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Ren L, Tan N, Ouyang J, Wang R, Tie F, Dong Q, Wang H, Hu N. Hypoglycaemic activity of the anthocyanin enriched fraction of Lycium ruthenicum Murr. Fruits and its ingredient identification via UPLC-triple-TOF-MS/MS. Food Chem 2024; 461:140837. [PMID: 39151350 DOI: 10.1016/j.foodchem.2024.140837] [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] [Received: 06/05/2024] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
Lycium ruthenicum Murr. is mainly distributed in the northwest region of China and its berries are rich in anthocyanin. This study evaluated the hypoglycaemic activity of the anthocyanin-enriched fraction (AEF) of L. ruthenicum Murr. on α-glucosidase in vivo and in vitro. Overall, 10 anthocyanins were identified via UPLC-Triple-TOF-MS/MS. The AEF exhibited strong inhibitory activity against α-glucosidase, with an IC50 value of 4.468 mg/mL. It behaved as a reversible, mixed-type inhibitor. Molecular docking and dynamic results indicated that the compounds in AEF interacted with enzymes primarily through van der Waals and hydrogen bond and the complex system was stable. The postprandial blood glucose and area under the curve of diabetic mice was significantly decreased by AEF in the carbohydrate tolerance experiments. The results indicate that the AEF from L. ruthenicum Murr. berries could be as a promising food supplement for managing blood sugar levels in patients with diabetes mellitus.
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Affiliation(s)
- Lichengcheng Ren
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China; School of Medicine, Qinghai University, Xining, Qinghai 810001, China
| | - Nixia Tan
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China; School of Medicine, Qinghai University, Xining, Qinghai 810001, China
| | - Jian Ouyang
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China
| | - Ruinan Wang
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China
| | - Fangfang Tie
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China
| | - Qi Dong
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China
| | - Honglun Wang
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China
| | - Na Hu
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research and CAS Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, 810008, Xining, PR China.
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Shao M, Chen J, Zhang F, Su Q, Lin X, Wang W, Chen C, Ren H, Zheng S, Hui S, Qin S, Ni Y, Zhong J, Yang J. 4-Octyl itaconate attenuates renal tubular injury in db/db mice by activating Nrf2 and promoting PGC-1α-mediated mitochondrial biogenesis. Ren Fail 2024; 46:2403653. [PMID: 39291665 PMCID: PMC11411562 DOI: 10.1080/0886022x.2024.2403653] [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] [Received: 01/02/2024] [Revised: 07/11/2024] [Accepted: 09/08/2024] [Indexed: 09/19/2024] Open
Abstract
Objectives: The aim of this study was to investigate the mechanism of itaconate's potential effect in diabetic kidney disease. Methods: Renal immune responsive gene 1 (IRG1) levels were measured in db/db mice and streptozotocin (STZ) + high-fat diet (HFD)-induced diabetic mice. Irg1 knockout mice were generated. db/db mice were treated with 4-octyl itaconate (4-OI, 50 mg/kg), a derivative of itaconate, for 4 weeks. Renal function and morphological changes were investigated. Ultrastructural alterations were determined by transmission electron microscopy. Results: Renal IRG1 levels were reduced in two diabetic models. STZ+HFD-treated Irg1 knockout mice exhibited aggravated renal tubular injury and worsened renal function. Treatment with 4-OI lowered urinary albumin-to-creatinine ratio and blood urea nitrogen levels, and restored renal histological changes in db/db mice. It improved mitochondrial damage, increased expressions of peroxisome-proliferator-activated receptor γ coactivator-1α (PGC-1α) and mitochondrial transcription factor A (TFAM) in the renal cortex of db/db mice. These were confirmed in vitro; 4-OI improved high glucose-induced abnormal mitochondrial morphology and TFAM expression in HK-2 cells, effects that were inhibited by PGC-1α silencing. Moreover, 4-OI reduced the number of apoptotic cells in the renal cortex of db/db mice. Further study showed that 4-OI increased renal Nrf2 expression and decreased oxidative stress levels in db/db mice. In HK-2 cells, 4-OI decreased high glucose-induced mitochondrial ROS production, which was reversed by Nrf2 silencing. Nrf2 depletion also inhibited 4-OI-mediated regulation of PGC-1α, TFAM, and mitochondrial apoptotic protein expressions. Conclusions: 4-OI attenuates renal tubular injury in db/db mice by activating Nrf2 and promoting PGC-1α-mediated mitochondrial biogenesis.
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Affiliation(s)
- Muqing Shao
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayao Chen
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fuwei Zhang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Su
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqian Lin
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weiwei Wang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Caiyu Chen
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Hongmei Ren
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Shuo Zheng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Suocheng Hui
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Si Qin
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinxing Ni
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Zhong
- Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Wan H, Zhu W, Yan J, Han X, Yu J, Liao Q, Zhang T. Application of compound poisson model to estimate underreported risk of non-communicable diseases in underdeveloped areas. One Health 2024; 19:100889. [PMID: 39314245 PMCID: PMC11417528 DOI: 10.1016/j.onehlt.2024.100889] [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: 12/13/2023] [Revised: 08/08/2024] [Accepted: 09/05/2024] [Indexed: 09/25/2024] Open
Abstract
Background Hypertension and diabetes are major components of non-communicable diseases (NCDs), with a substantial number of patients residing in underdeveloped areas. Limited medical resources in these areas often results in underreporting of disease prevalence, masking the true extent of diseases. Taking the underdeveloped Liangshan Yi Autonomous Prefecture in China as an example, this study aimed to correct the underreported prevalence of hypertension and type 2 diabetes so as to provide inspiration for the allocation of medical resources in such areas. Methods Assuming the true number of patients in each area follows a Poisson distribution, we applied a Compound Poisson Model based on Clustering of Data Quality (CPM-CDQ) to estimate the potential true prevalence of hypertension and diabetes, as well as the registration rate of existing patients. Specifically, a hierarchical clustering approach was utilized to group the counties based on the data quality, and then the registration rate of the cluster with the best data quality was used as a priori information for the model. The model parameters were estimated by the maximum likelihood method. Sensitivity analyses were performed to test the robustness of the model. Results The estimated prevalence of hypertension in the entire Liangshan Prefecture from 2018 to 2020 ranged from 24.59 % to 25.28 %, and for diabetes, it ranged from 4.95 % to 8.42 %. The registration rates for hypertension and diabetes were 14.10 % to 24.59 % and 15.98 % to 29.12 %, respectively. Additionally, the accuracy of clustering the counties with the best data quality had a significant impact on the performance of the model. Conclusion Liangshan Prefecture is experiencing a significant high prevalence of hypertension and diabetes, accompanied by a concerningly low registration rate. The CPM-CDQ proved useful for assessing underreporting risks and facilitating targeted interventions for NCDs control and prevention, particularly in underdeveloped areas.
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Affiliation(s)
- Hongli Wan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wenhui Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jingmin Yan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xinyue Han
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie Yu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang 615000, Sichuan Province, China
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Chen Y, Sun T, Liu C, Gu L, Yuan P. In silico approach uncovers the shared genetic landscape of type 2 diabetes mellitus and asthenozoospermia. Syst Biol Reprod Med 2024; 70:272-288. [PMID: 39292564 DOI: 10.1080/19396368.2024.2395545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 07/14/2024] [Accepted: 08/10/2024] [Indexed: 09/20/2024]
Abstract
Asthenozoospermia (AZS) is one of the most common types of male infertility. Current evidence revealed that type 2 diabetes mellitus (T2DM) is closely associated with declining semen quality, especially for poor sperm motility. This study aimed to uncover the genetic interrelationships and important biomarkers between AZS and T2DM. Transcriptome data regarding AZS and T2DM were downloaded from the Gene Expression Omnibus (GEO) database. We performed GO and pathway analysis, and protein-protein interaction (PPI) network construction for T2DM-related differentially expressed genes (DMRGs). Moreover, we calculated receiver operator characteristic (ROC) curve and conducted external independent validation. Expression of hub DMRGs was assessed for patients using the qPCR method. MiRNA interaction and immune infiltration were subsequently characterized. A total of 554 overlapping DMRGs were identified between the AZS/T2DM and healthy groups. These overlapping DMRG participated in the DNA damage-, energy metabolism-, and immune-related biological pathways. Module function analysis discovered that the top three PPI modules were tightly correlated with DNA damage-related processes. After external validation in other independent datasets, two hub DMRGs (TBC1D12 and SCG5) were obtained. ROC analysis revealed that TBC1D12 and SCG5 had good diagnostic performance (area under the curve > 0.75). Immune infiltration profile showed that the level of T cell co-stimulation and CD8+_T_cells were negatively related to the hub DMRGs expression. Mirna interaction analysis showed 15 significant hub DMRGs-miRNA interactions. The qPCR results showed that expression of TBC1D12 and SCG5 were significantly different between sperm samples from diabetic patients with AZS and controls. The present study revealed molecular signatures and critical pathways between the AZS and T2DM, and identified two hub DMRGs of TBC1D12 and SCG5. The data would provide novel understandings of shared pathogenic mechanisms in T2DM-associated AZS.
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Affiliation(s)
- Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Taotao Sun
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chang Liu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Longjie Gu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Penghui Yuan
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Maheshwari V, Basu S. Sleep problems and their predictors in community-dwelling older adults with diabetes in India: Evidence from the Longitudinal Ageing Study in India. Sleep Med X 2024; 7:100108. [PMID: 38500780 PMCID: PMC10945249 DOI: 10.1016/j.sleepx.2024.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/04/2023] [Accepted: 03/03/2024] [Indexed: 03/20/2024] Open
Abstract
Objectives To ascertain the prevalence and predictors of sleep disorders and poor sleep quality among older adults with Diabetes (DM) in India, and to assess the relationship between sleep quality and DM. Methods Data was utilized from the nationally representative Longitudinal Ageing Study in India (Wave-1, 2017-18), with a total sample of 66606 older adults (≥45 years) selected for the study. Sleep problems and sleep quality score were assessed using an adaptation based on the Jenkins Sleep Scale. Multivariate linear and logistic regressions were conducted to determine the effect of sociodemographic and clinical factors on sleep quality. Mediation analysis (Karlson-Holm-Breen) was done to assess the direct and indirect effects of independent variables on the sleep quality scores. Further, Propensity score matching (PSM) was done to assess the impact of diabetes on sleep problems. Results The prevalence of DM was 12.34% (n = 8564, 95% CI: 11.54, 13.20) among whom 24.38% (95% CI: 21.38, 27.65) reported sleep problems. On adjusted analysis, sleep problems were significantly associated with increasing education, higher wealth quintile, lack of physical activity, and multimorbidity. Mediation analysis showed adherence to anti-diabetes medication improved sleep quality (aB = -0.28 (95% CI: -0.54, -0.02)), while comorbidities worsened sleep quality (aB = 0.79 (95% CI: 0.67, 0.92)). Analysis from PSM indicated that DM was associated with a 6.2% higher chance of sleep problems. Conclusions Poor sleep quality is present in nearly one in four individuals diagnosed with DM in India and linked with certain adverse social determinants. Focused interventions to improve assessment and treatment of sleep problems in resource-limited primary care settings require prioritization.
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Affiliation(s)
- Vansh Maheshwari
- Indian Institute of Public Health – Delhi, Public Health Foundation of India, India
| | - Saurav Basu
- Indian Institute of Public Health – Delhi, Public Health Foundation of India, India
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Wan H, Yu G, He Y, Liu S, Chen X, Jiang Y, Duan H, Lin X, Liu L, Shen J. Associations of thyroid feedback quantile-based index with diabetes in euthyroid adults in the United States and China. Ann Med 2024; 56:2318418. [PMID: 38382636 PMCID: PMC10883085 DOI: 10.1080/07853890.2024.2318418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND We aimed to investigate the associations between thyroid hormone sensitivity indices and diabetes in euthyroid adults in the United States and China. METHODS 2296 euthyroid adults from the NHANES in the United States and 8319 euthyroid adults from the SPEED-Shunde in China were involved. The thyroid sensitivity indices, namely TFQIFT4 and TFQIFT3, were calculated. Multivariable logistic regression, restricted cubic spline analysis, and general ordinal logit regression were utilized. RESULTS In the NHANES, compared with participants in quartile 1st (Q1), those in Q4 of TFQIFT3 (OR 2.12, 95% CI (1.18, 3.81)) and those in Q3 of TFQIFT4 (OR 2.31, 95% CI (1.18, 4.53)) (both P for trend < 0.05) were associated with a greater prevalence of diabetes. In the SPEED-Shunde, compared with participants in Q1, those in Q4 of TFQIFT3 had a greater prevalence of diabetes (OR 1.36, 95% CI (1.11, 1.66) (P for trend < 0.05), while no significant associations between TFQIFT4 and diabetes were found. CONCLUSIONS TFQIFT3 was associated with a higher prevalence of diabetes both in the United States and China. However, TFQIFT4 was only associated with a higher prevalence of diabetes in the United States, not in China. Further prospective cohort studies are necessary to validate these findings.
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Affiliation(s)
- Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Genfeng Yu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Yajun He
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Siyang Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Xingying Chen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Yuqi Jiang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Hualin Duan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Xu Lin
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Lan Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Jie Shen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong, China
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Chen Z, Wei W, Hu Y, Niu Q, Yan Y. Associations between co-exposure to per- and polyfluoroalkyl substances and metabolic diseases: The mediating roles of inflammation and oxidative stress. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 953:176187. [PMID: 39265689 DOI: 10.1016/j.scitotenv.2024.176187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 08/17/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) pose potential risks to human health. In real-world settings, humans are exposed to various PFAS through numerous pathways. OBJECTIVES This study evaluated the associations between co-exposure to PFAS and obesity and its comorbidities, along with the mediating roles of inflammation and oxidative stress. METHODS We analyzed 11,090 participants from National Health and Nutrition Examination Survey (NHANES), 2003-2018. Linear regression, logistic regression, and generalized additive models were used to assess the individual effects of PFAS exposure on obesity and its comorbidities. The environmental risk score (ERS) was calculated using the adaptive elastic-net model to assess the co-exposure effects. Linear and logistic regression models explored the associations between ERS and obesity and its comorbidities. Mediation analyses explored the roles of inflammatory (neutrophils, lymphocytes, and alkaline phosphatase) and oxidative stress (gamma-glutamyl transferase, total bilirubin, and uric acid) markers in the associations between ERS and obesity and its comorbidities. RESULTS For each unit increase in ERS, the odds of obesity and type 2 diabetes mellitus (T2DM) increased 3.60-fold (95 % CI: 2.03, 6.38) and 1.91-fold (95 % CI: 1.28, 2.86), respectively. For each unit increase in ERS, BMI increased by 2.36 (95 % CI: 1.24, 3.48) kg/m2, waist circumference increased by 6.47 (95 % CI: 3.56, 9.37) cm, and waist-to-height ratio increased by 0.04 (95 % CI: 0.02, 0.06). Lymphocytes, alkaline phosphatase, and total bilirubin were significantly associated with both ERS and obesity, with mediation proportions of 4.17 %, 3.62 %, and 7.37 %, respectively. Lymphocytes, alkaline phosphatase, total bilirubin, and uric acid were significantly associated with both ERS and T2DM, with the mediation proportions of 8.90 %, 8.74 %, 29.73 %, and 38.19 %, respectively. CONCLUSIONS Co-exposure to PFAS was associated with obesity and T2DM, and these associations may be mediated by inflammation and oxidative stress. Further mechanistic and prospective studies are required to verify these associations.
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Affiliation(s)
- Zuhai Chen
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Wanting Wei
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yunhua Hu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Qiang Niu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
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Rajkumari N, Shalayel I, Tubbs E, Perrier Q, Chabert C, Lablanche S, Benhamou PY, Arnol C, Gredy L, Divoux T, Stephan O, Zebda A, van der Sanden B. Matrix design for optimal pancreatic β cells transplantation. BIOMATERIALS ADVANCES 2024; 164:213980. [PMID: 39126900 DOI: 10.1016/j.bioadv.2024.213980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/15/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
New therapeutic approaches to treat type 1 diabetes mellitus relies on pancreatic islet transplantation. Here, developing immuno-isolation strategies is essential to eliminate the need for systemic immunosuppression after pancreatic islet grafts. A solution is the macro-encapsulation of grafts in semipermeable matrixes with a double function: separating islets from host immune cells and facilitating the diffusion of insulin, glucose, and other metabolites. This study aims to synthesize and characterize different types of gelatin-collagen matrixes to prepare a macro-encapsulation device for pancreatic islets that fulfill these functions. While natural polymers exhibit superior biocompatibility compared to synthetic ones, their mechanical properties are challenging to reproduce. To address this issue, we conducted a comparative analysis between photo-crosslinked gelatin matrixes and chemically crosslinked collagen matrixes. We show that the different crosslinkers and polymerization methods influence the survival and glucose-stimulated insulin production of pancreatic β cells (INS1) in vitro, as well as the in vitro and in vivo stability of the matrix and the immuno-isolation in vivo. Among the matrixes, the stiff multilayer GelMA matrixes (8.5 kPa), fabricated by digital light processing, were the best suited for pancreatic β cells macro-encapsulation regarding these parameters. Within the alveoli of this matrix, pancreatic β cells spontaneously formed aggregates.
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Affiliation(s)
- Nikita Rajkumari
- Laboratory of Fundamental and Applied Bioenergetics (LBFA), Grenoble Alpes University and INSERM U1055, France; Nantes University, CRCI2NA, INSERM 1307, 44000 Nantes, France.
| | - Ibrahim Shalayel
- SyNaBi & Platform of Intravital Microscopy, TIMC-IMAG, CNRS UMR 5525, Grenoble Alpes University, Grenoble INP, INSERM, Grenoble, France.
| | - Emily Tubbs
- Grenoble Alpes University, CEA, INSERM, IRIG, 38000 Grenoble, Biomics, France.
| | - Quentin Perrier
- Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Department of Pharmacy, LBFA U1055, Grenoble, France.
| | - Clovis Chabert
- Laboratory of Fundamental and Applied Bioenergetics (LBFA), Grenoble Alpes University and INSERM U1055, France.
| | - Sandrine Lablanche
- Laboratory of Fundamental and Applied Bioenergetics (LBFA), Grenoble Alpes University and INSERM U1055, France; Department of Endocrinology-Diabetology-Nutrition, Grenoble University Hospital, France.
| | - Pierre-Yves Benhamou
- Laboratory of Fundamental and Applied Bioenergetics (LBFA), Grenoble Alpes University and INSERM U1055, France; Department of Endocrinology-Diabetology-Nutrition, Grenoble University Hospital, France.
| | - Capucine Arnol
- SyNaBi & Platform of Intravital Microscopy, TIMC-IMAG, CNRS UMR 5525, Grenoble Alpes University, Grenoble INP, INSERM, Grenoble, France
| | - Laetitia Gredy
- MoVe, Laboratoire interdisciplinaire de physique, CNRS UMR 5588, Grenoble Alpes University, St-Martin d'Hères, France.
| | - Thibaut Divoux
- ENSL, CNRS, Laboratoire de Physique, F-69342 Lyon, France.
| | - Olivier Stephan
- MoVe, Laboratoire interdisciplinaire de physique, CNRS UMR 5588, Grenoble Alpes University, St-Martin d'Hères, France.
| | - Abdelkader Zebda
- SyNaBi & Platform of Intravital Microscopy, TIMC-IMAG, CNRS UMR 5525, Grenoble Alpes University, Grenoble INP, INSERM, Grenoble, France.
| | - Boudewijn van der Sanden
- SyNaBi & Platform of Intravital Microscopy, TIMC-IMAG, CNRS UMR 5525, Grenoble Alpes University, Grenoble INP, INSERM, Grenoble, France.
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9
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Zhang H, Zhou XD, Shapiro MD, Lip GYH, Tilg H, Valenti L, Somers VK, Byrne CD, Targher G, Yang W, Viveiros O, Opio CK, Mantzoros CS, Ryan JD, Kok KYY, Jumaev NA, Perera N, Robertson AG, Abu-Abeid A, Misra A, Wong YJ, Ruiz-Úcar E, Ospanov O, Kızılkaya MC, Luo F, Méndez-Sánchez N, Zuluaga M, Lonardo A, Al Momani H, Toro-Huamanchumo CJ, Adams L, Al-Busafi SA, Sharara AI, Chan WK, Abbas SI, Sookoian S, Treeprasertsuk S, Ocama P, Alswat K, Kong APS, Ataya K, Lim-Loo MC, Oviedo RJ, Szepietowski O, Fouad Y, Zhang H, Abdelbaki TN, Katsouras CS, Prasad A, Thaher O, Ali A, Molina GA, Sung KC, Chen QF, Lesmana CRA, Zheng MH. Global burden of metabolic diseases, 1990-2021. Metabolism 2024; 160:155999. [PMID: 39151887 DOI: 10.1016/j.metabol.2024.155999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex. METHODS Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Age-standardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI). RESULTS In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190-259] DALYs), whilst T2DM (75 million [95 % UI: 63-90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90-4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34-0.51]) and obesity (0.26 % [95 % UI: 0.17-0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (-0.30 % [95 % UI: -0.34 to -0.25]) and hypercholesterolemia (-0.33 % [95 % UI: -0.37 to -0.30]) is slowing. There is no significant change in MASLD over time (0.05 % [95 % UI: -0.06 to 0.17]). CONCLUSION In the 21st century, common metabolic diseases are presenting a significant global health challenge. There is a concerning surge in DALYs and mortality associated with these conditions, underscoring the necessity for a coordinated global health initiative to stem the tide of these debilitating diseases and improve population health outcomes worldwide.
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Affiliation(s)
- Huai Zhang
- Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Dong Zhou
- Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA
| | - Christopher D Byrne
- Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Octavio Viveiros
- Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
| | | | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
| | - John D Ryan
- Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
| | - Kenneth Yuh Yen Kok
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei
| | | | - Nilanka Perera
- Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Andrew Gerard Robertson
- Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
| | - Adam Abu-Abeid
- Division of Surgery, Tel Aviv Sourasky Medical Center affiliated to Tel Aviv University, Tel Aviv, Israel
| | - Anoop Misra
- Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Elena Ruiz-Úcar
- Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
| | - Oral Ospanov
- Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan
| | - Mehmet Celal Kızılkaya
- Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Türkiye
| | - Fei Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | | | - Mauricio Zuluaga
- Department of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia
| | - Amedeo Lonardo
- Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Hazem Al Momani
- Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
| | - Carlos Jesus Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Lima, Peru; OBEMET Center for Obesity and Metabolic Health, Lima, Peru; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
| | - Leon Adams
- Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
| | - Said A Al-Busafi
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ala I Sharara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical center, Beirut, Lebanon
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Syed Imran Abbas
- Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
| | - Silvia Sookoian
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Faculty of Health Science, Maimónides University, Buenos Aires, Argentina; Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina
| | | | - Ponsiano Ocama
- Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
| | - Khalid Alswat
- Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alice Pik-Shan Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | - Karim Ataya
- Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada
| | | | - Rodolfo J Oviedo
- Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, USA
| | - Olivia Szepietowski
- Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, United Kingdom
| | - Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Huijie Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tamer N Abdelbaki
- Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Christos S Katsouras
- First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
| | - Arun Prasad
- Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
| | - Omar Thaher
- Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, Herne, NRW, Germany
| | - Arshad Ali
- Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
| | | | - Ki-Chul Sung
- Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Qin-Fen Chen
- Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cosmas Rinaldi Adithya Lesmana
- Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia; Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia; Gastrointestinal Cancer Center, Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital, Jakarta, Indonesia
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China.
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10
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Wang R, Cheng X, Long T, Jia C, Xu Y, Wei Y, Zhang Y, He X, He M. Plasma metals, genetic risk, and rapid kidney function decline among type 2 diabetes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174069. [PMID: 38908586 DOI: 10.1016/j.scitotenv.2024.174069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/22/2024] [Accepted: 06/15/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Rapid kidney function decline (RKFD) is a main clinical feature of early chronic kidney disease (CKD) in type 2 diabetes (T2D). Environmental and genetic factors influencing RKFD remain inadequately elucidated. OBJECTIVES This study aimed to examine the associations of metals with RKFD among T2D and to further investigate the effect of metal mixtures on RKFD with the modifying effect of genetic susceptibility. METHODS This study included 2209 people with T2D (1942 had genotyping data) free of CKD at baseline from the Dongfeng-Tongji cohort. We used inductively coupled plasma-mass spectrometry (ICP-MS) to measure 23 metals in baseline plasma. Using elastic net (ENET), multivariate logistic regression, and Bayesian kernel machine regression (BKMR) model, we examined independent associations of multiple metals with RKFD. We calculated the environmental risk score (ERS) to assess the effects of metal mixtures on RKFD and the genetic risk score (GRS) to assess genetic susceptibility. RKFD was defined as estimated glomerular filtration rate (eGFR) loss > 3 mL/min/1.73 m2/year. RESULTS During a median of 9.8 years follow-up, 262 participants developed RKFD. Aluminum, vanadium, zinc, selenium, rubidium, tin, barium, and tungsten were screened from ENET. In multivariate logistic models, vanadium, selenium, and tungsten were negatively associated with RKFD, while zinc, tin, and rubidium were positively associated. The BKMR showed a nonlinear association of vanadium and rubidium with RKFD and interactions between metals (barium‑vanadium, barium‑rubidium). The ERS was positive associated with RKFD (per SD increase in ERS, OR = 1.94, 95% CI: 1.66, 2.27). No significant interaction between ERS and GRS was observed on RKFD, however, participants in the highest ERS and GRS group had the highest RKFD risk. CONCLUSION Vanadium and rubidium were associated with RKFD in T2D. Metal mixtures was associated with an increased risk of RKFD in T2D, particularly in those at high genetic risk.
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Affiliation(s)
- Ruixin Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xu Cheng
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Tengfei Long
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Chengyong Jia
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yali Xu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yue Wei
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Ying Zhang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xiangjing He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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11
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Zhang J, Wang F, Zhong H, Pi J, Chen G, Chen Z. Oral sericin ameliorates type 2 diabetes through passive intestinal and bypass transport into the systemic circulation. JOURNAL OF ETHNOPHARMACOLOGY 2024; 332:118342. [PMID: 38750984 DOI: 10.1016/j.jep.2024.118342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/19/2024] [Accepted: 05/12/2024] [Indexed: 06/02/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Boiled silkworm cocoons have been used to treat 'Xiaoke disease' (diabetes mellitus) recorded in Chinese medicine for over 800 years. In recent years, it has been found that the active substance silk sericin (SS) has therapeutic benefits in treating type 2 diabetes mellitus (T2DM). SS promotes pancreatic islet signalling, the proliferation of pancreatic islet cells, and insulin secretion. It is inferred that SS enters the bloodstream after oral administration and plays a role in the body's circulation. As a natural protein, SS needs to resist digestion by proteases in the gastrointestinal tract and cross the gastrointestinal barrier after oral administration. It is currently unclear how SS crosses the gastrointestinal barrier and whether it exerts therapeutic effects on T2DM by entering the circulation. AIM OF THE STUDY To study how SS crosses the gastrointestinal barrier and whether it enters the body circulation to exert a therapeutic effect on T2DM. MATERIALS AND METHODS SS was extracted from silkworm cocoons using an alkaline method with sodium carbonate. The antidigestive capacity of SS was detected using SDS-PAGE gel electrophoresis experiments. The mode of uptake and translocation of orally consumed SS in vivo was analysed using the AP-side to BL-side and BL-side-AP-side translocations, apparent Permeability coefficient (Papp), and Exocytosis rates (ER). The study compared the differences between the adSS group and the adSS + EDTA group by using Ethylenediaminetetraacetic acid (EDTA) to separate the tight junctions between Caco-2 cells. The aim was to analyze whether the transport mode of oral filaggrin proteins in vivo could be absorbed by bypass transport. By administering SS through oral and intraperitoneal injection to type 2 diabetic mice, we measured its concentration in the blood, as well as blood glucose and insulin levels, to determine its effectiveness in treating diabetes and its ability to enter the body's circulation for treatment. RESULTS The molecular weight of SS decreased from 10k∼25 kDa to 10k∼15 kDa after in vitro simulated gastrointestinal fluid digestion, indicating its good antidigestive properties. The apparent Papp was greater than 1 × 10-6 cm·s-1, and the ER was between 0.5 and 1.5, indicating that adSS was well-absorbed and mainly passively transported. The Caco-2 cell model showed that the addition of EDTA promoted the transport of adSS, resulting in significantly larger Papp and ER values, indicating that adSS was absorbed by bypass transport. After oral administration of SS, the concentration of SS in the blood was lower than after intraperitoneal injection, which is 60% of intraperitoneal administration. Mice with a T2DM model who were administered SS for 5 weeks showed significant improvement in insulin resistance and glucose tolerance. Additionally, the pancreatic tissue appeared more regular. In the treatment of T2DM, injections of SS have been shown to be more effective than oral administration. Both oral and intraperitoneal injections have been partially involved in the circulation. CONCLUSIONS SS is enzymatically cleaved by proteolytic enzymes in the gastrointestinal tract. The smaller molecules are partially absorbed into the body's circulation through passive and paracrine transport, exerting a therapeutic effect on T2DM.
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Affiliation(s)
- Jun Zhang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China
| | - Fuping Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China
| | - Hailing Zhong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China
| | - Jin Pi
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China
| | - Guobao Chen
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China
| | - Zhongmin Chen
- School of Pharmacy and Bioengineering, Chongqing University of Technology, 69 Hongguang Avenue, Chongqing, 400054, China; The Center Affiliated Hospital of Chongqing University of Technology, Intersection of Lishi Road and Mawangping Main Street, Banan District, Chongqing, 400054, China.
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Lu X, Xie Q, Pan X, Zhang R, Zhang X, Peng G, Zhang Y, Shen S, Tong N. Type 2 diabetes mellitus in adults: pathogenesis, prevention and therapy. Signal Transduct Target Ther 2024; 9:262. [PMID: 39353925 DOI: 10.1038/s41392-024-01951-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/21/2024] [Accepted: 08/06/2024] [Indexed: 10/03/2024] Open
Abstract
Type 2 diabetes (T2D) is a disease characterized by heterogeneously progressive loss of islet β cell insulin secretion usually occurring after the presence of insulin resistance (IR) and it is one component of metabolic syndrome (MS), and we named it metabolic dysfunction syndrome (MDS). The pathogenesis of T2D is not fully understood, with IR and β cell dysfunction playing central roles in its pathophysiology. Dyslipidemia, hyperglycemia, along with other metabolic disorders, results in IR and/or islet β cell dysfunction via some shared pathways, such as inflammation, endoplasmic reticulum stress (ERS), oxidative stress, and ectopic lipid deposition. There is currently no cure for T2D, but it can be prevented or in remission by lifestyle intervention and/or some medication. If prevention fails, holistic and personalized management should be taken as soon as possible through timely detection and diagnosis, considering target organ protection, comorbidities, treatment goals, and other factors in reality. T2D is often accompanied by other components of MDS, such as preobesity/obesity, metabolic dysfunction associated steatotic liver disease, dyslipidemia, which usually occurs before it, and they are considered as the upstream diseases of T2D. It is more appropriate to call "diabetic complications" as "MDS-related target organ damage (TOD)", since their development involves not only hyperglycemia but also other metabolic disorders of MDS, promoting an up-to-date management philosophy. In this review, we aim to summarize the underlying mechanism, screening, diagnosis, prevention, and treatment of T2D, especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of "MDS-related TOD".
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Affiliation(s)
- Xi Lu
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Qingxing Xie
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Pan
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Ruining Zhang
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyi Zhang
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Ge Peng
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Yuwei Zhang
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Sumin Shen
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, Research Centre for Diabetes and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
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Wong R, Hall MA, Wiggen T, Johnson SG, Huling JD, Turner LE, Wilkins KJ, Yeh HC, Stürmer T, Bramante CT, Buse JB, Reusch J. Effect of SARS-CoV-2 Infection on Incident Diabetes by Viral Variant: Findings From the National COVID Cohort Collaborative (N3C). Diabetes Care 2024; 47:1846-1854. [PMID: 39207804 PMCID: PMC11417274 DOI: 10.2337/dc24-1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE The coronavirus 2019 (COVID-19) pandemic has evolved over time by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, disease severity, treatment, and prevention. There is evidence of an elevated risk of incident diabetes after COVID-19; our objective was to evaluate whether this association is consistent across time and with contemporary viral variants. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study using National COVID Cohort Collaborative (N3C) data to evaluate incident diabetes risk among COVID-positive adults compared with COVID-negative patients or control patients with acute respiratory illness (ARI). Cohorts were weighted on demographics, data site, and Charlson comorbidity index score. The primary outcome was the cumulative incidence ratio (CIR) of incident diabetes for each viral variant era. RESULTS Risk of incident diabetes 1 year after COVID-19 was increased for patients with any viral variant compared with COVID-negative control patients (ancestral CIR 1.16 [95% CI 1.12-1.21]; Alpha CIR 1.14 [95% CI 1.11-1.17]; Delta CIR 1.17 [95% CI 1.13-1.21]; Omicron CIR 1.13 [95% CI 1.10-1.17]) and control patients with ARI (ancestral CIR 1.17 [95% CI 1.11-1.22]; Alpha CIR 1.14 [95% CI 1.09-1.19]; Delta CIR 1.18 [95% CI 1.11-1.26]; Omicron CIR 1.20 [95% CI 1.13-1.27]). There was latency in the timing of incident diabetes risk with the Omicron variant; in contrast with other variants, the risk presented after 180 days. CONCLUSIONS Incident diabetes risk after COVID-19 was similar across different SARS-CoV-2 variants. However, there was greater latency in diabetes onset in the Omicron variant era.
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Affiliation(s)
- Rachel Wong
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY
- Department of Internal Medicine, Stony Brook University, Stony Brook, NY
| | - Margaret A. Hall
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
| | - Talia Wiggen
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Steven G. Johnson
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN
| | - Jared D. Huling
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Lindsey E. Turner
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Kenneth J. Wilkins
- Office of the Director, Biostatistics Program/Office of Clinical Research Support, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Hsin-Chieh Yeh
- Department of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carolyn T. Bramante
- Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - John B. Buse
- Division of Endocrinology and Metabolism, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
- North Carolina Translational and Clinical Sciences Institute, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Jane Reusch
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
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Huang D, Lai H, Shi X, Jiang J, Zhu Z, Peng J, Zhang S, Chen Y, Yu H, Zhao Q, Chen Y, Chen J. Global temporal trends and projections of acute hepatitis E incidence among women of childbearing age: Age-period-cohort analysis 2021. J Infect 2024; 89:106250. [PMID: 39181413 DOI: 10.1016/j.jinf.2024.106250] [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] [Received: 07/15/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND & AIMS Acute hepatitis E (AHE) poses a significant threat to global public health, particularly among women of childbearing age (WCBA), who are at heightened risk for severe pregnancy-related complications. This study aimed to delineate the temporal trends and project future incidence of AHE in WCBA, providing insights crucial for targeted prevention and control strategies. METHODS Data on AHE incidence from the Global Health data 2021. The age-period-cohort (APC) model was applied to analyze trends across different age groups, periods, and birth cohorts, and the Bayesian APC model was utilized for forecasting future epidemiological trajectories. RESULTS Globally, AHE incidence numbers among WCBA rose from 2,831,075 in 1992 to 3,420,786 in 2021, while the age-standardized incidence rate (ASIR) declined from 194.66 to 179.54 per 100,000 with a global net drift of -0.28%. However, high SDI regions showed a contrasting trend with a positive net drift of 0.02%. The age effect was consistent across SDI regions and globally, showing a decrease with advancing age, while unfavorable period and cohort effects were exhibited in high-SDI region. At the national level, locations exhibited varying trends of change. The BAPC model predicted a total of 3,759,384 AHE global cases in WCBA by 2030, with an expected mild increase in the ASIR. The outlook for the management and containment of AHE is grim in certain countries, including India. CONCLUSIONS The study revealed a complex epidemiological landscape of AHE in WCBA, with increasing global incidence numbers juxtaposed against a declining ASIR. The AHE burden by 2030 remain severe among WCBA. Young WCBA and high SDI region merit particular attention. The findings underscore the need for region-specific strategies to curb the projected rise in AHE incidence and align with the 2030 WHO goals.
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Affiliation(s)
- Deliang Huang
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China.
| | - Huiyi Lai
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Xia Shi
- National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China; Department of General Medicine, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China
| | - Jinyan Jiang
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Zhibin Zhu
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Jinghan Peng
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Siyu Zhang
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Yuanyuan Chen
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Hong Yu
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Qi Zhao
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Yanping Chen
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China
| | - Jun Chen
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China.
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15
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Burton AE, Owen A, Taylor J, Dean SE, Povey R. A World Café Approach to Exploring Perspectives on Diabetes Stigma in the United Kingdom. Health Expect 2024; 27:e70023. [PMID: 39238333 PMCID: PMC11377845 DOI: 10.1111/hex.70023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 08/14/2024] [Accepted: 08/23/2024] [Indexed: 09/07/2024] Open
Abstract
INTRODUCTION Research has found that a high percentage of people with diabetes experience stigma, with perceptions of stigma being significantly higher among people with Type 1 diabetes compared to those with Type 2 diabetes. These experiences of diabetes stigma can lead to psychological, behavioural and medical consequences. The aim of the current study was to explore the perceptions of diabetes stigma and propose strategies for addressing this from the perspective of key stakeholders. METHODS A mixed methods design was used, commencing with an online qualitative survey (n = 128) and followed by a World Café (n = 11), where attendees reflected on their own experiences with stigma and discussed the survey findings. RESULTS The survey indicated that 75% of those with Type 1 diabetes and 51% with Type 2 had experienced diabetes stigma. The World Café identified three main areas that participants felt impacted their experiences with stigma or had the potential to help improve stigma: healthcare interactions, public awareness and media representations. CONCLUSIONS The findings supported previous research showing that diabetes stigma is prevalent among people with diabetes. The World Café was an excellent means of sharing knowledge and experiences among stakeholders, the findings of which will inform strategies to bring about change. PATIENT OR PUBLIC CONTRIBUTION World Café is a collaborative method where stakeholders contribute to the production and analysis of data through rounds of discussion and feedback.
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Affiliation(s)
- Amy Elizabeth Burton
- Centre for Applied Psychology and Performance, Staffordshire University, Stoke-on-Trent, UK
| | - Alison Owen
- Centre for Applied Psychology and Performance, Staffordshire University, Stoke-on-Trent, UK
| | - Jennifer Taylor
- Centre for Applied Psychology and Performance, Staffordshire University, Stoke-on-Trent, UK
| | - Sarah Elizabeth Dean
- Centre for Applied Psychology and Performance, Staffordshire University, Stoke-on-Trent, UK
| | - Rachel Povey
- Centre for Applied Psychology and Performance, Staffordshire University, Stoke-on-Trent, UK
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16
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Wändell P, Carlsson AC, Wierzbicka M, Sigurdsson K, Ärnlöv J, Eriksson J, Wachtler C, Ruge T. A machine learning tool for identifying patients with newly diagnosed diabetes in primary care. Prim Care Diabetes 2024; 18:501-505. [PMID: 38944562 DOI: 10.1016/j.pcd.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND AND AIM It is crucial to identify a diabetes diagnosis early. Create a predictive model utilizing machine learning (ML) to identify new cases of diabetes in primary health care (PHC). METHODS A case-control study utilizing data on PHC visits for sex-, age, and PHC-matched controls. Stochastic gradient boosting was used to construct a model for predicting cases of diabetes based on diagnostic codes from PHC consultations during the year before index (diagnosis) date and number of consultations. Variable importance was estimated using the normalized relative influence (NRI) score. Risks of having diabetes were calculated using odds ratios of marginal effects (ORME). Four groups by age and sex were studied, age-groups 35-64 years and ≥ 65 years in men and women, respectively. RESULTS The most important predictive factors were hypertension with NRI 21.4-29.7 %, and obesity 4.8-15.2 %. The NRI for other top ten diagnoses and administrative codes generally ranged 1.0-4.2 %. CONCLUSIONS Our data confirm the known risk patterns for predicting a new diagnosis of diabetes, and the need to test blood glucose frequently. To assess the full potential of ML for risk prediction purposes in clinical practice, future studies could include clinical data on life-style patterns, laboratory tests and prescribed medication.
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Affiliation(s)
- Per Wändell
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Axel C Carlsson
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.
| | - Marcelina Wierzbicka
- Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Lund University & Department of Internal Medicine, Skåne, Sweden
| | - Karolina Sigurdsson
- Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Lund University & Department of Internal Medicine, Skåne, Sweden
| | - Johan Ärnlöv
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - Julia Eriksson
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Wachtler
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Toralph Ruge
- Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Lund University & Department of Internal Medicine, Skåne, Sweden
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17
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Taranto D, Kloosterman DJ, Akkari L. Macrophages and T cells in metabolic disorder-associated cancers. Nat Rev Cancer 2024:10.1038/s41568-024-00743-1. [PMID: 39354070 DOI: 10.1038/s41568-024-00743-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 10/03/2024]
Abstract
Cancer and metabolic disorders have emerged as major global health challenges, reaching epidemic levels in recent decades. Often viewed as separate issues, metabolic disorders are shown by mounting evidence to heighten cancer risk and incidence. The intricacies underlying this connection are still being unraveled and encompass a complex interplay between metabolites, cancer cells and immune cells within the tumour microenvironment (TME). Here, we outline the interplay between metabolic and immune cell dysfunction in the context of three highly prevalent metabolic disorders, namely obesity; two associated liver diseases, metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH); and type 2 diabetes. We focus primarily on macrophages and T cells, the critical roles of which in dictating inflammatory response and immune surveillance in metabolic disorder-associated cancers are widely reported. Moreover, considering the ever-increasing number of patients prescribed with metabolism disorder-altering drugs and diets in recent years, we discuss how these therapies modulate systemic and local immune phenotypes, consequently impacting cancer malignancy. Collectively, unraveling the determinants of metabolic disorder-associated immune landscape and their role in fuelling cancer malignancy will provide a framework essential to therapeutically address these highly prevalent diseases.
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Affiliation(s)
- Daniel Taranto
- Division of Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Daan J Kloosterman
- Division of Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leila Akkari
- Division of Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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18
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Maltese G, McAuley SA, Trawley S, Sinclair AJ. Ageing well with diabetes: the role of technology. Diabetologia 2024; 67:2085-2102. [PMID: 39138689 DOI: 10.1007/s00125-024-06240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/24/2024] [Indexed: 08/15/2024]
Abstract
Over the past two decades there has been a substantial rise in the adoption of diabetes therapeutic technology among children, adolescents and younger adults with type 1 diabetes, and its use is now also advocated for older individuals. Older people with diabetes are more prone to experience hypoglycaemia because of numerous predisposing factors and are at higher risk of hypoglycaemic events requiring third-party assistance as well as other adverse sequelae. Hypoglycaemia may also have long-term consequences, including cognitive impairment, frailty and disability. Diabetes in older people is often characterised by marked glucose variability related to age-associated changes such as variable appetite and levels of physical activity, comorbidities and polypharmacotherapy. Preventing hypoglycaemia and mitigating glucose excursions may have considerable positive impacts on physical and cognitive function and general well-being and may even prevent or improve frailty. Technology for older people includes continuous glucose monitoring systems, insulin pumps, automated insulin delivery systems and smart insulin pens. Clinical trials and real-world studies have shown that older people with diabetes benefit from technology in terms of glucose management, reductions in hypoglycaemic events, emergency department attendance and hospital admissions, and improvement in quality of life. However, ageing may bring physical impairments and other challenges that hinder the use of technology. Healthcare professionals should identify older adults with diabetes who may benefit from therapeutic technology and then adopt an individualised approach to education and follow-up for individuals and their caregivers. Future research should explore the impact of diabetes technology on outcomes relevant to older people with diabetes.
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Affiliation(s)
- Giuseppe Maltese
- Department of Diabetes and Endocrinology, Epsom & St Helier University Hospitals NHS Trust, Surrey, UK.
- School of Cardiovascular Medicine & Sciences, King's College London, London, UK.
| | - Sybil A McAuley
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology & Diabetes, The Alfred, Melbourne, VIC, Australia
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
- Cairnmillar Institute, Melbourne, VIC, Australia
| | - Steven Trawley
- Cairnmillar Institute, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Alan J Sinclair
- Foundation for Diabetes Research in Older People (fDROP), Droitwich Spa, UK
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19
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Feigin VL, Abate MD, Abate YH, Abd ElHafeez S, Abd-Allah F, Abdelalim A, Abdelkader A, Abdelmasseh M, Abd-Elsalam S, Abdi P, Abdollahi A, Abdoun M, Abd-Rabu R, Abdulah DM, Abdullahi A, Abebe M, Abeldaño Zuñiga RA, Abhilash ES, Abiodun OO, Abiodun O, Abo Kasem R, Aboagye RG, Abouzid M, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualhasan A, Abualruz H, Abu-Gharbieh E, Abukhadijah HJ, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Acuna JM, Adane DE, Adane MM, Addo IY, Adedoyin RA, Adegboye OA, Adekanmbi V, Adhikari K, Adnani QES, Adra S, Adzigbli LA, Afify AY, Afolabi AA, Afrashteh F, Afzal MS, Afzal S, Aghamiri S, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed SA, Ajami M, Aji B, Akara EM, Akinyemi RO, Akkaif MA, Akrami AE, Al Awaidy S, Al Hamad H, Al Hasan SM, Al Qadire M, Al Ta'ani O, Al-Ajlouni Y, Alalalmeh SO, Alalwan TA, Al-Aly Z, Al-amer RM, Aldhaleei WA, Aldossary MS, Alemohammad SY, Al-Fatly B, Al-Gheethi AAS, Alhalaiqa FN, Alharrasi M, Ali A, Ali MU, Ali R, Ali SS, Ali W, Al-Ibraheem A, Alif SM, Aljunid SM, Almahmeed W, Al-Marwani S, Alomari MA, Alonso J, Alqahtani JS, Al-Raddadi RMM, Alrawashdeh A, Alsabri MA, Alshahrani NZ, Altaany Z, Altaf A, Al-Tammemi AB, Altwalbeh D, Alvis-Guzman N, Alwafi H, Al-Wardat M, Al-Worafi YM, Aly H, Aly S, Alyahya MSI, Alzoubi KH, Al-Zyoud WA, Amani R, Amegbor PM, Amera TG, Amin TT, Amindarolzarbi A, Amiri S, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Angappan D, Anil A, Ansari MTT, Ansari-Moghaddam A, Ansong R, Anvari S, Anwar S, Anwar SL, Anyabolo EE, Anyasodor AE, Apostol GLC, Appiah F, Aqeel M, Arabloo J, Arabzadeh Bahri R, Arafat M, Aravkin AY, Ardekani A, Areda D, Aregawi BB, Aregu GM, Aremu O, Arifin H, Ärnlöv J, Artamonov AA, Arulappan J, Aryal UR, Aryan Z, Asbeutah AM, Asemahagn MA, Asemu MT, Asghari-Jafarabadi M, Ashemo MY, Ashraf T, Aslani A, Asmerom HA, Astell-Burt T, Athari SS, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awad H, Awotidebe AW, Ayana LAA, Aychiluhm SB, Aynalem AA, Aynalem ZB, Azadnajafabad S, Azami H, Aziz S, Azzam AY, Babu AS, Babu GR, Badar M, Badiye AD, Bahrami Taghanaki P, Bahramian S, Bai R, Baig AA, Bakkannavar SM, Bako AT, Baltatu OC, Bam K, Banach M, Banakar M, Bandyopadhyay S, Banik PC, Bansal K, Bao Y, Barboza MA, Bardhan M, Barengo NC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Barrow A, Barua L, Bashiri A, Bashiru HA, Basiru A, Bastan MM, Basu S, Basu S, Batra K, Begde A, Behnam B, Behnoush AH, Belayneh MBY, Belingheri M, Bello UM, Bennett DA, Bensenor IM, Berhe FT, Bermudez ANC, Beyene HBB, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JSS, Bhuiyan MA, Bhusal S, Bikbov B, Bilgin C, Biondi A, Bishaw KA, Biswas A, Biswas B, Bodhare T, Bogale EK, Boloor A, Bonakdar Hashemi M, Bonny A, Bora Basara B, Borhany H, Bosoka SA, Bouaoud S, Bouyahya A, Boyko EJ, Bozic MM, Braithwaite D, Breitner S, Brenner H, Britton G, Brunoni AR, Bryazka D, Bugiardini R, Bulto LN, Burkart K, Bustanji Y, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos LA, Campos-Nonato IR, Cao F, Capodici A, Cárdenas R, Carr S, Carreras G, Carvalho AF, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catapano AL, Cattaruzza MS, Cegolon L, Cembranel F, Cenko E, Cerin E, Chadwick J, Chakraborty C, Chakraborty S, Chan JSK, Chandika RM, Chandrasekar EK, Chanie GS, Chattu VK, Chaudhary AA, Chaurasia A, Chen H, Chen M, Chen S, Chi G, Chichagi F, Chimoriya R, Ching PR, Chitheer A, Cho SMJ, Choi DW, Chong B, Chong CL, Chopra H, Choudhari SG, Choudhary R, Chu DT, Chukwu IS, Chung SC, Cindi Z, Cioffi I, Cogen RM, Columbus A, Costanzo S, Couto RAS, Criqui MH, Cruz-Martins N, Cuadra-Hernández SM, da Silva AG, Dadana S, Dadras O, Dai X, Dalal K, Dalli LL, Damiani G, D'Amico E, Dandona L, Dandona R, Darwish AH, Das S, Dashti M, Dashtkoohi M, Dashtkoohi M, Dastmardi M, Davletov K, De la Cruz-Góngora V, DeAngelo S, Debele AT, Debopadhaya S, Delgado-Enciso I, Demessa BH, Demetriades AK, Denova-Gutiérrez E, Dervišević E, Desai HD, Desale AT, Desta F, Devanbu VGC, Devegowda D, Dewan SMR, Dhane AS, Dhimal M, Dhulipala VR, Diaz MJ, Diress M, Dodangeh M, Doegah PT, Dohare S, Doheim MF, Dokova KG, Dongarwar D, D'Oria M, Doshi OP, Doshi RP, Douiri A, Dowou RK, Dsouza AC, Dsouza HL, Dsouza VS, Duncan BB, Duraes AR, Dziedzic AM, Ekholuenetale M, El Bayoumy IF, El Sayed Zaki M, Elbarazi I, El-Dahiyat F, Elgendy IY, Elhadi M, El-Huneidi W, Elmonem MA, Elmoselhi AB, Eltaha C, Emeto TI, Esezobor CI, Esfandiari N, Esmaeili Z, Esposito F, Etoom M, Fabin N, Fadhil I, Fagbamigbe AF, Fagbule OF, Faghani S, Fahim A, Fakhradiyev IR, Falzone L, Fareed M, Fares J, Farinha CSES, Faris MEM, Faris PS, Farjoud Kouhanjani M, Faro A, Farrokhpour H, Fasanmi AO, Fauk NK, Fazeli P, Fazylov T, Feizkhah A, Fekadu G, Feng X, Fereshtehnejad SM, Ferrara P, Ferreira N, Fetensa G, Feyisa BR, Fischer F, Flor LS, Foley KM, Fonseca AC, Foroumadi R, Foroutan B, Fortuna D, Foschi M, Franklin RC, Fridayani NKY, G S, Gaal PA, Gaidhane AM, Gaipov A, Galali Y, Gallus S, Gandhi AP, Ganesan B, Gasevic D, Gautam P, Gautam RK, Gebregergis MW, Gebrehiwot M, Gebrekidan KG, Getacher L, Getahun GK, Getie M, Ghadimi DJ, Ghadirian F, Ghaffari Jolfayi A, Ghafourifard M, Ghasemi MR, Ghasemzadeh A, Ghazy RM, Gholami E, Gholami Z, Ghozy S, Giannoni Luza S, Gilani JA, Gill TK, Gillum RF, Gindaba EZ, Gnedovskaya EV, Goel A, Goldust M, Golechha M, Goleij P, Golinelli D, Gona PN, Gorini G, Goulart AC, Goulart BNG, Gouravani M, Grivna M, Grosso G, Grover A, Guan SY, Guarducci G, Guha A, Guicciardi S, Gulati S, Gunawardane DA, Guo C, Guo Z, Gupta AK, Gupta B, Gupta M, Gupta R, Gupta RD, Gupta R, Gupta S, Habibzadeh F, Hadi NR, Haghani Dogahe M, Haghi-Aminjan H, Haghmorad D, Haj-Mirzaian A, Halimi A, Hamdy NM, Hamidi S, Hamilton EB, Hanif A, Hanifi N, Hankey GJ, Hannan MA, Haq ZA, Hargono A, Harlianto NI, Haro JM, Has EMM, Hasaballah AI, Hasan I, Hasnain MS, Hassan I, Hassan Zadeh Tabatabaei MS, Haubold J, Havmoeller RJ, Hay SI, Hbid Y, Hebert JJ, Hegazi OE, Heidari M, Hemmati M, Heyi DZ, Hezam K, Hiraike Y, Hoan NQ, Holla R, Horita N, Hossain MM, Hosseinzadeh H, Hosseinzadeh M, Hosseinzadeh Adli A, Hostiuc M, Hostiuc S, Hu B, Hu C, Huang J, Humayun A, Hussain S, Huy LD, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ikiroma A, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Inbaraj LR, Iqhrammullah M, Iradukunda A, Irham LM, Islam MR, Ismail F, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CDCD, J V, Jaafari J, Jacob L, Jafarzadeh A, Jahrami H, Jain A, Jain N, Jairoun AA, Jaiswal A, Jakovljevic M, Jalilzadeh Yengejeh R, Janakiraman B, Jatau AI, Jayapal SK, Jayaram S, Jee SH, Jeganathan J, Jegnie M, Jema AT, Jeswani BM, Jeyakumar A, Jha AK, Jha RP, Ji Z, Jiang H, Jin S, Jin Y, Jokar M, Jonas JB, Joo T, Jose J, Joseph N, Joshua CE, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir MA, Kabir Z, Kadashetti V, Kalani R, Kalra S, Kamal VK, Kamireddy A, Kan H, Kanaan M, Kandel H, Kanmodi KK, Kantar RS, Kapoor N, Karakasis P, Karaye IM, Karch A, Karimi H, Karimi SE, Karimi Y, Karimi Behnagh A, Karki P, Kasraei H, Kauppila JH, Kaur H, Kaydi N, Kayode GA, Kazemi F, Kazemian S, Kesse-Guyot E, Khader YS, Khafaie MA, Khaing IK, Khajuria H, Khalaji A, Khalid N, Khalil AA, Khan A, Khan F, Khan MN, Khan M, Khan MJ, Khan MAB, Khan YH, Khanmohammadi S, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khidri FF, Khokhar M, Khosla AA, Khosravi M, Khubchandani J, Kian S, Kim K, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kolahi AA, Koly KN, Kompani F, Kondlahalli SKMM, Korja M, Korshunov VA, Korzh O, Kosen S, Kostev K, Kothari N, Kotnis AL, Koulmane Laxminarayana SL, Krishan K, Krishna V, Krishnamoorthy V, Krishnan B, Kruja J, Kuate Defo B, Kucuk Bicer B, Kuddus MA, Kuddus M, Kugbey N, Kulimbet M, Kulkarni V, Kumar A, Kumar A, Kumar D, Kumar GA, Kumar N, Kumar R, Kumaran D S, Kundu A, Kundu S, Kunutsor SK, Kurmi OP, Kusuma D, Kutikuppala LVS, Kuttikkattu A, Kytö V, La Vecchia C, Lacey B, Lahariya C, Lal DK, Lallukka T, Lám J, Landires I, Larsson AO, Lasrado S, Latifinaibin K, Lauriola P, Lavados PM, Lawal BK, Le LKD, Le NHH, Le TTT, Le TDT, Lee PH, Lee SW, Lee WC, Lee YH, Li MC, Li W, Li X, Li Y, Lim LL, Lim SS, Lin JC, Lindholm D, Linn S, Liu G, Liu R, Liu S, Liu X, Liu X, Llanaj E, Lo CH, Lo WD, Lohner V, López-Gil JF, Lorenzovici L, Lorkowski S, Lotufo PA, Lucchetti G, Luo L, Lusk JB, Ma ZF, Machoy M, Madadizadeh F, Maddison R, Mahmoudi E, Mahmoudvand G, Makram OM, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Manla Y, Mansouri MH, Mansouri P, Mansouri V, Mansournia MA, Mantovani LG, Manu E, Marateb HR, Marjani A, Martini D, Martini S, Martorell M, Maryam S, Marzo RR, Masrie A, Mathangasinghe Y, Maulik PK, Mayeli M, Mazidi M, McKee M, McPhail SM, Mechili EA, Mehmood A, Mehrabani-Zeinabad K, Mekene Meto T, Meles HN, Mendoza W, Menezes RG, Mensah GA, Meo SA, Meretoja A, Meretoja TJ, Mestrovic T, Mettananda CDK, Miazgowski T, Michalek IM, Micheletti Gomide Nogueira de Sá AC, Minervini G, Minh LHN, Mini GK, Mirghafourvand M, Mirica A, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Mishra M, Misra S, Mithra P, Mohamed AI, Mohamed J, Mohamed NS, Mohammad AM, Mohammadi E, Mohammadi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammadzadeh I, Mohammed H, Mohammed M, Mohammed S, Mohammed S, Mokdad AH, Molavi Vardanjani H, Molokhia M, Momani S, Monasta L, Moni MA, Montazeri F, Moodi Ghalibaf A, Moosazadeh M, Moradi M, Moradi Y, Moraga P, Morawska L, Moreira RS, Morrison SD, Mosaddeghi Heris R, Mossialos E, Mousavi P, Msherghi A, Mubarik S, Muccioli L, Mulita A, Muniyandi M, Munjal K, Murillo-Zamora E, Muthu S, Myung W, Nabavi A, Nabhan AF, Nafei A, Nagarajan AJ, Naghavi P, Naik GR, Naik G, Naimzada MD, Nair S, Nair TS, Najdaghi S, Najmuldeen HHR, Nakhostin Ansari N, Nangia V, Narasimha Swamy S, Nargus S, Narimani Davani D, Nascimento BR, Nascimento GG, Nasrollahizadeh A, Nasrollahizadeh A, Natto ZS, Nauman J, Navaratna SNK, Nayak BP, Nayak VC, Nazri-Panjaki A, Ndejjo R, Negoi I, Negoi RI, Nejadghaderi SA, Nejjari C, Nematollahi MH, Nepal S, Newton CRJ, Nguyen DH, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NNY, Nguyen PT, Nguyen VT, Niazi RK, Nigatu YT, Nikravangolsefid N, Ningrum DNA, Nnaji CA, Nnyanzi LA, Nomura S, Noor STA, Norrving B, Nawsherwan N, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nugen F, Nurchis MC, Nurrika D, Nzoputam CI, Nzoputam OJ, Oancea B, Obamiro KO, Odetokun IA, O'Donnell MJ, Oguta JO, Oh IH, Ojo-Akosile TR, Okati-Aliabad H, Okeke SR, Okekunle AP, Okidi L, Okonji OC, Oladnabi M, Olagunju AT, Olaiya MT, Olalusi OV, Olasehinde TA, Olasupo OO, Olatubi MI, Oliveira AB, Oliveira GMM, Olorukooba AA, Olufadewa II, Oluwafemi YDD, Oluwatunase GO, Omar HA, Omar Bali A, O'Neil AE, Ong SK, Onwujekwe OE, Opejin AO, Ordak M, Ornello R, Ortega-Altamirano DV, Ortiz A, Ortiz-Prado E, Osman WMS, Osuagwu UL, Otstavnov SS, Owolabi MO, Oyeyemi IT, Ozair A, P A MP, Pacheco-Barrios K, Padron-Monedero A, Padubidri JR, Palicz T, Palma-Alvarez RF, Pan F, Panda-Jonas S, Pande Katare D, Pandey A, Pandey A, Pandi-Perumal SR, Panos LD, Pantazopoulos I, Papadopoulou P, Pardhan S, Parija PP, Parikh RR, Parsons N, Passera R, Patoulias D, Paudel U, Pawar S, Peden AE, Pedersini P, Peprah P, Pereira MO, Peres MFP, Perianayagam A, Perico N, Perna S, Pestell RG, Petcu IR, Petermann-Rocha FE, Pham HN, Pham HT, Phillips MR, Pilgrim T, Piradov MA, Pirouzpanah S, Plotnikov E, Poddighe D, Poluru R, Popovic DS, Postma MJ, Pourshams A, Pourtaheri N, Pradhan J, Pradhan PMS, Prakash V, Prasad M, Prates EJS, Pribadi DRA, Puvvula J, Qattea I, Qian G, Qiao Y, Raggi A, Raghav PR, Raghuveer P, Rahim F, Rahim MJ, Rahimifard M, Rahimi-Movaghar V, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmanian M, Rahmanian N, Rahmanian V, Rahmati R, Rahmawaty S, Raj GM, Rajaa S, Rajendran V, Rajpoot PL, Rajput P, Ram P, Ramadan MM, Ramadan M, Ramanarayanan V, Ramasamy SK, Ramazanu S, Rana J, Rana K, Rana RK, Ranabhat CL, Rancic N, Rane A, Ranta A, Rao M, Rao SJ, Rashedi S, Rashidi MM, Rasouli-Saravani A, Rathish D, Rauniyar SK, Rawaf S, Razo C, Reddy MMRK, Redwan EMM, Rehman IU, Remuzzi G, Rezaei N, Rezaeian M, Rezazadeh H, Rhee TG, Riaz MA, Ribeiro ALP, Rodrigues M, Rodrigues da Silva TPR, Rodriguez JAB, Roever L, Romadlon DS, Ross AG, Rout HS, Roy B, Roy P, Roy S, Ruela GDA, Russo M, Rwegerera GM, S N C, Saad AMA, Saber K, Saber-Ayad MM, Sabet CJ, Sabour S, Sacco S, Saddik BA, Sadeghi E, Saeb MR, Saeed U, Safi SZZ, Sagar R, Saghafi A, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Sahoo PM, Sahoo SS, Sajid MR, Salami AA, Salaroli LB, Saleh MA, Salem MZY, Salum GA, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanabria J, Santos IS, Santric-Milicevic MM, Sarasmita MA, Saravanan A, Sarikhani Y, Sarode GS, Sarode SC, Satpathy M, Sattouf Z, Saya GK, Sayeed MA, Sayyah M, Scarmeas N, Schaarschmidt BM, Schlaich MP, Schmidt MI, Schneider IJC, Schuermans A, Schumacher AE, Schutte AE, Schwebel DC, Selvaraj S, Sen P, Senapati S, Senthilkumaran S, Sergindo MT, Sethi Y, Seylani A, Shafie M, Shah PA, Shahabi S, Shahbandi A, Shahid S, Shahsavari HR, Shahwan MJ, Shaikh MA, Shalash AS, Shamim MA, Shams-Beyranvand M, Shamsi A, Shamsutdinova A, Shanawaz M, Shannawaz M, Sharath M, Sharifan A, Sharifi A, Sharifi-Rad J, Sharma A, Sharma M, Sharma S, Sharma U, Sharma V, Sheikhi RA, Shetty A, Shetty M, Shetty PK, Shiferaw D, Shigematsu M, Shimels T, Shin MJ, Shiri R, Shittu A, Shitu AKO, Shiue I, Shorofi SA, Shrestha S, Shuval K, Si Y, Siddig EE, Sikdar M, Silva JP, Silva LMLR, Singh A, Singh B, Singh G, Singh H, Singh JA, Singh K, Singh NP, Singh P, Singh P, Sipilä JOT, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Sobia F, Socea B, Sohag AAM, Solanki R, Solanki S, Solomon Y, Song Y, Soraneh S, Sorensen RJD, Sotoudeh H, Soyiri IN, Spartalis M, Sreeramareddy CT, Srinivasamurthy SK, Stachteas P, Stafford LK, Stark BA, Starodubova AV, Subedi N, Subramaniyan V, Suleman M, Sultana A, Sun Z, Sundström J, Suresh V, Susanty S, Swain CK, Szarpak L, T Y SS, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabche C, Tabish M, Tadakamadla J, Tadakamadla SK, Taheri A, Taiba J, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tang H, Tanwar M, Tarigan IU, Tarkang EE, Tat NY, Tavangar SM, Tehrani-Banihashemi A, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfamariam WB, Tesfaye Gta EG, Thakur R, Thangaraju P, Thapa R, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas J, Thomas NKK, Thrift AG, Tian J, Tichopad A, Ticoalu JHV, Tiruneh C, Tiwari K, Tiyuri A, Tonelli M, Topor-Madry R, Tovani-Palone MR, Trabelsi K, Tran NH, Tran TH, Tran Minh Duc N, Trico D, Tromans SJ, Truyen TTTT, Tsai DHT, Tsatsakis A, Tsermpini EE, Turuse EAA, Tyrovolas S, Udoakang AJ, Udoh A, Ullah A, Ullah S, Umair M, Umar M, Unim B, Unnikrishnan B, Urso D, Usman JS, Vacante M, Vahabi SM, Vahdati S, Vaithinathan AG, Vakili O, Valizadeh R, Van den Eynde J, Varga O, Varthya SB, Vasankari TJ, Vellingiri B, Venketasubramanian N, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villani S, Vinayak M, Viskadourou M, Volovat SR, Volovici V, Wafa HA, Waheed Y, Wahood W, Wang C, Wang F, Wang S, Wang S, Wang Y, Wang YP, Wanjau MN, Waqas M, Wassie EG, Wassie GT, Wei Z, Weintraub RG, Weldetinsaa HL, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Willeit P, Wolfe CDA, Wong YJ, Wongsin U, Wu C, Wu F, Wu Y, Wu Z, Xiao H, Xu S, Xu X, Yamagishi K, Yang D, Yano Y, Yarahmadi A, Yaribeygi H, Yasufuku Y, Yatsuya H, Yazdanpanah F, Yazdanpanah MH, Ye P, Yesodharan R, Yezli S, Yi S, Yi X, Yin D, Yon DK, Yonemoto N, Yu C, Yu EA, Yun K, Yusuf H, Zadey S, Zafari N, Zaman BA, Zaman SB, Zanghì A, Zare I, Zarimeidani F, Zarrintan A, Zastrozhin M, Zemedikun D, Zeng Y, Zhang B, Zhang H, Zhang L, Zhang Y, Zhang Z, Zhao H, Zhong CC, Zhou SC, Zhu B, Zhu L, Zhumagaliuly A, Ziafati M, Zielińska M, Zikarg YT, Zoghi G, Zyoud SH, Zyoud SH, Johnson CO, Roth GA, Nair BS, Rautalin I, Bhati A, Bisignano C, Vos T, Murray CJL. Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:973-1003. [PMID: 39304265 DOI: 10.1016/s1474-4422(24)00369-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/10/2024] [Accepted: 08/28/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990-2021. METHODS We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. FINDINGS In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6-7·8] deaths; 10·7% [9·8-11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8-171·6] DALYs; 5·6% [5·0-6·1] of all DALYs). In 2021, there were 93·8 million (89·0-99·3) prevalent and 11·9 million (10·7-13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4-67·7), intracerebral haemorrhage constituted 28·8% (28·3-28·8), and subarachnoid haemorrhage constituted 5·8% (5·7-6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4-117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7-38·1]), diet high in sugar-sweetened beverages (23·4% [12·7-35·7]), low physical activity (11·3% [1·8-34·9]), high systolic blood pressure (6·7% [2·5-11·6]), lead exposure (6·5% [4·5-11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5-10·5]). INTERPRETATION Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. FUNDING Bill & Melinda Gates Foundation.
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Chin WS, Guo YLL, Chang YK, Huang LF, Hsu CC. Long-term exposure to NO 2 and PM 2.5 and the occurrence of chronic kidney disease among patients with type 2 diabetes in Taiwan. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 284:116940. [PMID: 39232296 DOI: 10.1016/j.ecoenv.2024.116940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 08/23/2024] [Accepted: 08/23/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Individuals diagnosed with type 2 diabetes (T2D) frequently exhibit chronic kidney disease (CKD) which may be caused by environmental hazards such as exposure to air pollutants. However, limited research has explored the effects of prolonged exposure to air pollutants on CKD development in this population. This study examines the relationship between long-term exposure to air pollutants and CKD incidence in a longitudinal cohort of individuals with type 2 diabetes in Taiwan METHODS: Between 2003 and 2005, we recruited 1316 T2D patients (693 females [52.66 %]; mean age 56.16 ± 8.97 years). Patients were followed until December 31, 2012, with at least two clinical visits. Baseline demographics, medical history, and biomarker levels were collected. The development of CKD was determined by eGFR level < 60 mL/min/1.73 m2. Monthly averages of nitrogen dioxide (NO2) and fine particulate matter [PM ≤ 2.5 μm in aerodynamic diameter (PM2.5)] were acquired from 72 ambient air monitoring stations. The kriging method was employed to estimate the exposure levels to PM2.5, NO2, temperature, and relative humidity in the participants' residential areas. Cox regression with time-dependent covariates regression was applied to assess the impact of long-term exposure to air pollutants and CKD risk. RESULTS Of 992 patients with normal renal function at baseline, 411 (41.43 %) experienced CKD occurrence over a median follow-up period of 5.45 years. The incidence of CKD was 93.96 cases per 1000 person-years. In multivariable adjusted models, patients exposed to PM2.5 levels above the third quartile of (>33.44 μg/m3) and NO2 levels above the fourth quartile (>22.55 ppb) were found to have an increased risk of CKD occurrence compared to lower exposure levels. CONCLUSIONS This longitudinal study highlights the increased risk of CKD in individuals with type 2 diabetes due to prolonged exposure to NO2 and PM2.5, emphasizing the need for tailored air quality management strategies for this high-risk population.
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Affiliation(s)
- Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of medicine and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, Taipei, Taiwan.
| | - Yu-Kang Chang
- Department of Medical Research, Tung's Taichung Metro Harbor Hospital, Taichung City, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.; Department of Nursing, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
| | - Li-Feng Huang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan.
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Chen AX, Fletcher R, Neuen BL, Neal B, Arnott C. An overview of the CANVAS Program and CREDENCE trial: The primary outcomes and key clinical implications for those managing patients with type 2 diabetes. Diabetes Obes Metab 2024; 26 Suppl 5:5-13. [PMID: 39036974 DOI: 10.1111/dom.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 07/23/2024]
Abstract
AIMS To provide an overview of the primary outcomes and key clinical implications of the CANVAS Program and CREDENCE trial, which were event-driven, double-blind randomized controlled trials that established the efficacy and safety of canagliflozin in those with type 2 diabetes (T2D) and high cardiovascular risk (CV) or albuminuric chronic kidney disease (CKD). METHODS AND RESULTS The CANVAS programme (CANVAS and CANVAS-R trials) randomized 10 142 people with T2D and high CV risk to canagliflozin or placebo and followed them for a median of 126 weeks. The primary efficacy outcome was met, with canagliflozin treatment associated with a 14% reduction in major adverse CV events (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.75 to 0.97; p < 0.001) as compared to placebo. The CREDENCE trial randomized 4401 individuals with T2D and albuminuric CKD to canagliflozin or placebo and followed them for 109 weeks. The CREDENCE trial also met its primary endpoint; canagliflozin treatment was associated with a 30% reduction in the composite of kidney failure, sustained doubling of serum creatinine level, or death from kidney or CV causes (HR 0.70, 95% CI 0.59 to 0.82; p < 0.001). Substantial reductions in hospitalization for heart failure (CANVAS: HR 0.67, 95% CI 0.52 to 0.87; CREDENCE: HR 0.61, 95% CI 0.47 to 0.80) and other key CV and kidney outcomes were also identified. Relative clinical benefits were consistent across subgroups defined by baseline age, sex, kidney function and history of CV disease but absolute benefits were greatest in those at highest baseline risk. Total serious adverse events were less common with canagliflozin treatment. Concerns about amputation and fracture risk observed in the CANVAS Program were not seen in CREDENCE and appear to have been spurious chance findings. CONCLUSION Canagliflozin reduced important CV, kidney and mortality outcomes in those with T2D and high CV risk or CKD across diverse patient groups, with a good safety profile. Taken together with the other sodium-glucose cotransporter-2 inhibitor CV and renal outcomes trials, these landmark findings have changed the treatment landscape for patients worldwide.
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Affiliation(s)
- Angela X Chen
- Cardiovascular Program, The George Institute of Global Health, University of New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, Australia
| | - Robert Fletcher
- Cardiovascular Program, The George Institute of Global Health, University of New South Wales, Sydney, Australia
| | - Brendon L Neuen
- Cardiovascular Program, The George Institute of Global Health, University of New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- Department of Renal Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Bruce Neal
- Cardiovascular Program, The George Institute of Global Health, University of New South Wales, Sydney, Australia
| | - Clare Arnott
- Cardiovascular Program, The George Institute of Global Health, University of New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Du Y, Zhang M, Wang Z, Hu M, Xie D, Wang X, Guo Z, Zhu J, Zhang W, Luo Z, Yang C. A real-world disproportionality analysis of semaglutide: Post-marketing pharmacovigilance data. J Diabetes Investig 2024; 15:1422-1433. [PMID: 38943656 DOI: 10.1111/jdi.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 07/01/2024] Open
Abstract
AIM/INTRODUCTION The recent adverse reactions associated with semaglutide have led the Food and Drug Administration (FDA) to issue a "black box warning", and it is necessary to analyze all reports of adverse reactions to improve the safety of its clinical use. MATERIALS AND METHODS Statistical analyses and signal mining were performed by obtaining the adverse event reports related to semaglutide in the FAERS database from the first quarter of 2018 to the fourth quarter of 2023. We used disproportionality and Bayesian analysis to examine clinical and demographic attributes, trends reported quarterly, and contrasts between two distinct indications (obesity and type 2 diabetes). RESULTS We found 10 unexpected adverse signals related to "pancreatic cancer", "intestinal obstruction", "cholecystitis", and "polycystic ovary" and both the two different indications had the same serious adverse reaction events occurring. CONCLUSIONS This study identified many unexpected signals of serious adverse reactions, suggesting the importance of continuous post-marketing surveillance of semaglutide to understand its potential risks.
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Affiliation(s)
- Yikuan Du
- Central Laboratory, The Tenth Affiliated Hospital of Southern Medical University, Dongguan, China
| | - Mengting Zhang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Zhenjie Wang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Mianda Hu
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Dongxia Xie
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Xiuzhu Wang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Zhuoming Guo
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Jinfeng Zhu
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Weichui Zhang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Ziyi Luo
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Chun Yang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
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Pan G, Lu Y, Wei Z, Li Y, Li L, Pan X. A review on the in vitro and in vivo screening of α-glucosidase inhibitors. Heliyon 2024; 10:e37467. [PMID: 39309836 PMCID: PMC11415703 DOI: 10.1016/j.heliyon.2024.e37467] [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: 06/25/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
As a global metabolic disease, the control and treatment of diabetes have always been the focus of medical research. α-Glucosidase is a key enzyme in regulating blood glucose levels and has important applications in the treatment of diabetes. This review aims to explore the enzyme activity of α-glucosidase and its inhibition mechanism and evaluate the efficacy and limitations of existing inhibitor screening methods. First, the chemical structure, biological activity, and influencing factors of α-glucosidase on diabetes are discussed in detail. Then, the various methods that have been used to screen α-glucosidase inhibitors in recent years are reviewed, including in vivo animal experiments, in vitro experiments, and virtual molecular docking. The experimental principles, advantages, and limitations of each method and their application in discovering new inhibitors are also discussed. Finally, this review emphasizes the importance of developing efficient and safe α-glucosidase inhibitors, summarizes the advantages and disadvantages of various screening models, and proposes future research directions. This review comprehensively examines the enzyme activity of α-glucosidase and the screening methods for α-glucosidase inhibitors, provides an important perspective in the field of diabetes drug discovery and development, and provides a reference for future research.
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Affiliation(s)
- Guangjuan Pan
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Yantong Lu
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Zhiying Wei
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Yaohua Li
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Li Li
- Guangxi University of Chinese Medicine, Nanning, 530200, China
- Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine, Nanning, 530200, China
- The Collaborative Innovation Center of Zhuang and Yao Ethnic Medicine, Nanning, 530200, China
- Guangxi Engineering Research Center of Ethnic Medicine Resources and Application, Nanning, 530200, China
| | - Xiaojiao Pan
- Guangxi University of Chinese Medicine, Nanning, 530200, China
- Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine, Nanning, 530200, China
- The Collaborative Innovation Center of Zhuang and Yao Ethnic Medicine, Nanning, 530200, China
- Guangxi Engineering Research Center of Ethnic Medicine Resources and Application, Nanning, 530200, China
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Liu M, Liu T, Zhang J, Liu Y, Zhao Y, Zhu Y, Bai J, Fan S, Cui S, He Y, Xiao X. Study on the Mechanism of Effect of Protein on Starch Digestibility in Fermented Barley. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024. [PMID: 39344594 DOI: 10.1021/acs.jafc.4c04264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Previous studies have shown that fermented barley has a lower digestion rate. However, it remains unclear whether the antidigestibility of starch in fermented barley is affected by other nonstarch components. In this paper, the removal of protein, lipid, and β-glucan improved the hydrolysis rate of starch and the protein showed the greatest effect. Subsequently, the inhibitory mechanism of protein on starch digestion was elucidated from the perspective of starch physicochemical properties and structural changes. The removal of protein increased the swelling power of starch from 10.09 to 11.14%. The short-range molecular ordered structure and the helical structure content decreased. The removal of protein reduced the coating and particle size of the starch particles, making the Maltese cross more dispersed. In summary, protein in fermented barley enhanced the ordered structure of starch by forming a physical barrier around starch and prevented the expansion of starch, which inhibited the hydrolysis of starch.
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Affiliation(s)
- Mengting Liu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Tao Liu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Jiayan Zhang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Yuhao Liu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Yansheng Zhao
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Ying Zhu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Juan Bai
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Songtao Fan
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Shumao Cui
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Yufeng He
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Xiang Xiao
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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Morales J, King A, Oser S, D'Souza S. Advances in insulin: a review of icodec as a novel once-weekly treatment for type 2 diabetes. Postgrad Med 2024. [PMID: 39348567 DOI: 10.1080/00325481.2024.2410694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 09/25/2024] [Accepted: 09/26/2024] [Indexed: 10/02/2024]
Abstract
Type 2 diabetes (T2D) is a chronic condition that requires not only a team-based approach but also substantial self-management by those affected. Patient-clinician barriers such as lack of educational resources, hesitancy in initiation of therapy, concerns over treatment-related side effects, frequency of dosing, and the establishment of treatment goals, can prevent a patient from achieving optimal glycemic management. Recently, advances in diabetes technology and insulin formulations have helped to address some of these concerns. Insulin icodec, the first once-weekly basal insulin analog, has demonstrated efficacy and safety comparable to traditional basal insulin formulations. Since clinicians and patients may benefit from a once-weekly therapy, this review sought to evaluate the potential clinical implications of insulin icodec. A literature search was performed using PubMed, Google Scholar, and ClinicalTrials.gov up to 31 January 2024. Key search terms such as once-weekly basal insulin, icodec, and ONWARDS were utilized to compile relevant publications. Further, studies involving patients living with T2D on once-weekly insulin icodec compared with once-daily basal insulin were considered for this review. Findings from this review suggest insulin icodec can offer a reduced dosing frequency that may improve medication adherence, provide effective glycemic management, and a comparable safety profile to existing basal insulins. In summary, insulin icodec may help to remove patient-clinician barriers associated with suboptimal glycemic management with its once-weekly dosing schedule. Clinicians can further support a patient's ability to self-manage the disease through continued monitoring and guidance on the use of icodec.
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Affiliation(s)
- Javier Morales
- Donald and Barbara Zucker School of Medicine at Hofstra University Northwell, Uniondale, NY, USA
| | - Aaron King
- Baptist Medical Center, San Antonio, TX, USA
| | - Sean Oser
- University of Colorado School of Medicine, Denver, CO, USA
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26
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Valensi P. Evidence of a bi-directional relationship between heart failure and diabetes: a strategy for the detection of glucose abnormalities and diabetes prevention in patients with heart failure. Cardiovasc Diabetol 2024; 23:354. [PMID: 39342254 PMCID: PMC11439233 DOI: 10.1186/s12933-024-02436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 09/10/2024] [Indexed: 10/01/2024] Open
Abstract
Prevalence of heart failure (HF) and diabetes are markedly increasing globally. In a population of HF patients, approximately 40% have diabetes which is associated with a more severe HF, poorer cardiovascular outcomes and higher hospitalization rates for HF than HF patients without diabetes. Similar trends were shown in HF patients with prediabetes. In addition, the association between HF and renal function decline was demonstrated in patients with or without diabetes. However, the exact prevalence of dysglycemia in HF patients requires further investigation aiming to clarify the most accurate test to detect dysglycemia in this population. The relationship between HF and diabetes is complex and probably bidirectional. In one way, patients with diabetes have a more than two-fold risk of developing incident HF with reduced or preserved ejection fraction than those without diabetes. In the other way, patients with HF, when compared with those without HF, show an increased risk for the onset of diabetes due to several mechanisms including insulin resistance (IR), which makes HF emerging as a precursor for diabetes development. This article provides epidemiological evidence of undetected dysglycemia (prediabetes or diabetes) in HF patients and reviews the pathophysiological mechanisms which favor the development of IR and the risks associated with these disorders in HF patients. This review also offers a discussion of various strategies for the prevention of diabetes in HF patients, based first on fasting plasma glucose and HbA1c measurement and if normal on an oral glucose tolerance test as diagnostic tools for prediabetes and unknown diabetes that should be performed more extensively in those patients. It discusses the implementation of diabetes prevention measures and well-structured management programs for HF patients who are generally overweight or obese, as well as current pharmacotherapeutic options for prediabetes, including sodium-glucose cotransporter 2 inhibitors which are among the pillars of HF treatment and which recently showed a benefit in the reduction of incident diabetes in HF patients. Thus, there is an urgent need of routine screening for dysglycemia in all HF patients, which should contribute to reduce the incidence of diabetes and to treat earlier diabetes when already present.
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Affiliation(s)
- Paul Valensi
- Polyclinique d'Aubervilliers, Aubervilliers and Paris Nord University, Bobigny, France.
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27
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Li Y, Yao W, Wang T, Yang Q, Song K, Zhang F, Wang F, Dang Y. Association of semaglutide treatment with coronary artery inflammation in type 2 diabetes mellitus patients: a retrospective study based on pericoronary adipose tissue attenuation. Cardiovasc Diabetol 2024; 23:348. [PMID: 39342279 PMCID: PMC11439223 DOI: 10.1186/s12933-024-02445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 09/17/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND The pericoronary fat attenuation index (FAI) has emerged as a novel and sensitive biomarker reflecting the degree of coronary artery inflammation. Semaglutide has been demonstrated to exert a cardiovascular protective effect independent of hypoglycemia; however, its impact on coronary artery inflammation remains elusive. This study aimed to investigate the association between semaglutide treatment and coronary artery inflammation based on FAI in patients with type 2 diabetes mellitus (T2DM). METHODS This study enrolled 497 T2DM patients who underwent coronary computed tomography angiography (CCTA) at Hebei General Hospital, of whom 93 treated with semaglutide (Sema+) and 404 did not (Sema-). Clinical data, laboratory indicators, and CCTA parameters were collected and compared between the two groups at baseline. Propensity score matching (PSM) was used to adjust for confounders, and pericoronary FAI was compared. Multivariate linear regression models were used to analyze the association between semaglutide treatment and pericoronary FAI. RESULTS Before PSM, pericoronary FAI of the LAD and LCX was lower in patients treated with semaglutide than those without semaglutide treatment. The results of the PSM analysis revealed a lower FAI in all three major coronary arteries in the Sema + group compared to the Sema- group. Multivariate linear regression analyses revealed an independent association between semaglutide treatment and reduced FAI in all three major coronary arteries. This association varied across T2DM patients of differing profiles. CONCLUSION Semaglutide treatment may be associated with lower coronary artery inflammation in patients with T2DM, which might partially explain its cardiovascular protective mechanism.
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Affiliation(s)
- Yanhong Li
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China
- Department of Internal Medicine, Graduate School of Hebei Medical University, Shijiazhuang, China
| | - Wenjing Yao
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China
| | - Tianxing Wang
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China
| | - Qian Yang
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China.
| | - Kexin Song
- Department of Internal Medicine, Graduate School of Hebei Medical University, Shijiazhuang, China
| | - Feifei Zhang
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China
| | - Fan Wang
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China
| | - Yi Dang
- Department of Cardiology Center, Hebei General Hospital, Shijiazhuang, China.
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Naghavi M, Vollset SE, Ikuta KS, Swetschinski LR, Gray AP, Wool EE, Robles Aguilar G, Mestrovic T, Smith G, Han C, Hsu RL, Chalek J, Araki DT, Chung E, Raggi C, Gershberg Hayoon A, Davis Weaver N, Lindstedt PA, Smith AE, Altay U, Bhattacharjee NV, Giannakis K, Fell F, McManigal B, Ekapirat N, Mendes JA, Runghien T, Srimokla O, Abdelkader A, Abd-Elsalam S, Aboagye RG, Abolhassani H, Abualruz H, Abubakar U, Abukhadijah HJ, Aburuz S, Abu-Zaid A, Achalapong S, Addo IY, Adekanmbi V, Adeyeoluwa TE, Adnani QES, Adzigbli LA, Afzal MS, Afzal S, Agodi A, Ahlstrom AJ, Ahmad A, Ahmad S, Ahmad T, Ahmadi A, Ahmed A, Ahmed H, Ahmed I, Ahmed M, Ahmed S, Ahmed SA, Akkaif MA, Al Awaidy S, Al Thaher Y, Alalalmeh SO, AlBataineh MT, Aldhaleei WA, Al-Gheethi AAS, Alhaji NB, Ali A, Ali L, Ali SS, Ali W, Allel K, Al-Marwani S, Alrawashdeh A, Altaf A, Al-Tammemi AB, Al-Tawfiq JA, Alzoubi KH, Al-Zyoud WA, Amos B, Amuasi JH, Ancuceanu R, Andrews JR, Anil A, Anuoluwa IA, Anvari S, Anyasodor AE, Apostol GLC, Arabloo J, Arafat M, Aravkin AY, Areda D, Aremu A, Artamonov AA, Ashley EA, Asika MO, Athari SS, Atout MMW, Awoke T, Azadnajafabad S, Azam JM, Aziz S, Azzam AY, Babaei M, Babin FX, Badar M, Baig AA, Bajcetic M, Baker S, Bardhan M, Barqawi HJ, Basharat Z, Basiru A, Bastard M, Basu S, Bayleyegn NS, Belete MA, Bello OO, Beloukas A, Berkley JA, Bhagavathula AS, Bhaskar S, Bhuyan SS, Bielicki JA, Briko NI, Brown CS, Browne AJ, Buonsenso D, Bustanji Y, Carvalheiro CG, Castañeda-Orjuela CA, Cenderadewi M, Chadwick J, Chakraborty S, Chandika RM, Chandy S, Chansamouth V, Chattu VK, Chaudhary AA, Ching PR, Chopra H, Chowdhury FR, Chu DT, Chutiyami M, Cruz-Martins N, da Silva AG, Dadras O, Dai X, Darcho SD, Das S, De la Hoz FP, Dekker DM, Dhama K, Diaz D, Dickson BFR, Djorie SG, Dodangeh M, Dohare S, Dokova KG, Doshi OP, Dowou RK, Dsouza HL, Dunachie SJ, Dziedzic AM, Eckmanns T, Ed-Dra A, Eftekharimehrabad A, Ekundayo TC, El Sayed I, Elhadi M, El-Huneidi W, Elias C, Ellis SJ, Elsheikh R, Elsohaby I, Eltaha C, Eshrati B, Eslami M, Eyre DW, Fadaka AO, Fagbamigbe AF, Fahim A, Fakhri-Demeshghieh A, Fasina FO, Fasina MM, Fatehizadeh A, Feasey NA, Feizkhah A, Fekadu G, Fischer F, Fitriana I, Forrest KM, Fortuna Rodrigues C, Fuller JE, Gadanya MA, Gajdács M, Gandhi AP, Garcia-Gallo EE, Garrett DO, Gautam RK, Gebregergis MW, Gebrehiwot M, Gebremeskel TG, Geffers C, Georgalis L, Ghazy RM, Golechha M, Golinelli D, Gordon M, Gulati S, Gupta RD, Gupta S, Gupta VK, Habteyohannes AD, Haller S, Harapan H, Harrison ML, Hasaballah AI, Hasan I, Hasan RS, Hasani H, Haselbeck AH, Hasnain MS, Hassan II, Hassan S, Hassan Zadeh Tabatabaei MS, Hayat K, He J, Hegazi OE, Heidari M, Hezam K, Holla R, Holm M, Hopkins H, Hossain MM, Hosseinzadeh M, Hostiuc S, Hussein NR, Huy LD, Ibáñez-Prada ED, Ikiroma A, Ilic IM, Islam SMS, Ismail F, Ismail NE, Iwu CD, Iwu-Jaja CJ, Jafarzadeh A, Jaiteh F, Jalilzadeh Yengejeh R, Jamora RDG, Javidnia J, Jawaid T, Jenney AWJ, Jeon HJ, Jokar M, Jomehzadeh N, Joo T, Joseph N, Kamal Z, Kanmodi KK, Kantar RS, Kapisi JA, Karaye IM, Khader YS, Khajuria H, Khalid N, Khamesipour F, Khan A, Khan MJ, Khan MT, Khanal V, Khidri FF, Khubchandani J, Khusuwan S, Kim MS, Kisa A, Korshunov VA, Krapp F, Krumkamp R, Kuddus M, Kulimbet M, Kumar D, Kumaran EAP, Kuttikkattu A, Kyu HH, Landires I, Lawal BK, Le TTT, Lederer IM, Lee M, Lee SW, Lepape A, Lerango TL, Ligade VS, Lim C, Lim SS, Limenh LW, Liu C, Liu X, Liu X, Loftus MJ, M Amin HI, Maass KL, Maharaj SB, Mahmoud MA, Maikanti-Charalampous P, Makram OM, Malhotra K, Malik AA, Mandilara GD, Marks F, Martinez-Guerra BA, Martorell M, Masoumi-Asl H, Mathioudakis AG, May J, McHugh TA, Meiring J, Meles HN, Melese A, Melese EB, Minervini G, Mohamed NS, Mohammed S, Mohan S, Mokdad AH, Monasta L, Moodi Ghalibaf A, Moore CE, Moradi Y, Mossialos E, Mougin V, Mukoro GD, Mulita F, Muller-Pebody B, Murillo-Zamora E, Musa S, Musicha P, Musila LA, Muthupandian S, Nagarajan AJ, Naghavi P, Nainu F, Nair TS, Najmuldeen HHR, Natto ZS, Nauman J, Nayak BP, Nchanji GT, Ndishimye P, Negoi I, Negoi RI, Nejadghaderi SA, Nguyen QP, Noman EA, Nwakanma DC, O'Brien S, Ochoa TJ, Odetokun IA, Ogundijo OA, Ojo-Akosile TR, Okeke SR, Okonji OC, Olagunju AT, Olivas-Martinez A, Olorukooba AA, Olwoch P, Onyedibe KI, Ortiz-Brizuela E, Osuolale O, Ounchanum P, Oyeyemi OT, P A MP, Paredes JL, Parikh RR, Patel J, Patil S, Pawar S, Peleg AY, Peprah P, Perdigão J, Perrone C, Petcu IR, Phommasone K, Piracha ZZ, Poddighe D, Pollard AJ, Poluru R, Ponce-De-Leon A, Puvvula J, Qamar FN, Qasim NH, Rafai CD, Raghav P, Rahbarnia L, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman MA, Ramadan H, Ramasamy SK, Ramesh PS, Ramteke PW, Rana RK, Rani U, Rashidi MM, Rathish D, Rattanavong S, Rawaf S, Redwan EMM, Reyes LF, Roberts T, Robotham JV, Rosenthal VD, Ross AG, Roy N, Rudd KE, Sabet CJ, Saddik BA, Saeb MR, Saeed U, Saeedi Moghaddam S, Saengchan W, Safaei M, Saghazadeh A, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahu M, Saki M, Salam N, Saleem Z, Saleh MA, Samodra YL, Samy AM, Saravanan A, Satpathy M, Schumacher AE, Sedighi M, Seekaew S, Shafie M, Shah PA, Shahid S, Shahwan MJ, Shakoor S, Shalev N, Shamim MA, Shamshirgaran MA, Shamsi A, Sharifan A, Shastry RP, Shetty M, Shittu A, Shrestha S, Siddig EE, Sideroglou T, Sifuentes-Osornio J, Silva LMLR, Simões EAF, Simpson AJH, Singh A, Singh S, Sinto R, Soliman SSM, Soraneh S, Stoesser N, Stoeva TZ, Swain CK, Szarpak L, T Y SS, Tabatabai S, Tabche C, Taha ZMA, Tan KK, Tasak N, Tat NY, Thaiprakong A, Thangaraju P, Tigoi CC, Tiwari K, Tovani-Palone MR, Tran TH, Tumurkhuu M, Turner P, Udoakang AJ, Udoh A, Ullah N, Ullah S, Vaithinathan AG, Valenti M, Vos T, Vu HTL, Waheed Y, Walker AS, Walson JL, Wangrangsimakul T, Weerakoon KG, Wertheim HFL, Williams PCM, Wolde AA, Wozniak TM, Wu F, Wu Z, Yadav MKK, Yaghoubi S, Yahaya ZS, Yarahmadi A, Yezli S, Yismaw YE, Yon DK, Yuan CW, Yusuf H, Zakham F, Zamagni G, Zhang H, Zhang ZJ, Zielińska M, Zumla A, Zyoud SHH, Zyoud SH, Hay SI, Stergachis A, Sartorius B, Cooper BS, Dolecek C, Murray CJL. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. Lancet 2024; 404:1199-1226. [PMID: 39299261 DOI: 10.1016/s0140-6736(24)01867-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/20/2024] [Accepted: 09/03/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Antimicrobial resistance (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future forecasts. METHODS We estimated all-age and age-specific deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 22 pathogens, 84 pathogen-drug combinations, and 11 infectious syndromes in 204 countries and territories from 1990 to 2021. We collected and used multiple cause of death data, hospital discharge data, microbiology data, literature studies, single drug resistance profiles, pharmaceutical sales, antibiotic use surveys, mortality surveillance, linkage data, outpatient and inpatient insurance claims data, and previously published data, covering 520 million individual records or isolates and 19 513 study-location-years. We used statistical modelling to produce estimates of AMR burden for all locations, including those with no data. Our approach leverages the estimation of five broad component quantities: the number of deaths involving sepsis; the proportion of infectious deaths attributable to a given infectious syndrome; the proportion of infectious syndrome deaths attributable to a given pathogen; the percentage of a given pathogen resistant to an antibiotic of interest; and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden attributable to and associated with AMR, which we define based on two counterfactuals; respectively, an alternative scenario in which all drug-resistant infections are replaced by drug-susceptible infections, and an alternative scenario in which all drug-resistant infections were replaced by no infection. Additionally, we produced global and regional forecasts of AMR burden until 2050 for three scenarios: a reference scenario that is a probabilistic forecast of the most likely future; a Gram-negative drug scenario that assumes future drug development that targets Gram-negative pathogens; and a better care scenario that assumes future improvements in health-care quality and access to appropriate antimicrobials. We present final estimates aggregated to the global, super-regional, and regional level. FINDINGS In 2021, we estimated 4·71 million (95% UI 4·23-5·19) deaths were associated with bacterial AMR, including 1·14 million (1·00-1·28) deaths attributable to bacterial AMR. Trends in AMR mortality over the past 31 years varied substantially by age and location. From 1990 to 2021, deaths from AMR decreased by more than 50% among children younger than 5 years yet increased by over 80% for adults 70 years and older. AMR mortality decreased for children younger than 5 years in all super-regions, whereas AMR mortality in people 5 years and older increased in all super-regions. For both deaths associated with and deaths attributable to AMR, meticillin-resistant Staphylococcus aureus increased the most globally (from 261 000 associated deaths [95% UI 150 000-372 000] and 57 200 attributable deaths [34 100-80 300] in 1990, to 550 000 associated deaths [500 000-600 000] and 130 000 attributable deaths [113 000-146 000] in 2021). Among Gram-negative bacteria, resistance to carbapenems increased more than any other antibiotic class, rising from 619 000 associated deaths (405 000-834 000) in 1990, to 1·03 million associated deaths (909 000-1·16 million) in 2021, and from 127 000 attributable deaths (82 100-171 000) in 1990, to 216 000 (168 000-264 000) attributable deaths in 2021. There was a notable decrease in non-COVID-related infectious disease in 2020 and 2021. Our forecasts show that an estimated 1·91 million (1·56-2·26) deaths attributable to AMR and 8·22 million (6·85-9·65) deaths associated with AMR could occur globally in 2050. Super-regions with the highest all-age AMR mortality rate in 2050 are forecasted to be south Asia and Latin America and the Caribbean. Increases in deaths attributable to AMR will be largest among those 70 years and older (65·9% [61·2-69·8] of all-age deaths attributable to AMR in 2050). In stark contrast to the strong increase in number of deaths due to AMR of 69·6% (51·5-89·2) from 2022 to 2050, the number of DALYs showed a much smaller increase of 9·4% (-6·9 to 29·0) to 46·5 million (37·7 to 57·3) in 2050. Under the better care scenario, across all age groups, 92·0 million deaths (82·8-102·0) could be cumulatively averted between 2025 and 2050, through better care of severe infections and improved access to antibiotics, and under the Gram-negative drug scenario, 11·1 million AMR deaths (9·08-13·2) could be averted through the development of a Gram-negative drug pipeline to prevent AMR deaths. INTERPRETATION This study presents the first comprehensive assessment of the global burden of AMR from 1990 to 2021, with results forecasted until 2050. Evaluating changing trends in AMR mortality across time and location is necessary to understand how this important global health threat is developing and prepares us to make informed decisions regarding interventions. Our findings show the importance of infection prevention, as shown by the reduction of AMR deaths in those younger than 5 years. Simultaneously, our results underscore the concerning trend of AMR burden among those older than 70 years, alongside a rapidly ageing global community. The opposing trends in the burden of AMR deaths between younger and older individuals explains the moderate future increase in global number of DALYs versus number of deaths. Given the high variability of AMR burden by location and age, it is important that interventions combine infection prevention, vaccination, minimisation of inappropriate antibiotic use in farming and humans, and research into new antibiotics to mitigate the number of AMR deaths that are forecasted for 2050. FUNDING UK Department of Health and Social Care's Fleming Fund using UK aid, and the Wellcome Trust.
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Stel VS, Boenink R, Astley ME, Boerstra BA, Radunovic D, Skrunes R, Ruiz San Millán JC, Slon Roblero MF, Bell S, Ucio Mingo P, Ten Dam MAGJ, Ambühl PM, Resic H, Rodríguez Arévalo OL, Aresté-Fosalba N, Tort I Bardolet J, Lassalle M, Trujillo-Alemán S, Indridason OS, Artamendi M, Finne P, Rodríguez Camblor M, Nitsch D, Hommel K, Moustakas G, Kerschbaum J, Lausevic M, Jager KJ, Ortiz A, Kramer A. A comparison of the epidemiology of kidney replacement therapy between Europe and the United States: 2021 data of the ERA Registry and the USRDS. Nephrol Dial Transplant 2024; 39:1593-1603. [PMID: 38439701 DOI: 10.1093/ndt/gfae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND This paper compares the most recent data on the incidence and prevalence of kidney replacement therapy (KRT), kidney transplantation rates, and mortality on KRT from Europe to those from the United States (US), including comparisons of treatment modalities (haemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx)). METHODS Data were derived from the annual reports of the European Renal Association (ERA) Registry and the United States Renal Data System (USRDS). The European data include information from national and regional renal registries providing the ERA Registry with individual patient data. Additional analyses were performed to present results for all participating European countries together. RESULTS In 2021, the KRT incidence in the US (409.7 per million population (pmp)) was almost 3-fold higher than in Europe (144.4 pmp). Despite the substantial difference in KRT incidence, approximately the same proportion of patients initiated HD (Europe: 82%, US: 84%), PD (14%; 13%, respectively), or underwent pre-emptive KTx (4%; 3%, respectively). The KRT prevalence in the US (2436.1 pmp) was 2-fold higher than in Europe (1187.8 pmp). Within Europe, approximately half of all prevalent patients were living with a functioning graft (47%), while in the US, this was one third (32%). The number of kidney transplantations performed was almost twice as high in the US (77.0 pmp) compared to Europe (41.6 pmp). The mortality of patients receiving KRT was 1.6-fold higher in the US (157.3 per 1000 patient years) compared to Europe (98.7 per 1000 patient years). CONCLUSIONS The US had a much higher KRT incidence, prevalence, and mortality compared to Europe, and despite a higher kidney transplantation rate, a lower proportion of prevalent patients with a functioning graft.
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Affiliation(s)
- Vianda S Stel
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Rianne Boenink
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Megan E Astley
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Brittany A Boerstra
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Danilo Radunovic
- Clinical Center of Montenegro, Clinic for Nephrology, Podgorica, Montenegro
| | - Rannveig Skrunes
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Juan C Ruiz San Millán
- Nephrology Department, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Maria F Slon Roblero
- Nephrology Department, Hospital Universitario de Navarra, Pamplona, Navarre, Spain
| | - Samira Bell
- Scottish Renal Registry, Public Health Scotland, Meridian Court, Glasgow, UK
- Division of Population Health and Genomics, University of Dundee, Dundee, UK
| | - Pablo Ucio Mingo
- Coordinación Autonómica de Trasplantes de Castilla y León, Dirección General de Asistencia Sanitaria y Humanización, Gerencia Regional de Salud de Castilla y León, Valladolid, Castilla y León, Spain
| | | | | | - Halima Resic
- Society for Nephrology, Dialysis and Transplantation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Olga Lucia Rodríguez Arévalo
- Registry of Kidney Patients of the Valencian Community, General Directorate of Public Health, Ministry of Health, Valencia, Spain
- Health and Well-being Technologies Program, Polytechnic University of Valencia, Valencia, Spain
| | - Nuria Aresté-Fosalba
- Nephrology Department, Virgen Macarena Hospital, Seville, Andalusia, Spain
- Information System of Andalusian Transplant Coordination (SICATA), Seville, Andalusia, Spain
| | - Jaume Tort I Bardolet
- Catalan Transplant Organization (OCATT), Catalan Health Service, Department of Health, Barcelona, Spain
| | - Mathilde Lassalle
- REIN Registry (Renal Epidemiology and Information Network), Paris, France
| | - Sara Trujillo-Alemán
- Health Quality Assessment and Information System Service, Dirección General de Programas Asistenciales, Servicio Canario de la Salud, Las Palmas de Gran Canaria, Spain
| | - Olafur S Indridason
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Marta Artamendi
- Nephrology Department, Hospital San Pedro, Logroño, La Rioja, Spain
| | - Patrik Finne
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Renal Unit, Royal Free London NHS Foundation Trust, UK Kidney Association, Bristol, UK
| | - Kristine Hommel
- Department of Nephrology, Holbaek Hospital, Holbaek, Denmark
| | - George Moustakas
- Nephrology Department, General Hospital of Athens 'G.Gennimatas', Athens, Greece
| | - Julia Kerschbaum
- Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Mirjana Lausevic
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic of Nephrology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Alberto Ortiz
- Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
- Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Anneke Kramer
- ERA Registry, Department of Medical Informatics, Amsterdam UMC Location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Matsuda N, Seo D, Suzuki R, Dannoura Y, Horiuchi K. Free Flap Limb Salvage and Ulcer Recurrence in Chronic Limb-threatening Ischemia. INT J LOW EXTR WOUND 2024:15347346241287335. [PMID: 39328168 DOI: 10.1177/15347346241287335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Abstract
Free flap transfer is a well-established treatment for foot reconstruction in patients with chronic limb-threatening ischemia (CLTI) and can achieve prolonged amputation-free survival. However, reports on ulcer recurrence after free flap transfer are scarce, with most focusing on trauma patients. Therefore, we retrospectively reviewed patients with CLTI who underwent free flap reconstruction at our institution over a 17-year period. Patient characteristics, ulcer recurrence rates, activity level, and variables associated with ulcer recurrence were investigated in patients who met the following criteria: successful reconstructive surgery, complete wound healing, and at least 1 year of follow-up. Free flap foot reconstruction was performed in 42 patients (92.9% male, 7.1% female; mean age 57.1 years, range 37-81 years). Among them, 39 patients (92.9%) had diabetes mellitus, 15 (35.7%) had critical limb ischemia, and 15 (35.7%) had end-stage renal disease/hemodialysis. Mean postoperative follow-up was 60.5 (range 12.0-208.0) months. The 5-year primary ulcer recurrence-free survival rate was 48.7%. High activity level and selection of the posterior tibial artery as the recipient artery were significantly associated with ulcer recurrence [hazard ratio, 3.59 and 9.81; P = .046 and P < .001, respectively]. Activity levels were not significantly different before and 1 year after surgery. In conclusion, survival analysis revealed that ulcer recurrence is most likely to occur within the first 2 years after surgery. Although recurrence occurred in approximately half of the patients, most patients maintained activity levels comparable to their preoperative levels.
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Affiliation(s)
- Norifumi Matsuda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Plastic and Reconstructive Surgery, Sapporo City General Hospital, Sapporo, Japan
| | - Dongkyung Seo
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Plastic and Reconstructive Surgery, Sapporo City General Hospital, Sapporo, Japan
| | - Riho Suzuki
- Department of Cardiovascular Medicine, Sapporo City General Hospital, Sapporo, Japan
- Limb Salvage Center, Sapporo City General Hospital, Sapporo, Japan
| | - Yutaka Dannoura
- Department of Cardiovascular Medicine, Sapporo City General Hospital, Sapporo, Japan
- Limb Salvage Center, Sapporo City General Hospital, Sapporo, Japan
| | - Katsumi Horiuchi
- Department of Plastic and Reconstructive Surgery, Sapporo City General Hospital, Sapporo, Japan
- Limb Salvage Center, Sapporo City General Hospital, Sapporo, Japan
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Ma Y, Chen Y, Ge A, Long G, Yao M, Shi Y, He X. Healthy lifestyle associated with dynamic progression of type 2 diabetes: A multi-state analysis of a prospective cohort. J Glob Health 2024; 14:04195. [PMID: 39327893 PMCID: PMC11427933 DOI: 10.7189/jogh.14.04195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Abstract
Background Although the association of a healthy lifestyle with type 2 diabetes (T2D) has been extensively studied, its impact on the dynamic trajectory, including progression, onset and prognosis, of T2D has not been investigated. Methods Using data from the UK Biobank, 461 168 participants without diabetes or diabetes-related events were included. We incorporated four lifestyle factors to construct the healthy lifestyle score (HLS). We employed a multi-state model to examine the relationship between a healthy lifestyle and transition in T2D progression, including transitions from baseline to diabetes, complications, and further to death. The cumulative probability of above transitions based on the health lifestyle score was calculated. Results The results indicated that adhering to 3-4 healthy lifestyles had an inverse association with the risk of transition from baseline to diabetes (hazard ratio (HR) = 0.966; 95% confidence interval (CI) = 0.935-0.998, P = 0.038), diabetes to complications (HR = 0.869; 95% CI = 0.818-0.923, P = 5.2 × 10-6), baseline to death (HR = 0.528; 95% CI = 0.502-0.553, P < 2 × 10-16, and diabetes to death (HR = 0.765; 95% CI = 0.591-0.990, P = 0.041) compared with maintaining 0-1 healthy lifestyles. In addition, the transition probability of the above transitions can be lower with maintaining 3-4 healthy lifestyles. Conclusions Healthy lifestyles are negatively associated with the risk of multiple outcomes during the dynamic progression of T2D. Adherence to 3-4 healthy lifestyle behaviours before diabetes onset can lower the risk of developing T2D, further reducing the risk of diabetes complications and death in patients with T2D.
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Affiliation(s)
- Yuanyuan Ma
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Yufeng Chen
- Department of Laboratory Medicine, People's Hospital of Rizhao, Rizhao, Shandong, China
| | - Aichen Ge
- Department of Science and Technology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Guangfeng Long
- Department of Clinical Laboratory, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Min Yao
- Department of Stomatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yanli Shi
- Department of Clinical Laboratory, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaowei He
- Guangxi Medical University, Nanning, China
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Zhang P, Liu Z, Ma G, Wang J, Shao J, Ma C, Wang L, Ma C. Huaiqihuang (HQH) protects podocytes from high glucose-induced apoptosis and inflammation response by regulating PI3K/AKT/mTOR pathway. Arch Physiol Biochem 2024:1-8. [PMID: 39329410 DOI: 10.1080/13813455.2024.2407552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 08/03/2024] [Accepted: 09/16/2024] [Indexed: 09/28/2024]
Abstract
Diabetic kidney disease (DKD) is one of the common microvascular complications of diabetes, and there are still lack of effective treatments. Huaiqihuang (HQH) is a kind of traditional Chinese medicine mixed preparation, which is mainly made of Trametes robiniophila Murr, Fructus Lycii, and Polygonatum sibiricumhas. It has been shown to be effective in the treatment of DKD, but the specific mechanism has not been fully elucidated. Our results showed that HQH increased the protein expressions of synaptopodin, podocin, WT-1, and Bcl-2, decreased the protein expressions of Bax and cleaved-casepase-3, and activated the NF-ĸB and PI3K/AKT/mTOR pathway in MPC5 cells exposed to high-glucose (HG). Real-time PCR results showed that HQH reduced the mRNA expression of TNF-α, IL-1β, MCP-1, and IL-6. In conclusion, our results showed that HQH may attenuate podocyte injury by inhibiting MPC5 cell apoptosis induced by HG and NF-κB-mediated inflammation response through activation of the PI3K/AKT/mTOR pathway.
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Affiliation(s)
- Peipei Zhang
- Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, Taiyuan, PR China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
| | - Zhilong Liu
- Hebei Key Laboratory of Integrated Traditional and Western Medicine in Osteoarthrosis Research (Preparing), Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China
| | - Guiqiao Ma
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
- The Third Clinical College, Shanxi University of Chinese Medicine, Jinzhong, PR China
| | - Junwei Wang
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
- The Third Clinical College, Shanxi University of Chinese Medicine, Jinzhong, PR China
| | - Jing Shao
- Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, Taiyuan, PR China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
| | - Chaojing Ma
- Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, Taiyuan, PR China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
| | - Liping Wang
- Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, Taiyuan, PR China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
| | - Chanjuan Ma
- Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, Taiyuan, PR China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, Taiyuan, PR China
- The Third Clinical College, Shanxi University of Chinese Medicine, Jinzhong, PR China
- Department of Nephrology, Shanxi Provincial People's Hospital, Taiyuan, PR China
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Ha WS, Nguyen VK, Chu MK. Epidemiological linkage between migraine and diabetes mellitus: a systematic review and meta-analysis. J Headache Pain 2024; 25:158. [PMID: 39333866 PMCID: PMC11438040 DOI: 10.1186/s10194-024-01868-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This study aimed to elucidate the nature and extent of the associations between diabetes mellitus (DM) and migraine through a systematic review and meta-analysis. METHODS We searched the PubMed, Web of Science, and Scopus databases without a specified start date until June 2, 2024. Cross-sectional and cohort studies analyzing the risk of migraine in individuals with DM and vice versa were included. Studies without at least age and sex adjustments were excluded. Data were extracted to calculate odds ratios (ORs) and hazard ratios (HRs). Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. RESULTS Eight cross-sectional studies (131,361 patients with DM and 1,005,604 patients with migraine) and four cohort studies (103,205 patients with DM patients and 32,197 patients with migraine) were included. Meta-analyses of the cross-sectional studies showed no significant overall association between DM and migraine. Subgroup analyses revealed that type 1 diabetes reduced the odds of having migraine (OR 0.48, 95% confidence interval [CI] 0.30-0.77), while migraine without aura (MO) increased the odds of having DM (OR 1.19, 95% CI 1.02-1.39). The cohort studies indicated that DM decreased the risk of developing migraine (HR 0.83, 95% CI 0.76-0.90), and a history of migraine increased the risk of developing DM (HR 1.09, 95% CI 1.01-1.17). CONCLUSIONS DM, particularly type 1 diabetes, is negatively associated with migraine occurrence, whereas migraine, especially MO, is positively associated with DM occurrence. However, most of the results remained at a low or very low level of evidence, indicating the need for further research.
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Affiliation(s)
- Woo-Seok Ha
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Vinh Khang Nguyen
- Department of Neurology, University Medical Center HCMC, Ho Chi Minh City, Vietnam
| | - Min Kyung Chu
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Neurology, Severance Hospital Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Mikki N, McCormick I, Mactaggart I. Prevalence of vision impairment, diabetic retinopathy and disability in adults 50+ in the occupied Palestinian territories. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003613. [PMID: 39325759 PMCID: PMC11426490 DOI: 10.1371/journal.pgph.0003613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/24/2024] [Indexed: 09/28/2024]
Abstract
The Rapid Assessment of Avoidable Blindness methodology is a population-based survey of vision impairment among the population 50 and above, with optional modules on diabetes, diabetic retinopathy and disability. The first Rapid Assessment of Avoidable Blindness study in the occupied Palestinian territories (oPt) was conducted in 2008. Prevalence of blindness (50+) was 3.4%. 80% of blindness was avoidable. Between July 2018 and April 2019, we completed a nationally-representative follow up survey in oPt using the Rapid Assessment of Avoidable Blindness methodology including the optional modules. We tested distance visual acuity (presenting and pinhole) using a bespoke mobile data collection application. 4223 Palestinians aged 50 years and above were enumerated, of whom 3847 participated (response rate 91.1%). Prevalence of any vision impairment (presenting vision impairment <6/12 in the better seeing eye), blindness (<3/60), severe vision impairment (<6/60 but ≥3/60), moderate vision impairment (<6/18 but ≥6/60) and mild vision impairment (<6/12 but ≥6/18) were 25.8% (95% confidence interval [CI] 23.8-27.8%), 2.6% (1.9-3.2%), 1.4% (1.0-1.8%), 10.2% (9.1-11.2%) and 11.6% (10.3-12.8%), respectively. Avoidable causes of poor vision accounted for 82.4% of blindness, 83.3% of severe vision impairment, 82.0% of moderate vision impairment and 90.2% of mild vision impairment. Diabetes prevalence (reported or suspected based on random blood glucose ≥200 milligrams/decilitre) was 33.8% (32.1-35.5). Half of diabetes participants had diabetic retinopathy and/or maculopathy. Prevalence of disability (reported functional limitations) was 23.8% (21.0-26.5), and higher in women than men. The prevalence of vision impairment and blindness in oPt compared with 2008 was similar. Prevalence of diabetes, diabetic retinopathy and disability were all high, highlighting key areas for public health prioritization among older adults in oPt.
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Affiliation(s)
- Nahed Mikki
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England
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Li J, Cui HL, Xie DD, Wang QY, Luo C, Tian L, Shi LK, Sheng ZF. Global and regional estimates of hip fracture burden associated with type 1 diabetes from 1990 to 2021. Diabetes Obes Metab 2024. [PMID: 39323371 DOI: 10.1111/dom.15970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/28/2024] [Accepted: 09/06/2024] [Indexed: 09/27/2024]
Abstract
AIM To assess the global and regional burden of hip fractures associated with type 1 diabetes (T1D) from 1990 to 2021. MATERIALS AND METHODS The population attributable fraction was calculated by combining the published risk ratio with T1D prevalence (age ≥ 20 years) from the Global Burden of Disease study to estimate the T1D-associated hip-fracture burden. Trends were assessed using the age-standardized incidence rate (ASIR) and estimated annual percentage change (EAPC). RESULTS The global incidence of T1D-related hip fractures was 290 180 in 2021 with an ASIR of 3.96 (95% confidence interval: 1.92-5.87) per 100 000 population and a male-to-female ratio of 0.54. At the super-regional level, the highest incidence (204 610) and ASIR (13.09 per 100 000 population; 6.40-25.53) were observed in high-income regions, in particular in Australasia and Western Europe. Notably, Australasia exhibited the highest EAPC, 2.90% in T1D-associated ASIR, followed by East Asia (2.73%). The incidence among those aged 45-64 years grew significantly in 14 regions over the past decade. Nationally, the ASIR increased in 166 countries from 1990 to 2021. CONCLUSIONS High-income regions experienced the greatest burden of T1D-associated hip fracture, while Australasia and East Asia witnessed the largest increase over the last 32 years. Prioritizing the promotion of T1D treatment and hip-fracture screening for middle-aged females living with T1D is crucial in these regions.
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Affiliation(s)
- Jing Li
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hao-Liang Cui
- School of Public Health, Peking University, Beijing, China
| | - Dan-Dan Xie
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
- School of Basic Medical Sciences and Life Sciences, Hainan Medical University, Haikou, China
- Department of Clinical Nutrition, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Qin-Yi Wang
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chuo Luo
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lin Tian
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lin-Ke Shi
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhi-Feng Sheng
- Health Management Center, National Clinical Research Center for Metabolic Diseases, Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
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Essop T, Tran K, Purdy AC, Daly SC. Comparative Effects of GLP-1 Agonists, Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Diabetes Mellitus Outcomes. Curr Diab Rep 2024:10.1007/s11892-024-01554-2. [PMID: 39325334 DOI: 10.1007/s11892-024-01554-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to assess the effects of glucagon-like peptide-1 (GLP-1) agonists, sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) on type 2 diabetes mellitus (T2DM) remission. This review explores the efficacy, safety, and durability of these surgical and medical modalities of diabetes management. RECENT FINDINGS Studies have shown that GLP-1 agonists achieve higher rates of T2DM remission compared to standard glucose-lowering medications and lifestyle changes. In addition to weight loss, bariatric surgery has been found to be highly effective in treating and inducing remission of T2DM. Studies suggest that post-surgical patients see enhanced glycemic control. Both surgical interventions and GLP1 agonists are effective in achieving T2DM remission. Long-term follow-up and randomized controlled trials comparing bariatric surgery and GLP-1 agonists are necessary to evaluate their relative effectiveness in T2DM control. Further research is also needed to assess the combined effects of these treatment modalities.
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Affiliation(s)
- Tasiyah Essop
- Norton College of Medicine, State University of New York Upstate Medical University, 750 E Adams St, 13210, Syracuse, NY, United States
| | - Kyle Tran
- College of Osteopathic Medicine, Pacific Western University of Health Sciences, 309 E 2nd St, 91766, Pomona, CA, United States
| | - Amanda C Purdy
- Department of Surgery, University of California Irvine, 3800 W Chapman Ave, 92868, Orange, CA, USA
| | - Shaun C Daly
- Department of Surgery, University of California Irvine, 3800 W Chapman Ave, 92868, Orange, CA, USA.
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Adžić Zečević A, Vujović Kalinić V, Potpara Z, Zečević K. Correlation between macular sensitivity and kidney function in patients with diabetes. Eur J Ophthalmol 2024:11206721241286563. [PMID: 39318346 DOI: 10.1177/11206721241286563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
PURPOSE The aim of this study is to investigate the correlation between kidney function in patients with diabetes and macular sensitivity at central 10° using microperimetry. METHODS A cross-sectional study was carried out on 30 diabetic patients (58 eyes). A full-threshold microperimetry of the central 10° of retina (the macula) was performed on all subjects, consisting of 37 measurement points, using a 4-2 representation strategy. Macular sensitivity was expressed as the average threshold value in decibels for the entire field tested. The correlation between macular sensitivity and GFR, as well as microalbuminuria, blood glucose and HbA1c, was calculated using Pearson correlation rank. RESULTS A significant positive correlation was observed between GFR and macular sensitivity among both male and female study subjects. For male participants, the correlation was measured to r([16]) = [.615], p = [<.007] and r([15]) = [.844], p = [<.001] for the left and right eyes, respectively. As for female participants, the correlation was r ([9]) = [.903], p = [<.001] and r([10]) = [.941], p = [<.001] for the left and right eyes, respectively. The correlation between macular sensitivity and the following variables was statistically insignificant: microalbuminuria, blood glucose, and HbA1c. CONCLUSION Despite intact visual acuity measured on standard ophthalmic examination, patients with impaired kidney function had decreased macular sensitivity. This emphasizes the importance of microperimetry in preventative care and detection of early signs of diabetic retinopathy. Furthermore, we should consider the use of microperimetry as an auxiliary tool for monitoring kidney function in diabetics.
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Affiliation(s)
- Antoaneta Adžić Zečević
- Department of Medicine, Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro
- Department of Ophthalmology, Clinical Center of Montenegro, Ljubljanska bb, Podgorica, Montenegro
| | - Valentina Vujović Kalinić
- Department of Internal Medicine, Endocrinology Section, Clinical Center of Montenegro, Ljubljanska bb, Podgorica, Montenegro
| | - Zorica Potpara
- Department of Pharmacy, Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro
| | - Ksenija Zečević
- Department of Medicine, Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro
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Ma Z, Zuo T, Frey N, Rangrez AY. A systematic framework for understanding the microbiome in human health and disease: from basic principles to clinical translation. Signal Transduct Target Ther 2024; 9:237. [PMID: 39307902 PMCID: PMC11418828 DOI: 10.1038/s41392-024-01946-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/03/2024] [Accepted: 08/01/2024] [Indexed: 09/26/2024] Open
Abstract
The human microbiome is a complex and dynamic system that plays important roles in human health and disease. However, there remain limitations and theoretical gaps in our current understanding of the intricate relationship between microbes and humans. In this narrative review, we integrate the knowledge and insights from various fields, including anatomy, physiology, immunology, histology, genetics, and evolution, to propose a systematic framework. It introduces key concepts such as the 'innate and adaptive genomes', which enhance genetic and evolutionary comprehension of the human genome. The 'germ-free syndrome' challenges the traditional 'microbes as pathogens' view, advocating for the necessity of microbes for health. The 'slave tissue' concept underscores the symbiotic intricacies between human tissues and their microbial counterparts, highlighting the dynamic health implications of microbial interactions. 'Acquired microbial immunity' positions the microbiome as an adjunct to human immune systems, providing a rationale for probiotic therapies and prudent antibiotic use. The 'homeostatic reprogramming hypothesis' integrates the microbiome into the internal environment theory, potentially explaining the change in homeostatic indicators post-industrialization. The 'cell-microbe co-ecology model' elucidates the symbiotic regulation affecting cellular balance, while the 'meta-host model' broadens the host definition to include symbiotic microbes. The 'health-illness conversion model' encapsulates the innate and adaptive genomes' interplay and dysbiosis patterns. The aim here is to provide a more focused and coherent understanding of microbiome and highlight future research avenues that could lead to a more effective and efficient healthcare system.
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Affiliation(s)
- Ziqi Ma
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.
| | - Tao Zuo
- Key Laboratory of Human Microbiome and Chronic Diseases (Sun Yat-sen University), Ministry of Education, Guangzhou, China
- Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Norbert Frey
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.
| | - Ashraf Yusuf Rangrez
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.
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Ritchie SC, Taylor HJ, Liang Y, Manikpurage HD, Pennells L, Foguet C, Abraham G, Gibson JT, Jiang X, Liu Y, Xu Y, Kim LG, Mahajan A, Mccarthy MI, Kaptoge S, Lambert SA, Wood A, Sim X, Collins FS, Denny JC, Danesh J, Butterworth AS, Di Angelantonio E, Inouye M. Integrated clinical risk prediction of type 2 diabetes with a multifactorial polygenic risk score. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.22.24312440. [PMID: 39228710 PMCID: PMC11370520 DOI: 10.1101/2024.08.22.24312440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Combining information from multiple GWASs for a disease and its risk factors has proven a powerful approach for development of polygenic risk scores (PRSs). This may be particularly useful for type 2 diabetes (T2D), a highly polygenic and heterogeneous disease where the additional predictive value of a PRS is unclear. Here, we use a meta-scoring approach to develop a metaPRS for T2D that incorporated genome-wide associations from both European and non-European genetic ancestries and T2D risk factors. We evaluated the performance of this metaPRS and benchmarked it against existing genome-wide PRS in 620,059 participants and 50,572 T2D cases amongst six diverse genetic ancestries from UK Biobank, INTERVAL, the All of Us Research Program, and the Singapore Multi-Ethnic Cohort. We show that our metaPRS was the most powerful PRS for predicting T2D in European population-based cohorts and had comparable performance to the top ancestry-specific PRS, highlighting its transferability. In UK Biobank, we show the metaPRS had stronger predictive power for 10-year risk than all individual risk factors apart from BMI and biomarkers of dysglycemia. The metaPRS modestly improved T2D risk stratification of QDiabetes risk scores for 10-year risk prediction, particularly when prioritising individuals for blood tests of dysglycemia. Overall, we present a highly predictive and transferrable PRS for T2D and demonstrate that the potential for PRS to incrementally improve T2D risk prediction when incorporated into UK guideline-recommended screening and risk prediction with a clinical risk score.
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Li Y, Yan M, Cai Q, Tse LA, Liu Z, Lang X, Wang B, Ma Q, Li M, Qiu Q, Li W. Achievement of recommended targets for cardiovascular disease prevention in adults with diabetes in 38 low- and middle-income countries. J Glob Health 2024; 14:04148. [PMID: 39301596 DOI: 10.7189/jogh.14.04148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024] Open
Abstract
Background Implementation of guideline recommendations for cardiovascular disease (CVD) prevention in people with diabetes in low- and middle-income countries (LMICs) is unclear. We assessed the achievement of CVD prevention targets among patients with diabetes in LMICs. Methods We pooled nationally representative cross-sectional surveys from 38 LMICs. We evaluated three targets according to the World Health Organization's (WHO) recommendations: treatment (glucose-lowering drugs, statins, antihypertensive drugs, and aspirin); metabolism (blood glucose, body mass index, blood pressure, and cholesterol); and lifestyle (non-smoking, non-drinking, physical activity, and diet). We used multivariable Poisson regression models to assess sociodemographic factors influencing adherence to guideline recommendations. Results The study included 110 083 participants, of whom 6789 (6.0%) had self-reported diabetes. The prevalence of achieving the treatment, metabolic and lifestyle targets for all components were 9.9%, 8.1%, and 7.2%, respectively. The components with the lowest prevalence of the three targets were 11.1% for statin use, 27.3% for body mass index control, and 19.5% for sufficient consumption of fruit and vegetables, respectively. Upper-middle-income countries were better at achieving the treatment, non-drinking, and dietary targets than lower-middle-income countries. Women, middle-aged and older patients, and highly educated patients had a lower prevalence of metabolic adherence. Conclusions In LMICs, the prevalence of patients with diabetes meeting WHO-recommended treatment, metabolic and lifestyle targets for CVD prevention was low. Our findings highlighted the need to strengthen the prevention of CVD in patients with diabetes in LMICs.
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Affiliation(s)
- Yang Li
- Interventional Centre of Valvular Heart Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Minghai Yan
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiujing Cai
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Zhiguang Liu
- Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xinyue Lang
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Biyan Wang
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuyan Ma
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengya Li
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Qiu
- Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei Li
- Medical Research and Biometrics Centre, National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Kc P, Madsen IEH, Rugulies R, Xu T, Westerlund H, Nyberg A, Kivimäki M, Hanson LLM. Exposure to workplace sexual harassment and risk of cardiometabolic disease: a prospective cohort study of 88 904 Swedish men and women. Eur J Prev Cardiol 2024; 31:1633-1642. [PMID: 38875457 DOI: 10.1093/eurjpc/zwae178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 06/16/2024]
Abstract
AIMS Exposure to work-related sexual harassment may increase the risk for certain adverse behavioural and emotional outcomes but less is known about its association with somatic diseases such as cardiovascular disease (CVD) and type 2 diabetes. This study investigated the prospective association of work-related sexual harassment and risk of cardiometabolic diseases. METHODS AND RESULTS This cohort study included 88 904 Swedish men and women in paid work who responded to questions on workplace sexual harassment in the Swedish Work Environment Survey (1995-2015) and were free from cardiometabolic diseases at baseline. Cardiometabolic diseases (CVD and type 2 diabetes) were identified from the National Patient Register and Causes of Death Register through linkage. Cox proportional hazard regression was used, adjusting for socio-demographic, work-related psychosocial, and physical exposure at baseline. Overall, 4.8% of the participants (n = 4300) reported exposure to workplace sexual harassment during the previous 12 months. After adjustment for sex, birth country, family situation, education, income, and work-related factors, workplace sexual harassment was associated with increased incidence of CVD [hazard ratio (HR) 1.25, 95% confidence interval 1.03-1.51] and type 2 diabetes (1.45, 1.21-1.73). The HR for CVD (1.57, 1.15-2.15) and type 2 diabetes (1.85, 1.39-2.46) was increased for sexual harassment from superior or fellow workers, and sexual harassment from others was associated with type 2 diabetes (1.39, 1.13-1.70). The HR for both CVD (1.31, 0.95-1.81) and type 2 diabetes (1.72, 1.30-2.28) was increased for frequent exposure. CONCLUSION The results of this study support the hypothesis that workplace sexual harassment is prospectively associated with cardiometabolic diseases. Future research is warranted to understand causality and mechanisms behind these associations.
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Affiliation(s)
- Prakash Kc
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
- Stress Research Institute, Department of Psychology, Stockholm University, Albanovägen 12, 114 19 Stockholm, Sweden
| | - Ida E H Madsen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tianwei Xu
- Stress Research Institute, Department of Psychology, Stockholm University, Albanovägen 12, 114 19 Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Albanovägen 12, 114 19 Stockholm, Sweden
| | - Anna Nyberg
- Stress Research Institute, Department of Psychology, Stockholm University, Albanovägen 12, 114 19 Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mika Kivimäki
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- UCL Brain Sciences, University College London, London, UK
| | - Linda L Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, Albanovägen 12, 114 19 Stockholm, Sweden
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Arora E, Regan R, Surendra VU, Arumugam A. Prevalence of peripheral arterial disease among individuals with type 2 diabetes mellitus in India - A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:103124. [PMID: 39326343 DOI: 10.1016/j.dsx.2024.103124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 09/18/2024] [Accepted: 09/19/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Peripheral arterial disease (PAD) is a prevalent complication of type 2 diabetes mellitus (T2DM). As India ranks second in the population afflicted by T2DM, and the objective of this systematic review was to estimate the pooled prevalence of PAD in individuals living with T2DM in India. METHODS Five databases (Cochrane (CENTRAL), MEDLINE (via PubMed), CINAHL (via EBSCO), PEDro, and Scopus) were searched using database-specific search terms from inception to August 2023. Inclusion criteria included studies reporting the prevalence of PAD in Indian adults diagnosed with T2DM of either or both sexes, employing ankle brachial index measurements with a Doppler test or sphygmomanometer. The risk of bias was evaluated using the JBI checklist, and the certainty of evidence was determined via the GRADE approach. RESULTS Twenty-three articles met the inclusion criteria which comprised of 196,883 individuals with T2DM aged between 30 and 70 years from nine states and one union territory. Utilizing a random effects model, the meta-analysis revealed that the pooled prevalence of PAD among individuals with T2DM in India was 18 % (95 % confidence interval: 10-28 %), with statistically significant heterogeneity observed between studies (I2 = 100 %, P < 0.001). Overall certainty in the evidence was low. CONCLUSION The combined prevalence of PAD among individuals with T2DM in India is 18 %, indicating a significant portion of the Indian population has been affected. Epidemiological studies utilizing precise assessment tools can enhance the early detection and prevention of PAD in T2DM and improve the certainty of findings.
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Affiliation(s)
- Esha Arora
- School of Physiotherapy, Faculty of Allied Health Professions, AIMST University, Kedah, 08100, Malaysia.
| | - Raja Regan
- School of Physiotherapy, Faculty of Allied Health Professions, AIMST University, Kedah, 08100, Malaysia.
| | - Vyshak Uddur Surendra
- Department of Respiratory Medicine, Yenepoya Medical College, Yenepoya Deemed to be University, Mangalore, Karnataka, India.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates; Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Harmon DC, Levene JA, Rutlen CL, White ES, Freeman IR, Lapidus JA. Preadmission Metformin Use Is Associated with Reduced Mortality in Patients with Diabetes Mellitus Hospitalized with COVID-19. J Gen Intern Med 2024:10.1007/s11606-024-08864-x. [PMID: 39299975 DOI: 10.1007/s11606-024-08864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/10/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Observational studies have reported an association between metformin and improved outcomes in COVID-19, but most have been small and with significant limitations. OBJECTIVE To evaluate the association between preadmission metformin exposure and mortality in patients with diabetes mellitus hospitalized with coronavirus disease 2019 (COVID-19) infection. DESIGN Retrospective cohort analysis using electronic health records extracted from the American Heart Association COVID-19 Registry. PARTICIPANTS Adults (n = 11,993) with diabetes mellitus but without chronic kidney disease (CKD) or need for hemodialysis who were hospitalized with COVID-19 between January 25, 2020, and February 9, 2022. MAIN MEASURES We used propensity score modeling to address differences between metformin and non-metformin users prior to multivariable log-binomial models to examine the association between metformin use at time of hospital admission for COVID-19 infection and in-hospital death; composite of in-hospital death or discharge to hospice; composite of in-hospital death, discharge to hospice, or ICU admission; and composite of in-hospital death, discharge to hospice, ICU admission, or mechanical ventilation. KEY RESULTS Compared to metformin non-use, pre-admission metformin use was associated with lower risk of in-hospital death (risk ratio (RR) 0.81 [95% CI 0.75-0.90]); composite of in-hospital death or discharge to hospice (RR 0.79 [95% CI 0.74-0.87]); composite of in-hospital death, discharge to hospice, or ICU admission (RR 0.90 [95% CI 0.86-0.95]); and composite of in-hospital death, discharge to hospice, ICU admission, or mechanical ventilation (RR 0.9 [95% CI 0.84-0.98]). Metformin use was also associated with lower risk of death due to respiratory cause (RR 0.86 [95% CI 0.74-0.97]) but not cardiovascular (RR 0.84 [95% CI 0.58-1.2]) or other (RR 0.78 [95% CI 0.60-1.0]) causes. CONCLUSIONS Pre-admission metformin use was associated with lower risk of in-hospital mortality and markers of disease severity among adults with diabetes mellitus without CKD and not requiring hemodialysis who were hospitalized with COVID-19 infection.
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Affiliation(s)
- David C Harmon
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
| | - Jacqueline A Levene
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christine L Rutlen
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Elizabeth S White
- Oregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA
- Biostatistics & Design Program, Oregon Health & Science University, Portland, OR, USA
| | - Ilana R Freeman
- Oregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA
- Biostatistics & Design Program, Oregon Health & Science University, Portland, OR, USA
| | - Jodi A Lapidus
- Oregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA
- Biostatistics & Design Program, Oregon Health & Science University, Portland, OR, USA
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Raza A, Mushtaq MN, Hassan S, Sharif A, Akhtar B, Akhtar MF. Mitigation of Diabetes Mellitus Using Euphorbia helioscopia Leaf Ethanolic Extract by Modulating GCK, GLUT4, IGF, and G6P Expressions in Streptozotocin-Induced Diabetic Rats. J Diabetes Res 2024; 2024:5497320. [PMID: 39329045 PMCID: PMC11424858 DOI: 10.1155/2024/5497320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/27/2024] [Accepted: 08/12/2024] [Indexed: 09/28/2024] Open
Abstract
Diabetes mellitus is a metabolic disorder. Synthetic antidiabetics are the commonly used treatment options associated with complications. The objective of this study was to explore the antioxidative and antidiabetic potential of Euphorbia helioscopia whole plant ethanolic extract using in vitro and in vivo models. For that purpose, the antioxidative potential was explored by using 2,2-diphenyl-1-picrylhydrazyl analysis. In vitro antidiabetic potential of the extract was evaluated using amylase inhibitory analysis. In vivo antidiabetic activity of the extract was assessed in diabetic rats using streptozotocin/nicotinamide (60 mg/kg/120 mg/kg) as an inducing agent. Metformin was used as standard. The results indicated the presence of significant quantities of phenolic 82.18 ± 1.28 mgg-1 gallic acid equivalent (GAE) and flavonoid 66.55±1.22 mgg-1 quercetin equivalent (QE) contents in the extract. Quantitation of phytoconstituents exhibited the presence of sinapic acid, myricetin, and quercetin using HPLC analysis. The extract inhibited α-amylase by 84.71%, and an antiglycemic potential of 50.34% was assessed in the OGTT assay. Biochemical analysis demonstrated a reduction in urea, creatinine, cholesterol, low-density lipoprotein, and alkaline phosphatase (p < 0.001) as compared to diabetic control rats at the dose of 500 mg/kg. An upregulation in the expressions of glucokinase, glucose transporter 4, peroxisome proliferator-activated receptor γ, and insulin-like growth factor was observed in treated rats in contrast to G6P expression, which was downregulated upon treatment. In conclusion, this study provided evidence of the antioxidative and antidiabetic potential of E. helioscopia whole plant ethanolic extract through in vitro and in vivo analysis and emphasized its promising role as a natural alternative.
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Affiliation(s)
- Ahmed Raza
- Faculty of PharmacyThe University of Lahore, Lahore 54000, Pakistan
| | | | - Sadia Hassan
- Department of Biomedical Engineering and SciencesSchool of Mechanical and Manufacturing EngineeringNational University of Science and Technology, Islamabad 24090, Pakistan
| | - Ali Sharif
- Department of PharmacologyFaculty of Pharmaceutical and Allied Health SciencesLahore College for Women University, Lahore 54000, Pakistan
| | - Bushra Akhtar
- Department of PharmacyUniversity of Agriculture, Faisalabad 38000, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical SciencesRiphah International UniversityLahore Campus, Lahore 54000, Pakistan
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Zi H, Liu MY, Luo LS, Huang Q, Luo PC, Luan HH, Huang J, Wang DQ, Wang YB, Zhang YY, Yu RP, Li YT, Zheng H, Liu TZ, Fan Y, Zeng XT. Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021. Mil Med Res 2024; 11:64. [PMID: 39294748 PMCID: PMC11409598 DOI: 10.1186/s40779-024-00569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 09/01/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND The burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases. METHODS We obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI). RESULTS In 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths. CONCLUSIONS The global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
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Affiliation(s)
- Hao Zi
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Evidence-Based Medicine Center, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, Hubei, China
| | - Meng-Yang Liu
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Li-Sha Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Peng-Cheng Luo
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Department of Urology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, 430060, China
| | - Hang-Hang Luan
- Department of Forensic Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Dan-Qi Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yong-Bo Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yuan-Yuan Zhang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Ren-Peng Yu
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yi-Tong Li
- School of Clinical Medicine, Hubei University of Arts and Science, Xiangyang, 441053, Hubei, China
| | - Hang Zheng
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
| | - Tong-Zu Liu
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
| | - Yu Fan
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, Beijing, 100034, China.
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
- Department of Urology, Wuhan Clinical Research Center of Tumors of the Urinary System and Male Genital Organs, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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46
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Silfer JL, Tonyushkina KN. Global trends in type 1 diabetes in adolescents and young adults (1990-2019). Pediatr Res 2024:10.1038/s41390-024-03554-0. [PMID: 39294242 DOI: 10.1038/s41390-024-03554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 09/20/2024]
Affiliation(s)
| | - Ksenia N Tonyushkina
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Rainbow Babies and Children's Hospital/CWRU School of Medicine, Cleveland, OH, USA.
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47
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Yokoi A, Asahara SI, Inoue H, Seike M, Kido N, Suzuki H, Kanno A, Kimura-Koyanagi M, Kido Y, Ogawa W. Dapagliflozin administration to a mouse model of type 2 diabetes induces DNA methylation and gene expression changes in pancreatic islets. Biochem Biophys Res Commun 2024; 725:150254. [PMID: 38901223 DOI: 10.1016/j.bbrc.2024.150254] [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] [Received: 06/03/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024]
Abstract
Decreased pancreatic β-cell volume is a serious problem in patients with type 2 diabetes mellitus, and there is a need to establish appropriate treatments. Increasingly, sodium/glucose cotransporter 2 (SGLT2) inhibitors, which have a protective effect on pancreatic β-cells, are being prescribed to treat diabetes; however, the underlying mechanism is not well understood. We previously administered SGLT2 inhibitor dapagliflozin to a mouse model of type 2 diabetes and found significant changes in gene expression in the early-treated group, which led us to hypothesize that epigenetic regulation was a possible mechanism of these changes. Therefore, we performed comprehensive DNA methylation analysis by methylated DNA immunoprecipitation using isolated pancreatic islets after dapagliflozin administration to diabetic model mice. As a result, we identified 31 genes with changes in expression due to DNA methylation changes. Upon immunostaining, cystic fibrosis transmembrane conductance regulator and cadherin 24 were found to be upregulated in islets in the dapagliflozin-treated group. These molecules may contribute to the maintenance of islet morphology and insulin secretory capacity, suggesting that SGLT2 inhibitors' protective effect on pancreatic β-cells is accompanied by DNA methylation changes, and that the effect is long-term and not temporary. In future diabetes care, SGLT2 inhibitors may be expected to have positive therapeutic effects, including pancreatic β-cell protection.
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MESH Headings
- Animals
- Benzhydryl Compounds/pharmacology
- Benzhydryl Compounds/therapeutic use
- DNA Methylation/drug effects
- Glucosides/pharmacology
- Glucosides/therapeutic use
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/pathology
- Mice
- Islets of Langerhans/metabolism
- Islets of Langerhans/drug effects
- Islets of Langerhans/pathology
- Male
- Sodium-Glucose Transporter 2 Inhibitors/pharmacology
- Mice, Inbred C57BL
- Disease Models, Animal
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/pathology
- Epigenesis, Genetic/drug effects
- Gene Expression Regulation/drug effects
- Cadherins/metabolism
- Cadherins/genetics
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Affiliation(s)
- Aisha Yokoi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Shun-Ichiro Asahara
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Hiroyuki Inoue
- Division of Medical Chemistry, Department of Metabolism and Diseases, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
| | - Masako Seike
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Nozomi Kido
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Hirotaka Suzuki
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Ayumi Kanno
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Maki Kimura-Koyanagi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Yoshiaki Kido
- Division of Medical Chemistry, Department of Metabolism and Diseases, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
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48
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Kantreva K, Katsaounou P, Saltiki K, Trakada G, Ntali G, Stratigou T, Tzanela M, Psaltopoulou T, Paschou SA. The possible effect of anti-diabetic agents GLP-1RA and SGLT-2i on the respiratory system function. Endocrine 2024:10.1007/s12020-024-04033-6. [PMID: 39289244 DOI: 10.1007/s12020-024-04033-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 09/03/2024] [Indexed: 09/19/2024]
Abstract
Type 2 Diabetes (T2D) is a chronic disease with increasing incidence and prevalence and serious chronic complications, especially from cardiovascular system. However, other organs can be affected too. Several studies have associated T2D, especially when poorly controlled, with multiple pulmonary diseases. T2D is a common comorbidity among patients with asthma, Chronic Obstructive Pulmonary Disease (COPD), and Obstructive Sleep Apnea Syndrome (OSAS), and it is related to higher respiratory infection incidence, prevalence and severity. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) are novel antihyperglycaemic agents with established cardiovascular benefits. There are also limited studies indicating their potential benefit in respiratory function. The aim of this article is to review data on the impact of GLP-1RA and SGLT-2i on respiratory function and describe the possible clinical benefits. Key findings indicate that GLP-1RA significantly improve lung function in patients with COPD, evidenced by improvements in spirometry measurements. Additionally, both GLP-1RA and SGLT-2i are associated with a decreased risk of severe and moderate exacerbations in COPD patients and have shown potential in reducing the incidence of respiratory disorders, including asthma and pneumonia. The mechanisms underlying these benefits are not yet fully understood and include multiple effects, such as anti-inflammatory action and oxidative stress reduction.
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Affiliation(s)
- Kanella Kantreva
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Endocrinology, Diabetes Centre, Endo ERN member, Evangelismos General Hospital, Athens, Greece
| | - Paraskevi Katsaounou
- Department of Critical Care Medicine, Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Saltiki
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Trakada
- Respiratory Medicine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Ntali
- Department of Endocrinology, Diabetes Centre, Endo ERN member, Evangelismos General Hospital, Athens, Greece
| | - Theodora Stratigou
- Department of Endocrinology, Diabetes Centre, Endo ERN member, Evangelismos General Hospital, Athens, Greece
| | - Marinella Tzanela
- Department of Endocrinology, Diabetes Centre, Endo ERN member, Evangelismos General Hospital, Athens, Greece
| | - Theodora Psaltopoulou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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49
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Takayama A, Yoshida S, Kawakami K. Tadalafil use is associated with a lower incidence of Type 2 diabetes in men with benign prostatic hyperplasia: A population-based cohort study. J Intern Med 2024. [PMID: 39287476 DOI: 10.1111/joim.20012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND Tadalafil, commonly prescribed for benign prostatic hyperplasia (BPH), may benefit patients with Type 2 diabetes mellitus (T2DM) for glycemic markers and complications. However, the association between the long-term use of tadalafil and the incidence of T2DM has not been investigated. METHODS We emulated a target trial of tadalafil use (5 mg/day) and the risk of T2DM using a population-based claims database in Japan. Patients who initiated tadalafil or alpha-blockers for BPH and had no history of diabetes diagnosis, no dispensing of glucose-lowering drugs, and no history of hemoglobin A1c levels of ≥6.5% (47-48 mmol/mol) were included. The primary outcome was the incidence of T2DM. Pooled logistic regression was used to estimate adjusted risk ratios (RRs) and 5-year cumulative incidence differences (CIDs). RESULTS A total of 5180 participants initiated tadalafil treatment and were compared with 20,049 patients who initiated alpha-blockers. The median follow-up time for each arm was 27.2 months (interquartile range [IQR], 12.0-47.9) in tadalafil users and 31.3 months (IQR, 13.7-57.2) in alpha-blocker users. The incidence rates of T2DM in tadalafil and alpha-blocker users were 5.4 (95% confidence interval [CI], 4.0-7.2) and 8.8 (95% CI, 7.8-9.8) per 1000-person years, respectively. Initiation of tadalafil was associated with a reduced risk of T2DM (RR, 0.47; 95% CI, 0.39-0.62; 5-year CID, -0.031; 95% CI, -0.040 to -0.019). CONCLUSION The incidence of T2DM was lower in men with BPH treated with tadalafil than in those treated with alpha-blockers. Thus, tadalafil may be more beneficial than alpha-blockers in preventing T2DM.
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Affiliation(s)
- Atsushi Takayama
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
| | - Satomi Yoshida
- Department of Clinical Medicine, Division of Social Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
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50
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Rao G, Peng B, Zhang G, Fu X, Tian J, Tian Y. MicroRNAs in diabetic macroangiopathy. Cardiovasc Diabetol 2024; 23:344. [PMID: 39285459 PMCID: PMC11406791 DOI: 10.1186/s12933-024-02405-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Diabetic macroangiopathy is a leading cause of diabetes-related mortality worldwide. Both genetic and environmental factors, through a multitude of underlying molecular mechanisms, contribute to the pathogenesis of diabetic macroangiopathy. MicroRNAs (miRNAs), a class of non-coding RNAs known for their functional diversity and expression specificity, are increasingly recognized for their roles in the initiation and progression of diabetes and diabetic macroangiopathy. In this review, we will describe the biogenesis of miRNAs, and summarize their functions in diabetic macroangiopathy, including atherosclerosis, peripheral artery disease, coronary artery disease, and cerebrovascular disease, which are anticipated to provide new insights into future perspectives of miRNAs in basic, translational and clinical research, ultimately advancing the diagnosis, prevention, and treatment of diabetic macroangiopathy.
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Affiliation(s)
- Guocheng Rao
- Department of Endocrinology and Metabolism, Department of Biotherapy, Center for Diabetes and Metabolism Research, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, Sichuan, China
| | - Boqiang Peng
- Department of General Surgery and Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Guixiang Zhang
- Department of General Surgery and Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xianghui Fu
- Department of Endocrinology and Metabolism, Department of Biotherapy, Center for Diabetes and Metabolism Research, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, Sichuan, China.
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yan Tian
- Department of Endocrinology and Metabolism, Department of Biotherapy, Center for Diabetes and Metabolism Research, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, Sichuan, China.
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