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Wang J, Song X, Xia Z, Feng S, Zhang H, Xu C, Zhang H. Serum biomarkers for predicting microvascular complications of diabetes mellitus. Expert Rev Mol Diagn 2024; 24:703-713. [PMID: 39158206 DOI: 10.1080/14737159.2024.2391021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Diabetic microvascular complications such as retinopathy, nephropathy, and neuropathy are primary causes of blindness, terminal renal failure, and neuropathic disorders in type 2 diabetes mellitus patients. Identifying reliable biomarkers promptly is pivotal for early detection and intervention in these severe complications. AREAS COVERED This review offers a thorough examination of the latest research concerning serum biomarkers for the prediction and assessment of diabetic microvascular complications. It encompasses biomarkers associated with glycation, oxidative stress, inflammation, endothelial dysfunction, basement membrane thickening, angiogenesis, and thrombosis. The review also highlights the potential of emerging biomarkers, such as microRNAs and long non-coding RNAs. EXPERT OPINION Serum biomarkers are emerging as valuable tools for the early assessment and therapeutic guidance of diabetic microvascular complications. The biomarkers identified not only reflect the underlying pathophysiology but also align with the extent of the disease. However, further validation across diverse populations and improvement of the practicality of these biomarkers in routine clinical practice are necessary. Pursuing these objectives is essential to advance early diagnosis, risk assessment, and individualized treatment regimens for those affected by diabetes.
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Affiliation(s)
- Jiajia Wang
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital Chuandong Hospital & Dazhou First People's Hospital, Dazhou, China
| | - Xiaoyi Song
- School of medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ziqiao Xia
- Laboratory medicine, Qianwei People's Hospital, Leshan, Sichuan, China
| | - Shu Feng
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hangfeng Zhang
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chengjie Xu
- Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui Zhang
- Department of Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Kardoust Parizi M, Rouprêt M, Singla N, Teoh JYC, Chlosta P, Babjuk M, Abufaraj M, Margulis V, D'Andrea D, Klemm J, Matsukawa A, Laukhtina E, Fazekas T, Karakiewicz PI, Bhanvadia R, Gontero P, Shariat SF. Preoperative Plasma Insulin-Like Growth Factor-I and Its Binding Proteins-Based Risk Stratification of Patients Treated With Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Clin Genitourin Cancer 2024; 22:102133. [PMID: 38945766 DOI: 10.1016/j.clgc.2024.102133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION We evaluate the predictive and prognostic value of insulin-like growth factor-I (IGF-1), IGF binding protein-2 (IGFBP-2) and -3 (IGFBP-3) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS This is a retrospective analysis of a multi-institutional database comprising 753 patients who underwent RNU for UTUC and had a preoperative plasma available. Logistic and Cox regression analyses were performed. The discriminative ability and clinical utility of the models was calculated using the lasso regression test, area under receiver operating characteristics curves, C-index, and decision curve analysis (DCA). RESULTS Lower preoperative plasma levels of IGFBP-2 and -3 independently correlated with increased risks of lymph node metastasis, pT3/4 disease, nonorgan confined disease, and worse recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) (all P ≤ .004). The addition of both IGFBP-2 and -3 to a postoperative multivariable model, that included standard clinicopathologic characteristics, improved the model's concordance index by 10%, 9%, and 8% for RFS, CSS, and OS, respectively. On DCA, addition of both IGFBP-2 and -3 to base models improved their performance for RFS, CSS, and OS by a statistically and clinically significant margin. Plasma IGF-1 was not associated with any of outcomes. CONCLUSIONS We confirmed that a lower plasma levels of IGFBP-2 and -3 both are independent and clinically significant predictors of adverse pathological features and survival outcomes in UTUC patients treated with RNU. These findings might help guide the clinical decision-making regarding perioperative systemic therapy and follow-up scheduling.
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Affiliation(s)
- Mehdi Kardoust Parizi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morgan Rouprêt
- Department of Urology, Pitié Salpêtrière Hospital, AP-HP, GRC 5, Predictive Onco-Urology, Sorbonne University, Paris, France
| | - Nirmish Singla
- Departement of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD
| | - Jeremy Yuen-Chun Teoh
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University, Cracow, Poland
| | - Marek Babjuk
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Mohammad Abufaraj
- Department of Special Surgery, Division of Urology, The University of Jordan, Amman, Jordan
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jakob Klemm
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Akihiro Matsukawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Tamas Fazekas
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Semmelweis University, Budapest, Hungary
| | - Pierre I Karakiewicz
- Departement of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Raj Bhanvadia
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Paolo Gontero
- Department of Surgical Sciences, Division of Urology, Torino School of Medicine, Turin, Italy
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Special Surgery, Division of Urology, The University of Jordan, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Departments of Urology, Weill Cornell Medical College, New York, NY; Departement of Urology, Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Research Center for Evidence Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Zhou N, Zheng W, Peng L, Gao S, Shi Y, Cao M, Xu Y, Sun B, Li X. HIF1α Elevations at Tissue and Serum Levels and Their Association With Metabolic Disorders in Children With Obesity. J Clin Endocrinol Metab 2024; 109:1241-1249. [PMID: 38051959 DOI: 10.1210/clinem/dgad710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/03/2023] [Accepted: 12/03/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE We aimed to examine the expression profile and circulating level of hypoxia-inducible factor 1 alpha (HIF1α) in children and the relationships with metabolic disorders. METHODS A total of 519 children were recruited, with paired subcutaneous and omental adipose tissues collected from 17 children and serum samples from the remaining children. All children underwent anthropometric and biochemical analyses. The mRNA, protein, and serum levels of HIF1α were determined by real-time PCR, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. RESULTS Both HIF1α mRNA and protein levels, especially in omental adipose tissue, were increased in overweight or obese (OV/OB) children (P < .05). Likewise, serum HIF1α level was remarkably higher in OV/OB children than in normal-weight children (P < .05). Serum HIF1α level was positively correlated with BMI z-score, fat mass percentage, waist to height ratio, systolic blood pressure, alanine aminotransferase, total triglycerides, uric acid, and homeostasis model assessment of insulin resistance (IR). Furthermore, a binary logistic regression analysis of serum HIF1α level indicated that the risks for IR, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome remained significant in the presence of all potential confounding variables. Finally, the area under the receiver operating characteristic curves for serum HIF1α level in children who were diagnosed with IR, NAFLD, and metabolic syndrome were 0.698 (95% CI, 0.646-0.750; P < .001), 0.679 (95% CI, 0.628-0.731; P < .001), and 0.900 (95% CI, 0.856-0.945; P < .001). CONCLUSION HIF1α expression is higher in the adipose tissue, especially omental, of children with obesity than in children with normal weight. Elevated serum HIF1α level is associated with adiposity and metabolic disorder, which may predict a higher risk of obesity complications.
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Affiliation(s)
- Nan Zhou
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Wen Zheng
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Luting Peng
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Shenghu Gao
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Yanan Shi
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Mengyao Cao
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Yao Xu
- Department of Pediatric General Surgery, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Bin Sun
- Department of Pediatric General Surgery, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Xiaonan Li
- Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
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Rentflejsz J, Wojszel ZB. Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers. J Clin Med 2024; 13:1107. [PMID: 38398421 PMCID: PMC10889814 DOI: 10.3390/jcm13041107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers' levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice.
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Affiliation(s)
- Justyna Rentflejsz
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
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Tian F, Yi X, Yang F, Chen Y, Zhu W, Liu P, Li S. Research progress on the treatment of diabetic nephropathy with leech and its active ingredients. Front Endocrinol (Lausanne) 2024; 15:1296843. [PMID: 38344666 PMCID: PMC10853373 DOI: 10.3389/fendo.2024.1296843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Diabetic nephropathy (DN) is a major microvascular complication of diabetes and a common cause of chronic kidney disease. There is currently a lack of effective treatments for DN, and the prognosis for patients remains poor. Hirudin, one of the primary active components derived from leeches, demonstrates anti-coagulant, anti-fibrotic, anti-thrombotic, and anti-inflammatory properties, exhibiting significant protective effects on the kidneys. In recent years, there has been a surge of interest in studying the potential benefits of hirudin, especially in its role in the management of DN. This article delves into the mechanisms by which hirudin contributes to the treatment of DN and its clinical efficacy.
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Affiliation(s)
- Feng Tian
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
| | - Xiang Yi
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
| | - Feifei Yang
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
| | - Yao Chen
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
| | - Wenhui Zhu
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
| | - Peng Liu
- Shunyi Hospital, Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Shuju Li
- Renal Division, Department of Medicine, Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China
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Tshivhase AM, Matsha T, Raghubeer S. Resveratrol attenuates high glucose-induced inflammation and improves glucose metabolism in HepG2 cells. Sci Rep 2024; 14:1106. [PMID: 38212345 PMCID: PMC10784549 DOI: 10.1038/s41598-023-50084-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024] Open
Abstract
Diabetes mellitus (DM) is characterized by impaired glucose and insulin metabolism, resulting in chronic hyperglycemia. Hyperglycemia-induced inflammation is linked to the onset and progression of diabetes. Resveratrol (RES), a polyphenol phytoalexin, is studied in diabetes therapeutics research. This study evaluates the effect of RES on inflammation and glucose metabolism in HepG2 cells exposed to high glucose. Inflammation and glucose metabolism-related genes were investigated using qPCR. Further, inflammatory genes were analyzed by applying ELISA and Bioplex assays. High glucose significantly increases IKK-α, IKB-α, and NF-kB expression compared to controls. Increased NF-kB expression was followed by increased expression of pro-inflammatory cytokines, such as TNF-α, IL-6, IL-β, and COX2. RES treatment significantly reduced the expression of NF-kB, IKK-α, and IKB-α, as well as pro-inflammatory cytokines. High glucose levels reduced the expression of TGFβ1, while treatment with RES increased the expression of TGFβ1. As glucose levels increased, PEPCK expression was reduced, and GCK expression was increased in HepG2 cells treated with RES. Further, HepG2 cells cultured with high glucose showed significant increases in KLF7 and HIF1A but decreased SIRT1. Moreover, RES significantly increased SIRT1 expression and reduced KLF7 and HIF1A expression levels. Our results indicated that RES could attenuate high glucose-induced inflammation and enhance glucose metabolism in HepG2 cells.
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Affiliation(s)
- Abegail Mukhethwa Tshivhase
- SAMRC/CPUT Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, 7535, South Africa
| | - Tandi Matsha
- SAMRC/CPUT Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, 7535, South Africa
- Sefako Makgatho Health Sciences University, Ga-Rankuwa, 0208, South Africa
| | - Shanel Raghubeer
- SAMRC/CPUT Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, 7535, South Africa.
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Sharma JK, Khan S, Wilson T, Pilkey N, Kapuria S, Roy A, Adams MA, Holden RM. Are There Any Pleiotropic Benefits of Vitamin D in Patients With Diabetic Kidney Disease? A Systematic Review of Randomized Controlled Trials. Can J Kidney Health Dis 2023; 10:20543581231212039. [PMID: 38033482 PMCID: PMC10683388 DOI: 10.1177/20543581231212039] [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: 04/24/2023] [Accepted: 10/03/2023] [Indexed: 12/02/2023] Open
Abstract
Background Type 2 diabetes (T2D) and kidney disease are risk factors for vitamin D deficiency. Native forms of vitamin D have a lower risk of hypercalcemia than calcitriol, the active hormone. The enzyme responsible for activating native vitamin D is now known to be expressed throughout the body; therefore, native vitamin D may have clinically relevant effects in many body systems. Objective The objective of this systematic review was to examine the effect of native vitamin D supplementation on clinical outcomes and surrogate laboratory measures in patients with T2D and diabetic kidney disease (DKD). Design Systematic review. Setting Randomized controlled trials (RCTs) conducted in any country. Patients Adults with T2D and DKD receiving supplementation with any form of native vitamin D (eg, ergocalciferol, cholecalciferol, calcifediol). Measurements Clinical outcomes and surrogate clinical and laboratory measures reported in each of the trials were included in this review. Methods The following databases were searched from inception to January 31, 2023: Embase, MEDLINE, Cochrane CENTRAL, Web of Science, ProQuest Dissertations and Theses, and medRxiv. Only RCTs examining supplementation with a native vitamin D form with a control or placebo comparison group were included. We excluded studies reporting only vitamin D status or mineral metabolism parameters, without any other outcomes of clinical relevance or surrogate laboratory measures. Study quality was evaluated using the Cochrane risk-of-bias tool (RoB2). Results were synthesized in summary tables for each type of outcome with the P values from the original studies displayed. Results Nine publications were included, corresponding to 5 separate RCTs (377 participants total). Mean age ranged from 40 to 63. All trials administered vitamin D3. Intervention groups experienced improvements in vitamin D status and a reduction in proteinuria in 4 of the 5 included RCTs. There was a decrease in low-density lipoprotein and total cholesterol in the 2 trials in which they were measured. Improvements in bone mass, flow-mediated dilation, and inflammation were also reported, but each was only measured in 1 RCT. Effects on glucose metabolism, high-density lipoprotein, triglycerides, blood pressure, oxidative stress, and kidney function were mixed. No serious adverse effects were reported. Limitations Limitations include the small number of RCTs and lack of information on the use of drugs that affect measured outcomes (eg, proteinuria-lowering renin-angiotensin-aldosterone system inhibitors and lipid-lowering medication) in most studies. Our study is also limited by the absence of a prestudy protocol and registration. Conclusions Native vitamin D is a safe treatment that improves vitamin D status in patients with DKD. Vitamin D may modify proteinuria and lipid metabolism in DKD, but further well-designed trials that include well-established treatments are necessary. Overall, there is limited evidence for beneficial pleiotropic effects of vitamin D in patients with DKD.
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Affiliation(s)
- Jaya K. Sharma
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Sono Khan
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Tristin Wilson
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Nathan Pilkey
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Sanjana Kapuria
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Angélique Roy
- Bracken Health Sciences Library, Queen’s University, Kingston, ON, Canada
| | - Michael A. Adams
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Rachel M. Holden
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
- Department of Medicine, Queen’s University, Kingston, ON, Canada
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Dean YE, Elawady SS, Shi W, Salem AA, Chotwatanapong A, Ashraf H, Reddi T, Dundi POR, Habash WY, Habash MY, Ahmed S, Samir HM, Elsayed A, Arora A, Arora A, Elsayed A, Mady T, Tanas Y, Hazimeh Y, Alazmy M, Aiash H. Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients. Endocrinol Diabetes Metab 2023; 6:e453. [PMID: 37743677 PMCID: PMC10638614 DOI: 10.1002/edm2.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND AIM Low serum Vitamin D levels have been associated with diabetic nephropathy (DN). Our study aimed to analyse the serum levels of vitamin D in patients suffering from DN and the subsequent changes in serum vitamin D levels as the disease progresses. METHODS PubMed, Embase, SCOPUS and Web of Science were searched using keywords such as '25 hydroxyvitamin D' and 'diabetic nephropathy'. We included observational studies that reported the association between the serum 25 hydroxy vitamin D levels and diabetic nephropathy without restriction to age, gender, and location. R Version 4.1.2 was used to perform the meta-analysis. The continuous outcomes were represented as mean difference (MD) and standard deviation (SD) and dichotomous outcomes as risk ratios (RR) with their 95% confidence interval (CI). RESULTS Twenty-three studies were included in our analysis with 7722 patients. Our analysis revealed that vitamin D was significantly lower in diabetic patients with nephropathy than those without nephropathy (MD: -4.32, 95% CI: 7.91-0.74, p-value = .0228). On comparing diabetic patients suffering from normoalbuminuria, microalbuminuria, or macroalbuminuria, we found a significant difference in serum vitamin D levels across different groups. Normoalbuminuria versus microalbuminuria showed a MD of -1.69 (95% CI: -2.28 to -1.10, p-value = .0002), while microalbuminuria versus macroalbuminuria showed a MD of (3.75, 95% CI: 1.43-6.06, p-value = .0058), proving that serum vitamin D levels keep declining as the disease progresses. Notwithstanding, we detected an insignificant association between Grade 4 and Grade 5 DN (MD: 2.29, 95% CI: -2.69-7.28, p-value = .1862). CONCLUSION Serum Vitamin D levels are lower among DN patients and keep declining as the disease progresses, suggesting its potential benefit as a prognostic marker. However, on reaching the macroalbuminuria stage (Grades 4 and 5), vitamin D is no longer a discriminating factor.
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Affiliation(s)
- Yomna E. Dean
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Sameh Samir Elawady
- Neuro‐endovascular Surgery DepartmentMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Wangpan Shi
- Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | | | | | - Haya Ashraf
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Tharun Reddi
- Arkansas College of Osteopathic MedicineFort SmithArkansasUSA
| | | | | | | | - Safaa Ahmed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Hana M. Samir
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Ahmed Elsayed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | | | | | - Tamer Mady
- International American University, College of MedicineVieux FortSaint Lucia
| | - Yousef Tanas
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Yusef Hazimeh
- Lebanese UniversityBeirutLebanon
- Zahraa Hospital, University Medical CenterBeirutLebanon
| | - Mohamed Alazmy
- Medical director, Dhaman Health Assurance CompanyKuwaitKuwait
| | - Hani Aiash
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
- SUNY Upstate Medical UniversitySyracuseNew YorkUSA
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Gacche RN. Changing landscape of anti-angiogenic therapy: Novel approaches and clinical perspectives. Biochim Biophys Acta Rev Cancer 2023; 1878:189020. [PMID: 37951481 DOI: 10.1016/j.bbcan.2023.189020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
Targeting angiogenesis has remained one of the important aspects in disease biology in general and cancer in particular. Currently (June 2023), over 593 clinical trials have been registered at ClinicalTrials.gov having inference of term 'angiogenesis'. A panel of 14 anti-angiogenic drugs have been approved by FDA for the treatment of variety of cancers and other human ailments. Although the anti-angiogenic therapy (AAT) has gained significant clinical attention as a promising approach in the treatment of various diseases, particularly cancer, however, sizable literature has accumulated in the recent past describing the aggressive nature of tumours after the drug holidays, evolving drug resistance and off-target toxicities. Nevertheless, the emergence of inscrutable compensatory or alternative angiogenic mechanisms is limiting the efficacy of anti-angiogenic drugs and focussing the therapeutic regime as a puzzle of 'Lernaean hydra'. This review offers an overview of recent updates on the efficacy of antiangiogenic therapy and the current clinical performance of aaRTK inhibitors. Additionally, it also explores the changing application landscape of AAT, focusing on its role in diabetic nephropathy, age-related macular degeneration and other neovascular ocular disorders. Combination therapy with antiangiogenic drugs and immune check point inhibitors (ICIs) has emerged as a potential strategy to enhance the therapeutic index of cancer immunotherapy. While clinical studies have demonstrated the clinical efficacy of this approach, they also highlight the complex and sometimes unpredictable adverse events associated with it. Normalizing tumour vasculature has been identified as a key factor in unlocking the full potential of ICIs, thereby providing hope for improved treatment outcomes. The future prospects and challenges of AAT have been described with special reference to integration of technological advances for enhancing its efficacy and applications beyond its discovery.
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Affiliation(s)
- Rajesh N Gacche
- Department of Biotechnology, Savitribai Phule Pune University, Pune 411007, MS, India.
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Gao Q, Jin H, Xu W, Wang Y. Predicting diagnostic gene biomarkers in patients with diabetic kidney disease based on weighted gene co expression network analysis and machine learning algorithms. Medicine (Baltimore) 2023; 102:e35618. [PMID: 37904449 PMCID: PMC10615450 DOI: 10.1097/md.0000000000035618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/21/2023] [Indexed: 11/01/2023] Open
Abstract
The present study was designed to identify potential diagnostic markers for diabetic kidney disease (DKD). Two publicly available gene expression profiles (GSE142153 and GSE30528 datasets) from human DKD and control samples were downloaded from the GEO database. Differentially expressed genes (DEGs) were screened between 23 DKD and 10 control samples using the gene data from GSE142153. Weighted gene co expression network analysis was used to find the modules related to DKD. The overlapping genes of DEGs and Turquoise modules were narrowed down and using the least absolute shrinkage and selection operator regression model and support vector machine-recursive feature elimination analysis to identify candidate biomarkers. The area under the receiver operating characteristic curve value was obtained and used to evaluate discriminatory ability using the gene data from GSE30528. A total of 110 DEGs were obtained: 64 genes were significantly upregulated and 46 genes were significantly downregulated. Weighted gene co expression network analysis found that the turquoise module had the strongest correlation with DKD (R = -0.58, P = 4 × 10-4). Thirty-eight overlapping genes of DEGs and turquoise modules were extracted. The identified DEGs were mainly involved in p53 signaling pathway, HIF-1 signaling pathway, JAK - STAT signaling pathway and FoxO signaling pathway between and the control. C-X-C motif chemokine ligand 3 was identified as diagnostic markers of DKD with an area under the receiver operating characteristic curve of 0.735 (95% CI 0.487-0.932). C-X-C motif chemokine ligand 3 was identified as diagnostic biomarkers of DKD and can provide new insights for future studies on the occurrence and the molecular mechanisms of DKD.
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Affiliation(s)
- Qian Gao
- Affiliated Hospital of Shaoxing University of Edocrine and Metabolism Department, Zhejiang, China
| | - Huawei Jin
- Affiliated Hospital of Shaoxing University of Edocrine and Metabolism Department, Zhejiang, China
| | - Wenfang Xu
- Affiliated Hospital of Shaoxing University of Clinical Laboratory, Zhejiang, China
| | - Yanan Wang
- Affiliated Hospital of Shaoxing University of Clinical Laboratory, Zhejiang, China
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11
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Sharma P, Sri Swetha Victoria V, Praneeth Kumar P, Karmakar S, Swetha M, Reddy A. Cross-talk between insulin resistance and nitrogen species in hypoxia leads to deterioration of tissue and homeostasis. Int Immunopharmacol 2023; 122:110472. [PMID: 37392570 DOI: 10.1016/j.intimp.2023.110472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/19/2023] [Accepted: 06/07/2023] [Indexed: 07/03/2023]
Abstract
Hypoxia has been linked with insulin resistance as it produces changes in the metabolism of the cell; in which the adipocytes impede the insulin receptor tyrosine, phosphorylation, directing at decreased levels of transport of glucose. At this juncture, we are focusing on cross-talk between insulin resistance and nitrogen species in hypoxia, leading to the deterioration of tissue and homeostasis. Physiological levels of nitric oxide play a very crucial role in acting as a priority effector and signaling molecule, arbitrating the body's responses to hypoxia. Both ROS and RNS are associated with a reduction in IRS1 phosphorylation in tyrosine, which leads to reduced levels of IRS1 content and insulin response, which further leads to insulin resistance. Cellular hypoxia is a trigger to inflammatory mediators which signal tissue impairment and initiate survival requirements. But, hypoxia-mediated inflammation act as a protective role by an immune response and promotes wound healing during infection. In this review, we abridge the crosstalk between the inflammation and highlight the dysregulation in physiological consequences due to diabetes mellitus. Finally, we review various treatments available for its related physiological complications.
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Affiliation(s)
- Priyanshy Sharma
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India
| | - V Sri Swetha Victoria
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India
| | - P Praneeth Kumar
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India
| | - Sarbani Karmakar
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India
| | - Mudduluru Swetha
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India
| | - Amala Reddy
- Animal Cell Culture Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nādu, India.
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12
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Violetta L, Kartasasmita AS, Supriyadi R, Rita C. Circulating Biomarkers to Predict Diabetic Retinopathy in Patients with Diabetic Kidney Disease. Vision (Basel) 2023; 7:vision7020034. [PMID: 37092467 PMCID: PMC10123608 DOI: 10.3390/vision7020034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/05/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
The purpose of this review is to outline the currently available circulating biomarkers to predict diabetic retinopathy (DR) in patients with diabetic kidney disease (DKD). Studies have extensively reported the association between DR and DKD, suggesting the presence of common pathways of microangiopathy. The presence of other ocular complications including diabetic cataracts may hinder the detection of retinopathy, which may affect the visual outcome after surgery. Unlike DKD screening, the detection of DR requires complex, costly machines and trained technicians. Recognizing potential biological markers related to glycation and oxidative stress, inflammation and endothelial dysfunction, basement membrane thickening, angiogenesis, and thrombosis as well as novel molecular markers involved in the microangiopathy process may be useful as predictors of retinopathy and identify those at risk of DR progression, especially in cases where retinal visualization becomes a clinical challenge. Further investigations could assist in deciding which biomarkers possess the highest predictive power to predict retinopathy in clinical settings.
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Affiliation(s)
- Laurencia Violetta
- Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta 10410, Indonesia
| | | | - Rudi Supriyadi
- Faculty of Medicine, Universitas Padjajaran, Bandung 40132, Indonesia
| | - Coriejati Rita
- Faculty of Medicine, Universitas Padjajaran, Bandung 40132, Indonesia
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Huang HY, Lin TW, Hong ZX, Lim LM. Vitamin D and Diabetic Kidney Disease. Int J Mol Sci 2023; 24:ijms24043751. [PMID: 36835159 PMCID: PMC9960850 DOI: 10.3390/ijms24043751] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/28/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Vitamin D is a hormone involved in many physiological processes. Its active form, 1,25(OH)2D3, modulates serum calcium-phosphate homeostasis and skeletal homeostasis. A growing body of evidence has demonstrated the renoprotective effects of vitamin D. Vitamin D modulates endothelial function, is associated with podocyte preservation, regulates the renin-angiotensin-aldosterone system, and has anti-inflammatory effects. Diabetic kidney disease (DKD) is a leading cause of end-stage kidney disease worldwide. There are numerous studies supporting vitamin D as a renoprotector, potentially delaying the onset of DKD. This review summarizes the findings of current research on vitamin D and its role in DKD.
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Affiliation(s)
- Ho-Yin Huang
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ting-Wei Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Zi-Xuan Hong
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Lee-Moay Lim
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101-7351; Fax: +886-7-3228721
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14
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Chen X, Zhang X, Gong Z, Yang Y, Zhang X, Wang Q, Wang Y, Xie R. The link between diabetic retinal and renal microvasculopathy is associated with dyslipidemia and upregulated circulating level of cytokines. Front Public Health 2023; 10:1040319. [PMID: 36733289 PMCID: PMC9886881 DOI: 10.3389/fpubh.2022.1040319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose To investigate the mechanisms underlying the correlations between diabetic retinopathy (DR) and diabetic nephropathy (DKD) and examine whether circulating cytokines and dyslipidemia contribute to both DR and DKD in patients with 2 diabetes mellitus (T2DM). Methods A total of 122 patients with T2DM were enrolled and categorized into the DM group (without no DR and DKD), DR group [non-proliferative DR (NPDR), and proliferative DR (PDR)] with no DKD), DR complicated with DKD groups (DR+DKD group). The biochemical profile, including fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and lipid profile were estimated, and plasma inflammatory and angiogenic cytokines [monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF)-A, C, D, and placental growth factor (PlGF)] were analyzed by protein microarrays. The atherogenic plasma index (API) was defined as low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein-cholesterol (HDL-C); atherogenic index (AI) was calculated as [(total cholesterol (TC) -HDL-C)/HDL-C], and atherogenic index of plasma (AIP) was defined as log (TG/HDL-C). Results By multivariable disordered regression analysis, after controlling for duration of DM and hypertension, LDL-C (p = 0.019) and VEGF-D (p = 0.029) resulted as independent risk factors for DR. Albumin-to-creatinine ratio (uACR) (p = 0.003) was an independent risk factor for DR with DKD. In DR, NPDR, and PDR groups, grades of A1, A2, and A3 of albuminuria increased with the severity of DR. In A1, A2, and A3 grade groups, the severity of DR (DM, NPDR, and PDR) increased with higher albuminuria grades. Kendall's tau-b correlation coefficient analysis revealed that FBG (p = 0.019), circulating level of PlGF (p = 0.002), and VEGF-D (p = 0.008) were significantly positively correlated with the grades of uACR (p < 0.001), and uACR grades were significantly correlated with DR severity (p < 0.001). Conclusions The occurrence and severity of DR are closely correlated with kidney dysfunction. Among the three kidney functional parameters, uACR resulted as the better indicator of DR severity and progression than glomerular filtration (eGFR) and serum creatinine (Scr). Impaired FBG was associated with microalbuminuria, emphasizing that well-controlled FBG is important for both DR and DKD. The link between diabetic retinal and renal microvasculopathy was associated with dyslipidemia and upregulated circulating level of angiogenic cytokines.
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Affiliation(s)
- Xiaosi Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China
| | - Xinyuan Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China,*Correspondence: Xinyuan Zhang ✉
| | - Zhizhong Gong
- Division of Medical Affairs, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yang Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China
| | - Xiaohong Zhang
- Clinical Laboratory of Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qiyun Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, School of Basic Medicine, Peking Union Medical College, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China
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15
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Kassab HS, Morsy EY, Abdirahman AN, Amin NG. Study of the relation between plasma level of von Willebrand factor and diabetic retinopathy in type 2 diabetes. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Purpose
Diabetic retinopathy (DR) is a major preventable health complication of type 2 diabetes (T2DM). Hyperglycemia represents the main mechanism in the pathogenesis of DR leading eventually to endothelial dysfunction. vWF is a marker of endothelial dysfunction, but its relation to DR is not yet well-established.
Methods
The present study included 60 patients with T2DM divided into three equal groups according to the presence and the stage of retinopathy. Each patient was subjected to full history taking, physical examination including fundus examination, and laboratory investigations including glycemic and lipid profile, urinary albumin to creatinine ratio (UACR), and plasma vWF level.
Results
Plasma vWF was significantly higher in patients with DR than in patients without retinopathy. vWF was positively correlated to age, HbA1c, diabetes duration, and UACR in DR groups and the total sample. Univariate regression analysis revealed that HbA1c, vWF, BMI, diabetes duration, and UACR were independent risk factors for DR, while multivariate regression analysis showed none of them to be an independent risk factor for DR. A vWF cut-off value of > 180 could differentiate patients with DR from patients without DR with a sensitivity of 97.5%, specificity of 75%, and AUC 0.937*.
Conclusions
vWF level is higher in patients with DR reflecting the role of endothelial dysfunction in the development of DR. Moreover, it is one of the risk factors affecting DR in univariate but not in multivariate analysis. A cut-off value of vWF level was set to differentiate between patients with and without DR.
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16
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Shobatake R, Ota H, Takahashi N, Ueno S, Sugie K, Takasawa S. The Impact of Intermittent Hypoxia on Metabolism and Cognition. Int J Mol Sci 2022; 23:12957. [PMID: 36361741 PMCID: PMC9654766 DOI: 10.3390/ijms232112957] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/15/2022] [Accepted: 10/23/2022] [Indexed: 11/29/2022] Open
Abstract
Intermittent hypoxia (IH), one of the primary pathologies of sleep apnea syndrome (SAS), exposes cells throughout the body to repeated cycles of hypoxia/normoxia that result in oxidative stress and systemic inflammation. Since SAS is epidemiologically strongly correlated with type 2 diabetes/insulin resistance, obesity, hypertension, and dyslipidemia included in metabolic syndrome, the effects of IH on gene expression in the corresponding cells of each organ have been studied intensively to clarify the molecular mechanism of the association between SAS and metabolic syndrome. Dementia has recently been recognized as a serious health problem due to its increasing incidence, and a large body of evidence has shown its strong correlation with SAS and metabolic disorders. In this narrative review, we first outline the effects of IH on the expression of genes related to metabolism in neuronal cells, pancreatic β cells, hepatocytes, adipocytes, myocytes, and renal cells (mainly based on the results of our experiments). Next, we discuss the literature regarding the mechanisms by which metabolic disorders and IH develop dementia to understand how IH directly and indirectly leads to the development of dementia.
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Affiliation(s)
- Ryogo Shobatake
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
- Department of Neurology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara 630-8305, Japan
- Department of Biochemistry, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan
| | - Hiroyo Ota
- Department Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
| | - Nobuyuki Takahashi
- Department of Neurology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara 630-8305, Japan
| | - Satoshi Ueno
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan
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17
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Guo R, Wang P, Zheng X, Cui W, Shang J, Zhao Z. SGLT2 inhibitors suppress epithelial-mesenchymal transition in podocytes under diabetic conditions via downregulating the IGF1R/PI3K pathway. Front Pharmacol 2022; 13:897167. [PMID: 36225569 PMCID: PMC9550168 DOI: 10.3389/fphar.2022.897167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
Loss of podocyte is a characteristic pathological change of diabetic nephropathy (DN) which is associated with increased proteinuria. Many studies have shown that novel inhibitors of sodium-glucose cotransporter 2 (SGLT2-is), such as dapagliflozin, exert nephroprotective effect on delaying DN progression. However, the mechanisms underlying SGLT2-associated podocyte injury are still not fully elucidated. Here, we generated streptozotocin-induced DN models and treated them with dapagliflozin to explore the possible mechanisms underlying SGLT2 regulation. Compared to mice with DN, dapagliflozin-treated mice exhibited remission of pathological lesions, including glomerular sclerosis, thickening of the glomerular basement membrane (GBM), podocyte injury in the glomeruli, and decreased nephrotoxin levels accompanied by decreased SGLT2 expression. The mRNA expression profiles of these treated mice revealed the significance of the insulin-like growth factor-1 receptor (IGF1R)/PI3K regulatory axis in glomerular injury. KEGG analysis confirmed that the phosphatidylinositol signaling system and insulin signaling pathway were enriched. Western blotting showed that SGLT2-is inhibited the increase of mesenchymal markers (α-SMA, SNAI-1, and ZEB2) and the loss of podocyte markers (nephrin and E-cad). Additionally, SGLT2, IGF1R, phosphorylated PI3K, α-SMA, SNAI-1, and ZEB2 protein levels were increased in high glucose-stimulated human podocytes (HPC) and significantly decreased in dapagliflozin-treated (50 nM and 100 nM) or OSI-906-treated (inhibitor of IGF1R, 60 nM) groups. However, the use of both inhibitors did not enhance this protective effect. Next, we analyzed urine and plasma samples from a cohort consisting of 13 healthy people and 19 DN patients who were administered with (n = 9) or without (n = 10) SGLT2 inhibitors. ELISA results showed decreased circulating levels of IGF1 and IGF2 in SGLT2-is-treated DN patients compared with DN patients. Taken together, our study reported the key role of SGLT2/IGF1R/PI3K signaling in regulating podocyte epithelial-mesenchymal transition (EMT). Modulating IGF1R expression may be a novel approach for DN therapy.
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Affiliation(s)
- Ruixue Guo
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Zhengzhou University, Zhengzhou, China
| | - Peipei Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Zhengzhou University, Zhengzhou, China
| | - Xuejun Zheng
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Zhengzhou University, Zhengzhou, China
| | - Wen Cui
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Zhengzhou University, Zhengzhou, China
| | - Jin Shang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Laboratory of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Laboratory Animal Platform of Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China,*Correspondence: Zhanzheng Zhao, ; Jin Shang,
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Laboratory of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Laboratory Animal Platform of Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China,*Correspondence: Zhanzheng Zhao, ; Jin Shang,
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18
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Zhao T, Li M, Xiang Q, Lie B, Chen D, Wang W, Li X, Xu T, Zhang X, Li Y, Dong R, Du X, Wang Y, Yang J, He B, Zhu Q, Duan T, Li Z, Xu Y. Yishen Huashi Granules Ameliorated the Development of Diabetic Nephropathy by Reducing the Damage of Glomerular Filtration Barrier. Front Pharmacol 2022; 13:872940. [PMID: 35935814 PMCID: PMC9353776 DOI: 10.3389/fphar.2022.872940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 02/03/2023] Open
Abstract
Background: Diabetic nephropathy (DN) is one of the most common complications of diabetes and the primary cause of end-stage renal disease. At present, renin–angiotensin–aldosterone system (RAAS) blockers have been applied as first-class drugs to restrain development of DN; however, its long-term effect is limited. Recent evidence has shown definite effects of Chinese medicine on DN. Yishen Huashi (YSHS) granule is a traditional Chinese Medicine prescription that has been used in the clinic to treat DN, but its mechanism is not understood. Methods: In the present study, both in vitro and in vivo studies were carried out. The DN model was induced by STZ in Wistar rats, and GEnC and HPC cell lines were applied in the in vitro study. Quality of YSHS was evaluated by LC-MS/MS. A metabolomic study of urine was carried out by LC-MS; influence of YSHS on composition of DN was analyzed by network pharmacology. Mechanism of the YSHS on DN was analyzed by Q-PCR, Western Blot, and multi-immunological methods. Results: We found YSHS administration significantly reduced levels of HbA1c and mALB. Histopathological analysis found that YSHS preserved integrity of glomerular filtration barrier by preserving viability of glomerular endothelial cells and podocytes, inhibiting glomerular fibrosis, reducing oxidative stress damage, and enhancing cross-talk among glomerular endothelial cells and podocytes. Network pharmacology, differential metabolite analysis, as well as intracellular pathway experimental study demonstrated that the PI3K/AKT/mTOR signaling pathway played a pivotal role in it. Conclusion: Our present findings supplied new understanding toward the mechanism of YSHS on inhibiting DN.
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Affiliation(s)
- Tingting Zhao
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Minyi Li
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Qian Xiang
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Beifeng Lie
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Deqi Chen
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Weiming Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Xuling Li
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Tiancheng Xu
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Xi Zhang
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Yuntong Li
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Ruixue Dong
- State Key Laboratory of Quality Research in Chinese Medicines, School of Pharmacy, Macau University of Science and Technology, Macao, China
| | - Xinwen Du
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Yilin Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
- Department of Endocrinology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Junzheng Yang
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Bao He
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Quan Zhu
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
| | - Tingting Duan
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
- *Correspondence: Tingting Duan, ; Zhenghai Li, ; Youhua Xu,
| | - Zhenghai Li
- Institute of Consun Co., for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, Guangzhou, China
- *Correspondence: Tingting Duan, ; Zhenghai Li, ; Youhua Xu,
| | - Youhua Xu
- State Key Laboratory of Quality Research in Chinese Medicines, Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
- State Key Laboratory of Quality Research in Chinese Medicines, School of Pharmacy, Macau University of Science and Technology, Macao, China
- Department of Endocrinology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
- Macau University of Science and Technology Zhuhai MUST Science and Technology Research Institute, Zhuhai, China
- *Correspondence: Tingting Duan, ; Zhenghai Li, ; Youhua Xu,
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Alsharidah AS. Diabetes mellitus and diabetic nephropathy: a review of the literature on hemostatic changes in coagulation and thrombosis. Blood Res 2022; 57:101-105. [PMID: 35620906 PMCID: PMC9242838 DOI: 10.5045/br.2022.2021204] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Vascular complications lead to morbidity and mortality in patients with diabetes. Diabetic nephropathy (DN) is one of the main life-threatening problems for these patients, as it is the main cause of end-stage renal disease. This study aimed to measure the clinical effects of diabetes in patients with diabetes and in patients with diabetic nephropathy. Improved hypoglycemic control in patients with diabetes could impressively reduce platelet hyperreactivity, and oxidative stress alters the levels of many coagulation and thrombosis factors, resulting in an abnormal hemostasis and impaired levels of numerous serum markers. Most studies have revealed that coagulation factor levels are high in patients with diabetes and nephrodiabetes. Serum inflammatory factors, and coagulation and endothelial functions are good predictors of diabetic nephropathy. This literature review was conducted with access to scholarly databases and Google Scholar through Qassim University, and it analyzes studies from early 2010 until November 2020. Many studies have inferred that diabetes severely affects hemostasis and increases the risk of cardiovascular disease.
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Affiliation(s)
- Ashwag S Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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Liu Q, Sun J, Xu T, Bian G, Yang F. Associations of serum amyloid A and 25-hydroxyvitamin D with diabetic nephropathy: A cross-sectional study. J Clin Lab Anal 2022; 36:e24283. [PMID: 35133014 PMCID: PMC8906018 DOI: 10.1002/jcla.24283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The present study investigated the relationships between serum amyloid A (SAA), 25-hydroxyvitamin D (25(OH)VD) and diabetic nephropathy (DN) to provide evidence for the prevention and management of DN. METHODS A total of 182 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. The levels of SAA, 25(OH)VD, and other conventional indicators were measured and analyzed. Receiver operating characteristic curve analysis was applied for the combined measurement of SAA and 25(OH)VD, and risk factors for DN were evaluated using binary logistic regression analysis. RESULTS The levels of SAA in T2DM patients were significantly higher than those in healthy subjects, and the level significantly increased with the progression of DN (p < 0.05). In contrast, the level of 25(OH)VD in T2DM patients was significantly lower than that in healthy subjects, and the level significantly decreased with the progression of DN (p < 0.05). The combined measurement of SAA and 25(OH)VD distinguished DN patients from T2DM patients better than the measurement of SAA or 25(OH)VD alone. SAA was an independent risk factor for DN, and 25(OH)VD was an independent protective factor for DN. CONCLUSION SAA and 25(OH)VD might be used as potential markers to identify patients at increased risk of developing DN.
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Affiliation(s)
- Qian Liu
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Jin Sun
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Tongdao Xu
- Department of Endocrinology, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Guangrong Bian
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Fumeng Yang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
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The Role of Vitamin D in Diabetic Nephropathy: A Translational Approach. Int J Mol Sci 2022; 23:ijms23020807. [PMID: 35054991 PMCID: PMC8775873 DOI: 10.3390/ijms23020807] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 12/29/2022] Open
Abstract
According to several animal and human studies, vitamin D appears to play a significant role in the development of diabetic nephropathy. However, the possible renoprotective effect of vitamin D and its influence on the reversal of already existing renal damage remains doubtful. At this moment, there are a few hypotheses concerning the underlying molecular and genetic mechanisms including the link between vitamin D and inflammation, oxidative stress, and extracellular matrix accumulation. The present review aims to investigate the potential role of vitamin D in the development of diabetic kidney disease from a translational approach.
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Huang B, Wen W, Ye S. Correlation Between Serum 25-Hydroxyvitamin D Levels in Albuminuria Progression of Diabetic Kidney Disease and Underlying Mechanisms By Bioinformatics Analysis. Front Endocrinol (Lausanne) 2022; 13:880930. [PMID: 35634488 PMCID: PMC9133500 DOI: 10.3389/fendo.2022.880930] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/11/2022] [Indexed: 01/07/2023] Open
Abstract
AIM This study aimed to assess the correlation between serum concentration of 25-hydroxyvitamin D and albuminuria progression of diabetic kidney disease (DKD) and to use bioinformatics methods to determine the potential mechanism in the pathological process of advanced DKD. METHODS A total of 178 type 1 diabetes mellitus (T1DM) patients with microalbuminuria complications who were hospitalized at least twice (with an interval > 24 months) in the Department of Endocrinology of The First Affiliated Hospital of USTC were included in this study. According to the urinary albumin creatinine ratio (UACR), we classified DKD stages as follows: microalbuminuria (UACR, 30-300 mg/g), and macroalbuminuria (UACR, >300 mg/g). We divided the patients into DKD progression (N=44) and stable group (N=134) on account of urinary albumin-to-creatinine ratio (UACR) by at least two randomized measurements. Stable group was defined as UACR between 30 and 300 mg/g, whereas progression group was defined as UACR >300 mg/g at the end of follow-up. Data were obtained from participants' medical records, and the 25-hydroxyvitamin D level was categorized into three groups as follows: G1 (N=45), <10 ng/mL; G2 (N=80), 10-20 ng/ml; and G3 (N=53), ≥20 ng/mL. The Nephroseq database (http://v5.nephroseq.org) was used to identify VDR expression in diabetic nephropathy. The dataset GSE142025 from GEO (http://www.ncbi.nlm.nih.gov/geo) was downloaded. After stratification by the median-centered log2 VDR expression value, the 21 advanced DKD samples were divided into two groups (low VDR expression group and high VDR expression group). Gene set enrichment analysis (GSEA) (http://software.broadinstitute.org/gsea/index.jsp). Differentially expressed genes (DEGs) were screened by the limma package (adjusted p < 0.05, |logFC| > 1). The Gene Ontology (GO; http://www.geneontology.org/) database and pathway analysis within the Kyoto Encyclopedia of Genes and Genomes (KEGG; https://www.kegg.jp/) were performed using the R package ClusterProfile. The CIBERSORT (Cell type Identification By Estimating Relative Subsets Of known RNA Transcripts) algorithm was utilized for calculating the infiltrated immune cells in advanced kidney tissues. RESULTS 1) A multivariate Cox regression analysis revealed that DR (diabetic retinopathy), eGFR (estimated glomerular filtration rate), and 25-hydroxyvitamin D were significant independent predictors of DKD progression (HR: 2.57, 95% CI: 1.44.4.24, p=0.007; HR: 2.13, 95% CI: 1.58.3.79, p = 0.011; HR: 0.732, 95% CI: 0.232-0.816, p = 0.023, respectively). 2) Kaplan-Meier survival curves of DKD progression by serum 25-hydroxyvitamin D stratification showed that the G2 and G3 groups were significantly different when compared with the G1 group (log-rank χ2 = 14.69, p <0.001; χ2 = 28.26, p <0.001, respectively). 3) There was a weak negative correlation between 25-hydroxyvitamin D level and UACR at baseline,and the overall mean rate of change in eGFR was 1.121 ± 0.19 ml/min/1.73 m2/year. Neither crude nor adjusted rate of decline in eGFR was significantly different among patients classified according to baseline serum 25-hydroxyvitamin D levels (all p<0.05). 4) The high expression of VDR group was most positively correlated with enriched gene sets like reactome innate immune system and reactome G alpha I signaling events when compared with the low expression of VDR group. 5) The CIBERSORT algorithm showed decreased M2 macrophage infiltration in advanced kidneys in comparison to low VDR expression and high VDR expression. CONCLUSION This study concluded that low 25-hydroxyvitamin D levels can predict an increased risk of DKD albuminuria progression and eGFR decline. Decreased M2 macrophage infiltration may be a potential mechanism involved in this pathogenesis.
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Affiliation(s)
- Bin Huang
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
| | - Wenjie Wen
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shandong Ye
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Shandong Ye,
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Shobatake R, Ota H, Takahashi N, Ueno S, Sugie K, Takasawa S. Anorexigenic Effects of Intermittent Hypoxia on the Gut-Brain Axis in Sleep Apnea Syndrome. Int J Mol Sci 2021; 23:364. [PMID: 35008784 PMCID: PMC8745445 DOI: 10.3390/ijms23010364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/07/2023] Open
Abstract
Sleep apnea syndrome (SAS) is a breathing disorder characterized by recurrent episodes of upper-airway collapse, resulting in intermittent hypoxia (IH) during sleep. Experimental studies with animals and cellular models have indicated that IH leads to attenuation of glucose-induced insulin secretion from pancreatic β cells and to enhancement of insulin resistance in peripheral tissues and cells, such as the liver (hepatocytes), adipose tissue (adipocytes), and skeletal muscles (myocytes), both of which could lead to obesity. Although obesity is widely recognized as a major factor in SAS, it is controversial whether the development of SAS could contribute directly to obesity, and the effect of IH on the expression of appetite regulatory genes remains elusive. Appetite is regulated appropriately by both the hypothalamus and the gut as a gut-brain axis driven by differential neural and hormonal signals. In this review, we summarized the recent epidemiological findings on the relationship between SAS and feeding behavior and focused on the anorexigenic effects of IH on the gut-brain axis by the IH-induced up-regulation of proopiomelanocortin and cocaine- and amphetamine-regulated transcript in neuronal cells and the IH-induced up-regulation of peptide YY, glucagon-like peptide-1 and neurotensin in enteroendocrine cells and their molecular mechanisms.
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Affiliation(s)
- Ryogo Shobatake
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan; (S.U.); (K.S.)
- Department of Neurology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara 630-8305, Japan;
- Department of Biochemistry, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan;
| | - Hiroyo Ota
- Department Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan;
| | - Nobuyuki Takahashi
- Department of Neurology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara 630-8305, Japan;
| | - Satoshi Ueno
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan; (S.U.); (K.S.)
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan; (S.U.); (K.S.)
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan;
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Liu Q, Wang M, Xu T, Liang W, Yang F. Significance of serum miR-29a in the occurrence and progression of diabetic nephropathy: A cross-sectional study. J Clin Lab Anal 2021; 36:e24210. [PMID: 34964177 PMCID: PMC8842137 DOI: 10.1002/jcla.24210] [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: 10/21/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Diabetic nephropathy (DN), a common microvascular complication of type 2 diabetes mellitus (T2DM), is an important factor causing chronic kidney disease. However, the relationship between miR-29a and DN remains unknown. Therefore, a cross-sectional study was conducted to identify a potential molecular biomarker for DN prevention and management by detecting the serum miR-29a levels. METHODS The serum miR-29a levels were measured in 360 subjects (180 T2DM patients and 180 healthy controls) using quantitative reverse transcription PCR (qRT-PCR), and other conventional indicators were measured and analysed. A binary logistic regression was used to evaluate the DN risk factors; a receiver operating characteristic (ROC) curve was applied to analyse the diagnostic efficacy of miR-29a for DN, and a Spearman's rank correlation analysis was used to evaluate the correlation between serum miR-29a and cystatin C. RESULTS The serum miR-29 levels in the T2DM patients were higher than those in the healthy subjects and significantly increased with the progression of DN (p < 0.05). Serum miR-29a and cystatin C are independent predictors of the occurrence of DN. Compared with a single indicator, the combination of serum miR-29a and cystatin C has better DN diagnostic performance. In addition, the serum miR-29a levels were positively correlated with cystatin C in the patients with DN (r = 0.521, p < 0.001). CONCLUSION The expression of serum miR-29a was significantly associated with the occurrence and progression of DN and is expected to become a potential biomarker for the diagnosis of DN.
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Affiliation(s)
- Qian Liu
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China.,Department of Laboratory Medicine, Lianyungang Hospital Affiliated to Jiangsu University, Lianyungang, China
| | - Menglin Wang
- Department of Laboratory Medicine, Suqian First Hospital, Suqian, China
| | - Tongdao Xu
- Department of Endocrinology, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Wei Liang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China.,Department of Laboratory Medicine, Lianyungang Hospital Affiliated to Jiangsu University, Lianyungang, China
| | - Fumeng Yang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China.,Department of Laboratory Medicine, Lianyungang Hospital Affiliated to Jiangsu University, Lianyungang, China
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Araki T, Sangtian J, Ruanpeng D, Tummala R, Clark B, Burmeister L, Peterson D, Venteicher AS, Kawakami Y. Acute elevation of interleukin 6 and matrix metalloproteinase 9 during the onset of pituitary apoplexy in Cushing's disease. Pituitary 2021; 24:859-866. [PMID: 34041660 PMCID: PMC8551006 DOI: 10.1007/s11102-021-01157-0] [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] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Pituitary apoplexy is a rare endocrine emergency. The purpose of this study is to characterize physiological changes involved in pituitary apoplexy, especially during the acute phase. METHODS A Cushing's disease patient experienced corticotroph releasing hormone (CRH)-induced pituitary apoplexy during inferior petrosal sinus sampling (IPSS). The IPSS blood samples from the Cushing's disease patient were retrospectively analyzed for cytokine markers. For comparison, we also analyzed cytokine markers in blood samples from two pituitary ACTH-secreting microadenoma patients and one patient with an ectopic ACTH-secreting tumor. RESULTS Acute elevation of interleukin 6 (IL-6) and matrix metalloproteinase 9 (MMP9) was observed in the IPSS blood sample on the apoplectic hemorrhagic site of the tumor. In contrast, such a change was not observed in the blood samples from the contralateral side of the apoplexy patient and in other IPSS samples from two non-apoplexy Cushing's disease patient and a patient with ectopic Cushing's syndrome. CONCLUSION IL-6 and MMP9 may be involved in the acute process of pituitary apoplexy in Cushing's disease.
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Affiliation(s)
- Takako Araki
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA.
| | - Jutarat Sangtian
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA
| | - Darin Ruanpeng
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA
| | - Ramachandra Tummala
- Department of Neurosurgery, University of Minnesota, 500 SE Harvard St., Minneapolis, MN, 55455, USA
| | - Brent Clark
- Department of Laboratory Medicine and Pathology, University of Minnesota, 500 SE Harvard St., Minneapolis, MN, 55455, USA
| | - Lynn Burmeister
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, 516 Delaware Street, SE, Minneapolis, MN, 55455, USA
| | - Daniel Peterson
- Special Chemistry Laboratory, University of Minnesota Fairview Clinic, 500 SE Harvard St., Minneapolis, MN, 55455, USA
| | - Andrew S Venteicher
- Department of Neurosurgery, University of Minnesota, 500 SE Harvard St., Minneapolis, MN, 55455, USA
| | - Yasuhiko Kawakami
- Department of Genetics, Cell Biology and Development, University of Minnesota, 321 Church St. SE., 6-160 Jackson Hall, Minneapolis, MN, 55455, USA
- Stem Cell Institute, University of Minnesota, 2001 6th Street SE, Minneapolis, MN, 55455, USA
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Saccharin and Sucralose Protect the Glomerular Microvasculature In Vitro against VEGF-Induced Permeability. Nutrients 2021; 13:nu13082746. [PMID: 34444906 PMCID: PMC8401733 DOI: 10.3390/nu13082746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetic kidney disease (DKD) has become a global health concern, with about 40% of people living with type 1 and type 2 diabetes mellitus developing DKD. Upregulation of vascular endothelial growth factor (VEGF) in the kidney is a significant pathology of DKD associated with increased glomerular vascular permeability. To date, however, current anti-VEGF therapies have demonstrated limited success in treating DKD. Recent studies have shown that artificial sweeteners exhibit anti-VEGF potential. The aim of this study was therefore to assess the effects of aspartame, saccharin, and sucralose on VEGF-induced leak using an in vitro model of the glomerular endothelium. Saccharin and sucralose but not aspartame protected against VEGF-induced permeability. Whilst the sweeteners had no effect on traditional VEGF signalling, GC-MS analysis demonstrated that the sweetener sucralose was not able to enter the glomerular endothelial cell to exert the protective effect. Chemical and molecular inhibition studies demonstrated that sweetener-mediated protection of the glomerular endothelium against VEGF is dependent on the sweet taste receptor, T1R3. These studies demonstrate the potential for sweeteners to exert a protective effect against VEGF-induced increased permeability to maintain a healthy endothelium and protect against vascular leak in the glomerulus in settings of DKD.
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Al-Ishaq RK, Kubatka P, Brozmanova M, Gazdikova K, Caprnda M, Büsselberg D. Health implication of vitamin D on the cardiovascular and the renal system. Arch Physiol Biochem 2021; 127:195-209. [PMID: 31291127 DOI: 10.1080/13813455.2019.1628064] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vitamin D regulates the calcium and phosphorus balance in the body. The activated form of vitamin D (1 α,25-dihydroxyvitamin D) binds to vitamin D receptor which regulates genes that control cell proliferation, differentiation and apoptosis. In the cardiovascular system, the vitamin D receptor is present in cardiomyocytes and the arterial wall. A clear correlation between vitamin D level and cardiovascular diseases is established. Vitamin D deficiency affects the renin-angiotensin system leading to ventricular hypertrophy and eventually to stroke. While clinical trials highlighted the positive effects of vitamin D supplements on cardiovascular disease these still need to be confirmed. This review outlines the association between vitamin D and cardiovascular and renal disease summarising the experimental data of selective cardiovascular disorders.
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Affiliation(s)
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
- Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University, in Bratislava, Martin, Slovakia
| | - Martina Brozmanova
- Department of Pathophysiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
- Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University, in Bratislava, Martin, Slovakia
| | - Katarina Gazdikova
- Department of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, Bratislava, Slovak
- Department of General Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovak
| | - Martin Caprnda
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Dietrich Büsselberg
- Department of Physiology and Biophysics, Weill Cornell College of Medicine, Doha, Qatar
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Tao QR, Chu YM, Wei L, Tu C, Han YY. Antiangiogenic therapy in diabetic nephropathy: A double‑edged sword (Review). Mol Med Rep 2021; 23:260. [PMID: 33655322 PMCID: PMC7893700 DOI: 10.3892/mmr.2021.11899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes and the associated complications are becoming a serious global threat and an increasing burden to human health and the healthcare systems. Diabetic nephropathy (DN) is the primary cause of end-stage kidney disease. Abnormal angiogenesis is well established to be implicated in the morphology and pathophysiology of DN. Factors that promote or inhibit angiogenesis serve an important role in DN. In the present review, the current issues associated with the vascular disease in DN are highlighted, and the challenges in the development of treatments are discussed.
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Affiliation(s)
- Qian-Ru Tao
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Ying-Ming Chu
- Department of Integrated Traditional Chinese Medicine, Peking University First Hospital, Beijing 100034, P.R. China
| | - Lan Wei
- Department of Internal Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Chao Tu
- Department of Internal Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
| | - Yuan-Yuan Han
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, Yunnan 650118, P.R. China
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Probe into the Target and Mechanism of Jianpi Xiaoke Prescription for Treating Type 2 Diabetes Mellitus through miRNA Expression Profiling. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2020:7370350. [PMID: 33456489 PMCID: PMC7785360 DOI: 10.1155/2020/7370350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/24/2020] [Accepted: 12/05/2020] [Indexed: 02/07/2023]
Abstract
Methods Ten of the 31 SPF male Wistar rats were randomly taken as the control group; the remaining rats were fed a high-sugar and high-fat diet, combined with Streptozotocin (STZ, 35 mg/kg) that induced a type 2 diabetes model. The model rats were randomly divided into model groups (n = 11) and the JPXK group (n = 10). After 8 weeks of JPXK intervention, we detected the function of islet cells through HE staining and ELISA. High-pass sequencing technology was adopted to identify the differential expression of miRNA to explore the target of JPXK treatment, assess the relevant target genes, conduct functional analysis, and lastly verify the sequencing data by qRT-PCR. Results After treatment, FPG, FINS, and HOMA-IR levels of the treatment group improved significantly compared with those of the control group (P < 0.05). Among the miRNAs differentially expressed between the model group and the control group, there were 7 reversals after JPXK treatment, including miR-1-3p, miR-135a-5p, miR-181d-5p, miR-206-3p, miR-215, miR-3473, and miR-547-3p (log2FC ≥ 1 or ≤ -1, P < 0.05). Besides, the 1810 target genes associated with these 7 miRNAs were assessed by multiMiR. According to the results of the GO and KEGG analyses, they were associated with biological processes (e.g., glucose transport and fat cell formation), and it covered multiple signaling pathways, capable of regulating islet cell function (e.g., MAPK, PI3K-Akt, Ras, AMPK, and HIF-1 signaling pathways). The PCR verification results were consistent with the sequencing results. Conclusion This discovery interpreted the potential therapeutic targets and signaling pathways of JPXK prescription against T2DM based on miRNA expression profiling. In conclusion, our research provided novel research insights into traditional Chinese medicine (TCM) treatment of diabetes.
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Kim SY, Kim M, Oh Y, Lee DY. Relationship of Serum Total Insulin-Like Growth Factor Binding Protein-3 with Insulin-Like Growth Factor-I and Glucose Tolerance in Korean Children and Adolescents. Int J Endocrinol 2021; 2021:9966114. [PMID: 34239560 PMCID: PMC8241499 DOI: 10.1155/2021/9966114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022] Open
Abstract
Insulin is important in glucose metabolism. However, insulin-like growth factor binding protein (IGFBP) also plays an important role in glucose homeostasis, although the IGF-independent role of IGFBP-3 in the glucose intolerance state is poorly understood. We investigated the relationship of serum IGF-I with total IGFBP-3 levels and glucose tolerance in Korean children and adolescents who underwent the oral glucose tolerance test (OGTT). A total of 187 children without known diabetes underwent OGTT, and data related to their clinical and laboratory parameters were collected. Serum IGF-I and total IGFBP-3 levels, fasting plasma glucose levels, lipid profiles, insulin levels, C-peptide levels, homeostasis model assessment of insulin resistance (HOMA-IR) index, and glycated hemoglobin (HbA1c) levels were measured. Serum IGF-I and total IGFBP-3 levels were significantly higher in individuals with impaired glucose tolerance and type 2 diabetes (DM) than in those with normal glucose tolerance (NGT) (P < 0.05). Serum IGF-I and IGFBP-3 levels were correlated with age, HbA1c, C-peptide, insulin, and HOMA-IR in the NGT group. However, these relationships were altered in patients with glucose intolerance, especially in those with DM. In the DM group, serum IGF-I and total IGFBP-3 levels were positively correlated with fasting plasma glucose and HbA1c levels. In addition, total IGFBP-3 levels were positively correlated with total cholesterol and low-density lipoprotein cholesterol and IGF-I levels but not with age or body mass index. The IGF-I-IGFBP-3 axis, especially IGFBP-3, may be involved in the pathogenesis and metabolic control of glucose intolerance, specifically in diabetes patients. Moreover, IGFBP-3 might be a therapeutic marker.
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Affiliation(s)
- Sun-Young Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Minsun Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
- Department of Pediatrics, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
| | - Youngman Oh
- Department of Pathology, School of Medicine Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Dae-Yeol Lee
- Department of Pediatrics, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
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Vitamin D(3) regulates hepatic VEGF-A and apelin expression in experimental type 1 diabetes. UKRAINIAN BIOCHEMICAL JOURNAL 2020. [DOI: 10.15407/ubj92.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gabryelska A, Karuga FF, Szmyd B, Białasiewicz P. HIF-1α as a Mediator of Insulin Resistance, T2DM, and Its Complications: Potential Links With Obstructive Sleep Apnea. Front Physiol 2020; 11:1035. [PMID: 33013447 PMCID: PMC7509176 DOI: 10.3389/fphys.2020.01035] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/28/2020] [Indexed: 12/20/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSA) is described as an independent risk factor for the onset and progression of type 2 diabetes (T2DM), as well as for insulin resistance (IR). The mechanisms underlying these processes remain unclear. One of the proposed molecular mechanism is based on the oxygen-sensitive α-subunit of hypoxia-inducible factor 1 (HIF-1α)-a key regulator of oxygen metabolism. The concept that stabilization of HIF-1α may influence T2DM and IR is supported by cell and animal models. Cell culture studies revealed that both glucose uptake and glycolysis are regulated by HIF-1α. Furthermore, animal models indicated that increased fasting glucose may be caused by a single night with intermittent hypoxia. Moreover, in these models, hypoxia time was correlated with IR. Mice models revealed that inhibition of HIF-1α protein may downregulate fasting blood glucose and plasma insulin level. Administration of superoxide dismutase mimetic resulted in inhibition of HIF-1α protein, catecholamines, and chronic intermittent hypoxia-induced hypertension in a mice model. The hypothesis that hypoxia is an independent risk factor for IR is strengthened by experimentally confirmed improvement of insulin sensitivity among OSA patients treated with the continuous positive airway pressure. Furthermore, recent studies suggest that HIF-1α protein concentration is increased in individuals with OSA. In this literature review, we summarize the current knowledge about HIF-1α in OSA in relation to the possible pathways in which they contribute to metabolic disorders.
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Affiliation(s)
- Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Łódź, Łódź, Poland
| | - Filip Franciszek Karuga
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Łódź, Łódź, Poland
| | - Bartosz Szmyd
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Łódź, Łódź, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Łódź, Łódź, Poland
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Huang Y, Jin L, Yu H, Jiang G, Tam CHT, Jiang S, Zheng C, Jiang F, Zhang R, Zhang H, Chan JCN, Ma RCW, Jia W, Hu C, Liu Z. SNPs in PRKCA-HIF1A-GLUT1 are associated with diabetic kidney disease in a Chinese Han population with type 2 diabetes. Eur J Clin Invest 2020; 50:e13264. [PMID: 32394523 DOI: 10.1111/eci.13264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/14/2020] [Accepted: 05/03/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To explore the relationship between SNPs in PRKCA-HIF1A-GLUT1 and diabetic kidney disease in Chinese Han people. MATERIALS AND METHODS A total of 2552 participants from Shanghai Diabetes Institute Inpatient Database of Shanghai Jiao Tong University Affiliated Sixth People's Hospital were involved in the stage 1 cross-sectional population. A total of 6015 subjects from the Hong Kong Diabetes Register were included for validation. Genotyping of participants was conducted by the MassARRAY Compact Analyzer (Agena Bioscience). The data were analysed by plink, SAS, Haploview. RESULTS We identified variants associated with diabetic kidney disease in stage 1. Rs1681851 (P = .0105, OR = 1.331) in GLUT1 as well as rs2301108 (P = .0085, OR = 1.289) and rs79865957 (P = .0204, OR = 1.263) in HIF1A were significantly associated with diabetic kidney disease. Regarding DKD-related traits, rs1681851 was associated with plasma creatinine levels (P = .0169, β = 4.822) and eGFR (P = .0457, β = -6.956). Moreover, the results showed the interactions between PRKCA-GLUT1 in the occurrence of DKD. We further sought validation of the 17 SNPs in a prospective cohort and found that rs900836 and rs844501 were associated with the percentage change in eGFR slope. We performed a meta-analysis of case-control analysis data from the Hong Kong samples together with the stage 1 data from Shanghai. Rs9894851 showed significant correlation with the serum creatinine level as well as eGFR and no SNP showed association with DKD after meta-analysis. CONCLUSIONS Our results suggest potential association between SNPs in PRKCA-HIF1A-GLUT1 and diabetic kidney disease in Chinese Han people.
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Affiliation(s)
- Yan Huang
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Li Jin
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hairong Yu
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China
| | - Guozhi Jiang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Claudia H T Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Song Jiang
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chunxia Zheng
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Feng Jiang
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China
| | - Rong Zhang
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China
| | - Hong Zhang
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.,Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.,CUHK-SJTU Joint Research Centre in Diabetes Genomics and Precision Medicine, Hong Kong, China
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.,Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.,CUHK-SJTU Joint Research Centre in Diabetes Genomics and Precision Medicine, Hong Kong, China
| | - Weiping Jia
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China
| | - Cheng Hu
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Jiaotong University affiliated 6th People's Hospital, Shanghai, China.,SJTU-CUHK Collaborative Grant, Shanghai, China.,Institute for Metabolic Diseases, Fengxian Central Hospital, The Third School of Clinical Medicine, Southern Medical University, Shanghai, China
| | - Zhihong Liu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Mao X, Guo Y, Lu Z, Wen F, Liang H, Sun W. Enhanced CT Textures Derived From Computer Mathematic Distribution Analysis Enables Arterial Enhancement Fraction Being an Imaging Biomarker Option of Hepatocellular Carcinoma. Front Oncol 2020; 10:1337. [PMID: 32850426 PMCID: PMC7431458 DOI: 10.3389/fonc.2020.01337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose: This study aims to explore the imaging–clinic relationship and an optional imaging biomarker of hepatocellular carcinoma (HCC) by using texture analysis on arterial enhancement fraction (AEF). Materials and Methods: The HCC patients treated in No. 2 Interventional Ward, ShengJing Hospital of China Medical University from June 2018 to June 2019 were enrolled, for whom tri-phasic enhanced CT scans were acquired. Perfusion analysis and texture analysis were then performed on the tri-phasic enhanced CT images. After the region of interest (ROI) of viable HCC was drawn, 13 AEF textures describing the values distribution were conducted. A between-groups comparison of AEF textures was made where the cases had grouping properties, a correlation analysis was made between AEF textures and alpha-fetoprotein (AFP) as well as other clinical data which were digital, and regression analysis was made when a significant correlation was found. SPSS 19.0 (IBM) was utilized for statistical analysis; a significant difference was considered when P < 0.05. Results: Twenty-five HCC patients were enrolled. Several AEF textures were found to have a correlation with clinical features, including previous surgery history, age, glutamic oxaloacetylase, indirect bilirubin, creatinine, and AFP. The majority of AEF textures (up to 9/13) were found to have a correlation with AFP (SD, variance, uniformity, energy, entropy, inertia, correlation, inverse difference moment, and cluster prominence), while six or seven textures have a linear or cubic relationship with AFP (SD, variance, uniformity, inertia, correlation, cluster prominence, plus inverse difference moment). Conclusion: The AEF textures of HCC are strongly correlated with and are impacted by AFP, which may enable AEF to act as an optional imaging biomarker of HCC.
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Affiliation(s)
- Xiaonan Mao
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Yan Guo
- GE Healthcare, Shanghai, China
| | - Zaiming Lu
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Feng Wen
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Hongyuan Liang
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Wei Sun
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
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Dall’Agnol A, Brondani LDA, Cancelier VDA, Camargo EG, Silveiro SP. Lower serum 25-hydroxyvitamin D levels are associated with impaired glomerular filtration rate in type 2 diabetes patients. Ther Adv Endocrinol Metab 2020; 11:2042018820930904. [PMID: 32782774 PMCID: PMC7385831 DOI: 10.1177/2042018820930904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND 25-Hydroxyvitamin D [25(OH)D] deficiency has been implicated as a possible risk factor for the onset and progression of diabetes kidney disease (DKD). The aim of this study was to evaluate the interaction between levels of 25(OH)D and DKD in type 2 diabetes mellitus (DM) patients. METHODS Cross-sectional design, outpatient type 2 DM. Glomerular filtration rate (GFR) was measured by 51Cr-EDTA and estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), urinary albumin excretion (UAE) by immunoturbidimetry, and 25(OH)D by chemiluminescence. Receiver operating characteristic (ROC) curve analysis and generalized linear model (Poisson robust regression estimator) were used to assess the interaction between 25(OH)D levels and renal function. RESULTS A total of 114 type 2 DM patients aged 60 ± 10 years, 49 males (43%), DM duration 22 ± 10 years, with GFR > 60 ml/min/1.73 m2 were evaluated. Patients with GFRs 60-90 (n = 50) had significantly lower 25(OH)D levels than individuals with GFRs > 90 ml/min/1.73 m2 (n = 64), respectively 40 ± 20 versus 48 ± 20 nmol/l, p = 0.027. This difference was more pronounced for older individuals (39 ± 20 versus 54 ± 23 nmol/l, respectively), and Poisson robust regression disclosed that lower 25(OH)D [Poisson regression (PR) = 0.989, confidence interval (CI): 0.978-0.999, p = 0.034], and advanced age (PR = 1.050, CI: 1.007-1.096, p = 0.023) were significantly associated with the lower GFR category, adjusted for seasons. ROC curve analysis showed that the cutoff point of 25(OH)D of 41 nmol/l was associated with lower GFR [area under the curve (AUC) = 0.694, p = 0.009]. CKD-EPI estimated GFR (eGFR) was not associated with 25(OH)D in any analysis. There was no difference in 25(OH)D levels between patients with elevated UAE as compared with normoalbuminuric ones (44 ± 21 versus 46 ± 19 nmol/l, p = 0.587). CONCLUSION Lower levels of 25(OH)D are associated with decreased GFR in patients with type 2 DM, especially in older patients, with no evidence of interaction with UAE levels.
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Affiliation(s)
- Angélica Dall’Agnol
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Letícia de Almeida Brondani
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vítor da Agostim Cancelier
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo Guimarães Camargo
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sandra Pinho Silveiro
- Endocrine Division, HCPA, Rua Ramiro Barcelos, Porto Alegre, RS Brazil
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, 2350, 4° andar, Porto Alegre, RS 90035-003, Brazil
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Yuan S, Jiang X, Michaëlsson K, Larsson SC. Genetic Prediction of Serum 25-Hydroxyvitamin D, Calcium, and Parathyroid Hormone Levels in Relation to Development of Type 2 Diabetes: A Mendelian Randomization Study. Diabetes Care 2019; 42:2197-2203. [PMID: 31548248 DOI: 10.2337/dc19-1247] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/02/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We conducted a Mendelian randomization study to investigate the associations of genetically predicted serum 25-hydroxyvitamin D (S-25OHD), calcium (S-Ca), and parathyroid hormone (S-PTH) levels with type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODS Seven, six, and five single nucleotide polymorphisms (SNPs) associated with S-25OHD, S-Ca, and S-PTH levels, respectively, were used as instrumental variables. Data on T2DM were available for 74,124 case subjects with T2DM and 824,006 control subjects. The inverse variance-weighted method was used for the primary analyses, and the weighted median and Mendelian randomization (MR)-Egger methods were used for supplementary analyses. RESULTS Genetically predicted S-25OHD but not S-Ca and S-PTH levels were associated with T2DM in the primary analyses. For 1 SD increment of S-25OHD levels, the odds ratio (OR) of T2DM was 0.94 (95% CI 0.88-0.99; P = 0.029) in an analysis based on all seven SNPs and 0.90 (95% CI 0.83-0.98; P = 0.011) in an analysis based on three SNPs within or near genes involved in vitamin D synthesis. Only the association based on the SNPs involved in vitamin D synthesis remained in the weighted median analysis, and no pleiotropy was detected (P = 0.153). Pleiotropy was detected in the analysis of S-Ca (P = 0.013). After correcting for this bias using MR-Egger regression, the OR of T2DM per 1 SD increment of S-Ca levels was 1.41 (95% CI 1.12-1.77; P = 0.003). CONCLUSIONS Modest lifelong higher S-25OHD levels were associated with reduced odds of T2DM, but the association was only robust for SNPs in the vitamin D synthesis pathway. The possible role of S-Ca levels for T2DM development requires further research.
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Affiliation(s)
- Shuai Yuan
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Xia Jiang
- Unit of Translational Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Susanna C Larsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden .,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Afsar CU, Uysal P. HIF-1α Levels in patients receiving chemoradiotherapy for locally advanced non-small cell lung carcinoma. ACTA ACUST UNITED AC 2019; 65:1295-1299. [PMID: 31721962 DOI: 10.1590/1806-9282.65.10.1295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/31/2019] [Indexed: 12/13/2022]
Abstract
AIM To examine the relationship between treatment response and hypoxia-inducible factor-1 alpha (HIF-1α) levels in patients with locally advanced non-small cell lung cancer (NSCLC) who received chemoradiotherapy (CRT). METHODS Eighty patients with NSCLC were included in the study and treated at Acibadem Mehmet Ali Aydınlar University Medical Faculty. HIF-1 α levels were measured before and after CRT by the enzyme-linked immunosorbent assay (ELISA) method. RESULTS Patients' stages were as follows; stage IIIA (65%) and stage IIIB (35%). Squamous histology was 45%, adenocarcinoma was 44%, and others were 11%. Chemotherapy and radiotherapy were given concurrently to 80 patients. Forty-five (56%) patients received cisplatin-based chemotherapy, and 35 (44%) received carboplatin-based chemotherapy. Serum HIF-1α levels (42.90 ± 10.55 pg/mL) after CRT were significantly lower than the pretreatment levels (63.10 ± 10.22 pg/mL, p<0.001) in patients with locally advanced NSCLC. CONCLUSION The results of this study revealed that serum HIF-1α levels decreased after CRT. Decrease of HIF-1α levels after the initiation of CRT may be useful for predicting the efficacy of CRT.
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Affiliation(s)
- Cigdem Usul Afsar
- . Acıbadem Mehmet Ali Aydınlar University Medical Faculty, Bakirkoy Acıbadem Hospital, Department of Internal Medicine and Medical Oncology, Istanbul, Turkey
| | - Pelin Uysal
- . Acıbadem Mehmet Ali Aydınlar University Medical Faculty, Atakent Acıbadem Hospital, Department of Pulmonary Medicine, Istanbul, Turkey
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Du X, Liu Y, Zhao C, Fang J, Wang X, Wei L. Changes of serum 25(OH) D3 and IGF-1 levels in patients with thyroid nodules. BMC Endocr Disord 2019; 19:48. [PMID: 31077177 PMCID: PMC6509827 DOI: 10.1186/s12902-019-0376-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/25/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The present study aimed to study the relationship between serum 25 hydroxyvitamin D3(25(OH)D3) and insulin-like growth factor-1 (IGF-1) and thyroid nodules. METHODS Two hundred eighty-nine cases with thyroid nodules and 109 health subjects (control group) who admitted to the Hebei General Hospital during June 2016 to December 2016 were included in the study. Basic clinical information (age, sex, thyroid function, liver and kidney function, hypertension history, etc.) of patients were collected. Serum 25(OH) D3 and Serum IGF-1 were detected by electrochemiluminescence and radioimmunoassay methods, respectively. The relationship between the above-mentioned factors and thyroid nodules was statistically analyzed. RESULTS Serum 25(OH)D3, IGF-1, fasting blood glucose (FBG), total cholesterol (TC), waist circumference (WC), total triiodothyronine (TT3), total thyroxine (TT4), hypertension history, and drinking history were significantly different between the nodules group and the control group (P < 0.05). Logistic regression analysis showed that there was a negative correlation between thyroid nodules and levels of 25(OH)D3, IGF-1, TT3, as well as a positive correlation with FBG, TC, TT4, and hypertension. There was a positive correlation between IGF-1 and serum 25(OH)D3 in thyroid nodules (P < 0.05). After correcting the aforementioned factors, high-level of serum 25(OH)D3 was significantly correlated with the decreased incidence of thyroid nodules. CONCLUSIONS The incidence of thyroid nodules is relatively lower in a high-level of serum 25(OH)D3, and serum 25(OH)D3 may be a direct protective factor for thyroid nodules. Serum IGF-1 can be one of the indirect protective factors for thyroid nodules as well.
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Affiliation(s)
- Xueqin Du
- Hebei Medical University, Shijiazhuang, 050017 Hebei China
| | - Yi Liu
- Hebei North University, Zhangjiakou, 075000 Hebei China
| | - Chunhui Zhao
- Department of Pediatrics, Shijiazhuang Fourth Hospital, Shijiazhuang, 050011 Hebei China
| | - Jingzhou Fang
- Hebei North University, Zhangjiakou, 075000 Hebei China
| | - Xiangna Wang
- Hebei North University, Zhangjiakou, 075000 Hebei China
| | - Limin Wei
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050051 Hebei China
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Lai X, Tong D, Ai X, Wu J, Luo Y, Zuo F, Wei Z, Li Y, Huang W, Wang W, Jiang Q, Meng X, Zeng Y, Wang P. Amelioration of diabetic nephropathy in db/db mice treated with tibetan medicine formula Siwei Jianghuang Decoction Powder extract. Sci Rep 2018; 8:16707. [PMID: 30420600 PMCID: PMC6232159 DOI: 10.1038/s41598-018-35148-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
Siwei Jianghuang Decoction Powder (SWJH) documented originally in the Four Medical Tantras-Blue Glaze exhibited beneficial effects on diabetic nephropathy (DN) via combined synergistically action of multiple formula components including Curcumae longae Rhizoma, Berberidis dictyophyllae Cortex, Phyllanthi Fructus and Tribuli Fructus. This study investigated the effects of SWJH on DN in db/db mice and possible underlying mechanisms. The ten weeks old db/db mice treated with SWJH by intra-gastric administration once a day for 8 weeks. After 8 weeks, body weight, water and food intake of mice were recorded. The level of fasting blood glucose (FBG) was measured. Serum creatinine (Scr), blood urea nitrogen (BUN), urine microalbumin (UMAlb), serum uric acid (UA) and urinary albumin excretion (UAE) were detected. An enzyme-linked immunosorbent assay was performed to test serum vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1). Real-time PCR and Western blot analysis were used to test mRNA and protein expression of hypoxia inducible factor-1α (HIF-1α), VEGF and TGF-β1 in kidney tissue. SWJH treatment significantly reduced the levels of FBG, Scr, BUN, UMAlb, UA and UAE and retarded renal fibrosis. SWJH treatment further significantly reduced serum TGF-β1 level and downregulated the expression of HIF-1α, VEGF and TGF-β1 at both mRNA and protein levels. Principal component analysis and partial least squares regression and hierarchical cluster analysis demonstrated that SWJH treatment significantly ameliorated renal damage in DN mice. These consequences suggested that SWJH formulations were effective in the treatment of DN through regulating the HIF-1α, VEGF and TGF-β1 overexpression.
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Affiliation(s)
- Xianrong Lai
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
- School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Dong Tong
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xiaopeng Ai
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Jiasi Wu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yu Luo
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Fang Zuo
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Zhicheng Wei
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yanqiao Li
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Wanyi Huang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Wenqian Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Qing Jiang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xianli Meng
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yong Zeng
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Ping Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
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Balci Yuce H, Karatas Ö, Tulu F, Altan A, Gevrek F. Effect of diabetes on collagen metabolism and hypoxia in human gingival tissue: a stereological, histopathological, and immunohistochemical study. Biotech Histochem 2018; 94:65-73. [PMID: 30317872 DOI: 10.1080/10520295.2018.1508745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Diabetes mellitus and periodontitis are chronic inflammatory diseases that disrupt soft tissue metabolism. The diseases separately or together increase apoptosis in gingival fibroblast cells and reduce cell renewal. We investigated the effects of diabetes and periodontitis on the composition and structure of gingival connective tissue. We used gingival biopsies from 16 healthy individuals (control group, C), 16 type 2 diabetic patients with chronic periodontitis (diabetes + periodontitis group, D + P) and 16 healthy chronic periodontitis patients (periodontitis group, P). Biopsies were obtained under local anesthesia. Clinical attachment level (CAL), gingival index (GI) and plaque index (PI) were measured prior to gingival biopsies. Fibroblast cells were counted stereologically. Inflammatory cells were counted histomorphometrically. Hypoxia-inducible factor (HIF)-1α, lysyl hydroxylase (PLOD-2), neutrophil collagenase (MMP-8), and vascular endothelial growth factor (VEGF) levels were evaluated immunohistochemically. CAL, GI and PI for the C group were lower than for the other groups (p < 0.05). Fibroblast cell counts were lower for the D + P group than for the other groups (p < 0.05). Diabetes increased inflammatory cell numbers in the D and D + P groups compared to the C and P groups. MMP-8 levels were higher for the D + P group than for the other groups. VEGF was elevated in both the P and D + P groups compared to the C group, while HIF-1α and PLOD-2 levels were comparable. Diabetes increased tissue destruction and inflammation, and decreased fibroblast cell numbers without affecting collagen crosslinking and HIF-1α levels.
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Affiliation(s)
- H Balci Yuce
- a Departments of Periodontology , Gaziosmanpaşa University , Tokat , Turkey
| | - Ö Karatas
- a Departments of Periodontology , Gaziosmanpaşa University , Tokat , Turkey
| | - F Tulu
- a Departments of Periodontology , Gaziosmanpaşa University , Tokat , Turkey
| | - A Altan
- b Oral and Maxillofacial Surgery , Gaziosmanpaşa University , Tokat , Turkey
| | - F Gevrek
- c Histology and Embryology, Faculty of Medicine , Gaziosmanpaşa University , Tokat , Turkey
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Barnard SA, Smith W, Mels CMC, Botha S, Schutte AE. Bioavailable IGF-1 is beneficially associated with biomarkers of endothelial function in young healthy adults: The African-PREDICT study. Growth Horm IGF Res 2018; 41:28-33. [PMID: 29936324 DOI: 10.1016/j.ghir.2018.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/01/2018] [Accepted: 06/10/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Low circulating levels of insulin-like growth factor-1 (IGF-1) are associated with endothelial dysfunction, subsequently leading to the development of cardiovascular disease. OBJECTIVE To better understand the early phases of vascular deterioration in a young, healthy population, we investigated, cross-sectionally, whether biomarkers of endothelial function (intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and von Willebrand factor antigen (vWFag)) are associated with IGF-1 in a healthy study population forming part of the larger African Prospective study on the Early Detection and Identification of Cardiovascular diseases and Hypertension (African-PREDICT). METHOD We included 825 black and white men and women (aged 20-30 years) and determined IGF-1, IGF binding protein-3 (IGFBP-3), ICAM-1, VCAM-1 and vWFag from blood samples. We also measured 24-h blood pressure and health behaviours namely waist circumference, accelerometery, cotinine and gamma glutamyl transferase. We used the IGF-1/IGFBP-3 M ratio as an estimate of bioavailable IGF-1. RESULTS In multivariable-adjusted regression analyses performed in the total group, VCAM-1 associated positively with IGFBP-3 (β = 0.21; p < .001) and negatively with IGF-1/IGFBP-3 (β = -0.18; p < .001). ICAM-1 showed a borderline negative association with IGF-1 (β = -0.09; p = .054) and IGF-1/IGFBP-3 (β = -0.08; p = .057). vWFag was not associated with IGF-1, IGFBP-3 or bioavailable IGF-1. CONCLUSION VCAM-1 is beneficially associated with IGF-1 in a young healthy cohort, independent of sex, ethnicity, blood pressure and health behaviours - thereby confirming the potential importance of bioavailable IGF-1 in early vascular endothelial protection.
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Affiliation(s)
- Sunelle A Barnard
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Shani Botha
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular disease, North-West University, Potchefstroom, South Africa.
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Lasom S, Komanasin N, Settasatian N, Settasatian C, Kukongviriyapan U, Intharapetch P. Association of a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 polymorphisms with severity of coronary stenosis in type 2 diabetes mellitus. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:59. [PMID: 30181741 PMCID: PMC6091132 DOI: 10.4103/jrms.jrms_518_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 11/21/2017] [Accepted: 03/18/2018] [Indexed: 01/11/2023]
Abstract
Background: The imbalance of von Willebrand factor (vWF) and a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13) has been associated with atherosclerosis progression. A high level of vWF which regulates thrombus formation is associated with diabetes mellitus (DM), and some ADAMTS13 and vWF polymorphisms have effects on their levels. Therefore, this study aimed to evaluate the associations of ADAMTS13 and vWF polymorphisms and their levels with DM and severity of coronary stenosis. Materials and Methods: Eighty-seven DM and 84 control individuals were recruited. vWF and ADAMTS13 activities as well as vWF antigen were measured by collagen-binding assay (CBA), residual-CBA, and in-house enzyme-linked immunosorbent assay, respectively. ADAMTS13 and vWF polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism. Results: The E and G alleles and AA genotype of ADAMTS13 Q448E, rs2073932, and rs652600, respectively, were independently associated with DM (odds ratio [OR] [95% confidence interval (CI)] = 2.5 [1.1, 5.6], 2.3 [1.0, 5.2], and 4.7 [1.2, 18.6], respectively). Moreover, E allele and AA genotype of Q448E and rs652600 were also significantly associated with multi-vessel disease (OR [95% CI] = 2.2 [1.0, 4.8] and 3.2 [1.0, 10.0], respectively), while the E and G allele of Q448E and rs2073932 were associated with high Gensini score (OR [95% CI] = 2.3 [1.1, 4.9] and 2.3 [1.1, 5.1], respectively). Conclusion: Association of ADAMTS13 polymorphisms with DM, number of vessel stenosis, and Gensini score may indicate the possible contribution of ADAMTS13 polymorphisms to atherosclerosis progression and severity of coronary stenosis in DM.
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Affiliation(s)
- Supakanya Lasom
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand.,Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Nantarat Komanasin
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Nongnuch Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chatri Settasatian
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Upa Kukongviriyapan
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pongsak Intharapetch
- Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand.,Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
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Hamzawy M, Gouda SAA, Rashed L, Morcos MA, Shoukry H, Sharawy N. 22-oxacalcitriol prevents acute kidney injury via inhibition of apoptosis and enhancement of autophagy. Clin Exp Nephrol 2018; 23:43-55. [PMID: 29968126 DOI: 10.1007/s10157-018-1614-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/26/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The pathophysiology of ischemic acute kidney injury (AKI) is thought to include a complex interplay between tubular cell damage and regeneration. Several lines of evidences suggest a potential renoprotective effect of vitamin D. In this study, we investigated the effect of 22-oxacalcitriol (OCT), a synthetic vitamin D analogue, on renal fate in a rat model of ischemia reperfusion injury (IRI) induced acute kidney injury (AKI). METHODS 22-oxacalcitriol (OCT) was administered via intraperitoneal (IP) injection before ischemia, and continued after IRI that was performed through bilateral clamping of the renal pedicles. 96 h after reperfusion, rats were sacrificed for the evaluation of autophagy, apoptosis, and cell cycle arrest. Additionally, assessments of toll-like receptors (TLR), interferon gamma (IFN-g) and sodium-hydrogen exchanger-1 (NHE-1) were also performed to examine their relations to OCT-mediated cell response. RESULTS Treatment with OCT-attenuated functional deterioration and histological damage in IRI induced AKI, and significantly decreased cell apoptosis and fibrosis. In comparison with IRI rats, OCT + IRI rats manifested a significant exacerbation of autophagy as well as reduced cell cycle arrest. Moreover, the administration of OCT decreased IRI-induced upregulation of TLR4, IFN-g and NHE-1. CONCLUSION These results demonstrate that treatment with OCT has a renoprotective effect in ischemic AKI, possibly by suppressing cell loss. Changes in the expression of IFN-g and NHE-1 could partially link OCT to the cell survival-promoted effects.
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Affiliation(s)
- Magda Hamzawy
- Department of Physiology, Faculty of Medicine, Kasr El-Aini, Cairo University, AlSaray Street, Cairo, 11562, Egypt
| | - Sarah Ali Abdelhameed Gouda
- Department of Physiology, Faculty of Medicine, Kasr El-Aini, Cairo University, AlSaray Street, Cairo, 11562, Egypt
| | - Laila Rashed
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mary Attia Morcos
- Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba Shoukry
- Department of Physiology, Faculty of Medicine, Kasr El-Aini, Cairo University, AlSaray Street, Cairo, 11562, Egypt
| | - Nivin Sharawy
- Department of Physiology, Faculty of Medicine, Kasr El-Aini, Cairo University, AlSaray Street, Cairo, 11562, Egypt. .,Cairo University Hospitals, Cairo, Egypt.
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Brosius FC, Ju W. The Promise of Systems Biology for Diabetic Kidney Disease. Adv Chronic Kidney Dis 2018; 25:202-213. [PMID: 29580584 DOI: 10.1053/j.ackd.2017.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/21/2022]
Abstract
Diabetic kidney disease (DKD) has a complex and prolonged pathogenesis involving many cell types in the kidney as well as extrarenal factors. It is clinically silent for many years after the onset of diabetes and usually progresses over decades. Given this complexity, a comprehensive and unbiased molecular approach is best suited to help identify the most critical mechanisms responsible for progression of DKD and those most suited for targeted intervention. Systems biological investigations provide such an approach since they examine the entire network of molecular changes that occur in a disease process in a comprehensive way instead of focusing on a single abnormal molecule or pathway. Systems biological studies can also start with analysis of the disease in humans, not in animal or cell culture models that often poorly reproduce the changes in human DKD. Indeed, in the last decade, systems biological approaches have led to the identification of critical molecular abnormalities in DKD and have directly led to development of new biomarkers and potential treatments for DKD.
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Toker H, Balci Yuce H, Lektemur Alpan A, Gevrek F, Elmastas M. Morphometric and histopathological evaluation of the effect of grape seed proanthocyanidin on alveolar bone loss in experimental diabetes and periodontitis. J Periodontal Res 2018; 53:478-486. [PMID: 29446089 DOI: 10.1111/jre.12536] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Grape seed proanthocyanidine extract (GSPE) is a strong antioxidant derived from the grape seeds (Vitis vinifera, Terral J.F.) and has a polyphenolic structure with a wide range of biological activity. The aim of the present study was to evaluate the effects of GSPE on alveolar bone loss and histopathological changes in rats with diabetes mellitus and ligature-induced periodontitis. MATERIAL AND METHODS Forty rats were divided into 6 study groups. Control (C, 6 rats) group, periodontitis (P, 6 rats) group, diabetes (D, 6 rats) group, diabetes and periodontitis (D+P, 6 rats) group, diabetes, periodontitis and 100 mg/kg/day GSPE (GSPE-100, 8 rats), and diabetes, periodontitis and 200 mg/kg/day GSPE (GSPE-200, 8 rats) group. Diabetes mellitus was induced by intraperitoneal injection of a single dose of streptozotocin (60 mg/kg). Periodontitis was induced via ligation method. Silk ligatures were placed at the mandibular right first molars. GSPE was administered by oral gavage. After 30 days, all rats were killed. Alveolar bone loss was measured morphometrically via a stereomicroscope. For histopathological analyses, Alizarin red staining, and matrix metalloproteinase (MMP)-8, vascular endothelial growth factor and hypoxia inducible factor (HIF)-1α immunohistochemistry were performed. Tartrate-resistant acid phosphatase-positive osteoclast cells and relative total inflammatory cells were also determined. RESULTS The highest alveolar bone loss was observed in the D+P group (P < .05). GSP-200 group decreased alveolar bone loss (P < .05). The D+P group had the highest osteoclast counts, but the difference was not significant compared to the P, GSPE-100 and GSPE-200 groups (P > .05). The inflammation in the D+P group was also higher than the other groups (P < .05). The osteoblast numbers increased in the GSPE-100 and GSPE-200 groups compared to the P and D+P groups (P < .05). MMP-8 and HIF-1α levels were highest in the D+P group and GSPE significantly decreased these levels (P < .05). CONCLUSION Within the limits of this animal study, it can be suggested that GSPE administration may decrease periodontal inflammation and alveolar bone loss via decreasing MMP-8 and HIF-1α levels and increase osteoblastic activity in diabetic rats with experimental periodontitis.
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Affiliation(s)
- H Toker
- Department of Periodontology, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
| | - H Balci Yuce
- Department of Periodontology, Faculty of Dentistry, Gaziosmanpaşa University, Tokat, Turkey
| | - A Lektemur Alpan
- Department of Periodontology, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
| | - F Gevrek
- Department of Histology and Embryology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
| | - M Elmastas
- Department of Chemistry, Faculty of Arts and Science, Gaziosmanpaşa University, Tokat, Turkey
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Hyun YY, Kim H, Lee KB. Red cell distribution width predicts incident dipstick albuminuria in Korean adults without chronic kidney disease. Kidney Res Clin Pract 2017; 36:232-239. [PMID: 28904874 PMCID: PMC5592890 DOI: 10.23876/j.krcp.2017.36.3.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/16/2017] [Accepted: 04/01/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Red cell distribution width (RDW) is an emerging marker of inflammation and a predictor of high cardiovascular morbidity and mortality as well as all-cause mortality. A previous cross-sectional study showed that RDW was associated with microalbuminuria, an indicator of target organ damage. However, the longitudinal association of RDW and development of albuminuria is not known. METHODS We analyzed 83,040 participants without chronic kidney disease (CKD) at baseline who underwent two health check-ups at a 4-year interval during 2005 to 2014. Urine albumin was determined by single urine dipstick semi-quantitative analysis, and incident albuminuria was defined as ≥ 1+ dipstick albumin at the second check-up. We used logistic regression analysis to determine the relationship between RDW and incident albuminuria. RESULTS Participants were divided into quartiles according to baseline RDW. After 4 years, 982 cases of incident albuminuria were observed. The cumulative incidences of albuminuria were 0.94, 1.05, 1.18, and 1.62% for the 1st through 4th quartiles of RDW, respectively. Multivariate logistic analysis showed that the odds ratios (95% confidence interval) for incident albuminuria compared to those in the 1st quartile were 1.11 (0.92-1.34), 1.26 (1.04-1.52), and 1.88 (1.58-2.24) for the 2nd, 3rd and 4th quartiles, respectively. CONCLUSION RDW was associated with development of albuminuria in relatively healthy Korean adults without CKD. Further research is needed to verify the role of RDW in the development of albuminuria and renal injury.
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Affiliation(s)
- Young Youl Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Hyang Kim
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Kyu-Beck Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
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Antiangiogenic Therapy for Diabetic Nephropathy. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5724069. [PMID: 28835895 PMCID: PMC5556994 DOI: 10.1155/2017/5724069] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/16/2017] [Accepted: 06/13/2017] [Indexed: 12/28/2022]
Abstract
Angiogenesis has been shown to be a potential therapeutic target for early stages of diabetic nephropathy in a number of animal experiments. Vascular endothelial growth factor (VEGF) is the main mediator for abnormal angiogenesis in diabetic glomeruli. Although beneficial effects of anti-VEGF antibodies have previously been demonstrated in diabetic animal experiments, recent basic and clinical evidence has revealed that the blockade of VEGF signaling resulted in proteinuria and renal thrombotic microangiopathy, suggesting the importance of maintaining normal levels of VEGF in the kidneys. Therefore, antiangiogenic therapy for diabetic nephropathy should eliminate excessive glomerular angiogenic response without accelerating endothelial injury. Some endogenous antiangiogenic factors such as endostatin and tumstatin inhibit overactivation of endothelial cells but do not specifically block VEGF signaling. In addition, the novel endothelium-derived antiangiogenic factor vasohibin-1 enhances stress tolerance and survival of the endothelial cells, while inhibiting excess angiogenesis. These factors have been demonstrated to suppress albuminuria and glomerular alterations in a diabetic mouse model. Thus, antiangiogenic therapy with promising candidates will possibly improve renal prognosis in patients with early stages of diabetic nephropathy.
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The relationship between fasting blood glucose variability and coronary artery collateral formation in type 2 diabetes patients with coronary artery disease. Coron Artery Dis 2017. [PMID: 28644211 DOI: 10.1097/mca.0000000000000520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Coronary collaterals are an alternative source of blood supply to ischemic myocardium. Well-developed coronary collateral arteries in patients with coronary artery disease (CAD) limit the size of acute myocardial infarction and improves survival. The aim of this study was to investigate the relationship between glycemic variability and coronary collateral formation in patients with type 2 diabetes mellitus and CAD. METHODS Consecutive patients undergoing percutaneous coronary intervention or coronary artery bypass grafting procedures were studied. Multivariate logistic regression models were used to examine the association between coronary artery collateral formation graded by Rentrope classification and glycemic variability, measured by coefficient variation of fasting blood glucose. RESULTS In our study, we retrospectively enrolled 300 patients, of whom 239 were diabetic (age: 70.1±11.9, 56% men) and 61 were nondiabetic (age: 71.5±11.5, 72% men). Diabetic patients were further stratified as follows: those with poor coronary collateral artery development (n=171, age: 69.7±12.4, 55% men) and those with good coronary collateral artery development (n=68, age 71.1±10.8, 59% men) according to the Rentrope classification. Our findings did not show association between glycemic variability and coronary collateral vessels development after controlling for potential confounders (odds ratio: 2.51; 95% confidence interval: 0.57-11.03; P=0.22). The culprit lesion (≥75% stenosis) in the left anterior descending artery and the right coronary artery was more frequent in the good collateral group compared with the poor collateral group (66 vs. 50%, P=0.02; 63 vs. 45%, P=0.01 respectively). CONCLUSION Glycemic variability is not associated with coronary collateral artery formation in patients with type 2 diabetes mellitus and CAD.
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Schiffer TA, Friederich-Persson M. Mitochondrial Reactive Oxygen Species and Kidney Hypoxia in the Development of Diabetic Nephropathy. Front Physiol 2017; 8:211. [PMID: 28443030 PMCID: PMC5386984 DOI: 10.3389/fphys.2017.00211] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/23/2017] [Indexed: 12/21/2022] Open
Abstract
The underlying mechanisms in the development of diabetic nephropathy are currently unclear and likely consist of a series of dynamic events from the early to late stages of the disease. Diabetic nephropathy is currently without curative treatments and it is acknowledged that even the earliest clinical manifestation of nephropathy is preceded by an established morphological renal injury that is in turn preceded by functional and metabolic alterations. An early manifestation of the diabetic kidney is the development of kidney hypoxia that has been acknowledged as a common pathway to nephropathy. There have been reports of altered mitochondrial function in the diabetic kidney such as altered mitophagy, mitochondrial dynamics, uncoupling, and cellular signaling through hypoxia inducible factors and AMP-kinase. These factors are also likely to be intertwined in a complex manner. In this review, we discuss how these pathways are connected to mitochondrial production of reactive oxygen species (ROS) and how they may relate to the development of kidney hypoxia in diabetic nephropathy. From available literature, it is evident that early correction and/or prevention of mitochondrial dysfunction may be pivotal in the prevention and treatment of diabetic nephropathy.
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Affiliation(s)
- Tomas A Schiffer
- Department of Medical Cell Biology, Uppsala UniversityUppsala, Sweden.,Department of Medical and Health Sciences, Linköping UniversityLinköping, Sweden
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Vitamin D Decreases Serum VEGF Correlating with Clinical Improvement in Vitamin D-Deficient Women with PCOS: A Randomized Placebo-Controlled Trial. Nutrients 2017; 9:nu9040334. [PMID: 28350328 PMCID: PMC5409673 DOI: 10.3390/nu9040334] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/11/2017] [Accepted: 03/20/2017] [Indexed: 11/19/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) has been suggested to play a role in the pathophysiology of polycystic ovary syndrome (PCOS) and may contribute to increased risk of ovarian hyperstimulation syndrome (OHSS) in affected individuals. Vitamin D (VitD) supplementation improves multiple clinical parameters in VitD-deficient women with PCOS and decreases VEGF levels in several other pathologic conditions. Unveiling the basic mechanisms underlying the beneficial effects of vitamin D on PCOS may enhance our understanding of the pathophysiology of this syndrome. It may also suggest a new treatment for PCOS that can improve it through the same mechanism as vitamin D and can be given regardless of vitamin D levels. Therefore, we aimed to explore the effect of VitD supplementation on serum VEGF levels and assess whether changes in VEGF correlate with an improvement in characteristic clinical abnormalities of PCOS. This is a randomized placebo-controlled trial conducted between October 2013 and March 2015. Sixty-eight VitD-deficient women with PCOS were recruited. Women received either 50,000 IU of oral VitD3 or placebo once weekly for 8 weeks. There was a significant decrease in serum VEGF levels (1106.4 ± 36.5 to 965.3 ± 42.7 pg·mL–1; p < 0.001) in the VitD group. Previously reported findings of this trial demonstrated a significant decrease in the intermenstrual intervals, Ferriman-Gallwey hirsutism score, and triglycerides following VitD supplementation. Interestingly, ∆VEGF was positively correlated with ∆triglycerides (R2 = 0.22; p = 0.02) following VitD supplementation. In conclusion, VitD replacement significantly decreases serum VEGF levels correlating with a decrease in triglycerides in women with PCOS. This is a novel molecular explanation for the beneficial effects of VitD treatment. It also suggests the need to investigate a potential role of VitD treatment in reducing the incidence or severity of OHSS in VitD-deficient women with PCOS.
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