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Sanghera DK, Hopkins R, Malone-Perez MW, Bejar C, Tan C, Mussa H, Whitby P, Fowler B, Rao CV, Fung KA, Lightfoot S, Frazer JK. Targeted sequencing of candidate genes of dyslipidemia in Punjabi Sikhs: Population-specific rare variants in GCKR promote ectopic fat deposition. PLoS One 2019; 14:e0211661. [PMID: 31369557 PMCID: PMC6675050 DOI: 10.1371/journal.pone.0211661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/28/2019] [Indexed: 12/18/2022] Open
Abstract
Dyslipidemia is a well-established risk factor for cardiovascular diseases. Although, advances in genome-wide technologies have enabled the discovery of hundreds of genes associated with blood lipid phenotypes, most of the heritability remains unexplained. Here we performed targeted resequencing of 13 bona fide candidate genes of dyslipidemia to identify the underlying biological functions. We sequenced 940 Sikh subjects with extreme serum levels of hypertriglyceridemia (HTG) and 2,355 subjects were used for replication studies; all 3,295 participants were part of the Asian Indians Diabetic Heart Study. Gene-centric analysis revealed burden of variants for increasing HTG risk in GCKR (p = 2.1x10-5), LPL (p = 1.6x10-3) and MLXIPL (p = 1.6x10-2) genes. Of these, three missense and damaging variants within GCKR were further examined for functional consequences in vivo using a transgenic zebrafish model. All three mutations were South Asian population-specific and were largely absent in other multiethnic populations of Exome Aggregation Consortium. We built different transgenic models of human GCKR with and without mutations and analyzed the effects of dietary changes in vivo. Despite the short-term of feeding, profound phenotypic changes were apparent in hepatocyte histology and fat deposition associated with increased expression of GCKR in response to a high fat diet (HFD). Liver histology of the GCKRmut showed severe fatty metamorphosis which correlated with ~7 fold increase in the mRNA expression in the GCKRmut fish even in the absence of a high fat diet. These findings suggest that functionally disruptive GCKR variants not only increase the risk of HTG but may enhance ectopic lipid/fat storage defects in absence of obesity and HFD. To our knowledge, this is the first transgenic zebrafish model of a putative human disease gene built to accurately assess the influence of genetic changes and their phenotypic consequences in vivo.
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Affiliation(s)
- Dharambir K. Sanghera
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Ruth Hopkins
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Megan W. Malone-Perez
- Department of Pediatrics, Section of Pediatric Hematology-Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Cynthia Bejar
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Chengcheng Tan
- Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Huda Mussa
- Department of Pediatrics, Section of Infectious Diseases, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Paul Whitby
- Department of Pediatrics, Section of Infectious Diseases, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Ben Fowler
- Oklahoma Medical Research Foundation, Imaging Core Facility, Oklahoma City, Oklahoma, United States of America
| | - Chinthapally V. Rao
- Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - KarMing A. Fung
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Oklahoma, United States of America
| | - Stan Lightfoot
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Oklahoma, United States of America
| | - J. Kimble Frazer
- Department of Pediatrics, Section of Pediatric Hematology-Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
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Ahmadi F, Moogahi S, Bahrami H. Determining frequency and pattern of infections associated with diabetes based educational hospitals in Ahvaz city; Iran. Diabetes Metab Syndr 2019; 13:2441-2444. [PMID: 31405657 DOI: 10.1016/j.dsx.2019.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/10/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Diabetes mellitus is a metabolic disease known as one of the most common illness in the world. It is believed that diabetic patients are at high risk of varied infections than non-diabetics. The aim of this study was to determine the frequency and pattern of infections in diabetic patients admitted to the internal wards of educational hospitals of Ahvaz Jundishapur University of Medical Sciences. METHODS This descriptive cross-sectional study was performed on 700 diabetic patients from January 2014 to December 2015 in internal wards (general, endocrine, gastroenterology, lung, nephrology, cardiology, neurology and infectious diseases) of educational hospitals affiliated to Ahvaz JundishapurUniversity of Medical Sciences. Data includeddemographic information, type of diabetes treatment, duration of diabetes mellitus, final diagnosis, and blood sugar on admission that were analyzed statistically. RESULTS Out of 700 patients, 374 (53.4%) women and 326 (46.6%) men were entered into this study. The number of non-infectious and infectious patients were 506 (72.3%) and 194 (27.7%). The mean of age,duration of diabetes, and glucose were 62.34 ± 14.38 years, 11.11 ± 7.18 years, and 271.98 ± 90 (mg/dl) in patients with infectious diseases respectively. The most common infectious illnesses were diabetic foot infections (32.5%), pneumonia (18%), soft tissue abscess(13.9%), and urinary tract infections (11.3%). CONCLUSION Infectious diseases are one of the most common factorsto hospitalize diabetic patients (27.7%), most of whom had diabetic foot infections, pneumonia, and soft tissue abscess.
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Affiliation(s)
- Fatemeh Ahmadi
- Department of Infectious Diseases, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sasan Moogahi
- Department of Infectious Diseases, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hoda Bahrami
- Medical Student of Ahvaz Jundishapur University of Medical Sciences, Student Research Committee, Ahvaz jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
Over the past 50 years, the diabetes technology field progressed remarkably through self-monitoring of blood glucose (SMBG), continuous subcutaneous insulin infusion (CSII), risk and variability analysis, mathematical models and computer simulation of the human metabolic system, real-time continuous glucose monitoring (CGM), and control algorithms driving closed-loop control systems known as the "artificial pancreas" (AP). This review follows these developments, beginning with an overview of the functioning of the human metabolic system in health and in diabetes and of its detailed quantitative network modeling. The review continues with a brief account of the first AP studies that used intravenous glucose monitoring and insulin infusion, and with notes about CSII and CGM-the technologies that made possible the development of contemporary AP systems. In conclusion, engineering lessons learned from AP research, and the clinical need for AP systems to prove their safety and efficacy in large-scale clinical trials, are outlined.
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Affiliation(s)
- Boris Kovatchev
- Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia 22908
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154
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Alsayed KA, Ghoraba MK. Assessment of diabetic patients' adherence to insulin injections on basal-bolus regimen in diabetic care center in Saudi Arabia 2018: Cross sectional survey. J Family Med Prim Care 2019; 8:1964-1970. [PMID: 31334163 PMCID: PMC6618221 DOI: 10.4103/jfmpc.jfmpc_276_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Since insulin became a focal point of diabetes management, several studies have been carried out to monitor and improve patient outcomes. Adherence insulin therapy is an important part of diabetes management. AIM This study reviews the responses of patients being managed in a diabetic care setting in monitoring their adherence to basal bolus insulin therapy. METHOD A pre-validated questionnaire containing 18 questions was administered to patients in the diabetic care unit of the Security Forces Hospital, Riyadh, Saudi Arabia. RESULTS The levels of adherence with basal bolus insulin therapy was 61.9%. There is no considerable difference in adherence levels of male and female respondents with 31.62% and 31.58% respectively. The younger age groups (14-29) had the highest adherence levels at 65.75%. Higher levels of patient literacy and the location also have a positive relationship with adherence. CONCLUSION To improve adherence levels, dosing should be made with consideration for patient convenience, and patients should be encouraged to build positive psychological relationships. Further studies should look to studying outcomes of therapy, and markers should be developed to monitor patient progress on therapy regimen regularly. The aspect of short clinic visits is another major consideration that needs to be look into properly to understand and monitor patients' proper adherence toward the basal bolus insulin.
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Affiliation(s)
- Khalid A. Alsayed
- Family Medicine Resident, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
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155
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Corbatón Anchuelo A, Martínez-Larrad MT, Serrano-García I, Fernández Pérez C, Serrano-Ríos M. Body fat anthropometric indexes: Which of those identify better high cardiovascular risk subjects? A comparative study in Spanish population. PLoS One 2019; 14:e0216877. [PMID: 31120940 PMCID: PMC6532872 DOI: 10.1371/journal.pone.0216877] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 04/30/2019] [Indexed: 01/20/2023] Open
Abstract
Aim To determine the association of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtr) and Body Shape Index (ABSI) with high cardiovascular risk (CVR), as well as to determine whether how strong are these relationships. Material and methods A cross-sectional study was carried out in Spanish Caucasian adults. 3,456 subjects completed the study, 45.78% males, aged < 65 years and non-diabetic subjects. Anthropometric/biochemical variables were measured. We determined ABSI based on WC adjusted for height and weight. High CVR was defined as ≥ 20% according to the Framingham chart, ≥ 5% with the SCORE chart, and ≥ 7.5% with the ACC/AHA guide. Areas under the receiver operating characteristic curves (AUCs) were estimated for each anthropometric measure. Results Most significant AUCs in males were: WHtr and ABSI for Framingham ≥ 20% and SCORE ≥ 5%. Also significant were WHtr, WC and ABSI for ACCA/AHA ≥ 7.5%. On the other hand, most significant AUCs in females were: WHtr and WC for Framingham ≥ 20%; and WHtr and WHR for SCORE ≥ 5%, WHtr, and WC for ACC/AHA guide ≥ 7.5%. Conclusions Overall, the best anthropometric index identifying Spanish males and females who are at high risk for CV events is WHtr. ABSI was also found to be a good anthropometric index to predict high CVR in Spanish males according to FR, SCORE and ACC/AHA charts. For Spanish females, WC is a good anthropometric index according to FR and ACC/AHA guide, while WHR is better according to SCORE.
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Affiliation(s)
- Arturo Corbatón Anchuelo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- * E-mail:
| | - María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Irene Serrano-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- UGC de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
| | - Cristina Fernández Pérez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- UGC de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Enfermería, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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156
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Change in visceral adiposity is an independent predictor of future arterial pulse pressure. J Hypertens 2019; 36:299-305. [PMID: 28857792 DOI: 10.1097/hjh.0000000000001532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Pulse pressure (PP), a marker of arterial stiffness, and body composition are both risk factors for cardiovascular disease. Little is known about whether changes in body composition may be linked to future PP. We sought to determine whether change in amount of abdominal and thigh fat over 5 years predicted PP at 10 years. METHODS Visceral fat as well as abdominal and thigh subcutaneous fat areas were measured by computed tomography at baseline and 5 years later in 284 Japanese Americans (mean age 49.3 years; 50.4% men) without hypertension, heart disease, and glucose-lowering medication use at baseline. PP at 10 years was calculated as the difference between SBP and DBP measured with a mercury sphygmomanometer. The association between change in fat at 5 years and arterial PP at 10 years, adjusted for baseline PP, was examined using linear regression analysis. MAIN RESULTS Change in abdominal visceral fat area at 5 years was positively associated with 10-year PP independent of sex, 5-year change in BMI, and baseline age, BMI, PP, abdominal visceral fat, smoking status, alcohol consumption, physical activity, homeostasis model assessment insulin resistance, and fasting plasma glucose. There were no significant associations between baseline amounts or change in abdominal or thigh subcutaneous fat areas and future PP. CONCLUSION The accumulation of abdominal visceral fat over time independently predicted future PP in Japanese Americans.
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157
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Dong PT, Lin H, Huang KC, Cheng JX. Label-free quantitation of glycated hemoglobin in single red blood cells by transient absorption microscopy and phasor analysis. SCIENCE ADVANCES 2019; 5:eaav0561. [PMID: 31093524 PMCID: PMC6510558 DOI: 10.1126/sciadv.aav0561] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
As a stable and accurate biomarker, glycated hemoglobin (HbA1c) is clinically used to diagnose diabetes with a threshold of 6.5% among total hemoglobin (Hb). Current methods such as boronate affinity chromatography involve complex processing of large-volume blood samples. Moreover, these methods cannot measure HbA1c fraction at single-red blood cell (RBC) level, thus unable to separate the contribution from other factors such as RBC lifetime. Here, we demonstrate a spectroscopic transient absorption imaging approach that is able to differentiate HbA1c from Hb on the basis of their distinct excited-state dynamics. HbA1c fraction inside a single RBC is derived quantitatively through phasor analysis. HbA1c fraction distribution of diabetic blood is apparently different from that of healthy blood. A mathematical model is developed to derive the long-term blood glucose concentration. Our technology provides a unique way to study heme modification and to derive clinically important information void of bloodstream glucose fluctuation.
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Affiliation(s)
- Pu-Ting Dong
- Department of Chemistry, Boston University, Boston, MA 02215, USA
| | - Haonan Lin
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Kai-Chih Huang
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Ji-Xin Cheng
- Department of Chemistry, Boston University, Boston, MA 02215, USA
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Department of Electrical and Computer Engineering, Boston University, Boston, MA 02215, USA
- Photonics Center, Boston University, Boston, MA 02215, USA
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158
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Kim G, Lee SG, Lee BW, Kang ES, Cha BS, Ferrannini E, Lee YH, Cho NH. Spontaneous ketonuria and risk of incident diabetes: a 12 year prospective study. Diabetologia 2019; 62:779-788. [PMID: 30788528 DOI: 10.1007/s00125-019-4829-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/14/2019] [Indexed: 12/25/2022]
Abstract
AIMS/HYPOTHESIS Ketones may be regarded as a thrifty fuel for peripheral tissues, but their clinical prognostic significance remains unclear. We investigated the association between spontaneous fasting ketonuria and incident diabetes in conjunction with changes in metabolic variables in a large population-based observational study. METHODS We analysed 8703 individuals free of diabetes at baseline enrolled in the Korean Genome and Epidemiology Study, a community-based 12 year prospective study. Individuals with (n = 195) or without fasting ketonuria were matched 1:4 by propensity score. Incident diabetes was defined as fasting plasma glucose ≥7.0 mmol/l, post-load 2 h glucose ≥11.1 mmol/l on biennial OGTTs, or current use of glucose-lowering medication. Using Cox regression models, HRs for developing diabetes associated with the presence of ketonuria at baseline were analysed. RESULTS Over 12 years, of the 925 participants in the propensity score-matched cohort, 190 (20.5%) developed diabetes. The incidence rate of diabetes was significantly lower in participants with spontaneous ketonuria compared with those without ketonuria (HR 0.63; 95% CI 0.41, 0.97). Results were virtually identical when participants with fasting ketonuria were compared against all participants without ketonuria (after multivariate adjustment, HR 0.66; 95% CI 0.45, 0.96). During follow-up, participants with baseline ketonuria maintained lower post-load 1 h and 2 h glucose levels and a higher insulinogenic index despite comparable baseline values. CONCLUSIONS/INTERPRETATION The presence of spontaneous fasting ketonuria was significantly associated with a reduced risk of diabetes, independently of metabolic variables. Our findings suggest that spontaneous fasting ketonuria may have a potential preventive role in the development of diabetes.
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Affiliation(s)
- Gyuri Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Guk Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung-Wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bong-Soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Systems Biology, Glycosylation Network Research Center, Yonsei University, Seoul, Republic of Korea.
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
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Sexual Dysfunction in Women Treated for Type 1 Diabetes and the Impact of Coexisting Thyroid Disease. Sex Med 2019; 7:217-226. [PMID: 30954495 PMCID: PMC6523036 DOI: 10.1016/j.esxm.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/12/2019] [Accepted: 03/03/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction More sexual problems are reported among people treated for diabetes; however, this situation is less explored in women than in men. Aim To analyze the presence and causal links of female sexual dysfunction (FSD) among Czech women treated for type 1 diabetes. Methods 40 women completed a national version of the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-revised (FSDS-R), and Beck’s Depression Inventory–II (BDI-II). A metabolic and endocrine analysis was done using blood samples. Data were statistically analyzed using SPSS v.24 and the R environment. Main Outcome Measures Patient details (personal information, diabetes-related data, and sex history), sexual performance (the FSFI and FSDS-R scores), and level of depression (the BDI-II score) were measured. Results FSD was present in 58% of the participants (based on the FSFI score), and 38% women declared significant sexual distress (according to their FSDS-R score). Even though only 4 women fulfilled the criteria for depression, we observed a strong association between BDI-II and FSFI (for total FSFI score P = .012, ρ = −0.394) resp. FSDS-R scores (P < .001, ρ = 0.552). Although we were not able to establish a clear direct connection between FSD and metabolic control, BDI-II scores were closely correlated with glycosylated hemoglobin (P = .009, ρ = 0.407). The duration of diabetes (based on FSDS-R: P = .046) but neither age nor the presence of chronic diabetic microvascular complications was associated with a higher FSD occurrence. We also observed an association between FSD and the presence of autoimmune hypothyroidism, even when successfully treated (FSDS-R: P = .009; FSFI: P = .067). Conclusion FSD is more common in women with type 1 diabetes than in healthy women, and coexisting thyroid autoimmune disease seems to exacerbate FSD. Women suffering from type 1 diabetes, and particularly those with additional endocrinopathies, should be actively screened for FSD. Stechova K, Mastikova L, Urbaniec K, et al. Sexual Dysfunction in Women Treated for Type 1 Diabetes and the Impact of Coexisting Thyroid Disease. Sex Med 2019;7:217–226.
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Mori K, Nishide K, Okuno S, Shoji T, Emoto M, Tsuda A, Nakatani S, Imanishi Y, Ishimura E, Yamakawa T, Shoji S, Inaba M. Impact of diabetes on sarcopenia and mortality in patients undergoing hemodialysis. BMC Nephrol 2019; 20:105. [PMID: 30922266 PMCID: PMC6437886 DOI: 10.1186/s12882-019-1271-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/27/2019] [Indexed: 12/19/2022] Open
Abstract
Background Sarcopenia has become a serious disorder in modern society. Chronic kidney disease requiring dialysis and diabetes are some of the disorders that accelerate the onset and progression of sarcopenia. We, therefore, investigated the prevalence of sarcopenia in patients undergoing hemodialysis (HD) and confirmed the impact of diabetes mellitus (DM) on this population. Methods This study included 308 patients whose muscle strength and mass had been evaluated using handgrip strength and dual-energy X-ray absorptiometry, respectively. Sarcopenia was defined according to the criteria established by the Asian Working Group on Sarcopenia. In addition, this cohort had been followed up for 9 years. Results The prevalence of sarcopenia was 40% (37% in males and 45% in females) with gender differences being insignificant (p = 0.237). The DM morbidity rate was significantly higher in those with sarcopenia than in those without sarcopenia (41% vs. 27%, p = 0.015). Multivariate regression analyses showed that the presence of DM was an independent contributor to sarcopenia in patients undergoing HD (odds ratio 3.11; 95% confidence interval 1.63–5.93; p < 0.001). During the follow-up of 76 ± 35 months, 100 patients died. Patients with sarcopenia demonstrated significantly higher rates of all-cause mortality than those without sarcopenia (p < 0.001 using the log-rank test). Multivariate Cox proportional hazards analyses revealed that the presence of DM was significantly associated with higher all-cause mortality (adjusted hazard ratio: 2.39; 95% confidence interval 1.51–3.81; p < 0.001). Conclusions The prevalence of sarcopenia among this cohort of patients undergoing HD was determined to be 40%. Moreover, the presence of DM was an independent contributor to sarcopenia and an independent predictor of all-cause mortality in this population. Electronic supplementary material The online version of this article (10.1186/s12882-019-1271-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katsuhito Mori
- Department of Nephrology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Kozo Nishide
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Senji Okuno
- Kidney Center, Shirasagi Hospital, Osaka, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akihiro Tsuda
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinya Nakatani
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Eiji Ishimura
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | | | - Masaaki Inaba
- Department of Nephrology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
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161
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SoJung L, Libman I, Hughan K, Kuk JL, Jeong JH, Zhang D, Arslanian S. Effects of Exercise Modality on Insulin Resistance and Ectopic Fat in Adolescents with Overweight and Obesity: A Randomized Clinical Trial. J Pediatr 2019; 206:91-98.e1. [PMID: 30554789 PMCID: PMC7193538 DOI: 10.1016/j.jpeds.2018.10.059] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/24/2018] [Accepted: 10/25/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether a combined aerobic exercise and resistance exercise is more effective than either aerobic exercise or resistance exercise alone in improving insulin sensitivity and reducing total adiposity and ectopic fat in adolescents. STUDY DESIGN A total of 118 sedentary adolescents with overweight/obesity (body mass index >85th percentile, 12-17 years) were recruited from October 2013 through April 2017 at Children's Hospital of Pittsburgh. Participants were randomized to 1 of the following 6-month exercise groups (3 d/wk, 180 min/wk): aerobic exercise (n = 38), resistance exercise (n = 40), and combined aerobic exercise and resistance exercise (n = 40). The primary outcome was the change in insulin-stimulated glucose disposal by a 3-hour hyperinsulinemic-euglycemic clamp. The secondary outcomes were changes in liver fat by proton magnetic resonance spectroscopy and intermuscular adipose tissue by computed tomography. RESULTS Of the 118 participants randomized, 85 participants (72%) completed the study with 90% exercise attendance. Total adiposity reduced similarly in all groups (-2%, P < .05). After adjusting for age and sex, insulin-stimulated glucose disposal increased (P < .05) in all groups, with the increase in the aerobic exercise group being greater than the resistance exercise group (1.7 ± 0.1 vs 0.7 ± 0.1 mg/kg/min, P < .05) but not different from the combined group (1.2 ± 0.1 mg/kg/min). Liver fat was reduced (P < .05) in the aerobic exercise (-0.6%) and combined (-0.6%) groups but not in the resistance exercise group (-0.3%, P > .05). Intermuscular adipose tissue decreased (P < .05) similarly in all groups. CONCLUSION Combined aerobic exercise and resistance exercise and aerobic exercise alone are similarly beneficial in improving insulin sensitivity and reducing ectopic fat in adolescents with obesity. TRIAL REGISTRATION ClinicalTrials.gov: NCT01938950.
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Affiliation(s)
- Lee SoJung
- Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Republic of Korea 17104
| | - Ingrid Libman
- Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children’s Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15224
| | - Kara Hughan
- Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children’s Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15224
| | - Jennifer L. Kuk
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada M3J 1P3
| | - Jong H. Jeong
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15224
| | - Di Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15224
| | - Silva Arslanian
- Center for Pediatric Research in Obesity and Metabolism, Children’s Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15224,Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children’s Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15224
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He J, Stryjecki C, Reddon H, Peralta-Romero J, Karam-Araujo R, Suarez F, Gomez-Zamudio J, Burguete-Garcia A, Alyass A, Cruz M, Meyre D. Adiponectin is associated with cardio-metabolic traits in Mexican children. Sci Rep 2019; 9:3084. [PMID: 30816311 PMCID: PMC6395686 DOI: 10.1038/s41598-019-39801-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 12/31/2018] [Indexed: 02/07/2023] Open
Abstract
The adipocyte-derived adiponectin hormone bridges obesity and its cardio-metabolic complications. Genetic variants at the ADIPOQ locus, in ADIPOR1, and ADIPOR2 have been associated with adiponectin concentrations and cardio-metabolic complications in diverse ethnicities. However, no studies have examined these associations in Mexican children. We recruited 1 457 Mexican children from Mexico City. Six genetic variants in or near ADIPOQ (rs182052, rs2241766, rs266729, rs822393), ADIPOR1 (rs10920533), and ADIPOR2 (rs11061971) were genotyped. Associations between serum adiponectin, genetic variants, and cardio-metabolic traits were assessed using linear and logistic regressions adjusted for age, sex, and recruitment center. Serum adiponectin concentration was negatively associated with body mass index, waist to hip ratio, low-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting glucose, fasting insulin, homeostatic model assessment of insulin resistance, dyslipidemia and overweight/obesity status (7.76 × 10−40 ≤ p ≤ 3.00 × 10−3). No significant associations between genetic variants in ADIPOQ, ADIPOR1, and ADIPOR2 and serum adiponectin concentration were identified (all p ≥ 0.30). No significant associations between the six genetic variants and cardio-metabolic traits were observed after Bonferroni correction (all p < 6.9 × 10−4). Our study suggests strong associations between circulating adiponectin concentration and cardio-metabolic traits in Mexican children.
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Affiliation(s)
- Juehua He
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Carolina Stryjecki
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Hudson Reddon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Jesus Peralta-Romero
- Medical Research Unit in Biochemistry, Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Roberto Karam-Araujo
- Health Promotion Division, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Fernando Suarez
- Medical Research Unit in Biochemistry, Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jaime Gomez-Zamudio
- Medical Research Unit in Biochemistry, Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Ana Burguete-Garcia
- Centro de investigación sobre enfermedades infecciosas. Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Akram Alyass
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - David Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada. .,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada.
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Increased prelaminar tissue thickness in patients with open-angle glaucoma and type 2 diabetes. PLoS One 2019; 14:e0211641. [PMID: 30730917 PMCID: PMC6366732 DOI: 10.1371/journal.pone.0211641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The characteristics of the optic nerve head (ONH) in open angle glaucoma (OAG) patients with diabetes have not been reported. This study aimed to characterize the ONH structures and glaucomatous damage in diabetic OAG patients, using age-matched non-diabetic OAG patients and control subjects. METHODS The locations of visual field defects of OAG patients were classified and the prelaminar thickness and lamina cribrosa depth were measured in 64 OAG patients with type 2 diabetes (OAG+DM), 68 OAG patients without diabetes (OAG-DM), and 36 controls. All participants were scanned by spectral domain-optical coherence tomography. The anterior prelaminar depth and lamina cribrosa depth were measured at the center of the reference line (the Bruch's membrane opening plane). The prelaminar tissue thickness was obtained by subtracting the anterior prelaminar depth from the anterior lamina cribrosa depth. RESULTS The visual field defects in the OAG+DM group were more commonly found in the inferior hemifield (P = 0.010), and tended to involve the central visual field compared to the OAG-DM group (P = 0.044). In the comparison of ONH parameters, the prelaminar thickness was highest in the OAG+DM group, followed by the control subjects and the OAG-DM group (P = 0.035). Post-hoc testing showed that prelaminar thickness was significantly greater in the OAG+DM group than in the OAG-DM group (P = 0.033). The lamina cribrosa depth was deepest in the OAG+DM group, followed by the OAG-DM group and the control subjects (P = 0.006). CONCLUSIONS Diabetic and non-diabetic OAG patients exhibit different characteristics of glaucoma, particularly increased prelaminar thickening in diabetics.
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Vinodhini S, Rajeswari VD. Exploring the antidiabetic and anti-obesity properties of Samanea saman through in vitro and in vivo approaches. J Cell Biochem 2019; 120:1539-1549. [PMID: 30378154 DOI: 10.1002/jcb.27385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/09/2018] [Indexed: 01/24/2023]
Abstract
In recent years, diabetes and obesity have become a major problem in global health care because of changes in lifestyle, food habits, and age-related metabolic disorders. Diabetes mellitus is one of the most common diseases, affecting millions of people worldwide. Currently, herbal drugs are used to control obesity and diabetes. The present study investigates the anti-obesity, antidiabetic, and antioxidant activities of Samanea saman leaf extract. A methanolic extract of S. saman leaves was prepared by a maceration method. The S. saman leaf extract was studied for its inhibitory effect on glucose utilization using specific in vitro procedures to analyze its antioxidant, anti-obesity, and antidiabetic activities via different assays, such as α-amylase and α-glucosidase inhibition assay, glucose uptake by yeast cells, nonenzymatic glycosylation assay followed by glucose diffusion assay. The outcome of the study showed that the methanolic extract strongly inhibited the pancreatic lipase, α-amylase, and glucosidase activities, compared with the standard drug. The results showed that the extract possessed considerable antioxidant and antidiabetic activities, and further studies are needed to confirm the results using an in vivo model. Thus, it is proposed that S. saman can be used as a therapeutic agent.
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Affiliation(s)
- Shanmugam Vinodhini
- Department of Biomedical Sciences, School of Biosciences and Technology, VIT, Vellore, Tamil Nadu, India
| | - V Devi Rajeswari
- Department of Biomedical Sciences, School of Biosciences and Technology, VIT, Vellore, Tamil Nadu, India
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165
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Abebe M, Adane T, Kefyalew K, Munduno T, Fasil A, Biadgo B, Ambachew S, Shahnawaz S. Variation of Urine Parameters among Diabetic Patients: A Cross-Sectional Study. Ethiop J Health Sci 2019; 29:877-886. [PMID: 30700955 PMCID: PMC6341436 DOI: 10.4314/ejhs.v29i1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Diabetic kidney disease is a common and severe microvascular complication of diabetes mellitus (DM). There are limited data regarding alteration of urine parameters other than proteinuria among DM patients. Methods Institution based cross-sectional study was conducted from February to May 2017 to assess alteration of urine parameters among DM patients at the University of Gondar Hospital, Northwest Ethiopia. A Systematic random sampling technique was used to recruit adult (≥18 years) diabetic participants. Data were collected after ethical requirements had been fulfilled. The degree of association between variables was evaluated through bivariable and multivariable logistic regression models. Results The majority (69.4%) of the study participants were type 2 DM patients. The prevalence of altered urine chemical parameters was 11.3% proteinuria, 4.5% ketonuria, 13.6% hematuria, 53.8% glucosuria, 24.9% leukocyturia and 1.7% positive for nitrite. Diastolic blood pressure and poor glycemic control were significantly associated with proteinuria. Male participants were 2.4 times more likely to have leukocyturia than female participants. The prevalence of abnormally increased microscopic findings was red blood cells 3.1%, white blood cells 12.5%, epithelial cells 27.5%, yeast cells 1.7%, bacteria 17.8%, casts 3.7% and crystals 29.2%. Conclusions The prevalence of altered urine parameters among DM patients is found to be considerable. These increased prevalences of altered urine parameters are potential indicators for diabetic kidney disease.
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Affiliation(s)
- Molla Abebe
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tiruneh Adane
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassa Kefyalew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Munduno
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Fasil
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Saira Shahnawaz
- Department of Biochemistry, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
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166
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Cardoso CRL, Salles GC, Leite NC, Salles GF. Prognostic impact of carotid intima-media thickness and carotid plaques on the development of micro- and macrovascular complications in individuals with type 2 diabetes: the Rio de Janeiro type 2 diabetes cohort study. Cardiovasc Diabetol 2019; 18:2. [PMID: 30630491 PMCID: PMC6327523 DOI: 10.1186/s12933-019-0809-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background The prognostic importance of carotid atherosclerosis in individuals with diabetes is unsettled. We aimed to evaluate the relationships between parameters of carotid atherosclerosis and the future occurrence of micro- and cardiovascular complications in individuals with type 2 diabetes. Methods Ultrasonographic parameters of carotid atherosclerosis, intima-media thickness (CIMT) and plaques, were measured at baseline in 478 participants who were followed-up for a median of 10.8 years. Multivariate Cox analysis was used to examine the associations between carotid parameters and the occurrence of microvascular (retinopathy, renal, and peripheral neuropathy) and cardiovascular complications (total cardiovascular events [CVEs] and cardiovascular mortality), and all-cause mortality. The improvement in risk stratification was assessed by using the C-statistic and the integrated discrimination improvement (IDI) index. Results During follow-up, 116 individuals had a CVE and 115 individuals died (56 from cardiovascular diseases); 131 newly-developed or worsened diabetic retinopathy, 156 achieved the renal composite outcome (94 newly developed microalbuminuria and 78 deteriorated renal function), and 83 newly-developed or worsened peripheral neuropathy. CIMT, either analysed as a continuous or as a categorical variable, and presence of plaques predicted CVEs occurrence and renal outcomes, but not mortality or other microvascular complications. Individuals with an increased CIMT and plaques had a 1.5- to 1.8-fold increased risk of CVEs and a 1.6-fold higher risk of renal outcome. CIMT and plaques modestly improved cardiovascular risk discrimination over classic risk factors, with IDIs ranging from 7.8 to 8.4%; but more markedly improved renal risk discrimination, with IDIs from 14.8 to 18.5%. Conclusions Carotid atherosclerosis parameters predicted cardiovascular and renal outcomes, and improved renal risk stratification. Ultrasonographic carotid imaging may be useful in type 2 diabetes management.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil
| | - Guilherme C Salles
- Civil Engineering Program, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nathalie C Leite
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil
| | - Gil F Salles
- Department of Internal Medicine, School of Medicine, University Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Rodolpho Rocco, 255, Cidade Universitária, Rio de Janeiro, CEP 21941-913, Brazil.
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Cui F, Qian ZK, Ling YX, Zhu WJ, Li XQ, Mao Z, Li MT. Alisma orientalis (Sam.) juzep polysaccharide-regulated glucose-lipid metabolism in experimental rats and cell model of diabetes mellitus with regulation of mir-126. Pharmacogn Mag 2019. [DOI: 10.4103/pm.pm_441_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Lee KW, Lyu J, Park JK, Jo C, Kim SS. Dietary carbohydrate quality and quantity in relation to the incidence of type 2 diabetes: A prospective cohort study of middle-aged and older Korean adults. Nutrition 2019; 57:245-251. [DOI: 10.1016/j.nut.2018.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/26/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022]
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Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, Wan Sulaiman WA, Suppiah S, Mohamed MH, Veettil SK. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18:494. [PMID: 30547769 PMCID: PMC6295048 DOI: 10.1186/s12884-018-2131-4] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 11/30/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. METHODS We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). RESULTS Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9-12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35-13.23); macrosomia (OR 4.41, 95% CI 3.09-6.31); and congenital anomalies (OR 4.25, 95% CI 1.52-11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81-3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19-4.68); family history of diabetes (OR 2.77, 2.22-3.47); history of stillbirth (OR 2.39, 95% CI 1.68-3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72-3.17); history of abortion (OR 2.25, 95% CI 1.54-3.29); age ≥ 25 (OR 2.17, 95% CI 1.96-2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24-1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21-3.07). CONCLUSION We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy. TRIAL REGISTRATION PROSPERO (2017: CRD42017070104 ).
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Affiliation(s)
- Kai Wei Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, University of Malaya Center for Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Fan Kee Hoo
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Yook Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 47500 Bandar Sunway, Selangor Malaysia
| | - Wan Aliaa Wan Sulaiman
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Subapriya Suppiah
- Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Mohd Hazmi Mohamed
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - Sajesh K. Veettil
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia
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Anekwe TD, Rahkovsky II. Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2. Am J Public Health 2018. [DOI: 10.2105/ajph.2013.301661s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tobenna D. Anekwe
- Servicio de Investigaciones Económicas, Departamento de Agricultura de los Estados Unidos, Washington, D. C., Estados Unidos de América
| | - IIya Rahkovsky
- Servicio de Investigaciones Económicas, Departamento de Agricultura de los Estados Unidos, Washington, D. C., Estados Unidos de América
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Abstract
BACKGROUND AND AIMS Different bariatric procedures have been associated with variable weight loss and decrease in serum levels of lipids and lipoproteins. This variation could be partly related to the length of the small intestinal bypass. We evaluated the association of the small intestinal length with the non-alcoholic fatty liver disease (NAFLD) at baseline and with lipid metabolism before and after laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS Seventy consecutive morbidly obese patients were recruited to this prospective study. A standard 60-cm biliopancreatic limb (BPL) and 120-cm alimentary limb (AL) was performed, and thereafter, the common channel (CC) length was measured during elective LRYGB. Histological analysis of liver biopsy to diagnose NAFLD was performed. The mRNA expression of genes participating in the cholesterol and fatty acid metabolism in the liver was analyzed. RESULTS Female sex (p = 0.006), serum triglycerides (TG, p = 0.016), serum alanine aminotransferase (ALT, p = 0.007), and liver steatosis (p = 0.001) associated with the small intestinal length (BPL + AL + CC) at baseline. Association remained significant between levels of serum TG and CC length (p = 0.048) at 1-year follow-up. Liver mRNA expression of genes regulating cholesterol synthesis and bile metabolism did not associate with the baseline small intestinal length. CONCLUSIONS Our findings support the suggestions that small intestinal length regulates TG metabolism before and after LRYGB. Therefore, modification of the length of bypassed small intestine based on measured total small intestinal length could optimize the outcomes of the elective LRYGB.
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Naing C, Htet NH, Basavaraj AK, Nalliah S. An association between IL-10 promoter polymorphisms and diabetic nephropathy: a meta-analysis of case-control studies. J Diabetes Metab Disord 2018; 17:333-343. [PMID: 30918869 PMCID: PMC6405406 DOI: 10.1007/s40200-018-0349-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/10/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND This study aimed to synthesize evidence on the association between IL-10 gene (-819 C/T, -1082 A/G, -592 A/C) polymorphisms and the risk of developing diabetic nephropathy. METHODS A systematic literature search was done in health-related electronic databases. The search was limited to studies published in English until September 2017. We also checked the references of retrieved articles and relevant reviews for any additional studies. The methodological quality of the studies included in this review was assessed using the 'Scales for Quality Assessment'. The I 2 test was used to quantify between-study heterogeneity. A value of I 2 > 50% indicated substantial heterogeneity. For the pooled analysis, summary odds ratio (OR) and its 95% confidence interval (CI) in random effect model were used. RESULTS Eight case-control studies (1192 cases with diabetic nephropathy and 2399 controls) met the inclusion criteria. Three groups of people namely Africans, Asians and Caucasians were included in this review. There were significant protective effects of SNP -819 C/T in overall population (OR 0.32, 95% CI 0.26-0.4) and - 1082 A/G SNP in the Asian population (OR 0.64, 95% CI 0.47-0.86) on diabetic nephropathy in the recessive model. There was no significant effect of -592 A/C on diabetic nephropathy. CONCLUSION The findings suggest the protective effects of -1082A/G and -819G/A polymorphisms on the risk of developing diabetic nephropathy in type 2 diabetes mellitus, especially in the Asian population. Well- designed, prospective studies with sufficient number of participants are recommended to substantiate these findings.
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Affiliation(s)
- Cho Naing
- Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia
- Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland Australia
| | - Norah Htet Htet
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | | | - Sivalingam Nalliah
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Anekwe TD, Rahkovsky I. The Association Between Food Prices and the Blood Glucose Level of US Adults With Type 2 Diabetes. Am J Public Health 2018. [DOI: 10.2105/ajph.2013.301661r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objectives. We estimated the association between the price of healthy and less-healthy food groups and blood sugar among US adults with type 2 diabetes. Methods. We linked 1999–2006 National Health and Nutrition Examination Survey health information to food prices contained in the Quarterly Food-at-Home Price Database. We regressed blood sugar levels on food prices from the previous calendar quarter, controlling for market region and a range of other covariates. We also examined whether the association between food prices and blood sugar varies among different income groups. Results. The prices of produce and low-fat dairy foods were associated with blood sugar levels of people with type 2 diabetes. Specifically, higher prices for produce and low-fat dairy foods were associated with higher levels of glycated hemoglobin and fasting plasma glucose 3 months later. Food prices had a greater association with blood sugar for low-income people than for higher-income people, and in the expected direction. Conclusions. Higher prices of healthy foods were associated with increased blood sugar among people with type 2 diabetes. The association was especially pronounced among low-income people with type 2 diabetes.
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Affiliation(s)
- Tobenna D. Anekwe
- The authors are with the Economic Research Service, US Department of Agriculture, Washington, DC
| | - Ilya Rahkovsky
- The authors are with the Economic Research Service, US Department of Agriculture, Washington, DC
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Campbell F, Lawton J, Rankin D, Clowes M, Coates E, Heller S, de Zoysa N, Elliott J, Breckenridge JP. Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model): A systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme. BMC Health Serv Res 2018; 18:898. [PMID: 30482202 PMCID: PMC6258400 DOI: 10.1186/s12913-018-3655-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/26/2018] [Indexed: 11/23/2022] Open
Abstract
Background People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. To inform the design of more effective follow-up support we undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control. Methods We undertook a meta-ethnography of relevant qualitative studies, identified using systematic search methods. Studies were included which focused on participants’ experiences of self-managing type 1 diabetes after attending structured education which incorporated training in flexible intensive insulin therapy. A line of argument approach was used to synthesise the findings. Results The search identified 18 papers from six studies. The studies included were judged to be of high methodological quality. The line of argument synthesis developed the Follow-Up Support for Effective type 1 Diabetes self-management (FUSED) model. This model outlines the challenges participants encounter in maintaining diabetes self-management practices after attending structured education, and describes how participants try to address these barriers by adapting, simplifying or personalising the self-management approaches they have learned. To help participants maintain the skills taught during courses, the FUSED model presents ten recommendations abstracted from the included papers to provide a logic model for a programme of individualised and responsive follow-up support. Conclusions This meta-ethnography highlights how providing skills training using structured education to people with type 1 diabetes does not necessarily result in participants adopting and sustaining recommended changes in behaviour. To help people sustain diabetes self-management skills after attending structured education, it is recommended that support be provided over the longer-term by appropriately trained healthcare professionals which is responsive to individuals’ needs. Although developed to inform support for people with type 1 diabetes, the FUSED model provides a framework that could also be applied to support individuals with other long term conditions which require complex self-management skills to be learned and sustained over time. Trial registration PROSPERO registration: CRD42017067961. Electronic supplementary material The online version of this article (10.1186/s12913-018-3655-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fiona Campbell
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, England.
| | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School of Molecular, Genetic and Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland
| | - David Rankin
- The Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School of Molecular, Genetic and Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland
| | - Mark Clowes
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, England
| | - Elizabeth Coates
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, England
| | - Simon Heller
- Sheffield University School of Medicine, Academic Unit of Diabetes, Endocrinology, and Metabolism, School of Medicine and Biomedical Sciences, Sheffield, UK
| | - Nicole de Zoysa
- Diabetes Centre, King's College Hospital, Denmark Hill, London, SE5 9RS, England
| | - Jackie Elliott
- Sheffield University School of Medicine, Academic Unit of Diabetes, Endocrinology, and Metabolism, School of Medicine and Biomedical Sciences, Sheffield, UK
| | - Jenna P Breckenridge
- School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, Scotland
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175
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Arthur R, Møller H, Garmo H, Häggström C, Holmberg L, Stattin P, Malmström H, Lambe M, Hammar N, Walldius G, Robinson D, Jungner I, Van Hemelrijck M. Serum glucose, triglycerides, and cholesterol in relation to prostate cancer death in the Swedish AMORIS study. Cancer Causes Control 2018; 30:195-206. [PMID: 30421156 DOI: 10.1007/s10552-018-1093-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 10/29/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Lifestyle-related conditions such as obesity are associated with prostate cancer progression, but the associations with hyperglycemia and dyslipidemia are unclear. This study, therefore, aims to examine the association of glucose, triglycerides, and total cholesterol with prostate cancer death. METHODS From the Swedish AMORIS cohort, we selected 14,150 men diagnosed with prostate cancer between 1996 and 2011 who had prediagnostic measurements of serum glucose, triglycerides, and total cholesterol. Multivariable Cox proportional hazards regression models were used to determine the hazard ratios for death in relation to the aforementioned metabolic markers. RESULTS Using clinical cut-off points, a non-significant positive association was observed between glucose and prostate cancer death. When compared to those with glucose in the lowest quartile, those in the highest quartile had greater risk of prostate cancer death (HR 1.19; 95% CI 1.02-1.39). However, neither total cholesterol nor triglycerides were associated with prostate cancer death. Glucose and triglycerides were positively associated with overall, cardiovascular, and other deaths. Hypercholesterolemia was only associated with risk of CVD death. CONCLUSION Our results suggest that glucose levels may influence prostate cancer survival, but further studies using repeated measurements are needed to further elucidate how glucose levels may influence prostate cancer progression.
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Affiliation(s)
- Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA.
- Translational Oncology & Urology Research, Kings College London, London, UK.
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park, Bronx, NY, USA.
| | - Henrik Møller
- Translational Oncology & Urology Research, Kings College London, London, UK
| | - Hans Garmo
- Translational Oncology & Urology Research, Kings College London, London, UK
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Christel Häggström
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Lars Holmberg
- Translational Oncology & Urology Research, Kings College London, London, UK
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Håkan Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Biostatistics, Data Management and Medical Writing, Research & Development, Swedish Orphan Biovitrum (Sobi), Stockholm, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Niklas Hammar
- Medical Evidence & Observational Research, Global Medicines Development, AstraZeneca, Mölndal, Sweden
| | - Göran Walldius
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David Robinson
- Department of Urology, Ryhov Hospital, Jönköping, Sweden
| | - Ingmar Jungner
- Department of Clinical Epidemiology, Karolinska Institutet and CALAB Research, Stockholm, Sweden
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176
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Xu G, Gaul MD, Kuo GH, Du F, Xu JZ, Wallace N, Hinke S, Kirchner T, Silva J, Huebert ND, Lee S, Murray W, Liang Y, Demarest K. Design, synthesis and biological evaluation of (2S,3R,4R,5S,6R)-5-fluoro-6-(hydroxymethyl)-2-aryltetrahydro-2H-pyran-3,4-diols as potent and orally active SGLT dual inhibitors. Bioorg Med Chem Lett 2018; 28:3446-3453. [DOI: 10.1016/j.bmcl.2018.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/13/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022]
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177
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Sudasinghe BH, Wijeyaratne CN, Ginige PS. Long and short-term outcomes of Gestational Diabetes Mellitus (GDM) among South Asian women - A community-based study. Diabetes Res Clin Pract 2018; 145:93-101. [PMID: 29679628 DOI: 10.1016/j.diabres.2018.04.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/04/2018] [Indexed: 11/20/2022]
Abstract
AIMS To quantify short and long-term outcomes of Gestational Diabetes Mellitus (GDM) among South Asians. METHODS Prospective cohort-study in Gampaha District, Sri Lanka following a community-prevalence study (WHO 1999 criteria). All women with GDM (exposed) and within sample non-GDM (non-exposed) were recruited. Data was gathered at selected intervals until one-year post-partum by interviewer-administered questionnaire, anthropometry, blood pressure, post-partum 75gOGTT and cholesterol. Two groups were compared for pregnancy outcomes; and age, parity, first-trimester BMI adjusted odds ratios (aOR) calculated. RESULTS GDM and non-GDM (n = 194 each) had 169 (87.1%) and 178 (91.8%) responders respectively. Significant differences in outcomes: Antenatal/Perinatal - obstetric and/or medical complications (aOR = 1.8; 95% CI = 1.1-2.7), pregnancy induced hypertension (aOR = 3.1; 95% CI = 1.5-6.5), birth-weight ≥ 3.5 kg (aOR = 2.8; 95% CI = 1.4-5.5), special baby-care for prematurity (aOR = 4.1; 95% CI = 1.1-15.1), low mean POA at delivery (p = 0.005), vaginal moniliasis (aOR = 4.9; 95% CI = 1.4-17.4) and breast-engorgement (aOR = 2.6; 95% CI = 1.02-6.4). Two months postpartum: impaired glucose tolerance (IGT) (aOR = 6.1; 95% CI = 2.7-13.8) and abnormal glucose tolerance [AGT = diabetes, impaired fasting glucose (IFG) and IGT collectively] (aOR = 9.1; 95% CI = 4.3-19.1). One-year postpartum (participation rate = 39.7%): exclusive breastfeeding for six months (aOR = 0.3; 95% CI = 0.1-0.7), diabetes mellitus (aOR = 4.1; 95% CI = 1.1-15.7), IGT (aOR = 5.8; 95% CI = 1.5-21.8), AGT (aOR = 7.7; 95% CI = 2.9-20.6). CONCLUSIONS Hyperglycaemia in Pregnancy detected and followed up in a sub-urban community setting in Sri Lanka, had significantly worse pregnancy outcomes with a high risk of maternal pre-diabetes/diabetes in first post-partum year.
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Affiliation(s)
- B H Sudasinghe
- Health Promotion Bureau, No. 02, Kynsey Road, Colombo 08, Sri Lanka.
| | - C N Wijeyaratne
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Sri Lanka
| | - P S Ginige
- Epidemiological Unit, No. 231, De Saram Place, Colombo 01, Sri Lanka
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178
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Magee MJ, Salindri AD, Gujral UP, Auld SC, Bao J, Haw JS, Lin HH, Kornfeld H. Convergence of non-communicable diseases and tuberculosis: a two-way street? Int J Tuberc Lung Dis 2018; 22:1258-1268. [PMID: 30355404 PMCID: PMC6281291 DOI: 10.5588/ijtld.18.0045] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The intersection of tuberculosis (TB) with non-communicable diseases (NCDs), including diabetes mellitus (DM), chronic lung disease (CLD), and cardiovascular disease (CVD), has emerged as a critical clinical and public health challenge. Rapidly expanding NCD epidemics threaten TB control in low- and middle-income countries, where the prevention and treatment of TB disease remain a great burden. However, to date, the notion that TB may adversely impact NCD risk and severity has not been well explored. This review summarizes biomedical hypotheses, findings from animal models, and emerging epidemiologic data related to the progression of DM, CLD and CVD during and after active TB disease. We conclude that there is sufficient empirical evidence to justify a greater research emphasis on the syndemic interaction between TB and NCD.
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Affiliation(s)
- Matthew J Magee
- Division of Epidemiology and Biostatistics, Georgia State University
| | - Argita D Salindri
- Division of Epidemiology and Biostatistics, Georgia State University
| | - Unjali P Gujral
- Global Diabetes Research Center, Rollins School of Public Health, Emory University
| | - Sara C Auld
- Division of Pulmonary, Allergy and Critical Care Medicine, Emory University School of Medicine
| | - Jing Bao
- National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - J Sonya Haw
- Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine
| | | | - H Kornfeld
- Department of Medicine, University of Massachusetts Medical School
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179
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Izadi Z, Hajizadeh-Saffar E, Hadjati J, Habibi-Anbouhi M, Ghanian MH, Sadeghi-Abandansari H, Ashtiani MK, Samsonchi Z, Raoufi M, Moazenchi M, Izadi M, Nejad ASSH, Namdari H, Tahamtani Y, Ostad SN, Akbari-Javar H, Baharvand H. Tolerance induction by surface immobilization of Jagged-1 for immunoprotection of pancreatic islets. Biomaterials 2018; 182:191-201. [DOI: 10.1016/j.biomaterials.2018.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 12/12/2022]
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180
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Ustulin M, Rhee SY, Chon S, Ahn KK, Lim JE, Oh B, Kim SH, Baik SH, Park Y, Nam MS, Lee KW, Kim YS, Woo JT. Importance of family history of diabetes in computing a diabetes risk score in Korean prediabetic population. Sci Rep 2018; 8:15958. [PMID: 30374195 PMCID: PMC6206127 DOI: 10.1038/s41598-018-34411-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023] Open
Abstract
Prediabetic subjects represent a vulnerable population, requiring special care to reduce the risk of diabetes onset. We developed and validated a diabetes risk score for prediabetic subjects using the Korea National Diabetes Program (KNDP) cohort. Subjects included in the multicenter and prospective cohort (n = 1162) had high diabetes risk at baseline (2005) and were followed until 2012. Survival analysis was performed to analyze the prospective cohort over time, and the bootstrap method was used to validate our model. We confirmed our findings in an external cohort. A diabetes risk score was calculated and the cut-off defined using a receiver operating characteristic curve. Age, body mass index, total cholesterol, and family history of diabetes were associated with diabetes. The model performed well after correction for optimism (Cadj = 0.735). A risk score was defined with a cut-off of ≥5 that maximized sensitivity (72%) and specificity (62%), with an area under the curve of 0.73. Prediabetic subjects with a family history of diabetes had a higher probability of diabetes (risk score = 5) irrespective of other variables; this result was confirmed in the external cohort. Hence, prediabetic subjects with a family history of diabetes have a higher probability of developing diabetes, regardless of other clinical factors.
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Affiliation(s)
- Morena Ustulin
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyu Keung Ahn
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji Eun Lim
- Department of Biochemistry and Molecular Biology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Bermseok Oh
- Department of Biochemistry and Molecular Biology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung-Hoon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Yongsoo Park
- Department of Internal Medicine, College of Medicine, Hanyang University, Guri, Korea
| | - Moon Suk Nam
- Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Kwan Woo Lee
- Department of Endocrinology and Metabolism, College of Medicine, Ajou University, Suwon, Korea
| | - Young Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong-Taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
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181
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Chang HC, Wang MC, Chen MH, Liao HC, Wang YH. The Impact of the Hazard Correlation between Risk Factors and Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102213. [PMID: 30309023 PMCID: PMC6210006 DOI: 10.3390/ijerph15102213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 12/23/2022]
Abstract
This study examined the occurrence of diabetes and sustainable risk factors in residents aged 30 and above of a community in Taoyuan County, Taiwan. The main purpose of this research was to explore the correlations between related variables and the occurrence of diabetes. The demographic variables, health exam variables, healthy behavior variables, and environmental variables had obvious impacts on the risk of diabetes. As age increased, the risk of developing the disease also increased; higher educational levels lowered risk, while unemployment raised it. Also, analysis of the health exam variables showed that abnormal BMIs, waist-hip ratios, and body fat percentages had significant impacts on individuals' risk of diabetes. Moreover, it was found that smoking affected the risk of having diabetes: smokers, particularly male smokers, had a relatively higher risk of developing the disease. Lastly, the results showed that exposure to second-hand smoke did not have a significant effect on the diabetes proportion in the male population. However, a significantly higher proportion of females who had been exposed to second-hand smoke had diabetes.
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Affiliation(s)
- Huan-Cheng Chang
- Division of Nephrology, Department of Medicine, Taiwan Landseed Hospital, No. 77, Guangtai Road, Pingzhen Dist., Taoyuan 324, Taiwan.
- Department of Health Care Management, Chang Gung University, No. 259, Wenhua 1st Road, Guishan Dist., Taoyuan 33302, Taiwan.
| | - Mei-Chin Wang
- Noble Health Management Center, Taiwan Landseed Hospital, No. 77, Guangtai Road, Pingzhen Dist., Taoyuan 324, Taiwan.
| | - Meng-Hao Chen
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
| | - Hung-Chang Liao
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
- Department of Health Services Administration, Chung Shan Medical University, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
| | - Ya-Huei Wang
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
- Department of Applied Foreign Languages, Chung Shan Medical University, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
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182
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In Vitro α-Amylase and Protein Glycation Inhibitory Activity of the Aqueous Extract of Flueggea leucopyrus Willd. J CHEM-NY 2018. [DOI: 10.1155/2018/2787138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
There is much interest in plant-based medicine with antidiabetic and antiglycation properties. Chronic hyperglycemia plays a vital role in the development of long-term diabetic complications by inducing protein glycation and the gradual formation of advanced glycation end products (AGEs) in various body tissues. The main objectives of this study were to investigate the aqueous extract of the whole plant of Flueggea leucopyrus Willd (FLAE), a medicinal plant used in traditional medicine in Sri Lanka for its in vitro α-amylase inhibitory activity and its inhibitory potential on the formation of AGEs. α-Amylase inhibitory activity determined by 3,5-dinitrosalicylic acid method revealed that FLAE possesses 29%–91% inhibitory activity at a concentration range of 2.5–400 μg/mL, respectively. Nonenzymatic protein glycation inhibitory capacity assessed by bovine serum albumin-fructose fluorescence spectrometric assay showed that FLAE at 15.6–250.0 μg/mL inhibited AGE formation by 0.9%–98%, respectively. Radical scavenging ability of FLAE using 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay and total phenolic and flavonoid contents of FLAE were also determined. This study shows that Flueggea leucopyrus Willd not only inhibits α-amylase enzyme, which is known to break starch to glucose, but also inhibits the formation of AGEs, which occur due to chronic hyperglycemia that leads to the onset of diabetic complications.
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183
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Mousa N, Abdel-Razik A, Sheta T, Shabana W, Zakaria S, Awad M, Abd Elsalam M, El-Wakeel N, Elkashef W, Effat N, Elgamal A, Deiab AG, Eldars W. Serum leptin and homeostasis model assessment-IR as novel predictors of early liver fibrosis in chronic hepatitis B virus infection. Br J Biomed Sci 2018; 75:192-196. [PMID: 30079841 DOI: 10.1080/09674845.2018.1505187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The relationship between hepatitis B virus (HBV) infection, leptin and insulin resistance remains unclear. We hypothesised links between serum leptin and insulin resistance in non-diabetic patients with chronic viral hepatitis B infection and their relation to liver fibrosis. METHODS We recruited 190 untreated patients with chronic HBV infection and 72 healthy controls. Serum leptin, fasting glucose, insulin, liver function tests (LFTs), C-peptide and Homeostasis model assessment-IR (HOMA-IR) were measured/calculated by ELISA and standard techniques. RESULTS Serum leptin, C-peptide (both P < 0.001), HOMA-IR (P = 0.021) and several LFTs were increased in patients with chronic HBV-infection. In multivariate regression analysis, both HOMA-IR (P = 0.003) and leptin (P = 0.002) were significant independent predictors of HBV infection. There were significant positive correlations (P < 0.01) between leptin and HOMA-IR (r = 0.81), between serum leptin and METAVIR activity (r = 0.95), and between HOMA-IR and BMI (r = 0.75), fasting glucose (r = 0.005), and fasting insulin (r = 0.81). Several LFTs, glucose and insulin correlated modestly (r = 0.61-0.69, P < 0.05) with leptin. CONCLUSION Serum leptin may be related to the rate of fibrosis progression in nondiabetic patients with chronic HBV infection. Follow-up by serial measurement of serum leptin and HOMA-IR in non diabetic HBV-infected patients may be used as a non-invasive marker of early liver fibrosis.
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Affiliation(s)
- N Mousa
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - A Abdel-Razik
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - T Sheta
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - W Shabana
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - S Zakaria
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - M Awad
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - M Abd Elsalam
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - N El-Wakeel
- c Department of Medical Microbiology and Immunology , Mansoura University , Mansoura , Egypt
| | - W Elkashef
- d Department of Pathology , Mansoura University , Mansoura , Egypt
| | - N Effat
- e Clinical Pathology Department , Mansoura University , Mansoura , Egypt
| | - A Elgamal
- f Department of Tropical Medicine , Menoufia University , Mansoura , Egypt
| | - A G Deiab
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - W Eldars
- c Department of Medical Microbiology and Immunology , Mansoura University , Mansoura , Egypt
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184
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Du Q, Jovanović S, Sukhodub A, Ngoi YS, Lal A, Zheleva M, Jovanović A. Insulin down-regulates cardioprotective SUR2A in the heart-derived H9c2 cells: A possible explanation for some adverse effects of insulin therapy. Biochem Biophys Rep 2018; 16:12-18. [PMID: 30211323 PMCID: PMC6132176 DOI: 10.1016/j.bbrep.2018.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/28/2018] [Accepted: 08/27/2018] [Indexed: 12/12/2022] Open
Abstract
Some recent studies associated insulin therapy with negative cardiovascular events and shorter lifespan. SUR2A, a KATP channel subunit, regulate cardioprotection and cardiac ageing. Here, we have tested whether glucose and insulin regulate expression of SUR2A/KATP channel subunits and resistance to metabolic stress in heart H9c2 cells. Absence of glucose in culture media decreased SUR2A mRNA, while mRNAs of Kir6.2, Kir6.1, SUR1 and IES SUR2B were increased. 2-deoxyglucose (50 mM) decreased mRNAs of SUR2A, SUR2B and SUR1, did not affect IES SUR2A and IES SUR2B mRNAs and increased Kir6.2 mRNA. No glucose and 2-deoxyglucose (50 mM) decreased resistance to an inhibitor of oxidative phosphorylation, DNP (10 mM). 50 mM glucose did not alter KATP channel subunits nor cellular resistance to DNP (10 mM). Insulin (20 ng/ml) in both physiological and high glucose (50 mM) down-regulated SUR2A while upregulating Kir6.1 and Kir6.2 (in high glucose only). Insulin (20 ng/ml) in physiological and high glucose decreased cell survival in DNP (10 mM). As opposed to Kir6.2, infection with SUR2A resulted in titre-dependent cytoprotection. We conclude that insulin decreases resistance to metabolic stress in H9c2 cells by decreasing SUR2A expression. Lower cardiac SUR2A levels underlie increased myocardial susceptibility to metabolic stress and shorter lifespan.
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Affiliation(s)
- Qingyou Du
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
| | - Sofija Jovanović
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
| | - Andriy Sukhodub
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
| | - Yong Shi Ngoi
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
| | - Aashray Lal
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
| | - Marina Zheleva
- Division of Molecular and Clinical Medicine, Medical School, University of Dundee, United Kingdom
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185
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Akkaya S, Küçük B, Doğan HK, Can E. Evaluation of the lamina cribrosa in patients with diabetes mellitus using enhanced depth imaging spectral-domain optical coherence tomography. Diab Vasc Dis Res 2018; 15:442-448. [PMID: 29895175 DOI: 10.1177/1479164118782091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To compare the lamina cribrosa thickness and anterior lamina cribrosa depth between patients with and without diabetes mellitus and to investigate the effect of metabolic control and duration of diabetes mellitus on lamina cribrosa thickness and anterior lamina cribrosa depth using enhanced depth imaging spectral-domain optical coherence tomography. METHODS A total of 70 patients were enrolled in this cross-sectional study and were divided into the diabetes and control groups. Intraocular pressure, circumpapillary retinal nerve fibre layer thickness, anterior lamina cribrosa depth and lamina cribrosa thickness were compared between the groups. RESULTS In the control group, the mean intraocular pressure was 14.6 ± 3.1 (mean ± standard deviation) mmHg, mean circumpapillary retinal nerve fibre layer thickness was 105.41 ± 5.86 μm, mean anterior lamina cribrosa depth was 420.3 ± 90.2 μm and mean lamina cribrosa thickness was 248.5 ± 5.4 μm. In the diabetes group, the mean intraocular pressure was 13.9 ± 2.2 mmHg, mean circumpapillary retinal nerve fibre layer thickness was 101.37 ± 10.97 μm, mean anterior lamina cribrosa depth was 351.4 ± 58.6 μm and mean lamina cribrosa thickness was 271.6 ± 33.9 μm. Lamina cribrosa thickness was significantly higher ( p < 0.001) and anterior lamina cribrosa depth was significantly lower ( p = 0.003) in the diabetes group. There was no statistical difference between the groups with regard to age, spherical equivalent, axial length, circumpapillary retinal nerve fibre layer thickness and intraocular pressure ( p = 0.69, 0.26, 0.47, 0.06 and 0.46, respectively). Lamina cribrosa thickness and anterior lamina cribrosa depth were not significantly correlated with duration of diabetes mellitus (lamina cribrosa thickness: r = -0.078, p = 0.643; anterior lamina cribrosa depth: r = -0.062, p = 0.710) or HbA1c levels (lamina cribrosa thickness: r = -0.078, p = 0.596; anterior lamina cribrosa depth: r = -0.228, p = 0.169). CONCLUSION The results of this study showed that the optical coherence tomography measurement of lamina cribrosa revealed thicker and more anteriorly positioned lamina cribrosa for patients with diabetes mellitus compared with those for healthy controls.
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Affiliation(s)
- Serkan Akkaya
- 1 Department of Ophthalmology, Kayseri Egitim ve Arastirma Hastanesi, Kayseri, Turkey
| | - Bekir Küçük
- 2 Department of Ophthalmology, Bozok Universitesi Tip Fakultesi, Yozgat, Turkey
| | - Hatice Karaköse Doğan
- 3 Department of Endocrinology and Metabolic Disorders, Kayseri Egitim ve Arastirma Hastanesi, Kayseri, Turkey
| | - Ertuğrul Can
- 4 Department of Ophthalmology, Ondokuz Mayis Universitesi Tip Fakultesi, Samsun, Turkey
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Salem MG, Abdel Aziz YM, Elewa M, Elshihawy HA, Said MM. Molecular modelling and synthesis of spiroimidazolidine-2,4-diones with dual activities as hypoglycemic agents and selective inhibitors of aldose reductase. Bioorg Chem 2018; 79:131-144. [DOI: 10.1016/j.bioorg.2018.04.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/30/2018] [Accepted: 04/30/2018] [Indexed: 01/07/2023]
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187
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Lee SJ, Lee HJ, Oh HJ, Go T, Kang DR, Kim JY, Huh JH. Metabolic syndrome status over 2 years predicts incident chronic kidney disease in mid-life adults: a 10-year prospective cohort study. Sci Rep 2018; 8:12237. [PMID: 30115983 PMCID: PMC6095861 DOI: 10.1038/s41598-018-29958-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/18/2018] [Indexed: 12/15/2022] Open
Abstract
We investigated whether changes in MetS status over two years modify the 10-year risk of CKD and proteinuria. A prospective cohort study was conducted in 7,251 subjects without CKD at baseline. We categorized subjects according to MetS status over two years: non-MetS (no MetS at either visit), intermittent MetS (positive for MetS at one assessment), and persistent MetS (positive for MetS at two assessments). The hazard ratio (HR) of new-onset CKD over 10-year was calculated using Cox models. During the 10-year follow-up period, 923 (12.7%) developed CKD. Compared to the non-MetS group, the fully adjusted HR for new-onset CKD was the highest in the persistent MetS group (HR, 1.53; 95% CI, 1.23-1.90), followed by the intermittent MetS group (HR, 1.29; 95% CI, 1.04-1.59) (P for trend <0.001). The HR for developing proteinuria was 1.79 (95% CI, 1.15-2.79) in the persistent MetS group and 0.70 (95% CI, 0.42-1.19) in the intermittent MetS group when the non-MetS group was considered as the reference group. Temporal changes in MetS status over two years influenced the 10-year risk of incident CKD and proteinuria. Our findings suggest that monitoring and strictly controlling MetS are important in preventing renal function decline.
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Affiliation(s)
- So Jin Lee
- Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hun Ju Lee
- Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hyun Jeong Oh
- Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Taehwa Go
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
| | - Ji Hye Huh
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
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Bream KDW, Breyre A, Garcia K, Calgua E, Chuc JM, Taylor L. Diabetes prevalence in rural Indigenous Guatemala: A geographic-randomized cross-sectional analysis of risk. PLoS One 2018; 13:e0200434. [PMID: 30091976 PMCID: PMC6084861 DOI: 10.1371/journal.pone.0200434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/26/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Developing countries and Indigenous populations are disproportionately affected by global trends in diabetes (T2DM), but inconsistent data are available to corroborate this pattern in Guatemala and indigenous communities in Central America. Historic estimates of T2DM, using a variety of sampling techniques and diagnostic methods, in Guatemala include a T2DM prevalence of: 4·2% (1970) and 8·4% (2003). Objectives of this geographically randomized, cross-sectional analysis of risk include: (1) use HbA1c to determine prevalence of T2DM and prediabetes in rural Indigenous community of Atitlán (2) identify risk factors for T2DM including age, BMI and gender. METHODS A spatially random sampling method was used to identify 400 subjects. Prevalence was compared using the confidence interval method, and logistic regression and linear regression were used to assess association between diabetes and risk factors. FINDINGS The overall prevalence of T2DM using HbA1c was 13·81% and prediabetes was also 13·81% in Atitlán, representing a tripling in diabetes from historic estimates and a large population with pre-diabetes. The probability of diabetes increased dramatically with increasing age, however no significant overall relationship existed with gender or BMI. CONCLUSIONS Diabetes is a larger epidemic than previously expected and appears to be related to ageing rather than BMI. Our proposed explanations for these findings include: possible Indigenous unique genetic susceptibility to T2DM, shortcomings in BMI as a metric for adiposity in assessing risk, changes in lifestyle and diet, and an overall aging population. The conclusion of this study suggest that (1) T2DM in rural regions of Guatemala may be of epidemic proportion. With pre-diabetes, more than 25% of the population will be diabetic in the very near future; (2) Age is a significant risk factor in the Indigenous population but BMI is not. This suggests that in some populations diabetes may be a disease of ageing.
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Affiliation(s)
- Kent D. W. Bream
- Department of Family Medicine and Community Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Global Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Harnwell College House, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Facultad de Ciencias Medicas, Universidad de San Carlos de Guatemala, Ciudad Guatemala, Guatemala
- * E-mail:
| | - Amelia Breyre
- Center for Global Health, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Emergency Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kristian Garcia
- Harnwell College House, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Health and Societies Program, Department of History and Sociology of Science, School of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Erwin Calgua
- Harnwell College House, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Facultad de Ciencias Medicas, Universidad de San Carlos de Guatemala, Ciudad Guatemala, Guatemala
| | - Juan M. Chuc
- Hospitalito Atitlán, Canton Ch’utch’aj, Santiago Atitlán, Sololá, Guatemala
| | - Lynne Taylor
- Center of Excellence for Diversity in Health Education and Research, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Bhujbal S, Dash AK. Metformin-Loaded Hyaluronic Acid Nanostructure for Oral Delivery. AAPS PharmSciTech 2018; 19:2543-2553. [PMID: 29948986 DOI: 10.1208/s12249-018-1085-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/24/2018] [Indexed: 01/12/2023] Open
Abstract
The objective of this study was to develop a nanodelivery system containing a mucoadhesive polymer hyaluronic acid (HA) for oral delivery. Metformin was used as a model drug. Blank and drug-loaded HA nanostructures were prepared by precipitation method and characterized for particle size (PS), zeta potential (ZP), physical stability (over 65 days), surface morphology, moisture content, and physical state of the drug in the nanostructures. The cytotoxicity and hemolysis potential of the delivery system was assessed in Caco-2 cells and whole human blood, respectively. The in vitro release of metformin and its uptake in Caco-2 cells was evaluated using high-performance liquid chromatography. Ex vivo permeability of metformin was measured through goat intestinal membrane. The nanoparticles were physically stable and neutrally charged with an average PS of 114.53 ± 12.01 nm. This nanodelivery system existed as nanofibers containing metformin in a crystalline state. This delivery system released the drug rapidly with > 50% of metformin released within 1 h. Cellular uptake studies on Caco-2 cells indicated higher uptake of metformin from nanoparticle as compared to metformin in solution, up to first 45 min. Ex vivo permeability studies on the other hand showed a higher metformin permeability from solution relative to that from nanoparticles through the goat intestinal membrane. Metformin nanoparticles were non-toxic at therapeutic concentrations in Caco-2 cells and showed no hemolytic effect to RBCs. This study indicates the preparation, characterization, as well as the potential use of HA nanostructures for oral delivery.
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190
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Yang Q, Cui Y, Luo F, Liu X, Wang Q, Bai J, Dong F, Sun Q, Lu L, Xu H, Xue J, Chen C, Xiang Q, Liu Q, Zhang Q. MicroRNA-191, acting via the IRS-1/Akt signaling pathway, is involved in the hepatic insulin resistance induced by cigarette smoke extract. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:22400-22407. [PMID: 28963693 DOI: 10.1007/s11356-017-0277-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
Cigarette smoke causes insulin resistance, which is associated with type 2 diabetes mellitus (T2DM). However, the mechanism by which this occurs remains poorly understood. Because the involvement of microRNAs (miRNAs) in the development of insulin resistance is largely unknown, we investigated, in hepatocytes, the roles of miR-191 in cigarette smoke extract (CSE)-induced insulin resistance. In L-02 cells, CSE not only decreased glucose uptake and glycogen levels but also reduced levels of insulin receptor substrate-1 (IRS-1) and Akt activation, effects that were blocked by SC79, an activator of Akt. CSE also increased miR-191 levels in L-02 cells. Furthermore, the inhibition of miR-191 blocked the decreases of IRS-1 and p-Akt levels, which antagonized the decreases of glucose uptake and glycogen levels in L-02 cells induced by CSE. These results reveal a mechanism by which miR-191 is involved in CSE-induced hepatic insulin resistance via the IRS-1/Akt signaling pathway, which helps to elucidate the mechanism for cigarette smoke-induced T2DM.
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Affiliation(s)
- Qianlei Yang
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Yan Cui
- School of Public Health, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Fei Luo
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Xinlu Liu
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Qiushi Wang
- Jiangsu Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, People's Republic of China
| | - Jun Bai
- School of Public Health, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Faqin Dong
- Key Laboratory of Solid Waste Treatment and the Resource Recycle, Southwest University of Science and Technology, Mianyan, 621010, Sichuan, People's Republic of China
| | - Qian Sun
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Lu Lu
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Hui Xu
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Junchao Xue
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Chao Chen
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Quanyong Xiang
- Jiangsu Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, People's Republic of China
| | - Qizhan Liu
- Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, People's Republic of China.
| | - Qingbi Zhang
- School of Public Health, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
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Hirata A, Sugiyama D, Kuwabara K, Hirata T, Tsutatani H, Funamoto M, Watanabe K, Miyamatsu N, Okamura T. Fatty liver index predicts incident diabetes in a Japanese general population with and without impaired fasting glucose. Hepatol Res 2018; 48:708-716. [PMID: 29341419 DOI: 10.1111/hepr.13065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/27/2017] [Accepted: 01/15/2018] [Indexed: 12/17/2022]
Abstract
AIM Fatty liver is associated with the development of diabetes. However, to our knowledge, no study has examined the relationship between the fatty liver index (FLI), calculated scores of hepatic steatosis, and the development of diabetes among individuals without impaired fasting glucose (IFG). We aimed to examine whether FLI predicts the development of diabetes in individuals with and without IFG in a Japanese general population. METHODS We selected 1498 men and 2941 women who participated in Specific Health Checkups in Japan. We divided all participants into six groups according to tertiles of FLI (low, moderate, and high) and the presence or absence of IFG, by sex. We calculated hazard ratios for incident diabetes for each group using a Cox proportional hazard model, adjusting for potential confounders. RESULTS During a mean follow-up period of 3.0 years, 176 cases of diabetes in men and 320 cases in women were identified. Compared with the low FLI group without IFG, the high FLI group without IFG was significantly associated with incident diabetes in both men (hazard ratio, 1.90; 95% confidence interval, 1.08-3.36) and women (hazard ratio, 1.72; 95% confidence interval, 1.18-2.51). All IFG groups were significantly associated with incident diabetes regardless of FLI levels. CONCLUSIONS Our results showed that FLI is associated with the development of diabetes regardless of sex and the presence or absence of IFG, and that it may be a useful predictor of future risk of incident diabetes even in individuals without IFG.
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Affiliation(s)
- Aya Hirata
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Sugiyama
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Kazuyo Kuwabara
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Takumi Hirata
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | | | | | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
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192
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Cha S, Lee SH, Kang SH, Hasan MN, Kim YJ, Cho S, Lee YK. Antibody-mediated oral delivery of therapeutic DNA for type 2 diabetes mellitus. Biomater Res 2018; 22:19. [PMID: 30065848 PMCID: PMC6062860 DOI: 10.1186/s40824-018-0129-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/27/2018] [Indexed: 12/02/2022] Open
Abstract
Background Diabetes mellitus (DM) is a chronic progressive metabolic disease that involves uncontrolled elevation of blood glucose levels. Among various therapeutic approaches, GLP-1 prevents type 2 diabetes mellitus (T2DM) patients from experiencing hyperglycemic episodes. However, the short half-life (< 5 min) and rapid clearance of GLP-1 often limits its therapeutic use. Here, we developed an oral GLP-1 gene delivery system to achieve an extended antidiabetic effect. Methods Human IgG1 (hIgG1)-Fc-Arg/pDNA complexes were prepared by an electrostatic complexation of the expression plasmid with various ratios of the positively modified Fc fragments of an antibody (hIgG1-Fc-Arg) having a targeting ability to FcRn receptor. The shape and size of the complexes were examined by atomic force and field emission electron microscope. The stability of the complexes was tested in simulated gastrointestinal pH and physiological serum condition. Cellular uptake, transport, and toxicity of the complexes were tested in the Caco-2 cells. Biodistribution and antidiabetic effect of the complexes were observed in either Balb/c mice or Lepdb/db mice. Results A 50/1 ratio of the hIgG1-Fc-Arg/pDNA produced a complex structure having approximately 40 ~ 60 nm size and also demonstrated protection of pDNA in the complex from the physiological pH and serum conditions. Cellular uptake and transport of the complex were demonstrated in Caco-2 cells having FcRn receptor expression and forming the monolayer-polarized structure. The cellular toxicity of both delivery vehicle and the complex revealed their minimal toxicity comparable with nontoxicity of a commercial transfection reagent. Biodistribution of the complex showed the detectable distribution of the complex in the most parts of gastrointestinal tract due to ubiquitous expression of the FcRn receptors. An in vivo type 2 diabetes treatment study of oral administration of hIgG1-Fc-9Arg/pGLP-1 complexes showed absorption and expression in GI tract of either Balb/c mice or Lepdb/db mice. Conclusion In this study, we developed an oral GLP-1 gene delivery system on the platform of cationic hIgG1-Fc-9Arg. Prolonged t1/2, less immunoactivity, and better bioactivities of hIgG-Fc-9Arg/pGLP-1 complexes appeared to be a promising approach to achieve potent treatment of type 2 diabetes treatment. Electronic supplementary material The online version of this article (10.1186/s40824-018-0129-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seungbin Cha
- 1Department of Biomedical Chemistry, Konkuk University, Chungju, 27478 Republic of Korea
| | | | | | - Mohammad Nazmul Hasan
- 3Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju, 27469 Republic of Korea
| | - Young Jun Kim
- 1Department of Biomedical Chemistry, Konkuk University, Chungju, 27478 Republic of Korea
| | - Sungpil Cho
- 44D Biomaterials Center, Korea National University of Transportation, Jeungpyeong, 27909 Republic of Korea
| | - Yong-Kyu Lee
- KB-Biomed, Chungju, 27469 Republic of Korea.,3Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju, 27469 Republic of Korea.,44D Biomaterials Center, Korea National University of Transportation, Jeungpyeong, 27909 Republic of Korea
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193
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Transcription factor 7-like 2 single nucleotide polymorphisms are associated with lipid profile in the Balinese. Mol Biol Rep 2018; 45:1135-1143. [PMID: 30027476 DOI: 10.1007/s11033-018-4265-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/13/2018] [Indexed: 12/12/2022]
Abstract
Transcription factor 7-like 2 (TCF7L2) protein plays an important role in glucose and lipid metabolisms. Single nucleotide polymorphisms (SNPs) in the TCF7L2 gene contribute to increased fasting plasma glucose (FPG) and body mass index (BMI), and altered lipid concentrations in various population. We investigated whether the TCF7L2 SNPs were associated with obesity, high FPG and altered lipid profile in the Balinese. A total of 608 Balinese from rural and urban Bali, Indonesia, were recruited. Triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and FPG were measured, and BMI was calculated. Ratios of TG/HDL-C, LDL-C/HDL-C, and TC/HDL-C were determined. Genotyping of SNPs rs7903146, rs10885406, and rs12255372 were done in all samples. Genetic association analyses under a dominant model showed that the rs7903146 (OR 5.50, 95% CI 2.34-12.91, p = 8.5 × 10-5), rs12255372 (OR 4.15, 95% CI 1.66-10.33, p = 0.003) and rs10885406 (OR 2.43, 95% CI 1.39-4.25, p = 0.003) were significantly associated with high TC/HDL-C ratio. The rs10885406 also presented a significant association with high TG (OR 2.21, 95% CI 1.29-3.81, p = 0.004) and low HDL-C (OR 3.02, 95% CI 1.58-5.80, p = 0.001) concentrations, as well as high TG/HDL-C ratio (OR 1.95, 95% CI 1.16-3.27, p = 0.013). None of the SNPs exhibited significant association with obesity or high FPG. SNPs in the TCF7L2 gene are associated with altered lipid profile in the Balinese.
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Muñoz MP, Valdés M, Muñoz-Quezada MT, Lucero B, Rubilar P, Pino P, Iglesias V. Urinary Inorganic Arsenic Concentration and Gestational Diabetes Mellitus in Pregnant Women from Arica, Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071418. [PMID: 29976896 PMCID: PMC6069383 DOI: 10.3390/ijerph15071418] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/25/2022]
Abstract
Introduction: The association of total arsenic exposure with impaired glucose tolerance and gestational diabetes has been shown; however, evidence regarding urinary inorganic arsenic in pregnant women is still limited. Our aim was to evaluate the association between urinary inorganic arsenic concentration and gestational diabetes among pregnant women living in Arica, Chile. Methods: Cross-sectional study of pregnant women receiving care at primary health centers in urban Arica. The exposure was urinary inorganic arsenic concentration, while gestational diabetes was the outcome. The association was evaluated using multiple logistic regression models adjusted by age, education level, ethnicity, and pre-pregnancy body mass index. Results: 244 pregnant women were surveyed. The median urinary inorganic arsenic was 14.95 μg/L, and the prevalence of gestational diabetes was 8.6%. After adjusting, we did not find a significant association between gestational diabetes and inorganic arsenic exposure tertiles (Odds ratio (OR) 2.98, 95% CI = 0.87–10.18), (OR 1.07, 95% CI = 0.26–4.33). Conclusion: This study did not provide evidence on the relationship between urinary inorganic arsenic concentration and gestational diabetes. Further research is needed to elucidate the factors underlying this association.
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Affiliation(s)
- María Pía Muñoz
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, 8380453 Santiago, Chile.
| | - Macarena Valdés
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, 8380453 Santiago, Chile.
| | | | - Boris Lucero
- Facultad de Ciencias de la Salud, Universidad Católica del Maule, 3480112 Talca, Chile.
| | - Paola Rubilar
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, 8380453 Santiago, Chile.
| | - Paulina Pino
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, 8380453 Santiago, Chile.
| | - Verónica Iglesias
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, 8380453 Santiago, Chile.
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Vella CA, Cushman M, Van Hollebeke RB, Allison MA. Associations of Abdominal Muscle Area and Radiodensity with Adiponectin and Leptin: The Multiethnic Study of Atherosclerosis. Obesity (Silver Spring) 2018; 26:1234-1241. [PMID: 29877610 PMCID: PMC6014896 DOI: 10.1002/oby.22208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study examined the associations of muscle area and radiodensity with adiponectin and leptin. METHODS A total of 1,944 participants who enrolled in the Multi-Ethnic Study of Atherosclerosis underwent computed tomography to quantify body composition and measurements of adiponectin, leptin, interleukin-6, C-reactive protein, and resistin. RESULTS The mean age and BMI of participants were 64.7 years and 28.1 kg/m2 and 49% were female. With adjustment for age, gender, race/ethnicity, traditional cardiovascular disease risk factors, inflammatory biomarkers, physical activity, and sedentary behavior, a 1-SD increment in total abdominal, stability, and locomotor muscle area was associated with a 19%, 17%, and 12% lower adiponectin level, respectively (P < 0.01 for all) but not leptin (P > 0.05). Muscle radiodensity was more robustly associated with adiponectin and leptin in the multivariable linear regression models. That is, with full adjustment for all covariates, a 1-SD increment in total abdominal, stability, and locomotor muscle radiodensity was associated with a 31%, 31%, and 18% lower adiponectin level (P < 0.01 for all) and a 6.7%, 4.6%, and 8.1% higher leptin level (P < 0.05 for all), respectively. CONCLUSIONS The data suggest that increases in muscle area and radiodensity may have positive impacts on chronic inflammation and, in turn, reduce the risk of cardiometabolic disease.
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Affiliation(s)
- Chantal A Vella
- Department of Movement Sciences and WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
| | - Mary Cushman
- Hematology and Oncology Division, Department of Medicine, University of Vermont, Colchester, Vermont, USA
| | - Rachel B Van Hollebeke
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Matthew A Allison
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
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Tasdemir Z, Özsarı Tasdemir F, Gürgan C, Eroglu E, Gunturk I, kocyigit I. The effect of periodontal disease treatment in patients with continuous ambulatory peritoneal dialysis. Int Urol Nephrol 2018; 50:1519-1528. [DOI: 10.1007/s11255-018-1913-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/07/2018] [Indexed: 02/02/2023]
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197
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Association between multimorbidity and undiagnosed obstructive sleep apnea severity and their impact on quality of life in men over 40 years old. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2018; 3:e10. [PMID: 30263134 PMCID: PMC6152492 DOI: 10.1017/gheg.2018.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 03/05/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023]
Abstract
Background. Multimorbidity is common but little is known about its relationship with obstructive sleep apnea (OSA). Methods. Men Androgen Inflammation Lifestyle Environment and Stress Study participants underwent polysomnography. Chronic diseases (CDs) were determined by biomedical measurement (diabetes, dyslipidaemia, hypertension, obesity), or self-report (depression, asthma, cardiovascular disease, arthritis). Associations between CD count, multimorbidity, apnea-hyponea index (AHI) and OSA severity and quality-of-life (QoL; mental & physical component scores), were determined using multinomial regression analyses, after adjustment for age. Results. Of the 743 men participating in the study, overall 58% had multimorbidity (2+ CDs), and 52% had OSA (11% severe). About 70% of those with multimorbidity had undiagnosed OSA. Multimorbidity was associated with AHI and undiagnosed OSA. Elevated CD count was associated with higher AHI value and increased OSA severity. Conclusion. We demonstrate an independent association between the presence of OSA and multimorbidity in this representative sample of community-based men. This effect was strongest in men with moderate to severe OSA and three or more CDs, and appeared to produce a greater reduction in QoL when both conditions were present together.
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198
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Drug-induced hyperglycaemia and diabetes: pharmacogenomics perspectives. Arch Pharm Res 2018; 41:725-736. [PMID: 29858981 DOI: 10.1007/s12272-018-1039-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/10/2018] [Indexed: 01/18/2023]
Abstract
Drug-induced diabetes is widely reported in clinical conditions, and it is becoming a global issue because of its potential to increase the risk of severe cardiovascular complications. However, which drug mechanisms exert their diabetogenic effects and why the effects present significant inter-individual differences remain largely unknown. Pharmacogenomics, which is the study of how genomic variation influences drug responses, provides an explanation for individual differences in drug-induced diabetes. We highlight that pharmacogenomics can be involved in regulating the expression of genes in signaling pathways related to the pharmacokinetics or pharmacodynamics of drugs or the pathogenesis of diabetes, contributing to the differences in drug-induced glucose impairment. The pharmacogenomics studies of the major diabetogenic drugs are reviewed, including calcineurin inhibitors, antipsychotics, hormones, and antihypertensive drugs. We intend to elucidate the genetic basis of drug-induced diabetes and pave the way for the precise use of these drugs in the clinic.
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Nazari M, Hashemi Nazari S, Zayeri F, Gholampour Dehaki M, Akbarzadeh Baghban A. Estimating transition probability of different states of type 2 diabetes and its associated factors using Markov model. Prim Care Diabetes 2018; 12:245-253. [PMID: 29396206 DOI: 10.1016/j.pcd.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/30/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
Abstract
AIMS Type 2 diabetes is a chronic metabolic disorder and one of the most common non-contagious diseases which is on the rise all over the world. The present study aims to assess the trend of change in fasting blood sugar (FBS) and factors associated with the progression and regression of type 2 diabetes. Moreover, this study estimates transition intensities and transition probabilities among various states using the multi-state Markov model. METHODS In this study Multi-Ethnic Study of Atherosclerosis (MESA) dataset, from a longitudinal study, was used. The study, at the beginning, included 6814 individuals who were followed during the five phases of the study. FBS, serving as the criterion to assess the progression of diabetes, was classified into four states including (a) normal (FBS<100mg/dl), (b) impaired fasting glucose I (IFG I) (100mg/dl<FBS<110mg/dl), (c) impaired fasting glucose II (IFG II) (110mg/dl<FBS<126mg/dl), and (d) diabetes status (FBS>126mg/dl). A continuous-time Markov process was used to describe the evaluation of disease changes over the four states. The model estimated the mean sojourn time for each state. RESULTS Based on the results obtained from fitting the Markov model, the transition probability for a normal individual to remain in the same status over a 10-year period was 0.63, while the probability for a person in the diabetes state was 0.40. The mean sojourn time for the normal and diabetic individuals aged 45-84 years was 6.26 and 5.20 respectively. The covariates of age, race, body mass index (BMI), physical activity, waist-to-hip ratio (WHR) and blood pressure, significantly affected the progression and regression of diabetes. CONCLUSION An increase in physical activity could be the most important factor in the regression of diabetes, while an increase in WHR and BMI could be the most significant factors in progression of the disease.
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Affiliation(s)
- Mahsa Nazari
- Department of Biostatistics, Faculty of Paramedical Sciences, Student Research Committee, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Saeed Hashemi Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farid Zayeri
- Department of Biostatistics and Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehrzad Gholampour Dehaki
- Department of Internal Medicine, School of Medicine, Aja University of Medical Science, Tehran, Iran.
| | - Alireza Akbarzadeh Baghban
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Castedal M, Skoglund C, Axelson C, Bennet W. Steroid-free immunosuppression with low-dose tacrolimus is safe and significantly reduces the incidence of new-onset diabetes mellitus following liver transplantation. Scand J Gastroenterol 2018; 53:741-747. [PMID: 29688072 DOI: 10.1080/00365521.2018.1463390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Corticosteroids (CS) are traditionally used as part of the basal immunosuppression (IS) following liver transplantation (LT) but are known to be associated with an increased risk of new-onset diabetes mellitus (NODM), cardiovascular morbidity and mortality. The aim of this study was to retrospectively compare the incidence of transient as well as persistent NODM, rejection rate and patient- and graft survival between patients receiving steroid-based and steroid-free maintenance IS. MATERIALS AND METHODS A total of 238 patients liver transplanted (2008-2011) with deceased donor livers were divided into two groups, one group that received steroid-based IS (tacrolimus (TAC), corticosteroids (CS), ± mycophenolate mofetil (MMF); n = 155) (2008-2011) and another group of non-autoimmune recipients that received steroid-free IS (TAC, MMF; n = 83) according to our new maintenance IS-protocol starting January 2010. The primary and secondary end-points were patient- and graft survival, rejection rates and the incidence of NODM. The median follow-up times were 1248 days and 681 days, respectively. RESULTS The one-year patient- and graft survival in the steroid-based and steroid-free group was 92.7% and 93.3% (ns) and 87.6% and 84.9% (ns), respectively. The incidence of biopsy proven acute rejection (BPAR) was 27.7% in both groups (ns) during follow-up. The overall incidence of persistent NODM in the two groups were 16.8% and 2.9%, respectively (p < .01). CONCLUSIONS The results show that steroid-free low-dose tacrolimus-based IS following LT is safe and decreases the incidence of NODM significantly.
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Affiliation(s)
- M Castedal
- a The Transplant Institute , Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - C Skoglund
- a The Transplant Institute , Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - C Axelson
- a The Transplant Institute , Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - W Bennet
- a The Transplant Institute , Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
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