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Shankar SS, Shankar RR, Mixson LA, Miller DL, Chung C, Cilissen C, Beals CR, Stoch SA, Steinberg HO, Kelley DE. Linearity of β-cell response across the metabolic spectrum and to pharmacology: insights from a graded glucose infusion-based investigation series. Am J Physiol Endocrinol Metab 2016; 310:E865-73. [PMID: 27072496 DOI: 10.1152/ajpendo.00527.2015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/05/2016] [Indexed: 11/22/2022]
Abstract
The graded glucose infusion (GGI) examines insulin secretory response patterns to continuously escalating glycemia. The current study series sought to more fully appraise its performance characteristics. Key questions addressed were comparison of the GGI to the hyperglycemic clamp (HGC), comparison of insulin secretory response patterns across three volunteer populations known to differ in β-cell function (healthy nonobese, obese nondiabetic, and type 2 diabetic), and characterization of effects of known insulin secretagogues in the context of a GGI. Insulin secretory response was measured as changes in insulin, C-peptide, insulin secretion rates (ISR), and ratio of ISR to prevailing glucose (ISR/G). The GGI correlated well with the HGC (r = 0.72 for ISR/G, P < 0.01). The insulin secretory response in type 2 diabetes (T2DM) was significantly blunted (P < 0.001), whereas it was significantly increased in obese nondiabetics compared with healthy nonobese (P < 0.001). Finally, robust (P < 0.001 over placebo) pharmacological effects were observed in T2DM and healthy nonobese volunteers. Collectively, the findings of this investigational series bolster confidence that the GGI has solid attributes for assessing insulin secretory response to glucose across populations and pharmacology. Notably, the coupling of insulin secretory response to glycemic changes was distinctly and uniformly linear across populations and in the context of insulin secretagogues. (Clinical Trial Registration Nos. NCT00782418, NCT01055340, NCT01373450).
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Affiliation(s)
| | | | | | | | | | | | - Chan R Beals
- Merck & Company, Inc., Kenilworth, New Jersey; and
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152
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Type 2 Diabetes, Diabetes Genetic Score and Risk of Decreased Renal Function and Albuminuria: A Mendelian Randomization Study. EBioMedicine 2016; 6:162-170. [PMID: 27211558 PMCID: PMC4856750 DOI: 10.1016/j.ebiom.2016.02.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/14/2016] [Accepted: 02/17/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a risk factor for dysregulation of glomerular filtration rate (GFR) and albuminuria. However, whether the association is causal remains unestablished. RESEARCH DESIGN AND METHODS We performed a Mendelian Randomization (MR) analysis in 11,502 participants aged 40 and above, from a well-defined community in Shanghai during 2011-2013, to explore the causal association between T2D and decreased estimated GFR (eGFR) and increased urinary albumin-to-creatinine ratio (uACR). We genotyped 34 established T2D common variants in East Asians, and created a T2D-genetic risk score (GRS). We defined decreased eGFR as eGFR<90ml/min/1.73m(2) and increased uACR as uACR≥30mg/g. We used the T2D_GRS as the instrumental variable (IV) to quantify the causal effect of T2D on decreased eGFR and increased uACR. RESULTS Each 1-standard deviation (SD, 3.90 points) increment in T2D_GRS was associated with decreased eGFR: odds ratio (OR)=1.18 (95% confidence interval [CI]: 1.01, 1.30). In the MR analysis, we demonstrated a causal relationship between genetically determined T2D and decreased eGFR (OR=1.47, 95% CI: 1.15, 1.88, P=0.0003). When grouping the genetic loci according to their relations with either insulin secretion (IS) or insulin resistance (IR), we found both IS_GRS and IR_GRS were significantly related to decreased eGFR (both P<0.02). In addition, T2D_GRS and IS_GRS were significantly associated with Log-uACR (both P=0.04). CONCLUSION Our results provide novel evidence for a causal association between T2D and decreased eGFR by using MR approach in a Chinese population.
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153
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Watabe S, Morikawa M, Kaneda M, Nakaishi K, Nakatsuma A, Ninomiya M, Yoshimura T, Miura T, Ito E. Ultrasensitive detection of proteins and sugars at single-cell level. Commun Integr Biol 2016; 9:e1124201. [PMID: 27064305 PMCID: PMC4802808 DOI: 10.1080/19420889.2015.1124201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 11/10/2022] Open
Abstract
Each cell produces its own responses even if it appears identical to other cells. To analyze these individual cell characteristics, we need to measure trace amounts of molecules in a single cell. Nucleic acids in a single cell can be easily amplified by polymerase chain reaction, but single-cell measurement of proteins and sugars will require de novo techniques. In the present study, we outline the techniques we have developed toward this end. For proteins, our ultrasensitive enzyme-linked immunosorbent assay (ELISA) coupled with thionicotinamide-adenine dinucleotide cycling can detect proteins at subattomoles per assay. For sugars, fluorescence correlation spectroscopy coupled with glucose oxidase-catalyzed reaction allows us to measure glucose at tens of nM. Our methods thus offer versatile techniques for single-cell-level analyses, and they are hoped to strongly promote single-cell biology as well as to develop noninvasive tests in clinical medicine.
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Affiliation(s)
| | - Mika Morikawa
- R&D Headquarters, TAUNS Laboratories, Inc., Izunokuni, Japan; Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Japan
| | - Mugiho Kaneda
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University , Sanuki, Japan
| | | | - Akira Nakatsuma
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University , Sanuki, Japan
| | - Masaki Ninomiya
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University , Sanuki, Japan
| | - Teruki Yoshimura
- Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido , Ishikari-Tobetsu, Japan
| | - Toshiaki Miura
- Graduate School of Pharmaceutical Sciences, Hokkaido University , Sapporo, Japan
| | - Etsuro Ito
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University , Sanuki, Japan
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154
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Huang CC, Leu HB, Huang PH, Lin LY, Wu TC, Lin SJ, Chen JW. Hypertension subtypes modify metabolic response to thiazide diuretics. Eur J Clin Invest 2016; 46:80-91. [PMID: 26584406 DOI: 10.1111/eci.12571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 11/12/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Blood pressure (BP) and metabolic response to thiazide diuretics might be varied in patients with different hypertension subtypes and ethnicities. This study aimed to investigate the response of BP and metabolic profiles to short-term thiazide treatment in an Asian cohort with different hypertension subtypes. DESIGN Serial ethnic Chinese nondiabetic subjects with hypertension were evaluated. After diet instruction and lifestyle modification for 2 weeks, patients who still had elevated systolic BP (SBP≥140 mmHg) and/or diastolic BP (DBP≥90 mmHg) were given 50 mg of hydrochlorothiazide daily for 2 weeks. The responses of BP and metabolic profiles were evaluated before and after treatment according to the patient's baseline BP subtype - isolated systolic hypertension (ISH), systo-diastolic hypertension (SDH) and isolated diastolic hypertension (IDH). RESULTS Hydrochlorothiazide treatment significantly reduced the BP in all 92 patients (62 males, aged 45·7 ± 9·6 years), irrespective of their baseline BP subtypes. In patients with SDH (n = 39) or IDH (n = 40), hydrochlorothiazide treatment significantly increased serum adiponectin (P = 0·001 and 0·007, respectively) and reduced asymmetric dimethylarginine levels (P < 0·001, in both groups). Serum cholesterol (P = 0·027) and fasting blood sugar levels (P = 0·044) were significantly improved only in the IDH patients. Furthermore, IDH was independently associated with changes in fasting blood sugar (β = -11·178, P = 0·022) and cholesterol (β = -22·654, P = 0·027). CONCLUSIONS The characteristics of the Asian hypertensive patients with diastolic hypertension can present a favourable metabolic response to the short-term hydrochlorothiazide treatment. The potential positive effect on cardiovascular risk should be validated in long-term studies in this diastolic type of hypertension.
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Affiliation(s)
- Chin-Chou Huang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Bang Leu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Yu Lin
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tao-Cheng Wu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jaw-Wen Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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155
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Klefter ON, Vilsbøll T, Knop FK, Larsen M. Retinal vascular and structural dynamics during acute hyperglycaemia. Acta Ophthalmol 2015; 93:697-705. [PMID: 26146858 DOI: 10.1111/aos.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 06/01/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare retinal vascular dynamics during acute hyperglycaemia in patients with type 2 diabetes and healthy volunteers. METHODS Twenty-one patients with type 2 diabetes and 27 healthy controls were examined with fundus photographic measurement of retinal vessel diameters, retinal oximetry, macular perfusion velocities and optical coherence tomographic measurement of subfoveal choroidal thickness every 30 min during a 3-hr 75 g oral glucose tolerance test (OGTT). Patients paused antidiabetic therapy for 1 week prior to the OGTT. RESULTS Plasma glucose (PG) and fluctuations in PG were larger in patients with diabetes (p < 0.0001). PG increased significantly 30 min after ingestion of glucose (p < 0.0001 in both groups). With a delay of 0-120 min, the PG increase was followed by increased retinal arterial oxygen saturations and arteriovenous oxygen saturation differences, narrowed retinal veins and increased arteriovenous diameter ratios. No effect of age, gender or diabetes status was observed. Choroidal thickness was transiently reduced in controls and unchanged in patients with diabetes (p = 0.021). Macular perfusion velocities increased after 150 min in patients with diabetes but not in controls (arterial p = 0.059; venous p = 0.16). Higher age and diabetes tended to be associated with higher retinal arterial oxygen saturation. CONCLUSION The transition from fasting to acute hyperglycaemia is followed, with a delay of up to 2 hr, by retinal vascular changes, notably increased oxygen extraction, suggesting an effect of secondary metabolic changes. Retinal responses were similar in patients with type 2 diabetes and controls despite differences in glucose levels. It is necessary to standardize measurement conditions in studies of retinal physiology.
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Affiliation(s)
- Oliver N. Klefter
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Tina Vilsbøll
- Center for Diabetes Research; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Filip K. Knop
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Center for Diabetes Research; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; University of Copenhagen; Glostrup Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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156
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Immunoreactive insulin in diabetes mellitus patient sera detected by ultrasensitive ELISA with thio-NAD cycling. Biotechniques 2015; 59:359, 361-7. [PMID: 26651515 DOI: 10.2144/000114355] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/17/2015] [Indexed: 11/23/2022] Open
Abstract
To minimize patient suffering, the smallest possible volume of blood should be collected for diagnosis and disease monitoring. When estimating insulin secretion capacity and resistance to insulin in diabetes mellitus (DM), increasing insulin assay immunosensitivity would reduce the blood sample volume required for testing. Here we present an ultrasensitive ELISA coupled with thio-NAD cycling to measure immunoreactive insulin in blood serum. Only 5 μL of serum was required for testing, with a limit of detection (LOD) for the assay of 10(-16) moles/assay. Additional recovery tests confirmed this method can detect insulin in sera. Comparisons between a commercially available immunoreactive insulin kit and our ultrasensitive ELISA using the same commercially available reference demonstrated good data correlation, providing further evidence of assay accuracy. Together, these results demonstrate our ultrasensitive ELISA could be a powerful tool in the diagnosis and treatment of not only DM but also many other diseases in the future.
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157
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Triplitt C, Solis-Herrera C, Cersosimo E, Abdul-Ghani M, Defronzo RA. Empagliflozin and linagliptin combination therapy for treatment of patients with type 2 diabetes mellitus. Expert Opin Pharmacother 2015; 16:2819-33. [PMID: 26583910 DOI: 10.1517/14656566.2015.1114098] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Many patients with type 2 diabetes mellitus (T2DM) fail to achieve the desired A1c goal because the antidiabetic medications used do not correct the underlying pathophysiologic abnormalities and monotherapy is not sufficiently potent to reduce the A1c to the 6.5 - 7.0% range. Insulin resistance and islet (beta and alpha) cell dysfunction are major pathophysiologic abnormalities in T2DM. We examine combination therapy with linagliptin plus empagliflozin as a therapeutic approach for the treatment of inadequately controlled T2DM patients. AREAS COVERED A literature search of all human diabetes, metabolism and general medicine journals from year 2000 to the present was conducted. Glucagon like peptide-1 (GLP-1) deficiency/resistance contributes to islet cell dysfunction by impairing insulin secretion and increasing glucagon secretion. DPP-4 inhibitors (DPP4i) improve pancreatic islet function by augmenting glucose-dependent insulin secretion and decreasing elevated plasma glucagon levels. Linagliptin, a DPP-4 inhibitor, reduces HbA1c, is weight neutral, has an excellent safety profile and a low risk of hypoglycemia. The expression of sodium-glucose cotransporter-2 (SGLT2) in the proximal renal tubule is upregulated in T2DM, causing excess reabsorption of filtered glucose. The SGLT2 inhibitor (SGLT2i), empagliflozin, improves HbA1c by causing glucosuria and ameliorating glucotoxicity. It also decreases weight and blood pressure, and has a low risk of hypoglycemia. EXPERT OPINION The once daily oral combination of linagliptin plus empagliflozin does not increase the risk of hypoglycemia and tolerability and discontinuation rates are similar to those with each as monotherapy. At HbA1c values below 8.5% linagliptin/empagliflozin treatment produces an additive effect, whereas above 8.5%, there is a less than additive reduction with combination therapy compared with the effect of each agent alone. Linagliptin/empagliflozin addition is a logical combination in patients with T2DM, especially those with an HbA1c < 8.5%.
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Affiliation(s)
- C Triplitt
- a Department of Medicine, Diabetes Division , University of Texas Health Science Center and Texas Diabetes Institute , San Antonio , TX 78229 , USA
| | - C Solis-Herrera
- a Department of Medicine, Diabetes Division , University of Texas Health Science Center and Texas Diabetes Institute , San Antonio , TX 78229 , USA
| | - E Cersosimo
- a Department of Medicine, Diabetes Division , University of Texas Health Science Center and Texas Diabetes Institute , San Antonio , TX 78229 , USA
| | - M Abdul-Ghani
- a Department of Medicine, Diabetes Division , University of Texas Health Science Center and Texas Diabetes Institute , San Antonio , TX 78229 , USA
| | - Ralph A Defronzo
- a Department of Medicine, Diabetes Division , University of Texas Health Science Center and Texas Diabetes Institute , San Antonio , TX 78229 , USA
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158
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Liang J, Pei Y, Liu X, Qiu Q, Sun Y, Zhu Y, Yang M, Qi L. The CDKAL1 gene is associated with impaired insulin secretion and glucose-related traits: the Cardiometabolic Risk in Chinese (CRC) study. Clin Endocrinol (Oxf) 2015; 83:651-5. [PMID: 26119585 DOI: 10.1111/cen.12838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/20/2015] [Accepted: 06/18/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Insulin secretion and insulin resistance, which affect metabolic homoeostasis, each have a significant genetic component. Cyclin- dependent kinase 5 (CDK5) regulatory subunit-associated protein 1-like 1 (CDKAL1) rs10946398, a novel body mass index (BMI)-associated locus specifically in the Asian population, may impair insulin secretion and may be associated with insulin resistance and type 2 diabetes. Our objective was to investigate the impact of the rs10946398 polymorphism of CDKAL1 on insulin secretion, insulin resistance and glucose-related traits in the Chinese population. SUBJECTS AND METHODS The study samples were based on a community-based health examination survey conducted in central China. Indices of insulin resistance and insulin secretion were derived from fasting glucose measurements and oral glucose tolerance tests (OGTTs). Using multivariate linear regression models, the relationships between the rs10946398 polymorphism of CDKAL1 and insulin secretion, insulin resistance and quantitative glucose-related traits were investigated in 2313 participants. RESULTS The CDKAL1 rs10946398 C allele showed a significant association with decreased insulin secretion (β = -0·05, P < 0·0005), but not with insulin resistance (β = 0·02, P = 0·08). We also found that the CDKAL1 rs10946398 C allele was significantly associated with glucose-related traits (fasting glucose, fasting insulin, 2-h glucose and HbA1c). There was no significant relationship between rs10946398 and other metabolic traits. CONCLUSIONS rs10946398 of CDKAL1 was associated with markers of impaired insulin secretion. It is reasonable to infer that the relationship between CDKAL1 and metabolic diseases is mediated by its effect on glucose-related traits.
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Affiliation(s)
- Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu, China
- Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, Jiangsu, China
| | - Ying Pei
- School of Medicine, Southeast University, Nanjing, China
| | - Xuekui Liu
- Department of Endocrinology, Xuzhou Central Hospital, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu, China
- Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, Jiangsu, China
| | - Qinqin Qiu
- Xuzhou Medical College, Xuzhou, Jiangsu, China
| | - Yuting Sun
- Xuzhou Medical College, Xuzhou, Jiangsu, China
| | - Yan Zhu
- Xuzhou Medical College, Xuzhou, Jiangsu, China
| | - Manqing Yang
- Department of Endocrinology, Xuzhou Central Hospital, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu, China
- Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Xuzhou, Jiangsu, China
| | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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159
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Peterson RG, Jackson CV, Zimmerman K, de Winter W, Huebert N, Hansen MK. Characterization of the ZDSD Rat: A Translational Model for the Study of Metabolic Syndrome and Type 2 Diabetes. J Diabetes Res 2015; 2015:487816. [PMID: 25961053 PMCID: PMC4415477 DOI: 10.1155/2015/487816] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/05/2014] [Accepted: 09/16/2014] [Indexed: 12/16/2022] Open
Abstract
Metabolic syndrome and T2D produce significant health and economic issues. Many available animal models have monogenic leptin pathway mutations that are absent in the human population. Development of the ZDSD rat model was undertaken to produce a model that expresses polygenic obesity and diabetes with an intact leptin pathway. A lean ZDF rat with the propensity for beta-cell failure was crossed with a polygenetically obese Crl:CD (SD) rat. Offspring were selectively inbred for obesity and diabetes for >30 generations. In the current study, ZDSD rats were followed for 6 months; routine clinical metabolic endpoints were included throughout the study. In the prediabetic metabolic syndrome phase, ZDSD rats exhibited obesity with increased body fat, hyperglycemia, insulin resistance, dyslipidemia, glucose intolerance, and elevated HbA1c. As disease progressed to overt diabetes, ZDSD rats demonstrated elevated glucose levels, abnormal oral glucose tolerance, increases in HbA1c levels, reductions in body weight, increased insulin resistance with decreasing insulin levels, and dyslipidemia. The ZDSD rat develops prediabetic metabolic syndrome and T2D in a manner that mirrors the development of metabolic syndrome and T2D in humans. ZDSD rats will provide a novel, translational animal model for the study of human metabolic diseases and for the development of new therapies.
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Affiliation(s)
- Richard G. Peterson
- PreClinOmics, Inc., 7918 Zionsville Road, Indianapolis, IN 46268, USA
- *Richard G. Peterson:
| | | | - Karen Zimmerman
- PreClinOmics, Inc., 7918 Zionsville Road, Indianapolis, IN 46268, USA
| | - Willem de Winter
- Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Norman Huebert
- Janssen Research & Development, LLC, Spring House, PA 19477, USA
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160
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Worsley R, Jane F, Robinson PJ, Bell RJ, Davis SR. Metformin for overweight women at midlife: a double-blind, randomized, controlled trial. Climacteric 2014; 18:270-7. [DOI: 10.3109/13697137.2014.954997] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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161
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Declining ß-cell function is associated with the lack of long-range negative correlation in glucose dynamics and increased glycemic variability: A retrospective analysis in patients with type 2 diabetes. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2014; 1:192-199. [PMID: 29159101 PMCID: PMC5685022 DOI: 10.1016/j.jcte.2014.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/01/2014] [Accepted: 09/12/2014] [Indexed: 11/24/2022]
Abstract
Objective To determine whether characteristics of glucose dynamics are reflections of β-cell function or rather of inadequate diabetes control. Materials/methods We analyzed historical liquid meal tolerance test (LMTT) and continuous glucose monitoring (CGM) data, which had been obtained from 56 non-insulin treated type 2 diabetic outpatients during withdrawal of antidiabetic drugs. Computed CGM parameters included detrended fluctuation analysis (DFA)-based indices, autocorrelation function exponent, mean amplitude of glycemic excursions (MAGE), glucose SD, and measures of glycemic exposure. The LMTT-based disposition index (LMTT-DI) calculated from the ratio of the area-under-the-insulin-curve to the area-under-the-glucose-curve and Matsuda index was used to assess relationships among β-cell function, glucose profile complexity, autocorrelation function, and glycemic variability. Results The LMTT-DI was inverse linearly correlated with the short-range α1 and long-range scaling exponent α2 (r = −0.275 and −0.441, respectively, p < 0.01) such that lower glucose complexity was associated with better preserved insulin reserve, but it did not correlate with the autocorrelation decay exponent γ. By contrast, the LMTT-DI was strongly correlated with MAGE and SD (r = 0.625 and 0.646, both p < 0.001), demonstrating a curvilinear relationship between β-cell function and glycemic variability. On stepwise regression analyses, the LMTT-DI emerged as an independent contributor, explaining 20, 38, and 47% (all p < 0.001) of the variance in the long-range DFA scaling exponent, MAGE, and hemoglobin A1C, respectively, whereas insulin sensitivity failed to contribute independently. Conclusions Loss of complexity and increased variability in glucose profiles are associated with declining β-cell reserve and worsening glycemic control.
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Key Words
- ACF, autocorrelation function
- AUC, area under the curve
- CGM, continuous glucose monitoring
- Cp, C-peptide
- DFA, detrended fluctuation analysis
- Disposition index
- Glucose profile dynamics
- LMTT, liquid meal tolerance test
- LMTT-DI, LMTT-based disposition index
- MAGE, mean amplitude of glycemic excursions
- OHA, oral hypoglycemic agent
- SD, standard deviation
- TZDs, thiazolidinediones
- Type 2 diabetes
- β-Cell reserve
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