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Mellor J, Jeyam A, Beulens JW, Bhandari S, Broadhead G, Chew E, Fickweiler W, van der Heijden A, Gordin D, Simó R, Snell-Bergeon J, Tynjälä A, Colhoun H. Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment. OPHTHALMOLOGY SCIENCE 2024; 4:100494. [PMID: 38694495 PMCID: PMC11061755 DOI: 10.1016/j.xops.2024.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 05/04/2024]
Abstract
Topic To review clinical evidence on systemic factors that might be relevant to update diabetic retinal disease (DRD) staging systems, including prediction of DRD onset, progression, and response to treatment. Clinical relevance Systemic factors may improve new staging systems for DRD to better assess risk of disease worsening and predict response to therapy. Methods The Systemic Health Working Group of the Mary Tyler Moore Vision Initiative reviewed systemic factors individually and in multivariate models for prediction of DRD onset or progression (i.e., prognosis) or response to treatments (prediction). Results There was consistent evidence for associations of longer diabetes duration, higher glycosylated hemoglobin (HbA1c), and male sex with DRD onset and progression. There is strong trial evidence for the effect of reducing HbA1c and reducing DRD progression. There is strong evidence that higher blood pressure (BP) is a risk factor for DRD incidence and for progression. Pregnancy has been consistently reported to be associated with worsening of DRD but recent studies reflecting modern care standards are lacking. In studies examining multivariate prognostic models of DRD onset, HbA1c and diabetes duration were consistently retained as significant predictors of DRD onset. There was evidence of associations of BP and sex with DRD onset. In multivariate prognostic models examining DRD progression, retinal measures were consistently found to be a significant predictor of DRD with little evidence of any useful marginal increment in prognostic information with the inclusion of systemic risk factor data apart from retinal image data in multivariate models. For predicting the impact of treatment, although there are small studies that quantify prognostic information based on imaging data alone or systemic factors alone, there are currently no large studies that quantify marginal prognostic information within a multivariate model, including both imaging and systemic factors. Conclusion With standard imaging techniques and ways of processing images rapidly evolving, an international network of centers is needed to routinely capture systemic health factors simultaneously to retinal images so that gains in prediction increment may be precisely quantified to determine the usefulness of various health factors in the prognosis of DRD and prediction of response to treatment. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Joe Mellor
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Anita Jeyam
- Centre for Genomic & Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital Crewe Road, Edinburgh, Scotland
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | - Sanjeeb Bhandari
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Geoffrey Broadhead
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Emily Chew
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Ward Fickweiler
- Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Amber van der Heijden
- Department of General Practice, Amsterdam Public Health Institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | - Daniel Gordin
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Department of Nephrology, Helsinki University Hospital, University of Helsinki, Finland
| | - Rafael Simó
- Endocrinology & Nutrition, Institut de Recerca Hospital Universitari Vall d’Hebron (VHIR), Barcelona, Spain
| | - Janet Snell-Bergeon
- Clinical Epidemiology Division, Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Colorado
| | - Anniina Tynjälä
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Department of Nephrology, Helsinki University Hospital, University of Helsinki, Finland
| | - Helen Colhoun
- Centre for Genomic & Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital Crewe Road, Edinburgh, Scotland
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Muvhulawa N, Mazibuko-Mbeje SE, Ndwandwe D, Silvestri S, Ziqubu K, Moetlediwa MT, Mthembu SXH, Marnewick JL, Van der Westhuizen FH, Nkambule BB, Basson AK, Tiano L, Dludla PV. Sarcopenia in a type 2 diabetic state: Reviewing literature on the pathological consequences of oxidative stress and inflammation beyond the neutralizing effect of intracellular antioxidants. Life Sci 2023; 332:122125. [PMID: 37769808 DOI: 10.1016/j.lfs.2023.122125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
Sarcopenia remains one of the major pathological features of type 2 diabetes (T2D), especially in older individuals. This condition describes gradual loss of muscle mass, strength, and function that reduces the overall vitality and fitness, leading to increased hospitalizations and even fatalities to those affected. Preclinical evidence indicates that dysregulated mitochondrial dynamics, together with impaired activity of the NADPH oxidase system, are the major sources of oxidative stress that drive skeletal muscle damage in T2D. While patients with T2D also display relatively higher levels of circulating inflammatory markers in the serum, including high sensitivity-C-reactive protein, interleukin-6, and tumor necrosis factor-α that are independently linked with the deterioration of muscle function and sarcopenia in T2D. In fact, beyond reporting on the pathological consequences of both oxidative stress and inflammation, the current review highlights the importance of strengthening intracellular antioxidant systems to preserve muscle mass, strength, and function in individuals with T2D.
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Affiliation(s)
- Ndivhuwo Muvhulawa
- Cochrane South Africa, South African Medical Research Council, Tygerberg 7505, South Africa; Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa
| | | | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Sonia Silvestri
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona 60131, Italy
| | - Khanyisani Ziqubu
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa
| | - Marakiya T Moetlediwa
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa
| | | | - Jeanine L Marnewick
- Applied Microbial and Health Biotechnology Institute, Cape Peninsula University of Technology, Bellville 7535, South Africa
| | | | - Bongani B Nkambule
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Albertus K Basson
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona 60131, Italy
| | - Phiwayinkosi V Dludla
- Cochrane South Africa, South African Medical Research Council, Tygerberg 7505, South Africa; Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa.
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Mukherjee S, Ghosh S, Ghosh S. Association of midlife cognition impairment with diabetic retinopathy in type 2 diabetes mellitus in an Indian population. PRACTICAL DIABETES 2022. [DOI: 10.1002/pdi.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Karjee H, Ghosh S, Dhibar T. Association of mid-life cerebral small vessel disease with diabetic retinopathy in type 2 diabetes in an Indian population. J Diabetes Complications 2022; 36:108149. [PMID: 35172935 DOI: 10.1016/j.jdiacomp.2022.108149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/18/2022] [Accepted: 02/06/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Prevalence of cerebral small vessel disease (SVD) in elderly patients with diabetic retinopathy (DR) is higher than in those without DR. We determined the prevalence and severity of SVD in middle-aged patients with DR and compared it with those without DR (NODR) in a subset of the Indian population. We feel this information is critical with evolving trends of an increasing incidence of stroke at younger ages. METHOD Institution-based analytical cross-sectional study with 88 middle-aged type 2 diabetes patients; 44 in each group with <10 years diabetes duration, <8% HbA1C value, and with no history of cardiovascular disease. The presence and severity of SVD were determined by magnetic resonance imaging (MRI). RESULT Prevalence of SVD was 59.1% among study participants; 70.5% in DR and 47.7% in NODR (p = .03). Significantly increased SVD score (p = .008), high SVD score (p = .030), and white matter hyperintensity (WMH) load (p = .017) were observed in DR compared to NODR. There was no difference in the load of lacune and microbleed. SVD score did not differ according to the severity of DR (p = .395). The location-wise study of MRI revealed a significantly higher SVD load at the centrum semiovale in DR than in NODR (p = .014). We observed a 2.6 times greater chance of SVD (Odds ratio: 2.6, 95% CI 1.1-6.3) and a 9.6 times greater chance of high SVD score (Odds ratio: 9.6, 95% CI 1.1-80.0) in DR compared to NODR. CONCLUSION Significantly higher burden of SVD in DR was observed, particularly affecting the centrum semiovale suggesting an association of mid-life SVD with DR in this population.
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Affiliation(s)
- Himadri Karjee
- Department of Ophthalmology, Calcutta National Medical College, 32 Gorachand Road, Kolkata 700014, India
| | - Sambuddha Ghosh
- Department of Ophthalmology, Calcutta National Medical College, 32 Gorachand Road, Kolkata 700014, India.
| | - Tapan Dhibar
- Department of Radiology, Bangur Institue of Neurosciences, 52/1a, Sambhunath Pandit St, Gokhel Road, Bhowanipore, Kolkata 700020, India
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Chen J, Wan Y, Su J, Zhu Z, Pan E, Shen C, Wen J, Wang K, Yu H, Qin Y, Cui L, Zhou J, Wu M. Association of Generalized and Abdominal Obesity with Diabetic Retinopathy in Chinese Type 2 Diabetic Patients. Acta Diabetol 2022; 59:359-367. [PMID: 34713323 DOI: 10.1007/s00592-021-01806-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/24/2021] [Indexed: 01/06/2023]
Abstract
AIMS Obesity has been proposed to promote the progression of diabetic retinopathy (DR), but previous studies have not shown consistent results. We aimed to explore the association between generalized and abdominal obesity and DR risk, and to assess the joint effect of these two different types of obesity on DR development. METHODS A nested case-control study within a large prospective study on type 2 diabetes was conducted in communities in Huai'an City, Jiangsu Province, China. Cases were individuals who had diagnoses of DR during the 6-year follow-up. A total number of 1544 DR cases and 1:1 matched controls were included. Binomial and multinomial logistic regression models were used to investigate the effects of obesity on DR occurrence and DR severity. RESULTS Compared with individuals in the first tertile of the baseline waist-to-hip ratio (WHR), subjects in the third tertile at baseline had significantly higher risk of DR (OR 1.44, 95% CI 1.17-1.78) during the follow-up period. Conversely, body mass index (BMI) (continuous) had an adjusted OR of 0.97 (95% CI 0.95-0.99) of developing DR. Individuals with low BMI and high WHR levels were identified as a high-risk population with a higher likelihood of developing DR (OR 1.65, 95% CI 1.17-2.33) than those in the lowest BMI category and simultaneously in the first WHR tertile. CONCLUSIONS Type 2 diabetic individuals with low BMI levels and high WHR levels had a significantly increased risk of developing DR which indicated that isolated abdominal obesity might be involved in the pathogenesis of DR.
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Affiliation(s)
- Jiaxian Chen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yanan Wan
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jian Su
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Zheng Zhu
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Engchun Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jinbo Wen
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Kai Wang
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Hao Yu
- Qingjiangpu District Center for Disease Control and Prevention, Huai'an, 223300, China
| | - Yu Qin
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Lan Cui
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jinyi Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Ming Wu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
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Su Z, Wu Z, Liang X, Xie M, Xie J, Li H, Wang X, Jiang F. Diabetic retinopathy risk in patients with unhealthy lifestyle: A Mendelian randomization study. Front Endocrinol (Lausanne) 2022; 13:1087965. [PMID: 36733810 PMCID: PMC9887126 DOI: 10.3389/fendo.2022.1087965] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE This study aimed to investigate the causal association between unhealthy lifestyle factors and diabetic retinopathy (DR) risk and to determine better interventions targeting these modifiable unhealthy factors. DESIGN Two-sample Mendelian randomization (MR) analysis was performed in this study. The inverse variance-weighted method was used as the primary method. METHOD Our study included 687 single-nucleotide polymorphisms associated with unhealthy lifestyle factors as instrumental variables. Aggregated data on individual-level genetic information were obtained from the corresponding studies and consortia. A total of 292,622,3 cases and 739,241,18 variants from four large consortia (MRC Integrative Epidemiology Unit [MRC-IEU], Genetic Investigation of Anthropometric Traits [GIANT], GWAS & Sequencing Consortium of Alcohol and Nicotine Use [GSCAN], and Neale Lab) were included. RESULT In the MR analysis, a higher body mass index (BMI) (odds ratio [OR], 95% confidence interval [CI] = 1.42, 1.30-1.54; P < 0.001] and cigarettes per day (OR, 95% CI = 1.16, 1.05-1.28; P = 0.003) were genetically predicted to be causally associated with an increased risk of DR, while patients with higher hip circumference (HC) had a lower risk of DR (OR, 95% CI = 0.85, 0.76-0.95; P = 0.004). In the analysis of subtypes of DR, the results of BMI and HC were similar to those of DR, whereas cigarettes per day were only related to proliferative DR (PDR) (OR, 95% CI = 1.18, 1.04-1.33; P = 0.009). In the MR-PRESSO analysis, a higher waist-to-hip ratio (WHR) was a risk factor for DR and PDR (OR, 95% CI = 1.24, 1.02-1.50, P = 0.041; OR, 95% CI = 1.32, 1.01-1.73, P = 0.049) after removing the outliers. Furthermore, no pleiotropy was observed in these exposures. CONCLUSION Our findings suggest that higher BMI, WHR, and smoking are likely to be causal factors in the development of DR, whereas genetically higher HC is associated with a lower risk of DR, providing insights into a better understanding of the etiology and prevention of DR.
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Affiliation(s)
- Zixuan Su
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhixin Wu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xueqing Liang
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Meng Xie
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Xie
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiqing Li
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinghua Wang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Fagang Jiang, ; Xinghua Wang,
| | - Fagang Jiang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Fagang Jiang, ; Xinghua Wang,
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Yi QX, Zhu LN, Ma J, Yu XJ, Liu L, Shen J. Use of Anthropometric Measures of Obesity to Predict Diabetic Retinopathy in Patients with Type 2 Diabetes in China. Diabetes Metab Syndr Obes 2021; 14:4089-4095. [PMID: 34594120 PMCID: PMC8477615 DOI: 10.2147/dmso.s321030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/25/2021] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Obesity is an established risk factor for type 2 diabetes (T2D). Diabetic retinopathy (DR) is a major microvascular complication of T2D. In this cross-sectional study, we investigated the association between various anthropometric indices of obesity and DR. PATIENTS AND METHODS A representative sample of 1952 patients with T2D participated in this cross-sectional study conducted in Shanghai, China. Anthropometric measures of obesity including weight, height, waist circumference, hip circumference, body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were evaluated. The association between WHtR, WHR, and BMI and the presence of DR was examined with logistic regression models. RESULTS The prevalence of DR was higher in T2D patients with high WHtR compared to those with normal WHtR (p<0.05). A higher BMI was associated with elevated risk of DR (model 1, p=0.034; model 2, p=0.036). WHR was unrelated to the occurrence of DR (p>0.05). CONCLUSION WHtR and BMI but not WHR are risk factors for DR in obese patients with T2D. Patients with high WHtR and BMI should be closely monitored to prevent the development of DR.
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Affiliation(s)
- Qiu-Xue Yi
- Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
| | - Li-Na Zhu
- Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
| | - Jing Ma
- Department of Endocrinology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
| | - Xin-Jie Yu
- Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
| | - Lin Liu
- Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
- Correspondence: Lin Liu; Jie Shen Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Pudong New District, Shanghai, 200127, People’s Republic of China Email ;
| | - Jie Shen
- Department of Ophthalmology, Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China
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Chiu H, Tsai HJ, Huang JC, Wu PY, Hsu WH, Lee MY, Chen SC. Associations between Triglyceride-Glucose Index and Micro- and Macro-angiopathies in Type 2 Diabetes Mellitus. Nutrients 2020; 12:nu12020328. [PMID: 31991925 PMCID: PMC7071226 DOI: 10.3390/nu12020328] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 01/31/2023] Open
Abstract
The aim of this study was to investigate the associations between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and microangiopathies and macroangiopathies in patients with type 2 diabetes mellitus (DM). Our study enrolled 1990 type 2 diabetic patients from local hospitals in Taiwan during the period of 2002–2004. Multivariate logistic regression analysis was used to identify the factors related to microangiopathies, macroangiopathiess and TyG index. The patients were stratified by TyG index quartile (Q1–Q4). Adjusted odds ratios (aORs) of albuminuria for Q3 versus Q1 and Q4 versus Q1 were 1.424 (95% confidence interval [CI], 1.062–1.910, p = 0.018) and 1.948 (95% CI, 1.437–2.642, p < 0.001), respectively. The aOR of cerebrovascular disease (CVA) was 2.264 for Q4 versus Q1 (95% CI, 1.243–4.122, p = 0.008), but there were no significant associations with diabetic retinopathy (DR), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). Significant stepwise increases were found in CVA (p = 0.0013) and albuminuria ≥30 mg/g (p < 0.001) corresponding to TyG index quartiles, but not DR (p = 0.573), CAD (p = 0.880) or PAOD (p = 0.223). There was a significant association between a high TyG index and a high risk of microalbuminuria and CVA in the study cohort. Further studies to investigate the use of medications in patients with DM to prevent micro- and macro-angiopathies are thus warranted.
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Affiliation(s)
- Hsuan Chiu
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Hui-Ju Tsai
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-C.H.); (P.-Y.W.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-C.H.); (P.-Y.W.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Wei-Hao Hsu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Mei-Yueh Lee
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 7375)
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-C.H.); (P.-Y.W.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
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Yaribeygi H, Butler AE, Barreto GE, Sahebkar A. Antioxidative potential of antidiabetic agents: A possible protective mechanism against vascular complications in diabetic patients. J Cell Physiol 2019; 234:2436-2446. [DOI: 10.1002/jcp.27278] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/26/2018] [Indexed: 08/30/2023]
Abstract
AbstractMany vascular complications are related to exposure of tissues to elevated levels of glucose, a condition that promotes oxidative stress. The primary goal of antidiabetic medication is for normalization of blood glucose. However, antidiabetic medications may have antioxidant effects that go beyond their hypoglycemic influences. Therefore, antidiabetic drugs may be doubly beneficial in preventing diabetic complications. Vascular dysfunction due to uncontrolled diabetes is a serious complication of the disease and one which has a severe impact on quality of life. Readjustment of the oxidative balance in subjects with diabetes, and the positive effects thereof is a topic of intense interest at present. In the current review, we highlight the antioxidant effects of antidiabetic medications which may prevent or delay the onset of vascular dysfunction.
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Affiliation(s)
- Habib Yaribeygi
- Chronic Kidney Disease Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | | | - George E. Barreto
- Departamento de Nutrición y Bioquímica Facultad de Ciencias Pontificia Universidad Javeriana Bogotá D.C. Colombia
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile Santiago Chile
| | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center Mashhad University of Medical Sciences Mashhad Iran
- Biotechnology Research Center Pharmaceutical Technology Institute, Mashhad University of Medical Sciences Mashhad Iran
- School of Pharmacy, Mashhad University of Medical Sciences Mashhad Iran
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The Relationship between Carotid Intima-Media Thickness and Ocular Circulation in Type-2 Diabetes. J Ophthalmol 2019; 2019:3421305. [PMID: 30915237 PMCID: PMC6402216 DOI: 10.1155/2019/3421305] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 12/11/2018] [Accepted: 12/24/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose To compare clinical findings, including ocular blood flow and intima-media thickness (IMT) of the carotid artery, in mild nonproliferative diabetic retinopathy (NPDR) and no diabetic retinopathy (NDR) patients, and to determine risk factors contributing to mild NPDR. Methods In 129 subjects (129 eyes) with type-2 diabetes patients and mild NPDR or NDR, standard statistical techniques were used to determine associations between clinical findings, including diabetes duration, blood levels of creatinine and hemoglobin A1c (HbA1c), central macular thickness (CMT; measured with optical coherence tomography), mean blur rate (MBR; measured with laser speckle flowgraphy), and ultrasound-measured carotid IMT. Results Diabetes duration, IMT, and CMT were significantly higher in the mild NPDR patients than the NDR patients (P=0.004, P=0.004, and P=0.003, respectively), while conversely, MBR in the overall optic nerve head (MBR-A) was lower in the mild NPDR patients. Furthermore, a logistic regression analysis showed that diabetes duration (OR, 1.11; P=0.006), diastolic blood pressure (OR, 0.93; P=0.025), heart rate (OR, 1.07; P=0.004), IMT (OR, 8.65; P=0.005), and CMT (OR, 1.03; P=0.007) were independent contributing factors to mild NPDR. Spearman's rank correlation test also showed that IMT was negatively correlated with MBR-A (P=0.011). Conclusions Increased IMT showed a close association with ocular ischemia in patients with type-2 diabetes and contributed to the presence of mild NPDR. These findings suggest that IMT may be an early biomarker of mild NPDR.
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Mbata O, Abo El-Magd NF, El-Remessy AB. Obesity, metabolic syndrome and diabetic retinopathy: Beyond hyperglycemia. World J Diabetes 2017; 8:317-329. [PMID: 28751954 PMCID: PMC5507828 DOI: 10.4239/wjd.v8.i7.317] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/22/2017] [Accepted: 06/06/2017] [Indexed: 02/05/2023] Open
Abstract
Diabetic retinopathy (DR) is the most feared ocular manifestation of diabetes. DR is characterized by progressive retinal damage that may eventually result in blindness. Clinically, this blindness is caused by progressive damage to the retinal microvasculature, which leads to ischemia, retinal swelling, and neovascularization. Retinopathy is associated with both type 1 and type 2 diabetes, with DR being the leading cause of new onset blindness in United States adults. Despite this strong association with diabetes, it must be noted that the development of retinopathy lesions is multifactorial and may occur in individuals without an established history of diabetes. Metabolic syndrome is a multifactorial condition of central obesity, hypertriglyceridemia, dyslipidemia, hypertension, fasting hyperglycemia, and insulin resistance. Although several studies examined the individual components observed in the metabolic syndrome in relation to the development of DR, there is conflicting data as to the association of the metabolic syndrome with the development of retinopathy lesions in non-diabetic subjects. This review will summarize the current literature on the evidence of the metabolic syndrome on retinopathy in subjects with and without an established history of diabetes. This review will also discuss some of the mechanisms through which metabolic syndrome can contribute to the development of retinopathy.
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Wang D, Shen B, Wu C, Xue Y, Liu Y. The Relationship between Cardiovascular Autonomic Dysfunction and Ocular Abnormality in Chinese T2DM. J Diabetes Res 2017; 2017:7125760. [PMID: 28656153 PMCID: PMC5471552 DOI: 10.1155/2017/7125760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/14/2017] [Accepted: 03/26/2017] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE This study aims to explore the relationship between autonomic nerve dysfunction-assessed by cardiovascular autonomic neuropathy risk score (CAN-RS)-and ocular abnormality in Chinese type 2 diabetes mellitus (T2DM). METHOD This is a cross-sectional study. A total of 335 subjects with T2DM were enrolled. The state of visual acuity, the lens, the vitreous, and the fundus were tested by professional ophthalmic instruments. The electrochemical skin conductance (ESC) of the hands and feet was measured by SUDOSCAN, from which a cardiovascular autonomic neuropathy risk score (CAN-RS) was calculated. Receiver operating characteristic (ROC) curves were drawn to evaluate the feasibility and accuracy of CAN-RS in diabetic oculopathy screening. RESULTS Abnormalities of the lens, vitreous, and fundus accounted for 7.8%, 5.1%, and 9.9%, respectively, in this study. The means of hands and feet ESC were higher than 60 μS, and CAN-RS was 33.1 ± 14.8%. In logistic regression analysis, CAN-RS was positively associated with lens (OR = 1.055, P < 0.001) and vitreous (OR = 1.044, P < 0.01) abnormality. The area under ROC to detect lens and vitreous abnormality was 0.713 and 0.725, respectively. CONCLUSION CAN-RS, a cardiac autonomic nerve dysfunction index calculated by SUDOSCAN, may be a promising index for lens and vitreous abnormality screening in T2DM patients. Further studies are needed to confirm the conclusion.
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Affiliation(s)
- Dandan Wang
- Department of Endocrinology, The 306th Teaching Hospital of People's Liberation Army, Peking University, Beijing, China
| | - Baiyu Shen
- Department of Endocrinology, The 306th Teaching Hospital of People's Liberation Army, Peking University, Beijing, China
| | - Chunrong Wu
- Department of Endocrinology, The 306th Hospital of People's Liberation Army, Beijing, China
| | - Yanyan Xue
- Department of Endocrinology, The 306th Hospital of People's Liberation Army, Beijing, China
| | - Yanjun Liu
- Department of Endocrinology, The 306th Teaching Hospital of People's Liberation Army, Peking University, Beijing, China
- Department of Endocrinology, The 306th Hospital of People's Liberation Army, Beijing, China
- *Yanjun Liu:
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Zhou ZW, Ju HX, Sun MZ, Fu QP, Chen HM, Ji HB, Ji F, Jiang DM. Serum fetuin-A levels are independently correlated with vascular endothelial growth factor and C-reactive protein concentrations in type 2 diabetic patients with diabetic retinopathy. Clin Chim Acta 2016; 455:113-7. [PMID: 26851648 DOI: 10.1016/j.cca.2016.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/27/2016] [Accepted: 02/02/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The higher expression of vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) is associated with the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM). Fetuin-A is shown to have proangiogenic and proinflammatory effects. METHODS This study included 245 T2DM patients consisting of 95 cases with non-diabetic retinopathy (NDR), 78 cases with non-proliferative diabetic retinopathy (NPDR) and 72 cases with proliferative diabetic retinopathy (PDR), in addition to 65 healthy controls. Serum fetuin-A, VEGF and CRP concentrations and related parameters were measured. RESULTS Significant positive correlations were found between fetuin-A and VEGF and CRP, and between VEGF and CRP in T2DM patients (all p<0.001). After adjustment for confounders, fetuin-A was correlated independently with VEGF and CRP in NPDR and PDR patients, but not in NDR subjects. In addition, fetuin-A was correlated independently with HOMA-IR (all 4 groups), HbA1c (NDR, NPDR and PDR groups) and duration of diabetes (PDR group). When compared with NDR and control subjects, NPDR and PDR patients had higher HOMA-IR. CONCLUSIONS Serum fetuin-A concentrations are independently correlated with VEGF and CRP concentrations in T2DM patients with DR, but not in NDR subjects.
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Affiliation(s)
- Zhong-Wei Zhou
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Hui-Xiang Ju
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China.
| | - Ming-Zhong Sun
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Qing-Ping Fu
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Hong-Mei Chen
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Hong-Bin Ji
- Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Fei Ji
- Department of Ophthalmology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
| | - Dong-Mei Jiang
- Department of Endocrinology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, PR China
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Liu L, Yue S, Wu J, Zhang J, Lian J, Teng W, Huang D, Chen L. Prevalence and risk factors of retinopathy in patients with or without metabolic syndrome: a population-based study in Shenyang. BMJ Open 2015; 5:e008855. [PMID: 26667013 PMCID: PMC4679938 DOI: 10.1136/bmjopen-2015-008855] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate the relationship between metabolic syndrome (MS) and the prevalence of retinopathy. DESIGN A cross-sectional study was carried out from August 2013 to September 2014 in Fengyutan Sub-District. PRIMARY AND SECONDARY OUTCOME MEASURES A total of 1163 eligible participants attended. All the participants were subjected to stereo fundus photography to detect retinopathy. The discrepancy of prevalence of retinopathy in different participants was described. RESULTS The prevalence of retinopathy was 9.64% in patients with MS and 3.91% in patients without MS. A higher prevalence of retinopathy with proliferative diabetic retinopathy was found in patients with MS. In multiple logistic regression analysis, independent risk factors for any retinopathy in patients with MS were longer diabetes duration (OR 1.07; 95% CI 1.04 to 1.10, per year increase), higher systolic blood pressure (SBP) (OR 1.16; 95% CI 1.09 to 1.29, per 10 mm Hg increase), higher diastolic blood pressure (DBP) (OR 1.24; 95% CI 1.12 to 1.35, per 10 mm Hg increase), higher fasting plasma glucose (OR 1.07; 95% CI 1.02 to 1.11, per 10 mg/dL increase), higher 2 h postprandial plasma glucose (OR 1.17; 95% CI 1.12 to 1.21, per 10 mg/dL increase), and higher haemoglobin A1c (HbA1c) (OR 1.23; 95% CI 1.13 to 1.34, per % increase). Similar independent risk factors, except for DBP, were found for any retinopathy in patients without MS. CONCLUSIONS The presence of MS components, hyperglycaemia (fasting glucose and HbA1c) and hypertension (SBP and DBP), are significantly associated with the prevalence of retinopathy.
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Affiliation(s)
- Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Song Yue
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jingyang Wu
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiahua Zhang
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jie Lian
- Health Center, Fengyutan Sub-District, Shenyang, China
| | - Weiping Teng
- Key Laboratory of Endocrine Diseases in Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Desheng Huang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Lei Chen
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
- Key Laboratory of Endocrine Diseases in Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China
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Bonakdaran S, Shoeibi N. Is there any correlation between vitamin D insufficiency and diabetic retinopathy? Int J Ophthalmol 2015; 8:326-31. [PMID: 25938050 DOI: 10.3980/j.issn.2222-3959.2015.02.20] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 06/19/2014] [Indexed: 01/07/2023] Open
Abstract
AIM To determine a relation between vitamin D level, which is an inhibitor of angiogenesis, and diabetic retinopathy and its risk factors. METHODS In a clinic-based cross sectional study two hundred and thirty-five type 2 diabetic patients older than 20y were selected. Patients were classified according to ophthalmologic examination as following: no diabetic retinopathy (NDR) (n=153), non-proliferative diabetic retinopathy (NPDR) (n=64) and proliferative diabetic retinopathy (PDR) (n=18). Study subjects were tested for fasting blood glucose, glycated hemoglobin A1C (HbA1C), lipid profile, microalbuminuria, HsCRP, IGF1, insulin (in patients without history of insulin taking) and 25 hydroxy vitamin D [25 (OH) D] levels. Vitamin D insufficiency was defined according to 25 (OH) D level less than 30 ng/mL. The relationship between diabetic retinopathy and serum 25 (OH) D insufficiency was evaluated. RESULTS The prevalence of diabetic retinopathy was 34.8% in our patients. Long duration of diabetes, hypertension, poor glycemic control, diabetic nephropathy, hyperinsulinemia and insulin resistance were risk factors for diabetic retinopathy but 25 (OH) D level was not significant different between NDR, NPDR and PDR groups. Correlation between 25 (OH) D level and other known risk factors of diabetic retinopathy was not significant. CONCLUSION This study did not find any association between diabetic retinopathy and its severity and vitamin D insufficiency. Vitamin D insufficiency is not related to risk factors of diabetic retinopathy.
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Affiliation(s)
- Shokoufeh Bonakdaran
- Endocrine Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Mashhad 91766, Iran
| | - Nasser Shoeibi
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad 91766, Iran
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Bjornstad P, Snell-Bergeon JK, Nadeau KJ, Maahs DM. Insulin sensitivity and complications in type 1 diabetes: New insights. World J Diabetes 2015; 6:8-16. [PMID: 25685274 PMCID: PMC4317319 DOI: 10.4239/wjd.v6.i1.8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/24/2014] [Accepted: 12/01/2014] [Indexed: 02/05/2023] Open
Abstract
Despite improvements in glucose, lipids and blood pressure control, vascular complications remain the most important cause of morbidity and mortality in patients with type 1 diabetes. For that reason, there is a need to identify additional risk factors to utilize in clinical practice or translate to novel therapies to prevent vascular complications. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes that has been linked with the development and progression of both micro- and macrovascular complications. Adolescents and adults with type 1 diabetes have reduced insulin sensitivity, even when compared to their non-diabetic counterparts of similar adiposity, serum triglycerides, high-density lipoprotein cholesterol, level of habitual physical activity, and in adolescents, pubertal stage. Reduced insulin sensitivity is thought to contribute both to the initiation and progression of macro- and microvascular complications in type 1 diabetes. There are currently clinical trials underway examining the benefits of improving insulin sensitivity with regards to vascular complications in type 1 diabetes. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes, is implicated in the pathogenesis of vascular complications and is potentially an important therapeutic target to prevent vascular complications. In this review, we will focus on the pathophysiologic contribution of insulin sensitivity to vascular complications and summarize related ongoing clinical trials.
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Yun JS, Ko SH, Kim JH, Moon KW, Park YM, Yoo KD, Ahn YB. Diabetic retinopathy and endothelial dysfunction in patients with type 2 diabetes mellitus. Diabetes Metab J 2013; 37:262-9. [PMID: 23991404 PMCID: PMC3753491 DOI: 10.4093/dmj.2013.37.4.262] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/19/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. METHODS We used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were expressed as percent change over baseline values. RESULTS The mean±standard deviation of patient age was 54.1±8.6 years. The %FMD was significantly lower in patients with DR than without DR. The prevalence of retinopathy decreased across increasing tertiles of %FMD. After adjusting for patients' age, sex, diabetes duration, use of insulin, use of antihypertensive, antiplatelet, and lipid lowering medications, systolic blood pressure, fasting plasma glucose, 2-hour plasma glucose, glycated hemoglobin, and urinary albumin excretion, participants with a reduced %FMD were more likely to have DR (odds ratio, 11.819; 95% confidence interval, 2.201 to 63.461; P=0.004, comparing the lowest and highest tertiles of %FMD). CONCLUSION Endothelial dysfunction was associated with DR, which was most apparent when the endothelial dysfunction was severe. Our study provides insights into the possible mechanism of the influence of endothelial dysfunction on the development of DR.
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Affiliation(s)
- Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Ji-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Kun-Woong Moon
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Yong-Moon Park
- Department of Preventive Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
- Department of Epidemiology and Biostatistics, Arnold School of Public health, University of South Carolina, Columbia, SC, USA
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
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Moise MM, Benjamin LM, Etienne M, Thierry G, Ndembe Dalida K, Doris TM, Samy WM. Intake of Gnetum africanum and Dacryodes edulis, imbalance of oxidant/antioxidant status and prevalence of diabetic retinopathy in central Africans. PLoS One 2012; 7:e49411. [PMID: 23226496 PMCID: PMC3513305 DOI: 10.1371/journal.pone.0049411] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 10/10/2012] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of DR and to correlate cardiometabolic, sociodemographic, and oxidant/antioxidant imbalance data to the prevalence of DR. DESIGN This case-control study included type 2 DM (T2 DM) patients with DR (n = 66), T2 DM patients without DR (N = 84), and healthy controls (n = 45) without DR, in Kinshasa town. Diet, albuminemia, serum vitamins, and 8-isoprostane were examined. RESULTS No intake of safou (OR = 2.7 95% CI 1.2-5.8; P = 0.014), low serum albumin <4.5 g/dL (OR-2.9 95% CI 1.4-5.9; P = 0.003), no intake of fumbwa (OR = 2.8 95% CI 1.2-6.5; P = 0.014), high 8-isoprostane (OR = 14.3 95% CI 4.5-46; P<0.0001), DM duration ≥ 5 years (OR = 3.8 95% CI 1.6-9.1; P = 0.003), and low serum vitamin C (OR = 4.5 95% CI 1.3-15.5; P = 0.016) were identified as the significant independent determinants of DR. CONCLUSION The important role of oxidant/antioxidant status imbalance and diet is demonstrated in DR.
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Affiliation(s)
- Mvitu-Muaka Moise
- Department of Ophthalmology, University of Kinshasa, Kinshasa, The Republic of Congo
| | - Longo-Mbenza Benjamin
- Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
- * E-mail:
| | - Mokondjimobe Etienne
- Faculty of Health Sciences, University of Marien Ngouabi, Brazzaville, The Republic of Congo
| | - Gombet Thierry
- Faculty of Health Sciences, University of Marien Ngouabi, Brazzaville, The Republic of Congo
| | | | - Tulomba Mona Doris
- Biostatistics Unit, Lomo Medical Center and Heart of Africa Center of Cardiology, Kinshasa, The Republic of Congo
| | - Wayiza Masamba Samy
- Department of Chemistry and Chemical Technology, Walter Sisulu University, Mthatha, South Africa
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Huber M, Heiduschka P, Ziemssen F, Bolbrinker J, Kreutz R. Microangiopathy and visual deficits characterize the retinopathy of a spontaneously hypertensive rat model with type 2 diabetes and metabolic syndrome. Hypertens Res 2010; 34:103-12. [PMID: 20927114 DOI: 10.1038/hr.2010.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Retinopathy has been increasing in prevalence as a consequence of type 2 diabetes and a cluster of coexisting risk factors characterized as the metabolic syndrome. However, the combined effects of these conditions on the retina are poorly understood. Therefore, we focused on the spontaneously hypertensive corpulent rat (SHR/N-cp), a model with type 2 diabetes, obesity and features of the metabolic syndrome to characterize retinal changes at a structural and functional level. SHR/N-cp males at 4 and 8 months of age were used in this study. Metabolic parameters and blood pressure were measured by standard methods. Morphology was investigated by histological techniques supplemented by nicotinamide adenine dinucleotide phosphate-diaphorase staining of whole mounts and fluorescein angiography to analyze the retinal vasculature. The in vivo function of the retina was examined by electroretinography (ERG). Obese SHR/N-cp rats were hypertensive and showed significant increases in body weight, serum levels of glucose, triglycerides, total cholesterol and urinary glucose excretion compared with lean controls (P < 0.01 for each). Histology indicated an overall intact integrity of the retina and aspects of microangiopathy in obese SHR/N-cp rats. ERG revealed intact processing of light signals but significantly decreased amplitudes of b-waves for all (P < 0.01) and of a-waves for some examined light intensities (P < 0.05). Oscillatory potentials were significantly protracted (P < 0.01), whereas amplitudes were not reduced. Microangiopathy and electroretinographic deficits combine to produce an early non-proliferative retinopathy phenotype in the obese SHR/N-cp rats. Thus, this model represents a valuable experimental tool to obtain further insights into the mechanisms of retinopathy in the context of obesity, type 2 diabetes and metabolic syndrome.
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Affiliation(s)
- Matthias Huber
- Institut für Klinische Pharmakologie und Toxikologie, Charité Centrum für Therapieforschung, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Current World Literature. Curr Opin Ophthalmol 2010; 21:239-46. [DOI: 10.1097/icu.0b013e32833983a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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