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Gokulakrishnan K, Ranjani H, Weber MB, Pandey GK, Anjana RM, Balasubramanyam M, Prabhakaran D, Tandon N, Narayan KM, Mohan V. Effect of lifestyle improvement program on the biomarkers of adiposity, inflammation and gut hormones in overweight/obese Asian Indians with prediabetes. Acta Diabetol 2017; 54:843-852. [PMID: 28620678 DOI: 10.1007/s00592-017-1015-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/03/2017] [Indexed: 11/30/2022]
Abstract
AIMS While lifestyle modification is known to offer several metabolic benefits, there is paucity of comprehensive data on changes in biomarkers of adiposity, inflammation as well as gut hormones. We investigated these biomarkers in overweight/obese individuals with prediabetes randomized to either 4 months of a lifestyle improvement program or standard care and followed them up for a year. METHODS Participants [standard care and intervention arm (n = 75 each)] were randomly selected from the Diabetes Community Lifestyle Improvement Program trial. Glycemic and lipid control and anthropometric measurements were assessed by standard protocols. Adipokines, inflammatory markers and gut hormones were measured using multiplex and standard ELISA kits. RESULTS Along with modest benefits in primary outcomes (glycemic and lipid control and weight reduction), participants in the intervention group showed significant reductions (p < 0.001) in plasma levels of leptin (17.6%), TNF-α (35%), IL-6 (33.3%), MCP-1 (22.3%) and PYY (28.3%) and increased levels of adiponectin (33.1%) and ghrelin (23.6%) at the end of 4 months of lifestyle intervention. The changes were independent of weight and persisted even at 1 year of follow-up. In contrast, participants from the standard care arm did not show any statistically significant improvements on the above parameters. CONCLUSIONS Participants who underwent an intensive lifestyle improvement program showed metabolic benefits as well as favorable beneficial changes in systemic levels of adipokines, cytokines and gut hormones, not only during the intervention period, but also during 12-month follow-up period.
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Affiliation(s)
- Kuppan Gokulakrishnan
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India.
| | - Harish Ranjani
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | | | - Gautam Kumar Pandey
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ranjit Mohan Anjana
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Muthuswamy Balasubramanyam
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Dorairaj Prabhakaran
- Public Health Foundation of India (PHFI), Centre for Chronic Disease Control (CCDC), New Delhi, India
| | - Nikhil Tandon
- Public Health Foundation of India (PHFI), Centre for Chronic Disease Control (CCDC), New Delhi, India
| | | | - Viswanathan Mohan
- Department of Research Biochemistry, Madras Diabetes Research Foundation (MDRF), 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
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Sulaj A, Kopf S, Gröne E, Gröne HJ, Hoffmann S, Schleicher E, Häring HU, Schwenger V, Herzig S, Fleming T, Nawroth PP, von Bauer R. ALCAM a novel biomarker in patients with type 2 diabetes mellitus complicated with diabetic nephropathy. J Diabetes Complications 2017; 31:1058-1065. [PMID: 28325697 DOI: 10.1016/j.jdiacomp.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIM Activated leukocyte cell adhesion molecule (ALCAM/CD166) functions analogue to the receptor of advanced glycation end products, which has been implicated in the development of diabetic nephropathy (DN). We investigated the expression of ALCAM and its ligand S100B in patients with DN. METHODS A total of 34 non-diabetic patients, 29 patients with type 2 diabetes and normal albuminuria and 107 patients with type 2 diabetes complicated with DN were assessed for serum concentration of soluble ALCAM (sALCAM) by ELISA. Expression of ALCAM and S100B in kidney histology from patients with DN was determined by immunohistochemistry. Cell expression of ALCAM and S100B was analyzed through confocal immunofluorescence microscopy. RESULTS Serum concentration of sALCAM was increased in diabetic patients with DN compared to non-diabetic (59.85±14.99ng/ml vs. 126.88±66.45ng/ml, P<0.0001). Moreover sALCAM correlated positively with HbA1c (R=0.31, P<0.0001), as well as with the stages of chronic kidney disease and negatively correlated with eGFR (R=-0.20, P<0.05). In diabetic patients with normal albuminuria sALCAM was increased compared to patients with DN (126.88±66.45ng/ml vs. 197.50±37.17ng/ml, P<0.0001). In diabetic patients, ALCAM expression was significantly upregulated in both the glomeruli and tubules (P<0.001). ALCAM expression in the glomeruli correlated with presence of sclerosis (R=0.25, P<0.001) and localized mainly in the podocytes supporting the hypothesis that membrane bound ALCAM drives diabetic nephropathy and thus explaining sALCAM decrease in diabetic patients with DN. The expression of S100B was increased significantly in the glomeruli of diabetic patients (P<0.001), but not in the tubules. S100B was as well localized in the podocytes. CONCLUSIONS This study identifies for the first time ALCAM as a potential mediator in the late complications of diabetes in the kidney.
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Affiliation(s)
- Alba Sulaj
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
| | - Stefan Kopf
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany
| | - Elisabeth Gröne
- Division of Cellular and Molecular Pathology, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Hermann-Josef Gröne
- Division of Cellular and Molecular Pathology, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
| | - Sigrid Hoffmann
- Medical Research Center, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68135 Mannheim, Germany
| | - Erwin Schleicher
- Department of Internal Medicine, University of Tübingen, 72074 Tübingen, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine, University of Tübingen, 72074 Tübingen, Germany; German Center for Diabetes Research, 85764 Neuherberg, Germany
| | - Vedat Schwenger
- Department of Nephrology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany
| | - Stephan Herzig
- Institute for Diabetes and Cancer IDC, Helmholtz Center Munich and Joint Heidelberg-IDC Translational, Diabetes Program, University of Heidelberg, INF 410, 69120 Heidelberg, Germany
| | - Thomas Fleming
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany; German Center for Diabetes Research, 85764 Neuherberg, Germany
| | - Peter P Nawroth
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany; German Center for Diabetes Research, 85764 Neuherberg, Germany; Institute for Diabetes and Cancer IDC, Helmholtz Center Munich and Joint Heidelberg-IDC Translational, Diabetes Program, University of Heidelberg, INF 410, 69120 Heidelberg, Germany
| | - Rüdiger von Bauer
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany
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