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Thomas A, Haak T, Tombek A, Kulzer B, Ehrmann D, Kordonouri O, Kröger J, Schubert-Olesen O, Kolassa R, Siegmund T, Haller N, Heinemann L. How to Use Continuous Glucose Monitoring Efficiently in Diabetes Management: Opinions and Recommendations by German Experts on the Status and Open Questions. J Diabetes Sci Technol 2024:19322968241267768. [PMID: 39129243 DOI: 10.1177/19322968241267768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Today, continuous glucose monitoring (CGM) is a standard diagnostic option for patients with diabetes, at least for those with type 1 diabetes and those with type 2 diabetes on insulin therapy, according to international guidelines. The switch from spot capillary blood glucose measurement to CGM was driven by the extensive and immediate support and facilitation of diabetes management CGM offers. In patients not using insulin, the benefits of CGM are not so well studied/obvious. In such patients, factors like well-being and biofeedback are driving CGM uptake and outcome. Apps can combine CGM data with data about physical activity and meal consumption for therapy adjustments. Personalized data management and coaching is also more feasible with CGM data. The same holds true for digitalization and telemedicine intervention ("virtual diabetes clinic"). Combining CGM data with Smart Pens ("patient decision support") helps to avoid missing insulin boluses or insulin miscalculation. Continuous glucose monitoring is a major pillar of all automated insulin delivery systems, which helps substantially to avoid acute complications and achieve more time in the glycemic target range. These options were discussed by a group of German experts to identify concrete gaps in the care structure, with a view to the necessary structural adjustments of the health care system.
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Affiliation(s)
| | - Thomas Haak
- Diabetes consulting, Mergentheim Diabetes Center, Bad Mergentheim, Germany
| | - Astrid Tombek
- Diabetes consulting, Mergentheim Diabetes Center, Bad Mergentheim, Germany
| | - Bernhard Kulzer
- Diabetes consulting, Mergentheim Diabetes Center, Bad Mergentheim, Germany
- FIDAM, Forschungsinstitut Diabetes-Akademie Mergentheim (Diabetes Academy Mergentheim Research Institute), Bad Mergentheim, Germany
| | - Dominic Ehrmann
- FIDAM, Forschungsinstitut Diabetes-Akademie Mergentheim (Diabetes Academy Mergentheim Research Institute), Bad Mergentheim, Germany
| | - Olga Kordonouri
- AUF DER BULT Hospital, Diabetes Center for Children and Adolescents, Hannover, Germany
| | - Jens Kröger
- Diabetes, Hamburg City Diabetes Center, Hamburg, Germany
| | | | - Ralf Kolassa
- Diabetes, Diabetes Focus Practice Bergheim/Erft, Bergheim/Erft, Germany
| | | | - Nicola Haller
- Diabetes, Diabetes & Metabolic Center Starnberg, Starnberg, Germany
| | - Lutz Heinemann
- Science Consulting in Diabetes GmbH, Düsseldorf, Germany
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Sebastian-Valles F, Martínez-Alfonso J, Arranz Martin JA, Jiménez-Díaz J, Hernando Alday I, Navas-Moreno V, Armenta-Joya T, Fandiño García MDM, Román Gómez GL, Garai Hierro J, Lobariñas LEL, González-Ávila C, Martinez de Icaya P, Martínez-Vizcaíno V, Marazuela M, Sampedro-Nuñez MA. Time above range and no coefficient of variation is associated with diabetic retinopathy in individuals with type 1 diabetes and glycated hemoglobin within target. Acta Diabetol 2024:10.1007/s00592-024-02347-5. [PMID: 39105807 DOI: 10.1007/s00592-024-02347-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/17/2024] [Indexed: 08/07/2024]
Abstract
AIMS This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range. METHODS We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards. RESULTS Patients' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040). CONCLUSION TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.
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Affiliation(s)
- Fernando Sebastian-Valles
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain.
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Hospital Universitario de La Princesa, Talca, Chile.
- Hospital Universitario de La Princesa, Diego de León 62, Madrid, 28005, Spain.
| | - Julia Martínez-Alfonso
- Department of Family and Community Medicine, Hospital La Princesa/Centro de Salud Daroca, Madrid, 28006, Spain
| | - Jose Alfonso Arranz Martin
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain
| | - Jessica Jiménez-Díaz
- Department of Endocrinology and Nutrition, Hospital Universitario Severo Ochoa, Leganés, Madrid, 28194, Spain
| | - Iñigo Hernando Alday
- Department of Endocrinology and Nutrition, Hospital Universitario Basurto, Bilbao, 48013, Spain
| | - Victor Navas-Moreno
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain
| | - Teresa Armenta-Joya
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain
| | | | - Gisela Liz Román Gómez
- Department of Endocrinology and Nutrition, Hospital Universitario Severo Ochoa, Leganés, Madrid, 28194, Spain
| | - Jon Garai Hierro
- Department of Endocrinology and Nutrition, Hospital Universitario Basurto, Bilbao, 48013, Spain
| | | | - Carmen González-Ávila
- Department of Neurology, Hospital Universitario Infanta Elena, Valdemoro, 28342, Spain
| | | | - Vicente Martínez-Vizcaíno
- Department of Neurology, Hospital Universitario Infanta Elena, Valdemoro, 28342, Spain
- Health and Social Care Research Center, Universidad de Castilla-La Mancha, Cuenca, 16071, Spain
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain
| | - Miguel Antonio Sampedro-Nuñez
- Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain
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He HM, Zheng SW, Xie YY, Wang Z, Jiao SQ, Yang FR, Li XX, Li J, Sun YH. Simultaneous assessment of stress hyperglycemia ratio and glycemic variability to predict mortality in patients with coronary artery disease: a retrospective cohort study from the MIMIC-IV database. Cardiovasc Diabetol 2024; 23:61. [PMID: 38336720 PMCID: PMC10858529 DOI: 10.1186/s12933-024-02146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Stress hyperglycemia and glycemic variability (GV) can reflect dramatic increases and acute fluctuations in blood glucose, which are associated with adverse cardiovascular events. This study aimed to explore whether the combined assessment of the stress hyperglycemia ratio (SHR) and GV provides additional information for prognostic prediction in patients with coronary artery disease (CAD) hospitalized in the intensive care unit (ICU). METHODS Patients diagnosed with CAD from the Medical Information Mart for Intensive Care-IV database (version 2.2) between 2008 and 2019 were retrospectively included in the analysis. The primary endpoint was 1-year mortality, and the secondary endpoint was in-hospital mortality. Levels of SHR and GV were stratified into tertiles, with the highest tertile classified as high and the lower two tertiles classified as low. The associations of SHR, GV, and their combination with mortality were determined by logistic and Cox regression analyses. RESULTS A total of 2789 patients were included, with a mean age of 69.6 years, and 30.1% were female. Overall, 138 (4.9%) patients died in the hospital, and 404 (14.5%) patients died at 1 year. The combination of SHR and GV was superior to SHR (in-hospital mortality: 0.710 vs. 0.689, p = 0.012; 1-year mortality: 0.644 vs. 0.615, p = 0.007) and GV (in-hospital mortality: 0.710 vs. 0.632, p = 0.004; 1-year mortality: 0.644 vs. 0.603, p < 0.001) alone for predicting mortality in the receiver operating characteristic analysis. In addition, nondiabetic patients with high SHR levels and high GV were associated with the greatest risk of both in-hospital mortality (odds ratio [OR] = 10.831, 95% confidence interval [CI] 4.494-26.105) and 1-year mortality (hazard ratio [HR] = 5.830, 95% CI 3.175-10.702). However, in the diabetic population, the highest risk of in-hospital mortality (OR = 4.221, 95% CI 1.542-11.558) and 1-year mortality (HR = 2.013, 95% CI 1.224-3.311) was observed in patients with high SHR levels but low GV. CONCLUSIONS The simultaneous evaluation of SHR and GV provides more information for risk stratification and prognostic prediction than SHR and GV alone, contributing to developing individualized strategies for glucose management in patients with CAD admitted to the ICU.
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Affiliation(s)
- Hao-Ming He
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shu-Wen Zheng
- Department of Cardiology, Beijing University of Chinese Medicine School of Traditional Chinese Medicine, Beijing, China
| | - Ying-Ying Xie
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhe Wang
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Si-Qi Jiao
- Department of Cardiology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Fu-Rong Yang
- Department of Cardiology, Beijing University of Chinese Medicine School of Traditional Chinese Medicine, Beijing, China
| | - Xue-Xi Li
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jie Li
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi-Hong Sun
- Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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García-Vega D, Sánchez-López D, Rodríguez-Carnero G, Villar-Taibo R, Viñuela JE, Lestegás-Soto A, Seoane-Blanco A, Moure-González M, Bravo SB, Fernández ÁL, González-Juanatey JR, Eiras S. Semaglutide modulates prothrombotic and atherosclerotic mechanisms, associated with epicardial fat, neutrophils and endothelial cells network. Cardiovasc Diabetol 2024; 23:1. [PMID: 38172989 PMCID: PMC10765851 DOI: 10.1186/s12933-023-02096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Obesity has increased in recent years with consequences on diabetes and other comorbidities. Thus, 1 out of 3 diabetic patients suffers cardiovascular disease (CVD). The network among glucose, immune system, endothelium and epicardial fat has an important role on pro-inflammatory and thrombotic mechanisms of atherogenesis. Since semaglutide, long-acting glucagon like peptide 1- receptor agonist (GLP-1-RA), a glucose-lowering drug, reduces body weight, we aimed to study its effects on human epicardial fat (EAT), aortic endothelial cells and neutrophils as atherogenesis involved-cardiovascular cells. METHODS EAT and subcutaneous fat (SAT) were collected from patients undergoing cardiac surgery. Differential glucose consumption and protein cargo of fat-released exosomes, after semaglutide or/and insulin treatment were analyzed by enzymatic and TripleTOF, respectively. Human neutrophils phenotype and their adhesion to aortic endothelial cells (HAEC) or angiogenesis were analyzed by flow cytometry and functional fluorescence analysis. Immune cells and plasma protein markers were determined by flow cytometry and Luminex-multiplex on patients before and after 6 months treatment with semaglutide. RESULTS GLP-1 receptor was expressed on fat and neutrophils. Differential exosomes-protein cargo was identified on EAT explants after semaglutide treatment. This drug increased secretion of gelsolin, antithrombotic protein, by EAT, modulated CD11b on neutrophils, its migration and endothelial adhesion, induced by adiposity protein, FABP4, or a chemoattractant. Monocytes and neutrophils phenotype and plasma adiposity, stretch, mesothelial, fibrotic, and inflammatory markers on patients underwent semaglutide treatment for 6 months showed a 20% reduction with statistical significance on FABP4 levels and an 80% increase of neutrophils-CD88. CONCLUSION Semaglutide increases endocrine activity of epicardial fat with antithrombotic properties. Moreover, this drug modulates the pro-inflammatory and atherogenic profile induced by the adiposity marker, FABP4, which is also reduced in patients after semaglutide treatment.
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Affiliation(s)
- David García-Vega
- Cardiology department, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana SN, 15706, Santiago de Compostela, Spain
- CIBERCV, ISCIII, Madrid, Spain
- University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - David Sánchez-López
- Translational Cardiology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Gemma Rodríguez-Carnero
- Endocrinology and Nutrition Division, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Rocío Villar-Taibo
- Endocrinology and Nutrition Division, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
- Neoplasia and Differentiation of Endocrine Cells Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan E Viñuela
- Translational Cardiology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Immunology Laboratory, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Adán Lestegás-Soto
- Translational Cardiology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ana Seoane-Blanco
- Cardiology department, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana SN, 15706, Santiago de Compostela, Spain
- CIBERCV, ISCIII, Madrid, Spain
| | - María Moure-González
- Cardiology department, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana SN, 15706, Santiago de Compostela, Spain
- CIBERCV, ISCIII, Madrid, Spain
| | - Susana B Bravo
- Proteomics Unit, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel L Fernández
- Department of Cardiac Surgery, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - José R González-Juanatey
- Cardiology department, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana SN, 15706, Santiago de Compostela, Spain
- CIBERCV, ISCIII, Madrid, Spain
- University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Sonia Eiras
- Cardiology department, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana SN, 15706, Santiago de Compostela, Spain.
- CIBERCV, ISCIII, Madrid, Spain.
- Translational Cardiology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Li W, Wen CP, Li W, Ying Z, Pan S, Li Y, Zhu Z, Yang M, Tu H, Guo Y, Song Z, Chu DTW, Wu X. 6-Year trajectory of fasting plasma glucose (FPG) and mortality risk among individuals with normal FPG at baseline: a prospective cohort study. Diabetol Metab Syndr 2023; 15:169. [PMID: 37574540 PMCID: PMC10424387 DOI: 10.1186/s13098-023-01146-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Higher fasting plasma glucose (FPG) levels were associated with an increased risk of all-cause mortality; however, the associations between long-term FPG trajectory groups and mortality were unclear, especially among individuals with a normal FPG level at the beginning. The aims of this study were to examine the associations of FPG trajectories with the risk of mortality and identify modifiable lifestyle factors related to these trajectories. METHODS We enrolled 50,919 individuals aged ≥ 20 years old, who were free of diabetes at baseline, in the prospective MJ cohort. All participants completed at least four FPG measurements within 6 years after enrollment and were followed until December 2011. FPG trajectories were identified by group-based trajectory modeling. We used Cox proportional hazards models to examine the associations of FPG trajectories with mortality, adjusting for age, sex, marital status, education level, occupation, smoking, drinking, physical activity, body mass index, baseline FPG, hypertension, dyslipidemia, cardiovascular disease or stroke, and cancer. Associations between baseline lifestyle factors and FPG trajectories were evaluated using multinomial logistic regression. RESULTS We identified three FPG trajectories as stable (n = 32,481), low-increasing (n = 17,164), and high-increasing (n = 1274). Compared to the stable group, both the low-increasing and high-increasing groups had higher risks of all-cause mortality (hazard ratio (HR) = 1.18 (95% CI 0.99-1.40) and 1.52 (95% CI 1.09-2.13), respectively), especially among those with hypertension. Compared to participants with 0 to 1 healthy lifestyle factor, those with 6 healthy lifestyle factors were more likely to be in the stable group (ORlow-increasing = 0.61, 95% CI 0.51-0.73; ORhigh-increasing = 0.20, 95% CI 0.13-0.32). CONCLUSIONS Individuals with longitudinally increasing FPG had a higher risk of mortality even if they had a normal FPG at baseline. Adopting healthy lifestyles may prevent individuals from transitioning into increasing trajectories.
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Affiliation(s)
- Wanlu Li
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chi Pang Wen
- National Institute for Data Science in Health and Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Wenyuan Li
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhijun Ying
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Sai Pan
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yizhan Li
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zecheng Zhu
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Min Yang
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Huakang Tu
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yi Guo
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhenya Song
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | | | - Xifeng Wu
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- National Institute for Data Science in Health and Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China.
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
- Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China.
- School of Medicine and Health Science, George Washington University, Washington, DC, USA.
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Li WH, Wang F, Song GY, Yu QH, Du RP, Xu P. PARP-1: a critical regulator in radioprotection and radiotherapy-mechanisms, challenges, and therapeutic opportunities. Front Pharmacol 2023; 14:1198948. [PMID: 37351512 PMCID: PMC10283042 DOI: 10.3389/fphar.2023.1198948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Background: Since its discovery, poly (ADP-ribose) polymerase 1 (PARP-1) has been extensively studied due to its regulatory role in numerous biologically crucial pathways. PARP inhibitors have opened new therapeutic avenues for cancer patients and have gained approval as standalone treatments for certain types of cancer. With continued advancements in the research of PARP inhibitors, we can fully realize their potential as therapeutic targets for various diseases. Purpose: To assess the current understanding of PARP-1 mechanisms in radioprotection and radiotherapy based on the literature. Methods: We searched the PubMed database and summarized information on PARP inhibitors, the interaction of PARP-1 with DNA, and the relationships between PARP-1 and p53/ROS, NF-κB/DNA-PK, and caspase3/AIF, respectively. Results: The enzyme PARP-1 plays a crucial role in repairing DNA damage and modifying proteins. Cells exposed to radiation can experience DNA damage, such as single-, intra-, or inter-strand damage. This damage, associated with replication fork stagnation, triggers DNA repair mechanisms, including those involving PARP-1. The activity of PARP-1 increases 500-fold on DNA binding. Studies on PARP-1-knockdown mice have shown that the protein regulates the response to radiation. A lack of PARP-1 also increases the organism's sensitivity to radiation injury. PARP-1 has been found positively or negatively regulate the expression of specific genes through its modulation of key transcription factors and other molecules, including NF-κB, p53, Caspase 3, reactive oxygen species (ROS), and apoptosis-inducing factor (AIF). Conclusion: This review provides a comprehensive analysis of the physiological and pathological roles of PARP-1 and examines the impact of PARP-1 inhibitors under conditions of ionizing radiation exposure. The review also emphasizes the challenges and opportunities for developing PARP-1 inhibitors to improve the clinical outcomes of ionizing radiation damage.
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Affiliation(s)
- Wen-Hao Li
- School of Food and Biomedicine, Zaozhuang University, Zaozhuang, Shandong, China
| | - Fei Wang
- School of Food and Biomedicine, Zaozhuang University, Zaozhuang, Shandong, China
| | - Gui-Yuan Song
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Qing-Hua Yu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Rui-Peng Du
- School of Food and Biomedicine, Zaozhuang University, Zaozhuang, Shandong, China
| | - Ping Xu
- School of Food and Biomedicine, Zaozhuang University, Zaozhuang, Shandong, China
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
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Toma L, Sanda GM, Stancu CS, Niculescu LS, Raileanu M, Sima AV. Oscillating Glucose Induces the Increase in Inflammatory Stress through Ninjurin-1 Up-Regulation and Stimulation of Transport Proteins in Human Endothelial Cells. Biomolecules 2023; 13:biom13040626. [PMID: 37189375 DOI: 10.3390/biom13040626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Clinical data implicate fluctuations of high levels of plasma glucose in cardiovascular diseases. Endothelial cells (EC) are the first cells of the vessel wall exposed to them. Our aim was to evaluate the effects of oscillating glucose (OG) on EC function and to decipher new molecular mechanisms involved. Cultured human ECs (EA.hy926 line and primary cells) were exposed to OG (5/25 mM alternatively at 3 h), constant HG (25 mM) or physiological concentration (5 mM, NG) for 72 h. Markers of inflammation (Ninj-1, MCP-1, RAGE, TNFR1, NF-kB, and p38 MAPK), oxidative stress (ROS, VPO1, and HO-1), and transendothelial transport proteins (SR-BI, caveolin-1, and VAMP-3) were assessed. Inhibitors of ROS (NAC), NF-kB (Bay 11-7085), and Ninj-1 silencing were used to identify the mechanisms of OG-induced EC dysfunction. The results revealed that OG determined an increased expression of Ninj-1, MCP-1, RAGE, TNFR1, SR-B1, and VAMP-3 andstimulated monocyte adhesion. All of these effects were induced bymechanisms involving ROS production or NF-kB activation. NINJ-1 silencing inhibited the upregulation of caveolin-1 and VAMP-3 induced by OG in EC. In conclusion, OG induces increased inflammatory stress, ROS production, and NF-kB activation and stimulates transendothelial transport. To this end, we propose a novel mechanism linking Ninj-1 up-regulation to increased expression of transendothelial transport proteins.
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Qi J, Liu W, Gan L, Guo H, Xie Y, Gou L, Cai D, Zhang J, Deng J, Ren Z, Fang J, Zuo Z. Process of Glucose Increases Rather Than Constant High Glucose Was the Main Cause of Abnormal Glucose Induced Glomerulus Epithelial Cells Inflammatory Response. Int J Mol Sci 2022; 24:ijms24010600. [PMID: 36614042 PMCID: PMC9820529 DOI: 10.3390/ijms24010600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022] Open
Abstract
Abnormal glycemia is frequently along with nephritis, whose pathogenesis is unexplicit. Here, we investigated the effects of abnormal glucose on the renal glomerulus epithelial cells by stimulating immortalized bovine renal glomerulus epithelial (MDBK) cells with five different levels of glucose, including low glucose (2.5 mM for 48 h, LG), normal glucose (5 mM for 48 h, NG), high glucose (25 mM for 48 h, HG), increasing glucose (24 h of 2.5 mM glucose followed by 24 h of 25 mM, IG), and reducing glucose (24 h of 25 mM glucose followed by 24 h of 2.5 mM, RG). The results showed that LG and RG treatments had nonsignificant effects (p > 0.05) on the viability of MDBK cells. HG treatment decreased the viabilities of cells (p < 0.01) without triggering an apparent inflammatory response by activating the nox4/ROS/p53/caspase-3-mediated apoptosis pathway. IG treatment decreased the viabilities of cells significantly (p < 0.01) with high levels of pro-inflammatory cytokines IL-1β and IL-18 in the supernatant (p < 0.05) by triggering the txnip/nlrp3/gsdmd-mediated pyroptosis pathway. These results indicated that the process of glucose increase rather than the constant high glucose was the main cause of abnormal glucose-induced MDBK cell inflammatory death, prompting that the process of glycemia increases might be mainly responsible for the nephritis in diabetic nephropathy, underlining the importance of glycemic control in diabetes patients.
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9
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Liu S, Shi L, Wang B, Lou J, Sun M, Yang H, Zhang F, Liu M, Song Y, Mi W, Ma Y. Preoperative hyperglycemia is associated with elevated risk of perioperative ischemic stroke in type 2 diabetic patients undergoing non-cardiovascular surgery: A retrospective cohort study. Front Aging Neurosci 2022; 14:990567. [PMID: 36337712 PMCID: PMC9631439 DOI: 10.3389/fnagi.2022.990567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/03/2022] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) has been reported to be associated with perioperative stroke, but the effects of preoperative hyperglycemia on the risk of perioperative stroke in diabetic patients undergoing non-cardiovascular surgery remain unclear. This study investigated the association between preoperative hyperglycemia and the risk of perioperative ischemic stroke in type 2 diabetic patients undergoing non-cardiovascular surgery. METHODS This retrospective cohort study screened 27,002 patients with type 2 DM undergoing non-cardiovascular surgery with general anesthesia between January 2008 and August 2019 at The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital. The exposure of interest was preoperative hyperglycemia, defined as a fasting plasma glucose (FPG) ≥ 7 mmol/L. The outcome of interest was a new diagnosis of perioperative ischemic stroke within 30 days after surgery. Residual confounding was minimized by controlling for observable patient and intraoperative factors. Logistic regression was conducted in the total and propensity score matched cohorts. In addition, we stratified patients into six subgroups to investigate whether the association between preoperative hyperglycemia and perioperative ischemic stroke differs in these subgroups. RESULTS The overall incidence of perioperative ischemic stroke was 0.53% (n = 144) in the current cohort. The odds of perioperative ischemic stroke were significantly increased for patients with preoperative hyperglycemia after adjusting for patient- related variables (OR: 1.95; 95% CI: 1.39-2.75; p < 0.001), surgery-related variables (OR: 2.1; 95% CI: 1.51-2.94; p < 0.001), and all confounding variables (OR: 1.78; 95% CI: 1.26-2.53; p < 0.001). The risk of perioperative stroke was significantly increased in patients with preoperative hyperglycemia (OR: 2.51; 95% CI: 1.66-3.9; p < 0.001) in the propensity score matched cohort. Preoperative hyperglycemia was associated with the outcome for all the subgroups except for patients undergoing neurosurgery. CONCLUSION Preoperative hyperglycemia is associated with an elevated risk of perioperative stroke in patients with type 2 DM undergoing non-cardiovascular surgery. The effect could be eliminated for patients undergoing neurosurgery, during which specific risk factors should be considered.
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Affiliation(s)
- Siyuan Liu
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, China
| | - Likai Shi
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Binbin Wang
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, China
| | - Jingsheng Lou
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Sun
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Huikai Yang
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Faqiang Zhang
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Min Liu
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuxiang Song
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Weidong Mi
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yulong Ma
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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10
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Thomas A, Haak T, Tombek A, Kulzer B, Ehrmann D, Kordonouri O, Kroeger J, Schubert-Olesen O, Kolassa R, Siegmund T, Haller N, Heinemann L. Expertenaustausch zum Einsatz von kontinuierlichem Glukosemonitoring (CGM) im Diabetesmanagement: Eine aktuelle Bestandsaufnahme und Blick in die Zukunft. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1849-2137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungCGM mit Darstellung der aktuellen Glukosewerte (rtCGM) ist aktuell einer der wichtigsten diagnostischen Optionen in der Diabetologie. Es ermöglicht eine umfangreiche und unmittelbare Unterstützung und Erleichterung des Diabetesmanagements, besonders wenn eine Insulintherapie angewendet wird. Weiterhin stellt rtCGM den notwendigen Systempartner für die Steuerung der automatisierten Insulinabgabe in AID-Systemen dar. In Verbindung mit Smart-Pens unterstützt ein rtCGM die korrekte Durchführung des Insulinmanagements und erinnert an Bolusinjektionen.RtCGM-Daten sind heute das Fundament des personalisierten Datenmanagements und Alltagscoachings und stellen die Basis der Digitalisierung und telemedizinischen Intervention dar. Die Möglichkeit der interoperablen Nutzung ist aus therapeutischer Sicht eine zentrale Eigenschaft eines rtCGMs und kann zur Erweiterung der Indikationen, unabhängig von Diabetestyp oder Therapieform führen. Dies könnte auch den vorübergehenden oder intermittierenden Einsatz bei Menschen mit Typ-2-Diabetes ohne Insulinbehandlung betreffen. Kürzlich veröffentlichte internationale Leitlinien, z.B. der Amerikanischen Gesellschaft für klinische Endokrinologie (AACE) fordern auf der Basis umfangreicher Evidenz, dass die Glukosemessung mit einem rtCGM für alle Menschen mit Diabetes nutzbar und verfügbar sein sollte. Bereits in der Phase gestörter Glukosetoleranz kann ein rtCGM-System als Alltagscoaching oder Biofeedback bei Einbettung in ein Gesamtbehandlungskonzept unterstützen, mit dem Ziel aktiver und fundierter Handlungen des Anwenders im Diabetesalltag.Die Vielfalt der Nutzungsoptionen und die immer schnelleren technischen Innovationszyklen von rtCGM-Systemen wurden mit Blick auf aktuelle Anforderungen und die notwendigen Strukturanpassungen des Gesundheitssystems von einer rtCGM-erfahrenen Expertengruppe diskutiert. Ziel war es, konkrete Lücken in der Versorgungsstruktur sowie potenzielle Handlungsfelder in der Diabetologie zu identifizierten und mögliche Indikationserweiterungen für den Einsatz von rtCGM darzustellen. Dieses, sowie die Erkenntnisse und Schlussfolgerungen der Diskussionen werden in diesem Artikel dargestellt.
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Affiliation(s)
| | - Thomas Haak
- Diabetes, Diabetes Zentrum Mergentheim, Bad Mergentheim
| | - Astrid Tombek
- Diabetesberatung, Diabetes Zentrum Bad Mergentheim, Bad Mergentheim
| | - Bernhard Kulzer
- Diabetes, Diabetes Zentrum Mergentheim, Bad Mergentheim
- FIDAM, Forschungsinstitut Diabetes-Akademie Mergentheim, Bad Mergentheim
| | - Dominic Ehrmann
- FIDAM, Forschungsinstitut Diabetes-Akademie Mergentheim, Bad Mergentheim
| | - Olga Kordonouri
- Diabeteszentrum für Kinder und Jugendliche, Kinderkrankenhaus AUF DER BULT, Hannover
| | | | | | - Ralf Kolassa
- Diabetes, Diabetologische Schwerpunktpraxis Bergheim/Erft, Bergheim/Erft
| | | | - Nicola Haller
- Diabetes, Diabetes & Stoffwechsel Zentrum Starnberg, Starnberg
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11
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Huang Y, Yue L, Qiu J, Gao M, Liu S, Wang J. Endothelial Dysfunction and Platelet Hyperactivation in Diabetic Complications Induced by Glycemic Variability. Horm Metab Res 2022; 54:419-428. [PMID: 35835141 PMCID: PMC9282943 DOI: 10.1055/a-1880-0978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The development and progression of the complications of chronic diabetes mellitus are attributed not only to increased blood glucose levels but also to glycemic variability. Therefore, a deeper understanding of the role of glycemic variability in the development of diabetic complications may provide more insight into targeted clinical treatment strategies in the future. Previously, the mechanisms implicated in glycemic variability-induced diabetic complications have been comprehensively discussed. However, endothelial dysfunction and platelet hyperactivation, which are two newly recognized critical pathogenic factors, have not been fully elucidated yet. In this review, we first evaluate the assessment of glycemic variability and then summarise the roles of endothelial dysfunction and platelet hyperactivation in glycemic variability-induced complications of diabetes, highlighting the molecular mechanisms involved and their interconnections.
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Affiliation(s)
- Ye Huang
- Emergency Department, China Academy of Chinese Medical Sciences Xiyuan
Hospital, Beijing, China
| | - Long Yue
- Emergency Department, China Academy of Chinese Medical Sciences Xiyuan
Hospital, Beijing, China
| | - Jiahuang Qiu
- Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing, China
| | - Ming Gao
- Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing, China
| | - Sijin Liu
- Research Center for Eco-Environmental Sciences, Chinese Academy of
Sciences, Beijing, China
| | - Jingshang Wang
- Department of Traditional Chinese Medicine, Capital Medical University
Beijing Obstetrics and Gynecology Hospital, Beijing, China
- Correspondence Prof. Jingshang
Wang Capital Medical University Beijing Obstetrics and
Gynecology HospitalDepartment of Traditional Chinese
MedicineBeijingChina 18811213525
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12
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Ciechanowska A, Gora IM, Sabalinska S, Ladyzynski P. The Effect of High and Variable Glucose on the Viability of Endothelial Cells Co-Cultured with Smooth Muscle Cells. Int J Mol Sci 2022; 23:ijms23126704. [PMID: 35743147 PMCID: PMC9223437 DOI: 10.3390/ijms23126704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus causes endothelial dysfunction. The aim of this study was to investigate the effect of normal (5 mmol/L), high (20 mmol/L), and fluctuating (5 and 20 mmol/L changed every day) glucose concentration in the culture medium on the viability of human umbilical vein endothelial cells (HUVECs) co-cultured with human umbilical artery smooth muscle cells (HUASMCs). The cultures were conducted on semi-permeable flat polysulfone (PSU) fibronectin-coated membranes immobilized in self-made inserts. The insert contained either HUVECs on a single membrane or HUASMCs and HUVECs on two membranes close to each other. Cultures were conducted for 7 or 14 days. Apoptosis, mitochondrial potential, and the production of reactive oxygen species and lactate by HUVECs were investigated. The results indicate that fluctuations in glucose concentration have a stronger negative effect on HUVECs viability than constant high glucose concentration. High and fluctuating glucose concentrations slow down cell proliferation compared to the culture carried out in the medium with normal glucose concentration. In conclusion, HUASMCs affect the viability of HUVECs when both types of cells are co-cultured in medium with normal or variable glucose concentration.
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13
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Fiorello ML, Treweeke AT, Macfarlane DP, Megson IL. Intermittent exposure of cultured endothelial cells to physiologically relevant fructose concentrations has a profound impact on nitric oxide production and bioenergetics. PLoS One 2022; 17:e0267675. [PMID: 35560114 PMCID: PMC9106152 DOI: 10.1371/journal.pone.0267675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Hyperglycaemia is known to induce endothelial dysfunction and changes in metabolic function, which could be implicated in diabetes-induced cardiovascular disease. To date, however, little is known about the impact of physiologically relevant concentrations of fructose on endothelial cells. A novel in vitro model was devised to establish the impact of substitution of a small proportion of glucose with an equal concentration (0.1 mM or 1 mM) of fructose on EA.hy926 endothelial cells during periodic carbohydrate “meals” superimposed on a normoglycaemic (5.5 mM) background. Parallel experiments were conducted using meals consisting of normoglycaemic glucose, intermediate glucose (12.5 mM) or profound hyperglycaemia (25 mM), each delivered for 2 h, with and without substituted fructose over 50 h. Outcome measures included nitrite as a surrogate marker of the mediator of healthy endothelial function, nitric oxide (NO), and a range of bioenergetic parameters using a metabolic analyser. Despite its relatively low proportion of carbohydrate load, intermittent fructose induced a substantial reduction (approximately 90%) in NO generation in cells treated with either concentration of fructose. Cell markers of oxidative stress were not altered by this treatment regimen. However, the cells experienced a marked increase in metabolic activity induced by fructose, irrespective of the glucose concentration delivered simultaneously in the “meals”. Indeed, glucose alone failed to induce any metabolic impact in this model. Key metabolic findings were a 2-fold increase in basal oxygen consumption rate and a similar change in extracellular acidification rate–a marker of glycolysis. Non-metabolic oxygen consumption also increased substantially in cells exposed to fructose. There was no difference between results with 0.1 mM fructose and those with 1 mM fructose. Low, physiologically relevant concentrations of fructose, delivered in a pattern that mimics mealtime consumption, had a profound impact on endothelial function and bioenergetics in an in vitro cell model. The results suggest that endothelial cells are exquisitely sensitive to circulating fructose; the potential ensuing dysfunction could have major implications for development of atherosclerotic disease associated with high fructose consumption.
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Affiliation(s)
- Maria Luisa Fiorello
- Division of Biomedical Sciences, University of the Highlands & Islands, Inverness, United Kingdom
| | - Andrew T. Treweeke
- Division of Biomedical Sciences, University of the Highlands & Islands, Inverness, United Kingdom
| | - David P. Macfarlane
- Department of Diabetes, NHS Highland, Raigmore Hospital, Inverness, United Kingdom
| | - Ian L. Megson
- Division of Biomedical Sciences, University of the Highlands & Islands, Inverness, United Kingdom
- * E-mail:
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14
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Walsh JJ, Caldwell HG, Neudorf H, Ainslie PN, Little JP. Short-term ketone monoester supplementation improves cerebral blood flow and cognition in obesity: A randomized cross-over trial. J Physiol 2021; 599:4763-4778. [PMID: 34605026 DOI: 10.1113/jp281988] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/13/2021] [Indexed: 11/08/2022] Open
Abstract
Adults with obesity are at increased risk of neurocognitive impairments, partly as a result of reduced cerebral blood flow and brain-derived neurotrophic factor (BDNF). Ketone supplements containing β-hydroxybutyrate (β-OHB) are a purported therapeutic strategy for improving brain health in at-risk populations. We tested the hypothesis that short-term β-OHB supplementation will elevate cerebral blood flow and BDNF, as well as improve cognition in adults with obesity. In a placebo-controlled double-blind, cross-over design, 14 adults with obesity (10 females; aged 56 ± 12 years; body mass index = 33.8 ± 6.9 kg m-2 ) consumed 30 mL (12 g) of β-OHB or placebo thrice-daily for 14 days. Blood flow (Q) and cerebrovascular conductance (CVC) were measured in the common carotid (CCA), internal carotid (ICA) and vertebral (VA) arteries by duplex ultrasound. BDNF was measured by an enzyme-linked immunosorbent assay. Cognition was assessed by the digit-symbol substitution (DSST), Stroop and task-switching tests. Following 14 days of ketone supplementation, we observed significant improvements in cerebrovascular outcomes including QCCA (+12%), QVA (+11%), VACVC (+12%) and VA shear rate (+10%). DSST performance significantly improved following ketone supplementation (+2.7 correct responses) and improved DSST performance was positively associated improvements in cerebrovascular outcomes including QCCA , CCACVC , QVA and VACVC . By contrast to one hypothesis, β-OHB did not impact fasting serum and plasma BDNF. β-OHB supplementation improved cognition in adults with obesity, which may be partly facilitated by improvements in cerebral blood flow. β-OHB supplementation was well-tolerated and appears to be safe for cerebrovascular health, suggesting potential therapeutic benefits of β-OHB in a population at risk of neurocognitive impairment. KEY POINTS: People with obesity are at increased risk of neurocognitive dysfunction, partly as a result of -induced reductions in cerebral blood flow (CBF) and brain-derived neurotrophic factor (BDNF). Ketone supplements containing β-hydroxybutyrate (β-OHB) reduce postprandial hyperglycaemia, which may increase CBF and BDNF, thereby protecting against obesity-related cognitive dysfunction. We show for the first time that 14 days of thrice-daily β-OHB supplementation improves aspects of cognition and increases cerebrovascular flow, conductance and shear rate in the extracranial arteries of adults with obesity. Our preliminary data indicate a significant positive relationship between elevated CBF and improved cognition following β-OHB supplementation. This trial provides a foundation for the potential non-pharmacological therapeutic application of β-OHB supplementation in patient groups at risk of hyperglycaemic cerebrovascular disease and cognitive dysfunction.
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Affiliation(s)
- Jeremy J Walsh
- School of Health and Exercise Sciences, Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada.,Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Hannah G Caldwell
- School of Health and Exercise Sciences, Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Helena Neudorf
- School of Health and Exercise Sciences, Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Philip N Ainslie
- School of Health and Exercise Sciences, Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
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15
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Ciechanowska A, Gora I, Sabalinska S, Foltynski P, Ladyzynski P. Effect of glucose concentration and culture substrate on HUVECs viability in in vitro cultures: A literature review and own results. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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16
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Alfieri V, Myasoedova VA, Vinci MC, Rondinelli M, Songia P, Massaiu I, Cosentino N, Moschetta D, Valerio V, Ciccarelli M, Marenzi G, Genovese S, Poggio P. The Role of Glycemic Variability in Cardiovascular Disorders. Int J Mol Sci 2021; 22:ijms22168393. [PMID: 34445099 PMCID: PMC8395057 DOI: 10.3390/ijms22168393] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 01/01/2023] Open
Abstract
Diabetes mellitus (DM) is one of the most common and costly disorders that affect humans around the world. Recently, clinicians and scientists have focused their studies on the effects of glycemic variability (GV), which is especially associated with cardiovascular diseases. In healthy subjects, glycemia is a very stable parameter, while in poorly controlled DM patients, it oscillates greatly throughout the day and between days. Clinically, GV could be measured by different parameters, but there are no guidelines on standardized assessment. Nonetheless, DM patients with high GV experience worse cardiovascular disease outcomes. In vitro and in vivo studies showed that high GV causes several detrimental effects, such as increased oxidative stress, inflammation, and apoptosis linked to endothelial dysfunction. However, the evidence that treating GV is beneficial is still scanty. Clinical trials aiming to improve the diagnostic and prognostic accuracy of GV measurements correlated with cardiovascular outcomes are needed. The present review aims to evaluate the clinical link between high GV and cardiovascular diseases, taking into account the underlined biological mechanisms. A clear view of this challenge may be useful to standardize the clinical evaluation and to better identify treatments and strategies to counteract this DM aspect.
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Affiliation(s)
- Valentina Alfieri
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Veronika A. Myasoedova
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Maria Cristina Vinci
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Maurizio Rondinelli
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Paola Songia
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Ilaria Massaiu
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Nicola Cosentino
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Donato Moschetta
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, 20122 Milano, Italy
| | - Vincenza Valerio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80138 Napoli, Italy
| | - Michele Ciccarelli
- Chirurgia ed Odontoiatria, Dipartimento di Medicina, Università degli Studi di Salerno, 84084 Salerno, Italy;
| | - Giancarlo Marenzi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Stefano Genovese
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (V.A.); (V.A.M.); (M.C.V.); (M.R.); (P.S.); (I.M.); (N.C.); (D.M.); (V.V.); (G.M.); (S.G.)
- Correspondence: ; Tel.: +39-025-800-2853
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17
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Buscemi C, Ferro Y, Pujia R, Mazza E, Boragina G, Sciacqua A, Piro S, Pujia A, Sesti G, Buscemi S, Montalcini T. Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women. Nutrients 2021; 13:nu13061909. [PMID: 34199375 PMCID: PMC8227668 DOI: 10.3390/nu13061909] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/18/2022] Open
Abstract
Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.
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Affiliation(s)
- Carola Buscemi
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giada Boragina
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Angela Sciacqua
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Salvatore Piro
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giorgio Sesti
- Dipartimento di Medicina clinica e molecolare, Università la Sapienza, 00185 Roma, Italy;
| | - Silvio Buscemi
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
- Correspondence:
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Suresh V, Reddy A. Dysregulation of nitric oxide synthases during early and late pathophysiological conditions of diabetes mellitus leads to amassing of microvascular impedement. J Diabetes Metab Disord 2021; 20:989-1002. [PMID: 34178871 PMCID: PMC8212285 DOI: 10.1007/s40200-021-00799-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/11/2021] [Indexed: 12/20/2022]
Abstract
Diabetes is a major killer worldwide and its unprecedented rise poses a serious threat to mankind. According to recent estimation, 387 million people worldwide are affected from the disease with a prevalence rate of 8.3 and 46.3 % still remains undiagnosed. Important characteristics of diabetes are abnormalities of the physiological signalling functions of reactive oxygen species and reactive nitrogen species. Increased oxidative stress contributes to the activation of stress-sensitive intracellular signalling pathways and the development of gene products that trigger cellular damage and contribute to the vascular complications of diabetes. Growing evidence from studies into many diseases suggests that the pathogenesis of diabetes, obesity, cancer, ageing, inflammation, neurodegenerative disorders, hypertension, apoptosis, cardiovascular diseases, and heart failure are correlated with oxidative stress. This leads to cell metabolism and cell-cell homeostasis to be complexly dysregulated. This review focuses to investigate the status of oxidative stress, nitric oxide and reactive species in early and diabetes. Significance of nitric oxide synthases Evidences has accumulated indicating that the generation of reactive oxygen species (oxidative stress) may play an important role in the etiology of diabetic complications thus attention was given on the reactive oxygen and reactive nitrogen species and their potential role in pathogenesis. Additionally, the therapeutic advances in diabetes management are included. Nanotechnology, statins and stem cell technology are some techniques which can be considered to have a possible future in the treatment sector of diabetes.
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Affiliation(s)
- Varuna Suresh
- Animal Cell Culture Laboratory, Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kancheepuram District-603203, Kattankulathur, Tamil Nadu India
| | - Amala Reddy
- Animal Cell Culture Laboratory, Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kancheepuram District-603203, Kattankulathur, Tamil Nadu India
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Wang F, Xiao Y, Neupane S, Ptak SH, Römer R, Xiong J, Ohmes J, Seekamp A, Fretté X, Alban S, Fuchs S. Influence of Fucoidan Extracts from Different Fucus Species on Adult Stem Cells and Molecular Mediators in In Vitro Models for Bone Formation and Vascularization. Mar Drugs 2021; 19:194. [PMID: 33805470 PMCID: PMC8066524 DOI: 10.3390/md19040194] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 01/03/2023] Open
Abstract
Fucoidans, sulfated polysaccharides extracted from brown algae, are marine products with the potential to modulate bone formation and vascularization processes. The bioactivity and safety of fucoidans are highly associated with their chemical structure, which may vary with algae species and extraction method. Thus, in depth evaluation of fucoidan extracts in terms of endotoxin content, cytotoxicity, and their detailed molecular biological impact on the individual cell types in bone is needed. In this study, we characterized fucoidan extracts from three different Fucus species including Fucus vesiculosus (Fv), Fucus serratus (Fs), and Fucus distichus subsp. evanescens (Fe) for their chemical features, endotoxin content, cytotoxicity, and bioactive effects on human outgrowth endothelial cells (OEC) and human mesenchymal stem cells (MSC) as in vitro models for bone function and vascularization. Extracts contained mainly high molecular weight (HMW) fucoidans and were free of endotoxins that may cause inflammation or influence vascularization. OEC tolerated fucoidan concentrations up to 200 µg/mL, and no indication of cytotoxicity was observed. The inflammatory response, however, investigated by real-time PCR (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) and endothelial barrier assessed by impedance measurement differed for the individual extracts. MSC in comparison with endothelial cells were more sensitive to fucoidans and showed partly reduced metabolic activity and proliferation at higher doses of fucoidans. Further results for MSC indicated impaired osteogenic functions in alkaline phosphatase and calcification assays. All tested extracts consistently lowered important molecular mediators involved in angiogenesis, such a VEGF (vascular endothelial growth factor), ANG-1 (angiopoietin 1), and ANG-2 (angiopoietin 2), as indicated by RT-PCR and ELISA. This was associated with antiangiogenic effects at the functional level using selected extracts in co-culture models to mimic bone vascularization processes during bone regeneration or osteosarcoma.
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Affiliation(s)
- Fanlu Wang
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Yuejun Xiao
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Sandesh Neupane
- Department of Pharmaceutical Biology, Pharmaceutical Institute, Kiel University, 24148 Kiel, Germany; (S.N.); (S.A.)
| | - Signe Helle Ptak
- SDU Chemical Engineering, University of Southern Denmark, 5230 Odense, Denmark; (S.H.P.); (X.F.)
| | - Ramona Römer
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Junyu Xiong
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Julia Ohmes
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Andreas Seekamp
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
| | - Xavier Fretté
- SDU Chemical Engineering, University of Southern Denmark, 5230 Odense, Denmark; (S.H.P.); (X.F.)
| | - Susanne Alban
- Department of Pharmaceutical Biology, Pharmaceutical Institute, Kiel University, 24148 Kiel, Germany; (S.N.); (S.A.)
| | - Sabine Fuchs
- Experimental Trauma Surgery, Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany; (F.W.); (Y.X.); (R.R.); (J.X.); (J.O.); (A.S.)
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20
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Walsh JJ, Neudorf H, Little JP. 14-Day Ketone Supplementation Lowers Glucose and Improves Vascular Function in Obesity: A Randomized Crossover Trial. J Clin Endocrinol Metab 2021; 106:e1738-e1754. [PMID: 33367782 PMCID: PMC7993591 DOI: 10.1210/clinem/dgaa925] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Indexed: 12/18/2022]
Abstract
CONTEXT Postprandial hyperglycemia increases systemic inflammation and is a risk factor for cardiovascular disease. A ketone monoester (KME) drink containing β-hydroxybutyrate (β-OHB) rapidly lowers plasma glucose, which may be a strategy protecting against postprandial hyperglycemia. OBJECTIVE We hypothesized that KME would attenuate 2-hour postprandial glucose, lower systemic inflammation, and improve vascular function in adults with obesity. METHODS In a randomized crossover design, 14 participants with obesity (age = 56 ± 12 years; body mass index = 32.8 ± 7.7 kg/m2) consumed KME (12 g β-OHB) or placebo 15 minutes prior to each meal for 14 days with all meals provided and matched between conditions. Postprandial glycemia was assessed by continuous glucose monitoring. Vascular function and inflammation were assessed before and after treatment periods. RESULTS Postprandial glucose was 8.0% lower in KME versus placebo (g = 0.735; P = 0.011) and 24-hour average glucose reduced by 7.8% (g = 0.686; P = 0.0001). Brachial artery flow-mediated dilation increased from 6.2 ± 1.5% to 8.9 ± 3.3% in KME (g = 1.05; P = 0.0004) with no changes in placebo (condition × time interaction, P = 0.004). There were no changes in plasma cytokines; however, lipopolysaccharide-stimulated monocyte caspase-1 activation was lower following KME supplementation versus placebo (stimulation × condition × time interaction; P = 0.004). The KME supplement was well tolerated by participants and adherence to the supplementation regimen was very high. CONCLUSIONS In adults with obesity, 14 days of premeal KME supplementation improves glucose control, enhances vascular function, and may reduce cellular inflammation. KME supplementation may be a viable, nonpharmacological approach to improving and protecting vascular health in people with heightened cardiometabolic risk.
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Affiliation(s)
- Jeremy J Walsh
- Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Helena Neudorf
- Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jonathan P Little
- Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada
- Correspondence: Jonathan P Little, Ph.D., The University of British Columbia Okanagan, 1147 Research Road, Kelowna, BC V1V 1V7, Canada.
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21
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Ozyel B, Le Gall G, Needs PW, Kroon PA. Anti-Inflammatory Effects of Quercetin on High-Glucose and Pro-Inflammatory Cytokine Challenged Vascular Endothelial Cell Metabolism. Mol Nutr Food Res 2021; 65:e2000777. [PMID: 33481349 PMCID: PMC8614122 DOI: 10.1002/mnfr.202000777] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/09/2020] [Indexed: 12/15/2022]
Abstract
SCOPE Pro-inflammatory stimuli such as hyperglycemia and cytokines have been shown to negatively affect endothelial cell functions. The aim of this study is to assess the potential of quercetin and its human metabolites to overcome the deleterious effects of hyperglycemic or inflammatory conditions on the vascular endothelium by modulating endothelial cell metabolism. METHODS AND RESULTS A metabolomics approach enabled identification and quantification of 27 human umbilical vein endothelial cell (HUVEC) metabolites. Treatment of HUVECs with high-glucose concentrations causes significant increases in lactate and glutamate concentrations. Quercetin inhibits glucose-induced increases in lactate and adenosine 5'-triphosphate (ATP) and also increased inosine concentrations. Tumor necrosis factor α-treatment (TNFα) of HUVECs causes increases in asparagine and decreases in aspartate concentrations. Co-treatment with quercetin reduces pyruvate concentrations compared to TNFα-only treated controls. Subsequently, it was shown that quercetin and its HUVEC phase-2 conjugates inhibit adenosine deaminase, xanthine oxidase and 5'nucleotidase (CD73) but not ectonucleoside triphosphate diphosphohydrolase-1 (CD39) or purine nucleoside phosphorylase activities. CONCLUSION Quercetin was shown to alter the balance of HUVEC metabolites towards a less inflamed phenotype, both alone and in the presence of pro-inflammatory stimuli. These changes are consistent with the inhibition of particular enzymes involved in purine metabolism by quercetin and its HUVEC metabolites.
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Affiliation(s)
- Besim Ozyel
- Nutrition and Dietetics DepartmentEuropean University of LefkeLefke, Northern Cyprus, TR‐10Mersin9910Turkey
| | - Gwénaëlle Le Gall
- Norwich Medical SchoolUniversity of East AngliaBob Champion Research and Education Building, James Watson Road, Norwich Research ParkNorwichNR4 7UQUK
| | - Paul W. Needs
- Quadram Institute BioscienceNorwich Research ParkNorwichNR4 7UQUK
| | - Paul A. Kroon
- Quadram Institute BioscienceNorwich Research ParkNorwichNR4 7UQUK
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22
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Xing Y, Chen J, Song G, Zhao L, Ma H. Impact of Diabetic Ketoacidosis on Thyroid Function in Patients with Diabetes Mellitus. Int J Endocrinol 2021; 2021:2421091. [PMID: 34188679 PMCID: PMC8192218 DOI: 10.1155/2021/2421091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/21/2020] [Accepted: 03/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Changes in thyroid function in diabetes patients who developed diabetic ketoacidosis (DKA) still need to be fully elucidated. The aim of this study was to systematically review available data on the relationship between thyroid function and DKA in diabetes patients who developed DKA. METHODS Electronic databases (PubMed, EMBASE, Cochrane Library, and China Academic Journal Full-text Database (CNKI)) were searched systematically to search relevant literature before December 2020. The mean ± standard deviation and 95% confidence interval (95% CI) were used for evaluation, and sensitivity analysis was performed. Publication bias was estimated by funnel plot, Egger's test, and Begger's test. RESULTS 29 studies were included in the meta-analysis, and the indicators (T4, T3, FT3, FT4, TSH, T3RU, and rT3) of patients with DKA were compared and analyzed. The results of this study showed that the levels of T4, T3, FT3, FT4, and TSH were decreased and the level of rT3 was increased in patients with DKA. Compared with after treatment, the levels of T4, T3, FT3, and FT4 in patients with DKA were decreased before treatment, while the levels of rT3 were increased, and there was no significant difference in changes of TSH. With the aggravation of DKA, the levels of T4, T3, FT3, and FT4 will further decrease, while the changes of TSH have no statistical difference. CONCLUSION Thyroid function changed in diabetic patients with DKA. It changed with the severity of DKA. This condition may be transient, preceding further recovery of DKA.
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Affiliation(s)
- Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Jinhu Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
| | - Guangyao Song
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Liying Zhao
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, China
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Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS, Yun JM, Kim SG, Hwang SS, Park SY, Kim YY, Park SM. Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia 2020; 63:2305-2314. [PMID: 32820349 DOI: 10.1007/s00125-020-05252-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS The increasing incidence of diabetes among young adults is a disease burden; however, the effects of early-onset diabetes, prediabetes and glycaemic recovery on CVD or mortality remain unclear. We aimed to investigate the association of these factors with 10 year all-cause mortality, CVD mortality and CVD incidence in Korean young adults. METHODS This large and longitudinal cohort study included data from the Korean National Health Insurance Service-National Health Information Database; 2,502,375 young adults aged 20-39 years without diabetes mellitus and CVD at baseline were included. Glycaemic status was measured twice, first in 2002-2003 and second in 2004-2005. Changes in fasting glucose levels were evaluated according to fasting glucose status: normal fasting glucose (NFG; <5.5 mmol/l), impaired fasting glucose (IFG; 5.5-6.9 mmol/l), and diabetic fasting glucose (DFG; ≥7.0 mmol/l). Primary outcomes were all-cause and CVD mortality risk. The secondary outcome was incidence of CVD, including acute myocardial infarction and stroke. All outcomes arose from the 10 year follow-up period 1 Jan 2006 to 31 December 2015. RESULTS Individuals with NFG at baseline, who were subsequently newly diagnosed with diabetes and prediabetes (IFG), had increased all-cause mortality (HR [95% CI] 1.60 [1.44, 1.78] and 1.13 [1.09, 1.18], respectively) and CVD incidence (1.13 [1.05, 1.23] and 1.04 [1.01, 1.07], respectively). In those with DFG at baseline, early recovery to NFG and IFG was associated with decreased all-cause mortality (0.57 [0.46, 0.70] and 0.65 [0.53, 0.81], respectively) and CVD incidence (0.70 [0.60, 0.81] and 0.78 [0.66, 0.91], respectively). Among patients with IFG at baseline, early recovery to NFG was associated with decreased CVD mortality (0.74 [0.59, 0.93]). CONCLUSIONS/INTERPRETATION Early-onset diabetes or prediabetes increased CVD risks and all-cause mortality after the 10 year follow-up. Furthermore, recovery of hyperglycaemia could reduce the subsequent 10 year risk for CVD incidence and all-cause mortality. Graphical abstract.
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Affiliation(s)
- Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Su-Min Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jae-Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Seong Yong Park
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Yeon-Yong Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
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Eyre JJ, Williams RL, Levis HJ. A human retinal microvascular endothelial-pericyte co-culture model to study diabetic retinopathy in vitro. Exp Eye Res 2020; 201:108293. [PMID: 33039459 DOI: 10.1016/j.exer.2020.108293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/22/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022]
Abstract
This human primary co-culture model using human retinal microvascular endothelial cells (hREC) and human retinal pericyte cells (hRP) aims to improve current understanding of the cellular changes occurring in the retinal microvasculature during diabetic retinopathy (DR). Currently, patients often present in clinic with late-stage DR, only when vision becomes impaired. Therefore, new strategies for earlier detection in clinic, combined with novel pharmaceutical and cellular interventions are essential in order to slow or halt the progression of DR from background to sight-threatening stage. This co-culture model can be used as a simple, replicable in vitro tool to discover and assess novel drug therapies and improve fundamental understanding of alterations to cell behaviour in the human retinal microvasculature during DR. hRP and hREC were cultured for up to 21 days in normoxic (20%) or hypoxic (2%) oxygen levels and physiological (5.5 mM) or very high (33 mM) glucose, to maintain a healthy, or induce a diabetic-like phenotype in vitro. Mono- or co-cultured hREC and hRP were seeded 1:1 in healthy (20% oxygen and 5.5 mM glucose) or diabetic-like (2% oxygen and 33 mM glucose) conditions, on either side of untreated polyethylene terephthalate (PET) transwell inserts, and cultured for 21 days. Mono- and co-cultures were analysed for changes in metabolic activity, angiogenic response and junctional protein expression, using immunofluorescence antibody labelling, flow cytometry and multiplex ELISA technology. hRP and hREC were successfully co-cultured, and the glucose and oxygen concentrations selected for the in vitro healthy and diabetic-like conditions were sufficient for cell viability and EC monolayer integrity, with evidence of an angiogenic response in diabetic-like conditions within the 21 day timeframe. Angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF) secretion were all increased, whilst hepatocyte growth factor (hHGF), tissue inhibitor for metalloproteinase-2 (TIMP-2) and interleukin-8 (IL-8) secretion were all reduced in the in vitro diabetic-like conditions. The secretion profile of co-cultures was different to mono-cultures, highlighting the importance of using co-culture models to collect data more reflective of the close relationship between hRP-hREC in vivo. Previous groups have developed useful co-culture models utilising non-human, immortalised or large vessel-sourced cells to explore changes to the vasculature during hypoxia and/or high glucose insult. In this study the use of human primary, retina-specific microvascular cells, mono- and co-cultured, collected over a longer culture period, has enabled detection of changes that may have been missed in previous models.
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Affiliation(s)
- Jessica J Eyre
- Department of Eye and Vision Science, Institute of Life Course & Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby St, Liverpool, United Kingdom.
| | - Rachel L Williams
- Department of Eye and Vision Science, Institute of Life Course & Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby St, Liverpool, United Kingdom.
| | - Hannah J Levis
- Department of Eye and Vision Science, Institute of Life Course & Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby St, Liverpool, United Kingdom.
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Xu SJ, Wang X, Wang TY, Lin ZZ, Hu YJ, Huang ZL, Yang XJ, Xu P. Flavonoids from Rosaroxburghii Tratt prevent reactive oxygen species-mediated DNA damage in thymus cells both combined with and without PARP-1 expression after exposure to radiation in vivo. Aging (Albany NY) 2020; 12:16368-16389. [PMID: 32862153 PMCID: PMC7485694 DOI: 10.18632/aging.103688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 06/13/2020] [Indexed: 11/25/2022]
Abstract
This study aimed to evaluate the role of FRT in ROS/DNA regulation with or without PARP-1 in radiation-injured thymus cells. The administration of FRT to PARP-1-/- (KO) mice demonstrated that FRT significantly increased the viability of thymus cells and decreased their rate of apoptosis through PARP-1. Radiation increased the levels of ROS, γ-H2AX and 53BP1, and induced DNA double strand breaks. Compared with wild type (WT) mice, levels of ROS, γ-H2AX and 53BP1 in KO mice were much less elevated. The FRT treatment groups also showed little reduction in these indicators in KO mice compared with WT mice. The results of the KO mice study indicated that FRT reduced ROS activation through inhibition of PARP-1. Furthermore, FRT reduced the concentrations of γ-H2AX by decreasing ROS activation. However, we found that FRT did not regulate 53BP1, a marker of DNA damage, because of its elimination of ROS. Levels of apoptosis-inducing factor (AIF), exhibited no significant difference after irradiation in KO mice. To summarize, ROS suppression by PARP-1 knockout in KO mice highlights potential therapeutic target either by PARP-1 inhibition combined with radiation or by treatment with a drug therapy alone. AIF-induced apoptosis could not be activated in KO mice.
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Affiliation(s)
- Sai-Juan Xu
- Department of Pharmacy, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Xia Wang
- College of Medical Laboratory, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Tao-Yang Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Zheng-Zhan Lin
- Department of Pharmacy, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Yong-Jian Hu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Zhong-Lin Huang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Xian-Jun Yang
- International Joint Research Laboratory for Recombinant Pharmaceutical Protein Expression System of Henan, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Ping Xu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang 453003, Henan, China
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Pérez-Torres I, Manzano-Pech L, Rubio-Ruíz ME, Soto ME, Guarner-Lans V. Nitrosative Stress and Its Association with Cardiometabolic Disorders. Molecules 2020; 25:molecules25112555. [PMID: 32486343 PMCID: PMC7321091 DOI: 10.3390/molecules25112555] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 02/07/2023] Open
Abstract
Reactive nitrogen species (RNS) are formed when there is an abnormal increase in the level of nitric oxide (NO) produced by the inducible nitric oxide synthase (iNOS) and/or by the uncoupled endothelial nitric oxide synthase (eNOS). The presence of high concentrations of superoxide anions (O2−) is also necessary for their formation. RNS react three times faster than O2− with other molecules and have a longer mean half life. They cause irreversible damage to cell membranes, proteins, mitochondria, the endoplasmic reticulum, nucleic acids and enzymes, altering their activity and leading to necrosis and to cell death. Although nitrogen species are important in the redox imbalance, this review focuses on the alterations caused by the RNS in the cellular redox system that are associated with cardiometabolic diseases. Currently, nitrosative stress (NSS) is implied in the pathogenesis of many diseases. The mechanisms that produce damage remain poorly understood. In this paper, we summarize the current knowledge on the participation of NSS in the pathology of cardiometabolic diseases and their possible mechanisms of action. This information might be useful for the future proposal of anti-NSS therapies for cardiometabolic diseases.
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Affiliation(s)
- Israel Pérez-Torres
- Vascular Biomedicine Department, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico;
- Correspondence: (I.P.-T.); (V.G.-L.)
| | - Linaloe Manzano-Pech
- Vascular Biomedicine Department, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico;
| | - María Esther Rubio-Ruíz
- Physiology Department, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico;
| | - María Elena Soto
- Immunology Department, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico;
| | - Verónica Guarner-Lans
- Physiology Department, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico;
- Correspondence: (I.P.-T.); (V.G.-L.)
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Xing Y, Chen J, Zhao L, Ma H. Analysis of the effect of liraglutide on glycemic variability in patients with type 2 diabetes. Endocr J 2020; 67:455-468. [PMID: 31996492 DOI: 10.1507/endocrj.ej19-0530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The efficacy of liraglutide in the treatment of glycemic variability in type 2 diabetic patients remains to be fully elucidated. Some studies evaluated the efficacy and safety of liraglutide in glycemic variability, and this meta-analysis was performed to evaluate the accuracy of the results of existing studies on the efficacy of liraglutide. We conducted a comprehensive search for all relevant studies published in PubMed, EMBASE, Cochrane Library, and China Academic Journal Full-Text Database from the beginning of 2011 to October 31, 2019. The mean ± SD and 95% confidence interval were used for evaluation, and subgroup and sensitivity analysis were carried out. Publication bias was estimated by funnel plots and Egger's tests. A total of 16 studies were included in the meta-analysis involving 492 participants. MAGE (mean amplitude of glycemic excursion), LAGE (largest amplitude of glycemic excursions), SD (standard deviation of blood glucose), and MODD (mean of daily differences) were collected to reflect the variability of blood glucose. The glycemic variability indexes of patients before and after treatment with liraglutide were compared. Patients with treatment had lower glycemic variability compared with patients receiving treatment of liraglutide. Compared with the patients before the treatment, the patients after the treatment had a smaller glycemic variability (MAGE: I2 = 92%, p < 0.01, Z = 11.91, p < 0.01, MD = -2.78, 95%CI: -3.24 - -2.32; LAGE: I2 = 76%, p = 0.08, Z = 9.94, p < 0.01, MD = -2.20, 95%CI: -2.59 - -1.81; MODD: I2 = 74%, p = 0.002, Z = 14.03, p < 0.01, MD = -0.90, 95%CI: -1.02 - -0.77; SD: I2 = 93%, p < 0.01, Z = 3.62, p < 0.01, SMD = -1.77, 95%CI: -2.73 - -0.81). Sensitivity analysis showed that our results were reliable and no evidence of significant publication bias was detected. The results of this study suggest that patients with type 2 diabetes treated with liraglutide are associated with lower glycemic variability.
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Affiliation(s)
- Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Jinhu Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
| | - Liying Zhao
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital Shijiazhuang, Hebei 050051, China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, China
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Gao F, Ma X, Peng J, Lu J, Lu W, Zhu W, Bao Y, Vigersky RA, Jia W, Zhou J. The Effect of Acarbose on Glycemic Variability in Patients with Type 2 Diabetes Mellitus Using Premixed Insulin Compared to Metformin (AIM): An Open-Label Randomized Trial. Diabetes Technol Ther 2020; 22:256-264. [PMID: 31638433 DOI: 10.1089/dia.2019.0290] [Citation(s) in RCA: 11] [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] [Indexed: 02/07/2023]
Abstract
Background: Acarbose (ACA) can effectively reduce the postprandial blood glucose and has similar antidiabetic effects as metformin (MET). To our knowledge, few studies have compared the effect of ACA or MET on glucose fluctuations. In the present study, we explored the effect of ACA or MET combined with premixed insulin (INS) on glycemic control and glycemic variability (GV). Methods: This was an open-label randomized trial that was conducted in type 2 diabetic patients taking premixed insulin. The patients were assigned to 12 weeks of MET (n = 62) or ACA (n = 62) treatment combined with INS. The main outcomes were changes in GV and glycosylated hemoglobin A1c (HbA1c) compared with baseline. Results: Compared with baseline, several GV indices (standard deviation [SD], mean amplitude of glycemic excursions [MAGE]) and blood glucose control indices (mean glucose [MG], time in range [TIR] and HbA1c) were both significantly improved in INS+ACA and INS+MET after 12-week therapy. However, coefficient of variation (CV) was significantly reduced in INS+ACA but not in INS+MET. Moreover, compared with INS+MET, INS+ACA led to a more pronounced percentage change from baseline in CV (26.3% [1.7%-44.6%] vs. 11.9% [-7.0% to 29.9%], P = 0.022), MAGE (40.5% [20.1%-60.5%] vs. 25.2% [-2.1% to 43.4%], P = 0.007) and SD (38.6% [25.2%-57.9%] vs. 30.1% [10.8%-46.5%], P = 0.041). Conclusion: Both MET and ACE combined with INS effectively reduced blood glucose. Compared with MET, ACA combined with INS reduced GV.
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Affiliation(s)
- Fei Gao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiahui Peng
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jingyi Lu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Lu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Zhu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Robert A Vigersky
- Diabetes Institute of the Walter Reed National Military Medical Center, Bethesda, Maryland
- Medtronic Diabetes, Northridge, California
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Livingstone R, Boyle JG, Petrie JR. How tightly controlled do fluctuations in blood glucose levels need to be to reduce the risk of developing complications in people with Type 1 diabetes? Diabet Med 2020; 37:513-521. [PMID: 30697804 DOI: 10.1111/dme.13911] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 12/12/2022]
Abstract
In 2011, the James Lind Alliance published a 'top 10' list of priorities for Type 1 diabetes research based on a structured consultation process. Whether reducing fluctuations in blood glucose can prevent long-term microvascular and macrovascular complications was one of these. In this narrative review, 8 years on, we have assessed the updated evidence for the assertion that increased glucose variability plays an independent and clinically important role in the complications of Type 1 diabetes, over and above mean blood glucose and the effects of hypoglycaemia: the 'glucose variability hypothesis'. Although studies in cultured cells and ex vivo vessels have been suggestive, most studies in Type 1 diabetes have been small and/or cross-sectional, and based on 'finger-prick' glucose measurements that capture glucose variability only in waking hours and are affected by missing data. A recent analysis of the Diabetes Control and Complications Trial that formally imputed missing data found no independent effect of short-term glucose variability on long-term complications. Few other high-quality longitudinal studies have directly addressed the glucose variability hypothesis in Type 1 diabetes. We conclude that there is little substantial evidence to date to support this hypothesis in Type 1 diabetes, although increasing use of continuous glucose monitoring provides an opportunity to test it more definitively. In the meantime, we recommend that control of glycaemia in Type 1 diabetes should continue to focus on the sustained achievement of target HbA1c and avoidance of hypoglycaemia.
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Affiliation(s)
- R Livingstone
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, UK
| | - J G Boyle
- School of Medicine, University of Glasgow, Glasgow, UK
- Glasgow Royal Infirmary, Glasgow, UK
| | - J R Petrie
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, UK
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Mu P, Tang X, Tan Y, Wang Y, Lin S, Wang M, Shu J, Wang J, Zhang Y, Liang H, Lin B, Cai M, Chen Y. Effect of basal insulin supplement therapy on diabetic retinopathy in short-duration type 2 diabetes: A one-year randomized parallel-group trial. J Diabetes 2019; 11:949-957. [PMID: 30973204 PMCID: PMC6899662 DOI: 10.1111/1753-0407.12928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/25/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In this study, we compared the effect on diabetic retinopathy (DR) between oral antidiabetic drugs (OADs) alone and in combination with basal insulin-supported OADs therapy (BOT). [Correction added on 11 November 2019, after first online publication: In Abstract under Background section, "DR" has been corrected into "diabetic retinopathy (DR)".] METHODS: Between January 2015 and January 2018, this study enrolled 290 patients (age 18-65 years) with diabetes duration between 0 and 5 years. Patients were randomly assigned to receive OADs or BOT after 14 days intensive insulin treatment. Examinations were performed at the beginning and end of the study. RESULTS Fewer patients developed DR in the BOT than OADs group (8 [6.06%] vs 12 [8.3%], respectively), and all cases of DR were non-proliferative. Blood glucose concentrations were higher in the BOT than OADs group at the 3rd month, but lower in the former at the 6th and 12th month. The rate of reaching target HbA1c ≤7% was lower in the BOT than OADs group at the 3rd month (63.6% vs 72.2%, respectively), similar between the two groups at the 6th month (60.6% vs 66.6%, respectively) and higher in the BOT group at the 12th month (75.0% vs 61.1%, respectively). The SD of fasting blood glucose (FBG), coefficient of variation of FBG, SD of blood glucose (SDBG), and mean amplitude of glycemic excursions were lower in the BOT than OADs group. Changes in the levels of three cytokines (interleukin [IL]-1β, IL-6, and IL-17α) were significantly less in the BOT than OADs group. CONCLUSIONS Twelve months of BOT decreased the incidence of DR in short-duration type 2 diabetes by reducing glycemia more effectively, stably, and completely than OADs alone.
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Affiliation(s)
- Pan‐Wei Mu
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Xi‐Xiang Tang
- Advanced Medical CenterThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Ying Tan
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Yi‐Na Wang
- Advanced Medical CenterThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Shuo Lin
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Man‐Man Wang
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Jiong Shu
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Jing Wang
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen University, Yuedong HospitalMeizhouChina
| | - Yong‐Jun Zhang
- Department of EndocrinologyThe Fifth Affiliated Hospital of Zunyi Medical UniversityZhuhaiChina
| | - Hua Liang
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Bai‐Run Lin
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen University, Yuedong HospitalMeizhouChina
| | - Meng‐Yin Cai
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
| | - Yan‐Ming Chen
- Department of EndocrinologyThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of Science and Technology, Guangdong Provincial Key Laboratory of DiabetologyGuangzhouChina
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Endothelial Dysfunction is Related to Glycemic Variability and Quality and Duration of Sleep in Adults With Type 1 Diabetes. J Cardiovasc Nurs 2019; 33:E21-E25. [PMID: 29629915 DOI: 10.1097/jcn.0000000000000485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Elevated cardiovascular disease risk in people with type 1 diabetes (T1DM) is incompletely understood. Glycemic control, glycemic variability, and sleep quality and duration may relate to cardiovascular disease risk in this population via endothelial dysfunction. OBJECTIVE The aim of this study was to examine relationships among glycemic control, glycemic variability, sleep quality and duration, and endothelial function in adults with T1DM. METHODS Endothelial function was measured using flow-mediated dilation. Glycemic control and glycemic variability were measured using A1C and a continuous glucose monitor, respectively; sleep quality and duration were measured with the Pittsburgh Sleep Quality Index. RESULTS Twenty subjects were recruited. Reduced flow-mediated dilation and higher glucose levels were associated with poorer sleep quality (r = -0.51, P = .01; r = 0.52, P = .03). Subjects with shorter sleep duration had greater glycemic variability. CONCLUSIONS Endothelial dysfunction (a precursor to cardiovascular disease) relates to glycemic control, glycemic variability, and sleep quality in T1DM.
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Effect of Short-Term Increase in Meal Frequency on Glucose Metabolism in Individuals with Normal Glucose Tolerance or Impaired Fasting Glucose: A Randomized Crossover Clinical Trial. Nutrients 2019; 11:nu11092126. [PMID: 31489910 PMCID: PMC6769465 DOI: 10.3390/nu11092126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/04/2022] Open
Abstract
Effects of meal frequency on blood glucose levels and glucose metabolism were evaluated over 3 days in adult males with normal glucose tolerance (NGT, n = 9) or impaired fasting glucose (IFG, n = 9) in a randomized, crossover comparison study. Subjects were provided with an isocaloric diet 3 times daily (3M) or 9 times daily (9M). Blood glucose was monitored on Day 3 using a continuous glucose monitoring system, and subjects underwent a 75-g oral glucose tolerance test (OGTT) on Day 4. Daytime maximum blood glucose, glucose range, duration of glucose ≥180 mg/dL, and nighttime maximum glucose were significantly lower in the NGT/9M condition than in the NGT/3M condition. Similar findings were observed in the IFG subjects, with a lower daytime and nighttime maximum glucose and glucose range, and a significantly higher daytime minimum glucose in the 9M condition than in the 3M condition. The OGTT results did not differ significantly between NGT/3M and NGT/9M conditions. In contrast, the incremental area under the curve tended to be lower and the maximum plasma glucose concentration was significantly lower in the IFG/9M condition than in the IFG/3M condition. In IFG subjects, the 9M condition significantly improved glucose metabolism compared with the 3M condition. Higher meal frequency may increase glucagon-like peptide 1 secretion and improve insulin secretion.
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Jiang SJ, Tsai PI, Peng SY, Chang CC, Chung Y, Tsao HH, Huang HT, Chen SY, Hsu HJ. A potential peptide derived from cytokine receptors can bind proinflammatory cytokines as a therapeutic strategy for anti-inflammation. Sci Rep 2019; 9:2317. [PMID: 30783144 PMCID: PMC6381106 DOI: 10.1038/s41598-018-36492-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/22/2018] [Indexed: 01/19/2023] Open
Abstract
Chronic inflammation is a pivotal event in the pathogenesis of cardiovascular diseases, including atherosclerosis, restenosis, and coronary artery disease. The efficacy of current treatment or preventive strategies for such inflammation is still inadequate. Thus, new anti-inflammatory strategies are needed. In this study, based on molecular docking and structural analysis, a potential peptide KCF18 with amphiphilic properties (positively charged and hydrophobic residues) derived from the receptors of proinflammatory cytokines was designed to inhibit cytokine-induced inflammatory response. Simulations suggested that KCF18 could bind to cytokines simultaneously, and electrostatic interactions were dominant. Surface plasmon resonance detection showed that KCF18 bound to both tumor necrosis factor-α (TNF-α) and interleukin-6, which is consistent with MM/PBSA binding free energy calculations. The cell experiments showed that KCF18 significantly reduced the binding of proinflammatory cytokines to their cognate receptors, suppressed TNF-α mRNA expression and monocyte binding and transmigration, and alleviated the infiltration of white blood cells in a peritonitis mouse model. The designed peptide KCF18 could remarkably diminish the risk of vascular inflammation by decreasing plasma cytokines release and by directly acting on the vascular endothelium. This study demonstrated that a combination of structure-based in silico design calculations, together with experimental measurements can be used to develop potential anti-inflammatory agents.
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Affiliation(s)
- Shinn-Jong Jiang
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Pei-I Tsai
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu, 30010, Taiwan
| | - Shih-Yi Peng
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Chun-Chun Chang
- Institute of Medical Sciences, Tzu Chi University, Hualien, 97004, Taiwan.,Department of Laboratory Medicine, Tzu Chi Medical Center, Hualien, 97004, Taiwan
| | - Yi Chung
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Hao-Hsiang Tsao
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Hsin-Ting Huang
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - San-Yuan Chen
- Department of Materials Science and Engineering, National Chiao-Tung University, Hsinchu, 30010, Taiwan
| | - Hao-Jen Hsu
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan. .,Department of Life Sciences, Tzu Chi University, Hualien, 97004, Taiwan.
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Kuhlman P, Isom S, Pardee TS, Burns C, Tawfik B, Lamar ZS, Powell BL, Klepin HD. Association between glycemic control, age, and outcomes among intensively treated patients with acute myeloid leukemia. Support Care Cancer 2018; 27:2877-2884. [PMID: 30554278 DOI: 10.1007/s00520-018-4582-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/27/2018] [Indexed: 01/28/2023]
Abstract
PURPOSE To investigate the impact of hyperglycemia and glycemic variability during intensive acute myeloid leukemia therapy (AML) on outcomes by age. METHODS Retrospective study of 262 consecutive patients with newly diagnosed AML hospitalized for intensive induction. Hyperglycemia was assessed by mean blood glucose (BG) (mg/dL) during hospitalization and glycemic variability was determined by the standard deviation (SD) of mean BG. Outcomes were complete remission ± incomplete count recovery (CR + CRi), and overall survival (OS). We used logistic regression to evaluate CR + CRi, and Cox proportional hazard models for OS, stratified by age (< 60 vs ≥ 60 years). RESULTS Older patients (N = 138, median age 70) had higher baseline comorbidity (CCI > 1 60.1% vs 25.8%) and prevalence of diabetes (20.3% vs 7.3%) compared to younger (N = 124, median age 47). The mean ± SD number of BG values obtained per patient during hospitalization was 61 ± 71. The mean (± SD) glucose (mg/dL) during hospitalization was 121.7 (25.9) in older patients (≥ 60 years) versus 111.6 (16.4) in younger. In older patients, higher mean glucose and greater glycemic variability were associated with lower odds of remission (OR 0.80, 95% CI 0.69-0.93 and OR 0.73, 95% CI 0.61-0.88 respectively, per 10-unit increase) and higher mortality rates (HR 1.13, 95% CI 1.05-1.21 and HR 1.17, 95% CI 1.09-1.26, respectively, per 10-unit increase) in multivariate analyses. CONCLUSIONS Our observations that hyperglycemia and increased glycemic variability were associated with lower remission rates and increased mortality in older patients suggest glycemic control may be a potentially modifiable factor to improve AML outcomes.
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Affiliation(s)
- Patrick Kuhlman
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Scott Isom
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Timothy S Pardee
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Cynthia Burns
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Bernard Tawfik
- University of Texas Southwestern Medical Center, Harry Hines Blvd, Dallas, TX, USA
| | - Zanetta S Lamar
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Bayard L Powell
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Heidi D Klepin
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
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Sallam NA, Palmgren VAC, Singh RD, John CM, Thompson JA. Programming of Vascular Dysfunction in the Intrauterine Milieu of Diabetic Pregnancies. Int J Mol Sci 2018; 19:E3665. [PMID: 30463313 PMCID: PMC6275067 DOI: 10.3390/ijms19113665] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 02/07/2023] Open
Abstract
With the rising global tide of obesity, gestational diabetes mellitus (GDM) burgeoned into one of the most common antenatal disorders worldwide. Macrosomic babies born to diabetic mothers are more likely to develop risk factors for cardiovascular disease (CVD) before they reach adulthood. Rodent studies in offspring born to hyperglycemic pregnancies show vascular dysfunction characterized by impaired nitric oxide (NO)-mediated vasodilation and increased production of contractile prostanoids by cyclooxygenase 2 (COX-2). Vascular dysfunction is a key pathogenic event in the progression of diabetes-related vascular disease, primarily attributable to glucotoxicity. Therefore, glucose-induced vascular injury may stem directly from the hyperglycemic intrauterine environment of GDM pregnancy, as evinced by studies showing endothelial activation and inflammation at birth or in childhood in offspring born to GDM mothers. This review discusses potential mechanisms by which intrauterine hyperglycemia programs dysfunction in the developing vasculature.
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Affiliation(s)
- Nada A Sallam
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Calgary, AB T2N 4N1, Canada.
- Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 4N1, Canada.
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Victoria A C Palmgren
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Calgary, AB T2N 4N1, Canada.
| | - Radha D Singh
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Calgary, AB T2N 4N1, Canada.
- Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Cini M John
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Calgary, AB T2N 4N1, Canada.
| | - Jennifer A Thompson
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Calgary, AB T2N 4N1, Canada.
- Children's Hospital Research Institute; University of Calgary, Calgary, AB T2N 4N1, Canada.
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Kato A, Tatsumi Y, Yako H, Sango K, Himeno T, Kondo M, Kato Y, Kamiya H, Nakamura J, Kato K. Recurrent short-term hypoglycemia and hyperglycemia induce apoptosis and oxidative stress via the ER stress response in immortalized adult mouse Schwann (IMS32) cells. Neurosci Res 2018; 147:26-32. [PMID: 30444976 DOI: 10.1016/j.neures.2018.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/02/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022]
Abstract
Hypoglycemia and fluctuating high or low glucose conditions are under-appreciated sources of oxidative stress contributing to diabetic neuropathy. We investigated the effects of recurrent short-term hypoglycemia and hyperglycemia, on apoptosis and oxidative stress in Schwann cells. Immortalized adult mouse Schwann (IMS32) cells were exposed to five different glucose treatments over 3 days: 1) normal glucose (NG), 2) constant low glucose (LG), 3) constant high glucose (HG), 4) intermittent low glucose (ILG; 1 h three times per day), 5) intermittent high glucose (IHG; 1 h three times per day). Cell viability was decreased by all treatment variants, in comparison to NG. Thiobarbituric acid reactive substance (TBARS) levels were increased by HG, LG, IHG, and ILG. High glucose (HG and IHG) and low glucose (LG and ILG) increased the expression of cleaved caspase-3 and reduced that of Bcl-2. In addition, endoplasmic reticulum (ER) stress-responsive transcription factor C/EBP homologous protein (CHOP) expression was increased under low and high glucose conditions. Cell death and oxidative stress induced by HG, LG, IHG, and ILG were significantly reduced by 4-phenyl butyric acid (4-PBA), an ER stress inhibitor. These findings indicate that recurrent short-term hypoglycemia and hyperglycemia induce apoptosis and oxidative stress via the ER stress response in Schwann cells.
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Affiliation(s)
- Ayako Kato
- Laboratory of Medicine, Aichi Gakuin University School of Pharmacy, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan
| | - Yasuaki Tatsumi
- Laboratory of Medicine, Aichi Gakuin University School of Pharmacy, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan
| | - Hideji Yako
- Diabetic Neuropathy Project, Department of Sensory and Motor Systems, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, 156-8506 Japan
| | - Kazunori Sango
- Diabetic Neuropathy Project, Department of Sensory and Motor Systems, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, 156-8506 Japan
| | - Tatsuhito Himeno
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Masaki Kondo
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Yoshiro Kato
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Hideki Kamiya
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Jiro Nakamura
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Koichi Kato
- Laboratory of Medicine, Aichi Gakuin University School of Pharmacy, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan.
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Li X, Zhou X, Wei J, Mo H, Lou H, Gong N, Zhang M. Effects of Glucose Variability on Short-Term Outcomes in Non-Diabetic Patients After Coronary Artery Bypass Grafting: A Retrospective Observational Study. Heart Lung Circ 2018; 28:1580-1586. [PMID: 30322761 DOI: 10.1016/j.hlc.2018.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/04/2018] [Accepted: 08/20/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postoperative hyperglycaemia has been shown to have adverse effects on patients after coronary artery bypass grafting surgery (CABG). However, whether glucose variability has an effect on patients' outcomes is still uncertain. The aim of this study is to explore the effects of glucose variability on short-term outcomes in non-diabetic patients undergoing coronary artery bypass grafting. METHODS This is a retrospective observational study utilising data collected after patients had left the hospital. This study was performed on 137 non-diabetic patients undergoing coronary artery bypass grafting from January 2011 to June 2013. Blood glucose at 72hours post operation was obtained and glucose variability was measured by mean postoperative blood glucose and mean of daily difference (MODD). Short-term outcomes included duration of intensive care unit (ICU) stay, mechanical ventilation time, length of hospital stay, and occurrence of arrhythmia. Patients with mean postoperative blood glucose ≥7.00mmol/L were defined as hyperglycaemic, and patients with MODD ≥1.40mmol/L were considered to be abnormal. Outcome variables were compared between patients in euglycaemic and hyperglycaemic groups, and between patients in normal and abnormal groups. RESULTS In our study, patients with hyperglycaemia spent more time staying in ICU (p<0.01), and patients with large glucose variability (abnormal MODD) had higher incidences of arrhythmia (23% vs 4.2%, p<0.05). Regression analysis showed that MODD can affect occurrence of arrhythmia (p=0.004) and that mean postoperative blood glucose levels can affect duration of ICU stay (p<0.001). CONCLUSIONS Patients' postoperative glucose variability after CABG is an important predictor of the negative outcomes regarding duration of ICU stay and occurrence of arrhythmia. Large glucose variability can have negative effects on short-term outcomes in patients.
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Affiliation(s)
- Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xuezhen Zhou
- Department of Nursing, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong 510080, China
| | - Juan Wei
- Guangzhou Panyu Central Hospital, Guangzhou, Guangdong 510080, China
| | - Hongping Mo
- Department of Intensive Care Unit, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong 510080, China
| | - Hongyu Lou
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ni Gong
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
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Nafisa A, Gray SG, Cao Y, Wang T, Xu S, Wattoo FH, Barras M, Cohen N, Kamato D, Little PJ. Endothelial function and dysfunction: Impact of metformin. Pharmacol Ther 2018; 192:150-162. [PMID: 30056057 DOI: 10.1016/j.pharmthera.2018.07.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cardiovascular and metabolic diseases remain the leading cause of morbidity and mortality worldwide. Endothelial dysfunction is a key player in the initiation and progression of cardiovascular and metabolic diseases. Current evidence suggests that the anti-diabetic drug metformin improves insulin resistance and protects against endothelial dysfunction in the vasculature. Hereby, we provide a timely review on the protective effects and molecular mechanisms of metformin in preventing endothelial dysfunction and cardiovascular and metabolic diseases.
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Affiliation(s)
- Asma Nafisa
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, Australia.
| | - Susan G Gray
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, Australia.
| | - Yingnan Cao
- Xinhua College of Sun Yat-sen University, Tianhe District, Guangzhou, China
| | - Tinghuai Wang
- Xinhua College of Sun Yat-sen University, Tianhe District, Guangzhou, China.
| | - Suowen Xu
- Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Feroza H Wattoo
- Department of Biochemistry, PMAS Arid Agriculture University, Shamasabad, Muree Road, Rawalpindi 4600, Pakistan..
| | - Michael Barras
- Dept. of Pharmacy, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD 4102, Australia.
| | - Neale Cohen
- Baker Heart and Diabetes Institute, Melbourne, 3004, Victoria, Australia.
| | - Danielle Kamato
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, Australia; Xinhua College of Sun Yat-sen University, Tianhe District, Guangzhou, China.
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, Australia; Xinhua College of Sun Yat-sen University, Tianhe District, Guangzhou, China.
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Chen X, Wu Q, Jiang H, Wang J, Zhao Y, Xu Y, Zhu M. SET8 is involved in the regulation of hyperglycemic memory in human umbilical endothelial cells. Acta Biochim Biophys Sin (Shanghai) 2018; 50:635-642. [PMID: 29762637 DOI: 10.1093/abbs/gmy051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/24/2018] [Indexed: 11/13/2022] Open
Abstract
Hyperglycemic memory occurs in diabetic cardiovascular complications, but the underlying mechanism remains to be elucidated. Although the depletion of SET8 leads to increased mitochondrial oxidative stress via increasing cellular reactive oxygen species (ROS) production, the role of SET8 in hyperglycemic memory-induced mitochondrial dysfunction is not well understood. Here, we investigated the role of SET8 in this setting. Our results showed that high glucose-induced vascular inflammation, ROS production and apoptosis remained at high levels even when glucose returned to normal level. Elevated glucose reduced SET8 expression, which also remained at low level after returning to normoglycemia. SET8 overexpression protected cells from elevated glucose and hyperglycemic memory-induced endothelial injury by blocking ROS accumulation, attenuating vascular inflammation, and restoring nitric oxide production. Thus, our results suggest that SET8 may be a key mediator in hyperglycemic memory.
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Affiliation(s)
- Xiangyuan Chen
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Anaesthesiology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qichao Wu
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Anaesthesiology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui Jiang
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaqiang Wang
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Anaesthesiology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yanjun Zhao
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yajun Xu
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Minmin Zhu
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Low-level laser irradiation modifies the effect of hyperglycemia on adhesion molecule levels. Lasers Med Sci 2018; 33:1521-1526. [PMID: 29725945 DOI: 10.1007/s10103-018-2511-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
Endothelium plays a key role in maintaining vascular homeostasis by secreting active factors involved in many biological processes such as hemostasis, angiogenesis, and inflammation. Hyperglycemia in diabetic patients causes dysfunction of endothelial cells. Soluble fractions of adhesion molecules like sE-selectin and vascular cell adhesion molecule (sVCAM) are considered as markers of endothelial damage. The low-level laser therapy (LLLT) effectively supports the conventional treatment of vascular complications in diabetes, for example hard-to-heal wounds in patients with diabetic foot syndrome. The aim of our study was to evaluate the effect of low-energy laser at the wavelength of 635 nm (visible light) and 830 nm (infrared) on the concentration of adhesion molecules: sE-selectin and sVCAM in the supernatant of endothelial cell culture of HUVEC line. Cells were cultured under high-glucose conditions of 30 mM/L. We have found an increase in sE-selectin and sVCAM levels in the supernatant of cells cultured under hyperglycemic conditions. This fact confirms detrimental influence of hyperglycemia on vascular endothelial cell cultures. LLLT can modulate the inflammation process. It leads to a decrease in sE-selectin and sVCAM concentration in the supernatant and an increase in the number of endothelial cells cultured under hyperglycemic conditions. The influence of LLLT is greater at the wavelength of 830 nm.
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Sáez T, de Vos P, Kuipers J, Sobrevia L, Faas MM. Fetoplacental endothelial exosomes modulate high d-glucose-induced endothelial dysfunction. Placenta 2018; 66:26-35. [PMID: 29884299 DOI: 10.1016/j.placenta.2018.04.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is associated with fetoplacental endothelial dysfunction, which may be induced by hyperglycemia. We hypothesized that endothelial exosomes, which are extracellular nanovesicles affecting endothelial function, play a role in the high glucose (HG)-induced endothelial dysfunction. METHODS Exosomes were isolated from HUVECs incubated with basal glucose (5.5 mmol/L; HUVEC- BG; exo-BG) and from HUVECs incubated with HG for 24 h (25 mmol/L; HUVEC-HG; exo-HG) in exosome-free medium. Exosomes were isolated and characterized by ultracentrifugation, sucrose gradient, electron microscopy, nanotracking analysis and Western blotting. HUVEC-BG and HUVEC-HG were exposed to exo-BG and exo-HG in two different concentrations: 5 μg and 1 μg exosome protein/mL. The exosomal effect on endothelial cell function was determined by wound healing assay, expression of endothelial nitric oxide synthase (eNOS), human cationic amino acid transporter type 1 (hCAT-1), vascular endothelial growth factor (VEGF) and intracellular adhesion molecule type 1 (ICAM-1) by Western blotting, qPCR or flow cytometry. RESULTS HG increased the exosomal release from HUVECs, endothelial wound healing and expression of phosphorylated (P∼Ser1177)-eNOS, hCAT-1, VEGF and ICAM-1. Exo-HG also increased endothelial cell wound healing, P∼Ser1177-eNOS, hCAT-1 and ICAM-1 expression in HUVEC-BG. Exo-BG reverted the effect of HG on endothelial cell wound healing and hCAT-1 mRNA expression to normal values. DISCUSSION Our results show that HG may induce endothelial dysfunction in HUVECs and that exosomes from HUVEC-HG mimicked some of the effects of HG. This study contributes to the unraveling of the mechanism by which hyperglycemia affects the fetoplacental vasculature in GDM.
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Affiliation(s)
- Tamara Sáez
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands; Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Paul de Vos
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Jeroen Kuipers
- Molecular Imaging and Electron Microscopy, Dept Cell Biology, University of Groningen, University Medical Centre Groningen (UMCG), Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville, E-41012, Spain; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Queensland, Australia.
| | - Marijke M Faas
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands; Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Intermittent High Glucose Exacerbates A-FABP Activation and Inflammatory Response through TLR4-JNK Signaling in THP-1 Cells. J Immunol Res 2018; 2018:1319272. [PMID: 29850615 PMCID: PMC5925160 DOI: 10.1155/2018/1319272] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/15/2018] [Accepted: 03/19/2018] [Indexed: 01/01/2023] Open
Abstract
Background Glucose fluctuation confers additional risks on diabetes-related vascular diseases, but the underlying mechanisms are unknown. Macrophage activation mediated by TLR4-JNK signaling plays an important role during the progress of diabetes. In the present study, we hypothesize that glucose fluctuation results in macrophage inflammation through TLR4-JNK signaling pathways. Methods THP-1 cells were treated with normal glucose (5 mM), constant high glucose (25 mM), and intermittent high glucose (rotation per 6 h in 5 mM or 25 mM) for 24 h. The mRNA and protein expression levels of TLR4, p-JNK, and adipocyte fatty acid-binding protein (A-FABP) were determined, and the proinflammatory cytokines TNF-α and IL-1β were quantified. Results In constant high glucose, TLR4 expression and JNK phosphorylation levels increased, and this effect was more pronounced in intermittent high glucose. Accordingly, the expression of A-FABP and the release of the proinflammatory cytokines TNF-α and IL-1β also increased in response to constant high glucose, an effect that also was more evident in intermittent high glucose. The inhibition of p-JNK by SP600125 did not attenuate TLR4 expression, but totally inhibited both A-FABP expression and the production of the proinflammatory cytokines TNF-α and IL-1β in both constant and intermittent high glucose. Conclusions Intermittent high glucose potentiates A-FABP activation and inflammatory responses via TLR4/p-JNK signaling in THP-1 cells. These findings suggest a more detrimental impact of glucose fluctuation on macrophage inflammation in diabetes-related vascular diseases than thus far generally assumed.
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Lee G, Kim SM, Choi S, Kim K, Jeong SM, Son JS, Yun JM, Park SM. The effect of change in fasting glucose on the risk of myocardial infarction, stroke, and all-cause mortality: a nationwide cohort study. Cardiovasc Diabetol 2018; 17:51. [PMID: 29626936 PMCID: PMC5889526 DOI: 10.1186/s12933-018-0694-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/28/2018] [Indexed: 12/25/2022] Open
Abstract
Background The effect of change in blood glucose levels on the risk of cardiovascular disease among individuals without diabetes is currently unclear. We aimed to examine the association of change in fasting serum glucose with incident cardiovascular disease and all-cause mortality among representative large population. Methods We analyzed the data from retrospective cohort of Korean National Health Insurance Service. In total, 260,487 Korean adults aged over 40 years, without diabetes mellitus and cardiovascular disease at baseline measured change in fasting serum glucose according to the criteria of impaired and diabetic fasting glucose status: normal fasting glucose (NFG, fasting glucose: < 100 mg/dL), impaired fasting glucose (IFG, fasting glucose: 100.0–125.9 mg/dL), and diabetic fasting glucose (DFG, fasting glucose: ≥ 126.0 mg/dL). Compared to the persistently unchanged group (i.e. NFG to NFG or IFG to IFG), Cox proportional hazards regression analyses were performed in the changed group to obtain the hazards ratio (HR) with 95% confidence interval (CI) for the subsequent median 8-year myocardial infarction, stroke, and all-cause mortality. Results Compared to individuals with persistent NFG (i.e., NFG to NFG), individuals who shifted from NFG to DFG had an increased risk of stroke (HR [95% CI]: 1.19 [1.02–1.38]) and individuals who shifted from NFG to IFG or DFG had increased risks of all-cause mortality (HR [95% CI]: 1.08 [1.02–1.14] for NFG to IFG and 1.56 [1.39–1.75] for NFG to DFG). Compared to individuals with persistent IFG, individuals who shifted from IFG to DFG had an increased risk of MI and all-cause mortality (HR [95% CI]: 1.65 [1.20–2.27] and 1.16 [1.02–1.33], respectively). Conclusions Increasing fasting glucose in non-diabetic population is associated with risks of the MI, stroke, and all-cause mortality, which is more rapid, more severe. Electronic supplementary material The online version of this article (10.1186/s12933-018-0694-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gyeongsil Lee
- Department of Family Medicine, Health Promotion Center, Chung-Ang University Hospital, Seoul, South Korea
| | - Sung Min Kim
- Clinical Medical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
| | - Seulggie Choi
- Clinical Medical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
| | - Kyuwoong Kim
- Clinical Medical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
| | - Su-Min Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jae-Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sang Min Park
- Clinical Medical Sciences, College of Medicine, Seoul National University, Seoul, South Korea. .,Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
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Maiorino MI, Bellastella G, Casciano O, Cirillo P, Simeon V, Chiodini P, Petrizzo M, Gicchino M, Romano O, Caruso P, Giugliano D, Esposito K. The Effects of Subcutaneous Insulin Infusion Versus Multiple Insulin Injections on Glucose Variability in Young Adults with Type 1 Diabetes: The 2-Year Follow-Up of the Observational METRO Study. Diabetes Technol Ther 2018; 20:117-126. [PMID: 29303370 DOI: 10.1089/dia.2017.0334] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Type 1 diabetic patients have high instability of daily glucose levels. The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy, compared with multiple daily injections of insulin (MDI), on glucose variability, in young type 1 diabetic patients transitioned to the adult diabetes care. METHODS Patients aged 18-30 years and considered eligible for insulin pump therapy were included in the study. Ninety-eight patients who started CSII therapy and 125 who remained in MDI completed a 2-year follow-up. Glucose variability was assessed with continuous glucose monitoring using blood glucose standard deviation (BGSD), mean amplitude of glycemic excursion (MAGE), continuous overall net glycemic action (CONGA-2 h), low blood glucose index, high blood glucose index, and average daily risk range. RESULTS MAGE and BGSD decreased in both groups, with adjusted differences at 2 years of -0.74 mM (95% confidence interval [CI] -1.22 to -0.26, P = 0.003) and -0.3 (CI -0.52 to -0.1, P = 0.005) favoring the pump-therapy group. No significant differences between groups in the other variability indexes were observed. HbA1c decreased in both groups without significant difference (0.05%, -0.26, 0.35, P = 0.77); fasting glucose, insulin dose, and overall hypoglycemia (daily, nocturnal, and severe) decreased more in patients with CSII, compared with those with MDI. CONCLUSIONS Among young adults with type 1 diabetes transitioning from the pediatric care, the use of CSII is associated with lower glucose variability, fasting glycemia, and overall hypoglycemic events than MDI during a 2-year period of follow-up.
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Affiliation(s)
- Maria Ida Maiorino
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Giuseppe Bellastella
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Ofelia Casciano
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Paolo Cirillo
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Vittorio Simeon
- 2 Medical Statistics Unit, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Paolo Chiodini
- 2 Medical Statistics Unit, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Michela Petrizzo
- 3 Diabetes Unit, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Maurizio Gicchino
- 3 Diabetes Unit, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Ornella Romano
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Paola Caruso
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Dario Giugliano
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
| | - Katherine Esposito
- 1 Unit of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli ," Naples, Italy
- 3 Diabetes Unit, University of Campania "Luigi Vanvitelli ," Naples, Italy
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Qin WD, Liu GL, Wang J, Wang H, Zhang JN, Zhang F, Ma Y, Ji XY, Li C, Zhang MX. Poly(ADP-ribose) polymerase 1 inhibition protects cardiomyocytes from inflammation and apoptosis in diabetic cardiomyopathy. Oncotarget 2018; 7:35618-35631. [PMID: 27027354 PMCID: PMC5094949 DOI: 10.18632/oncotarget.8343] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 03/14/2016] [Indexed: 01/08/2023] Open
Abstract
Diabetic cardiomyopathy (DCM) is characterized by structural alterations such as cardiomyocyte hypertrophy, necrosis and focal fibrosis. Poly(ADP-ribose) polymerase 1 (PARP-1) is a nuclear enzyme which can be activated by DNA damage and plays a critical role in various diseases. We hypothesized that PARP-1 may play an important role in DCM and that its inhibition may protect cardiomyocytes from inflammation and apoptosis in DCM. H9c2 cardiomyocytes were treated with normal glucose, mannitol or high glucose (HG). Male C57BL/6 mice or PARP-1−/− mice were treated with streptozotocin (STZ) by intraperitoneal injection for 5 consecutive days to induce diabetes. In vitro, HG stimulation induced oxidative stress and DNA damage and increased PARP-1 expression and activity. Compared with the control, pretreatment with PARP-1 siRNA significantly reduced HG-induced inflammatory response, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6 secretion, and intercellular adhesion molecule-1 (ICAM-1) and inducible nitric oxide synthase (iNOS) expression. PARP-1 inhibition reduced HG-induced cardiomyocyte apoptosis through downregulation of cleaved caspases and activation of IGF-1R/Akt pathway. In vivo, hyperglycemia increased the protein expression of nitrotyrosine and PARP-1 as well as PARP-1 activity. PARP-1 gene deletion significantly improved cardiac dysfunction and reduced inflammatory response and apoptosis. This work demonstrated the critical role of PARP-1 in diabetic heart injury, and suggested that PARP-1 inhibition may be a feasible strategy for the treatment of DCM.
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Affiliation(s)
- Wei-Dong Qin
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Guo-Liang Liu
- The Henan Provincial Key Engineering Laboratory of Antibody Drugs, School of Medicine, Henan University, Kaifeng, Henan, China
| | - Juan Wang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, Shandong, China
| | - Hao Wang
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jian-Ning Zhang
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Fan Zhang
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yang Ma
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xin-Ying Ji
- The Henan Provincial Key Engineering Laboratory of Antibody Drugs, School of Medicine, Henan University, Kaifeng, Henan, China
| | - Chen Li
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Ming-Xiang Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Vigersky RA, Shin J, Jiang B, Siegmund T, McMahon C, Thomas A. The Comprehensive Glucose Pentagon: A Glucose-Centric Composite Metric for Assessing Glycemic Control in Persons With Diabetes. J Diabetes Sci Technol 2018; 12:114-123. [PMID: 28748705 PMCID: PMC5761978 DOI: 10.1177/1932296817718561] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Composite metrics have the potential to provide more complete and clinically useful information about glycemic control than traditional individual metrics such as hemoglobin A1C, %/time/area under curve of hypoglycemia and hyperglycemia. METHODS Using five key metrics that are derived from continuous glucose monitoring, we developed a new, multicomponent composite metric, the Comprehensive Glucose Pentagon (CGP) that demonstrates glycemic control both numerically and visually. Two of its axes are composite metrics-the intensity of hypoglycemia and intensity of hyperglycemia. This approach eliminates the use of the surrogate marker, hemoglobin A1C (A1C), and replaces it with glucose-centric metrics. RESULTS We reanalyzed the data from two randomized control trials, the STAR 3 and ASPIRE In-Home studies using the CGP. It provided new insights into the effect of sensor-augmented pumping (SAP) in the STAR 3 trial and sensor-integrated pumping with low-glucose threshold suspend (SIP+TS) in the ASPIRE In-Home trial. CONCLUSIONS The CGP has the potential to enable health care providers, investigators and patients to better understand the components of glycemic control and the effect of various interventions on the individual elements of that control. This can be done on a daily, weekly, or monthly basis. It also allows direct comparison of the effects on different interventions among clinical trials which is not possible using A1C alone. This new composite metric approach requires validation to determine if it provides a better predictor of long-term outcomes than A1C and/or better predictor of severe hypoglycemia than the low blood glucose index (LBGI).
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Affiliation(s)
| | - John Shin
- Medtronic Diabetes, Northridge, CA, USA
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Owens DR, Monnier L, Hanefeld M. A review of glucagon-like peptide-1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus. Diabetes Obes Metab 2017; 19:1645-1654. [PMID: 28474401 PMCID: PMC5697665 DOI: 10.1111/dom.12998] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular (CV) comorbidities, with CV disease being the most common cause of death in adults with T2DM. Although glucocentric therapies may improve glycaemic control (as determined by glycated haemoglobin levels), evidence suggests that this approach alone has limited beneficial effects on CV outcomes relative to improvements in lipid and blood pressure control. This may be explained in part by the fact that current antidiabetic treatment regimens primarily address overall glycaemia and/or fasting plasma glucose, but not the postprandial plasma glucose (PPG) excursions that have a fundamental causative role in increasing CV risk. This literature review evaluates the relationship between PPG and the risk of CV disease, discusses the treatment of T2DM with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and examines the associated CV outcomes. The literature analysis suggests that exaggerated PPG excursions are a risk factor for CV disease because of their adverse pathophysiologic effects on the vasculature, resulting in increased all-cause and CV-related mortality. Although GLP-1 RAs are well established in the current T2DM treatment paradigm, a subgroup of these compounds has a particularly pronounced, persistent and short-lived effect on gastric emptying and, hence, lower PPG substantially. However, current long-term data on CV outcomes with GLP-1 RAs are contradictory, with both beneficial and adverse effects having been reported. This review explores the opportunity to direct treatment towards controlling PPG excursions, thereby improving not only overall glycaemic control but also CV outcomes.
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Affiliation(s)
- David R. Owens
- Diabetes Research Group, Institute of Life Sciences College of MedicineSwansea UniversitySwanseaUK
| | - Louis Monnier
- Laboratory of Human Nutrition and Atherosclerosis, Institute of Clinical ResearchUniversity of MontpellierMontpellierFrance
| | - Markolf Hanefeld
- Study Centre “Professor Hanefeld”GWT‐Technical University DresdenDresdenGermany
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Sáez T, de Vos P, Sobrevia L, Faas MM. Is there a role for exosomes in foetoplacental endothelial dysfunction in gestational diabetes mellitus? Placenta 2017; 61:48-54. [PMID: 29277271 DOI: 10.1016/j.placenta.2017.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/18/2017] [Accepted: 11/13/2017] [Indexed: 01/14/2023]
Abstract
Gestational diabetes mellitus (GDM) is a disease of pregnancy associated with endothelial dysfunction in the foetoplacental vasculature. Foetoplacental endothelial dysfunction is characterized by changes in the l-arginine-adenosine signalling pathway and inflammation. The mechanisms involved in these alterations are suggested to be hyperglycaemia, hyperinsulinemia, and oxidative stress. These conditions increase the release of exosomes, nanovesicles that are generated from diverse cell types, including endothelial cells. Since exosomes can modulate vascular function, they may play an important role in foetoplacental endothelial dysfunction seen in GDM pregnancies. In this review, we summarized current knowledge on the potential role of exosomes in foetoplacental endothelial dysfunction seen in this disease of pregnancy.
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Affiliation(s)
- Tamara Sáez
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Paul de Vos
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Queensland, Australia.
| | - Marijke M Faas
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands; Department of Obstetrics and Gynaecology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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Klimontov VV, Tyan NV, Fazullina ON, Myakina NE, Orlov NB, Konenkov VI. [Acute-phase serum proteins and adipocytokines in women with type 2 diabetes mellitus: Relationships with body composition and blood glucose fluctuations]. TERAPEVT ARKH 2017; 88:35-41. [PMID: 27801417 DOI: 10.17116/terarkh2016881035-41] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM To estimate the relationships between the serum concentrations of acute-phase proteins (APPs) and adipocytokines, body composition (BC), and blood glucose (BG) fluctuations in women with type 2 diabetes mellitus (T2DM). SUBJECTS AND METHODS A total of 165 women with T2DM and 22 with a normal body mass index (BMI) at the age of 40 to 70 years were examined. The concentrations of high-sensitivity C-reactive protein (hs-CRP) and acid α1-glycoprotein (α1-AGP) were determined by ELISA. The levels of interleukins 6, 8, and 18 (IL-6, IL-8, IL-18), tumor necrosis factor-α (TNF-α), and plasminogen activator inhibitor type 1 (PAI-1) were measured by a multiplex analysis. Dual energy X-ray absorptiometry was used to estimate BC parameters. BG fluctuations were estimated via continuous glucose monitoring. RESULTS The levels of hs-CRP, α1-AGP, IL-6, IL-8, IL-18, TNF-α, and PAI-1 were significantly higher in the obese women with T2DM than those in the control group. In the diabetic normal weight women, only hs-CRP, α1-AGP, and IL-8 concentrations exceeded those in the controls. The level of hs-CRP (other than α1-AGP) correlated positively with BMI, the mass of adipose tissue, body trunk (android), and gynoid fats. A multivariate regression analysis showed that adipose tissue mass and trunk fat proportion were independent predictors of hs-CRP levels. The concentrations of IL-6, IL-8, IL-18, PAI-1, and TNF-α correlated positively with waist-to-hip ratio, but demonstrated no associations with BMI and BC. Only the serum α1-AGP level showed a positive association with mean BG and its variability parameters. CONCLUSION In the women with T2DM, the serum concentrations of APPs and adipocytokines correlate differently with the mass of adipose tissue, its distribution, and BG fluctuations. The findings indicate the multifactorial genesis of chronic inflammation in these patients.
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Affiliation(s)
- V V Klimontov
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
| | - N V Tyan
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
| | - O N Fazullina
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
| | - N E Myakina
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
| | - N B Orlov
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
| | - V I Konenkov
- Research Institute of Clinical and Experimental Lymphology, Novosibirsk, Russia
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50
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Hogan MF, Liu AW, Peters MJ, Willard JR, Rabbani Z, Bartholomew EC, Ottley A, Hull RL. Markers of Islet Endothelial Dysfunction Occur in Male B6.BKS(D)-Leprdb/J Mice and May Contribute to Reduced Insulin Release. Endocrinology 2017; 158:293-303. [PMID: 27870582 PMCID: PMC5413084 DOI: 10.1210/en.2016-1393] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022]
Abstract
Islet endothelial cells produce paracrine factors that support β-cell function and growth. Endothelial dysfunction underlies diabetic microvascular complications; thus, we hypothesized that in diabetes, islet endothelial cells become dysfunctional, which may contribute to β-cell secretory dysfunction. Islets/islet endothelial cells were isolated from diabetic B6.BKS(D)-Leprdb/J male (db/db) mice, treated with or without the glucose-lowering agent phlorizin, or from C57BL/6J mice fed a high-fat diet for 18 weeks and appropriate controls. Messenger RNA (mRNA) and/or the protein levels of the cell adhesion molecule E-selectin (Sele), proinflammatory cytokine interleukin-6 (Il6), vasoconstrictor endothelin-1 (Edn1), and endothelial nitric oxide synthase (Nos3; Nos3) were evaluated, along with advanced glycation end product immunoreactivity. Furthermore, an islet endothelial cell line (MS-1) was exposed to diabetic factors (glucose, palmitate, insulin, and tumor necrosis factor-α) for six days. Conditioned media were collected from these cells, incubated with isolated islets, and glucose-stimulated insulin secretion and insulin content were assessed. Islet endothelial cells from db/db mice exhibited increased Sele, Il6, and Edn1 mRNA levels, decreased Nos3 protein, and accumulation of advanced glycation end products. Phlorizin treatment significantly increased Nos3 protein levels but did not alter expression of the other markers. High-fat feeding in C57BL/6J mice resulted in increased islet Sele, Il6, and Edn1 but no change in Nos3. Exposure of islets to conditioned media from MS-1 cells cultured in diabetic conditions resulted in a 50% decrease in glucose-stimulated insulin secretion and 30% decrease in insulin content. These findings demonstrate that, in diabetes, islet endothelial cells show evidence of a dysfunctional phenotype, which may contribute to loss of β-cell function.
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Affiliation(s)
- Meghan F Hogan
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | - Amy W Liu
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | - Michael J Peters
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Joshua R Willard
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Zaheen Rabbani
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | | | - Adam Ottley
- Department of Medicine, University of Washington, Seattle, Washington
| | - Rebecca L Hull
- Division of Metabolism, Endocrinology and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
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