrogel/scaffolds for wound healing.
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Affiliation(s)
- Shubhrajit Mantry
- Department of Pharmaceutics, Department of Pharmacy, Sarala Birla University, Birla Knowledge City, Ranchi 835103, Jharkhand, India.
| | - Ashutosh Behera
- Department of Pharmaceutical Quality Assurance, Department of Pharmacy, Sarala Birla University, Birla Knowledge City, Ranchi 835103, Jharkhand, India; Department of Pharmaceutical Quality Assurance, Florence College of Pharmacy, IRBA, Ranchi, 835103, Jharkhand, India
| | - Shaktiprasad Pradhan
- Department of Pharmaceutical Chemistry, Koustuv Research Institute of Medical Science (KRIMS), Koustuv Technical Campus, Patia, Bhubaneswar, Odisha 751024, India
| | - Lalatendu Mohanty
- Department of Pharmacology, Department of Pharmaceutical Sciences, HNB Garhwal University (A Central University), Tehri Garhwal, Uttarakhand 24916, India
| | - Ragni Kumari
- School of Pharmacy, LNCT University, Bhopal 462022, Madhya Pradesh, India
| | - Ankita Singh
- Department of Pharmacy, Faculty of Medical Science & Research (FMSR), Sai Nath University, Ranchi, Jharkhand 835219, India
| | - Mahesh Kumar Yadav
- Department of Pharmacy, Faculty of Medical Science & Research (FMSR), Sai Nath University, Ranchi, Jharkhand 835219, India
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Jatana S, Abbadi A, West GA, Ponti AK, Braga-Neto MB, Smith JL, Marino-Melendez A, Willard B, Nagy LE, Motte CDL. Hyperglycemic environments directly compromise intestinal epithelial barrier function in an organoid model and hyaluronan (∼35 kDa) protects via a layilin dependent mechanism. Matrix Biol 2024; 133:116-133. [PMID: 39187208 DOI: 10.1016/j.matbio.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/12/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Metabolic syndrome and diabetes in obese individuals are strong risk factors for development of inflammatory bowel disease (IBD) and colorectal cancer. The pathogenic mechanisms of low-grade metabolic inflammation, including chronic hyperglycemic stress, in disrupting gut homeostasis are poorly understood. In this study, we sought to understand the impact of a hyperglycemic environment on intestinal barrier integrity and the protective effects of small molecular weight (35 kDa) hyaluronan on epithelial barrier function. METHODS Intestinal organoids derived from mouse colon were grown in normal glucose media (5 mM) or high glucose media (25 mM) to study the impact of hyperglycemic stress on the intestinal barrier. Additionally, organoids were pretreated with 35 kDa hyaluronan (HA35) to investigate the effect of hyaluronan on epithelial barrier under high glucose stress. Immunoblotting as well as confocal imaging was used to understand changes in barrier proteins, quantitative as well as spatial distribution, respectively. Alterations in barrier function were measured using trans-epithelial electrical resistance and fluorescein isothiocyanate flux assays. Untargeted proteomics analysis was performed to elucidate mechanisms by which HA35 exerts a protective effect on the barrier. Intestinal organoids derived from receptor knockout mice specific to various HA receptors were utilized to understand the role of HA receptors in barrier protection under high glucose conditions. RESULTS We found that high glucose stress decreased the protein expression as well as spatial distribution of two key barrier proteins, zona occludens-1 (ZO-1) and occludin. HA35 prevented the degradation or loss of ZO-1 and maintained the spatial distribution of both ZO-1 and occludin under hyperglycemic stress. Functionally, we also observed a protective effect of HA35 on the epithelial barrier under high glucose conditions. We found that HA receptor, layilin, was involved in preventing barrier protein loss (ZO-1) as well as maintaining spatial distribution of ZO-1 and occludin. Additionally, proteomics analysis showed that cell death and survival was the primary pathway upregulated in organoids treated with HA35 under high glucose stress. We found that XIAP associated factor 1 (Xaf1) was modulated by HA35 thereby regulating apoptotic cell death in the intestinal organoid system. Finally, we observed that spatial organization of both focal adhesion kinase (FAK) as well as F-actin was mediated by HA35 via layilin. CONCLUSION Our results highlight the impact of hyperglycemic stress on the intestinal barrier function. This is of clinical relevance, as impaired barrier function has been observed in individuals with metabolic syndrome. Additionally, we demonstrate barrier protective effects of HA35 through its receptor layilin and modulation of cellular apoptosis under high glucose stress.
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Affiliation(s)
- Samreen Jatana
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Amina Abbadi
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Gail A West
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - András K Ponti
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Manuel B Braga-Neto
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Jordyn L Smith
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Armando Marino-Melendez
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Belinda Willard
- Proteomics and Metabolomics Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Laura E Nagy
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Northern Ohio Alcohol Center, Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Carol de la Motte
- Department of Inflammation & Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
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Pham VM. Targeting PI3K/AKT and MEK/ERK pathways for synergic effects on improving features of peripheral diabetic neuropathy. J Diabetes Investig 2024; 15:1537-1544. [PMID: 39162579 PMCID: PMC11527830 DOI: 10.1111/jdi.14289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/08/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024] Open
Abstract
Diabetic neuropathy is one of the most serious and common complications of diabetes with a wide spectrum, affecting 30-50% of diabetic patients. However, the current treatments of this disorder, mainly based on controlling blood glucose level, show an inadequate clinical outcome. Better approaches are needed. In this fashion, it is noted that promoting nerve regeneration and preventing nerve degeneration should be focused on equally and appropriately. In this mini review, how more effective approaches are in targeting PI3K/AKT and MEK/ERK pathways in the treatment of peripheral diabetic neuropathy is discussed. Future treatment of peripheral diabetic neuropathy should consider these approaches.
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Affiliation(s)
- Vuong M. Pham
- Faculty of Biology and EnvironmentHo Chi Minh City University of Industry and TradeHo Chi Minh CityVietnam
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170
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Hayashino Y, Tsuboi S, Yamamoto Y, Ishii H. Burden of Current Insulin Therapy and Expectations for Future Insulin Therapy: Results from INBEING, a Web-Based Survey in Japan. Diabetes Ther 2024:10.1007/s13300-024-01664-w. [PMID: 39485624 DOI: 10.1007/s13300-024-01664-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 10/15/2024] [Indexed: 11/03/2024] Open
Abstract
INTRODUCTION This survey assessed the perspectives of physicians, people with diabetes (PWD), and caregivers in Japan regarding initiation barriers and treatment burden associated with insulin therapy, and expectations for new insulin therapies. METHODS An online survey, conducted May-June 2023, was completed by physicians (n = 411), PWD (type 1 diabetes, n = 108; type 2 diabetes [T2D]: insulin-naive, n = 114; insulin-treated, n = 108), and caregivers (family members, n = 107; nurses, n = 117; care workers, n = 104). Agreement with statements regarding initiation barriers, current feelings, and burden of insulin therapy was assessed. Physicians' views on ideal glycated hemoglobin (HbA1c) levels and actual levels in PWD at insulin initiation were captured. RESULTS Most PWD agreed with the statements "I don't want to be bothered with doing injections" (77.8-92.1%) and "I don't want to inject myself for the rest of my life" (78.7-91.2%). Physicians also considered these factors to be of high importance for PWD; however, physician and PWD (insulin-naive T2D) responses were significantly different for 11 statements. The greatest underestimation by physicians was for the statement "my family will be worried" (41.8% vs. 66.7%), whereas social factors (e.g., "my friendships may suffer," "if I take insulin I will be discriminated against") were overestimated by physicians (49.1% vs. 33.3% and 46.5% vs. 24.6%, respectively). Although > 70% of physicians considered HbA1c < 9.0% (< 75 mmol/mol) ideal for insulin initiation, only ~ 30% of PWD started insulin at HbA1c < 9.0% (< 75 mmol/mol). Nurses rated the burden of assisting with insulin injections significantly lower than family members or care workers. Respondents agreed the need for less frequent injections and improved glycemic control were important attributes expected from future insulin therapies. CONCLUSION Differences in perceptions between physicians and PWD in Japan regarding insulin therapy persist, but this gap may be narrowing. Both groups agreed that future insulin therapies should be simpler and provide better glycemic control.
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Affiliation(s)
| | | | | | - Hitoshi Ishii
- Department of Doctor-Patient Relationships, Nara Medical University, Kashihara, Japan
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171
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Kornum DS, Brock C, Okdahl T, Bertoli D, Kufaishi H, Wegeberg AM, Høyer KL, Mark EB, Brock B, Hansen CS, Knop FK, Drewes AM, Krogh K. Diabetic gastroenteropathy: Associations between gastrointestinal symptoms, motility, and extraintestinal autonomic measures. Neurogastroenterol Motil 2024:e14956. [PMID: 39485948 DOI: 10.1111/nmo.14956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 10/03/2024] [Accepted: 10/21/2024] [Indexed: 11/03/2024]
Abstract
BACKGROUND Diabetic gastroenteropathy can cause significant diagnostic challenges. Still, it remains unknown if measures of extraintestinal autonomic function reflect diabetic gastroenteropathy. We aimed to assess the associations between (1) gastrointestinal symptoms and motility measures and (2) gastrointestinal symptoms/motility measures and extraintestinal autonomic markers. METHODS We included 81 persons with type 1 or type 2 diabetes (65% female, mean age 54) with gastrointestinal symptoms and autonomic neuropathy. The Gastroparesis Cardinal Symptom Index (GCSI) and the Gastrointestinal Symptom Rating Scale (GSRS) assessed gastrointestinal symptoms. The wireless motility capsule (Smartpill™) assessed panenteric transit times and motility indices. Cardiovascular reflex tests (VAGUS™) and cardiac vagal tone (eMotion Faros) estimated cardiovascular autonomic neuropathy, while the SUDOSCAN™ evaluated sudomotor function. KEY RESULTS Proximal gastrointestinal symptoms were positively associated with the gastric motility index (GCSI: 1.18 (1.04-1.35), p = 0.01; GSRS: 1.15 (1.03-1.29), p = 0.02; median ratio (95% CI)), while only satiety correlated with gastric emptying time (1.24 (1.03-1.49), p = 0.02). Diarrhea was associated with decreased small bowel transit time (0.93 (0.89-0.98), p = 0.005), while constipation were associated with prolonged colonic transit time (1.16 (1.03-1.31), p = 0.02). Gastrointestinal symptoms increased with the degree of abnormal cardiovascular reflex tests (GCSI: 0.67 (0.16-1.19), p = 0.03; GSRS: 0.87 (0.30-1.45), p = 0.01; mean difference (95% CI)) but not with motility measures. Cardiac vagal tone and sudomotor function were not associated with gastrointestinal markers. CONCLUSIONS & INFERENCES Gastrointestinal and extraintestinal autonomic measures were not associated. However, proximal gastrointestinal symptoms were associated with the gastric motility index and cardiovascular reflex tests. Hence, the latter may contribute to evaluating whether proximal gastrointestinal symptoms are autonomically derived.
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Affiliation(s)
- Ditte S Kornum
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christina Brock
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Tina Okdahl
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Davide Bertoli
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Anne-Marie Wegeberg
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Thisted Research Unit, Aalborg University Hospital Thisted, Aalborg, Denmark
| | - Katrine L Høyer
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Esben B Mark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | | | - Filip K Knop
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk A/S, Bagsværd, Denmark
| | - Asbjørn M Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
- Thisted Research Unit, Aalborg University Hospital Thisted, Aalborg, Denmark
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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172
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Biz C, Belluzzi E, Rossin A, Mori F, Pozzuoli A, Bragazzi NL, Ruggieri P. Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (MIS-DMDO) for the Prevention and Treatment of Chronic Plantar Diabetic Foot Ulcers. Foot Ankle Int 2024; 45:1184-1197. [PMID: 39305167 DOI: 10.1177/10711007241268082] [Citation(s) in RCA: 1] [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] [Indexed: 11/06/2024]
Abstract
BACKGROUND Diabetic foot is one of the major complications of diabetes, affecting 15% of patients with diabetes. This study aims to evaluate and compare the clinical and radiographic outcomes of patients with diabetes affected by forefoot plantar preulcerative or ulcerative lesions who have undergone minimally invasive distal metatarsal diaphyseal osteotomy (MIS-DMDO) to assess its efficacy in the prevention and treatment of chronic plantar diabetic foot ulcers (CPDFUs). METHODS The study included 60 patients, 38 with preulcers and 22 with ulcers, with at least 2 years of clinical and radiologic follow-up. Clinical outcomes were assessed using the European Foot and Ankle Society (EFAS) score, the Foot Function Index (FFI), and the Manchester-Oxford Foot Questionnaire (MOXFQ). The radiographic evaluation was performed according to the Maestro criteria. RESULTS Both groups improved in clinical and radiologic outcomes when comparing baseline measurements to those at the final follow-up. There were no statistical differences between preulcer and ulcer groups in terms of both clinical and radiologic outcomes, with the only exception being FFI, which was lower in the preulcerative group. In multivariate analysis, gender and glycated hemoglobin (HbA1c) were predictors of better outcomes. Specifically, FFI and MOXFQ (P < .05) exhibited larger improvements in females, while Maestro 1 and 2 were better in patients with lower HbA1c (P < .05). All patients were considered healed at the final follow-up. CONCLUSION Carefully performed minimally invasive distal metatarsal diaphyseal osteotomy can be an effective approach to the care of impending or chronically present plantar diabetic foot ulcers.
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Affiliation(s)
- Carlo Biz
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Elisa Belluzzi
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy
| | - Alessandro Rossin
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
| | - Fabiana Mori
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
| | - Assunta Pozzuoli
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy
| | | | - Pietro Ruggieri
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University-Hospital of Padova, Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
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173
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Boscia F, Veritti D, Iaculli C, Lattanzio R, Freda S, Piergentili B, Varano M. Management of treatment-naïve diabetic macular edema patients: Review of real-world clinical data. Eur J Ophthalmol 2024; 34:1675-1694. [PMID: 38462923 DOI: 10.1177/11206721241237069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
The high prevalence of Diabetic macular edema (DME) is a real global health problem. Its complex pathophysiology involves different pathways. Over the last decade, the introduction of intravitreal treatments has dramatically changed the management and prognosis of DME. Among the different treatment options, inhibitors of vascular endothelial growth factor (anti-VEGF) and intravitreal steroids implants represent the first-line therapy of DME. We conducted a review of electronic databases to compile the available evidence about the clinical management of DME in a clinical setting, with a special focus on treatment-naïve patients. Anti-VEGF therapies represent a valuable option for treating DME patients. However, many patients do not respond properly to this treatment and, due to its administration regimen, many patients receive suboptimal treatment in real life. Current evidence demonstrated that in patients with DME, DEX-i improved significantly both anatomic and visual outcomes. Besides eyes with insufficient anti-VEGF respond or recalcitrant DME cases, DEX-i can be effectively and safely used in treatment-naïve DME patients as first line therapy. DEX-i may be considered first line therapy in different clinical scenarios, such as DME eyes with a greater inflammatory component, patients with cardiovascular events, vitrectomized eyes, or those requiring cataract surgery. In conclusion, there are still many points for improvement pending in the clinical management of the patient with DME. Since DME treatment must follow a patient-tailored approach, selecting the best therapeutic approach for each patient requires a good understanding of the pathophysiology of DME.
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Affiliation(s)
- Francesco Boscia
- Department of Translational Medicine and Neurosciences (DiBraiN), University of Bari, Bari, Italy
| | - Daniele Veritti
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy
| | - Cristiana Iaculli
- Department of Ophthalmology, Policlinico Riuniti Di Foggia, University of Foggia, 71122, Foggia, Italy
| | - Rosangela Lattanzio
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Simona Freda
- AbbVie S.r.l., SR 148 Pontina, 04011, Campoverde, LT
| | | | - Monica Varano
- Ophthalmology Department, IRCCS - Fondazione Bietti, Rome, Italy
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174
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Fan S, Liu Q, Du Q, Zeng X, Wu Z, Pan D, Tu M. Multiple roles of food-derived bioactive peptides in the management of T2DM and commercial solutions: A review. Int J Biol Macromol 2024; 279:134993. [PMID: 39181375 DOI: 10.1016/j.ijbiomac.2024.134993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/13/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
Type 2 diabetes mellitus (T2DM), a disease that threatens public health worldwide and can cause a series of irreversible complications, has been a major concern. Although the treatment based on hypoglycemic drugs is effective, its side effects should not be ignored, which has led to an urgent need for developing new hypoglycemic drugs. Bioactive peptides with antidiabetic effects obtained from food proteins have become a research hotspot as they are safer and with higher specificity than traditional hypoglycemic drugs. Here, we reviewed antidiabetic peptides that have the ability to inhibit key enzymes (α-glucosidase, α-amylase, and DPP-IV) in T2DM, the hypoglycemic mechanisms and structure-activity relationships were summarized, some antidiabetic peptides that improve insulin resistance and reverse gut microbiota and their metabolites were overviewed, the bitterness of antidiabetic peptides was predicted in silico, proposed solutions to the current challenges encountered in the development of antidiabetic peptide drugs, and provided an outlook on the future focus of commercial production. It provides a reference for the application of food-derived antidiabetic peptides.
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Affiliation(s)
- Shuo Fan
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Qirui Liu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Qiwei Du
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Xiaoqun Zeng
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Zhen Wu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Daodong Pan
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China
| | - Maolin Tu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang-Malaysia Joint Research Laboratory for Agricultural Product Processing and Nutrition, College of Food Science and Engineering, Ningbo University, Ningbo 315800, China; Zhejiang Key Laboratory of Food Microbiology and Nutritional Health, Hangzhou 310018, China.
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175
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Zhu L, Zhao J, Li Q. Clinical study on prescription used for invigorating spleen, reinforcing kidney and warming yang combined with calcium dobesilate in treatment of senile diabetic nephropathy. Biotechnol Genet Eng Rev 2024; 40:1737-1747. [PMID: 37013894 DOI: 10.1080/02648725.2023.2196483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To analyze the clinical effect of prescription used for invigorating spleen, reinforcing kidney and warming yang combined with calcium dobesilate to treat senile diabetic nephropathy (DN). METHODS The clinical data of 110 elderly patients with DN in our hospital from November 2020 to November 2021 were selected for retrospective analysis, and they were divided into the observation group (OG, n = 55) and the control group (CG, n = 55) according to the principle of random grouping. The CG received conventional therapy and calcium dobesilate, and the OG received conventional therapy, calcium dobesilate and prescription used for invigorating spleen, reinforcing kidney and warming yang to evaluate the clinical value of different treatment programs by comparing their clinical indicators after treatment. RESULTS The total effective rate of clinical treatment in the OG was clearly higher than the CG (P < 0.05). The blood glucose indexes, and the levels of ALB and RBP in the OG were visibly lower than the CG after treatment (P < 0.001). After treatment, the average levels of BUN and Cr in the OG were visibly lower than the CG (P < 0.001), while the average eGFR level was significantly higher than the CG (P < 0.001). CONCLUSION The prescription used for invigorating spleen, reinforcing kidney and warming yang combined with calcium dobesilate is a reliable method to improve the hemorheology indexes and renal function of DN patients, which benefits patients, and further studies are helpful to establish a better solution for such patients.
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Affiliation(s)
- Lin Zhu
- Department of Endocrinology, Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jianqun Zhao
- Department of Endocrinology, Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qian Li
- Department of Endocrinology, Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, Shandong, China
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176
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Ghareghomi S, Arghavani P, Mahdavi M, Khatibi A, García-Jiménez C, Moosavi-Movahedi AA. Hyperglycemia-driven signaling bridges between diabetes and cancer. Biochem Pharmacol 2024; 229:116450. [PMID: 39059774 DOI: 10.1016/j.bcp.2024.116450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
Growing epidemiological evidence indicates an association between obesity, type 2 diabetes, and certain cancers, suggesting the existence of common underlying mechanisms in these diseases. Frequent hyperglycemias in type 2 diabetes promote pro-inflammatory responses and stimulate intracellular metabolic flux which rewires signaling pathways and influences the onset and advancement of different types of cancers. Here, we review the provocative impact of hyperglycemia on a subset of interconnected signalling pathways that regulate (i) cell growth and survival, (ii) metabolism adjustments, (iii) protein function modulation in response to nutrient availability (iv) and cell fate and proliferation and which are driven respectively by PI3K (Phosphoinositide 3-kinase), AMPK (AMP-activated protein kinase), O-GlcNAc (O-linked N-acetylglucosamine) and Wnt/β-catenin. Specifically, we will elaborate on their involvement in glucose metabolism, inflammation, and cell proliferation, highlighting their interplay in the pathogenesis of diabetes and cancer. Furthermore, the influence of antineoplastic and antidiabetic drugs on the unbridled cellular pathways will be examined. This review aims to inspire the next molecular studies to understand how type 2 diabetes may lead to certain cancers. This will contribute to personalized medicine and direct better prevention strategies.
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Affiliation(s)
- Somayyeh Ghareghomi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; Department of Biotechnology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran
| | - Payam Arghavani
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Majid Mahdavi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Ali Khatibi
- Department of Biotechnology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran.
| | - Custodia García-Jiménez
- Department of Basic Health Sciences, Faculty of Health Sciences, University Rey Juan Carlos. Alcorcón, Madrid, Spain.
| | - Ali A Moosavi-Movahedi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; UNESCO Chair on Interdisciplinary Research in Diabetes, University of Tehran, Tehran, Iran.
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177
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Uyar A, Cellat M, Kanat Ö, Etyemez M, Kutlu T, Deveci MZY, Yavaş İ, Kuzu M. Bisphenol AF Caused Reproductive Toxicity in Rats and Cineole Co-Treatment Exhibited Protective Effect. Reprod Sci 2024; 31:3462-3474. [PMID: 39160422 DOI: 10.1007/s43032-024-01677-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024]
Abstract
Bisphenol AF (BPAF) is increasingly used and now found in products intended for human consumption. The protective effect of 1,8-cineole (CIN) against BPAF-induced reproductive toxicity was investigated. Four groups were created, with each group consisting of eight rats: control, BPAF (200 mg/kg), CIN (200 mg/kg), and BPAF + CIN groups. The results demonstrated that the BPAF group exhibited a decline in testosterone levels and a decrease in sperm parameters compared with the control. Additionally, higher levels of MDA were observed, along with lower levels of GSH and GPx activity. CAT activity also decreased slightly. Tnf-α, Nf-κB levels were significantly higher, and caspase-3 expression was elevated, while PCNA expression decreased. BPAF significantly increased tissue degeneration compared with the control. However, the BPAF + CIN group showed statistically significant improvements in sperm parameters, except for concentration. They also exhibited an increase in testosterone levels and an improvement in MDA and GSH levels compared with the BPAF group. However, GPx activity partially enhanced. Tnf-α and Nf-κB levels were significantly reduced, and caspase-3 levels declined while PCNA and Bcl-2 levels increased. The Johnsen Testicular Biopsy score showed a substantial increase. Overall, these results suggest that CIN co-treatment in rats enhanced reproductive health and exhibited antioxidant, antiapoptotic, and anti-inflammatory properties against BPAF-induced testicular damage.
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Affiliation(s)
- Ahmet Uyar
- Department of Pathology, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, 31060, Hatay, Türkiye.
| | - Mustafa Cellat
- Department of Physiology, Hatay Mustafa Kemal University, Hatay, Türkiye
| | - Özgür Kanat
- Department of Pathology, Necmettin Erbakan University, Konya, Türkiye
| | - Muhammed Etyemez
- Department of Physiology, Hatay Mustafa Kemal University, Hatay, Türkiye
| | - Tuncer Kutlu
- Department of Pathology, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, 31060, Hatay, Türkiye
| | | | - İlker Yavaş
- Department of Reproduction and Artificial Insemination, Mustafa Kemal University, Hatay, Türkiye
| | - Müslüm Kuzu
- Department of Nutrition and Dietetics, Karabuk University, Karabuk, Türkiye
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178
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Masalin S, Klåvus A, Rönö K, Koistinen HA, Koistinen V, Kärkkäinen O, Jääskeläinen TJ, Klemetti MM. Analysis of early-pregnancy metabolome in early- and late-onset gestational diabetes reveals distinct associations with maternal overweight. Diabetologia 2024; 67:2539-2554. [PMID: 39083240 PMCID: PMC11519293 DOI: 10.1007/s00125-024-06237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 10/29/2024]
Abstract
AIMS/HYPOTHESIS It is not known whether the early-pregnancy metabolome differs in patients with early- vs late-onset gestational diabetes mellitus (GDM) stratified by maternal overweight. The aims of this study were to analyse correlations between early-pregnancy metabolites and maternal glycaemic and anthropometric characteristics, and to identify early-pregnancy metabolomic alterations that characterise lean women (BMI <25 kg/m2) and women with overweight (BMI ≥25 kg/m2) with early-onset GDM (E-GDM) or late-onset GDM (L-GDM). METHODS We performed a nested case-control study within the population-based prospective Early Diagnosis of Diabetes in Pregnancy cohort, comprising 210 participants with GDM (126 early-onset, 84 late-onset) and 209 normoglycaemic control participants matched according to maternal age, BMI class and primiparity. Maternal weight, height and waist circumference were measured at 8-14 weeks' gestation. A 2 h 75 g OGTT was performed at 12-16 weeks' gestation (OGTT1), and women with normal results underwent repeat testing at 24-28 weeks' gestation (OGTT2). Comprehensive metabolomic profiling of fasting serum samples, collected at OGTT1, was performed by untargeted ultra-HPLC-MS. Linear models were applied to study correlations between early-pregnancy metabolites and maternal glucose concentrations during OGTT1, fasting insulin, HOMA-IR, BMI and waist circumference. Early-pregnancy metabolomic features for GDM subtypes (participants stratified by maternal overweight and gestational timepoint at GDM onset) were studied using linear and multivariate models. The false discovery rate was controlled using the Benjamini-Hochberg method. RESULTS In the total cohort (n=419), the clearest correlation patterns were observed between (1) maternal glucose concentrations and long-chain fatty acids and medium- and long-chain acylcarnitines; (2) maternal BMI and/or waist circumference and long-chain fatty acids, medium- and long-chain acylcarnitines, phospholipids, and aromatic and branched-chain amino acids; and (3) HOMA-IR and/or fasting insulin and L-tyrosine, certain long-chain fatty acids and phospholipids (q<0.001). Univariate analyses of GDM subtypes revealed significant differences (q<0.05) for seven non-glucose metabolites only in overweight women with E-GDM compared with control participants: linolenic acid, oleic acid, docosapentaenoic acid, docosatetraenoic acid and lysophosphatidylcholine 20:4/0:0 abundances were higher, whereas levels of specific phosphatidylcholines (P-16:0/18:2 and 15:0/18:2) were lower. However, multivariate analyses exploring the early-pregnancy metabolome of GDM subtypes showed differential clustering of acylcarnitines and long-chain fatty acids between normal-weight and overweight women with E- and L-GDM. CONCLUSIONS/INTERPRETATION GDM subtypes show distinct early-pregnancy metabolomic features that correlate with maternal glycaemic and anthropometric characteristics. The patterns identified suggest early-pregnancy disturbances of maternal lipid metabolism, with most alterations observed in overweight women with E-GDM. Our findings highlight the importance of maternal adiposity as the primary target for prevention and treatment.
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Affiliation(s)
- Senja Masalin
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
- Department of General Practice and Primary Healthcare, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Kristiina Rönö
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland
| | - Heikki A Koistinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | | | - Olli Kärkkäinen
- Afekta Technologies Ltd, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Tiina J Jääskeläinen
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Miira M Klemetti
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
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Omidi F, Hajarian H, Karamishabankareh H, Soltani L, Dashtizad M. Comparison of the Effect of Adding Different Levels of Zinc Chloride, Curcumin, Zinc Oxide Nanoparticles (Zano-NPs), Curcumin Loaded on Zano-NPs on Post-Thawing Quality of Ram Semen. Vet Med Sci 2024; 10:e70091. [PMID: 39495034 PMCID: PMC11533303 DOI: 10.1002/vms3.70091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 09/25/2024] [Accepted: 10/11/2024] [Indexed: 11/05/2024] Open
Abstract
OBJECTIVE This study looked at how different concentrations of curcumin (Curc), zinc chloride (ZnCl2), zinc oxide nanoparticles (ZnO-NPs) and Curc loaded on ZnO-NPs (Curc-co-ZnO-NPs) in cryopreservation dilution affected the quality of ram sperm after thawing. METHODS ZnO-NPs were synthesised using Berberis vulgaris leaf aqueous extract. Then, Curc was loaded on the ZnO-NPs that had been synthesised. We used analytical methods to look at the composition, morphology and size of green synthesised ZnO-NPs and Curc-co-ZnO-NPs, including UV-Vis, zeta potential, EDX, DLS, FE-SEM and FT-IR. Using a Tris-base extender containing various concentrations of Curc, ZnCl2, ZnO-NPs and Curc-co-ZnO-NPs (0, 1, 10 and 100 µg/mL), semen samples from four rams were combined. Sperm motility, viability, DNA and plasma membrane integrity, total abnormalities and malondialdehyde (MDA) generation were all evaluated in treatment groups after thawing. RESULTS The results showed that adding 1 µg/mL of ZnO-NPs and Curc-co-ZnO-NPs significantly reduced the level of MDA and total abnormalities (p < 0.05). Additionally, following the freeze-thawing procedure, the presence of 1 µg/mL of Curc-co-ZnO-NPs in the diluent of ram sperm significantly increased the percentage of sperm viability and motility in comparison to the control and other treatment groups (p < 0.05). Furthermore, as compared to the control group and other treatments, treatments containing 1 µg/mL of Curc-co-ZnO-NPs significantly improved membrane and DNA integrity (p < 0.05). CONCLUSIONS It appears that following freeze-thawing, the Curc-co-ZnO-NPs (1 µg/mL) enhanced sperm parameters.
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Affiliation(s)
- Fatemeh Omidi
- Department of Animal ScienceFaculty of Agricultural and Engineering ScienceRazi UniversityKermanshahIran
| | - Hadi Hajarian
- Department of Animal ScienceFaculty of Agricultural and Engineering ScienceRazi UniversityKermanshahIran
| | - Hamed Karamishabankareh
- Department of Animal ScienceFaculty of Agricultural and Engineering ScienceRazi UniversityKermanshahIran
| | - Leila Soltani
- Department of Animal ScienceFaculty of Agricultural and Engineering ScienceRazi UniversityKermanshahIran
| | - Mojtaba Dashtizad
- Department of Animal ScienceNational Institute of Genetics and BiotechnologyTehranIran
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Ficial B, Dolce P, Petoello E, Flore AI, Nogara S, Ciarcià M, Brancolini G, Alfarano A, Marzollo R, Bosio I, Raimondi F, Risso FM, Beghini R, Dani C, Benfari G, Ribichini FL, Corsini I. Left atrial strain assessment unveils left ventricular diastolic dysfunction in neonates with transient tachypnea of the newborn: A prospective observational study. Pediatr Pulmonol 2024; 59:2910-2921. [PMID: 38953730 DOI: 10.1002/ppul.27156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/02/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION An inadequate clearance of lung fluid plays a key role in the pathogenesis of transient tachypnea of the newborn (TTN). OBJECTIVES To evaluate if left ventricular diastolic dysfunction contributes to reduced clearance of lung fluid in TTN. MATERIALS AND METHODS This was a prospective, observational study. Echocardiography and lung ultrasound were performed at 2, 24 and 48 h of life (HoL) to assess biventricular function and calculate lung ultrasound score (LUS). Left atrial strain reservoir (LASr) provided surrogate measurement of left ventricular diastolic function. RESULTS Twenty-seven neonates with TTN were compared with 27 controls with no difference in gestation (36.1 ± 2 vs. 36.9 ± 2 weeks) or birthweight (2508 ± 667 vs. 2718 ± 590 g). Biventricular systolic function was normal in both groups. LASr was significantly lower in cases at 2 (21.0 ± 2.7 vs. 38.1 ± 4.4; p < 0.01), 24 (25.2 ± 4.5 vs. 40.6 ± 4.0; p < 0.01) and 48 HoL (36.5 ± 5.8 and 41.6 ± 5.2; p < 0.01), resulting in a significant group by time interaction (p < 0.001), after adjusting for LUS and gestational diabetes. A logistic regression model including LUS, birth weight and gestational diabetes as covariates, showed that LASr at 2 HoL was a predictor of respiratory support at 24 HoL, with an adjusted odds ratio of 0.60 (CI 0.36-0.99). CONCLUSIONS LASr was reduced in neonates with TTN, suggesting diastolic dysfunction, that may contribute to the delay in lung fluid clearance.
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Affiliation(s)
- Benjamim Ficial
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Pasquale Dolce
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Enrico Petoello
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Alice Iride Flore
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Silvia Nogara
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Martina Ciarcià
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Giovanna Brancolini
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Angela Alfarano
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Roberto Marzollo
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Ilaria Bosio
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Raimondi
- Division of Neonatology and Department of Translational Medical Sciences, Università "Federico II" di Napoli, Naples, Italy
| | - Francesco Maria Risso
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Renzo Beghini
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
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Kelly AS, Bahlke M, Baker JL, de Beaufort C, Belin RM, Fonseca H, Hale PM, Holm JC, Hsia DS, Jastreboff AM, Juliusson PB, Murphy M, Pak J, Paul E, Rudolph B, Srivastava G, Tornøe CW, Weghuber D, Fox CK. Considerations for the design and conduct of pediatric obesity pharmacotherapy clinical trials: Proceedings of expert roundtable meetings. Pediatr Obes 2024; 19:e13161. [PMID: 39289849 DOI: 10.1111/ijpo.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 09/19/2024]
Abstract
Anti-obesity medications (AOMs) have emerged as one element of comprehensive obesity clinical care intended to improve long-term health outcomes for children and adolescents. The number of pediatric AOM clinical trials has burgeoned in recent years as new pharmacotherapeutics have been developed. Factors related to growth and development in children and adolescents can present unique challenges in terms of designing and conducting clinical trials investigating the safety and efficacy of AOMs. These barriers can delay the AOM development and evaluation process, increase the cost of performing trials, create challenges in the interpretation of results, influence the generalizability of the findings and present ethical dilemmas. In an effort to address these issues and provide guidance to streamline the process of designing and conducting pediatric AOM clinical trials, relevant key stakeholders convened a series of roundtable meetings to discuss, debate and achieve harmonization on design features. Stakeholder participants included a multidisciplinary group of international pediatric obesity experts, patient (parent) representatives and representatives from academic medicine, key regulatory agencies and industry. Topics of discussion included primary efficacy end-points, secondary end-points, eligibility criteria, trial run-in and follow-up phases, use of active comparators and guidelines for down-titration and/or stopping rules for excessive weight reduction. Consensus recommendations were agreed upon. Regarding end-points, emphasis was placed on moving away from BMI z-score as a primary outcome, incorporating multiple alternative BMI-related outcomes and measuring adiposity/body fat as a prominent secondary end-point. Trial eligibility criteria were carefully considered to maximize generalizability while maintaining safety. The limited value of trial run-in phases was discussed. It was also underscored that designing trials with extended follow-up periods after AOM withdrawal should be avoided owing to ethical issues (including possible psychological harm) related to weight regain without providing the opportunity to access other treatments. The panel emphasized the value of the randomized, placebo-controlled trial but recommended the thoughtful consideration of the use of active comparators in addition to, or instead of, placebo to achieve clinical equipoise when appropriate. Finally, the panel recommended that clinical trial protocols should include clear guidance regarding AOM down-titration to avoid excessive weight reduction when applicable.
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Affiliation(s)
- Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- The Obesity Society, Rockville, Maryland, USA
| | - Melanie Bahlke
- European Coalition for People Living with Obesity, Dublin, Ireland
- Global Patient Alliance
- Adipositaschirurgie Selbsthilfe Deutschland e.V. (Obesity Surgery Patient Organisation), Germany
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- European Association for the Study of Obesity, Teddington, England
| | - Carine de Beaufort
- Pediatric Clinic/Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
- Department of Science, Technology, and Medicine, University of Luxembourg, Luxembourg City, Luxembourg
| | - Ruth M Belin
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Helena Fonseca
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | | | - Jens-Christian Holm
- European Association for the Study of Obesity, Teddington, England
- Department of Paediatrics, The Children's Obesity Clinic, European Center of Management, Holbaek, Denmark
| | - Daniel S Hsia
- The Obesity Society, Rockville, Maryland, USA
- Clinical Trials Unit, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Ania M Jastreboff
- The Obesity Society, Rockville, Maryland, USA
- Department of Medicine (Endocrinology) and Pediatrics (Pediatric Endocrinology), Yale Obesity Research Center (Y-Weight), New Haven, Connecticut, USA
| | - Petur B Juliusson
- Department of Pediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Jonathan Pak
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut, USA
- Boehringer Ingelheim Pharmaceuticals, Inc., Ingelheim, Germany
| | | | - Bryan Rudolph
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut, USA
- Boehringer Ingelheim Pharmaceuticals, Inc., Ingelheim, Germany
| | - Gitanjali Srivastava
- Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
- The European Childhood Obesity Group, Brussels, Belgium
| | - Claudia K Fox
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Alanazi NF, Almutairi M, Aldohayan L, AlShareef A, Ghallab B, Altamimi A. The incidence and risk factors of post-transplant diabetes mellitus in living donor kidney transplantation patients: a retrospective study. BMC Nephrol 2024; 25:394. [PMID: 39487407 PMCID: PMC11531175 DOI: 10.1186/s12882-024-03816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 10/09/2024] [Indexed: 11/04/2024] Open
Abstract
BACKGROUND Post-transplant diabetes mellitus (PTDM) is a well-known complication of kidney transplantation that significantly impacts recipient morbidity and mortality. Over the recent years, the incidence of PTDM has increased considerably worldwide. Therefore, the primary purpose of this study was to evaluate the incidence and risk factors for PTDM in living donor kidney transplantation patients in Riyadh, Saudi Arabia. METHODS A retrospective cohort study was conducted at a tertiary transplant center in Riyadh, Saudi Arabia, and data were extracted between February 2016 and March 2022. Patients aged ≥ 18 years who underwent renal transplant with at least one year of post-transplant follow-up were included in the analysis, and their medical records were comprehensively reviewed. Patients < 18 years of age, history of diabetes mellitus, other organ transplants, or those who underwent transplantation outside the Kingdom of Saudi Arabia were excluded from the study. RESULTS The study included 247 living donor kidney transplant patients, with a mean age of 39.5 ± 14.6 years. 17.0% of the patients were diagnosed with PTDM. Patient age and fasting glucose levels at 6-months and 12-months after transplantation were found to be significant risk factors for the development of PTDM. CONCLUSION An increased occurrence of PTDM emphasizes the importance of identifying high-risk patients prior to transplantation and implementing early interventions to prevent potential complications that could affect graft and patient survival.
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Affiliation(s)
- Noura Farhan Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.
| | - Malak Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Latifah Aldohayan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Ala AlShareef
- Hepatobiliary Sciences and Organ Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Basmah Ghallab
- Hepatobiliary Sciences and Organ Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abdulrahman Altamimi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Hepatobiliary Sciences and Organ Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
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183
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Kristensen JM, Kjøbsted R, Larsen TJ, Carl CS, Hingst JR, Onslev J, Birk JB, Thorup A, Steenberg DE, Knudsen JR, Henriksen NS, Needham EJ, Halling JF, Gudiksen A, Rundsten CF, Hanghøj KE, Stinson SE, Hoier B, Hansen CC, Jensen TE, Hellsten Y, Pilegaard H, Grarup N, Olesen J, Humphrey SJ, James DE, Pedersen ML, Richter EA, Hansen T, Jørgensen ME, Wojtaszewski JFP. Skeletal muscle from TBC1D4 p.Arg684Ter variant carriers is severely insulin resistant but exhibits normal metabolic responses during exercise. Nat Metab 2024:10.1038/s42255-024-01153-1. [PMID: 39482542 DOI: 10.1038/s42255-024-01153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 09/27/2024] [Indexed: 11/03/2024]
Abstract
In the Greenlandic Inuit population, 4% are homozygous carriers of a genetic nonsense TBC1D4 p.Arg684Ter variant leading to loss of the muscle-specific isoform of TBC1D4 and an approximately tenfold increased risk of type 2 diabetes1. Here we show the metabolic consequences of this variant in four female and four male homozygous carriers and matched controls. An extended glucose tolerance test reveals prolonged hyperglycaemia followed by reactive hypoglycaemia in the carriers. Whole-body glucose disposal is impaired during euglycaemic-hyperinsulinaemic clamp conditions and associates with severe insulin resistance in skeletal muscle only. Notably, a marked reduction in muscle glucose transporter GLUT4 and associated proteins is observed. While metabolic regulation during exercise remains normal, the insulin-sensitizing effect of a single exercise bout is compromised. Thus, loss of the muscle-specific isoform of TBC1D4 causes severe skeletal muscle insulin resistance without baseline hyperinsulinaemia. However, physical activity can ameliorate this condition. These observations offer avenues for personalized interventions and targeted preventive strategies.
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Affiliation(s)
- Jonas M Kristensen
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Kjøbsted
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Trine J Larsen
- Greenland Center of Health Research, Institute of Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Christian S Carl
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Janne R Hingst
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Johan Onslev
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jesper B Birk
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anette Thorup
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Dorte E Steenberg
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jonas R Knudsen
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Nicolai S Henriksen
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elise J Needham
- Charles Perkins Centre, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Jens F Halling
- Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Anders Gudiksen
- Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Carsten F Rundsten
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristian E Hanghøj
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Sara E Stinson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Hoier
- August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Camilla C Hansen
- August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas E Jensen
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Pilegaard
- Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Olesen
- Queen Ingrid Primary Health Care Center, Nuuk, Greenland
| | - Sean J Humphrey
- Charles Perkins Centre, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - David E James
- Charles Perkins Centre, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Michael L Pedersen
- Greenland Center of Health Research, Institute of Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Steno Diabetes Center Greenland, Nuuk, Greenland
| | - Erik A Richter
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marit E Jørgensen
- Greenland Center of Health Research, Institute of Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jørgen F P Wojtaszewski
- August Krogh Section for Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
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Zhang J, Liu X, Sun Y, Ge Z, Shen J, Yuan J. Quercetin@β-Cyclodextrin Conjugated Keratin/Polyurethane Biocomposite Mats for Infected Diabetic Wound Healing. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2024. [PMID: 39480120 DOI: 10.1021/acs.langmuir.4c02555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2024]
Abstract
Chronic diabetic wounds suffer from severe complications caused by long-term high levels of oxidative stress and bacterial infection. Quercetin (Que) has excellent anti-inflammatory, antioxidant, and antibacterial activity, making it a promising drug to address the above issues. To exploit the benefits of Que in a more effective and sustained way to treat diabetic wounds, carboxymethyl β-cyclodextrin (CMCD) was synthesized and conjugated to keratin, then complexed with Que to form Que@Ker-CMCD inclusion, followed by electrospinning with polyurethane (PU) to afford Que@Ker-CMCD/PU mats. The approach significantly enhanced water solubility, bioavailability, and sustained release of Que. Crucially, these mats exhibited robust antioxidant and antibacterial activities. Moreover, the mats fostered an environment conducive to cell proliferation, migration, angiogenesis, and re-epithelialization, pivotal processes in wound healing and remodeling. Consequently, a marked acceleration in remodeling chronic diabetic wounds was observed. In conclusion, this study introduces a novel therapeutic strategy that not only harnesses the multifaceted benefits of Que but also enhances its delivery and performance, offering a promising avenue for the effective treatment of chronic diabetic wounds.
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Affiliation(s)
- Jie Zhang
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
| | - Xu Liu
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
| | - Yu Sun
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
| | - Zhaoyan Ge
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
| | - Jian Shen
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
| | - Jiang Yuan
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Bio-Functional Materials, Department of Materials Science and Engineering, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210023, P. R. China
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Riehl-Tonn VJ, Medak KD, Rampersad C, MacPhee A, Harrison TG. GLP-1 Agonism for Kidney Transplant Recipients: A Narrative Review of Current Evidence and Future Directions Across the Research Spectrum. Can J Kidney Health Dis 2024; 11:20543581241290317. [PMID: 39492845 PMCID: PMC11528610 DOI: 10.1177/20543581241290317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/25/2024] [Indexed: 11/05/2024] Open
Abstract
Purpose of Review Diabetes is the most common cause of kidney disease in individuals that receive a kidney transplant, and those without pre-existing diabetes are at greater risk of developing diabetes following kidney transplant. A class of diabetes treatment medications called glucagon-like peptide-1 receptor agonists (GLP-1RA) has seen recent widespread use for people with diabetes or obesity, with efficacy for improved glycemic control, weight loss, and reduced risk of cardiovascular events. Given these benefits, and indications for use that often co-occur in kidney transplant recipients, use of GLP-1RAs warrants consideration in this population. Therefore, we sought to review the current literature to better understand the mechanisms of action, clinical application, and person-centred considerations of GLP-1RAs in kidney transplant recipients. Sources of Information Original articles were identified between December 2023 and July 2024 from electronic databases including the Ovid MEDLINE database, PubMed, and Google Scholar using terms "kidney transplant," "GLP-1," "glucagon-like peptide-1 receptor agonist," and "diabetes." Methods A comprehensive review of the literature was conducted to explore the relationship between GLP-1RAs and kidney transplant recipients. We reviewed the current state of evidence across the research disciplines of basic or fundamental science, clinical and health services research, and person-centred equity science, and highlighted important knowledge gaps that offer opportunities for future research. Key Findings Numerous clinical studies have demonstrated the benefit of GLP-1RAs in people with and without diabetic kidney disease, including decreased risk of cardiovascular events. However, there is a paucity of high-quality randomized controlled trials and observational studies analyzing use of GLP-1RAs in kidney transplant recipients. Evidence of benefit in this population is therefore limited to small studies or inferred from research conducted in nontransplant populations. Growing evidence from preclinical and clinical studies may elucidate renoprotective mechanisms of GLP-1RAs and remove barriers to application of these drugs in the transplant recipient population. Individuals who are female, non-white, have lower socioeconomic status, and live in rural communities are at greater risk of diabetes and have lower uptake of GLP-1RAs. There is a need for clinical trials across diverse kidney transplant populations to estimate the efficacy of GLP-1RAs on important health outcomes. Limitations The search strategy for this narrative review may not have been sensitive to identify all relevant articles. Our search was limited to English language articles.
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Affiliation(s)
- Victoria J. Riehl-Tonn
- Department of Medicine, University of Calgary, AB, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Kyle D. Medak
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Christie Rampersad
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada
| | - Anne MacPhee
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), Vancouver, BC, Canada
| | - Tyrone G. Harrison
- Department of Medicine, University of Calgary, AB, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, AB, Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, AB, Canada
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Datta A, Li XY, Nagpaul M. Early expression of osteopontin glycoprotein on the ocular surface and in tear fluid contributes to ocular surface diseases in type 2 diabetic mice. PLoS One 2024; 19:e0313027. [PMID: 39480896 PMCID: PMC11527294 DOI: 10.1371/journal.pone.0313027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 10/16/2024] [Indexed: 11/02/2024] Open
Abstract
PURPOSE Osteopontin (OPN) is a glycosylated, secreted phosphoprotein known to be elevated in both human and mouse retinas during various stages of diabetic retinopathy. However, its specific roles in modulating ocular surface dynamics and immune responses in diabetes remain unexplored. This study aims to investigate the role of OPN in the development of ocular surface disease (OSD) in type 2 diabetic (T2D) mice. METHODS Three- to four-week-old C57BL/6 wild-type (WT) and OPN-knockout (OPN-/-) mice were fed a high-fat diet (HFD) and were rendered diabetic by streptozotocin (STZ; 40 mg/kg body weight) in citrate buffer (vehicle); non-diabetic controls were injected with vehicle alone. Diabetes was confirmed if blood glucose levels were >200 mg/dL, measured 1-2 weeks post-STZ injection. Control, age- and sex-matched db/db diabetic mice fed a standard chow diet were also included in this study. Ocular surface inflammation was assessed using ELISA to quantify inflammatory cytokine proteins and wheat germ agglutinin (WGA) staining was utilized to highlight corneal surface irregularities. Clinical signs were evaluated by corneal fluorescein staining, tear production measurements, and tear sodium (Na+) concentration assessments. These evaluations were conducted 4, 6, 8 and 16-weeks post-diabetes onset in WT and OPN-/- mice and were compared to those obtained in non-diabetic controls. Statistical analysis was performed using a two-way ANOVA, with significance set at P < 0.05. RESULTS Both WT and OPN-/- mice developed T2D within 4 and 8 weeks, respectively, following HFD + STZ treatment. Corneal OPN levels in WT diabetic mice increased ~2-fold at 2 weeks and ~4-fold at 16 weeks compared to non-diabetic controls, with similar elevations observed in their tear fluid. Diabetic db/db mice also exhibited elevated OPN levels in the blood and ocular surface, which persisted as diabetes progressed. Enhanced fluorescein staining, indicating corneal irregularities, appeared in WT mice at 8 weeks and in OPN-/- mice at 10 weeks post-T2D induction. Additionally, WGA staining showed a significant reduction in fluorescence intensity in WT mice treated with HFD and STZ, confirming corneal surface irregularities that were delayed in OPN-/- mice. Elevated tear sodium concentration was observed in both WT and OPN-/- diabetic mice without affecting tear production rates. Notably, OPN levels increased early, at week 2, following HFD and STZ treatment, preceding changes in interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and matrix metalloproteinase-9 (MMP-9). Upregulation of IL-6 became apparent at 6 weeks in WT mice and was delayed until 10 weeks in OPN-/- mice post-T2D induction. CONCLUSIONS Elevated OPN levels were detected early post-T2D induction in diabetic WT and db/db mice corneas without initial subclinical changes. This early increase in OPN precedes other proinflammatory cytokines associated with eventual ocular surface inflammation as diabetes progresses. Persistence of OPN also correlated with clinical signs such as increased corneal surface irregularities and elevated tear Na+ concentration. Future research will explore OPN's role as a biomarker in ocular surface disease (OSD), including dry eye disease (DED), and investigate its impact on inflammatory processes and other mechanistic pathways in diabetic ocular complications.
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Affiliation(s)
- Ananya Datta
- New England College of Optometry, Boston, MA, United States of America
| | - Xin Yi Li
- New England College of Optometry, Boston, MA, United States of America
| | - Manshul Nagpaul
- New England College of Optometry, Boston, MA, United States of America
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Nikola L, Iva L. Gut microbiota as a modulator of type 1 diabetes: A molecular perspective. Life Sci 2024:123187. [PMID: 39488260 DOI: 10.1016/j.lfs.2024.123187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 10/04/2024] [Accepted: 10/24/2024] [Indexed: 11/04/2024]
Abstract
Type 1 diabetes (T1D) is defined as an autoimmune metabolic disorder, characterized by destruction of pancreatic β-cells and high blood sugar levels. If left untreated, T1D results in severe health complications, including cardiovascular and kidney disease, as well as nerve damage, with ultimately grave consequences. Besides the role of genetic and certain environmental factors in T1D development, in the last decade, one new player emerged to affect T1D pathology as well, and that is a gut microbiota. Dysbiosis of gut bacteria can contribute to T1D by gut barrier disruption and the activation of autoimmune response, leading to the destruction of insulin producing cells, causing the development and aggravation of T1D symptoms. The relationship between gut microbiota and diabetes is complex and varies between individuals and additional research is needed to fully understand the effects of gut microbiome alternations in T1D pathogenesis. Therefore, the goal of this review is to understand the current knowledge in underlying molecular mechanism of gut microbiota effects, which leads to the new approaches for further studies in the prevention and treatment of T1D.
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Affiliation(s)
- Lukic Nikola
- Laboratory for Molecular Biology and Endocrinology, Institute of Nuclear Sciences "Vinca", National Institute of the Republic of Serbia, University of Belgrade, Serbia
| | - Lukic Iva
- Laboratory for Molecular Biology and Endocrinology, Institute of Nuclear Sciences "Vinca", National Institute of the Republic of Serbia, University of Belgrade, Serbia.
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188
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Miya MB, Ashutosh, Maulishree, Chandra Gupta P, Pathak V, Mishra R, Chaturvedi P, Kalani A. Therapeutic effects of OXY- Exo Aloe in diabetic wound injury. Biochem Biophys Res Commun 2024; 731:150398. [PMID: 39032360 DOI: 10.1016/j.bbrc.2024.150398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Delayed wound healing are common complications for diabetic patients. In light of chronic hypoxia's delay in wound healing, it is hypothesized that providing a better oxygen environment at the wound site will promote diabetic wound healing. OXY-ExoAloe is an innovative and effective therapy prepared from exosome-like vesicles of aloe vera gel, ginger juice and neem fruit sap. A combination of three herbal, oxygen-delivering and medicinally valued plants was standardized to determine if the combination had the desired effect. Interestingly, when we used OXY-ExoAloe at a particular ratio on a diabetic wound, the herbal therapy speeded up wound healing by reducing swelling, and the severity of the wound. Further, our data suggests that OXY-ExoAloe promoted wound healing by increasing wound oxygenation, reducing inflammation, cytokine production, and matrix remodeling. It is also safe and effective, with no reported side effects.
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Affiliation(s)
- Mumtaj Bano Miya
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Ashutosh
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Maulishree
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Prakash Chandra Gupta
- Toxicology Lab, School of Pharmaceutical Sciences, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Vandana Pathak
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Rajeev Mishra
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India
| | - Pankaj Chaturvedi
- Department of Physiology, University of Louisville, Louisville, 40202, KY, USA
| | - Anuradha Kalani
- Disease Biology Lab and Molecular Oncology Lab, Department of Life Science and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, 208024, India; Department of Physiology, University of Louisville, Louisville, 40202, KY, USA.
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189
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Alahmari KA, Reddy RS. Knee proprioception, muscle strength, and stability in Type 2 Diabetes Mellitus- A cross-sectional study. Heliyon 2024; 10:e39270. [PMID: 39498014 PMCID: PMC11533566 DOI: 10.1016/j.heliyon.2024.e39270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 10/10/2024] [Accepted: 10/10/2024] [Indexed: 11/07/2024] Open
Abstract
Background The burgeoning prevalence of Type 2 Diabetes Mellitus (T2DM) has been linked to a spectrum of health complications, including those affecting the musculoskeletal system. Knee proprioception, muscle strength, and stability are essential for maintaining functional mobility and preventing falls, yet their relationship with T2DM is not fully elucidated. Objectives This study aimed to compare knee proprioception, muscle strength, and limits of stability (LOS) between individuals with T2DM and asymptomatic controls and to examine the moderating role of physical activity on these relationships. Methods In a cross-sectional design, 192 participants (96 with T2DM and 96 asymptomatic) underwent assessments for knee proprioception using a digital inclinometer, muscle strength via a handheld dynamometer, and LOS through dynamic posturography, graded as a percentage of maximum lean without losing balance. Results Our analysis revealed that individuals with T2DM demonstrated reduced knee muscle strength, with mean differences of 12.90 Nm (right) and 18.80 Nm (left) in 25° of flexion, and 25.78 Nm (right) and 26.36 Nm (left) in 40° of flexion, compared to asymptomatic controls. Proprioception errors were greater in the T2DM group (p < 0.001), with significant deficits noted in both knee 25° of flexion and 40° of flexion. Stability limits were also compromised, with the T2DM group displaying a decreased ability to maintain balance across all tested directions (p < 0.001). Physical activity emerged as a positive moderator, with higher activity levels correlating with improved muscle strength and stability. Conclusion T2DM significantly impairs musculoskeletal function, highlighting the need for integrated management strategies. The study underscores the importance of physical activity in mitigating T2DM-related musculoskeletal deterioration, suggesting that therapeutic interventions should include a focus on enhancing muscle strength and stability to improve the quality of life in this population.
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Affiliation(s)
- Khalid A. Alahmari
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
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190
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Dhar S, Kothari DS, Reeves C, Sheyn AM, Gillespie MB, Rangarajan SV. The Effect of Obesity on Postoperative Analgesia Practices and Complications Following Endoscopic Sinus Surgery: A Propensity Score-Matched Cohort Study. Ann Otol Rhinol Laryngol 2024:34894241295471. [PMID: 39469746 DOI: 10.1177/00034894241295471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2024]
Abstract
BACKGROUND Despite growing concern regarding over-prescription of narcotic pain medication following ambulatory surgery, little is known about the analgesic prescribing practices following endoscopic sinus surgery (ESS) in obese patients in comparison to non-obese patients. OBJECTIVE To compare the rates of opioid versus non-opioid prescriptions, the need for steroids, and post-operative adverse events between obese and non-obese adult patients undergoing ESS. METHODS Using TriNetX Live database, we identified all patients aged ≥18 years who underwent ESS (n = 1303) between 2014 and 2022 across several healthcare institutions across the state of Tennessee. We 1:1 propensity score-matched obese (BMI ≥ 30 kg/m2) and non-obese (18.5 kg/m2 ≤ BMI < 30 kg/m2) cohorts for age, gender, race, and comorbidities including asthma, nicotine dependence, and sleep apnea. Rates of prescriptions and post-operative adverse events between cohorts were analyzed using risk ratios (RR) and confidence intervals (CI). RESULTS A toal of 532 obese patients were compared to 532 propensity score-matched non-obese patients in the first 14 post-operative days following ESS. The obese cohort was significantly more likely to be prescribed analgesics generally (RR = 1.72; 95% CI = 1.20-2.47), non-opioid analgesics (RR = 1.73; 95% CI = 1.19-2.50), and opioid analgesics (RR = 1.64; 95% CI = 1.14-2.36) than non-obese patients. There was no difference in rates of antibiotic or antiemetic prescription, prednisone/methylprednisolone, dexamethasone, ED visits, critical care service, epistaxis, transfusion, anemia, revision sinus surgery, mechanical ventilation, CPAP, or inhalation airway treatments. CONCLUSION Obese patients undergoing ESS were significantly more likely to be prescribed non-opioid and opioid analgesia in the first 14 days post-operatively compared to non-obese patients. There were no differences in post-operative adverse events or other prescriptions. Otolaryngologists should be aware that obese patients are at increased risk of opioid induced airway obstruction and steroid induced hyperglycemia, especially in patients with comorbid sleep apnea or diabetes. Emphasis on non-opioid analgesics and multimodal pain management should be advocated for this population.
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Affiliation(s)
- Sarit Dhar
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Dhruv S Kothari
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Camille Reeves
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anthony M Sheyn
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Marion Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sanjeet V Rangarajan
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, USA
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191
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Jiang H, Zhang H, Wen Z, Yuan J, Wang H, Zhang X. Association of sleep duration with obesity in older adults: A systematic review and meta-analysis. Geriatr Gerontol Int 2024. [PMID: 39469806 DOI: 10.1111/ggi.15004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 09/11/2024] [Accepted: 10/08/2024] [Indexed: 10/30/2024]
Abstract
BACKGROUND Research on sleep duration and obesity is extensive in children and young individuals but limited and inconsistent for older adults. Our study aims to clarify the current status of this association in the elderly population. METHODS We searched six English and four Chinese databases up to January 25, 2024, for observational studies on sleep duration and obesity in older adults. Two researchers independently conducted the literature search and data extraction. Study quality was assessed using the Newcastle-Ottawa Scale for cohort studies and the Agency for Healthcare Research and Quality for cross-sectional studies. Meta-analyses were performed using Stata 15.0 software, using both random-effects and fixed-effects models to calculate pooled odds ratios with 95% confidence intervals (CIs). RESULTS The meta-analysis of 15 studies found a correlation between short sleep duration and obesity in older individuals (pooled odds ratio, 1.40 [95% CI: 1.12-1.73]; P = 0.003). However, no significant correlation was found between long sleep duration and obesity among the elderly (pooled odds ratio, 1.04 [95% CI, 0.95-1.13]; P = 0.426). CONCLUSIONS Short sleep duration in the elderly was associated with obesity. More prospective studies need to be included in the future to improve the reliability of the conclusions. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Huan Jiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hanyu Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiang Yuan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, China
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Mirzaei Khalil Abadi M, Hemmatinafar M, Koushkie Jahromi M. Effects of menstrual cycle on cognitive function, cortisol, and metabolism after a single session of aerobic exercise. PLoS One 2024; 19:e0311979. [PMID: 39471167 PMCID: PMC11521275 DOI: 10.1371/journal.pone.0311979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/27/2024] [Indexed: 11/01/2024] Open
Abstract
AIM This study aimed to investigate the effects of the two pre-ovulatory and mid-luteal phases of the menstrual cycle on cognitive function, as well as possible mediators of metabolism and salivary cortisol, at rest and after an aerobic exercise session. STUDY DESIGN Twelve active young unmarried women aged 22-30 years volunteered to participate in the study. The participants performed a 20-min exercise session on a cycle ergometer at 60-70% of their reserve heart rate twice, during the follicular (pre-ovulation: days 7-10) and luteal (mid-luteal: days 21-24) phases of the menstrual cycle. Saliva samples were collected to measure cortisol. Fat utilization, respiratory exchange ratio (RER), and energy expenditure (during exercise) were measured using a spiroergometer. Cognitive function was assessed using the Stroop test. Cognitive function and cortisol levels were measured before and after each exercise session. RESULTS The findings of this study indicated no significant differences in variables during the resting follicular and luteal phases. Cortisol levels and cognitive function were increased after exercise compared with before exercise in both the follicular and luteal phases. Cortisol and fat utilization after exercise were significantly higher in the follicular phase than in the luteal phase. There were no significant differences between the follicular and luteal phasesregarding the effects of exercise on cognitive function, energy expenditure, and RER. CONCLUSION In general, the follicular and luteal phases of menstruation may not affect cognitive function in response to a single aerobic exercise session, although they change some metabolic factors and cortisol.
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Affiliation(s)
| | - Mohammad Hemmatinafar
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Maryam Koushkie Jahromi
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran
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193
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Yang Y, Wang S, Jia B, Chen S. Association Between Triglyceride-Glucose Index and Lung Function Parameters in the General Population Undergoing Health Examinations. Diabetes Metab Syndr Obes 2024; 17:4031-4047. [PMID: 39492961 PMCID: PMC11531295 DOI: 10.2147/dmso.s487744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 10/23/2024] [Indexed: 11/05/2024] Open
Abstract
Purpose To investigate the relationship between the triglyceride-glucose (TyG) index and pulmonary function metrics among the general population undergoing health examinations. Materials and Methods The enrollment totaled 696 participants. Fasting triglycerides and glucose levels were used to calculate the TyG index. Participants were divided into two categories according to their median TyG: one with high TyG and the other with low TyG. A portable spirometer was used to assess lung function. Fundamental clinical features and lung function indicators were compared between the two groups, and the relationship between the TyG index and lung function parameters was explored. Results Compared with the low TyG group, the high TyG group exhibited significantly reduced levels of FEV1/FVC, FVC% pred, FEV1% pred, FEV3% pred, FEV3/FVC, FEF75, FEF75% pred, FEF25-75% pred, and MVV% pred, suggesting poor pulmonary function. The TyG index was significantly inversely correlated with multiple pulmonary function metrics, including FVC% pred, FEV1% pred, FEV3% pred, FEV1/FVC, FEV3/FVC, FEF75, FEF75% pred and FEF25-75% pred, which persisted even after accounting for confounding variables. Conclusion In summary, the present study establishes a correlation between the TyG index and some lung function indicators, offering a new indicator of metabolic abnormalities related to lung functionality.
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Affiliation(s)
- Yu Yang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Shuqi Wang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Boying Jia
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Shuchun Chen
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
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194
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Huang H, Peng Y, Xiao L, Wang J, Xin YH, Zhang TH, Li XY, Wei X. Electroacupuncture Promotes Gastric Motility by Suppressing Pyroptosis via NLRP3/Caspase-1/GSDMD Signaling Pathway in Diabetic Gastroparesis Rats. Chin J Integr Med 2024:10.1007/s11655-024-3821-6. [PMID: 39470921 DOI: 10.1007/s11655-024-3821-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 11/01/2024]
Abstract
OBJECTIVE To investigate the mechanism of electroacupuncture (EA) in treating diabetic gastroparesis (DGP) by inhibiting the activation of Nod-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome and pyroptosis mediated via NLRP3/cysteinyl aspartate specific proteinase-1 (caspase-1)/gasdermin D (GSDMD) signaling pathway. METHODS Forty Sprague-Dawley rats were randomly divided into 4 groups including the control, DGP model, EA, and MCC950 groups. The DGP model was established by a one-time high-dose intraperitoneal injection of 2% streptozotocin and a high-glucose and high-fat diet for 8 weeks. EA intervention was conducted at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) with sparse-dense wave for 15 min, and was administered for 3 courses of 5 days. After intervention, the blood glucose, urine glucose, gastric emptying, and intestinal propulsive rate were observed. Besides, HE staining was used to observe histopathological changes in gastric antrum tissues, and TUNEL staining was utilized to detect DNA damage. Protein expression levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), pro-caspase-1, caspase-1 and GSDMD were measured by Western blot. Immunofluorescence staining was employed to assess the activity of GSDMD-N. Lactate dehydrogenase (LDH) levels were detected by using a biochemical kit. RESULTS DGP rats showed persistent hyperglycemia and a significant decrease in gastrointestinal motility (P<0.05 or P<0.01), accompanied by pathological damage in their gastric antrum tissues. Cellular DNA was obviously damaged, and the expressions of NLRP3, ASC, pro-caspase-1, caspase-1 and GSDMD proteins were significantly elevated, along with enhanced fluorescence signals of GSDMD-N and increased LDH release (P<0.01). EA mitigated hyperglycemia, improved gastrointestinal motility in DGP rats and alleviated their pathological injury (P<0.05). Furthermore, EA reduced cellular DNA damage, lowered the protein levels of NLRP3, ASC, pro-caspase-1, caspase-1 and GSDMD, suppressed GSDMD-N activity, and decreased LDH release (P<0.05 or P<0.01), demonstrating effects comparable to MCC950. CONCLUSION EA promotes gastrointestinal motility and repairs the pathological damage in DGP rats, and its mechanism may be related to the inhibition of NLRP3 inflammasome and pyroptosis mediated by NLRP3/caspase-1/GSDMD pathway.
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Affiliation(s)
- Hao Huang
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Yan Peng
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Le Xiao
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Jing Wang
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Yu-Hong Xin
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Tian-Hua Zhang
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Xiao-Yu Li
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Xing Wei
- College of Acupuncture-Moxibustion-Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China.
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Zieleniewska NA, Jamiołkowski J, Chlabicz M, Łukasiewicz A, Dubatówka M, Kondraciuk M, Sowa P, Kowalska I, Kamiński KA. The impact of prediabetes on preclinical atherosclerosis in general apparently healthy population: A cross-sectional study. PLoS One 2024; 19:e0309896. [PMID: 39471178 PMCID: PMC11521245 DOI: 10.1371/journal.pone.0309896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 08/19/2024] [Indexed: 11/01/2024] Open
Abstract
BACKGROUND The hypothesis that not only diagnosed diabetes (DM), but also milder dysglycemia may affect the development of atherosclerosis still requires further study. In our population-based study, we aimed to evaluate the impact of prediabetic state on preclinical atherosclerosis and whether it may affect the cardiovascular risk (CVR) in the general population. METHODS The analysis was a part of the Bialystok PLUS cohort study and represented a random sample of Bialystok (Poland) residents aged 20-79 years at the time of sampling (July 2017-January 2023). The cross-sectional analysis included 1431 participants of a population-based study (mean age 46.82 years). Comprehensive biochemical assessments were performed. An Oral Glucose Tolerance Test (OGTT) was performed on fasting patients who did not report having a DM. RESULTS The population with prediabetes, based on HbA1c and OGTT, accounted for more than half of the study participants (n = 797, 55.7%). Atherosclerotic plaques in the carotid arteries were significantly more common in individuals with prediabetes considering all CVR categories. Prediabetes was associated with the occurrence of more advanced preclinical atherosclerosis, especially in the low to moderate CVR category. Serum glucose concentration after 1h and HbA1c proved to be statistically significant indicators of the presence of atherosclerotic plaques in ultrasound (respectively, AUC = 0.73 and 0.72). In multivariate logistic regression, prediabetes was independently associated with significantly increased risk of preclinical atherosclerosis (OR = 1.56, 95% CI 1.09-2.24), along with CVR categories, pulse wave velocity and central blood pressure augmentation index. CONCLUSIONS Prediabetes is associated with the occurrence and progression of the preclinical atherosclerosis. Importantly, many of those patients are in the low to moderate cardiovascular risk category, hence may have a severely underestimated risk. Inclusion of prediabetes into CVR assessment may improve risk stratification. An early identification of dysglycemic population is necessary to effectively implement the cardiovascular and metabolic prevention measures.
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Affiliation(s)
- Natalia Anna Zieleniewska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
- Department of Cardiology, University Hospital of Bialystok, Bialystok, Poland
| | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Małgorzata Chlabicz
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
- Department of Invasive Cardiology, University Hospital of Bialystok, Bialystok, Poland
| | - Adam Łukasiewicz
- Department of Radiology, Medical University of Bialystok, Bialystok, Poland
| | - Marlena Dubatówka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Marcin Kondraciuk
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
- Department of Cardiology, University Hospital of Bialystok, Bialystok, Poland
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Stefanakis K, Kokkorakis M, Mantzoros CS. The impact of weight loss on fat-free mass, muscle, bone and hematopoiesis health: Implications for emerging pharmacotherapies aiming at fat reduction and lean mass preservation. Metabolism 2024:156057. [PMID: 39481534 DOI: 10.1016/j.metabol.2024.156057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 10/28/2024] [Accepted: 10/28/2024] [Indexed: 11/02/2024]
Abstract
Incretin receptor agonists have revolutionized the treatment of obesity, achieving up to 15-25 % weight loss in many patients, i.e., at a rate approaching that achieved with bariatric surgery. However, over 25 % of total weight lost from both surgery and pharmacotherapy typically comes from fat-free mass, including skeletal muscle mass, which is often overlooked and can impair metabolic health and increase the risk of subsequent sarcopenic obesity. Loss of muscle and bone as well as anemia can compromise physical function, metabolic rate, and overall health, especially in older adults. The myostatin-activin-follistatin-inhibin system, originally implicated in reproductive function and subsequently muscle regulation, appears to be crucial for muscle and bone maintenance during weight loss. Activins and myostatin promote muscle degradation, while follistatins inhibit their activity in states of negative energy balance, thereby preserving lean mass. Novel compounds in the pipeline, such as Bimagrumab, Trevogrumab, and Garetosmab-which inhibit activins and myostatin signaling-have demonstrated promise in preventing muscle loss while promoting fat loss. Either alone or combined with incretin receptor agonists, these drugs may enhance fat loss while preserving or even increasing muscle and bone mass, offering a potential solution for improving body composition during significant weight loss. Since this dual therapeutic approach could help address the challenges of muscle and bone loss during weight loss, well-designed studies are needed to optimize these strategies and assess long-term benefits. For the time being, considerations like advanced age and prefrailty may affect the choice of suitable candidates in clinical practice for current and emerging anti-obesity medications due to the associated risk of sarcopenia.
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Affiliation(s)
- Konstantinos Stefanakis
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michail Kokkorakis
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA.
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197
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Zeinhom A, Fadallah SA, Mahmoud M. Human mesenchymal stem/stromal cell based-therapy in diabetes mellitus: experimental and clinical perspectives. Stem Cell Res Ther 2024; 15:384. [PMID: 39468609 PMCID: PMC11520428 DOI: 10.1186/s13287-024-03974-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 10/04/2024] [Indexed: 10/30/2024] Open
Abstract
Diabetes mellitus (DM), a chronic metabolic disease, poses a significant global health challenge, with current treatments often fail to prevent the long-term disease complications. Mesenchymal stem/stromal cells (MSCs) are, adult progenitors, able to repair injured tissues, exhibiting regenerative effects and immunoregulatory and anti-inflammatory responses, so they have been emerged as a promising therapeutic approach in many immune-related and inflammatory diseases. This review summarizes the therapeutic mechanisms and outcomes of MSCs, derived from different human tissue sources (hMSCs), in the context of DM type 1 and type 2. Animal model studies and clinical trials indicate that hMSCs can facilitate pleiotropic actions in the diabetic milieu for improved metabolic indices. In addition to modulating abnormally active immune system, hMSCs can ameliorate peripheral insulin resistance, halt beta-cell destruction, preserve residual beta-cell mass, promote beta-cell regeneration and insulin production, support islet grafts, and correct lipid metabolism. Moreover, hMSC-free derivatives, importantly extracellular vesicles, have shown potent experimental anti-diabetic efficacy. Moreover, the review discusses the diverse priming strategies that are introduced to enhance the preclinical anti-diabetic actions of hMSCs. Such strategies are recommended to restore the characteristics and functions of MSCs isolated from patients with DM for autologous implications. Finally, limitations and merits for the wide spread clinical applications of MSCs in DM such as the challenge of autologous versus allogeneic MSCs, the optimal MSC tissue source and administration route, the necessity of larger clinical trials for longer evaluation duration to assess safety concerns, are briefly presented.
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Affiliation(s)
- Alaa Zeinhom
- Biotechnology Department, Faculty of Science, Cairo University, Cairo Governorate, 12316, Egypt
| | - Sahar A Fadallah
- Biotechnology Department, Faculty of Science, Cairo University, Cairo Governorate, 12316, Egypt
| | - Marwa Mahmoud
- Human Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (NRC), Cairo, 12622, Egypt.
- Stem Cell Research Unit, Medical Research Centre of Excellence, NRC, Cairo, Egypt.
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198
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Oprea AD, Umpierrez GE, Sweitzer B, Hepner DL. Perioperative Management of Patients Taking Glucagon-like Peptide-1 Receptor Agonists: Applying Evidence to Clinical Practice. Anesthesiology 2024:142136. [PMID: 39471345 DOI: 10.1097/aln.0000000000005204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2024]
Abstract
This review discusses recent evidence addressing risks in patients taking
glucagon-like peptide-1 receptor agonist medications and proposes a framework for perioperative management.
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Affiliation(s)
- Adriana D Oprea
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | | | - BobbieJean Sweitzer
- Department of Anesthesiology and Surgical Services, Inova Health Foundation, Falls Church, Virginia; and Department of Medical Education, University of Virginia, Charlottesville, Virginia
| | - David L Hepner
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Shahpar A, Sofiani VH, Nezhad NZ, Charostad M, Ghaderi R, Farsiu N, Kiskani AK, Pezeshki S, Nakhaie M. A narrative review: exploring viral-induced malignancies through the lens of dysregulated cellular metabolism and glucose transporters. BMC Cancer 2024; 24:1329. [PMID: 39472817 PMCID: PMC11520837 DOI: 10.1186/s12885-024-13013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 10/01/2024] [Indexed: 11/02/2024] Open
Abstract
INTRODUCTION In this narrative review, we unravel the complex interplay between oncogenic viruses, cellular metabolism, and glucose transporter (GLUT) dysregulation in viral-induced malignancies. METHODS By explaining the diverse mechanisms through which seven major oncoviruses manipulate metabolic pathways and GLUT expression, particularly GLUT1, we provide novel insights into the critical role of metabolic reprogramming in viral replication and oncogenesis. RESULTS Our exploration of the molecular pathways targeted by viral oncoproteins reveals a similarity between the metabolic alterations induced by viral infections and those observed in neoplastic transformation. A key finding of our review is the overexpression of GLUTs, particularly GLUT1, as a hallmark of both viral infections and many cancers. CONCLUSIONS By elucidating the complex interplay between viral oncoproteins, oncogene activation, tumor suppressor gene loss, and GLUT overexpression, we highlight the potential of GLUTs as novel targets for diagnosis, prognosis, and therapy of viral-induced malignancies.
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Affiliation(s)
- Amirhossein Shahpar
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Nazanin Zeinali Nezhad
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Charostad
- Department of Biology, Faculty of Science, Yazd University, Yazd, Iran
| | - Reza Ghaderi
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Niloofar Farsiu
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Amin Karimzadeh Kiskani
- Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Pezeshki
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Nakhaie
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
- Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
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Bohara S, Bagheri A, Ertugral EG, Radzikh I, Sandlers Y, Jiang P, Kothapalli CR. Integrative analysis of gene expression, protein abundance, and metabolomic profiling elucidates complex relationships in chronic hyperglycemia-induced changes in human aortic smooth muscle cells. J Biol Eng 2024; 18:61. [PMID: 39473010 PMCID: PMC11523773 DOI: 10.1186/s13036-024-00457-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 10/14/2024] [Indexed: 11/02/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a major public health concern with significant cardiovascular complications (CVD). Despite extensive epidemiological data, the molecular mechanisms relating hyperglycemia to CVD remain incompletely understood. We here investigated the impact of chronic hyperglycemia on human aortic smooth muscle cells (HASMCs) cultured under varying glucose conditions in vitro, mimicking normal (5 mmol/L), pre-diabetic (10 mmol/L), and diabetic (20 mmol/L) conditions, respectively. Normal HASMC cultures served as baseline controls, and patient-derived T2DM-SMCs served as disease controls. Results showed significant increases in cellular proliferation, area, perimeter, and F-actin expression with increasing glucose concentration (p < 0.01), albeit not exceeding the levels in T2DM cells. Atomic force microscopy analysis revealed significant decreases in Young's moduli, membrane tether forces, membrane tension, and surface adhesion in SMCs at higher glucose levels (p < 0.001), with T2DM-SMCs being the lowest among all the cases (p < 0.001). T2DM-SMCs exhibited elevated levels of selected pro-inflammatory markers (e.g., ILs-6, 8, 23; MCP-1; M-CSF; MMPs-1, 2, 3) compared to glucose-treated SMCs (p < 0.01). Conversely, growth factors (e.g., VEGF-A, PDGF-AA, TGF-β1) were higher in SMCs exposed to high glucose levels but lower in T2DM-SMCs (p < 0.01). Pathway enrichment analysis showed significant increases in the expression of inflammatory cytokine-associated pathways, especially involving IL-10, IL-4 and IL-13 signaling in genes that are up-regulated by elevated glucose levels. Differentially regulated gene analysis showed that compared to SMCs receiving normal glucose, 513 genes were upregulated and 590 genes were downregulated in T2DM-SMCs; fewer genes were differentially expressed in SMCs receiving higher glucose levels. Finally, the altered levels in genes involved in ECM organization, elastic fiber synthesis and formation, laminin interactions, and ECM proteoglycans were identified. Growing literature suggests that phenotypic switching in SMCs lead to arterial wall remodeling (e.g., change in stiffness, calcific deposits formation), with direct implications in the onset of CVD complications. Our results suggest that chronic hyperglycemia is one such factor that leads to morphological, biomechanical, and functional alterations in vascular SMCs, potentially contributing to the pathogenesis of T2DM-associated arterial remodeling. The observed differences in gene expression patterns between in vitro hyperglycemic models and patient-derived T2DM-SMCs highlight the complexity of T2DM pathophysiology and underline the need for further studies.
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Affiliation(s)
- Smriti Bohara
- Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, 44115, USA
| | - Atefeh Bagheri
- Department of Biological, Geological and Environmental Sciences, Cleveland State University, Cleveland, OH, 44115, USA
| | - Elif G Ertugral
- Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, 44115, USA
| | - Igor Radzikh
- Department of Chemistry, Cleveland State University, Cleveland, OH, 44115, USA
| | - Yana Sandlers
- Department of Chemistry, Cleveland State University, Cleveland, OH, 44115, USA
| | - Peng Jiang
- Department of Biological, Geological and Environmental Sciences, Cleveland State University, Cleveland, OH, 44115, USA.
- Center for Gene Regulation in Health and Disease, Cleveland State University, Cleveland, OH, 44115, USA.
- Center for RNA Science and Therapeutics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Chandrasekhar R Kothapalli
- Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, 44115, USA.
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