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Wang JT, Yu ZY, Tao YH, Liu YC, Wang YM, Guo QL, Xue JZ, Wen XH, Zhang Q, Xu XD, He CF, Xue WJ, Guo JC, Zhou HG. A novel palmitic acid hydroxy stearic acid (5-PAHSA) plays a neuroprotective role by inhibiting phosphorylation of the m-TOR-ULK1 pathway and regulating autophagy. CNS Neurosci Ther 2021; 27:484-496. [PMID: 33459523 PMCID: PMC7941174 DOI: 10.1111/cns.13573] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
Aims Type 2 diabetes mellitus (T2DM) can lead to brain dysfunction and a series of neurological complications. Previous research demonstrated that a novel palmitic acid (5‐PAHSA) exerts effect on glucose tolerance and chronic inflammation. Autophagy was important in diabetic‐related neurodegeneration. The aim of the present study was to investigate whether 5‐PAHSA has specific therapeutic effects on neurological dysfunction in diabetics, particularly with regard to autophagy. Methods 5‐PAHSA was successfully synthesized according to a previously described protocol. We then carried out a series of in vitro and in vivo experiments using PC12 cells under diabetic conditions, and DB/DB mice, respectively. PC12 cells were treated with 5‐PAHSA for 24 h, while mice were administered with 5‐PAHSA for 30 days. At the end of each experiment, we analyzed glucolipid metabolism, autophagy, apoptosis, oxidative stress, cognition, and a range of inflammatory factors. Results Although there was no significant improvement in glucose metabolism in mice administered with 5‐PAHSA, ox‐LDL decreased significantly following the administration of 5‐PAHSA in serum of DB/DB mice (p < 0.0001). We also found that the phosphorylation of m‐TOR and ULK‐1 was suppressed in both PC12 cells and DB/DB mice following the administration of 5‐PAHSA (p < 0.05 and p < 0.01), although increased levels of autophagy were only observed in vitro (p < 0.05). Following the administration of 5‐PAHSA, the concentration of ROS decreased in PC12 cells and the levels of CRP increased in high‐dose group of 5‐PAHSA (p < 0.01). There were no significant changes in terms of apoptosis, other inflammatory factors, or cognition in DB/DB mice following the administration of 5‐PAHSA. Conclusion We found that 5‐PAHSA can enhance autophagy in PC12 cells under diabetic conditions. Our data demonstrated that 5‐PAHSA inhibits phosphorylation of the m‐TOR‐ULK1 pathway and suppressed oxidative stress in PC12 cells, and exerted influence on lipid metabolism in DB/DB mice.
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Affiliation(s)
- Jian-Tao Wang
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
| | - Zhong-Yu Yu
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
| | - Ying-Hong Tao
- Department of Medical Examination Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying-Chao Liu
- Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Yan-Mei Wang
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
| | - Qi-Lin Guo
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jian-Zhong Xue
- Department of Neurology, Fifth Clinical Medical College of Yangzhou University, Changshu Second People's Hospital of Jiangsu Province, Changshu, China
| | - Xiao-Hong Wen
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Qian Zhang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xiao-Die Xu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Cheng-Feng He
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wen-Jiao Xue
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jing-Chun Guo
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
| | - Hou-Guang Zhou
- Department of Geriatric Neurology of Huashan Hospital, National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai, China
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Jendle J, Heinemann L. Real-Time Continuous Glucose Monitoring Usage in Pilots with Diabetes: An Option to Improve Safety. Diabetes Technol Ther 2018; 20:453-454. [PMID: 29958024 DOI: 10.1089/dia.2018.0099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Johan Jendle
- 1 Department of Medicine, Örebro University Hospital , Örebro, Sweden
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Mehta HB, Mehta V, Goodwin JS. Association of Hypoglycemia With Subsequent Dementia in Older Patients With Type 2 Diabetes Mellitus. J Gerontol A Biol Sci Med Sci 2017; 72:1110-1116. [PMID: 27784724 DOI: 10.1093/gerona/glw217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 10/12/2016] [Indexed: 12/18/2022] Open
Abstract
Background Studies have found conflicting evidence regarding the association of hypoglycemia with dementia. We evaluated an association of hypoglycemia with subsequent dementia in patients with type 2 diabetes. Methods This retrospective longitudinal cohort study used the Clinical Practice Research Datalink, an electronic medical records data from the United Kingdom, from 2003 to 2012. We included patients aged >65 years diagnosed with type 2 diabetes, with no prior diagnosis of dementia. Dementia was defined using diagnosis codes from medical records. All patients were followed from the date of initial diabetes diagnosis. To account for competing risk of death, we used Fine and Gray's competing risk model to determine the association of hypoglycemia with dementia while adjusting for potential confounders. Hypoglycemia was modeled as a time-dependent covariate. Results Of 53,055 patients, 5.7% (n = 3,018) had at least one hypoglycemia episodes. The overall incidence rate of dementia was 12.7 per 1,000 person-years. In the fully adjusted model that controlled for all confounders, the occurrence of at least one hypoglycemia episode was associated with 27% higher odds of subsequent dementia (hazard ratio = 1.27; 95% confidence interval = 1.06-1.51). The risk increased with the number of hypoglycemia episodes: one episode (hazard ratio = 1.26; 95% confidence interval = 1.03-1.54); two or more episodes (hazard ratio = 1.50; 95% confidence interval = 1.09-2.08). Conclusions Hypoglycemia is associated with a higher risk of dementia and may be responsible in part for the higher risk of dementia in patients with diabetes. Alternatively, hypoglycemia may be a marker for undiagnosed cognitive impairment, and we cannot rule out the possibility of reverse causation between hypoglycemia and dementia.
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Affiliation(s)
| | | | - James S Goodwin
- Department of Internal Medicine, University of Texas Medical Branch, Galveston
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Roy S, Kim N, Desai A, Komaragiri M, Baxi N, Jassil N, Blessinger M, Khan M, Cole R, Desai N, Terrigno R, Hunter K. Cognitive Function and Control of Type 2 Diabetes Mellitus in Young Adults. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:220-6. [PMID: 26110134 PMCID: PMC4462818 DOI: 10.4103/1947-2714.157627] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Type 2 diabetes mellitus (T2DM) has been associated with impairment of cognitive function. Studies show a strong negative correlation between the levels of glycosylated hemoglobin and cognitive function in adult patients above the mean age of 60 years. In healthy adults, age-related cognitive impairment is mostly reported after the age of 60 years, hence the decline in cognitive function can be a part of normal aging without diabetes. Since the majority of patients with diabetes are between the ages of 40 and 59 years, it is crucial to ascertain whether the levels of glycosylated hemoglobin negatively correlate with the levels of cognitive function scores in adult patients of age 60 years or younger, similar to the way it correlates in patients older than 60 years of age, or not. Aims: We observed the relationship between the levels of glycosylated hemoglobin and the levels of cognitive function in patients of age 60 years or younger with T2DM. Materials and Methods: Eighty-two patients with T2DM underwent cognitive assessment testing by using a Modified Mini-Mental State Examination (3MS), and their cognitive function scores were correlated with their glycosylated hemoglobin levels, durations of diabetes, and levels of education. Results: Cognitive impairment was observed in 19.5% of the studied patients. We found a weakly negative relationship between the glycosylated hemoglobin level and cognitive function score (r = -0.292), a moderately negative relationship between the duration of diabetes and cognitive function score (r = -0.303), and a weakly positive relationship between the level of education and cognitive function score (r = 0.277). Conclusion: Cognitive impairment affects one-fifth of the patients of age 60 years or younger with T2DM. It is weakly negatively related to the glycosylated hemoglobin level, moderately negatively related to the duration of diabetes, and weakly positively related to the level of education.
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Affiliation(s)
- Satyajeet Roy
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Nami Kim
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Anjali Desai
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Mahathi Komaragiri
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Namrata Baxi
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Navinder Jassil
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Megan Blessinger
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Maliha Khan
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Robert Cole
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Nayan Desai
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Rocco Terrigno
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Krystal Hunter
- Cooper Research Institute, Cooper Medical School of Rowan University, Camden, New Jersey, USA
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Rawlings AM, Sharrett AR, Schneider ALC, Coresh J, Albert M, Couper D, Griswold M, Gottesman RF, Wagenknecht LE, Windham BG, Selvin E. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med 2014; 161:785-93. [PMID: 25437406 PMCID: PMC4432464 DOI: 10.7326/m14-0737] [Citation(s) in RCA: 267] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Type 2 diabetes is associated with dementia risk, but evidence is limited for possible associations of diabetes and prediabetes with cognitive decline. OBJECTIVE To determine whether diabetes in midlife is associated with 20-year cognitive decline and to characterize long-term cognitive decline across clinical categories of hemoglobin A1c (HbA1c) levels. DESIGN Prospective cohort study. SETTING The community-based ARIC (Atherosclerosis Risk in Communities) study. PARTICIPANTS 13,351 black and white adults aged 48 to 67 years at baseline (1990 to 1992). MEASUREMENTS Diabetes was defined by self-reported physician diagnosis or medication use or HbA1c level of 6.5% or greater. Undiagnosed diabetes, prediabetes, and glucose control in persons with diagnosed diabetes were defined by clinical categories of HbA1c level. Delayed word recall, digit symbol substitution, and word fluency tests were used to assess cognitive performance and were summarized with a global Z score. RESULTS Diabetes in midlife was associated with a 19% greater cognitive decline over 20 years (adjusted global Z-score difference, -0.15 [;95% CI, -0.22 to -0.08];) compared with no diabetes. Cognitive decline was significantly greater among persons with prediabetes (HbA1c level of 5.7% to 6.4%) than among those with an HbA1c level less than 5.7%. Participants with poorly controlled diabetes (HbA1c level ≥ 7.0%) had greater decline than those whose diabetes was controlled (adjusted global Z-score difference, -0.16; P = 0.071). Longer-duration diabetes was also associated with greater late-life cognitive decline (P for trend < 0.001). Rates of decline did not differ significantly between white and black persons (P for interaction = 0.44). LIMITATION Single HbA1c measurement at baseline, 1 test per cognitive domain, and potential geographic confounding of race comparisons. CONCLUSION Diabetes prevention and glucose control in midlife may protect against late-life cognitive decline. PRIMARY FUNDING SOURCE National Institutes of Health.
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Investigating the role of neuropathic pain relief in decreasing gait variability in diabetes mellitus patients with neuropathic pain: a randomized, double-blind crossover trial. J Neuroeng Rehabil 2014; 11:125. [PMID: 25139539 PMCID: PMC4150964 DOI: 10.1186/1743-0003-11-125] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 07/25/2014] [Indexed: 12/20/2022] Open
Abstract
Background Subjects with diabetes mellitus (DM) develop gait dysfunction contributing to falls, reluctance to perform activities and injuries. Neuropathic pain (NeP) related to diabetic peripheral neuropathy (DPN) is associated with increased gait variability that may contribute to gait dysfunction. We used a portable device (GaitMeter™) and related gait and balance measures to measure gait parameters in painful DPN (PDPN) subjects prior to and during analgesia. Our hypothesis was that PDPN subjects would have decreased gait step variability when receiving pharmacological relief of NeP. Methods DPN subjects with at least moderate NeP were assessed in a randomized, double-blind crossover study of pregabalin versus placebo. The outcome measure was variability in step length and step velocity. Testing for Timed Get-Up-and-Go Test, Tinetti Mobility Scales, Sway Testing, a Physiological Profile Approach, and fall-related surveys were also performed. DPN severity was quantified using the Utah Early Neuropathy Score. Results PDPN subjects developed increased, rather than decreased, step length and step velocity variability during pregabalin treatment. There were no significant differences between cohorts for other physiological gait and balance testing. Non-significant NeP relief occurred in the pregabalin phase of study as compared with placebo. There was a negative relationship for step length with pain severity. Conclusion Analgesia did not decrease gait variability in PDPN patients, and in fact, increased gait variability was seen during pregabalin treatment. Other important relationships of gait dysfunction with PDPN should be sought. Electronic supplementary material The online version of this article (doi:10.1186/1743-0003-11-125) contains supplementary material, which is available to authorized users.
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Belfort-DeAguiar R, Constable RT, Sherwin RS. Functional MRI signal fluctuations: a preclinical biomarker for cognitive impairment in type 2 diabetes? Diabetes 2014; 63:396-8. [PMID: 24464717 PMCID: PMC4179310 DOI: 10.2337/db13-1685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - R. Todd Constable
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT
| | - Robert S. Sherwin
- Section of Endocrinology, Yale University School of Medicine, New Haven, CT
- Corresponding author: Robert S. Sherwin,
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