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Li Y, Bharath LP, Qian Y, Ruan T, Anandh Babu PV, Bruno RS, Symons JD, Jalili T. γ-Carboxyethyl hydroxychroman, a metabolite of γ-tocopherol, preserves nitric oxide bioavailability in endothelial cells challenged with high glucose. Exp Biol Med (Maywood) 2016; 241:2056-2062. [PMID: 27465143 DOI: 10.1177/1535370216661780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Endothelial dysfunction occurs when there are imbalances between factors that regulate the synthesis and degradation of nitric oxide (NO•), and has been reported in patients with hyperglycemia and insulin resistance. We reported that supplementation with γ-tocopherol (γ-T) in humans limits impairments in endothelial function otherwise induced by postprandial hyperglycemia. Given the rapid metabolism of γ-T into γ-carboxyethyl hydroxychroman (γ-CEHC), we hypothesized that the vasoprotective activities of γ-T could be attributed to its metabolite γ-CEHC. To test this, human aortic endothelial cells (HAECs) treated with 0 (vehicle control) or 3 µM γ-CEHC for 24 h prior to incubation with normal (5 mM) or high (25 mM) glucose for 48 h. High-glucose increased levels of uncoupled endothelial nitric oxide synthase (eNOS) as evidenced by reduced ( p < 0.05) eNOS dimer:monomer. High glucose also prevented insulin-stimulated increases in p-AktSer473: total Akt, p-eNOSSer1177: total eNOS, and NO• production. These adverse changes were accompanied by increased ( p < 0.05) reactive oxygen species and mRNA expression of inflammatory mediators (VCAM-1, E-selectin, IL-8). However, each deleterious response evoked by high glucose was prevented when HAECs were incubated with γ-CEHC prior to the high glucose challenge. Taken together, our data support the hypothesis that vascular protection provided by γ-T in vivo may be elicited through the bioactivity of its metabolite, γ-CEHC. Furthermore, it is possible that the antioxidant and anti-inflammatory activities of γ-CEHC may mediate this protective activity.
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Affiliation(s)
- Youyou Li
- 1 Department of Aerospace Physiology, Fourth Military Medical University, Xi'an 710032, China
- 2 Division of Endocrinology, Metabolism, and Diabetes, University of Utah, Salt Lake City, UT 84112, USA
- 3 Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
| | - Leena P Bharath
- 2 Division of Endocrinology, Metabolism, and Diabetes, University of Utah, Salt Lake City, UT 84112, USA
- 3 Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
| | - Ying Qian
- 4 Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Ting Ruan
- 2 Division of Endocrinology, Metabolism, and Diabetes, University of Utah, Salt Lake City, UT 84112, USA
| | | | - Richard S Bruno
- 5 Department of Nutrition, Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - J David Symons
- 2 Division of Endocrinology, Metabolism, and Diabetes, University of Utah, Salt Lake City, UT 84112, USA
- 3 Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
- 4 Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Thunder Jalili
- 4 Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
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Papanas N, Ziegler D. Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015. Rev Diabet Stud 2015; 12:48-62. [PMID: 26676661 PMCID: PMC5397983 DOI: 10.1900/rds.2015.12.48] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 04/27/2015] [Accepted: 05/07/2015] [Indexed: 01/01/2023] Open
Abstract
Distal symmetric sensorimotor polyneuropathy (DSPN) is the most common neurological manifestation in diabetes. Major risk factors of DSPN include diabetes duration, hyperglycemia, and age, followed by prediabetes, hypertension, dyslipidemia, and obesity. Height, smoking, insulin resistance, hypoinsulinemia, and others represent an additional risk. Importantly, hyperglycemia, hypertension, dyslipidemia, obesity, and smoking are modifiable. Stringent glycemic control has been shown to be effective in type 1, but not to the same extent in type 2 diabetes. Antilipidemic treatment, especially with fenofibrate, and multi-factorial intervention have produced encouraging results, but more experience is necessary. The major comorbidities of DSPN are depression, autonomic neuropathy, peripheral arterial disease, cardiovascular disease, nephropathy, retinopathy, and medial arterial calcification. Knowledge of risk factors and comorbidities has the potential to enrich the therapeutic strategy in clinical practice as part of the overall medical care for patients with neuropathy. This article provides an updated overview of DSPN risk factors and comorbidities.
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Affiliation(s)
- Nikolaos Papanas
- Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Ziegler D, Buchholz S, Sohr C, Nourooz-Zadeh J, Roden M. Oxidative stress predicts progression of peripheral and cardiac autonomic nerve dysfunction over 6 years in diabetic patients. Acta Diabetol 2015; 52:65-72. [PMID: 24898524 DOI: 10.1007/s00592-014-0601-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/17/2014] [Indexed: 12/11/2022]
Abstract
Oxidative stress is implicated in the pathogenesis of experimental diabetic neuropathy, but prospective studies in diabetic patients are lacking. We aimed to evaluate whether the plasma levels of various biomarkers of oxidative stress predict the progression of diabetic neuropathy and mortality over 6 years. We followed 89 diabetic patients aged 54 ± 14 years (59 % with polyneuropathy), 72 of whom underwent nerve function reassessment after 6.2 ± 0.8 years, whereas 17 died after 4.2 ± 1.0 years. Plasma markers of oxidative stress at baseline included superoxide anion, hypochlorous acid, peroxynitrite, 8-iso-prostaglandin F2α, vitamin E/lipid ratio, and vitamin C. Neuropathy was assessed by symptoms and deficits, motor and sensory nerve conduction velocity (MNCV, SNCV), vibration perception thresholds (VPT), thermal detection thresholds, and heart rate variability (HRV). Despite a reduction in HbA1c by 1.4 ± 1.6 % (p < 0.001), median SNCV, sural SNCV, peroneal MNCV, malleolar VPT, and warm TDT deteriorated after 6 years (all p < 0.05). In multivariate models, increased superoxide generation was associated with a decline in median SNCV (β = -0.997; p = 0.036) and deterioration in HRV at rest (OR 1.63 [95 % CI 1.09-2.44]; p = 0.017) over 6 years. Low vitamin E/lipid ratio tended to predict a decrease in peroneal MNCV (β = 0.781; p = 0.057) and an increase in malleolar VPT (β = -0.725; p = 0.077). Plasma superoxide generation was associated with an increased risk of mortality (HR 23.2 [95 % CI 1.05-513]; p = 0.047). In conclusion, increased plasma superoxide generation predicted the decline in sensory and cardiac autonomic nerve function and mortality over 6 years in diabetic patients, but larger studies are required for confirmation.
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Affiliation(s)
- Dan Ziegler
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research, German Diabetes Center at Heinrich Heine University, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany,
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Lin CC, Huang HH, Hu CW, Chen BH, Chong IW, Chao YY, Huang YL. Trace elements, oxidative stress and glycemic control in young people with type 1 diabetes mellitus. J Trace Elem Med Biol 2014; 28:18-22. [PMID: 24315963 DOI: 10.1016/j.jtemb.2013.11.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 01/12/2023]
Abstract
Trace elements and oxidative stress are associated with glycemic control and diabetic complications in type 1 diabetes mellitus. In this study, we analyzed the levels of serum copper, zinc, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) and urinary MDA and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in 33 type 1 diabetic patients with optimal and suboptimal glycemic control (HbA1C<9.0%) and 40 patients with poor glycemic control (HbA1C≥9%) and 27 age- and sex-matched non-diabetic controls to evaluate the differences between these markers in different glycemic control states. Diabetic patients, especially poor-glycemic-control subjects (HbA1C≥9%), exhibited significantly lower levels of serum zinc and increased levels of serum copper (and, therefore, increased serum copper-to-zinc ratios), serum SOD, blood MDA, and urinary MDA and 8-OHdG, relative to non-diabetic subjects. Furthermore, significant correlations existed in these patients between the serum copper, serum copper-to-zinc ratio, and urinary MDA (all p<0.001) and the levels of urinary 8-OHdG (p=0.007) and HbA1C. Our results suggest that high serum copper levels and oxidative stress correlate with glycemic control. Therefore, strict glycemic control, decreased oxidative stress, and a lower copper concentration might prevent diabetic complications in patients with type 1 diabetes mellitus.
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Affiliation(s)
- Ching-Chiang Lin
- Community Healthcare Center, Fooyin University Hospital, Pingtung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Hsiu-Hua Huang
- Department of Laboratory Medicine, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Bai-Hsiun Chen
- School and College of Medicine, Kaohsiung Medical University, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Ying Chao
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yeou-Lih Huang
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Lazalde-Ramos BP, Zamora-Perez AL, Sosa-Macías M, Guerrero-Velázquez C, Zúñiga-González GM. DNA and oxidative damages decrease after ingestion of folic acid in patients with type 2 diabetes. Arch Med Res 2012; 43:476-81. [PMID: 22964462 DOI: 10.1016/j.arcmed.2012.08.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 08/22/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND AIMS Type 2 diabetes mellitus (T2DM) is a chronic degenerative disease that promotes autoxidation of sugars, leading to the production of reactive oxygen species. This damage occurs especially at the level of cellular proteins, carbohydrates, lipids and DNA, thus playing an important role in the pathogenesis of late complications of T2DM. We investigated the effect of folic acid on DNA and oxidative damage in patients with T2DM. METHODS We studied 30 individuals diagnosed with T2DM and 30 control individuals without disease. Individuals with T2DM were prescribed 5 mg of folic acid, taken orally three times daily for 1 month. Samples were taken 15 and 30 days after treatment. DNA damage was determined using the micronucleus test in oral mucosa and oxidative stress by quantifying 8-hydroxy-2'-deoxyguanosine (8-OHdG) as well as by quantifying total lipid peroxides. RESULTS Individuals with T2DM had a higher number of micronuclei as well as higher levels of 8-OHdG and lipid peroxides than the control group (p = 0.001). Individuals with T2DM showed a significant reduction in the number of micronuclei and the concentration of 8-OHdG and lipid peroxides over time with folic acid intake. CONCLUSIONS A positive correlation exists between oxidative stress produced by T2DM and DNA damage, so the use of an antioxidant such as folic acid in DM2 therapy is advisable for delaying complications due to T2DM-induced oxidative stress and DNA damage.
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Oxidative stress and autonomic nerve function in early type 1 diabetes. Clin Auton Res 2010; 21:19-28. [DOI: 10.1007/s10286-010-0084-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 08/19/2010] [Indexed: 02/04/2023]
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Fatehi-Hassanabad Z, Chan CB, Furman BL. Reactive oxygen species and endothelial function in diabetes. Eur J Pharmacol 2010; 636:8-17. [DOI: 10.1016/j.ejphar.2010.03.048] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 02/27/2010] [Accepted: 03/22/2010] [Indexed: 02/07/2023]
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Matheson A, Willcox MDP, Flanagan J, Walsh BJ. Urinary biomarkers involved in type 2 diabetes: a review. Diabetes Metab Res Rev 2010; 26:150-71. [PMID: 20222150 DOI: 10.1002/dmrr.1068] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diabetes mellitus is one of the most challenging health concerns of the 21st century. With at least 30% of the diabetic population remaining undiagnosed, effective and early diagnosis is of critical concern. Development of a diagnostic test, more convenient and reliable than those currently used, would therefore be highly beneficial. Urine as a diagnostic medium allows for non-invasive detection of biomarkers, including some associated with type 2 diabetes and its complications. This review provides a synopsis of those urinary biomarkers that potentially may provide a basis for the development of improved diagnostic tests. Three main pathways for the sourcing of potential makers are identified: kidney damage, oxidative stress and low-grade inflammation including atherosclerosis/vascular damage. This review briefly presents each pathway and some of the most relevant urinary biomarkers that may be used to monitor the development or progression of diabetes and its complications. In particular, biomarkers of renal dysfunction such as transferrin, type IV collagen and N-acetyl-beta-D-glucosaminidase might prove to be more sensitive than urinary albumin, the current gold standard, in the detection of incipient nephropathy and risk assessment of cardiovascular disease. Inflammatory markers including orosomucoid, tumour necrosis factor-alpha, transforming growth factor-beta, vascular endothelial growth factor and monocyte chemoattractant protein-1, as well as oxidative stress markers such as 8-hydroxy-2'deoxyguanosine may also be useful biomarkers for diagnosis or monitoring of diabetic complications, particularly kidney disease. However, the sensitivity of these markers compared with albumin requires further investigation.
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Affiliation(s)
- Agnès Matheson
- Minomic Pty Ltd, Frenchs Forest, New South Wales, Australia.
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