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Liu CH, Chang CF, Chen IC, Lin FM, Tzou SJ, Hsieh CB, Chu TW, Pei D. Machine Learning Prediction of Prediabetes in a Young Male Chinese Cohort with 5.8-Year Follow-Up. Diagnostics (Basel) 2024; 14:979. [PMID: 38786280 PMCID: PMC11119884 DOI: 10.3390/diagnostics14100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
The identification of risk factors for future prediabetes in young men remains largely unexamined. This study enrolled 6247 young ethnic Chinese men with normal fasting plasma glucose at the baseline (FPGbase), and used machine learning (Mach-L) methods to predict prediabetes after 5.8 years. The study seeks to achieve the following: 1. Evaluate whether Mach-L outperformed traditional multiple linear regression (MLR). 2. Identify the most important risk factors. The baseline data included demographic, biochemistry, and lifestyle information. Two models were built, where Model 1 included all variables and Model 2 excluded FPGbase, since it had the most profound effect on prediction. Random forest, stochastic gradient boosting, eXtreme gradient boosting, and elastic net were used, and the model performance was compared using different error metrics. All the Mach-L errors were smaller than those for MLR, thus Mach-L provided the most accurate results. In descending order of importance, the key factors for Model 1 were FPGbase, body fat (BF), creatinine (Cr), thyroid stimulating hormone (TSH), WBC, and age, while those for Model 2 were BF, white blood cell, age, TSH, TG, and LDL-C. We concluded that FPGbase was the most important factor to predict future prediabetes. However, after removing FPGbase, WBC, TSH, BF, HDL-C, and age were the key factors after 5.8 years.
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Affiliation(s)
- Chi-Hao Liu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
| | - Chun-Feng Chang
- Divisions of Urology, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
- Divisions of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - I-Chien Chen
- Department of Nursing, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
| | - Fan-Min Lin
- Division of Pulmonary Medicine, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
| | - Shiow-Jyu Tzou
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Chung-Bao Hsieh
- Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- MJ Health Research Foundation, Taipei 114, Taiwan
| | - Dee Pei
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 243, Taiwan
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Taylor JA, Greenhaff PL, Bartlett DB, Jackson TA, Duggal NA, Lord JM. Multisystem physiological perspective of human frailty and its modulation by physical activity. Physiol Rev 2023; 103:1137-1191. [PMID: 36239451 PMCID: PMC9886361 DOI: 10.1152/physrev.00037.2021] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
"Frailty" is a term used to refer to a state characterized by enhanced vulnerability to, and impaired recovery from, stressors compared with a nonfrail state, which is increasingly viewed as a loss of resilience. With increasing life expectancy and the associated rise in years spent with physical frailty, there is a need to understand the clinical and physiological features of frailty and the factors driving it. We describe the clinical definitions of age-related frailty and their limitations in allowing us to understand the pathogenesis of this prevalent condition. Given that age-related frailty manifests in the form of functional declines such as poor balance, falls, and immobility, as an alternative we view frailty from a physiological viewpoint and describe what is known of the organ-based components of frailty, including adiposity, the brain, and neuromuscular, skeletal muscle, immune, and cardiovascular systems, as individual systems and as components in multisystem dysregulation. By doing so we aim to highlight current understanding of the physiological phenotype of frailty and reveal key knowledge gaps and potential mechanistic drivers of the trajectory to frailty. We also review the studies in humans that have intervened with exercise to reduce frailty. We conclude that more longitudinal and interventional clinical studies are required in older adults. Such observational studies should interrogate the progression from a nonfrail to a frail state, assessing individual elements of frailty to produce a deep physiological phenotype of the syndrome. The findings will identify mechanistic drivers of frailty and allow targeted interventions to diminish frailty progression.
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Affiliation(s)
- Joseph A Taylor
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Paul L Greenhaff
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - David B Bartlett
- Division of Medical Oncology, Department of Medicine, Duke University, Durham, North Carolina.,Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Thomas A Jackson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom
| | - Niharika A Duggal
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom
| | - Janet M Lord
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
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Zangerolamo L, Carvalho M, Barssotti L, Soares GM, Marmentini C, Boschero AC, Barbosa HCL. The bile acid TUDCA reduces age-related hyperinsulinemia in mice. Sci Rep 2022; 12:22273. [PMID: 36564463 PMCID: PMC9789133 DOI: 10.1038/s41598-022-26915-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Aging is associated with glucose metabolism disturbances, such as insulin resistance and hyperinsulinemia, which contribute to the increased prevalence of type 2 diabetes (T2D) and its complications in the elderly population. In this sense, some bile acids have emerged as new therapeutic targets to treat TD2, as well as associated metabolic disorders. The taurine conjugated bile acid, tauroursodeoxycholic acid (TUDCA) improves glucose homeostasis in T2D, obesity, and Alzheimer's disease mice model. However, its effects in aged mice have not been explored yet. Here, we evaluated the actions of TUDCA upon glucose-insulin homeostasis in aged C57BL/6 male mice (18-month-old) treated with 300 mg/kg of TUDCA or its vehicle. TUDCA attenuated hyperinsulinemia and improved glucose homeostasis in aged mice, by enhancing liver insulin-degrading enzyme (IDE) expression and insulin clearance. Furthermore, the improvement in glucose-insulin homeostasis in these mice was accompanied by a reduction in adiposity, associated with adipocyte hypertrophy, and lipids accumulation in the liver. TUDCA-treated aged mice also displayed increased energy expenditure and metabolic flexibility, as well as a better cognitive ability. Taken together, our data highlight TUDCA as an interesting target for the attenuation of age-related hyperinsulinemia and its deleterious effects on metabolism.
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Affiliation(s)
- Lucas Zangerolamo
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Marina Carvalho
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Leticia Barssotti
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Gabriela M. Soares
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Carine Marmentini
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Antonio C. Boschero
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
| | - Helena Cristina L. Barbosa
- grid.411087.b0000 0001 0723 2494Obesity and Comorbidities Research Center, Department of Structural and Functional Biology, University of Campinas, UNICAMP, Campinas, Sao Paulo CEP: 13083-864 Brazil
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Naseri P, Amiri P, Masihay-Akbar H, Vaighan NS, Ahmadizad S, Ghanbarian A, Azizi F. Time-varying association between physical activity and risk of diabetes in the early and late adulthood: A longitudinal study in a West-Asian country. Prim Care Diabetes 2021; 15:1026-1032. [PMID: 34326015 DOI: 10.1016/j.pcd.2021.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The time-varying association between physical activity (PA) and incidence of type 2 diabetes (T2DM) is still unclear. The present study aimed to investigate this association in the early- and late-adulthood during a 9-year follow-up. METHODS This study was conducted on 3905 participants in early and late adulthood, using the Tehran Lipid and Glucose Study (TLGS) dataset. PA was assessed via the Iranian version of Modified Activity Questionnaire (MAQ). The association between trend of PA and incident T2DM was investigated using time-varying Cox's proportional hazard model. Variables including job, education, smoking and body mass index (BMI) were adjusted in the final model. RESULTS The distribution of sex- and age-specific levels of PA changed significantly over time. Compared with physically inactive women, for older women with high level of PA, the risk of T2DM was 0.64 (95% CI: 0.43-0.95, P = 0.02) in adjusted model. Moreover, hazard for low PA group was significantly higher than the moderate group, and for these two groups were significantly higher than high PA level (P < 0.05). CONCLUSION High PA level can postpone the incident T2DM in early-aged and elderly women, over time. Therefore, gender and age are of great importance in designing the PA modifying programs to prevent T2DM.
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Affiliation(s)
- Parisa Naseri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hasti Masihay-Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navideh Sahebi Vaighan
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajad Ahmadizad
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Arash Ghanbarian
- Prevention of Metabolic Disease Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Salvadori G, Mirisola MG, Longo VD. Intermittent and Periodic Fasting, Hormones, and Cancer Prevention. Cancers (Basel) 2021; 13:cancers13184587. [PMID: 34572814 PMCID: PMC8472354 DOI: 10.3390/cancers13184587] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/09/2021] [Indexed: 12/25/2022] Open
Abstract
The restriction of proteins, amino acids or sugars can have profound effects on the levels of hormones and factors including growth hormone, IGF-1 and insulin. In turn, these can regulate intracellular signaling pathways as well as cellular damage and aging, but also multisystem regeneration. Both intermittent (IF) and periodic fasting (PF) have been shown to have both acute and long-term effects on these hormones. Here, we review the effects of nutrients and fasting on hormones and genes established to affect aging and cancer. We describe the link between dietary interventions and genetic pathways affecting the levels of these hormones and focus on the mechanisms responsible for the cancer preventive effects. We propose that IF and PF can reduce tumor incidence both by delaying aging and preventing DNA damage and immunosenescence and also by killing damaged, pre-cancerous and cancer cells.
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Affiliation(s)
- Giulia Salvadori
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
- IFOM, FIRC Institute of Molecular Oncology, 20139 Milan, Italy
| | - Mario Giuseppe Mirisola
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Valter D. Longo
- IFOM, FIRC Institute of Molecular Oncology, 20139 Milan, Italy
- Department of Biological Sciences, Longevity Institute, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
- Correspondence:
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Lado-Baleato Ó, Roca-Pardiñas J, Cadarso-Suárez C, Gude F. Modeling conditional reference regions: Application to glycemic markers. Stat Med 2021; 40:5926-5946. [PMID: 34396576 DOI: 10.1002/sim.9163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/07/2021] [Accepted: 07/29/2021] [Indexed: 12/31/2022]
Abstract
Many clinical decisions are taken based on the results of continuous diagnostic tests. Usually, only the results of one single test is taken into consideration, the interpretation of which requires a reference range for the healthy population. However, the use of two different tests, can be necessary in the diagnosis of certain diseases. This obliges a bivariate reference region be available for their interpretation. It should also be remembered that reference regions may depend on patient variables (eg, age and sex) independent of the suspected disease. However, few proposals have been made regarding the statistical modeling of such reference regions, and those put forward have always assumed a Gaussian distribution, which can be rather restrictive. The present work describes a new statistical method that allows such reference regions to be estimated with no insistence on the results being normally distributed. The proposed method is based on a bivariate location-scale model that provides probabilistic regions covering a specific percentage of the bivariate data, dependent on certain covariates. The reference region is estimated nonparametrically and the nonlinear effects of continuous covariates via polynomial kernel smoothers in additive models. The bivariate model is estimated using a backfitting algorithm, and the optimal smoothing parameters of the kernel smoothers selected by cross-validation. The model performed satisfactorily in simulation studies under the assumption of non-Gaussian conditions. Finally, the proposed methodology was found to be useful in estimating a reference region for two continuous diagnostic tests for diabetes (fasting plasma glucose and glycated hemoglobin), taking into account the age of the patient.
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Affiliation(s)
- Óscar Lado-Baleato
- Department of Statistics, Mathematical Analysis, and Optimization, Universidade de Santiago de Compostela, Galicia, Spain
| | - Javier Roca-Pardiñas
- Statistical Inference, Decision and Operations Research, Universidade de Vigo, Galicia, Spain
| | - Carmen Cadarso-Suárez
- Department of Statistics, Mathematical Analysis, and Optimization, Universidade de Santiago de Compostela, Galicia, Spain
| | - Francisco Gude
- Clinical Epidemiology Unit, Complexo Hospitalario de Santiago de Compostela, Galicia, Spain
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7
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Do trends of adiposity and metabolic parameters vary in women with different ovarian reserve status? A population-based cohort study. ACTA ACUST UNITED AC 2021; 27:684-692. [PMID: 32301892 DOI: 10.1097/gme.0000000000001513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate whether trends of adiposity and glucose metabolism parameters in women with low ovarian reserve status based on their anti-Mullerian hormone (AMH) levels differ from those with high ovarian reserve. METHODS In this population-based prospective study, eligible women, aged 20 to 50 years, were selected from among participants of the Tehran Lipid and Glucose Study (TLGS). Generalized estimating equation (GEE) models were applied to compare changes in various adiposity and metabolic parameters across time between women in the first and fourth quartiles of age-specific AMH, after adjustment for confounders. Pooled logistic regression was used to compare progression of prediabetes mellitus (pre-DM) and diabetes mellitus (DM) between the women of these two age-specific AMH quartiles. RESULTS In this study of a total of 1,015 participants and with a median follow-up of 16 years, we observed that over time, both groups of women in the first and fourth quartiles of age-specific AMH experienced significant positive trends in their adiposity indices including central obesity, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and a negative trend in visceral adiposity index (VAI), whereas there was no significant difference in these parameters between the two groups. This study revealed that odds ratios of diabetes and prediabetes in women in the first quartile of age-specific AMH were not significantly different, compared with those in the fourth quartile. CONCLUSION Women with lower ovarian reserve do not experience different over time trends of adiposity and glucose metabolism parameters during their reproductive life span.
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Pataky MW, Young WF, Nair KS. Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications. Mayo Clin Proc 2021; 96:788-814. [PMID: 33673927 PMCID: PMC8020896 DOI: 10.1016/j.mayocp.2020.07.033] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/01/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
Increased life expectancy combined with the aging baby boomer generation has resulted in an unprecedented global expansion of the elderly population. The growing population of older adults and increased rate of age-related chronic illness has caused a substantial socioeconomic burden. The gradual and progressive age-related decline in hormone production and action has a detrimental impact on human health by increasing risk for chronic disease and reducing life span. This article reviews the age-related decline in hormone production, as well as age-related biochemical and body composition changes that reduce the bioavailability and actions of some hormones. The impact of hormonal changes on various chronic conditions including frailty, diabetes, cardiovascular disease, and dementia are also discussed. Hormone replacement therapy has been attempted in many clinical trials to reverse and/or prevent the hormonal decline in aging to combat the progression of age-related diseases. Unfortunately, hormone replacement therapy is not a panacea, as it often results in various adverse events that outweigh its potential health benefits. Therefore, except in some specific individual cases, hormone replacement is not recommended. Rather, positive lifestyle modifications such as regular aerobic and resistance exercise programs and/or healthy calorically restricted diet can favorably affect endocrine and metabolic functions and act as countermeasures to various age-related diseases. We provide a critical review of the available data and offer recommendations that hopefully will form the groundwork for physicians/scientists to develop and optimize new endocrine-targeted therapies and lifestyle modifications that can better address age-related decline in heath.
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Affiliation(s)
- Mark W Pataky
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - William F Young
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - K Sreekumaran Nair
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN.
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Søndertoft NB, Vogt JK, Arumugam M, Kristensen M, Gøbel RJ, Fan Y, Lyu L, Bahl MI, Eriksen C, Ängquist L, Frøkiær H, Hansen TH, Brix S, Nielsen HB, Hansen T, Vestergaard H, Gupta R, Licht TR, Lauritzen L, Pedersen O. The intestinal microbiome is a co-determinant of the postprandial plasma glucose response. PLoS One 2020; 15:e0238648. [PMID: 32947608 PMCID: PMC7500969 DOI: 10.1371/journal.pone.0238648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/20/2020] [Indexed: 12/15/2022] Open
Abstract
Elevated postprandial plasma glucose is a risk factor for development of type 2 diabetes and cardiovascular disease. We hypothesized that the inter-individual postprandial plasma glucose response varies partly depending on the intestinal microbiome composition and function. We analyzed data from Danish adults (n = 106), who were self-reported healthy and attended the baseline visit of two previously reported randomized controlled cross-over trials within the Gut, Grain and Greens project. Plasma glucose concentrations at five time points were measured before and during three hours after a standardized breakfast. Based on these data, we devised machine learning algorithms integrating bio-clinical, as well as shotgun-sequencing-derived taxa and functional potentials of the intestinal microbiome to predict individual postprandial glucose excursions. In this post hoc study, we found microbial and clinical features, which predicted up to 48% of the inter-individual variance of postprandial plasma glucose responses (Pearson correlation coefficient of measured vs. predicted values, R = 0.69, 95% CI: 0.45 to 0.84, p<0.001). The features were age, fasting serum triglycerides, systolic blood pressure, BMI, fasting total serum cholesterol, abundance of Bifidobacterium genus, richness of metagenomics species and abundance of a metagenomic species annotated to Clostridiales at order level. A model based only on microbial features predicted up to 14% of the variance in postprandial plasma glucose excursions (R = 0.37, 95% CI: 0.02 to 0.64, p = 0.04). Adding fasting glycaemic measures to the model including microbial and bio-clinical features increased the predictive power to R = 0.78 (95% CI: 0.59 to 0.89, p<0.001), explaining more than 60% of the inter-individual variance of postprandial plasma glucose concentrations. The outcome of the study points to a potential role of the taxa and functional potentials of the intestinal microbiome. If validated in larger studies our findings may be included in future algorithms attempting to develop personalized nutrition, especially for prediction of individual blood glucose excursions in dys-glycaemic individuals.
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Affiliation(s)
- Nadja B. Søndertoft
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- * E-mail: (OP); (NBS)
| | - Josef K. Vogt
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Manimozhiyan Arumugam
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kristensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rikke J. Gøbel
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Yong Fan
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Liwei Lyu
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Martin I. Bahl
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Carsten Eriksen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Lars Ängquist
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Frøkiær
- Department of Veterinary Disease Biology, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Tue H. Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Ramneek Gupta
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Tine R. Licht
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- * E-mail: (OP); (NBS)
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Bharath LP, Agrawal M, McCambridge G, Nicholas DA, Hasturk H, Liu J, Jiang K, Liu R, Guo Z, Deeney J, Apovian CM, Snyder-Cappione J, Hawk GS, Fleeman RM, Pihl RMF, Thompson K, Belkina AC, Cui L, Proctor EA, Kern PA, Nikolajczyk BS. Metformin Enhances Autophagy and Normalizes Mitochondrial Function to Alleviate Aging-Associated Inflammation. Cell Metab 2020; 32:44-55.e6. [PMID: 32402267 PMCID: PMC7217133 DOI: 10.1016/j.cmet.2020.04.015] [Citation(s) in RCA: 316] [Impact Index Per Article: 79.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 01/28/2020] [Accepted: 04/20/2020] [Indexed: 12/20/2022]
Abstract
Age is a non-modifiable risk factor for the inflammation that underlies age-associated diseases; thus, anti-inflammaging drugs hold promise for increasing health span. Cytokine profiling and bioinformatic analyses showed that Th17 cytokine production differentiates CD4+ T cells from lean, normoglycemic older and younger subjects, and mimics a diabetes-associated Th17 profile. T cells from older compared to younger subjects also had defects in autophagy and mitochondrial bioenergetics that associate with redox imbalance. Metformin ameliorated the Th17 inflammaging profile by increasing autophagy and improving mitochondrial bioenergetics. By contrast, autophagy-targeting siRNA disrupted redox balance in T cells from young subjects and activated the Th17 profile by activating the Th17 master regulator, STAT3, which in turn bound IL-17A and F promoters. Mitophagy-targeting siRNA failed to activate the Th17 profile. We conclude that metformin improves autophagy and mitochondrial function largely in parallel to ameliorate a newly defined inflammaging profile that echoes inflammation in diabetes.
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Affiliation(s)
- Leena P Bharath
- Department of Nutrition and Public Health, Merrimack College, North Andover, MA, USA
| | - Madhur Agrawal
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA; Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, USA
| | - Grace McCambridge
- Department of Nutrition and Public Health, Merrimack College, North Andover, MA, USA
| | - Dequina A Nicholas
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Diego, San Diego, CA, USA
| | | | - Jing Liu
- Department of Computer Science, University of Kentucky, Lexington, KY, USA
| | - Kai Jiang
- Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Rui Liu
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, USA
| | - Zhenheng Guo
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Jude Deeney
- Department of Medicine, Endocrinology, Diabetes & Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Caroline M Apovian
- Department of Medicine, Endocrinology, Diabetes & Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Jennifer Snyder-Cappione
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA; Flow Cytometry Core Facility, Boston University School of Medicine, Boston, MA, USA
| | - Gregory S Hawk
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - Rebecca M Fleeman
- Departments of Neurosurgery and Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Riley M F Pihl
- Flow Cytometry Core Facility, Boston University School of Medicine, Boston, MA, USA
| | | | - Anna C Belkina
- Flow Cytometry Core Facility, Boston University School of Medicine, Boston, MA, USA; Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Licong Cui
- Department of Computer Science, University of Kentucky, Lexington, KY, USA; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Elizabeth A Proctor
- Departments of Neurosurgery and Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, USA; Departments of Biomedical Engineering, and Engineering Science & Mechanics and Center for Neural Engineering, Pennsylvania State University, University Park, PA, USA
| | - Philip A Kern
- Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, USA; Department of Medicine, University of Kentucky, Lexington, KY, USA
| | - Barbara S Nikolajczyk
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA; Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, USA.
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11
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Liu Y, Smith CE, Parnell LD, Lee YC, An P, Straka RJ, Tiwari HK, Wood AC, Kabagambe EK, Hidalgo B, Hopkins PN, Province MA, Arnett DK, Tucker KL, Ordovas JM, Lai CQ. Salivary AMY1 Copy Number Variation Modifies Age-Related Type 2 Diabetes Risk. Clin Chem 2020; 66:718-726. [PMID: 32337541 PMCID: PMC7192522 DOI: 10.1093/clinchem/hvaa072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/28/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Copy number variation (CNV) in the salivary amylase gene (AMY1) modulates salivary α-amylase levels and is associated with postprandial glycemic traits. Whether AMY1-CNV plays a role in age-mediated change in insulin resistance (IR) is uncertain. METHODS We measured AMY1-CNV using duplex quantitative real-time polymerase chain reaction in two studies, the Boston Puerto Rican Health Study (BPRHS, n = 749) and the Genetics of Lipid-Lowering Drug and Diet Network study (GOLDN, n = 980), and plasma metabolomic profiles in the BPRHS. We examined the interaction between AMY1-CNV and age by assessing the relationship between age with glycemic traits and type 2 diabetes (T2D) according to high or low copy numbers of the AMY1 gene. Furthermore, we investigated associations between metabolites and interacting effects of AMY1-CNV and age on T2D risk. RESULTS We found positive associations of IR with age among subjects with low AMY1-copy-numbers in both studies. T2D was marginally correlated with age in participants with low AMY1-copy-numbers but not with high AMY1-copy-numbers in the BPRHS. Metabolic pathway enrichment analysis identified the pentose metabolic pathway based on metabolites that were associated with both IR and the interactions between AMY1-CNV and age. Moreover, in older participants, high AMY1-copy-numbers tended to be associated with lower levels of ribonic acid, erythronic acid, and arabinonic acid, all of which were positively associated with IR. CONCLUSIONS We found evidence supporting a role of AMY1-CNV in modifying the relationship between age and IR. Individuals with low AMY1-copy-numbers tend to have increased IR with advancing age.
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Affiliation(s)
- Yuwei Liu
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- School of Public Health, Fudan University, Shanghai, China
| | - Caren E Smith
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Laurence D Parnell
- USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Yu-Chi Lee
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Ping An
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Robert J Straka
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN
| | - Hemant K Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Alexis C Wood
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | | | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Paul N Hopkins
- Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Donna K Arnett
- College of Public Health, University of Kentucky, Lexington, KY
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
- IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Chao-Qiang Lai
- USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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12
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Dodds SG, Parihar M, Javors M, Nie J, Musi N, Dave Sharp Z, Hasty P. Acarbose improved survival for Apc +/Min mice. Aging Cell 2020; 19:e13088. [PMID: 31903726 PMCID: PMC6996958 DOI: 10.1111/acel.13088] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 10/24/2019] [Accepted: 11/17/2019] [Indexed: 12/12/2022] Open
Abstract
Acarbose blocks the digestion of complex carbohydrates, and the NIA Intervention Testing Program (ITP) found that it improved survival when fed to mice. Yet, we do not know if lifespan extension was caused by its effect on metabolism with regard to the soma or cancer suppression. Cancer caused death for ~80% of ITP mice. The ITP found rapamycin, an inhibitor to the pro-growth mTORC1 (mechanistic target of rapamycin complex 1) pathway, improved survival and it suppressed tumors in Apc+/Min mice providing a plausible rationale to ask if acarbose had a similar effect. Apc+/Min is a mouse model prone to intestinal polyposis and a mimic of familial adenomatous polyposis in people. Polyp-associated anemia contributed to their death. To address this knowledge gap, we fed two doses of acarbose to Apc+/Min mice. Acarbose improved median survival at both doses. A cross-sectional analysis was performed next. At both doses, ACA fed mice exhibited reduced intestinal crypt depth, weight loss despite increased food consumption and reduced postprandial blood glucose and plasma insulin, indicative of improved insulin sensitivity. Dose-independent and dose-dependent compensatory liver responses were observed for AMPK and mTORC1 activities, respectively. Only mice fed the high dose diet exhibited reductions in tumor number with higher hematocrits. Because low-dose acarbose improved lifespan but failed to reduced tumors, its effects seem to be independent of cancer. These data implicate the importance of improved carbohydrate metabolism on survival.
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Affiliation(s)
- Sherry G. Dodds
- Department of Molecular Medicine and Institute of BiotechnologyUniversity of Texas HealthSan AntonioTXUSA
| | - Manish Parihar
- Department of Molecular Medicine and Institute of BiotechnologyUniversity of Texas HealthSan AntonioTXUSA
| | - Martin Javors
- Department of PsychiatryUniversity of Texas HealthSan AntonioTXUSA
| | - Jia Nie
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas HealthSan AntonioTXUSA
| | - Nicolas Musi
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas HealthSan AntonioTXUSA
- San Antonio Geriatric ResearchEducation, and Clinical CenterSouth Texas Veterans Health Care SystemSan AntonioTXUSA
| | - Zelton Dave Sharp
- Department of Molecular Medicine and Institute of BiotechnologyUniversity of Texas HealthSan AntonioTXUSA
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas HealthSan AntonioTXUSA
- Mays Cancer CenterUniversity of Texas HealthSan AntonioTXUSA
| | - Paul Hasty
- Department of Molecular Medicine and Institute of BiotechnologyUniversity of Texas HealthSan AntonioTXUSA
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas HealthSan AntonioTXUSA
- Mays Cancer CenterUniversity of Texas HealthSan AntonioTXUSA
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13
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Espasandín‐Domínguez J, Cadarso‐Suárez C, Kneib T, Marra G, Klein N, Radice R, Lado‐Baleato O, González‐Quintela A, Gude F. Assessing the relationship between markers of glycemic control through flexible copula regression models. Stat Med 2019; 38:5161-5181. [DOI: 10.1002/sim.8358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 01/30/2023]
Affiliation(s)
- J. Espasandín‐Domínguez
- Department of Statistics, Mathematical Analysis, and OptimizationUniversidade de Santiago de Compostela Santiago de Compostela Spain
| | - C. Cadarso‐Suárez
- Department of Statistics, Mathematical Analysis, and OptimizationUniversidade de Santiago de Compostela Santiago de Compostela Spain
| | - T. Kneib
- Chair of StatisticsGeorg‐August‐Universität Göttingen Göttingen Germany
| | - G. Marra
- Department of Statistical ScienceUniversity College London London UK
| | - N. Klein
- Humboldt‐Universitat zu Berlin Berlin Germany
| | - R. Radice
- Cass Business SchoolCity, University of London London UK
| | - O. Lado‐Baleato
- Department of Statistics, Mathematical Analysis, and OptimizationUniversidade de Santiago de Compostela Santiago de Compostela Spain
| | - A. González‐Quintela
- Department of Internal MedicineComplejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela Spain
| | - F. Gude
- Clinical Epidemiology UnitComplejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela Spain
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14
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Kurupati RK, Haut LH, Schmader KE, Ertl HC. Age-related changes in B cell metabolism. Aging (Albany NY) 2019; 11:4367-4381. [PMID: 31283526 PMCID: PMC6660053 DOI: 10.18632/aging.102058] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/24/2019] [Indexed: 12/18/2022]
Abstract
Antibody responses to vaccinations or infections decline upon aging. In this study we tested if metabolic changes in B cells may contribute to attenuation of responses to influenza vaccination in aged humans. Our data show that aging affects mitochondrial functions in B cells leading to increases in mitochondrial reactive oxygen species (MROS) and mitochondrial mass (MM) in some aged B cell subsets and decreases in expression levels of Sirtuin 1 (SIRT1), Forkhead box protein (FOX)O1 and carnitine palmitoyltransferase 1 (CPT-1). Seahorse analyses showed minor defects in glycolysis in the aged B cells after activation but a strong reduction in oxidative phosphorylation. The analyses of the transcriptome revealed further pronounced defects in one-carbon metabolism, a pathway that is essential for amino acid and nucleotide metabolism. Overall our data support the notion that the declining ability of aged B cells to increase their metabolism following activation contributes to the weakened antibody responses of the elderly.
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Affiliation(s)
| | | | - Kenneth E Schmader
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
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15
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Sex Differences in Age-Associated Type 2 Diabetes in Rats-Role of Estrogens and Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6734836. [PMID: 31089412 PMCID: PMC6476064 DOI: 10.1155/2019/6734836] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/14/2018] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
Females live longer than males, and the estrogens are one of the reasons for this difference. We reported some years ago that estrogens are able to protect rats against oxidative stress, by inducing antioxidant genes. Type 2 diabetes is an age-associated disease in which oxidative stress is involved, and moreover, some studies show that the prevalence is higher in men than in women, and therefore there are sex-associated differences. Thus, the aim of this study was to evaluate the role of estrogens in protecting against oxidative stress in type 2 diabetic males and females. For this purpose, we used Goto-Kakizaki rats, which develop type 2 diabetes with age. We found that female diabetic rats showed lower glycaemia levels with age than did diabetic males and that estrogens enhanced insulin sensitivity in diabetic females. Moreover, glucose uptake, measured by positron emission tomography, was higher in the female brain, cerebellum, and heart than in those from male diabetic rats. There were also sex-associated differences in the plasma metabolic profile as determined by metabolomics. The metabolic profile was similar between estrogen-replaced and control diabetic rats and different from ovariectomized diabetic rats. Oxidative stress is involved in these differences. We showed that hepatic mitochondria from females produced less hydrogen peroxide levels and exhibited lower xanthine oxidase activity. We also found that hepatic mitochondrial glutathione oxidation and lipid oxidation levels were lower in diabetic females when compared with diabetic males. Ovariectomy induced oxidative stress, and estrogen replacement therapy prevented it. These findings provide evidence for estrogen beneficial effects in type 2 diabetes and should be considered when prescribing estrogen replacement therapy to menopausal women.
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16
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Ehrhardt N, Cui J, Dagdeviren S, Saengnipanthkul S, Goodridge HS, Kim JK, Lantier L, Guo X, Chen YDI, Raffel LJ, Buchanan TA, Hsueh WA, Rotter JI, Goodarzi MO, Péterfy M. Adiposity-Independent Effects of Aging on Insulin Sensitivity and Clearance in Mice and Humans. Obesity (Silver Spring) 2019; 27:434-443. [PMID: 30801985 PMCID: PMC6474357 DOI: 10.1002/oby.22418] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Aging is associated with impaired insulin sensitivity and increased prevalence of type 2 diabetes. However, it remains unclear whether aging-associated insulin resistance is due to increased adiposity or other age-related factors. To address this question, the impact of aging on insulin sensitivity was investigated independently of changes in body composition. METHODS Cohorts of mice aged 4 to 8 months ("young") and 18 to 27 months ("aged") exhibiting similar body composition were characterized for glucose metabolism on chow and high-fat diets. Insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamp analyses. The relationship between aging and insulin resistance in humans was investigated in 1,250 nondiabetic Mexican Americans who underwent hyperinsulinemic-euglycemic clamps. RESULTS In mice with similar body composition, age had no detrimental effect on plasma glucose and insulin levels. While aging did not diminish glucose tolerance, hyperinsulinemic-euglycemic clamps demonstrated impaired insulin sensitivity and reduced insulin clearance in aged mice on chow and high-fat diets. Consistent with results in the mouse, age remained an independent determinant of insulin resistance after adjustment for body composition in Mexican American males. CONCLUSIONS This study demonstrates that in addition to altered body composition, adiposity-independent mechanisms also contribute to aging-associated insulin resistance in mice and humans.
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Affiliation(s)
- Nicole Ehrhardt
- Department of Basic Medical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Jinrui Cui
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sezin Dagdeviren
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Suchaorn Saengnipanthkul
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Helen S. Goodridge
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jason K. Kim
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Louise Lantier
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37235, USA
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Yii-Der I. Chen
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Leslie J. Raffel
- Department of Pediatrics, Division of Genetic and Genomic Medicine, University of California, Irvine, CA 92697, USA
| | - Thomas A. Buchanan
- Department of Physiology and Biophysics and Department of Medicine, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
| | - Willa A. Hsueh
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH 43210, USA
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Corresponding authors: Mark O. Goodarzi () and Miklós Péterfy () Tel: +1 909 706 3949
| | - Miklós Péterfy
- Department of Basic Medical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Corresponding authors: Mark O. Goodarzi () and Miklós Péterfy () Tel: +1 909 706 3949
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17
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Preuss HG, Mrvichin N, Kaats GR, Bagchi D, Clouatre D. Reflecting on Concepts Relevant to Contemplating the Relationships Between Glucose-Insulin Perturbations, Nutrition, and Aging. J Am Coll Nutr 2019; 38:463-469. [PMID: 30810506 DOI: 10.1080/07315724.2018.1529640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Medical professionals attribute a crucial role in the development of several age-related, chronic health maladies to glucose-insulin perturbations - particularly, discernible insulin resistance (IR). However, little information is available concerning the degree to which relatively minor changes in IR participate over time in overall aging population, e.g., when circulating glucose and/or insulin concentrations are consistently within the higher end of normally accepted ranges. Objective: Obtaining precise knowledge is important, because proper nutritional management has the distinct capability of ameliorating the consequences. Methods: Five key concepts are suggested to underpin current thinking as to the applicable mechanisms and these are (1) the practical use of fasting blood glucose (FBG) levels as an estimate of IR, (2) the potential role of even slightly aberrant insulin regulation over time in the aging process, (3) the implementation of "continuum of risks" rather than checkpoints in considering prevention, (4) the presence and meaning of an aging paradox discovered in a recent study, and (5) the importance nutritional considerations in the "deadly triangle" as key factors in aging. Conclusions: Maintaining relatively low levels of FBG representing IR during aging via nutritional means has the potential to deliver a longer, more healthful lifespan as well as ameliorate many adverse manifestations of aging.
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Affiliation(s)
- Harry G Preuss
- a Department of Biochemistry , Georgetown University Medical Center , Washington , DC , USA
| | - Nate Mrvichin
- b Integrative Health Technologies , San Antonio , Texas , USA
| | - Gilbert R Kaats
- b Integrative Health Technologies , San Antonio , Texas , USA
| | - Debasis Bagchi
- c Department of Pharmacological and Pharmaceutical Services , University of Houston , Houston , Texas , USA
| | - Dallas Clouatre
- d Glykon Technologies Group, LLC , Seattle , Washington , USA
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18
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Masuch A, Friedrich N, Roth J, Nauck M, Müller UA, Petersmann A. Preventing misdiagnosis of diabetes in the elderly: age-dependent HbA1c reference intervals derived from two population-based study cohorts. BMC Endocr Disord 2019; 19:20. [PMID: 30755204 PMCID: PMC6371438 DOI: 10.1186/s12902-019-0338-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 01/09/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Measurement of gylcated hemoglobin A1c (HbA1c) plays a central role in monitoring quality of antidiabetic therapy and in the diagnosis of diabetes. Several studies report increased levels of HbA1c in nondiabetic elderly. However, this observation did not reach incorporation into daily clinical practice or the respective guidelines. The present study aimed to evaluate HbA1c levels in relation to age in two independent population-based cohorts and to derive age-specific reference intervals. METHODS Four thousand two hundred sixty three participants from the Study of Health in Pomerania (SHIP-0) and 4402 participants from the independent study SHIP-Trend were included. HbA1c was determined by means of high-performance liquid chromatography. Multivariable linear regression models were performed. Reference intervals for HbA1c were determined. RESULTS Reference intervals were derived from a healthy subpopulation with the upper reference limit (URL) for HbA1c of 42.1 mmol/Mol (6.0%) for individuals aged 20-39 years increasing to 43.2 mmol/Mol (6.1%) for individuals aged 40-59 years. For people aged ≥60 years the URL was 47.5 mmol/Mol (6.5%). In both study populations an increase in HbA1c with age was observed. ANOVA revealed up to 8.5 mmol/Mol (0.77%) or 7.3 mmol/Mol (0.68%) higher estimated mean levels of HbA1c in the oldest compared to the youngest age group in SHIP-0 or SHIP-trend, respectively. Linear regression analyses confirmed the positive associations of HbA1c with age which was independent of BMI CONCLUSION: The present study confirmed the previously observed increase of HbA1c with increasing age in non-diabetic individuals. As a consequence age-dependent reference values for HbA1c were derived from two large and well defined reference populations. Implementation of them into daily practice may improve patient care and diagnosis of diabetes and reduce the risk of misdiagnosis and subsequent overtreatment of diabetes in elderly patients.
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Affiliation(s)
- Annette Masuch
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- German Center for Cardiovascular Research (DZHK e.V.), partner site Greifswald, Greifswald, Germany
| | - Johannes Roth
- Department Internal Medicine III, Endocrinology and Metabolic Diseases, University Hospital Jena, Jena, Germany
- Present address: Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- German Center for Cardiovascular Research (DZHK e.V.), partner site Greifswald, Greifswald, Germany
| | - Ulrich Alfons Müller
- Department Internal Medicine III, Endocrinology and Metabolic Diseases, University Hospital Jena, Jena, Germany
| | - Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
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Abstract
Aging and diabetes mellitus are 2 well-known risk factors for cardiovascular disease (CVD). During the past 50 years, there has been an dramatic increase in life expectancy with a simultaneous increase in the prevalence of diabetes mellitus in the older population. This large number of older individuals with diabetes mellitus is problematic given that CVD risk associated with aging and diabetes mellitus. In this review, we summarize epidemiological data relating to diabetes mellitus and CVD, with an emphasis on the aging population. We then present data on hyperglycemia as a risk factor for CVD and review the current knowledge of age-related changes in glucose metabolism. Next, we review the role of obesity in the pathogenesis of age-related glucose dysregulation, followed by a summary of the results from major randomized controlled trials that focus on cardiovascular risk reduction through glycemic control, with a special emphasis on older adults. We then conclude with our proposed model of aging that body composition changes and insulin resistance link possible dysregulation of physiological pathways leading to obesity and diabetes mellitus-both forms of accelerated aging-and risks for CVD.
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Affiliation(s)
- Chee W Chia
- From the Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Josephine M Egan
- From the Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Luigi Ferrucci
- From the Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
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van Gastel J, Boddaert J, Jushaj A, Premont RT, Luttrell LM, Janssens J, Martin B, Maudsley S. GIT2-A keystone in ageing and age-related disease. Ageing Res Rev 2018; 43:46-63. [PMID: 29452267 DOI: 10.1016/j.arr.2018.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 12/15/2022]
Abstract
Since its discovery, G protein-coupled receptor kinase-interacting protein 2, GIT2, and its family member, GIT1, have received considerable interest concerning their potential key roles in regulating multiple inter-connected physiological and pathophysiological processes. GIT2 was first identified as a multifunctional protein that is recruited to G protein-coupled receptors (GPCRs) during the process of receptor internalization. Recent findings have demonstrated that perhaps one of the most important effects of GIT2 in physiology concerns its role in controlling multiple aspects of the complex ageing process. Ageing can be considered the most prevalent pathophysiological condition in humans, affecting all tissue systems and acting as a driving force for many common and intractable disorders. The ageing process involves a complex interplay among various deleterious activities that profoundly disrupt the body's ability to cope with damage, thus increasing susceptibility to pathophysiologies such as neurodegeneration, central obesity, osteoporosis, type 2 diabetes mellitus and atherosclerosis. The biological systems that control ageing appear to function as a series of interconnected complex networks. The inter-communication among multiple lower-complexity signaling systems within the global ageing networks is likely coordinated internally by keystones or hubs, which regulate responses to dynamic molecular events through protein-protein interactions with multiple distinct partners. Multiple lines of research have suggested that GIT2 may act as one of these network coordinators in the ageing process. Identifying and targeting keystones, such as GIT2, is thus an important approach in our understanding of, and eventual ability to, medically ameliorate or interdict age-related progressive cellular and tissue damage.
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Juang JH, Hsu BRS, Kuo CH, Yao NK. Influence of Donor Age on Mouse Islet Characteristics and Transplantation. Cell Transplant 2017; 10:277-284. [DOI: 10.3727/000000001783986738] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Old donor age has been considered as a risk factor and relative contraindication for transplantation. This study was designed to investigate the influence of donor age on islet characteristics and transplantation. Islets isolated from 8 (I-A)-, 32 (I-B)-, or 64 (I-C)-week-old C57BL/6 mice were studied for number, size, insulin content, and secretion. After syngeneically transplanting 300 islets under the kidney capsule of strep-tozotocin-diabetic mice (R-A, R-B, and R-C, respectively), we measured recipients' metabolic parameters as well as the β-cell mass and insulin content of the graft. Eight-week-old donors had better glucose tolerance than 32- and 64-week-old donors. However, 64-week-old donors had more pancreatic insulin content than 8- and 32-week-old donors. I-B and I-C were greater in number, larger in size, and higher in insulin content than I-A. But perifusion study showed I-C secreted less insulin, albeit with a similar stimulation index compared with that of I-A and I-B. After transplantation, the fall of blood glucose in R-C was faster than that in R-A and R-B. At 12 weeks, the recipients' blood glucose, body weight, HbA1c, and the β-cell mass and insulin content of the graft were comparable in all groups. However, R-C had better glucose tolerance than R-A. During follow-up, R-A and R-B maintained lifelong normoglycemia and their glucose tolerance did not deteriorate. These data indicate that islets isolated from donors with different ages have different characteristics and effects on transplantation. The islets isolated from aged donors are functioning well and can be a potential source for transplantation; however, because we transplanted a large islet mass from the aged donors, the role of the islet dose needs to be further clarified.
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Affiliation(s)
- Jyuhn-Huarng Juang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Brend Ray-Sea Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Hung Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Nan-Kuang Yao
- Microsystem Laboratory, Industrial Technology Research Institute, Hsinchu, Taiwan
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Kuo CH, Chen SC, Fang CT, Nien FJ, Wu ET, Lin SY, Chuang LM, Lee CN, Li HY. Screening gestational diabetes mellitus: The role of maternal age. PLoS One 2017; 12:e0173049. [PMID: 28296923 PMCID: PMC5351872 DOI: 10.1371/journal.pone.0173049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/14/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Using a specific cutoff of fasting plasma glucose (FPG) to screen gestational diabetes mellitus (GDM) can reduce the use of oral glucose tolerance tests (OGTT). Since the prevalence of GDM increases with age, this screening method may not be appropriate in healthcare systems where women become pregnant at older ages. Therefore, we aimed to develop a screening algorithm for GDM that takes maternal age into consideration. METHODS We included 945 pregnant women without history of GDM who received 75g OGTT to diagnose GDM in 2011. Screening algorithms using FPG with or without age were developed. Another 362 pregnant women were recruited in 2013-2015 as the validation cohort. RESULTS Using FPG criteria alone, more GDM diagnoses were missed in women ≥35 years than in women <35 years (13.2% vs. 5.8%, p <0.001). Among GDM women ≥35 years, 63.6% had FPG <92 mg/dL (5.1 mmol/L). Use of the algorithm with an "age plus FPG" cutoff could reduce the use of OGTT (OGTT%) from 77.6% to 62.9%, while maintaining good sensitivity (from 91.9% to 90.2%) and specificity (from 100% to 100%). Similar reduction in OGTT% was found in the validation cohort (from 86.4% to 76.8%). In the simulation, if the percentage of women ≥35 years were 40% or more, the screening algorithm with an "age plus FPG" cutoff could further reduce OGTT% by 11.0%-18.8%. CONCLUSIONS A screening algorithm for GDM that takes maternal age into consideration can reduce the use of OGTT when women become pregnant at older ages.
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Affiliation(s)
- Chun-Heng Kuo
- Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan
| | - Szu-Chi Chen
- Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan
| | - Chi-Tai Fang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Feng-Jung Nien
- Department of Internal Medicine, National Taiwan University Hospital, Yun-lin branch, Yun-lin, Taiwan
| | - En-Tzu Wu
- Department of Obstetrics and Gynecology, Dianthus MFM Clinic, Taiwan
| | - Shin-Yu Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (HYL); (CNL)
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (HYL); (CNL)
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23
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Di Sebastiano KM, Bell KE, Mitchell AS, Quadrilatero J, Dubin JA, Mourtzakis M. Glucose metabolism during the acute prostate cancer treatment trajectory: The influence of age and obesity. Clin Nutr 2016; 37:195-203. [PMID: 27998647 DOI: 10.1016/j.clnu.2016.11.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/14/2016] [Accepted: 11/28/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND & AIMS Obesity and age, key risk factors for aggressive prostate cancer, are associated with insulin resistance. Glucose-related parameters in patients with aggressive prostate cancer were compared with 2 reference groups: men of similar age and body mass index (BMI) without cancer, and healthy young men. Acute changes in these parameters following radiation treatment were also evaluated. METHODS Nine patients with aggressive prostate cancer underwent metabolic assessments prior to treatment (baseline), 7 and 33 weeks post-baseline (post-treatment initiation). Baseline measures were compared with the 2 reference groups. Evaluations included: 1) fasting and oral glucose tolerance test (OGTT) blood samples for glucose, C-peptide, and insulin, 2) fasting blood samples for triglycerides, cholesterols, leptin, adiponectin, IL-6, and TNF-α, 3) body composition, 4) nutrition, and 5) physical activity. RESULTS At baseline, patients had normal fasting glucose concentrations (<5.6 mM; 4.9 ± 1.2 mM) but impaired 2-h OGTT glucose concentrations (>7.8 mM; 8.7 ± 2.9 mM). Both reference groups had normal fasting (matched males: 4.2 ± 0.5 mM; young males: 3.7 ± 0.4 mM) and 2-h OGTT glucose concentrations (matched males: 5.6 ± 1.8 mM; young males: 3.1 ± 0.1 mM) that were significantly lower than patient values. During the OGTT, patients had higher insulin (120 min) and C-peptide (45, 60, 90, 120 min) concentrations compared to the matched males. At 7 weeks, 2-h OGTT glucose concentrations in patients improved to healthy ranges without changes in insulin, C-peptide, IGF-1, IGFBP-3 or other metabolic parameters. CONCLUSIONS At baseline patients with aggressive prostate cancer demonstrated impaired glucose tolerance compared with men of similar age and body size. Following treatment, glucose tolerance improved in the absence of changes in expected modifiers of glucose metabolism. These improvements may be related to treatment.
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Affiliation(s)
| | - Kirsten E Bell
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Andrew S Mitchell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Joel A Dubin
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
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Correlation of thiamine metabolite levels with cognitive function in the non-demented elderly. Neurosci Bull 2016; 31:676-84. [PMID: 26519048 DOI: 10.1007/s12264-015-1563-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Thiamine metabolism is critical for glucose metabolism and also vital for brain function, which is susceptible to decline in the elderly. This study aimed to investigate whether thiamine metabolites correlate with cognitive function in the non-demented elderly and their impact factors. Volunteers >60 years old were recruited and their blood thiamine metabolites and Mini-Mental State Examination (MMSE) scores were measured. The apolipoprotein E (APOE) genotype, routine blood parameters, liver and kidney function, and levels of fasting blood glucose and triglycerides were also measured. The results showed that the thiamine diphosphate (TDP) level weakly correlated with MMSE score in the non-demented elderly. Participants with high TDP levels performed better in Recall and Attention and Calculation than those with low TDP. TDP levels were associated with the APOE ε2 allele, body mass index, hemoglobin level, fasting blood glucose, and triglycerides. Our results suggest that TDP, which is easily affected by many factors, impacts cognitive function in the elderly.
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25
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Fried LP. Interventions for Human Frailty: Physical Activity as a Model. Cold Spring Harb Perspect Med 2016; 6:cshperspect.a025916. [PMID: 27143701 DOI: 10.1101/cshperspect.a025916] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In the last 100 years, populations in developed countries have experienced an unprecedented addition of 30 years to life expectancy. Developing countries are now experiencing this same phenomenon, but over a shorter time frame. With this success comes the challenge of maximizing health and vitality across these added years. The compression of morbidity to the latest point in the human life span could unleash a sustained third demographic dividend that benefits all of society. To accomplish this, society needs to invest in the prevention and treatment of frailty, as well as in the prevention of chronic diseases at every age and stage of life. A model intervention, physical activity, may offer a road map.
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Affiliation(s)
- Linda P Fried
- Columbia University Medical Center, New York, New York 10032
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26
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Van Bussel IPG, Jolink-Stoppelenburg A, De Groot CPGM, Müller MR, Afman LA. Differences in genome-wide gene expression response in peripheral blood mononuclear cells between young and old men upon caloric restriction. GENES AND NUTRITION 2016; 11:13. [PMID: 27551314 PMCID: PMC4968441 DOI: 10.1186/s12263-016-0528-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/19/2016] [Indexed: 12/02/2022]
Abstract
Background Caloric restriction (CR) is considered to increase lifespan and to prevent various age-related diseases in different nonhuman organisms. Only a limited number of CR studies have been performed on humans, and results put CR as a beneficial tool to decrease risk factors in several age-related diseases. The question remains at what age CR should be implemented to be most effective with respect to healthy aging. The aim of our study was to elucidate the role of age in the transcriptional response to a completely controlled 30 % CR diet on immune cells, as immune response is affected during aging. Ten healthy young men, aged 20–28, and nine healthy old men, aged 64–85, were subjected to a 2-week weight maintenance diet, followed by 3 weeks of 30 % CR. Before and after 30 % CR, the whole genome gene expression in peripheral blood mononuclear cells (PBMCs) was assessed. Results Expression of 554 genes showed a different response between young and old men upon CR. Gene set enrichment analysis revealed a downregulation of gene sets involved in the immune response in young but not in old men. At baseline, immune response-related genes were higher expressed in old compared to young men. Upstream regulator analyses revealed that most potential regulators were controlling the immune response. Conclusions Based on the gene expression data, we theorise that a short period of CR is not effective in old men regarding immune-related pathways while it is effective in young men. Trial registration ClinicalTrials.gov, NCT00561145 Electronic supplementary material The online version of this article (doi:10.1186/s12263-016-0528-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- I P G Van Bussel
- Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands
| | - A Jolink-Stoppelenburg
- Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands
| | - C P G M De Groot
- Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands
| | - M R Müller
- Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands ; Current Address: Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - L A Afman
- Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands ; Division of Human Nutrition, Wageningen University & Research centre, PO BOX 8129, NL-6700 EV Wageningen, The Netherlands
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Caillaud K, Boisseau N, Ennequin G, Chavanelle V, Etienne M, Li X, Denis P, Dardevet D, Lacampagne A, Sirvent P. Neuregulin 1 improves glucose tolerance in adult and old rats. DIABETES & METABOLISM 2016; 42:96-104. [DOI: 10.1016/j.diabet.2015.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/30/2015] [Accepted: 08/19/2015] [Indexed: 12/29/2022]
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28
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Zhang M, Ma Z, Qin H, Yao Z. Monocarboxylate Transporter 1 in the Medial Prefrontal Cortex Developmentally Expresses in Oligodendrocytes and Associates with Neuronal Amounts. Mol Neurobiol 2016; 54:2315-2326. [DOI: 10.1007/s12035-016-9820-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/29/2016] [Indexed: 01/10/2023]
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Milan AM, Cameron-Smith D. Digestion and Postprandial Metabolism in the Elderly. ADVANCES IN FOOD AND NUTRITION RESEARCH 2015; 76:79-124. [PMID: 26602572 DOI: 10.1016/bs.afnr.2015.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The elderly are an increasing segment of the population. Despite the rapid gains in medical knowledge and treatments, older adults are more likely to experience chronic illnesses that decrease quality of life and accelerate mortality. Nutrition is a key modifiable lifestyle factor which greatly impacts chronic disease risk. Yet despite the importance of nutrition, relatively little is known of the impact of advancing age on the gastrointestinal function, the digestive responses, and the post-meal metabolic adaptations that occur in response to ingested food. Knowledge of the age-related differences in digestion and metabolism in the elderly is essential to the development of appropriate nutritional recommendations for the maintenance of optimal health and prevention of disease.
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Affiliation(s)
- Amber M Milan
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Wang HH, Chowdhury KK, Lautt WW. A synergistic, balanced antioxidant cocktail, protects aging rats from insulin resistance and absence of meal-induced insulin sensitization (AMIS) syndrome. Molecules 2015; 20:669-82. [PMID: 25569521 PMCID: PMC6272698 DOI: 10.3390/molecules20010669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 12/26/2014] [Indexed: 11/16/2022] Open
Abstract
A series of in vivo and in vitro studies using animal and human models in the past 15 years have demonstrated that approximately 55% (~66% in humans) of the glucose disposal effect of an i.v. injection of insulin in the fed state is dependent on the action of a second hormone, hepatic insulin sensitizing substance (HISS), which is released from the liver and stimulates glucose uptake in muscle, heart and kidneys. Sensitization of the insulin response by a meal through release of HISS is called meal-induced insulin sensitization (MIS). Absence of HISS action results in postprandial hyperglycemia, hyperinsulinemia, hyperlipidemia, adiposity, increased free radical stress and a cluster of progressive metabolic and cardiovascular dysfunctions referred to as the AMIS (absence of meal-induced insulin sensitization) syndrome. Reduced HISS release accounts for the insulin resistance that occurs with aging and is made worse by physical inactivity and diets high in sucrose or fat. This brief review provides an update of major metabolic disturbances associated with aging due to reduction of HISS release, and the protection against these pathological changes in aging animals using a balanced synergistic antioxidant cocktail SAMEC (S-adenosylmethionine, vitamins E and C). The synergy amongst the components is consistent with the known benefits of antioxidants supplied by a mixed diet and acting through diverse mechanisms. Using only three constituents, SAMEC appears suitable as an antioxidant specifically targeting the AMIS syndrome.
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Affiliation(s)
- Hui Helen Wang
- Department of Pharmacology & Therapeutics, College of Medicine, Faculty of Health Sciences, University of Manitoba, A224-753 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada.
| | - Kawshik K Chowdhury
- Department of Pharmacology & Therapeutics, College of Medicine, Faculty of Health Sciences, University of Manitoba, A224-753 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada.
| | - W Wayne Lautt
- Department of Pharmacology & Therapeutics, College of Medicine, Faculty of Health Sciences, University of Manitoba, A224-753 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada.
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Duivenvoorde LPM, van Schothorst EM, Swarts HJM, Keijer J. Assessment of Metabolic Flexibility of Old and Adult Mice Using Three Noninvasive, Indirect Calorimetry-Based Treatments. J Gerontol A Biol Sci Med Sci 2014; 70:282-93. [DOI: 10.1093/gerona/glu027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Masoro EJ. In vivo glucose fuel use. Aging Clin Exp Res 2013. [DOI: 10.1007/bf03324372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hopper MK, Koch CE, Koch JL. A preliminary study on the variability of blood glucose following meal consumption as it relates to differences in oral glucose tolerance in young adults. Nutr Health 2013; 22:197-214. [PMID: 26320117 DOI: 10.1177/0260106015599480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Insulin resistance (IR) affects the ability to maintain normal glycemia and places one at greater risk of the development of disease. The aim of this study was to assess IR via the administration of an oral glucose tolerance test (OGTT) and then determine the relationship between IR and postprandial blood glucose levels in young adults 19-24 years of age. Following a 10 hour fast, 10 men and 10 women completed an OGTT and in three subsequent weeks consumed high, medium, and low glycemic load (GL) meals in random order. Fasted and two-hour (2 h) blood glucose levels were determined. Height, weight, and waist circumference were measured and subjects completed a questionnaire recording recent weight gain, family history of diabetes, and physical fitness. Although all fasted blood glucose levels were normal, two subjects classified as impaired glucose tolerant based on 2 h OGTT values >140 mg/dL. OGTT and high glycemic load meal 2 h blood glucose levels were highly significantly correlated (p = 0.0012). Significantly higher blood glucose levels were also found in women, high BMI, low fitness, and rapid weight gain groups. Although limited by a small sample, these preliminary data suggest that glycemic response to meal ingestion is based on both the GL of the meal and the individual's level of IR.
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Affiliation(s)
- Mari K Hopper
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Evansville IN, USA Department of Biology, University of Southern Indiana, Evansville IN, USA
| | - Carynn E Koch
- Department of Biology, University of Southern Indiana, Evansville IN, USA
| | - Jenny L Koch
- Department of Biology, University of Southern Indiana, Evansville IN, USA
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Abstract
Diabetes and impaired glucose tolerance affect a substantial proportion of older adults. Abnormal glucose metabolism is not a necessary component of aging. Older adults with diabetes and altered glucose status likely represent a subset of the population at high risk for complications and adverse geriatric syndromes. Goals for treatment of diabetes in the elderly include control of hyperglycemia, prevention and treatment of diabetic complications, avoidance of hypoglycemia, and preservation of quality of life. Research exploring associations of dysglycemia and insulin resistance with the development of adverse outcomes in the elderly may ultimately inform use of future glucose-lowering therapies in this population.
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Affiliation(s)
- Rita Rastogi Kalyani
- Division of Endocrinology and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, The Johns Hopkins University, Baltimore, MD 21287, USA.
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de Moura LP, Souza Pauli LS, Cintra DE, de Souza CT, da Silva ASR, Marinho R, de Melo MAR, Ropelle ER, Pauli JR. Acute exercise decreases PTP-1B protein level and improves insulin signaling in the liver of old rats. IMMUNITY & AGEING 2013; 10:8. [PMID: 23442260 PMCID: PMC3599175 DOI: 10.1186/1742-4933-10-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/20/2013] [Indexed: 11/17/2022]
Abstract
It is now commonly accepted that chronic inflammation associated with obesity during aging induces insulin resistance in the liver. In the present study, we investigated whether the improvement in insulin sensitivity and insulin signaling, mediated by acute exercise, could be associated with modulation of protein-tyrosine phosphatase 1B (PTP-1B) in the liver of old rats. Aging rats were subjected to swimming for two 1.5-h long bouts, separated by a 45 min rest period. Sixteen hours after the exercise, the rats were sacrificed and proteins from the insulin signaling pathway were analyzed by immunoblotting. Our results show that the fat mass was increased in old rats. The reduction in glucose disappearance rate (Kitt) observed in aged rats was restored 16 h after exercise. Aging increased the content of PTP-1B and attenuated insulin signaling in the liver of rats, a phenomenon that was reversed by exercise. Aging rats also increased the IRβ/PTP-1B and IRS-1/PTP-1B association in the liver when compared with young rats. Conversely, in the liver of exercised old rats, IRβ/PTP-1B and IRS-1/PTP-1B association was markedly decreased. Moreover, in the hepatic tissue of old rats, the insulin signalling was decreased and PEPCK and G6Pase levels were increased when compared with young rats. Interestingly, 16 h after acute exercise, the PEPCK and G6Pase protein level were decreased in the old exercised group. These results provide new insights into the mechanisms by which exercise restores insulin signalling in liver during aging.
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Affiliation(s)
- Leandro Pereira de Moura
- Universidade Estadual Paulista, UNESP, Curso de Pós-Graduação em Ciências da Motricidade Humana, Rio Claro, SP, Brazil
| | - Luciana Santos Souza Pauli
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Curso de Pós-Graduação em Nutrição, Esporte e Metabolismo. UNICAMP, Limeira, SP, Brazil
| | - Dennys Esper Cintra
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Curso de Pós-Graduação em Nutrição, Esporte e Metabolismo. UNICAMP, Limeira, SP, Brazil
| | | | | | - Rodolfo Marinho
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Curso de Pós-Graduação em Nutrição, Esporte e Metabolismo. UNICAMP, Limeira, SP, Brazil
| | - Maria Alice Rostom de Melo
- Universidade Estadual Paulista, UNESP, Curso de Pós-Graduação em Ciências da Motricidade Humana, Rio Claro, SP, Brazil
| | - Eduardo Rochete Ropelle
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Curso de Pós-Graduação em Nutrição, Esporte e Metabolismo. UNICAMP, Limeira, SP, Brazil
| | - José Rodrigo Pauli
- Universidade Estadual Paulista, UNESP, Curso de Pós-Graduação em Ciências da Motricidade Humana, Rio Claro, SP, Brazil.,Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Curso de Pós-Graduação em Nutrição, Esporte e Metabolismo. UNICAMP, Limeira, SP, Brazil.,Curso de Ciências do Esporte, FCA-UNICAMP, Rua Pedro Zaccaria, 1300, Jardim Santa Luzia, Limeira, SP, Brazil
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Hutchinson MS, Joakimsen RM, Njølstad I, Schirmer H, Figenschau Y, Svartberg J, Jorde R. Effects of Age and Sex on Estimated Diabetes Prevalence Using Different Diagnostic Criteria: The Tromsø OGTT Study. Int J Endocrinol 2013; 2013:613475. [PMID: 23365572 PMCID: PMC3556443 DOI: 10.1155/2013/613475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/04/2012] [Accepted: 12/05/2012] [Indexed: 12/30/2022] Open
Abstract
HbA(1c) 6.5% has recently been recommended as an alternative diagnostic criterion for diabetes. The aims of the study were to evaluate the effects of age, sex, and other factors on prevalence of diabetes and to compare risk profiles of subjects with diabetes when defined by HbA(1c) and glucose criteria. Subjects were recruited among participants in the longitudinal population-based Tromsø Study. HbA(1c), fasting plasma glucose, and 2-hour plasma glucose were measured in 3,476 subjects. In total, 294 subjects met one or more of the diagnostic criteria for diabetes; 95 met the HbA(1c) criterion only, 130 met the glucose criteria only, and 69 met both. Among subjects with diabetes detected by glucose criteria (regardless of HbA(1c)), isolated raised 2-hour plasma glucose was more common in subjects aged ≥ 60 years as compared to younger subjects and in elderly women as compared to elderly men. Subjects with diabetes detected by glucose criteria only had worse cardiometabolic risk profiles than those detected by HbA(1c) only. In conclusion, the current HbA(1c) and glucose criteria defined different subjects with diabetes with only modest overlap. Among a substantial proportion of elderly subjects, and especially elderly women, the 2-hour plasma glucose was the only abnormal value.
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Affiliation(s)
- Moira Strand Hutchinson
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
- *Moira Strand Hutchinson:
| | - Ragnar Martin Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway
| | - Henrik Schirmer
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Yngve Figenschau
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
- Department of Medical Biology, University of Tromsø, 9037 Tromsø, Norway
- Division of Laboratory Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Johan Svartberg
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
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Catalano KJ, Bergman RN, Ader M. Increased Susceptibility to Insulin Resistance Associated with Abdominal Obesity in Aging Rats**. ACTA ACUST UNITED AC 2012; 13:11-20. [PMID: 15761159 DOI: 10.1038/oby.2005.4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Recent data have suggested that the insulin resistance observed with aging may be more related to adiposity than aging per se. We asked whether the insulin resistance observed in aged rats was comparable (both in magnitude and location) to that of fat-fed rats. RESEARCH METHODS AND PROCEDURES We performed hyperinsulinemic (5 mU/min per kg) euglycemic clamps with tracer in conscious, 6-hour fasted young (YL), fat-fed young (YF), fat-fed old (OF), and calorically restricted old (OL) rats. RESULTS Intraabdominal fat measurements showed that OF and YF rats were more obese than YL (p<or=0.001; YF>OF>YL). Caloric restriction not only prevented age-related obesity but also reduced the ratio of intraabdominal fat to lean body mass (LBM) compared with YL (OL: 0.59+/-0.05 vs. YL: 1.07+/-0.04; p=0.017). Despite similar incremental insulin, YF and OF rats required 40% less infused glucose to maintain euglycemia than YL and OL rats (p<0.001). Insulin-stimulated glucose uptake (Si(Rd): DeltaRd/(DeltaInsulin x Glucose(SS)) was impaired in OF rats (OF: 14.03+/-1.79 vs. YL: 23.08+/-1.87x10(3) dL/min x kg LBM per pM; p=0.004) and improved in OL rats (29.41+/-1.84x10(3) dL/min x kg LBM per pM; p=0.031) compared with YL. Despite greater obesity, YF rats did not exhibit lower SiRd compared with OF rats (p=0.58). In contrast, the ability of insulin to suppress endogenous glucose production (EGP; Si(EGP): DeltaEGP/(DeltaInsulin x GlucoseSS) was not impaired in OF rats (OF vs. YL; p=0.61) but was markedly impaired in YF rats by approximately 75% (1.72+/-0.66x10(3) dL/min x kg per pM; p=0.013). Surprisingly, separate regression analysis for old and young animals revealed that old rats exhibited a significantly steeper regression between Si (Rd and EGP) and adiposity than young rats (p<0.05). Thus, older rats showed a proportionately greater decrement in insulin sensitivity with an equivalent increase in adiposity. DISCUSSION These data suggest that, in rodents, youth affords significant protection against obesity-induced insulin resistance.
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Affiliation(s)
- Karyn J Catalano
- Department of Physiology and Biophysics, University of Southern California Keck School of Medicine, 1333 San Pablo St., MMR 624, Los Angeles, CA 90033, USA
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Morterá P, Herculano-Houzel S. Age-related neuronal loss in the rat brain starts at the end of adolescence. Front Neuroanat 2012; 6:45. [PMID: 23112765 PMCID: PMC3481355 DOI: 10.3389/fnana.2012.00045] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 10/09/2012] [Indexed: 02/03/2023] Open
Abstract
Aging-related changes in the brain have been mostly studied through the comparison of young adult and very old animals. However, aging must be considered a lifelong process of cumulative changes that ultimately become evident at old age. To determine when this process of decline begins, we studied how the cellular composition of the rat brain changes from infancy to adolescence, early adulthood, and old age. Using the isotropic fractionator to determine total numbers of neuronal and non-neuronal cells in different brain areas, we find that a major increase in number of neurons occurs during adolescence, between 1 and 2-3 months of age, followed by a significant trend of widespread and progressive neuronal loss that begins as early as 3 months of age, when neuronal numbers are maximal in all structures, until decreases in numbers of neurons become evident at 12 or 22 months of age. Our findings indicate that age-related decline in the brain begins as soon as the end of adolescence, a novel finding has important clinical and social implications for public health and welfare.
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Affiliation(s)
- Priscilla Morterá
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil ; Instituto Nacional de Neurociência Translacional São Paulo, Brazil
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Saltevo JT, Kautiainen H, Niskanen L, Oksa H, Puolijoki H, Sundvall J, Keinänen-Kiukaanniemi S, Peltonen M, Tuomilehto J, Uusitupa M, Mäntyselkä P, Vanhala MJ. Ageing and associations of fasting plasma glucose and 2 h plasma glucose with HbA(1C) in apparently healthy population. "FIN-D2D" study. Diabetes Res Clin Pract 2011; 93:344-9. [PMID: 21632144 DOI: 10.1016/j.diabres.2011.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 04/28/2011] [Accepted: 05/05/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In this FIN-D2D cross-sectional survey the relationship of age with HbA(1c) and fasting and 2h glucose in the oral glucose tolerance test (OGTT) was explored in apparently randomly selected healthy population. PATIENTS AND METHODS The glycaemic parameters were measured in 1344 men and 1482 women (aged 45-74 years), and among them we excluded all subjects with known diabetes, hypertension or dyslipidaemia. The final analyses for HbA(1c) and the ratios of fasting glucose/HbA(1c) and 2h glucose/HbA(1c) included 649 men and 804 women. RESULTS Mean age was 57 years and BMI 26.1kg/m(2) for both genders. HbA(1c) increased in both genders with age (p<0.001). For a particular fasting glucose level HbA(1c) level was higher in older age groups (p<0.001 for linearity). By contrast, a particular 2h plasma glucose value in OGTT implied significantly lower HbA(1c) in the elderly (p<0.001 for linearity). CONCLUSION In apparently healthy population, screened with OGTT, in older individuals compared with younger ones a particular HbA(1c) value implies slightly lower fasting glucose, but relatively higher 2h glucose. These results need to be verified in different populations. The effects of age on relation between HbA(1c) and plasma glucose should be taken into account in classifying people into different dysglycaemia categories.
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Affiliation(s)
- J T Saltevo
- Department of Medicine, Central Finland Central Hospital, 40620 Jyväskylä, Finland.
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Kalyani RR, Varadhan R, Weiss CO, Fried LP, Cappola AR. Frailty status and altered glucose-insulin dynamics. J Gerontol A Biol Sci Med Sci 2011; 67:1300-6. [PMID: 21873592 DOI: 10.1093/gerona/glr141] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We examined women in their 80s and 90s and evaluated the hypothesis that abnormalities in the dynamic response of glucose and insulin to a glucose load are associated with frailty status. METHODS We performed a 75 g oral glucose tolerance test in 73 community-dwelling women aged 84-95 years without known diabetes enrolled in the Women's Health and Aging Study II. We examined the association of frailty status (nonfrail, prefrail, or frail) with oral glucose tolerance test glucose and insulin levels at 0, 30, 60, 120, and 180 minutes using multiple linear regression models. RESULTS Using American Diabetes Association criteria, only 27% of older women had normal glucose status, 48% had prediabetes, and 25% had undiagnosed diabetes. Fasting glucose, fasting insulin, homeostasis model of assessment-insulin resistance, and Matsuda index were similar by frailty status, adjusting for age and body mass index. Conversely, mean oral glucose tolerance test glucose levels were higher at 60 minutes (44.6 ± 18.1 mg/dL higher) and 120 minutes (67.1 ± 23.5 mg/dL higher) and to a lesser extent at 180 minutes (44.3 ± 22.5 mg/dL higher) in frail versus nonfrail women as was integrated glucose area after adjustment. Mean 120-minute insulin level was also higher in frail versus nonfrail women (45.7 ± 22.4 μU/mL higher). Overall, glucose and insulin responses were more exaggerated and prolonged in frail versus nonfrail or prefrail women. CONCLUSIONS Our data demonstrate dysregulation in response to glucose challenge as a component of physiologic vulnerability associated with frailty in old-old women. Future studies should examine the timing of abnormal glucose-insulin dynamics with respect to the pathogenesis of frailty.
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Affiliation(s)
- Rita Rastogi Kalyani
- Division of Endocrinology and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA.
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Ghosh S, Lertwattanarak R, Lefort N, Molina-Carrion M, Joya-Galeana J, Bowen BP, de Jesus Garduno-Garcia J, Abdul-Ghani M, Richardson A, DeFronzo RA, Mandarino L, Van Remmen H, Musi N. Reduction in reactive oxygen species production by mitochondria from elderly subjects with normal and impaired glucose tolerance. Diabetes 2011; 60:2051-60. [PMID: 21677280 PMCID: PMC3142073 DOI: 10.2337/db11-0121] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Aging increases the risk of developing impaired glucose tolerance (IGT) and type 2 diabetes. It has been proposed that increased reactive oxygen species (ROS) generation by dysfunctional mitochondria could play a role in the pathogenesis of these metabolic abnormalities. We examined whether aging per se (in subjects with normal glucose tolerance [NGT]) impairs mitochondrial function and how this relates to ROS generation, whether older subjects with IGT have a further worsening of mitochondrial function (lower ATP production and elevated ROS generation), and whether exercise reverses age-related changes in mitochondrial function. RESEARCH DESIGN AND METHODS Mitochondrial ATP and ROS production were measured in muscle from younger individuals with NGT, older individuals with NGT, and older individuals with IGT. Measurements were performed before and after 16 weeks of aerobic exercise. RESULTS ATP synthesis was lower in older subjects with NGT and older subjects with IGT versus younger subjects. Notably, mitochondria from older subjects (with NGT and IGT) displayed reduced ROS production versus the younger group. ATP and ROS production were similar between older groups. Exercise increased ATP synthesis in the three groups. Mitochondrial ROS production also increased after training. Proteomic analysis revealed downregulation of several electron transport chain proteins with aging, and this was reversed by exercise. CONCLUSIONS Old mitochondria from subjects with NGT and IGT display mitochondrial dysfunction as manifested by reduced ATP production but not with respect to increased ROS production. When adjusted to age, the development of IGT in elderly individuals does not involve changes in mitochondrial ATP and ROS production. Lastly, exercise reverses the mitochondrial phenotype (proteome and function) of old mitochondria.
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Affiliation(s)
- Sangeeta Ghosh
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Raweewan Lertwattanarak
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Natalie Lefort
- Center for Metabolic Biology, Arizona State University, Phoenix, Arizona
| | - Marjorie Molina-Carrion
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Joaquin Joya-Galeana
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Benjamin P. Bowen
- Center for Metabolic Biology, Arizona State University, Phoenix, Arizona
- Lawrence Berkeley National Laboratory, Berkeley, California
| | - Jose de Jesus Garduno-Garcia
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Muhammad Abdul-Ghani
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Arlan Richardson
- Sam and Ann Barshop Institute for Longevity and Aging Studies, San Antonio, Texas
- Geriatric Research, Education, and Clinical Center, Audie L. Murphy VA Hospital, San Antonio, Texas
| | - Ralph A. DeFronzo
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Texas Diabetes Institute, San Antonio, Texas
| | - Lawrence Mandarino
- Center for Metabolic Biology, Arizona State University, Phoenix, Arizona
| | - Holly Van Remmen
- Sam and Ann Barshop Institute for Longevity and Aging Studies, San Antonio, Texas
- Geriatric Research, Education, and Clinical Center, Audie L. Murphy VA Hospital, San Antonio, Texas
| | - Nicolas Musi
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Geriatric Research, Education, and Clinical Center, Audie L. Murphy VA Hospital, San Antonio, Texas
- Texas Diabetes Institute, San Antonio, Texas
- Corresponding author: Nicolas Musi,
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Ravikumar P, Bhansali A, Walia R, Shanmugasundar G, Ravikiran M. Alterations in HbA(1c) with advancing age in subjects with normal glucose tolerance: Chandigarh Urban Diabetes Study (CUDS). Diabet Med 2011; 28:590-4. [PMID: 21244476 DOI: 10.1111/j.1464-5491.2011.03242.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To study the alterations in HbA(1c) with advancing age in subjects with normal glucose tolerance. METHODS Community-based cross-sectional study involving 2368 subjects aged ≥ 20 years from Chandigarh, India. All the subjects underwent an oral glucose tolerance test with 75 g anhydrous glucose and were classified as having normal glucose tolerance, pre-diabetes or diabetes according to World Health Organization 1999 criteria. HbA(1c) was measured on a National Glycohemoglobin Standardization Program-certified Bio-Rad D-10 system and the data were available for 1972 subjects. RESULTS Out of 1972 subjects, 1317 (67%) subjects had normal glucose tolerance. There was a significant positive correlation between mean HbA(1c) and age in these subjects (r = 0.308, P(trend) < 0.001). The increase in HbA(1c) with each advancing year was 0.01% above the age of 20 years and corrected HbA(1c) (%) for age was 5.09 + 0.01 (age). The 95th percentile of HbA(1c) exceeded 6.5% (48 mmol/mol) (the American Diabetes Association cut-off for diagnosis of diabetes) in subjects aged ≥ 70 years. A significantly higher number (6.5%, 21/325) of subjects had HbA(1c) of ≥ 6.5% (48 mmol/mol) in those above the age of 50 years compared with those below the age of 50 years (1.7%, 17/992) in the group with normal glucose tolerance (P < 0.001). On multivariate regression analysis, after adjusting for BMI, fasting plasma glucose and 2-h plasma glucose post-glucose load, the correlation of HbA(1c) with age still remained significant (r = 0.241, P < 0.01). CONCLUSION HbA(1c) increases with advancing age independent of glycaemia, suggesting caution when seeking to achieve the recommended HbA(1c) targets in the elderly population.
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Affiliation(s)
- P Ravikumar
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Wijsman CA, Rozing MP, Streefland TCM, le Cessie S, Mooijaart SP, Slagboom PE, Westendorp RGJ, Pijl H, van Heemst D. Familial longevity is marked by enhanced insulin sensitivity. Aging Cell 2011; 10:114-21. [PMID: 21070591 DOI: 10.1111/j.1474-9726.2010.00650.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Insulin resistance is a risk factor for various age-related diseases. In the Leiden Longevity study, we recruited long-lived siblings and their offspring. Previously, we showed that, compared to controls, the offspring of long-lived siblings had a better glucose tolerance. Here, we compared groups of offspring from long-lived siblings and controls for the relation between insulin and glucose in nonfasted serum (n = 1848 subjects) and for quantitation of insulin action using a two-step hyperinsulinemic-euglycemic clamp (n = 24 subjects). Groups of offspring and controls were similar with regard to sex distribution, age, and body mass index. We observed a positive bi-phasic linear relationship between ln (insulin) levels and nonfasted glucose with a steeper slope from 10.7mU L(-1) insulin onwards in controls compared to offspring (P = 0.02). During the clamp study, higher glucose infusion rate was required to maintain euglycemia during high-dose insulin infusion (P = 0.036) in offspring, reflecting higher whole-body insulin sensitivity. After adjustment for sex, age, and fat mass, the insulin-mediated glucose disposal rate (GDR) was higher in offspring than controls (42.5 ± 2.7 vs. 33.2 ± 2.7 micromol kg(-1) min(-1) , mean ± SE, P = 0.025). The insulin-mediated suppression of endogenous glucose production and lipolysis did not differ between groups (all P > 0.05). Furthermore, GDR was significantly correlated with the mean age of death of the parents. In conclusion, offspring from long-lived siblings are marked by enhanced peripheral glucose disposal. Future research will focus on identifying the underlying biomolecular mechanisms, with the aim to promote health in old age.
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Affiliation(s)
- Carolien A Wijsman
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
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Evans WJ, Farrell PA. The Aging Pancreas: Effects of Aging on Insulin Secretion and Action. Compr Physiol 2011. [DOI: 10.1002/cphy.cp070232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kumar Mishra S. Menopausal transition and postmenopausal health problems: a review on its bio-cultural perspectives. Health (London) 2011. [DOI: 10.4236/health.2011.34041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wang Y, Qin MZ, Liu Q, Liu Q, Chang ZW. Clinical analysis of elderly patients with elderly-onset type 2 diabetes mellitus in China: assessment of appropriate therapy. J Int Med Res 2010; 38:1134-41. [PMID: 20819452 DOI: 10.1177/147323001003800342] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Patients with elderly-onset diabetes have specific characteristics. This study was designed to investigate these characteristics and to evaluate methods for appropriate control of glycaemia and cardiovascular risk factors in elderly-onset diabetes patients. A total of 155 elderly patients with type 2 diabetes mellitus were divided into those diagnosed at >or= 65 years of age (elderly-onset group, 75 patients) and those diagnosed at < 60 years of age (usual-onset group, 80 patients). Differences in clinical variables, diabetic complications, diagnosed comorbidities and the use of medications were analysed. Mean glycosylated haemoglobin, fasting plasma glucose and fasting insulin levels were significantly lower in the elderly-onset group than in the usual-onset group. The usual-onset group showed significantly greater homeostasis model assessment insulin resistance than the elderly-onset group. Microvascular complications and insulin use were significantly more common in the usual-onset group. In conclusion, insulin resistance was less severe in elderly-onset diabetes than in usual-onset diabetes. As hyperglycaemia was relatively mild or moderate, oral hypoglycaemic agents might be effective for elderly-onset diabetes.
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Affiliation(s)
- Y Wang
- Department of Geriatrics, Beijing Tong Ren Hospital, Capital Medical University, Beijing, China
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DHEA, important source of sex steroids in men and even more in women. PROGRESS IN BRAIN RESEARCH 2010; 182:97-148. [PMID: 20541662 DOI: 10.1016/s0079-6123(10)82004-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A major achievement from 500 million years of evolution is the establishment of a high secretion rate of dehydroepiandrosterone (DHEA) by the human adrenal glands coupled with the indroduction of menopause which stops secretion of estrogens by the ovary. Cessation of estrogen secretion at menopause eliminates the risks of endometrial hyperplasia and cancer which would result from non-opposed estrogen stimulation during the post-menopausal years. In fact, from the time of menopause, DHEA becomes the exclusive and tissue-specific source of sex steroids for all tissues except the uterus. Intracrinology, a term coined in 1988, describes the local formation, action and inactivation of sex steroids from the inactive sex steroid precursor DHEA. Over the past 25 years most, if not all, the genes encoding the human steroidogenic and steroid-inactivating enzymes have been cloned and sequenced and their enzymatic activity characterized. The problem with DHEA, however, is that its secretion decreases from the age of 30 years and is already decreased, on average, by 60% at time of menopause. In addition, there is a large variability in the circulating levels of DHEA with some post-menopausal women having barely detectable serum concentrations of the steroid while others have normal values. Since there is no feedback mechanism controlling DHEA secretion within 'normal' values, women with low DHEA will remain with such a deficit of sex steroids for their remaining lifetime. Since there is no other significant source of sex steroids after menopause, one can reasonably believe that low DHEA is involved, in association with the aging process, in a series of medical problems classically associated with post-menopause, namely osteoporosis, muscle loss, vaginal atrophy, fat accumulation, hot flashes, skin atrophy, type 2 diabetes, memory loss, cognition loss and possibly Alzheimer's disease. A recent randomized, placebo-controlled study has shown that all the signs and symptoms of vaginal atrophy, a classical problem recognized to be due to the hormone deficiency of menopause, can be rapidly improved or corrected by local administration of DHEA without systemic exposure to estrogens. In addition, the four domains of sexual dysfucntion are improved. For the other problems of menopause, although similar large scale, randomized and placebo-controlled studies usually remain to be performed, the available evidence already strongly suggests that they could be improved, corrected or even prevented by exogenous DHEA. In men, the contribution of adrenal DHEA to the total androgen pool has been measured at 40% in 65-75-year-old men. Such data stress the necessity of blocking both the testicular and adrenal sources of androgens in order to achieve optimal benefits in prostate cancer therapy. On the other hand, the comparable decrease in serum DHEA levels observed in both sexes has less consequence in men who continue to receive a practically constant supply of testicular sex steroids during their whole life. In fact, in men, the appearance of hormone-deficiency symptoms common to women is observed at a later age and with a lower degree of severity. Consequently, DHEA replacement has shown much more easily measurable beneficial effects in women. Most importantly, despite the non-scientific and unfortunate availability of DHEA as a food supplement in the United States, a situation that discourages rigorous clinical trials on the crucial physiological and therapeutic role of DHEA, no serious adverse event related to DHEA has ever been reported in the world literature (thousands of subjects exposed) or in the monitoring of adverse events by the FDA (millions of subjects exposed), thus indicating, as expected from its known physiology, the excellent safety profile of DHEA. With today's knowledge, one can reasonably suggest that DHEA offers the promise of a safe and efficient replacement therapy for the multiple problems related to hormone deficiency after menopause without the risks associated with estrogen-based or any other treatments.
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Rosso D, Campagna S, Di Stefano F, Romano G, Maugeri D, Maggi S, Motta M, Catanzaro S, Carnazzo G. Prevalence of diabetes mellitus in a sample of the elderly population of the city of Catania. Arch Gerontol Geriatr 2009; 27:223-35. [PMID: 18653165 DOI: 10.1016/s0167-4943(98)00114-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/1998] [Revised: 05/21/1998] [Accepted: 05/27/1998] [Indexed: 10/18/2022]
Abstract
The prevalence of diabetes mellitus is increasing world-wide, even if it varies markedly in the geographical areas and populations investigated. This study is part of the Progetto Finalizzato Invecchiamento (Aging Project) of the Italian NCR (National Research Council) and is aimed at investigating the prevalence of diabetes and selected clinical characteristics in a study sample aged between 65 and 84 years of age resident in Catania (Italy). The prevalence rate for type II diabetes was 22.8% and it is certainly among the highest values recorded to date in other areas of Italy and abroad. We distinguished between two forms of diabetes in subjects >70 years of age: aged diabetes with onset in middle age (AD); and diabetes of senescence with onset after 70 years of age (DS). Prevalence rate was 18% for AD and 4.8% for DS, respectively. The age-specific rates of AD and DS show the progressive lower prevalence rates of the former and the higher rates of the latter. We assume that DS is mainly caused by atherosclerotic processes and represents the typical form of diabetes in the elderly.
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Affiliation(s)
- D Rosso
- Institute of Internal Medicine and Geriatrics, University of Catania, Via Messina 829, 95126 Catania, Italy
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Abstract
Type 2 diabetes mellitus affects 5.9% of the world adult population, with older people and some ethnic groups disproportionately affected. Treatment of older people with diabetes differs in many ways from that in younger adults since the majority have type 2 disease and are at particular risk of macrovascular rather than disabling microvascular disease. Insulin therapy, the most effective of diabetes medications, can reduce any level of elevated HBA1c if used in adequate doses. However, some clinicians are often reluctant to initiate insulin therapy in older people with diabetes mainly out of their concerns about adverse reactions to insulin, particularly hypoglycemia. There is evidence suggesting that insulin aspart appears to act similarly to regular human insulin in older people with type 2 diabetes mellitus. Insulin aspart can be used in the treatment of older people with diabetes, but this should be individualized. There is evidence that it improves postprandial glucose control, improves long-term metabolic control, reduces risk of major nocturnal hypoglycemia and increases patient satisfaction compared with soluble insulin.
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Affiliation(s)
- Eltayeb Marouf
- Institute of Diabetes for Older People – IDOP, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire, UK
| | - Alan J Sinclair
- Institute of Diabetes for Older People – IDOP, Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire, UK
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