1
|
Jakubek-Kipa K, Galiniak S, Łagowska K, Krupa I, Ludwin A, Tabarkiewicz J, Mazur A. Bioleptin as a useful marker of metabolic status in children with diabetes mellitus type 1. Front Endocrinol (Lausanne) 2023; 14:1235409. [PMID: 37670877 PMCID: PMC10475937 DOI: 10.3389/fendo.2023.1235409] [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: 06/06/2023] [Accepted: 08/02/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction The purpose of our study was tomeasure the level of leptin and biologically active leptin (bioLEP) in children with type 1 diabetes, depending on the duration of diabetes and its degree of metabolic control. Methods The study included 94 children (58 boys and 36 girls). In a group of children with diabetes, 40 patients were newly diagnosed with type 1 diabetes, 40 children who have diabetes for more than a year (20 with good metabolic control and 20 with poor metabolic control). The control group consisted of 14 healthy children. The serum level of leptin and bioLEP was measured using a sandwich enzyme-linked immunosorbent assay. To our knowledge, this is the first study to describe bioLEP levels among diabetic children with different forms of disease control. Results Lower levels of leptin were found in children with diabetes compared to healthy children. Furthermore, we found a statistically higher concentration of leptin in the group of children with newly diagnosed diabetes compared to children from the diabetic group with poor metabolic control and lower than healthy children (11.19 vs. 7.84 and 20.94 ng/mL). Moreover, children in the metabolically well-controlled group had statistically lower levels of this hormone (5.11 ng/mL) than healthy children. Leptin concentrations differed significantly between underweight, overweight, and obese children. Discussion In our study, the level of bioLEP differed significantly between children in the newly diagnosed diabetes group and children in the long-term, poorly controlled diabetes group and healthy controls. Despite many studies published in recent years, many aspects of leptin secretion, action, and mechanisms of its influence on carbohydrate and fat metabolism are still to be clarified. In our opinion, studies evaluating the status of bioLEP in diabetes can also contribute to a better understanding of the mechanisms regulating metabolism.
Collapse
Affiliation(s)
- Katarzyna Jakubek-Kipa
- Department of Pediatrics, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - Sabina Galiniak
- Department of Biochemistry and General Chemistry, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - Katarzyna Łagowska
- Laboratory for Translational Research in Medicine, Centre for Innovative Research in Medical and Natural Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Izabela Krupa
- Laboratory for Translational Research in Medicine, Centre for Innovative Research in Medical and Natural Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Aleksandra Ludwin
- Laboratory for Translational Research in Medicine, Centre for Innovative Research in Medical and Natural Sciences, Medical College of Rzeszów University, Rzeszow, Poland
| | - Jacek Tabarkiewicz
- Laboratory for Translational Research in Medicine, Centre for Innovative Research in Medical and Natural Sciences, Medical College of Rzeszów University, Rzeszow, Poland
- Department of Human Immunology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - Artur Mazur
- Department of Pediatrics, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| |
Collapse
|
2
|
Non-Invasive Assessment of Metabolic Adaptation in Paediatric Patients Suffering from Type 1 Diabetes Mellitus. J Clin Med 2019; 8:jcm8111797. [PMID: 31717811 PMCID: PMC6912469 DOI: 10.3390/jcm8111797] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
An analysis of exhaled volatile organic compounds (VOC) may deliver systemic information quicker than available invasive techniques. Metabolic aberrations in pediatric type 1 diabetes (T1DM) are of high clinical importance and could be addressed via breathomics. Real-time breath analysis was combined with continuous glucose monitoring (CGM) and blood tests in children suffering from T1DM and age-matched healthy controls in a highly standardized setting. CGM and breath-resolved VOC analysis were performed every 5 minutes for 9 hours and blood was sampled at pre-defined time points. Per participant (n = 44) food intake and physical activity were identical and a total of 22 blood samples and 93 minutes of breath samples were investigated. The inter-individual variability of glucose, insulin, glucagon, leptin, and soluble leptin receptor relative to food intake differed distinctly between patients and controls. In T1DM patients, the exhaled amounts of acetone, 2-propanol, and pentanal correlated to glucose concentrations. Of note, the strength of these correlations strongly depended on the interval between food intake and breath sampling. Our data suggests that metabolic adaptation through postprandial hyperglycemia and related oxidative stress is immediately reflected in exhaled breath VOC concentrations. Clinical translations of our findings may enable point-of-care applicability of online breath analysis towards personalized medicine.
Collapse
|
3
|
Üner AG, Keçik O, Quaresma PGF, De Araujo TM, Lee H, Li W, Kim HJ, Chung M, Bjørbæk C, Kim YB. Role of POMC and AgRP neuronal activities on glycaemia in mice. Sci Rep 2019; 9:13068. [PMID: 31506541 PMCID: PMC6736943 DOI: 10.1038/s41598-019-49295-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 08/20/2019] [Indexed: 11/23/2022] Open
Abstract
Leptin regulates both feeding and glycaemia primarily through its receptors expressed on agouti-related peptide (AgRP) and pro-opiomelanocortin-expressing (POMC) neurons; however, it is unknown whether activity of these neuronal populations mediates the regulation of these processes. To determine this, we injected Cre-dependent designer receptors exclusively activated by designer drugs (DREADD) viruses into the hypothalamus of normoglycaemic and diabetic AgRP-ires-cre and POMC-cre mice to chemogenetically activate or inhibit these neuronal populations. Despite robust changes in food intake, activation or inhibition of AgRP neurons did not affect glycaemia, while activation caused significant (P = 0.014) impairment in insulin sensitivity. Stimulation of AgRP neurons in diabetic mice reversed leptin’s ability to inhibit feeding but did not counter leptin’s ability to lower blood glucose levels. Notably, the inhibition of POMC neurons stimulated feeding while decreasing glucose levels in normoglycaemic mice. The findings suggest that leptin’s effects on feeding by AgRP neurons are mediated by changes in neuronal firing, while the control of glucose balance by these cells is independent of chemogenetic activation or inhibition. The firing-dependent glucose lowering mechanism within POMC neurons is a potential target for the development of novel anti-diabetic medicines.
Collapse
Affiliation(s)
- Aykut Göktürk Üner
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA.,Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University, Efeler, Aydin, 09010, Turkey
| | - Onur Keçik
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Paula G F Quaresma
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Thiago M De Araujo
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Hyon Lee
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Wenjing Li
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Hyun Jeong Kim
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Michelle Chung
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Christian Bjørbæk
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA
| | - Young-Bum Kim
- Department of Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, MA, 02215, USA.
| |
Collapse
|
4
|
Smitka K, Marešová D. Adipose Tissue as an Endocrine Organ: An Update on Pro-inflammatory and Anti-inflammatory Microenvironment. Prague Med Rep 2015; 116:87-111. [PMID: 26093665 DOI: 10.14712/23362936.2015.49] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Adipose tissue is recognized as an active endocrine organ that produces a number of endocrine substances referred to as "adipokines" including leptin, adiponectin, adipolin, visfatin, omentin, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), resistin, pigment epithelium-derived factor (PEDF), and progranulin (PGRN) which play an important role in the food intake regulation and significantly influence insulin sensitivity and in some cases directly affect insulin resistance in skeletal muscle, liver, and adipose tissue. The review summarizes current knowledge about adipose tissue-derived hormones and their influence on energy homeostasis regulation. The possible therapeutic potential of these adipokines in the treatment of insulin resistance, endothelial dysfunction, a pro-inflammatory response, obesity, eating disorders, progression of atherosclerosis, type 1 diabetes, and type 2 diabetes is discussed.
Collapse
Affiliation(s)
- Kvido Smitka
- Institute of Physiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Dana Marešová
- Institute of Physiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
| |
Collapse
|
5
|
Abstract
Over the past decade, knowledge of the pathogenesis and natural history of type 1 diabetes has grown substantially, particularly with regard to disease prediction and heterogeneity, pancreatic pathology, and epidemiology. Technological improvements in insulin pumps and continuous glucose monitors help patients with type 1 diabetes manage the challenge of lifelong insulin administration. Agents that show promise for averting debilitating disease-associated complications have also been identified. However, despite broad organisational, intellectual, and fiscal investments, no means for preventing or curing type 1 diabetes exists, and, globally, the quality of diabetes management remains uneven. This Seminar discusses current progress in epidemiology, pathology, diagnosis, and treatment of type 1 diabetes, and prospects for an improved future for individuals with this disease.
Collapse
Affiliation(s)
- Mark A Atkinson
- Department of Pathology and Department of Pediatrics, University of Florida, Gainesville, FL, USA.
| | | | - Aaron W Michels
- Barbara Davis Center for Childhood Diabetes, Aurora, CO, USA
| |
Collapse
|
6
|
Moon HS, Dalamaga M, Kim SY, Polyzos SA, Hamnvik OP, Magkos F, Paruthi J, Mantzoros CS. Leptin's role in lipodystrophic and nonlipodystrophic insulin-resistant and diabetic individuals. Endocr Rev 2013; 34:377-412. [PMID: 23475416 PMCID: PMC3660716 DOI: 10.1210/er.2012-1053] [Citation(s) in RCA: 187] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Leptin is an adipocyte-secreted hormone that has been proposed to regulate energy homeostasis as well as metabolic, reproductive, neuroendocrine, and immune functions. In the context of open-label uncontrolled studies, leptin administration has demonstrated insulin-sensitizing effects in patients with congenital lipodystrophy associated with relative leptin deficiency. Leptin administration has also been shown to decrease central fat mass and improve insulin sensitivity and fasting insulin and glucose levels in HIV-infected patients with highly active antiretroviral therapy (HAART)-induced lipodystrophy, insulin resistance, and leptin deficiency. On the contrary, the effects of leptin treatment in leptin-replete or hyperleptinemic obese individuals with glucose intolerance and diabetes mellitus have been minimal or null, presumably due to leptin tolerance or resistance that impairs leptin action. Similarly, experimental evidence suggests a null or a possibly adverse role of leptin treatment in nonlipodystrophic patients with nonalcoholic fatty liver disease. In this review, we present a description of leptin biology and signaling; we summarize leptin's contribution to glucose metabolism in animals and humans in vitro, ex vivo, and in vivo; and we provide insights into the emerging clinical applications and therapeutic uses of leptin in humans with lipodystrophy and/or diabetes.
Collapse
Affiliation(s)
- Hyun-Seuk Moon
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Sanlioglu AD, Altunbas HA, Balci MK, Griffith TS, Sanlioglu S. Clinical utility of insulin and insulin analogs. Islets 2013; 5:67-78. [PMID: 23584214 PMCID: PMC4204021 DOI: 10.4161/isl.24590] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/05/2013] [Accepted: 04/06/2013] [Indexed: 02/08/2023] Open
Abstract
Diabetes is a pandemic disease characterized by autoimmune, genetic and metabolic abnormalities. While insulin deficiency manifested as hyperglycemia is a common sequel of both Type-1 and Type-2 diabetes (T1DM and T2DM), it does not result from a single genetic defect--rather insulin deficiency results from the functional loss of pancreatic β cells due to multifactorial mechanisms. Since pancreatic β cells of patients with T1DM are destroyed by autoimmune reaction, these patients require daily insulin injections. Insulin resistance followed by β cell dysfunction and β cell loss is the characteristics of T2DM. Therefore, most patients with T2DM will require insulin treatment due to eventual loss of insulin secretion. Despite the evidence of early insulin treatment lowering macrovascular (coronary artery disease, peripheral arterial disease and stroke) and microvascular (diabetic nephropathy, neuropathy and retinopathy) complications of T2DM, controversy exists among physicians on how to initiate and intensify insulin therapy. The slow acting nature of regular human insulin makes its use ineffective in counteracting postprandial hyperglycemia. Instead, recombinant insulin analogs have been generated with a variable degree of specificity and action. Due to the metabolic variability among individuals, optimum blood glucose management is a formidable task to accomplish despite the presence of novel insulin analogs. In this article, we present a recent update on insulin analog structure and function with an overview of the evidence on the various insulin regimens clinically used to treat diabetes.
Collapse
MESH Headings
- Animals
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/metabolism
- Diabetic Angiopathies/prevention & control
- Drug Monitoring
- Evidence-Based Medicine
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/chemistry
- Hypoglycemic Agents/metabolism
- Hypoglycemic Agents/therapeutic use
- Insulin/administration & dosage
- Insulin/analogs & derivatives
- Insulin/metabolism
- Insulin/therapeutic use
- Insulin, Regular, Human/administration & dosage
- Insulin, Regular, Human/analogs & derivatives
- Insulin, Regular, Human/genetics
- Insulin, Regular, Human/therapeutic use
- Recombinant Proteins/administration & dosage
- Recombinant Proteins/chemistry
- Recombinant Proteins/therapeutic use
Collapse
Affiliation(s)
- Ahter D. Sanlioglu
- Human Gene and Cell Therapy Center; Akdeniz University Faculty of Medicine; Antalya, Turkey
- Department of Medical Biology and Genetics; Akdeniz University Faculty of Medicine; Antalya, Turkey
| | - Hasan Ali Altunbas
- Human Gene and Cell Therapy Center; Akdeniz University Faculty of Medicine; Antalya, Turkey
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Akdeniz University Faculty of Medicine; Antalya, Turkey
| | - Mustafa Kemal Balci
- Human Gene and Cell Therapy Center; Akdeniz University Faculty of Medicine; Antalya, Turkey
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Akdeniz University Faculty of Medicine; Antalya, Turkey
| | | | - Salih Sanlioglu
- Human Gene and Cell Therapy Center; Akdeniz University Faculty of Medicine; Antalya, Turkey
- Department of Medical Biology and Genetics; Akdeniz University Faculty of Medicine; Antalya, Turkey
| |
Collapse
|
8
|
Chatzigeorgiou A, Karalis KP, Bornstein SR, Chavakis T. Lymphocytes in obesity-related adipose tissue inflammation. Diabetologia 2012; 55:2583-2592. [PMID: 22733483 DOI: 10.1007/s00125-012-2607-0] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 05/17/2012] [Indexed: 12/17/2022]
Abstract
Inflammation in the white adipose tissue (WAT) is considered a major player in the development of insulin resistance. The role of macrophages accumulating in the WAT during obesity, promoting WAT inflammation and insulin resistance is well established. In contrast, less is known about the role of lymphocytes. Recent studies have implicated different lymphocyte subsets in WAT inflammation. For instance, cytotoxic CD8(+) T cells infiltrating the WAT may contribute to the recruitment, differentiation and activation of macrophages. On the other hand, a differential role for CD4(+) Th1 and CD4(+) Th2 cells has been suggested. Levels of WAT regulatory T cells decrease during the course of obesity and may represent a crucial factor for the maintenance of insulin sensitivity. Moreover, activation of natural killer T cells, an innate-like T cell population, which recognises lipid antigens, promotes insulin resistance and WAT inflammation. Finally, B cells may infiltrate WAT very early in response to high-fat feeding and worsen glucose metabolism through modulation of T cells and the production of pathogenic antibodies. These interesting new findings however bear controversies and introduce novel, yet unanswered, questions. Here, we review and discuss the impact of the different lymphocyte subsets in obesity-related WAT inflammation and attempt to identify the open questions to be answered by future studies.
Collapse
Affiliation(s)
- A Chatzigeorgiou
- Department of Internal Medicine III, Division of Vascular Inflammation, Diabetes and Kidney, University Clinic Carl-Gustav-Carus, University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Institute of Physiology, University of Dresden, Dresden, Germany.
| | - K P Karalis
- Department of Internal Medicine III, University Clinic Carl-Gustav-Carus, University of Dresden, Dresden, Germany
- Developmental Biology Section, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Division of Endocrinology, Children's Hospital, Boston, MA, USA
| | - S R Bornstein
- Department of Internal Medicine III, University Clinic Carl-Gustav-Carus, University of Dresden, Dresden, Germany
| | - T Chavakis
- Department of Internal Medicine III, Division of Vascular Inflammation, Diabetes and Kidney, University Clinic Carl-Gustav-Carus, University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Institute of Physiology, University of Dresden, Dresden, Germany.
| |
Collapse
|
9
|
Cho YH, Besser REJ, Craig ME. Highlights from the 37th Annual Meeting for ISPAD, Miami. Pediatr Diabetes 2012; 13:124-31. [PMID: 22280122 DOI: 10.1111/j.1399-5448.2011.00850.x] [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] [Indexed: 12/15/2022] Open
Abstract
The 37th Annual Meeting for the International Society of Pediatric and Adolescent Diabetes was held in Miami Beach, Florida, USA. The meeting, titled 'Possibilities for Prevention and Diabetes and its Complications', attracted over 1000 delegates from 52 countries. Fifty-six oral abstracts were presented, along with 294 posters, representing the diversity of research and clinical innovations in the field of pediatric and adolescent diabetes around the world. Abstracts to the Oral and Poster Sessions can be found in a recent supplement of Pediatric Diabetes. Here are some highlights from the plenary sessions, symposia, and oral presentations.
Collapse
Affiliation(s)
- Yoon Hi Cho
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | | | | |
Collapse
|