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Serés-Noriega T, Viñals C, Perea V, Mesa A, Boswell L, Mariaca K, Blanco J, Vinagre I, Pané A, Milad C, Solà C, Esmatjes E, Conget I, Giménez M, Amor AJ. Adherence to an energy-restricted Mediterranean diet is associated with the presence and burden of carotid atherosclerosis in people with type 1 diabetes. Diabetes Metab Res Rev 2024; 40:e3783. [PMID: 38402458 DOI: 10.1002/dmrr.3783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
AIMS People with type 1 diabetes (T1D) have an increased risk of cardiovascular disease (CVD). The Mediterranean diet is associated with reduced CVD; however, the evidence in T1D is scarce. We aimed to analyse the relationships between adherence to the energy-restricted Mediterranean diet (erMEDd) and carotid atherosclerosis. MATERIALS AND METHODS We included children with T1D without CVD, with ≥1 of the following: age ≥40 years, diabetic kidney disease, or ≥10 years of disease duration with another risk factor. Plaque presence (intima-media thickness ≥1.5 mm) was determined by ultrasonography. The PREDIMED-Plus 17-item questionnaire (PP-17) was used to assess adherence to the erMEDd. RESULTS Four hundred one individuals were included (48% males, age 48.3 ± 11 years, diabetes duration 26.8 ± 11.4 years). Those harbouring plaques (42%) showed lower adherence to the erMEDd (PP-17: 8.9 ± 2.3 of a maximum of 17 vs. 9.8 ± 2.5, p < 0.001). Greater adherence to the erMEDd was correlated with an overall better metabolic profile. After adjusting for multiple confounders, adherence to the erMEDd was independently associated with carotid atherosclerosis (OR 0.86 [0.77-0.95] for plaque presence and OR 0.85 [0.75-0.97] for ≥2 plaques). The consumption of fruit and nuts and preference of white over red meat was higher in individuals without atherosclerosis (p < 0.05). Fruit and nut consumption was associated with lower plaque prevalence in the fully adjusted models (OR 0.38 [0.19-0.73] and 0.51 [0.29-0.93]). CONCLUSIONS Greater adherence to the erMEDd is associated with less carotid atherosclerosis in children with T1D at high risk of CVD. Strategies to improve and implement healthy dietary patterns in this population should be encouraged.
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Affiliation(s)
- Tonet Serés-Noriega
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Clara Viñals
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Verónica Perea
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Alex Mesa
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Laura Boswell
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
- Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Spain
| | - Karla Mariaca
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Jesús Blanco
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Irene Vinagre
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Adriana Pané
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición. (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Camila Milad
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Clara Solà
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Enric Esmatjes
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Ignacio Conget
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Marga Giménez
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Antonio J Amor
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
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Lu Y, Wang W, Liu J, Xie M, Liu Q, Li S. Vascular complications of diabetes: A narrative review. Medicine (Baltimore) 2023; 102:e35285. [PMID: 37800828 PMCID: PMC10553000 DOI: 10.1097/md.0000000000035285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Diabetes mellitus is a complex chronic metabolic disease characterized by hyperglycemia and various complications. According to the different pathophysiological mechanisms, these complications can be classified as microvascular or macrovascular complications, which have long-term negative effects on vital organs such as the eyes, kidneys, heart, and brain, and lead to increased patient mortality. Diabetes mellitus is a major global health issue, and its incidence and prevalence have increased significantly in recent years. Moreover, the incidence is expected to continue to rise as more people adopt a Western lifestyle and diet. Thus, it is essential to understand the epidemiology, pathogenesis, risk factors, and treatment of vascular complications to aid patients in managing the disease effectively. This paper provides a comprehensive review of the literature to clarify the above content. Furthermore, this paper also delves into the correlation between novel risk factors, such as long noncoding RNAs, gut microbiota, and nonalcoholic fatty liver disease, with diabetic vascular complications.
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Affiliation(s)
- Yongxia Lu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Wei Wang
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Jingyu Liu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Min Xie
- Department of Cardiovascular Medicine, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Qiang Liu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Sufang Li
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
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Christoforidis A, Georeli I, Dimitriadou M, Galli-Tsinopoulou A, Stabouli S. Arterial stiffness indices in children and adolescents with type 1 diabetes mellitus: A meta-analysis. Diabetes Metab Res Rev 2022; 38:e3555. [PMID: 35675380 DOI: 10.1002/dmrr.3555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
AIMS Cardiovascular disease (CVD) represents the most frequent cause of morbidity and mortality among patients with type 1 diabetes mellitus (T1DM). Our aim was to review the evidence and conduct a meta-analysis assessing measures of arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx) in children and adolescents with T1DM compared to healthy controls. METHODS PubMed and the Cochrane Library were searched for relevant studies published up to 10 May 2021. RESULTS Twenty-one studies were finally included in the meta-analysis. The T1DM group had significantly higher carotid to femoral PWV levels than that of the control group (mean difference [d]: 0.53 CI: 0.35-0.71, P < 0.00001) but with a fair heterogeneity (I 2:73%). By omitting one study with marked heterogeneity, mean difference in cfPWV remained significantly increased in the T1DM group compared to the control group (mean difference [d]: 0.37 CI: 0.27-0.48, P < 0.00001) but with improved heterogeneity (I2 = 26%). Regarding Aix, the T1DM group had a significantly higher AI@75 index than that of the control group (mean difference [d]: 0.28 CI: 0.17-0.39, P < 0.00001) and with no heterogeneity (I 2 = 8%). CONCLUSIONS Youths with T1DM show increased arterial stiffness, either as increased carotid-femoral pulse wave velocity or increased augmentation index, early in their course of life compared to healthy controls. PROSPERO REGISTRATION NUMBER CRD42021253236.
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Affiliation(s)
| | - Irene Georeli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | - Meropi Dimitriadou
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | | | - Stella Stabouli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
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Petrelli A, Ravà L, Mascali A, Rapini N, Massoud M, Manca Bitti ML, Cianfarani S, Manco M. Estimated insulin sensitivity, cardiovascular risk, and hepatic steatosis after 12 years from the onset of T1D. Diabetes Metab Res Rev 2022; 38:e3479. [PMID: 34077603 DOI: 10.1002/dmrr.3479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 11/07/2022]
Abstract
AIM To test the hypothesis that intensive insulin treatment and optimal glycaemic control are not fully protective against reduction of insulin sensitivity in children with type 1 diabetes. MATERIAL AND METHODS Cohort study of 78 normal-weight patients with prepubertal onset (T0 ) and follow-up waves at 1 (T1 ), 5 (T5 ), 10 (T10 ), and 12 (T12 ) years; matched for age and sex to 30 controls at T12 . Estimated insulin sensitivity (eIS) by three formulae; ultrasound evaluation of para and perirenal fat thickness; hepatic steatosis (HS); carotid intima media thickness (cIMT) at T12 . RESULTS At T12, the 36 patients (46%) who had constantly or prevalently haemoglobin A1c (HbA1c) < 58 mmol/l during follow-up showed better eIS indexes (p = 0.049 to <0.0001); lipid profile (p = 0.042 to <0.0001), reduced fat mass (p = 0.012) and required lower insulin dose (p = 0.032) than the 42 patients (54%) with HbA1c ≥ 58 at T12. Patients (N = 25) with eISEDC < 8.77 mg kg-1 min-1 showed higher cIMT (p < 0.0001). HS was found in 6 patients (∼8%). In patients and normal-weight controls, fat mass (p = 0.03), age (p = 0.03), cIMT (p = 0.05) predicted HS; eIS indexes (p from 0.04 to <0.0001) predicted cIMT. Body mass index, perirenal fat, fat mass, and triglycerides to high density lipoprotein cholesterol ratio were associated with eIS indexes (p from 0.03 to <0.0001). CONCLUSIONS Young T1D patients have reduced insulin sensitivity and higher cIMT. Adiposity, glucose, and lipid control over follow-up are likely to influence both. Enhanced adiposity seems of paramount relevance for the onset of HS in T1D patients alike in healthy youths.
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Affiliation(s)
- Arianna Petrelli
- Unit of Paediatric Diabetology, University of Tor Vergata, Rome, Italy
| | - Lucilla Ravà
- Epidemiology Unit, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy
| | - Alberto Mascali
- Department of System Medicine, Dipartimento Pediatrico Universitario Ospedaliero, University of Tor Vergata, Rome, Italy
| | - Novella Rapini
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy
| | - Michela Massoud
- Research Area for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy
| | | | - Stefano Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Melania Manco
- Research Area for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy
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Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes. Nutrients 2021; 13:nu13082625. [PMID: 34444784 PMCID: PMC8401117 DOI: 10.3390/nu13082625] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/18/2022] Open
Abstract
Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.
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Bosco O, Vizio B, Gruden G, Schiavello M, Lorenzati B, Cavallo-Perin P, Russo I, Montrucchio G, Lupia E. Thrombopoietin Contributes to Enhanced Platelet Activation in Patients with Type 1 Diabetes Mellitus. Int J Mol Sci 2021; 22:ijms22137032. [PMID: 34210000 PMCID: PMC8269076 DOI: 10.3390/ijms22137032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022] Open
Abstract
Atherosclerotic cardiovascular disease is the major cause of morbidity and mortality in patients with type 1 diabetes mellitus (T1DM). Enhanced platelet reactivity is considered a main determinant of the increased atherothrombotic risk of diabetic patients. Thrombopoietin (THPO), a humoral growth factor able to stimulate megakaryocyte proliferation and differentiation, also modulates the response of mature platelets by enhancing both activation and binding to leukocytes in response to different agonists. Increased THPO levels have been reported in different clinical conditions characterized by a generalized pro-thrombotic state, from acute coronary syndromes to sepsis/septic shock, and associated with elevated indices of platelet activation. To investigate the potential contribution of elevated THPO levels in platelet activation in T1DM patients, we studied 28 T1DM patients and 28 healthy subjects. We measured plasma levels of THPO, as well as platelet-leukocyte binding, P-selectin, and THPO receptor (THPOR) platelet expression. The priming activity of plasma from diabetic patients or healthy subjects on platelet–leukocyte binding and the role of THPO on this effect was also studied in vitro. T1DM patients had higher circulating THPO levels and increased platelet–monocyte and platelet–granulocyte binding, as well as platelet P-selectin expression, compared to healthy subjects, whereas platelet expression of THPOR did not differ between the two groups. THPO concentrations correlated with platelet–leukocyte binding, as well as with fasting glucose and Hb1Ac. In vitro, plasma from diabetic patients, but not from healthy subjects, primed platelet–leukocyte binding and platelet P-selectin expression. Blocking THPO biological activity using a specific inhibitor prevented the priming effect induced by plasma from diabetic patients. In conclusion, augmented THPO may enhance platelet activation in patients with T1DM, potentially participating in increasing atherosclerotic risk.
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Affiliation(s)
- Ornella Bosco
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
| | - Barbara Vizio
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
| | - Gabriella Gruden
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
| | - Martina Schiavello
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
| | | | - Paolo Cavallo-Perin
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
| | - Isabella Russo
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
- Correspondence: (I.R.); (G.M.); (E.L.)
| | - Giuseppe Montrucchio
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
- Correspondence: (I.R.); (G.M.); (E.L.)
| | - Enrico Lupia
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (O.B.); (B.V.); (G.G.); (M.S.); (P.C.-P.)
- Correspondence: (I.R.); (G.M.); (E.L.)
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Qin B, Cao X. LncRNA PVT1 Regulates High Glucose-Induced Viability, Oxidative Stress, Fibrosis, and Inflammation in Diabetic Nephropathy via miR-325-3p/Snail1 Axis. Diabetes Metab Syndr Obes 2021; 14:1741-1750. [PMID: 33907435 PMCID: PMC8064675 DOI: 10.2147/dmso.s303151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/19/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Diabetic nephropathy (DN), as a complication of diabetes, is a leading cause of mortality in diabetic patients. It has been reported that lncRNA PVT1 (PVT1) could accelerate the progression of DN by promoting ECM accumulation and increasing the expression of fibronectin 1 (FN1). However, the underlying mechanism of PVT1 on DN remains unknown. METHODS To study the effect of PVT1 on DN, mice were injected 50 mg/kg STZ to build the DN models. Mesangial cells (MCs) were induced by high glucose as in vitro model of DN. The expression level of PVT1, miR-325-3 and Snail1 was assessed by qRT-PCR and Western blot. Luciferase reporter assay, RNA pull-down and RIP were used to explore the interaction among PVT1, miR-325-3 and Snail1. RESULTS In in vivo and in vitro DN models, the expression of PVT1 was upregulated. High glucose (HG) induced cell viability, oxidative stress, fibrosis and inflammation in MCs, which were reversed in the PVT1-KD MCs. The level of miR-325-3p was also increased in in vivo and in vitro experiments. Additionally, PVT1 can directly bind to miR-325-3p. Finally, Snail1 was a direct target of miR-325-3p. CONCLUSION PVT1 inhibits viability, oxidative stress, fibrosis, and inflammation in DN via miR-325-3p/Snail1 axis.
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Affiliation(s)
- Baoyu Qin
- Division of Endocrinology and Metabolic, Department of Geriatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People’s Republic of China
- Correspondence: Baoyu Qin Division of Endocrinology and Metabolic, Department of Geriatrics, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, People’s Republic of ChinaTel +86-13977179605 Email
| | - Xiaoli Cao
- Department of Endocrinology, Shanxi Cardiovascular Hospital, Taiyuan, 030024, Shanxi Province, People’s Republic of China
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