1
|
Yoshino H, Kawakami K, Yoshino K, Yoshino G. Prominent Hyperproinsulinemia in a Middle Age Patient. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211042241. [PMID: 34483693 PMCID: PMC8414601 DOI: 10.1177/11795476211042241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022]
Abstract
Introduction: Insulin is synthesized in the β-cells from preproinsulin. Preproinsulin
becomes proinsulin after leaving the signal peptide. Proinsulin is separated
into C-peptide and insulin by 2 enzymes. Hyperproinsulinemia is suspected to
be a pancreatic β-cell defect that is augmented by the increased demand
placed on the β-cell by hyperglycemia. Case presentation: A 39-year-old Japanese man visited to Shin-suma hospital in May 2013. Liver
dysfunction, dyslipidemia, and hyperuricemia had been found in medical
checkups in his workplace. Therefore, he visited Shin-suma hospital in order
to receive intensive examination. Diet and exercise therapy were initiated.
In November 2013, intact proinsulin and proinsulin per insulin (PI/I) ratio
were evaluated as part of an ongoing study. His intact proinsulin level and
PI/I ratio were markedly elevated. A 75 g oral OGTT revealed that his
glucose tolerance was impaired. His glycosylated hemoglobin was 6.9%. He was
diagnosed as having type 2 diabetes mellitus. Although, diet and exercise
therapy continued, his hyperproinslinemia and diabetes mellitus remained.
Therefore, aloguliptin was started in order to recover insulin secretion in
November 2014. Thereafter, pioglitazone was added to improve insulin
resistance. Finally, luseogliflozin was commenced to expect glucose-lowering
effects. His HbA1c was stabilized. To the best of our knowledge, there have
been few reports of patients with hyperproinsulinemia. Conclusion: When the physicians face treatment resistance in diabetes mellitus, we
emphasize that evaluation of proinsulin should be considered as one of the
methods.
Collapse
Affiliation(s)
- Hiroshi Yoshino
- Department of Geriatrics and Cognitive
Disorders, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Center for Diabetes, Shin-suma General
Hospital, Kobe, Japan
- Hiroshi Yoshino, Department of Geriatrics
and Cognitive Disorders, Fujita Health University School of Medicine, 98-1,
Dengakubo, Kutsugake-cho, Toyoake City, Aichi 470-1192, Japan.
| | - Kyoko Kawakami
- Center for Diabetes, Shin-suma General
Hospital, Kobe, Japan
| | - Kei Yoshino
- Division of Diabetes and Endocrinology,
Department of Internal of Medicine, Kobe University Graduate School of Medicine,
Kobe, Japan
| | - Gen Yoshino
- Center for Diabetes, Shin-suma General
Hospital, Kobe, Japan
| |
Collapse
|
2
|
Li T, Quan H, Zhang H, Lin L, Lin L, Ou Q, Chen K. Subgroup analysis of proinsulin and insulin levels reveals novel correlations to metabolic indicators of type 2 diabetes. Aging (Albany NY) 2020; 12:10715-10735. [PMID: 32532930 DOI: 10.18632/aging.103289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/27/2020] [Indexed: 11/25/2022]
Abstract
Proinsulin, insulin and proinsulin/insulin (P/I) ratio have been reported to be correlated with fasting plasma glucose (FPG) and Hemoglobin A1c (HbA1c) in whole population study therefore sensitive predictors of T2D progression. However, by analyzing data collected from 2018-2019 from a cohort of 1579 East Asian individuals from Hainan Province of China, we find that the associations of proinsulin, insulin and P/I ratio with diabetic indicators have distinct, sometimes opposite regression patterns in normal, prediabetic and diabetic subgroups. The strength of the associations are generally weak in normal and prediabetic groups, and only moderate in diabetic group between postprandial proinsulin and HbA1c, between postprandial insulin and FPG or HbA1c, and between postprandial P/I ratio and FPG or HbA1c. Receiver operating characteristic (ROC) curve analysis shows these parameters are weaker than age in predicting diabetes development, with P/I ratio being the weakest. Proinsulin and insulin levels are tightly associated with insulin sensitivity across all subgroups, as measured by Matsuda index. Together, our results suggest that proinsulin, insulin or P/I ratio are weak predictors of diabetes development in the whole population, urging the need for stratifying strategies and novel perspectives in evaluating and predicting hyperglycemia progression.
Collapse
Affiliation(s)
- Tangying Li
- Department of Health Care Centre, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Huachuan Zhang
- Department of Endocrinology Laboratory, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Lu Lin
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Qianying Ou
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, Hainan, China
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, Hainan, China
| |
Collapse
|
3
|
Peters V, Yard B, Schmitt CP. Carnosine and Diabetic Nephropathy. Curr Med Chem 2020; 27:1801-1812. [DOI: 10.2174/0929867326666190326111851] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/25/2018] [Accepted: 11/01/2018] [Indexed: 11/22/2022]
Abstract
Diabetic Nephropathy (DN) is a major complication in patients with type 1 or type 2 diabetes
and represents the leading cause of end-stage renal disease. Novel therapeutic approaches are
warranted. In view of a polymorphism in the carnosinase 1 gene CNDP1, resulting in reduced
carnosine degradation activity and a significant DN risk reduction, carnosine (β-alanyl-L-histidine)
has gained attention as a potential therapeutic target. Carnosine has anti-inflammatory, antioxidant,
anti-glycation and reactive carbonyl quenching properties. In diabetic rodents, carnosine supplementation
consistently improved renal histology and function and in most studies, also glucose metabolism.
Even though plasma half-life of carnosine in humans is short, first intervention studies in (pre-)
diabetic patients yielded promising results. The precise molecular mechanisms of carnosine mediated
protective action, however, are still incompletely understood. This review highlights the recent
knowledge on the role of the carnosine metabolism in DN.
Collapse
Affiliation(s)
- Verena Peters
- Centre for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Benito Yard
- Vth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Claus Peter Schmitt
- Centre for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
4
|
El-Messallamy FAF, El-Ashmawy HM, El Shabrawy AM, Radwan SE. Proinsulin/insulin ratio as a predictor of insulin resistance in patients with diabetic nephropathy. Diabetes Metab Syndr 2019; 13:2057-2060. [PMID: 31235136 DOI: 10.1016/j.dsx.2019.04.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/22/2019] [Indexed: 02/03/2023]
Abstract
Patients with Diabetic nephropathy (DN) have an increase in cardiovascular mortality, and since IR may be a contributing factor. Therefore, the aim of this study was to assess the role of pro insulin/insulin ratio as a predictor of insulin resistance in patients with diabetic nephropathy PATIENTS AND METHODS: A Case-control study was conducted in a total of 50 patients who diagnosed with type 2 diabetes mellitus from July 2017 to March 2018. The patients were divided into 2 groups according to presence of diabetic nephropathy. Demographic and clinical data were collected. RESULTS: There is a significant increase in serum pro insulin/insulin ratio in patients with diabetic nephropathy patients compared to patients without diabetic nephropathy An association was found between increase serum pro insulin/insulin ratio and increase predicting of insulin resistance. Cut-off value of serum pro insulin/insulin ratio ≥0.1145 with sensitivity and specificity of 92.3 and 60.3 respectively as a predictor for insulin resistance CONCLUSION: This study demonstrate a strong relationship between insulin resistance and CKD and this relationship was stronger in the presence of obesity. Pro insulin/insulin ratio was found to be a significant predictor for insulin resistance.
Collapse
Affiliation(s)
- Fawzy A F El-Messallamy
- Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hazem M El-Ashmawy
- Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Arafa M El Shabrawy
- Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Samia E Radwan
- Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
5
|
Zhang WQ, Tian Y, Chen XM, Wang LF, Chen CC, Qiu CM. Liraglutide ameliorates beta-cell function, alleviates oxidative stress and inhibits low grade inflammation in young patients with new-onset type 2 diabetes. Diabetol Metab Syndr 2018; 10:91. [PMID: 30564288 PMCID: PMC6296090 DOI: 10.1186/s13098-018-0392-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes in youth is escalating rapidly. We aimed to evaluate the effects of liraglutide on beta-cell function, metabolic productions of oxidative stress, low grade inflammation compared with metformin in young patients with recent onset type 2 diabetes mellitus. METHODS Sixty patients were randomly assigned to receive 8-week liraglutide or metformin treatment. Beta-cell function was assessed by modified beta cell function index (MBCI), early phase of insulin secretion index (ΔI30/ΔG30), proinsuin to insulin ratio (P/I) and the insulin area under the curve (AUCins). The expression of 8-OH-dG and 8-iso-PGF2α and hs-C-reactive protein (hs-CRP) were measured as indications of oxidative stress and low grade inflammation. RESULTS After 8 weeks liraglutide treatment, MBCI, ΔI30/ΔG30, AUCins significantly increased, 8-OH-dG, 8-iso-PGF2α, P/I and hs-CRP remarkably reduced. The differences before and after 8-week liraglutide treatment in ΔMBCI (11.1 [2.81, 43.08] vs 0.00 [- 8.16, 10.47], P = 0.017), ΔLNΔI30/ΔG30 (0.44 [0.04, 0.85] vs - 0.09 [- 0.33, 0.36], P = 0.049), ΔAUCins (117 [- 8, 376] vs - 21 [- 314, 109] mIU/L, P = 0.013), ΔP/I (- 0.05 [- 0.09, - 0.03] vs - 0.02 [- 0.04, 0.01], P = 0.026)were remarkably enhanced compared to those of the metformin therapy. The expression of 8-OH-dG, 8-iso-PGF2α and hs-CRP also decreased after 8-week metformin treatment. CONCLUSIONS These data demonstrated that liraglutide administration was more effective on ameliorating beta-cell function than metformin treatment in young patients with new-onset type 2 diabetes mellitus. Both liraglutide and metformin could alleviate the level of oxidative stress and attenuate low grade inflammatory, we speculate this effect may not the main mechanism of beta-cell function improvement by liraglutide in diabetic patients.Trial registration Chinese Clinical Trials registry, chiCTR1800018008, Registered 27 August 2018-retrospectively registered.
Collapse
Affiliation(s)
- Wen-qiang Zhang
- Department of Endocrinology and Metabolism, Zhongshan Hospital Xiamen University, 201-209 Hubin South Road, Xiamen, 361004 China
| | - Yuan Tian
- Department of Endocrinology and Metabolism, Zhongshan Hospital Xiamen University, 201-209 Hubin South Road, Xiamen, 361004 China
| | - Xiao-min Chen
- Department of Endocrinology and Metabolism, Zhongshan Hospital Xiamen University, 201-209 Hubin South Road, Xiamen, 361004 China
| | - Li-fen Wang
- Guangzhou Medicine University Second Affiliated Hospital, 250-296 Changgang East Road, Guangzhou, 510260 China
| | - Chan-chan Chen
- Department of Endocrinology and Metabolism, Zhongshan Hospital Xiamen University, 201-209 Hubin South Road, Xiamen, 361004 China
| | - Chuan-mei Qiu
- Department of Endocrinology and Metabolism, Zhongshan Hospital Xiamen University, 201-209 Hubin South Road, Xiamen, 361004 China
| |
Collapse
|
6
|
Prasad C, Davis KE, Imrhan V, Juma S, Vijayagopal P. Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification. Am J Lifestyle Med 2017; 13:384-404. [PMID: 31285723 DOI: 10.1177/1559827617708991] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 12/17/2022] Open
Abstract
Advanced glycation end products (AGEs) are a family of compounds of diverse chemical nature that are the products of nonenzymatic reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs bind to one or more of their multiple receptors (RAGE) found on a variety of cell types and elicit an array of biologic responses. In this review, we have summarized the data on the nature of AGEs and issues associated with their measurements, their receptors, and changes in their expression under different physiologic and disease states. Last, we have used this information to prescribe lifestyle choices to modulate AGE-RAGE cycle for better health.
Collapse
Affiliation(s)
- Chandan Prasad
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, Texas (CP, VI, SJ, PV).,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas (KED)
| | - Kathleen E Davis
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, Texas (CP, VI, SJ, PV).,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas (KED)
| | - Victorine Imrhan
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, Texas (CP, VI, SJ, PV).,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas (KED)
| | - Shanil Juma
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, Texas (CP, VI, SJ, PV).,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas (KED)
| | - Parakat Vijayagopal
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, Texas (CP, VI, SJ, PV).,Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas (KED)
| |
Collapse
|
7
|
Baye E, Ukropcova B, Ukropec J, Hipkiss A, Aldini G, de Courten B. Physiological and therapeutic effects of carnosine on cardiometabolic risk and disease. Amino Acids 2016; 48:1131-49. [PMID: 26984320 DOI: 10.1007/s00726-016-2208-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/25/2016] [Indexed: 12/12/2022]
Abstract
Obesity, type 2 diabetes (T2DM) and cardiovascular disease (CVD) are the most common preventable causes of morbidity and mortality worldwide. They represent major public health threat to our society. Increasing prevalence of obesity and T2DM contributes to escalating morbidity and mortality from CVD and stroke. Carnosine (β-alanyl-L-histidine) is a dipeptide with anti-inflammatory, antioxidant, anti-glycation, anti-ischaemic and chelating roles and is available as an over-the-counter food supplement. Animal evidence suggests that carnosine may offer many promising therapeutic benefits for multiple chronic diseases due to these properties. Carnosine, traditionally used in exercise physiology to increase exercise performance, has potential preventative and therapeutic benefits in obesity, insulin resistance, T2DM and diabetic microvascular and macrovascular complications (CVD and stroke) as well as number of neurological and mental health conditions. However, relatively little evidence is available in humans. Thus, future studies should focus on well-designed clinical trials to confirm or refute a potential role of carnosine in the prevention and treatment of chronic diseases in humans, in addition to advancing knowledge from the basic science and animal studies.
Collapse
Affiliation(s)
- Estifanos Baye
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC, 3168, Australia.,Department of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Barbara Ukropcova
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia.,Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Jozef Ukropec
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Alan Hipkiss
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Giancarlo Aldini
- Department of Pharmaceutical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC, 3168, Australia. .,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC, 3168, Australia.
| |
Collapse
|
8
|
Imai S, Takahashi T, Naito S, Yamauchi A, Okada C, Notsu Y, Sakikawa I, Hatanaka M, Iwasaki T, Morita A, Fujii I, Yamane S. Development of a novel immunoassay specific for mouse intact proinsulin. Anal Biochem 2015; 484:91-8. [DOI: 10.1016/j.ab.2015.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/13/2015] [Accepted: 05/18/2015] [Indexed: 11/16/2022]
|
9
|
Lu J, Zang J, Li H. Impact of three oral antidiabetic drugs on markers of β-cell function in patients with type 2 diabetes: a meta-analysis. PLoS One 2013; 8:e76713. [PMID: 24204660 PMCID: PMC3808360 DOI: 10.1371/journal.pone.0076713] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 08/24/2013] [Indexed: 01/09/2023] Open
Abstract
Background The effect of metformin, pioglitazone and sitagliptin on β-cell function in the treatment of type 2 diabetes is controversial. Therefore, we performed a systematic review and meta-analysis to obtain a better understanding in the β-cell effects of metformin, pioglitazone and sitagliptin. Methods We searched Pubmed and the Cochrane Center Register of Controlled Trials to identify relevant studies. Trials investigating effects of sitagliptin, metformin or pioglitazone on β-cell function were identified. The primary outcomes were homeostasis model assessment of β-cells (HOMA-β) and proinsulin/insulin ratio (PI/IR). Secondary outcome was hemoglobin A1c level. We used version 2 of the Comprehensive Meta Analysis software for all statistical analyses. Results Metformin monotherapy was more effective than sitagliptin in improving HOMA-β (18.01% (95% CI 11.09% to 24.94%) vs. 11.29% (95% CI 9.21% to 13.37%), P = 0.040) and more effective (−0.137 (95% CI −0.082 to −0.192)) than both sitagliptin (−0.064 (95% CI −0.036 to −0.092), P = 0.019) and pioglitazone (−0.068 (95% CI −0.044 to −0.093), P = 0.015) in decreasing PI/IR. Metformin and sitagliptin combined (40.23% (95%CI 32.30% to 48.16%)) were more effective than sitagliptin and pioglitazone (11.82% (95% CI 6.61% to 17.04%), P = 0.000) and pioglitazone and metformin(9.81% (95% CI 1.67% to 17.95%), P = 0.022) in improving HOMA-β and decreasing PI/IR (−0.177 (95% CI −0.118 to −0.237); −0.080 (95% CI −0.045 to −0.114), P = 0.007; −0.038 (95% CI, −0.005 to 0.071), P = 0.023). Limitations The included RCTs were of short duration (12–54 weeks). We could not determine long term effects on β-cells. Conclusions Metformin improves β-cell function more effectively than pioglitazone or sitagliptin in type 2 diabetes patients. Metformin and sitagliptin improved HOMA-β and PI/IR more than other combinations.
Collapse
Affiliation(s)
- Jin Lu
- Department of Endocrinology, Changhai hospital, Second Military Medical University, Shanghai, China
- * E-mail:
| | - Jiajie Zang
- Department of Nutrition Hygiene, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huihua Li
- Department of Endocrinology, Changhai hospital, Second Military Medical University, Shanghai, China
| |
Collapse
|
10
|
Puddu A, Sanguineti R, Mach F, Dallegri F, Viviani GL, Montecucco F. Update on the protective molecular pathways improving pancreatic beta-cell dysfunction. Mediators Inflamm 2013; 2013:750540. [PMID: 23737653 PMCID: PMC3659509 DOI: 10.1155/2013/750540] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 04/10/2013] [Indexed: 12/16/2022] Open
Abstract
The primary function of pancreatic beta-cells is to produce and release insulin in response to increment in extracellular glucose concentrations, thus maintaining glucose homeostasis. Deficient beta-cell function can have profound metabolic consequences, leading to the development of hyperglycemia and, ultimately, diabetes mellitus. Therefore, strategies targeting the maintenance of the normal function and protecting pancreatic beta-cells from injury or death might be crucial in the treatment of diabetes. This narrative review will update evidence from the recently identified molecular regulators preserving beta-cell mass and function recovery in order to suggest potential therapeutic targets against diabetes. This review will also highlight the relevance for novel molecular pathways potentially improving beta-cell dysfunction.
Collapse
Affiliation(s)
- Alessandra Puddu
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Roberta Sanguineti
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genova, Italy
| | - François Mach
- Division of Cardiology, Geneva University Hospitals, Faculty of Medicine, Foundation for Medical Researches, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland
| | - Franco Dallegri
- First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Giorgio Luciano Viviani
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Fabrizio Montecucco
- Division of Cardiology, Geneva University Hospitals, Faculty of Medicine, Foundation for Medical Researches, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland
- First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genova, Italy
| |
Collapse
|
11
|
Yu P, Li Q, Liu F, Sun Y, Zhang J. Relationship between proinsulin and beta cell function in different states of glucose tolerance. Int J Diabetes Dev Ctries 2012. [DOI: 10.1007/s13410-012-0089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
12
|
Shu T, Zhu Y, Wang H, Lin Y, Ma Z, Han X. AGEs decrease insulin synthesis in pancreatic β-cell by repressing Pdx-1 protein expression at the post-translational level. PLoS One 2011; 6:e18782. [PMID: 21533167 PMCID: PMC3078922 DOI: 10.1371/journal.pone.0018782] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 03/10/2011] [Indexed: 01/13/2023] Open
Abstract
Advanced glycation end products (AGEs) have been implicated in diverse pathological settings of many diabetic complications, and the possible mechanisms have been widely reported. However, the relationship between AGEs and pancreatic β-cell dysfunction is still poorly understood. Recent studies have shown that AGEs can impair β-cell function by inducing apoptosis or decreasing insulin secretion. Our previous research revealed that AGEs could significantly down-regulate insulin transcription and reduce β-cell glucose-stimulated insulin secretion (GSIS). Here, we investigated the possible mechanisms underlying AGE-related suppression of insulin synthesis. In the rat pancreatic β-cell line INS-1, we found that AGEs induced dephosphorylation of Foxo1 and increased its accumulation in the nucleus. The translocation of Foxo1 subsequently inhibited pancreatic-duodenal homeobox factor-1 (Pdx-1) levels in both nuclear and cytoplasmic compartments. We observed that with AGEs treatment, Pdx-1 protein levels decreased after 4 h, but there was no change in the Pdx-1 mRNA level or promoter activity at the same time point; this demonstrated that the decrease in Pdx-1 expression was not regulated at the transcriptional level. In our study, the decrease in Pdx-1 protein level was related to its reduced stability, overexpression of DN-Foxo1 could partially reverse the inhibition of Pdx-1 expression. Pretreatment with AGEs receptor (RAGE) antibody also prevented the AGE-induced diminution of Pdx-1 protein and insulin mRNA expression. In summary, AGEs induced nuclear accumulation of Foxo1; this in turn reduced Pdx-1 expression by decreasing its protein stability, ultimately affecting insulin synthesis.
Collapse
Affiliation(s)
- Tingting Shu
- Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yunxia Zhu
- Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongdong Wang
- Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Lin
- Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhuo Ma
- Hubei University of Technology, Wuhan, Hubei, China
| | - Xiao Han
- Key Laboratory of Human Functional Genomics of Jiangsu Province, Nanjing Medical University, Nanjing, Jiangsu, China
- * E-mail:
| |
Collapse
|
13
|
Saisho Y, Miyakoshi K, Tanaka M, Shimada A, Ikenoue S, Kadohira I, Yoshimura Y, Itoh H. Beta cell dysfunction and its clinical significance in gestational diabetes. Endocr J 2010; 57:973-80. [PMID: 20847480 DOI: 10.1507/endocrj.k10e-231] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The aim of this study is to explore beta cell dysfunction and its clinical significance in gestational diabetes mellitus (GDM). We assessed insulin sensitivity and insulin secretion in a total of 277 Japanese women between 24 and 27 weeks of pregnancy who underwent a 2 h, 75 g oral glucose tolerance test (OGTT) because of an abnormal result on a 1 h 50 g oral glucose challenge conducted as part of a standard screening for GDM. Insulin sensitivity was evaluated by an insulin sensitivity index derived from OGTT (IS(OGTT)), whereas insulin secretion was calculated as a ratio of the total area under the insulin curve to the total area under the glucose curve (AUC(ins/glu)). Beta cell function in relation to insulin sensitivity (i.e. disposition index) was derived from the product of insulin sensitivity and insulin secretion (i.e. AUC(ins/glu) × IS(OGTT)). In women diagnosed with GDM (n=57), the disposition index was significantly lower than that in those without GDM, irrespective of obesity. The disposition index in women with GDM was significantly correlated with levels of fasting and mean preprandial capillary glucose and HbA1c before initiating insulin therapy (r = -0.45, -0.38, -0.49, respectively). Furthermore, there was a significant correlation between the disposition index and total insulin dosage to achieve glycemic goal (r = -0.41). In conclusion, we demonstrated beta cell dysfunction in Japanese women with GDM irrespective of obesity. The level of beta cell dysfunction in GDM was associated with the severity of glucose intolerance and total insulin dosage required. These findings underpin clinical significance of beta cell dysfunction in GDM.
Collapse
Affiliation(s)
- Yoshifumi Saisho
- Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Abstract
BACKGROUND Progressive beta-cell dysfunction and beta-cell failure are fundamental pathogenic consequences of type 2 diabetes. Dipeptidyl peptidase-IV inhibitors may exhibit improvement on preclinical measures of both beta-cell function, homeostasis model assessment of beta-cell (HOMA-beta) index, and beta-cell dysfunction, proinsulin/insulin ratio (PI/IR), correlating to beta-cell survival. RESEARCH DESIGN AND METHODS A systematic literature search through July 2008 was conducted to extract a consensus of randomized, controlled trials of sitagliptin therapy on measures of beta-cell function. A random-effects model meta-analysis evaluated effects on HOMA-beta and PI/IR versus placebo. Several subgroup analyses, including active control, were conducted. Studies were included if they met the following criteria: (1) randomized trials on sitagliptin; (2) placebo or active control; and (3) data reported on HOMA-beta or PI/IR. RESULTS A total of 11 trials (n = 3039) reported effects on HOMA-beta and 8 trials (n = 2325) on PI/IR versus placebo. Four trials (n = 1425) were included in the active control subgroup analysis. Sitagliptin significantly improved HOMA-beta index by 12.03% [95% confidence interval (CI), 9.45-14.60] versus placebo. Sitagliptin also significantly decreased PI/IR -0.06 (95% CI, -0.08 to -0.04). Sitagliptin was inferior to active control for HOMA-beta index [5.64% (95% CI, 0.38-10.90)], but not different in terms of PI/IR [0.01 (95% CI, -0.04 to 0.06)]. CONCLUSIONS Despite significant improvement in HOMA-beta index and PI/IR from placebo, there does not seem to be a benefit of dipeptidyl peptidase-IV inhibitors over other agents with respect to beta-cell function/activity. Long-term prevention of beta-cell dysfunction cannot be ruled out.
Collapse
|
15
|
Abstract
Sitagliptin (Januvia™) is a new oral agent approved by the US FDA to treat Type 2 diabetes. This is the first approved agent in a new class of antihyperglycemics, dipeptidyl peptidase (DPP)-4 inhibitors. Sitagliptin selectively inhibits the action of DPP-4, the primary enzyme degrading the incretin hormones, allowing glucagon-like peptide-1 and glucose-dependent insulinotropic peptide to facilitate glucose regulation in response to a meal. Studies demonstrate that sitagliptin decreases hemaglobin A1c, postprandial glucose excursion and fasting plasma glucose. Sitagliptin presents some advantages over other drugs used in the management of diabetes. One advantage is its oral administration; another, is its low incidence of hypoglycemia, similar to that of a placebo. Sitagliptin has a low incidence of adverse events, consisting of stomach discomfort, diarrhea, upper respiratory infection, stuffy or runny nose, sore throat and headache. Unlike many other drugs used to treat diabetes, sitagliptin does not cause weight gain. Animal studies have shown that it can help prevent β-cell apoptosis and improve β-cell functioning; therefore, it may have a role in preventing diabetes, although human data are currently lacking.
Collapse
Affiliation(s)
- Joan K Bardsley
- a MedStar Research Institute, 6495 New Hampshire Avenue, Suite 201, Hyattsville, MD 20783, USA.
| | - Robert E Ratner
- b MedStar Research Institute, 6495 New Hampshire Avenue, Suite 201, Hyattsville, MD 20783, USA.
| |
Collapse
|